Thursday, September 11, 2008

Pennsylvania Department of Health Misleading the Public by Suggesting a Greatly Exaggerated Death Toll Due to Secondhand Smoke

On a "frequently asked questions" web page designed to provide factual information to the public about Pennsylvania's new smoking ban, the Pennsylvania Department of Health offers the following statistics:

"Q. Why is this a big deal – not that many people smoke in Pennsylvania.
A. Two million Pennsylvania adults are current smokers

  • Over 20,000 Pennsylvania adults die each year from their own smoking
  • Approximately 300,000 kids under age 18 and alive in Pennsylvania who will ultimately die prematurely from smoking
  • It is estimated that between 1 and 3 million adults non smokers die each year from exposure to secondhand smoke
  • Over $5 billion in annual health care costs in Pennsylvania are directly caused by smoking"
The Rest of the Story

The claim in question is that between 1 and 3 million adult nonsmokers die each year from secondhand smoke.

All of the other statistics provided refer to the state of Pennsylvania. The answer to the question is headlined by a smoking statistic from the state of Pennsylvania. Therefore, I think that most readers viewing this 3rd bullet point would naturally assume that it relates to Pennsylvania. Perhaps some people who see that the number of deaths is just too high for one state would assume that it is referring to data for the nation as a whole.

However, this statistic is clearly absurdly false unless it is referring to the entire world. Since there are only about 2.5 million deaths annually in the United States from all causes, there are obviously not 1-3 million deaths from secondhand smoke. Even assuming that the statement refers to the entire world, it still appears to be an exaggeration (based on the estimate of 53,000 deaths per year in the United States, there would be approximately 660,000 deaths worldwide). But let's assume, for a moment, that the statistic is at least somewhat close to representing a reasonable estimate of the annual number of worldwide deaths due to secondhand smoke.

Why would the Pennsylvania Department of Health fail to qualify this 3rd statement by making it clear that it refers to the entire world? Especially when all the other statistics refer only to the state of Pennsylvania!

In my opinion, this appears to be a deliberate attempt to mislead people into believing that the death toll from secondhand smoke is greater than it actually is.

In fact, I find this to be worse than what I originally thought, which is that the Department of Health was simply making a careless, errant statement. Had the Department of Health actually been claiming that 1-3 million people in the U.S. die each year from secondhand smoke, then it would represent a blatantly false claim, but it could probably be explained as being an errant statement resulting from some very careless factual preparation and review.

However, in the context in which it is presented, it now appears that a more likely explanation is that the statement was intentionally thrown in there to mislead the public and to exaggerate the perceived death toll from secondhand smoke.

It seems that the natural statistic to include as the 3rd bullet would have been the annual number of deaths in Pennsylvania due to secondhand smoke. Sticking worldwide data on the deaths from secondhand smoke in the midst of all the state-specific estimates seems quite odd. So odd that I question whether this is not a deliberate attempt to mislead people.

Whether deliberate or not, it is extremely misleading. Clearly, the reporter who wrote about these statistics in the article I discussed yesterday was greatly misled. It was her clear impression that the health department was stating that there are 1-3 million deaths each year from secondhand smoke in the U.S.

Under the circumstances, the health department would need to be extremely careful in communicating this statistic, since it is a worldwide estimate in the midst of a large number of statewide estimates. Clearly, little care was taken and I believe little care was taken to ensure that the site communicates information clearly and accurately to the public.

As I stated yesterday, anti-smoking groups do not appear to be taking any reasonable degree of care in communicating information to the public these days. The truth be told - the truth just doesn't matter any more. These groups believe that they have goodness on their side. The ends are good and noble ones and so it just doesn't matter whether every statistic you put out there is correct or not or whether the information you are communicating is wildly misleading. These groups are trying to save lives. Why should scientific accuracy get in the way?

I'll tell you why. Because scientific accuracy, honesty in public communications, and scientific integrity are treasured core ethical values of public health practice. By violating these basic standards, these groups are giving the tobacco control movement, and perhaps public health at large, a bad name.

In the long run, the damage to the reputation of the tobacco control movement and public health will be far greater than any fleeting benefits of the public having an exaggerated perception of the death toll from secondhand smoke.

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