While the letter I sent out to my secondhand smoke mailing list went out to a large number of anti-smoking groups which have misleading or inaccurate health claims about secondhand smoke on their web sites, there are several sentinel groups that I will be watching with special interest. Each of these groups has been directly contacted and has been sent my letter, so their misleading claims have been brought directly to their attention.
In this post, I list these groups, their fallacious claims, and the reasons why I consider these particular groups' actions to be important in indicating the direction that the movement is going and in assessing whether or not these are simply innocent mistakes or whether there is an intentional effort to deceive people by hiding information and not telling the complete story or considering all the evidence.
First, let me say that this has been going on now for nine months. It was January 30 that I first brought this issue to the attention of the tobacco control community. My initial post on this issue, which pointed out the fallacious claim being made by Action on Smoking and Health (ASH) - that 30 minutes of secondhand smoke raises a nonsmoker's risk of suffering a fatal heart attack to that of a smoker's - was widely circulated on tobacco control list-serves and discussion forums, including GLOBALink. ASH apparently was aware of my post, which was what presumably prompted them to defend their misleading claims.
A highly visible and very contentious series of attacks against me on GLOBALink ensued, ending in my expulsion from GLOBALink for not agreeing to stop criticizing anti-smoking groups for misleading the public.
As more and more fallacious claims were uncovered, I publicized them as well, noting that the amount of time that it apparently takes for secondhand smoke to cause heart disease kept dropping from 30 minutes to 20 minutes to 5 minutes and ultimately, to 30 seconds.
Here are the key groups, their claims that I believe are misleading, the reasons why the claims are deceptive, and why I consider the particular group's response to be critical. It is important to note that each of these groups has been contacted directly about these claims, so they cannot claim that they were not aware that they might be communicating inaccurate or misleading information to the public.
The Rest of the Story
1. Action on Smoking and Health
The Claim: "Even for people without such respiratory conditions, breathing drifting tobacco smoke for even brief periods can be deadly. For example, the Centers for Disease Control [CDC] has warned that breathing drifting tobacco smoke for as little as 30 minutes (less than the time one might be exposed outdoors on a beach, sitting on a park bench, listening to a concert in a park, etc.) can raise a nonsmoker's risk of suffering a fatal heart attack to that of a smoker."
Why It is Misleading: First of all, the CDC never warned that 30 minutes of secondhand smoke exposure raises a nonsmoker's risk of a fatal heart attack to that of a smoker. Such a claim is absurd on its face. How could a nonsmoker possibly be at equal heart attack risk as that of a smoker after only 30 minutes of exposure? This would mean that chronic active smoking is no more dangerous to the heart than breathing in drifting smoke for 30 minutes.
Why the Response is Critical: ASH is one of the most important national anti-smoking organizations and has been at the center of the movement for decades.
The 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."
Why It is Misleading: There is no evidence that the increase in platelet activity caused by 20 minutes of secondhand smoke exposure reduces the ability of the heart to pump. Brief exposure to secondhand smoke actually increases cardiac output. There is no evidence that this platelet activation can cause a heart attack, and it certainly cannot cause a heart attack in an individual without severe existing coronary artery stenosis.
The Claim: "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."
Why It is Misleading: It doesn't appear to be true. There is considerable debate over the extent to which long-term exposure to secondhand smoke causes significant decrements in lung function in non-asthmatic nonsmokers, much less pulmonary emphysema. The two most recent and most comprehensive reports on the health effects of secondhand smoke (those of the Surgeon General and the California EPA) failed to conclude that secondhand smoke causes emphysema. The Surgeon General concluded that there was not sufficient evidence to draw such a conclusion.
The Claim: "Other Conclusions of the Surgeon General's Report: 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."
Why It is Misleading: The Surgeon General's report did not conclude that breathing secondhand smoke for even a short time increases the risk of a heart attack. Such a claim is simply nowhere to be found in the report.
Why the Response is Critical: SmokeFreeOhio is trying to win a very contentious ballot initiative battle against Smoke Less Ohio by convincing voters that the opposition is misleading the public. If SmokeFreeOhio is also misleading the public, then they lose all credibility and don't have a leg to stand on in making this public appeal. Discontinuing its own deception is a prerequisite to asking the public to reject the pleas of the opposition because of its deception.
3. Americans for Nonsmokers' Rights
The Claim: "Even a half hour of secondhand smoke exposure causes heart damage similar to that of habitual smokers. Nonsmokers' heart arteries showed a reduced ability to dilate, diminishing the ability of the heart to get life-giving blood."
Why It is Misleading: It is absurd to claim that the damage caused to the heart by chronic active smoking is no worse than that caused by a mere 30 minutes of passive exposure. While the coronary arteries are impaired in their ability to dilate, this is an experimental finding and has no clinical significance in terms of decreasing the flow of life-giving blood to the heart. In fact, the study being used to support this claim documented that there was no decline in basal coronary blood flow among the subjects exposed to 30 minutes of secondhand smoke.
Why the Response is Critical: ANR is the leading national organization promoting smoking bans and providing technical assistance and scientific information to anti-smoking groups throughout the country. If they don't have their facts straight, then the entire tobacco control movement will end up misleading the public. In addition, ANR has been vocal in criticizing others for junk science claims. It must have some scientific integrity of its own if it is going to maintain any credibility in issuing these attacks.
4. Association for Nonsmokers - Minnesota
The Claim: "Research studies have shown that even just thirty seconds of exposure to secondhand smoke can make coronary artery function of non-smokers indistinguishable from smokers."
Why It is Misleading: First of all, it is absurd to claim that just 30 seconds of exposure is enough to cause coronary artery dysfunction. There is no evidence at all to support such a claim. It is also absurd to claim that 30 minutes of exposure makes coronary artery function of nonsmokers indistinguishable from that of chronic active smokers. If this were the case, then the coronary disease risks of lifetime, chronic active smoking would only be as dangerous as a mere 30 minutes of passive smoking. In fact, active smoking often causes coronary artery stenosis in smokers, which is easily distinguishable from the coronary arteries of an individual nonsmoker exposed for only 30 minutes, which would show no stenosis.
Why the Response is Critical: This claim is so fallacious and so damaging to public health goals (it undermines the public's appreciation of the dangers of active smoking) that it requires an immediate correction.
5. ClearWay Minnesota
The Claim: "Blood flow in the coronary arteries is decreased in healthy young adults exposed to secondhand smoke."
Why It is Misleading: In fact, the study that is being used as the basis for this claim revealed that coronary blood flow in healthy young adults exposed to secondhand smoke was not decreased. What was decreased was the coronary flow velocity reserve, which has no clinical meaning for these young adults in the absence of sustained or repeated exposure. The clear impression of the statement is that a healthy young person exposed to secondhand smoke for 30 minutes will suffer a reduction in coronary artery blood flow. This is untrue.
The Claim: "Current scientific data suggest that eating in a smoky restaurant can precipitate myocardial infarctions in nonsmokers and increase the risk of fatal and non-fatal cardiac events in nonsmokers by about 30 percent."
Why It is Misleading: There are no scientific data which show that eating in a smoky restaurant can cause a heart attack. It is impossible that eating in a smoky restaurant could increase the risk of cardiac events by 30%, since being exposed to secondhand smoke for a lifetime only increase the risk of cardiac events by about 30%.
Why the Response is Critical: These inaccurate claims appear in a toolkit that is designed to be used by many local anti-smoking groups to promote smoking bans. Failure to correct these "facts" will result in the widespread dissemination of false health claims by anti-smoking groups. These claims are particularly fallacious, especially the suggestion that a mere 30 minutes of exposure can increase heart disease risk by 30%.
6. Smoke Free Wisconsin
The Claim: "Accumulating evidence suggests that even short-term exposure to secondhand smoke can trigger a heart attack."
Why It is Misleading: There is actually no direct evidence that short-term exposure to secondhand smoke can trigger a heart attack. Moreover, it is implausible that short-term exposure could trigger a heart attack in a person without severe existing coronary artery disease. Thus, this statement is not only unsupported by the evidence, but it is misleading by virtue of not specifying that it is referring only to individuals with severe coronary artery stenosis.
Why the Response is Critical: I think Smoke Free Wisconsin's response is critical because it was this group that made perhaps the most absurd public claim about secondhand smoke: that 5 minutes of exposure causes the body to start closing off arteries.