This commentary by Michael Siegel is interesting because of considerations that apply universally.
Ah, yes … the numbers game of “smoking mortality”. This extreme example by Dr. Siegel says it all: smoking kills 124,000 young people a year — no, smoking kills 340 young people a year.
As Siegel points out, both claims are obviously false on their face. He then reaches the only logical conclusion: “It is truly becoming clear to me that the cause is more important than anything, even the truth. If we need to tell lies to accomplish our goals, so be it, because the cause is just so important. I find it ironic that much of the basis for tobacco control is the premise that the tobacco companies have been communicating misleading and inaccurate information to the public for many years. Interestingly, there are few examples of outright material misrepresentations of facts by the tobacco industry. Mostly, the examples are those of misleading portrayal of information. But here, we have an example of outright dishonesty. I would argue that the statement in question is not merely misleading; it is demonstrably false.”
If the tobacco industry is “evil”, the antitobacco industry is not demonstrably better. But let’s not stop here: if 124,000/340 “deaths” are false, what makes the 390,000/440,000 “smoking-related deaths” in the US (or whatever number in other countries or in the world) “true”?
Those figures are at the foundation of any and all antismoking policies, as well as the infamous line that “smoking is the first cause of preventable death in the world”. Those figures have justified the investment of billions of dollars, the demonization of a wealth-producing industry and the growing persecution of hundreds of million of people.
One would think that, given the gravity of the statement and its consequences, an in-depth, thorough examination is needed; after all, extraordinary claims require extraordinary proof. Yet, everybody repeats the "party line" as if it was gospel truth, and those who question it are looked at with incredulity if not with contempt, as if blasphemy were being uttered – yet everybody denies that antismoking is a religion!
The statistical mechanism to produce the mortality numbers is very complex, thus the public and journalists leave "the numbers" to the “experts” and blindly believe the results. But there is no need to be an expert to see that the basis for these numbers is unreliable – and if the basis is unreliable, the complexity of the mechanism becomes irrelevant, as its output is untrue.
We are harshly criticized when we say that “not even one death can be scientifically demonstrated to be caused by smoking”. We have been called flat earthers, deniers, tobacco industry stooges and “not credible” in general – yet none of those critics has been able to say: “look, fools, here is one death that is solely caused by smoking”. That is because no one can do that. If smoker X dies of disease Y, his doctor cannot – ever – state with certainty that disease Y would not have occurred if Mr. X had not smoked. He can do that with polio, TB and a myriad of other afflictions, but not with smoking. That is because there is no disease that is caused solely by smoking, and because smoking itself is not a disease. All that is available is a preponderance of certain diseases amongst smokers, but those diseases are amongst non smokers too.
The figures we see (i.e.: the 440,000 “tobacco-related deaths”) are a sheer speculation, and the worst possible scenario of that speculation. Here is an example: if in country A there are 10,000 lung cancer deaths a year and 9,000 deaths are amongst smokers, the “causality” of the 9,000 deaths is “attributed” to smoking by basically ignoring all the nearly 40 other known factors or the thousands of possible combinations of factors that could have caused the lung cancer in smokers. That is because those other factors are also present in non smokers – yet this is something that is impossible to verify and especially to measure. In other words, since all people (smokers or not) are exposed to all other factors except smoking and there is more of disease X amongst smokers, then smoking must be the cause of disease X. Thus, by arbitrary exclusion, smoking becomes some sort of monofactorial disease.
Hence the resulting line: “In country A smoking ‘causes’ 9,000 lung cancer deaths a year” – and often with the implication that the other 1,000 in nonsmokers are "caused" by passive smoking; the resulting emotional implication is that if smoking is eliminated, so is lung cancer. Repeat the exercise for the other 100+ diseases “attributed” to smoking and you can easily see why smoking becomes such a “scourge” – and why this dishonest mentality is dangerous. Were smoking to disappear tomorrow, such reasoning could be applied to anything else, perpetuating social persecution and waste of public resources.
The mentality that gives rise to this reasoning is illogical and dishonest, because people are not industrial products all coming from a production line, thus identical except in one detail (smoking). The opposite is true: each individual is unique and he is exposed to a unique set of circumstances throughout his life. Multifactorial epidemiology – which, by definition, cannot establish causality – wants to ignore all that, and the "experts" basically say that “the fact that we cannot even demonstrate (thus count) the causality of one death does not mean that we cannot claim the causality of millions”. That is tantamount to saying that “the fact that we can’t demonstrate that one Sicilian has ever stolen a car does not mean that Sicilians are not a bunch of mafiosos because the Mafia exists, so let’s put them all in prison!" Yet, that is exactly what the health authorities and the mass media are telling us. Yet again, antitobacco apologists call all of the above a "technicality" and "hair splitting" — to project their belief that "smoking kills" anyway and represent this belief as science. So why bother with the fundamentals? The decision that "smoking kills" has been made, "public health" has spoken. Doubts are foolish and any revisiting of the evidence is subversive and corrupt.
For more on this issue, we invite our readers to take a look at the essay “Lies, damn lies and the 400,000 smoking-related deaths” by Robert Levy and Rosalind Marimont , published in 1998.
The statistical and intellectual fraud has been known for many years. When the tobacco companies were the ones to point it out, they were accused of “communicating misleading and inaccurate information to the public”. In fact, the companies were crucified for having the temerity to defend themselves at all. Why? Because antitobacco IS a religion whose dogma is unquestionable; thus if “public health” says that “smoking is the first preventable cause of death and disease” it must be true, and those who object must either be “educated” or dismissed as lunatics. If tobacco companies point to the problems with their opponents’ arguments, they must, according to this gospel, be lying.
Have we just said that smoking cannot kill? No. Anything can kill, and smoking can kill too. We are merely stating that the “smoking mortality” is incommensurable – that is, it cannot be computed. It means that any number from zero to infinity is false. It means, therefore, that any number we read is a wild guess. It also means that any number is a public lie – whether it is the 124,000/340 young “deaths” that Siegel talks about, or the 440,000 in the Unites States or the 5,000,000 a year the WHO talks about. It is a public lie because the authorities do not tell us that it is a wild guess, but present those numbers as if they were actual bodies counted after an earthquake struck. Thus, ironically, public health authorities all over the world are “communicating misleading and inaccurate information to the public”.
Hence FORCES’ statement that public health has become an institutional problem that must be solved.
It is that simple – and, perhaps for that very reason, it seems so difficult to understand.