Breathing difficulties
Thursday, June 17, 2010 Further to yesterday's post about my interview on Radio Cornwall, the programme also featured a woman called Lyn Mitchell who is in her fifties and is confined to a wheelchair because she is suffering from chronic obstructive pulmonary disease (COPD) which she claims is the result of growing up with parents who smoked.
In media terms, this is the equivalent of the fictional tobacco lobbyist Nick Naylor being introduced on a TV show to a 15-year old diagnosed with cancer. (See Thank You For Smoking, the very sharp 2006 film starring Aaron Eckhart.)
It doesn't happen to me very often but it's always a delicate moment. One has to be firm yet sensitive to the person's predicament and also their opinions, which may be strongly held.
Yesterday was relatively easy because Lyn's interview was pre-recorded so we weren't addressing one another directly. I sympathised with her plight, made the rather obvious point that I wasn't her doctor so I couldn't possibly comment on the cause of her illness, but added that whatever the reasons we should put her case in perspective.
How many people, I asked the presenter, did he know who have to carry a portable oxygen cylinder with them to help them breathe? Personally, I said, I don't know anyone. (Apart from Lyn I'm sure there are others, but they are few and far between. And I would take some convincing that it was caused by their parents smoking in a car when they were young.)
The point is, however distressing it is for the people concerned, it doesn't justify a blanket ban on smoking in cars, or the home ... or anywhere else.
Meanwhile, on BBC Somerset this morning, I was reminded of a statistic (from the Royal College of Physicians) that suggests that 22,000 children seek medical help for asthma and wheezing as a result of passive smoking every year.
Hmmm, I said. Interesting, isn't it, that cases of asthma have (I am told) tripled since 1970 yet the number of smokers has more than halved. And still smokers are blamed for their children's asthma and "wheezing".
I was a "wheezy" child. Until the age of five or six I occasionally had bouts of croup, which made breathing quite painful. (I remember spending several nights with my head under a towel, breathing in the steam from a bowl of hot water to help relieve the symptoms.)
Neither of my parents smoked but I bet, if I were a child today, I would be listed as one of the 22,000 children suffering from "asthma and wheezing as a result of passive smoking".
Simon Clark
I notice that in THIS information about croup it asks the question "Will smoking effect croup?" and gives the reply, "Smoking will make croup worse. Do not let anyone smoke around your child at any time."
That seems not unreasonable to me. It doesn't say that smoking causes croup. It simply says it will (may?) make it worse. Solution: err on the side of caution when in the presence of very small children.
Likewise, if someone suffers seriously from asthma it makes sense to avoid a smoky environment because it may/will make it worse. But again, it doesn't mean that exposure to tobacco smoke caused asthma in the first place and it doesn't justify a comprehensive ban on smoking in all public places.
Reader Comments (15)
I grew up in the 50s and 60s in a world where almost everybody smoked. I didn't have asthma. None of my school friends has asthma either. I never heard of anyone having asthma until the 1970s, when suddenly it seemed to become an epidemic. Just when fewer and fewer people were smoking.
Back in the 1950s, it seems that doctors would prescribe smoking a a cure for asthma. I'm beginning to see why.
"Likewise, if someone suffers seriously from asthma it makes sense to avoid a smoky environment because it may/will make it worse"
What do you Simon, or indeed anyone else, class as a "smoky environment?"
A smoke filled kitchen perhaps?
Roadworks where they are laying new tarmac?
A BBQ?
A smoky grill in a restauarnt?
Heavy traffic on a main road?
Joss sticks burning in an Indian restaurant?
Bonfires?
Where does one stop? The list is endless. But the blame game always seems to come to an abrupt stop when the word "smoking" is used, in context with tobacco of course, and all these other causes of "smoke" are conveniently wiped clean off the slate.
As sorry as I feel for Ms Mitchell, she should stop laying the blame on her parents, and look at "all" the other possible causes to her illness.
I have a question.
If she has to carry around an oxygen bottle because her parents smoked, did her parents both have to carry oxygen bottles too?
Even if we assume passive smoking causes health issues, surely active smoking causes worse health issues?
Ergo, if she needs oxeygen because of her parents, they must need even more oxygen than she does.
Or such. You get the general idea.
Delicate situation indeed Simon, and one you must encounter frequently. Well said, well handled!
The increase in asthma is put down, in some journals, to the reduction in strength of the common immune system, relating to the improvement in sanitation over the last hundred years. Unlikely to be directly related to smoking at all.
If you accept that smoking might exacerbate a pre-existing condition, why do you limit 'erring on the side of caution' only to very small children? Would it be OK to smoke in the company of Ms Mitchell, however misguided she may be about the source of her problem?
All I can say is that my nephew has asthma and he smokes roll ups. His parents were never smokers.
children who grow up in a non-smoking household are 6 times more likely to develop asthma than those who grow up in a smoking household. there are many studies that shew this.
Simon, I have done the science here.
http://takingliberties.squarespace.com/taking-liberties/2010/6/16/banned-wagon.html#comments
I would say that the medical org that warns that croup can be caused by smoking in front of a child must need pharma funding. It's American. Profit comes comes first. I'd also like to know who funded the research that came to this conclusion and what other risk factors it was compared with.
Personally, I am too cynical of these modern medical people and scientists. My grandparents smoked in front of my parents who smoked in front of me who smoked in front of my children (Three of whom don't smoke as adults). None of us ever had croup nor any other serious illness. It was odd that when I began to smoke in another room from my youngest, as the hysteria built in the 90s, that he was the only one to ever get asthma.
Simon put BBC Radio Humbs in touch with me yesterday for a live broadcast on why I don't quit. The question of whether I smoked or not, and whether I felt guilty about it, came up. You can listen here. It's about half way through http://patnurseblog.blogspot.com/2010/06/why-should-i-quit-smoking.html
Sorry, Simon, but I really think the time has come for this junk science, the roots of its funding, and it's conclusions, to be put into perspective. Swallowing it because that is the "right" thing to do because we should "err of the side of caution" just plays into the anti-smoking industry's hands and gives credence to something that I honestly believe should be scrutinised in the public interest. If we accept this, then the next move is to equate smokers with child abusers. It must stop now and we must challenge it.
On asthma they blame everything except smoking in the latest research.
"A decline in aspirin use, exposure to household sprays and cleaners and lack of vitamin D may all help explain surging asthma rates in the past few decades.
For years the hygiene hypothesis has been used to explain stark differences in asthma rates around the world. In Western countries, asthma rates are about 50 times higher than in rural Africa, for instance. The hygiene hypothesis suggests that Westerners have less exposure to bacteria, viruses and parasites, altering the immune response and increasing risk for allergic diseases."
"The concern with household cleaners is that the spray mist can be inhaled and irritate the lungs, increasing risk for asthma. The biggest culprits appear to be glass cleaners and air fresheners. A major European study of cleaning product use in 10 countries found that people who used the cleaners four days a week faced double the risk of adult asthma. Weekly use increased risk by 50 percent. Australian researchers have also found a link with household cleaning sprays and asthma in children.
http://well.blogs.nytimes.com/2009/02/12/new-risk-factors-linked-to-asthma-rise/
I agree with Pat (sounds vaguely familiar doesn't it?). The "right" thing to do is not to "err of the side of caution" at all, but to use one's mind and question everything that is thrown at us.
If the great explorers, scientists, artists, writers, doctors and inventors down through the ages, had all decided to "err of the side of caution" we would not have the great advances in art, science, and technology that we have today.
"In media terms, this is the equivalent of the fictional tobacco lobbyist Nick Naylor being introduced on a TV show to a 15-year old diagnosed with cancer."
If this ever does come up in an interview the sad reason a 15 year old has cancer is that they usually have only inherited one copy of the P53 gene from one parent. The P53 gene stops the multiplication of types of cancer cells in the body.
One thing no one has talked about is the older smokers who now require oxygen, like Lyn, but who still smoke. Now, I am no rocket scientist, but I do believe that is a dangerous combination. When I was a lot younger, I remember going over to my friends house to play Golden Eye (ya know, the Bond game for the N64) and my friends grandma would smoke right next to her oxygen tank! My friend used to joke about how close they were to perpetually exploding. Now, don't get me wrong, I think smoking is very bad for you (and, the people around you), but let's not add insult to injury by adding explosions into the mix. I think at the point your require oxygen to breath you should probably quit smoking. But, this does not resolve the problem of potentially exploding. I think if you HAVE to smoke and you require oxygen you should probably use Portable Oxygen . These little miracles of science produce oxygen, so its not just sitting there waiting to explode. I do not know, that's just my two cents.
Justin -
Re:
" I think smoking is very bad for you .........................."
Just the sort of statement we love on this blog, Justin.
Perhaps you'd care to clarify your thinking just a little:
a) What TYPE of 'smoking' ?
b) What LEVEL of 'smoking' ?
This sounds like pure pedantry, I know - but the blanket condemnation of ALL smoking as 'very bad for you', rather than a calm and measured assessment of the risk (and ALL the variables) involved is pure Intellectual Laziness, I'm afraid.
And when used as a thinly-disguised version of "I don't like smoking', pure Intellectual Dishonesty.
Many of your fellow-countrymen are suffering as a result of both.
As to the danger of Smoking Near Oxygen Tanks (for God's sake, don't tell ASH about THAT one!), I must be a pretty lucky fellow !
Ditto the millions of gas-welders around the world.
For a couple of years or so, I worked on a profile-cutting rig - with a flame hot enough to cut through an inch of mild steel - that used both Propane and Oxygen cylinders rather larger than the ones you mention. And, yes, I frequently smoked about two feet away from them.
Nonetheless, if you hear of any Exploding Grannies in your neighbourhood, please let us (and the HSE) know.
They're the last thing we need................................
I am a pharmacist from New Zealand, where the Aveotsd originated. I myself have been along time suffer of sleep apnea and sleeping related problems. I have been on the cpap. Not effective hat so ever. So after reading "kiwi drug" news about the aveo i decided to give it a try. The secret is in learning the simple technique to use the device and now for me ive never had a better sleep.
COPD is also often referred to as chronic obstructive lung disease (COLD) or chronic obstructive airway disease (COAD). The main problem with this disease is that it is a progressive disease and it gets worse day by day. Only effective treatment can cure them. Thanks for sharing good information. My best wishes to you.
regards,
oncology center