Friday, April 20, 2007

New Anti-Smoking Advertisement Suggests that Secondhand Smoke Kills Instantaneously

A new internet advertisement from the Department of Health (UK) tries to convince the public that people drop dead almost instantaneously from brief exposure to secondhand smoke.

In the internet advertisement, guests at a wedding are mysteriously dropping dead on the spot. The reader is asked to guess the culprit. When the reader clicks to reveal the answer, a pop-up window appears which exposes the fact that the deaths were due to secondhand smoke exposure: "With secondhand smoke present the identity of the killer finally becomes obvious and fears increase as it is clear that everyone in a room with secondhand smoke is at risk. Secondhand smoke is dangerous, as 85 per cent of it is invisible and odourless. What’s more, a smoker's well intentioned attempts to blow or waft smoke away from non-smokers does not eliminate the potential risk of secondhand smoke. Visit gosmokefree.co.uk or call the NHS Smoking Helpline on 0800 169 0 169 for free and friendly advice on how to stop."

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I find this advertisement to be deceptive because it suggests that secondhand smoke routinely causes people to drop dead almost instantaneously from brief exposure. While it is true that chronic exposure to secondhand smoke causes heart disease and lung cancer and that acute exposure could have severe consequences for an asthmatic, it seems misleading to me to suggest that brief exposure puts people at widespread risk of immediate death.

A second problem with the ad, beyond the fact that it misleads the public about the true health risks of secondhand smoke, is that it undermines the public's appreciation of the known dangers of active smoking. After all, you don't see any anti-smoking ads showing people dropping dead from a few puffs of active smoking. The implication is that secondhand smoke is more deadly than active smoking because even a very brief exposure can kill you. In return for sensationalizing the health effects of secondhand smoke, I fear we are undermining the public's appreciation of the hazards of active smoking.

A third problem is that the advertisement is unlikely to be effective. People do not observe individuals dropping dead instantaneously from brief secondhand smoke exposure. The advertisement does not accord with people's observations and life experience. Thus, it is not believable. It seems unlikely, therefore, that anyone would take the ad seriously.

When you exaggerate too much, you may end up undermining the very message you are trying to deliver. By going this far overboard, the ad is actually destroying any chance it has of educating people about the real hazards of secondhand smoke. It is a lost opportunity. In fact, it risks alienating the public from secondhand smoke messages. Eventually, if we continue this type of blatant exaggeration, the public is going to completely tune out to our messages, because the whole thing will simply not be taken seriously.

The misleading nature of the Department of Health's secondhand smoke campaign is not restricted to this advertisement. Some of the "facts" about secondhand smoke on the NHS "Smokefree" web site are also quite misleading.

For example, the web site states that: "When you breathe in secondhand smoke you increase your risk of getting lung cancer by 24% and heart disease by 25%."

This is misleading, because it suggests that any exposure to secondhand smoke, even brief exposure, increases your risk of lung cancer and heart disease by 25%. The truth is that only if you breathe in secondhand smoke regularly for many, many years (such as living with a smoker or working for many years in a smoky workplace) do you increase your risk of lung cancer and heart disease by 25%.

The fact sheet, however, does not state that when you breathe in secondhand smoke for many years you increase your risk of lung cancer and heart disease by 25%. It simply states that when you breathe in secondhand smoke, the risk increases by this amount. The implication is that brief exposure has this effect, which is not true.

The web site also states that: "You can't see or smell 85% of secondhand smoke. So no matter how much you try to avoid it, it's pointless."

This is very misleading, because it suggests that there is no way to avoid exposure to secondhand smoke. It seems to me that this is a dangerous message, because it tells the public that it is futile to even try to avoid exposure to secondhand smoke. The truth is that the public should be warned to try to avoid secondhand smoke exposure. And it is largely possible to avoid such exposure, especially when workplaces are smoke-free. While it is true that the vapor phase of secondhand smoke is not visible, I find that it is usually quite easy to smell secondhand smoke and know that it is there. In fact, I can usually detect the instant a smoker lights up in an environment, even if that person is located in a remote area of a room, far away from me. I don't see the point in trying to make people believe that it is pointless to even try to avoid secondhand smoke exposure.

Elsewhere on the web site, it states: "Breathing in other peoples' secondhand smoke can damage almost every organ in the human body. It increases the risk of lung cancer by 24% and heart disease by 25%."

This is misleading in two ways. First, while secondhand smoke can damage the heart and lungs, that doesn't represent almost every organ in the body. Second, once again, the statement implies that any exposure to secondhand smoke increases the risk of lung cancer and heart disease by 25%. It does not state that breathing in other peoples' secondhand smoke chronically increases these risks by 25%.

The web site also states that: "Breathing in secondhand smoke makes the blood more sticky. This means that there is a risk of blood clots forming. A blood clot can block an artery and cause heart attacks, strokes, angina or even complete heart failure."

This, too, is misleading because it suggests that any breathing of secondhand smoke, even brief exposure, increases the risk of forming a blood clot. This is simply not true. The only risk of clot formation from brief exposure is for someone who already has severe existing coronary artery disease. The "fact sheet" makes it sound like any person exposed to secondhand smoke is at risk of developing a blood clot, which could lead to a heart attack, stroke, or complete heart failure.

Interestingly, I've never heard any anti-smoking group warn the public that taking a few puffs on a cigarette makes the blood more sticky, increasing the risk of blood clots which can cause heart attacks, stroke, and complete heart failure. If it is true that even a little secondhand smoke can cause blood clots and death, then shouldn't we be warning kids that they put themselves at risk of death by actively smoking even a few puffs on a cigarette?

The implication, of course, is that secondhand smoke is far more deadly than active smoking. And this message, while presumably unintended, is a clear message that is coming from this campaign.

It is not worth undermining 4 decades of education about the hazards of active smoking in order to try to sensationalize the health effects of secondhand smoke and create a more emotional appeal to the public.

But most importantly, it's simply wrong to misrepresent the science and mislead the public. We risk losing all credibility, even when we are speaking truthfully about the hazards of secondhand smoke.

Finally, this makes me feel like there is little point to continuing my research on the actual health effects of secondhand smoke. After all, if anti-smoking groups are going to claim - regardless of the actual science - that secondhand smoke causes instant death, then what point is there to doing careful research to study the actual health effects? As the UK Department of Health's campaign states, "It's pointless."

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