Yesterday Dr Michael Siegel had published an opinion piece in the New York times called “A Smoking Ban Too Far“.
While I normally respect the integrity of the good doctor his Tobacco Control roots are showing through and he is playing a little fast and loose with the facts. In the first paragraph he states;
“But while there is a strong public-health case for banning smoking indoors, the case for banning it outdoors is much weaker”
The fact is good doctor the so called “strong public health case” is not all that strong, as a matter of fact it is so weak that it is almost non-existent. Using your own words in a response to Diethelm and McKee.
In the response, I write: “Diethelm and McKee have endangered the integrity of public health by comparing those who challenge the conclusion that secondhand smoke causes heart disease and lung cancer with those who deny the Holocaust. As a primarily science-based movement, public health is supposed to have room for those who dissent from consensus opinions based on reasonable scientific grounds. To argue that those who fail to conclude that the small relative risk for lung cancer of 1.3 among persons exposed to secondhand smoke is indicative of a causal connection are comparable to Holocaust deniers is to turn public health into a religion, where the doctrines must be accepted on blind faith to avoid being branded as a heretic.” …
Indeed you are correct good Dr as no cause of a disease has ever been proven with such low relative risks. And at no point have you ever touched on the methodology used to get to that tiny 1.3 RR.
Of course we are talking about the use of Meta-analysis. Many experts like Dr John C. Bailar, III argue against its use PERIOD. This questionable methodology has been used by tobacco control since the 1992 EPA report. (Which by the way was harshly criticized because of the deliberate publication bias by cherry picking the studies to be included?) And by their own admission they used this questionable methodology because they “deemed it useful“. This is their own words from page 21
Recognizing that there is still an active discussion
around the use of meta-analysis to pool data
from observational studies (versus clinical trials),
the authors of this Surgeon General’s report used
this methodology to summarize the available data
when deemed appropriate and useful, even while
recognizing that the uncertainty around the metaanalytic
estimates may exceed the uncertainty indicated
by conventional statistical indices, because of
biases either within the observational studies or produced
by the manner of their selection.
This of course ignores Property Rights Freedom of Choice and personal responsibility issues. We who firmly believe in all three of those still await this strong and compelling evidence!