Passive smoking
SINCE 1975 a new weapon has been added to the anti-smokers' armoury. This is the notion, repeated ad nauseum, that smokers are harming non-smokers through environmental tobacco smoke (ETS). In November 2002 the British Medical Association made the extraordinary claim that 'there is no safe level of environmental tobacco smoke' and in January 2003 a coalition of anti-smoking charities claimed that 12 million British workers (half the workforce) are worried about passive smoking, despite the fact that only three million (according to anti-smoking sources) are estimated to experience tobacco smoke at work. What the hell is going on?!
What is ETS?
ETS is often confused with mainstream smoke and sidestream smoke. ETS is the final stage of tobacco smoke dispersion when it becomes highly diluted in the surrounding air. Although assumed to possess the same properties as mainstream and sidestream smoke, this remains unproven.
Mainstream smoke is that which the smoker consumes when smoking, and where nicotine is in its particulate phase. Sidestream smoke is a combination of exhaled smoke and that released from the end of a burning cigarette. At this stage nicotine is moving from the particulate phase into its gas or vapour phase. Both possess different physical properties, and it is therefore wrong to assume that they are identical to ETS, although studies on ETS have a tendency to do this.
Are non-smokers at risk from ETS?
This is what everyone wants to know. The truth is that the scientific establishment has found it impossible to reach agreement on the issue. Interviewed on Radio 4's Desert Island Discs (23 February 2001), Professor Sir Richard Doll, the first scientist to publish research that suggested a correlation between lung cancer and primary smoking, commented: 'The effects of other people smoking in my presence is so small it doesn't worry me.'
Professor Doll's comments may surprise some people but not those who have analysed the argument about passive smoking in detail. In 1992, for example, the American Environmental Protection Agency published a report that was said to demonstrate the link between passive smoking and ill health in non-smokers. In 1996 however a US federal court ruled that the EPA had completely failed to prove its case. It was found not only to have abandoned recognised statistical practice, but to have excluded studies which did not support its pre-determined conclusion, and to have been inconsistent in its classification of ETS compared with other substances.
Likewise, in 1997, the National Health & Medical Research Council in Australia was found guilty by a federal court judge of acting improperly in preparing its draft report on passive smoking because it didn't consider all the relevant scientific evidence and submissions.
If that wasn't damning enough, in March 1998 the World Health Organisation was forced to admit that the results of a seven-year study (the largest of its kind) into the link between passive smoking and lung cancer were not 'statistically significant'. This is because the risk of a non-smoker getting lung cancer has been estimated at 0.01%. According to WHO, non-smokers are subjecting themselves to an increased risk of 16-17% if they consistently breathe other people's tobacco smoke. This may sound alarming, but an increase of 16-17% on 0.01 is so small that, in most people's eyes, it is no risk at all.
Case against passive smoking rests on an absurdity
Writing in the Daily Telegraph (24 March 1998), medical editor Dr James Le Fanu replied to claims that he had misled readers about the WHO study by pointing out that the case against passive smoking rests on an absurdity (ie 'that it allegedly causes a type of cancer in non-smokers, adenocarcinoma, known not to be related to smoking'). Referring to an editorial on ETS in The Lancet that identified 'a special risk with adenocarcinoma in contrast to the squamous cancers of the airways seen most often in active smokers', Le Fanu wrote, 'Passive smoking cannot conceivably cause lung cancer.'
A further critique of WHO's ETS study, which appeared in the Economist (15 March 1998), pointed out that, 'It is dangerous to become involved in campaigns that are not solidly based on scientific evidence' and added: 'Although passive smoking is unpleasant and irritating for non-smokers, that alone cannot justify banning it in public places.'
A year later, in July 1999, in its draft Approved Code of Practice on Smoking at Work, the United Kingdom's Health and Safety Commission declared that, 'Proving beyond reasonable doubt that passive smoking ... was a risk to health is likely to be very difficult, given the state of the scientific evidence.' Interestingly, the UK Government has yet to implement the ACoP, which may have something to do with the lack of conclusive evidence about passive smoking and ill health.
Greater London Assembly report
Worse was to follow for anti-smoking campaigners. In April 2002, following an exhaustive six-month investigation during which written and oral evidence was supplied by organisations including ASH, Cancer Research UK and FOREST, the Greater London Assembly Investigative Committee on Smoking in Public Places declined to recommend ANY further restrictions on smoking in public places, stating very clearly that it is not easy to prove a link between passive smoking and lung cancer.
As joint author of the report, Angie Bray put on record her opposition to a total ban on smoking in public places in a letter to the Daily Telegraph (5 July 2003). According to Bray, 'The assembly spent six months investigating whether a smoking ban should be imposed in public places in London. After taking evidence from all sides, including health experts, it was decided that the evidence gathered did not justify a total smoking ban.'
British Medical Journal report
Most recently of all, an explosive new study that seriously questions the impact of environmental tobacco smoke on health was published by the British Medical Journal (16 May 2003). According to the study, one of the largest of its kind, the link between environmental tobacco smoke and coronary heart disease and lung cancer may be considerably weaker than generally believed.
The analysis, by James Enstrom of the University of California, Los Angeles and Geoffrey Kabat of New Rochelle, New York, involved 118,094 California adults enrolled in the
American Cancer Society cancer prevention study in 1959, who were followed until 1998. Particular focus was on the 35,561 never smokers who had a spouse in the study with known smoking habits.
The authors found that exposure to environmental tobacco smoke, as estimated by smoking in spouses, was not significantly associated with death from coronary heart disease or lung cancer at any time or at any level of exposure. These findings, say the authors, suggest that environmental tobacco smoke could not plausibly cause a 30% increased risk of coronary heart disease, as is generally believed, although a small effect cannot be ruled out.
No clear connection
Perhaps admitting defeat on the link between ETS and lung cancer, the anti-smokers now argue that passive smoking is responsible for a whole range of other problems, including the rising number of asthmatics. Incredibly, smoking is being held responsible for the increased prevalence of a range of illnesses over a period when the prevalence of smoking has dramatically declined and the places where people smoke have been increasingly restricted.
The simple fact is that in terms of establishing a clear causal connection between exposure to ETS and illness in non-smokers, the anti-smoking industry has continually failed to prove its case.
Neddless to say. none of the above has deterred the anti-smoking lobby. Indeed, the British Medical Association, aided and abetted by ASH, is now claiming (November 2002) that 'There is no safe level of environmental tobacco smoke"
QuoteOriginally Posted by eoinh
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