The controversial controversy of a passionate controversialist

Alvan Feinstein was among the pioneers who perceived the need to apply epidemiologic principles and methods to clinical medicine. In his attempt to convert his peers to his own views, he was very liberal in criticizing the work of others. Epidemiologists still recall his 1988 article in Science entitled "Scientific Standards in Epidemiologic Studies of the Menace of Daily Life," in which he criticized observational epidemiology for its lack of scientific rigor. In this context, Feinstein's work has also been the center of controversies. One in particular, related to the fact that he carried out research and consulted for industries, in particular the tobacco industry, has tainted the last years of Feinstein's career. My purpose in this article is to discuss Feinstein's relationship with the tobacco industry. It is not to judge the validity of his work. Against this background, a question of historic relevance, one that can be discussed on the basis of some evidence, is whether Feinstein, world-reknowned epidemiologist and editor of this journal from 1982 until his recent death, helped the tobacco industry to publish articles minimizing the deleterious effects of smoking in the Journal of Chronic Diseases and (since 1988) the Journal of Clinical Epidemiology. To address this question I have searched the articles related to the effects of tobacco that were published in the Journal since 1978. The tobacco industry has had the opportunity, via its consultants, to defend its own ideas in the "Variance and Dissent" section. Perhaps in hindsight Feinstein could be criticized for not having clearly indicated the sponsorship of the tobacco industry behind these publications, of which he was fully aware. However, this does not suffice to infer that he was the tobacco industry's "man." Feinstein's attitude in matters of publication appears balanced.