Liberty and Medicine

Sunday, March 25, 2007

Health Facts And Fears: The Intolerance and Arrogance of the Modern-Day Anti-Smoking Movement

By Elizabeth M. Whelan, Sc.D., M.P.H.

Cigarettes kill. Cigarettes are bad for your health. The American Council on Science and Health has made that clear since we opened our doors in 1978. Cigarette smoking is the leading preventable cause of premature death, accounting for approximately 400,000 deaths annually in the U.S. -- nearly one in every four deaths, and one in every two premature deaths each year.

But we at ACSH hold to the belief that the best way to lose an argument is to overstate it. And overstatement is exactly what a growing number of members of the anti-smoking community are doing. Indeed, anti-smokers are becoming increasingly unscientific, arrogant, absolutist, and intolerant of dissenting views.

Two immediate examples come to mind.

First, scientific studies from around the world have now confirmed that smokeless tobacco is far less hazardous to health than is cigarette smoking.

No sane public health professional would advocate that non-smokers take up the use of smokeless tobacco. But it is an undeniable fact that, for an addicted, inveterate cigarette smoker, the use of a smokeless product instead of cigarettes would dramatically reduce the level of health hazard he or she faces. The switch from cigarettes to smokeless tobacco in men in Sweden -- and the resulting decline in lung cancer and other systemic diseases associated with cigarette smoking -- is stark evidence of this harm-reduction phenomenon. While the risks of oral cancer associated with smokeless tobacco are still a concern, it is important to note that (a) the risks of oral cancer from cigarette smoking have always been significantly greater than the risks of oral cancer from using smokeless and (b) the smokeless products have been chemically altered over the years to significantly reduce the risk of oral cancer.

But the anti-smoking community has been vocal in its rejection of smokeless tobacco as a means of harm reduction for addicted cigarette smokers.

Indeed, their protests against smokeless have been so loud and permeating that they even misled the United States Surgeon General, Dr. Richard Carmona, into stating that smokeless tobacco was no less hazardous than cigarette smoking -- a clearly false statement.

About four years ago, ACSH hosted a media seminar on harm reduction as it relates to cigarette smoking and alcohol abuse. ACSH brought in speakers representing a variety of views, including one anti-smoker who vehemently rejected the option of smokeless tobacco as a means of harm reduction for cigarette smokers. Despite ACSH's attempt at balance, veteran members of the anti-smoking community were irate that ACSH was hosting such a meeting, and one anti-smoking leader called ACSH to announce that I would be "excommunicated" from the anti-smoking movement if I moved forward with this event. (ACSH did move forward, so I guess I am out.)

The message of the anti-smokers seems to be this: "Tobacco in all forms is bad and should not be tolerated. Cigarette smokers have only two choices: give up tobacco or die."

ACSH begs to differ.

Second, the anti-smoking movement has gone off the deep end over secondhand smoke (also known as environmental tobacco smoke).

Sure, exposure to cigarette smoke has all types of negative acute effects, including increased risk of earaches, inner ear infections, asthma, upper respiratory ailments, and more. No argument about that. And it smells nasty, makes your clothes and hair stink, and can ruin a perfectly nice dinner (ACSH did a report in 1999 on the limited but real effects of secondhand smoke).

But anti-smokers can't let it rest at that. They claim that even transient exposure to secondhand smoke causes everything from breast cancer to heart disease.

A few egregious examples: a leading tobacco researcher made the improbable claim that the smoking ban in Helena, Montana resulted in a 40% decline in heart attack admissions in a six-month period after the ban. "We used to think that heart disease came after years of exposure" said Dr. Richard Sargent, an anti-smoking Montana physician, who then went on to argue that even short-term exposure to exhaled smoke can damage the heart: "if you go into a restaurant for a sandwich, if you go into a bar for a beer, and you get exposed to a heavy amount of secondhand smoke, you're just as at risk for a heart attack as a smoker."

Sargent, vice chairman of the Montana Tobacco Advisory Board, noted that secondhand smoke has "an acute, rapid effect on the heart...[T]hirty minutes of exposure doubles your risk for the next forty-eight hours."

Americans for Nonsmokers' Rights makes similar claims: "even a half hour of secondhand smoke exposure causes heart damage similar to that of habitual smokers. Nonsmokers' heart arteries showed a reduced ability to dilate, diminishing the ability of the heart to get life-giving blood."

Give me a break.

While being exposed to cigarette smoke for hours a day for many years certainly could have negative effects, it is unacceptable to use such exaggerated claims to justify a ban on smoking.

The good news is that the radical anti-smoking movement may at last have met its, er, match. Dr. Michael Siegel, a physician specializing in preventive medicine -- and an anti-smoking activist in his own right -- is taking on these hyperbolists. In his Tobacco Analysis blog, he calls these claims -- often used to justify outdoor smoking bans -- "ridiculous."

Funny thing about communication in science and medicine. When a politically correct theory or claim takes hold and is loudly trumpeted ( as in "secondhand smoke, even in trace amounts, kills"), dissenters are terrified to step forward and challenge that theory lest (a) they be called apologists for, in this case, the cigarette industry or (b) they be accused of not getting on the bandwagon of what is an inherently good public health cause.

At this point, with their hype and self-righteousness, the anti-smokers really have gone too far -- they have triggered a counterattack. Stay tuned for a major magazine expose by a well-known journalist (and network TV segment) on the smoke-and-mirrors statistics being spewed out by anti-smokers who decry the health effects of secondhand smoke to justify banning even outdoor smoking.

The moral of the story: stick to science. Cigarette smoking is a multi-faceted disaster for the smoker and for those who are exposed to secondhand smoke for long periods of time. Nothing is to be gained by exaggerating this already-grim story to get even more attention. The only result of such hyperbole is the loss of credibility of the public health profession.

Reprinted from the American Council on Science and Health.

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At 5:01 AM, Blogger M. Simon said...

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You can look it up.

To say there are no benefits from smoking is rediculous.

In addition our public understanding of "addiction" is almost 100% superstition.

Is Addiction Real?

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