Rollo, ASH Scotland and freedom of speech

On my post https://daveatherton.wordpress.com/2011/12/03/professor-simon-chapman-replies/#comments I accused Rollo as possibly being an employee of ASH Scotland, I also added tongue in cheek that “Gene Borio today, next Debs Arnott of ASH might pick up the keyboard, who knows.” Ironically Rory Morrison of ASH Scotland did write back in  the comments

“Dave/Jonathan
As I work for ASH Scotland I can hopefully clarify for you that: 1) I’m not Rollo Tomasi (though I do like L.A. Confidential); 2) none of my colleagues have, as far as I’m aware, ever used that alias; and 3) if there’s been an effort within my workplace to train people up to ‘fight you on the web’ then it’s been exceptional well hidden from me.

I wouldn’t think it would be logical for us to employ somebody to use an online pseudonym for the express purpose of disagreeing with you or others here or anywhere else. What would be the benefit?

As you’ve described your blog in an email to us previously as comments being ‘vigorously encouraged’, I would have thought you’d welcome dissenting opinion from everybody, even those who chose to use a pseudonym online (which people could have a whole variety of reasons for doing).

Though of course, if I *was* Rollo Tomasi, this would be exactly the kind of thing I would write…”

My reply was:

@Rory

Thanks for taking the trouble to reply, and with your real name and photo. To be fair I did say it was the thinnest of circumstantial evidence. I really do encourage dissent and want a polite and intellectually vigorous debate, which frankly the anti smoker movement want to deny me. My blog is entirely unmoderated, any delays are because someone has posted 3 or more URLs and is flagged up as potential spam.

Examples are ASH England blocked me from posting comments on their Facebook page, Simon Williams the Lib Dem MP and Chairman of the All Party Group on Smoking and Health where ASH are the “Secretariat” have denied me the right to offer evidence. I tried to post on Professor Stanton Glantz blog, as of yet my comments are to appear. (Washington) DC Smoke Free also censored my comments. The double standards are glaring.

I will however take this opportunity to apologise to Rollo for questioning his background. I presume he may well have a relative or loved one who may have suffered from a smoking related disease.

On the 28th June of this year I posted this “Editor-in-Chief of Lifestyle Reviews Rollo Tomassi has been mentioning the late Konrad Jamrozik’s paper on “Estimate of deaths attributable to passive smoking among UK adults: database analysis.” So I have acted on his suggestions as to what goes in my blog.

Rory if you like ASH Scotland can have the freedom of my blog and post an unedited and unmoderated piece of your choice, on any subject.

Notwithstanding my offer which will stand whatever the circumstances, I would like ASH Scotland, Wales and England to have a public debate on the science of passive smoking. Witnesses, cross examination recorded for the public and media. I fear my request may well be declined.”

 

I hope we can have a full debate.

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24 Responses to Rollo, ASH Scotland and freedom of speech

  1. harleyrider1978 says:

    Yep,the last thing theyd want is an open debate! Itd lead to REPEALS!

  2. harleyrider1978 says:

    Here rests ASH

    Burned to cynder today by MPs
    Upon its demise Pubs and eateries reclaimed their own right to life along with the buried freedom of the people.

    Ashes to Ashes Dust to Dust

    goodbye ASH youve taken your last tax dollar home!

  3. John H Baker says:

    I applaud Rory’s comments on this blog and I wish more comments from the ‘paid’ anti smoking fake charities, like ASH, who rely on their income from government, ie the public, smokers or no, to push their agenda, would throw their hats into such blogs, but they don’t and it is indicitive that many of the anti smoking fake charities may resort to subterfuge to push their money spinning agenda. No wonder us bloggers are suspicious.

    One things for sure, Rollo is a anti smoking government stooge.

    TheBigYin

  4. LA Confidential? Wasn’t Rollo Tomassi a character in The Usual Suspects, or has the booze finally addled me? 😉

  5. Tony Hand says:

    Dick, it has finally addled you mate. Kevin Spacey starred as Keyser Soze in the usual suspects while his character was killed by Rollo Tomasi (The characters real name in the film was Capt Smith) in LA Confidential.
    Rollo was played by the actor James Cromwell.

  6. Gary K. says:

    Let them post; but, do not trust their numbers.

    These people claim that it is 100% absolutely certain that 20% of the lung cancer/heart attack deaths, in America, that occur to never-smokers exposed to SHS are due to the SHS.

    They claim 3,000 lung cancer deaths and 46,000 heart attack deaths are due to SHS exposure.

    The CDC says that about 29,000 lung cancer deaths occur to never-smokers and since probably half are exposed to SHS the 3,000 fits their claim of 20%.

    The 46,000 heart attack deaths would be 20% of 230,000 and you would double that for a total never-smoker heart attack deaths of 460,000 per year.

    The CDC says there are 80,000 heart attack deaths attributed to smokers.

    The total has now become 540,000 yearly heart attack deaths in the USA.

    However, the CDC says that there are ONLY about 487,000 total heart attack deaths per year and someone,somewhere, is obviously lying.

  7. Ta Tony. I’ve never been much of a fan of TV or film, does it show much? 😉

  8. Thanks for the offer, but that’d be problematic several reasons.

    I didn’t post here on behalf of my employer, I’m not acting as a spokesperson for ASH Scotland, tobacco control etc, I’m just some guy writing on the internet during my spare time. Even with caveats like this I think there’s a reasonably high likelihood (because of the way the web works) of anything I contribute being later quoted at some point as ‘an ASH person says…’

    Secondly, my interests are more in clinical trials and the evidence around smoking cessation interventions. I started working at ASH Scotland years after the smoking ban (in Scotland), I’m not a particular expert in second-hand smoke epidemiology, so am not well-qualified to debate it. If a high-quality scientific debate on second-hand smoke is your interest, you’d be best engaging with somebody who has a record of publication in SHS epidemiology.

    Lastly, it’s not as if every study on second-hand smoke for the last twenty-odd years has somehow sneaked into publication without any degree of scrutiny or critique. See the correspondence pages of journals following significant second-hand smoke studies, there are a whole range of methodological and data interpretation issues debated again & again & again …

    Given all of this, I don’t think any limited scientific opinion I could personally offer on second-hand smoke would add much extra value.

    • Rory you are welcome to write a piece on smoking cessation and clear it with Sheila Duffy, that is fine by me.

      If that is your area expertise I have a number of questions and points, I can supply links if you like but most will be on my link at the bottom. My first question is why ASH in the UK do not recommend Allen Carr’s The Easy Way To Give Up Smoking. I can find no mention on your website, especially as Deborah Arnott has admitted it has a 53% peer reviewed success rate, on this I will provide a link.

      “Following a complaint by Allen Carr’s Easyway International, Deborah Arnott and ASH now acknowledge that it was wrong for Ms Arnott to have made the comments relating to the 53% success rate and have issued an unreserved apology.

      ASH has agreed to pay the legal costs incurred by Allen Carr’s Easyway”

      Are ASH lobbying the EU to have snus legalised? Sweden have half the smoking rates and funnily enough half of our lung cancer rates because of snus.

      Why are ASH not recommending and promoting e cigarettes, where quit rates?

      “The researchers conducted an online survey of 222 first-time purchasers of electronic cigarettes, also known as e-cigarettes, from a leading electronic cigarette distributor. Of those who were not smoking at six months, 34.3 percent reported not using electronic cigarettes or any nicotine-containing products. Almost 67 percent of respondents reported having reduced the number of cigarettes they smoked after using electronic cigarettes.”

      The research was executed in South Africa about 349 participants for two months. Out of the total participants 45% had been effective in quitting smoking cigarette following they adapted e cigarettes.”

      Why is NRT continued as the main weapon when the 1-2 year quit rate is 6-7% at the very best, this quote is from the BMJ.

      “The long term (that is, greater than six months) quit rates for OTC NRT was 1% and 6% in two studies and 8–11% in five other studies. These results were not homogenous; however, when combined the estimated OR was 7% (95% CI 4% to 11%).”

      Is it too much of a cheap shot to suggest that ASH are indirectly funded by Big Pharma? It seems to us on the choice side it is not about health but rent seeking and control.

      https://daveatherton.wordpress.com/2011/04/24/is-smoking-a-disease-or-a-habit/

      http://allencarr.com/133/ash-apologise-to-allen-carrs-easyway Debs apologises.

      • I don’t think that’ll (a blog) happen, but I’ll happily answer your questions (again, from a solely personal perspective, if you want organisational opinions contact the organisation). It takes longer to answer than to ask, so I’m going to take the liberty of being selective in what I respond to and as it’s late, for now it’ll only be Allen Carr.

        For the complete avoidance of all doubt in blazing all caps: THESE OPINIONS (OR ANY OTHER TIME I POST) ARE MY OWN NOT NECESSARILY THOSE OF ASH SCOTLAND OR ANYBODY ELSE.

        Yes, for the Allen Carr method there are two observational studies that show around ~50% abstinence. However, they’re uncontrolled observational studies (no control group or assessment of any unique treatment effect of Allen Carr against what would be usual care) and from pretty atypical circumstances (all employees at the same steel plant from a particular demographic, all quitting at the same time, including some who quit with their families).

        There are also atypical features of the way the outcomes are assessed, if this was a controlled trial as is typical for NRT you’d probably use what’s called a ‘intention to treat’ analysis where you use as the denominator for your success rate all people that made an initial quit attempt, not just those who you were able to follow-up (this helps avoids a certain bias in the follow-up where you’re more likely to contact those who are more likely to be quit). For the Allen Carr studies there were actually 1,300ish participants originally, but the ~50% success rate reported is only for the 500 odd that were able to be contacted for follow-up. Nothing inherently wrong with reporting it that way, but for patently obvious reasons you need to be mindful of it when comparing it with methods where outcomes have been assessed differently (i.e most of the cessation literature on NRT).

        The short answer is that it’s often pretty bad practice to compare the outcome rates from an intervention trial in one population (particularly when it’s not likely to be representative) directly with another different trial in a different population because there are more variables at work influencing successful outcomes than just the type of intervention delivered. Not having a control group of any kind in your study with the ‘good’ results makes such comparisons especially, especially, bad practice.

        The Allen Carr results from the two studies that exist certainly seem promising (and I’ve discussed these same issues with an Allen Carr employee). What the method needs is a well-designed randomised trial directly comparing Allen Carr in one arm to UK standard care (‘standard’ behavioural counselling with the option of pharmacotherapy). It’s a pity that it hasn’t been done, because there’s nothing against the method in principle, it just hasn’t been robustly demonstrated to be as good or better than existing practice.

  9. Iro Cyr says:

    I don’t want to overwhelm anyone, but just to add to what David asked Rory : ”Why is NRT continued as the main weapon when the 1-2 year quit rate is 6-7% at the very best (…).”

    Especially that Fagerström, one of the strongest proponents of the nicotine addiction theory has just recently changed his mind about nicotine alone being the addictive property of cigarettes http://cagecanada.homestead.com/fagerstromfindshiswaytodamascus.html

    • Hello Iro, I think that Molimard commentary you link to is a bit hyperbolic, as the actual Fagerström paper itself (here: http://ntr.oxfordjournals.org/content/early/2011/10/20/ntr.ntr137.short) says:

      “Nicotine plays a central role in tobacco use. It is a necessary condition for regular tobacco use but is it sufficient?”

      All very reasonable, few informed people would say the other aspect of smoking (including behavioural ones) aren’t at all important in forming habituation. This is consistent with other knowledge, and really the revision seems more to make a sensible alteration to a title than ‘a bomb’ as your linked commentary puts it.

      NRT and other ‘conventional’ things are still the front line options because 1) they tend to have the most robust safety and efficacy evidence supporting their use (no big surprise, they are sold by wealthy companies who can afford to conduct that kind of research regularly) and 2) even if they aren’t as effective in the absolute sense that we’d wish for, they are still (in the clinical sense) significantly better than doing nothing.

      Of course, this could all be challenged with products like e-cigs that promise to cover more of the experiences of smoking than just the “necessary condition” (as Fagerström puts it) of nicotine.

      • daveatherton says:

        Rory I will reply in more detail later, but a couple of points. Firstly you have to separate the social smoker from the regular smoker. Saying that even I can go on a 14 hour flight without a cigarette. I am a bit tetchy, easy to irritate and for a bet gave up for 8 hours at work on Breast Cancer Day, but got through without a major incident.

        Dr. Martin Jarvis of ASH believes that 84% are “social” smokers and 16% “addicts.”

      • Iro Cyr says:

        I don’t believe it’s hyperbolic Rory as even Fagerström himself knew this for the longest of times. Why did he wait until retirement to speak about it? It makes all the difference in the world whether one is addicted to nicotine or to tobacco. Snus will do the trick if one is addicted to tobacco, NRT on the other hand won’t. Shouldn’t smokers who wish to quit be told the truth of what makes them dependant instead of constantly hammering in the message that it’s nicotine alone that’s doing it? It can’t be nicotine alone, otherwise NRT would be working every time. Yet most anti-smoking groups peddle NRT left, right and center. Either anti-smoking groups are totally ignorant of what tobacco dependence is (I somehow doubt it) or they don’t work for the smoker and as long as the public is catching on to this in ever increasing numbers smoking prevalence will increase as people have stopped believing even what might effectively be true.

    • I’m not sure I completely understand the point you’re making, but what I do take from it doesn’t seem inconsistent with what I wrote previously (most people acknowledge there more to tobacco dependence than just the psychoactive effects of nicotine alone, but current options like NRT still have the best evidence supporting their use, even though they are far from perfect).

      “Either anti-smoking groups are totally ignorant of what tobacco dependence is (I somehow doubt it) …”

      So what would you say tobacco dependence is, and what evidence would you suggest I look at that supports the alternative to NRT?

  10. db says:

    Talking of control groups, who are the totally smoke free people that form the control group in studies regarding SHS? I find it highly unlikely that anyone has not had any exposure to ETS, particularly in countries where smoking is widespread (other than perhaps pre-school infants). Even if there were such people, their sheltered lifestyle would surely predispose any inclusion in scientific studies that purport to assess the effects of ETS on the general, non smoking, population.

    • Frank says:

      You’re correct, very good point. Not so long ago people smoked in most places (excepting libraries, Churches, non smoking compartments, schoolrooms, all the obvious ones) so, imo, it would be virtually impossible for anybody to avoid some element of ETS. Even with pre school infants, maybe the parents, relatives, etc. smoked as most people did in those days.

      Just who are these so called ‘control groups’, people who maintain they’ve never been touched by the devil?

      They don’t bloody well exist!

      • db says:

        Of course they don’t exist. A control group is a fundamental and crucial factor with regard to scientific studies and experiments. Without a benchmark, they are flawed from the outset. This was drummed into me at school and university. I’m surprised it has been seemingly overlooked by those who challenge SHS stats (though not surprised that TC has chosen to ignore it).

      • As I said, I don’t know that much about SHS literature, but consider this:

        Yes, it’s very difficult/impossible to get an ‘unexposed’ control group (e.g. somebody who has never been near an atom of smoke). But if control groups used to derive relative risks were being exposed to smoke (as they almost certainly were to some greater or lesser extent), how would that influence the results you’d get?

        Take an example of calculating excess risk from SHS and lung cancer (which is the incidence of lung cancer in those exposed to SHS divided by the incidence of lung cancer in those not exposed).

        If SHS made no different to lung cancer, the fact you have a contaminated control group wouldn’t matter, it wouldn’t influence either the numerator or denominator in the relative risk equation. If it *did* make a difference, then it would serve to actually weaken the association you’d observe, not strengthen it (because you’d be getting more lung cancer cases in your ‘unexposed’ denominator group). The one thing it wouldn’t do would be to give you more false positive findings, if anything it’d increase the chance of false negatives.

        Just a thought … 🙂

  11. db says:

    ‘Take an example of calculating excess risk from SHS and lung cancer (which is the incidence of lung cancer in those exposed to SHS divided by the incidence of lung cancer in those not exposed). ‘

    Thanks for responding Rory. I can see what you’re getting at (I think), but the above presumes that there are people who have never been exposed – in the slightest. Clearly, this is not the case, which thus undermines the credibility of the statement. And, I have to say, those who make it.

    It also brings into question the patently ridiculous claim that there is no safe level of ETS. How is this conclusion arrived at? You might be familiar with the tale of the general who ordered his army to to cross a 10ft deep river? 10% drowned. Broadly speaking, by TC methods of reckoning (as applied to SHS), had the river been 1ft deep 1% would have drowned. Had it been 1″ deep that’d be…er…(should have gone metric)…not a lot. One could claim (again using TC methodology) that actual number drowned would depend on the size of the army, soldiers average height, the amount of armour they were wearing, and the ratio of swimmers v non swimmers etc. etc. Of course, in reality none would have drowned in 1ft, let alone an inch.

    • “… but the above presumes that there are people who have never been exposed – in the slightest …”

      Not at all, rather it recognised that there will be some mismeasurement (some ‘unexposed’ will actually be exposed), but the important thing to consider is the effect that it’ll have on the relative risk you derive from it. In this case it’ll either have no effect (if no true relationship exists, that is, if SHS doesn’t cause disease) or, if a true relationship exists (SHS does cause disease) it’ll always reduce the strength of association, so will make it harder to demonstrate an increased risk, and easier to demonstrate no increased risk.

      If you want to check yourself, it’s easy, go check out the very start of the wiki on relative risk (http://en.wikipedia.org/wiki/Relative_risk), and, for the little example they give right at the top, put (2/100) in the denominator instead of the (1/100) to represent one extra case of lung cancer caused by misclassification of active smoking (because the example is for active smoking, but it’s the same principle). See what happens to the risk estimate.

      For your other comment, ignoring the fact that in some situations, (e.g. infants in bathtubs) it doesn’t take much water to drown, the biological mechanisms that cause drowning are different to the mechanisms that cause lung cancer, or CHD, so the analogy is imperfect. The argument gets a bit esoteric after that, because it’s a complicated debate between a threshold model of disease (http://en.wikipedia.org/wiki/Threshold_model) & a linear no-threshold model (http://en.wikipedia.org/wiki/Linear_no-threshold_model).

      Probably more important is, even if there is no threshold which there is absolutely no raised risk, how much are you willing to accept exposure to without worrying about?

      • daveatherton says:

        Hi Rory, if you post 3 links on my blog it thinks it is spam. I was out last night at a political event and could not approve until this morning.

        This is 100% true a former Tory cabinet minister seeing me smoking outside referred to us smokers as the “oppressed,” and not ironically.

      • daveatherton says:

        Rory if you want to keep the debate simple let me help. Let me quote you from page 8 of the SCOTH report, bullet point 14.

        “The 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. Thus it appears that a substantial risk arises from quite modest exposure to SHS.”

        So my figures of 1% for ingestion by non smokers is correct and at the most exposed. Rory can you explain to me why most papers on active smoking suggest 4-5 fags a day do not increase your chances of lung cancer and heart disease?

        As smoking is linear in the sense that if you are a smoker and double your cigarette consumption you do not double your chances of lung cancer, but you triple or quadruple your chances. Surely it is implied that the reverse is true?

        Your lifetime chances of lung cancer if you are smoker are 8%. Basic maths implies that the worst case is 1% of 8%. If linear regression is used surely this figure must tend to zero.

        Yep misclassification is probably the reason in some studies show a small non statistical significant rise.

        http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4101475.pdf

  12. db says:

    Rory, nevertheless the SHS issue has been deliberately exaggerated and pitched to frighten non smokers, as part of the denormalisation process. The studies were cherry picked to enhance risk. And now it seems that we have progressed from science to ‘morality’, hence demands for outdoor bans. Yet this move relies on well laid scaremongery. I’m sorry, but whatever one’s feelings are regarding smoking, it has now become an out and out witch hunt. ASH don’t appear to have any inkling what this is doing to people’s lives and businesses. And whatever claims are made regarding costs to the health services, smokers contribute c.three times as much to the public purse. It’s not as though smoking rates have dramatically decreased since the Scottish and English bans were introduced.

    I’m slightly bemused – if tobacco/nicotine are that dangerous why don’t ASH call for an outright ban?

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