Science should never be distorted to fit political goals.

July 12, 2007

A Study Delayed: Helena, MT's Smoking Ban and the Heart Attack Study

By Michael J. McFadden and David W. Kuneman

Near the end of 2005, we (David W. Kuneman, a retired pharmaceutical
chemist, and Michael J. McFadden, author of Dissecting Antismokers'
Brains) and the SmokersClubInc. Newsletter issued a press release and
published the outline and results of a study (1) that should have
made media headlines around the world while bringing the juggernaut
of smoking bans, if not to a crashing halt, at least to a stumble.

Using a database of fully verifiable public data and covering a
subject base literally 1,000 times as large as that covered by a
previous and heavily publicized study in Helena, Montana (2), the new
study showed clearly that claims -- ostensibly bolstered by that
Helena study -- of drastic and instant reductions in heart attacks
upon the implementation of smoking bans simply do not occur in larger
populations. Such a result should have rocked both the media and
medical worlds. Thousands of news stories, expert statements, and
legislative testimonies based upon the Helena results had resulted in
profound lifestyle and economic impacts upon the lives of tens of
millions of people and had now been found to be in grievous error.

Instead, the study's announcement was greeted with virtual media

A Journal Uninterested in Correcting the Record

Then we realized that a "medical study" not critical of smoking, even
one carefully done and based upon open and sound data and analysis,
would simply not be considered newsworthy unless it was endorsed by
prominent medical and antismoking organizations or presented in the
pages of an authoritative peer-reviewed medical journal.

It was at that point that Mr. Kuneman and I set out to formalize our
findings for proper submission to the British Medical Journal, the
home of the "Great Helena Heart Miracle" study. We were confident
that our research would be considered dispassionately and that the
journal that had served as a worldwide podium for the earlier limited
and misleading study would support the publication of a corrective

We were sorely disappointed. We submitted our study on April 22nd and
received a rejection without the possibility of a rewrite or
resubmission almost eleven weeks later on July 6th. An "appeal" of
the rejection consisted of a review by a single editor who concurred
with the initial rejection.

The primary reason given for the rejection was this: "Our main
problem with the paper was that we did not think it added enough, for
general readers, to what is already known about smoking and health."
This statement was made despite the fact that a Google search on
Helena smoking study produces over 400,000 hits and despite the fact
that our results were clearly and diametrically opposed to the
results of that study.

The rejection went on to note that the Helena study had "been pretty
roundly criticised already" and then amazingly suggested that we
simply post our study as a Rapid Response. If we had been truly
naive, we might actually have believed that such a posting would
carry as much weight in the medical and political world as a fully
published peer-reviewed study.

The Helena Notion Spreads, Largely Unopposed

We politely declined and resubmitted our study to the journal
Circulation in December of 2006. We chose Circulation, since it had
just published a study similar to Helena's but based in Pueblo, CO.

Oddly, the Pueblo authors emulated Helena's in refusing to provide a
separate analysis of heart attacks in nonsmokers. As with Helena,
this lack left the authors, media, and antismoking organizations free
to infer that not only did the smoking ban "cause" a decline in heart
attacks among smokers but that it also "caused" a reduction among
nonsmokers. This research decision seemed particularly odd, since the
Pueblo authors had conferred with their Helena counterparts and had
to be quite aware that this deficiency in Helena had been strongly
criticized in the BMJ's Rapid Responses. Such neglect seemed
deliberately designed to create a "desirable" political impression
that would simply not be supported by the scientific data.

In the face of such a seemingly egregious breach of research ethics,
Dave and I believed that Circulation might be more concerned about
setting the record straight than the BMJ had been.

We were wrong. Although this time our paper was dealt with in a
timely manner, it was again rejected without a possibility for
improvement or resubmission, and in this instance we were not even
offered the full comments made by our lone and unidentified peer-
reviewer but merely an edited summary.

Nonetheless we forged forward, once again re-examining our paper in
light of that summary, and submitted it to a journal we thought might
feel a particular sense of responsibility in this area: Tobacco
Control. Tobacco Control is a journal formally committed to a fully
open review process and, as in the case for our previous submissions,
we were asked for and offered a list of qualified "recommended

We were again rebuffed without the possibility of resubmission. And
while Tobacco Control provided the verbatim reviews of our paper,
their "open review process" broke down completely as far as
identifying even a single one of the three reviewers: none of the
three were willing to sign their name to their work. Without such
identification, there is of course no way of really knowing, but the
overall tone of the reviews was such that it is highly unlikely that
any of them came from our recommended list. Indeed, they seemed more
like reviews written by those we had noted as specifically not
suitable, as they contained many points that were quite negative but
seemingly groundless or irrelevant.

Bans Based on a Palatable Misconception?

We believe our study is both scientifically sound and quite important
to both the medical research community and to the wider public
community that such research affects. While we are continuing to
submit our work to other medical journals, such a process simply does
not address the political need for the information to be made
available to the public in a timely manner. This is a time in which
far-reaching political decisions are being made based upon the
imperfect -- perhaps deliberately imperfect -- data and
interpretation of the previously published studies.

Even as we were considering our next best step after Tobacco
Control's rejection, a third "copycat" study resembling the original
Helena study found publication in Preventive Medicine (4). This
study, based in Bowling Green, Kentucky, blithely repeated the
imperfections of the previous two and is also being used to bolster
political support for smoking bans, based upon an urgent need to
protect nonsmokers from heart attacks caused by secondary tobacco
smoke. It was the publication of this study that prompted the current

Medical journals have come under criticism in recent years for being
influenced by large pharmaceutical corporations, putatively
publishing research that favors expensive and profitable drug
interventions while selectively suppressing contrary research. While
we have not researched that question, our experience with having
valid but "politically undesirable" research rejected by three
journals (which should have felt a particular sense of responsibility
to publish it) makes accusations of politicized publishing decisions
at journals seem more plausible to us than it once did.

How much more research might be out there, unfunded, unpublished, or
simply unrecognized, that goes against the body of accepted thought
regarding the supposed "deadly threat" of exposure to secondary smoke
and benefits of smoking bans?

The answers to these questions may never be known, but for the sake
of the integrity of science, as well as to repair the damage that
politicized science can do to people's lives, the questions need to
be addressed. As a start, the Kuneman/McFadden study needs to be
given recognition and prominence comparable to smaller and
contradictory studies, and the criticisms of the failings of those
studies need to be revisited by researchers, journals, and the media.

Science should never be distorted to fit political goals. Physicians,
the public, and society depend upon the integrity of medical
journalism to fairly present scientific facts, regardless of their
political desirability, in order to reach the best decisions about
our lives and our world. Science bent to the service of politics is
no longer science.

Statement of competing interests:

Michael J. McFadden (Cantiloper[at]; is the author of the book Dissecting
Antismokers' Brains.

David W. Kuneman (sharz28hus[at]; is a retired pharmaceutical chemist
who worked for several years in the 1980s as an analytical chemist
for 7-Up at a time when that company was owned by Philip Morris.

Both authors smoke and both are quite active, completely without
compensation of any kind, with various smokers' rights and free-
choice groups.


(1) Kuneman DW, McFadden MJ. "Do smoking bans cause a 27 to 40% drop
in admissions for myocardial infarction in hospitals?"

(2) Sargent, R et al. "Reduced incidence of admissions for myocardial
infarction associated with public smoking ban: before and after
study." BMJ 2004;0:bmj.38055.715683.55v1

(3) Bartecchi, C et al. "Reduction in the Incidence of Acute
Myocardial Infarction Associated With a Citywide Smoking Ordinance."
Circulation. 2006;114:1490-1496.

(4) Khuder, SA et al. "The impact of a smoking ban on hospital
admissions for coronary heart disease." Preventive Medicine, April
4th, 2007.






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You're right, Starling. But they'll never believe it. They'll ignore it. The Montana "study" was done after less than a year of evidence and showed an infinitesimally low, and statistically ambiguous, number of reductions of heart attacks and other cardiovascular deaths, all of which the Anti's attributed to the implementation of the Helena smoking ban. B**S***! Yet it is still trotted out as proof positive of the great effects of banning smoking.

This is a propaganda war, Starling. And we have already lost it. You're tilting at windmills at this point.

In an incendiary report Tuesday to the House Committee on Oversight and Government Reform, former Surgeon General Richard H. Carmona (who served from 2002 to 2006) pointed a finger at the Bush administration for prioritizing politics over truth.

Carmona contends that he was dissuaded by White House officials from speaking about stem cells, emergency contraception, sex education, or prison and mental and global health issues. He also describes the efforts of top administration officials to manipulate a notable report on secondhand smoke.


NASA scientist rips Bush on global warming
Renowned expert says data 'screened and controlled'

IOWA CITY, Iowa - The Bush administration is trying to stifle scientific evidence of the dangers of global warming in an effort to keep the public uninformed, a NASA scientist said Tuesday night.

took a long time to get overturned, too, Pete.



"They keep talking about drafting a constitution for Iraq.Why don't we give them ours? It was written by a lot of really smart guys, and we're not using it any more".


'I used to have compassion, but they taxed it and legislated it out of existence.'

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