I was off today, but I thought I’d share this image that is in my “teaching” folder on my laptop.
In 1946 – 1949, US media commonly featured ads for cigarettes recommended by doctors.
Shocked?
It really wasn’t until early 1950’s that a group of doctors studied the direct link between smoking and cancer. Now, this seems really, really obvious to us. Why wasn’t it then?
Actually, a few doctors started raising questions in publications about the links between smoking and cancer from as early as 1912. However, smoking was so much a part of culture then, further studies to time to get traction. In the 1950’s, in the wake of industrial and nuclear advances made after WW2, the public was in keen to take scientific expert opinion seriously. So when a major study was published in JAMA in 1950 and then covered extensively in media in 1952, tobacco sales dropped.
What followed was a large scale unethical misinformation campaign by what we now call “Big Tobacco”, the Frank Memo. This ad was published widely across the US, and made an entire series of false claims questioning the validity of the published research. (Never heard of this? I’m usually loathe to recommend them but Wikipedia actually has it fairly spot-on this time: https://en.wikipedia.org/wiki/A_Frank_Statement)
Nowadays, we can agree that even the most committed conspiracy theorist would be hard-pressed to believe that smoking does not have real and substantial health risks.
So, why does these ads matter today to a group of young doctors and empowered patients?
1. Science advances. We know more today than we did yesterday. Science questions everything, constantly. What was we thought was true, to the best of current evidence, 10 or 20 years ago changes. We need to do what is right for our patients – not just do what “we have always done” or “what we were taught.” What does it matter for you as a patient? “how things were always done” may need to change. Getting a second opinion may mean getting an opinion from a doctor with a different, but more up-to-date approach. It also means challenging old ideas , such as vaccine complacency. What does it mean for us as doctors? Constant change. Constant re-education. With the volume and speed of medical information, this means that it’s not always easy to keep up-to-date on everything, but that we need to be open-minded, use critical thinking, and change our practices. Flu vaccine is now recommended as routine. Measles and mumps are no longer accepted as a routine part of childhood. These are global ideas still slow to get a foothold in Ireland.
2. The rise of misinformation campaigns has had a massive impact on patient health (think Dr. Google answers or cults of personality, like Goop) and in the doctor-patient communication. The legacy of misinformation techniques started by Hill+Knowlton in 1953 to sell cigarettes was so powerful that it has since been adopted and used by any and every organisation seeking to confuse the public and obstruct scientific advancement for its own financial gain: climate change deniers, anti-vaccination movement , and populist politics (Brexit is a great example).
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