John: For 40 years, fluoride has been added to public drinking water.
Conclusion (should)
I should stop drinking fluoridated water.
Intermediate Conclusion
Only if I stop drinking fluoridated water will I be sure not to develop bone cancer.
Evidence
In a study, fluoridated water given to lab rats caused bone cancer in 90% of the males (0% of the females).
Evaluate
There seem to be a couple potential issues here -- 1. are we really convinced that fluoridated water poses a cancer risk to humans?
2. are we really convinced that if John avoided fluoridated water, then he will be sure not to develop bone cancer?
When it comes to #1, we might object that fluoridated water could be carcinogenic to rats but not to humans. Or we could just point to the weirdness that 90% of males and 0% of females were affected as evidence that something screwy is going on with this experiment or with the physiology of male rats.
When it comes to #2, obviously eliminating one risk of bone cancer would not guarantee that John will not develop bone cancer.
The use of "only then" with "I will be sure" seems to convey a bi-conditional idea.
if he doesn't stop → won't be sure to avoid drinking FL water bone cancer
if he does stop → will be sure to avoid drinking FL water bone cancer
Goal
Look for an answer resisting the move from , or an answer resisting the move from .