Cigarette smoking is addictive. Cigarette smoking causes lung cancer. Today these statements are uncontroversial, but it’s easy to forget that this was not the case until relatively recently. The first studies reporting a link between smoking and lung cancer appeared in the 1950’s (although scientists in Germany had reported a link earlier), while the addictiveness of tobacco, and the isolation of nicotine as the principal addictive constituent, was not established until some time later. Part of the reason for this is simply that scientific progress is generally slow, and scientists themselves are typically not the kind of people to get ahead of themselves.

However, another factor is that at every stage the tobacco industry has resisted the scientific evidence that has indicated the harms associated with the use of its products. One way in which it has done this is by suggesting that there is uncertainty around the core evidence base used to support tobacco control efforts. A 1969 Brown and Williamson document outlines this strategy: “Doubt is our product, since it is the best means of competing with the ‘body of fact’ [linking smoking with disease] that exists in the mind of the general public”.

This approach seeks to “neutralize the influence of academic scientists”, and has since been adopted more widely by other lobby groups. The energy industry has used a similar approach in response to consensus among climate scientists on the role of human activity in climate change. But what’s the problem? There are always a number of ways to interpret data, scientists will hold different theoretical positions despite being in possession of the same basic facts, people are entitled to their opinion… That’s fine, but the tobacco industry goes beyond this and actively misrepresents the facts. Why do I care? Because recently our research was misrepresented in this way…

There is ongoing debate around whether to introduce standardised packaging for tobacco products. Public health researchers mostly favour it, while the tobacco industry is opposed to it. No particular surprises there, but there’s a need for more research to inform the debate. We have done some research here in Bristol suggesting that standardised packs increase the prominence of health warnings in non-smokers and light smokers. Interestingly, we didn’t see this in regular smokers. This research contributed to the recent European Commission Tobacco Products Directive and the UK government consultation on standardised packaging. British American Tobacco (BAT) submitted a response to this consultation, which cited our research and said:

“The researchers concluded that daily smokers exhibited more eye movements towards health warnings when the pack was branded than when it was plain, but the opposite was true for non-smokers and non-daily smokers”.

We didn’t find that, and we didn’t say that. This isn’t a matter of interpretation or opinion – this is simple misrepresentation. What we actually concluded was:

“…among non-smokers and weekly … smokers, plain packaging increases visual attention towards health warning information and away from brand information. This effect is not observed among daily (i.e. established) cigarette smokers”.

In other words, standardised packaging increases the prominence of health warnings in non-smokers and light smokers, but don’t seem to have any effect in daily smokers. This is an important difference compared to how BAT represents this research. In their response to the consultation, BAT argues that “plain packaging may actually reduce smokers’ attention to warnings”. Of course it’s possible that there could be negative unintended consequences to standardised packaging, but there is no evidence in our study for this.

Why does this matter? Maybe it doesn’t – people get misrepresented all the time. But scientists produce data and ideas, the latter ideally based on the former, and so to misrepresent their conclusions is fundamentally distorting. Unfortunately this sort of thing happens all the time, including in media coverage of scientists’ work. This often makes scientists less willing to engage in important debates where they could make a valuable contribution. If this happens, then those with clear vested interests will succeed in removing valuable evidence from these debates. More importantly, this example illustrates why it’s vital that scientists do engage with the public and the media. Only by doing so can scientists make sure that their research is accurately represented, and that attempts to misrepresent their research are challenged.

As the health effects of smoking became apparent, successive governments acted to reduce the prevalence of smoking in the population. In the United Kingdom these efforts have been pretty successful – the overall prevalence of smoking is currently around 20%, down from a peak of over 50% in the 1950’s. This is due to restrictions on tobacco advertising, increases in taxation on tobacco products, and other tobacco control measures, as well as public health campaigns to increase awareness of the health consequences of tobacco use and greater availability of services to help people stop smoking. We want these policies to be evidence-based, and we don’t want this evidence to be knowingly distorted. Scientists have an important part to play in this.

Posted by Marcus Munafo @MarcusMunafo