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Secondhand Smoke Exaggerations Challenged

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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.

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