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Thursday 27 August 2009

Ash at it again

Scientists Examine ASH Smoking Claims

On its website, Action on Smoking and Health makes a number of claims regarding smoking, including that the very breath and smell of smokers, even when they are not smoking, can be extremely hazardous to people's health.

E Cigarette Direct asked three respected Professors of Medicine to examine these claims.

ASH's Health Claims | Professor Brad Rodu | Professor Michael Siegel | Professor Carl Phillips

ASH.org's Health Claims

1. 30 minutes of exposure to drifting tobacco smoke can trigger a fatal heart attack.

ASH states that: "...someone else’s smoke can kill you if even if you can barely smell it, and even if you can’t smell it."

2. E Cigarettes pose dangers for both smokers and non-smokers.

According to ASH, electronic cigarettes are dangerous both for smokers and non-smokers.

3. Third hand smoke can pose serious risks for non-smokers.

Proven or not, this claim has been used to:

4. Smoker's breath can be harmful to health, especially to children, the elderly and those especially sensitive to many chemicals.

John Banzhaf says:

"We've always known that a smoker's breath stinks. Now we know that it also creates indoor air pollution which can harm children and perhaps some adults."

Scientist's Responses to ASH

Professor Brad Rodu

Brad Rodu is a Professor of Medicine at the University of Louiseville, and holds an endowed chair in Tobacco Harm Reduction Research. He also runs the Tobacco Truth Blog.

Quite simply, these statements are either gross exaggeration or pure fiction.

With respect to exposure to second hand smoke, it is true that it can initiate some subtle changes in blood chemistry and other factors, but it is a specious exaggeration to claim that it causes heart attacks. There is a general consensus that the important risk factors for heart attacks are primary smoking, diet, high cholesterol and triglyceride levels, low physical activity, hypertension and family history. Compared with these, brief exposure to secondhand smoke is insignificant.

The ASH statement about e-cigarettes is wishful thinking. With respect to smokers, there is substantial and compelling scientific research documenting that consuming the ingredients in e-cigarettes (nicotine, propylene glycol, water and flavors) is vastly safer than burning tobacco and inhaling 3000+ toxic by-products. Claiming that e-cigarettes are dangerous for non-smokers is about as credible as claiming that air travel is dangerous for people who never set foot in an airplane.

Third hand smoke is an invention by Harvard University anti-tobacco extremists; it consists of “breathing air today in a room or car where people smoked yesterday.” The Harvard extremists collected “evidence” for the dangers of third hand smoke, which were the survey responses from 1,500 non-scientists from the U.S. who believe that it can harm babies and children. Third hand smoke has as much scientific credibility, and carries about as much risk, as third hand rain.

John Banzhaf’s comments about the harm related to smokers’ breath has no medical rationale, but it is an excellent example of the increasing marginalization of smokers using pseudoscience. Extending Banzhaf’s logic, non-garlic eaters may be able to absorb the possible health benefits of garlic by moving into the vicinity of garlic aficionados.

Also see Professor Brad Rodu's letter to E Cigarette Direct.

Professor Michael Siegel

Formerly a physician who specialised in preventative medicine, Professor Michael Siegel is now a Professor in the Social and Behavioral Sciences Department, Boston University School of Public Health. Michael also has 20 years experience in Tobacco Control, primarily in the field of research, and runs the Tobacco Analysis Blog.

1. 30 minutes of exposure to drifting tobacco smoke can trigger a fatal heart attack.

It may be true, on theoretical grounds, that 30 minutes of tobacco smoke exposure could trigger a fatal heart attack, but this would only be the case for individuals with severe pre-existing heart disease. A healthy person is not going to die from a heart attack due to 30 minutes of secondhand smoke. ASH makes no attempt to qualify its statement. Even worse, ASH gets even more specific in its claim, asserting that the risk of a fatal heart attack in a nonsmoker exposed for 30 minutes is the same as that of an active smoker. This latter claim is factually inaccurate.

2. E Cigarettes pose dangers for both smokers and non-smokers.

There is no existing evidence that e-cigarettes pose a risk for nonsmokers. The nicotine exposure from the exhaled vapor produced the the vapor is likely to be extremely small and there is no reason to think that it poses a danger for nonsmokers. But there certainly is no evidence to suggest that it poses a hazard.

3. Third hand smoke can pose serious risks for non-smokers.

While there is evidence that there are detectable levels of tobacco smoke constituents in exhaled tobacco smoke of smokers after they have finished smoking and on surfaces in rooms after smoking has been completed, there is no evidence that the levels are high enough to cause demonstrable harm to most individuals. The only potential side effect is likely an adverse response among individuals who are exquisitely sensitive to tobacco smoke.

4. Smoker's breath can be harmful to health, especially to children, the elderly and those especially sensitive to many chemicals: "We've always known that a smoker's breath stinks. Now we know that it also creates indoor air pollution which can harm children and perhaps some adults."

As above: There is no evidence that the levels of exposure to tobacco smoke constituents are high enough to cause any problem. The only potential problem could be an adverse response among individuals who are exquisitely sensitive to tobacco smoke.

Note - You can also read our interview with Professor Michael Siegel.

Professor Carl Phillips

Carl V Phillips is Associate Professor at the University of Alberta School of Public Health, where he publishes the TobaccoHarmReduction.org website that provides educational and research information. Much of his work focuses on scientific epistemology, and he recently started the epiereview.com project to help improve the quality of public health science publishing.

First, as an overview, all four of these statements are clear examples of a phenomenon that we have documented in several of our studies: Most major anti-tobacco (and now also anti-e-cig) political actors, including those who are (mistakenly) trusted by the public, demonstrate a willingness to make whatever pseudo-scientific claims they think will further their worldly goals, regardless of the whether they are true, apparently unconcerned with the damage that such claims do to people and to science itself. I have written about this.

1,3,4 on the list are out-and-out scientifically false in the sense that there is no evidence to support them. That is, these are epidemiological claims (claims about actual human health effects) but there is absolutely no epidemiological evidence that supports the claim.

If they had made claims about "detectable levels of chemicals that are known to cause...." or something like that, as many others have, it would be a different kind of lie -- an attempt to take advantage of scientific ignorance to be dishonest without actually making an explicitly false statement.

But given that purely speculative epidemiologic claims were stated as if they were facts, this has to be seen as explicit falsehood. Keep in mind that a scientific hypothesis about a phenomenon needs to be supported before it can be claimed as true; simply finding some reason to propose a particular hypothesis (e.g., a particular exposure might be harmful because there are tiny quantities of some chemical) and then declaring it to be true without evidence is not just unethical - it also damages the public's ability to make sense of science.

Again, these people try to take advantage of scientific ignorance to claim whatever strikes them as expedient without regard to the science. Points 3 and 4 are particularly absurd since the "study" that gets cited as the basis for saying "third hand smoke" is harmful was actually an unethical push-poll that manipulated lay people into saying they feared the effects. This obviously offers no useful information at all.

Point 2 is a bit more complicated of a lie.

Since the claim is juxtaposed with discussions of ETS, it is a clear attempt to imply that the spillover from e-cigs is just as bad as people think ETS is. This is obviously false, since ETS is not even as bad as people think ETS is, and e-cig vapor is, beyond much doubt at all, less harmful still.

It is conceivable that e-cig vapor poses some small risk, but this is speculative since there is no epidemiology and not even any chemistry/physiology to support it.

The claim that the trivial amount of nicotine in the vapor would be much of a risk seems ridiculously far-fetched. That said, the headline statement is literally true if we consider the risk to children of certain e-cig products that are contact poison or swallowing risks.

Of course, referring to such risks (which should be reduced through product engineering!) to try to trick readers into thinking that there is a substantial externality from the vapor is clearly a lie.

What do you think?


H/T to "Freedom to choose"