Journalists are bad for your health

The Guardian’s Bad Science Awards give a well-deserved kicking to some of the charlatans, snake oil salesmen and clueless hacks who fill page after page of our newspapers with health news that’s wrong in many cases and completely invented in others. But it also raises a serious point: journalists are bad for your health.

There are exceptions, of course – the Guardian’s Ben Goldacre, for example, does a wonderful job of skewering health hackery in the aforementioned Bad Science column; some of the health correspondents for the more serious newspapers are incredibly knowledgeable – but in many cases, the people who write health stories and features for newspapers and consumer magazines have qualifications in writing, not in medicine. That’s why every day or so there’s a “cure” for cancer, and why every drug is a “miracle drug”.

Incidentally when I mention a product or health issue here, it’s not from a position of knowledge: I’m as clueless as, well, a youngish hack on a newspaper writing a story about the latest health fad, desperately trying to write 500 words on something they don’t really understand on a half-hour deadline.

Part of the problem, I’m sure, is that if you go to the doctor he or she won’t tell you what you want to hear. We don’t want to be told to change our diets or our lifestyles, to take more exercise or to cut down on the things that are bad for us; we want a quick fix, a miracle drug, a magic bullet. That such things rarely, if ever, exist doesn’t stop newspapers from levelling entire forests to bring us articles expounding the virtues of assorted quackeries.

Before his death, John Diamond began writing Snake Oil, a broadside against some of the quackery that’s printed without qualification in newspapers. He recalls a visit to the GP when he was suffering “one of the routine bouts of vague and minor mental and physical distress which strike most men as they slip out of young manhood”:

What I needed was somebody to tell me to stop working fifteen-hour days and playing twelve-hour nights; what I wanted the doctor to say was “Ah! Chronic Farnsbards Syndrome! Take this linctus twice a day for a week and you’ll feel better again.”

In many cases, newspapers do just that: Chronic Farnsbards Syndrome makes a better story than “stop overdoing it, you silly sod”.

The list of examples is depressingly long. Faddy diet after faddy diet, alternative treatments that are presented as cast-iron cures when the evidence for their efficacy is questionable at best and entirely absent at worst, “breakthrough” after “breakthrough”. Soon afterwards, the backlash. For example, Goldacre writes:

The Daily Mail… made big meat of a scientific study proving that the Atkins diet worked. The study, which only lasted six months, showed that the Atkins group lost just 4% more weight than the control group. A month later the paper turned on the Atkins diet as a result of a passing comment from an expert who had worked for the carbohydrate-peddling Flour Marketing Board.

Do you remember the Zyban hype, and the Zyban scares? They’re fairly typical of how tabloid and middle-market newspapers report health stories.

First, the hype: a new miracle drug stops people smoking, by removing the desire to smoke. It’s amazingly effective! It’s the drug everyone who’s tried and failed to stop smoking has been waiting for! Hallelujah! Look at all of these case studies! Zyban changed their lives!

Such claims were largely lifted from press releases – and when Zyban was made available on the NHS, GPs were inundated. But as GPs tried to explain to their patients, Zyban wasn’t a miracle cure: its success rate was one in three – still double that of nicotine replacement therapy, but hardly miraculous – and for it to be effective, you also needed to take part in counselling sessions. There was also a serious risk of side-effects: where most drugs have side effects that affect 1 in 1,000,000 people, Zyban’s side-effects seemed to affect 1 in 1,000.

(I have first-hand knowledge of this: I took Zyban and it plunged me into the worst depression I’ve ever experienced.)

Soon afterwards, the backlash came. Zyban is dangerous! It’s killing people! It’s plunging Scottish hacks into severe depression! It doesn’t stop everyone from smoking!

True enough, some people did die while taking Zyban – by 2001, the toll was 18 people out of the 1,000,000 Brits taking the drug. Most of those deaths were unlikely to be connected to Zyban – people whose doctors urge them to stop smoking because of serious heart disease or other severe health problems, people with underlying and undiagnosed health problems and so on – and people also die while taking nicotine replacement therapy, or going cold turkey, or while merrily puffing away on a cigarette, or while living a virtuous, smoke-free life.

The truth about Zyban is that it’s neither a miracle cure nor a tool of the grim reaper: it’s a drug that in the right circumstances and with the right support and attitude, can improve someone’s chances of stopping smoking; its side effects can be nasty, and it should be prescribed with caution. But “new drug slightly improves your chances of binning the cigs, but you’ll still need determination and willpower; it isn’t suitable for everybody and you really need to talk to your GP about it” doesn’t make a good headline.

You can see the same trends in other health stories: the Atkins diet, MMR jabs, cosmetic or eye surgery, miracle homeopathic treatments, magic drugs that shift weight, improve your skin and make your hair glossy, and so on. The hype is usually based on press releases and the excitable claims of people with something to promote – self-appointed health gurus, pharmaceutical companies, beauty firms – and the backlash is the inevitable result of the products, services or treatments failing to live up to the ridiculous claims parroted from the original press release, or made by a well-meaning but clueless “expert”. Most of these stories are flatly contradicted soon afterwards: coffee kills you, coffee is good for you, no, coffee kills you, oops, we meant it’s good for you… and so on.

In many cases the problem is that the writer doesn’t understand what he or she is reading. Goldacre again:

The Daily Express [declared] in September that “recent research” has shown turmeric to be “highly protective against many forms of cancer, especially of the prostate” on the basis of laboratory studies into the effects of a chemical extract on individual cells in dishes, and no (zero) trials in humans.

One of the most worrying developments is the way in which information about alternative treatments is often presented. If that information you’re given is wrong, it could kill you. As Goldacre explains:

Ah, Susan Clark of the Sunday Times (What’s the Alternative?), how I love her. This time she’s giving advice about which natural substances are safe to take with warfarin. First, she bemoans the dearth of research on the subject. Then she ignores the useful stuff in what we do know. “As a simple guideline, patients who are taking warfarin should avoid any natural remedies that have an action on the cardiovascular system.” I have no idea where that idea came from: but warfarin is famous for being interfered with by other drugs. St John’s Wort, for example, is a very popular drug – herb, collection of drugs in a plant, whatever – that reduces the plasma concentration of warfarin, along with phenytoin and rifampicin: that’s not because they’re active on the cardiovascular system, that’s probably because they interfere with liver enzymes, which means it makes them work harder. Those enzymes also break down warfarin, so if they’re working harder, they break down the warfarin more too, so there’s less of it around in your blood, and you’re more likely to have another nasty clot and die. Likewise, ginseng reduces the plasma levels of warfarin, so they shouldn’t be mixed either. And lots of others.

This is serious. He continues:

In a recent study, 2,600 patients on warfarin were sent a questionnaire on what alternative therapies they took: 1,360 responded (believe me, that’s a high response rate) and a whole 19.2% of those responders were, it turned out, taking one or more complementary therapies. Ninety-two per cent of them hadn’t thought to mention this to their doctor. Only 28.3% of all respondents had even thought that herbal medicines could interfere with prescription drugs. Because hardly anybody’s telling them.

That doesn’t mean that all of the claims made by alternative health “experts” are without merit; the problem is the way in which they’re reported. As Diamond points out:

Alternative medicine in Britain is a business with a turnover of billions of pounds and an establishment all of its own, a business which gets regular and often uncritical coverage in most of our popular papers and magazines, which regularly makes – or allows to be made on its behalf – remarkable claims for its abilities, which are often untested, let alone proven, which has no independent body monitoring its activities and which from time to time kills its customers as a direct result of the advice or actions of its practitioners.

Of course, traditional medicine often kills its customers too – and not just when your GP is Harold Shipman. But to become a GP or a hospital consultant you need to undergo years of intensive study followed by a tough apprenticeship, and you need to stay on top of developments in medicine.

A quick quiz for you. You’re ill – who do you ask for advice?

(a) a qualified medical professional who spends all day every day dealing with health issues
(b) a journalism graduate whose last assignment was comparing lipsticks
(c) a self-appointed health guru with a mail-order PhD
(d) Big Dave down the pub

I’m a simple soul: if my car’s knackered I call a mechanic, if the central heating packs up I’ll call a plumber, and if I want advice on interviewing techniques, subheadings or newspaper style I’ll ask a journalist. But if I’m sick, I’ll go to the doctor.