What Happens When Science Clashes with the Public?: Crash Course Scientific Thinking #7

Smoking causes cancer.

I know that; you know that; and the tobacco industry definitely knows that.

But not all that long ago,

you couldn’t even watch Saturday morning cartoons without being bombarded with messages

that cigarettes aren’t that bad for you.

Tobacco companies ran ads in magazines

and periodicals saying that “numerous scientists” question smoking’s risks,

that there are “many possible causes of lung cancer,”

and that there’s “no proof

that cigarette smoking is one of.”

So, if you had been there:

How would you have figured out what was true?

Hi!

I'm Hank Green, and this is Crash Course Scientific Thinking.

Before scientific knowledge reaches people like you and me, it takes a long,

arduous journey.

And big stretches of it are dedicated to collecting, testing, and scrutinizing empirical evidence,

information collected through rigorous scientific methods that either support or refute an idea.

The vast majority of scientific progress hums along quietly,

its evidence becoming widely accepted without much hullaballoo.

You won’t hear pundits debate whether carbon has six protons,

and there won’t be dramatic headlines about the mating behaviour of sea slugs.

Though I, for one, definitely would, and do, read those articles.

But here’s the thing.

Sometimes, science produces a nugget of knowledge that resists the status quo.

It challenges an economic system, or a hierarchy,

or a choice people make in their lives.

And when it lands with the public, tensions can flair.

Which is what happened in 1964 with smoking.

So, in this episode, we’re gonna do two things: first,

we’ll peel back the curtain on how the scientific process pieced together evidence about

the risks of smoking.

And then we’ll unpack why

that knowledge got so much pushback

—and what we can learn from the tale about the public consumption of science

news.

At the beginning of the 20th century, lung cancer was so rare,

doctors treated cases of it like once-in-a-lifetime learning opportunities.

But then, in the 1920s and ‘30s, lung cancer rates started to spike,

and scientists began working to figure out why.

There were a lot of early ideas about the possible cause.

Maybe it was atmospheric pollution or newly paved roads.

Maybe it was X-rays, poison gas from World War I,

or the after-effects of the 1918 flu pandemic.

Those were all correlations, but as we learned in an earlier episode,

correlation doesn’t mean causation.

So over two decades,

scientists tested different explanations and shared the results with each other.

Each study was like a pebble added to a pile of evidence.

Scientists had to weigh that evidence by examining each study skeptically,

and asking things like: “How well was the study designed?”

“Did it find a strong or weak relationship to lung cancer?”

And “How directly did the methods actually get at the question they were trying

to answer?”

For some explanations, no evidence emerged.

You’re off the hook, flu.

But eventually, four main lines of evidence pointed to one suspect.

Exhibit A: Observational studies

which had followed groups of people over a period of time showed

that smokers developed lung cancer at higher rates than non-smokers.

But there were other factors in people’s lives

that could be affecting cancer rates,

so these studies alone weren’t enough.

Enter Exhibit B: Experimental studies were done on mice—

because you can better control conditions in a lab.

And mice exposed to tobacco developed tumors.

But how?

What actually happens when lungs are exposed to smoke?

Exhibit C: Further studies showed

that cigarette smoke destroys cilia— the tiny structures in lungs

that keep out bad stuff.

And finally, Exhibit D:

Tobacco smoke itself contains a chemical compound

that was previously shown to cause cancer in people exposed to coal tar.

All of that evidence, when weighed collectively, began to tip the scales!

By the late 1950s, scientists had reached a consensus widespread agreement,

given all of the evidence— that smoking was the leading cause of lung cancer.

So in 1964 the U.S.

Surgeon General — himself a smoker — announced to reporters that cigarettes cause lung cancer.

But for the public, that message got drowned out by a lot of noise.

So, let’s rewind the tape.

And this time, let’s look at what was going on in the public view.

Even in the 1930s, people suspected smoking wasn’t exactly great for you.

But tobacco companies worked to stay ahead of the narrative:

boasting that their cigarettes were healthier, safer, gentler, “fresh as mountain air.”

The RJ Reynolds Tobacco Company ran ads citing “studies”

that claimed “More doctors smoke Camels than any other cigarette.”

And you want to know how they got that statistic?

By giving doctors free Camel cigarettes,

and then asking them what kind of cigarettes they smoked.

I mean, come on.

By the 1950s, tobacco companies knew about the mounting scientific evidence.

But they were still invested in selling their product.

So they changed the message.

Instead of “Our cigarettes are better for you,” the ads became “We don’t know

yet if cigarettes are bad for you.”

And by doing so, they manufactured a controversy that didn’t actually exist.

This is where things get wild.

In 1954, a committee called the Tobacco Industry Research Committee

which was formed by the tobacco companies

released a statement claiming the link between smoking and lung cancer wasn’t settled,

and they would be “researching” the issue themselves.

These people would have thrived on social media.

This went on for decades, long after the scientific consensus had been settled.

The tobacco industry distracted from smoking’s harms by funding

and publicizing research looking into alternative explanations for lung cancer.

They suppressed and criticized studies that found smoking was bad for you.

And all the while they publicly denied that smoking was risky or addictive,

and blasted ads that made cigarettes seem as enticing as possible.

They did all of this knowingly and strategically, to keep making money.

A 1969 internal memo at the tobacco company Brown & Williamson stated:

“Doubt is our product since it is the best means of competing with the

'body of fact' that exists in the mind of the general public.

It is also the means of establishing a controversy.”

Wow, they just said it.

And selling that doubt worked.

The tobacco industry preyed upon people’s cognitive biases

those predictable patterns our brains tend to take

that can sway us away from accepting valid information,

especially when it challenges something we already do or think.

The news that smoking causes cancer just didn’t vibe with a world where smoking

was common,

widely accepted, and everybody did it.

Doctors!

Astronauts!

Movie stars!

Plus, cigarettes are highly addictive.

When you’re addicted to something,

you pay more attention to reasons to keep doing that thing.

And the tobacco industry was willing to give smokers those reasons,

even though the reasons were made up.

They systematically attacked the widely accepted scientific explanation in order to sow doubt among

the public.

But here’s what finally turned the tide against smoking.

In the 1990s, scientists uncovered evidence of exactly how cigarette smoke can trigger a

normal cell to become a cancerous cell.

Then, in 1998, a major settlement required the tobacco industry to pay up billions

of dollars for the damage they had caused.

The writing was on the wall.

But the tobacco industry still tried to spin the narrative!

The message this time?

They claimed they’d always been transparent about the risks of smoking

and said that it had always been an individual’s choice to take those risks.

Which brings me to another common point of tension

that can make scientific knowledge seem controversial— sometimes scientific knowledge clashes with people’s values.

There’s stuff science can tell us like,

the precise mechanism that causes a cell to become cancerous,

or how much smoking increases your individual risk of developing cancer.

But science can’t tell us what to do with that knowledge.

It’s on us

as individuals and as societies— to decide what to do now

that we know what we know.

For example: in the early 2000s,

as the dangers of secondhand smoke became more widely known,

many cities and states began banning smoking in public places.

Not everybody agreed with the move, but the disagreement wasn’t over the science.

It was about how that knowledge should mesh with values.

What’s more important?

A person’s freedom to make their own choices, with their own body?

Or a person’s freedom to protect their body from the choices someone else is

making?

Science can’t answer those questions.

And I can’t answer these questions for you.

So you might be wondering: why did I even tell you all of this?

You can think of the war over smoking as a kind of fable.

It’s a story that can teach us something,

like “The Tortoise and the Hare,”

or “The Boy Who Cried Wolf,” except it really happened.

And there are three lessons we can take away from this story

that can help us navigate the wilderness where science

and public opinion meet.

First, follow the scientific consensus.

When a certain idea is backed by broad agreement among experts,

it has already cleared an extraordinarily high bar of skepticism.

I trust the experts for a reason.

Like, when I notice an electrical outlet is broken,

I could try to fix it myself.

But I’ll—at best—spend much more time trying

and do a much shabbier job than an electrician would.

At worst, I’ll look like this.

The same is true with science.

You'll have better information

and get better outcomes

when you trust the process of science.

So when there is scientific consensus, pay attention to it.

Second, when there isn’t yet consensus,

we should be skeptical of science-related claims we encounter,

and keep in mind that a single study doesn’t settle anything.

The studies we do hear about the ones that make headlines

are the ones that have a surprising or attention-grabbing angle.

But a single study is just one pebble of evidence on the pile.

You should look to what other experts say about it,

to understand how that study compares to the rest of the evidence,

and how much it actually changes what we know.

Third, in science, “challenging”

or “debating” an idea has a very different meaning than it often has in

everyday life.

Even with a strong consensus,

not every scientist agrees on every detail of an issue.

But scientists don’t hold evidence back,

or try to keep other scientists from finding the flaws in their argument.

They put it all on the table.

They share everything they know, all of the evidence, in good faith,

so that their ideas can be challenged well.

That’s the whole point!

See kids, if you like arguing you can make a whole career of it!

Sage, I don’t think you were scheduled for today.

I just had to say goodbye to the people, Hank!

It’s been a pleasure to have you along, Sage.

Oh I’ll be back… Is that a teaser?

It might be...

Bye people.

Hope you enjoyed your Sage Advice.

Thanks Sage.

There are times when scientific knowledge seems controversial to the public eye,

but actually isn’t controversial among the experts who know it best.

That’s why the “argument”

that smoking causes cancer wasn’t just an opinion among other opinions.

Often, when a scientific idea sparks controversy among the public,

it’s because it challenges our biases, our values, or powerful interests.

Scientific consensus is so impactful because it happens independent of those external considerations.

And it’s why science, the process,

is so powerful at helping us become less wrong over time.

As we wrap up this series, I’ll leave you with this:

When we recognize how science really works, the world makes so much more sense.

We can be skeptical of individual studies, yet place trust in the collective process.

We can appreciate the long journey an idea takes before it becomes widely accepted

knowledge,

yet be open to ideas changing with new evidence.

And we know that if an idea is wrong,

there’s a good chance scientists will find out.

From all of us here at Crash Course, thanks for watching.

This episode of Crash Course Scientific Thinking was produced in partnership with HHMI BioInteractive,

bringing real science stories to thousands of high school and undergrad life science classrooms.

If you’re a teacher,

visit their website for resources

that explore the topics we discussed in the video today.

Thanks for watching this episode of Crash Course Scientific Thinking

which was filmed in Missoula,

Montana, and made with the help of all these nice people.

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you can join our community on Patreon.