An op-ed that appears in today's New York Daily News exposes the widespread misleading claims being made by anti-smoking groups about the acute cardiovascular effects of secondhand smoke. The unsupported and biased conclusions of the IOM report about smoking bans and heart attacks are only one example of the loss of scientific integrity of the tobacco control movement, and that loss of integrity is now being publicly exposed.
The op-ed points to hundreds of claims by anti-smoking groups that are scientifically inaccurate; most of them relate to claims that brief secondhand smoke exposure causes hardening of the arteries (atherosclerosis), heart disease, fatal arrhythmias, or clinically meaningful heart or artery damage that puts even a healthy person at risk of suffering a heart attack or stroke.
Sadly, these claims are headlined by the Surgeon General himself, who stated that: "Even brief exposure to secondhand smoke has immediate adverse effects on the cardiovascular system and increases risk for heart disease and lung cancer."
There is no evidence whatsoever that a brief exposure to secondhand smoke poses any lung cancer risk, nor is there any evidence that a brief exposure can cause heart disease. The Surgeon General should have ended his sentence after stating that brief tobacco smoke exposure has immediate adverse effects on the cardiovascular system. Trying to falsely extrapolate from those adverse physiologic effects to heart disease and lung cancer turned an important piece of health information into a dishonest communication (i.e., a lie).
Other major claims called out in the op-ed are Americans for Nonsmokers' Rights' (ANR) claim that: "Even a half hour of secondhand smoke exposure causes heart damage similar to that of habitual smokers."
Heart damage? In just a half hour? Equal to that of habitual smokers? What secondhand smoke does is cause endothelial dysfunction in nonsmokers and that endothelial dysfunction is similar to that seen in chronic active smokers. But endothelial dysfunction is hardly "heart damage." It is certainly misleading of ANR to imply that the damage caused by a brief tobacco smoke exposure is similar to the heart damage suffered by chronic active smokers who actually experience destruction of heart muscle due to heart attacks brought on by tobacco smoke-induced atherosclerosis of the coronary arteries.
Another claim called out in the op-ed is that of the American Cancer Society: "Immediate effects of secondhand smoke include cardiovascular problems such as damage to cell walls in the circulatory system, thickening of the blood and arteries, and arteriosclerosis (hardening of the arteries) or heart disease, increasing the chance of heart attack or stroke."
While it is true that brief secondhand smoke exposure does cause temporary damage to cell walls in the circulatory system and does thicken the blood, it cannot possibly cause hardening of the arteries -- which is a process that takes many years to develop. You can't walk into a bar with clean arteries and come out 30 minutes later with atherosclerotic arteries. Even 4 pack a day smokers do not develop atherosclerosis overnight.
A further claim called out in the op-ed is that of the New York City health department: "Just 30 minutes of exposure to second-hand smoke produces some of the same physical reactions that would occur from long-term smoking, and increases the risk of heart disease in non-smokers."
There is no way that a person can develop heart disease in 30 minutes. It typically takes at least 20 to 30 years, even in a chronic, active smoker.
What is the point of all of this exaggeration, deception, and lying? According to the op-ed, it appears that anti-smoking groups are feeling the sensationalization of the scientific evidence is necessary to support the increasingly aggressive agenda of banning smoking just about everywhere, including in the wide-open outdoors (such as in all areas of every public park in New York City).
The op-ed concludes: "By wildly exaggerating the health risks of secondhand smoke exposure, the anti-smoking groups are risking their credibility. They are threatening to undermine the public’s trust in their pronouncements about the very real evidence demonstrating that tobacco smoke exposure is a severe health hazard. In fact, the hysteria may actually convince smokers that active smoking is no worse than brief exposure to secondhand smoke, which could well undermine their appreciation of the severity of the health consequences of smoking. The well-documented effects of chronic exposure to secondhand smoke — which include heart disease and lung cancer — combined with the acute effects of brief exposure on individuals with existing respiratory and cardiac disease are enough to justify efforts to ban smoking in all workplaces, as well as in public places where nonsmokers cannot easily avoid smoke exposure, such as stadiums and arenas. We do not need to exaggerate the health effects of secondhand smoke. The truth is more than enough."
The Rest of the Story
Although I know that I am going to face severe criticism from many of my colleagues for going public with this criticism of anti-smoking groups, I feel that it is important to expose the truth about the science, and that I need to do so beyond just the confines of this blog. This is why I have tried to maintain a consistent presence on op-ed pages of major newspapers.
The anti-smoking movement is not going to change from within. I tried that for about five to seven years before even starting this blog and it produced no results. No one was interested in listening and I was merely attacked as being some sort of heretic. That was when I decided to go public. That was the beginning of the "rest" of the story.
I feel that it is only by exposing the deception of anti-smoking groups publicly that they are going to be held accountable for their statements and actions.
And while colleagues may criticize me for what they perceive as hurting the movement, I feel that in the long-run, what is hurting the movement is the loss of scientific integrity and that by trying to reform the movement and save its credibility, I am actually doing something that is desperately needed to save the movement.
Perhaps more importantly, I think it is important for the overall reputation of public health as a whole. We need to be perceived as credible. We need to be beyond reproach in our scientific communications to the public.
Remember, the main thing that has always separated us from the tobacco industry is our honesty. If we eliminate that separation by following Big Tobacco's lead and turning into a movement that misleads and deceives the public, then we lose all credibility. That means we also lose the ability to make a difference in the lives of the public. We lose the ability to save lives and protect the public's health.
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