My personal moment of really empathizing with Trump voters

Let me get the mandatory out of the way first: It is a terrible tragedy that those American voters who resent how the elite establishment treats them were offered Donald Trump as their only Brexit-like option for expressing that. I blame the Democratic Party establishment that made sure their other option was the epitome of that elite establishment, rather than the man who should now be President Elect Sanders.

I cannot imagine a level of resentment that would cause me to support Trump (though that may be due to limits of my imagination, due to my modestly comfortable life). The clearest reason is that his was just a more successful version of the standard Republican big con: Get economically distraught voters to support you, and then use their votes to implement tax and financial policies (basically the only concrete policy plans Trump has offered) that benefit the rich at their expense. In addition, the Affordable Care Act is the most positively transformative piece of domestic policy of my adult life, and I would not vote to lose it. Then there is the overt racism and associated policy statements and empowerment of the worst people in our society; I would never want to be associated with that. And finally there is the dire threat to the foundations of the republic, the barely-veiled facism, including the incitement of mob violence, the statement he would imprison his opponent, and the like. I would not support a candidate who did that even if I agreed with all of his policy positions.

On the other hand, it is sometimes pretty easy to understand one aspect of the latter, the disdain for the arrogant establishment press. For what did I see in the Washington Post this morning, in one of the many attack pieces about Mr. Trump’s relationship with science that everyone seems to be running today? This:

wapo-attacks-me

Trump’s tweet represents one citation more from him than I have gotten from any previous POTUS, as far as I am aware, so I have to like that (though I would not say that makes up for losing the ACA). I am not trying to defend Mr. Trump’s scientific views or future policies in general. I am not even suggesting that a 2012 tweet means that he will improve policy in this one area, though I would really like to think so. I am not expecting to become a special advisor on the issue or anything — especially not after that second paragraph above.

But the present post, like the election result, is not about Mr. Trump himself. Rather, it is about the other player in this, the Washington Post (in the person of its shoddy reporter, Sarah Kaplan), and the arrogant Acela Corridor elite it represents. Before getting to the personal empathy from the title, a few objective points:

Did Kaplan contact me for a comment before including me by name as collateral damage in her hit piece on Trump? Nope. Did she identify me as a professor of public health and evidence-based medicine, or as an award-winning expert in how we can improve health science methodology? Or (as I might have suggested), as the most methodologically skilled scientist to delve into the evidence in this particular area of public health? Nope. That would not fit with the narrative she was trying to concoct, after all. And to the elite insiders, impressing their pals with their narrative is more important than doing their jobs properly.

Instead of citing my credentials she noted another area in which I worked. WTF? Was that informative to the reader? Obviously not — some of the best minds of the generation have worked for tobacco companies, as well as some very subpar researchers. People who have done such work are, on average, better than the average researcher in health science (to overstate comically), but there is a lot of variation, so the information is not useful. Did she note that my paid expert work for industry had (and still has) all been about the truth about low-risk products, including some of the more important contributions to that field? Or that I have done similar work as a professor and a paid expert consumer advocate, and plenty of unpaid work too? Of course not. Because her intentional game, in her out-of-touch arrogance, was to construct lazy smears — in this case to imply that I appeared via a wormhole from 1970, when some scientists working for the industry denied truth rather than doing the extraordinarily careful science they do now.

But most important, does she have any idea whatsoever what she is talking about on the subject of industrial wind turbines. Clearly no. Ironically, her link from “Multiple reviews” is actually a single junk science paper written by the hired guns who were paid by the wind power industry to write it. Yes, that’s right, Kaplan, who baselessly tried to smear me by referencing industry association does not even know enough about this topic to avoid citing the most obviously intentionally-biased “review” out there, a paper that blatantly ignores the data I show to be most informative (to say nothing of the fact that the people who wrote it are hacks with no apparent skill in interpreting public health evidence). And yet there she is saying Trump is wrong on a point where he happens to be right. The worst she could have legitimately said about his statement was that the issue is controversial (which is the case only because of doubt about the evidence that has been expertly and successfully manufactured by industry and its allies using — more irony — the tactics the tobacco industry used c.1970). But presumably she did not know that because she thought it was just fine to smear two people based on her arrogant confidence in some incorrect assertions that she heard at a cocktail party.

So bringing this back to the point about empathy, I am not suggesting that my life’s experience is nearly as bad as the canonical frustrated Trump voter. I am not someone who saw his father and grandfathers help make this country what it is, only to be forced to scrounge for minimum wage jobs and wonder if his kids have any hope at all, and after seeing his brother commit suicide and his son get hooked on opioids. But I have suffered some of the frustrations of a lifelong outsider, watching the insiders march on in ever-increasing comfort and arrogance. In my scientific work, I have made quite a few serious original observations. I am usually ahead of their curve when working in insider circles. And not once have I ever had to reverse a scientific position I have taken due to counter-evidence or compelling contrary analysis (yes, really). A few times during that journey I have had personal success and gotten a lot of respect in some circles, but that life as a whole has been a story of a frustrating lack of credit and respect. Like, for example, when some of my more important work — in this case, done on behalf of rural residents who are treated like crap by the wealthy urban elite by having noxious electric generators forced into their neighborhoods — is casually dismissed by a clueless arrogant reporter. (Aside: Many of those people may have voted for Trump as a result of that treatment. Ultra-blue Vermont elected a Republican governor on Tuesday, and a lot of his support was due to his opposition to building more wind turbines.)

Of course we can debate whether I have any entitlement to have my ideas taken seriously merely because they are right, and whether that cartoon Trump voter I described is entitled to the American Dream just because he dutifully did what he was expected of him for the first decades of his life. You could argue that I am not very good at marketing and self promotion and he did not equip himself to succeed in the 21st century economy, and so it is our own fault. But whatever side you take on that question, you ought to be able to understand the frustration of people who have worked hard to do a good job in their life, but are treated like crap by a self-perpetuating system.

The analogy does not end there. Those Trump voters who voted for Obama in 2008 and were the key swing in 2016, the forgotten and frustrated in midwestern towns, do not see the insiders of either party as being on their side. The party that we thought of as supporting labor and the little guy when I was a kid is the party that recently maneuvered to make sure Bernie could not be president. I find some similarities in my life, the frustrating experience of insiders adopting or co-opting a half-assed version of my insights, positioning themselves as the alternative, when actually they are no better than the conventional wisdom I am challenging. (Incidentally, that does not describe the topic I was attacked for here, the health effects of wind turbines, where I believe my work is generally respected and important to the opposition. I am thinking mainly about my challenges to the core flaws in epidemiology and my work on tobacco harm reduction.)

Again, I am not trying to suggest my experience is nearly as bad as those lives that make someone turn to the likes of Trump. But the focusing event of being caught up in a WaPo slime job made me feel kind of the same. I worked my ass off, for very modest compensation, to try to help people who are desperately defending their homes against rapacious companies, and the East Coast snobs denigrate me because someone they see as gauche happened to cite my work. I know that Sarah Kaplan’s (multiple) abuses of science in her article were fewer and considerably less momentous than those she criticized as coming from Mr. Trump. I know that she probably thought she was trying to write the truth, and was merely too arrogant to know her limits, whereas it is not exactly clear Trump worries a lot about even trying. Still, it makes me want to say “they are all the same; fuck ’em; it would not be any worse to just blow it all up” about my little niche in the world.

I expect I will get over that. But in the meantime, having this experience in this context washed over me as a wave of genuine empathy with the Trump voters I just described. Not the genuine deplorables, mind you, nor the comfortable suburbanites who voted for him because… well, honestly I have no idea. But in spite of my increased sympathy from reading the work of Chris Arnade over the last few days (if you haven’t, do so at @Chris_arnade or at least here), I would have not otherwise mustered feelings that outweighed my contempt for anyone who cast a vote for Trump that ignored the huge risk to our nation and the overt hatred. But in a flash, there it was: “they are all the same; fuck ’em; it would not be any worse to just blow it all up.” My grudging but limited sympathy became empathy.

My immediate intense feelings about being attacked by WaPo have mostly faded. But I will not forget the empathy with those whose life’s efforts to just do the right thing are ignored or casually dismissed by the ruling class. I will now never think of any of my neighbors here in semi-rural New Hampshire, “he seems like a perfectly nice guy, but he voted for Trump and that is unforgivable”, which I very well might have done yesterday. I get it now.

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Working paper: Phillips – Preferences, practices, and intentions of a population of U.S. adult enthusiast vapers (CASAA member survey)

Comments are welcome on this new working paper (pdf), either in the comments here or via email. Some readers will recognize it as an improved version of preliminary reports from this survey (which are referenced in the paper).

Abstract: Existing surveys of e-cigarette users have provided useful information, but have been limited to convenience samples with no identifiable target population. The membership of The Consumer Advocates for Smoke-free Alternatives Association, a U.S. NGO, offers a unique opportunity for a survey of enthusiasts vapers. The survey, conducted in 2015, included 20,000 adult current vapers residing in the USA, with a far higher response rate than any previous survey. The results support several pieces of conventional wisdom, also reflected in previous survey results, that enthusiast vapers prefer open systems, interesting flavors (particular sweet flavors), and have a history of failed smoking cessation attempts using most of the “officially approved” methods. Almost all subjects who quit smoking with e-cigarettes believe they would still be smoking without them. About 90% of subjects indicated an intention to flout regulatory restrictions on available products, notably including a scenario that basically describes the effects of the announced FDA regulation. This suggests that assessments of that regulation grossly understate the probability and scope of a black market and do-it-yourself manufacturing, and thus overstate the impact on actual consumption. There are clear contrasts between this population and the average e-cigarette user, which commentators frequently ignore, but these results are probably representative of half a million and perhaps a million U.S. vapers.

Opting out of hand-washing regulation: a great case-study in not understanding regulation

My attention was called to this story (which I don’t think is a parody, but it is sometimes hard to tell), in which a U.S. Senator proposed a thought experiment of “easing the regulatory burden” by letting restaurants opt out of (real) public health rules requiring employees to wash their hands after visiting the toilet. His claim was that the market can take care of this: If the restaurant were simply required to post a notice that they have opted out of that regulation, customers would stop going there and the problem would be solved. Continue reading