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The Disconnect Between Science and Policy

Back in 1912, when hardly anyone smoked cigarettes, lung cancer was like a museum curiosity: extremely rare. In the next few decades, however, it rose dramatically around the world, roughly fifteen-fold. But researchers had already nailed it way back then. By mid-century, the evidence linking lung cancer and tobacco was considered overwhelming. Says who? Says the tobacco industry’s own research scientists in an internal memo. We now know that “senior scientists and executives within the cigarette industry knew about the cancer risks of smoking at least as early as the 1940s.”

Publically, though, they said things like, “Sure there are statistics associating lung cancer and cigarettes. There are statistics associating lung cancer with divorce, and even with lack of sleep. But no scientist has produced clinical or biological proof that cigarettes cause the diseases they are accused of causing.”

What was the government saying? My video American Medical Association Complicity with Big Tobacco includes several real cigarette advertisements, including one in which a leading U.S. Senator advises readers to smoke Lucky Strikes. Who wouldn’t want to “give [their] throat a vacation,” as another ad proclaimed? Others assured “not one single case of throat irritation,” and how could your throat and nose be adversely affected when cigarettes “are just as pure as the water you drink”? What if you do feel irritation from smoking? No problem—your doctor can write you a prescription for cigarettes, according to an ad from the Journal of the American Medical Association. After all, “don’t smoke” is advice hard for patients to swallow, as we’re told in another ad.

This reminds me of the recent survey of doctors that found the number-one reason doctors don’t prescribe heart-healthy diets was their perception that patients fear being deprived of all the junk they’re eating. After all, Philip Morris reminded doctors in an ad that we want to keep our patients happy and to “make a radical change in habit…may do harm.”

The tobacco industry gave medical journals big bucks to run ads like the ones I’m sharing with you. Should we be concerned about a conflict of interest? Not if we listen to Philip Morris, who assured us their “claims come from completely reliable sources” based on studies conducted by “recognized authorities…whose findings have been published in leading medical journals.” They even kindly offered to send free packs of cigarettes to doctors so they can test them out themselves and invited physicians to “make the doctors’ [smoking] lounge your club” at the American Medical Association convention.

What did the AMA have to say for itself? Like most other medical journals, they accepted tobacco ads but asserted that “[p]ostmortem examinations do not reveal lesions in any number of cases that could be definitely traced to the smoking of cigarettes.” So, as far as the AMA was concerned, case closed.

In fact, even after the Surgeon General’s Report on Smoking and Health came out, the American Medical Association, American Cancer Society, and Congress continued to drag their feet. The government was still subsidizing tobacco, just as our tax dollars subsidize the sugar and meat industries today. The AMA actually went on record refusing to endorse the Surgeon General’s report. Could that have been because they had just been handed ten million dollars from the tobacco industry?

Today the money is coming from big food. The American Academy of Family Physicians has accepted large sums of money from Coca-Cola “to fund patient education on obesity prevention.” I wonder what that pamphlet will say.

Who was featured as a top partner on Coca Cola’s website? The American College of Cardiology.

Just as it would have been hazardous to your health to take the medical profession’s advice on your smoking habits in the 1950s, it may be hazardous to your health today to take the medical profession’s advice on your eating habits.


If the balance of scientific evidence favors plant-based eating, why isn’t the medical profession at the forefront of encouraging people to eat healthier? That’s the question this video tries to answer. Looking back to smoking in the 1950s, we can see how all of society, the government, and even the medical profession itself could be in favor of habits that decades of science had already overwhelmingly condemned as harmful.

For more on the influence industry can have on food policy, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Discuss

Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.


51 responses to “The Disconnect Between Science and Policy

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  1. It’s not just doctors who may have been misled by their professional bodies. Dietitians may also have been given guidance that was influenced by financial donations.

    The US Academy of Nutritian and Dietetics took money from the National Dairy Council for a number of years although it is now (2019) no longer the Premier sponsor of AND. I recall that AND changed its policy position on saturated fat shortly after the National Dairy Council became its sole national sponsor. It also promoted consumption of dairy foods topeople with lactose intolerance.
    https://www.eatrightpro.org/-/media/eatrightpro-files/about-us/advertising-and-sponsorship/lowdown_on_lactose_intolerance.pdf

    https://integritydietitians.org/2016/09/26/concerns-dairy-industry-sponsorship/\
    https://www.foodpolitics.com/tag/adaamerican-dietetic-association/

  2. Please watch the documentary, “Cowspiracy,” to see how the livestock industry keeps us unaware of animal agriculture’s MAJOR role in climate change and environmental degradation. This science is being silenced in much the same way as the medical science regarding meat/dairy’s health impact.

  3. I was director of soil, water, air and climate change research with USDA’s Agriicultural Research Service in the 1990’s.
    I am well aware of the impact lobbyists have on governmental policy. I’m pleased to see the growing number of websites such as this one to bring the solid scientific facts on nutrition to the consumers of food products. I think we need a national or a national organization to combine the membership of all of these sites to show policy makers just how great the plant- based consumer public is. We too could then begin to have some voter clout.

  4. Science and policy has been disconnected since Socrates was forced to drink hemlock after refusing to change his views about how a science-based social order had the potential to achieving eternal peace/harmony/joy to all humans. Galileo was forced to ex-communication until he changed his public views about heliocentric to geocentric universe.
    Policy is interested in preserving the status quo of the privileged/dominant group while science is revealing the fundamental laws of nature and how to improve life for all, not just a few. Until we remove the purchase power of voting by major interest groups (really a cartel of privileged individuals), there will be efforts to demonization science, especially those sciences which challenges the privileges of the status quo. Imagine in 21st century, people believe in hollow/flat earth and geocentric universe despite enjoying the fruits of science from the round, heliocentric universe. Nature has made 50% of the people dumb, about 2% genius, 2% who don’t have the intelligence to take care of their needs. It seems the last category is recently amalgamated in the GOP policy making systems.

  5. While I do not know the specifics, the battle for a plant based diet is going to be a tougher one. I’m guessing, at it’s peak, maybe 50-60% of the population smoked, however, about 95% consume animal based foods today. My point is that while not nearly everyone smoked, nearly everyone eats animal foods. I know from personal experience no amount of data will convince people. Many would prefer death while still eating their steaks. The “vegan” movement is catching on, am happy to see when plant-eaters are the majority, but doubt it will ever happen in my lifetime. Considering I’m also eating a plant-based diet, I hope to still have at least 50 years remaining.

        1. And “everyone” should, of course, include the animals who are forced to suffer horrific cruelty inherent in factory farming.

        2. “Being entitled to your own opinion is totally fine. However, a personal choice stops being just that once it interferes with the life of another being. The “right” to do so is only make-believe, ignorant tradition, and because you can. But you steal the rights from someone else in the process. Choosing to eat meat is anything but a personal choice. You are choosing the fate of other living beings, and also removing the opportunity for a real life from them. It’s also a decision that affects our environment/planet in a very bad way, which in turn is something that affects all of us. “-John Fritzell

          1. By “personal choice” I only meant an action one can take without the consent or aid of another i.e. an act of free will, without regard to ethical/moral concerns (note my follow up post) including killing. As an “ethical vegan” (I know, for some that’s redundant but I say that because the term ‘vegan’ has largely been co-opted to mean only ‘not animal product eating’), I am acutely aware of the ethical implications of meat eating, etc., but would not define or use ‘personal choice’ in such a restrictive manner i.e. I do not think personal choices stop being such when victims are involved. What people need to do is to realize and focus on the effects of their personal choices, including meat eating.

    1. I suspect that the problem is not the percentage of people who eat meat. IMHO the problem is that the evidence supporting plant based diets for health is nowhere near as compelling as the evidence against smoking for health. Both arguments are largely based on observational studies yet the association between smoking and cancer is exponentially more robust than that between plant based diets and improvements in health or longevity. If and when plant based diet studies achieve the same hazard ratios as cigarette smoking studies, it will become equally difficult to ignore them.

      1. Alex, my evidence for the health benefits of plant based eating is anecdotal — case studies, if you will. My strongest is my brother, who about 15 years ago was overweight and out of shape, and on several meds, including for type 2 diabetes. He must have read what his future might hold, because he changed his lifestyle: he started eating more plant based (more recently, plant based whole foods) and started exercising. He eventually lost 70 pounds, and went off all his meds, including for diabetes.

        My next strongest is me. A little more than 20 years ago, I too was overweight and out of shape — and I was vegetarian! (There are a lot of junk vegetarian and vegan foods — processed.) So, I started exercising — and one year later, I was much fitter, but hadn’t lost any weight. So then I changed my eating habits, to making healthier choices and practicing portion control (I continued exercising). I gradually lost 25 pounds over 18 months, and I haven’t regained it.

        I know more examples. It’s hard for me to think that the evidence is not compelling.

        But even if you think it isn’t, you can’t argue that eating a plant based diet is much more sustainable, far less environmentally degrading, less cruel to animals and workers, and contributes nothing to the development of antibiotic resistance.

        Climate catastrophe is here; we are only starting to see the tip of the iceberg.

    2. I wonder if the best hope for a societal shift to plant-based nutrition might be Darwinian!

      The people clinging to less healthful eating should, on average, live less long. Over time this might cause an overall increase in plant-based eaters.

      Of course the flaw in this is that both groups now live longer than normal procreative age so the effect would be at least partially dependent on children emulating good habits and recognizing less healthful ones

    3. Getting the majority of the people to eat meat, say twice a week, and plants/fungi the other days, is really doable. Turning everyone into vegans has never occurred in any society ever and never will.

      1. Depends what you mean by vegans.

        If you mean vegetarians ie people who eat a diet of vegetables (ie plants), then I don’t see why not.

        Anyway, your argument is fallacious. it’s the assertion fallacy.

        This has never happened before so it can never occur in the future is basically what you are saying. Sounds faintly ludicrous to me. No society had ever had spaceflight until the 1950s. That must have meant it was impossible I suppose

  6. Before the internet, there may have been weak excuses for ignorance, but now we have a plethora of educators readily available to inform the public, even for free as does Dr Greger. Unfortunately, there is an even greater availbility of poor nutrional information not even supported by science. The paleo diet is an example; scientific evidence about teeth and mastication, bowel length and complexity, and even examination of the plaque on teeth of early man, show that we have evolved to be primarily herbivores. Only a plant based diet has been shown to stop and reverse heart disease, as shown by Dr Ornish, Dr Esselyston, and others. I had an extremely poor prognosis from 2 cancers, hard to control high blood pressure, and severe hypertriglyceridemia(> 2,000) at age 50. I switched to a WFPBD, and at 70, I am alive and well. As an MD, I realized that it was vital to educate my patients to replce animal based products with plants. The audience of Dr Greger may be unaware of the resistance to change based on habit, brain washing by big food, and confusion by misleading and dishonest “scientific” publications by big food and profiteers. One thing that seems to be turning the tide is the revelation of severe and widespread animal abuse, statements about the dangers of animal products by the WHO, but nothing is more important than educated caregivers counseling their patients to switch to a WFPBD!

  7. I can’t help but wonder what diseases Juul has found that are caused by its vaping products. They claim they are helping people because their product is safer than smoking. Now we have approx 30% of teens who have reported that they have vaped in the past 12 months with a significant % addicted. FDA asleep at the switch or is history repeating itself like it is with meat?

    1. I have young vapers around me.

      It isn’t their only habit.

      One rolled his vehicle a month ago and has a suspended license and I don’t think it was Juul he was vaping.

      One young man said that sports and military don’t vape, they chew, which my close friend’s son who was a star little league player got caught up in.

      Pick your poison.

      By God’s grace, I understood that and didn’t pick a peck of poisons. For me, it was soda, coffee, junk food and the rest of the dietary no-no’s. Though I did drink poisonous things as a hormonal young person, so I have to include myself in a few of them.

      1. I have elderly people who still haven’t gotten off of cigarettes. I am wondering if Juul would be better than cigarettes for them.

        One of the people who worked on my house just needed jaw surgery.

        And one of my not-all-that-elderly relatives died of oral cancer, but one of the drinkers died of a different cancer.

    2. Nicotine IS addictive, that’s a given, and should never be sold to teens in any form, but they are notorious for getting what they think they really want no matter how we try to protect them. As a teen I did the same with cigarettes, which besides the obvious issues, are adulterated to make them even more addictive, and was I hooked! As a 40 year (former) smoker, I had tried quitting more times and in more ways than I can count, UNTIL e-cigs became available. The fluid I used was just glycerin, menthol and nicotine, vaporized by a simple heating coil, and in short order all the scary symptoms I was having started to abate. I was able to cut back that nicotine a little at a time, until it was none. There is all kinds of propaganda out there and people have all kinds of opinions about the “evil” E-cigs, but they have helped so many adults quit far more lethal cigarettes when everything else failed.

  8. There is a term: Commercial Research. Companies hire a group of researchers to prove their product or supplement is beneficial. The research is shabby, or intentionally misinterpreted. Often, ignorant media journalists, looking for a great headline, will write about this so-called research. For example, Butter is Back (research showed butter is better than transfats). The writer then declares butter is healthy. We need to look at who sponsors research. We need to be educated consumers. Rule of thumb: EAT PLANTS in their natural form: and organic.

  9. Also, FYI, the California Nutgrowers contribute lots of money to Loma Linda University (7th Day Adventist studies). Nuts are NOT SUPER FOODS. No one food or nutrient is going to save you. Check out Jeff Nelson and Marion Nestle. Even blueberries are not miracles. Companies want profits. Eat a variety of healthy foods. And most supplements are a waste of money.

      1. I personally believe that nuts have way too much ‘fat’ for the average ‘Joan’. And more fat is the last thing most Americans need. I think ‘seeds’ are only slightly better. My man Caldwell says…’no nuts’, and I believe him.

        1. Actually, Esselstyn does not say “no nuts” for those who do not have documented heart disease, at least anymore. Of course, he is for moderation. Check his website.

    1. Lora,

      I understand what you are saying, but each person makes a group of decisions and that becomes a diet.

      Information about each food helps us to make those decisions and what I have found is that the more I try to go WFPB, the more I want to know about each food.

      Dr. Greger does the choices at the salad bar. Do you eat iceberg lettuce and baby carrots or do you add in what people call “superfoods” or does it matter?

      If you don’t have a concept of superfoods, you just eat what you enjoy and in the USA, it is white potatoes, iceberg lettuce, baby carrots, corn, and tomatoes. It is only because of the nutritional value of the “superfoods” that people are doing a different process.

      WNPR is doing a Food Schmooze on how to do Plant-Based without the lectures right now. So far, I think half of it has been alcohol, but that is my snarky observation, but it was refreshing.

        1. If you read white rice and look for brown rice or black rice or a mixture, then, you buy into the concept of superfoods.

          I don’t know if you just make decisions like, “Nope, I had kale yesterday, I am up to iceberg lettuce tonight.” Or if you just don’t worry about any of it.

          Most of the people around me wouldn’t have a “wide variety” of any of fruits, vegetables or grains and probably no beans or lentils unless I cook.

          They need a logic to move away from eating white potatoes every night and a lot of them moved from white potatoes to leaving white potatoes out and they are called Keto.

    1. Ron,

      Yes.

      The first surgeon’s general’s report was in the early ’60s and smoking decreased after that.

      My parents were smokers. I remember having my father flick his cigarette out the driver’s window and it came back in the back window. The one time when not having seat belt laws really helped.

    2. I was a kid in the 1950s. My mother and others often observed that smokers were more prone to lung diseases and respitaory infections than non-smokers ….. TB and bronchitis in particular. People also used to regularly refer to cigarettes as ‘coffin nails’ – even the smokers.

  10. “We live in imaginary, virtual worlds created by corporations that profit from our deception.” – Chris Hedges

    “Whoever is content with the world, and who profits from its lack of justice, does not want to change it.” -Friedrich Durrenmatt

    “Livestock farmers, no matter what kind — from the largest, most cynical, and inhumane factory farm­ers to the smallest, seemingly most ethical pasture-based farmers — traffic in death. It is death that is our aim, our purpose. Death is the end. Life is the means. Money the reward.”- Bob Comis, former pig farmer

    1. Very tough to argue with Bob Comis’ stark statement. Once one recognizes that animals are sentient beings, it takes a lot of self-stupifaction to continue eating their flesh. This viewpoint is not new; It’s been asked for years – how many people could sit down to a steak dinner if they had to participate in the slaughter and butchering of the steer they were about to eat.

      1. I catch and kill fish, crabs, and clams and I eat them. I also pray before I eat, and I know that some day, I will be food for some other animal to eat. I give thanks that today is not that day, but I also realize that I am part of a larger world and that we all have our time. I can’t run as fast as I used to, and some day, I won’t be able to run at all. It’s called life.

        1. You would say your view of life is realistic; I’d say it’s depressing.
          Eat them before they eat you, you say. But isn’t it possible to just not eat them? Yes we are all going to die eventually. But can’t we choose to live in a less violent world?

  11. During World War II, when my father was stationed in South Korea, as the war was coming to an end, he told us of cigarettes as part of his daily rations, along with chocolate. He would trade them with other soldiers for food items he preferred. Note: cigarettes were considered a necessity for the average enlistee.

    Some soldiers returned home and never broke the cigarette habit.

  12. Nancy H. It didn’t stop with WWII or Korea. I was in the US Army from 1966 to 1969. In our field rations, every GI, smoker or not, got a half-pack of cigarettes, with every meal, compliments of the tax-payers. The only thing less healthy, in those rations, was a thing called canned bread. It was in a can, and it looked somewhat similar to “white” bread; but it was not of this planet, and singularly inedible. The military has a lot to answer for.

  13. So just spread the word. I figure, my one life is much better on a whole food, plant based diet, as is the rest of the earth. So if I tell one person and their health improves, that might be a some one like me. Dr Greger’s information and knowledge has changed my life for the better.

  14. It is not so much that the AMA gets millions from Big Food, it is that more healthy people will mean less need for kwaks, leading to fewer doctors, and lower salaries.
    These folks are just trying to protect their livelihoods. The AMA represents a sickness industry, not health professionals.

  15. Why can’t we print these articles any longer? I like to print some of the articles to share with others who will not go to this website. Nothing personal with website, they just aren’t inclined. Thanks.

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