It would have to be seen as the most intriguing question of our era;
to understand how, with all the most educated of scholarly voices
abdicating for world wide smoking bans, how not one of those participants
has the vision to see outside the box. To understand with very little
imagination how beneficial it could be to society as a whole to simply
look at the product before punishing it’s victims. When we view
tobacco a...
It would have to be seen as the most intriguing question of our era;
to understand how, with all the most educated of scholarly voices
abdicating for world wide smoking bans, how not one of those participants
has the vision to see outside the box. To understand with very little
imagination how beneficial it could be to society as a whole to simply
look at the product before punishing it’s victims. When we view
tobacco as one of the most dangerous products on the shelf, does it make
sense to anyone it is also the only product on the shelf with no list of
ingredients. While we are well informed as to the contents of, the smoke
it could produce, it is downplayed how significantly the quantities
present, individually or as a whole, represent a substantial risk. It is
indisputable, the lack of ingredients list can be directly associated to
the potential harm. If we look at what is revealed it is also indisputable
many of the toxins and carcinogens could not be derived from the burning
of Tobacco alone. The scientific community as a whole can still err in the
description of the product as tobacco, either through lack of proper
information or as a deliberate act to substantiate political will. Either
excuse adds to the misinformation being supplied to the public with a
scientific community rubber stamp of approval, contrary to well-
established rules of informed consent. Human rights are no longer a
priority in fact are being deliberately ignored in seek of the greater
good. A major mistake, one which one-day, will greatly expand the list of
names attributed to the Darwin awards. The danger is, the words scientific
integrity could also be included on that list of casualties.
Simplistic regulation barring the use of known dangerous ingredients
would reduce the harm of the product in its use. If as advocacy would
proclaim the protection of health is the purpose for anti smoker advocacy
perhaps the mortality figures stated as preventable could be greatly
reduced by regulating the products. Of course, this would result in a
decreased risk to non-smokers and the most efficient means of solving the
problem at hand. Perhaps advocacy would be less effective if the numbers
were reduced and we could deal with a more significant problem of violence
and impunity, which is the most prominent effect of anti smoker advocacy.
The alternative is relying on case research studies investigating the
effects of a range, of millions of possible combinations in the products
being consumed. Predictably, we see a wide range of determined theoretic
results of little scientific value. Further confusion added by the
absolutes of smoking debates resulting in biases which undermine the
credibility of any research study, with the current indicator being, who
paid for the study as a judgment of integrity. No matter how much care and
integrity was incorporated by the researcher, his absolute credibility
will be determined by who pays the bill.
Is this the best we have to offer in the realm of scientific
discovery? Facts by consensus and that consensus determined by the size of
our gang, our ability to create facts or having the finances to establish
those facts in the media and through that a silencing of all opposition.
Public confidence in the process is understandably reserved to say the
least.
It was revealed to me today the president of mychoice.ca in Canada
was threatened with death on her doorstep for nothing more than a
perceived threat she represents, as a non-smoker advocating for nothing
more than respect of her neighbors in community. She has never stated
smoking is not dangerous and has consistently stated it is, in every
public discussion. She was once given an award by her peers speaking out
on the topic of violence against women. Now she is disassociated from
integrity in her opinion, in advocacy against the same topic, Hatred and
Violence. Where are the advocates rushing to her aid and praise this time
around? Have our values now changed so absolutely it is permissible to
excuse the abuse of others as long as we can create a good enough reason?
Not original in fact in 1930s Germany those same assessments were made
Praised and encouraged internationally, using the smoking issue as a wedge
to join the parties in health advocacy lobbying, we know how that turned
out, how soon we did forget. On the other hand, perhaps we are smarter now
and are assured the results will be different. Consistent with the
insanity theory of repetitive actions expecting a different result.
Lunacy? I would say so.
Are we so bent we cannot see the damage to us all here? The bullies
are campaigning confidently and without fear of reprisals, for barring a
smoker from Employment, Housing or Community Many others join in declaring
child abuse against parents in custody hearings could be justifyable. The
Ontario Government dispensing hatred to our children endorsed and
applauded, at a site they call stupid, it’s very name screams
violence, this is indefensible by a government in a civilized society yet
no one noticed. The same Government ministry has recently announced a
couple of decries of note; "Quit or be punished" and more recently "Fat is
the new tobacco" Will the term fat have a similar wide berth of definition
in science, so we can repeat the process in the coming decade? Now they
approach our homes the castle to some will be a fortress to others,
defending their fading right to escape from their insidious tormentors.
The diagnosis should be clear we could do a lot better. The
alternative again could be defense of a momentous lawsuit on our horizon
in the civil rights abuses against the victims of both the product and the
gang of bullies. Justice will have the final say in the campaign of
hatred, a deliberately created pandemic in our culture.
Does a smoking ban result in protection of non-smokers who now deal
with an increasingly meaner more violent society?
Do we reduce preventable death by ignoring the cause?
Can any deny informed consent is not well served in our current approach?
If any are determined enough to answer yes to any of these questions;
a self-examination is in order, to understand your need to express
intolerance and abdicate for crimes against others for the use of a legal
product.
Food for thought
From the British Medical Journal;
http://tc.bmjjournals.com/cgi/content/full/14/suppl_2/ii3?ijkey=51532084409cd1fe36c22cbb2fb51ee231739f0c
I read the article by Offen et al with great interest. It is an
excellent elucidation of the concepts of ‘boycott,’ ‘buycott,’ and
‘perimetric.’ One opportunity for perimetric action not mentioned is the
option each academic has to boycott and/or draw attention to universities
and medical schools that accept tobacco industry funds or hold tobacco
stock. (1) The converse is equally appropriate; ‘buycott’ centers that
hav...
I read the article by Offen et al with great interest. It is an
excellent elucidation of the concepts of ‘boycott,’ ‘buycott,’ and
‘perimetric.’ One opportunity for perimetric action not mentioned is the
option each academic has to boycott and/or draw attention to universities
and medical schools that accept tobacco industry funds or hold tobacco
stock. (1) The converse is equally appropriate; ‘buycott’ centers that
have clear policies abhorring tobacco investments or funding.
When information on such policies – or the lack of them – becomes freely
available, we can engage in “less research and more action” as has been
suggested elsewhere. (2)
1. Wander N, Malone RE. Selling Off or Selling Out? Medical Schools
and Ethical Leadership in Tobacco Stock Divestment. Acad Med
2004;79(11):1017-26.
2. Blum A, Solberg E, Wolinsky H. The Surgeon General's report on smoking
and health 40 years later: still wandering in the desert. Lancet
2004;363(9403):97-8.
The trial testimony of Sanford Barsky, offered by David Egilman in
his email letter to Tobacco Control, provides an illustrative example of
why tobacco industry sponsored research should not be published in Tobacco
Control or other responsible scientific periodicals. In the testimony
Barsky argues for non-tobacco causation of a case of squamous cancer of
the lung.
Examination of tobacco industry documents housed in the...
The trial testimony of Sanford Barsky, offered by David Egilman in
his email letter to Tobacco Control, provides an illustrative example of
why tobacco industry sponsored research should not be published in Tobacco
Control or other responsible scientific periodicals. In the testimony
Barsky argues for non-tobacco causation of a case of squamous cancer of
the lung.
Examination of tobacco industry documents housed in the Legacy Tobacco
Documents Library http://www.legacy.library.ucsf.edu
reveals that the tobacco industry organized and funded an effort, Council
for Tobacco Research (CTR) Special Projects (SP) 47 and 110, to recruit
eminent physicians to identify cases of epidermoid (squamous) carcinoma of
the lungs in non-smokers. [1], [2] This search was important to the
tobacco industry because of public testimony by prominent pathologists
like Oscar Auerbach MD that he "had never seen a case of squamous cancer
in a nonsmoker". [3] The stated purpose of SP-110 was "To demonstrate that
epidermoid lung cancers do occur in nonsmokers and thus refute assertions
that these cancers occur only in smokers." [4]
This research effort was led by pathologist Lauren Ackerman MD and
included a number of thoracic surgeons, including Society of Thoracic
Surgeons president Lyman Brewer III.MD and Thomas Burford MD Chair of
Thoracic Surgery at Washington University. Ackerman, a pathologist at
Washington University was the recipient of a $3.6 million tobacco industry
research grant. [5] Also involved in SR-110 was Yale epidemiologist Alvan
Feinstein PhD, who received more than $2 million from the industry during
his long career. Other participants in the study are listed in a footnote
below. Of these individuals, only Feinstein ever published on the topic.
He reported after a review of medical records that he had found 17 cases
of epidermoid cancer in non-smokers. This assertion prompted a review and
1970 publication by Yale pathologists Raymond Yesner and N.A. Gelfman who
determined that none of Feinstein's cases were, in fact, epidermoid
cancers. Remarkably, although he was a coauthor on this
publication, in two letters to the editors of JAMA and the Medical
Tribune, Feinstein "regretted the premature publication" and disassociated
himself from Yesner's conclusions, stating that he did not believe that
epidermoid cancer was a "tobacco cancer" based upon his interpretation of
data. [6][7]
Finally, in 1973 another reexamination of 449 Yale lung cancer cases by
the same authors confirmed that the incidence of squamous and small cell
lung cancers is very uncommon in non-smokers (approximately 1%). There
were no cases among non-smoking men. [8] In 1974, Feinstein took a new
tack, suggesting that the reason that there was an increase in lung cancer
in smokers was a "bias" on the part of clinicians who were more likely to
consider a diagnosis of lung cancer and initiate testing for the disease
in smokers. [9]
No publication on this topic by any of the other researchers involved in
SP-110 could be found in a search of the Index Medicus. The clear
implication is that none of the experts could find cases of squamous lung
cancer in non-smokers in the records of their medical centers.
This should cause no surprise to clinicians and pathologists experienced
in the care of lung cancer, who know that cases of such cancers in non-
smokers are rare. It is also reasonable to assume that, if the SP-110 and
SP-47 investigators had identified cases of squamous lung
cancer in never-smokers, the results would have been published and
trumpeted by the industry in courtroom testimony. The fact that the
results of SP-110 were not published reflects the willingness of the
tobacco industry to stifle publication of adverse results, and represents
a clear and typical example of the insidious and self-serving nature of
tobacco industry funded research. Good science
involves the publication of all results, not just those that serve the
agenda of a killer industry.
Appendix:
Physicians and scientists mentioned in documents as participating in
these CTR "Special Projects"included.
Robert E. Stowell MD
Dean Davies
Lauren Ackerman MD St.Louis MO
Avrill Liebow MD New Haven CT
Samuel G. Taylor MD Chicago IL
Russell Irwin MD San Diego CA
William H. Sheffield MD
Thomas Burford St. Louis MO
Haynes Shepherd San Diego TS
Homer Peabody MD San Diego CA
John R. Kiser MD San Diego CA
Alvan Feinstein MD New Haven CT
Doris Herman Los Angeles CA
Lyman Brewer MD Los Angeles CA
References:______________________________
[1]http://legacy.library.ucsf.edu/cgi/getdoc?tid=zxz95a00&fmt=pdf&ref=res
ults ; "Special Project # 47." Bates # 92613988
[2]http://legacy.library.ucsf.edu/cgi/getdoc?tid=aqw90c00&fmt=pdf&ref=res
ults ; "Special Projects" January 1, 1968. Bates #995007392
[3]http://legacy.library.ucsf.edu/cgi/getdoc?tid=dod3aa00&fmt=pdf&ref=res
ults Memorandum Leonard Zahn and Associates "American College of
Surgeons". Bates # unknown.
[4]. http://legacy.library.ucsf.edu/tid/ydm06a00 "Collect Cases of
Epidermoid Lung Cancer in Non-Smokers". Bates # 955008212 19660226
American Tobacco Company
[5]http://legacy.library.ucsf.edu/cgi/getdoc?tid=dzg33f00&fmt=pdf&ref=res
ults ; "Washington University March 1971". Bates # 680601980
[6] Feinstein AR. Smoking and cancer morphology. JAMA. July 6, 1970,
213:131
[7]Feinstein AR. Smoking-histology study. Medical Tribune 1 June
1970;33:11.
[8]Yesner R, Gelfman NA, Feinstein AR. Reappraisal of histopathology in
lung cancer and correlation of cell types with antecedent smoking. Am Rev
Resp Dis 973;107:790-7
[9]Feinstein AR, Wells CK. Cigarette smoking and lung cancer: the problems
of "detection bias" in epidemiologic rates of disease. Trans Assoc Am
Physicians. 1974;87:180-5
While I'm delighted that these tobacco industry trial products of
unproven merit continue to "taste like s__t" (-a reference to the RJR
president's famous quote in "Barbarians at the Gate"), I hope that we'll
not see much more of OSH's time spent on what amounts mostly to market
research valuable to the tobacco malefactors.
I certainly agree with most of the comments of Dr
Kamal Chaouachi but the need to develop one generic
name for the different types of this form of tobacco
smoking is definite and we tend to prefer the term water-
pipe smoking as it denotes the similarity that links all
these forms and shapes and local names. Certainly
these different names are associated with local
geographical languages and idenified best in the
reps...
I certainly agree with most of the comments of Dr
Kamal Chaouachi but the need to develop one generic
name for the different types of this form of tobacco
smoking is definite and we tend to prefer the term water-
pipe smoking as it denotes the similarity that links all
these forms and shapes and local names. Certainly
these different names are associated with local
geographical languages and idenified best in the
repsective languages. The need to use a common generic name is recognized
to avoid using three to five different names in every paper to make sure
that the study covers these
types. Water-pipe tobacco smoking is a good common
name and reflects the major difference from direct
tobacco smoking which is a lower temperature of
burning as well as cooler smoke temperature. This is
reflected in the composition of the smoke and
characteristics of toxic and carcinogenic componenets
as alluded to in some work from Lebanon by Alan
Shihada cited in the original paper discussed here.
Mostafa K. Moahmed
Professor of Community Medicine
AinShams University Faculty of Medicine
Abbassia , Cairo, Egypt
Principal investigator
Egyptian Smoking Prevention Research institute ESPRI
Tel /fax Office 20-2-368-2774 / 368-6275/ 368-8400
Mobile 20-12-241-7933
email: ecgc@internetegypt.com
We wish to draw your attention to some misconceptions in the
following study:
Rima AFIFI SOWEID. Lebanon: water pipe line to youth. Tobacco Control
2005;14:363-4.
>"In Lebanon, youth and women are the target of a marketing
campaign featuring a new tobacco product for use with the more traditional
water pipe."
The caption for the embedded picture is a an erroneous
interpretation. Sociological semiology showed us in the fifties that if
you want to sell a car (to men, of course), you have to depict it with a
nice looking girl leaning on it. Once again, in the present case, the
message is not directed to "youth and women" but to men in the first
instance.
Then, the word "water pipe", in the title and elsewhere, is not
appropriate. It is used only in a certain orientalist or neo-orientalist
literature,(1) just like the sometimes disparaging "hubble-bubble" (2). If
you enter a café in the Middle East or in Europe and North America
nowadays, and order a "water pipe" or a "hubble-bubble", in most cases you
will not be understood. So, let us use the words people use in the real
human world we are interested in, as scientists serving the public health.
-"(N)arghile" is widely used in the Middle East: from Turkey to Iran
via Lebanon, Syria, etc.
-"Hookah" is quite common in Asia (India, Pakistan, etc.) and the English-
speaking world.
-"Shisha" fits first the North of Africa: countries such as Tunisia,
Libya, Egypt and now Morocco but it is also common in the Arab-Persian
Gulf region and now, thanks to the world hookah craze, in every part of
the globe (3).
>"The water pipe is a traditional form of tobacco smoked in Arab
countries, including Lebanon."
It is not. It has been used for centuries in Asia and Africa and not
only in the Arab countries (4).
> "Recently, trends have shifted between tobacco types, and water
pipe smoking is becoming the preference for young people and women
specifically, ousting the once more popular cigarette."
We are afraid they have not. It is also becoming the preference for
men too. It is not ousting the cigarette; on the contrary. People, in
countries like Lebanon, smoke indistinctly hookahs and cigarettes (5).
Tobaccologists are not that much interested in the dozens of millions of
recreational hookah smokers around the word who have been smoking a hookah
once a week or a month over the past centuries. What is of utmost concern
to them is those dual smokers and those who have switched from cigarette
(or bidi, etc.) smoking to narghile use. The body memory of their past
career and their inhaling patterns are different. This is the real health
concern we have to focus on (6)(7).
> "Ironically, with an eye on an ever "health conscious consumer",
the new product comes in individually wrapped portions (hitherto in large
bales) and the promise that it has not been touched by human hands."
We are sorry to say that it is not a "new product". Indian
manufacturers, like Afzal, for instance, have been providing with these
individually wrapped portions for a very long time now. Besides, this
marketing concept, adopted and developed further by Western manufacturers,
will be very soon available in the whole world.
Generally speaking, this article is interesting and, despite the
above commented upon misconceptions, we cannot but share the author's
concern regarding the existence of this kind of advertisement. Any
advertisement for any substance should be prohibited as a rule.
Kamal Chaouachi, Paris Universities.
Researcher in Socio-Anthropology and Tobaccology
REFERENCES
(1) CHAOUACHI Kamal. Culture matérielle et orientalisme. L'exemple
d'une recherche socio-anthropologique sur le narguilé, Arabica (Paris III
Sorbonne et EHESS), 2005. [Engl.: Material Culture and Orientalism. The
Example of a Socio-Anthropological Research on Narghile]
(2) CHAOUACHI Kamal. Le narguilé. Anthropologie d'un mode d'usage de
drogues douces [Engl.: An Anthropology of Narghile: its Use and Soft
Drugs], Ed. L'Harmattan, 1997, 262 pages.
(3) CHAOUACHI Kamal. The Recent Development of Hookah Use in the
World : a Serious Epidemic or just a Passing Fad ? The Need for a Socio-
Anthropological and Medical Approach. IFSSH (International Forum for
Social Sciences and Health), World Congress "Health Challenges of the
Third Millenium". Istanbul, 21-26 Aug. 2005. Published by YEDITEPE
University, Dept. of Anthropology, Aug. 2005, tome I, pp. 360-1.
(4) CHAOUACHI Kamal. Le narguilé : analyse socio-anthropologique.
Culture, convivialité, histoire et tabacologie d'un mode d'usage populaire
du tabac. Doctoral Thesis, Université Paris X (France), 420 pages. [Engl.:
"Narghile (hookah): a Socio-Anthropological Analysis. Culture,
Conviviality, History and Tobaccology of a Popular Tobacco Use Mode"].
(5) Baddoura R., Wehbeh-Chidiac C. Prevalence of tobacco use among
the adult Lebanese population. July-Sept. 2001; 7 (4/5): 819-28. St-Joseph
University, Beirut, Lebanon. Published by WHO/EMRO.
(6) CHAOUACHI Kamal. Presentazione del narghilè e del suo uso. Guida
critica della letteratura scientifica sul narghilè (shisha, hookah,
waterpipe). Dalle origini ai giorni nostri : necessità di un approccio
interdisciplinare socio-antropologico, medico e farmacologico.
Tabaccologia 2005; 1: 39-47. [Engl.: A critical review of scientific
literature on narghile (Shisha, Hookah, Waterpipe) from its origins to
date: the need for a comprehensive socio-anthropological, medical and
pharmacological approach].
(7) CHAOUACHI Kamal. Shisha, hookah. Le narguilé au XXIe siècle. Bref
état des connaissances scientifiques. [Eng.: Narghile, Hookah in the 21st
Century: An Overview of the Scientific Knowledge]. Le Courrier des
Addictions 2004 (Oct) ; 6 (4) : 150-2.
Prochaska and Velicer have commented on this trial(1), and, having
been alerted to this comment elsewhere, we feel we need to respond
belatedly. They suggest the study had important flaws but do not name
them. We drew attention to those flaws in the conduct of the study in the
report. The major flaw was that midwives in the control arm were less
enthused about the intervention and complied with the protocol less well,...
Prochaska and Velicer have commented on this trial(1), and, having
been alerted to this comment elsewhere, we feel we need to respond
belatedly. They suggest the study had important flaws but do not name
them. We drew attention to those flaws in the conduct of the study in the
report. The major flaw was that midwives in the control arm were less
enthused about the intervention and complied with the protocol less well,
which overstated the benefit of the intervention, which we addressed in
the report. In retrospect, it might also have been better to have had two
larger arms than three.
In addition, they state that this is a population-based trial and
this is partly true- we certainly intended that it should be so- but the
trial fell short of this ideal. We asked midwives to recruit every smoker
into the trial regardless of willingness to stop smoking, but, as is clear
from Figure 1, only a minority of smokers were approached. Nearly all
those who were approached agreed. This was a cluster-randomised trial
because we thought it would be difficult for midwives to switch
counselling styles between the TTM-based approach and their normal
approach. However, we trained midwives to approach participants in all
arms of the study in the same way. That is, we asked midwives not to say
to women in the control arm- you will receive my usual care- while for the
intervention arms, midwives were asked not to describe the specific
intervention a woman was to receive. Rather, midwives were trained to
present the possibility that a woman would potentially receive any of the
interventions, when in reality she could only receive one. To have done
otherwise would have risked biasing the trial. Thus, any differences in
the rate at which midwives approached women to participate in the trial
were nothing to do with the attractiveness of the intervention. They were
to do with the enthusiasm of the midwife as we discussed in the trial
report. This may sound subtle but it is important. If the NHS had chosen
to implement the TTM-based intervention, then as every midwife has to
raise smoking and record it on the maternity record, if her standard
intervention was now the TTM-based one, then all women who admitted to
smoking would receive this intervention. Differences in uptake in the
‘real world’ outside this trial would not occur. Consequently, the eight
times the population impact figure of Prochaska and Velicer is wrong, as
the main driver of it is the uptake rates which would not differ outside a
trial, where recruitment meant lots of extra work for the midwife.
Prochaska and Velicer state that we recommend programmes with no
evidence. Actually, the last sentence of our report was ‘Smoking in
pregnancy is currently a problem for which there is no good currently
available solution.’ We still believe this is true at a population level,
but it also reasonable to suggest that all midwives should discuss
smoking, as this seems like an ethical imperative. It seems reasonable
also for midwives to offer assistance to stop, mainly referral to a
specialist who can give that help, and there is good evidence that this is
effective(2). I am pleased to say that one local service manages to see
around half of all pregnant smokers, of whom a third of these set a quit
date and around a quarter of those sustain validated 4-week abstinence.
This clearly shows the small population impact- around 4% of all pregnant
smokers (see
http://www.uknscc.org/2005_UKNSCC/presentations/carmel_ogorman.html), but
this is better than the population impact of the TTM-based interventions
in our trial (where the comparable figure is 2-3%).
One way to better understand the population impacts of the TTM-based
interventions in pregnancy is to see more trials with similar
interventions. Prochaska, Velicer and colleagues completed such a trial
before ours was completed and it is still not published. Understanding
the efficacy of these interventions would be improved if it were.
Reference List
(1) Lawrence PT, Aveyard P, Evans O, Cheng KK. A cluster randomised
controlled trial of smoking cessation in pregnant women comparing
interventions based on the transtheoretical (stages of change) model to
standard care. Tobacco Control 2003; 12:168-177.
(2) Lumley J, Oliver S, Waters E. Interventions for promoting
smoking cessation during pregnancy (Cochrane Review). In: The Cochrane
Library, Issue 1, 2003.
As Professor Chapman has noted some have questioned the merits of
publishing papers that the tobacco industry funded. In the spirit of
Justice Brandeis who noted that, “Sunlight is the best disinfectant” I
believe that more not fewer tobacco industry consultants opinions should
see the light of day. For example I believe that court room opinions
offered under oath, by tobacco hired historians, physicians and others
sho...
As Professor Chapman has noted some have questioned the merits of
publishing papers that the tobacco industry funded. In the spirit of
Justice Brandeis who noted that, “Sunlight is the best disinfectant” I
believe that more not fewer tobacco industry consultants opinions should
see the light of day. For example I believe that court room opinions
offered under oath, by tobacco hired historians, physicians and others
should be published as often as possible perhaps as a regular TC offering
with pro and con commentary. This would permit real peer review of
opinions that have great importance in the creation of policy. I offer
your readers an example. Dr. Sanford H. Barsky gave this opinion on the
case of Mr. Vandenberg, a seventy-nine year old ex-marine and postal
worker who had a 75 pack-year smoking history.
“My opinion is that he has a fairly well differentiated squamous cell
carcinoma of the lung that's arising within a bronchiectatic focus of the
lung and that's going through the stages time [including] the stage of
metaplasia, dysplasia, in situ carcinoma and invasive carcinoma… I think
the squamous cell cancer is arising within this bronchiectatic focus. I
think the chronic inflammation and irritation of this focus is what's
giving rise to the squamous cell cancer; that it's a peripheral squamous
cell cancer, away from the main airways and that his tobacco smoking is
not causally related to the genesis of this particular tumor.” He noted
that, “no one has mentioned the term, bronchiectasis in the medical
records.” And based his opinion, “primarily on pathology” buttressed by
case reports and Spencer’s Textbook of pathology that had “commonly” note
the association between bronchiectasis and lung cancer. He went on to
state that smoking did not contribute to cause the cancer.
I invite your readers to shed light on this opinion.
I serve as an expert witness in Tobacco litigation
It would have to be seen as the most intriguing question of our era; to understand how, with all the most educated of scholarly voices abdicating for world wide smoking bans, how not one of those participants has the vision to see outside the box. To understand with very little imagination how beneficial it could be to society as a whole to simply look at the product before punishing it’s victims. When we view tobacco a...
I read the article by Offen et al with great interest. It is an excellent elucidation of the concepts of ‘boycott,’ ‘buycott,’ and ‘perimetric.’ One opportunity for perimetric action not mentioned is the option each academic has to boycott and/or draw attention to universities and medical schools that accept tobacco industry funds or hold tobacco stock. (1) The converse is equally appropriate; ‘buycott’ centers that hav...
The trial testimony of Sanford Barsky, offered by David Egilman in his email letter to Tobacco Control, provides an illustrative example of why tobacco industry sponsored research should not be published in Tobacco Control or other responsible scientific periodicals. In the testimony Barsky argues for non-tobacco causation of a case of squamous cancer of the lung. Examination of tobacco industry documents housed in the...
While I'm delighted that these tobacco industry trial products of unproven merit continue to "taste like s__t" (-a reference to the RJR president's famous quote in "Barbarians at the Gate"), I hope that we'll not see much more of OSH's time spent on what amounts mostly to market research valuable to the tobacco malefactors.
I certainly agree with most of the comments of Dr Kamal Chaouachi but the need to develop one generic name for the different types of this form of tobacco smoking is definite and we tend to prefer the term water- pipe smoking as it denotes the similarity that links all these forms and shapes and local names. Certainly these different names are associated with local geographical languages and idenified best in the reps...
Dear Editor,
We wish to draw your attention to some misconceptions in the following study:
Rima AFIFI SOWEID. Lebanon: water pipe line to youth. Tobacco Control 2005;14:363-4.
>"In Lebanon, youth and women are the target of a marketing campaign featuring a new tobacco product for use with the more traditional water pipe."
The caption for the embedded picture is a an erroneous int...
Prochaska and Velicer have commented on this trial(1), and, having been alerted to this comment elsewhere, we feel we need to respond belatedly. They suggest the study had important flaws but do not name them. We drew attention to those flaws in the conduct of the study in the report. The major flaw was that midwives in the control arm were less enthused about the intervention and complied with the protocol less well,...
As Professor Chapman has noted some have questioned the merits of publishing papers that the tobacco industry funded. In the spirit of Justice Brandeis who noted that, “Sunlight is the best disinfectant” I believe that more not fewer tobacco industry consultants opinions should see the light of day. For example I believe that court room opinions offered under oath, by tobacco hired historians, physicians and others sho...
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