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Why do we die?
Assignment America: Smoke screens
By John Bloom
Published 8/22/2002 12:35 PM
NEW YORK, Aug. 22 (UPI) -- If you were to be strapped down on a surgical table while four guys exhaled smoke directly into your mouth and nostrils for 30 years, you MIGHT get lung cancer 40 years after they stopped -- but it's not likely.
I'm using this absurd example, because ALL of the other examples in the available scientific literature are equally absurd.
The second-hand smoke scare is a political farce. It was invented in the mid-1990s by the Clinton administration -- it has Hillary's hands all over it -- because anti-smoking radicals, who tend to be like anti-abortion radicals in their zealous devotion to the cause, actually convinced the Environmental Protection Agency to change its "conventional standard for statistical significance" so that second-hand smoke could be proven to be a killer.
Normally nobody but specialists would care -- substandard scientific reports get released all the time -- except that it's now being used to justify anti-smoking legislation that, in the case of New York City, could result in smokers not even being able to light up in their own clubs, their own bars, and, in one case, their own apartment buildings -- even if the place is clearly marked as a smoking establishment. If Mayor Michael Bloomberg gets his way, they won't even be able to smoke in smoking lounges, cigar bars or tobacco shops.
Wouldn't the American way be to put a big sign on the front of your restaurant? "People Smoke In Here -- Don't Come In If It Bugs You." And then let everyone act like grownups?
The simple fact of the matter is that by about 1990 everyone had reached a compromise on this issue. Smokers would sit in smoking sections. Ventilation systems would be installed in public buildings. Everyone would live and let live.
Not good enough for the smoke-haters. They knew that arguing against a legal substance on the basis that it was hurting the people who LIKED IT was a losing battle, and un-American besides. But if they could somehow prove that innocent people were dying ...
And so they proved it with "junk science." The Bush administration recently rejected a scientific report, 30 years in the making, signed by some of the top researchers in the world that said fossil fuels were the principle cause of global warming in the form of air pollution. The reason Bush rejected the findings: it was "junk science" from "the bureaucracy."
If that was junk science, then the second-hand smoke research comes from a junkyard infested with giant rats and scavenging stray dogs. Most of the available studies have "confidence intervals" right around 1.0 -- which means no confidence at all. And almost all of them fail to take into account the other sources of air pollution. It's as though our polluted air were made up of 140 parts car exhaust, 70 parts smoke from fossil-fuel-burning factories, 40 parts methane, and .0000001 parts smoke from that guy on the corner sneaking a cigarette on his lunch hour. So what do we do? KILL THE SMOKER. HE'S DESTROYING THE AIR.
The fact is, there have been 40 epidemiological studies of second-hand smoke, almost all of them based on the experience of non-smokers married to smokers. Thirty-two of them found no evidence of second-hand smoke causing any disease at all. The other eight showed "weak association" -- but in some of the studies there was actually a NEGATIVE result, indicating that non-smoking spouses of smokers are LESS likely to get a serious disease.
Of course, the ones that showed a negative result were thrown out as wacky, but the others are equally wacky. For one thing, they're all infected with what science calls "recall bias." People interviewed are asked to reconstruct smoking patterns over their entire lifetimes, and it's been shown time and again that their memories are faulty, and in many cases, designed to mislead. The non-smoker frequently turns out to be a smoker for a portion of those years; he changes his story for insurance reasons or because of pending litigation. And the non-smoker with lung cancer tends to seek external causes and fasten on the most convenient one, even when we know that a person living in an urban area is subject to multiple possible causes of lung cancer, most of them far more potent than cigarette smoke.
Complicating the issue is the media treatment of second-hand smoke. If you say something often enough, it acquires the patina of truth even if the original basis for it is phony. I could use dozens of examples, but I'll just use the most recent one that I know of. Here's the lead paragraph from a July 12 article in the Globe and Mail, the Canadian newspaper:
"People who are routinely exposed to a lot of secondhand smoke, such as workers in bars and restaurants, can see their risk of lung cancer triple, a new study says. The Canadian study provides some of the most compelling scientific evidence yet for a total ban on workplace smoking, including bars and restaurants."
Okay, now let's look at the study the article was based on. It was published in the International Journal of Cancer and signed by a lead researcher for Health Canada -- a government agency with a vested interest. (Public health agency research tends to be uniformly alarmist.) Even so, the Globe and Mail's report leaves out the most important conclusion in the study:
"Although more years of and more intense residential passive smoke exposure tended to be associated with higher risk estimates, no clear dose-response relationship was evident."
Any particular reason this would be left out? Other than that it's inconvenient? Of course, to report the data without any agency spin on it, you would need to study the tables, evaluate the "confidence intervals," allow for "recall bias," and do all the other things scientists normally do, and journalists SHOULD do.
Apparently Australian journalists are a little more diligent. When the Australian National Health and Medical Research Council released a second-hand smoke report in 1997, the authors decided to omit the statistical tables entirely because they feared the press might study them. An outraged judge eventually censured the government agency for what he called lying by omission -- the same thing that happened in a North Carolina court case, when a judge said the Environmental Protection Agency's report was rife with "cherry picking" of statistics, and had excluded half the available studies for no good reason. Later the Congressional Research Service issued a blistering report of its own, essentially calling the EPA study irresponsible and alarmist.
The reason the issue of second-hand smoke is such a raging issue right now is that it's being used as the rationale for additional anti-smoking laws. Waiters, bartenders and cooks need to be protected. This is what Bloomberg is basing his whole campaign on.
People might not LIKE smoke. They might find it unpleasant. But it's a huge jump to say it's actually harming their bodies, as though they were coal miners, soon to be diagnosed with Black Lung Disease. In fact, we have two studies that measured Environmental Tobacco Smoke -- the scientific name for it -- and came to the conclusion that, first of all, the smoke inhaled from the air is chemically and physically different from the smoke inhaled from the end of the cigarette, and, secondly, people who work eight hours a day in heavy-smoking environments had the following CE's (Cigarette Equivalents):
That's cigarettes PER YEAR. The worst case they could find had the bartender adding to his cancer risk at the rate of 4.3 cigarettes per year, which is, of course, like saying somebody who eats six Lifesavers is a candidate for heart disease.
Even more to the point, scientists computed what would happen if a 20-by-20-foot room with a 9-foot ceiling were filled with smoke, and then compared that exposure to the EPA's lowest published "danger" doses. Here are the results:
For the lowest level of danger for benzopyrene, you would need to have 222,000 cigarettes burning in the room. For the lowest level of acetone, you would need to burn 118,000 cigarettes. For the lowest level of hydrazine, you would need 14,000 cigarettes. And for toluene, you would need a cool million smokes, all burning at the same time. Unless, of course, you opened the door or window -- then you would need more.
John C. Bailar, writing in the New England Journal of Medicine recently, said that, if you sum up all the available evidence, the MOST alarming case you can make for second-hand smoke being related to disease is "We don't know." (He was primarily writing about heart disease, but the conclusions on lung cancer are similar.)
Bailar was being polite. We know. Get a ventilation fan. Put up a sign. Go to separate rooms. But let's not start a whole new era of Prohibition in which people have to open speakeasies and private clubs just to enjoy a meal or a drink. We can't all afford to go to Paris to smoke.
(John Bloom, a smoker, writes a number of columns for UPI and may be contacted at firstname.lastname@example.org or through his Web site at joebobbriggs.com. Snail mail: P.O. Box 2002, Dallas, Texas 75221.)