Tobacco & Nicotine (T&N) vs Physics and other

Roberto A Sussman, Institute of Nuclear Sciences, National University of Mexico

Credentials we trust

Scientists in one discipline tend to trust scientists in other disciplines. They assume that their credentials are equivalent to their own. This is reinforced by the external similarities (trappings and markings). It is also unavoidable. Ideally, the output from a certain discipline could be reviewed collectively by scientists in general, as it happened historically (XIX and early XX centuries). Visualize historical Academies of Sciences, Royal Societies, were a new development in medicine or biology was collectively presented and discussed by chemists, physicists, engineers, etc.. However, scientific activity has become so extensive since the mid XX century that this form of evaluation is no longer possible, thus collective evaluation is conducted internally within the disciplines, or even within clusters of closely related scientists in universities, with external scientists trusting these evaluators (and expected to be trusted by them).

Because of this common trust it is so hard for me (as an external scientist) to challenge T&N science (as a subset of science) as an outsider. When I bring up criticism of T&N science to my colleagues in Physics, they become immediately suspicious because they regard T&N scientists (with whom they share trappings and markings) as bona fide scientists that are mirror images of themselves. My criticism seems to them either resentment or envy, or a tantrum for being a smoker/vaper or being paid by e-cig vendors or the tobacco industry.

Dissent & disruption, “inside” and “outside”

How does scientific dissent and disruption within one science is seen by other scientists given the trust among credentialized scientists?

Many disciplines face external and internal dissent and disruption. In my own field, Cosmology, all sorts of non-credentialized crackpots (and a few with credentials) from “outside” academia claim that Physics “inside” is all wrong, but they have the clue and “know better”, explaining their rejection by us “insiders” as a corrupt arrangement between us “fake experts” to hide the truth that they “externals” are willing to reveal. This external disruption is kept “outside” and is easy to identify and ignore.. Therefore, the perception that the science is “inside” and is “outside” is shared not only by other scientists, but by intellectuals and educated sectors, the political class and even by most of the general public.

Internal credentialized disruption from “inside” is a different matter in physics. A successful disruption of an established paradigm is a worthy and reputable task, but it is a very difficult matter. It is met by a mixture of resistance (even ridicule) and welcoming curiosity, but it is in general subjected to very harsh demands of consistency and fitting of facts. It can (and has) lead some times to a breakthrough for new physics, but (more often) ends in failure but very seldom in academic disgrace or in the end of a career.

Let’s see the case of T&N science before the vaping disruption around 2010. Scrutiny was purely an internal matter of credentialized scientists, as in other sciences. Because of the common trust of credentials, outside scientists trusted the internal scrutiny of T&N established scientists. From the generalized acceptance that “science is inside and pseudoscience outside”, T&N science was able to convince other scientists and wide sectors of the public that “outside” criticism of core issues was either pseudoscience or interference from industry, whose science cannot be trusted because it is compromised by its vested commercial interests.

The issue of “conflicts of interest” plays a major role in the narrative of T&N science, while it is practically non-existent in Physics. This is related to the unique scientific development: of T&N science: the impressive advance of medical science discovering the associations between smoking and disease between 1960 and the mid 1990’s (itself a disruption of established knowledge), a development with large social impact and opposed by the powerful tobacco industry. The perception of these relatively recent historical developments (less than 50 years ago) has facilitated the narrative that “we are right”, so that criticism is pseudoscience or reaction defending vested interests by the industry. Other scientists and the general public have accepted this narrative.

Peculiarities of T&N science

While oral tobacco existed during these developments and there were MD’s recognizing its potential to reduce harms, it met with undeserved resistance, partly explained by failed (and deceptive) efforts by the industry to market safer “low tar” or filter cigarettes. The deception from these efforts excessively conditioned T&N scientists to be unreasonably suspicious of any claim of reduced harm.

Given the profound social and financial implications of outcomes of T&N science in the XX century, it evolved in the 1990’s from a scientific discipline like others (as part of medical science) into a whole political powerful movement in the USA, acting as a special interest lobby, aiming at specific regulatory goals to be expanded globally. Dissent and disruption cannot operate within a political movement of this type as it does in other sciences. They are not perceived as creative or innovative, but as distractions and retreats (like refusals or major dissent in implementing grand gubernamental schemes, like the New Deal). Given the reputation of previous medical on smoking, science becomes essential for this political movement, but only to strengthen and secure the goals on regulatory policies.

Clarification: the fact that T&N science became subservient to regulatory politics does not imply that all scientific inputs are technically mistaken or inconsistent with facts. However, its politization paved the way to a large number of publications that are technically flawed (some times fatally flawed) but lend credentialized support to the political goals (like Marxist within the Soviet Union).

The vaping disruption

Vaping was a genuine unpredictable disruption to T&N science. It came from consumers and small industries, not from health , nor the tobacco or pharmaceutic industries. As opposed to non-credentialized criticism from “outside”, it gradually gave rise to credentialized dissidence from “inside” T&N science. This created an opposing majority orthodoxy, specially but not only in the USA, but also a dissidence (specially but not only in the UK) that received between 2013 and 2018 a lot of attention, with key institutions like the Royal College of Physicians, the NASEM, the Cochrane Review generating large reviews and reports incorporating the facts and the arguments of the disruptive proposals. However, as expected, this provoked a reaction by the orthodoxy.

The fact that the THR disruption was carried “inside” had the potential to earn the trust of external scientists who are more used to dissent and disruption in their own disciplines. It also had the potential to attract the attention of the full health establishment and the political class, as it happened in the UK.

Seen from the point of view of a physicist, this is natural. The T&N scientists who embraced vaping as a harm reduction tool reacted as physicists and scientists in other disciplines would react when a disruption appears to be supported by hard experimental facts, even admitting uncertainties, Disruptions are usually met with a mixture of suspicion and rejection (initially justified given the novelty) and curiosity and fascination for finding a breakthrough.

If T&N research had not become the political lobby with the markings of a scientific activity, as it was in 2010, the THR disruption would have prevailed without so much opposition by an orthodoxy, as was supported “inside” and had the potential to advance the original goal of justifying with hard facts (and more efficiently) an anti-smoking policy that early T&N research sought to influence before becoming a political movement. In a sense, vaping became the victim of its own success. Had the e-cigarette resulted a faulty impopular or harmful product, it would have been easily discredited (as low tar cigarettes). But its success threatened the modus operandi and even the identity and sense of achievement of a global political movement employing hundreds of thousands of professionals worldwide and receiving large amounts of public and private funds.

How science operates

It is important to examine how science operates to understand the power of a political movement disguised as scientific community, as orthodox T&N science. Science is a corporative activity (institutions, jobs, contracts, salaries, pensions), it involves hierarchies (from full tenured professors to students), it requires and receives funds to operate (experiments, instruments, labs, assistants, congresses). Funds are allocated by government agencies or industry (the tobacco industry is a no-go for T&N science). There is always politics in all science, thus an academic bureaucracy determines the flow of funds to specific projects and subjects. In Physics technical merit plays the most important role in this allocation, but there are also subjective elements (a fashionable problem, powerful scientists) and hierarchical preferences (top universities or labs). In my field, Cosmology, research on gravitational waves and observations is favored over theoretical research, but the latter is also funded.

Besides funding, jobs and job security are other important features of scientific activity that determine the flow direction of scientific output. Doctoral students and postdocs have no security, they are essentially slave labour. Junior, non-tenured or tenured track staff have more stability but are still vulnerable, while tenured staff with job stability are the ones receiving grants for projects, as well as the ones deciding the promotion of junior colleagues. All of them are conditioned by the agencies providing funds, which are in full tune with university bureaucracies. A postdoc knows that carrying diligently the tasks assigned by the head of the project will earn a good recommendation for the next postdoc or possible a stable position in academia or industry. Junior staff knows that promotions and tenure will unlikely come if they become open dissidents against the research direction of their projects. This means that disruptions and dissent tend to come from senior staff, even if the latter also tend to be more cautious and conservative.

These features around jobs and hierarchies also exist in T&N science, but in this case the political need to produce outcomes that advance a regulation policy is much more overbearing, even to the point that technical competence or consistency can be sacrificed.

In the ultra-politicized T&N science funds (for example by the NIH or the FDA) are allocated only to projects that advance the agreed agreed regulatory policy. This goes in parallel with reputation and promotion.

Asymmetry between orthodox T&N science vs THR scientists

The conflict between orthodoxy and dissidence in T&N science is not symmetric. The appropriation of funding mechanisms, as well as the political leverage through non- scientific actors in tobacco control, provides an uneven level field that favors orthodoxy and is an almost unsurmountable obstacle for dissidents from “inside”.

This uneven field can be appreciated in the composition of the literature on vaping and THR. Since technical merit is secondary to policy advancement, there is a huge incentive in T&N orthodoxy to easily publish low quality studies that pass the peer review process (referees belong to the same base of “inside” researchers as authors), giving rise to a large flow of studies, often including many clones, that highlight harmful effects of THR products, as dictated by the needs of the orthodox reaction to the disruption. Dissidents from “inside”, specially (but not only) in the UK where THR through vaping became official policy, have also generated a smaller flow of literature. Both bodies of literature can be cited by anyone wishing to support or oppose THR. However, attitudes are also not symmetric: pro-THR scientists do cite and recognize opposing views, while articles by the orthodoxy tend to either ignore or misrepresent THR. Unfortunately, both rival groups have become locked in their own echo chambers, but it is the orthodoxy (which is majority and wields political power) which most contributes to this state of affairs.

This phenomenon also occurs in physics, for example in off equilibrium thermodynamics there are several schools proposing different interpretations for dissipative phenomena and thermodynamic variables (especially entropy). However, research from all schools is regarded as legitimate and is published, all researchers agree on basic core principles of physics and thermodynamics, restricting the conflict to specific phenomena. Researchers from different schools welcome the debate as an essential exercise of intellectual esgrima in large international congresses attended by all schools of thought. Authors of one school might fear the referee could reject their paper because of his/her belonging to the opposite school, but they know there is a high probability that the next referee will not act in this way. Conflicts are seldom totemic or existential and very infrequently lead to deep personal enmities. Also, there is no external evil interest (like “industry” in T&N research) that can be used to discredit opponents. This type of conflicts between schools of thought are well known, they are often seen as a destructive creativity that in the end can serve as incentive to new ideas and new physics.

As a contrast, orthodox T&N science is continuously fighting a totemic existential intellectual crusade in which any concession beyond minor issues can bring unspeakable consequences to world health (and favor the industry). Most orthodox T&N scientists refuse to attend events organized by THR platforms or colleagues, refuse debate and engagement, often refusing (in the most extreme cases) all communication with pro-THR dissidents. Among the most extreme, THR is completely illegitimate and destructive, or a marketing plan by the industry, and thus they try to discredit minimally pro-THR scientists as having a conflict of interest with the industry that is defined to extensive limits bordering on the ridicule.

Evidently, regardless of similarity of external features, the way orthodox T&N science works is closer to dogmatic political sects or movements than to other scientific communities. This form of forceful dogmatism seems to be overwhelming, but it is also a sign of rigidity and weakness. There is a Spanish saying that goes “it is enough to pierce a small hole in a can of sardines to get the whole of it to rot”. Perhaps the extreme dogmatism of orthodox T&N science comes from the fear that even piercing a small hole in their core beliefs through a concessions to THR might trigger their own implosion.