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Week 8

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Article Evaluation

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I chose to read the Wikipedia article on Personalized medicine.

Everything in the article was definitely related to the topic of personalized medicine because the article covered the basic background information, the usage of personalized medicine in diagnosis, and some challenges facing personalized medicine. The article is written from a neutral point of view as no personal viewpoints are included. When addressing the controversy surrounding personalized medicine, the article is very factual, stating only the reasons for the controversy and the laws that have been put in place to address it. I did not find any viewpoints to be over or underrepresented, but I did notice that the article discussed in length the benefits of personalized medicine in more accurate diagnosis and treatment, especially in cancer, but only briefly discussed some of the challenges that personalized medicine faces as it becomes more readily available in modern medicine.

Yes, the citations in the article are working. The linked terms bring readers to the Wikipedia article on that term, and facts stated in the article have citations from reputable studies/articles published in major scientific journals or articles from major government health organizations. The sources support the claims in the article as the article usually states a major conclusion reached by the source, which for the most part was a research paper. The research papers themselves seem to be neutral sources as they deal mostly with data, with little room to manipulate data to fit biases. Information included in the article seems up-to-date, but more information on cancer genomics could be included since that is a very large topic within personalized medicine. In fact, cancer genetic testing/personalized medicine could be a separate Wikipedia article since there are so many different types of cancer that benefit from genetic testing and so many famous cases (like Angelia Jolie) surrounding genetic testing for cancer.

On the article's talk page, several editors have reacted strongly to the article, deeming it "hopeless" and "antiquated" and needing "major revision." The reasons behind these comments is that the article does not include enough information on cutting-edge research and does not convey strongly enough that personalized medicine has been around for a long time, but only now includes genomics. The comments on the talk page are productive, however, as editors have been modifying the article to remove biased/unsubstantiated information and to include more accurate and up-to-date information. The article is rated B-class as part of WikiProject Medicine and WIkiProject Genetics. Thus, although the article is overall sufficient, it could use more information to provide a more complete understanding of personalized medicine.

Wikipedia discusses personalized medicine in a much more science-heavy manner than we discussed in class as it focuses more on the specifics of personalized medicine rather than the social implications of genetic testing, like we discussed in class with Ellen Matloff. As a result, I think it would be beneficial to include more about the social implications and challenges facing personalized medicine in the article.

Discussion: What's a content gap?

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I think a content gap is when information is missing. Some possible ways of identifying content gaps is when you are looking for information and an article does not exist for the topic or a related article does not give enough information on the topic. Content gaps may arise because articles have not been fully developed or because volunteers have not written an article for the topic yet. Content gaps can be remedied by improving articles that have not been fully developed or by starting a new article on a topic.

Yes, who writes for Wikipedia matters because depending on the writer, the article may be biased. Being "unbiased" on Wikipedia means only stating facts that have been well established in reputable sources that have no personal links to the topic being discussed. This is relatively similar to my own definition of "bias" because I imagine bias to be when someone has strong opinions on a topic and tries to convince readers to believe in this point of view through their writing.

Week 9

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Choose your topic / Find your sources

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A Frank Statement

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The A Frank Statement article is rated as a start class article; thus, if I were to work on this article, the first subject I would elaborate on is the strategy behind the advertisement and how tobacco companies were trying to install doubt in the public regarding the health effects of cigarettes. The article gives a brief summary of the history and the science that prompted the Frank Statement, but fails to describe how significantly this affected the public's opinions and how calculated the tobacco companies' response was. I would like to add more details in the "Historical Context" section to show how the public's views on the health effects of smoking shifted as more and more science piled up. I would also like to add a section on the tobacco companies' use of social engineering to foster doubt despite the mounting scientific evidence, and the role that the Frank Statement played in the tobacco companies' plan. The article does not discuss the aftermath of the Frank Statements as it ends after discussing the promises that the advertisement made; thus, I would add a section on the impact of the Frank Statement.

Bibliography for A Frank Statement (in addition to the references already used in the article)

Torches of Freedom

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The Torches of Freedom article does not have any ratings on its talk page, but from reading through the article, it is clear that more information could be added. If I were to work on this article, I would elaborate more on how the Torches of Freedom march was a part of a much larger campaign targeting women smokers. I would add a section about the other advertisements directly targeting women, and elaborate more (and maybe include some graphs) on how the percentage of women smokers rose as a result of this direct advertising.

Bibliography for Torches of Freedom (in addition to the references already used in the article)

Copyedit your article

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A Frank Statement to Cigarette Smokers was a historic advertisement run by major American tobacco companies on January 4, 1954, in response to a study showing that cigarette tar causes cancerous tumors on mouse skin. The advertisement ran in more than 400 newspapers throughout the U.S. aimed at an estimated 43 million people. It was the first in a campaign to dispute reports that smoking cigarettes could cause lung cancer and had other dangerous health effects.

The public relations firm Hill & Knowlton created the advertisement after a meeting in New York late in 1953 between it and Paul Hahn (head of American Tobacco) and other tobacco executives. The tobacco industry followed it with other advertisements expressing doubt about scientific research linking disease and smoking.

Contents

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Historical context[edit]

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Reports of a link between tobacco and lung cancer had emerged as early as 1912, although until the 1950s, the evidence was circumstantial. In the early 1950s, Richard Doll released the results of the British Doctors Study which showed a 20-fold increase in lung cancer susceptibility in smokers. In 1953, an animal study by Ernst Wynder found that tobacco tar was carcinogenic when applied to the skin of mice. The increased evidence that tobacco causes cancer was covered in the Reader's Digest article, Cancer by the carton. This article provoked a health scare, resulting in a small drop in consumption and a fall in stock prices. In this context, some tobacco industry executives, led by Paul Hahn, head of American Tobacco, met with Hill & Knowlton, who created A Frank Statement.

Claims[edit]

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The advertisement claimed:

  1. That medical research of recent years indicates many possible causes of lung cancer.
  2. That there is no agreement among the authorities regarding what the cause is.
  3. That there is no proof that cigarette smoking is one of the causes.
  4. That statistics purporting to link cigarette smoking with the disease could apply with equal force to any one of many other aspects of modern life. Indeed the validity of the statistics themselves is questioned by numerous scientists.

Promises[edit]

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The advertisement also made several promises on behalf of the tobacco industry which were later disputed by the scientific community. A Frank Statement says that its authors believed that the products they made were safe. In a 2002 assessment of the promises made by the advertisement, it was concluded that some tobacco industry scientists had concluded that there was a causal relationship between tobacco and cancer. The tobacco industry did not acknowledge a causal link with cancer until 1999.

The statement also pledged "aid and assistance to the research effort into all phases of tobacco use and health", and announced the establishment of the Tobacco Industry Research Committee (TIRC) towards that aim. Much of the TIRC funded research was not directly connected to smoking and health, and neither it nor its successor, the Council for Tobacco Research, ever acknowledged a proven link between smoking and serious and life-threatening illness. Despite the lack of relevance of many TIRC funded research to the health effects of smoking, some in the tobacco industry publicized their funding of the TIRC to reassure the public. (add sentence or two here about using credentialed scientists who already doubted the health effects of smoking to discredit the work of other scientists and instill doubt)

Finally, the advertisement promised that the tobacco companies "always have and always will cooperate closely with those whose task it is to safeguard the public health". According to Cummings, Morley, and Hyland, "there is abundant evidence that the tobacco industry went to great lengths to undermine tobacco control efforts of the public health community." An example of this is a memo from the vice-president to the president of the Tobacco Institute in which the industry's strategy was described as "creating doubt about the health charge without actually denying it", and "advocating the public's right to smoke, without actually urging them to take up the practice".

- Add section on the role of social engineering in the tobacco companies' response, and how A Frank Statement was an example of this

- Add section on the impacts of A Frank Statement on the public's opinion on smoking - include graphs/statistics if possible

- Maybe include section on modern-day examples of A Frank Statement/how the tobacco industry is doing essentially the same thing in developing countries

See also[edit]

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Week 10

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Draft Your Article

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Historical Context: Elaborate more on the studies linking smoking with cancer that prompted the Frank Statement.

- Doll & Hill

- Wydham

Social Engineering: Discuss the strategy of the tobacco companies and how they used A Frank Statement to instill doubt

- Background on Hill & Knowlton company

- Discussion of social engineering and how tobacco companies wanted to maintain their image that they had created, so they refuted the findings of the studies by installing doubt in the public concerning the validity of the science.

- Usage of successful scientists who are skeptics to contradict the conclusions of many other scientists

- Place responsibility of smoking on the consumer - consumer has to assume all risks, but they have the "right" to smoke

- Relate back to Frank Statement and how it was the beginning of huge campaign to cast doubt on scientific findings regarding smoking and cancer

Claims: Analyze each specific claim made in A Frank Statement

Promises: Discuss TIRC more, including some examples of their research, tobacco companies created a false image of caring for the consumers, guise of transparency

Impact On Public: Graphs/statistics on how advertisements like A Frank Statement impacting the public's opinion on smoking

Modern-Day Examples: Modern-day examples of A Frank Statement/how the tobacco industry is doing essentially the same thing in developing countries by advertising smoking despite the well-known health consequences of smoking

Week 11

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First Draft

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A Frank Statement to Cigarette Smokers was a historic first advertisement in a campaign run by major American tobacco companies on January 4, 1954, to dispute recent scientific studies linking smoking cigarettes to lung cancer and other dangerous health effects.[1]

Reaching an estimated 43 million people through more than 400 newspapers throughout the United States, A Frank Statement to Cigarette Smokers and subsequent advertisements were designed by public relations firm Hill & Knowlton to socially engineer the public's perceptions of tobacco and to install doubt about scientific research linking disease and smoking.[1][2] As a result of A Frank Statement and tobacco advertisements that endure today, the tobacco industry continues to expand its markets by avoiding health concerns and portraying its products in a positive light.[3]

Historical context

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Reports of a link between tobacco and lung cancer had emerged as early as 1912, although until the 1950s, the evidence was circumstantial because smoking was so pervasive in society.[4]

In 1950, hoping to find the cause of the significant surge in lung cancer incidence in the US and in England, Dr. Richard Doll and Professor Bradford Hill conducted a case-control study in which lung cancer, other cancer, and non-cancer patients from twenty London-area hospitals were interviewed about their smoking habits. The study, published in the British Medical Journal, found that the lung cancer patients were more likely to be heavier, more frequent smokers than the other cancer and non-cancer control patients.[5] These results revealed to the medical community that a link between smoking and cancer may exist. Previously, smoking was so prevalent that the increase in lung cancer incidence was attributed to the growing presence of automobiles, roads, and factories in cities.[6]

In 1950, Dr. Ernst Wynder and Evarts Ambrose Graham published a study in the Journal of the American Medical Association in which they interviewed 684 people with proven cases of lung cancer about their smoking habits. The study found that heavy and sustained usage of tobacco, especially in the form of cigarettes, increases the induction of lung cancer.[7] In 1952, to study the biological likelihood of cancer being linked to smoking, Wynder published an animal study in the US journal Cancer Research that found that tobacco tar was carcinogenic when applied to the skin of mice.[8]

The December 1952 issue of Reader's Digest featured an article, titled Cancer by the Carton, that discussed these recent studies on the link between smoking and lung cancer. The article presented to the public the studies' conclusion that tobacco causes cancer.[9] As a result, the article provoked a health scare, which resulted in a small drop in consumption, and a fall in stock prices.[2]

In 1954, Doll and Hill published another article in the British Medical Journal releasing the results of the British Doctors Study, which revealed a significant pattern of increased death from lung cancer as the amount of tobacco smoked increased.[10]

In the early 1950s, which were the immediate post-war years and the beginning of the nuclear age, science was very highly regarded, so the accumulating scientific evidence linking tobacco to lung cancer posed a major threat to the tobacco companies' public image.[11]

Social engineering

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With mounting evidence of a link between smoking tobacco and lung cancer, tobacco companies were faced with the dilemma of whether to admit to or deny the health risks of smoking. In order to preserve their industry, the tobacco companies opted to completely deny health risks and to craft a strategy that, through creative advertising and marketing, would manipulate the cultural context surrounding their product from one that regarded the product unfavorably to one that held the product in high esteem. This strategy is known as social engineering, which early public relations theorist Edward Bernays called the “engineering of consent."[11]

On December 15, 1953, led by Paul Hahn, the head of American Tobacco, the six major tobacco companies, American Tobacco Co., R. J. Reynolds, Philip Morris, Benson & Hedges, U.S. Tobacco Co., and Brown & Williamson, met with public relations company Hill & Knowlton in New York City to create an advertisement that would assuage the public's fears and create a false sense of security in order to regain the public's confidence in the tobacco industry.[12] Hill and Knowlton's president, John W. Hill, realized that simply denying the health risks would not be enough to convince the public. Instead, a more effective method would be to create a major scientific controversy in which the scientifically established link between smoking tobacco and lung cancer would appear to not be conclusively known.[13]

The tobacco companies fought against the emerging science by producing their own science, which suggested that existing science was incomplete and that the industry was not motivated by self-interest.[11] With the creation of the Tobacco Industry Research Committee, headed by accomplished scientist C.C. Little, the tobacco companies manufactured doubt and turned scientific findings into a topic of debate. The recruitment of credentialed scientists like Little who were skeptics was a crucial aspect of the tobacco companies' social engineering plan to establish credibility against anti-smoking reports. By amplifying the voices of a few skeptical scientists, the industry created the illusion that the larger scientific community had not reached a conclusive agreement on the link between smoking and cancer.[11]

Internal documents released through whistleblowers and litigation such as the Tobacco Master Settlement Agreement reveal that while advertisements like A Frank Statement made tobacco companies appear to be responsible and concerned for the health of their consumers, in reality, they were deceiving the public into believing that smoking did not have health risks. The whole project was aimed to protect the tobacco companies' image of glamour and all-American individualism at the cost of the public's health.[14]

Claims

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A Frank Statement to Cigarette Smokers claimed:

  1. That medical research of recent years indicates many possible causes of lung cancer.
  2. That there is no agreement among the authorities regarding what the cause is.
  3. That there is no proof that cigarette smoking is one of the causes.
  4. That statistics purporting to link cigarette smoking with the disease could apply with equal force to any one of many other aspects of modern life. Indeed the validity of the statistics themselves is questioned by numerous scientists.[1]

The claims made in A Frank Statement were largely false as:

  1. Recent medical research had indicated that while lung cancer does have many possible causes, smoking is by far the leading cause in many different types of cancer.[15]
  2. Most scientists, except for skeptics hired by the tobacco companies, agreed that cigarette smoking is linked to lung cancer incidence.[14]
  3. Multiple studies had shown a clear link between cigarette smoking and lung cancer.[5][7][10]
  4. The studies linking cigarette smoking to lung cancer controlled for the "many other aspects of modern life" to show that cigarette smoking is the main cause.[7] Many of the "numerous scientists" who questioned the validity of the statistics were under the payroll of the tobacco companies.[1][11]

Promises

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The advertisement also made several promises on behalf of the tobacco industry which were later disputed by the scientific community. In A Frank Statement, the tobacco companies stated that they believed that their products were safe; however, in a 2002 assessment of the promises made by the advertisement, it was concluded that some tobacco industry scientists believed that there was a causal relationship between tobacco and cancer.[16] Research was undertaken to find a safer cigarette, but tobacco companies realized that they could not produce a safer cigarette because doing so would mean admitting that current cigarettes were not safe. Thus, the industry responded to the growing public concern by marketing their cigarettes as having filters, milder smoke, and lower tar and nicotine content; however, they did not acknowledge a causal link with cancer until 1999.[16]

A Frank Statement also pledged "aid and assistance to the research effort into all phases of tobacco use and health," and announced the establishment of the Tobacco Industry Research Committee (TIRC) to work towards that aim.[1] Much of the TIRC funded research was not directly connected to smoking as it focused mainly on cancer basics, such as immunology, genetics, cell biology, pharmacology, and virology, rather than cancer's connection to smoking.[11] Neither the TIRC nor its successor, the Council for Tobacco Research, ever acknowledged a proven link between smoking and serious and/or life-threatening illness. When research did find a link between smoking and cancer, however, the findings were often not reported to the public.[16] Despite the lack of relevance of many TIRC funded research to the health effects of smoking, the tobacco industry continued to publicize its funding of the TIRC to reassure the public.[16] In reality, the TIRC was created as a public relations measure for the purposes of discrediting independent science and of portraying the tobacco companies as transparent and concerned for the well-being of consumers.[11]

Finally, the advertisement promised that the tobacco companies "always have and always will cooperate closely with those whose task it is to safeguard the public health."[1] According to Cummings, Morley, and Hyland,[16] "there is abundant evidence that the tobacco industry went to great lengths to undermine tobacco control efforts of the public health community." An example of this is a memo from the vice-president of the Tobacco Institute in which the industry's strategy was described as "creating doubt about the health charge without actually denying it", and "advocating the public's right to smoke, without actually urging them to take up the practice."[16] By proclaiming that the health risks were not conclusively linked to smoking, the tobacco companies manipulated the situation to place all liability on the consumer rather than on the companies.[11]

Impact on the public

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Although the tobacco industry claims that their advertising is used only to convince current smokers to switch between brands and that it does not increase total cigarette consumption, research into the effects of advertising shows that it plays an essential role in projecting positive connotations of smoking cigarettes onto potential new smokers.[14] From 1954, when Hill & Knowlton first started working with the tobacco industry, to 1961, the number of cigarettes sold annually rose from 369 billion to 488 billion, and the annual per capita consumption rose from 3344 to 4025 cigarettes.[11]

The first cigarette advertisements claimed that smoking cigarettes had a variety of health benefits such as prolonged youth, thinness, and attractiveness.[14] However, as more research revealed the deceptiveness of these claims, tobacco companies began to use advertisements, like A Frank Statement, to deny that their products caused cancer. Claiming that bans on advertising would infringe on "commercial free speech," the tobacco industry has continually fought against the banning of tobacco advertising; however, it has never responded to criticism that much of its advertising, like the claims made in A Frank Statement, is deceptive.[14] As a result, the tobacco industry's manipulation of science as a public relations tactic is still used today in debates on a wide variety of subjects including global warming, food, and pharmaceuticals.[17]

Modern-day examples

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Today, tobacco companies continue to aggressively advertise cigarettes. As cigarette consumption has declined in the United States, tobacco companies have greatly increased their advertising expenditure. In 1991, the industry spent $4.6 billion on advertising and promoting cigarette consumption,[3] and in 2015, tobacco companies spent $8.9 billion on advertising just in the United States.[18] Tobacco companies continue to use this money to fund social engineering techniques, such as campaigns featuring themes of social desirability and specific cultural references, to target women, children, and specific racial/ethnic communities.[18] For example, to make cigarettes appealing to African American communities, the industry has implemented campaigns that use urban culture and language while sponsoring Chinese and Vietnamese New Year festivals to target Asian Americans.[18]

With declining levels of smoking in the West due to smoking bans and increased education on the health risks of smoking, tobacco companies have also expanded their market into developing countries to fulfill the industry's ever-present need for new smokers and more money. Using many of the same advertising techniques of glamour, sex, and independence, the industry has begun to target women and children in Eastern Europe, Asia, Latin America, and Africa, where government bans and health education may not be as prevalent.[14]

See also

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References

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  1. ^ a b c d e f "Daily Doc: The "Frank Statement" of 1954". www.tobacco.org. 2017-11-07. Retrieved 2017-11-07.
  2. ^ a b Martha, Derthick (26 July 2011). Up in smoke : from legislation to litigation in tobacco politics (Third ed.). Washington, D.C.: CQ Press. pp. 33–41. ISBN 978-1452202235. OCLC 900540359.
  3. ^ a b Youths, Institute of Medicine (US) Committee on Preventing Nicotine Addiction in Children and; Lynch, Barbara S.; Bonnie, Richard J. (1994). TOBACCO ADVERTISING AND PROMOTION. National Academies Press (US).
  4. ^ J, Thun, Michael (2005). "When truth is unwelcome : the first reports on smoking and lung cancer : Public Health Classics". {{cite journal}}: Cite journal requires |journal= (help)CS1 maint: multiple names: authors list (link)
  5. ^ a b Doll, Richard; Hill, A. Bradford (1950-09-30). "Smoking and Carcinoma of the Lung". British Medical Journal. 2 (4682): 739–748. doi:10.1136/bmj.2.4682.739. ISSN 0007-1447. PMC 2038856. PMID 14772469.
  6. ^ LaMorte MD, PhD, MPH, Wayne W. (October 18, 2017). "Epidemiology of Chronic Diseases". sphweb.bumc.bu.edu. Retrieved 2017-11-07.{{cite web}}: CS1 maint: multiple names: authors list (link)
  7. ^ a b c Wynder, Ernest L.; Graham, Evarts A. (1985-05-24). "Tobacco Smoking as a Possible Etiologic Factor in Bronchiogenic Carcinoma: A Study of Six Hundred and Eighty-Four Proved Cases". JAMA. 253 (20): 2986–2994. doi:10.1001/jama.1985.03350440064033. ISSN 0098-7484. PMC 2623809. PMID 15744408.
  8. ^ Nutt, David (2012). Drugs-- without the hot air : minimising the harms of legal and illegal drugs. Cambridge, England: UIT. pp. 201–202. ISBN 978-1906860165. OCLC 795182557.
  9. ^ Norr, Roy (December 1952). "Cancer by the Carton". legacy.library.ucsf.edu. Retrieved 2017-11-07.
  10. ^ a b Doll, Richard; Hill, A. Bradford (1954-06-26). "The Mortality of Doctors in Relation to Their Smoking Habits". British Medical Journal. 1 (4877): 1451–1455. doi:10.1136/bmj.1.4877.1451. ISSN 0007-1447. PMC 2085438. PMID 13160495.
  11. ^ a b c d e f g h i Brandt, Allan M. (2012-1). "Inventing Conflicts of Interest: A History of Tobacco Industry Tactics". American Journal of Public Health. 102 (1): 63–71. doi:10.2105/AJPH.2011.300292. ISSN 0090-0036. PMC 3490543. PMID 22095331. {{cite journal}}: Check date values in: |date= (help)
  12. ^ GOODMAN, MICHAEL J. (1994-09-18). "Tobacco's Pr Campaign : The Cigarette Papers". Los Angeles Times. ISSN 0458-3035. Retrieved 2017-11-07.
  13. ^ University of Bath (October 17, 2012). "Hill & Knowlton". www.TobaccoTactics.org.
  14. ^ a b c d e f Bates 1. Rowell 2., Clive 1. Andy 2. "Tobacco Explained" (PDF). World Health Organization.
  15. ^ Wynder, Ernest L. (2010-01-12). "Some Practical Aspects of Cancer Prevention". New England Journal of Medicine. 246 (14): 538–546. doi:10.1056/nejm195204032461405. PMID 14910855. Retrieved 2017-11-12.
  16. ^ a b c d e f Cummings, K. M.; Morley, C. P.; Hyland, A. (March 2002). "Failed promises of the cigarette industry and its effect on consumer misperceptions about the health risks of smoking". Tobacco Control. 11 Suppl 1: I110–117. doi:10.1136/tc.11.suppl_1.i110. ISSN 0964-4563. PMC 1766060. PMID 11893821.
  17. ^ Brownell, Kelly D.; Warner, Kenneth E. (March 2009). "The perils of ignoring history: Big Tobacco played dirty and millions died. How similar is Big Food?". The Milbank Quarterly. 87 (1): 259–294. doi:10.1111/j.1468-0009.2009.00555.x. ISSN 1468-0009. PMC 2879177. PMID 19298423.
  18. ^ a b c Health, CDC's Office on Smoking and (2017-11-16). "CDC - Fact Sheet - Tobacco Industry Marketing - Smoking & Tobacco Use". Smoking and Tobacco Use. Retrieved 2017-12-06.
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