Orac finds some super-cranks

I thought the denial of the link between smoking and cancer had gone out of style. The link between smoking and cancer is so thoroughly established that I thought no one could continue to defend cigarettes with a straight face.

Well, all Orac has to do is write a piece about the evidence for a health risk from second-hand smoke and soon enough the denialists come crawling out of the woodwork. The reason is pretty simple, smoking bans are unpopular with a certain group of people, and what do you do when science suggests something that people don't want to believe? Well, you whip out the tactics of course.

Orac then follows the trail of BS back to one of the more incredible crank sites I've ever seen. It's called forces.org, and it meets every single possible criteria of both crankery and denialism. It's pretty incredible. They have conspiracy theories about drug companies being behind smoking bans to promote their nicotine replacements and anti-addiction drugs. They have quote-mines galore (every scientific paper they cite is misquoted, it's incredible). They have these unbelievable crank fake experts. They clearly aren't convinced by any amount of scientific evidence or expertise. And their logical fallacies are great! Not only do they conflate all sorts of different cancers, it seems that if something besides smoking can cause any type of cancer, then it must cause all cancers - including those cigarettes have been falsely implicated in. All of this is permeated by one of the more hilarious persecution complexes about their rights being violated because they can't persist in a behavior that is a nuisance and health-hazard to other people.

The point of the site seems mostly to be opposition of the extension of smoking bans, and their reasoning is somewhat intriguing, at the same time it's hilariously self-defeating. According to the mission statement of their West Virginia division, they have no chance to oppose smoking bans because there is no legitimate right to be a nuisance and hurt others' health in public. Therefore they have to make sure to deny the science until they die of old age (or cancer). It's almost like a public admission of using denialist tactics.

For ten long years, most of the activists in the United States have been fighting the smoking bans on "Rights Issues", whether they are Property Rights, Constitutional Rights, Personal Rights, Smokers Rights - even Personal Freedoms.

They have yet to have a win that has not immediately been lost at the anti tobacco extremists' whim and will.

The "smokers rights" arguments have yet to stop the any of the anti smokers, anywhere, with a permanent win. They get occasional concessions such as instead of a total ban, the antis will allow smoking in bars for a year or so, but the antis always come back and do the 'total ban'.
...
But one would think after ten years of a losing argument they might re evaluate the argument. I put the links there so you would know you are not alone in wanting to stop this - but there is an unsuccessful way to do it also.

Let's look a little closer at the "Property Rights" issue.

That is certainly an important consideration and under proper circumstances property rights, as well as all other "rights" should be taken very seriously.

Were ETS to actually present the extraordinary health risks that anti-tobacco activists claim, however, bingo halls and state run casinos would have no more "right" to permit it in their establishments than they have a right to serve tainted food or contaminated drinking water

When it comes to addressing well-documented and certain health risks that are credibly proven by legitimate science public health departments are properly granted very strong powers of inspection and enforcement..

Should there be a breakout of typhoid any where in West Virginia the Health Departments would quite properly demand that the business owner repair an open cess-pool behind their establishment. Were the dinking water in a bar shown to include dangerous bacteria well above established limits that bar would be required to fix the problem or close their doors.

Any bar or tavern owner who refused to do so because they had "rights" would properly be cited and then closed down if they persisted in refusing to address that threat to public health.

So, they acknowledge they don't have a legal leg to stand on if cigarettes cause cancer and second-hand smoke is a legitimate environmental toxin. What is there left to do? Well, deny the science of course!

Orac does a perfectly good job justifying the science behind second-hand smoke, and we don't even need to go into the proof that smoking causes cancer. But one only has to visit their EVIDENCE ARCHIVE to see these are some fantastically prolific cranks. They have literally hundreds of articles attacking the basis of cigarettes causing anything bad from cancer to emphysema! They even suggest that it's radiation from medical tests that is causing cancer, not the cigarette smoke. One could spend their life debunking this nonsense. Luckily, since we know the tactics of denialists, we don't need to waste our time carefully researching every single one of their claims. It only takes about one or two examinations of their sourcing as Orac does and you see, they're just quote-mining the literature, holding on to outdated studies, and generally pulling the same denialist garbage as any other crank out there. They also have the classic crank characteristic of latching on to any theory that is critical of the established science, no matter how horribly inconsistent it makes their position.

So visit, check it out, shudder, and come back. It's a trip.

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I don't have a problem with the science of second hand smoke: I don't have the ability to evaluate the science, but the consensus seems to be that it's moderately harmful, and given that smoking in general is clearly harmful, it's plausible on its face that even a smaller dose would be harmful.

However, I don't think that it's correct that property owners are losing the rights argument, and I gloating over that is not particularly becoming. The references to contaminated food and so forth are a false analogies. Smokingand is a risk done in return for pleasure and it is now a known risk, including if you choose to be around smokers. So I don't see why offerring smoking establishments is any better or worse than offering anything risky if everyone knows what they are getting into (including the workers). All sorts of professions have different levels of health risk, and people are free to choose amongst them. Of course, many anti-smoking advocates just aren't content with people freely choosing things if they make what they have decided are the objectively wrong choices (of course, they are far far from being coherent or consistent in this). I think that's wrong, ok?

"So, they acknowledge they don't have a legal leg to stand on if cigarettes cause cancer and second-hand smoke is a legitimate environmental toxin. What is there left to do?"

I guess establish that alcohol causes liver damage and contributes to traffic deaths of those who didn't even choose to go into the bar. We could call it... ummm...Prohibition.

How about Stanton Glance and his Helena heart study? If it comes out the way you want it's valid. What about diesel fumes in the inner city? I wonder if the effect of this had any influence in these so-called studies?

Bad argument, because alcohol doesn't cause liver damage in people who do not consume it. SHS from tobacco does cause health problems in people who are not smoking the tobaccco.

While you are so busy laughing at forces.org, please explain something.

If SHS is a health risk that is of such a magnitude that bans are imposed on perfectly legal behavior on private property to protect workers - then how can other workers be required to work in toll booths and mines and plating factories or welding stations?

oh yes - that is right. OSHA protect workers through legislation that establishes standards and requires the employer to meet those standards by any means it chooses (ie isolate the worker, isolate the source of the risk or provide ventilaton.

But in comparison to fumes from vehicle exhaust, mine gases, tanks of pure chromium and nickel and welding fumes, the smoke from burning less than a gram of dried leaves is so toxic that there is no "safe" level of exposure, ventilation is not an option, isolation is not an option -the only option is for public health to step in and ban indoor smoking on private property.

Are you absolutely 100 % sure that its forces that has a little difficulty with logic?

By Michelle Gervais (not verified) on 17 Jul 2007 #permalink

The folks over at Forces.org have said for the longest time that private business owners should choose whether to allow smoking in their establishments.

That is, until Marriott decided go smoke free. You know Marriott, right? It's a private business.

Well, Forces promptly put up on its website an image of KKK members next to a link to a story about Marriott's private business decision (to go smoke free).

Instead of praising Marriott for making a private business decision about smoking, Forces instead chose to contradict itself.

Finally, what Forces didn't say was that if a smoker doesn't like Marriott's (private business) decision (about smoking on its property), he doesn't have to stay there. He has a choice.

By Forces' Hypocracy (not verified) on 17 Jul 2007 #permalink

Unbelievable.

Like people who argue for both sides of the issue you lose objectivity and go off on a SHS rant.

Yup, its risky for some people to smoke.
They could be the one out of five it will kill.

But in your rant you sound like the denier you despise.

Maybe you should stay away from issues you are too emotionally involved in.

"I guess establish that alcohol causes liver damage and contributes to traffic deaths of those who didn't even choose to go into the bar. We could call it... ummm...Prohibition"

"Bad argument, because alcohol doesn't cause liver damage in people who do not consume it. SHS from tobacco does cause health problems in people who are not smoking the tobaccco."

Orac -- slow down -- you have to read the WHOLE sentence -- the part AFTER the "and".

This is an interesting blog by the way. Although it would be good to remember that on controversial subjects the "denialism" sword cuts two ways.

One more thing, I'd like to leave with. And I don't think this is a "tactic". It's simply reasoning. IF you wanted to prohibit a product, say alcohol, would it be enough anymore to prove a primary harmful effect? (Seems not given your answer about alcohol) Your real chance is in demonstrating a secondary effect. Get the non-users on your side by convincing them that the product is harmful to non-users.

IF you were in a position to manipulate the science. You'd have it made.

I think you misunderstand the position of forces.org. What they are saying is that they are battling the "science" of SHS because they find it suspect. They trust science that was produced by pharmceutical funding NO MORE than that produced by tobacco companies. They may believe that the pharmaceutical industry has had the motive, means and the opportunity to scam the American public. Would this be the first time?

Perhaps rather than "denialists", they are "whistle-blowers".

One should remember that it was their argument I cited, not mine. I thought it was funny that they would argue that if SHS had health effects that public health regulation would be mandatory, and then all their proof that SHS does nothing was just denialist garbage. I don't think they win on rights or on the science behind the health.

As far as the sword cutting both ways, that's not what this blog is about. Denialism is not just an epithet, it's a specific set of tactics used to deny science. All of these tactics are present at the forces site.

They're not whistle blowers, their tactics are fundamentally deceptive. Quote-mining isn't some clever takedown of science, it's lying, it's deceit. Conspiracy theories about pharmaceutical companies, nicotine replacement product manufactureres and doctors etc., is just more silliness. The science is solid, and doesn't come from big pharma. It comes from the CDC, the EPA, the NIH, and public health agencies from around the world.

Ohhh.. I really have to get to that pizza. Good grief Mark. Now you are simply misinformed. The science comes from the funders. (I know -- that's what I do). And who are the biggest funders?

But I am happy enough to let people belive what they want to believe. I was just trying to clarify things.

But let me ask you. Is Richard Smith a denialist or a whistle-blower.

Sometimes it's hard to tell - huh?

http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10…

Medical Journals Are an Extension of the Marketing Arm of Pharmaceutical Companies

Richard Smith

Competing Interests: RS was an editor for the BMJ for 25 years. For the last 13 of those years, he was the editor and chief executive of the BMJ Publishing Group, responsible for the profits of not only the BMJ but of the whole group, which published some 25 other journals. He stepped down in July 2004. He is now a member of the board of the Public Library of Science, a position for which he is not paid.

"Journals have devolved into information laundering operations for the pharmaceutical industry", wrote Richard Horton, editor of the Lancet, in March 2004 [1]. In the same year, Marcia Angell, former editor of the New England Journal of Medicine, lambasted the industry for becoming "primarily a marketing machine" and co-opting "every institution that might stand in its way" [2]. Medical journals were conspicuously absent from her list of co-opted institutions, but she and Horton are not the only editors who have become increasingly queasy about the power and influence of the industry. Jerry Kassirer, another former editor of the New England Journal of Medicine, argues that the industry has deflected the moral compasses of many physicians [3], and the editors of PLoS Medicine have declared that they will not become "part of the cycle of dependency...between journals and the pharmaceutical industry" [4]. Something is clearly up."

Interesting column Mark. I'd like to see you try to criticize some of my own work on the subject. For starters, how abour my Critique of the Welsh Goverment proposal for a smoking ban? Or some of the lies at my companion site www.TheTruthIsALie.com ? How about visiting the American Council on Science and Health and reading about the "passive fraud" committed by medical journals when they refuse to publish studies that might contradict their holy grail? (See: http://www.acsh.org/factsfears/newsID.990/news_detail.asp )

You might also enjoy today's Press Release from the SmokersClubInc.com site at:

http://kuneman.smokersclub.com/pr071707.html

Looking forward to hearing what you have to say. Feel free to comment on any of my other writings at the website below as well.

Michael J. McFadden
Author of Dissecting Antismokers' Brains
http://pasan.TheTruthIsALie.com

I guess establish that alcohol causes liver damage and contributes to traffic deaths of those who didn't even choose to go into the bar. We could call it... ummm...Prohibition

But drink driving is already illegal, so what's your point?

By Ian B Gibson (not verified) on 17 Jul 2007 #permalink

Dear Mr. Mark H. (afraid to post your last name?) I fear it is you my friend who gets 4 stars for partaking in the propaganda machine. It is you who has been sucked up into the cyclone of lies represented by the anti tobacco zealots. The joke will be on you in the end.

GDF makes an excellent point. If smoking bans were truly based on public health concerns those for them would also favor greater restrictions on alchohol, at the very least the requirement alchohol can only be consumed in the home.

Hello Mark. I tried posting this about two hours ago, but perhaps it got swallowed by cyberspace:

======

Interesting column Mark. I'd like to see you try to criticize some of my own work on the subject. For starters, how abour my Critique of the Welsh Goverment proposal for a smoking ban? Or some of the lies at my companion site www.TheTruthIsALie.com ? How about visiting the American Council on Science and Health and reading about the "passive fraud" committed by medical journals when they refuse to publish studies that might contradict their holy grail? (See: http://www.acsh.org/factsfears/newsID.990/news_detail.asp )

You might also enjoy today's Press Release from the SmokersClubInc.com site at:

http://kuneman.smokersclub.com/pr071707.html

Looking forward to hearing what you have to say. Feel free to comment on any of my other writings at the website below as well.

Michael J. McFadden
Author of Dissecting Antismokers' Brains
http://pasan.TheTruthIsALie.com

Dear Mr. Mark H. (afraid to post your last name?)

b rogers doesn't read too well, does he? Obviously he didn't bother to look at Mark's profile near the top of the blog.

Oh, you guys aren't cranks. No, that would be crazy.

I actually follow the PLoS coverage attacking DTCA and the influence of drug companies on the medical literature, but that has absolutely nothing to do with the work on cigarette smoking, and is essentially a cherry-pick of the literature. The authors do not assert that all or even a majority of the medical literature is faulty or bought. What they suggest is that the journal's dependence on advertising revenue from drug companies, as well as the creation of journals which exist as dumping grounds for crummy pharmaceutical science, leads to a contamination of the literature by low quality and biased research in pharmaceutical science.

This has nothing to do with epidemiologic evidence of smoking which is overwhelming. Further, don't quote to me from the ACSH, they're full of shit too, and I wouldn't trust them if they told me the sky is blue. I haven't had time to cover them yet, but they're regular contributors to the TCS daily and aren't a trustworthy source of information. It's amazing that I'm being accused of being on the side of some industry, like I'm shilling for Chantix or something, and then the biggest industry apologists ever are cited against me. The irony.

Now I undertand the idea of this "denialist" blog. Those who don't agree with your views are "cranks".

Richard Smith was saying nothing of the sort. It's almost laughable what you just said, given the very next paragraph (quoted below), after paragraph one that I quoted (above post). (and I provided the link so that you could read it ALL for yourself). And you got *dependence on advertising* and *existence of crummy journals* out of this?

"The Problem: Less to Do with Advertising, More to Do with Sponsored Trials
The most conspicuous example of medical journals' dependence on the pharmaceutical industry is the substantial income from advertising, but this is, I suggest, the least corrupting form of dependence. The advertisements may often be misleading [5,6] and the profits worth millions, but the advertisements are there for all to see and criticise. Doctors may not be as uninfluenced by the advertisements as they would like to believe, but in every sphere, the public is used to discounting the claims of advertisers.

The much bigger problem lies with the original studies, particularly the clinical trials, published by journals. Far from discounting these, readers see randomised controlled trials as one of the highest forms of evidence. A large trial published in a major journal has the journal's stamp of approval (unlike the advertising), will be distributed around the world, and may well receive global media coverage, particularly if promoted simultaneously by press releases from both the journal and the expensive public-relations firm hired by the pharmaceutical company that sponsored the trial."

Smith goes on to say...

"By 2003 it was possible to do a systematic review of 30 studies comparing the outcomes of studies funded by the pharmaceutical industry with those of studies funded from other sources [8]. Some 16 of the studies looked at clinical trials or meta-analyses, and 13 had outcomes favourable to the sponsoring companies. Overall, studies funded by a company were four times more likely to have results favourable to the company than studies funded from other sources. In the case of the five studies that looked at economic evaluations, the results were favourable to the sponsoring company in every case.

The evidence is strong that companies are getting the results they want, and this is especially worrisome because between two-thirds and three-quarters of the trials published in the major journalsAnnals of Internal Medicine, JAMA, Lancet, and New England Journal of Medicineare funded by the industry [9]. For the BMJ, it's only one-thirdpartly, perhaps, because the journal has less influence than the others in North America, which is responsible for half of all the revenue of drug companies, and partly because the journal publishes more cluster-randomised trials (which are usually not drug trials) [9]."

***************

Smith is focusing in this article "particularly" on clinical trials, as he notes, but would it be plausible that pharmaceutical companies influence their sponsored drug trials but have clean hands with the SHS epi research they fund?

Mark H, this is my first visit to your site and I have to say the title of the piece 'Cranks' is very apt. I think it is you who is the crank. I simply ask you to produce one piece of epidemiological research that reaches the necessary level of 3+ to indicate a causative association. Unless of course you dispute the accepted scientific communities perceived wisdom on the subject. If you do you are in good company because Professor Britton the head of ASH (UK), in an email exchange with me stated that epidemiology cannot prove or disprove the dangers of ETS. Strange really given ASH's continual reference to the meta analysis, which I am sure you are referring to as the 'overwhelming' evidence. He went on to quote 'plausable biological mechanism' etc as the 'proof'. When I pointed out that no PBM had ever been established for ETS, given the high levels of exposure for humans would make it unethical and at no time, using dangerously high levels of ETS, had research on rodents induced cancers associated with smoking. The truth is even the WHO's multi centre research by Boffatta etal in 1998 failed to prove ETS as anything more than an irritant. For anyone to say otherwise is indeed in DENIAL.

GDF,
It appears you are correct. I will re-read that paper as I did not remember the conclusions correctly.

I do not believe that changes the fact that epidemiologic studies performed using NIH grant money have anything to do with skewed pharmaceutical studies.

And yes I will continue to consider those who deny the science tying cigarette smoke to cancer to be cranks and denialists.

As far as the ACSH I think that needs clarification too.

The ACSH is actually quite an established group. Started almost 30 years ago now, it was in response to quite a lot of fearmongering in the popular press, and had a skeptical bent to evaluating health fears.

The ACSH has held the position continuously that tobacco is a cause of cancer, and to its credit was an early advocate for increased education on the dangers of tobacco smoke and the link between smoking and cancer.

However, I think in an attempt to attack fearmongering and over time, it has become untrustworthy. I've discussed the ACSH with some other skeptic bloggers and they feel about the same. They're right on some issues and downright batty on a lot of others, taking industry positions almost by default. Not to say that industry is always wrong, but they do take positions that I think my brother would whip out his deck of cards on. Lots of "no problem" analysis. I do not trust them as a source of unbiased information, and citing them is a major red flag.

Now, seeing them publish some serious crap in TCS, I've thought about going after them on some issues. I find it very ironic that those who complain of my siding with some industry conspiracy to attack tobacco would cite the ACSH, which, if anything, tows the industry line by default. Sometime in the future, maybe with another particularly ridiculous TCS post, I'll take them on.

Mark - I haven't said a word about primary smoking. My concerns are about smoking bans based on pseudo-science (which, as noted, have nothing to do with primary smoking), and about what I see as the destruction of the integrity of public health by political and corporate interest.

Your point about NIH funded studies may have some validity. Someone else can comment on that. (Most studies I've ever seen were funded by pharmaceuticals or health organizations that receive large amounts of funding from pharmaceutical companies.) But even, for example, NIH funded researchers have to publish. (You sure don't get more funds by NOT publishing). Mr. McFadden's 2nd link is illustrative of the publication *climate* in this area. That is, the publication bias that exists now. That is NOT how science should work. Nor should people who raise valid questions about how it IS working (or NOT working) be dismissed as cranks.

Dr. Richard Carmona testified the other day about caving to political influences with regard to his statements to the American public. I have to wonder how it is that he believes that public health researchers, who produced the work that he reviewed, do not cave to similar influences (in areas of politically charged "health" topics) with the same regard for their own careers.

Many scientists, like myself, are recognizing this problem (well exemplified by the SHS debate). To call me a science denier, because I question the "science" of SHS is silly. I am a science defender.

GDF excellent and well thought out post. It is indeed tragic for the integrity of Science and Scientists, when any 'criticism' of the Politically Motivated purge of smokers, by hypocritical Governments and vested interest groups such as Big Pharma' is allowed to undermine any serious attempt to address what many in the Scientific community see as the destruction of it's credibility. One only has to follow the money to know that Johnson and Johnson the largest provider of smoking cessation products, through the Roberts Wood Johnson Foundation gives tens of millions to loosely describe anti smoking groups, who fund junk science. Does anyone in their right mind actually believe, Helena or Pueblo. Rocket science it ain't to know both are fiction, sadly they are quoted by the 'experts' as fact. More denial.

Dr. Richard Carmona testified the other day about caving to political influences with regard to his statements to the American public.

Funny you should mention that. It's been speculated among the medical profession that one major reason that Dr. Carmona wasn't reappointed when his term as Surgeon General expired had to do with the hard line he took on SHS in the Surgeon General's report on the topic last year. If anything, the political pressure these days, at least at the federal level, is on the side trying to downplay the risks of SHS.

I think it is you who is the crank. I simply ask you to produce one piece of epidemiological research that reaches the necessary level of 3+ to indicate a causative association.

Wow, this myth has gone from 2+ to 3+. Well done!

GDF says:

Perhaps rather than "denialists", they are "whistle-blowers".

forces.org says:

No worries, Mr. McFadden: Big Pharma and �public health� are working on that - just give them time, not even Nazi Germany was built in a day!

Hmmm....I'll go with denialist crank conspiracy theorists FTW.

GDF makes an excellent point. If smoking bans were truly based on public health concerns those for them would also favor greater restrictions on alchohol, at the very least the requirement alchohol can only be consumed in the home.

But, again, driving whilst under the influence of alcohol is already illegal, for public safety reasons. This invalidates GDF's point.

By Ian B Gibson (not verified) on 18 Jul 2007 #permalink

I am not a scientist. "Science" has lost all credibility with me, as an ordinary person. For the simple reason that so much of it has turned out to be wrong.

Every single day I'm bombarded by one study or another telling me eat fish! No don't eat fish! Coffee gives you cancer! Or does it? All "science" is anymore (to me) is the business of the most trendy health scare or profit craze. Just about everything we're told to be afraid of turns out to be nonsense.

Remember carbs? Or oat bran? What is it now? Whole grains? Every other commercial on TV is for prescription medications.

I'm not even sure what you mean by "denialism." Science isn't about "truth." Looking closer at any article tells me things like probability of increased risk.

With the small increased risk from SHS I read in your other post, it seems a simple sign on the door of a bar will adequately inform anyone walking in about it. Workers knowledgably assume far greater risks than this.

The hysteria about it is very telling to me, that your precious "science" is being manipulated for political ends. For the love of G-d, please stop trying to "protect" me.

Do I get my point back if I counter that there seems to be a "safe" level of blood alcohol -- although no (zip, zero, none) safe level of SHS? Does this claim sound like science, or rhetoric? We're not talking mustard gas here folks. (Not that I know much about mustard gas -- but, you get my point, I hope).

I was also suggesting that the "safest" solution for drunk driving is "Prohibition." If one had an interest in "prohibition" one could make that case. Even exaggerate the effect.

Orac - That could well be. Govt. surely has interest in tobacco taxes. It's despicable either way. A shame if science comes down to opposing politico/financial interests. My point was however, that he bows to his "paycheck" just as do the funded researchers he reviews. I suggest it's naive (of him) to think that one side is clean and the other dirty.

It's been an interesting conversation. Sorry to hurry with these responses. I have to skip out of the conversation however, due to time constraints. But I hope we all keep questioning and learning.

I am not a scientist. "Science" has lost all credibility with me, as an ordinary person. For the simple reason that so much of it has turned out to be wrong.

So you're an idiot. Congratulations. What do you want, a cookie?

Besides, you seem perfectly happy to make use of that which science has provided you. Computers, for instance. I suspect we'd all be better off if you were consistent in your distrust of science and got rid of all that nasty technology, just in case.

"Science" has lost all credibility with me, as an ordinary person. For the simple reason that so much of it has turned out to be wrong.

The amount of science that has been wrong is infintesimally small compared to how much science has gotten right. Look around you for God's sake.

Your main complaint seems to be with TV, not science.

I forgot, we have some newbies here.

Information about what denialism is or how we describe cranks can be found in the links at the top of the page for "about denialism", and the "crank howto".

It's not an epithet, rather it's the use of specific tactics to deny a body of science or fact. It's the use of arguments like the ones the being used here. All science is false, it's a conspiracy of pharmaceutical companies, citation of some fake expert and dismissal of expert opinion from people who actually study the problem, moving goalposts and logical fallacies is a brief rundown of denialist tactics.

I wonder if Mark feels the same indignation toward Stanton Glantz and his "Miracle of Helena" hoax. Before being exposed as a fraud, this study helped push thru the Chicago smoking ban and hence the Illinois ban "to level the playing field." Is Mark also indignant when the American Cancer Society assures the Illinois press that working eight hours in a bar that allows smoking has the same health effects as smoking 16 cigarettes. Yet when challenged, the ACS can produce no study to support such an absurd claim. This is the sort of "science" citizens trying to protect the freedoms and property rights of bar owners and their patrons in Illinois have been up against. This is the science Cowbell has learned not to trust.

http://www.acsh.org/factsfears/newsID.990/news_detail.asp

By Bill Hannegan (not verified) on 18 Jul 2007 #permalink

I wonder if Mark feels the same indignation toward Stanton Glantz and his "Miracle of Helena" hoax.

I'm supposed to be impressed by the McFadden's and Kuneman's whining that they couldn't get their "study" supposedly "refuting" the Helena study published in a peer review journal? Let them post their data if they think they're being "repressed" or "silenced" and let the scientific community judge. Or let them stop whining until their results are fully published.

Whatever the flaws of the Helena study, they have been well hashed out in the scientific literature, and the study was never represented in the scientific literature as anything other than a preliminary study that had provocative findings suggestive of an effect but needed a lot of confirmation. The authors of the study were quite honest about the limitations of their study. In a section entitled "Weaknesses of the Study," they even pointed out themselves the discussion section of their article that the study was small, that it used historical controls, and that biomarkers for SHS exposure were not measured. There was no deception or "scam" involved. Indeed, the authors were quite cautious in their assessment of the results, as any objective reading of the paper, particularly the discussion section, will show.

What Bill seems upset about is not how the authors represented their results, but rather how the press represented them, and that is a different issue entirely. He needs to learn how not to tar the investigators with that.

Cannard
Science is a series of provisional truths, backed by evidence, that are amended when better evidence is available

The McFadden/Kune study shows that the Helena/Pueblo etc miracles are suspect. Yet the studies on Helena get wide publicity and the M/K study struggles to get published.

Accordingly the canon on SHS and Heart attacks continues to contain errors that form the basis of public policy.

The study was commented on favourably by Dr Michael Siegel and I am confident, given his stance, he would not have done this if the study was flawed.

To the point, if the canon is erroneous, then correction is order, yet that seems difficult in the current environemnt. This can not be good for science. Yet you call those that challenge the current orhtodoxy crank or denier?

It would also seem you have gone off on a tangent, talking about Forces.org. Were the questions in the previous thread related to this site or are you trying to lump them together to avoid the questions?

Even if Epidemilogy showed a high relative risk, even you are aware it can not establish causation. Your previous article simple gave food for thought and further investigation may/may not be warranted. Yet you seem to have made up your mind, pity.

west
----

The McFadden/Kune study shows that the Helena/Pueblo etc miracles are suspect. Yet the studies on Helena get wide publicity and the M/K study struggles to get published.

Did the possibility ever occur to you that the reason the McFadden study can't get published is because it has fatal flaws? Of course, I have no way of knowing if that's the case until I actually see it, but McFadden apologists simply leap to the conclusion that the reason he's having a hard time getting his study published is ideology. They completely ignore the equally likely possibility that he can't get it published because its design or analysis just isn't up to snuff.

I have no way of knowing yet which is the case, but I do find it interesting that people like west won't even entertain the possibility that the study just isn't any good. After all, they haven't read it either and have no more way of knowing whether it's any good than I do.

Did the possibility ever occur to you that the reason the McFadden study can't get published is because it has fatal flaws?
Of course.

McFadden apologists
I have no reason to apologise for Mr McFadden, he can do that for himself if need be.

but I do find it interesting that people like west won't even entertain the possibility that the study just isn't any good

How did you come to this conclusion? I have read the Nov 2005 prelimary study and Dr Siegel's notes. It offers a view on large populations rather than the smaller populations used in the Helena/Pueblo studies, which adds to the debate. If you could refer me to another study on large populations and SHS that has been published, then I would be glad to view that and make a comparison.

I have no way of knowing yet which is the case
Wouldn't it be easier to take a look at the study rather than mind read my motivations? At least then you would have a view on it's validity. If the study does not deserve to be published on the grounds that it is has fatal flaws then fair enough, yet at this point in time, as you say, you have 'no way of knowing' .

be well
west
----

By Anonymous (not verified) on 18 Jul 2007 #permalink

Ian: Despite murder already being illegal, we still have laws regulating firearms.

Restricting alchohol consumption to private homes is no more inconveniencing than restricitng smoking to private homes, and doing so would have benefits greater than SHS bans.

These folks comparing second hand smoke to alcohol are confusing me. Perhaps I'm just not as sloppy a drunk as you folks, but when I drink, the alcohol only goes in me. I rarely spill a drop. When you smoke, your smoke also goes in me. The day that I wander past you in a bar, sloshing my drink all over your precious silk shirt (and down your gullet), then you can compare the two.

I'd be perfectly happy to have you smoking at the table beside me if you kept your head and cigarette inside a tightly sealed ziploc bag. Though I imagine that might present other problems for you...

Personally, I am philosophically opposed to blanket smoking bans. That's the libertarian in me, I guess. I do support banning it in places like hospitals, schools, government buildings, offices, stores, etc, but I feel that restaurants and bars ought to be able to allow smoking, as long as adequate ventilation is provided. I would expect the majority of such establishments to provide nonsmoking sections, as has already happened simply due to market pressure and a growing awareness of the risks. I do not feel that government strong-arming is necessary.

I dislike smoking intensely, in part because I am allergic to it, but also because of the significant health risks. I do not think it needs to be banned outside of private residences, and generally consider government movements to regulate smoking to be political grandstanding -- it's something that is fairly easy to enact, earns brownie points for the politician, and makes them look proactive on public health. I'd rather they spent their energy on more serious issues, like how to deal with the problems the lower middle class has in coping with health problems.

So I'm opposed to smoking bans.

But I'm also opposed to denialism. The science is pretty clear; secondhand smoke is harmful, just as firsthand smoke is harmful. It is therefore courteous for establishments to offer a nonsmoking area, and to provide a means of removing the harmful smoke from the smoking area.

By Calli Arcale (not verified) on 18 Jul 2007 #permalink

This article will probably be touted as "good science" by the commuinistic anti-smoking movement. Let's have a lesson in American history, shall we? In the 1970's, the US Supreme Court ruled that a private business is private (not public) property. So, smoking bans are invalid, sais the Supreme Court. This means only one thing - the anti-smoking movement is in contemopt of a court order. Further, in 1989, the US Surgeon General stated that there is very little, if any, dangers in secondary smoke. He specifically mentioned that while there really are 4,000 chemicols in cigarette smoke, only 2% of that smoke contains any of them. The other 98% is composed of water vapor and air. In other words, and I quote, "It is the dose that makes the poison." Also, if a person was a 2 pack a day smoker, smoked occasionally, had only one cigarette their entire lives, or just knew someone who smoked, and they die, it's written down as a "smoking-related death." Hmm...interesting.

By Luke Smithers (not verified) on 18 Jul 2007 #permalink

Calli,

I'm mostly with you. I also am against a blanket smoking ban. In addition to the fact that it wouldn't work (ala Prohibition), I tend to think if someone wants to breathe that stuff, that's their call. I think sniffing glue should be legal for adults, though I also wouldn't tend to indulge.

I disagree with you on restaurants and bars, however. Making a non-smoking section in a restaurant is about as effective as having a non-pissing section in a swimming pool. Unless you're outside, there's just insufficient air to properly dilute the smoke. That said, I strongly support the rights of smokers to smoke in areas where they are not spewing it on the rest of us. Smokers clubs. Tobacco shops. Their own homes. But public areas? No way.

Orac wrote, "McFadden apologists simply leap to the conclusion that the reason he's having a hard time getting his study published is ideology. They completely ignore the equally likely possibility that he can't get it published because its design or analysis just isn't up to snuff."

However Orac, as is clearly pointed out in the article, the PRIMARY reason, stated as such, by the BMJ for its decision had nothing to do with "fatal flaws" or design or analysis: just that it didn't "add enough to what is already known" for "general readers" to be worth publishing... a clearly bogus rationale since its results were diametrically opposed to what is supposedly "already known".

You request a publication of the study to prove its value and design. I would love to oblige, but any publication beyond the preliminary version that can be posted at:

http://kuneman.smokersclub.com/hospitaladmissions.html

would preclude future publication in ANY peer-reviewed medical journal... which is exactly what would make the antismoking lobby the happiest.

As far as soundness of data goes, one of the main differences between our study and those from antismoking researchers is that our data is all publicly accessible and verifiable. Orac, I'd like to see you ask for the hospital records that would allow you to verify the Helena data... you won't get them.

I find it interesting that you repeat one of the assertions of the BMJ editor when you say the flaws of the Helena study "have been well hashed out in the scientific literature,"

Orac, the only place they have been "hashed out in the scientific literature" is within the Rapid Response section of the BMJ at:

http://www.bmj.com/cgi/eletters/bmj.38055.715683.55v1

and if you visit there you'll find that a good bit of that hashing out was done by me, and was never met with a response or defense by the Helena authors DESPITE the ethical and scientific importance of defending their work in that forum.

Orac, the Helena study doesn't stand alone you realize. I could grab any of a half dozen other "flagship studies" that the antisomking lobby has used to push smoking bans and the results would all be similar: designs deliberately skewed to give desired results and presentations to the media that distort even those results.

Smoking bans are bad laws based upon lies. Kudos to the citizens of Britain for having the courage to stand up to them!

Michael J. McFadden
Author of Dissecting Antismokers' Brains
http://pasan.TheTruthIsALie.com

Orac, there are a number of points raised by several different people largely addressed to me. I hope you won't mind my answering them together in one post here.

Factician wrote, "but when I drink, the alcohol only goes in me." Factician, that's actually clearly and scientifically wrong. Alcohol, a recognized unique Class A Carcinogen, is a highly volatile liquid. Secondary smoke contains seven such Class A Carinogens, total amount per cigarette emitted being .5 milligram (one-half of one-thousandth of a gram).

A standard martini, over the course of an hour puts one full gram of its carcinogen into the air for your fellow diners to breathe. That's an amount equal to 2,000 cigarettes even though you don't see it or even smell it much. See:

http://bmj.bmjjournals.com/cgi/eletters/330/7495/812#105082

for a fuller explication of this.

Factician also wrote, "Making a non-smoking section in a restaurant is about as effective as having a non-pissing section in a swimming pool." Actually, that's also not true. A swimming pool gets its water changed about once a year. The air in any decently ventilated smoking-allowed restaurant is changed roughly 50,000 times per year. That's a difference of five million percent! So not the same at all. One of the antismoking lobby's favorite propaganda tricks here is to say that ASHRAE has determined that ventilation is ineffective. If one actually examines ASHRAE's guidelines however one finds that ventilation is determined to be ineffective ONLY in that it cannot guarantee a 100% non-contact with smoke within a smoking room! ASHRAE goes on to state that a separate room with a proper exhaust fan works quite well in keeping smoke from nonsmokers in a non-smoking area.

As for the slurs against ACSH, I'd ask Mark et al to explain just what influence they feel "the industry" has over that organization, in what form that influence is wielded, and by specifically what industries? Are you implying that ACSH is funded by Philip Morris? If not, then what are you implying or stating?

I would finally like to ask Factician, Mark, Orac and others with a similar position: Do you believe it should be illegal for a smoker to open a smoking bar, hiring only smoking staff, to serve only smokers, their friends, and happy nonsmokers? Before complaining about "discrimination", I'd suggest you visit Scott's Miracle Gro or Weyco or even the UN's WHO to see how well their decisions to discriminate against smokers have gone.

Michael J. McFadden
Author of Dissecting Antismokers' Brains
http://pasan.TheTruthIsALie.com

Mark & Chris,
A number of years ago I probably would have agreed with your assessment that people who thought there was a conspiracy were cranks. Not now. The parallels of anti-obesity campaigns with those of anti-tobacco are glaring. Perhaps the motive of RJWF in funding both groups is not profit. Perhaps they are just a bunch of people who pay to have others believe as they do. The problem for the world is that tactics have been created that produce results regardless if they are right or wrong. Smokers cost us more in health care, fat people cost us more in heath care ... doesn't matter if its true. Your "denialism" tactics are cute but harmless. The tactics of public health could dominate our future.

If smoking bans were truly based on public health concerns those for them would also favor greater restrictions on alcohol, at the very least the requirement alchohol can only be consumed in the home.

It is my impression that the reason people don't favor greater restrictions on alcohol is not the lack of a valid public health concern, but rather that prior experience with attempting to restrict alcohol use was so disastrous that people are reluctant to try it again. So far, this doesn't seem to be the case for tobacco, perhaps because there has been no attempt to ban it altogether. And of course, there are key differences. Requiring people to consume alcohol only in the home runs into the problem that alcohol is not merely a hazard to others while it is being consumed, but for quite a while afterwards, so the problem is not where people consume it, but what they do afterwards. This also means that relatively benign restrictions such as have been so effective with tobacco (i.e. requiring people to go outside to smoke) wouldn't do much good for alcohol

I do not think it needs to be banned outside of private residences, and generally consider government movements to regulate smoking to be political grandstanding -- it's something that is fairly easy to enact, earns brownie points for the politician, and makes them look proactive on public health. I'd rather they spent their energy on more serious issues, like how to deal with the problems the lower middle class has in coping with health problems.

Tobacco smoking is the leading preventable cause of premature death in the United States. The government estimates that smoking causes 24 times as many premature deaths as inadequate health insurance.

Orac wrote, "McFadden apologists simply leap to the conclusion that the reason he's having a hard time getting his study published is ideology. They completely ignore the equally likely possibility that he can't get it published because its design or analysis just isn't up to snuff."

However Orac, as is clearly pointed out in the article, the PRIMARY reason, stated as such, by the BMJ for its decision had nothing to do with "fatal flaws" or design or analysis: just that it didn't "add enough to what is already known" for "general readers" to be worth publishing... a clearly bogus rationale since its results were diametrically opposed to what is supposedly "already known".

You request a publication of the study to prove its value and design. I would love to oblige, but any publication beyond the preliminary version that can be posted at:

http://kuneman.smokersclub.com/hospitaladmissions.html

would preclude future publication in ANY peer-reviewed medical journal... which is exactly what would make the antismoking lobby the happiest.

As far as soundness of data goes, one of the main differences between our study and those from antismoking researchers is that our data is all publicly accessible and verifiable. Orac, I'd like to see you ask for the hospital records that would allow you to verify the Helena data... you won't get them.

I find it interesting that you repeat one of the assertions of the BMJ editor when you say the flaws of the Helena study "have been well hashed out in the scientific literature,"

Orac, the only place they have been "hashed out in the scientific literature" is within the Rapid Response section of the BMJ at:

http://www.bmj.com/cgi/eletters/bmj.38055.715683.55v1

and if you visit there you'll find that a good bit of that hashing out was done by me, and was never met with a response or defense by the Helena authors DESPITE the ethical and scientific importance of defending their work in that forum.

Orac, the Helena study doesn't stand alone you realize. I could grab any of a half dozen other "flagship studies" that the antisomking lobby has used to push smoking bans and the results would all be similar: designs deliberately skewed to give desired results and presentations to the media that distort even those results.

Smoking bans are bad laws based upon lies. Kudos to the citizens of Britain for having the courage to stand up to them!

Michael J. McFadden
Author of Dissecting Antismokers' Brains
http://pasan.TheTruthIsALie.com

Orac, there are a number of points raised by several different people largely addressed to me. I hope you won't mind my answering them together in one post here.

Factician wrote, "but when I drink, the alcohol only goes in me." Factician, that's actually clearly and scientifically wrong. Alcohol, a recognized unique Class A Carcinogen, is a highly volatile liquid. Secondary smoke contains seven such Class A Carinogens, total amount per cigarette emitted being .5 milligram (one-half of one-thousandth of a gram).

A standard martini, over the course of an hour puts one full gram of its carcinogen into the air for your fellow diners to breathe. That's an amount equal to 2,000 cigarettes even though you don't see it or even smell it much. See:

http://bmj.bmjjournals.com/cgi/eletters/330/7495/812#105082

for a fuller explication of this.

Factician also wrote, "Making a non-smoking section in a restaurant is about as effective as having a non-pissing section in a swimming pool." Actually, that's also not true. A swimming pool gets its water changed about once a year. The air in any decently ventilated smoking-allowed restaurant is changed roughly 50,000 times per year. That's a difference of five million percent! So not the same at all. One of the antismoking lobby's favorite propaganda tricks here is to say that ASHRAE has determined that ventilation is ineffective. If one actually examines ASHRAE's guidelines however one finds that ventilation is determined to be ineffective ONLY in that it cannot guarantee a 100% non-contact with smoke within a smoking room! ASHRAE goes on to state that a separate room with a proper exhaust fan works quite well in keeping smoke from nonsmokers in a non-smoking area.

As for the slurs against ACSH, I'd ask Mark et al to explain just what influence they feel "the industry" has over that organization, in what form that influence is wielded, and by specifically what industries? Are you implying that ACSH is funded by Philip Morris? If not, then what are you implying or stating?

I would finally like to ask Factician, Mark, Orac and others with a similar position: Do you believe it should be illegal for a smoker to open a smoking bar, hiring only smoking staff, to serve only smokers, their friends, and happy nonsmokers? Before complaining about "discrimination", I'd suggest you visit Scott's Miracle Gro or Weyco or even the UN's WHO to see how well their decisions to discriminate against smokers have gone.

Michael J. McFadden
Author of Dissecting Antismokers' Brains
http://pasan.TheTruthIsALie.com

"Were the dinking water in a bar shown to include dangerous bacteria well above established"

Where do bars keep their dinking water? Does it come from urinals or is that where it winds up after being poured into the other end of people as ethanol?

These guys are a perfect denialist complement to Big Fat Blog. Every "oppressed" group with enough people in it eventually organizes into a buzzing hive of crankery with momentum all its own; lies that are rightfully exposed in the world of legitimate medical science can easily be recast as truth within communities consisting solely of other liars with the same cranky agenda.

I think that Orac, like so many knee-jerkers, has made up his mind without serious critical thinking. There is nothing at Forces.org suggestive of his overblown terms like 'denialist' or 'crankery'. Everything is well-researched and both rationally and eloquently articulated. It actually makes sense, and is backed-up, which is something that the ETS concept most definitely is not. Why is Orac so annoyed simply because he doesn't get the sublime enjoyment of smoking that he deprives himself of? It helps you chill out you know

By Adeimantus (not verified) on 19 Jul 2007 #permalink

There is nothing at Forces.org suggestive of his overblown terms like 'denialist' or 'crankery'.

"Nothing at Forces.org suggestive of his overblown terms like 'denialist' or 'crankery'"?

ROTFLMAO!

That's the funniest thing I've read all week. Really. It's so amazingly disconnected from reality that it's hard to do anything other than laugh at it. Thanks for brightening my morning.

Perhaps Orac is willing to take forces.org on their challenge (its currently at the top of their page,) to directly email them for a discussion or debate? I mean truly since you are laughing so hard you must not feel threatened whatsoever. I'm not trying to lower anyone here to a level of "denialism," nor make out any person involved a victim or purveyor of "crankery," but certainly if Orac is willing to speak out here on this site, they appreciate forces.org's offer and would love to tell all those who read the site how SHS is effecting them and the non-emotional and solid scientific proof behind this?

Let's not forget that if you read the preliminary version of the kuneman/ McFadden study on my page, you will notice one other important difference between our study, and those of the small cities which were published:

Our study looks at multiple bans. If you go to hcup, you will see we used data from every state with a ban which is in the hcup database. We are also the only study which uses 2 different controls, one is the USA, as a whole; the other is all of the states which hcup provides data for, which did not allow local bans. Ergo, we are not reporting research selectively.

Since our results differ significantly with those of the small cities, it is logical to conclude that it is those studies which utilized selective research to form their conlcusions. Dave K

'That's the funniest thing I've read all week. Really. It's so amazingly disconnected from reality that it's hard to do anything other than laugh at it. Thanks for brightening my morning.'.
What a typically predictable response from the anti smoking lobby handbook. Once you run out of 'argument', ridicule. The M/K study has drawn on the strongest of scientific criteria, verifiable data and a control group the study is scientifically sound which is why the Scientific Journals will not publish it. It finally destroys the junk science funded by Big Pharma. Big Pharma will never allow that to happen.

Nothing at Forces that qualifies as denialism? You have to be kidding.

They deny the link between smoking and cancer! And emphysema! And COPD! There's an essay there blaming medical imaging of all things.

As far as your alcohol/carcinogens link McFadden, that is the dumbest thing I've ever heard. If anyone wants a laugh, go check out his self-citation over at the BMJ comments.

It's not _only_ the tobacco.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1440792
http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=50324
http://links.jstor.org/sici?sici=0091-6765%28200305%29111%3A5%3C714%3AC…
http://thorax.bmj.com/cgi/content/full/59/7/569

You've got several major industries under threat here, all of which externalize major expenses as air pollution. It's far cheaper to subsidize attacks on the science than clean up their business model.

By Hank Roberts (not verified) on 19 Jul 2007 #permalink

"I guess establish that alcohol causes liver damage and contributes to traffic deaths of those who didn't even choose to go into the bar. We could call it... ummm...Prohibition."

"But drink driving is already illegal, so what's your point?"

Are you saying that banning alcohol in bars wouldn't save lives? Isn't that the point, saving lives? There's plenty of justification for banning alcohol in bars, too. The difference is the anti-drinkers don't have the funding that the anti-smokers have, and they have a harder road ahead of them.

Are you *really* suggesting that the alcohol evaporating from a martini is more carcinogenic than the smoke from a cigarette? Am I understanding that correctly? Really? Really?!?

All carcinogens are equal, right? Tobacco smoke? Ethanol? Hydroxylamine? You'd happily guzzle 10g of any of those, right? Eeeee....

I think what's interesting here is that the Forces crew seem to be forcibly concentrating on the discussion of Second Hand Smoke, rather than trying to back up any of their hilarious claims that smoking does not cause cancer in smokers.

Like Creationists, they seem to try and steer discussion onto the slightly more plausible areas of their beliefs.

"It is my impression that the reason people don't favor greater restrictions on alcohol is not the lack of a valid public health concern, but rather that prior experience with attempting to restrict alcohol use was so disastrous that people are reluctant to try it again. So far, this doesn't seem to be the case for tobacco, perhaps because there has been no attempt to ban it altogether."

Sure it is. Wherever there are Smoking Bans for bars, there are Smoke-Easies. The bartenders put out cups of water for ashtrays, or empty beer cans, or some other variation. If they have political connections, they just ignore the law altogether. Same thing happened during Prohibition.

Mark H wrote, "As far as your alcohol/carcinogens link McFadden, that is the dumbest thing I've ever heard. If anyone wants a laugh, go check out his self-citation over at the BMJ comments."

Mark seems to be showing some reading problems here. He evidently never managed to get to the end of the analysis where I state:

"Do I really think alcohol should be banned from bars and restaurants, from movies and TV, from sports events and wedding champagne toasts? Of course not: the risk levels of nondrinkers, if evaluated honestly in studies not funded by pressure groups would be below consideration by any rational person. And anyone who did not want to be exposed to such fantastical wisps of risk could simply avoid establishments where alcohol was allowed. Exactly the same argument can be made about smoking and smoking bans."

The entire point of the analysis, which you will note is both carefully referenced with citations and has never been challenged by the authors of the study, was to illustrate how even a much greater exposure to a "potential threat" was laughable in the context of the real world.

And, as usual in discussions with the antismoking crowd, most of the points raised are simply ignored. But perhaps it will help if I repeat my primary question in a more prominent and less-easy-to-dodge setting:

Do you believe it should be illegal for a smoker to open a smoking bar, hiring only smoking staff, to serve only smokers, their friends, and happy nonsmokers?

Michael J. McFadden
Author of Dissecting Antismokers' Brains
http://pasan.TheTruthIsALie.com

I don't think it was challenged because it was so laughably absurd for reasons factician pointed out among others.

It's proof, more than anything, that we shouldn't take anything you say seriously. We're having a laugh about it in the backchannels.

Sure it is. Wherever there are Smoking Bans for bars, there are Smoke-Easies. The bartenders put out cups of water for ashtrays, or empty beer cans, or some other variation. If they have political connections, they just ignore the law altogether. Same thing happened during Prohibition.

If the only issue with Prohibition had been that people occasionally drank anyway, then we'd probably still have it. The concern was not that the law wasn't perfectly or uniformly enforced (what law is?), but that the black market in alcoholic beverages that it created was pumping money into organized crime.

Let's just consider that one of the profiles running this blog declares himself to be 'an attorney with experience in consumer protection advocacy in Washington and Sacramento.' Sacramento, of all places. California, the freefree state.

Okay, now I've read though all of this insanity. Rather than lash out at the Force-skins, I think those on the side of reason here ought to be looking at this not from the standpoint of denialism but from one of Darwin Awardism in an unusally disseminated and protracted form.

Could you deluded nicotine lovers do everyone else a favor and smoke a lot harder and faster and maybe inhale more deeply? Just not in public, of course. Thanks!

That, and of course, that the alcohol would have to be aerosolized rapidly and efficiently rather than drunk.

Let's cut to the chase. If anyone really wants to know about the effect of smoking (and I'm talking active not passive) go and see two sets of crucially important figures: life expectancy and percentage of smokers, then compare them between countries of similar wealth, e.g. the countries of Western Europe.
Look at the figures for life expectancy here at the UNECE's own website:

http://www.unece.org/stats/trends/ch6/6.1.xls

Then, see the percentages of the population who smoke:

http://www.unece.org/stats/trends/ch6/6.18.xls

Now, we are told that smoking sheers off 5/8/10/14/delete where applicable years of life expectancy. Then why are the life expectancies of European countries so similar, whilst their percentage of smokers ranges from 7.9% (Portuguese women) to 46.8% (Greek men)? Shouldn't Portuguese women (and this is not by any means confined to them) be living significantly longer than Duthc women? Shouldn't Greek men be dying young in their droves and driving the average down? It is not because Greek men smoke considerably less cigarettes per head than elsewhere (if you've been to Greece, you'll know that isn't the case). Perhaps it's diet, the well-publicised health benefits of the Mediterranean? Or genetics, or the potential confounders of relative industrialisation. Perhaps, but taking this view does rather grant that smoking is not the one-way death sentence that is made out by health authorities.
And if the message about active smoking is so anomalous, you can forget passive smoking.
Denialist? Well yes, but not in the sense that Orac meant (i.e. on a par with holocaust deniers) but in the sense of appraising publicly available data and making commonsense judgements.

By Adeimantus (not verified) on 19 Jul 2007 #permalink

Adeimantus, you wouldn't happen to have the corresponding pr. capita alcohol consumption rates, would you? If so, please post.

I'm with Kemibe - this is the Darwin Awards at their most pure - except they have a club, a website (Forces.org is truely batty) and even a website song (although shouldn't it be 'Smoke gets in your Eyes?). Unfortunately, SHS also means they'll take out innocent bystanders. But of course SHS doesn't exist...

Adeimantus - smoking may not be an automatic death sentence, but just what is the percentage of people with lung cancer who dont smoke?

BTW - Orac - thanks for mentioning 'ROTFLMAO' - it was new to me, and I had to look it up - certainly one to use from now on.

Just to let you know. The spill over to this sight comes from Dr. Michael Seigel's blog:

http://tobaccoanalysis.blogspot.com/

He has been taking the tobacco control (TC) crowd to task for presenting misleading information. Dr. Siegel, is not entirely incorrect, that the medical sciences, in particular TC, are losing credibility by putting out misinformation. Researchers that are published have accepted money with the objective of proving second hand smoke causes harm (bias). The American Cancer Society (ACS) has stated that they will fund no researcher who in the past has accepted money from tobacco interests. Why? I cannot answer that question, but it also begs the question whether or not researchers who accepted funding from ACS are not also bias. If we are to accept that the conclusions reached in the medical community are due to the funding source, you have a problem. This is why the Helena study is such a sore point. With Dr. Stanton Glantz, who is known to use present misleading information for a political agenda as author, it causes people to think, the medical community is driven by politics, not science. The two do not mix. For this reason, Dr. Siegel started his blog. Most here seem to come from the medical community and while you may want to bury your heads in the sand, there is a real danger, that you (the medical community) may loss your credibility. Thus, while forces.org claiming smoking the not cause cancer, etc. makes them look like cranks, the danger is that the misinformation that tobacco control uses to achieve a political goal, smoking bans, is putting the medical research community in danger of being perceived as cranks. This is a real danger and should not be taken lightly.

1. I'm not a smoker
2. My wife, a couple of sisters and a few friends smoke and I've found that they really aren't so bad.
3. I'm not all that much afraid of breathing some smoke, I think my body has ways of protecting and repairing itself.
4. I'm all for anti-smoking adverts and education.
5. I think that anything else is about money and power.
a. researchers and non-profits follow the money and there's lots of money to prove again and again that smoking is bad.
b. the MSA agreement protected big tobacco and let the states fund their medicare liability.
c. a tyranny of the majority gives government permission
to pass bans when all the non-smoking 80% need to do is
stop going to places that allow smoking.

ok, maybe that was a rant, but I do think that the anti-"fill in the blank" campaigns/organization are bad.
They foster intolerance and misinformation. I also think
its intolerable when it comes from government.

I am still confounded that an RR of less than 2 only applies when it realates to SHS. In reference to the abortion and breast cancer link (RR 1.5), I suppose if enough studies were funded and repeated the RR of less than 2 then we could logically banned abortion.
Lastly, Engstrom was criticized for applying similar methods to previous studies. They collected data for 25 years using computer records and phone interviews. This is the same method most other studied employ only they are for a much shorter duration and a smaller population. Orec also used a biased source to try and debunk the study. He accuses others of the same. He also fails to mention that the study was initially funded by the ACS (27 years). when it became apparent that it was not going to come out as they thought, they jerked the funding. Sounds like Big Tobacco. In any case, he only recognizes studies that come out the way he likes. The bottom line is that the RR of SHS averages less than 2.
I have always been against socialized medicine. It just seemed fundementally unamerican. But, I am beginning to see the merits.

Mark, you seem to have posted the same question on three separate blogs. I'll paste below what I believe I just pasted on the second one... (along with a plea for some consolidation since I seem to be in the position of responding to a number of different challengers...)

========

Heh... finding this trail of blogginess makes me think back to the comment (by Mark H? Orac?) yesterday or so about the "Crank Bat Signal" summons.

Mark C., no dishonesty involved at all. I was unaware of the existence of the tables and information you post above and will examine it. At the moment though I haven't even gotten back to the denialism/insolence blogs where I believe I am both awaiting some responses and owe a few.

I noticed your selection of carcinogens though and am wondering, since you seem to be aware of such things, why you did not choose the proper carcinogens for comparison: i.e. the unique Class A carcinogens in tobacco smoke and their quantities. See the 10th IARC report at http://ehp.niehs.nih.gov/roc/toc10.html#search (I believe there's an 11th by this point but don't have the URL handy) and the SGR '89 or '06 for particulars.

I think if you do so, and THEN apply your analysis, you may come up with a somewhat different conclusion (you may not also... I haven't done that analysis myself).

I also wonder why you seem to think that tobacco smoke in the air would behave so much differently than alcohol vapors. Granted one is a gas form and one a particulate, but I believe that very small particulate matter behaves aerodynamically in ways quite similar to gas. Do you have evidence or reason to believe to the contrary?

And a final note: I believe your and your blog friends are consistently missing the MAIN point I was making: it *IS* crazy to worry about such exposures to alcohol, and it is similarly crazy to worry about such exposures to secondary smoke. You can argue for a degree of difference, even a *great* degree of difference, but as the Surgeon General has so painstakingly pointed out, "there is no safe level of exposure" to carcinogens. So was he lying? Or is it dangerous to be near you while you're sipping your Beefeater?

Or *is* there perhaps a "safe level" in normal parlance that is simply ignored and twisted by the antismoking lobby?

======

Michael J. McFadden
Author of Dissecting Antismokers' Brains
http://pasan.TheTruthIsALie.com

Plunge wrote, "I don't have a problem with the science of second hand smoke: I don't have the ability to evaluate the science, but the consensus seems to be that it's moderately harmful, and given that smoking in general is clearly harmful, it's plausible on its face that even a smaller dose would be harmful."

Plunge I largely agree with you, but I *do* feel you probably have at least some ability to evaluate the science. Go to my website below and scroll down past the red headlined essays to the first boxed item. It is labled "Day Of Defiance!". Click on "Read More" and then download and print out the booklet I've uploaded there. Examine the five "flagship studies" that are so often used by the antismoking lobby in their push for smoking bans and look at their defects, both internally and in the way they've been used.

You don't need a graduate degree to spot charletons shilling at sideshows.

Michael J. McFadden
Author of Dissecting Antismokers' Brains
http://pasan.TheTruthIsALie.com

By Anonymous (not verified) on 19 Jul 2007 #permalink

Then why are the life expectancies of European countries so similar, whilst their percentage of smokers ranges from 7.9% (Portuguese women) to 46.8% (Greek men)? Shouldn't Portuguese women (and this is not by any means confined to them) be living significantly longer than Duthc women? Shouldn't Greek men be dying young in their droves and driving the average down?

This is such a mind-numbingly ridiculous argument that it is hard to imagine how anybody could be so biased as to take it seriously. Anybody who knows even a little bit about science knows that to draw a valid conclusion, you have to keep every variable the same except one. So to determine the effect of smoking on cancer, you look at cancer rates in people who have the same diet, the same genetic background, the same socioeconomic class, and live in the same place, differing only in whether or not they smoke. Who could reasonably imagine that it is meaningful to evaluate the effect of smoking by comparing, not even cancer rates, but overall life expectancy between different countries?

Do you believe it should be illegal for a smoker to open a smoking bar, hiring only smoking staff, to serve only smokers, their friends, and happy nonsmokers?

This is the sort of thing that sounds reasonable unless you actually bother to think it through. For example, what is the evidence that being in a smoky environment day in and day out is not dangerous to smokers? One might reasonably speculate that the damage due to smoking is so great that it would overwhelm the additional harm from being in a smoke-filled room all day long, but this is not necessarily the case. If the iniitiation of cancer is nonlinear--for example, if there is a multi-hit mechanism in which damage to DNA at multiple points is required for cancer, as is generally believed--then smokers might be even more vulnerable than nonsmokers. Or continuous exposure might be much more dangerous than intermitten exposure. Or side-stream smoke might be much more dangerous than smoke that is filtered through tobacco.

And even if it were shown to be true that working in a smoking bar adds no appreciable risk to smokers, such a proposal could run afoul of antidiscrimination statutes. Can you really tell somebody that they must take a dangerous drug to get a particular job? Can you fire somebody for taking their doctor's advice and quitting smoking?

I am still confounded that an RR of less than 2 only applies when it realates to SHS. In reference to the abortion and breast cancer link (RR 1.5), I suppose if enough studies were funded and repeated the RR of less than 2 then we could logically banned abortion.

Yes, if they were done properly, controlling for such factors as the increased breast cancer risk associated with not having children, this might have been a legitimate concern with respect to the medical status of abortion. But in fact, as more comprehensive studies were carried out, properly controlled to eliminate confounding factors, the supposed breast cancer risk was disproved. However, even if it were true, it would be a matter of personal choice. Smoking has not been banned, because it is regarded as a matter of personal choice, even though the RR is much greater than 2. As a society, we are willing to accept that people may choose to take substantial risks with their own health; we are less tolerant of them risking the health of others.

I was just wondering why the owner and visitors of this blog are so worked up about those he considers "cranks". Wouldn't you just ignore a crank? Since a crank is obviously not worthy of attention?

By oldstudent (not verified) on 19 Jul 2007 #permalink

I was just wondering why the owner and visitors of this blog are so worked up about those he considers "cranks". Wouldn't you just ignore a crank? Since a crank is obviously not worthy of attention?

Good question! Ordinarily people ignore cranks. It's a natural response to idiocy, and for the most part cranks are ignored.

It's when cranks become a public nuisance that they deserve to be addressed, and the need to inform and educate others on crank tactics becomes critical. Take, for instance, the evolution debate. The cranks aren't happy home-noschooling their kids and misinforming their relatives. They want to teach other people's kids their crank theories about science. There also are notable cranks in very high positions. I think Dan Burton for instance would qualify.

There also is this thing called the internet, which allows them to recruit and spread misinformation like manure all over the world. Our goal is to provide resources to identify and rapidly dismiss crankery to those who run across it, as well as provide some recourse to address some of the more ridiculous stuff that appears.

Sometimes, it's also just fun. I have to admit a personal fascination with crankery. I'm not alone. Anyone else watch the Colbert Report? What else is it other than someone pretending to be a crank for laughs?

""I was just wondering why the owner and visitors of this blog are so worked up about those he considers "cranks". Wouldn't you just ignore a crank? Since a crank is obviously not worthy of attention?

Good question! Ordinarily people ignore cranks. It's a natural response to idiocy, and for the most part cranks are ignored.""

"It's when cranks become a public nuisance that they deserve to be addressed, and the need to inform and educate others on crank tactics becomes critical. Take, for instance, the evolution debate. The cranks aren't happy home-noschooling their kids and misinforming their relatives. They want to teach other people's kids their crank theories about science. There also are notable cranks in very high positions. I think Dan Burton for instance would qualify."

The evolution debate is what got me interested is the SHS debate. Seemly science being misrepresented as science. I come from the 'hard' science world (think physics). When science and politics mix, we have no science, only politics and agendas. While this is not completely true in my world, there is a danger that is will be perceived as such is the medical world. The problem is medical science is starting to perceived as crank science. The reason being that much of the research is being overstated and being used to achieve a political objective. Science + Politics = Bullshit.

While the RRs are low in every study that I have seen, the Surgeon General stated that there is no save level of SHS. This was a political statement and had nothing to do with the finding of the report. The Surgeon General himself stated the he was binded by politics (not with regard to SHS).

Finally it was President Bush who allowed the evolution debate to even happen. I do recall the link to the person the was appointed to NASA who tried to suppress their findings. It should be easy to look up. It was a big news story when it came out.

By Anonymous (not verified) on 19 Jul 2007 #permalink

To Charles,

Alcohol consumption figures...just change the number in the address to 6.19

To Trll,

Why did you read my post improperly, react, and show yourself thus as a fool? I DID point out that there would be confounding factors such as diet, genetic profile, industrialisation, the country's health service, and so on. But try to be reasonable for a minute. If you believe that smoking inevitably, apart from the lucky few, leads to reduced life span, then it would show up somewhere in these figures which are sample sizes on a population level. You cannot seriously follow "Smoking kills" with "but the average life span in Greece where almost HALF the men smoke is the same as in the UK where only a quarter of men smoke". It would not be fair to compare and contrast the UK and, say, Romania, because of the level of confounders (Romania being poorly developed), but it IS perfectly reasonable to compare western European countries. Perhaps not to get a thesis published in a medical journal, but enough for the reasonable man to say, Hold on, there is something not quite right here

By Adeimantus (not verified) on 19 Jul 2007 #permalink

'Wouldn't you just ignore a crank? Since a crank is obviously not worthy of attention?'. Depends on the crank. As MarkH puts it , its when they 'become a public nuisance'. If some idiot wants to try to make a perpetual motion machine in their garden shed, then at least it keeps them off the streets. But cranks can kill.

Think of the 'AIDS doesn't exist' or 'AIDS can be cured by African veg - antivirals are bad' brigade. Or there is of course the anti-MMR fools, who have ensured that my kids are more likely to get measles, etc because enough idiots in the UK have decided not to have the jab (down to 85% in some areas). A kid has died of measles - thats at the door of cranks like Wakefield. And of course a certain Adolf Hitler was just a crank in 1919, as was Himmler, Rosenberg, etc..

But lets take a leaf out of Michael J. McFadden's book and Dissect the Smokers' Brain:

I smoked for a very short while, so I'm vaguely familiar with the way smokers brains are wired. Excuses include:

I enjoy it
I look good smoking (like Bogart)
It relaxes me
It wakes me up
It helps me think
It gives me something to do with my hands
All my friends are doing it
My grandad smoked 100 a day and lived until he was 90/There this bloke down the pub who smokes far more than I do, and he's OK
We give lots of money in tax
What do scientists know about the danger
I'll be alright, because its only smoke
I'm only smoking lights
I could get hit by a bus tomorrow
Think of all the other fumes I breath in - smoking is only a small part of the total - so how can it be dangerous?
Life so dangerous anyway, what are the chances of getting cancer - they say that everything gives you cancer..

There are lots of others, but the one thing they have in common is that they are all crap. Total denial. Total bollocks. In reality, smokers are hooked on a product which is more addictive than heroin. If you ask smokers why they are smoking, the honest answer you get is - 'Well, I know I should give up', or 'I get cranky if I dont have one', etc.

Addicts. Addicts who spend a large amount of money on fags (the cost of ciggies in the UK http://www.life-insurance-quotations.co.uk/life-insurance-cost.php is about �5 a packet), and smell of smoke. And who get shirty when the majority of people tell them not to smoke around them.

Now if you want to smoke yourself into an early grave while lying to yourself, thats up to you. But I think whats happening here (in both Oracs SHS articles and on this thread) is smokers having to deny that SHS exists, or at least isn't dangerous, because no matter how you justify smoking to youself, you can't in all honesty justify harming someone else.

Thats why the arguements have been so load, yet illogical. The second someone admits SHS is actually harmful, the classic 'my rights' arguement goes out the window, because SHS has to also be messing with some else rights.

One poster on SHS said that it was a)smokers & b)who are politically motivated. I think its often even more personal that that. Its smokers who know in their heart of hearts that what they are doing is harmful to theselves. They can evidently live with that. But harming other people is simply indefencible, even to the most addled of smokers. You guys are protesting way too much.
McFadden arguements are loopy because he's trying to argue about something which is simply not credible, that non-smokers are somehow not normal, etc. Indeed his book paints anti-smokers as:

1. The Innocents
2. The Neurotics
3. The Truly Affected
4. The Bereaved
5. The Ex-Smokers and The Victims
6. The Controllers
7. The Idealists
8. The Moralists
9. The Greedy

I personally find the idea that a bereaved person, having lost a loved one to an illness caused by smoking ( like the 90% of oral cancers http://info.cancerresearchuk.org/cancerstats/types/oral/riskfactors/), should continue to think that smoking might be a good idea to be totally barking, but this argument is not about logic, its about denial. Its 'down-the-rbbbit-hole' stuff.

Now why don't you just be honest, and admit you smoke becuase you enjoy the hit. Thats OK, because at least you are admitting that you are addicted to the stuff. Then we can have a sane debate, rather than the screaming of a load of smokers who haven't had their morning fix yet.

Mike B...you are not qualified to make a judgement. I smoke so I feel I am better qualified to understand smoking. I know I find it a sublime enjoyment, and who cares if it's a biochemical reaction creating that feeling? It's also a biochemical reaction creating the flavour of nice food or the intense enjoyment of an orgasm!
As to denial, this is totally fallacious. Denial is an auto-defense mechanism experienced in time of trauma. Smokers, coming from a cross-section of society, come in all shapes and sizes. The idea that all their judgements are clouded and twisted by addiction is patronising, ill thought out, and in fact total claptrap. I'm a biomedical scientist, and whilst I am not arguing from authority, I do know enough basic medical science to be able to read and interpret data. And if you read my previous post, interpreting real data, you should be made to stop and think (but you won't because YOUR judgement is clearly clouded and YOU are in denial!). It's like with Christians when you argue perhaps that they can't be sure about the existence of a God for such-and-such a reason and they don't listen. That's you, that is

By Adeimantus (not verified) on 20 Jul 2007 #permalink

Again someone tries to link primary and secondary smoke. My arguement is with the perceived dangers of secondary smoke.
One of the most exhaustive studies ever done by Engstrom and Kabat proved the sham. The Anti's immediately attack it as invalid because the last three years were funded by a tobacco funded group. They fail to mention that the American Cancer Society dumped funding when the data was not their liking.
Can someone name another substance that has an RR of less than 2 that is held on par with SHS?
Lastly, the motivation becomes obvious when smokeless tobacco is banned along with smoking. The elitist in this country have decided they know best. Any use of tobacco is bad and they are going to force you to conform to their standards. This is a very dangerous trend. What will be their flavor of the day tomorrow? Is it obesity? It appears they have already begun. I hear that higher insurance rates are being proposed for obese persons. Who decides what is obese? No other than guess who.
As I said earlier, I have always been against socialized medicine. Maybe the time is right. Is that why they call it "practicing medicine".

Why did you read my post improperly, react, and show yourself thus as a fool? I DID point out that there would be confounding factors such as diet, genetic profile, industrialisation, the country's health service, and so on. But try to be reasonable for a minute. If you believe that smoking inevitably, apart from the lucky few, leads to reduced life span, then it would show up somewhere in these figures which are sample sizes on a population level.

It is not any less foolish to say "of course there will be confounding factors" and then procede to ignore them. Only a fraction of the people who smoke get cancer; only a fraction of the people who die, die of smoking related cancer. So even the most rudimentary understanding of science or statistics would immediately lead to the realization that confounding factors would almost surely completely wash out any signal from smoking when considering people in different countries, with different environmental hazards apart from smoking, and with different genetic backgrounds. Why would anybody try to make such a patently absurd argument? The only reason I can imagine is that asking the question in the intelligent way--by comparing cancer incidence or death rates in the same country between smokers and nonsmokers--does not provide an answer that you like. The strategy of "if asking the question the right way doesn't give the answer you want, ask the question the wrong way" is a sure hallmark of a crank.

Can someone name another substance that has an RR of less than 2 that is held on par with SHS

You'll find examples on Orac's blog, which demolishes the nonsensical notion that 2 is some sort of magic number for relative risk.

Adeimantus - behind the 'biochemical reaction' that you so enjoy, why do you smoke? You point out that there are other enjoyable 'biochemical reactions', such as nice food or sex. So why choose one that is so dangerous? (although the orgasm could be dangerous if you are Davis Vitter http://news.yahoo.com/s/thenation/20070710/cm_thenation/15212429 !).

You say you are a
'biomedical scientist, and whilst I am not arguing from authority, I do know enough basic medical science to be able to read and interpret data' -
so why do you choose to indulge in something that you must know from the data gives you a much greater chance of lung, oral and other cancers, MI's, emphysema, sexual disfunction , etc http://info.cancerresearchuk.org/cancerstats/causes/lifestyle/tobacco/ .
You do it because it gives a high ( 'biochemical reaction'), but why do you keep doing it? Could you stop? Have you tried? How many do you smoke a day? Come on, be honest. You can't be seriously suggesting that its something that you have to do, so why do you smoke? And no stuff about 'biochemical reaction's', because thats just blowing smoke.

As for your outrage about being in denial, lets take the denialism.org definition, 'Denialism is the employment of rhetorical tactics to give the appearance of argument or legitimate debate, when in actuality there is none. These false arguments are used when one has few or no facts to support one's viewpoint against a scientific consensus or against overwhelming evidence to the contrary. They are effective in distracting from actual useful debate using emotionally appealing, but ultimately empty and illogical assertions.'

Being in denial is about putting up barriers to seeing the truth. The truth is that smoking is very bad for you, and is addictive http://www.ash.org.uk/html/factsheets/html/fact09.html.

I've seen patients with lung cancer still sucking down one more drag before heading off for the operating theatre - now thats one powerful 'biochemical reaction'. So be honest, tell us why you continue to smoke.

BTW - 'That's you, that is' is straight out of the Mary Whitehouse Experience, so thanks for brings back fond memories.

rrgabe23 - If the smoke that goes into your lungs is dangerous to you (are you going to try to argue against that?), then why is it illogical to suppose that the smoke that you exhale or simply wafts from the cigarette that your holding is also dangerous?

One of the arguements against 'socialized medicine' (that you've always been against) is that the current US system encourages personal responsibility. If you look after yourself, you pay less (unlike the NHS for example). If smokers pay higher insurance rates, its because the companies see smokers as a higher risk (like higher insurance rates for the obese). Why is that a problem for you? Do you smoke, by any chance....?

Hi Trrll,

You say: It is not any less foolish to say "of course there will be confounding factors" and then procede to ignore them.

Firstly, this is exactly what studies that produce results that show that smoking causes cancer, or kills in general, do! The studies ask, by way of a questionnaire, "Have you got cancer (yes) and do you or have you ever smoked (yes)? Aha, the smoking caused your cancer!" without any factoring in of alcohol consumption, diet, socio-economic status, or sedentary lifestyle. And they can't factor them in, because enough people who smoke also have bad diets, hit the booze and don't exercise their bodies. As with everything in life, there tends to be a complex multi-factorial web of causality.

Yet a person who dies of, say, COPD, or heart disease, or cancer, and is found to smoke or to have smoked is marked off as another smoking-related disease victim. It's simplistic to say the least.

As I said, there may be confounding factors that affect lifespan on a country population level. Your implied thesis is that these confounding factors, by sheer coincidence, cancel out the deleterious effects of smoking in those countires where the reduced life span is not shown. Now that is a "patently absurd argument".
Your argument is: OK, heavy-smoking Greece, Spain and Italy don't have a reduced lifespans vis a vis other western European countries, THEREFORE, there must be protective confounding elements in place that DO NOT apply to the low-smoking, similar-lifespan countries such as Sweden, or, conversely, there are non-protective confounding elements in the latter that drive their lifespans down. By a massive coincidences all these counfounders cancel each other out. That's brilliant that! But not convincing

By Adeimantus (not verified) on 20 Jul 2007 #permalink

The Avandia example in Orac's blog is somewhat misleading. It encompases a group with type 2 diabetes, a group with an already elevated risk of heart attack.
From webmd:
"Experts including the doctor who sounded the Avandia alarm tell WebMD there's no need for patients to panic.

The concern comes from the early release of a report in The New England Journal of Medicine (NEJM) suggesting that Avandia increases a diabetes patient's already-high risk of heart attack by 43%.

Researcher Steven Nissen, M.D., is chairman of Cleveland Clinic's cardiovascular medicine department. Nissen, past president of the American College of Cardiology, was one of the first doctors to raise the alarm about the heart risks posed by Vioxx. Nissen says his findings are valid, but he warns that the data are not definitive and must be confirmed by further studies.

"What patients need to know is there is some evidence of cardiovascular harm from Avandia but there is not any reason to panic," Nissen tells WebMD.

So, more studies must be done to replicate the RR of less than 2? Any others?

Will anyone answer why smokeless tobaccos are included in these bans?

This is an attempt to socially engineer what some believe is an acceptable life style. Without the SHS issue most Americans are tolerant enough to live and let live.

My grandfather was 88 when he passed. He smoked, chewed, drank alcohol and ate fatty foods. He told me once something I will always remember. "Be careful, if you back an old dog into his own yard he will turn and bite you."

It appears that some people are starting to feel as if they are being backed into their own yard.

Thanks Adeimantus.

Firstly, this is exactly what studies that produce results that show that smoking causes cancer, or kills in general, do! The studies ask, by way of a questionnaire, "Have you got cancer (yes) and do you or have you ever smoked (yes)? Aha, the smoking caused your cancer!"

It is simply false that the evidence that smoking causes cancer comes only from retrospective studies of this sort. Smoking has been studied from every possible angle, retrospective or prospective. Everybody who has not been sticking their fingers in their ears and shouting "LA LA LA I CAN'T HEAR YOU" knows this. And yes, confounding factors have been controlled for. And even if confounding factors were a problem for studies of populations within a single country, it would be foolish to suppose that would be more informative to add more confounding factors by comparing rates (and not even cancer rates, but overall death rates) between different countries, where the confounding factors are even greater.

s I said, there may be confounding factors that affect lifespan on a country population level. Your implied thesis is that these confounding factors, by sheer coincidence, cancel out the deleterious effects of smoking in those countires where the reduced life span is not shown. Now that is a "patently absurd argument".

It's not a matter of "sheer coincidence," simply a matter of signal-to-noise. If 95% of the variance in death rates is due to things like differences in diet, genetic background, auto accident rates, health care quality, etc., etc., you'll never see the effect of smoking. Again, this is very basic statistics. This is one of the standard denialist arguments--pick a way of looking at the data where the variance from other sources is large enough to obscure the effect in question. No competent scientist would ever imagine that it is meaningful to do such a comparison--only somebody who is desperate to convince himself that there is no effect of smoking.

I am still confounded that an RR of less than 2 only applies when it realates to SHS. In reference to the abortion and breast cancer link (RR 1.5), I suppose if enough studies were funded and repeated the RR of less than 2 then we could logically banned abortion.

Well, I don't know an increase in RR would have led to an abortion ban, because again, we're talking about something someone does to themselves. And smoking with an RR > 5 isn't banned.

As far as RRs being less than 2 being unimportant, this is simply incorrect. It's a matter of power of the study. I just mentioned with HRT that the use of a progestin/estrogen HRT in postmenopausal women increased the risk of breast cancer with an RR of 1.26, causing them to stop the study. The reason? The WHI was a big enough study with enough statistical power that the effect was considered to be very real. It's not just SHS.

trrll -- "Smoking has been studied from every possible angle, retrospective or prospective".

You would think such a statement would be true - given the strong emotions this topic generates. And I think I understand what you're trying to say. But I think it may be more accurate to state that smoking has been studied from a few angles, again and again. (And far too often with little reference to important confounders). As the recent information on the neg. association of Parkinson's and smoking reveals, there are lots of new angles to look at. Especially in the realm of smoking interactions.

"we're talking about something someone does to themselves"

wow !

The anti-smokers want to SHS to be harmful so they can use it as a justification to ban smoking. They think by banning smoking they are helping people, and in their minds the ends justify the means since they are doing good, so they are willing to twist the facts to fit their agenda.

Or to put it another way, the sequence was not: "We've discovered that SHS is harmful, so let's ban smoking."

It was: "We can't get more people to quit smoking, so let's discover that SHS is harmful. That will give us a useful tool to further restrict smoking and then more people will quit."

Ahhh! rj -- your post of July 18 at 5:56 p.m. was, I thought, right on point.

"Well, I don't know an increase in RR would have led to an abortion ban, because again, we're talking about something someone does to themselves. And smoking with an RR > 5 isn't banned." Posted by: MarkH | July 20, 2007 12:55 PM

is it a joke?

Ahhh! rj -- your post of July 18 at 5:56 p.m. was, I thought, right on point.

Really? He had a point? It wasn't evident to me.

"Really? He had a point? It wasn't evident to me."

Is that the card you are playing ?

Is that the card you are playing ?

Card? I'm sincerely mystified as to what the heck you are talking about. Is this some kind of code that only makes sense to denialists?

"Is this some kind of code that only makes sense to denialists?"

Ok, I'll accept that you may not be self aware.
first: baiting
and now: childish sarcasm /name calling.
I can't wait to see what comes next.

MikeB says "I've seen patients with lung cancer still sucking down one more drag before heading off for the operating theatre - now thats one powerful 'biochemical reaction'. So be honest, tell us why you continue to smoke."

Because like sex, drugs, rock and roll, etc is feels great. Who would want to live a boring life and live long? Better to live a great life and live short. Everyone dies. Does one want to live to 120 in a health care facility senile? Better to have great sex (often if possible), drugs, rock and roll, etc. then to live the boring (yawn)life. Life is short, live it. If you spend your time worrying about dieing you are doing it wrong. You will die anyways.

By Anonymous (not verified) on 20 Jul 2007 #permalink

"But drink driving is already illegal, so what's your point?"

But hold on a second. Isn't shooting people illegal? If so, then why did the British government feel it necessary to ban handguns and why are elements of the Scottish Parliment working so hard to ban airguns?

As for the evidence between SHS and smoke related illness being "thoroughly established", I'm sorry, but only those who don't understand either science OR statistical analysis, or those with an agenda, would make such a claim.
It's important to realise that many of the studies that *show* a link were little more than questionaires about exposure levels over the previous several decades. By no stretch of the imagination is that science.
It's also important to realise that many of these studies have results whose error margins include an RR of 1, meaning the possibility that there's no risk is right there in the answer.
And of course there's the results from the 40 year CA study, conducted by two self confessed anti-smokers that found no link.
In my opinion those that try and push the idea that the matter is settled, the debate is over, the conclusion is incontrovertableand being intellectually dishonest and trying to steamroller their opinion into the public consciousness and over the significant pile of opposing evidence.

Better a denialist than a postulant.

By Liz Barber (not verified) on 21 Jul 2007 #permalink

Mike B lists the "categories" of Antismokers that I examine in the first fifty pages of my book. With regard to one of them he says this:

"I personally find the idea that a bereaved person, having lost a loved one to an illness caused by smoking ( like the 90% of oral cancers http://info.cancerresearchuk.org/cancerstats/types/oral/riskfactors/), should continue to think that smoking might be a good idea to be totally barking, but this argument is not about logic, its about denial. Its 'down-the-rbbbit-hole' stuff."

Mike, I have never, EVER argued that someone who has lost a loved one to a cancer that was supposedly caused by smoking "should continue to think that smoking might be a good idea"

I was merely stating and explaining in an objective way how such people would tend, out of proportion to the general population, to become active Antismokers ("Active" has a range of meaning of its own that I explore elsewhere in the book.)

The "rabbit hole" folks are the ones who worry about someone smoking on a stage or outside on a patio or about "mini-lung cancers" being caused by third-hand-smoke on people's clothing.

Michael J. McFadden
Author of Dissecting Antismokers' Brains
http://pasan.TheTruthIsALie.com

I was hoping that this discussion will be informative and useful but, as usually, it ends with name calling.

There is a much more interesting discussion at the
http://www.imminst.org/forum/index.php?act=ST&f=169&t=15125&s=

It starts with article "Smoking lowers Parkinson's disease risk" but then it expands to many other sides of smoking. Read it all. Whatever your stand on smoking is - this link will probably shock you.

I've always really been struck by the similarities of the arguments and the tactics used by those claiming second-hand smoke is essentially harmless to the arguments used by people who oppose the teaching of evolution. I've tried to ask these people "what level of evidence of the harm of second-hand smoke would be enough to convince you?" and never gotten a straight answer. No matter how much evidence has been compiled, they simply refuse to accept any of its validity, just like those who oppose evolution.

Taking a job in a decently ventilated bar that allows smoking increases one's risk of heart disease and lung cancer no more than moving from rural Illinois to Chicago. In a free society, citizens should be allowed to take such risks once properly informed.

http://kuneman.smokersclub.com/urban.html

By Bill Hannegan (not verified) on 22 Jul 2007 #permalink

I've missed acouple of days on this thread, but only one smoker has come back with an answer to my question - why do you smoke? Its an honest one, with a touch of the Bill Hicks (dead of pancreatic cancer at 32) and Trainspotting ('Chose Life...of course this is from a smackhead). The sad thing is that although everybody dies, why chose a way which means you possibly end up sucking your last cigarette through a trac? Bill Hicks almost certainly didn't want to hang around senial until 120, but as a big fan of his when he first started appearing in the UK, he had a hell of a lot more to give. I think he would liked to have lived a little longer, I'm damned sure I and many others wanted him to.

Anonymous - thanks for being honest - but where are all the others?

MikeB - I imagine there are as many answers as there are smokers but, one answer from Peggy Noonan. I encourage you to read the whole article. It's rather charming.

http://www.opinionjournal.com/columnists/pnoonan/?id=110002624

"A short word on smokers. They are people who've made a deal. They are old-fashioned, and it's an old-fashioned deal. Their sense of life is essentially conservative: They know it is short, they know part of how you say thank you for it is to really feel it and enjoy it, and they know this life isn't the most transcendent and important one you'll be living. Smokers are disproportionately Catholic, did you know that? They know that eventually something will kill them. They accept death and illness as part of the equation. They love smoking so much, it so enhances their enjoyment of each day, that they'll gamble. Some of them, they know, will die in a car accident next year, so it won't matter if they smoked; some will die of old age at 97; some will get emphysema or lung cancer at 50 and pay the price. Fine. You buys your smokes and takes your chances.
This is a hardy and, as I said, old=fashioned approach to life. It is not modern. Modern people think that if they're tidy, floss and eat fennel they'll never die, and if they get sick they'll clone themselves and go get reborn. Smokers are more stoic and sacramental. They don't want to be cloned, they want to go to heaven and see grandma. I made up the part about how they're disproportionately Catholic but I bet it's true and in any case why shouldn't I assert phony facts? The other side does.

No, I don't smoke. I used to. I still have some feeling for my old messier, more anarchic self, but now I don't like the smell of smoke and don't think I'll ever go back to it. But that doesn't mean no one else can. And it doesn't mean I won't let you light up."

Or MikeB (taking your question seriously and trying to answer it), I guess some people may be more like James Delingpole...

http://comment.independent.co.uk/commentators/article2701060.ece

"But if I could claw back the lost years and do things differently next time round, would I? No way. For better or worse, all those fags (and the drinking and drugging that went with them) helped ease my path through life and shape the person I am. Cigarettes made grim InterRail trips across Europe more bearable; they enabled me to cope with difficult phone calls, grisly essay crises, hideous deadlines and bouts of post-relationship despair; they enhanced perfect moments and soothed anxious ones; they made me look cooler than I really am; they helped me pull girls with those cute origami roses you can make out of the silver foil; they gave me something to do with my hands at parties; they helped me meet lots of interesting new people.

Cigarettes are also good for: disguising smelly farts; warding off midges and mosquitoes; bonding with grizzled peasants in Greek villages; establishing a bond with your terrorist captors; escaping boring conversations; enjoying instant camaraderie with the huddle of fellow smokers outside the party (among them, very probably, Martin Amis or David Hockney); increasing the likelihood that you've got a light on you when your plane crashes in the middle of the jungle; saving the livelihoods of hard-working, honest tobacco growers in North Carolina and the developing world; warding off Alzheimer's; delaying your death by firing squad; giving you a sexy voice; connecting you with James Dean, Humphrey Bogart, Steve McQueen, Lauren Bacall, Marlene Dietrich, Isambard Kingdom Brunel, Groucho Marx, Clint Eastwood, Winston Churchill and all the other myriad people in history who ever looked good with a fag or a cigar or a stogy between their lips."

GDF - thanks for at least pointing to some points of view, where smokers do at least try to say they smoke. But of course both examples have 'issues'.

Peggy Noonan. Peggy 'I wrote Bush Snr's 'Read My Lips' speech' Noonan. Of course the fatalistic 'You buys your smokes and takes your chances' stuff (which is honest) has to be set alongside the 'smokers are victims'('We treat them the way India used to treat the untouchables.') stuff she also had in the article. And the article also has the totally illogical juxposition that although 'If you spend 24 hours a day in a 4-by-4-foot room with a chain smoker you'll feel it, and you'll be harmed by it. But are you damaged by the guy down the hall who smokes in the office at work? No, you're not, and you know it. You just don't like it. Your nostrils are dainty little organs, and your nostrils trump his rights.
But you definitely wouldn't be harmed if the handful of smokers in your office were allowed to smoke only in a common room with good ventilation'.

So having written '"Second hand smoke kills." But--how to put it?--we all know that's just politically correct propaganda invented by the prohibitionists, don't we?', she then admits it does exist, but then says that if it does , good ventilation will somehow cure it. Logical? No. But great smokers logic.

As for James Delingpole, you have to admit that his stuff is about as deep as a really shallow puddle. Even Toby Young (himself not exactly the most serious of writers) said of his 'Thinly Disguised Autobiography' (which apparently is...) that 'You start out as this smug git who's only interested in meeting famous people and shagging gorgeous birds and...you never change....... Okay, the character goes from being predominantly self-satisfied to being predominantly self-loathing, but that isn't the same as self-understanding. You never escape the prison of your own narcissism'. Lovely.

His works include 'How to Be Right: The Essential Guide to Making Lefty Liberals History', of which one Amazon reviewer wrote 'dont waste your money on this trash'. The Guardian digested read http://books.guardian.co.uk/digestedread/story/0,,2038161,00.html seemed to be the funniest bit of it. The fact that 'Spiked' thought it 'laugh out loud' speaks volumes...

As for his article itself, its the standard 'smoking is cool' stuff we got before the smoking ban came in. But when the best reasons for smoking you can come up with is cigarette paper origami, its hardly convincing.
On the other hand, there are a fair number of the usual excuses there.
Cool famous people smoked (he even mentions Bogart) - check.
Helps me when I'm stressed (dealines) - check.
Gives me something to do with my hands at parties - check.
All my friends are doing it (Martin Amis & David Hockney) - check.
There are also others, but I can't arsed to go through them all, since they are of course bollocks (especially the 'establishing a bond with your terrorist captors/increasing the likelihood that you've got a light on you when your plane crashes in the middle of the jungle/ delaying your death by firing squad stuff - why would you quote that?).

Of course Adeimantus has actually used the 'my grandad' excuse, which even Delingpole didn't bother with. On the other hand, he does mention Enstrom and Kabat and thus concludes that '"Passive smoking" in other words is a total lie, invented by health and safety agitators and connived in by the state in order to railroad through an iniquitous law by pretending it's about the "public interest"', while leaving out all the other research on SHS.

Its easy for a working writer to bang out 1500 words on why smokings so good, and why SHS doesn't exist. Its mostly light, probably a bit amusing, and appeals to the idea of having all points of view. Facts are not important, because its just an opinion. And all that stuff about not wanting to get old, well its just a bit of fun.

We did have a UK journalist who would bang out a a weekly amusing piece. Perhaps if he was writing last year, he would have written something along the lines of Delingpole's piece. But in 1996 he got a lump in his neck. He actually wrote about it, with, as he put it, a 'smug punchline'. By March 1997, he had it confirmed that it was cancer.

Was it smoking? The number of smokers in percentage terms who get his particular cancer? 95% - so yeah, it was the smoking. He went into remission, but it came back. He made it his personal mission to write about his cancer, and even made a TV programme about it. He died on March 2nd 2001.

The reason I'm writing about him is that I occasionally used to see him in the hospital where I then worked, while he was being treated. And I was the person on duty the day he died who had to explain to a friend of the family how to register his death, etc. His name was John Diamond http://www.times-archive.co.uk/JohnDiamond/index2.html http://en.wikipedia.org/wiki/John_Diamond_(journalist)
, he was married to Nigella Lawson, had two young childen, and was 47. Of his kids, he wrote "Fancy not seeing how that plot turns out."

He wrote 'By all means campaign for some phantom 'right' to smoke, but don't believe that right derives from corrupting the statistics about what smoking does to you. Understand it for what it is: the right to play Russian roulette, as I did, with the immune system'.

He didn't die being cool: he died with no tongue, no spoken voice, and no sense of taste. At least he could write. Read his book (which even Spiked liked), then ask the question, why do do people smoke?

Pierre,

"No matter how much evidence has been compiled, they simply refuse to accept any of its validity, just like those who oppose evolution."

First up, it's funny that I earlier used a simlar analogy about Christians not accepting evidence... and I am on the side of the 'denialists'! Please provide us, for our edification, a link to one or more studies showing the deleterious effects of SHS. For each one you provide, I will show you three that show the opposite

By Adeimantus (not verified) on 23 Jul 2007 #permalink

Adeimantus,

No prob:

http://www.circ.ahajournals.org/cgi/content/abstract/111/20/2684
http://content.onlinejacc.org/cgi/content/abstract/24/2/546
http://tobaccocontrol.bmj.com/cgi/content/abstract/8/2/156
http://www.chestjournal.org/cgi/content/abstract/122/3/1086

That's after a relatively quick search, someone who has actually done this research would be better at pointing out sources. Either way, you apparently owe me twelve legitimate studies that show the opposite (i.e. that second hand smoke has no ill effect).

Adeimantus,

No prob:

http://www.circ.ahajournals.org/cgi/content/abstract/111/20/2684
http://content.onlinejacc.org/cgi/content/abstract/24/2/546
http://tobaccocontrol.bmj.com/cgi/content/abstract/8/2/156
http://www.chestjournal.org/cgi/content/abstract/122/3/1086

That's after a relatively quick search, someone who has actually done this research would be better at pointing out sources. Either way, you apparently owe me twelve legitimate studies that show the opposite (i.e. that second hand smoke has no ill effect).

Posted by: Brian | July 23, 2007 12:29 PM

Thanks, Brian. There's plenty more, I'm sure.
Plus, Adeimantus, you've actually proved my point. Rather than acknowledge the possibility there might be *some* validity to the absolute reams of studies done on the dangers of second-hand smoke, you've used the exact technique used by the Creationism crowd, which is "for every study supporting evolution, there's three studies (or 5, or 10 ... whatever) rejecting it."

By Anonymous (not verified) on 23 Jul 2007 #permalink

MikeB -- watch out for that "smoker's logic" crack (you know... Einstein and all that...).

I saw a piece about Nigella Lawson that focused on her husband's death. I also felt terrible for her and her family. And in all seriousness, I admire your concern for people.

I usually prefer not to discuss primary smoking, because it really isn't my overall concern (which is the mis-representation of health effects of SHS and the problems for the integrity of public health that will stem from that...). But I'll make an exception and talk about primary smoking for a bit.

I make it a point to try to reply to questions on these sorts of blogs honestly, and with the assumption that the question was an honest and serious one. And I try to ask questions the same way. And I try my best to understand various points of view.

I think what you are saying is that you've seen a lot of devastation that you attribute to smoking -- and you can't imagine smoking as a "rational" choice. Fair enough.

What Noonan and Delingpole were saying in different ways, I think, is that in some instances, where people value the perceived benefits over the perceived negatives -it may be actually a rational choice within their own perceptions and value system. If it's a gamble -- people are calculating the "pot odds" -- some amount of health risk for some amount of pleasure.

The bottom line here is that many people smoke. To argue that it's *not* an extremely pleasurable activity (in many ways as outlined by the articles) to them is... ignoring the obvious. It may also be an addiction to some -- but again, it seems to (usually) be a pleasurable addiction.

Because *you* don't receive pleasure from smoking, you can't see the pleasure of it. So you will dismiss any *reason* as an excuse.

I've been down this same road with "safe sex". For some people, sex with a condom so diminishes the pleasure that they will take the risk. I wouldn't, but with the same information that I have, they do. I wouldn't fly a plane either. But some people do. All you can do is honestly inform people, to the best of your knowledge, and allow them to make choices. That's fair and admirable. Anything beyond that is, I think, the utmost disrespect for personal autonomy.

I part ways with some in public health however, when the honest communication of risks doesn't seem to be enough to control other people's behaviors. So the risks become ever exaggerated, which results in the promotion of mistrust and bad science. Which is how I see the SHS issue. What happened when we found out we *didn't* go blind...? (Which as I stated above is my primary concern, and a whole 'nother issue).

Oh - and MikeB --

"why would you quote that?)."

I went back and forth mentally on quoting that 2nd paragraph --but in the end, quoted it because I thought some of it better illustrated two important points that I thought addressed your question (why do people smoke?)-- identification with others and camaraderie.

GDF - thanks for the feedback. Your perfectly correct that 'Because *you* don't receive pleasure from smoking, you can't see the pleasure of it. So you will dismiss any *reason* as an excuse.' But its partially because I did briefly smoke that I do understand why people take it up, and I tend to dismiss the rationals that smokers such as Noonan make in regard to the habit (Delingpole is frankly a bit of a pillock - see 2nd paragraph!).

Now thats a slightly different matter from SHS, but I asked the original question because what I kept seeing were large numbers of smokers refusing to believe SHS existed, because it undermined their stance on the 'freedom' to smoke.

Noonan's retoric on the subject really does make you think that she's protesting too much - smokers are victims of people who think that SHS is bad, but of course this is a lie, etc. Yet she is honest enough to admit that she has made a bargin with fate - the pleasure of a puff now, versus the possibility of an untimely death. She even goes beyond that, and admits that being stuck in a small room with a chainsmoker would be bad for you, but then pulls away from the logical outcome of that line of thinking - that SHS does exists. However, I suspect that most smokers don't even have this logical debate. The fact that 70% seemingly want to give up, but relatively few actually do probably has more to do with with a mixture of the addictive properties of nicotine and a variation on the gamblers fallacy ('my number wont come up').

I think where we differ (although we are both ex-smokers who dislike the smell of smoke, etc), is how we feel about 'personal autonomy'. You bring up the example of safe sex, which is obviously about both personal pleasure and safety to the persons partner and the wider public. You could argue that ultimately it is up to the individual to decide what they want to do, but of course their personal freedom must be limited by any possible harm they could do to others. If someone has a STD, I'm sure we would all agree that they should either use a condom or not have sex at all.

For the non-smoking majority, SHS is a form of harm. The smokers personal freedom to smoke in your presence potentially causes you harm. Thats why SHS seems to be so difficult for many to take on board. If I smoke, then its my bargin with fate (takng the Noonan model), but I'm not harming anyone.

But if SHS exists, then I must be harming people (even the most hardcore smoker is unlikely to argue in public that harming other people is OK). Since my personal rights would be infringed by this (and I'm unwilling to give up or at least stop smoking outside my own home), it seems to be simply easier to wish SHS away.

Yet the exchange between Adeimantus and Brian will probably show that Adeimantus is wrong. The number of studies showing passive smoking to be a hazard are overwhelming http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=35422 - picking holes in one does seem to similar to the 'hockey stick is broken' mantra used by anti-AGW types. Its forgetting the whole picture.

The risks from SHS havn't been exaggerated - we know cigarette smoke is dangerous, whoever is breathing it.

Hey MikeB --

1) I was afraid that paragraph break might be confusing. Noonan is the ex-smoker who dislikes the smell of smoke - not me.

2) Obviously, I do not see the epi evidence of SHS harm in the same way you do. Maybe some people deny SHS harm for psychological reasons -- but my reasons (I believe) are sound scientific reasons. It could just as easily be claimed that those who interpret the risks as important are motivated by their dislike for smoke or smoking. (Smoking bans enacted based on an expectation of s 40% reduction in MI 6 months into a smoking ban - oh come now...) But I don't really want to beat that dead horse again. I think everyone has made their points on this thread or related ones.

3) Adeimantus and Brian should both be sent to their rooms. Brian for implying that all folks who interpret the weight of the evidence differently are "creationists", Adeimantus for implying that the sheer number of studies (without regard to their content) was important.

4) Now! The point I really wanted to get to. I was involved with HIV education way back in the beginning. Believe me, the debates were much like this one. Funny, but I was at least once, on the "other" side. (So, I think, I really see where you are coming from). I believed that people infected with HIV should not, for example, play basketball. Apparently, I wasn't enough of a basketball fan (joke) - because almost no one in public health seemed to agree with me. And in any case, "public health" made a different determination. (The current CDC online info about HIV in sports seems reasonably well balanced to me). In retrospect, I think I was wrong on that one. Many argued that people with AIDS shouldn't be allowed in public pools (are you old enough to remember that hysteria?)... or schools. Remember Ryan White? (and one must also ask, how much of the AIDS *hysteria* was based in a dislike/fear of gay people?).

So yes, if a person has an STD it is the moral thing to wear a condom. Clearly there are absolute risks that others *should* not be exposed to. But that raises the question -- what if the other partner is aware of the STD and concurs with the decision not to wear a condom? (Parallel to "should there be *smoking* hospitality venues run by and for smokers?", or "Is is there a problem with well ventilated *smoking rooms* in office buildings? (both prohibited where I live)).

But even beyond that, we are looking at *levels* of potential harm (as well as the ability to avoid it by not entering a *smoking* establishment) -- and balancing that with all sorts of other social concerns (like property rights). As a society, we don't ban ALL levels of potential harm. (My neighbor's boat spews (?) into the river in which I swim. - what level of risk must there be for me to ask him to stop boating? And what if I'm not even quite clear what the actual level is?).

These are, I think, complex social questions. And well, not to go back over it all again, but due to political, ideological and financial interest, I don't think the public is getting the honesty and integrity that *we* deserve. On another thread, someone suggested that with all of the conflicting interests, perhaps science can no longer speak to public policy questions. I don't want to go that far. But I do suggest that public policy questions demand the utmost integrity of the scientific community to speak to them. There are lots of people pointing out the problems with SHS research. Problems that are magnified by the public policy issue. We aren't all denialists or creationists.

MikeB -- Let me add something about primary smoking. (and let me know if this helps you understand what I was trying to say).

I used to talk to inner-city kids about HIV and condom use. For a long time I was hearing the "why should I worry about AIDS when I could get shot tomorrow?" (fatalistic)argument. And I would reply -- something like "well, (even if you believe that) why do you want to worry about two ways to die prematurely? - isn't one enough?" Hah! my *rational* argument trumped their *irrational* argument! Except it didn't. And they weren't *listening* to me anyway. Because what they were really trying to say was something more along the lines of "I expect my life to be hard, have a high risk of ending unpleasantly (prison, drugs, guns), perhaps prematurely, and you are asking me to give up one of the only sources of pleasure I can count on".

That's maybe not exactly what smokers are saying, but my point is that if you don't listen to what they *are* saying... well... then no one listens to anyone.

This is a strawman argument. He's using the website of a bunch of mentally retarded incompetents at FORCES to pretend that smokers have no legitimate case against anti-smoker scientific fraud. The real fraud - which those drooling morons refuse to attack - is that the anti-smokers deliberately use defective studies that ignore infection in order to falsely blame smoking and secondhand smoke. Ten times more lung cancer is caused by HPV than (supposedly) by ETS, yet those anti-smoker frauds pretend that HPV doesn't matter. Why don't you visit a REAL smokers' rights website instead of that bunch of phonies (who may by working for the anti-smokers).

http://www.smokershistory.com/hpvlungc.htm

Currently their is a scientific "consensus" the SHS is harmful. The truth is that a "consensus" in not proof or science for that matter. For a good article on the matter visit this site for a speach by Michael Crichton:

http://www.michaelcrichton.com/speech-alienscauseglobalwarming.html

A few quotes:

"I want to pause here and talk about this notion of consensus, and the rise of what has been called consensus science. I regard consensus science as an extremely pernicious development that ought to be stopped cold in its tracks. Historically, the claim of consensus has been the first refuge of scoundrels; it is a way to avoid debate by claiming that the matter is already settled. Whenever you hear the consensus of scientists agrees on something or other, reach for your wallet, because you're being had.

Let's be clear: the work of science has nothing whatever to do with consensus. Consensus is the business of politics. Science, on the contrary, requires only one investigator who happens to be right, which means that he or she has results that are verifiable by reference to the real world. In science consensus is irrelevant. What is relevant is reproducible results. The greatest scientists in history are great precisely because they broke with the consensus.

There is no such thing as consensus science. If it's consensus, it isn't science. If it's science, it isn't consensus. Period." -Michael Crichton

"Finally, I would remind you to notice where the claim of consensus is invoked. Consensus is invoked only in situations where the science is not solid enough. Nobody says the consensus of scientists agrees that E=mc2. Nobody says the consensus is that the sun is 93 million miles away. It would never occur to anyone to speak that way." -Michael Crichton

And the final quote:

"In 1993, the EPA announced that second-hand smoke was "responsible for approximately 3,000 lung cancer deaths each year in nonsmoking adults," and that it " impairs the respiratory health of hundreds of thousands of people." In a 1994 pamphlet the EPA said that the eleven studies it based its decision on were not by themselves conclusive, and that they collectively assigned second-hand smoke a risk factor of 1.19. (For reference, a risk factor below 3.0 is too small for action by the EPA. or for publication in the New England Journal of Medicine, for example.) Furthermore, since there was no statistical association at the 95% confidence limits, the EPA lowered the limit to 90%. They then classified second hand smoke as a Group A Carcinogen.

This was openly fraudulent science, but it formed the basis for bans on smoking in restaurants, offices, and airports. California banned public smoking in 1995. Soon, no claim was too extreme. By 1998, the Christian Science Monitor was saying that "Second-hand smoke is the nation's third-leading preventable cause of death." The American Cancer Society announced that 53,000 people died each year of second-hand smoke. The evidence for this claim is nonexistent.

In 1998, a Federal judge held that the EPA had acted improperly, had "committed to a conclusion before research had begun", and had "disregarded information and made findings on selective information." The reaction of Carol Browner, head of the EPA was: "We stand by our science�.there's wide agreement. The American people certainly recognize that exposure to second hand smoke brings�a whole host of health problems." Again, note how the claim of consensus trumps science. In this case, it isn't even a consensus of scientists that Browner evokes! It's the consensus of the American people.

Meanwhile, ever-larger studies failed to confirm any association. A large, seven-country WHO study in 1998 found no association. Nor have well-controlled subsequent studies, to my knowledge. Yet we now read, for example, that second hand smoke is a cause of breast cancer. At this point you can say pretty much anything you want about second-hand smoke." -Michael Crichton

Michael Crichton's background "He attended Harvard College in Cambridge, Massachusetts as an undergraduate, graduating summa cum laude in 1964.[3] Crichton was also initiated into the honors organization Phi Beta Kappa. He went on to become the Henry Russell Shaw Traveling Fellow, 1964-65 and Visiting Lecturer in Anthropology at Cambridge University, England, 1965. He graduated from Harvard Medical School, gaining an M.D. in 1969 and did post-doctoral fellowship study at the Salk Institute for Biological Studies, La Jolla, California, in 1969�1970. In 1988, he was Visiting Writer at the Massachusetts Institute of Technology." for wikipedia.org

Yep Michael Crichton and denialist. Yet, you believe you have a consensus and call it science.
depp=true
notiz=[disemvoweled for insipidity, and cut and paste of cranky Crichton nonsense]

MarkH I have in the past warned about the dangers of Tobacco Control turning Epidemioloty into junk science. There are three new journal articles that you may wish to read and comment on. Perhaps, you were the one in denial:

http://www.epi-perspectives.com/content/pdf/1742-5573-4-13.pdf

http://www.epi-perspectives.com/content/pdf/1742-5573-4-11.pdf

http://www.epi-perspectives.com/content/pdf/1742-5573-4-12.pdf

Please read and comment.

Do I see Dan using the "brainlessly throw up lots of denialist links" un-methodology? There's no indication whatsoever that Dan has actually read the very articles he linked to.

bi writes: "Do I see Dan using the "brainlessly throw up lots of denialist links" un-methodology? There's no indication whatsoever that Dan has actually read the very articles he linked to."

I am not sure what you consider denialists links? The lasts two post include recently published journal articles and a recent article published in Skeptic Magazine. My main point is that the misinformation tobacco control is putting out and the lack of the medical community calling them on it is hurting the medical sciences in general. No one is better then distorting the facts then Dr. Stanton Glantz who runs the TobaccoScam web site. He is a PhD in mechanical engineering who happens to have the title professor of medicine. His site can be found and fact sheet can be found here:

http://www.tobaccoscam.ucsf.edu/Secondhand/Secondhand_fs.cfm

Dr. Michael Siegel, a former student of his and an advocate of smoke free work places, is calling tobacco control to task. He is challenging them to back up their claims with real science and not just scare mongering. He made his challenge yesterday and it was reported in several papers. His challenge is here:

http://tobaccoanalysis.blogspot.com/2007/11/definitive-challenge-issued…

If you are criticizing me because I haven't figured out how to do the nice links or quotes that MarkH uses fine. I can see why you would think I only provide a list of links. But I would dispute that the links are to denialist sites. Do you believe claims that 30 seconds of second hand smoke (SHS) can cause a heart attack in healthy persons? Do you believe that SHS exposure increases the risks of heart attack to that of active smokers? These are not supported by the science and Dr. Siegel is calling them on that. Sorry I do not believe the statements and if you consider that denialism fine.

I am not a medical scientist. But most I believe who read this blog are. By being silent when people who act as advocates, misrepresent (exaggerate to achieve at political purpose) the science, you are hurting your field's credibility in general. Is it any wonder people believe woo as much if not more the science based medicine? That is the point I am making.

I never thought I would be writing a comment in defense of smoking cranks. But after some time observing those cranks on Michael Siegelâs blog (a sort of clubhouse for internet smoking cranks and denialists) and elsewhere, I have to say itâs not entirely their fault. Unscrupulous people find those who may be susceptible to their doctrine and basically BRAINWASH them with the sort of nonsense outlined very well in the article here. Mostly these are douche-bag lawyers and PR types, but occasionally the odd academic or even MD will get in on the act. These are the denialists, people who know they are spreading BS to sow confusion.

Maybe itâs time to call a spade a spade. IMHO this is part of a wider effort to slow down the decline of the social acceptability of smoking. These people referred to here as cranks were victimized once when they got hooked on nicotine, likely as children or teenagers, now they are being used once again to promote the interests of an industry which lacks the credibility to do so directly. (IMHO)