When Myth Trumps Science

In some circles, social media influencers’ opinions are often more important than a medical doctor’s.

By George Gay

Almost four years ago, a Conservative-voting friend of mine became almost apoplectic when I suggested that the election of the left-wing politician Jeremy Corbyn as leader of the U.K.’s Labour Party might help bring a welcome, partial correction to the decades-long rightward shift that had occurred to what my friend had come to accept as the political center ground.

A few months ago, however, amid the continuing chaos of the Conservative Party’s Brexit breakdancing routine, the same friend told me, in another apoplectic outburst, that he would never under any circumstances vote for the Conservatives again. I have to say, I felt pretty smug at the small part I seemed to have played in wrestling a voter from the Conservatives. I had not lived in vain, I thought.

But there was something about my friend’s conversion that troubled me, and that was the size of the swing that had occurred in his position. I mean, even I have to admit that there could come a day, possibly one occurring in a parallel universe, when the Conservative Party manages to shrug off what even the party’s leader and Prime Minister (at the time of writing on May 24) Theresa May (whose resignation will take effect on June 7) have accepted as its nasty-party image.

Have too many of us, I wonder, lost sight of the center ground and moved beyond the fringes of reasoned debate? At a one-day forum staged recently by the UK Vaping Industry Association (UKVIA), a medical doctor and television presenter told how, after appearing on the television chat show Loose Women, where he had suggested that a woman who had tried and failed to give up smoking using traditional methods should try vaping, he was hit by a Twitter storm that wouldn’t have been more extreme if he’d “crapped on the floor.”

Christian Jessen, a medical doctor who works with health charities looking for new ways to educate people on health matters, gave the keynote address at the UKVIA forum held on May 9 at the London headquarters of the Royal Aeronautical Society. Jessen, who is a writer best known for his presentations of popular TV medical programs, is a public campaigner and the UKVIA’s official VApril (vaping awareness month) campaign ambassador.

Why was it that Jessen’s suggestion was met with such vehement opposition? Partly, I think, people react in this way simply because they can. Through social media, they have a route to express their opinions publicly to a huge audience in a way that was denied them in the past.

And for those who crave the limelight, there is no point in beating around the bush. Launching a foul-mouthed tweet at somebody with millions of Twitter followers surely generates more reaction and more satisfaction than could have been initiated using avenues previously available, such as writing a stiff letter to The Times that might or might not have been published.

But there are two things that need to be considered here: The first is that, no matter how things might seem, the people who react in the way described probably comprise a tiny minority of the population, and that it is only the echo chamber of Twitter that seems to indicate otherwise. The other point is that, whereas the above might explain why, in general, certain people choose to fly off the handle on Twitter, it doesn’t explain why they chose in this case to attack Jessen’s particular suggestion, which, after all, comprised a perfectly reasonable proposal from a fully qualified medical doctor.

The woman in question had tried all other methods of quitting, so the choice she was left with was between continuing to smoke or giving quitting one last try with vaping, and there are relatively few people, even among those opposed to vaping, who, given that binary choice, would suggest sticking with smoking combustible cigarettes.

Could it be, I wonder, that Jessen, in trying to use the power of television to help educate people about health matters, had come to be seen as just another TV pundit rather than a doctor? He didn’t suggest such a thing, but he did question whether the public at large was particularly interested in how qualified the person presenting them with advice was.

During his work in television, he said, he had never been asked by producers to show his medical credentials or to demonstrate why he was suited to give medical advice on television. And this lack of interest in credentials was reflected in the wellness industry where celebrities encouraged their millions of followers to take up regimens of exercise or supplementation that were rarely based on anything remotely resembling science, or the truth or evidence.

Jessen said that at a time when people were bombarded with health advice on almost an hourly basis, some of it good, much of it bad and some of it downright ugly, it was a constant source of frustration for him that so many people seemed to prefer the opinion of a social media influencer to that of a doctor, scientist or experienced expert. Why is it that myth increasingly trumps science today?

The main reasons, he suggested, were mistrust in science and complacency. Sections of the public had come to mistrust science, medicine and institutions, and, in doing so, they had lost sight of the true value of progress. But Jessen refused to sneer at these doubters because, he said, he could see why they doubted. He needed only to say a few words to explain what he meant: Chernobyl, Bhopal, Challenger, weapons of mass destruction, thalidomide. And the trouble was that once you planted the seeds of doubt, you could rarely dig them out of the public’s consciousness.

There were several parts of Jessen’s presentation that seemed to face both ways: describing the benefits that science had brought but highlighting, too, where it had gone wrong; expressing frustration at people who rejected science but highlighting, too, that perhaps they had a point. I guess a kinder interpretation would be that the presentation was balanced and that when he talked, as above, about “the true value of progress,” it was necessary to recognize that progress isn’t an uninterrupted journey.

In fact, he was specific about this when he said he believed the scientific method—which has gotten us to where we are today, the greatest time to be alive—involved trying stuff out, seeing if it worked and changing it if it didn’t.

This method probably works well in many fields, but there is a problem when it comes to stuff such as smoking and vaping because the science is pulled out of shape by political and economic imperatives and shenanigans. One has to look only at what has happened with the U.S. Food and Drug Administration’s (FDA) attempt to use science as the guide for the future of tobacco.

In 2010, the year after responsibility for the regulation of tobacco products was handed to the FDA with the signing of the U.S. Family Smoking Prevention and Tobacco Control Act (FSPTCA), Dr. David L. Ashley, then the director of the Office of Science at the FDA’s Center for Tobacco Products (CTP), said that 443,000 Americans (U.S. citizens) died prematurely from tobacco use each year. Today, the U.S. Centers for Disease Control and Prevention’s website informs that cigarette smoking is responsible for 480,000 deaths annually in the U.S.

If you adjust the 2010 figure, 443,000, simply for population increase, annual deaths from tobacco use should now be at about 470,000. That is, the application of science to the tobacco issue seems to have an increase in deaths put down to this product by just over two percent, and that doesn’t take into account the fact that the 2010 figure includes deaths from tobacco use whereas today’s figure looks only at deaths from cigarette smoking.

OK, my figures are crude, and I’m sure that there are other factors that need to be taken into account in any robust comparison of the figures from 2010 with those of today, but I cannot help thinking that, nevertheless, the last 10 years have not been a roaring success for the FDA, assuming that the goal was to reduce tobacco’s public health toll.

It wasn’t meant to be this way. And in the heady days of 2010 when he gave his figure of 443,000, Ashley, who did so at the Coresta congress in Scotland, said that, for the first time ever, tobacco policy in the U.S. wasn’t being decided by politics—it was being driven by regulatory science.

I attended that conference and was skeptical about the claim that politics had been left behind, but I was also concerned that regulatory science was to be the sole driver. To my mind, there was a need to step outside the regulatory laboratory once in a while and take some risks. If the 443,000 statistic was correct, it was unconscionable to wait around for science to show us the way. Science is wonderful, but it can be slow.

At the time the FDA took responsibility for tobacco products, there were already tobacco and nicotine products on the market that at least some smokers found to be reasonable substitutes for combustible cigarettes and that could reasonably be assumed, given the level of knowledge then, to be considerably less risky than combustible cigarettes.

Ten years later, little action has been taken in respect of combustible cigarettes—apparently the main cause of tobacco-related deaths—but the FDA has maneuvered itself into a position whereby vapor devices, one of the most successful, low-risk substitutes for combustible cigarettes, face an existential crisis.

If this is science at work, no wonder people are disillusioned with science. But, of course, the fault lies not with science but with the version of science served up by the FDA between two thick slices of organic bureaucracy—perhaps as a result of the way that it was hemmed in by the FSPTCA. I hesitate to say it, but, in this case, what was probably needed was more political interference, not less. The FDA needed to be cut some slack.

One of the many problems that the FDA ran into or created in respect of vaping concerned the young person issue where it, egged on by a media that had never been happy with the good news stories of converted smokers, seemed largely to abandon regulatory science in favor of more pagan arts in which smokers were to be sacrificed on the alter of youth. And as science was abandoned, the FDA found itself besieged and undermined by politicians and special interest groups. The influencers were not only influencing the public, but also those experts who should have been holding the line against policies based on blood cults and moral panic.

In the U.K., the uptake of vaping by young people has not happened to any degree, so it has not faced such problems, but it was interesting that, at the forum, a flavor pamphlet was given out that would surely have raised eyebrows at the FDA, which is convinced that certain flavors, when applied to e-liquids, prove irresistible to young people.

And as somebody pointed out during one of the forum’s seven panel sessions, if the U.K. started to see a spike in vaping among young people, the vapor industry would suffer reputational damage if the media could point to the availability of “child-friendly” flavors. And what has to be remembered is that, in the febrile atmosphere of 24-hour news, as the media cried out for bloodletting and sacrifices, it would matter not a jot whether the flavors in question were the ones that young people were using.

But, to end on a positive note, at least in the U.K., Jessen said he believed that the U.K. industry is approaching things in a considered and responsible manner, and he made particular reference to its commitment to quality and the development of standards. The continuing emergence of evidence supporting vaping would mean that it would ultimately prevail, he added. Vaping is a gift to public health—one that must continue to be embraced and encouraged.

Sorry, just one more thing. I assure you that I am not making this up. Last night, I was speaking to the mother of my friend mentioned at the start of this piece who told me that she would never again vote for the Conservatives. That’s two down.