Author Affiliations: Civilian Emergency Medicine Faculty, Carl R. Darnall Army Medical Center, Fort Hood, Texas (Dr Dunn). Dr Arnett is in private practice in Helvetia, West Virginia.
In the article on smoking bans by Hurt et al,1 the results do not justify the claims made that smoking bans had beneficial health effects. As can be seen in Table 2 of the study by Hurt et al1
Ecological studies are plagued by confounders and biases. Ioannidis2 points out unreliability when there is “greater financial and other interest and prejudice.” Observational studies can never prove causality, and associations with RRs of less than 2 are particularly suggestive of confounding.3 Hurt et al1 and the commenters4 claimed no conflicts, but they are clearly conflicted by dependence on antismoking research funding and program income. Hurt et al1 and the commenters4 are conflicted in a most basic way—income, status, and career interest in antismoking programs.
Arnett J, Dunn JD. Smoking Bans Research. JAMA Intern Med. 2013;173(9):836–837. doi:10.1001/jamainternmed.2013.87