Secondhand Smoke Exaggerations Challenged

He finally threw down the gauntlet.

For years, Boston University School of Public Health Professor Dr. Michael Siegel has been skeptically questioning a particularly ominous allegation regarding the dangers of secondhand smoke. According to ASH (Action on Smoking and Health) and other groups, "Even for people without [certain] respiratory conditions, breathing drifting tobacco smoke for even brief periods can be deadly. For example, the Centers for Disease Controls [CDC] has warned that breathing drifting tobacco smoke for as little as thirty minutes (less than the time one might be exposed outdoors on a beach, sitting on a park bench, listening to a concert in a park, etc.) can raise a nonsmoker's risk of suffering a fatal heart attack to that of a smoker."

It is ironic that after decades of unscientific claims by the tobacco industry, this time it is the anti-smoking groups being accused of distorting the science.

The industry-funded Tobacco Institute denied the harmful consequences of smoking and did a great disservice to public health. Today, however, it's the "good guys," the anti-smoking advocates, who may be spreading disinformation by overstating certain risks. And because Dr. Siegel sees this exaggeration as a threat to the very credibility of the public health community, he wants to put an end to it.

In a recent study he published in the journal Epidemiologic Perspectives & Innovations, Siegel alleged that some groups are wildly inflating the health risks of exposure to second-hand smoke. In doing so, they tarnish the very credibility that the public-health community must have in order to save lives.

Let's be clear: Siegel is no friend of Big Tobacco, despite some claims made by the anti-smoking activists. In fact, he's a vocal opponent of smoking and a supporter of smoke-free workplace rules. Nor does Dr. Siegel consider secondhand smoke a good thing. After all, there is evidence that long-term, high-dose exposure increases the risk of heart disease and heart attack. And there is speculation that even short-term exposure may be unsafe to those with severe coronary artery disease. But the evidence does not support the claim that more than 100 groups are wantonly making -- which is that acute but transient exposure increases heart-attack risk in healthy individuals.

So today, Dr. Siegel is laying it on the line in form of a challenge on his blog: "Either provide the evidence to back up ASH's assertion that thirty minutes of secondhand smoke exposure increases the fatal heart attack risk of nonsmokers to the same level as active smokers, or else apologize to me for having improperly suggested that I am criticizing anti-smoking organizations for no valid reason," writes Dr. Siegel. He goes on to drop his call for an apology, saying he'd be satisfied with a statement acknowledging that the claim by ASH and others is "inaccurate and misleading and should therefore be corrected."

Do the Ends Justify the Mendacity?

The "evidence" behind the ASH assertion is flimsy. Comparably-weak evidence suggesting that smoking is less dangerous than previously thought would be laughed at. To me it is obvious: some anti-smoking activists have adopted an "ends justifies the means" approach in pursuit of their noble cause.

This is what makes Siegel's finding so troubling. We can no longer rely on the public-health establishment for scientifically accurate information. They'll fudge the numbers if they have to, so long as it promotes their overall agenda -- in this case, the drive to outlaw smoking in all public places.

While I doubt ASH will come forward with a science-based defense of their position by the Thursday deadline Dr. Siegel set out, I would not be surprised if they do respond with more personal attacks against him.

Some in the tobacco-control community are attacking anyone who raises questions. Dr. Siegel was banned from the primary tobacco listserv for simply sharing his dissenting views. And he's not the only one. UCLA epidemiologist (and trustee of the group I work for, the American Council on Science and Health Dr. James Enstrom has been personally vilified for, in his words, "questioning the lethality of [environmental tobacco smoke], such as a claim in the 2006 Surgeon General's Report," suggesting it kills about 50,000 Americans per year.

Science eventually catches up with those who hyperbolize about risks, and the public learns to disregard them. It would be tragic to see some public-health advocates lose the mantle of sound science and end up going the way of the old Tobacco Institute.

Cigarette smoking is the leading cause of preventable death in the United States and needs our urgent attention. Overstating the case may help the advocates win this political battle but at significant cost to the overall public-health war.

Comments

[geneb5]

By these reactions, it seems the Huffington Post has been anschlussed by the neocons.

The tobacco industry has certainly been successful in getting internet denizens to snark against their own best interests.

Hey, everybody! Let's all run out to a bunch of wingnut websites and swallow everything they say!

Alternately, you could just look up "secondhand smoke" at PubMed Central and examine at studies by, you know, normal scientists publishing openly in peer-reviewed journals.

http://www.ncbi.nlm.nih.gov/sites/entrez?term=%22secondhand%20smoke%22&search=Find%20Articles&db=pmc&cmd=search

Enstrom's studied disregard of the industry's history of funding diversional studies is like Leni Reifenstahl sending off one of her Gypsy slaves to tell us she has no idea the Nazis are doing anything naughty.

[BillHannegan]

The attack by Glantz and the ACS on James Enstrom has been truly criminal:

http://www.scientificintegrityinstitute.org/

[marcusarelius]

Tobacco control activists are not only exaggerating secondhand smoke effects, but since most have conducted air quality test results themselves; they are knowingly spreading lies.

http://cleanairquality.blogspot.com/2007/11/johns-hopkins-air-quality-testing-of.html

http://cleanairquality.blogspot.com/2007/04/bmj-published-air-quality-test-results.html

http://cleanairquality.blogspot.com/2007/02/smoking-bans-good-public-policy-or.html

http://cleanairquality.blogspot.com/2006/02/air-quality-testing-and-secondhand.html

[CarlOlson]

A good indication of the lethality of secondhand smoke is whether it appears on any death certificate.

I asked the Chief Medical Officer-Coroner of Los Angeles County what his office policy is. Dr. Lakshmanan Sathyavagiswaran wrote me, "...we as medical examiners do not list ETS [environmental tobacco smoke] on death certificates since the present state of our knowledge and controversial aspects of ETS adverse health effects neither allow us to document ETS as a direct cause of death nor to establish to a reasonable degree of medical certainty the role of ETS as a contributory cause of death."

Sounds pretty plain to me.

[RAMHaiti]

I'm happy to say I've quit smoking. I figure I haven't smoked about 5,000 cigarettes since April. I smoked for about 33 years. Second hand smoke hasn't become a problem to me yet....I'm glad they're studying it though. It gives people something to do.

[twillercat]

As always, one has to follow the money. For researchers, the money is in supporting an anti-smoker conclusion. For the "charities" that fund the researchers, the donations are in letting the anti-smokers feel superior to smokers. There is no money in truth.

If all the money spent on anti-smoker initiatives had instead been spent on truly making the air clean---clean cars, clean factories---we would actually have something. But there's no money in telling the majority that their cars are spewing carcinogens. The money is in telling the majority that they're just dandy, it's that minority that's causing the problem.

Sigh.

[geneb5]

>>Dr. James Enstrom has been personally vilified for, in his words, "questioning the lethality of [SHS]"

Enstrom was vilified not just for a truly bizarre study, but also for not fully and properly disclosing his tobacco ties.

Enstrom was cited in the massive, 7-year DOJ lawsuit, which found his study to be a part of the industry's racketeering effort to, in the words of Philip Morris, "keep the [SHS] controversy alive." The best tobacco lawyers in the country were unable to dispute this--though they had introduced this very study as a defense. Judge Kessler's 1700+ page ruling is a good precis of the main reasons this study should be looked on with the deepest suspicion.

http://www.tobacco-on-trial.com/files/20060817KESSLERORDER.pdf

Another precis of Enstrom's activities -- to which Enstrom provides a vigorous defense -- may be found here:

http://www.sourcewatch.org/index.php?title=James_E._Enstrom

Still unexplained is how Enstrom got involved in the anti-SHS-science movemment that began in earnest with the release of the EPA report in 1993.

Virtually upon release of the report, Michael Fumento, trained at a journalism school partly funded by Philip Morris, somehow unearthed a number of tobacco-funded scientists to dispute EPA's findings--without disclosing their tobacco funding. Enstrom is profusely quoted, as he was in the later Jacob Sullum articles that became part of massive full-page ad campaigns by Philip Morris and RJR. (One of the campaigns was headlined, "If we said it, you wouldn't believe it(!)"

The confluence of tobacco, tobacco-connected journalists and tobacco-connected scientists referencing, citing and reinforcing each others' positions is dizzying circular.
And apparently quite effective in "keep[ing] the controversy alive."

Let's see, when have we last seen this onslaught of funded studies and PR from tobacco? About primary smoking from the 50s to the 90s. (In 1975, documents show Enstrom asking for tobacco funding to examine _other_ causes of lung cancer.)

"Those who cannot remember the past are condemned to repeat it." -- George Santayana

[WorkingClass]

Birth is preventable and is the root cause of ALL DEATH.

[altohone]

The exaggerated claims are key to the anti-smokers efforts to extend their reach into private homes and businesses.

They think they're right, and the holier-than-thou have moved to infringe on personal freedoms in their crusade... see Belmont, CA for an example of what they hope to do across the country.

I am happy to see respected scientists challenge their claims... finally.

[BachelorJohnnyCool]

When I was growing up, people smoked everywhere, even in hospitals and doctors' offices. If all the current hysterical pronouncements about second hand smoke are to be believed, most of the U.S. population should be dead by now. And I'll believe 50,000 people a year die from second hand smoke when I see it listed as the cause of death on a death certificate. That number sounds like it was pulled out of someone's rear end.

And I have just one thing to say to the non-smokers who want to ban smoking everywhere - If you ride a bike or walk everywhere, you have a legitimate right to complain. However, if you own a car, you should just shut up because you're no better than the smokers you deplore. In fact, which do you think will kill you faster? Spending a few hours in a closed garage with someone who's chain smoking, or with a car with the engine running?

[trevor01]

Too many researchers are sidling up to the sure thing whether it's anti-smoking, HIV/Aids, asbestos, or global warming. No one is interesting in sticking their necks out and taking on these gigantic "non-profits". It's the difference between the search for truth and the quest for a lucrative career.