Smoked heavily for years and got throat cancer? You must've eaten too much salted fish

July 17, 2015
by Gus Iversen, Editor in Chief
A new study is shining light on ear, nose and throat doctors who have been testifying on behalf of tobacco corporations that smoking probably was not a major contributor to larynx, mouth, or esophageal cancer in patients who had been smoking more than a pack a day for many years.

Stanford University School of Medicine researcher Dr. Robert Jackler, professor and chair of otolaryngology, cited the testimonies in a study published online today in Laryngoscope.

"I was shocked by the degree to which these physicians were willing to testify, in my opinion in an unscientific way, to deny a dying plaintiff — suffering the aftermath of a lifetime of smoking — of a fair trial," said Jackler in a statement.

According to Jackler, six board-certified otolaryngologists were paid by one or more of the tobacco companies R.J. Reynolds, Phillip Morris, and Lorillard, to serve as expert witnesses on their behalf.

Those physicians cited several environmental factors, such as consumption of salted fish and use of mouthwash, as being more likely to have caused their cancer than years of heavy smoking.

The cases (which exceeded 50 in total) took place between 2009 and 2014 and included one case in which a physician was paid $100,000 for their testimony. Other doctors admitted to having their stance written for them by tobacco company lawyers, or took a position in their testimony that the Surgeon General is not an authoritative source of information.

According to Jackler, this research illustrates a defense strategy by tobacco lawyers in which other potential risk factors are highlighted in order to diminish the role of cigarette smoke in causing cancer.

"An obvious fallacy of this argument lies in the fact that literally billions of nonsmoking people are exposed regularly to gasoline fumes, use cleaning solvents, eat salted fish or live in urban environments," the study said.

If these causative factors were as impactful in a cancer diagnosis as heavy smoking, the study said the rate of head and neck cancer among nonsmokers would be drastically greater.

Although tobacco companies have admitted that their products cause cancer since the 1990s, they argue in court cases that smoking did not cause an individual plaintiff's cancer.

Given the ethical traditions of medicine, it seems likely that these physicians believe their well-compensated testimony on behalf of tobacco companies occurs in the shadows, out of view of their families, friends and professional colleagues, Jackler said.