Monday, April 17, 2006

From 30 Minutes to 20 Minutes to 5 Minutes: 300 Seconds to Artery Closure from Secondhand Smoke - Can the Claims Get Any More Absurd?

First, it was 30 minutes: Action on Smoking and Health (ASH) claimed that just 30 minutes of secondhand smoke exposure increases a nonsmoker's risk of a fatal heart attack to that of a smoker's.

Then, it was 20 minutes: SmokeFreeOhio claimed that just 20 minutes of secondhand smoke reduces the heart's ability to pump and puts a nonsmoker at increased risk of a heart attack.

Now, it is just 5 minutes.

Yes, that's right.

Just 5 minutes of exposure to secondhand smoke can be fatal. According to SmokeFree Wisconsin, it takes only 300 seconds of secondhand smoke exposure for the body to start closing off arteries.

This past Friday, SmokeFree Wisconsin publicly claimed that: "In five minutes of exposure to secondhand smoke, your body starts closing off arteries."

The Rest of the Story

As a physician, I can tell you that if the body starts closing off arteries, you are at great risk of catastrophic injury or death. It depends what artery you are talking about, but the effects could range from losing a limb to suffering a heart attack or stroke to death.

If SmokeFree Wisconsin's claim were true, I think we would have no choice but to ban smoking just about everywhere. If only 5 minutes of exposure causes nonsmokers arteries to start closing off, then there would simply be no excuse to allow any smoke exposure whatsoever in public places.

In fact, I could easily criticize SmokeFree Wisconsin in this post for not calling on an immediate ban on smoking in all public places, indoors and outside. If they truly believe that 5 minutes of secondhand smoke exposure causes nonsmokers' arteries to become closed off, then there is simply no justification for their not calling for a ban on smoking. This is a level of risk that would be irresponsible for a public health group to accept. And it would be almost criminal for SmokeFree Wisconsin to knowingly ignore these data and allow people to die of artery closure left and right because of secondhand smoke exposure.

The fact is, however, that SmokeFree Wisconsin is not calling on a complete and immediate ban on smoking. Presumably, they are aware that just 5 minutes of secondhand smoke does not actually cause nonsmokers' arteries to close off.

But if that's true, then they are being dishonest in this public communication in an intentionally deceptive way. In other words, they would be lying.

So which is it? Is SmokeFree Wisconsin serious about the "fact" that nonsmokers exposed to 5 minutes of secondhand smoke suffer closing off of their arteries (and therefore catastrophic events or death)? If so, then how can they justify sitting around and letting all these nonsmokers die (because the prevalence of people being exposed to 5 minutes of secondhand smoke exposure is astronomical)?

Or does SmokeFree Wisconsin know that nonsmokers are not actually suffering artery closure due to 5 minutes of secondhand smoke exposure and therefore there is no need to completely ban smoking? But if this is the case, then are they not lying in publicly claiming that 5 minutes of exposure does lead to artery closure in nonsmokers?

This is a no-win situation for SmokeFree Wisconsin, and I'm afraid it's a no-win situation for the anti-smoking movement. Either we have to immediately call for a complete ban on smoking, now that we have the "knowledge" that just 5 minutes of secondhand smoke exposure is catastrophic, or we have to call for a retraction of this claim and a public apology.

Frankly, this is getting a bit ridiculous. These claims are becoming so absurd that I don't know how the anti-smoking movement thinks it can continue to get away with this. And if we are "caught," is our credibility not going to suffer considerably?

It is difficult to know exactly where this absurd scientific claim comes from, but presumably it is a completely errant interpretation of the study by Stefanidis et al., which showed that 5 minutes of exposure to secondhand smoke decreased aortic distensibility in patients with coronary artery disease (see: Stefanidis S, et al. Unfavorable effects of passive smoking on aortic function in men. Annals of Internal Medicine 1998; 128:426-434).

While this study did demonstrate that the aorta stiffens slightly in response to a brief secondhand smoke exposure, it certainly did not demonstrate that the aorta (or any other artery) starts to "close off."

In fact, the study showed that the aorta actually opened up a bit. The authors reported that: "The mean systolic and diastolic aortic diameters during the study are shown in Figure 5. Both diameters increased with passive smoking over time (peak at 4 minutes, 23.98 mm for systolic diameter [P = 0.04] and 22.53 mm for diastolic diameter [P = 0.001]."

Incidentally, if secondhand smoke caused the aorta to close off, the result would be instant death. People would be walking into bars and dropping dead within minutes. And you would have to dodge all the dead bodies on the gaming floor to play the slots at the New Jersey casinos.

On March 13, I jokingly wrote: "So as we stand today, the claim that 30 minutes of secondhand smoke exposure increases heart attack risk among nonsmokers is a conservative one. Now we're down to 20 minutes. Does any anti-smoking group care to go for 10 minutes? Anybody? Anybody?:

Well Friday, my question was answered. SmokeFree Wisconsin came through. And in a grand way.

They beat 10 minutes, and came in at just 5 minutes.

Does any anti-smoking group want to go for 1 minute?

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