- NOTE: This article was first posted on my old site on July 7, 2011.
In a previous blog I criticized the Metropolitan Manila Development Authority’s new regulation that bans smoking in public places. I
stated that the new smoking ban was based on junk science and downright stupidity.
To support its smoking ban, the MMDA came up with a new term: “smoke-free environment”, which it defines as “an environment where everyone is protected from the hazards of secondhand smoke, in all enclosed workplaces and public places, including restaurants, bars and other hospitality venues.” This definition implies two things: 1) that secondhand smoke is dangerous, and 2) that everyone must be protected from in all “enclosed workplaces and public places, including restaurants, bars and other hospitality venues”. This means that the MMDA is not merely authorized or empowered to impose smoking ban in public places, but also in private establishments owned and/or operated by private individuals.
MMDA’s website enumerates the many effects of secondhand smoke, which are as follows:
- Non-smoking adults who are exposed to second-hand smoke at home or at work have a 25% to 30% increased risk of developing lung cancer.
- Babies of non-smoking women who are exposed to second-hand smoke during pregnancy are at risk of experiencing a small reduction in birth weight.
- Maternal milk production is less in smokers compared with non-smokers, and the production decreases as the number of cigarettes smoked per day increases.
- In infants and children, second-hand smoke exposure causes sudden infant death syndrome (SIDS), acute respiratory infections, middle ear disease, more severe asthma, respiratory symptoms, and slowed lung growth.
Now I did further research and found out that the MMDA’s source for this statement- “Non-smoking adults who are exposed to second-hand smoke at home or at work have a 25% to 30% increased risk of developing lung cancer”- is none other than the report released by the Surgeon General in the United States. The report is entitled “The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. ” The citation is as follows: U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006.
It turned out that the MMDA based its alleged passive smoking facts on junk science.
An American surgeon, Dr. Terry Simpson, published an article entitled The Myth of Second Hand Smoke (ETS) wherein he described the surgeon general’s claim as a “myth”, saying he was “incorrect”. Dr. Simpson further stated that “Second hand smoke may be an irritant and an annoyance, but it’s not a cause of death.”
In 1964, a controversial report entitled “The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General” claimed that passive or second hand smoke would likely cause heart disease and lung cancer. This report had a profound impact on America’s domestic policy, as lawmakers started issuing tobacco and smoking regulations that affected cigarette smokers.
Dr. Simpson states in his article that in 2006, Surgeon General Richard Carmona issued the following statements regarding second hand smoke:
- The scientific evidence is now indisputable: secondhand smoke is not a mere annoyance. It is a serious health hazard that can lead to disease and premature death in children and nonsmoking adults.
- Secondhand smoke contains more than 50 cancer-causing chemicals, and is itself a known human carcinogen.
- There is no risk-free level of exposure to secondhand smoke. Nonsmokers exposed to secondhand smoke at home or work increase their risk of developing heart disease by 25 to 40 percent and lung cancer by 20 to 30 percent.
Apart from scaring the public about the alleged danger of second hand smoke, the controversial Surgeon General also claimed
that 49,000 deaths per year were caused by passive smoke. Dr. Simpson, a surgeon, questioned the veracity and medical and scientific accuracy of the Surgeon General’s claim, saying he was “stunned” because he “had never seen an autopsy report listing second hand smoke as the cause of death. Nor had I seen this as a secondary cause of death.”
Dr. Simpson further states: “So I asked six pathologists if they had ever listed second hand smoke as a cause of death – not one had. In my years of clinical practice, I have seen patients die from many devastating diseases, and yet I have never seen anyone who has been disabled by, or has died as a result of, second hand smoke. This was my first clue that perhaps there was more hyperbole than science involved in the reports issuing from the Surgeon General’s Office. To give a contrast: 33,000 people die per year of pancreatic cancer – all of the pathologists have listed pancreatic cancer as a cause of death.”
In his article Dr. Simpson addressed the following issues:
What is second hand smoke?
Second hand smoke, also called Environmental Tobacco Smoke, is a combination of Mainstream Smoke, which is exhaled by smokers and Sidestream Smoke, which is released directly from the burning tip of cigarettes or cigars. Sidestream smoke is the primary constituent of environmental tobacco smoke, providing most of the vapor phase and over half the particles. Hence, at events such as “The Big Smoke”, the majority of particulate matter comes from sidestream smoke. Exhaled mainstream smoke contributes between 15 and 43 percent of the particulate matter in environmental tobacco smoke. Sidestream smoke is generated at lower temperatures and a higher alkalinity than mainstream smoke, and as a result has a different chemical composition.
During environmental tobacco smoke formation, both sidestream smoke and exhaled mainstream smoke are diluted by many orders of magnitude and subsequently undergo physical transformation and alterations in chemical composition. For example, nicotine and many other semi-volatile compounds of tobacco smoke tend to be present in the particle phase of inhaled mainstream smoke, but evaporate into the vapor phase as exhaled mainstream smoke is rapidly diluted during the formation of environmental tobacco smoke.
Is there any medically established connection between passive smoke and lung cancer?
If second hand smoke exposure is a significant risk factor for developing lung cancer, then we should expect to see increased numbers of cancer cases in non-smokers who are exposed to regular doses of second hand smoke. Has there been an increase in the incidence of lung cancer among nonsmokers over the last 40 years? The answer is quite simply… No.
Data from national mortality studies show that rates of lung cancer among non-smoking women remained stable between the 1950’s to the 1980’s (very few women smoked during those years) and didn’t rise until substantial numbers of women started smoking in more recent years. These non-smoking women were included in numerous studies as control groups for examining lung cancer rates in their smoking spouses. As anti-smoking logic would dictate, the longer one is exposed to second hand smoke the more we should see a rise in lung cancer. However, when we examine the data from the studies noted above, we do not see such a rise in cancer rates for these non-smoking women.
In 1992, second hand smoke was labeled a Class A carcinogen: one that causes lung cancer and is responsible for the deaths of 3,000 Americans annually (U.S. EPA, 1993). However, there were no autopsies, no bodies, nor one person that could be claimed as a victim. The EPA did not base their classification on their own independent study but examined over thirty epidemiological studies (i.e., studies that attempt to correlate various risk factors with early death in different populations). Eleven of those studies were done in the United States, and of those eight found a positive risk, three found a negative risk but none of them were statistically significant (that is, none of the U.S. studies could make the statement that there was a causal relationship between second hand smoke and cancer).
In medical research, a statistical confidence level of 95% means that there is only a five percent chance that a significant finding could be due to chance (i.e., a random result). In their interpretation of the epidemiological studies, the EPA made a critical procedural statistical alteration. They changed the confidence level to 90%. This statistical manipulation made it more likely that their findings would show significant negative health effects of second hand smoke, but also made more likely the potential for erroneous conclusions. Furthermore, the EPA did not take into consideration the factors independently associated with both the development of lung cancer and exposure to second hand smoke, factors that certainly could account for the purported relationship between second hand smoke and early death. Finally, they did not attempt to assure that the subjects were properly identified into the correct experimental group. The EPA left several important questions unanswered such as: Were the exposed cases truly ill with primary lung cancer? Had the subjects been smokers previously? Were they truly exposed to second hand smoke? And, did the subjects accurately report their exposure levels?
Is there any medical or scientific truth in the report and declarations of EPA?
The EPA also classified second hand smoke as a carcinogen based on chemical “similarities” between inhaled mainstream smoke and environmental tobacco smoke. Their logic was that since inhaled tobacco smoke is a carcinogen, environmental tobacco smoke must also be. Inhaled mainstream smoke, however, contains chemicals at concentrations of up to one million times those found in environmental tobacco smoke (which is a combination ofexhaled mainstream smoke and sidestream smoke). Further, deep inhalation affects the degree of exposure to those chemicals, as well as the deposition of those chemicals into the respiratory passages of the smoker. One of the frustrating issues is we do not know the chemical, or chemical compounds responsible for the link to lung cancer and/or heart disease. This leads to another difficult issue – the length of exposure to the chemical might not yield a linear relationship to the formation of cancer (also known as the exposure-risk relationship). Single dose exposure likely does not yield 100 percent incidence of carcinoma. For example, low exposures of materials in drinking water does not yield disease, but higher and longer exposures of materials – such as arsenic, certainly produce disease. Much as a single aspirin may produce the effect of headache relief, a large dose of aspirin will be toxic. What was not evident in many of these studies was a dose-response curve to second hand (passive) smoking and disease.
What’s the medical conclusion regarding the alleged relation between second hand smoke and lung cancer?
At the behest of Congressman Henry Waxman (D-Ca), the Congressional Research Service (CRS) spent two years examining reports and came up with the following conclusions regarding second hand smoke and lung cancer (Redhead and Rowberg, 1995):
(a) The statistical evidence does not appear to support a conclusion that there are substantial health effects of passive smoking.
(b) It is possible that very few or even no deaths can be attributed to second hand smoke.
(c) If there are any lung cancer deaths from second hand smoke, they are likely to be concentrated among those subjected to the highest exposure levels (e.g., spouses).
(d) The absolute risk, even to those with the greatest exposure levels, is uncertain.
The CRS found that, what was considered an “obvious” conclusion by the EPA was, in fact, flawed. The EPA reasoned that if the smoke inhaled by a smoker was close enough in composition to that which is exhaled, then if one was carcinogenic the other must also be carcinogenic. This assumption is chemically incorrect and was rejected.
The CRS examination of the various studies concluded that someone exposed to significant second hand smoke—a spouse for example—might increase their risk of dying from lung cancer to 2/10 of one percent, while those who are exposed on the job would have less risk: 7/100 of one percent.
The most devastating opinion about the EPA’s decision to classify second hand smoke as a class A carcinogen, came from Federal Judge William Osteen who interviewed scientists for four years and in 1998 opined,
The Agency disregarded information and made findings based on selective information… [The EPA] deviated from its risk assessment guidelines; failed to disclose important (opposing) findings and reasons; and left significant questions without answers… Gathering all relevant information, researching and disseminating findings, were subordinate to EPA’s [goal of] demonstrating [that] ETS was a Group A carcinogen… In this case, the EPA publicly committed to a conclusion before research had begun; adjusted established procedure and scientific norms to validate the Agency’s public conclusion, and aggressively utilized the Act’s authority to disseminate findings to establish a de facto regulatory scheme…and to influence public opinion… While doing so, [the EPA] produced limited evidence, then claimed the weight of the Agency’s researched evidence demonstrated ETS causes cancer.
Dr. Simpson made the following conclusion:
The press frequently overlooks inconsistent data when reporting about environmental tobacco smoke. The most recent example was when a group of radiologists noted that one-third of patients who had never smoked, but were exposed to “high levels” of second hand smoke, showed MRI changes in their lungs similar to the changes seen in smokers. What failed to make the mainstream news was that two-thirds of the patients who were listed as non-smokers, but exposed to “high levels” of second hand smoke, paradoxically, had lower diffusion through the lungs than the “low exposure” group. That is, they showed the opposite of changes seen with heavy smokers. Again, what made the news in most circles was that this was more proof about the negative effects of environmental tobacco smoke. What did not make the news was that the paradoxical report might prove the opposite of their conclusion. (Science Daily, 2007)
The Surgeon General was incorrect. Second hand smoke may be an irritant and an annoyance, but it’s not a cause of death. There are no body bags filled with those who have developed tumors or heart disease as a result of second-hand smoke. The body bags are filled, however, with scientists and physicians who dare go against the anti-smoking lobby and state the obvious—the science isn’t there. As much as they want to ban all smoking in all places, the health risk is grossly overstated. Whenever someone dies of lung cancer, such as Diane Reeves, the late wife of Christopher Reeves, the anti-smoking lobby uses the news as a media circus. They want to relate the unfortunate death to something… even if such a relationship has no basis in solid scientific research.
In 1633, the Catholic church condemned Galileo for asserting that the Earth revolves around the sun. Galileo was forced to recant his scientific findings to avoid being burned at the stake. This was a clear conflict between faith and science.