Possibly in response to The Rest of the Story pointing out scientific inaccuracies in its fact sheet on the health effects of secondhand smoke, SmokeFreeOhio has changed the fact sheet in an apparent attempt to eliminate its fallacious claims.
The anti-smoking group, which is pushing a smoke-free bar and restaurant ballot initiative that recently was approved for the November ballot, eliminated the following four fallacious scientific claims:
1. After twenty minutes of exposure to secondhand smoke, a nonsmoker's blood platelets become as sticky as a smoker's, reducing the ability of the heart to pump and putting a nonsmoker at an elevated risk of heart attack."
2. "Only 30 minutes of secondhand smoke exposure can cause narrowing of blood vessels, restricting the flow of blood and contributing to hardening of the arteries."
3. "In that same 30 minutes, changes to your blood boost your risk of building up fat deposits that could lead to heart attacks and strokes."
4. "After 120 minutes of exposure, your heart rate variability is reduced, increasing the chance of an irregular heart beat that can itself be fatal or trigger a heart attack."
Importantly, however, the group still claims that 20 minutes of secondhand smoke exposure increases a nonsmoker's risk of suffering a heart attack:
"After twenty minutes of exposure to secondhand smoke, a nonsmoker's blood platelets become as sticky as a smoker's, reducing the ability of the heart to pump and putting a nonsmoker at an elevated risk of heart attack.8"
The number 8 refers to a citation of a scientific article by Burghuber et al. which was published in the journal Chest in 1986.
In addition, SmokeFreeOhio now claims that secondhand smoke increases the risk of developing pancreatic cancer, based on the results of a single study: "Secondhand smoke increases your risk of developing pancreatic cancer."
And SmokeFreeOhio also lists diabetes in its list of diseases caused by secondhand smoke.
Further, SmokeFreeOhio now claims that secondhand smoke causes emphysema: "Secondhand smoke can cause the debilitating disease pulmonary emphysema, causing severe damage to the walls of the air sacs, with the lungs eventually losing their capacity to expand and contract."
Finally, in a separate fact sheet, SmokeFreeOhio now claims that the Surgeon General's report on secondhand smoke concluded that: "Breathing secondhand smoke for even a short time can have immediate adverse effects on the cardiovascular system and interferes with the normal functioning of the heart, blood, and vascular systems in ways that increase the risk of a heart attack."
The Rest of the Story
I view SmokeFreeOhio as being irresponsible in its reporting of the science of secondhand smoke to the public. They continue to mislead the public about the effects of secondhand smoke. But now they have increased the scope of their deceptive claims, going beyond simply acute cardiovascular effects. Now, diabetes, pancreatic cancer, and emphysema have been added to the list. And they continue to claim that just 20 minutes of exposure to secondhand smoke increases a nonsmoker's risk of suffering a heart attack.
Apparently, SmokeFreeOhio has admitted that its earlier claims were inaccurate, as I pointed out in March 2006, about 7 months ago. The fact that it took 7 months to correct these fallacious claims is bad enough. But SmokeFreeOhio failed to correct all of them. It still claims that a nonsmoker is at risk of dropping dead of a heart attack from just 20 minutes of secondhand smoke exposure!
It added a claim that the Surgeon General's report concluded that even a brief exposure to secondhand smoke increases the risk of a heart attack.
And to make things worse, SmokeFreeOhio now claims that secondhand smoke causes diabetes, pancreatic cancer, and emphysema.
Finally, it does not appear that SmokeFreeOhio has apologized for what it apparently admits was widespread misleading of the public about the health effects of secondhand smoke.
There is so much that is deceptive in this so-called "fact sheet" that it is difficult to know where to begin.
Let's start with the retained fallacious claim.
"After twenty minutes of exposure to secondhand smoke, a nonsmoker's blood platelets become as sticky as a smoker's, reducing the ability of the heart to pump and putting a nonsmoker at an elevated risk of heart attack.8"
There is simply no evidence that 20 minutes of secondhand smoke exposure reduces the ability of the heart to pump. If anything, cardiac output has been shown to increase in response to acute secondhand smoke exposure. While the platelets are activated and do become "stickier," there is no evidence that this causes a heart attack to occur. It is not even plausible that 20 minutes of secondhand smoke exposure could cause a heart attack in someone who does not already have severe coronary artery stenosis.
The citation used to support the statement is a study of platelet activation in response to secondhand smoke exposure. It doesn't even examine heart attack risk. How can SmokeFreeOhio possibly make claims about heart attack risk from a study that simply measured platelet activity?
Now let's take the new fallacious claims.
First, nowhere did the Surgeon General's report conclude that: "Breathing secondhand smoke for even a short time can have immediate adverse effects on the cardiovascular system and interferes with the normal functioning of the heart, blood, and vascular systems in ways that increase the risk of a heart attack."
I reviewed the report in detail, and nowhere did I see any evidence that a brief exposure to secondhand smoke interferes with the functioning of the heart at all, much less in a way that increases heart attack risk. The report draws no such conclusion. In fact, what the report concludes is that chronic exposure to secondhand smoke increases heart disease risk.
Second, I am aware of no evidence that diabetes should be added to the list of diseases caused by secondhand smoke. It is true that there is some evidence that secondhand smoke exposure may cause a certain degree of glucose intolerance, but this does not support a contention that secondhand smoke causes diabetes.
In fact, one major study actually failed to find that secondhand smoke caused glucose intolerance (see: Weitzman M, Cook S, Auinger P, et al. Tobacco smoke exposure is associated with the metabolic syndrome in adolescents. Circulation 2005; 112:862-869).
This paper actually found no evidence for insulin resistance associated with secondhand smoke or active smoke exposure. While 11.6% of adolescents had high fasting glucose levels, 14.1% of secondhand smoke exposed subjects did, and only 9.6% of active smoking adolescents did.
These differences were not significantly different, and there was no trend evident. I think there are serious problems with concluding that secondhand smoke is even a cause of insulin resistance, much less of diabetes. And active smoking, while it may cause insulin resistance, is not even recognized as a cause of diabetes. Increased weight is, and to the extent that smoking may keep weight down, it's not so clear whether quitting smoking would reduce someone's risk of developing type II diabetes.
Third, the fact sheet draws a conclusion that secondhand smoke causes pancreatic cancer based on the results of a single study.
The California Environmental Protection Agency report on secondhand smoke, which is probably the most comprehensive review of the subject and which drew the controversial (even within the tobacco control community) conclusion that secondhand smoke causes breast cancer, did not even mention a risk for pancreatic cancer associated with secondhand smoke exposure.
SmokeFreeOhio has completely jumped the gun here, and has no sufficient basis (not even close) for claiming that secondhand smoke causes pancreatic cancer.
The most fallacious (if there are degrees of fallaciousness) claim made by SmokeFreeOhio is that secondhand smoke is a cause of pulmonary emphysema. This is not sufficiently supported by the evidence. I will deal with it in a separate post. For now, suffice it to say that SmokeFreeOhio's fact sheet is far more misleading, deceptive, damaging, and irresponsible than it was before they started mucking with it in an apparent attempt to address the concerns expressed 7 months ago by The Rest of the Story.
For an organization which is attacking its opponent for misleading and deceiving the public, I don't see SmokeFreeOhio as having a leg to stand on. They are engaging in a misleading campaign of their own, based on scientific untruths and completely fallacious claims.
The November ballot initiative battle is shaping up to be a contest between two groups which apparently are incapable of communicating the truth.
If you want a battle in Ohio between two groups that will fight with some integrity, rather than deception, I think you'll be better off to head to Columbus for the Michigan-Ohio State game.
One final note. In its original fact sheet, I made it clear that I was not accusing SmokeFreeOhio of deliberate deception. I opined that they may simply have made errors in reporting the science. Now, however, it is clear that the organization has paid careful attention to some of these claims. It is more difficult to explain this as a simple mistake. You don't claim that secondhand smoke causes emphysema, it seems to me, by some sort of mistake. It's not like anyone else is making that claim and they are just transmitting false information, or they are exaggerating some studies.
We'll see what their response is to this, but it is certainly beginning to look like SmokeFreeOhio is doing its best to try to impress the public about the health effects of secondhand smoke, and that they are not willing to rely on the truth to accomplish that. It appears to me that this is either deliberate deception or else very poor science.
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