BMJ  2003;327:505 (30 August), doi:10.1136/bmj.327.7413.505-a

Letter

Passive smoking

Comment from the editor

Editor—I can't respond to all the points raised in this debate, and I thought I would simply share some reflections.

Firstly, we've considered again whether we should we have a blanket policy of refusing to publish research funded by the tobacco industry. We've twice considered this question in the BMJ and twice decided against. The BMJ is passionately antitobacco, but we are also passionately prodebate and proscience. A ban would be antiscience.

Secondly, we are not in the "truth" business. Scientific truths are all provisional. Most of science falls away as new paradigms emerge. This doesn't mean that we are in the "lies" business, but we are in the "debate" business. We judged this paper¹ to be a useful contribution to an important debate. We may be wrong, as we are with many papers. That's science.

Thirdly, with research papers we first ask if we are interested in the question. We must be interested in whether passive smoking kills, and the question has not been definitively answered. It's a hard question, and our methods are inadequate.

We then peer review the study, but we are well aware of the extreme deficiencies of peer review. Of course the study we published has flaws—all papers do—but it also has considerable strengths: long follow up, large sample size, and more complete follow up than many such studies. It's too easy to dismiss studies like this as "fatally flawed," with the implication that the study means nothing.

Fourthly, I found it disturbing that so many people and organisations referred to the flaws in the study without specifying what they were. Indeed, this debate was much more remarkable for its passion than its precision.

BMJ

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Competing interests: RS is the editor of the BMJ and accountable for all that it publishes.

References

1. Enstrom JE, Kabat, GC. Environmental tobacco smoke and tobacco related mortality in a prospective study of Californians, 1960-98. BMJ 2003;326: 1057. (17 May.)[Abstract/Free Full Text]

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