Apply federal research rules on deception to misleading health information: an example on smokeless tobacco and cigarettes.

Public Health Reports / May–June 2003 / Volume 118 187 Two respected agencies of the U.S. Department of Health and Human Services (DHHS)—the Centers for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration (SAMHSA)— have maintained websites which have erroneously reported that smokeless tobacco is not safer than cigarettes.1,2 This claim is not supported by science and acts unethically to mislead readers of these websites.3–10 Although others have examined ethical issues in health communication,11–15 we think these scholars did not go far enough. We think that the explicit ethical standards embodied in current federal regulations for deception in research should be applied to judge deceptive or misleading information in health communication interventions.16 The term deception usually refers to intended acts of deception; regardless of intention, however, erroneous information can cause the recipient to be deceived about the true state of affairs. The misleading health information on smokeless tobacco fails to meet the government criteria against deception in research. First, the misleading information may have adverse effects on some individuals (e.g., those who switch to cigarettes or fail to switch from cigarettes because they think they are not more dangerous than smokeless). Second, individuals have a right to know about the dramatically different dangers of smokeless tobacco and cigarettes. Third, there are alternative communication strategies that could be employed to inform people of the risks of both products. And, finally, such misleading information would be unallowable because it is not linked to debriefing. This article reviews the misleading information on the governmental websites, shows how modern ethical rules against deception can be applied to health information, and argues that providing information about the comparative risks of cigarettes and smokeless tobacco is the least evasive and most ethical course of action.