Tuesday, January 04, 2011

Americans for Nonsmokers' Rights Apparently Retains False Secondhand Smoke Claims; Why Is It Necessary to Lie When the Truth Would Be Enough?

Despite being informed about several factual inaccuracies in its fact sheet entitled "Secondhand Smoke: The Science," Americans for Nonsmokers' Rights (ANR) has apparently decided not to change or clarify the false health claims made in the fact sheet.

The false claims made in the fact sheet and the reasons why these claims are untrue are as follows:

The Lies: (1) "there are virtually no health disparities between active and passive smoking."; (2) "The risks of heart disease associated with secondhand smoke are twice what were previously thought and are virtually indistinguishable from those associated with active smoking."; (3) "Just thirty minutes of exposure to secondhand smoke can cause heart damage similar to that of habitual smokers."

The Rest of the Story: ANR's claim that there are virtually no health disparities between active and passive smoking is a lie. If ANR were being truthful in claiming that passive smoking has virtually the same level of health effects as active smoking, then there would be tens of thousands more deaths from secondhand smoke than we currently observe. How can ANR can claim that there are virtually no health disparities between active and passive smoking? That implies that active smoking is virtually no more dangerous than exposure to secondhand smoke. We know this is not true, because there is a dose-response relationship between tobacco smoke exposure and lung cancer. The relative risk of lung cancer among active smokers is about 17, while the relative risk of lung cancer among passive smokers is about 1.3. Even if we restrict ourselves to the risk of heart disease, the scientific evidence simply doesn't support the conclusion that the risk of heart disease is "virtually" the same for active and passive smokers. If ANR were to inform an active smoker that his risk of heart disease was no different than that of a passive smoker, it would essentially represent malpractice, because unless this smoker is an extremely light smoker, the information is undeniably false.

The statement that brief exposure to secondhand smoke causes heart damage in nonsmokers similar to that observed in active smokers is also a lie. Nonsmokers exposed briefly to secondhand smoke do not suffer heart damage similar to that of habitual smokers. In fact, they do not suffer heart damage at all. Brief tobacco smoke exposure does not cause heart damage. What is does cause is endothelial damage (reversible vascular injury to the cells that line the coronary arteries). Heart damage refers to actual damage to the heart muscle, such as one sustains after myocardial ischemia or a heart attack. Believe me, the subjects in the Otsuka experiment did not suffer heart damage. If they did, they could sue the university for causing this damage. The IRB would never approved the study if it was even thought that the tobacco smoke exposure might cause heart damage. ANR is disseminating a lie that distorts the truth and makes brief tobacco smoke exposure sound much worse that it actually is.

Despite being informed of these false scientific claims (presuming that my email was received) on October 28 and November 29 of last year, as of today, the fact sheet remains unchanged. I take this as an indication that ANR has decided not to change or clarify these claims.

The Rest of the Story

I just don't understand why ANR would not want to fix these statements so that they are true rather than false. In fact, they only require minor editing to correct them.

Here is how each of the three statements could be slightly altered in order to make them true instead of false:

1 - FALSE VERSION: "There are virtually no health disparities between active and passive smoking."

1 - ACCURATE VERSION: "The effects of secondhand smoke exposure on endothelial function are virtually identical to those of active smoking."

2 - FALSE VERSION: "The risks of heart disease associated with secondhand smoke are twice what were previously thought and are virtually indistinguishable from those associated with active smoking."

2 - ACCURATE VERSION: "The effects of tobacco smoke exposure on cardiovascular disease are nonlinear; as a result, the risk of heart disease associated with chronic exposure to secondhand smoke may actually approach that of very light, active smoking."

3 - FALSE VERSION: "Just thirty minutes of exposure to secondhand smoke can cause heart damage similar to that of habitual smokers."

3 - ACCURATE VERSION: "Just thirty minutes of exposure to secondhand smoke can cause endothelial dysfunction similar to that observed in active smokers."

If ANR were to correct these claims so that they are accurate, what exactly would be the loss? What possible reason is there not to make these corrections? The statements are still very powerful and convey the high level of health risk associated with secondhand smoke exposure. In fact, I think they explain more accurately exactly why secondhand smoke is so strongly linked to heart disease. The statements are no less powerful in providing a rationale for regulating tobacco smoke exposure in workplaces and public places. The only real difference is that these statements are accurate, while ANR's claims are inaccurate.

Why the need to lie to the public?

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