Monthly Archives: March 2012

March is coming to an end, and since this seems to be unofficial “make Simon Chapman regret his habit of saying really dumb things on Twitter” month, I figure I am running out of time to join the party.  It started out with blogs about some of Chapman’s tweets, with an absolutely hilarious post by Chris Snowdon, followed by Dick Puddlecote a week later.  Meanwhile, Dave Atherton presented him with a barrage of direct tweets asking Chapman to defend some of his positions in the face of the evidence (Chapman offered no response, as far as I can tell, and I would guess had none).

For those who do not know, Chapman is the Worst “Public Health” Person In The World.  (Like Olbermann, I reserve the right to pick different “Worst Persons” later, but I find it likely that others will remain runners up.)  You can learn a lot more by searching for his name in Snowdon’s blog, or mine, but to summarize:  He is the perfect storm of a card-carrying “public health” person who is harmful to both public health science and the public’s health:  terrible at scientific/analytic reasoning, and freely promotes junk science; believes that top-down authority, particularly promoting prohibition, is the defining characteristic of public health; will make any sciencey claim that seems to support his political positions, regardless of the lack of scientific support; displays no apparent humanitarian concern despite working in a field that can only be justified by such; is the worst kind of gadfly (parachuting in to topic areas he clearly knows nothing about and making sweeping declarations as if he is an expert); and does not even seem to display much more scientific expertise on tobacco, the subject he has been working on for decades.

None of that would matter much (there are tens of thousands of teenage bloggers who are characterized by all but the last of those, after all, and some write much worse things than Chapman), but for his last characteristic:  He has been granted an inexplicable measure of authority over public health in his country.  Fortunately for 99.5% of us, that country is Australia, but we should worry about people even when they are a minority living in some remote shark-infested flooded desert.  Besides, there is the matter of the spillover via telecom.

[Aside:  I suspect some readers might be thinking, “Worst? But what about Stanton Glantz, who occupies a fairly similar niche and makes even more absurd pseudo-scientific claims.”  I see your point, but I have become convinced that Glantz is actually an extended “bit”, like Stephen Colbert — someone playing a character by the same name that is a parody of an absurd group of people.  I mean, seriously, no one could actually believe what he claims to believe and be able to get through the day without some sort of custodial care.  Like Colbert, he has been asked to give sworn testimony while acting in character, and has some clueless followers who believe that the character is actually a real person making those claims.  So “Glantz” is not really in the running unless I turn out to be wrong about this.  Moreover, Chapman claims personal credit (i.e., blame) for the ban on low-risk alternatives to smoking in his country, making him the person responsible for the most pointless deaths of his countrymen since the guy who ordered the army to Gallipoli, and Glantz is never going to be able to touch that “accomplishment”.]

Getting back to Chapman, I do not have quite the writes-itself quality material that Snowdon did (if you have not read his post, do so — it is great) and I doubt I can come up with a phrase as catchy as Puddlecote’s “Swivel-Eyed Loon”, so the following (pictured) is what I have.  It is from just before “make Simon Chapman…month” began, and I have not experienced any cyberstalking from him since then, so maybe the project has already succeeded.  Still, I want to get in on it.

The background is that my government, specifically U.S. FDA’s new tobacco regulation unit, has a badly misused Twitter feed.  Keep in mind that this unit of the government is not some third-rate “public education” operation at a county health department.  It has no mandate or expertise to engage in general public education.  Its role is entirely to regulate corporations, making supposedly science-based decisions and issuing top-down edicts.  Despite this, about 20% of its tweets from @FDATobacco are inane anti-tobacco statements, whose style suggests they are intended to target the many fifth-graders who are reading the feed.  (The latest one, at the time I am writing this, is “True or False: Every day, approximately 1,000 youth under age 18 become daily smokers.”  That is the full content, down to lack of a question mark and the apparent failure to understand that such a statistic only makes sense if you tell us what population you are talking about.)

About 70% of the traffic from @FDATobacco seems to be thanking others by name for following the feed or for retweeting (funny, they have never once thanked me for any of my retweets — it might have something to do with the fact that I usually add some analysis).  That leaves maybe 10% that is the actual legitimate activities of this taxpayer funded official government communications channel from an agency that regulates commerce, telling us about what is going on that relates to the intersection of FDA and tobacco.

By far the biggest story of this year in that intersection was the court ruling that blocked FDA’s plans to put emotionally violent gory images (often mischaracterized as “warning labels”) on cigarettes.  Funny thing: @FDATobacco completely ignored the story, while continuing to post the wastes of space I noted above.  I am fairly certain that most of my readers recognized the intention of my post: biting sarcasm about how completely inappropriate the FDA Twitter feed is.  I hope the subtext was clear, that our government’s official communication channels should not be acting as a cheerleader for a particular political position, intentionally ignoring the important news that the government’s ultimate authority in the matter has taken an opposing position.  When the agency’s efforts fail, it should be reported by the agency; if whoever writes @FDATobacco does not like that, s/he should leave government and get a job in advertising.

So, let’s look at the tweet that Chapman sent in reply.  Start with the last line.  I am not sure exactly what “your descent” means.  Tweets are necessarily terse, but he had some slack to explain with a few more words, so I suspect he did not really know either.  Perhaps he is pointing out that my first foray of any significance into the scientific field that he claims expertise in, epidemiology, won several awards and helped redefine the discussion among the real scientists in field about how epidemiology should be done and what is fundamentally wrong with it.  The next topic I pursued was an even more important problem in the field, in my mind, though it did not generate much buzz.  So, most of the directions I could go after my debut were indeed down.  I would be the first to agree that after 13 years, and efforts by me and others, what I tried to promote with that work is still an unfulfilled promise, and epidemiology has not improved.  And I have given up on pursuing improvement from within.

Perhaps that was what he was trying to say.  But I kinda doubt it, given that he is not part of the scientific branch of the field, did not contribute to the attempted revolution I was part of, and seems to be thoroughly ensconced in the “part of the problem” side.

So what did he mean?  Did he think my criticizing the FDA was a descent?  That seems like a strange claim, since the aforementioned debut paper used as its main example an indefensible FDA decision.  Could it be the fact that I am criticizing someone?  Part of the reason epidemiology is so bad is because the non-scientists in the field have an attitude that you should never criticize anyone’s work (I am not kidding).  But I have never hesitated to criticize, coming from a scientific background, so there is no trend.

It is unclear, but my best guess is that the claim reflects Chapman’s activist zealot mentality, which often manifests in assuming that people in “your” group must agree with you on everything, and refusing to consider that they might have a good reason for not doing so upon finding out otherwise.  In this context, I speculate, he incorrectly assumed, when he followed my early contributions, that I agreed with him on everything, such as favoring emotionally violent labels on cigarettes.  But he interpreted this tweet as being a declaration that I now disagree with his goals, which is the zealot’s only basis for judging someone.  Thus, descent.

That takes us to his first sentence.  Setting aside the very incorrect implication that we are on a first-name basis, consider the claim.  I sounded happy?  I am not sure it is possible to sound happy in 140 characters without using words that explicitly declare happiness.  Surely if I had just posted the “Judge blocks…” headline, there would be no basis for a claim about sounding happy.  So it must come from the “Hey @FDATobacco….” part.  But, of course, what I expressed there was my dis-happiness with the high school intern or secretary who controls the @FDATobacco feed (I am going to give them the benefit of the doubt and assume the problem is that the agency is simply not taking it seriously), for their abuse of government authority.

Chapman’s misinterpretation of that is a perfect example of what makes him such a bad excuse for a scientist, and not because he misinterpreted (though I am still really not sure how that “you forgot” construction could be interpreted as happiness).

A scientist/scholar would have read and understood the actual analyses of opponents of his position, particularly people he presumes to pick fights with, rather than just their feeds.  Had he done so, he would surely have been aware that I have repeatedly argued that those graphic labels are bad public policy for numerous substantive reasons.  The last of the above links is to the testimony I offered about FDA’s plans which made the same core arguments used in the judge’s ruling.  Indeed, some of the phrasing in the ruling is so familiar that I suspect that one of the judge’s clerks must have read that or something else I wrote and used some of it in drafting the ruling, which is gratifying.

Thus, my tweet could convey no information about my happiness about the ruling, because anyone familiar with my work would already know I was happy about it.  It was a defense of freedom of speech, a repudiation of pseudo-science, and a push-back against perverse “public health” measures that are designed to harm people who are choosing to do something unhealthy rather than to help them.  Chapman’s behavior suggests that he does not care about any of these, but before he presumes to criticize me, he ought to be aware that I do.

Moreover, even allowing for his failure to understand the sarcasm I was conveying to/about the author of @FDATobacco, someone who thinks scientifically would have automatically wondered about the meaning.  There are plenty of ways to express happiness, and I employed none of them.  But apparently it never occurred to him (like it automatically would to someone who thinks scientifically), “wait a minute; my immediate impression of this does not add up; there is something I am not understanding.”  Leaping to the conclusion that I was expressing happiness might be another result of his activist mentality:  If everything is measured only in terms of whether it is good for The Cause or bad, and there are no complications other concerns in the world, then someone must either be expressing happiness or sadness about a policy decision.  Of course, if I had more data, I could perhaps do better, and might well figure out that my guess is wrong.

I wonder if Chapman has ever expressed that last thought.

I am tempted to say something about watching Chapman’s descent, but I think perhaps he has acted this way since I first became aware of him, and I just did not notice it at first.  A big difference is that he has gained power, and thus his folly is clearer.  And really terribly harmful.  I do not mean some abstract point about his behavior harming the science itself (though it does) or parochial point about his content-free personal attacks on people who are doing good science that he does not like; I refer to harm to the welfare of lots of people.

Oh, and of course the answer to the question in the title is the internet-age variation on the old canard about how you know a politician is lying:  “His fingers are moving.”

A couple of weeks ago, I posted about a move in the Wisconsin legislature that would basically declare that being a single mother (however that situation came about) constitutes negligent behavior that contributes to child abuse.  Understandably, there was an uproar about this; not surprisingly, it pretty much overlooked the epidemiology of the situation that I mentioned.

It was pretty clear that the epidemiologic observations (that a child is indeed better off in a two parent household all else equal, and that children in a household with a male partner of their mother who is not their biological father are at enormously greater risk of suffering physical abuse), while based in evidence, were rationalizations, not the real motives.  Other statements by the bill’s sponsor made it pretty clear he was not actually trying to improve the lives of the children, let alone their mothers.  A few days ago, that was compounded by a comment by a co-sponsor of the bill, which finishes off any doubt that this has to do with caring about people:

Instead of leaving an abusive situation, women should try to remember the things they love about their husbands, Representative Don Pridemore said. “If they can re-find those reasons and get back to why they got married in the first place it might help,”

(h/t to epidemiologist blogger Tara C. Smith for finding this, though I cannot quote her tweet about it without risk of getting my post censored by vocabulary-based filters)

This madness is fascinating in the context of the buzz about the new book by psychologist-turned-political-analyst Jonathan Haidt, The Righteous Mind.  The gist of the buzz (admittedly an oversimplification of the ideas, though so is the book — if you want a more complete summary, this review provides one) is that behavior of many voters on the American political right baffles thinkers on the left.  The latter think the former are just being duped by the 1% to vote against their interests.  Haidt argues that the conservatives just have a broader set of “moral” concerns.  The claim is that conservatives understand liberals’ values of compassion and fairness, and share them to some extent, but also consider as moral values such things as order, loyalty, authority, sanctity, tradition, and feelings of disgust.  These latter concepts are sufficiently foreign to liberals, the claim goes, that it is very difficult for them to even recognize these as morals that someone might have. 

One conclusion that gets drawn is that those on the right just have a richer and deeper moral sense than those narrow thinkers on the left.  I realize that Haidt’s intention is to offer a useful positive (i.e., descriptive) analysis, not a normative one, but there is something remarkably disturbing about the moral relativism that leaks through in the the conversation.  Ironically, American liberals are often characterized by or criticized for cultural/moral relativism.  But, this story claims that they do not extend that to a large portion of their fellow citizens. 

Whatever you might think of that observation, it should be clear that there is a good case to be made against relativism in the Wisconsin case.  Some “moral values” are just not, well, moral — they are not defensible under any set of modern Western moral guidelines I can think of, other than appeals to out-of-context statements from ancient Hebrew mythology.  A taste for sanctity, order, tradition, and authority might explain the urge to support public policies of denying reproductive freedom or encouraging a woman to keep an abusive family together.  Similarly, a sense of disgust and authority leads some people to want to punish tobacco users or deny rights to homosexuals.  But remember that a taste — for wealth and power at the expense of others — also explains the behavior of the 0.1%.  All are understandable, can be put in evolutionary terms, etc. but that does not make any of them ethically defensible.

Bringing this back to the epidemiology, I would argue that the use of epidemiologic claims as rationalization for a motive that is in no way motivated by the science is deplorable.  Moreover, it is evidence of the moral bankruptcy of the position.  If someone is not willing to stand up and say “I think people should not be allowed to use tobacco or cannabis, regardless of its effect on health” or “in-tact families are the only moral way to live, even if they are unhealthy on net”, then let them do so and see how their ideas stand up with the polity.  But if they are going to twist the evidence to try to pretend they are motivated by creating better physical or social/emotional/developmental health, then we should cry bullshit.

Importantly, from where I sit, it is pretty clear that Haidt and the others who try to put this in terms of standard American party politics are working along the wrong spectrum.  The most ridiculous cases seem to come from Republican state officials.  But Democratic officials and the Democrat-leaning permanent government (the long-term employees in the bureaucracy) pursue their taste for non-humanistic principles with (often junk) epidemiology rationalizations — they are just usually better at disguising it. 

I follow the comments and observations of hundreds of people who share my inclination to condemn junk science and disingenuous rationalization in pursuit of personal “moral” tastes.  It is fascinating to observe that for the substantial portion of them whose political identity is tied to these feelings, there are remarkably similar numbers who believe that the worst offenders are the political right and who believe it is the political left.

Previously I have posted about the media hype about energy drinks and there is a bizarre fixation on caffeine, to the exclusion of the other ingredients, either when they combined with alcohol or not.  The most criticized drinks — the original, Red Bull, and the controversial alcopop versions (which seem to have largely disappeared from the market following controversy) — actually have/had fairly modest amounts of caffeine, less than a small coffee.  But the “energy drink” label general means something contains other active ingredients, including other herbal stimulants (guarana, a source of caffeine and a other identified and perhaps unidentified stimulants; ginseng), taurine (an amino acid that is believed to usually be beneficial, but high doses of an isolated single amino can sometimes do weird things), and megadoses of some vitamins.

Personally, I have always been more worried about the other ingredients, though I hasten to add that there is not solid evidence indicting them.  I based my concern on the observation that (a) there is reasonable evidence that sometimes some people have a bad reaction to these drinks and (b) very few people have a very bad reaction to that quantity of caffeine, as evidenced by the tens of millions of people who drink that much caffeine every day.

This week it was widely reported that a 14-year-old Maryland girl, Anais Fournier, died after drinking two extra large energy drinks in December.  Was it caused by the drinks?  Quite possibly, though if so it seems most likely that they triggered a time-bomb condition rather than being like, say, a car crash that struck down someone who otherwise should have expected a 80 more healthy years.  Blogger Radley Balko suggested on Twitter the Huffington Post (which he writes for) should have headlined it, “Energy drinks demonized after girl w/ heart condition dies.” 

But if it was caused by the drinks, was the caffeine to blame? 

Unlike many of the other drinks, this is at least plausible in the recent case because the estimated amount of caffeine she consumed was 480 mg.  Alarmists in the press chose to point out that this was equivalent 14 cans of Coke.  They did not bother to mention that Coke is not really a very potent caffeine delivery system, and that this is in the neighborhood of a large Starbucks coffee.  Drinking a large coffee would not necessarily be the best thing for a girl with a diagnosed heart condition to be drinking, but hardly outside the realm of normal teenage behavior based on my observations at the local Starbucks.  (They also did not mention that volume of the Monster energy drink Fournier consumed was that of 4 cans of Coke or more than two large Starbucks — far short of downing more than two six-packs, but definitely a deliberate ingestion of a lot.)

We have no information on whether she had ever before drunk a large coffee, so the caffeine alone might have been too much.  But it still seems that there should have been some press mention of the other ingredients of the drink.  A search of the name of the girl or the drink in recent news yielded dozens of news stories, but when adding in the name of the other active ingredients, the only story that repeatedly appear was a post by a marijuana legalization advocate wondering why the drinks with all of these ingredients are legal and their drug of choice was not.  (Note to advocates of drug legalization:  Trying to embolden those who want to ban other substances is probably not your best strategy.)  Guarana showed up in longest story about the girl’s death, from her local newspaper, but only in the context of it being a source of caffeine; its several other active chemicals were not mentioned.

Fourneir’s death was officially attributed to cardiac arrhythmia due to caffeine toxicity.  Presumably this will be cited as evidence that the caffeine content in these drinks is toxic.  It will no doubt be used to make that claim about energy drinks that contain a more typical 80 mg. of caffeine.  But, obviously no such conclusion can be drawn, even about the 480 mg.  The epidemiology of caffeine is clear:  so few people die from it that we cannot even detect the effect. 

I also dread watching commentators pick up on the word “toxicity” in the diagnosis (which is strictly accurate, assuming it was the caffeine: death due to the acute effects of a chemical taken into the body) and start screaming “this is evidence that caffeine is toxic!!!!!”  Yes, people, of course it is — how could it be any different than every other chemical or compound, all of which are toxins in some form and quantity.

However, I am not the slightest bit worried that this will result in attacks on our society’s (and my personal) favorite caffeine delivery system, coffee (except, perhaps, at some fringe health kook sites, which don’t really worry about evidence anyway).  There will be actions in state capitols to ban energy drinks because of the caffeine — if not now, then after a couple of other headlined deaths.  But no one will give coffee a second thought.  The funny thing is that the people leading the charge are undoubtedly the same ones who worry about “chemicals” in food and the environment (not particular chemicals, just chemicals), and who are overlooking the list of untested chemicals that might really be causing a problem.