Should you trust some guy with a blog? Hell, no.

MOH's in Ontario have a statutory duty to undertake efforts such as this to protect the public's health. Peel's MOH has specifically stated that measures such as those proposed in the report are a matter of balancing public health and personal autonomy (as are most smoking-related proposals).

You are of course entitled to make conclusions based on as much non-empirical evidence as you like. But I would caution you against impugning the credibility of public health officials.

"Trust me, I'm a doctor." Yes I think I will trust a public health physician who has spent a career protecting the public's health, thank you very much. Or should I trust some guy with a blog? That, sir, would truly be "lunacy".

The above comments were posted in response to my last two columns.

In those columns, (prior to a brief and unexpected hiatus), I commented on a report prepared by public health officials in Peel Region (Toronto's neighbours to the West and Northwest) calling for a province wide ban on smoking in apartments and condos. The objective of the ban was, allegedly, to protect non-smoking residents in multi-unit dwellings from exposure to second-hand smoke.

I opined that there were measures short of an outright ban that might be used to mitigate the grossly exaggerated hazards associated with exposure to secondhand smoke seeping through electrical outlets and through the plumbing.

The problem, of course, is that there was no effort whatever to balance the issues of public health and personal autonomy. The authors of the report assumed the position that secondhand smoke wiggling through cracks in walls and floors of multi-unit dwellings was a health hazard of such significance that it warrants stripping smokers of any right to personal autonomy in their own homes. No other potential solutions were considered.

Let's look at the facts.

According to the October 19, 2009 article by Madeleine White for Torstar News Service, the report was compiled because Peel region “had been receiving an average of five calls a month from tenants complaining about second-hand smoke seeping into their dwellings from other units and open windows”.

There is no indication that health officials investigated the validity of any of the five complaints a month. How old were the buildings from which the complaints originated? What type of construction was involved? What kind of ventilation/heating system was installed? Was there any attempt to quantize the alleged problems? How much secondhand smoke were non-smokers being “forced” to inhale on a daily basis?

Were the complaints related to legitimate health concerns as opposed to the simple nuisance of what many non-smokers consider the “obnoxious smell” of secondhand smoke?

The point of my columns was to show that the extent of the alleged hazard will vary, depending on the age of the building, method of construction, ventilation , etc. In addition, there are a variety of methods available to alleviate the problem of smoke migrating from one apartment to another. There is no demonstrable need for draconian and discriminatory smoking bans.

And, I'm not alone in my observations. Hazel McCallion, the Mayor of Mississauga, the largest municipality in Peel Region, has suggested building code changes are among measures that could be taken; changes that would require retrofitting ventilation systems in old buildings and ensuring that new ones are capable of filtering out second-hand smoke.

The report from Peel Region health officials appears to have ignored all other potential solutions in favour of a blanket policy which would dictate what behaviour individuals would be permitted in the privacy of their own homes; a gross infringement on personal autonomy. And, their one size fits all solution, in the form of a province-wide smoking ban, is being promoted by anti-smoker activists despite the fact that there is absolutely no definitive evidence that any significant health hazard exists.

When groups formulate policy recommendations without addressing the science, it makes their motivation suspect. And, that has a negative impact on the credibility of their policy recommendations.

In fact, the evidence that secondhand smoke in any quantity represents a significant health risk to non-smokers remains open for debate. The anonymous commenter to my columns asks whether he (she) should trust a public health physician who has spent a career protecting the public's health or some guy with a blog?

My suggestion is that he (or she) should conduct a little research and trust the evidence. Start with a few of my previous columns. (The WHO Study (Part 1)), The WHO Study (Part 2), Faulty science from EPA) Then read about the secondhand smoke study conducted by professors James Enstrom and Geoffery Kabat on Enstrom's web site, the Scientific Integrity Institute.

Perhaps he/she may gain some insight as to why I question the credibility of many public health officials.

The Regional Municipality of Peel has a population of roughly 1.15 million people. Health officials claim to receive 60 complaints a year about secondhand smoke seeping into their apartments. On that basis those officials are now recommending that hundreds of thousands of smokers across Ontario be deprived of their right to use a perfectly legal product in the privacy of their own home.

Sorry, neighbour. The report from Peel Region should be filed under the category of bullshit and bafflegab.

Secondhand smoke and multi-unit dwellings

In my last post I commented on allegations by the anti-smoker crowd that secondhand smoke possessed supernatural powers. These otherworldly properties allow it to travel against the wind, drift downwards instead of up, and flow through minute openings in electrical outlets to attack non-smokers.

For the most part, these assertions by the anti-smoker crowd are pure nonsense. Modern methods of building construction already negate the likelihood of secondhand smoke migrating to a neighbour's apartment through most of these routes.

Drywall joints, for example, are taped where individual sheets abut, at corners and along ceiling joints. Drywall compound is added to give the walls a seamless appearance. The housing co-op in which I live was completed in 1993. I have never found a crack of any kind in the walls, let alone one that would allow secondhand smoke to migrate to a neighbour's unit.

And, even in much older buildings, there are inexpensive construction techniques that can be used to resolve such issues.

Older buildings, for example, may have used crown moulding to seal the joints where the walls meet the ceiling. A similar condition might exist along the baseboards, where the walls meet the floor. The simple remedy is to remove the moulding or the baseboards, fill the gaps with any of the dozens of products available for the purpose (silicone, expanding foam, etc.) and replace the moulding or baseboards. Problem solved with very little cost or effort.

Smoke traveling through drains is a non-starter. All drains are equipped with a P-trap (unless you're living in the bush and still have to make the trot to the little old shack out back). The P-trap holds standing water and is designed to prevent sewer gases from entering the home. And, if the sewer gases can't get in, smoke is unlikely to get out.

These days, special care is taken in the construction of bathrooms and kitchens, especially around plumbing fixtures. Care is taken, not because of potential problems with secondhand smoke, but because of the possibility of water damage from leaking water lines or drains. That's why, if you look closely, you will see fine beads of silicone around bath tubs, toilet bowls, counter tops, etc. And, if water can be prevented from seeping into walls, secondhand smoke doesn't stand a chance.

And, once again, in older buildings, solutions are inexpensive and really quite simple.

In my co-op, most of the apartments have only one door to a common hallway, although some multi-level units have two. So is it possible that smoke could travel through a crack under the door, into the hallway, then travel back into my neighbour's unit?

I decided to check it out. The idea was to have someone stand in the hallway while I stood in the apartment, close to the closed door, puffing merrily away on a Putter's Lights (and taking an occasional sip from a cold can of Keith's Ale). The observer in the hall would try and determine how much smoke was escaping into the hallway.

I lit up a fag, with the door wide open and advised the hallway monitor (my wife) to keep a close eye on what happened after I closed the door. I knew immediately it wasn't going to work. As I exhaled after a lengthy drag, a cloud of smoke blew back into my face.

The air make-up fans draw fresh air from the roof and force it down into the hallways, thereby equalizing the air pressure inside the building with the air pressure outside. Theoretically, if the air pressure outside exceeds the air pressure inside, the building could implode. And, as long as those fans were running, there was no way cigarette smoke from my apartment was going to get past the threshold of the door (and the current of air from the air make-up fans) and into the hallway.

Of course, if you smoked in the hallway, the smoke would seep into the apartment through the crack under the door. But, it could only seep in through under the door because there was weatherstripping on both sides of the door frame and along the top, creating a tight seal.

The solution to the problem could be as simple as adding weatherstripping along the underside of the door. Or, to prohibit smoking in the halls and common areas (already in effect), not in the member unit. And, I had to ask myself how many tenants stand in the hallway smoking cigarettes at any rate.

One area where the anti-smoker control freaks might have a legitimate grievance is from smoke migrating to an adjacent unit through duct work. I share a common wall with one neighbour who told me he could smell smoke in a bedroom on the shared wall through an air duct. I asked why he hadn't mentioned it over the five years he had lived next door. He gave me a puzzled look and said: “No big deal, Matt. I fixed it.”

Knowing the man has a degree in mechanical engineering, I was curious about how he'd resolved the problem. His hi-tech solution: he'd cut a piece of cardboard to fit the 6” X 10” vent, used duct tape to secure it to the inside of the vent cover and put the vent cover back in place. That's why he makes the big bucks.

In the case of older buildings, some legitimate concerns might be raised, but the remedies are usually inexpensive and are not labour intensive.

And, the problems are by no means universal.

For example, not all buildings use forced air heating which might allow secondhand smoke to move from one unit to another through the duct work. There are thousands of older, two and three storey walk-ups in the city that still rely on hot water radiators to heat their unit. The semi-detached townhouse units in my co-op use electric baseboard heating. In those situations, there's little probability of smoke migrating from one unit to the next via duct work.

The proposition that secondhand smoke seeps into a neighbour's unit through “electrical outlets, plumbing, duct work, ceiling light fixtures, cracks in walls, floors or doors and through common areas, such as hallways,” is a classic example of the scare-mongering tactics employed by the anti-smoker crowd.

And, with the fear, rational consideration of the problem and the common sense solutions which are readily available go out the window.

The anti-smoker brigade proposes a one-size-fits-all solution: impose a blanket smoking ban in multi-unit buildings. They would deprive millions of Canadians of their right to personal autonomy and choice. They would allow police, or other authorities, the right to intrude on the privacy of Canadians engaged in a perfectly legal activity. And, they would do it without a single shred of evidence that a problem of any proportion exists and without exploring other, less intrusive options.

More bullshit and bafflegab from morally bankrupt anti-smoker fanatics.

Secondhand smoke travels through solid walls

Peel Region (west of Toronto) has apparently been flooded with complaints about secondhand smoke seeping into the dwellings of non-smokers from other units and open windows. OK, so maybe it's not a flood, but the five complaints a month that have been pouring in were serious enough for Commissioner of Health Services Janette Smith, and Dr. David Mowat, Peel's medical officer of health to call for a smoking ban.

The region's public health officials have compiled a report suggesting Peel council demand that Queen's Park (the provincial government) enact a province wide ban on smoking in apartments and condos. The objective, of course, is to protect non-smoking residents in multi-unit dwellings from exposure to second-hand smoke.

The dynamic duo of healthscare professionals claim in their report. "Tobacco smoke can seep from various openings in a multi-unit dwelling, including electrical outlets, plumbing, duct work, ceiling light fixtures, cracks in walls, floors or doors and through common areas, such as hallways. Some units may share ventilation or heating systems, which can further spread the smoke throughout a building." Uh-huh.

I have read of the mystical powers of tobacco smoke; its ability to travel great distances against the wind, to pass through solid walls, to worm its way through electrical fixtures, etc., but I've always remained a skeptic. Could the deadly concoction of chemicals from the lit end of a fag really migrate from one apartment to another in sufficient quantities to cause death or serious illness? Through the plumbing?

Now, I have heard that some people like to browse through the latest edition of Popular Mechanics when they, er . . . do their business. I do not keep magazines in my bathroom. It's strictly an in and out affair. And, smoking in the shower is the next best thing to impossible; fags are very hard to light when they're all wet and soggy.

But, does the smoke from the living room travel the 22 feet down the hallway to the bathroom, turn the corner, navigate to the bathroom sink, resist the tendency to travel upwards, make its way down the drainpipe, past the P-trap, and enter my neighbour's unit through the drain of his bathtub? Are these people serious?

My old English teacher used to have a sign above the blackboard that read: “Impossible is a word found only in the dictionary of fools.” (I've often wondered if Bonaparte uttered those immortal words before or after Waterloo.)

At any rate, I hesitate to use the word impossible lest I be branded a fool. But, it's highly improbable that secondhand smoke could make such a journey. Unless, of course, it's possessed by evil spirits with a grudge against my neighbours.

In my bathroom, I found no gaps where the walls met the ceiling. They had been sealed with drywall tape and several layers of drywall compound during construction. There was a neatly laid bead of silicone around the back of the bath tub; another along the floor at the foot of the tub. The silicone is meant to prevent water damage inside the walls or along the floorboards. But if water can't get through, how can smoke?

In addition, the bathroom exhaust fan is tied into the light switch so that when you turn on the lights, you also activate the fan which vents directly to the outside. So, unless someone was perched on the throne, reading Popular Mechanics by candlelight while smoking up a storm, my neighbour is not likely to be bothered by secondhand smoke intruding on the “quiet enjoyment” of his premises. And, even then it's a stretch.

Bullshit and Bafflegab. On to the kitchen.

After a thorough investigation, I determined that it was unlikely smoke could move from one unit to another via the drains. The smoke would have to travel downwards, penetrate the standing water in both my P-trap and the neighbours. So that conduit was ruled out.

But, it might get through the openings where the pipes enter the wall. If the smoke traveled downwards, made its way through the rear of the cupboards, seeped through a similar opening on my neighbours side of the wall and into his unit. As noted previously, nothing is impossible.

So I removed the basket of cleaning material and the cute little garbage containers from beneath the sink. I lit up a fag, poked my head into the cupboard and prepared to bombard my neighbour with 4,000 deadly toxins.

Shit. Like in the bathroom, someone had plugged the opening around the pipes with silicone. No way any smoke was getting through there, even if it was anorexic. I withdrew from the confined space which was rapidly filling with smoke and making my eyes water.

OK, I thought, maybe the smoke could force itself through a gap between the countertop and the wall, down to the floor, find a crack where the floor meets the wall and steal into my neighbours unit? Nope. Along the ledge between the countertop and the wall behind it, was another neatly laid bead of silicone.

Even if I wanted to terrorize my neighbour with secondhand smoke, I couldn't. Unless, of course, I was prepared to spend some time with a brace-and-bit and make a mess of my walls. And, I suspect he might be more pissed off about the holes drilled in his wall than secondhand smoke.

How much smoke is likely to escape into a neighbours apartment through “cracks in walls, floors or doors”. Think about it folks. When drywall is installed, gaps between individual sheets and along the ceiling are sealed with drywall tape and two or more layers of drywall compound. The same technique is used in corners.

And, just how much secondhand smoke is actually going to seep through a ceiling fixture or an electrical outlet? Use a little common sense. If you were trapped in a sealed room and about to run out of oxygen, just how long do you think you'd last if the only source of air was coming through a light switch or a wall receptacle?

Yet, the anti-smoker crowd want people to believe that vast quantities of secondhand smoke are pouring into their neighbour's apartment through plumbing, cracks in the walls and electrical outlets. It's insane.

Let's be clear. There are ways that smoke can enter your neighbour's unit. But wall receptacles and cracks in the walls are not likely to be among them.

I'll have more to say on this lunacy in my next post.

Smoking bans, heart attacks & scientific fraud

“Smoking ban benefits come swiftly,” read the headline, “A new study at Kansas University found that smoking bans reduce the number of heart attacks each year by as much as 26 percent.”

But as noted in a previous blog, that “scientific study” by Dr. David Meyers at Kanas University was, er . . . somewhat less than credible. In that blog post, I quoted Dr. Michael Siegel of Boston University School of Public Health: “The rest of the story is that anti-tobacco researchers and groups are making ridiculous, highly exaggerated, and scientifically unsupported claims in order to try to justify smoking bans.”

That's tough talk from an anti-smoking advocate like Dr. Siegel. In fact, some people might refer to studies such as Meyers' as unequivocal scientific fraud and propaganda.

Then, on October 15, Siegel reported some serious misgivings with a new report on the same subject matter; this time from a committee of experts at the Institute of Medicine (IOM) in the US. In that article, he asserts that the conclusions reached by the experts contradicted the contents of the report itself; noting that most of the studies looked at by the committee were not only badly flawed, but that the committee was aware of the flaws.

Said Dr. Siegel: “The committee recognizes that the existing studies are so seriously flawed that one has no confidence in being able to judge the effect size. But, instead of concluding that the evidence is insufficient, they go ahead and conclude that smoking bans significantly reduce heart attacks anyway.”

What the committee did, in fact, was draw conclusions which were not supported by the evidence. And, what was even more egregious, they distributed their unwarranted assertions to the public as fact.

Staunch anti-smoking advocate that he is, Siegel stopped short of criticizing the committee of experts: “Finally, I want to make it very clear that I am not impugning the integrity of the committee or any of its members. I don't think they've done anything wrong. I just think that the report is biased and that subconsciously, there was some sort of pressure operating which led to the report drawing conclusions that were not appropriate given the report's own assertions and review of the evidence.”

So, the report issued by the IOM was biased, drew inappropriate conclusions and misled the public, but the experts who compiled the report did nothing wrong? The disingenuous report was merely the result of some unstated, subconscious pressure being exerted by some unidentified force. I wonder what a deliberate attempt to mislead would look like?

On October 16, Siegel commented on the subject again, noting that the IOM report failed to include data that found no effect of smoking bans on acute coronary events in three countries; England, Scotland and Wales. In other words they ignored data which was contrary to the unsupported conclusions of the committee.

Said Siegel: “These data are all national data which include all hospital admissions at all hospitals in these countries. Thus, they represent a better source of data than what was used in some of the published studies (which only included a sample of hospitals). Moreover, they cover large populations, with a sample size greater than that of all other studies combined. Thus, the data from these countries are critically important and carry much weight in the overall analysis.”

An oversight perhaps? The committee could hardly be expected to be aware of unpublished studies, especially if they failed to make the morning news. And, that's essentially what the IOM committee claimed in their report: “"no such (unpublished) studies were identified."

Unfortunately, those studies did make the news; big time. And then there's this from Dr. Siegel: ”I find this difficult to believe, especially since I was a reviewer of the report and I made the committee aware of several unpublished analyses which documented no significant effect of smoking bans on heart attacks.“

Whoops. Nothing like a little inside information to set the record straight.

One of the most definitive studies to date, an NBER (National Bureau of Economic Research) working paper, “Changes in US Hospitalization and Mortality Rates following Smoking Bans,” found no statistical evidence that smoking bans reduced heart attacks. “In contrast with smaller regional studies, we find that workplace bans are not associated with statistically significant short-term declines in mortality or hospital admissions for myocardial infarction or other diseases.”

This study was also ignored in the IOM report.

But then, presenting both sides of the argument might have detracted from the anti-smoker message.

How could the experts at the Institute of Medicine ignore all the contradictory data and conclude that smoking bans result in fewer heart attacks? How could a committee of experts acknowledge that they couldn't confirm the extent of any positive effect from smoking bans, yet insist that the effect exists nonetheless? Why the compulsion to manipulate scientific studies and data to score political points? Is this what science has become: an exercise in political propaganda devoid of honesty?

Could it be that science has become subordinate to the anti-smoker crusade in the Orwellian world of tobacco control? More and more, it seems, scientific integrity is being sacrificed to further the cause of smoker denormalization. Bullshit and bafflegab are the order of the day.

It's unfortunate. Science and medicine were once such noble professions.