American Cancer Society a Danger to Science?

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The credibility of the peer review process has come under vehement attack.

Scientists who receive no-strings-attached financial support for their research from demonized industries -- tobacco, pharmaceuticals, and food, among others -- are no longer deemed trustworthy.

Apparently, the rigors of the peer review process -- even in the world's best science and medical journals -- in addition to full disclosure requirements, isn't enough to prevent "biased" studies from being published. Activists -- displeased with results that undermine their agenda -- cry bias, and prestigious science and health organizations cave, preferring to appease the advocates, rather than allow the scientific method to weed out bad science.

One of the country's most distinguished cancer organizations has succumbed to the prohibitionist faction of the anti-tobacco movement's demagogic rhetoric -- accepting and adopting these crusaders' guilt-by-association arguments at face value, rather than identifying flaws in the research results they oppose.

Earlier this year, the American Cancer Society (ACS) passed a resolution barring scientists who receive financial support from the tobacco industry from receiving ACS grants. Responding to news of the resolution, Dr. Elizabeth Whelan warned ACS (see letter below) against their injurious adoption of such a litmus test. Using funding as a basis for rejection is detrimental to the process of providing unbiased, peer-reviewed health information.

Such policies have unseen costs and unintended consequences. They may produce biased research by cherry-picking authors and results and confusing public debate -- mirroring the tobacco industry's stratagem. Further, they set a dangerous precedent by giving opponents of sound science a new weapon. If the science is faulty, we should use science itself, not ad hominem or innuendo, to detect the problems.

ACS's response to our criticsm? Six months later, we're still waiting. Regardless of whether we ever receive a reply, we hope ACS got the message.

Putting science ahead of ideology is best for cancer patients as well as the general public, who rely on good science -- that which is able to survive the rigors of peer review -- not simply good intentions.

Text of Dr. Whelan's letter:

February 24, 2004

Gary J. Streit, J.D., President
Shuttleworth & Ingersoll, P.L.C.
Chair, American Cancer Society Board of Directors
115 Third Street SE, Suite 500
P.O. Box 2107
Cedar Rapids, IA 52401

Dear Mr. Streit:

I have just read in the February 20 Chronicle of Higher Education that your Board has passed a resolution that scientists who receive financial support from the tobacco industry will soon be barred from receiving grants from the American Cancer Society. I am concerned that the adoption of such a litmus test could ultimately undermine the integrity of cancer research. I am particularly disturbed that this policy may have been prompted by the publication of Dr. James E. Enstrom's May 17, 2003 BMJ paper on secondhand smoke.

Dr. Enstrom has acknowledged that he has received partial support from the tobacco industry. He notes, however, his sources of funding have had no influence on the direction of his work. Indeed, his work survived the rigors of the BMJ peer review process. If bias had been present, the peer review process would have flagged it.

As a public health scientist who has devoted a substantial portion of my career to writing about the extraordinary negative health consequences of tobacco -- more specifically, cigarettes -- I am writing to support the honesty and integrity of Dr. Enstrom, who has served as a Scientific Advisor to the American Council on Science and Health since 1984. His peer-reviewed research was published in one of the world's best medical journals. Simply because it was partially funded by the tobacco industry does not make the research less credible or less reliable.

Although the adverse health effects of active smoking are well established, ACSH's literature review has led us to conclude that the chronic health effects of secondhand smoke are not nearly as clear as the American Cancer Society states. I hope that you will take a moment to review the enclosed material: our 1999 ACSH Report "Environmental Tobacco Smoke: Health Risk or Health Hype?," our ACSH Update with several press accounts on secondhand smoke, and the August 30, 2003 letters in BMJ presenting Dr. Enstrom's response to criticisms and editor Richard Smith's defense of the paper.

Finally, I hope you will allow Dr. Enstrom to present his side of the story about his funding and his dealings with the ACS to you. A policy of guilt by association is detrimental to science, which establishes whether facts are correct via peer review, not funding source. It may also have the unintended consequence of producing biased research by cherry-picking authors and results and confusing public debate -- mirroring the tactics of the tobacco industry.

I am well aware that there was considerable negative reaction to Dr. Enstrom's paper from the so-called "anti-smoking" community. I would encourage ACS to resist pressure from these advocates -- and continue to focus on science, not sources of funding. Quite frankly, if the new ACS funding policy was triggered in an attempt to appease Dr. Enstrom's critics, it will only further encourage what I see as a very disturbing trend among anti-smoking advocates: intolerance and resistance to legitimate data and views that may conflict with their closely held beliefs.

Indeed, like Dr. Enstrom, ACSH -- surely one of the most vocal anti-smoking organizations in the nation -- has been the subject of ad hominem attacks by the anti-smoking community. Why? Because ACSH, like many other responsible public health organizations, is seriously evaluating the role of smokeless tobacco in harm reduction strategies which would save lives. These inflexible and intolerant anti-smoking advocates have long dismissed and ridiculed the work of competent researchers like Dr. Phil Cole and Dr. Brad Radu who have meticulously gathered data on the effectiveness of smokeless tobacco in reducing risk in inveterate smokers. Their charge against these researchers? That their data was intolerable because they have accepted tobacco research money. Instead of critiquing the science, the advocates claim the research is by definition biased because of funding.

Mr. Streit, I suggest to you that what these closed-minded anti-smoking advocates object to is not the funding of Dr.s Enstrom, Cole, and Radu but their data, findings, and views. An ACS policy which shuns scientists just because they take no-strings-attached research money from a tobacco interest only serves to silence a critical dialog which a) prevents hyperbole about the risk of secondhand smoke and b) allows thoughtful assessment of what role smokeless tobacco might play in reducing cigarette-related mortality and morbidity.

I strongly encourage you and your Board to re-consider your rejection of applicants on the basis of their prior or current funding -- and instead judge applicants on their scientific abilities, track record, and professional reputation in the general public health community -- not just among a small group of arrogant anti-smoking advocates who are intolerant of any views other than those which they hold closely. I hope you will speak directly to Dr. Enstrom to get his perspective.

Thank you for your consideration.

Sincerely yours,

Dr. Elizabeth M. Whelan
American Council on Science and Health

Also see Todd Seavey's piece "Ad Hominem and Who-Funds-'Em."