00:11 - 05:27

[Clive Bates]

I'm Clive Bates. It's my great pleasure and privilege to introduce Arielle Selyer for this year's Michael Russell Oration. I'm going to take the liberty to say a few kind of fanboy remarks about Arielle, who is, in my view, one of the best, if not the best, scientists in this field. One of the nicest people, one of the most energetic people in this field. I don't know whether it's a pleasure, a privilege, or a... a punishment, but Arielle and I collaborate weekly on producing a review of all the papers that have come out in PubMed. We get them on Friday afternoon. I send them over to Arielle. She chooses the ones that she wants. Thankfully, she chooses all the difficult ones. and writes absolutely brilliant reviews of all of them. If you don't get this publication, you're missing out, not on what I say, but on what she says, which is the most educational content you can get in tobacco harm reduction. Just by way of introduction, she is an awesome scientist and total respect, a first degree in physics, a PhD in neuroscience, and a postgraduate fellowship in psychology. Now, if that's not intimidating enough, I don't know what is. She spent 10 years in academia, got in with the wrong sort, doing sort of tobacco control research, and was very much, and I think you'll probably say something about this experience, but very much in the tobacco control zeitgeist of finding harm reduction a problem and working on proving there was a gateway effect. And then science happened, and she found results that were contrary to the dominant narrative in tobacco control. And instead of working out how to do something else or to change her mind or to polish the results, she followed the science. And that led, you know, and she'll describe this, to some pretty uncomfortable kind of clashes with academia. And the result was she left academia. But I don't like to think of it that way. I don't think she left academia. I think she followed the science. And that's a really important distinction to make in this meeting, especially as we're doing this to honour Michael Russell, great Michael Russell. And then from there, I went to Pinney Associates, a regulatory consultancy, where, again, she is doing some of the best science in the business, looking at the behavioral insights that Pinney have on behalf of Juul. So really, really good quality, relevant regulatory research, okay? And I think that's a great story, because a lot of people would say, well, you left academia and went to industry. What went wrong? Actually, what went right was following the science. She's not only a full-time scientist, but a full-time mum. Is that right? Full-time or more than full-time? Full-time mum. One son, Obi, a chess prodigy. The other, Dorian, an electrical genius, I am told already. So she's rearing the next generation of intimidating geniuses. She lives like a kind of warrior from ancient Sparta, eating a sort of ketogenic diet, one meal per day, fasting regularly, and probably slaying demons with a two-handed sword, for all I know, but that's not actually in the notes. She's a taste for the weird and loves fantasy science fiction. I would say she's just a great person to pass time with, really interesting, really funny, really clever. We are here to honor Michael Russell. I knew Michael Russell reasonably well. He died, unfortunately, in 2009. But I can tell you this. If he had met Arielle Selyer, she would have been one of his favorite students, one of his favorite academics. This approach to science and this attitude of, questioning, of relentless curiosity, of a drive to understand science as it is and how it can help people, that is very much Michael Russell. And he would have been, you know, dying to have her in his team when he was sort of, you know, a famous professor. So I think it's great. I think we're really lucky to have Arielle here to commemorate both Michael Russell and to give us her own insights into her academic experience. So ladies and gentlemen, put your hands together. I'd like to give you Arielle Seller for the Michael Russell Oration.

05:34 - 38:28

[Arielle Selya]

Thank you so much, Clive, for that introduction. And I'm not sure if Clive remembers this, but you were also kind of instrumental just as I was on the cusp of discovering tobacco harm reduction. You reviewed one of my papers in addiction and gave me the idea of exit gateway. And I was like, wow. So you were very instrumental too. And thank you to the GFN team for inviting me to this. I'm very honored to be here giving the Michael Russell oration. Thank you. Okay, so I've got my slide deck ready to go through. Thank you. So my talk is on the state of the academic research. As Clive mentioned, I'm a voracious consumer and try to produce it as well when I can. And I'll be talking about flaws in the existing research, incentive structures that led to the current state of affairs and opportunities for moving forward. By way of disclosures, Clive mentioned this, but I'm an employee of Penny Associates. We consult for Juul, and in the recent past, consulted to PMI. I also consult with Ricardo Pelosa at CoEHAR, which accepted global action funding. But this presentation is entirely my own and mainly draws from my time in academia. Three overall parts to my talk. First, I'll briefly cover the state of the academic research. I could go on about this and fill the entire time just on this, but I won't. I want to focus mainly on number two, how did it get this way in terms of incentive structures in research. And I'll wrap up with how we can improve things. On the state of the academic research, Tobacco harm reduction research is, as you guys know, a highly polarized field. By number, the anti-THR papers currently predominate. One of the problems, however, is that so many of them suffer from fundamental flaws, and the same fundamental flaws across many different papers week after week. And some of these flaws are not preventable, but many of them are at least mitigatable to an extent. But the research currently is not doing that. There's also a lot of hostility to industry. There's many places that I can no longer publish. And there's even criticisms that I've seen of industry adjacent authors or authors that write papers that are cited by industry or make the same arguments used by industry. Clive and I did a really fun panel last year identifying what we thought were the 10 common flaws in THR research. We got a lot of great feedback from the audience and we're currently trying to figure out how to write this up and publish it as a guide to evaluating the research. and hopefully make it more digestible. But just to give you a sense and a reminder for those who were there last year, this is our current working list of 10 common flaws. I'm not going to go into these into detail, but briefly, things like exaggerated harms or exposures is a big problem. Number three is also a common problem, unfounded causal conclusions and a related note, failure to consider alternative explanations that would produce exactly the same findings. But the authors kind of conclude one finding and don't consider the others. Number seven is sort of related from this, inappropriate policy recommendations. Sometimes the policy recommendations assume a causal relationship, even if the authors admit that one hasn't been established. And of course, hostility to industry and the questions not being asked. So Clive's major example of this is we need to have a better understanding of why people use nicotine and what the benefits are. And my example of this is policy studies that look at only the intended effects rather than looking at offshoot or unintended effects. I'm gonna go through a couple examples of recent papers and how they map onto this list of 10 flaws. And these are chosen simply because they were recent and a good example. These aren't even particularly glaring papers, but just goes to show how common some of these flaws are in run-of-the-mill research articles in this field. The first example I picked is a study of snus and nicotine pouch use among the Finnish adult population, 15 plus. The main results of this paper were that 29% of people ever used snus, 14% ever used pouches, and about 30% who used one of those products didn't know the nicotine strength of that product. The conclusions of the article were to focus concern on the fact that a lot of people don't know the strength that they're using, and they call for regulation, regulating specifically the nicotine levels and addictive potential. How does this map onto the flaws? It hits half the flaws at least on this list. Number one, it ignores the continuum of harm. So current snus use was 8.4%. Current pouch use was 3.7%. And all the paper's narrative is focused on this when cigarette smoking was much higher than the two of the other products combined. There's a missing counterfactual. What would people be using otherwise if they weren't using snus or pouches? Would they be using nothing or would they be smoking? Questionable definitions. The paper reports ever use, which by the paper's own breakdown is mostly 60% tried once or twice. So this is transient experimentation that doesn't continue. In fact, current use was 25% of those two figures. also makes inappropriate policy recommendations. So the conclusions, as I mentioned, called for regulating the nicotine content. However, both of those products were illegal at the time of the survey, and there's no reflection or consideration of how would additional regulations be expected to improve things when there's already a more severe one in place. A bonus flaw here, the use of SNUS is associated with the use of stronger SNUS. That's an illogical analysis. What's the alternative there? Not using SNUS is lower strength SNUS. So there's something going wrong in the analysis, probably with the way they handled missing data, but this should have been caught during peer review. Next recent example is on tobacco retail outlet marketing exposure. And this is using a longitudinal cohort of Texas students aged 11 to 22, asking them whether they were exposed to tobacco retail marketing for cigarettes or e-cigarettes, and then measuring use of the corresponding product. And they found that exposure to cigarette marketing is associated with higher odds of past month smoking. Similar result for e-cigarette marketing and e-cigarette use. The conclusions were that exposure to marketing increased the odds of tobacco product use for youths aging into young adulthood. And it calls for marketing restrictions to reduce tobacco use among youth and young adults. Kind of similar to the last paper, it has unfounded causal conclusions. So one of the sentences was, e-cigarette marketing may be particularly influential in early adolescence. Technically, this is not claiming causality because of the word may, but it's a causal and it's the only interpretation discussed in the paper. But there's important alternative explanations. For all of these studies on self-reported marketing exposure, there's attentional bias and recall bias, which means that youth who are already using these products or are interested in using them tend to notice and remember seeing such content before. I'm gonna skip ahead into seven because the unfounded causal interpretation leads directly into the policy recommendation, which of course is for calls for increased marketing restrictions. But again, there's kind of no consideration of the current marketing environment, which is already heavily restricted for youth, and what specifically might be done differently. And it also doesn't consider harmful consequences of that, such as on adults who smoke or on risk perceptions. And again, jumping back to number five, there's also questionable definitions here. So the definition of marketing exposure included simply visiting gas stations or convenience stores. And then this was multiplied by the actual variable for self-reported exposure. So the variable that they analyzed didn't really capture what it was supposed to. So I could go all day on that, but I won't. I want to focus more on how did it get this way? And from this, I'm going to pull on my decade in academia. Clive mentioned a lot of this history. I was a postdoc at Wesleyan University. My postdoc advisor was fantastic, and the team of collaborators I worked with were very supportive of everything I did. It was more when I made it into the junior faculty role and I was expected to carry on my own independent line of research that I got into more difficulty. My research activity throughout this time, when I started, it was on adolescent smoking behavior. And I was studying things like trajectories, development of dependence, and risk factors. When e-cigarettes came out and started becoming a big story around 2014, I initially bought the anti-THR view. I bought the idea that e-cigarettes are gateway products, and they attract youth, and they might lead to smoking. But I changed my mind, as Clive mentioned, with my own analysis. And I don't have time to get into that particular story, but happy to share that later at the after party. four to eight publications per year, so I was always a pretty prolific publisher, but where I ran into trouble was grant applications. And a disclaimer that what follows is my own experience. I don't know if it's any better at other universities. This might not be representative, but I feel it's important to share that these are some experiences and opinions that are out there in academia. So starting with kind of the basics, life as a tenure track faculty member revolves around your percent annual effort on paper in each of these three buckets, research, teaching, and service. So on paper, I was supposed to spend 50% of my time on research, 40% on teaching, and then some for service, which includes service to the university on committees, and service to the profession through peer reviews and things like that. In reality, it looked much different. So I spent almost all my time when I had a joint research teaching position on teaching. So not only the courses, like teaching time during the day, course prep, grading, helping students in office hours. And then another 25% where I was was supervising master students' projects. So this was very time intensive. I only, probably out of the year, if I add up all my days, there were only about three weeks in the early summer where I was actually able to work on publications, so that was catch-up time for getting papers ready for the year, and the rest of my research time was spent on grant applications that ended up going nowhere. And then service, as I mentioned, is split between soul-sucking committee work at the university and peer reviews. There's increasingly high expectations for faculty. So based on the percent effort on paper, you're expected to meet certain quotas within each of those buckets. Teaching takes a lot more time, but it's actually less valued over research. There's really no incentive for putting in effort to better educate your students or improve your coursework. In fact, it's considered much more highly prestigious to buy your way out of teaching with research grants. In the research bucket, it's still publish or perish, but it's also now get grants or get out. Grants determine survival for academic faculty members now. I was lucky and I joined at the tail end of when grants were encouraged but not specifically required. But now in most places, I think they're required to, even for entry level positions, to come in with grant funding that you attained from your previous institution. This was a quote from an administrator to me at one of my institutions that will be fine budget wise as long as you faculty members keep getting 10% more in NIH funding every year. This is obviously not sustainable and this was during a time of shrinking funding and I'm sure administrators all over the country were telling their faculty members the same thing. And what this results in, this is a plot from NIH themselves tracking grant applications. So the tall blue bars are the applications submitted and the smaller blue bars are the ones that are actually given out. And then the red line going across is the success rate. So obviously as there's more applications going in and fewer grants getting awarded, the success rate goes down. This graphic says 20% as an ending value. For the type of grant I was applying for, as somebody that didn't have existing funding, it was more like 7% when I was in academia. A colleague at another institution was expected to file multiple grant applications every cycle, so at least six per year, and cover more than 100% of their salary. And not all grants are created equal. This gets into the issue of indirect costs. So indirect costs have recently become a political issue, but I've recognized the problems of this for 10 years now, that indirect costs are an extra percent given to the university on top of the grant amount to cover overhead or operational costs. At least that's the intention. NIH grants are especially highly valued by institutions because they pay the institution's set rate for indirect costs. There's a wide range here, but it's roughly around 50% as a ballpark figure, whereas other funding agencies, such as Robert Wood Johnson, cap their indirects at 12%. And again, this is a direct quote from an administrator, that any non-NIH grants or contracts don't count towards your tenure and promotion because the university only cares about the indirects. So from the university's perspective, it's more about the financial bottom line than the quality of the research. So this kind of leads to a vicious cycle, because the more administrative pressure there is, the more faculty have to spend time and energy writing grant applications. And this creates its own ecosystem, because for every grant that's filed, there needs to be specialist staff that check everything, provide supporting documents, do the actual filing, and if a grant is awarded, they do the administration of those funds. and that raises the need for indirect costs. So I think the indirect cost issue is kind of offsetting some of the demands created by the need to apply for grants. And the reason this is all relevant to research is that NIH's high indirect rates in particular make academic research beholden to their funding priorities. They have to shape their research to fit into one of the research areas that NIH is specifically funding. How did things get so competitive with grants? This goes into a long-term side interest of mine, system dynamics simulation modeling. This is from a colleague who was one of the people who taught me system dynamics, but he has a really informative model treating the academic workforce as a population. So instead of a birth rate, there's a PhD production rate. And the idea is that because faculty positions are kind of stagnant over time, there's not a lot of growth in faculty positions, For every academic professor, they graduate more than one PhD over the course of their career, but only one of those students can take their place. For biomedical sciences, this number is 6.3. So that leaves 5.3 PhDs on average in competing, unable to find an academic position. So academia is oversaturated, and it's been like this for some time. And there's, meanwhile, only slow growth in faculty positions. This overproduction leads to, and continuing the system dynamics thread, I'm going to show a causal loop diagram, or a kind of conceptual diagram of what I think the dynamics are here. So this is what I've just described, the circle of the academic and PhD overproduction. Anybody that fails out of, is unable to find an academic position is considered failed if they leave academia to work for industry, for example. And the other ones might get stuck as postdocs or low paid research staff with not a lot of upward mobility in their career. And of course, the oversaturation of PhDs leads to competition for those limited slots. And this increases the pressure for grant funding. And this leads to, as I mentioned in the last slide, a kind of ecosystem of grant applications. And there's also, unrelated to the grant issue maybe, but there's also been a large increase in what these authors call the bullshit jobs in academia, including high paid administrators. High paid administrative positions have increased much faster than faculty positions. Grant applications mostly lead to wasted effort in my experience because the funding success rate is so low. But some grants are awarded. And the ones that are kind of require conformity with the funding agency priorities and views. And this is now in many places explicitly tied to hiring, promotion, and retention of faculty members. So many faculty members are kicked out after a certain number of years if they're not able to obtain NIH funding. Put a pin in this mentally, I'm going to come back to the conformity issue in a few slides, but just to follow through with some of the other offshoot effects in academia. I mentioned that successful grant awardees can buy their way out of teaching responsibilities. So that reduces their teaching load for those faculty members, but the courses still have to be taught. And this leads to a lot of outsourcing to low paid adjunct positions. And these are very difficult jobs to have as an adjunct. You're paid, last time I looked, was like 3,000 to 5,000 US dollars for an entire semester of work. And if you want to do a thorough job at teaching and course prep, it can easily turn to be lower than minimum wage. Grant priorities influence publications, too, because to get a successful grant for NIH, you need supporting papers to cite in the grant proposal. You need to produce new papers during the course of that grant to provide as updates to the funding agency. And it's common practice to use some of each grant to fund the pilot research for the next grant. So even when a grant is awarded, faculty members still aren't safe. They have to start immediately planning for what's the next one. And so they use some of those funds to produce publications that they can then use to ask for more money later. So all of these things create an incentive to produce a large number of, oh, did I do that? Sorry, it's different on my screen up here, but I think it's okay. On the other hand, if you espouse THR, so this is a quote from a grant review that I submitted, and this was early on as a junior faculty member. I wrote what I thought was a pretty neutrally and balanced grant proposing to look at the gateway versus diversion scenarios for youth e-cigarette use, and the comment that I got back was, it would appear inadvisable to encourage a teen to smoke e-cigarettes because they're better than traditional cigarettes. I did not get the grant, obviously, but that goes to show that going against the grain can really work against you when it comes to obtaining this sort of funding. Other publication disincentives that are worth talking about is going back to the annual evaluations and faculty quotas for producing publications. This incentivizes what's called salami publishing, where you might have a lot of content that you could slice up and publish as three separate papers instead of one more comprehensive paper. And there's an incentive to do that because then you can check your quota off for publications. So it encourages incremental rather than revolutionary papers. From the publisher's perspective, they are mainly interested in novel findings, and so that's an incentive for researchers to overstate their findings and engage in things like p-value hacking, where they'll run a ton of analyses and only present the ones that turned out to be significant. Peer review is also fairly broken. It's a thankless, unpaid task. It takes a lot of hours and probably isn't thorough unless the peer reviewer has access to the data and has the time to try to replicate the analyses. And there's really no incentive from the university structure to do a thorough job at peer review. I was told, don't do too many peer reviews. Just do enough to check off the box for your 10% effort on service. And then, of course, confirmation bias by reviewers that are invested in aligning with a certain viewpoint. So back to this slide, I highlighted the conformity issue. And in my opinion, this is the main driver of low quality and anti-THR research. So if the funding agency priorities drives that, what drives funding agency priorities? I don't know, but some speculation is that I think a lot of it is honestly naive with good intentions and this aligns with the misperceptions of risk that there's so many sessions about in this conference. I think some people genuinely believe that e-cigarettes are harmful and from that perspective, what they're doing makes sense to them. But there's also distrust of profit motive, especially considering the past bad behavior of the tobacco industry. I think there's also an emotional objection to recreational nicotine use. And Dr. Mike Siegel, I think, was the first to talk about this, the not invented here phenomenon, where if e-cigarettes came from the public health group, then they would be highly touted as a successful solution. But because they came outside of public health, outside of academia, and from industry, they're opposed. And this brings to mind a quote from the Dune series that I thought was relevant. Quite naturally, holders of power wish to suppress wild research. Unrestricted questing after knowledge has a long history of producing unwanted competition. The powerful want a safe line of investigations, which will develop only those products and ideas that can be controlled, and most important, that will allow the larger part of the benefits to be captured by inside investors. Unfortunately, in a random universe of relative variables, does not ensure a safe line of investigations. So I think that describes well some of the dynamics playing out here with e-cigarette and tobacco harm reduction research being the wild line of research. Moving on to how we can improve things, Academic funding maybe is in flux, at least in the U.S. There's legal challenges to this, so we'll see what happens. There's obviously upsides and downsides to this, but the fact is we're potentially facing the cancellation of a large number of grants, and not only the number of grants, but the funding for indirect research costs, which previously made NIH the singular thing to attain for junior faculty members. Couple of scenarios, pessimistically universities could respond by pressuring their faculty even more to go after a shrinking pool of money. They could raise already sky high tuition rates because they're used to having a certain income level and they need to recoup it from somewhere. They could rely even more on low paid research staff and adjunct faculty, all while preserving high paid administrator salaries. I hope that doesn't happen. So ending on a positive scenario, if there is a major change at NIH, it could force a realignment of what's considered acceptable by universities in terms of funding sources. And if there's a variety of funders available, this might reduce conformity of thought and broaden what's considered a scientifically valid line of inquiry. However, for the optimistic scenario to happen, a change needs to happen in the set of funding agencies. There are other funders of academic research, but at the moment the major ones all have the same stance on THR. So American Cancer Society, American Lung Association, and of course Bloomberg. So even if funding incentives change as far as the preference for NIH, the current options would not improve the state of the science. Ultimately, what we need is a range of funders with diversity of thought. I don't know what to do about this, but possibly it's a role for grants or contracts from industry. And even more optimistically, if this becomes normalized for academic researchers to start relying on grants or contracts from industry, maybe it could help the ostracization. Communication is also an opportunity going forward. So one more anecdote from academia. This is my Google Scholar profile, including my papers, in order from most cited to least cited. That top one there kind of has an interesting story. It's by far my highest impact paper, but it wasn't novel in an academic sense. I was wanting to do a certain statistical procedure for another paper I was working on, And it was hard to find how to do that because there wasn't one source. So essentially what I did is cobble together different parts of the process from disparate sources. And my postdoc advisor encouraged me to publish it, thinking it could help other people. And she was right. But the problem was with publishing, you need some novel angle to be able to publish it. And I didn't invent anything here. So as a result, we didn't pursue a traditional journal. We went open access to frontiers. And I was slapped on the wrist a few years later. I was told in one of my annual evaluations, this doesn't count, don't publish in Frontiers because it's predatory. Some open access journals are predatory, but there are some that are legit, and they reduce the focus on novelty, and they're more open to replication studies, negative findings, and other studies that are not as exciting, but still important for the science. So when even open access scientific journals are not considered pure enough, academia has a communication problem. But it needs to go just, oh yeah, this might be changing. I saw this recent defense of open access journals, which I agree with. But it needs to go much further beyond dialogue with other like-minded academics. And if I'm right that a lot of academics just have naive good intentions, maybe they're in a bubble like I was at one point, maybe they've just never heard of THR, then that's a good opportunity to engage in dialogue with people with different viewpoints. And maybe they just need to be exposed to different ideas. However, more communication in and of itself isn't always better. Most of you are aware of this alarmist article from earlier this year that severely over exaggerated the risks of vaping based on a study that was not only not published, but not even complete yet. So maybe it's not more communication we need, maybe it's impact. A couple of thoughts since leaving academia are that one of the biggest challenges for me going to industry was learning how to communicate to normal people. It's almost its own language to write for academic journals, and it's hard to break out of that. And I'm still trying to improve my language and how I can clearly explain my science using non-technical language. But I think that's a good practice that more academics should have. They need to be encouraged to communicate with people outside of academia. And I think maybe this could even cut down on some of the alarmist media coverage of research if academics are able to clearly communicate the limitations of their studies in plain language. Something that universities and journals can do is require better research practices, encourage transparency in data and analyses, like making your data available or your analysis code. I'm a big fan of preregistration as well, because that will cut down on things like selectively publishing only the exciting findings and p-value hacking. And also adversarial collaborations. It's good, it strengthens the science to plan a study with somebody of the opposing viewpoint and decide ahead of time what counts in one camp or the other. I'm involved in the early stages of an adversarial collaboration and it's been informative already. Lastly, there needs to be more understanding of how someone's research affects people. And the consumer voices are invaluable. You guys have been saying nothing about us without us for a while. And in other academic fields, that's been accepted and embraced by the researchers. But tobacco research seems to be slower on the uptake with that. But I think we're making progress. So keep sharing your stories. Change people's emotions, because facts don't always work. Also, for those producing science, keep publishing good science. For those consuming it, keep spreading good science. There's a quote from Arthur Schopenhauer that all truth passes through three stages. First, it's ridiculed. Second, it's violently opposed. And third, it's accepted as self-evident. I do see some signs, I think, that we're entering the third stage of truth. So there's been some recent pro-THR papers from research groups that are historically anti-THR. And there seems to be more acceptance at academic conferences that switching to e-cigarettes is a valid harm reduction strategy. There's still some pushback and concerns about things like dual use, but I think we're making progress. Wrapping this all up, nicotine tobacco research is highly polarized. There's pervasive flaws that are somewhat preventable. And unfortunately, at the moment, anti-THR studies currently dominate. Oh, sorry. This stems from academic incentive structures, so kind of a vicious cycle of PhD overproduction leading to over-competition with grants, and this affects faculty members' survival. But if the incentives change, then the behavior can change. So opportunities going forward for researchers, keep producing strong science with best practices, collaborate, reach out to those as much as they're willing, to those with different viewpoints, and communicate outside academia. Media, there's a lot of alarmist media studies out there, or media coverage out there, obviously. But I think they need to do better at acknowledging the limitations of the underlying research they're reporting on. And not only that, but understanding the harms that they're causing by perpetuating misperceptions. And finally, for consumers, keep sharing your stories and keep pushing for inclusion into research. And I'd like to thank all these people that have been very influential in my career and continue to be. And thank you so much for your attention.

38:34 - 39:14

[Clive Bates]

Thank you, Arielle. Brilliant. My dream of being a professor at a prestigious American university has ended here today. I don't think I'm going to be doing that. It sounds utterly awful. We have got a bit of time, I think, Gerry, is that right? I would like to just take any questions, if anyone would like to follow up. I'm going to start. I'm going to put one question. Why isn't science self-correcting? Where are the missing self-correction mechanisms? I'll come and sit next to you. Switch it on. Speak into it.

39:15 - 39:49

[Arielle Selya]

Hello. Hello. Okay. That's a great question. I think just because the incentive is missing for that. There's nobody incentivizing a corrective mechanism and there's too much incentive to keep producing because the science these days is so incremental. You have to publish a paper and then seek a grant for it and keep publishing along the same lines. So people build their careers on a certain narrative and there's a disincentive for them to change that. And nobody's rewarding people criticizing.

39:50 - 40:11

[Clive Bates]

Is that true in other fields? My impression is in other fields, it's like a dog-eat-dog. If I can disprove this other person's theory or rubbish their paper, that's prestige for me. Why isn't that a thing in the tobacco control science, if that's a reasonable reading?

40:11 - 40:31

[Arielle Selya]

Yeah, I'm not sure what to think about other fields, because I know nutrition research is similarly awful. And I know Roberto Sussman has talked about how physics is much better. So I'm not sure what the difference is. I think, again, it would probably go back to the funding incentives and the need to align with a singular voice.

40:32 - 40:54

[Clive Bates]

All right. Any questions to Ariel from the audience? There's Roberto. If you're in that corner, you're basically invisible, so make some sort of move. Roberto, please. Has somebody got a mic they can hand to him? No. Yes. Good. I've got you.

40:55 - 41:24

[Roberto Sussman]

Hi. A very simple question. We are seeing now with the Trump administration a massive disruption of this system. The details are uncertain, at least for me, but the question is how is all this maha and all this disruption affecting what you described?

41:25 - 42:00

[Arielle Selya]

Yeah, that's a great question, and we don't know what's going to happen. There's been legal challenges to the cuts to NIH, so I guess we'll see if anything changes. If it does, I think optimistically it could force a reevaluation by universities to deprioritize NIH as the primary source of funding. But then again, it goes into, well, where would they get funding from? If they go to American Cancer Society or Bloomberg, it's not going to be any different as far as the incentives to align with that particular viewpoint.

42:02 - 42:11

[Clive Bates]

Okay. Just a couple more questions, maximum, and then we'll move on to the Michael Russell Awards. Yes, there, please. Yes.

42:15 - 42:33

[Uladzimir Pikirenia]

My question is near the field about some self-regulation of academia. Was those articles that were mentioned in the start retracted from journals or some mails to journals about changes in these articles or retract them?

42:34 - 43:50

[Arielle Selya]

Yeah, that's a great question, too. It's very difficult to get a paper retracted. At best, in my experience, because on the particularly offending papers, I will take some time to compose a letter to the editor and submit that. And the idea is that the original authors can respond and maybe make corrections if they need to. I think I've only had a letter to the editor accepted and published once, and it didn't change anything about the underlying paper. Another source for that is Pubpeer, which is kind of a crowdsourcing platform to leave comments on published papers. And there's a browser plugin that will alert you if an article that you're viewing on a page has a Pubpeer comment. So that's a good way of doing it without having to be gated by the journals process. But as far as retraction, it rarely happens. It happens sometimes, but it's very difficult to do that. I don't think journals, it seems like they should care more about cleaning up their journal if there's something terribly wrong with a paper they've published. But in my experience, it's slow at best and very unlikely.

43:51 - 44:19

[Clive Bates]

And they don't want the embarrassment. Ariel, I think we're gonna wrap it up there. Thank you so much for sharing those insights. If anybody wants to take up these discussions in greater depth with Ariel, she'll be in position in the Sphinx later, I think, taking questions from all comers, no matter how drunk. So yes, put your hands together for Ariel Selyer. A great Michael Russell oration.