Michael Siegel and the tobacco taliban
Friday, April 3, 2009 As regular readers know, Michael Siegel is a professor at Boston University School of Public Health. With 20 years' experience in tobacco control, he writes a fascinating blog - The Rest of the Story: Tobacco News Analysis and Commentary - which is essential reading for anyone with an interest in the smoking debate.
In his time Siegel has published research on the harmful effects of passive smoking. He has also testified in support of indoor smoking bans in US cities. You might expect him therefore to be another one-eyed anti-smoker, like so many of his colleagues.
Not so. Demonstrating remarkable integrity, both personal and professional, Siegel has put his career on the line by questioning some of the medical claims about passive smoking, and opposing "next step" policies such as outdoor smoking bans.
For his pains he has been shunned by colleagues and accused of taking money from the tobacco industry. Courageously, Siegel has stuck to his guns and his story is featured in a must-read article in this week's New Scientist. Here's a taste:
Siegel's case is perhaps the most clear-cut example of a disturbing trend in the anti-smoking movement. There are genuine scientific questions over some of the more extreme claims made about the dangers of passive smoking and the best strategies to reduce smoking rates, but a few researchers who have voiced them have seen their reputations smeared and the debate stifled.
Putting aside the question of whether such tactics are ethical, they could ultimately backfire. About half of US states and many parts of Europe do not yet ban smoking even indoors in public places like bars and restaurants, so the anti-smoking movement cannot afford to lose credibility.
On the other hand, in some parts of the US, particularly California, the anti-smoking movement has grown so strong that smoking bans outdoors and in private apartments are in force in a few places, and being considered in more. These measures are at least partly based on disputed medical claims, so it is vital their accuracy be determined. But questioning the orthodoxy seems to be frowned on. "It's censorship," says Siegel. "We're heading towards scientific McCarthyism."
Read the full article HERE.
See also an accompanying editorial, The dangers of inhaling dubious facts.
Reader Comments (126)
In another time, I would have thought this was good news. But the New Scientist is uncritically accepting the dangers of first-hand and second-hand smoking, and only gagging on third-hand smoking.
The evidence that third-hand smoke has any physiological effects is tenuous.
No. It's not tenuous. It's non-existent.
It's the evidence for the dangers of secondhand smoking that is tenuous. And the evidence for the dangers of first-hand smoking isn't much better. The whole thing is a crock.
There once was a time when the New Scientist was a respectable scientific journal. Those days are over. And there's no better evidence for it than on the page on which the op-ed appears. Scroll down and to the right, and you find:
Most Read:
Masturbation could bring hay fever relief for men
Spanking 'brings couples together'
That's the sort of thing I'd expect to find in some trashy magazine, not a scientific journal. It would have been unimaginable to find articles like that in the New Scientist 20 or 30 years ago.
Simon: Since you’ve chosen to highlight Michael Siegel’s position of integrity, are you also prepared to demand that pro-smoking groups also apply the same integrity in how THEY deal with the passive smoking issue?
If you look at Forest’s page about the risks of passive smoking, you will find it is riddled with distortions:
It claims Sir Richard Doll said on Desert Island Discs that he wasn’t worried about the effects of passive smoking on his own health - that’s a complete misquotation and misrepresentation of his professional judgement on passive smoking.
It completely ignores most of the established scientific studies on passive smoking. The only studies it refers to are the 2003 Enstrom & Kabat report and the 1998 WHO study. Actually, Enstrom & Kabat was not especially large - it only covered around 250 lung cancer deaths. It also used a deeply flawed methodology. For instance, although the study continued until 1998, no attempt was made to check if participants’ circumstances changed after 1972. In this time, their spouse may have quit smoking or taken it up; they may have died, or the couple may have divorced or separated. Any of these changes could have had a major bearing on a participant’s exposure to passive smoke, but the study did not pick these up.
As for the 1998 WHO study, Forest try to suggest this shows that passive smoking is not a significant risk to health. Really? Konrad Jamrozik reported in the BMJ in 2005 about the scale of deaths attributable to passive smoking in the UK each year. He found that a 24% increased risk of lung cancer accounts for around 1,400 deaths each year; a 30% increased risk of heart disease accounts for over 5,000 deaths per annum, while a 45% increased risk of stroke means that possibly 4,000 people are dying prematurely from that cause each year due to the effects of passive smoking. That’s close to 11,000 people dying before their time each year - due to passive smoking.
Why don’t Forest refer to the major assessments of the available evidence - e.g. the reports by IARC (2002), SCOTH (2004) and the US Surgeon General in 2006? All are thorough in the evidence they consider and ALL conclude that passive smoking IS a real risk to health.
And why do Forest only mention the House of Lords Economic Affairs Committee? Their work on passive smoking was sketchy to say the least, as part of an investigation into risk more broadly. The Parliamentary Health Committees (at Westminster and Holyrood) have investigated the dangers of passive smoking in far greater detail. All have concluded that it presents a real risk to health.
So Simon - do you have the courage to label the same charge of distorting the science upon Forest as you are so happy to gloat in Michael Siegel saying about parts of the tobacco control movement?
Mr Tomasi its all very well quoting scientists findings from the 90's onwards. Did earlier scients not do 'reports' up to that time when nearly every second person was a smoker, and why did they not?
Because the spin doctors knew that the planning and brainwashing had to be put into effect at least 10years before they could turn people's thinking and pull of the coup.
These things are never done overnight. It takes a few years to get the psychobabble scientists/doctors/media fast boys on their side and on the payroll.
From the 90's onward, since the start of the false money economy, these guys never mentioned the increase in carbon monoxide from the massive increase in cars/trucks/gas gusslers, massive building works with the resultant disruption of buried gasses into the atmosphere and overcrowing from their open borders policy.
Why have scientists never done a 'report' on all these more dangerous factors.
Why is there never a debate between scientist's for and against the smoking ban that could give people a balanced view. Why is it always the gospel according to the 'scientists' who are anti smoking that are always shoved down our throats.
How come miles of media exposure can be given to the likes of Jade Goody's life, a nobody who happened to die of cancer, can you imagine the impact if she had smoked on the impressionable prolatariat.
Maybe as we speak they're grooming some other poor unfortunate media obsessed airhead with a smoking habit.
Dont tell me that all these factors have not got a worse effect on humans than a tiny trickle of smoke from a cigarette.
Mr Tommasi,
The Anti smoker test.
I sit in my car close the windows and chain smoke.
After 3 hours I smell a little smoky.
You get in your car and put a hosepipe on the exhaust and pass it through the window after ten minutes you will be quite dead im afraid.
So a simple piece of logic .
None of the anti smoker claims stand up to logic .
Less people smoke same rate of lung cancer an increase in childhood asthma an increase in heart desease.
Sorry the allegations don,t stand up to rational analysis.
I see 80 90 year olds smoking in fact its quite common amongst that age group.
Im not buying the propaganda im afraid.
Rigged polls, dodgy statistics, smells like a gravy train to me.
The ubiquitous Rollo Tommasi wrote: It claims Sir Richard Doll said on Desert Island Discs that he wasn’t worried about the effects of passive smoking on his own health - that’s a complete misquotation and misrepresentation of his professional judgement on passive smoking.
The last time I went to the BBC to re-read what Doll had said, the transcript was no longer available, so there would appear to be no way to find out what he actually said, unless the transcript is stored elsewhere.
But, from memory (I read what Doll said some years ago), I don't believe that Forest is misrepresenting him. Certainly my impression was that Doll was unconcerned about secondhand smoke. And again from memory, the programme was broadcast some time around 2000. about 5 years before Doll died. I remember wondering whether Doll was a bit at odds with some of his colleagues about secondhand smoke.
Ernst Wynder, who also published a paper on smoking and lung cancer in 1950, seems also to have been sceptical about the alleged dangers of passive smoking.
At the very least, neither of these two figures seem to have thrown their weight behind the crusade against secondhand smoke in the manner of Sir George Godber, Sir Charles George, or Sir Liam Donaldson.
As for the Enstrom and Kabat study, I wouldn't be surprised if there were only 250 lung cancer deaths. But nevertheless the study ran for some 40 years, and had something in the order of 100,000 participants. If that isn't 'large', what is?
It also used a deeply flawed methodology. For instance, although the study continued until 1998, no attempt was made to check if participants’ circumstances changed after 1972. In this time, their spouse may have quit smoking or taken it up; they may have died, or the couple may have divorced or separated. Any of these changes could have had a major bearing on a participant’s exposure to passive smoke, but the study did not pick these up.
Exactly the same charge can be made against the famed British Doctors Study by Doll and Hill. The doctors only reported their smoking status at the very beginning of the study in 1951, and not thereafter. Doll and Hill subsequently admitted this was a limitation. And I believe steps were taken to gather further information, by which time, of course, many of the doctors were already dead.
There are anyway plenty of other studies which show that the dangers of passive smoking are non-existent. Many of them are set out in Christopher Snowdon's Velvet Glove, Iron Fist.
Rollo, I hope you are well. Er, did you not say yesterday in the Daily Mail that passive smoking is harmless. Also Rollo can you tell me who you work ASH, CRUK Dept of Health?
"It's not really fair to the people who are next to use the room and for all you smokers who think we are making a fuss over almost nothing, then think again. The smell doesn't simply 'go a way with a squirt of air freshener.'
Whilst the risk to your health is probably zero it's nevertheless highly unpleasant."
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- Rollo Tomasi, 2/4/2009 9:06
http://www.dailymail.co.uk/news/article-1166470/War-hero-96-fined-100-lighting-cigarette-hotel-lobby.html?ITO=1490
Your mate Amanda Sandford ASH agrees with me too.
"Amanda Sandford of ASH ia rare lucid moment.
"Even Amanda Sandford admits: "A lot of the studies that have been done on passive smoking produce results that are not statistically significant according to conventional analysis.""
"Dr Ken Denson, of the Thame Thrombosis and Haemostasis Research Foundation, says: "I simply do not know where they conjure up their statistics. The statistics for passive smoking, in particular, would not be published or even considered in any other scientific discipline. Deaths from smoking in general have been grossly exaggerated, particularly in relation to heart disease. " Dr Denson is a medical scientist. He has published peer-reviewed research in respected academic journals. He is not funded by tobacco companies"
http://www.ipcvision.com/page05/t-luckhurst-01.htm
On Professor Jamrozik's study was it not paid for by ASH? Also did he make the fatal error of including active smokers as by definition they are passive smokers too? Completely worthless report.
Back to the drawing board Rollo.
Rollo while you are here I have unearthed the 1998 WHO report into SHS, the RR of 1.16 is even less than Enstrom/Kabat.
"“Conclusions: Our results indicate no association between childhood exposure to ETS and lung cancer risk.” And a comment by Dr John Dale Dunn “(Note: a relative risk of 1.16 is not proof of anything. It must be 2.0 or more, the equivalent of a 200 % increase in risk. This study shows less than 20% increase in risk, not valid in an uncontrolled population study.)”
http://www.heartland.org/custom/semod_policybot/pdf/23769.pdf
Rollo you are not telling me the SCOTH report was unbiased? Out of the 16 people two were members of ASH, 6 have received payments from pharmaceutical companies, 2 were members of the WHO, 5 were members of ZanuLabour and 3 worked for the largely pharmaceutical funded British Heart Foundation. Some had multiple felonies, eg money from big pharma and membership of ZanuLabour.
Out 16 members only 4 had no conflicts of interest and one of them in a private letter to me does not understand Relative Risk!
Dont tell me this was an unbiased report. Rollo take a peep here.
http://www.advisorybodies.doh.gov.uk/scoth/members.htm
Rollo you may want to go to page 5 for this gem that agrees we Amanda Sandford and me.
"In most studies considered individually the observed odds ratios failed to reach statistical significance."
http://www.advisorybodies.doh.gov.uk/scoth/PDFS/scothnov2004.pdf
Rollo I have also been able to find this jewel in the crown produced by Parliament in October 2003 and is pre SCOTH.
"Health effects of passive smoking. Evidence on the health effects of passive smoking comes
from population studies. As outlined in the box on page 2, when such studies are taken individually they are generally inconclusive, tending to show a positive, but not statistically significant, relation between passive smoking and coronary heart disease/lung cancer."
"However, there is still some scientific debate over the
method used to derive these figures. One potential source of
error is misclassification; the possibility that some of those classified as never having smoked in a study may actually once have smoked.3,4 Given the strong link between
smoking and lung cancer (over 80% of cases are attributed to smoking), this could have a significant affect on the results. Another is publication bias; the possibility that studies yielding positive results are more likely to be
published. A recent study concluded that a modest degree of publication bias leads to a substantial reduction in risk."
http://www.parliament.uk/post/pn206.pdf
Let us also look at this quote from this Parliamentary document "For lung cancer this represents an increase in cases from a typical 10 per 100,000 non-smokers to 12.5 per 100,000."
About 500,000 people die in the UK and that means that 5 x 2.5 = 12.5 people die of lung cancer per year from SHS. 3,000 people a year die on the roads. So crossing the road is 230 times more dangerous than SHS?
Going back to the SCOTH report the 2003 BMJ peer reviewed Enstrom/Kabat report is cited as number 20 in SCOTH's citations at the back.
Also one of the people who gave evidence to the SCOTH Committee was Peter Lee a statistician. I have been reading up on his work on misclassification in smoking studies. His opponents cite misclassification of people who tell fibs as to whether they smoke, how much they smoke and when they gave up etc. The bias is agreed at 2% minimum and it may rise to 20%.
At 2% the RR for Enstrom/Kabat would be 1.05 and the WHO 0.96. The figure of 3% would actually make SHS PROTECTIVE in heart desease and lung cancer.
Look at citations 23-27 in the SCOTH document.
http://www.advisorybodies.doh.gov.uk/scoth/PDFS/scothnov2004.pdf
Rollo for the credibility of Enstrom Kabat, which was in fact the largest study EVER done into passive smoking I will leave it to the editor of the British Medical Journal to comment on the validity of the report. As you can see for extra provenance I have downloaded it from ASH.
"Richard Smith, the Editor of the BMJ, commented...
Fourthly, I found it disturbing that so many people and organisations referred to the flaws in the study without specifying what they were. Indeed, this debate was much more remarkable for its passion than its precision."
http://www.ash.org.uk/ash_j9ml4esx_archive.htm?search=enstrom
Rollo can I ask a question. In the American 2006 Surgeon General's report was most of it written per chance by that obscure Mechanical Engineer, Professor Stanton Glantz?
Poor Rollo, still quoting from Jamrozik, SCOTH and the US Surgeon General! Your charlatan recepters are failing bigtime.
The Parliamentary Health Committeess at Westminister and Holyrood? For God's sake give it up.
I am not allowed to smoke at a bus-stop because it is classified as 'an enclosed space'. Even though the wind whistles around my ankles. Yet, I can legally stand on the pavement, and breathe diesel and petrol fumes! I don't suppose anyone will discover a link between these fumes and cancer. It would be too earth-shattering and costly.
22nd April is budget-day. Guess what; taxation on alcohol, cigarettes, and tobacco will increase. The money gathered for supporting the NHS ? No. It will go to support a war that none of us ever wanted !
Quote from http://www.freedom2choose.info/art1.php?id=87
“If you smoke around your children, they can inhale the equivalent of 150 cigarettes a year”.
That is 0.4 a day! Let me repeat, 0.4. I wonder how many fumes from school buses and 4 x 4s’ they inhale each year".
Brilliant blitz, Dave Atherton.
But I don't think Rollo works weekends.
Hi Timbone I hope you are well. Infact the figure of 0.4 is wildly exaggerated. The New England Journal Of Medicine puts it at 1/250th and the late Dr. KWE Denson at 1/500th. So hence a 20 a day smoker:
20/500 = 0.25
This figure also assumes 24 hours exposure too.
Professor Robert Nilsson the Swedish Toxicologist estimates that a bar worker doing an 8 hour shift, 5 days a week would consume between 1 cigarette a week to 2 a year.
If you guys want to see Profesor Konrad Jamrozik's work critically reviewed, please go to the British Medical Journal. Here is a taster:
"To summarise, this paper is biased and scientifically invalid. It draws upon material produced from other sources and rather than analysing them, accepts them as hard fact, even though it may not have been the case that the authors of the sources in question intended for their papers to be taken as fact. The act of taking potentially false information, then applying statistical analysis to it, results in a completely meaningless set of figures.
Alastair G Browne MSc BEng(Hons)"
http://www.bmj.com/cgi/eletters/330/7495/812#98957
Hi Dave. My, you’ve been busy. Judging by your mention of this other Rollo Tomasi, you’ve obviously not yet checked the New Scientist thread – I’ve answered that query there.
Where do I work? Not for ASH, CRUK or the Dept of Health (or its Scottish equivalent). I have the views I have by looking at all the evidence. I’ve not allowed myself to be blinkered by whatever biased nonsense I happen to agree with, which unfortunately is a flaw that all too many of your F2C cohort suffer from. To an extent, Dave, you suffer from that same problem yourself. In particular, you give far too much weight to points made in a trashy article by Tim Luckhurst, which was all about polemic argument and all too little about reasoned and evidence-based consideration.
You’ve produced a lot of posts. Some raise valid points, worthy of consideration and debate. Others, if you’ll excuse my saying this, are nonsensical statements which underline my point about the pro-smoking lobby often resorting to distorting the truth to further their argument.
I’ll take your more valid points first. Then I’ll go into your more dubious comments.
Valid points to raise (even if I disagree with them)......
Ken Denson: Yes he had the right to raise the points he did. But you give no reasons why I should treat his views as somehow being counting for more than the score of scientists of integrity and repute who are convinced that passive smoking presents a real risk to health.
Risks of misclassification bias: Yes, I accept the risk is there. But you only refer to a couple of studies. What about other studies which show that the risk of misclassification bias is minor (e.g. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1508460; http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1566193)?
Moreover, what about George Davey Smith - a cautious epidemiological expert - who points out that, not only are the risks of bias over-estimating the harm of passive smoking slight......but that also there is a risk of misclassification bias in UNDER-ESTIMATING the risk of harm from passive smoking? (http://www.bmj.com/cgi/content/full/326/7398/1048?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=davey+smith&fulltext=smoke&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT).
Richard Smith quote: What’s your point? Did some people attack Enstrom and Kabat in ad hominem way? Yes. Were they wrong to do so? Yes - just as you are wrong to launch ad hominem attacks on the members of SCOTH when you are unable to criticise their report on its merits.
But the first 3 points of Richard Smith’s editorial also acknowledged there were many legitimate criticisms made about Enstrom & Kabat’s work. I’ve set out some of those criticisms in my earlier post - I see you have no answer to these points.
Nonsensical points (Part 1).....
Your quotes of Amanda Sandford from Tim Luckhurst’s article - This quote looks very much the result of selective and mischievous misquoting by a known opponent of restrictions on public smoking (Tim Luckhurst) for the purposes of a polemic article. Or do you have the full transcript of what she said to prove me wrong?
You can’t argue about the substance of the IARC, SCOTH or US Surgeon General’s reports on their merits. So you resort to pitiful ad hominem attacks instead on SCOTH members and the people involved in the US Surgeon General’s report. How very brave of you. You ask if Stanton Glantz write most of the US Surgeon General’s report No. If you’ve seen the report, you’ll know that it lists scores of people who wrote, contributed to, edited or reviewed the work.
Jamrozik study: As far as I can tell, you are wrong on both points. ASH did not fund the study, while Jamrozik’s calculations assume that 37% of people aged 20-64 were exposed in the home, while 11% were exposed in the workplace - hardly exaggerated levels. If you’re arguing that it is a "worthless report" you need to get your arguments sorted.
Relative Risk: A relative risk of 2.0 or more is what is usually expected before the results of a SINGLE study are deemed to provide conclusive evidence. The pro-smoking lobby has deliberately misquoted several experts, including Robert Temple and Marcia Angell, in a cynical attempt to pretend otherwise. What we are talking about here is a large body of corroborating evidence showing the dangers of passive smoking. The conclusiveness is drawn from the consistency and overall assessment of those many findings.
Nonsensical points (Part 2)....
Individual statistical significance: More blatant selective misquoting Dave! You quote one sentence from the SCOTH report but not what is stated immediately afterwards. Let me remind you of what that was: "They were nevertheless comfortably within the confidence limits of the pooled odds from the 1997 meta-analysis presented to SCOTH (1) of 1.24 (95% confidence interval (CI) 1.13-1.36). That is an excess risk of 24% in non-smokers exposed to SHS compared to those not exposed."
You argue that most studies, taken individually, are not statistically significant. But what is the relevance of that? I have not found any scientific journal which states that a risk is not demonstrated from a large body of evidence unless individual studies are statistically significant. Have you? You forget that the large majority of studies corroborate each other’s findings, adding ever stronger demonstration of the risks of passive smoking. And, when these findings are pooled, the risks are demonstrated IN A STATISTICALLY SIGNIFICANT WAY.
Calculation of death levels: Dave, I think your calculations are totally wrong. The 2.5 per 100,000 figure is the additional risk that a non-smoker will die of ONE disease (lung cancer) in ONE year from being exposed to SHS. Over the course of a 40 year period, that risk increases by 40-fold (to 100 per 100,000, or 1 per 1,000). You’ve then got to add to that the additional risk of dying over the same 40 year period from other diseases. The added risk of premature death from heart disease is roughly 1 in 100. So, in the course of just 40 years, a non-smoker exposed to passive smoke has a roughly 1% risk of dying prematurely as a result of their exposure.
3,000 people a year die on our roads, as you say. Jamrozik tells us that passive smoking claims approximately 10,000 lives each year prematurely, from lung cancer, heart disease and stroke. You can quibble about the accuracy of the 10,000 figure if you want. But other studies have confirmed Jamrozik’s findings (e.g. McGhee et al, BMJ (2005)). I’ve not seen any alternative calculation of mortality figures which differs in any significant way from these. Any reasonable alternative calculation you produce will show that passive smoking accounts for more deaths in the UK each year than road traffic accidents.
Nonsensical points (Part 3)....
Nilsson/Denson: Why are you so selectively cherry-picking the one or two studies which agree with your perspective? Why have you not got the courage to refer to the overall body of evidence, as reports such as the IARC monograph (2002), SCOTH report (2004) and US Surgeon General’s report (2006) have done?
Alastair G Browne quote: These are clearly the comments of someone who does not understand the methodology of Jamrozik’s work. Browne complains that "rather than analysing them, [Jamrozik] accepts them as hard fact".
Actually, the purpose of Jamrozik’s report was to give a sense of the scale of deaths that would arise from an increased relative risk. He didn't need to calculate relative risks for himself. It was quite reasonable for him to use figures calculated in other published studies, which he referred to and which were clearly representative of the level of added relative risk calculated from a range of studies.
Rollo Tommasi wrote: Relative Risk: A relative risk of 2.0 or more is what is usually expected before the results of a SINGLE study are deemed to provide conclusive evidence... <snip> What we are talking about here is a large body of corroborating evidence showing the dangers of passive smoking. The conclusiveness is drawn from the consistency and overall assessment of those many findings. The conclusiveness is drawn from the consistency and overall assessment of those many findings.
This is garbage.
If, for example, someone measures the length of a piece of wood using an inaccurate ruler, the result they get will be inaccurate. And if the same piece of wood is measured by a lot of people using inaccurate rulers, the results they produce will also be inaccurate. The probability producing the right answer does not increase because a lot of people measure something the wrong way and get similar sorts of wrong answers.
It really doesn't matter how many people agree about something. That a lot of them agree doesn't mean they are right. It's the methodology they use that matters. It's the accuracy of the rulers they are using.
And in the case of epidemiology, the use of statistical methods to try to measure things is an inherently inaccurate method. It is, for example, not entirely clear just who is and who is not a 'smoker'. It is very often not very clear what was the cause their death, or how many cigarettes they smoked or did not smoke. The raw data is inherently inaccurate. And because it's inherently inaccurate, the conclusions drawn from them will also be inherently inaccurate, regardless of how many people do so.
The best that such statistical methods can do is to suggest what might be happening. It is at best a rough guide. It should only be used to frame a real scientific investigation to find out what is really happening.
The reliance upon statistical studies to guide policy has become a scientific scandal. It is a practice that ought to be stopped. It's not science. It's astrology.
Hi Rollo, I hope you are enjoying your weekend. Time prevents me from answering all your points now but I will reply to this one.
"But the first 3 points of Richard Smith’s editorial also acknowledged there were many legitimate criticisms made about Enstrom & Kabat’s work. I’ve set out some of those criticisms in my earlier post - I see you have no answer to these points."
Enstrom/Kabat was peer reviewed by 2 epidemiologists whom said the whole report holds water. I am not aware of a longer, more indepth and thorough study. If you are aware of one please point me to it.
Surely if E/K is invalid then any research into passive smoking is utterly worthless and it is impossble to establish scientifically ANY harm from SHS. N'est pas?
The fact is that there are more studies that show 'no risk' or 'preventative' than an increase in risk from ETS. These are TOTALLY ignored, of course, by Rollo and co, but stress the reality of ETS research.
Forget the 'bullshit baffles brains' details of epidemiology,because when ALL studies, negative and positive, in there tiny results, based on unmeasured data, are taken in cosideration the conclusion has to be a resounding ZERO.
When trash is repeated,multiplied and then given official creedence by 'Authority'it is still trash.
To see someone try to defend this is quite comical.
Even if I accepted your "evidence" that passive smoking harms others, Rollo, can you tell me how separate, segregated, and ventilated areas where smokers are welcome inside could possibly affect you and others obviously fanatically obsessed with health?
Smokers (that is people - other human beings) have been completely excluded socially on account of the sort of trash you spout above. How can you, or any other supporters of the anti-smoking cause, say that you care about people when you work to ensure that smokers are treated less than human?
In truth, and be honest, your sort will never stop until you have eradicated smokers from the face of the earth so that your chosen members of the human race can enjoy the pollution that's left to yourselves.
Are you also against other "harmful" lifestyle habits that you disapprove of or just this one?
Dave A, I was using a quote from a Smoke Free Home comic, sorry, Registration Form. It illustrates that even using their exagerrated guesswork, the dialy dose is minimal. Anyone who says that 0.4 cigarettes a day is harmful needs their head examined.
"How come miles of media exposure can be given to the likes of Jade Goody's life, a nobody who happened to die of cancer, can you imagine the impact if she had smoked on the impressionable prolatariat."
Sorry to correct you Ann, but Jade Goody smoked - easily missed if you did not watch her much. I saw her in Big Brother, the controversial Celebrity Big Brother, and only a few weeks ago in her wheelchair leaving hospital to go and buy her wedding dress. As she was wheeled out, she was lighting up.
What I find strange, is that the media have not mentioned the fact that she smoked. They did it with Wendy Richards. I have some ideas about this, but I would be very interested to hear what others think. I am sure that when the dust has settled, the Arsnotts of the world will crawl out from under their predjudice.
Rollo said "They were nevertheless comfortably within the confidence limits of the pooled odds from the 1997 meta-analysis presented to SCOTH "
We discussed Scoth and Meta-analysis a while back. You still persist in using the same old, same old script. Why?
If you check the references in SCOTH a number lead back to Hackshaw et al 1997, a meta-analysis. We have discussed this study with reference to its results and the authors relationship to SCOTH members. There were links back to SCOTH and the use of meta-analysis was suspect. The report did exclude certain studies which 'appeared' to go against its ultimate findings.
DaveA makes a valid point about SCOTH. It is touted as independant and clearly this claim is dubious. This is not an ad-hom attack by DaveA. it simply points out that an 'independant' body that has conflicts of interest is not truly independant. We therefore need to be skeptical of it's results and recommendations.
As a smoker of 42 years, I have watched this debate from the roots. I've accepted that active smoking could harm my health and I believed for a while that passive smoking harmed others. Then after years of being abused for not giving up, and feeling guilty to the point of being apologetic for my very existence, I found there was other research that had not been promoted publicly that cast doubt on the passive smoking evidence.
The very fact that I am reading here well-framed arguments on all sides of the pro-choice/anti-tobacco/pro-smoking argument, means that the evidence of passive smoking being harmful to others is most definately NOT conclusive.
It is this that makes me err on the side of freedom in this whole issue. If passive smoking does not conclusively cause harm in others, then it is not enough of a reason to ban a legal pastime that millions of other people enjoy in what is supposed to be a free country.
There are far more important issues worthy of all on here using their energies to fight - world poverty, unjust wars, child abuse ... etc.. etc... but it is a fact that smokers did not make smoking an issue at all. Anti-smoking campaigners did and they are the ones who should be accused of spending too much time on a trivial subject.
It is because smokers have had to fight against anti-smokers' personal abuse, because of what they do, unproven allegations from the well-funded anti-smoking lobby, that slanderously accuse them of being mass murderers, and now ultimately the right to exist, because anti-smokers have campaigned for their social exclusion,that smokers have no choice but to defend themselves.
The truth is there is enough room in this country for all of us and we can all live together. It takes only tolerance, respect from both sides for their views on this subject, and the end of prejudicial, bigoted, hatred inciting propaganda from the anti-smoking lobby to make that happen.
They have achieved their aims. It is time they backed off. This post is about how much further they are prepared to go and the underhanded methods they use against anyone who dares to challenge or disagree with them.
Something stinks in this whole debate - and it isn't smoke!
From April 6 the basic state pension will be £95.25 a week. Two pints a day for a week at, say £3 a pint would cost £42. Add to that 20 cigarettes a day at £ 5 for 20: total £35. Beer and cigarettes for a week would cost £77, out of the state pension (which is described as a 'benefit') of £95.25.
If pubs are not able to provide people with the ambience that suits them there is no reason to patronise them. I dislike 'passive music'. It can make me irritable. I leave a pub if I don't like its piped music. I don't want to ban the practice. If the pub prospers with it, well and good. I will find a hostelry, if there is one, that doesn't have it. At least I will if I can find one. I have loved the ambience of many pubs over my lifetime: the still and fragrant beer from the wood, before its death by keg and then its later revival by the valuable but now too p.c. Camra; the log fires, the gentle chat, the time to read a paper and think: company if one wanted it, quiet reflection if not. Freedom, tradition, warmth. And in the years when I did not smoke I still felt that way. July 1, 2007 ended that. Pubs have no appeal for me now. For me,I don't mind by now. I fear for the tolerance and live and let live which has been part of our national character.
Idlex/Zitori: Epidemiology is a sound and important aspect of science, provided it is conducted properly - which most studies into passive smoking have been. You complain about the limitations of interview techniques, but studies conducted in different ways (cohort and case-control studies) still demonstrate similar results. And it is the same epidemiological techniques which are used to assess the risk to health of such elements as diesel particles and radon gas. Are you seriously trying to suggest that these are therefore harmless?
And Zitori - you have demonstrated one of the most commonly used distortions of science by pro-smokers. For some ridiculous reason, you believe that when a study produces results showing a relative risk above 1 but with a 95% confidence interval straddling 1 (e.g. 1.2 (0.8-1.5)) it means that passive smoking is harmless or "no risk". That is TOTALLY WRONG. The reality is that the results are suggestive of harm, even though they do not provide conclusive evidence in their own right. If you bothered reading study reports (especially conclusions) for yourself, that point would be clear to you.
DaveA: If you’re looking for bigger studies of lung cancer, here are a few studies of women (Enstom & Kabat’s study included 177 female lung cancer cases):
Fontham et al (1994), 651 cases, adjusted relative risk 1.3 (1.0-1.6)
Zhong et al. (1999), 407 cases, adjusted RR 1.1 (0.8-1.5)
Lee et al (2000), 268 cases, adjusted RR 1.8 (1.3-2.5)
Stockwell et al (1992), 210 cases, adjusted RR 1.6 (0.8-3.0)
And - to prove the IARC, SCOTH and USSG reports are inclusive - they also took account of studies which were larger than Enstrom & Kabat but which low RRs, e.g.
Brownson et al (1992), 431 cases, adjusted RR 1.0 (0.8-1.2)
Wu-Williams (1990), 417 cases, adjusted RR 0.7 (0.6-0.9).
What this shows is that E&K was challenged for its methodology, not its results. And with good reason. How can a study be taken seriously if it records the exposure to passive smoking of a person who died in 1996 based on something they said in 1972?
I was supposed to meet my son for a drink today. He says I am becoming a bit of a recluse.
West2: If you are going to accuse the meta-analyses I’ve mentioned to be guilty of cherry-picking, you need to give me examples.
And trying to disregard the SCOTH report because of funding for members IS an ad hominem attack - in the same way as attacking Enstrom & Kabat for receiving tobacco industry funding was ad hominem. If you want to criticise SCOTH, do so on the merits of their report.
And you have never explained how bodies as diverse as SCOTH, IARC and the US Surgeon General can still reach such similar conclusions. You clearly are unable to criticise any of these reports on their merits. And it seems you don't even know how to launch ad hom attacks on the USSG or IARC either.
Pat Nurse: The issue of smoking in public is at long last becoming subject to the same social norms – and laws - as have always applied in other aspects of life. If I want to play music in my home, I know not to play it so loud that I might annoy my neighbours. If my wife and I are feeling a little amorous when we are out of an evening, we know to control ourselves until we’re in private. If I’m driving, I know I need to apply due care and consideration to other road users.
At long last, smokers are expected to exercise their freedom in a way which does not unfairly impinge on the rights of people around them. I have no desire to deprive a person of a right to smoke – they just need to do so with due care and consideration for people around them.
I find your second post quite alarming. You are aware of the evidence showing that passive smoking is harmful to the health of people around you. But that’s less important to you than being able to light up wherever you want. If I smoked, I am sure I would want to make sure I avoided any possibility that I might be harming the health of people around me. I’m so glad most smokers are not like you.
Rollo - do you have an opinion on whether smoking is really enough of a reason, given the disputed evidence, to exclude,isolate and dehumanise fellow human beings when we can all be satisfied at separate venues of our choice? What is your objection to choice?
I have just seen your post above as I was about to post the question here, so I'll address it now as well... :
You said : "I find your second post quite alarming. You are aware of the evidence showing that passive smoking is harmful to the health of people around you. But that’s less important to you than being able to light up wherever you want."
Firstly, I have never said that I have the right to smoke where ever I like. I don't believe I do. I do believe, however, that I have a right to smoke somewhere safe, warm, and ventilated when in public with other people who either smoke or have no objection to smoke.
Secondly, I am aware that there is no conclusive evidence to say that passive smoking harms others so therefore I don't believe I do. I err on the side of caution when around non-smokers. I have always been considerate on that issue.
I welcomed the segregation that market forces were beginning to impose so that smokers and anti-smokers didn't have to mix. I even suffered non-smoking venues when with non-smoking friends. I did no "harm" to anyone when in smoking venues with smoking friends. Smoking and non-smoking workers could choose to work in either and often did.
You said : "I’m so glad most smokers are not like you."
I am very glad that most non-smokers are not like you, too, Rollo. Selfish, inhumane, and health obsessed.
Pat Nurse: You have acknowledged that you do try to exercise consideration in how you smoke and I am happy to accept that. But I should point out what it was which made me direct strong words to you. This is what you said in your earlier post. “It is this that makes me err on the side of freedom in this whole issue. If passive smoking does not conclusively cause harm in others, then it is not enough of a reason to ban a legal pastime that millions of other people enjoy in what is supposed to be a free country.”
I found that remark staggering for two reasons. First, how “conclusive” does evidence about risk to health have to be before you would change your behaviour? And second, smoking is hardly being “banned” as you claim. Smoking was still legal the last time I checked. It is simply being made subject to exactly the same type of controls which already apply to other legal activities, such as (to return to my original examples) music, sex and driving.
You raise the question about smoking provision in pubs. You say you want the "right to smoke somewhere safe, warm, and ventilated when in public". I am not against that in principle. But there are real difficulties in practice. That probably explains why groups like Freedom 2 Choose are happy to complain about what they are against but do not have a consistent view of what they are looking for.
Giving landlords the choice to allow smoking or not is unacceptable - the public would not accept it. And it is no more acceptable to allow bar staff to be exposed to SHS than office or transport workers.
If some pubs were to be allowed to be "smoking pubs", then that would store up so many problems. Who would decide which pubs to grant a smoking license to, and which not? How would the authorities decide? What happened if a smoking license came up for renewal? It would be a litigator’s charter and the only people who would definitely benefit would be the lawyers. And again, you have the problem of bar staff being exposed to SHS.
I have some sympathy with the idea of separate smoking rooms. But I just don’t think they’d work in practice. First, they would be a pipe dream (if you’ll excuse the pun) for the many community pubs which are suffering most just now. The layout of many of these pubs does not suit carving out a separate room an, even if it did, the costs involved would be prohibitive. I think most of these publicans prefer a "level playing field" of a universal ban to a situation where larger pubs could create separate smoking rooms, but they could not.
Finally, experience tells us how absolutely appalling pub ventilation was when smoking was allowed. I know some people will argue that standards of ventilation continue to improve. But that’s only half the point. Ventilation in the past was poor because systems were either turned off or not maintained properly. I don’t see how you ensure that publicans maintain highest ventilation standards at all times.
If you are in control of your smoking (rather than it being in control of you), you can still enjoy being in a pub or any other enclosed public space. If your desire to smoke is strong enough, then you still have the choice to do so - you just have to move temporarily out of that enclosed public space.
Rollo said "West2: If you are going to accuse the meta-analyses I’ve mentioned to be guilty of cherry-picking, you need to give me examples."
Why do you insist in putting words into my mouth and setting up straw people?
I have previously outlined to you my concerns about meta-analysis in and of itself and also with Hackshaw et al,
wrt WU-Williams (1990) which you cited as evidence of inclusiveness, Hackshaw et al commented "This study suggested an implausible protective effect from exposure to environmental tobacco smoke (relative risk 0.79 (0.62 to 1.02)). The authors commented that, in their study, the effect of environmental tobacco smoke was probably obscured by another cause of lung cancer, indoor cooking using open coal fires with little ventilation."
An intersting use of the word 'implausible' given that 5 of the 6 studies you also cited had an RR that included 1 i.e no effect.
Rollo also said "And trying to disregard the SCOTH report because of funding for members IS an ad hominem attack "
I certainly have not stated that the report should be disregarded. Is it an ad-hom to question the independance of a body that claims independance? Dr Siegel has only recently written a note about NRT quit rates which showed the results may have been skewed due to a conflict of interest, I specificaly said the report should be treated skepticaly.
Then Rollo said "And you have never explained how bodies as diverse as SCOTH, IARC and the US Surgeon General can still reach such similar conclusions"
You never asked.
This is all by the by. I think the points raised by Pat Nurse and Dr Siegel are far more important. The examples you gave of self control are admirable, however they overlook the social needs for people who share a legal activity to arrange their socializing with others of the same like mind, in a civil setting.
The call for nore draconian measures and the groupthink evident in TC are matters of serious concern outside of the SHS debate. The blueprint is being applied in other areas (e.g Alcohol and Obesity). This is a worrying trend that has led to serious consequences in the past.
The actions of health Canada recently over e-cigs, show that TC are not as concerned about public health as they portray.
Rollo - I believe in freedom. I don't believe that it is justified to deny freedom of choice on the issue of passive smoking when it is not proven. It cannot be a "probably" or "maybe" or "more than likely" . It really has to be proven for me to accept that health outweighs ancient freedoms such as choice. I don't see why choice should be debated on what is, effectively, a health whim, nor why it is so wrong for landlords etc to decide their own policy - unless we live in a dictatorship, of course. If the public supports the ban as you suggest, then what is to fear? What level playing field is needed? Surely if you are right, those pubs that choose to allow smoking will go bust because "the public" will not go there.
I equate your passion against choice with unnatural health zealotry which I fear will do untold damage to future societies and their ability to be creative, independent, and free-thinking. I will always fight against it whether the subject is smoking, food or alcohol.
For me, the issue of the blanket public smoking ban has nothing to do with smoking and everything to do with freedom and, more importantly, culture. Yes, of course I can control my smoking. If not, I'd be like a heroin or crack addict unable to do a day's work, or get on a plane again, without revisiting my drug of choice every 20 minutes.
I enjoy smoking as much as some people enjoy mountain climbing, horse riding, motor racing - all far more dangerous than smoking for those actively and regularly involved. There are doctors who still believe smoking has medicinal values, btw. They are not all "on message".
The other main reason I have never been convinced by the anti-smoking debate is that other, more harmful, pollutants (traffic, for example) are usually ignored and most anti-smokers will happily drive a car and not give a damn about pedestrians or cyclists passively inhaling their car fumes
You might find it hard to accept, and there are some smokers who would indeed not agree with me, but I am not just someone who smokes. I am a smoker. If what I have done for almost all of my life is no longer acceptable in public, then neither am I.
You have no idea of how deep this feeling of exclusion runs and it has nothing to do with the enjoyment of a pub with or without a cigarette in my hand. It is to do with who I am and where I am welcome or not. I will not sneak off into a dark and filthy corner outside of a pub to smoke. I am not the only life-long smoker who feels this is undignified and humiliating. I feel like a Jew with a yellow star, and my head feels shaved. It's disgusting and unneccessary.
A blanket smoking ban is morally wrong. It panders to the whims of the health obsessed anti-smoking lobby, while driving legitimate hard-working businesses into the gound, and excluding people who have every right to expect that their cultural needs are taken into account in a free, fair and tolerant country.
It has never been acceptable to have sex in public, to play unreasonably loud music, or drive cars without due care etc.. It is only unacceptable to smoke in public today because an unjust law was passed on selected evidence which supported the prejudicial and personal views of anti-smoking groups, while encouraging personal abuse, discrimination, and exclusion of a minority group.
Timbone wrote: What I find strange, is that the media have not mentioned the fact that she smoked. They did it with Wendy Richards. I have some ideas about this, but I would be very interested to hear what others think.
Perhaps it's because cervical cancer is known to be caused by human papilloma virus..
Human papilloma virus can be detected in 99.7% of women with histologically confirmed cervical cancer, affecting some 500,000 women per year.
It's a great example of real science as opposed to epidemiological statistical mumb-jumbo. It was noticed that prostitutes contracted cervical cancer more often than nuns, suggesting the possibility of a viral transmission. And a German virologist, Harald zur Hausen, succeeded in isolating the papilloma virus in cervical cancer, and unravelling the way that it caused cancer. He went on to help to develop a vaccine against it. He received a Nobel prize last year.
Here the epidemiological studies were used properly - as indicators of a possible cause -, and the real science was carried out subsequently in the laboratory to find the real cause. And it turned out not to be caused by having sex, or smoking cigarettes, or drinking beer, but by a virus.
In the absence of real science there's only the hazy suspicions that epidemiological statistics can offer. If no real science had been done, the likes of Rollo Tommasi would be calling for sex and prostitution to be banned. - or perhaps lipstick and high heels shoes, which most nuns don't wear either -.
This sort of bastard epidemiology flourishes in the absence of science. It is a substitute for science. And it still flourishes, even in respect of cervical cancer. So Cancer Research UK continues to assert:
If you smoke, you are more likely to develop squamous cell cervical cancer. Researchers have found cancer causing chemicals (benzyrene) from cigarette smoke in the cervical mucus of women who smoke.
The end for all this epidemiological number-spinning will come when real scientists at last find out the real causes of cancer. And we can be pretty sure that it won't be smoking that causes lung cancer, any more than it's having sex that causes cervical cancer in prostitutes.
And when that day comes, the epidemiologists and their correlations and relative risks and confidence intervals will fade into deserved obscurity, or retreat into those areas of medicine where real science has yet to penetrate, and where epidemiological charlatanism and fraud can still flourish.
Rollo Tommasi wrote: ...you believe that when a study produces results showing a relative risk above 1 but with a 95% confidence interval straddling 1 (e.g. 1.2 (0.8-1.5)) it means that passive smoking is harmless or "no risk". That is TOTALLY WRONG. The reality is that the results are suggestive of harm, even though they do not provide conclusive evidence in their own right.
When the confidence interval straddles 1.0, as in 0.8-1.2, it means that it is equally probable that passive smoking has a small protective effect as that it poses a small health risk. It is NOT suggestive of harm. It hardly needs to be said that it not conclusive.
You say you want the "right to smoke somewhere safe, warm, and ventilated when in public". I am not against that in principle.
You are clearly getting a little off-message from your colleagues here, Rollo, as you bang on about the non-existent dangers of passive smoking. Most of them don't believe that passive smoking poses a health risk. One of them, Baroness Elaine Murphy,took the trouble to point out to Michael McFadden the real reason for the smoking ban.
"Dear Mr McFadden,
You and many others have completely missed the point about smoking and health. The aim is reduce the public acceptability of smoking and the culture which surrounds it. We know that legislation which discourages all public smoking will have the better impact on public understanding and perception of smoking as an unacceptable habit. Hence fewer people will smoke, hence health overall will improve."
The aim is not to protect people from the entirely imaginary health threat of passive smoking, but to denormalise smoking and the culture that surrounds it. People will give up smoking, and their health is supposed to improve as a result. The passive smoking scam is, and always was, a red herring.
So it is dangerously off-message of you even begin to entertain the idea of allowing people warm and comfortable places where they can meet their friends and smoke. The point is to make life as uncomfortable as possible for smokers. The aim is to force smokers to stop smoking. And if this means that smokers are denied medical care, fired from their jobs, fined, punched, raped, and beaten, then that is all part and parcel of making life as uncomfortable as possible for them. Perhaps when you next meet Baroness Murphy, she'll put you right on this score.
I don't know why sensible people are wasting their precious time arguing with this rollo person. He is obviously unhinged and not worth the trouble.
If nobody argues with him, he will have to stop his stupid posting.
I think that DaveA should be putting his talents into a more rewarding exercise than wasting time on idiots like rollo.
I echo your last paragraph Idlex which is 'spot on'.
Active denormalisation has certainly brainswashed many in our once free land.
I just wonder, for what purpose? Certainly not for health. There's been too many deaths as a result of the blanket ban, when modern ventilation systems or separate rooms could have provided the same effect.
Some people must be so full of hatred to go to these lengths to achieve the existence that they desire. They are happy to see the smokers slaughtered, battered, raped, drugged to death with NRT products, fired from jobs, ridiculed etc based on science that is dubious.
My mind boggles as to how sick these anti-smokers actually are