Opinion – Esper Kallás: Toxic smoke over Covid-19

After the first world war, a new habit would become increasingly popular: the use of cigarettes. Its use grew, including among young people, accompanied by an increase in serious lung problems, circulatory disorders and lung cancer, a relatively rare disease until then.

The discovery that smoking causes lung cancer, now a truism, took an extremely crooked path to be accepted as a fact. Even so, it remains contested by few, including the late Olavo de Carvalho.

The subject was researched in detail by two Englishmen: Richard Doll, a physician and smoker at the time, and Austin Bradford Hill, an epidemiologist and statistician. Together, they applied a questionnaire in a project known as The British Doctors Study, to more than 40,000 doctors since 1951. In 1954 it was already possible to perceive the association of smoking with lung cancer and, in 1956, with heart attack. The study continued for many decades and was able to show the relationship with several other health problems.

The tobacco industry reacted noisily, attributing the increase in cancer to pollution and other environmental factors. Not only did they refute the association, but they also invested large sums of money in advertising and studies with less rigorous methodologies to deny the undeniable.

The perception by public opinion was also slow. In 1960, for example, nearly half of American physicians still smoked. It was not until the late 1990s that the tobacco industry recognized cigarettes as a cause of cancer and other diseases. The decades of denialism continue to leave a trail of death and suffering. Cigarettes are considered the deadliest artifact in history, responsible for more than 8 million deaths a year, according to the WHO.

The controversy generated Hill’s criteria: a series of premises to assess cause-and-effect association. Such criteria have been improved and serve as a basis for rigorous analysis of scientific evidence and fostered the discussion on best practices to answer relevant health questions, including the adoption of biomedical treatments and preventions.

Many years later, already living the Covid-19 pandemic, something similar unfolds, involving the treatment of the disease. After periods of uncertainty, we have a large set of rigorous studies that point out which strategies and drugs are useful or not.

Misleading advertising, the artifice of looking for inadequate studies and using exceptions try to drive doctors and public opinion away from the guidelines that should be advocated. The note from the Ministry of Health’s Secretariat of Science, Technology, Innovation and Strategic Inputs, by denying the opinion prepared by the expert committee and approved by Conitec for the treatment of Covid-19, recalls the worst moments of the fight against tobacco and disregards scientific criteria, which must be making Hill turn over in his grave.

Diversionism employs tactics to distance the observer from solid evidence, as Olavo de Carvalho did when questioning the relationship between smoking and disease.

Making public opinion understand the distortion is no easy task. But here are some tips: avoid using rare cases to reach conclusions, look at the whole. Prefer to be guided by rigorous studies, published in good scientific journals. Seek information from experts on the subject, not occasional opportunists. Finally, read a lot about science, as it helps to build and exercise criticism.

By doing this, you get closer to the truth.