There is something deeply illogical about the way that antismokers reason. It all seems a bit twisted. It’s somehow strangely back to front. Or circular. Antismokers always seem to have decided in advance that smoking is an evil, and then gone round looking for justifications for that prejudice.
The smoking controversy started in Britain in 1950 with the publication of the Doll and Hill London Hospitals study. Richard Doll was a young doctor, and Bradford Hill was a statistician.
He and colleagues at the council interviewed hundreds of lung cancer patients. Doll thought that the increasing incidence of the disease might owe something to the hundreds of tonnes of tarmac being laid down across Britain at this time, but soon discovered that in 649 lung cancer cases there were only two non-smokers. Doll himself gave up the habit two thirds of the way through the research (Times)
They claimed that their study showed that there was a lung cancer risk associated with smoking, and that smoking caused lung cancer. It was a claim that was vigorously disputed by another statistician, Sir Ronald Fisher. In 1958 he even wrote a pamphlet on the subject.
Fisher’s opposition arose in part from statistical issues; correlation should not be taken as proof of causation. But it also emanated from his libertarian views, which meant that he was strongly against anti-smoking publicity. He thought that people should be given the data and draw their own conclusions. (Public Health in the 1950s)
Fisher was also able to show, using data that he eventually managed to obtain from the London Hospital study, that inhaling tobacco smoke had a protective effect against lung cancer, and he held this to be "a fair knockout blow" for the idea that smoking caused lung cancer.
In addition, while the fact that 647out of the 649 lung cancer patients were smokers would seem on the face of it to strongly suggest an association between smoking and lung cancer, it has to be pointed out that in the 1940s most men were smokers, and that 98% of the both the control and disease group in this study were smokers. This means that, even if lung cancer were not caused by smoking, 98% of the lung cancer patients could have been expected to be smokers. Just like 98% of lung cancer patients in London could have been expected to be English. But this wouldn’t mean that being English caused lung cancer.
A similar problem arises with the subsequent British Doctors study, in which 87% of the doctors were smokers. In such a circumstance, it is only to be expected if 87% of cases of lung cancer – or any other disease – are found among the smoking doctors.
The dispute between the two men, both eminent statisticians, is arguably the foundational dispute between smokers and antismokers. In 1950 it was a gentlemanly debate between two friends. A decade later, it had distinctly cooled.
By 1952 they were ‘My dear Ron’ and ‘My dear Tony’. But in 1958 and 1959 they exchanged cool letters about the data on inhaling from the case-control study of smoking and lung cancer. (‘Dear Fisher, I do not normally take notice of hearsay but I have recently been told on good authority that you are suggesting …’; ‘Dear Bradford Hill, What a stuffy letter!…’) (src)
The dispute ran on throughout the 1950s, and only ended with the death of Fisher in 1962. Hill lived on until 1991. It is a dispute that has now extended into a wider society, all around the world, and threatens to become a war between antismokers and smokers.
It’s a war that Sir Ronald Fisher’s side have been steadily losing. It was already being lost back in the 1950s. Fisher would not have written a book if he had felt that the debate was going his way. Conversely, the fact that Bradford Hill saw no need to write any book suggests that he was confident that the debate surrounding his work was tending to support his conclusions.
For it appears that while statisticians like Fisher were unimpressed by the London Hospitals study, a number of influential doctors now accepted that smoking caused lung cancer. Richard Doll was foremost among these. Indeed, he was convinced before the study was completed. So also was George Godber, who was many years later to help launch the passive smoking scare. Over these next half century, these doctors were able to exert continuous influence inside the medical establishment around the world, and to drive forward a relentless and repetitive anti-smoking message. Their opponents – men like Ronald Fisher – either died or faded into obscurity, leaving the distinct public impression that there never had been any opposition at all.
The London Hospitals study is almost lost in history. It was superseded and eclipsed by the subsequent Doll and Hill study, the long-running British Doctors study, which began in 1951, and ended in 2004. And there have been countless other smoking studies during subsequent years. But nevertheless the London Hospitals study is arguably more important than any of these studies, because it was this study which seems to have convinced Doll and Godber that smoking caused lung cancer, and served to frame the subsequent debate, and to create two camps which have been unequally at war ever since.
Why were doctors like Doll and Godber so ready to accept the hypothesis that smoking caused lung cancer, given so many powerful objections can be raised to the London Hospitals study? One possibility – even likelihood – is that these doctors already knew about previous Nazi research from the 1930s and 40s linking smoking and lung cancer, and had long since accepted and absorbed its findings, but had felt unable to publicly draw upon that tainted body of work, feeling it necessary to themselves first replicate (and thereby denazify) that work. The connections were there. Richard Doll had been to Nazi Germany in 1936. Ernst Wynder, who also published a paper on smoking and lung cancer in 1950, had grown up in Nazi Germany before emigrating to the USA. The London Hospitals study even referenced a 1939 German work by Muller, proving that Doll and Hill had access to German research. After the war, these doctors may have seized the opportunity to reproduce the Nazi research, and to make reputations for themselves in the process. In this they succeeded admirably. History was rewritten to make it seem that Doll and Wynder and others had independently and more or less simultaneously discovered the link between smoking and lung cancer in 1950, while a discreet veil was drawn over the earlier Nazi research.
In this respect, the war on smoking which began in 1950 may be seen as a continuation of the Nazi war on smoking, using the same methodology employed by the Nazis, of retrospective lifestyle questionnaires, followed by strident public health warnings and smoking bans. The historian Robert Proctor has argued that this post-war adoption of Nazi antismoking science is no different from the post-war adoption of Nazi rocket science, and is another example of how Nazi Germany was capable of doing ‘good’ research. But there was nothing specifically Nazi about German rocket science. Indeed, it largely continued despite the Nazis rather than because of them. But German antismoking research was very distinctly ideologically Nazi in character, and was actively supported by the Nazis, and indeed by Hitler himself. The Nazi war on smoking was integral to the entire Nazi eugenic programme. And in Nazi ideology the normal logic of research was inverted: it started with the conclusions, and hunted around for justifications of those conclusions. Hitler was an antismoker before any research had been done. The purpose of antismoking research was primarily to confirm Nazi prejudices. The very title of the Wissenschaftliches Institut zur Erforschung der Tabakgefahren in Jena – the Scientific Institute for the Research into the Hazards of Tobacco – advertises the question-begging nature of its research: tobacco had already been deemed to be a hazard before any research at all had been carried out.
The irrationality of the modern antismoking campaign is the irrationality of Nazism. Its twisted logic is the twisted logic of Nazism. Modern lifestyle healthism, obsessed with smoking and drinking and obesity, blaring out hysterical public warnings, imposing restrictions and prohibitions, is the renaissance of a Nazi eugenic programme that seeks to cleanse the body politic of largely imaginary poisons. The extreme hatred that antismokers have for smokers is a Nazi hatred for all impure and corrupting influences on racial health. In Nazi Germany, the antisemitic wing of the eugenic programme of social cleansing ultimately became genocidal, and was only terminated by the military defeat of Nazism. But the antismoking twin of antisemitism lived on. It was adopted and nurtured by the victorious Americans and British, and has now in turn grown into another monster. It acts to exclude and denormalise and degrade smokers in precisely the same way that its sibling once excluded and persecuted and ultimately exterminated Jews and Gypsies and other racial ‘poisons’, and for the exact same reasons of public health, and using the exact same methods.