Actually there is more than epidemiological evidence that smoking
causes lung cancer. For thirty years we had epi. evidence up the
wazoo, but it was only when we finally had tissue samples from mice
lungs (or it may have been rat lungs) that the causal link was
universally acknowledged. when the U.S. tobacco companies started
having to pay billions of dollars to state governments to compensate
for the health costs they had experienced owing to the hundreds of
thousands of lung cancer patients for whom they paid for treatment.
This standard was high enough to support legal culpability. These
were RCTs - just not in humans.
Peace,
Martha
>Salama:
>
>Randomized controlled trials (RCT's) are the most convincing form of medical
>evidence. RCT's can be done where the question is susceptible to an RCT and
>where sufficient resources exist to perform an RCT.
>
>A randomized controlled trial of smoking and lung cancer is ethically
>impossible, since overwhelming evidence from other scientific studies shows
>that lung cancer is caused by smoking. This causal relationship has been
>accepted by every independent scientist I know, since at least sometime in
>the 1970's.
>
>There is also no randomized controlled trial, at least known to me, showing
>that HIV causes AIDS. If such a trial were someday undertaken, would you
>volunteer to be one of the research subjects?
>
>A randomized controlled trial of most social determinants of health (SDOH)
>is also ethically and practically impossible. That doesn't mean SDOH aren't
>important! But it means that they must be studied by other methods, which
>individually are less certain than most RCT's but which can combine to
>produce a scientifically compelling picture.
>
>For discussion of the strengths of non-RCT evidence, and the potential for
>error in RCT's, please consult a good graduate-level epidemiology text.
>
>Best wishes!
>
>Dave Cundiff, MD, MPH
>Olympia, Washington, USA
>
>***
>
>On 3/10/07 9:48 PM, "Salama Habshi" <[log in to unmask]> wrote:
>
>> I have a question Is it ethically accepted to say that Lung cancer is caused
>> by smoking although there is no enough evidence (expriemental Randomized
>> Controledl Trial RCT) to support this hypothesis.
>>
>> Regards,
>> Salama
>>
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--
Martha Livingston, Ph.D.
Associate Professor of Health and Society
SUNY College at Old Westbury
Box 210
Old Westbury, New York 11568
(516) 876-2748
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