Anatomy of a Myth
The Freedom2Choose lobby has inundated my blog with comments over the past three days. Details follow the posting for the 29th June - all 120 comments and replies are visible by scrolling down. They have set many hares running and sent me searching after their flimsy excuses� for opposing the smoking ban. Their entire shared mythology has been constructed on the basis of wishful thinking, falsehoods and rumours.
Colln Grainger, who sent the original letter, has at last responded. In a pompous and inadequate reply he uses the excuse that he has no time to answer my comments. He indulges in a couple of weak schoolboy jibes including the hilarious one that I would not understand his scientific explanation. He calls me an anti-smoking zealot. In my 21 years in parliament and more than a million words on my website, I have rarely, if ever, mentioned the subject of the smoking ban until now. My interest this time was provoked by Grainger's foolish claim that the smoking ban had not been a success. I have campaigned on the health benefits of the smokeless tobacco Snus and on nn-smoking ways of ingesting cannabis. I have asked who funds Freedom2choose, Forest and Talking Liberties website. An answer might be interesting. None has been offered so far.
The motivation of those opposed to the ban are still a mystery. Some rall against Government 'dictatorship' - odd when the decision was taken by a near 2 to 1 majority after a full debate and the ban still enjoys increasing public support. If it is a matter of principle, why join forces with the tobacco lobby and FOREST who have a despicable record of lying to their customers and shortening their lives? Many of the tortuous nit-picking arguments offered come from tobacco lobby sources here or in the USA. Principle?
Second Hand Smoke
Myths
MYTH: Second Hand Smoke isn’t really dangerous?
FACT: Scientific evidence has firmly established that there is no safe level of exposure to second hand tobacco smoke (SHS), a pollutant that causes serious illnesses in adults and children (WHO)
•��� Tobacco companies continue to misrepresent the evidence on the health effects of SHS exposure and even claim that WHO has concluded that SHS is not dangerous. In fact, WHO has consistently concluded the opposite: SHS kills.
•��� SHS contains thousands of known chemicals, at least 250 of which are known to be carcinogenic or otherwise toxic.
•��� WHO, IARC, the United States Surgeon General, the United States Environmental Protection Agency (EPA), Cal/EPA, and numerous expert scientific and medical bodies worldwide have documented the adverse effects of SHS on the respiratory and circulatory systems, its role as a carcinogen in adults, and its impact on children’s health and development.
•��� SHS was the second most common form of exposure to carcinogens (after solar radiation) in the EU-15. (EU 2008)
•��� A review of the evidence in� November 2004 published since 1998 reinforces the conclusions of the SCOTH (Scientific Committee on Tobacco and Health report published at that time:
• The causal effect of exposure to SHS on risk of lung cancer has been confirmed by further original studies and by the authoritative review conducted by IARC. The pooled increased relative risk remains in good agreement with that estimated by Hackshaw, Law and Wald at 24%.
• The causal effect of exposure to SHS on risk of ischaemic heart disease has been confirmed and the weight of evidence is stronger now than at the time of the SCOTH report. The increased risk associated with exposure to SHS is in the order of 25%.
• There is a strong link between exposure to SHS and adverse health effects in children. There is no reason to revise SCOTH’s conclusions relating to a number of causal effects.
•��� According to the WHO- Impact on adults:
•��� Coronary heart disease (CHD). There is convincing evidence from studies on a wide geographical and racial range of populations that SHS causes both fatal and non-fatal heart disease. Many of these effects are nearly as large as those seen in active smokers. The American Heart Association, the United States Surgeon General, and the United Kingdom Scientific Committee on Tobacco and Health18 is that SHS exposure causes heart disease and increases the risk of death from heart disease by about 30%; recent evidence suggests that the effect could be more than twice as large.
•��� Lung cancer. SHS exposure has been linked to lung cancer in dozens of studies from around the world, beginning with studies in 1981 showing an increased risk of lung cancer in non-smoking women married to cigarette smokers.� The IARC, the United States Surgeon General and the United States EPA, among numerous other scientific bodies worldwide, have all concluded that SHS causes lung cancer in nonsmokers.
•��� Breast cancer. The 2005 Cal/EPA report, prepared as part of the process that led SHS to be listed by the state as a “toxic air contaminant,” indicates that 13 out of 14 studies reviewed, which contained data on pre- versus postmenopausal status found an elevated risk of� breast cancer in younger, primarily premenopausal women, leading to an overall estimate that SHS exposure was associated with a nearly 70% increased risk of breast cancer in this group. The Cal/EPA concluded that SHS causes breast cancer in younger, primarily premenopausal women based on this observed risk as well as the current state of knowledge on the biology of breast cancer and the fact that there are 20 known mammary carcinogens in SHS, which have caused detectable genetic damage in women’s breasts. The United States Surgeon General’s Report found the evidence to be suggestive of a causal relationship between SHS and breast cancer.
•��� Respiratory symptoms and illnesses. Data indicate that SHS exposure plays a role in the development of chronic respiratory symptoms and produces measurable decreases in pulmonary function.
•��� SHS also induces and exacerbates asthma in adults
Impact on children
•��� Respiratory illnesses and symptoms. Both maternal and paternal smoking cause lower respiratory tract illnesses such as bronchitis and pneumonia, particularly during the first year of life.
•��� Numerous surveys also show a greater frequency of the most common respiratory symptoms – cough, phlegm and wheeze – in the children of smokers.
•��� The highest levels of risk have been found in households where both parents smoke.
•��� Asthma. Exposure to SHS exacerbates pre-existing asthma and causes new-onset asthma among children (as well as adults, as discussed above).
•��� Lung growth and development. Since the United States Surgeon General concluded in 1986 that SHS reduces the rate of lung function growth during childhood, evidence has continued to accumulate to support this conclusion.
•��� Middle-ear disease (otitis media). SHS exposure causes otitis media, or middle ear disease
•��� Pre and postnatal effects: Exposure of non-smoking women to SHS during pregnancy causes low birth weight and preterm delivery.
•��� SHS exposure also causes Sudden Infant Death Syndrome (SIDS or cot death).
•��� Other perinatal health effects where there may be a link with SHS exposure are intrauterine growth retardation and spontaneous abortion (miscarriage).
MYTH: The evidence is ambiguous
FACT: “In humans, smoking produces gene mutations and chromosomal abnormalities….Most of the genetic effects seen in smokers are also observed in cultured cells or in experimental animals exposed to tobacco smoke or smoke condensate. Tobacco smoke is genotoxic in humans and in experimental animals” (WHO IARC Vol. 83 24 July 2002)
A clear scientific consensus on SHS exposure’s dangerous health effects has developed, based on accumulated evidence and copious new data, which show that SHS causes serious and fatal diseases in adults and children. Several current reports, including the 2004 monograph from the International Agency for Research on Cancer (IARC), the 2005 report from the California Environmental Protection Agency (Cal/EPA) in the United States of America and the 2006 report of the United States Surgeon General, have synthesized this evidence and
reached unambiguous and solid conclusions on SHS exposure’s adverse consequences.
MYTH: Epidemiology, the basis for risk estimates of exposure to SHS, is “junk science”
FACT: Use of the pejorative term “junk science” to describe the scientific method of epidemiology can be traced back to the tobacco industry and other industries, which are fearful of the implications that epidemiological research may have for their products. Tobacco industry documents have left an extensive trail showing an organized effort to discredit it. A well-established, fundamental science of public health, epidemiology is the scientific method for directly gathering information on the health effects of exposures as received in natural settings. The same approaches employed successfully for studying SHS have been used over decades for infectious
diseases and for major acute and chronic diseases. Epidemiological evidence is the
foundation for public policy in many areas, such as infection control and management of air and water pollution.
MYTH: The WHO doesn’t think SHS is a serious health issue
FACT; Since the 1970s, tobacco companies have considered smoke-free laws to be the “most dangerous development to the viability of the tobacco industry that has yet occurred.” The tobacco industry – usually working through front groups
operating with its support – vigorously opposes the passage and implementation of smoke-free laws, whether at local, subnational or national level. Tobacco companies continue to misrepresent the evidence on the health effects of SHS exposure and even claim that WHO has concluded that SHS is not dangerous. In fact, WHO has consistently concluded the opposite: SHS kills.� (Protection from exposure to second-hand tobacco smoke, WHO)
MYTH: The EU Green Paper March 2008 states that Second Hand Smoke is harmless
FACT: The EU Green Paper of March 2008 states that :
Comprehensive smoke-free regulation “would offer the highest reduction in ETS exposure and related harm, ensuring the quality of European citizens to protect their right to breathe healthy indoor air”.
The Green Paper further states that there is “unequivocal scientific evidence of the harm caused by second-hand smoke” and that several successful examples of comprehensive smoke-free policy now in force around the world have proved that the option is viable and enforceable”.
MYTH: Second Hand Smoke only affects a few bar staff
FACT: Exposure to SHS is widespread in most countries, even in health-care settings and among health professionals. Data from the Global Youth Tobacco Survey (GYTS) indicate that SHS exposure is common among youth. Surveys of children in school, aged 13 – 15 years, conducted between 1999 and 2006 in 132 countries found that 44% had been exposed at home and 56% in public places during the 7 days prior to the survey.
•��� A study of workers at Mexico’s National Institute of Health showed that 91% were exposed to some degree to tobacco smoke.
•��� A survey of third-year students in health professional schools in 10 countries found exposure to SHS at home ranging from 30% in Uganda to 87% in Albania, and exposure in public places from 53% in Uganda to 98% in Serbia.
•��� While exposure to tobacco smoke in the United States has declined substantially over the past several years, studies of cotinine (a by-product of nicotine) reviewed in the 2006 United States Surgeon General’s Report show that more than 40% of non-smoking adults and almost 60% of children aged 3 through 11 years are still exposed to SHS.
•��� Two recent studies of a variety of settings in 39 developed and developing countries found SHS in the great majority of the locations surveyed.
•��� In seven Latin American countries SHS (measured by ambient nicotine levels) was detected in 94% of the locations surveyed, including hospitals, schools and government buildings.
•��� A study comparing levels of fine particulate matter in indoor environments, where smoking was or was not observed, concluded that among the 32 countries studied, only the two countries with national comprehensive smoke-free air policies – Ireland and New Zealand – had acceptable levels of indoor air quality.
•��� Widespread exposure translates into significant health consequences at the population level. For example, Cal/EPA estimates that in the United States SHS causes 3 400 lung cancer deaths and between 23 000 and 70 000 heart disease deaths annually. In children, SHS is estimated to be responsible for the country’s annual 430 cases of SIDS, 24 500 low-birth weight babies, 71 900 pre-term deliveries, 200 000 episodes of asthma and 790 000 medical visits due to middle-ear infection.
•��� Estimates of deaths attributable to exposure to SHS are available for at least 27 other countries.
•��� International Labour Organization estimate 200 000 workers die every year due to exposure to second-hand tobacco smoke at work. WHO estimates that around 700 million children, or almost half of the world's children, breathe air polluted by tobacco smoke.
•��� MYTH: Ventilation systems protect non-smokers from exposure to SHS.
*���� FACT: Tobacco smoke contains both particles and gases. Ventilation systems cannot remove all particulate matter and certainly not gases. Furthermore, many particles are inhaled or deposited on clothing, furniture, walls, ceilings, etc. before they can be ventilated. While increasing the ventilation rate reduces the concentration of indoor pollutants, including tobacco smoke, ventilation rates more than 100 times above common standards would be required just to control odor. Even higher ventilation rates would be required to eliminate toxins, which is the only safe option for health. In order to eliminate the toxins in SHS from the air, so many air exchanges would be required that it would be impractical, uncomfortable and unaffordable.
The American Society of Heating, Refrigerating, and Air Conditioning Engineers (ASHRAE) no longer provides recommended standards for ventilation when tobacco smoking is present. In its 2005 environmental tobacco smokef (ETS) position document, ASHRAE concludes,
“At present, the only means of effectively eliminating [the] health risk associated with indoor exposure is to ban smoking activity.” “Because of ASHRAE’s mission to act for the benefit of the public, it encourages elimination of smoking in the indoor environment as the optimal way to minimize ETS exposure.”
•��� What about Designated Smoking Rooms (DSRs?): With exhaust of air to the outside, isolated return air, and negative pressurisation in relation to adjoining spaces, have been designed and tested for the degree of protection provided. Based on existing literature, such rooms may reduce but not eliminate the exposure to SHS inside the DSR. In addition, DSRs do not eliminate non-smokers’ exposure to second-hand smoke in adjacent spaces and offer no protection to workers required to work in them, and may also intensify exposure of smokers to SHS, thus increasing risks to their health
*��� MYTH: It is only a few countries and the odd US state that thinks there is any benefit in a ban.
•��� FACT: The WHO and EU have both publicly stated support for a ban on smoking in work places and public places. WHO issued policy recommendations in 2007 which recommended “100% smoke free environments”. The most recent document from the EU, March 2008, identifies a ban as offering the “ highest reduction in ETS exposure and related harm, ensuring the quality of European citizens to protect their right to breathe healthy indoor air”.
•��� The Green Paper further states that there is “unequivocal scientific evidence of the harm caused by second-hand smoke” and that several successful examples of comprehensive smoke-free policy now in force around the world have proved that the option is viable and enforceable”.
•��� Developed and developing countries like Ireland, New Zealand, Scotland and Uruguay, as well as territories such as Bermuda, have built on the implementation of smoke-free laws at the local and subnational level that began in North America in the late 1970s.
Impact of the ban:
•��� CHOICE project managed by the WHO identified smoke free public places as the second most effective form of intervention to reduce the mortality and morbidity related to tobacco use, after tax increases.
•��� England: August 2007 concentrations of fine particulate matter (the marker of second hand smoke concentration) in bars had dropped by 91%.
•��� Cotinine� (cotinine levels in saliva indicate how much nicotine a person has inhaled in last 24-48 hours) levels in non-smoking bar workers in England on average reduced by 76% (Smokefree Bars 07 project : Interim Report May 2008 )
•��� In Scotland, post-implementation studies of its ban showed a 17 per cent reduction in heart attack admissions to nine major Scottish hospitals7. One study comparing air quality before and after implementation found an 86 per cent improvement in bars and a 39 per cent reduction in second-hand smoke exposure in non-smoking adults and children.� (Sally Haw. Scotland's Smokefree Legislation: Results from a comprehensive evaluation. Presentation given at the "Towards a Smokefree Society Conference", Edinburgh Scotland, 10 - 11 September 2007).
•��� A study comparing levels of fine particulate matter in indoor environments, where smoking was or was not observed, concluded that among the 32 countries studied, only the two countries with national comprehensive smoke-free air policies – Ireland and New Zealand – had acceptable levels of indoor air quality. (WHO)
Effect on pubs
Even before the smoking ban in 2005 the Campaign for Real Ale (CAMRA) suggested that around 26 pubs in the UK are being closed down each month.� Caroline Nodder, editor of trade magazine The Publican, said this was attributed to “many reasons, an increase in red tape, more legislation and overheads are higher than they used to be.� Also the local village pub is not getting regular trade like it used to as in a lot of cases there is not the same village community or people are choosing to go into town more.” The decline of local pubs happened before the smoking ban.
Whilst many in the pub industry have pointed to the introduction of the smoking ban as being bad for business, they recognise that it is not the only reason that has led to a decline.�
Support for the smoking ban.
The Independent ran a story at the end of June this year which said that the smoking ban had saved over 40,000 lives.� It said “more than three out of four people support the law, and compliance has been virtually 100 per cent.”
Effect of the smoking ban on quitting
A survey, carried out by Cancer Research, of 32,000 people in England interviewed before and after the ban took effect found the decline in smoking had accelerated. In the nine months before the ban it fell 1.6 per cent compared with 5.5 per cent in the nine months after the ban. Researchers estimate on the basis of these figures that 400,000 people quit smoking as a result of the ban. http://news.bbc.co.uk/1/hi/health/7480856.stm
Passive smoking
A study issued in 2002 by the International Agency for Research on Cancer of the World Health Organization concluded that non-smokers are exposed to the same carcinogens as active smokers. (http://www.prnewswire.com/publicinterest/)
Sidestream smoke contains 69 known carcinogens, particularly benzopyrene and other polynuclear aromatic hydrocarbons, and radioactive decay products, such as polonium 210. (http://www.inchem.org/documents/iarc/vol83/02-involuntary.html)
Several well-established carcinogens have been shown by the tobacco companies' own research to be present at higher concentrations in secondhand smoke than in mainstream smoke.
A WHO report released in June said that smoking bans are an effective way of preventing heart disease, getting cigarette users to quit and protecting children from second-hand smoke.
Researchers wrote in the Lancet Oncology special report, "Not only do these policies achieve their aim of protecting the health of non-smokers by decreasing exposure to second-hand smoke, they also have many effects on smoking behavior, which compound the health benefits."
The WHO report cited studies that suggest smoke-free workplaces have lead to a 10 to 20 percent decrease in hospital admissions for heart disease a year after a smoking ban.
The WHO says smoking kills about four million people each year, causing a quarter of deaths related to heart disease. http://www.reuters.com/article/healthNews/idUSL291392620080630
The tobacco industry has focused on proposing ventilation as an alternative to smoking bans, though this approach has not been widely adopted in the U.S. due to the cost and complexity of widespread implementation of ventilation devices. The Italian smoking ban permits dedicated smoking rooms with automatic doors and smoke extractors. Nevertheless, few Italian establishments are creating smoking rooms due to the additional cost.
It's time to refuse NHS treatment for self inflicted illnesses.Unless mentally ill ,people who choose to self harm and pay for it should be forced to go private.
Why should the taxpayer pay for treatment for smokers?
Posted by: patrick | August 04, 2008 at 06:26 PM
Patrick,
The tax-payer doesn't - smokers contribute some £10 billion per annum to the Treasury, while 'costing' the NHS £1.75 billion per annum: therefore smokers contribute over £8 billion per annum to the Treasury in addition to the usual taxes that they pay.
You will, of course, in the interests of consistency, be expecting those who injure themselves while indulging in dangerous sports where there is a high risk of injury and those who become ill or injured through alcohol or drug abuse to also fund their own treatment.
Personally, I would be more than willing to take my share of the surplus £8 billion and the share of my NI contributions that is earmarked for the NHS and b*gger off to the private sector where health care isn't politicised and I would be treated without the accompanying sanctimonious finger wagging. While I am forced to opt in to the NHS, I will insist that I am treated without discrimination.
Posted by: J Stewart | August 04, 2008 at 07:04 PM
I do not understand, J Stewart. If you were not addicted to tobacco you need not be preparing for your future cancer treatment. I know it's an addiction for some people, but surely anyone with an once of willpower will give up now or else opt for slow suicide.
What's wrong with you?
Posted by: Gerwyn Edwards | August 04, 2008 at 07:14 PM
Patrick ... I would be careful what you wish for. Some day you might be held responsible for an accident that leaves you with life threatening injuries.
Psul ... I am impressed with your ability to absorb so many studies: you must have spent hours reading up on this!!
Unfortunately since you say that 'the WHO has consistently concluded ... that SHS kills', did you know that they have been attacked in the Lancet for ignoring vital evidence?
Not being a subscriber to the Lancet I don't have the relevant link. However since you also include the much criticised study claiming a 17 per cent drop in heart attacks in Scotland, I am inclined to think that most of the rest of your links have been similarly superficially researched. Quite simply there was no 17 per cent drop in heart attacks in Scotland following the ban's introduction in 2006. The largest drop in recent years was in 1999/2000, at 11 per cent and the trend has been downward for years. I know at least two critiques of this study's methodology, but the biggest blow came from this BBC report, six weeks after the results of this study was announced and several months before it was published.
http://news.bbc.co.uk/1/hi/magazine/7093356.stm
Your opening salvo is lengthy ... conclusive it is not.
Posted by: Belinda | August 04, 2008 at 07:38 PM
Gerwyn
Perhaps I have a rather blase attitude based on the fact that I was diagnosed with cancer in my mid 30s. Despite having had to undergo radical treatment because of its extent, I did live. The type of cancer was non-smoking related. Cancer is, indeed, dreadful, as is its treatment and I wouldn't wish to contract it again. On the other hand I don't wish to live in a state in which I obsess about every risk to my health. I have lost friends at an unexpected age who didn't smoke, hardly drank, ate properly and generally took care of themselves. I now have a more fatalistic attitude. I would rather live my life in peace, free of hectoring and finger wagging about smoking from people to whom longevity equals health. By smoking, I am elevating the risk of certain illnesses but it is by no means certain that I will eventually contract a fatal, smoking-related disease. If I do, I will accept that it was my choice to smoke. I don't expect - and I don't want - the Government or well-meaning zealots to take responsibility for my health and prescribe what is, after all, no more than their subjective view of how life should be lived. I wouldn't dream of imposing my views on others.
So, Gerwyn, there is nothing 'wrong with me', I just happen not to share your outlook and I refuse to join the hysteria that now surrounds smoking.
Posted by: J Stewart | August 04, 2008 at 08:16 PM
Is that the best you can do Belinda?
An article in the Lancet, that you have not read and do not have the reference for or know what it said?????
On these protozoan points is the anti-smoking nonsensical case based. I have carefully and fairly examined the 'evidence' and 'links' sent to me by you and your friends.
The evidence is massively and overwhelmingly against you.
So someone told you that an article in the Lancet said something??????... Why not just give up and admit your motivations are either an an addicted smoker, a publican or you have some other vested interest that overrides all sense and reason?
Posted by: PaulFlynn | August 04, 2008 at 08:40 PM
Hey, Paul. You really tore into Belinda there! Bit disappointed you didn't go further and defend Prof. Pell's 17%. Why is that, man?
Posted by: Michael | August 04, 2008 at 08:49 PM
I am not chasing any more hares.
Read the evidence. You are wrong in every aspect. You nitpick minute irrelevances in the belief that you are destroying rock solid arguments. You are not.
The best you can do is suggest that the 17% drop in heart attacks was only 8%! ONLY? That's a very substantial drop. Your quibble again is self -destructive. An 8% drop is very impressive.
Posted by: PaulFlynn | August 04, 2008 at 08:54 PM
I thought I did not bad actually, Paul ... you haven't looked at the link I did supply, concerning the fact that 17 per cent was arrived at by cherry picking the available data.
The 17 per cent was included in the 2007 'junk statistics of the year' in the Times http://www.timesonline.co.uk/tol/comment/columnists/guest_contributors/article3085272.ece
(paragraph headed 'can't say')
Why, when public money is being spent on compiling statistics, is more money given to researchers to produce their own versions in order to support dubious public policy goals? Don't you think this is a waste of money?
Posted by: Belinda | August 04, 2008 at 09:09 PM
First of all, Paul, why say it was 17 per cent when it was demonstrably 8 per cent? Is that honest?
Secondly if you look at the graph on the link I supplied you will see that the sharpest drop is at 1999/2000, as I said, not in the year following the ban.
Posted by: Belinda | August 04, 2008 at 09:14 PM
And since you ask, here is a link to what was said about WHO.
http://www.cbc.ca/health/story/2007/05/07/who-evidence.html
I don't have the primary link, but I just want to reasssure you that there was heavy criticism made of WHO's use of evidence in the Lancet.
Posted by: Belinda | August 04, 2008 at 09:16 PM
Might I suggest that we start by looking at what you claim is your first 'fact', Paul, a quote from the WHO:
"Scientific evidence has firmly established...no safe level of exposure to...(SHS), a pollutant that causes serious illness in adults and children."
In 1975 Sir George Godber, a former Chief Medical Officer addressed the WHO:
"We must foster an atmosphere where it is perceived that active smokers would injure those around them, especially their family and any infants or young children."
I can only interpret that statement as an intention to build a case for passive smoking. It doesn't, of course, mean that the researchers didn't succeed in building a legitimate case but, if the interpretation is correct, then the research was commissioned in the hope that a legitimate one would be built; the consequent studies should, therefore, be examined very closely.
Posted by: J Stewart | August 04, 2008 at 09:27 PM
"I wouldn't dream of imposing my views on others".J Stewart
you should have continued......
so they should be grateful to inhale my toxic SHS.
Think i'd rather take the views!
Posted by: patrick | August 04, 2008 at 09:28 PM
Paul. You say 8% is 'a substantial drop' but, as you are probably aware, it represents an improvement of just about 3% on the average in the previous three years, doesn't seem all that substantial to me, the rates have been dropping for years.
If 8% is so impressive, what about the 11% in 1999/2000? Does that prove smoking in pubs is good for health?
P.S. I see you are under the impression Freedom 2 Choose is funded by publicans. No, it's funded by its members; smokers, non smokers, people fed up with government interferance in their lives...very few are publicans though.
Posted by: Michael | August 04, 2008 at 09:31 PM
J.Stewart Are you trying to impose your view on me?
Posted by: patrick | August 04, 2008 at 09:46 PM
But i don't smoke!
Posted by: patrick | August 04, 2008 at 10:08 PM
You've been busy with the copy n' paste function Paul, but quantity should never be confused with quality. One example of what may lurk under the surface:
The IARC study referenced here is the 1998 Boffeta et al paper, which can fairly be said to provide ammunition for both sides. But whilst the study's suggestion of risk-elevation for spouses and co-workers was not statistically-significant [Odds Ratios in ranges straddling 1.0], their suggestion of risk-reduction for the "passive-smoking" children of smokers was. The OR in this case being 0.78; with a 95% confidence-interval [0.64–0.96]. A statistically-significant indication of a protective-effect.
Now, why did policymakers seize on the non-significant results to back their desire to enforce "smokefree", whilst completely ignoring [some would say "burying"] the significant result contained in the same study? Don't they care about children's lives?
It should be noted that epidemiology, being an inexact science subject to confounding-factors, should have it's results treated with caution. A high standard is required to indicate causation. This is generally held to be 3.0, or a trebling of risk above the baseline. No large-scale ETS study has come even close to this. From the IARC report:
"The OR for ever exposure to spousal ETS was 1.16 (95% CI = 0.93–1.44). No clear dose–response relationship could be demonstrated for cumulative spousal ETS exposure."
http://jnci.oxfordjournals.org/cgi/reprint/jnci%3b90/19/1440.pdf
It is by cherry-picking evidence to suit their case that the anti-tobacco industry have won their temporary victory. Their methods and lies are being exposed. Some on the anti-tobacco side, i.e. Michael Siegal in the US, have started speaking out about the anti-smokers' malpractices and the uncritical media-reporting of such studies as the Jill Pell one you quote, as they fear the movement is being discredited.
The risk from ETS, if it is there at all, is miniscule. It has never been proved to have killed anyone. How can confounders such as vehicle pollution, background radiation-levels, diet, fitness, industrial-pollution, exposure to solar-rays etc. all be evaluated to any degree of precision?
People should be able to make their own judgements of risk based on a full understanding of the evidence and a fair presentation of both sides of the arguments. Not to be subject to a state-sanctioned denormalisation-agenda based on misinformation, designed to exclude and to marginalise ordinary people.
Because that's not very nice.
Posted by: Basil Brown | August 04, 2008 at 10:11 PM
Oh dear oh dear oh dear.
"Welsh heart attack rate rises after smoking ban":
http://www.velvetgloveironfist.com/index.php?page_id=59
Posted by: Tim Clarke | August 04, 2008 at 10:22 PM
Paul you say:-
"Read the evidence. You are wrong in every aspect. You nitpick minute irrelevances in the belief that you are destroying rock solid arguments. You are not."
I have looked at what you have provided as 'evidence' for the myth: Second Hand Smoke isn’t really dangerous?
I see little evidence here just headline appeals to authority. There are no specific references or citations.
You do mention Scoth and give a 25% increased risk of IHD though no baseline is given so no real assesment can be made. Is this significant? Scoth seems to suggest a causal link, yet in the report itself, if I remember correctly, they need to discount several of the Bradford-Hills criteria for causation.
Without specific studies to review, your list of headlines is impressive though practicaly meaningless.
Indeed as far as Scottish law is concerned it is not known that Primary smoking is a cause of cancer (Judge in McTear case). The court had access to a number of the epidemiological studdies you seem to take your headlines from.
In that case the Judge critized the expert witnesses for not providing the logical progression from study to conclusion. Included among those experts was Professor Doll.
west
----
Posted by: west2 | August 04, 2008 at 10:28 PM
Let's continue with a few of the misleading statements in your posting, Mr Flynn:
"MYTH: Epidemiology, the basis for risk estimates of exposure to SHS, is “junk science”
FACT: Use of the pejorative term “junk science” to describe the scientific method of epidemiology can be traced back to the tobacco industry and other industries, which are fearful of the implications that epidemiological research may have for their products. Tobacco industry documents have left an extensive trail showing an organized effort to discredit it. A well-established, fundamental science of public health, epidemiology is the scientific method for directly gathering information on the health effects of exposures as received in natural settings. The same approaches employed successfully for studying SHS have been used over decades for infectious
diseases and for major acute and chronic diseases. Epidemiological evidence is the
foundation for public policy in many areas, such as infection control and management of air and water pollution."
I do not believe epidemiology is 'junk science'. Epidemiology is the study of epidemics (and there is little to indicate that there is, or ever has been, an epidemic of non-smokers dying from lung cancer). In the case of passive smoking, epidemiology was used to find an epidemic rather than the cause of one.
If you know anything about epidemiology, Mr Flynn, you will know that the case for passive smoking centres around a figure of between 1.25 (25% increased risk for contracting lung cancer / heart disease from exposure to environmental tobacco smoke). In individual studies, this figure is considered statistically insignificant, and could arise as a result of confounding factors, statistical bias, etc. We are told when corroborated by numerous other studies, and then extrapolated via metaanalysis, such small results can be considered significant.
However, this appears to be true SOLELY in the case of environmental tobacco smoke. Epidemiological studies indicate a raised risk of contracting leukemia from exposure to electricity pylons of approximately 70% (1.70). In June, 2005, the BMJ reported that children living within 200 metres of a pylon had a 70% increased risk of leukaemia. Although this research was supported by numerous previous studies, the
medical community was quick to dismiss the danger, with Cancer Research UK, the Health Protection Agency and Leukemia Research all stated that confounding factors could have been responsible.
Epidemiological studies have indicated that the relative risk (RR) for contracting lung cancer posed by drinking whole milk is consistently above 2.0 (100% increased risk), which, presumably, means it should carry a health warning, given that passive smoking merits justifies one on tobacco products.
"Effect of the smoking ban on quitting
A survey, carried out by Cancer Research, of 32,000 people in England interviewed before and after the ban took effect found the decline in smoking had accelerated. In the nine months before the ban it fell 1.6 per cent compared with 5.5 per cent in the nine months after the ban. Researchers estimate on the basis of these figures that 400,000 people quit smoking as a result of the ban. http://news.bbc.co.uk/1/hi/health/7480856.stm"
Yet, Paul, as I have pointed out you before, 400,000 people quit in 03-04. The ban working retrospectively, I suppose?
The 400,000 quitting figure pertaining to the year following the ban has been comprehensively debunked by an epidemiologist with extensive experience in tobacco control and a statistician:
http://tobaccoanalysis.blogspot.com/search?q=Study+on+Effect+of+England%27s+Smoking+Ban+on+Quit+Rates+Not+Only+Represents+Science+by+Press+Release%3B+It+Also+Appears+to+Be+Shoddy+Science+
http://freedom2choose.info/news_viewer.php?id=738
The 40,000 figure has simply been plucked out of the air. Besides - I take it these people will now live forever?
I am surprised, Mr Flynn, given that the first study on the health impacts of passive smoking on employee in licensed premises was published in the BMJ, and was very much quoted at the time yourself and your fellow right honourable members (no pun intended) were voting on the ban, that you haven't mentioned it.
I suspect because, in your digging, you have come across it and have realised it is complete codswallop:
"[T]he [BMJ] published the first study on passive smoking in pubs. This timely paper (Jamrozik, 2005) was pure extrapolation. A clue to the author’s partiality was provided
when he publicly equated those who disputed the passive smoking theory with medieval anti-Semites who believed that Jews ate Christian babies (q21) and stated that smoking should be undertaken "only by consenting adults in private" (4b). Drawing on conclusions made by Ichiro Kawachi (the
author of the February 5 editorial), Professor Jamrozik took a relative risk for nonsmokers exposed to secondhand smoke of 1.24 for lung cancer and 1.20 for heart disease. He then tripled these
figures on the basis that nonsmoking bar staff supposedly have three times as much cotinine in their saliva as nonsmokers married to smokers thereby turning negligible relative risks into more
substantial ones; 1.73, 1.61 and 2.52 for lung cancer, heart disease and stroke respectively.
Herein lay the problem. Once trebled, the heart disease risk for nonsmoking barworkers came in line with the known heart disease risk for regular smokers even though it was biologically implausible that secondhand smoke exposure was as damaging to the body as actually smoking. The
risk ratio Jamrozik arrived at for stroke was still more unlikely. His figure of 2.52 was substantially higher than that seen in smokers and was completely out of kilter with Whincup's study published the
previous year which had found no association at all between secondhand smoke and stroke (gw).
Only a few weeks earlier the BMJ had stressed that “cotinine is not associated with lung cancer or other diseases” and that “previous studies have stressed the limitations of cotinine as a biomarker of
exposure.”(45) Jamrozik's hypothesis rested on a previous study which had found that nonsmokers married to smokers had a cotinine level of 1.2 ng/ml while barworkers had a level of 3.65 ng/ml. He
assumed this threefold increase in cotinine must result in a threefold increase in risk and adjusted his numbers accordingly. What he did not mention was that cotinine levels in nonsmokers, whether they worked in a bar or not, were a tiny fraction of those found in smokers. Pack-a-day smokers consistently showed cotinine levels of at least 300ng/ml, and often much more than that (1p)(fn3).
J
amrozik multiplied the nonsmoking wives' supposed relative risk of 1.20 for heart disease to get a 1.61 risk for barworkers but the folly of this approach was writ large if one applied the same kind of
mathematics to smokers. Smokers had cotinine levels 250 times higher than those of the nonsmoking wives and therefore should, by Jamrozik's logic, be 250 times more likely to develop heart disease.
This would mean they had a heart disease risk of 50.0, making them 5,000% - or fifty times - more likely to die of a heart attack than nonsmokers. This would make them nothing short of walking timebombs liable to drop dead at any minute but in reality, smoking raises the risk of heart disease by 70% (gw), 4,930% away from what would be calculated using Jamrozik's model.
Jamrozik's mathematical premise was therefore demonstrably wrong. Like others before him, he had ignored the simple truism that the dose makes the poison. By extrapolating rates of disease from
very low doses of harmless cotinine he had overlooked the fact that the doses involved for bothnonsmoking wives and barworkers were, for all practical purposes, negligible. But should anyone be
tempted to question his mathematics or his assumptions of increased risk he simply stated: “Given that authorities on three continents have concluded that passive smoking causes disease in adults, my
calculations have a firm foundation,” a reference to the EPA's report and copycat efforts in Britain and Australia(47). He then announced a grand total of 7 deaths per year from ETS-related lung
cancer for pub, bar and nightclub workers and 8 deaths per year for hotel and restaurant workers(46). By adding in other estimates for heart disease and stroke Jamrozik came to a combined figure of 54 deaths for all bar, pub, club, restaurant, hotel and casino workers each year; a
convenient figure for the media since it worked out at about one a week. Conclusion: “Adoption of smoke free policies in all workplaces in the United Kingdom might prevent several hundred
premature deaths each year.”(48)
Jamrozik's study was a gift to the British pro-ban activists and kept on giving. The BBC picked up on an abstract of the report a year before publication, in May 2004, and reported that “Smoking at work kills hundreds”. The following March, they used a preliminary copy to report: “Passive smoke
killing thousands”, and when, a few weeks later, the paper was finally published a spokeswoman for the British Heart Foundation declared that the evidence against passive smoking was so strong that
there was “no room left for scientfic debate.”(w4)
Based on Jamrozik’s work, the BMA now gave a
figure of 11,000 as their official estimate of passive smoking deaths in the UK, an eleven-foldincrease on the figure they had previously touted. Two years earlier, a few UK newspapers had tentatively given a figure of 300 UK deaths from passive smoking. The Jamrozik study, such as it
was, led to a figure of 10,000 being quoted for the remainder of the campaign."
Source: http://www.velvetgloveironfist.com/pdfs/PassiveSmoking.pdf, pp. 37-38.
Posted by: Tim Clarke | August 04, 2008 at 11:01 PM
Designated smoking rooms and ventilation:
http://www.bsjonline.co.uk/story.asp?storyCode=3047478
See also:
Reduction of exposure to environmental tobacco smoke in the Hospitality Industry by
Ventilation and Air Cleaning by W.F. de Gids * and A. Opperhuizen:
"By making use of zoning, in combination with displacement ventilation, the exposure in the smoking zone compared with a smoking zone ventilated in accordance with the
current Buildings Decree requirements can be reduced by approx. 90%, while in the nonsmoking zone with adequate utilisation of such a system a greater reduction could be achieved". (p. 63)
This independent report was commissioned by, and conducted on behalf of, the Dutch gov't, hence the permitted glass partitions / dedicated smoking rooms in Holland, despite the baffling lack of regulation on the smoke emitted by joints.
Posted by: Tim Clarke | August 04, 2008 at 11:13 PM
"• Coronary heart disease (CHD) ... increases the risk of death from heart disease by about 30%; recent evidence suggests that the effect could be more than twice as large."
Which evidence?
Posted by: Tim Clarke | August 04, 2008 at 11:17 PM
I should know better and not bother.
Under a headline saying there had been a rise in heart attacks were these facts.
'In total, there were 4,199 heart attacks in 2006 and 4,155 in 2007.'
'Across the nation as a whole there was a 12.5% fall in the number of patients admitted to hospital with a heart attack between October and December last year, compared to the same period in 2006, before the ban on smoking in enclosed public spaces was introduced in Wales."
Yours is a world where a decrease is an an increase. Wrong is right. A fact is a lie.....
Posted by: paulflynn | August 04, 2008 at 11:39 PM
You write J stewart
"In 1975 Sir George Godber, a former Chief Medical Officer addressed the
WHO:"
Is this the best you can do?
1975 ???????
His comment is perfectly sensible. You have placed your perverse interpretation on it to match your own fevered neurosis. This is not sanity.
Posted by: paulflynn | August 04, 2008 at 11:56 PM
Err PaulFlynn where did you get those figures from?? What a hypocrasy when the antismokers are actually doing that- turm lies into facts through propaganda. SHS was manufactured as mentionned by the WHo at a 1975 conference. Cant you see by reading all those studies that it was a manufactured scam.
Posted by: Carlos | August 05, 2008 at 12:07 AM
Paul
You missed a bit:
"This is an outrageous distortion of the truth. It is plainly obvious to anyone who looks at 2007's Welsh heart attack statistics that heart attack incidence was unusually high in 5 out of the 6 months that immediately followed the ban. To exclude these months from analysis and focus solely on the last three months of the year (when incidence declined) is deeply dishonest. Two thirds of the data were ignored because - there can be no other explanation - it did not fit the preconceived hypothesis. This is as blatant a piece of statistical manipulation as one will ever encounter."
(You still haven't explained why they concocted a figure of 17 per cent for the Scottish heart attack incidence, when the actual 8 per cent figure is so impressive a drop?)
Posted by: Belinda | August 05, 2008 at 12:11 AM
Paul,
Then it is a world shared by, Dr Ken Denson of the Thames Thrombosis and Haemostasis Research Foundation who said,
"The ill effects of passive smoking are still intuition rather than scientific fact and billions have been spent by the medical institutions in pursuing this illusory myth." (2004)
and Dr Michael Fitzpatrick,
"The alarming estimates of deaths attributable to passive smoking result from multiplying miniscule risks of dubious validity by vast population numbers - an effective propaganda device but statistical sharp practice" (2004)
and Dr B.G. Charlton,
"There is a worrying trend in academic medicine which equates statistics with science, and sophistication in quantititative procedures with research excellence... Epidemiology is the main culprit, because statistical malpractice typically occurs when complex analytical techniques are combined with large data sets. The mystique of mathematics blended with the bewildering intricacies of big numbers makes a potential cocktail.." (1996)
"illusory myth", "statistical sharp practice", "a worrying trend..which equates statistics with science". This strongly suggests that the tobacco control lobby, by 2004, had still not managed to build a legitimate case.
Posted by: J Stewart | August 05, 2008 at 07:17 AM
The fact that George Godber made his remark in 1975 has absolutely no bearing on its validity, although, in fact, if the studies on passive smoking were subsequent to his remark then that reinforces my interpretation.
What alternative interpretation would you offer and how would you justify your interpretation?
Posted by: J Stewart | August 05, 2008 at 07:34 AM
Belinda, your arguments are now laughable.
First the accusation made many times in the past 7 days was that the WHO did not believe that the smoking ban worked.
Having established above that this claim is utterly untrue, your argument changes and you ATTACK the WHO.
I've read the criticism you quote. It is NOT connected in any way with the smoking ban.
This is the argument of the blind bigot whose case has collapsed.
Posted by: paulflynn | August 05, 2008 at 08:02 AM
J Stewart, your views make no sense.
The only explanation from your determined scraping of the bottom of the barrel to find a conspiracy against you is to hark back to a vague ambiguous statement made in 1975.
There are two possibilities. You have a vested interest and you are deaf to argument. The vested interest could be as a paid advocate of the industry, i/e. Forest, or an addicted smoker who lacks the will to control himself or you have a personal financial interest as a publican etc.
If that is not the explanation, I presume your personality in such that you are prone to victimhood and you see yourself as being persecuted by political parties and health bodies. If it is the latter, you are in a similar category to religious or other zealots to whom reason is secondary to their bigotry.
In these cases reason is futile. Which are you J Stewart?
Posted by: paulflynn | August 05, 2008 at 08:18 AM
Belinda, you have difficulty in spotting the difference between the facts and the tortured casuistry of one of your fellow anti-smoking ban zealots.
You believe in the propaganda. I'll continue to rely on the facts.
Posted by: paulflynn | August 05, 2008 at 08:23 AM
My views make no sense? Paul, I have not been quoting 'my views'.
If you are going to accuse me of 'perverse interpretation' of Godber's statement, then the least you can do is offer your alternative interpretion. Resorting to baseless ad hominem attack doesn't cut it in the world or rational and reasonable debate.
Are you also accusing Denson, Fitzpatrick and Charlton of being tobacco stooges, publicans or smoke-addled addicts?
I stated on your other thread that there is not one MP who voted for the ban who can produce a compelling case - you are proving my point by falling back on insult rather than substantive defence of your position.
Posted by: J Stewart | August 05, 2008 at 08:37 AM
You still cannot find anyone more mainstream than Denton, whose standing is not high in the medical profession or anywhere else.
"Dr Ken Denson, of the Thame Thrombosis and Haemostosis Research Foundation in Oxford, has spent the last decade studying smoking-related illnesses and concluded that the real problem isn't the cigarettes, but the poor diet of smokers.
'The risks attributed to the act of smoking, and especially passive smoking, have been greatly exaggerated,' said Denson. 'Nobody wants to rock the boat on smoking, but this has been swept under the carpet for too long.'
The heretical claims were immediately condemned as 'dangerous' by mainstream cancer experts. 'To say smok ing under 10 a day is not dangerous is patently ridiculous,' said Professor Richard Peto of the Imperial Cancer Research Fund. 'Any competent scientist is aware of the evidence that there is proof beyond reasonable doubt that smoking causes lung cancer.
'The overall pressure on scientists is to exaggerate the importance of their work, but you must realise that while this generates headlines it is a dangerous game.'
Posted by: paulflynn | August 05, 2008 at 08:37 AM
Paul
What you refer to as tortured casuistry is simply pointing out that the evidence used to demonstrate as 12.5 percent drop in Wales was deliberately selective and omitted the months following the introduction of the smoking ban in Wales when heart attack rates increased.
The fact is that heart attack rates are in steady decline but there are variations within that decline.
As for the article attacking the WHO, I used it to demonstrate that they were not immune to criticism for their methods. I was not trying to use it as primary evidence in this argument which is why I didn't include the link in the first place.
The evidence I asked you to consider, you have all but ignored, implying that it is somehow okay to say that the Scottish heart attack rate declined by 17 per cent even though the decline was only 8 per cent (against an underlying trend of 5 per cent over the previous three years), because 8 per cent is a substantial decrease (which it isn't, when considered in the context of the trend).
If the truth proves your point, why did someone have to invent something else?
Posted by: Belinda | August 05, 2008 at 08:49 AM
"The HERETICAL claims were immediately condemned as dangerous.."
Well, that suggests the position of his detractors, doesn't it? The tobacco control lobby is often accused of shouting down those whose work is 'off message'.
Before dismissing Denson I would want to know whether his work falls foul of the universally accepted standards of rigour and I'd also want to be assured that Peto's work conforms to it.
Posted by: J Stewart | August 05, 2008 at 09:00 AM
Paul
It may be helpful to read this statement to the US House Committee on Energy and Commerce amd Environemnt subcommittee statement from Hon. Thomas J Bliley Jr. July 21, 1993 --> www.pipes.org/Articles/Bliley.html
This gives the background to the role of the EPA, on whose reports/studies so much is based, and the politicalization of ETS.
west
----
Posted by: west2 | August 05, 2008 at 11:55 AM
I agree with your blog. Smoking is horrible for children and does influence them to smoke later on.
Unfortunately i think parents are smoking more in the home now due to ot being allowed in pubs.
One thing the government could do is disallow drinking alcohol outside the front of pubs. Smoking is made visible and there are pint glasses sometimes rolling around pavements and roads.
Posted by: Bob Innes | August 05, 2008 at 12:41 PM
Patrick has opened up a can of worms. There was a recent study into lifetime costs of smokers, the obese and the healthy. After you have read it I am happy to have all my income and smoking taxes refunded and pay for my own medical treatment.
"“Revealed: Why healthy patients cost more to treat than smokers and the obese”
“Based on healthcare costs in Holland, where the study was conducted, a person of normal weight can expect their medical bills from the age of 20 to total £210,000 over the course of their lifetime, while an obese person's costs will be £187,000. Smokers, whose life expectancy is the shortest of the three, cost the least, at £165,000, the researchers from the National Institute for Public Health and Environment calculated.”
http://www.dailymail.co.uk/pages/live/articles/health/healthmain.html?in_article_id=512333&in_page_id=1774&in_page_id=1774&expand=true#StartComments
Posted by: Dave Atherton | August 05, 2008 at 01:50 PM
Paul said: "You believe in the propaganda. I'll continue to rely on the facts."
In other words "My facts are better than your facts. My scientists are better than your scientists. I am on the side of reason and common-sense, you are a zealot and a heretic".
Paul, I agree with your stance on cannabis. This is also a minority point-of-view. I expect many pure authoritarians would also regard this viewpoint as "heretical".
There is no scientific consensus on ETS; far from it. There is a majority-opinion, the establishment view, which is being challenged. Attempting to discredit your opponents by calling them names will backfire on you. For it's looking to me like you hate smoking with a religious intensity, refusing to entertain any evidence not in line with your dogmatic thinking. The mark of a true zealot.
I mean. Many of us here are trying to help. Trying to show you Labour politicos why you're so very unpopular. As a lifelong Labour voter to 2001, I'd like to find something to support on the liberal left. But with the current state of authoritarian We Know Best arrogant power-drunk incompetant meddling sleazy warmongering nu-labor, I and many others with similar grievances are voting Tory, as the slightly more liberal alternative.
Posted by: Basil Brown | August 05, 2008 at 02:59 PM
Heresy? NOBODY EXPECTS THE SPANISH INQUISITION!!!
"[Y]ou are accused of heresy on three counts -- heresy by thought, heresy by word, heresy by deed, and heresy by action -- *four* counts. Do you confess?"
"This is the argument of the blind bigot whose case has collapsed."
God almighty, talk about psychological projection. From a man who has failed to counter any of my points, simply relying on 'please think of the children' and accusing us of heretical doctrines (????!!!!) Throughout all of this, you have simply failed to countenance an alternative to your longstanding view. You have voted on this issue, and are now unwilling to consider an alternative to your previous position.
I note my points are still being completely ignored.
Posted by: Tim Clarke | August 05, 2008 at 03:22 PM
"The tobacco industry has focused on proposing ventilation as an alternative to smoking bans, though this approach has not been widely adopted in the U.S. due to the cost and complexity of widespread implementation of ventilation devices. The Italian smoking ban permits dedicated smoking rooms with automatic doors and smoke extractors. Nevertheless, few Italian establishments are creating smoking rooms due to the additional cost."
The above quotation is truncated from the wikipedia article on smoking bans. Funny you selectively failed to cite the Building Services Journal article (or, indeed, James Repace's study. I suspect this is because you know Repace's work has been wholly discredited).
Mr Flynn, I naively thought you may have been willing to consider an alternative point of view. The above instance has only illustrated that you really are at home in the anti-smoking crowd, selectively drawing upon facts to corroborate a hypothesis which is immune to reason, while ignoring alternative facts - even when they are under your nose.
Posted by: Tim Clarke | August 05, 2008 at 03:31 PM
Paul
You might enjoy this article in which Dr Denson is quoted (perhaps because he's a medical scientist who has published peer-reviewed research in "respected academic journals" and not, therefore, to be dismissed when he criticises the tobacco control lobby as if he's a junior lab technician)
http://www.ipcvision.com/page05/t-luckhurst-01.htm
There again you might not: there is also a quote from Amanda Sandford which, in effect, admits that many of the studies which 'prove' the perils of ETS actually don't do any such thing, but, hey ho, it's all in a good cause, isn't it, so what does it matter if they play fast and loose with the truth?
Posted by: J Stewart | August 05, 2008 at 03:59 PM
http://tobaccoanalysis.blogspot.com/
"No Reduction in Heart Attacks in Wales During First Nine Months Following Smoking Ban; Anti-Smoking Groups Cherry-picked Data to Try to Show an Effect"
Some highlights from Dr Michael Siegel's analysis of Snowdon's findings on Welsh smoking ban:
"Data from Wales released by Christopher Snowdon yesterday reveal that there was no reduction in hospital admissions for myocardial infarction (heart attacks) during the first 9 months after implementation of the smoking ban throughout Wales. Snowdon obtained monthly data on heart attack admissions from all Welsh hospitals for the years 2006 and 2007. The smoking ban went into effect on April 2, 2007.
There were 4,199 heart attack admissions in 2006 and 4,155 in 2007. Thus, there was essentially no change in heart attacks between these two years. In contrast, there was a 6.3% decline in heart attack admissions from 2005 to 2006 and a 10.3% decline in admissions from 2004 to 2005, according to Snowdon.
When analyzing the data by month, Snowdon found that comparing 2007 to 2006, there was an increase in heart attack admissions during the first five months after the smoking ban (April through August) and a decline in heart attack admissions during the next four months (September through December)
...
How did the anti-smoking groups pull off this miraculous feat, given that the data so clearly indicate no reduction in heart attacks?
They used a technique known as cherry-picking. By citing data for the few specific months in which there was a decline in heart attacks from 2006 to 2007, they purported to show that the smoking ban had resulted in a reduction in heart attacks.
In an article published this past June in The Daily Post, Action on Smoking and Health (UK) was quoted as saying: "It seems likely that the drop in hospital admissions for heart attacks is linked to the implementation of the smoking ban. It shows just how quickly the benefits can be felt."
What data were ASH referring to in making this pronouncement? Clearly, it was not the data for the first nine months after implementation of the smoking ban (April through December)
...
In an article published in Wales Online, the British Heart Foundation is quoted as stating: "These new statistics are very significant, and indicate the smoking ban has had a beneficial effect on the number of heart attacks quicker than many people predicted."
What "new statistics" is the British Heart Foundation referring to which purportedly demonstrate that the smoking ban in Wales resulted in a reduction in heart attacks?
Once again, it turns out that the British Heart Foundation is referring to the cherry-picked data from October through December of 2007 which reveal a 13% decline in heart attacks during these months compared to the corresponding period in 2006. But a broader look, which includes all 9 months following the smoking ban, confirms that there actually was no change in heart attack admissions. Apparently, these three months were cherry-picked in order to show an effect
...
Will the British Heart Foundation and ASH now retract their earlier statements and apologize to the public for drawing and disseminating premature conclusions? I doubt it. This is why it is essentially that we get it right the first time around.
But when your sole criterion for scientific quality is whether the study results support your pre-determined conclusion, it is going to be difficult to get it right the first time, or any time."
Given the far greater reduction in heart attacks prior to the Welsh smoking ban, are we to conclude, using the premise of the Helena hypothesis, that the Welsh smoking ban has actually caused a long-term trend of heart attack reductions to almost grind to a shuddering halt? This may not be as ludicrous as it first sounds:
http://www.bmj.com/cgi/content/full/329/7469/760-d?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&andorexacttitle=and&andorexacttitleabs=and&fulltext=weather&andorexactfulltext=and&searchid=1097229087724_4428&stored_search=&FIRSTINDEX=0&sortspec=relevance&fdate=9/1/2004&resourcetype=1,2,3,4
http://uk.reuters.com/article/healthNews/idUKCOL66217120080606
Posted by: Tim Clarke | August 05, 2008 at 04:33 PM
To the Freedom to pollute people-
Instead of whinging on here like a bunch of cretins why not organise yourselves into a political party.
Is it because you know how out of touch you are?
To Dave Atherton -
The point i made about NHS treatment had nothing to do with costs per person.
I repeat-
If a person requires healthcare by ingesting poisonous substances then that should lose the person the right to NHS care.
Posted by: patrick | August 05, 2008 at 06:03 PM
Bob Innes, Your fears of increased smoking in the home are, apparently, unfounded as the tobacco control lobby says that 68% of people have imposed a ban in the home (Paul's previous posting "Freedom to Poison").
You suggest that drinking outside of pubs shouldn't be allowed because smokers are visible. Do you perhaps mean that smokers should not be allowed to stand outside pubs because they're visible?
So, smokers, who have been kicked into the streets by the Government, should not now be allowed to stand in the street and smoke? Why don't we confine smokers to their homes so that no-one will be exposed to the sight of someone smoking? In fact, let's deal with smokers once and for all and just outlaw tobacco! But I'm forgetting the flaw in that - the Government would suddenly lose £10 billion per year from the duty on tobacco products.
Posted by: J Stewart | August 05, 2008 at 06:06 PM
Patrick: "If a person requires healthcare by ingesting poisonous substances then that should lose the person the right to NHS care."
Despite having paid for it through disproportionate blame-taxes on cigarettes and that this tax-booty is also subsidising the NHS for you. And people ingesting the poisoned air caused by vehicle-pollution... they only have themselves to blame as well, huh?
"...whinging on here like a bunch of cretins..."
Such eloquence. Such reason. Such considered argument. Gosh, I'm really persuaded. You'll be hoping we all die of cancer next.
Posted by: Basil Brown | August 05, 2008 at 06:17 PM
Basil, why not answer the question?
I repeat - Instead of whinging on here like a bunch of cretins why not organise yourselves into a political party.
Is it because you know how out of touch you are?
Posted by: patrick | August 05, 2008 at 06:21 PM
Patrick ... give me an instance of a single issue whose supporters won the day by forming a political party.
Even the cause of women's suffrage didn't win its cause by forming a single-issue party. Voters don't like them.
Even in Scotland where we have Proportional Representation, the main parties get all the votes.
Posted by: Belinda | August 05, 2008 at 06:50 PM
I'll take that as a yes then Basil.
It doesn't suprise me from a man that cannot differenciate between traffic pollutants and smoking.
Posted by: patrick | August 05, 2008 at 06:53 PM
Freedomtowhingebuttoounpopulartoact
Posted by: patrick | August 05, 2008 at 07:02 PM