Media Lets the Surgeon General Get Away With "THE DEBATE IS OVER" on 2nd-hand Smoke

[Pangloss]

Here's a link to the surgeon general's report, released today amidst great hoopla, with all the major news networks headlining tonight's broadcasts with the story:

 

http://www.surgeongeneral.gov/library/secondhandsmoke/report/

 

I haven't read it yet (so I will try to keep an open mind), but as I understand it, the report offers no new science whatsoever. No causal evidence has ever been offered that secondhand smoke causes anything at all! It's all simple statistical correlations, many of which are within the margin of error of the study!

 

I guess I can understand the aspect of this that relates to smoking parents raising children in smoking environments. Ironically, however, that will be the VERY LAST PLACE where smoking is eliminated! Virtually everything in this report and how it was presented in the news was about smoking in restaurants and bars, where your exposure is very limited!

 

What do you all think?

[ecoli]

I'm all for not confusing causation with correlation, but, if you have chain smoking parents, but never once touched a cigarette, and somehow you still get emphasema, it's not f-ing correlation.

 

/me is drowning in a sea of stupidity.

[ecoli]

Industry documents indicate that the tobacco industry has engaged in widespread activities' date=' however,

that have gone beyond the bounds of accepted scientific practice (Glantz 1996; Ong and Glantz 2000, 2001; Rampton and Stauber 2000; Yach and Bialous 2001; Hong and Bero 2002; Diethelm et al. 2004). Through a variety of organized tactics, the industry has attempted to undermine the credibility of the scientific

evidence on secondhand smoke. The industry has funded or carried out research that has been judged to be biased, supported scientists to generate letters to editors that criticized research publications, attempted to undermine the findings of key studies, assisted in establishing a scientific society with a journal, and attempted to sustain controversy even as the scientific community reached consensus[/quote']

 

Surprize, surprize.

[KLB]

I saw an interview with the Surgeon General tonight on the News Hour. Jim Lehrer questioned him pretty hard and the Surgeon General made some very strong arguments. Even when baited, the Surgeon General refused to endorse a nationwide smoking ban in public places, but he did say he hoped local governments and private businesses would act on their own.

 

I think this report should really put a nail in the coffin so to speak on the debate about about second hand smoke. I imagine that later tonight or tomorrow the interview will be on the News Hour's website at: http://www.pbs.org/newshour/

[JustStuit]

I don't know if it is unhealthy, but I can't even eat when there is smoke around. On a cruise ship with people smoking all around I had to go to my cabin and order food. It makes it more enjoyable for most without smoke.

[Severian]

There is no boubt that second hand smoke causes cancer. The only question is whether the risk of cancer from second hand smoke is tolerable or not.

[Cap'n Refsmmat]

http://en.wikipedia.org/wiki/Passive_smoking

 

29 experts from 12 countries say:

"These meta-analyses show that there is a statistically significant and consistent association between lung cancer risk in spouses of smokers and exposure to secondhand tobacco smoke from the spouse who smokes. The excess risk is of the order of 20% for women and 30% for men and remains after controlling for some potential sources of bias and confounding."

Another study:

"Experimental studies in which animals are exposed to tobacco smoke have produced results supporting the view that exposure to secondhand or 'environmental' tobacco smoke is carcinogenic."

Many other groups agree. There's hardly any dispute on the subject right now. Let's not sensationalize things.

[bascule]

I recently asked the EPA why they don't regulate the presence of alpha emitters in cigarettes. They told me they aren't authorized to do so.

 

Ed Martell's paper has convinced me that alpha emitters are one of the most potent carcinogens in cigarettes:

 

http://www.pnas.org/cgi/content/abstract/80/5/1285

 

Those still unconvinced may wish to read Philip Morris's take on Martell's original paper:

 

http://tobaccodocuments.org/youth/CgHmPMI19800402.Me.html

 

I'm compiling a letter I plan to send to my senator asking him to give the EPA the authority to regulate alpha emitters in cigarettes.

 

I'm convinced that if cigarettes are required, by government mandate, to be free of alpha emitters, particularly polonium-210 and lead-210, that the incidence of cigarette-related cancers will be dramatically reduced.

 

I certainly believe that secondhand smoke causes cancer. I also believe it doesn't have to.

 

Marlboros, made by Philip Morris, contain higher levels of another carcinogen, nitrosamine, than any other cigarette in the world. Nitrosamine forms on flue-cured tobacco leaves during the curing process through a chemical reaction between nicotine and other compounds contained in the uncured leaf and various oxides of nitrogen found in all combustion gases. However, switching to indirect-fire curing has been shown to reduce nitrosamine to undetectable levels (less than 0.1 part per million).

[KLB]

There is no boubt that second hand smoke causes cancer. The only question is whether the risk of cancer from second hand smoke is tolerable or not.

This will be a totally unscientific reply and instead will look at the question from a more philosophical/societal stance.

 

In answer to your question, to a non-smoker, no amount of risk from second hand smoke is tolerable. Why should someone else be able to put my health at risk simply to satisfy their addiction? To me, smokers should not be allowed to harm or potentially harm others especially non-smokers. This isn't a matter of personal choice. People do not have a choice not to breath thus they can not choose not to breath in second hand smoke if it is present. Also, this is a public health issue. Society should also not be forced to pay the medical costs associated with the diseases caused by second hand smoke.

 

No longer can smokers rely on pseudoscience from bad tobacco industry funded studies to try and cause doubt about the risks associated with second hand smoke. This report isn't based on one study. It is based on hundreds of studies conducted over decades. Now it is time to clean the air of our public places.

[Pangloss]

Folks I admit that I haven't read or understand all the science or studies on this, so please feel free to correct or enlighten me. But what I'm hearing from this thread is that I should believe what I'm told because of who's telling me, not because of any science. What difference does it make what the tobacco industry has done, or how many "experts believe"? Shouldn't the decision be based on SCIENCE? When did we set aside the notion that science has to be demonstrably true and available to everyone, and settle for the notion that we only have to listen to the most politically correct data analysts?

 

According to ABC News, at some point in this report, the Surgeon General states -- STATES -- that 50,000 people die annually due to brief, casual contact with second-hand smoke, such as from bars and restaurants! This in spite of the fact that there is not one shred of causal evidence in this entire report! As I understand it, it's all statistical studies!

 

But, again as I understand it, statistics can never show a causal relationship. Not ever! So how can anyone state that something is factual when only a statistical study has ever been done?

 

Am I missing something here? Aren't we just perpetuating pseudoscience at the expense of science just because we all hate tobacco companies? What kind of nonsense is that?

[Cap'n Refsmmat]

"Experimental studies in which animals are exposed to tobacco smoke have produced results supporting the view that exposure to secondhand or 'environmental' tobacco smoke is carcinogenic."

My post above. Not a statistical study.

[Pangloss]

But animals are not people, and didn't that study expose those animals to VASTLY higher levels of smoke, more akin to PRIMARY smoking levels than anything we might call second-hand?

 

I'm sorry, I don't mean to be critical of anyone here, and obviously I'm way out of my depth here (hell, I can't even quote a source for the above, it's just something I read which for all I know might have been tobacco industry nonsense). Obviously I need to read more in order to actually form an opinion on this.

 

But you guys see my concern, right? I don't know, this thing just reeks of not even being able to pass the stink test. 50,000 people per year die just because they got a whiff from a stogey three tables away one New Year's Eve? Come on!

[KLB]

Folks I admit that I haven't read or understand all the science or studies on this, so please feel free to correct or enlighten me. But what I'm hearing from this thread is that I should believe what I'm told because of who's telling me, not because of any science.

Yes you are missing something. The surgeon general isn't just stating something for political purposes. His statements are based on the conclusions drawn in the 670-page study that is based on hundreds (note HUNDREDS) of scientific studies over decades. This is his point. Time for debate is over. The evidence has gone well beyond indicating a possible connection. It has has become so overwhelming as to be beyond debatable any longer. No I didn't read all 670 pages, but the conclusions shouldn't come as a suprise to anyone. This issue has been studied for decades and over those decades study after study kept drawing the same conclusions.

 

Here is the link to the surgeon general's interview on the News Hour I mentioned earlier as they have now posted it: http://www.pbs.org/newshour/bb/health/jan-june06/smoke_06-27.html

 

Here are some other news coverage on the report:

http://www.medpagetoday.com/PrimaryCare/Smoking/tb/3640

http://www.washingtonpost.com/wp-dyn/content/article/2006/06/27/AR2006062700525.html

http://www.usatoday.com/news/health/2006-06-27-smoking-report-qanda_x.htm

http://www.latimes.com/news/science/la-sci-smoking28jun28,0,6728507.story?coll=la-home-headlines

 

Here is the report itself if you are not satisfied with taking the surgeon generals word at what the report contains:

http://surgeongeneral.gov/library/secondhandsmoke/

 

Anyone who still wants to cast doubt on the health risks on second hand smoke are just trying to stick their head in the sand.

[Pangloss]

So the only difference between Richard Carmona saying "time for debate is over" and Dick Cheney saying "there can be no doubt that Saddam Hussein has weapons of mass destruction" is that one of them had proper political goals, and the other one had improper political goals? I mean, they both had plenty of "statistics" and "intelligence" -- who am I to say that one of them is right and the other one is wrong?

 

And the proof of this is a bunch more media reports, and another interview?

 

And this is science?

[KLB]

But animals are not people, and didn't that study expose those animals to VASTLY higher levels of smoke, more akin to PRIMARY smoking levels than anything we might call second-hand?

 

Let's go back to our never ending evolution "debates" and why evolution is so important to biological sciences and in particular biomedical research. Our understanding of evolution and the relationships between different species allow us to understand how things that affect animals also affect humans. Furthermore there is plenty of direct human evidence provided over the years of research that there is health risks without relying on research animals.

 

Also over the years I've seen or read different reports/articles that talk about how second hand smoke can actually be more concentrated than primary smoke because the filters on cigarettes. As a result primary smoke could actually be less of a threat than secondary smoke. The reports I saw were years ago so I couldn't bring them up, but I'm sure this issue would be addressed somewhere in the piles of research reports referenced. In the surgeon general's report. Simply think about the fact that in a smoke filled room, when one draws in through the filter the smoke is filtered, yet the second hand smoke is completely unfiltered.

[KLB]

So the only difference between Richard Carmona saying "time for debate is over" and Dick Cheney saying "there can be no doubt that Saddam Hussein has weapons of mass destruction" is that one of them had proper political goals' date=' and the other one had improper political goals? I mean, they both had plenty of "statistics" and "intelligence" -- who am I to say that one of them is right and the other one is wrong?

 

And the proof of this is a bunch more media reports, and another interview?

 

And this is science?[/quote']

No you are skipping over the report itself that was written by scientists and compiled over decades from all over the world. Dick Cheney's evidence was cherry picked and drawn together in a hasty haphazard fashion. Comparing Dick Cheney's reports and the surgeon general's report is like trying to compare intelligence design and evolution.

 

The surgeon general's report should come as no surprise to anyone. Can you bring forth hundreds of credible research reports complied over decades that second hand smoke poses no health risks the way the surgeon general brought forth hundreds of reports to support his conclusions? And don't go debunking his evidence if you aren't even willing to look at it.

 

 

• The National Toxicology Program estimates that at least 250 chemicals in secondhand smoke are known to be toxic or carcinogenic (cancer causing).

• Secondhand smoke contains a number of poisonous gases and chemicals' date=' including hydrogen cyanide (used in chemical weapons), carbon monoxide (found in car exhaust), butane (used in lighter fluid), ammonia (used in household cleaners), and toluene (found in paint thinners).

• Some of the toxic metals contained in secondhand smoke include arsenic (used in pesticides), lead (formerly found in paint), chromium (used to make steel), and cadmium (used to make batteries).

• There are more than 50 cancer-causing chemicals in secondhand smoke that fall into different chemical classes, including:

[indent']o Polynuclear aromatic hydrocarbons (PAHs) (such as Benzo[a]pyrene)

o N-Nitrosamines (such as tobacco-specific nitrosamines)

o Aromatic amines (such as 4-aminobiphenyl)

o Aldehydes (such as formaldehyde)

o Miscellaneous organic chemicals (such as benzene and vinyl chloride) and

o Inorganic compounds (such as those containing metals like arsenic, beryllium, cadmium, lead, nickel and radioactive polonium-210).

 

• Eleven compounds in tobacco smoke (2-naphthylamine, 4-aminobiphenyl, benzene, vinyl chloride, ethylene oxide, arsenic, beryllium, nickel compounds, chromium, cadmium and polonium-210) have been identified by the International Agency for Research on Cancer as Group 1 (known human carcinogen) carcinogens.

• Secondhand smoke has been designated as a known human carcinogen (cancer-causing agent) by the U.S. Environmental Protection Agency, National Toxicology Program and the International Agency for Research on Cancer (IARC). The National Institute for Occupational Safety and Health has concluded that secondhand smoke is an occupational carcinogen.

• Secondhand smoke is composed of sidestream smoke (the smoke released from the burning end of a cigarette) and exhaled mainstream smoke (the smoke exhaled by the smoker). Because sidestream smoke is generated at lower temperatures and under different conditions than mainstream smoke, it contains higher concentrations of many of the toxins found in inhaled cigarette smoke.

[/indent]

Now I will provide a little evidence of my own. Note data from my webpages is all compiled from OSHA, USDOT and EPA regulations, NIOSH guidelines, the US DOT Emergency Response Guidebook, NFPA (National Fire Protection Administration) and material safety datasheets from manufacturers of various chemicals in my database.

 

Hydrogen Cyanide

http://environmentalchemistry.com/yogi/chemicals/cn/Hydrogen%A0cyanide.html

http://www.atsdr.cdc.gov/MHMI/mmg8.html

 

Butane: http://environmentalchemistry.com/yogi/chemicals/cn/Butane.html

 

carbon monoxide: http://environmentalchemistry.com/yogi/chemicals/cn/Carbon%A0monoxide.html

 

ammonia: http://environmentalchemistry.com/yogi/chemicals/cn/Anhydrous%A0ammonia.html

 

toluene: http://environmentalchemistry.com/yogi/chemicals/cn/Toluene.html

 

arsenic: http://environmentalchemistry.com/yogi/chemicals/cn/Arsenic%A0metal%A7%A0Arsenia.html

 

lead: http://environmentalchemistry.com/yogi/chemicals/cn/Lead.html

 

chromium: http://environmentalchemistry.com/yogi/chemicals/cn/Chromium%A0metal.html

 

cadmium: http://environmentalchemistry.com/yogi/chemicals/cn/Cadmium%A0dust.html

also see: http://environmentalchemistry.com/yogi/environmental/200605norwegiansalmon.html

 

formaldehyde: http://environmentalchemistry.com/yogi/chemicals/cn/Formaldehyde.html

 

I could continue, but I've just spent over an hour on this post. Cigarette smoke is full of really hazardous chemicals that ought not be put into the human body. Common sense says that if cigarette smoking is hazardous to one's health spending a life time breathing second hand smoke is also going to be hazardous.

 

The only reason a strong report about the dangers of second hand smoke didn't come out sooner is because if one was going to set the stage for a report that would lead to the banning the consumption of a legal product in public spaces, then the evidence had better be so over whelming that smokers and the tobacco industry could no longer defend smokers' "right" to smoke in public places. I think we will find that this report will mark a massive turning point in smoking in America where non-smokers will finally demand that smoking be banned in public places across the entire country.

 

Again I challenge anyone who doesn't believe that second hand smoke is hazardous to human health to provide as much or more evidence to support your claim as the surgeon general provided in his report proving that second hand smoke is hazardous.

[Pangloss]

Ken, I appreciate the effort you put into your post. Certainly the least I can do is try to keep an open mind about this and take a hard look at the new analysis that's being presented here. I am willing to look at the evidence and the report, and I support your criticism of the concerns that I raised.

 

Common sense says that if cigarette smoking is hazardous to one's health spending a life time breathing second hand smoke is also going to be hazardous.

 

That seems logical enough to me. I can't imagine parents taking that kind of risk with their children.

 

But as I mentioned above, the main thrust of this report seems to be aimed at casual and brief contacts with second-hand smoke. Walking past a smoker outside a building. Catching a whiff from three tables away in a restaurant. That sort of thing.

 

Are we really saying that second-hand smoke is as dangerous as asbestos?! Is that actually backed-up by this data? Really?!

[Pangloss]

Also, do you understand the concern that I have about the larger issue here?

 

Am I completely wrong in wondering why a complete re-analysis of existing data by people with an admitted agenda holding massive press conferences and sounding tremendous alarm bells is substituting for actual science in the form of NEW data and NEW studies?

 

It just seems to me that we may be, once again, taking away the rights of human beings, on the basis of simple statistical correlations, merely because the right that those particular human beings are enjoying is antithetical to the ideology of the scientists (and their money men) doing the investigating.

 

We would all agree that that, if it were true, is a bad thing, right?

[bascule]

Folks I admit that I haven't read or understand all the science or studies on this, so please feel free to correct or enlighten me. But what I'm hearing from this thread is that I should believe what I'm told because of who's telling me, not because of any science. What difference does it make what the tobacco industry has done, or how many "experts believe"? Shouldn't the decision be based on SCIENCE? [b']When did we set aside the notion that science has to be demonstrably true and available to everyone, and settle for the notion that we only have to listen to the most politically correct data analysts?[/b]

 

Pangloss, here's the abstract from the Martell paper:

 

http://www.pnas.org/cgi/content/abstract/80/5/1285

 

Synergistic interactions of indoor radon progeny with the cigarette smoking process have been evaluated experimentally. Smoking enhances the air concentration of submicron particles and attached radon decay products. Fractionation in burning cigarettes gives rise to the association of radon progeny with large particles in mainstream cigarette smoke, which are selectively deposited in "hot spots" at bronchial bifurcations. Because smoke tars are resistant to dissolution in lung fluid, attached radon progeny undergo substantial radioactive decay at bifurcations before clearance. Radon progeny inhaled during normal breathing between cigarettes make an even larger contribution to the [math]\alpha[/math]-radiation dose at bifurcations. Progressive chemical and radiation damage to the epithelium at bifurcations gives rise to prolonged retention of insoluble ²¹⁰Pb-enriched smoke particles produced by tobacco trichome combustion. The high incidence of lung cancer in cigarette smokers is attributed to the cumulative [math]\alpha[/math]-radiation dose at bifurcations from indoor radon and thoron progeny--²¹⁸Po, ²¹⁴Po, ²¹²Po, and ²¹²Bi--plus that from ²¹⁰Po in ²¹⁰Pb-enriched smoke particles. It is estimated that a carcinogenic [math]\alpha[/math]-radiation dose of 80-100 rads (1rad=0.01J/kg=0.01 Gy) is delivered to [math]10^7[/math] cells ([math]10^6[/math] cells at individual bifurcations) of most smokers who die of lung cancer.

 

Cigarette smoke contains ionizing alpha emitters. Of course it's going to cause cancer. Secondhand smoke has not been filtered and is more hazardous than that inhaled directly by smokers.

 

I compiled a letter to my senators tonight which I'm sending off tomorrow, calling for them to grant the EPA the power to regulate alpha emitters in cigarettes. We'll see what happens.

[Dak]

But, again as I understand it, statistics can never show a causal relationship. Not ever! So how can anyone state that something is factual when only a statistical study has ever been done?

 

That's true to a degree. for example, proving a correlation between secondary smoke and cancer (which it is possible to do statistically) doesn't neccesarily prove that secondary smoke causes cancer: they could have a common cause, for example.

 

BUT, it is possible to come to the desision that causation is significantly more likely than shared-cause.

 

Espescially when we consider that a causative relationship between primary smoke and cancer has been proven.

 

Also, do you understand the concern that I have about the larger issue here?

 

Am I completely wrong in wondering why a complete re-analysis of existing data by people with an admitted agenda holding massive press conferences and sounding tremendous alarm bells is substituting for actual science in the form of NEW data and NEW studies?

 

I've not read the report, and, having seen the size, i'm not going to. but, in answre to your question, existing data can be presented as new data in one of two ways:

 

meta-analysises: data is draw from several different studies, 'normalilsed' so that the data forms one, large, data set, and then statistical investigations are carried out on that large data set, which are often more revealing than the smaller investigations.

 

reviews: numerouse studies, usually at the forefront of knowledge (at the time of the reviews righting), are brought together and synthesised into one cohesive set of knowledge. whilst not original research per se, reviews often reveal facts that are obfuscated when the knowledge is fractured amongst many different papers, each with a narrower scope, and usually present a clearer and easyer-to-access picture than the individual papers.

 

having skimmed through some of the preface, it looks like this is a review.

 

anyway,

 

Twenty years ago when Dr. C. Everett Koop released the Surgeon General’s report, The Health Consequences of Involuntary Smoking, it was the first Surgeon General’s report to conclude that involuntary exposure of nonsmokers to tobacco smoke causes disease. The topic of involuntary exposure of nonsmokers to secondhand smoke was first considered in Surgeon General Jesse Steinfeld’s 1972 report, and by 1986, the causal linkage between inhaling secondhand smoke and the risk for lung cancer was clear. By then, there was also abundant evidence of adverse effects of smoking by parents on their children.

 

looks like the review is treating the fact that secondary hand smoke causes health problems as a fact that has been demonstrated to be true in a previouse surgeon general's report.

 

as for the 'agenda', i'd guess that depends on wether the agenda was based on the evidence, or the evidence on the agenda.

[YT2095]

I don't know if it is unhealthy, but I can't even eat when there is smoke around.

 

LOL

 

as a 20-a-day smoker myself, I`m exactly the same as you, I don`t like smoking done around me whilst I`m eating either (unless it`s BBQ smoke or a campfire).

so you`re not alone in that feeling either:cool:

[KLB]

as for the 'agenda', i'd guess that depends on wether the agenda was based on the evidence, or the evidence on the agenda.

Pangloss, I think this is a very important observation to your Dick Cheney vs. surgeon general question earlier. It is very clear from the evidence I provided in our other discussion that Dick Cheney and the Bush administration made the evidence fit the agenda. In this case the agenda is public health based on hard science. Since the first surgeon general report was published in 1964 on smoking mountains of evidence has been building up that has lead to the conclusion that smoking is a serious public health concern.

 

The tobacco industry was a very/is a very big industry with a very powerful lobby. Politically speaking bringing forth reports that suggest there should be public smoking bans that infringe on people's liberties is going to be very unpopular among some segments of the population. If there is going to be any instances of the evidence being built upon an agenda, it is going to be (and has been) by those who stand to lose the most by public smoking bans (the tobacco industry).

 

As we have seen over the Iraq war issue, agenda lead evidence rarely withstands intense scrutiny for very long, yet the issue of the health risks related to second hand smoke was raised by a surgeon general twenty years ago and the evidence has only gotten more compelling. If this evidence had been agenda driven, it would have been completely debunked years ago by the tobacco industry.

[Pangloss]

Okay, I appreciate all the replies on this (and their tone). You've given me a lot of reading material and obviously I should read all this stuff before I comment further. You've given me a lot to think about as well. These are, of course, the very reasons why I post here. Thanks guys.

[GutZ]

This will be a totally unscientific reply and instead will look at the question from a more philosophical/societal stance.

 

In answer to your question' date=' to a non-smoker, no amount of risk from second hand smoke is tolerable. Why should someone else be able to put my health at risk simply to satisfy their addiction? To me, smokers should not be allowed to harm or potentially harm others especially non-smokers. This isn't a matter of personal choice. People do not have a choice not to breath thus they can not choose not to breath in second hand smoke if it is present. Also, this is a public health issue. Society should also not be forced to pay the medical costs associated with the diseases caused by second hand smoke.[/quote']

 

As a smoker I agree. I don't smoke near people, and I will move away from people that come close to me, especially children. There is a limit though. Yes people can't choose to breath, but there are other pollution sources as well. Cars, factories, etc. We all suffer from those, and it seems at times that a person who does not smoke blame smokers simply because it's easier, wanting to ban smoking all together. I am all for keeping it isolated from people in public but when someone drives to the corner store with their SUV leaving it running...I become less sympathic.

 

Smoking is banned in all public places in Canada, how is it in the US?

[ecoli]

Smoking is banned in all public places in Canada' date=' how is it in the US?[/quote']

 

Depends what state you live in, and even what county. My county, public smoking is banned if you indoors, and even outdoors in places like schools.