Tuesday, March 23, 2010

The American Cancer Society Controversy: An Emotional Battlefield

A commentary just published in the Journal of Public Health Policy from a faculty group at the University of Buffalo describes the debate about the role of smokeless tobacco in tobacco harm reduction as an “emotional quagmire” dominated by “anger”, “contempt” and “disgust”. The authors are Jess Alderman, “an attorney and physician specializing in public health law;” clinical psychologist Katherine Dollar; and professor of health behavior and School of Public Health Dean Lynn Kozlowski.

They describe “The American Cancer Society Controversy” -- the fallout from a short article published in 2008 in the Cancer Society journal CA that was critical of the Royal College of Physicians’ support for tobacco harm reduction. The article was followed by a series of letters to the editor from harm reduction advocates and opponents, all of which are available online here. I wrote the first published letter, and I agree with Alderman that this back-and-forth showcases the contrasting viewpoints. I recommend reading the article and letters, as well as the Royal College report.

Alderman and colleagues write that “the purpose of this essay is neither to advocate for one side nor to evaluate the merit of various positions.” Instead, they want to apply moral psychology “to improve the tone and constructiveness” of the debate. They suggest that both sides are “firmly grounded in moral principles,” but neither understands the other’s “viewpoint and underlying moral foundations.”

I think the time for constructive debate about tobacco harm reduction is long overdue. I have conducted research in this area for 16 years, and I have published my findings in professional medical journals and in the media. I welcome all invitations to present the facts about and explore the issues surrounding tobacco harm reduction in a rational, science-based manner.

1 comment:

CMN said...

The commentary is interesting, but there's something missing from this analysis. The fact that those against harm reduction engage in outright lying and rejection of evidence leaves a bad taste in my mouth, and it doesn't only have to do with the fact that I value autonomy above purity (being a harm reduction supporter), but that scientists simply shouldn't be engaging in logical fallacies (ad hominem arguments) and denial of evidence, regardless of motives. I think those who oppose harm reduction also engage in very black-and-white thinking, creating a false dichotomy with respect to harm reduction - an either we endorse it (and the world goes to hell), or we don't endorse it (and the children stay safe from the evils of tobacco). Totally fallacious thinking in my mind - including harm reduction as part of a public policy in tobacco use would not eliminate abstinence-only thinking. If, as the commentary mentioned, those against harm reduction valued autonomy at all, they would be more willing to accept that there is some grey area, but there's just more to it than that; I think individual interests - political and financial - are playing a far bigger role in opposing harm reduction than this paper would let on. They have a vested interest in keeping the status quo.