Monthly Archives: November 2015

2015-11-30 Dr Roach’s P-D column: “Doctors should practice what they preach”

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Kenneth Roach, MD

Kenneth Roach, MD

The St. Louis Post-Dispatch publishes a medical advice column every weekday in the  comics section. Originally written by Dr. Donahue, it’s been taken over by Dr. Kenneth Roach of the Weill Cornell  Medical College. Today he responded to a letter reproduced below concerning hospital smoking.

It’s amazing that this is still a problem, but I also recall how surprisingly difficult it has been to get hospitals to address this seriously until the relatively recent past. As I’ve noted before, instead of being in the vanguard of the smoke-free air movement, they were really slow to respond.

I recall a visit to Barnes-Jewish Hospital in downtown St. Louis to ask them about permitted smoking in the entrance foyer and in the wards. I also queried how they could square offering tobacco products in their shop with their medical mission. The reply to this was that their volunteers raised significant amounts from tobacco sales, and they also didn’t want to force their patients to have to leave the hospital for their smoking needs.

Back in those days smoking was permitted on the oncology floor with cancer patients, with visitors being allowed to smoke too. I was told of instances when nurses would respond aggressively when a by nonsmoking patient would complain. What hell that must have been.


Vivian Dietemann (Photo captured from TV)

Asthmatic Vivian Dietemann, whose son Christopher also had asthma needing many medical visits for treatment, had serious difficulty with the smoking she encountered when visiting doctor’s offices and clinics. She ended up filing multiple complaints under the Americans with Disabilities Act to try to bring about institutional change, which prompted MoGASP to follow suit over Lambert Airport’s smoking, embarking on our longest-running campaign. Starting in 1993, it didn’t end until the successful approval of Proposition-N: “Indoor Clean Air Code,” on the November 3, 2009 St. Louis County ballot. Lambert Airport finally took out it’s smoking rooms before the smokefree air ordinance went into effect on Jan. 2, 2011. 

Health professionals: Practice what you preach

Dear Dr. Roach • I retired from a large hospital after smoking was prohibited in the building. At that time, doctors still smoked in their lounge, and other employees — nurses, technicians, etc. — smoked on the adjacent strip-mall property or in their personal vehicles. I imagine that the doctors no longer smoke in their lounge and are not seen in public view, but employees still smoke in public view. It’s obvious because most of the medical staff wear scrubs. — L.

Answer • Health care professionals can make bad decisions about their health, but I agree with your implication that they have an obligation not to do so while in the role of someone concerned for health.

I certainly have seen physicians in white coats smoking outside my own (previous) hospital, and routinely see other health professionals do so. It’s hypocrisy for us to then tell others not to smoke. So, to my colleagues in medicine: Please don’t smoke when you are recognizable as a health professional. It makes it harder to get people to quit.

“Merchants of Doubt” Part 2

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As I wrote in my previous blog, The 2014 movie “Merchants of Doubt” & how tobacco deniers led the pack, this is a must-see movie, showing in an entertaining yet gripping way how the tactics originally used by the tobacco industry were subsequently successfully adopted by other deceitful industries, most recently climate change deniers.

Below is the movie trailer, kindly provided by Melissa Robledo, Robert Kenner Films, after a request to Dr. Stan Glantz, and from which the still images in the previous blog were captured.

In response to a TV host’s claim that his smoking harms no one at work, below is Stan Glantz’s memorable (bleeped) scientific rejoinder:

Glantz_No, that’s bullsh-t_5087

“No, that’s bullsh-t!”

Merchants of Doubt_5031Weaving a gifted performer of card tricks into this movie was a stroke of genius.
Jay Ian Swiss earns money legitimately by demonstrating to his audience something they know is fake but cannot fathom out how.

Contrast that to the successful tobacco industry, who knew their product was both highly addictive and killing hundreds of thousands of Americans, yet denying it strenuously and successfully for decades in order to continue profiting from it.

Subsequently other industries causing harm and facing critics recognized that they could learn from Big Tobacco, employing deniers to bamboozle the public.

Below are screen shots with audio transcript captured from the opening part of the movie, starting with an animated King of Diamonds in the movie’s credits:

King of diamonds sm_5029First the King of Diamonds is smoke-free …..

King of diamonds smoking_5030….. and then he’s not!

Jamy Ian Swiss_5046

Jay Ian Swiss, Magician:

     My expertise is in deception. The thing that sets magicians apart from con men and other kinds of thieves and liars is that we’re honest liars. It’s the moral contract.

Swiss is introduced to an intimate audience and while he’s shown performing he continues:

“I’m saying, I’m gonna fool you but it’s OK, right, that’s my job. But I’m gonna bring you back whence you began in a not severely altered condition.”

After being shown performing some amazing sleight-of-hand card tricks Swiss concludes:

“I make an honest living, right?
Therefore, it offends me when someone takes the skills of my honest living, if you will, and uses it to twist and distort and manipulate people and their sense of reality in how the world works.
I know how to fool people, and I know how to recognize when people are being fooled.”

Steve Milloy JunkScience.com_5052Short clip of Steve Milloy, who maintains a website which evidently focuses on attacking and seeking to undermine good science, being interviewed and stating:

“Dioxin, pesticides, chemicals in general: there’s no evidence that these are harming us.”

2014 movie “Merchants of Doubt” & how tobacco deniers led the pack

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I recently viewed this 2014 movie, rented from Netflix, called “Merchants of Doubt,” after it received highly rated reviews. It deserves those plaudits. In both an informative and entertaining way, it presents the facts about the deception practiced by polluting industries, leading with the tobacco industry which laid the groundwork for methods used by others, including more recently climate change deniers. It compares it with the deception practiced by a card trick performer, the only difference being that the latter is honest about his deception.

A two minute trailer is on-line at ‘Merchants of Doubt’ Trailer (2015)2:01’Merchants of Doubt’ Trailer (2015), but neither that nor this blog, nor “Merchants of Doubt” Part 2 which follows, really do justice to this movie.

After an introduction by an expert demonstrating a card trick, the movie begins by describing the tobacco industry’s deliberate tactic of creating doubt about the dangers of secondhand smoke (SHS), and how that was finally countered by science, helped by highly secret and damaging industry documents leaked anonymously to Dr. Stan Glantz at the University of California, Berkeley.

Glantz describes how he’s initially treated as a virtual pariah, with clips from one TV show in which he participates and is confronted both by a belligerent smoking host, and someone denying the dangers of secondhand smoke, whom he confronts head-on with study after study.

Here are screen shots from this segment of the movie together with a transcript. The host starts off by saying:
“What in the world is so wrong about smoking in the workplace. I mean, I smoke in my job every night and I’m not hurting anyone.”

Stan Glantz (SG) replies“That’s bullsh*t!” getting bleeped while arousing a strong audience reaction.

Glantz present_5018
Cut to SG being interviewed for the documentary:
“One thing you’ve got to be willing to do when you’re doing science that is not in the interests of these giant corporations: when people come after you for baloney reasons you’ve got to be willing to stand up to them.”

Secondhand smoke hazard denier (Denier):
Glantz opponent_5001
“I don’t know of any evidence, any CONCLUSIVE evidence …”

Glantz opponent raising hand_5019
Stan Glantz (SG), offering him the first EPA report on SHS:
Denier: “That, that …”
SG: “You can read this.”

Glantz dumps more reports on his lap and Denier reacts angrily, raising his voice:
Glantz opponent_5002

As Glantz plonks another study on his lap, the opponent holds up his hand:

Glantz opponent objecting 4th study_5020

Glantz opponent flinging studies_5005
Denier, exasperated, flings studies over his shoulder, to roars from the audience.

Back to Glantz, again being interviewed for the documentary:
“We spent a long time banging our heads up against the wall because these guys are rich, they’re politically powerful, and they’re mean.”

Host aggressively confronts a seated Glantz:
Host interrogating Glantz_5009
“How old are you?”
“I’m 42.”

Host 4 packs a day_5017
Host, emphasizing by holding up four fingers:

Host pointing finger_5013
“I am FIFTY FIVE.”(Audience erupts).
“Wait a second, wait a second.”

Host pointing at Glantz_5014

(View of Glantz with tousled hair leaning back in his chair.)

Glantz commentary: “But when you went to policy makers or media to talk about how dishonest and manipulative they were, people would kind of think you were a little paranoid delusional.”