The "public Health" Antismoking Scam
A Paper Of Dissent
A Manifesto For A Time Of Change
THE "PUBLIC HEALTH" ANTISMOKING SCAM: A PAPER OF DISSENT
A Manifesto for a Time of Change
| December 2001 |
© 2001 FORCES International
FORCES International is a globalorganisation with no direct or indirect funding or connections with the tobacco or pharmaceuticalindustries. It is funded with private donations, membership, and volunteer work. Its constituencyconsists of smokers and non-smokers who have the common goal of a lifestyle free from state andinstitutions' interference, and it includes doctors, scientists, writers, economists, researchers,politicians, lawyers, other professionals, as well as lay people from many nations. FORCES ispolitically non-partisan, and solely concerned with liberty, intellectual honesty and the integrityof science, and it is against the use of science as a tool for the control of politics, policies, customs and cultures, economics, and behaviour. Further information about FORCES International canbe found at its international multilingual website, www.forces.org.
The most recent attack on private individuals andthe tobacco industry by representatives of the World Health Organisation is another demonstration ofthe fragility of their arguments. A close look at "Junking Science to Promote Tobacco" by Derek Yachand Stella Aguinaga Bialous  (Derek Yach is withthe World Health Organisation, Geneva, Switzerland. Stella Aguinaga Bialous is a public healthpolicy consultant in San Francisco, Calif.) shows that the parameters of scientific, moral andpolitical evaluation adopted by "public health" are the same distorted ones that the tobaccoindustry is accused of using.
The main accusation of the WHO and internationalpublic health against the tobacco industry is that the industry has distorted science to deflect theimpact of primary and passive smoke on human health. Furthermore, the tobacco industry standsaccused of hiring prominent scientists to question the validity of the assertions of "public health"(with the not-so-subtle implication that this amounts to scientific corruption). We neitherdispute that experts have been hired by that industry to argue with the technicalities of "publichealth" assertions, nor do we dispute that such scientists have been paid fees for their consulting;that is, in fact, the normal way professionals earn their living.
That common practice, used by private industry todispute and argue points of contention, should not be the concern of governments and of the citizensthat they represent. Rather, the concern is that Public Health – an institution which, by definition,should be unbiased and solely concerned with policies based on solid scientific grounds -- uses the identical practices of the tobacco industry, while pocketing lavish public funding.
The deep enmeshment of today’s international "publichealth" with the interests of pharmaceutical multinationals is well-documented.     It is curious that Mr. Yach, inhis paper, states: "The debate over conflict of interest between academia and privatecommercial interests is gaining visibility. In a recent article in the Journal of theAmerican Medical Association, the dean of the Harvard medical school stated that moresafeguards against conflict of interest are necessary." Shortly thereafter, he adds: "How this debate will influence future tobacco industry funding of academia remains tobe seen. Even more important is how academia is going to respond to offers from thetobacco industry." Mr. Yach ignores that the debate over conflicts of interest mainlyconcerns the influence of the pharmaceutical giants – not the tobacco industry -- on academiaand scientific journals.     Nor does he mention his own potential conflict. He is a consultant topharmaceutical manufacturers. He is also aprofessional anti-tobacco activist, paid by the WHO, which in turn is deeply enmeshed with theinterests of the pharmaceutical multinationals, its "official partners."
Academia has always been in need of patronage andsponsorship to finance its work. Today’s "public health" tactics of denigrating the outcome ofstudies in function of their sponsorship represents a danger for the advancement of science, as ittends to eliminate "politically incorrect" sponsors from patronage, thus weakening the output andforcing one view at the expense of another. Furthermore, freedom of speech is guaranteed by theconstitution of many countries, and the WHO is not supposed to have KGB-like privileges. The issueis not who brings the message, but rather whether or not the message is true.
In the case of the epidemiology of multifactorialdiseases, for example, it is useful to quote Doll and Peto: ""[E]pidemiological observations…have serious disadvantages... [T]hey can seldom be made according to the strict requirements ofexperimental science and therefore may be open to a variety of interpretations. A particular factormay be associated with some disease merely because of its association with some other factor thatcauses the disease, or the association may be an artifact due to some systematic bias in theinformation collection…[T]hese disadvantages limit the value of observations in humans, but... until we know exactly how cancer is caused and how some factors are able to modify the effectsof others, the need to observe imaginatively what actually happens to various different categoriesof people will remain."  But speculative "imagination" should not be a determining factor of public policies in free democracies.
However, if funding (or the lack of it) is to beaccepted as the main meter of objectivity and credibility in scientific research, then that meter isto be universally applicable. Therefore it should be applied to antitobacco studies funded directlyor indirectly by the pharmaceutical industry as well asthose studies that are funded by the state under antitobacco programs. The purpose of science is tofind out, prove and quantify the truth – not to justify social engineering programs and foregonepolitical conclusions.
One of the tactics of the WHO in its effort todisinform governments and citizens about the health hazards of tobacco smoke is to mention mortalityrates, and to project the use of tobacco as a social problem and a disease. "Four million deaths per year, 1.2 billion smokers in the world today", Yach and Bialous flatly state.It is interesting to note that, according to the WHO's own l997 World Health Report, the deathswere 3 million. A mere two years later, WHO's l999 World Health Report states that there were 4million deaths. That's an increase of 33% more dead smokers in only two years – a number they saythat will increase to 10 million in 19 years from now. To impress people more emphatically,predictions are based on predictions, which are based on estimates and projected estimates.
The statistical models used by the WHO are fundamentally flawed , and the methodology to enumerate the data is deeply corrupt.   "Public health" is quick todismiss as "tobacco paid" any opposition to what basically amounts to fraudulent information if theopposition comes from experts who have had any dealing whatsoever with the tobacco industry. On theother hand, independent, "non-expert" critiques, no matter how acute and to the point, are dismissedas incompetent, thus not worthy of attention. In fact, only antismoking activists and doctors –doctors who embrace antitobacco – are admitted to this exclusive "debate." This "debate," however, profoundly affects the pockets and the liberties of billions of smokers. Those smokers areexpected to just blindly believe and obey public health’s directives and accept its disinformation,without the opportunity, let alone the right, to have any say about policies and taxationlaunched against them.
However, it does not take a general practitioner tounderstand that all the diseases attributed to tobacco are multifactorial, often with hundreds – ifnot thousands -- of concomitant causes which interact differently in every single human in functionof hundreds of ever-changing variables.  Another complication is that all the diseases attributed to tobacco also occur in non smokers.It is therefore clear that it is impossible for multifactorial epidemiology to confidentlyisolate single co-factors such as primary or passive tobacco smoke exposure; thus, it is impossibleto quantify the contribution (if any at all) of tobacco in a death or disease. From that fundamentalconcept alone it follows that the WHO’s figures concerning tobacco-related mortality and morbidityare invalid as policy-making tools, and can only be relegated to the role – if any – of arough indicator for speculative assumptions and/or further investigation. That is because thosefigures are based on impossible quantification – although a very complex, abstract, andhighly technical set of parameters, methodologies, assumptions and terminology are used to impressunskilled media and political targets. This is done to project the impression of a highlysophisticated (thus reliable) statistical technology, which is then presented by doctors and academicians to add the essential ingredient of credibility to the antismoking saga.Governments and institutions are then induced, in turn, to move legally and politically against thetobacco industry and its 1.2 billion customers. But there is no magic in multifactorial epidemiology:beyond the smokescreen, the WHO cannot prove, even for one single subject, that a directcause-effect relationship (that is, single etiological causality) exists beyond anyreasonable doubt. Yet, Yach states: "The causal relationship between tobacco use and death anddisease has been demonstrated in countless epidemiological studies over the last 50 years."  Projecting absolute certainty, without thehumility and the doubt that good science always expresses, is one of the well establishedstrategies of "modern public health."
In simple words, let us consider the enormousmagnitude of the WHO’s claims: four million-plus deaths per year "attributed" to smoking. With sucha massive background of "fatalities," there should be no problem at all in presenting one singledeath that can be proven to be caused uniquely by primary or passive smoking, and beyond any scientific objection. At least, the WHO should be able to firmly quantify thepercentage contribution of tobacco to that one death. But in no case can the WHO, or any otherentity or individual, make such a claim; and if all the apocalyptic documentation of the WHO is readanalytically, one sees that that claim is made nowhere.
Ironically, the same "public health" establishmentthat claims that so much death and disease is caused by primary and passive smoke wilfully ignoresor smears any alternative in connection with smoking other than the unrealistic, and at any ratevery long term, total elimination of smoking. Yet antismoking "education" is a credible cause of thedramatic increase in youth smoking, for which tobacco advertisement is instead blamed,  even in those countries (such as Italy) where it has been forbidden for nearlyfour decades.
For some time, the technology has existed todramatically reduce the risks of smoking – no matter how unquantifiable, and whatever those risksmay be – without depriving smokers of their lifestyle preference. The so-called "safer cigarette," based on halving the amount of untreated tobacco (thus halving pollutants in primary and passive smoke) and increasing the nicotine concentration (whose positive effects on health are widely recognised     to the point that the pharmaceutical industry attempts to seize the control of it) hasbeen available for many years,  and its merits,even recently, have been independently recognised. The high concentration of nicotine augments the smoker’s feeling of satisfaction, and furtherreduces the number of cigarettes smoked. But since its inception, the "safer cigarette" has beenignored or even fiercely opposed by the very establishment that often defines cigarette smoking asthe "greatest man-made source of preventable disease".
In fact, the science and technology asserting that safer (more properly: less-hazardous) cigarettes were possible goes back to the Smoking and Health Program of the US National Cancer Institute, a program held jointly with the co-operation of the tobacco industry. Information about this program and the technology resulting from the research was initially made public through the efforts of Dr. James Watson, of DNA and Nobel prize fame.  The opposition to a safer cigarette began in 1978 in the US. In 2001 the Institute of Medicine of the US National Academy of Sciences has confirmed that the suppressed 1980 policies for safer cigarettes were sound.  It follows that, with its opposition, "public health" by its own count may be responsible for untold millions of premature deaths and avoidable diseases worldwide.
There are only two logical explanations for thatopposition:
- "Public health" is aware that its figures for tobacco-relatedmortality and morbidity are grossly exaggerated, and at any rate not provable, and is concernedthat a wide use of a safer cigarette may prove, in a relatively short time range, that those figuresand attributions are false or distorted.
- "Public health" fears the wide acceptance of a safer cigarette,as it would dramatically curtail the interests of the pharmaceutical giants who use "publichealth" itself to market their own, poorly effective (and mostly nicotine-based) "cessationtherapies", for such a cigarette would likely halve the risk of smoking without taking away thepleasure of smoking – something that no pharmaceutical nicotine delivery device/substitution drugcan do.
In their paper, Yach and Bialous state: "Philip Morris announced that it is following other tobaccocompanies and intends to launch a ‘safer’ cigarette in 2 years. It is noteworthy thatrecent reports on these ‘safer’ cigarettes address only the carcinogenic properties of tobacco and largely ignore the fact that cancer is but one in a long list ofdiseases caused by passive and active smoking."
Furthermore: "The burden of proof of reduced harm must rest on the tobacco industry, andthe public health community must take the proactive step of developing internationallyaccepted means of verifying whether any tobacco product can truly be labeled safer thananother. Tobacco companies will find that the epidemiologic standards they sovigorously opposed (for example, dismissal of studies with odds ratios of less than 2)are the very standards they will need to use to demonstrate whether their new productsare indeed safer."
The purpose of those who are truly concerned withpublic health is to reduce harm, not to take abolitionist or moral postures. With that in mind, wecan comment as follows on the two statements above.
As noted earlier, of the "long list of diseases",no one single etiological causality can be proven for active smoking. There are strongstatistical links between active smoking and lung cancer (although, statistically, it occurs atover 70 years of age, when the probabilities of cancer in general are much higher), which justifyattributions of causality. But there is a fundamental difference between attribution and proof,as the former indicates a deductive extrapolation from indirect and often randomly occurringphenomena, and the latter an incontrovertible, predictably occurring phenomenon that removes alldoubt. That fundamental distinction has been shamefully blurred for public consumption by "publichealth" in its crusade against smokers and the tobacco industry, and for the purpose ofprohibition, taxation and behaviour control – and so has the use of the word "cause."Given that this is the case, how is it possible that the tobacco companies could ever demonstrateto the satisfaction of antismokers that less toxic cigarettes are safer, since the onlyacceptable level of risk seems to be zero"
Keep in mind that these crusaders tell us that "thereis no safe level of exposure to passive smoke." Yet, passive smoking has not been provento cause any disease, and the certainty expressed by the authors of the paper that passivesmoke is a danger has long been key to stimulating the social rejection of smokers – a use ofscience that is an insult to ethics and science itself, and to those who hold its integrity inhigh regard. As to the integrity of Environmental Tobacco Smoke "science," we refer readers, forexample, to the Osteen decision against the Environmental Protection Agency  for documentation of what passes for scientific evidence inthe antismoking movement. The point has been made that one does not have to be a specialist tounderstand that the EPA claims in this case were false. Again, it is difficult to see how thelikes of Yach and Bialous could come to accept any cigarette as safer in the context of passivesmoke. How can one prove that something is less risky than something else which has never beenproven to be risky"
The burden of proof rests indeed with those whomake the claim. However, the claims of "public health" about "tobacco-related" diseases have, forthe overwhelming majority, failed to prove causality other than with statistical studies. Fromsuch "studies" ridiculous associations such as those attributing cavities to passive smoke, and mental illness or lesbianism  to smoking and so on have emerged, about whichwe have heard no public dismissal by "public health", since those absurdities help itsprohibitionist agenda by augmenting public hysteria. It follows that the need for proof has notrestrained "public health" from its actions and its disinformative propaganda. To expect thetobacco industry to raise to a higher standard of scientific proof, ethics and morality thanpublic health institutions are willing to use themselves is unreasonable. Risk elevations gravitatingaround 1.2-1.3 are the best the anti-tobacco industry can produce with existing studies, evenafter heavy-duty manipulation,   while 80% of the studies on ETS do not even reachstatistical significance. 
It is plainly intuitive that maintaining the level of nicotine and reducing by some 50% the combustible materials in a cigarette holds the promise of halving toxicity, risk, and passive smoke – regardlessof impossible disease quantification. An honest Public Health should jump at the possibility of asafer product, and enthusiastically co-operate with the tobacco industry for its research,development and even its advertisement, even if only as a multigenerational transient towards asmokeless society, and put an end to the tobacco wars, which have proven to be economicallydestructive and socially devastating.
No one in good faith would object to a trulyindependent, open-minded entity evaluating a safer cigarette. In the current political environment,however, we can unfortunately expect any entity charged with that responsibility to stall, and throwbureaucratic obstacles against a potentially safer product in order to give more time to "publichealth" to expand its political web against tobacco. For years, the legal, moral, and politicalcornering of the tobacco industry has prevented that industry from making available a safercigarette, in fear of both legal entanglements from implicit admissions of "defectiveness" ofprevious products, and crucifixion from "public health" advocates and their media servants.
Risk assessment is, for the most part, unreliablescience, for it often proceeds from hypotheses and conjectures. And when risk assessment is used tojustify and implement predetermined conclusions and policies, it fits the definition of junk science.Nowhere is that more true than for passive smoke, where the quantification of risk elevation is soflimsy, it is absolutely unreliable. It has been argued that relative risk increases of under 2.0 (thatis, under 100% relative risk increase) do not justify public intervention because the margin oferror in quantification becomes more significant as the risk decreases.
At this point, a clarification on the validity ofpublic intervention on relative risks smaller than 2 becomes necessary, as this issue has been – andstill is – the subject of endless arguments among the parties involved in the tobacco control saga.There are, indeed, epidemiological conditions in which extremely small increases can be reliably andprecisely measured. The polio vaccine may cause one confirmed case of polio paralysis in five millionvaccinated people, that is, a relative risk of 1.0000002. Such minute risk increases can beprecisely calculated when the outcome is rare, and when what is measured is not subject to theconfounders (multifactoriality), and to the biases that are involved in the measurements concerningactive and passive smoke. For a study to be scientifically reliable and credible, three fundamentalguarantees must apply:
- To have measured only what it intended to measure
- The variables examined are the only differences betweenthe measured phenomenon (case) and what is taken as zero risk sample (control)
- The results can be reproduced by other laboratories
None of thestudies on smoking – especially passive smoke – can claim to have met even one of thoseconditions, thus they do not qualify as reliable science – let alone as the basis for propagandacampaigns and public policy making. If the above conditions are not met, the numerical riskelevation (whether it is 1.01 or 10) becomes irrelevant.
However, as we have seen, the WHO and itspharmaceutical partners choose to ignore those fundamental points, to simply overstepwell-established scientific practices, and to apply junk science to public policy. In fact, theyseize the terminology of those who appropriately use it. In their paper, Yach and Bialous state: "The junk science saga continues." That is among the few true statements of the entire paper,although not in the sense intended. Junk science, in fact, is the only tool available to the WHO tomislead governments and individuals on passive smoke, and to push its pharmaceutical agenda.
Antismoking studies, instead of being science are,to a remarkable extent, analyses of responses to questionnaires, analyses of groups of previousstudies that are based on questionnaires; and computer-generated projections of catastrophic figuresfrom studies based on assumptions, innuendoes – and questionnaires. Any pollster or modern marketingcompany knows that the results of a questionnaire are conditioned by what questions are asked, whatquestions are not asked, and how the questions are asked, as well as by the type and range ofresponses that the design of the questionnaire permits. Yet this type of technique, aggravated bythe fact that databases are often not available for peer scrutiny because of "proprietary concerns,"is the secret heart of the much ballyhooed "overwhelming mountain of evidence" against passive smoke.In reality, the mountain isn’t even a pimple,  and the studies are not science. Every attempt to prove disease causality bypassive smoke has failed,  sometimes withserious legal consequences as a result of the fraudulent nature of the studies.   Whenconfronted with solid objections that cannot be countered other than with more of the same junkscience, the antitobacco establishment resorts to a well established technique that is as widelyused as it is unethical: character smearing.
In their paper, Yach and Bialous turn to smearingnot just Philip Morris and the academics who are perspective consultants of the tobacco industry,but even an individual, Martha Perske, who objects to the way in which studies on passive smoke havebeen misrepresented to the public by anti-smoking advocates. From the paper, it is clear that thesmearing machine of antitobacco has been set into motion to find Mrs. Perske’s "vulnerable" pointssuch as – what’s new" – connections with the tobacco industry. " She describes herself as a ‘smokers' advocate,’ but industry documents show that she stayed in close contactwith Philip Morris, asking for their review of and comments on her activities," thepaper claims solemnly, as if it were revealing a shocking scandal.  Mr. Derek Yach takes the time and effort to investigate and smear a single, private individual, a womandedicated to uncovering the truth, who has spent thousands of hours of her own time doing unpaidresearch into a subject of concern to her, out of a sense of social responsibility. She has dared topoint a finger at the substantial passive smoke scientific deceit. As in all cases concerningdissent, Yach’s and Bialous’ reaction (and the one of the antismoking establishment in general) isnot to counter objections with solid scientific proof, but to attack their opponent’s credibility.In short, a highly placed WHO official wouldn’t bother to attack a retired private citizen,especially with such laughably flimsy "allegations", unless he were scared of what she represents.
Passive smoke is portrayed as a public health hazardfor one single purpose: to create a hostile environment to smokers, so that they are induced toquit by social pressures. In conjunction with disinformation on the consequences of health fromprimary smoking, smokers are told they are addicted to nicotine, and here is where the sale of thepharmaceutically produced smoking cessation "therapies" comes into play.
Although public consciousness is rapidly developingabout the pharmaceutical connections of the global antitobacco establishment, the large majority ofthe population, media, and politicians is still tragically unaware of the extent of that connection.For this dissertation, let us consider the investment in antismoking activities by the Robert WoodJohnson Foundation, philanthropic arm of Johnson & Johnson, between 1992 and 2000 in one nationalone, the United States: well over 300 million dollars have been invested by just onemultinational in financing antitobacco activities and "grass root" antismoking groups. Yach and Bialous state: " As discussed by Ongand Glantz, the use of front groups and consultants is a well established tobaccoindustry practice to avoid dealing with its lack of public credibility."Interestingly enough, one of the people mentioned by Yach and Bialous is an indirect recipient ofpharmaceutical funding.  Even more interestingis that the antismoking activists never bother to report their pharmaceutical funding, and the mostbasic common sense shows that multinationals such as J&J do not invest hundreds of millions ofdollars solely on humanitarian grounds. All that is compelling proof that the use of front groupsand consultants is a well established pharmaceutical industry practice to diffuse its marketing policies of smoking cessation products. Unfortunately, the words of Yachand Bialous apply equally well to "public health’s" current masters.
ETS is, in reality, one of the most powerfulmarketing tools for smoking cessation products of the antitobacco enterprise, for it supplies apseudo-scientific justification for the intolerance that is steadily stimulated by state, andpharmaceutically-funded propaganda through "public health." The WHO’s function in this marketingscheme is to globalise the process, with the help of the World Bank,   and the InternationalMonetary Fund,  which provide the necessaryarm-twisting for those financially vulnerable countries that do not want to embrace the "healthrevolution." Anyone who has closely observed the phenomenon of antitobacco"education" as it has developed in recent years will have noted how often the promotion of smoking cessation pharmaceutical "therapies" is now a key part of the message.
The concept of a world free of hunger and disease isnoble and desirable and, although we are still far away from that accomplishment, we must alwaystend to the achievement of that goal. Quality of life, however, is not measured only in terms ofclinical health. Many believe that a long, healthy life achieved at the price of brutal enforcement,regulation, suppression of pleasure -- not to mention the social cost of corrupting institutions andnegating liberties and personal choice -- is not worth living. That basic view, however, seems toelude the WHO and "public health" completely, as what they are doing is an absolute antithesis ofeverything a free civilised society stands for, and is ominously reminiscent of the darkest hoursof the USSR.
The "new approach" and tactics of the WHO, and"public health" in general, brings forward disturbing considerations with respect to the role ofhealth authorities – especially in times of advancing globalisation. An international authorityconcerned with threatening menaces such as malaria, or the communicable disease AIDS, isdesirable and indispensable. But the over-expansion of that authority for the imposition of "healthy"lifestyles on the global population is another matter altogether. For one thing, responding to thechallenge of conventional health emergencies is very different from taking on the project ofcoercing disease prevention and maximising healthy life styles. Permitting the WHO, or anygovernment, to proceed too far down the latter road poses serious questions for any society thatwishes to be liberal and democratic.
By going down this road the WHO is beginning tomeddle in internal policies of countries, to interfere with economics, commerce and advertising, andeven presumes to influence moral and ethical values. If this does not overstep the WHO’s moral andfunctional limits, it should. Furthermore, the adoption of intimidation, political arm-twisting, andthe systematic use of disinformation and junk science to push the WHO’s agenda is unworthy of itspurpose, and is deeply debilitating to the credibility of science in general, and medicine inparticular. Finally, and perhaps more importantly, the blatant conflict of interest between theWorld Health Organisation (and "public health" in general) and the pharmaceutical multinationalsshould be examined very closely -- and dramatically uprooted. Nowhere is that conflict morestrikingly visible than in tobacco control.
"Tobacco control" uses international treaties to undermine the sovereignty of individual nations so that its interests can create public policy with a fait accompli on a global scale. The menace that this initiative creates for the sovereignty of nations cannot be overemphasised: the tobacco control treaty forces nations to open their doors to the special interests of the pharmaceutical industry through a channel that is not the normal marketplace. At the same time, it sets into place the precedent of a undemocratic supra-national governing mechanism for health policy within nations. The pharmaceutical industry, which is rapidly consolidating and striving to realise the remarkable potential of contemporary biotechnology, may well be the most powerful industry in the world. That an international organisation supposedly representing the world’s peoples should see itself in partnership with such an industry, is cause for concern.
In the tobacco control field, for all intents andpurposes, the WHO has become the legitimising enabler of the marketing programs of thepharmaceutical multinationals:
- It ignores or discredits its own scientific evidence when itdoes not produce the desired antismoking results.    
- It openly undermines the tobacco industry, facilitating thepharmaceutical industry’s control of the nicotine market. 
- It accepts funds and resources from pharmaceutical conglomerates,to the point of becoming their "official partner".
- It promotes and supports pharmaceutically-funded antitobacco"studies" designed to further its antismoking agenda, while consciously ignoring the vast amountof scientific evidence that disputes, does not corroborate, or even exonerates tobacco fromunprovable allegations against it.
- It pushes pharmaceutical smoking cessation products with a zealunmatched by the best, for-hire marketing companies.  
- It wilfully promotes intolerance by instigating non smokersagainst smokers. The social hostility that is created is apparently designed to intimidatesmokers, and in this it largely succeeds with devastating long-term social effects.
- It interferes with the cultural and democratic processes ofnations in order to instigate smoking bans, and to induce smokers to purchase the products of its"benefactors" to socially "fit in."
- It interferes with the internal public health/socialisedmedicine of nations, pushing to change public health priorities, and to include cessationproducts that are either 80-85% defective, don’t work at all  – or may be deadly  –in state-subsidised drug programs, thus affecting the distribution of the resources allocated foressential drugs.
The attempt by the WHO and the international public health community to interfere with people’s lifestyles goes well beyond smoking. WHO functionaries have recently been applying pressure to the Australian government to force restaurants to serve vegetables to customers.  And at a recent Commonwealth health ministers meeting in New Zealand, delegates reponded to a report from The International Obesity Taskforce pressure group, a "collaborator" with the WHO according to the group’s website,  by discussing ways in which government might coerce citizens to slim down. Suggestions included the introduction of punitive taxes on food and legislating portion sizes at take-out restaurants. 
WHO Director Gro Harlem Bruntdland calls this sort of thing the "HealthRevolution", but a more appropriate definition would be "The Assault of the Thugs". It is temptingto call the prostitution of the WHO and public health institutions to the marketing and politicalagendas of multinationals a quantifiable "pandemic" that has reached global proportions, and thusdistinguish it from the phenomenon of "tobacco-related" diseases, but we will leave it to "publichealth" to abuse the language of epidemiology.
Who is to blame for the current state of affairs"Multinationals can be expected to push their agendas, for it is in the nature of corporations to tryto increase their profits. But public and international bodies should not be involved in the effort. The role of public health is surely not to be a shill for corporations,or a propaganda machine for the wholesale annihilation of what it considers the "undesirable" customs and habitsof private citizens. When private industry and uncontrolled and democratically unaccountable bureaucracycome together to realise mutual goals through disinformation and both economic and politicalrepression, it is an unholy matrimony. Perhaps it is time to carefully formulate and enforce aUniversal Code of Ethics for Public Health, with the recognition that our current public healthentities have overstepped legitimate boundaries, and are in much need of reform. It is also time tobegin investigating public health institutions in the public interest. For example, the citizens ofmember countries have a right to know how the WHO is influenced by "private" donations, also knownas "extra-budgetary funds," which have increased throughout the l990s with an astounding 50% growthbetween l996-97 and l998-l999 alone (from a total of US$658,012,975 to an estimated total of US$956,000,000). 
We need, in short, to return the WHO to itsfundamental function: the compassionate relief from the pain and suffering of the human conditionthrough research and help. We need to irreversibly immunise the WHO from politics and corporateinvolvement, impose public transparency and scrutiny on its agendas and scientific databases, and todramatically resize the bureaucratic monster it has become – a machine that eats up 75% of itsbudget in "administrative overheads."It isalso indispensable, before any other consideration, to focus its range of interests and authoritydirectly to basic and devastating diseases that are tangibly quantifiable without abstruse andquestionable computer programs and methodologies.
To close, it is indispensable that the practice of epidemiology be tightlycodified to much stricter standards, in order to impose transparency, demonstrability and dataverification on this afflicted branch of research. Some have called that GEP (Good EpidemiologicalPractice). It is not surprising that Ong and Glantz have attacked this initiative as "tobaccoindustry-funded", stating that "The European 'sound science' plans included a version of 'goodepidemiological practices' that would make it impossible to conclude that secondhand smoke - andthus other environmental toxins - caused diseases."  As this paper has pointed out, withthe present state of scientific technology, it is impossible for honest science to quantify thedamage (if any) of smoking - especially passive smoke - and to reliably attribute causality. This isan inescapable limitation that no political or marketing agenda should be allowed to circumvent. Itseems to us that the standards that Ong and Glantz (and the pharmaceutically-financed antitobaccoenterprise) fear and oppose are those of scientific integrity, and accountability on the claimsmade. In an environment where the moral poles are not reversed, any industry or other forceencouraging the improvement and integrity of science should be commended (regardless of currentpolitical trends and special interests) in the interests of all.
We predict that this paper will be assaulted anddismissed by the WHO and "public health" as "yet another scheme from the tobacco industry".Alternatively, it will be handled in the manner customary to those who don’t want to hear: it willbe ignored. At any rate, let it be known that we are not "stooges of the tobacco industry,"although we believe it is an industry as legitimate as any other. This paper is not in defence of the cigarettemakers, from whom we dissent in many ways, especially because that humiliated and politicallydefeated industry no longer has the fortitude to react, as it should, to the campaigns of hatredagainst it financed by "public health,"  orthe ability to effectively expose scientific frauds and disinformation against smoking, or to defendthe rights and freedoms of its customers. It is pathetically trying to re-climb the ladder ofpolitical correctness and public image (even sponsoring antitobacco ads!) with the help of too manylawyers, accountants, and PR firms.
We are the voice of millions of smokers who nolonger tolerate being regarded as second class citizens, or patients; who no longer want to listento the voice of Big Pharma dressed up in the white coats of international "public health." We arethose world citizens who demand that public scientific information be made available without thedressing of political, commercial, and behaviour-control spins; those who demand to be respected forthe choices they have made, without the unsolicited intrusion of the state, and pharmaceuticalenablers. We will no longer tolerate being stigmatised and accused of hurting other people. We areoutraged at being forbidden access to public places and workplaces as smokers, and at being deniedemployment. We are alarmed that our authority as parents has been attacked. We are alarmed that we can be prosecuted for smoking on our own property in some jurisdictions if a "concerned" neighbour sees fit to report us.  We do notaccept being outcast by societies to which we contribute billions of dollars each year. We do knowthe truth about ETS.
We are those who want their children to be left alone in schools, and who want freedom of speech and expression, which includes freedom for the advertisement of the products we consume. We want our governments to mind their own business, and to stay out of our lives, while dedicating the resources from our taxes to the fight against real – not computer-generated – epidemics. We are those who no longer believe that multiple choice questionnaires are "conclusive evidence" from"unequivocal science." We are those who are tired of seeing pharmaceutical stooges, who have been paid millions of dollars, preach distortion, falsehood and hatred from TV tubes, the internet, newspapers and radio waves. We want a peaceful, hysteria-free, hate-free society for ourselves and our children to live in, and to achieve quality of life through liberty, peaceful coexistence, self-determination, and freedom of choice and lifestyle as well as through physical health. In western democracies these are often assumed to be widely shared values, yet the project of maximising public health benefits through whatever means is necessary assumes the assumption of increasingly total control over the range of decisions available to citizens. The advent of what the eminent psychiatrist and social critic Thomas S. Szasz calls the Therapeutic State, in which the proper line between public health and private health becomes dangerously blurred, along with the proper distinction between treatment and coercion, is increasingly being recognised and documented.
Finally, we are the voice of all those respectablescientists, doctors and researchers who have been reduced to silence through intimidation, fear,career threats, slander and smearing, political "job repositioning," and media lynching. Such practices are used to achieve "scientific consensus"on tobacco and other issues. The names of many people may have been smeared, andtheir message may have been momentarily silenced. But their call fortruth and intellectual honesty remains, and their fight against political, corporate and "publichealth" junk science continues with purposeful dedication.
Indeed, it is time to ask the WHO and "public health"around the world a question that was asked nearly fifty years ago: "At long last, haveyou no shame"" History reports that question as the end of a lamentable era of inquisition andpersecution. May history repeat itself and, once again, in an equally constructive way.
FORCES International Board of Directors
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19. MMWR Morbidity and Mortality WeeklyReport l998 Oct 9;47(39):837-40. "...during l988-l996 among persons aged 12-17 years, the incidenceof initiation of first use [of cigarettes] increased by 30% and of first daily use increased by50%...." -- Incidence of initiation of cigarette smoking -- United States, l965-l996."
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21. FORCES International database. Nicotine benefits, 2000. Available at: /evidence/hamilton/other/nicotine.htm.
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24. FORCES International database. Smokers Have Reduced Risks Of Alzheimer's And Parkinson's Disease, bibliography.Available at: /evidence/files/liars.htm#alz.
26. Kathleen Stratton, Padma Shetty,Robert Wallace, and Stuart Bondurant, Editors, Committee to Assess the Science Base for Tobacco HarmReduction, Board on Health Promotion and Disease Prevention, National Academy Press. Clearing theSmoke: Assessing the Science Base for Tobacco Harm Reduction. Availableat: http://books.nap.edu/catalog/10029.html.
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33. FORCES Internationaldatabase. Passive smoke bibliography. Available at: /evidence/evid/second.htm.
34. FORCES Internationaldatabase. Passive Smoke And Disease: An Incredible Story, bibliography.Available at: /evidence/evid/story.htm.
35. FORCES International database. TheUS Federal Court Decision On Environmental Tobacco Smoke, Judge Osteen, July 17, 1998.Available at:/evidence/epafraud/files/damn.htm.
36. FORCES International database. TheAustralian Federal Court Decision On Environmental Tobacco Smoke, Justice Finn, TobaccoInstitute of Australia Ltd & Ors v National Health & Medical Research Council & Ors  1150 FCA1 (20 December 1996). Available at: http://www.data-yard.net/historic/files/austcort.htm
37. Incidentally, the wwwlink to Yach’s and Bialous’ Footnote 40, which allegedly shows that Mrs. Perske "grossly misstates"the WHO’s work, shows no such thing. The article referenced in Footnote 40 makes no mention of theWHO. Instead, Yach and Bialous have mistakenly referenced Mrs. Perske’s open letter to the Globe andMail, published on junkscience.com, pertaining to the misreporting of a Health Canada study. Nowheredo Yach and Bialous provide documentation to back up their claim that Mrs. Perske "grosslymisstates" the WHO’s work.
38. Hamilton w. Pharmaceutical Multinationals: Buying Governments, Selling Antismoking, 2000.Available at: /evidence/money/introph.htm.
39. Smokefree movies, funded byRobert Wood Johnson Foundation. Available at: http://smokefreemovies.ucsf.edu/about.html.
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48. Hamilton W. Big Drug's Nicotine War,2001 Available at: /evidence/pharma/index.htm
49. FORCES International database. Scientific Evidence Archive. Available at:/evidence/index.htm.
50. Hamilton W. The Safety and Efficacyof "Smoking Cessation" Drugs, August 10, 2001. Available at:/evidence/pharma/safety.htm.
51. Rendez-Vous. Rendez-vous with Derek Yach, February 5, 1999 (see question 5 and Yach's response). Available at: http://www.tobacco.org/News/rendezvous/yach.html . The interview is published on the site of Tobacco BBS, also indirect recipient of pharmaceutical money through Robert Wood Johnson Foundation (Johnson & Johnson-financed QuitNet). See: /evidence/money/listorg.htm#bbs . Also: Treatment For Tobacco Dependence. Available at: http://tobacco.who.int/en/treatment/index.html, written with the heavy contribution of the Mayo Clinic, whose director Richard Hurt is a recipient of pharmaceutical money from RWJF.
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61. See, for example, Thomas S. Szasz, The Therapeutic State: The Tyranny of Pharmacracy, The Independent Review, v. V, n. 4, Spring2001, pg. 485-521.