Tobacco Kontrol

Would a scientific article published in an international academic journal contain a crucial reference to a study that does not exist? Yes, if the journal is Tobacco Control and if the study referred to is by Rob Cunningham, a policy analyst with the Canadian Cancer Society (CCS).

The Winter 2001 issue of Tobacco Control featured an article entitled "Comprehensive tobacco control policies and the smoking behaviour of Canadian adults." The four co-authors are Thomas Stephens of the Ontario Tobacco Research Unit, Linda L. Pederson of the American Center for Disease Control, John J. Koval and Jennifer Macnab of the University of Western Ontario. Their econometric analysis of Canadian data suggests that tobacco control measures are effective at reducing smoking. The six-page article contains no less than 70 footnote references. Some statements are footnoted by many references — ten lined-up references in one case. Holy Health! This looks like very serious stuff.

I was interested in one of the 36 bibliographical references, the one that purported to contain data on tobacco control expenditures in Canada. The citation says, "Cunningham R. Evaluation of federal and provincial legislation to control tobacco, 1994. Ottawa: Canadian Cancer Society, 1995."

The problem is that the Cunningham paper does not exist, or at least cannot be found. No reference to this paper appears on the web, in university library catalogues, or in standard bibliographical databases. Repeated attempts to obtain a copy from the author and from the alleged publisher, the Canadian Cancer Society (first contacted on May 13, 2002), have been unsuccessful. One single page, numbered 31, was eventually sent anonymously from CCS's address. This page is entitled "Federal and Provincial Tobacco Control Budgets 1994-95 Fiscal Year," with the by-line "Rob Cunningham, March 21, 1995." This single page of scantily explained and unreliable data appears to be everything there is.

The Canadian Cancer Society later denied that it had published the Cunningham paper. In an e-mail message of June 15, Ms. Julie White, president of CCS, wrote: "Rob Cunningham currently works for us in the area of tobacco control. The paper you refer to was written by him, but not in relation to his employment with us. This paper has nothing to do with us, and because it is copyrighted by Rob, we do not have any control or influence over its distribution."

Standard academic practice is for authors to make their data and sources available to other researchers, whether or not they share the same viewpoints. Indeed, the essence of academic debates is to find the truth among contending claims. Since Mr. Cunningham appears not to be part of the civilized academic world, I decided to write directly to the authors of the Tobacco Control article, which cites his alleged paper.

The e-mail address of Dr. Stephens, the lead author of the Tobacco Control article, appears in the journal but is incorrect. I obtained from Tobacco Control the address of Dr. Linda Pederson, one of the co-authors, and asked if she could provide me with a copy of the elusive Cunningham article. On June 12, she replied, "I have forwarded your email to Dr. Stephens. I am certain that he will respond to you. I don't have the article that you refer to, but I am sure that Dr. Stephens does. It may be that is was something that was personal correspondence. Please let me know if you do not hear from Dr. Stephens by next week and I will see if I can find him for you." Dr. Stephens never wrote, and Dr. Pederson has not replied to my follow-up e-mail messages.

If the Cunningham paper exists and contains crucial data on tobacco control expenditures in Canada as it is supposed to, why is everybody hiding it? I decided to share my concerns with the editor of Tobacco Control, Professor Simon Chapman of the University of Sydney (Australia), an anti-smoking activist. On July 7, he replied: "Dear Prof Lemieux, My mail is that you are an industry stooge and spend your time doing whatever you can to undermine tobacco control. I imagine that in these circumstances, Mr Cunningham feels you are not worth the price of a postage stamp."

If the Cunningham article exists and is worth a postage stamp, I thought, Health Canada (the federal Department of Health) must have a copy. Moreover, since Cunningham must have obtained his federal expenditure data from Health Canada, the latter must have some records on the underlying research. On July 3, I filed a freedom of information request for "[1] All records related to a paper by a [Mr.] Rob Cunningham that would be approximately entitled 'Evaluation of federal and provincial legislation to control tobacco, 1994', and which would give data on tobacco control expenditures in Canada. [2] All records related to the research for this paper."

On July 22 and 24, Mr. Hank Schriel, Director of the Access to Information and Privacy Division at Health Canada, replied: "We do not have a copy of anything like that in our reference collection," and "we do not have a copy of this paper (and no, we did not provide him with any information for the paper either)."

Summing up, there is no Cunningham paper on anti-tobacco expenditures published by the Canadian Cancer Society, notwithstanding the citation in Tobacco Control. In fact, the alleged Cunningham paper is untraceable. Therefore, its methodology and estimates cannot be evaluated. The results of the Tobacco Control article that depend on Cunningham's data cannot be reproduced, and are thus worthless. There is something rotten in the state of tobacco control.

This is not new. In a 1974 official booklet entitled A New Perspective on the Health of Canadians: A Working Document, Canadian minister of Health Marc Lalonde wrote: "The spirit of inquiry and skepticism, and particularly the Scientific Method, so essential to research, are, however, a problem in health promotion. The reason for this fact is that science is full of 'ifs', 'buts' and 'maybes' while messages designed to influence the public must be loud, clear and unequivocal." "But," the author adds, "many of Canada's health problems are sufficiently pressing that action has to be taken on them even if all the scientific evidence is not in. [...] The scientific 'yes, but' is essential to research but for modifying the behaviour of the population it sometimes produces the 'uncertain sound' that is all the excuse needed by many to cultivate and tolerate an environment and lifestyle that is hazardous to health."

Now, I will confess my mortal sin: I became interested in the Cunningham article in the course of a research project sponsored by pariahs from the tobacco industry. But, contrary to the health fascists, I was looking only for the truth about tobacco control expenditures, with no a priori conclusion, no hidden agenda, and no secret evidence.

How "tobacco control," i.e., the overt goal of controlling smokers and their suppliers, can have become a field of academic research is a question that says much about the politically correct spirit of our times. How a non-existent piece of research from a Canadian anti-smoking activist can be cited in, and provide raw data for, an article purporting to be scientific says a lot about the academic standards of the anti-smoking crusaders.

Pierre Lemieux is co-director of the Economics and Liberty Research Group at the Université du Québec en Outaouais, and a Research Fellow at the Independent Institute (California). E-mail: PL@pierrelemieux.org.