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Lawrence Bergner, MDMPH

Correspondence: Requests for reprints should be sent to Lawrence Bergner, MD, MPH, 101 W 12th St, 9G, New York, NY 10011 (e-mail: bergner{at}attglobal.net).

"Cigarettes and the US Public Health Service in the 1950s"¹ in the Journal's February issue is not only interesting history. It is also a useful reminder of how outside forces and strongly held individual beliefs can influence what we would like to believe are purely scientific considerations in the promotion of health and the prevention of disease. But I think Dr Parascandola is too dismissive of the importance of the Surgeon General's Report Smoking and Health² when he notes that the report did not meet some new "evidentiary threshold."

Although it is true that there was little new data, the manner in which the evidence was marshaled, in particular the presentation and elucidation of the 5 criteria for judging the causal significance of an association—that is, the consistency, strength, specificity, temporal relationship, and coherence of the association—made it possible to overcome the resistance of those who insisted—out of honorable or venal motives—that the absence of a blinded prospective trial precluded a judgment of causation.

Despite advances in statistical analysis, the 5 criteria continue to serve as a useful basis for epidemiologic studies where an experimental approach is neither feasible nor ethical. Smoking and Health remains excellent reading for introductory courses in epidemiology.

References

1. Parascandola M. Cigarettes and the US Public Health Service in the 1950s. Am J Public Health.2001;91:196–205.[Abstract]

2. Advisory Committee to the Surgeon General. Smoking and Health. Washington, DC: US Public Health Service; 1964.

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This Article Extract Full Text (PDF) Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bergner, L. Search for Related Content PubMed PubMed Citation Articles by Bergner, L. Related Collections Epidemiology History Other Tobacco Cancer