Thursday 17 June 2010

Banning smoking in the home: Winickoff returns

Remember Dr Jonathan Winickoff? Early last year, he staked his claim as a rising star of quackademia by popularising the phantom menace of thirdhand smoke using nothing more than a phone survey. 

Would you stop smoking if you believed that toxins clung to your clothes and killed your children? You would? Cool! In that case, thirdhand smoke exists—let's send a press release; the BBC and the Daily Mail will fall for it. 

That's about the level of this guy's scientific integrity.

This utter, utter junk science was designed to further the 'next logical step' of banning smoking in the home and now, 18 months on, Winickoff has got down to brass tacks and published a call-to-arms in the New England Journal of Medicine

As is happening with terrifying regularity these days, the whole study is beyond parody. Basically, he wants smoking banned in all public housing on the basis that deadly levels of secondhand smoke travel down air vents and through walls. This is a man for whom 'the dose makes the poison' means absolutely nothing. (But then Winickoff's a paediatrician, not a toxicologist; his two co-authors—Michelle Mello and Mark Gottlieb—are both lawyers.)

The very fact that this garbage has been published in a respected journal like the NEJM is too depressing for words, but a few things about its basic premise need to be mentioned.

A resident who smokes in a single unit within a multiunit residential building puts the residents of the other units at risk.

This is an extraordinary claim that requires extraordinary evidence. Just two references are provided to support it. One points to the Surgeon General's report Children and Secondhand Smoke Exposure. The other is a transcript of a Surgeon General's press conference on the same subject. Both encourage parents not to smoke in the home (for the sake of the children), but neither of them make any scientific claim that smokers in one apartment harm people in surrounding homes.

Tobacco smoke can move along air ducts, through cracks in the walls and floors, through elevator shafts, and along plumbing and electrical lines to affect units on other floors.

How can the NEJM print such rubbish? 

Firstly, if you have a crack in the wall big enough to let in air from next door, you have bigger problems to worry about that secondhand smoke. 

Secondly, air ducts don't carry air from apartment to apartment, they take air in and out of the building. Likewise the plumbing.

Thirdly, tobacco smoke coming down electrical lines? We really are in the realms of the insane now, are we not? Last month, Smokles ran a contest to find "the most ludicrous article to appear in an anti-tobacco journal in the next 6 months." I submitted the following:

Toxins from cigarettes can be transmitted down phone lines

That's got to be close enough, no? Gentlemen, I claim my five dollars.

Winickoff gives three references here: this, this and this. None of them support his claims about cracks in the walls, electrical lines or anything else.

High levels of tobacco toxins can persist in the indoor environment long after the period of active smoking — a phenomenon known as third-hand smoke.

This is bullshit of Winickoff's own making and, of course, he provides a reference to his own phone survey study as evidence (this is how 'overwhelming' evidence accumulates—see Glantz). He also refers to the Georg Matt study and two other studies. None of these papers suggest that lingering tobacco toxins ever reach "high levels"—on the contrary, they are infinitesimally low—and none of them discuss secondhand smoke travelling between apartments.

These are the key statements upon which Winickoff hangs his case. There is not a shred of evidence for any of them. Isn't the peer-review process supposed to check these things?


timbone said...

I once wrote in a newspaper that children whose parents smoke could get web feet. I emphasised that the genetic nature of this meant that even if the parents did not smoke but grandparents had there was still a risk.

I did it to see the result. Noone challenged it's obvious stupidity. I got a result. You can say whatever you like about the harms of tobacco smoke, it is good press and people believe it.

Anonymous said...

We live in the Age of Unreason.

Nature and Science are beholden to global warming propaganda, while the medical journals have succumbed to even more ludicrous forms of hysteria.

How long can it be before intelligent people say, enough is enough. These esteemed journals are already verging on News of the World status. Will they die first? Or will they pull back from the brink?

Smoking Hot said...

Prediction ... soon we'll have a country that has a smoking ban claiming that the country it has borders with, but has no smoking ban, is a health hazard. :)

Anonymous said...

You’re going to have to start calling these fools for the derangement they suffer. They are pathological liars. The lying protects a complex of dysfunction, e.g., bigotry, tyranny. They are dangerously disturbed minds that in the last century have made criminals of ordinary people (USA, early-1900s) based on a plethora of inflammatory lies. And this is where they have been heading this time around. What else would pathological liars do?

What has legitimized these liars over the last three crusades (USA, Nazi Germany and now) is a eugenics-driven Public Health. The medical establishment no longer uses the “E” word. But lifestyle epidemiology, statistical risk aversion, healthism is all eugenics – particularly negative eugenics, i.e., preventative medicine. Tobacco and alcohol are viewed as “racial poisons” by eugenics. The eugenics framework dominates Public Health and provides the same advisement to politicians of all persuasions. Politicians, who wouldn’t have a clue about eugenics, simply toe the advisement line. It is the eugenics framework dominated by the medical establishment that is the iron fist that uses the derangement of antismokers for its own ends.

Michael J. McFadden said...

Beautifully done Chris! Tracking down the references is something I've found quite valuable too. There was some study a few months back about childhood exposure to secondary smoke. Part of the "proof" of this was the studies on cotninine in children's blood. I followed up the three footnotes used as "proof," found one of them that made some vague statement about children's exposures with a note that sometimes cotinine could be found in their blood, and two references that had NOTHING AT ALL to do with the subject: one of those didn't even HAVE the word "cotinine" in it!

It's almost as though antismoking researchers feel that they are so above questioning that they can simply say anything and cite anything and no one will even think about checking their work. They suggest friends as peer reviewers for their journal submissions and of course the "peers" then say the research is great - since they know the favor will be returned a few months later.

To see just how crazy Winnie Da Poo's last reesearch project was, read my Aftercomments to the Global Health Law article at:

and then think about how many three trillion year old babies with floor licking fetishes you've known.

Great job Chris!


Anonymous said...

Here in the US, there's a radio ad campaign in downstate NY. It involves two friends having a conversation. One friend complains that he's having respiratory problems because of a neighbor's smoking. In response, the other friend encourages him to visit a website and take action against his smoking neighbor.

Here's the website people are encouraged to visit. There's horror at every click.


Michael J. McFadden said...

Sweda (Northeastern Law Project) and Glantz (ANR) have both been big behind this thing as has ASH. And you're right: "horror at every click" is an accurate description!


Anonymous said...

What is overlooked in the apartment-building smoke insanity is that most apartments are equipped with kitchens intended for cooking. Cooking produces smoke not unlike tobacco smoke. It can even produce airborne nicotine from cooking such foods as potatoes, tomatoes, etc. Apparently cooking smoke is entirely safe. Only ETS, could it negotiate all the nooks and crannies from a distant room, is dangerous. Just more pathological lying.

Ann W. said...

Chris, you might find this study of interest.
Indoor concentrations of nicotine in low-income, multi-unit housing: associations with smoking behaviours and housing characteristics

Air nicotine levels in non-smoking homes were low, ranging from the LOD to 0.28 μg/m3, with a median of 0.04 μg/m3 and mean of 0.08 μg/m3. Concentrations were significantly higher in smoking homes, ranging from the LOD to 26.92 μg/m3, with a median of 1.50 μg/m3 and a mean of 4.66 μg/m3 (p<0.0001).

* These findings have important implications for smoking regulations in multi-unit homes and highlight the need to reduce involuntary exposure to tobacco smoke among low-income housing residents.

In addition to policy restrictions on smoking, efforts to educate the public about the risks associated with SHS exposure at home may be an effective means of reducing exposure. Healthcare providers and public health advocates need to play a stronger part in informing the public about the health effects of SHS exposure, and the positive impact that smoking restrictions can have on household members. Interventions to motivate smokers to consider cessation through the awareness of the benefits of exposure reduction should be implemented in low-income housing developments. Given the relatively serious health consequences associated with exposure to SHS, this study highlights the importance of continued efforts to develop and evaluate effective exposure assessments targeting racial/ethnic minorities and low-income housing populations. Such efforts would provide much needed information and education about this very common public health problem and give residents of multi-unit homes the tools to protect their families from the detrimental health effects of secondhand smoke.

Anonymous said...

When I first read this transcript of a Jan 2009 interview Dr. JONATHAN WINICKOFF , I thought it was a parody but it's real!!!! and you will notice that he brings up that multi-unit housing should be smoke free several times.

This was almost a year and a half go. Maybe this was the real intent of the third hand smoke study all along?

FLATOW: Mm hmm. So, if you go into an apartment that a smoker - or a house where a smoker has lived for many years, you should expect to have all these things on the furniture?

Dr. WINICKOFF: Absolutely.

FLATOW: And if you're worried about it, then the first thing you should do is get it cleaned? Is it a

Dr. WINICKOFF: Don't buy the property.

(Soundbite of laughter)

Dr. WINICKOFF: Don't buy the used car that smells like smoke. There's already a documented lowering of price. I would emphasize that's important. And I think that multi-unit housing should be completely smoke-free.

You can also listen to the interview here:

Snakey said...

This propagandist bull (and outright lies), on the surface, looks irrational and insane but I see the following agenda:

1. It is to force people to take NRT and thereby support the state subsidised pharma companies.

"but this problem is mitigated somewhat by the availability of other forms of nicotine, which permit smoke-free maintenance and treatment of the addiction."

"It is critical that no-smoking policies be accompanied by the provision of evidence-based smoking-cessation resources to public-housing residents, particularly since most state Medicaid programs currently do not cover comprehensive tobacco-dependence treatments."

2. It is to continue the agenda of making sure the slave livestock continues to be 'healthy'.

"actions by employers and insurers are motivated by the desire to maximize worker productivity"

3. Control.

"courts have permitted much heavier burdens to be imposed on people who smoke than the loss of public housing, such as loss of child custody."

The nasty threat inherent in the third point is what makes me really angry. Glanz is the same kind of scum bag.

Other threats used are:

You have NO rights:
Mentioning that the Fifth and Fourteenth Amendments of the U.S. Constitution, Americans with Disabilities Act, Fair Housing Act and the Civil Rights Act of 1964 don't protect you and don't apply to you.

The policy will be enforced upon you (i.e coercive threats):
"The greatest disincentive for PHAs to implement smoke-free policies may be the challenge of enforcement. Effective mechanisms for monitoring and for reporting noncompliance would need to be established, along with sanctions for residents who do not comply."

You will lose your home:
"displacement of residents who refused to comply with smoking restrictions"

I wonder if Dr Winickoff would so enthusiastic about all this if he had to pay for it all out of his own pocket instead of a) receiving funding for his eugenic stance and b) advocating it be paid for by citizens via violently coercive taxes.

Anonymous said...

Surely in the UK any such building construction would be in contravention of fire regulations.

Fredrik Eich said...

"Tracking down the references is something I've found quite valuable too." - MJM.
Yes but quite time consuming!A waste of Pub time!

Anonymous said...

"Concentrations were significantly higher in smoking homes, ranging from the LOD to 26.92 μg/m3, with a median of 1.50 μg/m3 and a mean of 4.66 μg/m3 (p<0.0001)."

Ann W. quoting from:

Why are these measurements a big deal. In fact, they're not impressive at all unless you believe the ETS/SHS fraud, and a fraud it is indeed.

I see the report contains the usual further nonsense about SIDS. SIDS campaigning groups would protest strongly about the blame for SIDS being placed on smoking given that the majority of their members who have experienced cot death are non-smokers.

Not impressive, Ann W. You'll have to do a lot better than that!

John Gray.

Ann W. said...

To John Gray, I think that was my point. Those figures are really small yet they somehow feel that it will compromise health of someone living in the same building.

and by the way, I'm not only pro choice, but I'm anti, anti smoker.

Michael J. McFadden said...

The numbers in Table 2 of Ann's reference are interesting. I've only looked at it quickly, but three things jumped out at me:

1) There are odd inconsistencies in some of the measurements. E.G. homes that don't even allow visitors to smoke have the same maximum measurements as the maximum home with two smokers living in it.

2) It's worth noting the discrepancies between the median and mean values. The median is likely the better measurement as it would exclude the effect of a few unusually high or low values that would bias the average. In most cases the median values were markedly lower than the mean values.

3) While there are a number of different comparisons that could be made it would generally appear, if my eyeballing is at all accurate, that the median nonsmoking home had between 1/100th and 1/1000th the amount of nicotine (and therefore supposedly smoke if we assume that there is absolutely ZERO contribution from any other sources: e.g. cooking fried green tomatoes or lots o' french fries.)

According to the EPA figures living with a smoker for 40 years increases one's chances of lung cancer by 19% over the general base rate of about 4 in one thousand to bring it up to about 5 in one thousand. That translates into one extra lung cancer per 40,000 years of exposure for those living in the same apartment/house as active smokers who smoke at home.

Now Table 2 shows the median N(icotine) level to be .04 in nonsmokers' homes where visitors are not allowed to smoke. The median N level in smokers' homes where visitors are also allowed to smoke is 2.93. That's about a 75x difference. Extending the EPA figures would indicate then that the nonsmokers who did not allow smoking would be at an extra risk of 1 extra lung cancer per (40,000 x 75) = 3,000,000 years of living in a building where other tenants and visitors smoked. Of course that's only true if we remember to assume that cooking eggplants and such gives off NO nicotine and if we assume that NO nicotine comes in from outdoors and if we assume that either Winnickoff's "Third Hand Smoke" is a total lie or that low income people never buy secondhand furniture from anyone who ever allowed smoking in their homes.

Of those four assumptions, the total lie of thirdhand smoke is the only reasonable one. The fourth assumption then becomes irrelvant but the first two assumptions are not as reasonable and the reality probably tacks a couple of hundred thousand extra years onto our figure.

If all my figurings are correct then, even according to the EPA's exaggerated figures, on the average you'd have to live in a low income smoking-allowed public housing complex with smokers for over three million years to get lung cancer from the situation.

Now, what are your chances of being stabbed by a crack addict during those 3,000,000+ years?

Michael J. McFadden
Author of "Dissecting Antismokers' Brains"

Anonymous said...

This is a legal question rather than a medical one. But as this research is so, SO deeply flawed is there any recourse to legal action bearing in mind public policy is being based on this stuff? Is there cause for incitement to hatred or somesuch (hey, I'm not a lawyer).

Peer review clearly doesn't work. But is there any chance of getting this rubbish exposed in the courts? At least the "science" behind global warming is complicated so it hides a multitude of sins. But you don't even need experience in research methodology to see through this stuff and it's getting published in supposedly respectable journals....?

Anonymous said...

Me again - and another thing that confuses me is how can real scientists let them get away with this guff? If I was conducting serious research and I saw all this crap being published I'd be furious! Especially when I saw all the money that was getting funnelled their way. Hell, I'm not a researcher (although I am an academic so know about research design) and even I get furious about it. In fact, the only reason I joined in the fight against anti-tobacco was because of the Pell Study. I'd meekly accepted the ban for 12 months until I hear the Pell study being reported on the BBC. It seemed like obvious twaddle. So I looked it up on the web and lo and behold, here I am three years later, fighting to expose their lies to everyone I meet.

But surely some real scientists must worry that this stuff (and the AGW material) is bringing science into disrepute? Why don't they expose these charlatans?

Anonymous said...

I'm out tomorrow to buy a anti-hazard suit.
This second hand smoke may be coming through the fucking walls !!
The bloke next door to me smokes and I am not taking any chances.
In fact sometimes I think that I can actually see the stuff coming through the walls.
God help us all and protect us from filthy smokers.

Anonymous said...

what about fourth hand smoking?