The Japanese smoking paradox

It’s been known for many years that lung cancer among smokers in Japan was significantly less in comparison to smokers in North America. In fact, a 2001 Japanese/American study has shown the relative risk is about 10 times higher in North America than in Japan. And, this is despite the fact that smoking prevalence is much higher in Japan than it is in the US or Canada.

It’s a phenomenon that’s come to be known as the Japanese smoking paradox. And, it’s a circumstance that’s puzzled scientists for decades. It’s also a contradiction of the evidence which the anti-smoker cult would like to ignore.

The very existence of this paradox brings into question the association between smoking and lung cancer. If smoking causes lung cancer, then smokers in Japan should experience the same relative risk as North Americans. They don’t.

And the reason for the difference is unlikely to be genetic. Other studies have shown that Japanese men raised in the US approximate the relative risk of white males. So, what causes the extraordinary difference in lung cancer rates and relative risk between Japan and North America?

According to a study conducted in 2007: “The main factors likely to have brought about the difference in the odds ratio/relative risk between Japan and the USA (and perhaps other Western countries as well) are: lower alcohol consumption by Japanese males; lower fat intake by Japanese males; higher efficiency of filters on Japanese cigarettes; lower levels of carcinogenic ingredients in Japanese cigarettes; and lung-cancer-resistant hereditary factors among Japanese males.”

All of these may be legitimate reasons for the difference. But, if lower alcohol intake, or lower fat intake are the reasons for the disparity in lung cancer rates, then we’re dealing with three separate risk factors. And, North American men should be strongly advised to reduce alcohol consumption and alter their diet as well as give up the fags.

Instead, the emphasis is on forcing smokers to quit . . . for their own good, of course. But, if changes in drinking habits and diet can reduce cancer incidence by 90% then concentrating on smoking cessation as a means of preventing lung cancer is disingenuous.

And, according to the American/Japanese study, the leading brands of US cigarettes deliver 35% more benzo(a)pyrene and 170% more NNK than do the leading Japanese brands, despite similar deliveries of nicotine. And, more than two-thirds of cigarettes sold in Japan have charcoal filters, compared with less than one per cent of cigarettes sold in the United States.

But, the contention that the difference could be attributed to lower levels of carcinogens in Japanese cigarettes, or more efficient filters, is also problematic. This would suggest that less hazardous cigarettes (LHCs) are not only feasible, but already exist. Anti-smokers have opposed the promotion and the development of LHCs in the US for decades.

Dr. Gio Gori is a former deputy director of the Division of Cancer Cause and Prevention at the National Cancer Institute, where he directed the Smoking and Health Program aimed at developing less hazardous cigarettes. Gori firmly believes that developing a less hazardous cigarette could result in significant harm reduction to those who can’t or won’t quit smoking.

But, the search for LHCs was dropped circa 1980 in favour of an all out war on smokers when the anti-smoker cabal insisted that smoking (and smokers) could be eradicated. The prohibitionists were concerned that LHCs might tempt some to take up the habit, or diminish the motivation for smokers to quit. Most regard LHCs (at least publicly) as a pipe dream.

But, if the tobacco blends and charcoal filters available in Japan are even partly responsible for the Japanese smoking paradox, then the anti-smoker cartel has done a disservice to smokers around the world. And, they may be complicit in the deaths of millions of smokers who otherwise might have benefited from the introduction of safer tobacco products into the markets of North America and Europe.

The real question is why the risk of smokers getting lung cancer is ten times greater in North America and Western Europe than it is in Japan.

And, the answer may be that in North America the real risk associated with smoking and lung cancer has been grossly exaggerated. Maybe the relative risk of smoking in the US has been inflated to such incredible numbers by simply ignoring or deliberately underestimating the effect of the dozens of other risk factors associated with lung cancer, including alcohol consumption and diet.

The Japanese/American study focused on smoking. But what other lifestyle, occupational and environmental variables exist between the two countries? How much effort has been put into investigating the possibility of LHCs?

Is anybody looking for an answer? Or are they content to simply crucify smokers?