The anti-smoker brigade issues press releases on a regular basis. Over the last couple of years, for example, they've announced a series of studies which purported to show that smoking bans immediately reduce hospital admissions for cardiovascular disease.
Widely distributed and highly publicized by the press, these studies, more often than not, are rather quickly shown to be sadly lacking in scientific integrity. But, the criticisms of these studies by knowledgeable experts are seldom reported in the mainstream media. So, the anti-smoker fanatics are free to continue their campaign of deceit and deception without fear of censure in the press.
For a prime example of what I'm talking about, check out this blog entry by anti-smoking activist Dr. Michael Siegel and his critique of the latest miracle study from Toronto, Canada. And, you can read more about these miracle studies on my Dec 10, 2009 blog entry.
But, let's look at some other facts about smoking and smoking related deaths that will never make headlines. Like the analysis critical of the smoking ban miracle studies, they're hidden away on obscure websites and blogs and scientific journals which the general public seldom reads.
For instance, an organization called the Lung Cancer Alliance claims that over 60% of all new lung cancer cases are among former smokers and those who have never smoked. “Over 60% of new cases are never smokers or former smokers, many of whom quit decades ago.”
In fact, they have a nice little chart on their page which breaks it down. It claims that current smokers account for 35% of new lung cancer cases, former smokers 50% and never smokers 15%.
Imagine. More former smokers are being diagnosed with (and presumably dying from) lung cancer than current smokers. I say “presumably dying” because, according to the Lung Cancer Alliance: “The majority of lung cancer patients are being diagnosed so late that they will die within a year.”
That's quite a startling revelation. It's easy to understand why the anti-smoker crowd and their allies in the press corps would hesitate to make that information available to the general public. Because it suggests that quitting the habit is no defense against lung cancer. In fact, if 50% of new lung cancers are found in former smokers, that, in turn, suggests that former smokers are at greater risk of developing lung cancer than smokers.
The same website claims there are over 40 million smokers in the US and over 45 million former smokers. And, if 50% of new lung cancer cases are among the 45 million who quit, and only 35% of new cases are among the 40 million who continue to smoke, well . . . you don't have to be a math major to figure it out.
Let's assume that the number of new lung cancer cases will correlate to actual lung cancer deaths. This is not an unreasonable assumption since only 15% of lung cancer patients survive more that five years, and as noted by the Lung Cancer Alliance “The majority of lung cancer patients . . . will die within a year.”
There are approximately 160,000 deaths from lung cancer every year in the US. If 35% of lung cancer deaths are among current smokers, that's 56,000 lung cancer deaths. There would be 80,000 deaths among former smokers (50% of 160,000). Therefore, former smokers are at a higher risk of developing lung cancer and dying from that dread disease than current smokers.
These are not precision numbers, but I believe they are sufficiently accurate to illustrate my point. And, to re-emphasize my point, according to the figures provided by Lung Cancer Alliance, more former smokers than current smokers will contract lung cancer and eventually die from that disease.
But, the anti-smoker crowd has been telling us for decades that the only way for smokers to escape lung cancer and other smoking related diseases, is to quit using the foul smelling weed. So, what gives?
Up here in the Great White North, Health Canada is very careful about disclosing the number of smokers, former smokers or non-smokers who die from lung cancer. Instead, they claim that 88.6% of lung cancers among males, and 62.5 among females, are attributed to smoking. Is there some legitimate reason that Health Canada lumps them all together, obscuring the number of smokers and former smokers allegedly dying from lung cancer?
I know what you're thinking. Does it really matter if more former smoker than current smokers die from lung cancer? After all, if you add up the numbers, that still means that 85% of lung cancers are caused by smoking.
And, if you believe the statistics from the anti-smoker crowd, you'd be correct. Unfortunately, I've become very cynical about all statistics provided by the fanatics. When it comes to smoking, they seem to ignore even the most basic principles of science and statistical analysis.
In this case, it's something called “reversible association”. In other words, if the ``cause'' is removed (e.g. people stop smoking) the proportions contracting the disease should reduce. And, smoking rates have been declining steadily for the past 45 years, while lung cancer rates have been mysteriously increasing.
Don't you just love a mystery?
According to a study published by the CMAJ (Canadian Medical Association Journal) and distributed widely by the Canadian news media, hospitalizations for cardiovascular and respiratory conditions dropped significantly after a restaurant smoking ban came into effect. The claim is that there was a 17 per cent drop in hospitalizations due to heart attacks in Toronto and a nearly 40 per cent decrease in hospitalizations for cardiovascular events in general.
Imagine that. Another smoking ban miracle . . . right here in my own back yard.
At any rate, according to study authors: “We calculated crude rates of admission to hospital in Toronto, Ontario, from January 1996 (three years before the first phase of a smoking ban was implemented) to March 2006 (two years after the last phase was implemented.”
That may not be entirely correct. The ban implemented in 1999 was meant to integrate already existing by-laws which were in effect when Toronto and five surrounding municipalities were amalgamated to form the new mega-city of Toronto.
And, as noted by the study authors, the smoking ban was implemented in stages. Effective 1999, smoking was restricted in public places, including restaurants, bars, billiard halls, bingo halls, bowling alleys, casinos, slots, etc. But, DSAs (Designated Smoking Areas) occupying maximum 25% of floor space were acceptable.
In June, 2001, more stringent rules were implemented in restaurants and bowling alleys with only designated smoking rooms (DSRs) permitted. Then, in June, 2004, following the anti-smoker tactic of incrementalism, the DSR rule was applied to all venues; restaurants, bars, billiard halls, bowling alleys, casinos, slots, etc. DSRs were restricted to a maximum 25% of seating area/floor space. In bingo halls, DSRs were restricted to a maximum 50% of floor space.
That right, folks, under the no smoking by-law enacted in 1999, right up until 2006, smokers were still being allowed to come in from the cold.
So what does this study actually show? If the partial bans were working so well, why was it necessary to toss smokers into the street?
Study authors note that “crude rates of admission to hospital because of cardiovascular conditions decreased by 39% and admissions because of respiratory conditions decreased by 33% during the ban period affecting restaurant settings. No consistent reductions in these rates were evident after smoking bans affecting other settings.”
But, these declines took place over a 10 year period. So, the average annual decrease in hospital admissions was 3.9%, 3.3% and 1.7% for cardiovascular disease, respiratory conditions and myocardial infarction respectively.
The study also notes that it has not proven a causal relation and acknowledged that the type of study used could not be restricted to the non-smoking population. “However, the ecological design of this study prevents the delineation of individual smoking status and other individual-level information, such as actual exposure to second-hand smoke and other risk factors (e.g., prior acute myocardial infarction and other comorbidities).”
The authors are quite frank in admitting that the study has its limitations; that smoking bans are only one factor involved in the observed decline in hospital admissions. Additional factors include increases in taxes on tobacco, tightened restrictions on advertising, the addition of graphic warnings to cigarette packaging and removal of smoking-related products from point-of-sale displays.
The point is simply that the decrease in hospital admissions may have resulted from factors other than the smoking ban.
But, as usual in these kinds of studies, the very real inadequacies in methodology and interpretation become all too apparent when they come under the scrutiny of knowledgeable experts in the field. And, the experts aren't convinced that the study has merit.
For example, anti-smoking advocate Dr. Michael Siegel notes on his blog that: “There are huge problems with this study.”
Siegel notes on his blog that similar declines in admissions for cardiovascular disease occurred in both cities used as controls in the study (Thunder Bay and Durham Region).
Hospital admissions for angina in Durham dropped by 53% between 2001 and 2004. A similar trend was evident in Thunder Bay where admissions for angina dropped by 43% between 2000 and 2006. Quipped Siegel: “The same reasoning used by this paper to conclude that the smoking ban led to the observed decline in angina in Toronto would also argue that the 53% decline in angina admissions in Durham Region was attributable to the absence of a smoking ban.”
Also ignored in the study was the fact that stroke admissions in Durham declined by 47% from 2000-2006. And, from 2003 to 2006, there was a 28% decline in heart attack admissions in Thunder Bay. So we have similar declines in hospital admissions for cardiovascular disease in the Lakehead and Durham, despite the fact that neither community had smoking bans in effect.
According to Siegel: “The rest of the story is that we have yet another study purporting to show a dramatic and immediate effect of smoking bans on acute cardiovascular event admissions which turns out to be severely flawed. In this case, the data presented in the paper (or at least in the appendix) not only fail to support the study conclusion, but they actually refute that conclusion.”
Yet few media accounts commented on these aspects of the study. They largely ignored the limitations noted by the study authors themselves, and focused on the more sensational, seemingly larger numbers over the ten year period of the study, concluding that “smoking bans may be paying big health dividends.” They simply ignored evidence suggesting that they may not do anything of the kind.
What this study points out is that the anti-smoker brigade is desperate to show that smoking bans have a significant beneficial impact on public health.
And, this one, like so many others in recent years, just doesn't cut it.
If you visit any website dedicated to the control of asthma and asthma symptoms, you will usually find reference to the fact that asthma has been increasing at an alarming rate over the past three decades.
A report released by the EPA in 2003 reported that “the percentage of children getting asthma has doubled in two decades, rising from 3.6 percent in 1980 to 8.7 percent, or 6.3 million children by 2001.”
According to an article from the Associated Press at that time: “Researchers don’t know exactly why asthma is increasing among children, but a number of factors in air quality, both outdoors and indoors, have been studied. Those range from exposure to dust mites, cockroaches and pesticides to tobacco smoke, ground-level ozone from cars and soot from diesel engines.”
Early on, the anti-smoker crowd were quick to pounce on secondhand smoke as a major factor in both the onset of asthma, and the exacerbation of asthma symptoms, especially among children. But, the rapid increase in the incidence of asthma at a time when smoking prevalence was declining should have been cause to re-evaluate the strength of the association between smoking and the onset of asthma. Of course, it wasn't.
Instead, a report entitled “ Passive smoking and children” was recently released by the Tobacco Advisory Group of the RCP (Royal College of Physicians) in the UK. Under a section with the heading, “The costs of passive smoking in children”, this august body of health scare professionals claims that: “The cost of providing asthma drugs for children who develop asthma each year as a result of passive smoking up until the age 16 in the UK is approximately £4 million.”
That's a pretty definitive statement. And, it's presented with such authority that people could almost be forgiven for believing it. After all, the public has been conditioned by anti-smoker propaganda to accept the most outrageous claims without question. And, it does come from a reputable body of health care professionals.
Still, the claim raises a few questions.
For example, to determine even an approximate value of drugs provided to children who develop asthma as a result of exposure to secondhand smoke, you have to know how many children will actually develop asthma from passive smoking. And, to do that, they would have to know how many children were exposed to secondhand smoke and what percentage of new asthma cases could be attributed to passive smoking.
And, that's something they can't know.
Even the “experts” aren’t entirely sure why some people develop asthma and others do not. The most they can say is that asthma, a chronic respiratory condition, is partly caused by an individuals genes. Studies involving twins suggest that 50% to 80% of a child’s asthma risk is due to genetic factors.
And, a visit to several web sites dealing with asthma suggests there is no evidence whatever that secondhand smoke causes asthma. In fact, most sites are pretty forthright and openly admit that the causes of asthma are unknown. Even the US Surgeon-General, in his 2006 report, admits that: “The evidence is suggestive but not sufficient to infer a causal relationship between secondhand smoke exposure from parental smoking and the onset of childhood asthma.” Uh-huh.
The Surgeon-General's 2006 report also notes: “The evidence is not sufficient to infer a causal relationship between secondhand smoke exposure and acute respiratory symptoms including cough, wheeze, chest tightness, and difficulty breathing among persons with asthma”.
So how could those learned gentlemen at the Royal College of Physicians calculate the cost of providing drugs for SHS induced asthma if they can't even show, with any degree of certainty, that asthma is caused by exposure to secondhand smoke?
The numbers are purely speculative; they have no basis in fact. They would be no more or less accurate if they had simply been plucked from somebody's posterior.
The RCP report also claims that: “Passive smoking in children costs at least £9.7 million each year in UK primary care visits and asthma treatment costs, and £13.6 million in UK hospital admissions.”
But, on what evidence do they base these figures?
Just how does a doctor determine that secondhand smoke, and not another of the numerous triggers, caused an asthma attack? Do parents of asthmatic children bring their kids to hospital claiming their children are having difficulty breathing due to an asthma attack caused by Mom or Dad forcing them to inhale secondhand smoke? Really?
There are likely asthmatics out there, both children and adults, who have a strong reaction to secondhand smoke. But, most parents, including smokers, will come to know what triggers cause a child's adverse reaction and seek to avoid them. The inference that smoking parents are somehow less caring or more irresponsible than non-smoking parents is pure unadulterated bullshit.
These wild, exaggerated claims are little more than blatant fear-mongering meant to score a few cheap political points. They're intended to support the anti-smoker contention that smoking in private homes needs to be banned to “protect the children.”
I wonder if the RCP can tell us how many hospital admissions for asthma are caused by exposure to pet dander, household cleaners, dust mites, automobile exhaust, etc? Can they tell us the annual drug costs associated with those asthma triggers?
Yeah. I doubt it too.
PS By the way, responsible parents should not allow their asthmatic children to watch too many comedies on TV . Old reruns of the 3 Stooges and the Roadrunner should also be avoided. Laughter is major asthma trigger.
Anti-smoker rhetoric becomes more shrill with every passing day as they call for ever-increasing sanctions on smokers. The objective of all anti-smoker initiatives, of course, is legislation meant to establish a new norm for what they consider anti-social behaviour; smoking. Smokers must be de-normalized; reduced to second-class citizens.
Their declared motivation is to save smokers from themselves, and to protect non-smokers from the alleged hazards of secondhand smoke. And, naturally, they want to “protect the children”, not only from the alleged hazards of secondhand (and now third hand) smoke, but from smokers.
Children tend to emulate the behaviour of those around them, especially adults and older siblings. And, if they see people around them smoking, then they will be more likely to pick up the habit themselves. That's the basis of the anti-smoker theory that, to protect future generations from the alleged harm of tobacco consumption, adult smokers must be forced to quit. That's why the UK Department of Health (and similar bodies around the world) are so insistent on smoking bans, higher taxes and other draconian interventions to “motivate” people to quit smoking.
Or, as noted in a UK Department of Health report entitled A Smokefree Future: “We need to focus on preventing young people from taking up smoking in the first place. The home environment is very important: young people are much more likely to smoke if they live with smokers. For this reason, supporting adult smokers to quit is a key aspect in encouraging young people not to take up smoking.”
In simpler terms, if children don't see people smoking, they won't take up the habit and tens of thousands of young lives will be saved compliments of the anti-smoker crusaders.
To this end a number of interventions have already been put in place, or are being considered, in jurisdictions around the globe. There are age restrictions on the sale of cigarettes to minors; tobacco products are hidden from the view of children and adults alike in retail outlets; tobacco advertising is prohibited in most forms of mass media; and efforts are afoot to curtail smoking in the movies and on television.
In addition, bans are being considered (or have been implemented) in outdoor areas such as parks, beaches, sidewalks, etc, not because of any real health hazard, but to protect children from the sight of a smoker. "One of the biggest impacts of smoking around children is that adult smokers can be seen as role models, increasing the likelihood that the child will, in due course, also become a regular smoker.”
Ignored is the fact marijuana use among teens (in Canada, at least) is claimed to be greater than cigarette use. Cannabis is an illegal substance which is not advertised in any venue. And, I suspect the number of parents toking up in front of their kids is miniscule.
So what's the driving force behind kids adopting the marijuana habit? It's not advertising. It's not exposure to misguided adult (parental) role models. You seldom see anyone toking up in the movies or on television.
At any rate, the latest anti-smoker initiative in the UK is to a ban smoking in private homes with children. Watch for similar campaigns in your little corner of the world, wherever that may be.
Not surprisingly, one of the arguments being put forward is that, since smoking bans have been implemented in so many other areas, it is perfectly reasonable to impose smoking bans in homes to protect the children. After all, the home is the major source of exposure and a ban on smoking in private homes would reduce the likelihood that adolescents will pick up the filthy habit and become (shudder) smokers themselves.
Of course, such legislation would be difficult to implement and almost impossible to enforce. But, that won't stop the anti-smoker fanatics from trying; for the good of the children, mind you.
But, given the anti-smoker penchant for draconian solutions, I can envision several ways by which a ban on smoking in the home might be enforced.
For example, snitch lines could be set up to allow concerned neighbours and relatives to report parents suspected of exposing their children to secondhand or third hand smoke. The children themselves could be “encouraged” to report offending parents, perhaps to teachers or other school authorities. Or, urine samples could be collected from the kids on a weekly or bi-weekly basis to allow authorities to check cotinine levels which might indicate exposure to secondhand smoke.
Physicians could be instructed to notify public health authorities whenever they treat youngsters with asthma or middle ear infections. After all, according to many in the anti-smoker cult, exposing children to secondhand smoke is tantamount to child abuse.
Once a child has been identified as being “at risk”, offending parents could be ordered by the courts to seek counseling and/or enroll in a smoking cessation program. To ensure compliance, parents could be fitted with personal monitoring devices to detect the presence of tobacco smoke. Whether they actually smoke in the presence of their children or not is immaterial since the kids would still be exposed to the hazards of third hand smoke.
If parents can't or won't comply with a court ordered directive to quit smoking, children could be made wards of the state. Or, in those cases where only one parent smokes, the offending parent could be incarcerated in a reeducation facility until they learn to control their abnormal urge to smoke and are deemed fit to return to respectable society.
The final solution, reserved only for the most incorrigible smokers, of course, would be a chemically induced frontal lobotomy. I'm sure the pharmaceutical industry can come up with an appropriate remedy.
The loss of a a little freedom is a small price to pay to protect our children. Don't you think?
The anti-smoker brigade issues press releases on a regular basis. Over the last couple of years, for example, they've announced a series of studies which purported to show that smoking bans immediately reduce hospital admissions for cardiovascular disease.
