Sunday, January 18, 2009

Smoking related deaths, not just for smokers

It’s nice to be retired. You have so much time to consider existential philosophy and the many mysteries of life. Do we really live in a world without meaning? Is life really some absurd joke?

And, just where in hell did the term “smoking related disease” come from? What makes a disease a smoking related disease? Do only smokers die from smoking related diseases? Does anyone remember when the anti-smoker crowd first started using the term?

While reading about yet another smoking ban the other day, it dawned on me that I hadn’t really given much thought to the concept. I’d simply accepted the term, like many people, knowing that it referred to diseases ostensibly caused by smoking.

But, what really makes a disease a smoking related disease? What makes Ischemic Heart Disease (IHD), for example, a smoking related disease? Is it simply because some smokers die of heart attacks?

It simply doesn’t make sense that, because someone who smokes dies of a heart attack, IHD is a smoking related disease, or that his or her death was “smoking related”.

After all, if a smoker dies in an automobile accident, his death is not considered smoking related. And, if a smoker steps off the roof of a ten storey building, it doesn’t make his almost certain demise a smoking related death. So, if a smoker dies of IHD, why is it a smoking related death?

So, I did what I usually do in such circumstances, I looked it up on the internet. It sure beats browsing through those big, heavy books.

Health Canada is a great place to go to find out about things like smoking related disease and smoking related death. They know a lot about smoking and health. So, I checked it out . . . and came away more confused than when I started.

In 2002, according to Statcan, there were 40,607 deaths from Ischemic Heart Disease (IHD). Of those 40 thousand plus deaths, 5,343 were estimated by Health Canada to be smoking related deaths and were therefore, presumably, smokers.

But, if only 13% of IHD deaths (5,343) were smokers, doesn’t that mean the other 87% (35,264 deaths) were non-smokers? And, if the vast majority of those who died (87%) were non-smokers, how can IHD be considered a smoking related disease?

According to Physicians for a Smokefree Canada (PSC), 21% of the population (5.377 million) smoked in 2002. But, if 21% of the population was smokers, wouldn’t you expect 21% of those who died from IHD to be smokers, reflecting their numbers in the general population?

In fact, if smoking created a greater risk of IHD, as the anti-smoker crowd claim, shouldn’t the percentage of smoking related deaths due to IHD be greater than the percentage of the smoking segment of society they represent? Shouldn’t the numbers be out of proportion to those in the general population in the other direction?

That’s apparently not the case. As noted previously, 5,343 of those IHD deaths were allegedly caused by smoking. This means that one in every 1006 smokers died of IHD in 2002. By contrast, the non-smoking segment of the population, 20.228 million, had 35,264 deaths from IHD. That’s one in every 574 non-smokers who died of IHD.

If non-smokers are dying of IHD at almost twice the rate of smokers, why is the anti-smoker brigade pressuring smokers to quit? According to their own figures, smokers are less susceptible to IHD than non-smokers.

Does it make sense that so many non-smokers are dying of a smoking related disease?

I’m neither an epidemiologist nor a statistician, so it should come as no surprise that I find numbers such as these confusing. But, they do make you think.

And, right now, I’m thinking of something I was told in an accounting class forty odd years ago.

“Two plus two always equals four. If the numbers don’t add up, one of three things has happened. You’ve made a mistake, someone has fudged the numbers . . . or you’re dealing with statistics.”

Anyway, I’m confident there’s a perfectly plausible, scientific explanation to account for this little anomaly. I’d ask Health Canada, but I’m still waiting for their “subject matter expert” to respond to my last question.

1 comment:

vincent1 said...

Excellant piece of writing Old Rambler, the other thing never mentioned are ages.
Given we all have to die of something, why are ages never mentioned?
Thank you for your thoughts.