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Richard J. Hickey, PhD
The Wharton School University of Pennsylvania Philadelphia

JAMA. 1986;255(8):1016-1017.

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In Reply—

Drs Wilke and Slade disapprove of my views that cigarette smoking is symptomatic of genetic deficiencies in one or more biogenic monoamine neurotransmitter hormones that nicotine tends to alleviate. Disapproval cannot reject an hypothesis. Causality is based on scientific evidence, not on opinion, popularity, authority, misused statistics, or ideology.

Epidemiology, as practiced by some nonepidemiologists, can be detrimental to the credibility of the discipline, and possibly to public health. Cause has been confused with symptom, and the fallacy of inferring causality from correlation has been found acceptable to some biomedical investigators and to some federal and private agencies.

For example, the 1964 Surgeon General's report on smoking and health¹ states: "Statistical methods cannot establish proof of a causal relationship in a correlation. The causal significance... is a matter of judgment which goes beyond any statement of statistical probability." This procedure equates opinion with fact; it is therefore . . . [Full Text PDF of this Article]

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