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What a week that was.

“VAPING STROKE RISK E-cigarette users may be at higher risk of a life-threatening stroke than smokers, study finds” on The Sun, 23rd February 2017

First, we had UK Tabloids screaming that e-cigarettes could increase the risk of stroke more than that of cigarette smoking. Never mind the fact that this defies common sense. The Sun and the Mirror ran with this story. The article in the Mirror stated: “The vapours also caused damage to a chemical vital for clotting, making a devastating brain haemorrhage more likely… As far as brain health goes, scientists warned the electronic devices was not safer than smoking and may pose a similar, if not bigger, risk for stroke severity.” I have highlighted the grammatical error because the interpretation of, ‘accuracy in journalism’ seems to be limited to technical writing errors [please learn the difference between breath and breathe] and the writer could not even get that right… but it is worse, far, far worse than just silly technical mistakes.

This story breaches the first rule of journalism.

This rule sometimes reads:

Journalists cannot always guarantee ‘truth’, but getting the facts right is the cardinal principle of journalism. We should always strive for accuracy, give all the relevant facts we have and ensure that they have been checked. When we cannot corroborate information, we should say so.

What the journalist did with this story was just copy down, almost verbatim, material supplied in a press release. So, let us look at the Mirror’s story in the light of the rules of good journalism. There are three aspects to the first rule.

“Journalists cannot always guarantee ‘truth’, but getting the facts right is the cardinal principle of journalism.” The cardinal rule no less! How much effort did the Mirror make to ensure they had got the facts right? Well, it seems to me that they read the press release… and… they read the press release, and promptly copied it down – Phew! The effort!

The next two sentences which make up the first rule are the ‘how’ to establish the facts and the procedure that should be followed when the information cannot be corroborated. “We should always strive for accuracy, give all the relevant facts we have and ensure that they have been checked. When we cannot corroborate information, we should say so.

So, did the Mirror check the facts? It would appear not.

The very first step the journalist should have taken was to find the study itself. It took me ages but the man at the Mirror only needed to pick up the phone and ask the American Heart Association for a link. Here is the abstract – sorry, a copy of the oral abstract.

Now, I am not a journalist, nor am I a scientist, but looking at the details given questions should have been raised, surely.

For example, did the journalist spot… silly me! Of course, he didn’t! He had not even bothered to find the abstract. But if he had he is bound to have noticed that there is not a single mention of cigarette smoke being measured during the project. Indeed, the only substance analysed was nicotine.

Now had he attempted to corroborate what he had been ‘instructed’ to include in his news report, and had he started to ask questions about what he had been told, he might have Googled, “Nicotine / stroke.” Having done this, on scrolling down the results, he would have noticed that a very large number of the entries involved nicotine and smoking – now this is all fine, however, our eagle-eyed sleuth might also have identified one or two items questioning whether nicotine replacement therapy (NRT) is associated with an increased risk of stroke. Ok! Google again! “Nicotine replacement therapy / stroke.” [Linked to save on typing – just in case you are a lazy journalist].

Something VERY interesting happens when one does this: 337,000 results, many saying the same thing show up: “The use of NRT is not associated with any increase in the risk of myocardial infarction, stroke, or death.

So, the intrepid investigator comes up against what appears to be a paradox. However, he does not have to boldly go where no man, sorry, no one has gone before. Dr Konstantinos Farsalinos has done the hard work. HERE. He says:

An observational study of more than 33,000 smokers found no evidence of increased risk for myocardial infarction or acute stroke after NRT subscription, although follow up was only 56 days [Hubbard et al. 2005]. Up to 5 years of nicotine gum use in the Lung Health Study was unrelated to cardiovascular diseases or other serious side effects [Murray et al. 1996]. A meta-analysis of 35 clinical trials found no evidence of cardiovascular or other life-threatening adverse effects caused by nicotine intake [Greenland et al. 1998]. Even in patients with established cardiovascular disease, nicotine use in the form of NRTs does not increase cardiovascular risk [Woolf et al. 2012; Benowitz and Gourlay, 1997]. It is anticipated that any product delivering nicotine without involving combustion, such as the EC, would confer a significantly lower risk compared with conventional cigarettes and to other nicotine containing combustible products.

So, there we have it. The studies reported in the Mirror and the Sun, and the conclusions drawn, are questionable in the extreme. They fly in the face of the findings of research which is based on human beings – the effect of nicotine on real people – Of Mice and Men right enough.

Our reporter at the Mirror drives a coach and horses through the middle of the first principle of good journalism – how does he fare with the other principles? Let’s see – the second principle reads: “Journalists must be independent voices; we should not act, formally or informally, on behalf of special interests whether political, corporate or cultural. We should declare to our editors – or the audience – any of our political affiliations, financial arrangements or other personal information that might constitute a conflict of interest.”

Oh dear! Oh dear! Oh dear!

‘Independent voices?’

The only independence demonstrated by the Mirror, ironically, as the title of the ‘newspaper’ would indicate, was to reflect the views of someone else.

Therefore, it is the ‘someone else’ we should look at here and, also, ask if the Mirror has been acting, formally or informally, on behalf of special interests, and I would include, deliberately or inadvertently?

Let us rule out the last point first. The journalist, as we have seen, has been, perhaps, too lazy, or perhaps too pressured, to do proper research, and not knowing how to, or has been instructed not to, do anything other than create a news report by copying from a press release. He would appear to be incapable of acting on behalf of a special interest group deliberately.

I would class the American Heart Association as both a special interest group and an agent for other special interest groups, the pharmaceutical and medical equipment industries. The Association itself has a special interest in being seen to be working against the smoking habit, while the Organisation’s existence depends, for a very large part, on a continuance of cigarette smoking. Following the links provided on the press release we come to a detailed list of monies received from the pharmaceutical and medical devices industries. Total income to the American Heart Association from just these sources for 2015 / 16: Yes, and this was 11 years ago, was $29,346,980 – not an inconsequential sum, I am sure you will agree.

The American heart Association and the above-mentioned sources of funding have a very special interest in the suffering and illness caused by smoking. I will leave you to work out what it is. I could say a great deal more about the forces and motivations which drive the anti-e-cigarette industry but suffice to say that the Mirror has breached, not just the first principle of good journalism, but the second one as well.

The third principle of good journalism reads: “ Most stories have at least two sides. While there is no obligation to present every side in every piece, stories should be balanced and add context. Objectivity is not always possible, and may not always be desirable (in the face for example of brutality or inhumanity), but impartial reporting builds trust and confidence.

Balanced? Impartial?

As I have pointed out, the simplest, most basic enquiry would have revealed another side to the story, and although the Sun did make a feeble attempt to create balance, the Mirror did absolutely nothing. This was nothing like an example of impartial reporting.

Third principle of good reporting: Fail.

Surely the Mirror got something right. Let us move on to the fourth principle of good reporting. It reads: “Journalists should do no harm. What we publish or broadcast may be hurtful, but we should be aware of the impact of our words and images on the lives of others.”

‘Journalists should do no harm.’

This story will do the ultimate in harm. It will result in the suffering and, perhaps, the premature death of any smokers who read the report [and others] and decide not to switch to e-cigarettes which are estimated, to be at least, a 95% safer alternative to cigarette smoking. So, the smokers continue to smoke and suffer the consequences because they have been deceived by the ramblings of a report which did not even take into account, or even to discover, the full picture. Now that is what I call harm.

Fourth principle: Absolute and total, utterly abject and miserable fail.

We now come to the fifth and last principle of good journalism. ” A sure sign of professionalism and responsible journalism is the ability to hold ourselves accountable. When we commit errors, we must correct them and our expressions of regret must be sincere not cynical. We listen to the concerns of our audience. We may not change what readers write or say but we will always provide remedies when we are unfair.

EJN supporters do not believe that we need to add new rules to regulate journalists and their work in addition to the responsibilities outlined above, but we do support the creation of a legal and social framework, that encourages journalists to respect and follow the established values of their craft.

In doing so, journalists and traditional media, will put themselves in a position to provide leadership about what constitutes ethical freedom of expression. What is good for journalism is also good for others who use the Internet or online media for public communications.”

All I will do here is copy out my response to the Mirror article – one which was censored out of the comment section. You can then match up my comment and judge for yourself if the Mirror is likely to live up to that last standard of journalism.

I wrote… “Referring to your paper [and others], Clive Bates had this to say: “British newspapers, the main domestic vector of the anti-scientific public health dogma and baseless fear-mongering, were yesterday filled with prominently positioned garbage articles about vaping…”

And, so the same continues with the story on stroke.

You are reporting on the acute effects of nicotine on mice. However, look what happens when you look at the LONG-TERM EFFECTS of nicotine on humans.

The full study is here… http://tobaccocontrol.bmj.com/content/14/6/416 [an irony that this is Tobacco Control] and it concludes…

Nicotine replacement therapy (NRT) is an effective treatment for smoking cessation. Concerns exist, arising from case reports and pharmacological data, that NRT may precipitate acute cardiovascular events. The results of this observational study of 33 247 first time users of NRT suggests that this treatment does not increase the risk of acute myocardial infarction or acute stroke, even in people with pre-existing cardiovascular disease.

Who do you believe, the people from Tobacco Control, or other people from Tobacco Control?

So here we have a story of mice and men. They are not the same and the evidence from mouse studies do warrant the kind of headlines which are suggested to you by organisations like the American Heart Association and which are reproduced slavishly, accompanied by startling, harmful and unjustifiable headlines.

And keep in mind the researchers did not even try to measure the effects of tobacco smoke.

 

  • Robert Innes

    American Heart Foundation should read American Heart Association.