Many readers will be aware that I have little faith in the smoking related statistics postulated by the anti-smoker brigade. I believe they've been grossly exaggerated and manipulated to the point where they're totally unreliable.
Last year, two long-time members of the housing co-op in which I live were diagnosed with lung cancer. Both are in their early seventies. As might be expected, the prognosis is not good for either of them.
One is male, a never smoker who was not exposed to secondhand smoke to any significant degree. He worked most of his life in a smoke-free environment (a school) and his now grown children never smoked in the house. He took care of himself, and up until a year or so back, still rode his bicycle on a regular basis.
The other, a female, has been smoking since she was a teenager in Northern Ireland many years ago. Her sister, also a resident of the co-op and a heavy smoker, died a few years back from the same dread disease. She continues to smoke. In fact, when doctors suggested she move into a palliative care facility, to make her remaining life a little easier, she refused. “Not bloody likely,” she told them, “they'll take me fags away.”
One of these two people will become a statistic; a smoking attributable death. As a smoker, she will be stigmatized in death, as she was in life. But what about the non-smoker, the male who never smoked a cigarette in his life? Will he too become a statistic? The answer, apparently, is yes.
Health Canada determines smoking attributable deaths by calculating an SAF (Smoking Attributable Fraction) which is applied to all lung cancer deaths whether the deceased was a smoker, a former smoker or a never smoker. The last report compiled for Health Canada (based on 2002 data from StatCan) indicates that the SAF for males was 88.6%.
So, if, or perhaps more accurately, when, my neighbours succumb to lung cancer, the man who never smoked a cigarette in his life will have 88.6% of his death attributed to smoking. The lifelong smoker will have 62.5% of her death attributed to smoking (the SAF for women). At an individual level, it's an absurd proposition, since only one of these lung cancer deaths can reasonably be associated with smoking.
Using an SAF means that for every 1,000 male smokers who die of lung cancer, 886 can be attributed to smoking. Likewise, for every 1,000 former smokers who die, 886 will be attributed to smoking. And, yes, for every lung cancer death experienced by those who have never smoked, the same number, 886, will be attributed to smoking. Uh-huh. 886 out of every 1,000 lung cancer deaths among those who have never smoked will be attributed to smoking.
Of course, this means that 2, 658 (3,000 X 88.6%) of those three thousand lung cancer deaths would be attributed to smoking, even though the maximum number that could reasonably have died as a result of smoking was 2,000, the combined total of smokers and former smokers. The numbers are inflated by statistical chicanery.
First, they estimate the relative risk through epidemiological studies. The Lung Cancer Alliance claims smokers face a risk of contracting lung cancer that is 23 times higher than those who have never smoked. Former smokers carry a Relative Risk of 9 according to the Lung Cancer Alliance.
Then, using a complicated mathematical equation, they calculate a smoking attributable fraction which is then applied to all lung cancer deaths, regardless of the actual smoking status of the deceased. But, doing so raises the possibility of serious error in the calculation of smoking related deaths, as noted in the 3,000 deaths scenario. Using this kind of statistical model can lead to an inflated, and misleading, number of deaths attributed to smoking.
A statistician would likely argue that, if the relative risks estimated in the epidemiological studies are accurate and the smoking prevalence rates estimated in telephone surveys are accurate, then the statistics derived from these data should provide an accurate snapshot of the number of deaths that could be attributed to smoking population wide.
And, being neither an epidemiologist nor a statistician I would be hard pressed to argue the fine points of statistical analysis. But . . .
First off, it's not really the mathematical precision of the calculations which concerns me. But, the reality is that the smoking related statistics Health Canada postulates as fact have never been verified. They are statistical deaths, based on assumptions that may, or may not, be accurate.
For example, up until November, 2007, estimates of smoking attributable mortality were based on 1998 mortality data. SAM (Smoking Attributable Mortality) was estimated to be 47,581, or according to Health Canada, 21% of all deaths recorded in that year. In 2007, Health Canada quietly revised these figures downwards to 37, 203, or 16.6% of total deaths.
Overnight, with the simple stroke of a pen, there were over 10,000 fewer deaths attributable to smoking. But, there was no change in the number of actual deaths. The change was in the statistical deaths attributed to smoking.
The reason – faulty data.
Health Canada had been using data from CPS-II, an American study, which they had been criticized for using for many years. Said Health Canada of the modification: “Thus, direct application of a large US survey to the Canadian population may not be appropriate.“ Uh-huh.
Knowing that inappropriate figures from a US study were used to generate what turned out to be grossly inflated numbers of smoking related deaths does not exactly inspire confidence in Health Canada's statistics. And, knowing that 88.6% of lung cancer deaths among those who have never smoked will be attributed to smoking also contributes to a degree of skepticism.
But, I'll have more to say on their damnable statistics in my next post.
“1,771 Casino Employees in PA Will Die from Secondhand-Smoke Illnesses, New PACT Study Says.” So claims the headline of a press release issued by the Pennsylvania Alliance to Control Tobacco (PACT). It's dated October 15, 2007, and provides a media resource list; Joy Blankley Meyer, Executive Director of PACT; Deborah P. Brown, Vice President, Community Outreach and Advocacy, American Lung Association of the Mid-Atlantic; and James Repace of Repace Associates.
Of course, the “almost 1,800” won't all die at once. Reading the full text you find out that it will take 40 years, at 44 non-smokers a year, for those non-smoking casino workers to die from exposure to secondhand smoke. But, that's still a lot of non-smokers dying from that nasty old secondhand smoke. If, in fact, they were non-smokers.
According to the October 15 press release: “Within the next few years, the five currently licensed casinos will employ approximately 10,000 people. Of those 10,000 people, 1,771 nonsmokers — or 44 nonsmokers per year — will die during the subsequent 40 years specifically as a result of exposure to secondhand smoke.”
But, did those casinos actually hire only non-smokers? That's the inference of the statement.
I came across this item while looking for information on a claim made on another anti-smoker site. The claim was that “six out of every 10,000 nonsmoking Pennsylvania casino workers will die each year because of exposure to secondhand smoke.” The claim referred to a study conducted by “internationally renowned secondhand smoke scientist James Repace.”
So, I followed the link to the study. And, sure enough, the Repace study concluded: “SHS-induced heart disease and lung cancer will cause an estimated 6 Pennsylvania casino workers' deaths annually per 10 000 at risk, 5-fold the death rate from Pennsylvania mining disasters. Casinos should not be exempt from smoke-free workplace laws.”
Only six non-smokers a year? But, that's only 240 non-smokers who will die from secondhand smoke over the next 40 years. That's a far cry from 1,771 claimed in the press release from PACT. And, even the 240 non-smoker deaths over the next 40 years is predicated on the assumption that all employees of casinos in Pennsylvania are non-smokers.
So, just how many people did those five casinos employ? They obviously weren't up to 10,000 in 2007.Time for another Google search.
I didn't find the employment figures for the Pennsylvania casinos. But I did find a number of links to the “1,771 non-smoking casino workers” who were about to die from secondhand smoke.
But, wait a minute. One link was a little different; it claimed the 1,800 deaths may have been over-stated.
It seems Jacob Sullum over at Reason.com had noticed a discrepancy between the October 15 press release and a second press release issued only three days later by the same bunch of anti-smoker fanatics (including the internationally renowned secondhand smoke scientist, James Repace).
The second press release was dated October 18, 2007. In three days, employment at the casinos had increased to 12,000. The additional 2,000 were, apparently, non-smokers. But, don't be concerned; smokers are becoming used to discrimination in employment.
But, the second press release was claiming only 300 dead non-smoking casino workers over the next forty years, or eight non-smoking deaths annually. In only three days they managed to save 1,500 non-smokers from the deadly effects of secondhand smoke. And, they did it with the stroke of a pen.
The fact is that both press releases were almost identical, except for the numbers.
In the first (Oct 15), James Repace is quoted as saying: “Twenty times OSHA’s Significant Risk Level will eventually kill 44 casino workers every year. This is comparable to the total number of deaths from coal mine disasters in 2006 – and we all appreciate that coal mining can be a dangerous job.”
In the second (Oct 18), the Repace quote is: “Twenty Seven times OSHA’s Significant Risk Level will eventually kill 8 casino workers every year. By comparison, between 1995 and 2002, 16 miners died in Pennsylvania mine disasters, or about 2 per year. We all appreciate that coal mining can be a dangerous job,”
And, although PACT, the American Lung Association of the Mid-Atlantic and Repace Associates issued a new press release, with revised numbers, the original, with the gross exaggerations, is still being widely circulated on the web.
And, by the way, did you think to look at the date on the Repace study I quoted from earlier. It was apparently published in the American Journal of Public Health in August, 2009. In fact, the AJPH indicates the study was published online, ahead of print, on June 18, 2009. It contains a similar reference to Pennsylvania coal miners as the quote attributed to Repace from the PACT press releases.
But, the PACT press releases were issued in October, 2007, and were based on a “new study”, presumably by Repace. Do these guys get extra credit for publishing the same “scientific” study in multiple journals?
Go ahead. Ask me again why I refer to the rantings of the anti-smoker cult as bullshit and bafflegab.
In China, a fifteen-year-old boy was allegedly beaten to death at a training camp designed as a rehabilitation facility for the treatment of internet addiction. Uh-huh. Chinese officials, apparently, believe there is a growing problem of wwweb addiction among teenagers and are taking steps to deal with the pandemic. In fact, rehab facilities for internet addicts appears to be a growth industry.
A pandemic, of course, is an epidemic on steroids, one that has spread beyond national borders, often affecting entire continents, or even the world. That's serious shit.
And, I hope Health Canada is taking appropriate action to prevent the spread of this gruesome affliction into Canada. We certainly don't need another addiction. I mean, we already have problems with drug addiction, caffeine addiction, video game addiction, work addiction, compulsive overeating, problem gambling, computer addiction, alcoholism, nicotine addiction, pornography addiction, etc.
The point I'm trying to make is that addiction has become a grossly overused (and abused) word.
Merriam-Webster's Dictionary defines addiction as “the state of being enslaved to a habit or practice or to something that is psychologically or physically habit-forming, as narcotics, to such an extent that its cessation causes severe trauma.”
Their medical definition says it's a: “compulsive physiological need for and use of a habit-forming substance (as heroin, nicotine, or alcohol) characterized by tolerance and by well-defined physiological symptoms upon withdrawal; broadly: persistent compulsive use of a substance known by the user to be physically, psychologically, or socially harmful.”
But, I'm not convinced that smoking, so called nicotine dependency, fills all the requisites usually associated with addiction.
For example, drug addiction and alcoholism are usually associated with an intoxicating effect which reduces cognitive skills, impairs judgment, and adversely affects motor responses; smoking does none of those things. It's unheard of for anyone to be arrested for driving under the influence of tobacco. And, airline pilots and commercial drivers are not prohibited from flying or driving after having a smoke as they are after using illegal drugs like heroin or prescription drugs like Chantix.
Drug addiction is also strongly linked to deviant behaviour and criminal activity. Drug addicts are known to steal and engage in prostitution to feed their habit. I would suggest that young women (or men) are unlikely to sell their body to feed a tobacco habit.
And, despite claims to the contrary, smoking cessation is unlikely to cause “severe trauma”. It may be difficult for many people to break the habit, but to suggest quitting smoking can be as traumatic as heroin withdrawal or the DTs is ridiculous.
Says Health Canada about quitting: “More than half of all people who have ever smoked in Canada have already quit smoking. This includes men and women of all ages and all levels of addiction. “
The fact is that there are more former smokers in Canada than there are current smokers. Far more. According to Health Canada, 21.8% of females and 26.3% of males smoked in 2002. But, their 2002 report on smoking related mortality also showed that 37.8% of women and 44.6% of men over the age of 15 were former smokers.
That means roughly 8 million Canadians were former smokers. And, the vast majority, perhaps as many as 95% managed to quit cold turkey, without smoking cessation aids; without taking up residence in a drug rehab facility or detox centre. Equating the smoking habit to heroin or alcohol addiction is just so much bullshit and bafflegab.
The simple truth: smoking has been declared an undesirable behaviour by the anti-smoker cult. And, everybody knows undesirable behaviour has to be corrected or eliminated. Branding smokers as poor, addicted misfits satisfies the anti-smoker strategy of denormalizing smokers.
The intent is to create feelings of guilt, shame, and anxiety; to convince the smoker he or she is a hopeless failure who needs to be converted from their wicked ways and to seek salvation. And, the road to salvation begins with a visit to the local drug store to stock up on Nicoderm, Nicorettes and candy-flavoured nicotine lozenges.
“Nicotine replacement therapy provides the body with nicotine - generally in the form of a gum or patch - without the other harmful parts of tobacco. These aids can help a person concentrate more on quitting the habit of smoking by relieving the symptoms of withdrawal.” (Health Canada)
Health Canada notes that, in addition to possibly creating a chemical dependency, “Smoking is also a learned behaviour. We begin to learn or associate things such as the way we hold or light a cigarette or take it out of the package with the pleasant feelings or sense of relief that it brings us.”
So, to cure the nicotine dependency, the anti-smoker cult prescribes nicotine. To cure the habit of smoking, they dictate a bizarre experiment in behavioural modification called denormalization.
I wonder how Health Canada will treat the deadly internet addiction.
On Friday, I erroneously stated that bans on tobacco displays had been implemented in Scotland and the UK. It seems I may have jumped the gun. That legislation is still pending and, as yet, has not been approved by parliament.
However, my comments about some public health and/or tobacco control groups misleading the House of Lords are no less valid.
For a very thorough analysis of the subject of my post, I would refer readers to an article on Spiked, by Patrick Basham. The piece is titled “ Displaying the truth about policymaking, Newly released correspondence shows how UK government tobacco policy is being created by anti-tobacco groups”,
Many readers will be aware that I have little faith in the smoking related statistics postulated by the anti-smoker brigade. I believe they've been grossly exaggerated and manipulated to the point where they're totally unreliable.
