Tag Archives: pediatrics

Time to change the diapers on Pediatrics Journal

Pediatrics cries wolf so often that it would be difficult to identify any real threats to child health within those pages. Not only do they construct visions of disaster out of little more than phone polls (that third hand smoke lunacy), generalize from ambiguous results (as will be elaborated on here) or just plain mislead (as in child poisonings from new nicotine products), this journal, as we have opined before, gives The Onion a good run for the money. For instance, where else would anyone take seriously the idea that paternal smoking around pregnant women could lead to subsequent obesity in the to-be-born children?

Just paging through the last couple of issues I found this article on the effect of breastfeeding on later academic achievement with the conclusions in the abstract as:

Predominant breastfeeding for 6 months or longer was positively associated with academic achievement in children at 10 years of age. However, the effectiveness of breastfeeding differed according to gender; the benefits were only evident for boys.

Notice that the result is just as much one of “predominant breastfeeding is not positively associated with academic achievement in girls”. I do not have access to the whole article so for all I know it actually negatively impacts females however the point is that a specific conclusion is being generalized without reason. It might be an interesting question as to why boys and not girls and the conclusion should have mentioned that.

But to the matter at hand, the latest movies cause smoking “evidence”. And let’s just state those conclusions right up front:

These findings imply that, beyond direct influences, the relationship between adolescents’ sensation seeking and parental R-rated movie restrictions in explaining smoking onset is bidirectional in nature. Finally, these findings highlight the relevance of motivating and supporting parents in limiting access to R-rated movies.

Note the word “bidirectional”. The definition for that is “moving or operating in two usually opposite directions” Not really the sort of thing you would want to encourage when suggesting behaviors. So what the conclusion actually is saying is that “we don’t know what causes what, we think they might both cause each other, but we have no problem using this to give advice”. But let’s delve just a little deeper into this intriguing study. And I quote:

We found that adolescents with lower levels of sensation seeking and those who reported R-rated movie restrictions were at lower risk for trying smoking. The results also revealed negative associations between adolescents’ levels of sensation seeking and later R-rated movie restrictions, which indicates that sensation-seeking adolescents are at higher risk for starting to smoke not only directly but also indirectly through changes in parenting. Sensation-seeking adolescents seem to influence their parents to become more indulgent regarding their movie viewing, which subsequently is related to higher risks for smoking.

Now, forgive me if I am wrong but I do see this being reprinted in the Journal of Results So Obvious That Only a Fool Needing to Pad the CV Would Submit It. And the results are: kids who are curious about things are more likely to act on that curiosity than kids who are not, and they are also more likely to pester their parents, and those parents are more likely to give in than parents who had never been pestered. (If following form, the next Pediatrics article about smoking precursors should encourage parents to administer growth inhibitors since aging is probably the single greatest determiner for later smoking).

But now, and I do apologize for going on and on about this, Pediatrics has turned its attention to caffeine consumption in youth. (I know, yes, these articles do not share the same authors but they do all get printed at this journal so I think it is not unfair to suggest that the journal is to blame, hence the title about changing diapers; the authors may provide the food but it is the journal that puts out the crap).

In this case, the study is not quite as bad as the media reports that follow though the authors do flap their lips a little more loosely as well once in the spotlight. The study reported that the findings indicated either that caffeine consumption led to disrupted sleep patterns or that children consumed caffeine in response to not sleeping well the night before. They were not sure which way this went but it still led to concluding that caffeine should be restricted, not because it was harmful but on the basis that the beverages had “detectable pharmacologic effects”. It does not sound like a bad idea in general not to ply your kids with pots of coffee or coke but I really do not see the above as actually supporting that.

By the way, the other grand finding in the study was (and they took pride in that this had not been widely documented) that children’s sleep patterns on the weekends varied from that of the school week. (Maybe this is what they mean when they talk about the great work of science being built up one small brick at a time!)

But come the media and we have the headline Caffeine Can Harm Children. And the quote:

“Parents should be aware of the potentially negative influence of caffeine on a child’s sleep quality and daily functioning,” Dr. Warzak asserts.

And as we know, when you put in the word potentially anything after is quite true. We could potentially fall into the sun tomorrow. Absolutely true.

Or more to the point: Pediatrics Journal could potentially tighten up their editorial policies. The journal has been around long enough to move on to potty training.

– Paul L. Bergen

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California, marijuana and the tobacco companies

When future archaeologists dig up the remains of California, they’re going to find all of those gyms their scary-looking gym equipment, and they’re going to assume that we were a culture obsessed with torture.

Doug Coupland

The Coupland quote is not entirely perfect but it does go toward illustrating the absurdity of life in California, a state often seen as odd, sometimes good, sometimes bad, and now a place that paradoxically hosts the anything goes dream factory that is Hollywood, was first in expressing and accepting gay lifestyles and now still the front runner when it comes to being narrow-minded and repressive with respect to health.


Take Proposition 65 which requires warning labels for any measurable levels of hazardous substances in foods (but as many non-Californians are aware, 1. few foods are entirely free of hazardous substances and 2. how much of it is in there matters a lot more than whether it is at all) which has been criticized for confusing consumers about real hazards especially when they appear on the same goods with FDA labels which attempt to provide more realistic guidelines. (See here.) These labels have not only given rise to many spurious lawsuits but have helped increase the already thriving toxiphobia with the healthiest bunch of people in history checking behind each door for some new threat to their goal of living forever.

And it is of course California which is the home of Stanton Glantz and his Soviet style actions to remove smoking images from the movies and from recorded history as well as the hotbed of the disreputable overstatement of 2nd hand smoking effects on heart attack rates. (Note to self: submit treatment to Hollywood re Glantz as deep cover Russian mole working to undermine American freedoms.) And while I am singling out this preposterous state, it is clear that the lunacy is no longer localized, that there is serious competition from Illinois (home of Pediatrics, the proud inventors of 3rd hand smoke), Washington (Banzhaf), New York (Bloomberg) and so many more.

And now the latest from that most interesting place. (And in the interests of transparency, every time I have been to California I have had a great time. But living there must be frustrating.) California (and some other states) has been seriously considering making marijuana legal partly because so many people are already using it without it bringing civilization to its knees and even more because of the budget shortfalls and huge deficits that state is in the throes of. And thought the millions still flow in to fund anti-tobacco research, they are otherwise desperate for money, partly to pay for incarcerating so many drug users.

In the LA Times, the article If pot becomes legal, California’s health will suffer Stanford expert says, the main issue is that there would be increased health costs (could certainly be if more people use it but not if current users simply shift over from the illegal market). Fair point. However what is interesting is the political cant coming from this clinical psychologist (Keith Humprhies):

he says his No. 1 fear is that it would create a lucrative product line for tobacco companies or create an industry that would stand “shoulder to shoulder with them lobbying against every anti-smoking restriction and expansion of public health and every taxation initiative.”

So, the worry here is not so much about health but that legalizing marijuana might lead to 1. some people pofiting from a new lucrative legal product (that sounds pretty anti-American to me), 2. that an existing legal enterprise would expand its product lines (ditto) and that 3. they would express themselves in a legal and time-honored fashion within a supposed democracy.

I have mixed feeling about no smoking policies (many I approve of for purely aesthetic and selfish reasons, and some I don’t for a more defensible live and let live policy) but to be active within a democracy is to hold an opinion and to express it. Though less smoking is without a doubt better for public health, it does not follow that the only reasonable political position is no smoking. Smoking is only one of many things to be juggled to maintain a society which is built partially on respecting self determination.

Psychologist Humphreys should be worried though. Grass smokers are not quite the timid bunch tobacco smokers are. Though active criminals, they have not been stigmatized into inaction; they tend to be much more vocal, and if the statistics are right, they are close to outnumbering smokers.

In terms of harm reduction, legalization is almost always a good thing. Controlled production means quality control which has the potential of decreasing the risks of using. And though anti-smoking is rife with mythologies of all sorts, the effects on smokers themselves are reasonably accurate and this would be a welcome development in terms of marijuana where many users have some pretty strange ideas about how healthy it is. An open licit market means we can better determine how risky it is and how better to minimize those risks, and it makes it easier to educate people about safer alternatives.

-Paul L. Bergen

Is Pediatrics the new Onion?

There are a few more laughs in the Onion usually but the Onion seems to have the firmer grasp on reality as well. But Pediatrics just keeps plugging along. Never a dull day when Winickoff and company are waxing wise. And what is the latest?


As reported in WebMD, the July print issue will feature a number of new insights into the risk parental smoking poses to child development. (These are not yet available online but I just cannot wait to report on this almost certainly important work.)

From study number one we have the following gem (to quote from WebMD): Mary-Jo Brion, PhD, of the University of Bristol, tells WebMD by email that babies exposed to smoke may be prone to rule breaking, such as lying, cheating, bullying, and disobedience.

From study number two we have: The study’s key finding, she says, is that paternal smoking clearly seems to be associated with higher childhood weight as assessed by body mass index. And -Jonathan P. Winickoff, MD, MPH, of Harvard Medical School, says the conclusion that paternal smoking also may influence “the developmental in utero origins of childhood obesity seems to be a novel finding.”

Novel, as in fiction?

Or from Doctors Lounge: Winickoff, co-author of the commentary, said it’s not true that smoking makes people skinnier. Instead, it boosts the weight around their bellies and hips, he explained. One theory is that secondhand smoke could do the same thing to those who are exposed, like the kids of dads who light up.

Alright, well that would explain why right along with the drop in smoking rates obesity is now at an all time low?

We’ll save the real analysis for when the articles become available.

You know, sometimes I feel a little bad about singling out Winickoff, but its just like that whack a weasel game, and his head just keeps popping up.

– Paul L. Bergen

The contest continues…

At the risk of running multiple threads but with the potential of gaining new participants I am starting another post to buttress the good entries already in place.

Here’s one from me:

In a rare public appearance today, the typically reclusive NYT health writer and journalism professor Roni Rabin came forward to answer questions regarding her article with its endorsement of the Canary in the Mines Petition being circulated. Previously Rabin had helped nationalize the concern about 3rd hand smoke but had in that case remained silent after her influential piece.

As reported in the latest article, a consortium of anti-smoking health organizations following the lead of the Campaign for Tobacco Free Kids suggested that what was missing in tobacco control were the voices of the children themselves. What would address this need would be a panel of children who would decide whether the tobacco companies were indeed marketing to them with their new smokeless products.

The same group at Pediatrics who did such fine work in regards to third hand smoke were asked to design the study that would show how much we needed children to weigh in on this important matter that directly concerned them. In an earlier interview, one of that team said “its really just a question of asking people “do you think tobacco companies should be allowed to market to children?” and if you say “no” then that is a fair indication that they are already doing so and that we direly need this new way of dealing with it.

Of course, because they are children and it is unethical and quite dangerous to expose them to even the sight of tobacco products of any kind, the Pediatrics group suggested that adults would be exposed to the toxic goods and then describe the colors, tastes and package design to the children (and if it helps tell them what products they are familiar with that they resembled) and then the children could safely tell them if they thought they were attractive and if those companies were trying to make them use them. (The children would receive continual reassurance that the companies could not get to them in the testing rooms).

Asked whether children should also be part of the FDA new tobacco control plans, Rabin nodded and then waving her arms and backing up croaked “fear good; tobacco bad” a number of times. She became progressively more excited and before any more questions could be asked had backed herself right out of the room.

-PLB

Enter our contest to predict the most ludicrous article to appear in an anti-tobacco journal in the next 6 months.

Following the latest madness in Pediatrics (which we covered here and will probably address again shortly), Carl Phillips proposed a contest to predict what will be the most absurd “scientific” claim to appear in an anti-tobacco journal in the near future.

Carl’s entry (from the talk he is presenting at the TMA meeting this week, challenging the concept that there is such a thing as “science-based policy”, as bandied about by the FDA and others): “A recent survey found that 38.72% more cigarettes are consumed by youth due to the lack of visible dog poo smears on the sticks, and therefore
tobacco companies’ persistent failure to apply such smears proves that they are continuing to market to children.” (If you want more context for that, he plans to post a movie of his talk to the website when he gets a chance.)

We cannot offer any great prizes, but if we do get some good entries we will make sure that the one that comes the closest to being accurate and the one that is just the most amusing are cited in a paper we will write on the topic of these absurdities (and we will even offer the invitation to write such a paper for inclusion in the next edition of the THR Yearbook to the contest winner if so desired).

(We had a spirited debate about phrasing. I (Paul) could not stand the thought of the word “poo” appearing in our blog. But it is Carl’s personal contest entry and he argued that it better fits the people who still refer to “spit tobacco” and who think that high school science projects constitute important research than does a more polite term. Also in regards to our modest prizes, we apologize that as a consequence of our views we do not have access to the multimillion dollar Legacy grants that could be easily secured by those doing the research we are referring to.)

-PLB

Third Hand Smoke, Again!?

I see that Chris Snowdon has a great post on the absurdity and a bit of history on the third hand smoke meme that refuses to die. It seems that while good ideas are often unnoticed or ignored that the really bad ones, and this one is bad in so many ways, tend to get a lot of press. I suppose that they do serve a purpose in uncovering which journalists uncritically repeat items without examining the source materials (for instance, this article from Roni Rabin at the NYT).

The third hand smoke nonsense is particularly dear to us here as we responded (quite some time prior to this blog’s existence) to the Journal of Pediatrics article when it came out. At the time, we had noticed how fast and furiously this story spread throughout the news media and the blogs. It was as though so many had been waiting for this, just like someone suddenly getting some small evidence of what previously rated as little more than a conspiracy theory. You could hear the “I knew it” s resounding throughout the land. Perhaps the most risible of the follow up stories was of Apple techs refusing to touch smokers’ computers.

One small excerpt from our letter:

The authors, in the article, press release and subsequent interviews, argue the danger of third hand smoke, such that smokers are encouraged to change clothing and bathe before holding their children. And yet, the authors still encourage the smoker to breastfeed the innocent child, rather than substitute a tobacco-free bottle of milk or formula (6). This can only mean that, despite repeating the nonsensical mantra of there is no safe level of exposure, whatever this non-safe level of exposure is, it must be much lower than the toxicity of bottle-feeding. The authors also suggest, not in the article but in related interviews, that the nose is an accurate determiner of toxicity, an interesting but outdated pre-scientific method that cynically takes advantage of the lay population (8, 19, 24, 26).

Many educated readers already have a jaundiced view of what passes for epidemiological research, and this article not only justifies their attitude but serves as the epitome of sloppy science, of politics and opinion and desire masquerading as science. We predict that a decade from now, if books and blogs continue to claim that epidemiology is junk science, they will still be citing this article as a perfect example.

-PLB