Tobacco Documents Online

......................................... Christopher Caldwell Smoke Gets in Your Eyes But it probably doesn't give you cancer, despite what the EPA says. weed to dust, and most people would grant to parents, not the state, the responsibility to keep them away from pollu- tanrs. Attempts to [ink heart disease to ETS have not bonx fruit. And in 1986. a Yale University medical school smdy of asthmatics exposed to ETS showed that not only did the smoke not cause any acute respiratory risk-it actually de- creased bronchial constriction. "Even with the 'rigged jury' of standard statistical proce- dures." wrote Dr. Kevin Dowd in the June 1991 issue of the British journal Economic Affairs, "it turns out. contrary to popular myth. that there is still no convincing evidence in favour of the adverse effects of passive smoking:" Yet. a year previous to that the EPA. having failed in its attempts to establish clear-cut and readily confirmable proof of the P roving dangers to non-smokers from "environmental to- bacco smoke" (ETS. or "passive smoke") has not been easy for and-smoking activists. While every nag in every airport waiting room complains about her "smoke allergy," no study has ever established aller- genic properties in tobacco smoke. While children have been shown to be sen- sitive to ETS. it has long been known that children are more sensitive to any- thing in the air, from rag- ~ Christopher Caldwell is assistant managing editor of The American Spectator. The Amencan Spectater May 1992 harms of ETS. had used a complicated and irregular scientific route to claim a minimal Link. Patching to- getber spousal studies, the EPA claimed that women married to smokers were 1.28 times as likely to con- tract lung cancer-and that ETS was to blame. The EPA leaked a draft risk as- sessment describing envi- ronmental tobacco smoke as a "known human car- cinogen." The months since have seen anti-smok- ing activists calling for more legislation in public places. and tobacco interests and libertarians pointing out gaps in what they say is dishonest and politicized science. xposure to environmental tobacco smoke is difficult to measure by increments. F'irst of all, although irte- sponsible scientists have tried, one can't extrapolate Lung cancer risk from the dosages active smokers rake into their lungs. For one, the substances are chemically and quantitatively different; "active" tobacco smoke is made up of smoke particles-and plenty of them-while "passive" smoke is highly diluted. with a partially vaporous content- In addition. "active" smokers take deep breaths through their mouths and hold the smoke in their lungs. "Passive" smokers breathe largely through the nose, which filters out impurides. While blood tests and urine samples do show that non- smokers absorb nicotine from the smokers around them, it zs 2074144184

0 is in such small doses that this can be seen as a triumph more for modem scientific calibration than for any cause- and-effect relationship. It's rather like remarking that every cubic foot of ocean water contains ash from Mount Pinatubo. or that almost all of the paper money in Miami contains traces of cocaine-it's true- impressive, and mean- ingless. In real-life settings, the dangers of particulates are even less impressive. A 1978 study in the International Archives of Occupational Environmental Health claimed that it would take 1I to 50 hours in an extremely smoke- polluted environment to absorb as much nicotine as a smok- er takes in from one cigarette. In Britain. where smoking was legal on subway trains until the mid-1980s and was un- til recently permitted on buses, the Freedom Organization for the Right to Enjoy Smoking Tobacco estimated that one would have to ride in the smoking section of a bus for four- and-a-half weeks to be exposed to one cigarette's worth of nicotine. ' It's possible to measure the "respirable suspended parti- cles" that surround a smoker. but very difficult to distin- guish them from other particles that may be in the air from cooking, rug fibers, car ex- haust. air-conditioning, etc. Pro-smoking activists like to mention "sick building syn- drome" as an major contrib- utor. At first glance. calling poor ventilation a "syn- drome" and a health threat appears as hysterical as us- ing the word "choc-a-holic" to claim that the science-fic- searchers have sought a link in epidemiological studies. i.e. studies based on the incidence of affliction across large pop- ulations. Here is what the thirtv studies that have been con- ducted to date report: twent,v-four show no statistically sig- niticant link at all; six show a weak link: nine show that being married to a smoker actually decreases one's chance of contracting lung cancer. One would think that a combined study-showing ETS exposure from atl sources- including the work environmenL and including other smoking family members-would show a clearer relationship. Yet no combined study has ever shown a statistically significant association. Even shoddier is the failure of most of the luna cancer tests to probe cancers histo- logically-that is. by sampling for oncogens in cells of the in- fected organs. Only limited histology was done even in the large and influential 1981 Hirayama study from Japan, which is the cornerstone of the ETS/cancer scare. As everyone knows, cancer metastasius, and failure to distinguish be- tween cancers that originated in the lungs and those that moved there from another organ makes the figures consider- ably "softer." The Hirayama study also relied on question- naires, which made no at- tempt to determine which non-smokers were u-smok- ers. Then there is the ques- tion of confounding factors. like Dr. Gao's rapeseed oil. Confounding factors in smoking are so numerous and unpredictable that it is almost impossible to unrav- "Active" smokers take deep breaths through their mouths and hold the smoke in their Iungs."'Passive" smokers breathe largely through the nose, which filters out impurities. tionesque terrors that afflict the true addict apply to some- one who is basically a glutton. But the 1976 LLegionnaires' disease outbteak is a sick-building incident that cost twenty- nine lives- and occupational studies tend to bear the pro- smokers out: in only 2 to 4 percent of indoor air quality problems is tobacco smoke the major culprit. H ow much particulate matter enters the air due to smoking? Anti-smoking activists would have us believe a tremendous amount. Dr. David Bums, testifying before the Los Angeles City Council Health Committee, argued that particulates, "when smoking is al- lowed. [increase) about ten-fold from the background lev- els." This is simply falsehood in the service of anti-smok- ing propaganda-a 1990 study of smoking sections in forty-one restaurants showed that only half of the particu- lates were from smoke; another study, from 1988, put the figure at 28 percent. As far as eating in restaurants is con- cerned, the cuisine might be as much of a risk as the smoke; a 1987 Shanghai study by Dr. Y.T. Gao and three researchers.from the National Cancer Institute found that nonsmoking women who cooked with rapeseed oil had an incidence of lung cancer 2.5 times as high as those who cooked with soybean oil. Given the ineffectiveness of exposure measurements, re- 26 ~ el smoking as a cause from a welter of non-smoking behav- iors that smokers engage in with shocking disproportion. ~~ Stanley Coren, a Canadian expert on "handedness." writes that a study in Michigan has shown that left-handers smoke i considerably more than right-handers.1 (They also die nine years earlier-and not due to smoking.) In 1990, two papers published in the !ou»sal of the American Medical Associa- tion by stop-smoking researchers Alexander Glassman and Robert Anda showed that smokers were six times as likely as nonsmokers to suffer from major depression and twice as likely to suffer from chronic depression. David Krogh, an anti-smoker, remarked on the smoking personality in one of the most fascinating btsoks of 19912: Does being a Rotarian or a scuba diver make a person more or less likely to be a smoker? ... Does being in group A make you any ttton: likely to be a smoker than being in group B? The answer to this is clearly yes. You are more likely (and increas- ingly likely) to be a smoker if you are poor, for example. or if you are poorly educated. No surprise dtere. But what about tThe Lsft-Hander Syndrvmev rha Causes and Consequences of frf7-Handedness. New York: The Free Press. 308 pa{es. 524.95. =SmolLq: rhe Amficid Parsinn. New York: W H. Freeman and Company. 176 pages. S 17.95. TLe Ameriraa Spmrar May 1992 2074144185

14 9 I these things: You are more likely to be a stneker if you are di- vorced: you am far less likely to wear a seat belt if you are a smoker, young white women who smoke are much more likely to be binge drinkers than ate ttieir nonsmoking counterparts tal- ntost half are, a rate two to three times higher than that of non- smoking women): men who are downwardly mobile relative to their parents are mote likely to be smokers. while men who are upwardly tnobile aro less likely.... As a group they « nd to tank higher than nonsmokers on scales that measure risk-taking and sensauon-seeking.... Smokers tend to tank high in a constellation of characterisdes that collectively are referred to in the now quaintly old-fash- ioned tertn "anti-social" ... They tend to be mote tebellious. be morc defiant, and have higher levels of misconduct. The correlations in this category are very saong... . Smoken seem to have what can only be called a higher sex drive-or perhaps a lower sex inhibition-than nonsmokers.. . . Smokers rank high in impulsiveness. . . . Finally, we have reason to believe that smokers are more honest than nonsmok- ers in the view of themselves that they present to others. Hans Jurgen Eysenck. whom Krogh describes as "perhaps the best known psychologist in Britain and certainly one of the most influential psycholo- gists in the world in the area of personality theory," has at- tempted to taxonondu smok- ers' confounding factors, and considers them so extensive as to undertnine, fot the ptrs- ent time, attempts to use smoking as an etiologicai fac- tor in disease. I t is easy to see how a study such as Hiraya- ma's could be drastically wrong: if his subjects came disproportionately from working-class industrial areas (they did), and if smoking is more prevalent among the Japanese working classes (it is), Hitayatna's wives of smokers would have a higher rate of lung cancer than wives of non-smok- ers, regardless of smoking behavior. Finally, rates of lung cancer infection vary drastically according to race and na- tionality: British epidemiologist P.R.J. Burch showed in the 1970s that Finns, who smoke only half as much as Ameri- cans. are twice as likely to develop lung cancer. Using for- eign studies to arrive at cancer links is like using African numbers to measure the threat of !dD5 in North America- the entire mechanism of infection may be different. [t's sig- nificant that the EPA did not cite a single U.S. study show- ing an ETSlcancer link in its risk assessment-in fact- no U.S. study has ever found such a link. A particularly weak aspect of the 1990 EPA report is that The Mtencan Spectator May 1992 it relied on meta-analysis, or weighting different studies to arrive at an aggregate figure-i.e.. not attalyzing data but analyzing analyses. It's very useful in narrowing down con- clusions from a battery of similar experiments with similar controls. but irresponsible when used-as it is here-to draw common assumptions about disparate populations. es- pecially when those populations have been established as having vastly varying rates of affliction. There was obvious selective bias at work in the 1990 EPA risk assessment. Three of the most comprehensive studies of passive strtoke ever undertaken were inexplicably excluded from the risk assessment: the so-called Shimizu and Sobue studies from Japan. and the largest American case-control study ever conducted, by Luis Varela of Yale University, which was later published in the New England Journal of Medicine. None of the three studies showed any statistical link between spousal smok- ing and lung cancer. Publica- tion bias. though not the EPA's fauit, is also a factor- studies showing no link be- tween ETS and lung cancer have tended not to be pub- lished. as they were non-news until the Hirayanv study. As Michael Fumento has written of Ams in these pages. "Oc- casionai heterosexual cases will make news for the same reason that planes that crash make news while planes that land safely do noc° The EPA went out on a limb to classify passive smoke as "Group A: Known Human Carcinogen;' even though most of the studies showed no significant risk, some showed a negative risk. and the final risk ratio, after meta-analysis. was a slim 1.28. (The highest ever recorded for ETS was another Hirayama study, the so-called "In- ouye/Hirayama." at 2.55.) When a sitnilar assessment was made of diesel emissions in 1989, the risk ratio was 2.6 and all the animal laboratory tests came out positive (all were negative for ETS). Despite the seemingly graver threat the EPA rated diesel only as "Group B: Probable Human Car- cinogen." An EPA review of the carcinogenic properties of etectromagnetic fields in 1990 found several risk ratios over 3.0- as well as a "consistently repeated pattern of lym- phoma. leukemiL nervous system cancer and lymphoma in childhood studies." But electromagnetic fields were not deemed suRciently perilous even to classify. The ETS risk assesstrtent is the only one the EPA has ever based solely on epidert»ological evidence. The fact that it failed to meet the EPA's own seven-point guidelines for epidemiological smd- 20741441g6 :7

. • • ies of potential carcinogens lissued in 19891 makes it seem even more like advocacy. Radical anti-smokers claim they have to act as advocates to counter the advocacy of tobacco compantes, and tobacco interests do indeed have major budgets for their own inde- pendent research into smoking hazards. But the industry has no monopoly on the profit motive. The EPA even commis- sioned and-smoking activist Stanton Glantz to write a chap- ter in its draft report on ETS hazards. Glantz. who runs cigarette-quitting seminars and develops anti-smoking regu- lations for profit, had this to say, at the 1990 World Confer- ence on Tobacco and Health in Australia. about his motives for opposing environmental smoke: The main thing the science has done on the issue of ETS. in ad- dition to help people like me pay monga¢es. is it has legit- Inuzed the concerns that people have that they don't like cigarette smoke. And that is a strong emotional force that needs to be harnessed and used. We're on a roll. and the bastards are on the run. Others may be motivated to push bad science not out of avarice but ignorance. There are even those who muddy the water out of a genuine social concern. Michael Gough, program manager of the Biological Applications Program of the Office of Technology As- sessment, chooses to ignore an's annual risk of contracting lung cancer-48 per IO0.000-and see what danger he poses to her. If we ac- cept, arguendo, the 1.28 risk ratio. the smoker's wife's risk nses to 61 per 100.000. That's 13 extra cases per 100.000. Put simply: maximizing in every way possible the most ex- treme scenario painted by the EPA study, a smoking hus- band has a 1-in-7,700 chance of giving his wife lung cancer in a given year in the future. How reasonable is it to torture him with the prospect that he is slowly knocking off his loved ones? inally, F it goes without saying that science suffers for the cause of smoking prevention. But what if the cause itself suffers? It is not uncommon that when bad sci- ence is introduced into the structure of social policy, the en- tire edifice of proscription and caution collapses. In 1985 the British government sent a hysterical mailing on AlnS to ev- ery household in the country. Making dire predictions of an epidemic. it warned that AIDS was an equal opportunity dis- ease from which no one was safe, and urged extreme cau- tion for all. The result? Old ladies in provincial towns were petrified. Non-monoga- mous homosexuals and in- travenous drug users, if con- vinced by the packet that their risk was no different from that of the rest of the country, now saw less reason "The main thing the science has done on the issue of ETS, in addition to help people like me pay mortgages, is it has legitimized the concerns that people have that they don't like cigarette smoke." the science of ETS in the interest of reducing smoking, as he indicated in an October 29. 1990 letter to Thomas Bore1- li, manager for scientific issues at Philip Morris: Without careful reading of the thesis (by Luis Varela- finding au link between ETS and lung cancerl or careful attention to rhe ETS issue. I tend to agree with the thests and the general con- clusions of your letter. On the other hand. I probably profoundly disagree with any use that might be made of those conclusions by Philip Monis or any other tobacco company. Anything that reduces smoking has substanttal health bene5ts, and making smokers into padahs, for whatever teasons. does just that. T T Ttto loses from willingness to accept bad science W as a basis policy? Citizens wishing to exercise their libetties, of course, and not just smokers. As Dr. Jasnes Le Fanu put it in Britain's Sunday Telegraph last May, "We could reach a situation where health activists- us- ing dubious scientific evidence. will be in a position to blackmail us into behaving the way they think we should. It is not an attractive prospect." Second. on a more personal level, the smoking widower who has lost his wife to lung cancer-and whose being fur- ther stigmatized as a murderer and a'-pariah" is the goal of the EPA report-loses again. For a closer examination of the grounds on which the husband is made a pariah. let's take the highest available estimate of a non-smoking wom- 2t . than ever to modify their be- havior. Within a year. the London Spectator was suggesting that this "public service" was actually spreading AIDS. Closer to home- paranoid anti-dntg organizanons like Part- nership for a Drug-Free America may be exacerbating the drug problem by demonizing drugs like marijuana-mild compared to the President's Halcion, and quite innocuous compared to aicohol. It is a point starkly made by Dr. Lester Grinspoon. a Harvard psychiatrist and drug specialist as writ- ten up by Richard Blow in an excellent exposE of Parmership that appeared in Washington's Ciry Paper last Dettmber. Partnership ads about marijuana "scare the hell" out of a high- school seniar. This student then goes off to collegeq where his roommate smokes ttuuijuana, with no apparent adverse effects and without going on to shoot heroin. He begins to wonder if he's been lied to. and winds up trying pot for himself. He lives. Having rejected Partnership warnings about marijuana. he might subsequendy reject more important warnings about riski- er drugs such as cocaine or hemin. Such a backlash could result if people consider the ques- tionable science of environmental tobacco smoke reason to ignore the surgeon general's and other warnings on the hazards of tobacco smoking itseif. If so. the EPA's hasty risk assessment could create more than inconvenience. raneor, and diminished personal liberty-it could create smoken. 0 The Amencw St>ectator May 1992 2074144187