TobaccoScam has responded to my challenge of its claim that 30 minutes of secondhand smoke causes clogged arteries that increase the immediate risk of a heart attack.
Here is its response: "If you carefully look at the peer reviewed papers on secondhand smoke, as well as the most recent Surgeon General and California Environmental Protection Agency reports on secondhand smoke (linked from the Resource Library section of the web site), you will see that the statements on the web site represent the scientific consensus. Mike Siegel has a blog, which is his (rather uninformed) opinion." ...
"Siegel has never done any work on cardiovascular disease, in particular work on the vascular endothelium and his statements clearly reflect a lack of understanding of the effects of smoking on the endothelium or the role that even seemingly minor damage to the endothelium plays in both the immediate risk of a heart attack and also the long term cumulative risk."
The Rest of the Story
Now this is getting interesting. The organization which claims that if you are exposed to secondhand smoke for just 30 minutes, you will develop clogged arteries ("30 minutes exposure = stiffened, clogged arteries" is a direct quote from its web site) is accusing me of being uninformed.
Before addressing the response itself, let me first reiterate what the claim is that is under contention. TobaccoScam claims that 30 minutes of secondhand smoke exposure will cause any person exposed to have clogged arteries, and therefore, to be at an immediate increased risk of a heart attack.
After all, an "equals" sign means equals, is equivalent to, is the same as." So according to TobaccoScam's equation, 30 minutes of secondhand smoke is equivalent to having, is the same as, or equals having clogged arteries. Note that this claim is unqualified. It doesn't say that someone with severe existing coronary artery stenosis who is exposed briefly to secondhand smoke could potentially have a thrombus (clot) triggered by the exposure, as the terminal event that causes a heart attack in this highly susceptible individual. Instead, the assertion is that any person exposed, even a health individual, will develop clogged arteries from 30 minutes of exposure to secondhand smoke.
You might also note that the contention is not even that 30 minutes of secondhand smoke increases your risk of clogged arteries. The claim is that 30 minutes exposure equals clogged arteries: in other words, that if you are exposed for 30 minutes, you will have clogged arteries.
You can see that it doesn't take a rocket scientist, or even a rocket endotheliologist, to appreciate that TobaccoScam's claim is not only false, but absurd.
If 30 minutes of secondhand smoke exposure caused clogged coronary arteries in healthy people that put them at risk of an immediate heart attack, then wouldn't you expect to see a fair number of young people (in their 20s perhaps) suffering heart attacks? Twenty-year olds, for example, tend to spend a lot of time in smoky bars. You would think that if their coronary arteries got clogged every time they spent 30 minutes in a bar, at least some of them would be likely to suffer heart attacks.
How a group that is telling the public that if they are exposed briefly to secondhand smoke they will suffer clogged arteries and possibly a heart attack can start attacking other scientists for being uninformed is beyond me, but nevertheless, it is happening before my eyes.
Now to my comment on the response itself.
If you carefully look at the peer reviewed papers on secondhand smoke, as well as the most recent Surgeon General and California Environmental Protection Agency reports on secondhand smoke (linked from the Resource Library section of the web site), you will see that the statements on the web site represent the scientific consensus.
First of all, the issue at hand is not "the statements" on the web site; it is the specific statements that have been challenged, which I highlighted in my post. The key claim under contention is that 30 minutes of secondhand smoke exposure clogs arteries in otherwise healthy people. I can assure you that there is nothing in the Surgeon General's report or the California EPA report which suggests that 30 minutes of secondhand smoke exposure causes clogged arteries in anyone other than someone with severe pre-existing coronary artery stenosis.
TobaccoScam is misrepresenting the conclusions of these two reports. It is not the scientific consensus that 30 minutes of secondhand smoke clogs your arteries. That's a bunch of baloney. The scientific consensus is that brief exposure to secondhand smoke activates platelets and causes endothelial dysfunction, which if prolonged and repeated, can cause atherosclerosis and clogged arteries. The scientific consensus is that chronic exposure to secondhand smoke can clog your arteries. Not 30 minutes of exposure.
By conflating endothelial dysfunction and platelet activation with clogged arteries, TobaccoScam is grossly distorting and misrepresenting the science.
Mike Siegel has a blog, which is his (rather uninformed) opinion.
A nice ad-hominem attack, taken right from the anti-smoking playbook. If you are challenged, do not respond substantively. Just attack the challenger and try to discredit him. But do not, by any means, address the actual arguments being made.
Siegel has never done any work on cardiovascular disease, in particular work on the vascular endothelium and his statements clearly reflect a lack of understanding of the effects of smoking on the endothelium or the role that even seemingly minor damage to the endothelium plays in both the immediate risk of a heart attack and also the long term cumulative risk.
This is a classic tobacco industry argument used in the courtroom to try to discredit plaintiff's witnesses, and it's a good thing that TobaccoScam is not testifying in court cases, because this type of statement would be devastating to the cause. Because I have never actually done direct research on the vascular endothelium, I am incapable of offering an informed opinion about the cardiovascular effects of secondhand smoke.
Well, if that's the case, then I suppose I am not capable of offering an informed opinion about any of the health effects of secondhand smoke because I've never done laboratory or clinical research on any human cells, endothelial or otherwise. I suppose I should therefore ask TobaccoScam to remove all references to my work on its site, including my articles that concluded that secondhand smoke is a health hazard to bar and restaurant workers. It's interesting that when I am arguing that secondhand smoke is harmful, I am a credible and reliable and informed source, but when I take a contrary position, I automatically and suddenly become unreliable and uninformed.
I have news for you though. It doesn't take a vascular endotheliologist, or even a cardiologist to evaluate the scientific evidence. It does, however, help to be a physician and an epidemiologist and to have some experience treating patients with heart disease and heart attacks and to have taken a large number of histories from patients with varying degrees of heart disease and vascular damage.
If it were true that minor damage to the endothelium, as observed with 30 minutes of secondhand smoke, increased heart attack risk, then don't you think we would see young people suffering heart attacks? There is a reason why you don't see people starting to suffer heart attacks until they reach at least their 30's. That's because it takes years of damage to develop heart disease.
You don't have a heart attack from eating a single Big Mac. And yes, eating a Big Mac has been demonstrated to cause endothelial dysfunction and platelet activation, just like secondhand smoke.
Can you imagine the American Heart Association putting out a fact sheet that said:
Eating a Big Mac = Clogged Arteries and Increased Risk of Immediate Heart Attack
Eating Big Macs for many years, sure. Even eating a Big Mac if you have severe coronary artery stenosis to begin with and are a heart attack waiting to happen. Sure. But not just a healthy person eating a single Big Mac.
It doesn't seem to me that it would be too difficult to qualify the claim so that it is at least a reasonable representation of the science. As public health practitioners, I think we should be striving for accurate communication of the science to the public, not stretching the science to try to scare people into believing something that is not true.
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