Smoking and Cancer

In his interview with me about The Truth in Small Doses (Part 1, Part 2), Clifton Leaf praised Racing to the Beginning of the Road (1996) by Robert Weinberg. “A masterful job . . . the single best book on cancer,” wrote Leaf. In an email, he continued:

In Chapter 3 of “Racing to the Beginning of the Road,” Weinberg goes through much of the early epidemiological work linking tobacco to smoking (John Hill, Percivall Pott, Katsusaburo Yamagiwa, Richard Doll), but then focuses on the story of Ernst Wynder, who just happens to be one of Weinberg’s cousins. [As a medical student, Wynder found a strong correlation between smoking and lung cancer.] Building on his own prior epidemiological work, and that of many others, Wynder actually built an experimental “smoking machine” at the Sloan-Kettering Institute in New York in the early 1950s. The machine collected the tar from cigarette smoke (and later, the condensate from the smoke) and Wynder used those to produce skin cancers in mice and rabbits. But the amazing part of the story is what happened later…with Wynder’s bosses at Sloan-Kettering and with one of the legendary figures in cancer research, Clarence Cook Little. I don’t want to give the story away. (If you have the time, you really would love reading the book.) But it’s one of the most damning stories of scientific interference I’ve read.

Wynder met a lot of opposition. His superiors at Sloan-Kettering required that his papers be okayed by his boss, who disagreed with his conclusions. Clarence Cook Little, according to Weinberg, made the following arguments:

The greater rates of lung cancer in smokers only gave evidence of a correlation, but hardly proved a causal connection. One’s credulity had to be strained to accept the ability of a single agent [he means smoking] to cause lung cancer along with so many other diseases including bronchitis, emphysema, coronary artery disease, and a variety of cancers of the mouth, pharynx, esophagus, bladder and kidney. After all, many of these diseases existed long before people started smoking.

A little masterpiece of foolishness . . . and more reason to never ever say correlation does not equal causation. Little was at one point President of the University of Michigan. Later he worked for the tobacco industry. It wasn’t just Little. Weinberg says that Wynder’s colleagues complained about his “statistical analyses and experimental protocols, which they found to be less than rigorous.”

Weinberg says little about epidemiology in the rest of the book — which, to be fair, is about the laboratory study of cancer. At the very end of the book, he writes:

We learned much about how cancer begins; it is no longer a mystery. We will surely learn more . . . but the major answers already rest firmly in our hands. . . . No, we have still not found the cure. But after so long, we know where to look.

The claim that “we know where to look” is not supported by examples. And Weinberg says nothing about prevention.

Weinberg’s book reminded me of a new-music concert I attended at the Brooklyn Academy of Music. Hard to listen to (non-melodic, etc.) like lots of new non-popular music. I didn’t enjoy it, but surely the composer did — this was fascinating. How did it happen? I wondered. Weinberg describes a great deal of research that has so far produced little practical benefit. Weinberg, it seems, has managed to avoid being bothered by this — if he even notices it. How did this happen?

I don’t think it’s “bad” or wrong or undesirable to do science with no practical benefit, just as I don’t complain about “unlistenable” music. Plenty of “useless” science has ultimately proved useful, but the transition from useless to useful can take hundreds of years, which is why there must be “scaffolding,” sources of support other than practicality. This is why scientists use the word elegant so much. Their enjoyment of “elegance” is scaffolding. Long before “useless” science, there was “useless” decoration (and nowadays there is “unlistenable” music). Thorstein Veblen showed no sign of understanding that the “waste” he mocked made possible exploration of the unknown, which is necessary for progress. (By supporting artisans, such as the artisans who make decorations, we support their research.) What is undesirable is when someone (like Wynder) manages to do something useful, to foolishly criticize it, as Little and Wynder’s colleagues did.