Smokers' Lung Function May Improve With Activity
March 21, 2007 (iVillage Total Health)
If you smoke, getting moderate to high levels of regular physical activity may slow the decline in breathing and lung function, according to a new study.
Exercise and physical activity may also help delay development of chronic obstructive pulmonary disease (COPD) -- a pulmonary disease commonly associated with prolonged smoking. COPD is a chronic, progressive disease of the lungs that reduces airflow over time. It is characterized by symptoms that include coughing, wheezing and shortness of breath. As the disease progresses, quality of life may be severely compromised.
Read


Science Journals Deliver 'Political Science'
Feb 23, 2006 Michael Fumento
Bottom line: First, there needs to be an outside body of peer-reviewers not picked by the journals themselves. Second, the media need to stop treating medical and science journals as somehow sacrosanct. Like seemingly everything in today’s world, they’ve gone political.
Read

Norwegian Researcher Confesses to More Faked Studies

1/23/2006

A Norwegian doctor who last week said he fabricated a mouth cancer research article that was published in October in the journal The Lancet has confessed to faking data for mouth cancer studies that appeared in two other journals

Dr. Jon Sudbo, a cancer expert at Norway's Radium Hospital, is said to regret the medical bluff he mounted over the past several years, his lawyer, Erling Lyngtveit, told the Aftenposten newspaper in Norway.

Sudbo admitted he also made up data for an article in the New England Journal of Medicine that appeared in April 2004, and another article that ran in the Journal of Clinical Oncology in March 2005.

Lyngtveit said Sudbo wants to be completely open about the faked studies and will cooperate with a hospital-appointed commission to investigate the research scandal, the Aftenposten reported.

Sudbo worked with some of the world's top cancer researchers. His admission about fabricating data could also have a serious impact on the other researchers' work. None of the fraudulent studies had any impact on patients, Lyngtveit contended.

For the 2004 oral cancer study in the NEJM, Sudbo determined that a new biopsy technique could help oral cancer specialists determine which patients would most likely benefit from surgery.

Sudbo's admission marked the second time in recent weeks that seemingly significant research has proven to be fraudulent. Earlier this month, the journal Science said it was retracting two papers by South Korean stem cell researcher Hwang Woo-suk, who acknowledged false data that claimed to show he created stem cells from the world's first cloned human embryos.

January 23, 2006
By David W. Kuneman

In 1995, Steven Milloy stated in Science Without Sense , “In fact, there’s something of a gold rush going on in public health today. Thanks to the general public’s neurosis about health, some strategic fearmongering, and of course, political considerations, public health (research) has struck it rich -- to the tune of billions of dollars in annual revenues.” He went on to say, “With half of us living beyond age 75, it is not surprising there are more public health professionals than ever before finding more public health problems than ever before.” Bottom line?…. If you want funding, publish the results those providing the funding want. And remember, studies with insignificant or negative findings don’t get future funding. After all, what funding source is going to fund research a research project that won’t help solve a public health problem?

This advice was apparently lost on two researchers, James Enstrom and Geoffrey Kabat, who studied 35,000 Californians and found no excess risk of lung cancer or heart disease among those exposed to excessive secondhand smoke. According to Michael Fumento, these researchers lost their funding from the University of California Tobacco-Related Disease Research Program: the “big bucks go to those who ‘discover’ that ETS causes everything from pimples to piles.” (Read)

Geof Givens, assistant professor at the Department of Statistics at Colorado State University found this must happen frequently. Givens applied a bayesian statistical approach to all the studies ever done on ETS and found the distribution of the results of these studies is different than the theoretical distribution which should have occurred. (Read)

Probability theory has found scientific measurement results from a set of data are usually equally distributed about the average of all the data, with half being above the average and half below. The distribution usually follows what is called a “gaussian” or bell-shaped curve. The trouble is, secondhand smoke study results don’t do that, and they appear to be one of the few kinds of scientific studies which do not. Givens believes this is due to publication bias. He believes that probability theory predicts there are many statistically insignificant secondhand smoke studies which have never been published, and these missing studies cause the excess risk of secondhand smoke to be overstated about 30%. Enstrom and Kabat eventually managed to find funding (from Big Tobacco!) to complete and publish their study, but give the University of California credit for trying… to prove Dr. Givens is right, that is.

Jon Robinson wrote in “Feeding a Risk Factor Frenzy” that Sander Greenland, leading epidemiologist at (you guessed it, UCLA!) said “There is nothing sinful about going out and getting evidence… nothing sinful about seeing if that evidence correlates… the sin comes in believing a causal hypothesis is true because your study came up with a positive result”. Robinson criticizes the feeding frenzy that drives our nation’s love affair with epidemiological research and closes with a quote by Dimetrious Trichopoulos (head of the epidemiology department at the Harvard School of Public Health) “We are fast becoming a nuisance to society… People don’t take us seriously anymore, and when they do take us seriously, we may unintentionally do more harm than good.” (READ)

Why don’t people take them seriously anymore? Remember Vit. E has long been called the sex vitamin, and then later claimed to reduce incidence of cancer and heart disease. But it is now claimed to increase the incidence of cancer and heart disease when taken in large doses! These same claims were made for female hormone replacement therapy, which is now found to increase chances of cancer and heart disease in large doses. Established epidemiological evidence was also contradicted when Dr. Atkins claimed diets rich in fatty red meat reduce the incidence of heart disease and the American Heart Association conducted a quick study which seemed to confirm his claims.
Low-Fat Diet Does Not Cut Health Risks, Study Finds. One of the latest, is that now dietary soy protein does not lower cholesterol.

Are we confused? You bet we are. But remember, the bottom line seems to be that in order to sort out all the confusion we need to fund even more studies to establish once and for all the truth or fallacy of the various health claims. This situation plays right into the pocketbooks of those who profit from this public health feeding frenzy. However, the confusion and contradictory results actually stem from the lack of ability of epidemiology to establish with certainty whether weak risks actually exist

But here we are in 2006, spending about two trillion dollars a year on healthcare, which is a figure almost as large as our entire federal budget. So the funds are there to perpetuate this onslaught of public health feeding frenzies. Now lets add the possibility of fraud to this scenario. Rule number one is… where there is lots of money, there is fraud.

It may start innocently enough. Consider a professor has a grant funding a group of graduate students to study a risk factor for exposure to something, and all of a sudden they discover no risk actually exists. If they lose the grant (and they will, if they are honest), the graduate students lose the funding needed to support themselves and publish to get their degrees. Alternately, the researcher may have a public agenda to support. A researcher may be supportive of public smoking bans but discovers passive smoking is not a risk factor. Getting back to Professor Given’s statistical bayesian model, and the loss of funding experience of Enstrom and Kabat, the possibility public agendas can trump scientific integrity is real.

The temptation is clearly there to cover up adverse findings. Not all researchers do this of course, but those who are honest tend to get bumped out of the feeding frenzy loop and find their careers ended. Recently, well known tobacco researcher, Dr. Michael Siegel has found himself victimized too, for having “the slightest doubt” that the motives of the tobacco control movement are pure. READ

Public health researchers can and do get punished for being honest.

This leads to rule number two: Most fraud does not get caught whether we’re speaking of monetary fraud such as tax evasions or of public health research fraud. Considering the likelihood of not getting caught is close to the likelihood of being punished for being truthful, it becomes tempting to commit research fraud. Even if the fraud eventually catches up with the researchers, many times the graduate students are already graduated and the smoking bans already enacted anyway.

Consider the recent example of Merck’s new arthritis drug Vioxx. Allegations have been made that Merck scientists covered up excess heart attacks when submitting data to the FDA for approval. What’s less well known is that the whistleblower was a doctor who also served as a consultant for an investment company that had shorted Merck stock! Without that external selfish motivation the fraud might never have been uncovered!

Without passing judgment as to who is in the right here, it can be concluded one of the two parties is wrong. Either a number of Vioxx patients were harmed by research fraud and had heart attacks, or a number of Merck shareholders were harmed by research fraud which falsely claimed Vioxx is unsafe. Whoever is in the wrong here, we all end up losers because an increasing number of patients and doctors are concerned that recently approved medications may not be safe. In the long run, this concern can delay the approval of other medications which are safe, and result in a delay of help for patients who would benefit from those medications. One thing’s for sure though, this whole scenario was driven by the almighty dollar and shows that researchers can be influenced by monetary considerations.

The FDA oversees research fraud connected with medications, but the Office of Research Integrity (ORI) oversees the integrity of Public Health Service (PHS) research activities on behalf of the Secretary of Health and Human Services.

According to the Office of Research Integrity’s annual report for 2004, the ORI received the highest number of allegations (267) since the tracking of allegations began in 1989. This was a 50% increase over allegations submitted during 2003. Although the percentage of closed cases that produced PHS misconduct for 2004 (35%) was slightly lower than the historical average of 37%, three-quarters of the 30 cases pending in the ORI at the end of 2004 with institutional determinations involved research misconduct findings. (READ)

According to the ORI’ December 2005 newsletter, two recent studies characterized the kind of fraud being discovered. The first study was done by Brian Martinson and found among the top ten misbehaviors:

*Failing to present data contradicting one’s own previous research.

*Overlooking other’s use of flawed data or questionable interpretation of data.

And…

*Falsifying or “cooking” data. READ

The second study, by Al-Marzonki, listed the common misbehaviors that have an adverse impact and are most likely to occur:

*over-interpretation of findings

*selective reporting

*negative or detrimental data not published

*inappropriate sub-group analysis

*selective reporting of positive results or omission of adverse results

*failure to report results or long delay

ORI’s research seems to clearly support the findings of Givens! According to ORI this is a growing problem. Right now, there is growing concern the authors of the famous Helena Heart Attack Study READ may have committed fraud. They claim the reason the 40% decline in heart attacks was detected is that Helena is an isolated community where all bar and restaurant patrons had no choice but to drink and dine in establishments covered by the ban. To quote from their study : "An important aspect of this study is that it was done in one isolated place with a single hospital that dealt with all admissions for acute myocardial infarction. In most other places that have implemented smoke-free policies, there are several hospitals with people moving across jurisdictional boundaries for work, housing, and health care." and "Helena's small size and isolation were important contributing factors to our ability to detect a change in admission rates." and "We do not know the prevalence of smoking in venues covered by ban, though the city-county health department reported that all but two businesses complied."

Yet testimony was given to the State Business Committee that some patrons simply went to non banned establishments in East Helena, and three casinos simply ignored the ban. Please note in the minutes, two of the authors, Sargent and Shepard were listed as present at the hearing, and were aware of this testimony which contradicted the claims made in their published in the British Medical Journal. http://kuneman.smokersclub.com/MTsenate040703.html

Norway has recently recognized the importance of this problem and has proposed legislation which seeks criminal prosecution of perpetuators of research fraud. (See below.)

Indeed, the societal costs of this growing problem should be dealt with criminally. Consider the Merck example, and consider the passage of smoking bans which this author have found actually do hurt business despite continuing claims to the contrary. Consider how the fake science surrounding secondhand smoke is splitting families, alienating friendships, and disrupting so many small aspects of our society on an everyday level. We all need to call for an end to this now. David Kuneman

OTHER RESOURCES: “The Prostitution of Science”

BMJ Rapid Responses to:
James E Enstrom and Geoffrey C Kabat
Environmental tobacco smoke and tobacco related mortality in a prospective study of Californians, 1960-98
Read

A recent news article has highlighted the clear scientific fraud of an Oslo researcher who simply made up hundreds of "case histories" of patients in order to create a study for a research grant. In its strictest political sense, that is the sort of behavior that the term is usually reserved for with regard to scientific research. But try to imagine how much of what we see about secondary smoke, with all the enormous financial payoffs involved in that area and all the secondary motivation of researchers believing that stretching the truth is "for the greater good" of reducing smoking, is the same sort of fraud even if not in the strictest definitional sense.

The greatest fraud that exists with regard to the Helena study is the claim that the study demonstrates anything at all about secondary smoke exposure. Even if one accepted the results as valid and even if those results HAD been replicated throughout the country, all that could be said would be that "banning smoking in workplaces reduces heart attacks." The authors and other responsible medical professionals were fully aware of this and yet they didn't hesitate for a moment to trot out all kinds of statements regarding Helena and secondary smoke exposure.

THAT is the real fraud.

Well, maybe that and the claims about the bounce back accompanied by hiding the data showing it wasn't true.

Or not noting the effect of an AMI increase in surrounding areas on producing Helena's statistical significance

Or maybe not reporting just what the numbers DID show about nonsmoking AMI rates in Helena.... did they go UP during the ban? If not, why didn't the authors make note of that rather than simply say the numbers were "too small" to analyze?

Or maybe simply not gathering separate data for smokers and nonsmokers to begin with, despite knowing full well that such a separation would be vitally important to proper media and public understanding and interpretation of one's research. This appears to be what happened recently in Pueblo.

"Making up the numbers" may indeed account for a disproportionate amount of classic scientific fraud in secondary smoke studies, due to both the "end justifying the means" effect and the need to produce studies pleasing to the megapowerful antismoking granting foundations; but I believe the term is also properly applied to a lot of what goes on beyond the pages of the journals when the results of research are misused, distorted, and exaggerated for political goals.

Michael J. McFadden
Author of "Dissecting Antismokers' Brains"
Mid-Atlantic Regional Director of The Smoker's Club, Inc.
web page: http://pasan.thetruthisalie.com/
mailto: Cantiloper@aol.com

Norwegian doctor admits faking it

24 January 2006
Pierre-Henry Deshayes

A Norwegian mouth cancer specialist has admitted to fabricating research data published in several international scientific magazines, in the latest fraud case to rock the medical research world.

A doctor at the Institute for Cancer Research at the Norwegian Radium Hospital, Dr Jon Sudbø, has confessed to forging data used to document research published last October in The Lancet as well as in two other articles.

The revelation comes on the heels of the disclosure that South Korea's celebrated cloning pioneer Professor Hwang Woo-Suk had faked research papers claiming breakthroughs in stem cell research.

Suspicion that Sudbø, 44, had forged data in The Lancet article surfaced earlier this month and several investigations have been launched into his conduct.

"He has indicated that in addition to the article in The Lancet, two of his other articles contained information in which the conclusions have no basis," says Sudbø's lawyer Erling Lyngtveit.

The two other articles appeared in the New England Journal of Medicine in April 2004 and the Journal of Clinical Oncology in March 2005.

"It appears that he started cheating a little bit, and then the deception got completely out of control in his last article in The Lancet," the lawyer adds.

Made-up study

In The Lancet article, the doctor maintained that anti-inflammatory drugs like aspirin were efficient in preventing mouth cancer, but they also increased the risk of cardiovascular disease.

He based this conclusion on data from 908 fictitious patients, 205 of whom had been given the same date of birth.

"This had nothing to do with money," Lyngtveit insists.

"In different circumstances, his motives would be perceived as positive since they are what helps research to move forward: the desire to contribute to something, the yearning for fame and glory," he says, adding however that "this got completely out of hand".

In Sudbø's article in the New England Journal of Medicine, he claimed that the resection of the first cancerous cells in the oral cavity did not have an impact on the mortality rate in patients.

According to his lawyer, he now admits he did not have the mortality statistics to back up that claim.

Sudbø's article in the Journal of Clinical Oncology discussed the possibility of calculating which heavy smokers would contract mouth cancer. But the study was flawed (Image: Reuters/Chip East)
Sudbø's article in the Journal of Clinical Oncology meanwhile discussed the possibility of calculating which heavy smokers would contract mouth cancer.

He has now admitted that he had only taken blood tests from some of the patients, and not all of them as previously claimed, to check if they had continued smoking, Lyngtveit says.

Over the past decade, Sudbø has published 38 articles in international scientific magazines, but his lawyer insists that "the forgery only occurred in three articles".

"Sudbø acted alone. His co-authors contributed to the articles in good faith," he adds.

The case has contributed to further weakening faith in research published in scientific reviews after the widely publicised Hwang scandal.

In 2005 Hwang claimed to have derived 11 stem cell lines tailored to specific patients, which are believed to have the potential to reduce the risk of rejection of new organs. In 2004, he said he had derived a stem cell from a human embryo.

But after a month-long probe, a panel of experts from Seoul National University found that Hwang had created no stem cells of any kind and that his research data was fabricated.

US research journal Science retracted Hwang's papers last week.

The Lancet meanwhile stated on its website earlier this week that "pending clarification, we now issue an expression of concern about the article by Sudbø".

Read

Oslo promises crackdown after cancer cheat scandal

Jan 16, 2006
By Alister Doyle

OSLO (Reuters) - Norway promised on Monday to speed up a new law that may bring jail terms for medical cheats after a hospital accused one of its cancer researchers of falsifying data published in a leading journal.

"There must be no doubt about the quality of our research," Health Minister Sylvia Brustad told Norway's NTB news agency. "So we are speeding up our draft law."

The government would present the law to parliament later this year, earlier than planned, after experts have worked on a review since 2003.

The law would propose stricter rules for overseeing research and might make cheats liable to criminal charges that could bring jail terms. Under existing rules, cheats can in the worst case be sacked and banned from practicing medicine.

Officials said at the weekend that 44-year-old Jon Sudbo, a researcher at Oslo's Radium Hospital, made up patients' case histories for a study about oral cancer published by the British journal The Lancet in October.

The hospital said an independent commission would probe all his research. Sudbo is on a sick leave and has not been available for comment.

"They will start the work mid-week. Hopefully they will give us answers in one to two months," said Stein Vaaler, a hospital director.

Among improbabilities in Sudbo's research, 250 of about 900 supposed patients were listed with the same date of birth.

Last year, South Korean scientist Hwang Woo-suk was exposed for fabricating two studies claming he had cloned human embryos to provide stem cells.

NOT RETROACTIVE

Any new Norwegian law making it a criminal offence to falsify data could not apply to Sudbo. "A law would not have retroactive effect," Deputy Health Minister Wegard Harsvik told Reuters.

Richard Horton, editor of The Lancet, said the report published in October would be retracted if Oslo supplied confirmation that it had been falsified.

The hospital's Vaaler said a retraction would be made quickly if the researcher admitted in writing to inventing the data. "So far he has admitted falsifying data verbally," he said.

"There are huge implications for the entire scientific community to make sure that it has the best safety checks in place to prevent fabrication and falsification of data," Horton told Reuters.

The panel investigating Sudbo's research would look at why errors were not spotted by a peer review.

Horton defended the current system of peer review but said the competitive nature of scientific research probably contributed in both the Norwegian and South Korean cases.

(additional reporting by Patricia Reaney in London)
Read

Heretic or Martyr?
Epidemiologist Still Scorned for Questioning Passive Smoking's Harm

By Michael Gibbons

Judging whether James Enstrom, PhD, MPH, is more sinned against than sinning might come down to whether you smoke or not, agree with smoking bans or not, have chronic obstructive pulmonary disease (COPD) or not, or treat COPD-ravaged lungs for a living or not.

As ADVANCE readers do the latter, they may already know about Enstrom. They may agree with critics who consider him, at best, a lone voice in the wilderness, at worst, an infuriating heretic. To his supporters in academia though, Enstrom is an objective scientist attacked because he presents research findings that happen to run counter to mainstream ideology.

In 2003, Enstrom and colleague Geoffrey Kabat, published a study in the British Medical Journal (BMJ) that downplayed the dangers of secondhand tobacco smoke exposure to human health and mortality. The resultant cacophony of criticism still sets Enstrom's ears ringing more than three years later, so much so that he created an entire Web site (www.scientificintegrityinstitute.org) to, in his words, "defend" himself.

"There are very few people in the world who would want to go through what I've gone through," Enstrom, a research professor at the University of California Los Angeles School of Public Health and Jonsson Comprehensive Cancer Center, told ADVANCE.

"This saga has been going on for three-and-a-half years. It's gradually dying down but, surprisingly, not as rapidly as I would have liked."

Smokers and Never-Smokers

Enstrom and Kabat set out to measure the relationship between environmental tobacco smoke (ETS) and long term mortality in the United States.

The pair studied 118,094 California adults enrolled in late 1959 in the American Cancer Society's (ACS) cancer prevention study and followed them for mortality from 1960 through 1998. Within that cohort, they focused on 35,561 never-smokers and compared those who were married to smokers with those married to never-smokers. Spousal smoking status was used as a qualitative measure of ETS exposure.

After controlling for confounding factors and participants with pre-existing disease, Enstrom and Kabat found no significant associations between ETS and the risk of dying from coronary heart disease, lung cancer or COPD.

"The results do not support a causal relation between environmental tobacco smoke and tobacco related mortality, although they do not rule out a small effect," they concluded. "The association between exposure to environmental tobacco smoke and coronary heart disease and lung cancer may be considerably weaker than generally believed."1

Critics fumed—especially because some of Enstrom's funding came from none other than the tobacco industry.

"We are appalled that the tobacco industry has succeeded in giving visibility to a study with so many problems it literally failed to get a government grant," Michael Thun, MD, MS, the ACS's vice president of Epidemiology and Surveillance Research, told Reuters.

Complaints about Methodology

More specifically, critics complained that Enstrom and Kabat failed to distinguish adequately between people exposed to secondhand smoke and people not exposed.

"The significance of Enstrom's error is that when you do an epidemiological study, you compare people who are exposed (say, to secondhand smoke) with people who are not exposed," Stanton Glantz, PhD, one of the foremost activists in the nonsmokers' rights movement, told ADVANCE.

"The ratio of disease in these two groups is the relative risk," Glantz explained. "A relative risk greater than 1 indicates that the exposure increases the risk of the disease. If people in the denominator (the unexposed group) are really exposed, that obscures the risk. Since Enstrom had a lot of exposed people in his nominally unexposed group, his analysis is heavily biased against actually detecting an effect."

Glantz and others contend Enstrom didn't distinguish between exposed and non-exposed subjects because:

Participants were enrolled in 1959, when exposure to secondhand smoke was so pervasive that virtually everyone was exposed to ETS, whether or not they were married to a smoker.

No information was collected on other sources of ETS exposure besides spousal smoking.

No information on smoking by the spouse after 1972 was included, even though the observation period continued another 26 years so any smokers who quit between 1972 and 1998 were still counted as smokers.

Study participants were on average 52 years old at enrollment. Many spouses who reported smoking in 1959 would have died, quit smoking, or ended their marriages during the 38-year follow-up, yet their surviving partners were still classified as "exposed" to ETS.

Enstrom Responds

Enstrom insists he addressed the issue of exposure misclassification "in great detail" prior to publication.

"That's why the British Medical Journal accepted the paper for publication," he said. "BMJ got so much criticism they posted the entire prepublication history of the study online." (see http://www.bmj.com/cgi/reprint/326/7398/1057.pdf).

In the lengthy defense portion of his Web site, Enstrom disputes the assertion that he was unable to distinguish between exposed and unexposed individuals. "This cohort study was done in the same way as the other spousal smoking studies and our 1999 follow-up questionnaire survey results showed that there were subjects who had varying degrees of exposure to ETS," the Web site reads.

It is "absolutely false," it goes on, "that exposure to secondhand smoke was so pervasive (in 1959) that virtually everyone was exposed to ETS, whether or not they were married to a smoker."

The 1999 survey "clearly shows that among never-smokers married to never-smokers as of 1959, 43.5 percent of males and 61.7 percent of females reported no regular exposure to cigarette smoke from others in work or daily life as of 1999."

Enstrom also told ADVANCE that an October 2006, study out of western New York State, funded by the National Institute on Alcohol Abuse and Alcoholism, a division of the U.S. Department of Health and Human Services, yielded findings "identical to mine."

That study compared health data from 1,197 women and men with histories of myocardial infarction (MI) with data from 2,850 healthy controls. Noting that exposure to secondhand smoke (SHS) "has declined sharply among nonsmokers in recent years," the researchers concluded that "in the absence of high levels of recent exposure to SHS, cumulative lifetime exposure to SHS may not be as important a risk factor for MI as previously thought."2

Stronger Link Abroad

Enstrom further contends that evidence of a link between ETS and coronary heart disease and lung cancer is stronger in other countries than in the U.S.

"The evidence in the U.S. is quite weak and is fairly consistent with what we found," he said, referring those interested to his March 2006 meta-analysis of the entire body of U.S. epidemiological evidence on the subject.3

In particular, "the lung cancer evidence is weak in the U.S., a fact shown in the U.S. Surgeon General's report in June, although it wasn't publicized," he said. "If you include my BMJ results, which were entirely omitted from the Surgeon General's report, the evidence is even weaker."

Glantz countered that epidemiological data outside the U.S. is more convincing in part because differences between men and woman are more acute in other societies, especially regarding smoking.

"The risks that have been reported in some of the other countries have been higher because many of the studies use marriage to a smoker as the surrogate for exposure to secondhand smoke," Glantz said.

"If few women smoke or work outside the home (as is the case in many countries outside the U.S.), the fact that they are married to a smoker is a better measure of exposure. Thus, you get a cleaner control group."

Tobacco Funding

Asked why he accepted funding from the tobacco industry, Enstrom said his renegade status left him no other option.

"When you go into areas that are controversial or not mainline opinion, the mainline agencies stop funding you," he said. "You're faced with not doing the research or getting funding in some other way."

In an ideal world, he added, "I would have never gotten involved with tobacco-funded research at all. The first 19 years of my epidemiological career I had no funding from the tobacco industry."

Now he considers tobacco funding a blessing in disguise because the experience has led him to "uncover a side of epidemiology I never thought existed." Ideological broadsides against objective scientific findings that don't match the prevailing sentiment are happening not only in the field of ETS research "but in several other areas related to weak effects," he said.

Activists "try to squelch" this legitimate research, Enstrom added, saying: "It gets pretty heated because of the intervention of activist groups that have nothing to do with science. They begin petitioning, introducing lawsuits and adding a political framework that has nothing to do with scientific study."

Glantz, however, bluntly dismissed Enstrom's complaint that he can't get funding from more politically correct benefactors because his contrary results ostracize him from traditional sources of grants.

"I think the reason Enstrom can't get funded is that the scientific approach he has taken is wrong," said the author of several books on the tobacco wars, including one about secondhand smoke targeted at second-graders titled The Uninvited Guest.

Enstrom's work "does not survive peer review because of its low quality," Glantz said.

Active Smoking Research

These days, Enstrom is exploring other "weak" epidemiological relationships involving air pollution and trans-fatty acids. But he's not finished with research into smoking.

More epidemiological research is needed to determine what factors besides active smoking cause 160,000 Americans to die of lung cancer each year, according to Enstrom. But what he terms the "anti-smoking" community won't hear of it.

"There is virtually no ability to do research in epidemiology involving active smoking," he said. "The same people who have frozen debate on passive smoking, like the Surgeon General, have frozen it on active smoking as well. It's hard to do epidemiological research on active smoking and mortality."

Officials within the American Cancer Society, he charged, are "going out of their way to make it difficult to do any more research."

Enstrom is pushing back, documenting what he calls "the phenomenon of the manipulation of science" in smoking-related research.

"Much of this is controlled by the American Cancer Society," he said. "They have engaged in what I consider to be an unethical campaign against me. I'm just trying to conduct honest and important research and to point out that the current focus on exaggerated effects of passive smoking is diverting attention from the important effects of active smoking. Since I've never smoked in my entire life, I think I can be very objective on issues involved with tobacco."

References:

1. Enstrom J, Kabat G. Environmental tobacco smoke and tobacco related mortality in a prospective study of Californians, 1960-98. BMJ. (2003;326:1057).

2. Stranges S, Bonner M, Fucci F, et al. Lifetime cumulative exposure to secondhand smoke and risk of myocardial infarction in never smokers. Results From the Western New York Health Study, 1995-2001. Arch Intern Med. (2006;166:1961-1967).

3. Enstrom JE, Kabat GC. Environmental tobacco smoke and coronary heart disease mortality in the United Statesa meta-analysis and critique. Inhalation Toxicology. (2006;18:199-210).
Read