A story today on cigarette sales to the mentally ill today seems
scientifically problematic though it emanated from a study by Dr. Karen
Lasser, et.al. She is a primary care physician at Cambridge Hospital and
research fellow at Harvard Medical School.
The story carried in the press lacks accurate data and expert analysis of
the significance of the report. We picked up from a link in the Physician's
News Digest of Southeasten Pennsylvania which carried a summary of the
story. The Latter gave the Dallas News link below which ran the LA Times
Story.Citation: Rosie Mestel, 11/27/2000, "Cigarette sales raise concerns -
Mentally ill make up big part of consumers" Los Angeles Times.
http://www.dallasnews.com/science/health/224391_smoking_27dis..html
The veracity of the data in the article of numbers of mentally ill and
smokers in the nation is questionable. Moreover, there is nothing new in
reporting that the mentally ill and drug addicts smoke; it is common
knowledge in the field. The proportion of all smokers in the nation who are
mentally ill is subject to question.<<From the survey, the scientists
estimated that 44.3 percent of the cigarettes smoked in the United States
are smoked by the mentally ill.>> How in the world the Harvard researchers
leaps to the conclusion is not explained by the LA Times article. While it
is plausible that the majority of smokers do at one time drink, use drugs,
or attend psychological counseling, they are not necessary mentally ill.
Surely addicts and dysfunctional abusers of substances and those who have
been diagnosed with serious psychological/psychiatric disorders can be
classified as mentally ill but in the absence of definitive data, it is
difficult to accept the premise on face value that approximately 50% smokers
nationally are mentally ill or that about 50% of those who purchase
cigarettes are mentally ill. The statement is counter-intuitive and contrary
to cursory observations at cigarette stands and counters in retail stores;
though in some communities the proportion may be high. Moreover, the
newspaper article contradicts itself: First it uses the 44.3 percent figure.
then it uses 20%: << Smoking rates are high in such groups. In addition, in
any given year, one in five U.S. adults is estimated to suffer from some
form of mental illness. One in 20 suffers from a severe mental illness>>
However, the lead of the articles states 50%: << Nearly half of all
cigarettes purchased in the United States are smoked by people who suffer
from mental illnesses, according to Harvard Medical School research.>>
The story lacked interviews and substantive comments from the authors of the
original study as well as comments from epidemiologists or medical/health
statisticians. However the interviews with experts about the consequences
and what should or could be done about smoking by the mentally ill are
important and should be expanded upon. The LA Times article states << The
authors of the journal's paper also suggest that the tobacco industry may
have been aware that mentally ill people were a psychologically vulnerable
segment of their market. The scientists quote a 1981 document by R.J.
Reynolds Tobacco Co., which noted that some smokers smoked for "mood
enhancement" and "positive stimulation" or because smoking "helps perk you
up," "gain self-control," "calm down," and "cope with stress." R.J.
Reynolds Co. did not return several telephone calls seeking comment.>>
The role of cigarette companies is a spin off story and diverts attention
from the problems of accurate reporting and analysis outlined above.
Moreover the conclusion of the researcher and her quote about the cigarette
companies adds bias to the article. The statement incorrectly infers and
leads one to conclude that smokers who seek to get perked up, "gain
self-control," "calm down," and "cope with stress" are mentally ill.
The LA Times is an excellent institution and it has the reputation of
excellent reporting. So are broadcast media such as NBC and ABC news.
However in the past we had the occasion to criticize the latter two for bad
medical research reporting and now we criticize the LA Times cigarette
story. Our criticism applies to others who ran the story without adequate
analysis. Publishing an important medical or scientific story without
investigating/analyzing it or by hyping/overplaying it can mislead readers
and policymakers. The first step at correcting the problem is for reporters
and editors being aware and vigilant that medical and scientific research
news releases are just an invitation to investigate the story and to delve
into the significance. There is a responsibility to take the time to get and
report accurate data and other expert interpretations of the original report
that allow readers to decide the significance on the merits and not on the
hype.
The rush to publish is not excusable for bad reporting and poor analysis of
stories. Moreover, medical/health and scientific reporters and editors
should be technically competent in the fields they cover. Generally
speaking, a journalism degree and experience in local news reporting are not
sufficient for the critically important mission of public communications of
science and health/medicine affairs to the nation. We invite scholarly
articles and expert commentary about the role of the news media in science
and health policy.
Best wishes,
Stephen Miles Sacks, MPA, Ph.D., Editor and Publisher
SCIPOLICY(tm)-The Journal of Science and Health Policy
Box 504, Haverford, PA 19041
Website: http://www.Scipolicy.net E-mail: [log in to unmask]
Volume 1, Number 1 of Scipolicy focuses on The Future of Large-Scale Health
Systems and includes 10l articles on health systems and the problems,
changes in institutional ethics, and a case study of the University of
Pennsylvania Health System. Subscriptions and orders for individual copies
can be placed on line at http://www.Scipolicy.net. Proposals and
contributed articles are welcome.
|
