Idiotic statistics

Tobacco Control recently published an 'e-letter' (known to the rest of us as an 'e-mail') from Konstantin Krasovsky, Head of Tobacco Control Unit in Ukraine, about the WHO's measure of "selected smoking-related causes". Bear with me, because it's more interesting than it sounds.

The WHO has a handy website for accessing health and demographic data. One of things you can look up is the smoking-related mortality per 100,000 people. But, as Krasovsky points out, these estimates seem to have no basis in fact.

In the case of Ukraine, to consider just one example, the WHO HFA database shows that in 2004 male "smoking-related mortality" was 1081 per 100,000 population. However, all-cause male mortality for the same year was 1920. So 56% of all deaths were to be considered smoking-related deaths. The respective figures for women were the following: 586, 978, and 60%.

Even if we ignore the fact that female smoking prevalence in Ukraine was about four times lower than among males, it is obvious that smoking could not cause so many deaths even for men.

He's got a point. According to this database, Armenian women—of whom just 1.5% are smokers—have a smoking-related mortality rate of 138 per 100,000, which is 16.3% of all deaths.

This is not a great deal lower than the rate for Armenian men—52% of whom are smokers—who have a rate of 259 per 100,00, or 19.6% of all deaths.

In Kyrgyztan, the smoking rate for women is just 1.7%, and yet the smoking-related mortality is 607 per 100,000. Since the total female mortality rate is only 931 per 100,000, this means that a habit practised by less than 1 in 50 women is responsible for 65% of all female mortality.

For men in Kyrgyztan, the smoking rate is 41%, but smoking is responsible for 60% of male deaths (934 per 100,000 out of total mortality of 1532 per 100,000).

No one expects absolute precision from these kinds of estimates, but what we have here are figures that are so wildly implausible they don't even pass the basic test of common sense.

The WHO quietly acknowledges their uselessness on the page of definitions which almost no one will ever read:

The mortality from combined, selected causes of death which are known from literature to be related to smoking. It has to be pointed out that it is relatively rough indicator and it is NOT the estimate of tobacco-attributable mortality, which is more complex and difficult to calculate.

In other words, they have taken all deaths from any cause that is related to smoking and bundled them together even if the person didn't actually smoke. Nonsmoker dies of a heart attack? Smoking-related death. Nonsmoker dies from throat cancer? Smoking-related death. Seriously, this is what it's come to.

So remember, "smoking-related mortality" is not the same thing as "tobacco-attributable mortality". One is only vaguely related to smoking and has no basis in fact, the other is too "complex and difficult" for the World Health Organisation to bother with.

I'm sure that campaigners, journalists, broadcasters and politicians will understand that these figures are essentially worthless and will explain that carefully to the public before citing figures that might as well have been plucked out of the air. And I'm sure that no serious researcher would ever use these meaningless figures as a basis for making real-world estimates.

Yes sir, that will definitely never happen.

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"It's very scientific"

It was a mark of the crankiness of Victorian-era anti-cigarette campaigners that they claimed cigarettes caused instantaneous death (see Chapter 2, Velvet Glove, Iron Fist). And it was partly because the public became weary of such obvious scare stories that they found it difficult to believe the real truth—several decades later—that chronic smoking could cause fatal diseases in middle- and old-age.

But everything comes full circle and the latest comments from the new Surgeon General, Regina Benjamin, seem designed to take us back at least 100 years. Her predecessor was a tough act to follow. Scientifically illiterate statements like "There is no significant scientific evidence that suggests smokeless tobacco is a safer alternative to cigarettes" and "There is no safe level of secondhand smoke" set new standards of quackery at the Surgeon General's office. But the new incumbent looks up to the job, and when you have an obese Surgeon General serving a president who smokes, all bets are off.

The latest headline claim—breathing a puff of secondhand smoke can kill you instantly—is really just a variation of Carmona's "no safe level" rhetoric. It takes the theoretical possibility that someone at death's door who is critically, terminally ill with heart disease could be finished off by smoking a cigarette, and then extends it to suggest that healthy people are being killed in the street from breathing secondhand smoke.

Benjamin has done nothing to distinguish between these very different situations. Indeed, she has gone out of her way to add to the confusion. This is very clear from her recent interview with Ed Baxter on KGO Radio. Baxter gives her every opportunity to clear up any misunderstanding but Benjamin just keeps piling it up. The transcript is below, and requires little further comment, but I recommend listening to the audio to get a measure of the woman. She doesn't exactly ooze authority. (Listen here - starts at 17.00). My thanks to Becky Johnson for helping with the transcript.

EB: Well, this may be, there have been a lot of warnings about cigarette smoking, but this may be the scariest I've seen. So we really wanted to get it straight from the person who did the study and the survey so we went straight to the top. Surgeon General, Regina Benjamin is on the KGO live line. Thank you for joining us.

RB: Thank you for having me.

EB: If I'm reading this correctly, you're saying your next cigarette could be your last. That's a dramatic way of putting it: "The next cigarette could be your last." This  is a report coming straight out of the Surgeon General's office. Cigarette smoking can cause instantaneous shut down of systems, is that true?

RB: It can certainly cause a heart attack and death, that's true. This report is the 30th Surgeon General's report on tobacco. The previous reports have focused on what diseases are caused by tobacco. But this particular report focuses on how tobacco smoke really damages every organ in your body. One of the things we know is that if you inhale cigarette smoke or inhale passive, second-hand smoke you might have an underlying cardiac disease like heart disease and didn't even know it. When you inhale it, those chemicals, they can irritate the blood vessels, irritate that lining, causing immediate damage. And also cause your blood to be thicker and clot quicker so that can cause an immediate heart attack. So just that one cigarette can cause a heart attack.

JLJ: So even just second hand smoke? Just a whiff of the smoke?

RB: That's correct. We know that cigarettes today have over 7,000 chemicals and chemical compounds. And inhaling those chemicals causes immediate damage to your blood vessels.

EB: And this, of course, would be more severe or traumatic to somebody who has a chronic condition, who has been smoking for a while....

RB: No, it's anyone! Most people who have heart disease, for example, don't even know they have heart disease because they never had any symptoms.

EB: So anyone just walking on a street, a first cigarette or just second hand smoke?
This could be caused by hypertension or any underlining disease, correct?

RB: Any underlying disease or people who may appear to be very healthy and just didn't know it! And also people who are healthy, it affects them as well. It affects your blood vessels and can damage your DNA. We find that people who, particularly women who have reproductive problems, because the DNA is affected by the chemicals in the tobacco. We didn't even know these chemicals existed. We didn't even know that there were 7,000 different chemicals and chemical compounds so these things are new. It's very scientific, but how these chemicals affect your body. Every organ in your body.

EB: We know it causes cancer. It may lead to heart disease. People are talking about chronic diseases. We're talking about instantaneous—and I just want to make sure we're understanding this correctly—instantaneous... your next cigarette or breathing someone's secondhand smoke could cause, basically, an acute episode that could lead to instant death.

RB: That's correct. The other thing is that these cigarettes today are more addicting. The nicotine, the chemical compounds that we now have the science behind—and this report tries to explain how it becomes much more addicting.

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Overkill

The big news today is that secondhand smoke causes 600,000 deaths a year worldwide. Anyone tempted to take this figure remotely seriously should bear in mind that the authors of the associated study also believe that "smoke-free laws banning smoking in indoor workplaces rapidly reduce numbers of acute coronary events" and "fully smoke-free policies have a net positive effect on businesses." And, interestingly in the light of the Moral Maze the other night, they consider the main aim of smoking bans to be denormalisation:

Above all, [smoke-free] policies contribute decisively to denormalise smoking, and help with the approval and implementation of other policies that reduce tobacco demand, such as increased tobacco taxes and a comprehensive ban of tobacco advertising, promotion, and sponsorship.

Still, you can't fault their impeccable methodology:

To identify national data for second-hand smoke, the keywords “second hand smoke”, “environmental tobacco smoke”, and “passive smoking” were combined with names of countries or regions, by searching Google and the PubMed database

The spirit of Newton and Darwin lives on, does it not?

What can be said of the 600,000 estimate? Obviously if you extrapolate a relative risk over a larger population, you will get a larger number. That doesn't make the study or studies you are extrapolating from any better, but I won't risk waking this blog's resident troll by going into all that again.

It's interesting that this study appeared in the Lancet because back in the 1990s, Lancet columnist Petr Skrabanek* remarked on the tendency of public health campaigners to use larger and larger populations to get scarier and scarier death counts. He called them "jumbo-jet numbers" because talking about the equivalent number of jumbo-jets that would have to crash for the same death toll sounds more dramatic than explaining that you have to die of something and that most of the people being "killed" were very old. This, from a collection his articles [PDF]:

The intoxication with numbers is another characteristic of the modern crusaders against smoking. They typically use big population blocks as denominators to obtain bigger and bigger numbers. Richard Peto, a leading anti-smoking exponent and a statistician, announced that 'of all children alive today in China under the age of 20 years, 50 million will eventually be killed by tobacco.' This would put the hecatombs of the Second World War in the shade. The British Medical Journal referring to another such statistic, 'typical of the Oxford epidemiologist Richard Peto', quoted that 'about 20 million children now living in Europe will be killed by tobacco in their middle age.' And The Times reported on January 1, 1988, that according to Mrs Risk-factor Epidemiology: Science or Non-science?

Edwina Currie, 'more than a million schoolchildren and 60,000 babies born this year will die of smoking-related diseases such as lung cancer.' Surprisingly, no-one has yet used the population of the whole world as a denominator: this would produce numbers of babies, toddlers, schoolchildren, and other children, killed by tobacco in truly phenomenal ranges. Perhaps the reason for this reticence is the fear of overkill.

Well, now they have. In fact, they've missed a trick by not using the other PR tool of multiplying by years (eg. here). So, to save someone the trouble, here's my study:

'A quantitative, longitudinal assessment of worldwide mortality from environmental tobacco smoke'

Christopher J. Snowdon

Methodology: Google and PubMed of course. I'm a professional.

Results: 600,000 x 10 = 6,000,000

Conclusion: Secondhand smoke will kill 6 million people over the next ten years. Where's my cheque?

[*nb. Petr Skrabanek was a skeptic about—amongst many other things—secondhand smoke. You can probably guess what the anti-smokers' response was. That's right, they accused him of working for the tobacco industry. Which was a lie. He died of a non-smoking related disease in 1994.]

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Just open the window!

I was interviewed on BBC Scotland radio this morning on the subject of banning smoking in cars (listen here for 7 days, 2.17 hours in). Sleepy though I was—and coming off the back of a hilariously one-sided vox pop—I tried to make the point that the simple act of opening a window in a moving vehicle provides ample ventilation to disperse secondhand smoke.

Prof John Britton had earlier told the BBC that levels of secondhand smoke in cars are twenty times higher than in smoky bars. As a medical man, his opinion naturally trumped mine as far as the presenter was concerned. Nevertheless, it's worth finding out this '20 times higher' claim comes from.

A good place to start is a heavily referenced report from ASH (UK). It claims that:

According to a report by the Ontario Medical Association, secondhand smoke levels in cars can be 23 times greater than in a house.

ASH give a citation of this report from the Ontario Medical Association, which says:

Based on the evidence that exposure to SHS in a vehicle is 23-times more toxic than in a house due to the smaller enclosed space, the state of Colorado drafted a bill that would impose fines on adults caught smoking in cars when a child is present.

But what evidence is this? Their only reference turns out to be a news story from the Rocky Mountain News, not exactly a reliable scientific source.

ASH do, however, have another source:

A study comparing secondhand smoke particle concentrations in a vehicle with those in a bar which allowed smoking, found in-vehicle concentrations 20-times greater than inside the bar.

Again there is a citation, this time to an actual scientific journal, but the article in question does not measure secondhand smoke in cars, nor does it attempt to. It certainly doesn't give any estimate of how much more secondhand smoke is in cars than other locations, and it doesn't cite any references that might lead us to find an article that does.

And there the trail ends. Such is the game of Chinese whispers that passes for evidence-based medicine these days.

If you want to find some real science on this issue, you have to turn to an American Journal of Preventive Medicine study from 2006, which measured particulate matter (PM2.5) in vehicles.

Bearing in mind that the EPA's 'hazardous' level for 24 hour exposure is 250 ng/m3, this study found average peak concentrations of 271 ng/m3. But they did so by keeping the windows closed. When a window was opened, the level was only 51 ng/m3. This is a fraction of what would be found in a smoky bar (200-500 ng/m3) and is well within the EPA's limit (which, remember, is for 24 hour exposures, not the occasional car journey). And after smoking, levels quickly fell to the same found in a nonsmokers' car.

The study also measured carbon monoxide levels, with even less impressive results. When the window was opened, levels barely changed at all.

Another study sometimes cited carried out a similar experiment but only opened the window by 3 inches. Even with this restricted ventilation, average levels of PM2.5 were 119 ng/m3—well below the EPA's hazardous level.

All of which suggests that—if smoking in cars is a problem at all—it is one that can be simply solved by opening the window. And that, of course, is what everyone already does. 

Would I agree with a law forcing people to open the window whilst smoking? I probably would, if I thought that would be the end of the matter, but we all know that it won't be because protecting people from secondhand smoke is not the purpose of the Royal College of Physicians' latest 'demands'. By calling for a total ban on smoking in cars, even when no one else is present, they have finally given the game away. This issue isn't about science and it's not about 'protecting' nonsmokers. It never has been.

UPDATE

While I was on BBC Scotland, Tony Blows was on Radio 5, making his point rather more forcefully. He called Deborah Arnott a liar which, considering she brought up the Scottish heart scam, I suppose is fair comment. F2C have the audio. 

Incidentally, I was told that the producers wanted me to debate with a spokesman from an anti-smoking group but the spokesman refused! I bet Arnott now wishes she'd ducked out as well.

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The Policy Exchange make fools of themselves

It has long been recognised that tobacco brings in far more in tax revenue than is spent on treating 'smoking-related' diseases. What is less well recognised—because few people are so indelicate as to say it—is that the government has a financial interest in seeing people die at the age of 65, or as soon as possible thereafter. It's not a nice thought, but it's simple economics. Between the ages of 16 to 65, most of us are net contributors to the state. Before and after that, we are an expense.

 

From a strictly economic perspective, the government's ideal citizen is someone who works all their life, pays a lot of tax and then dies not too long after retiring. Smokers, for instance.

 

This is an uncomfortable fact for tobacco control. Nonsmokers must be taught to believe that smokers hurt them both physically and financially. They don't, but they've done a good job of convincing them on the first count, and now it is time for the second.

 

Enter the Policy Exchange. This think-tank has released a report which makes the astounding claim that British smokers cost the state more than the £10 billion they pay in tobacco tax each year. They do so using the most appalling methodology.

 

The fundamental problem—and this is a feature of all such studies—is that they assume that if a smoker doesn't die from a 'smoking-related' disease, he won't die from anything. Or at least not anything that costs money to treat. This is, shall we say, rather counterintuitive. 

 

It also assumes that the money to treat these diseases shouldn't come from the 11p in the £1 National Insurance contribution that every Briton is compelled to pay, but from additional tax on tobacco. In effect, the smoker's National Insurance contributions are given to a nonsmoker. Again, this seems a tad unfair and is hardly in the spirit of the NHS. 

 

Once you've swallowed all that, you are asked to believe that smoking costs the NHS £2.7 billion. This figure is often bandied around and the usual source is a 2008 ASH document called 'Beyond Smoking Kills'. This, in turn, cites another ASH document: 'The Cost of Smoking to the NHS' by C. Callum. But this document does not seem to exist. There is no trace of it on the ASH website and, for all we know, the £2.7 billion was plucked out of thin air. All that is left is this vague leaflet, also from ASH. 

 

But it'll do for the Policy Exchange, who slap another £200 million on and...

 

Ker-ching: £2.9 billion in healthcare costs.

 

So far, so good. But a lot more is going to be required if we are to get beyond that pesky £10 billion mark. 

 

To that end, £4.8 billion is conjured up for 'lost output'. This is the contribution smokers would have made to society had they not died during their working life. Matthew Sinclair spots the problem with this at ConservativeHome:

That loss is clearly mostly to the smoker themselves (the income they miss out on), that means it isn't a societal cost but a private one and can't justify Pigovian taxation.

Quite so. Let's not forget that the government does not own its citizens' bodies or their lives. We do not have a duty to work for the state or to maximise our productivity. You would hope that a supposedly centre-right think tank might recognise that.

 

The Policy Exchange assumed that these smokers wouldn't have any other health problems (rather unlikely), and that they would have worked to the age of 74 (what?!!). This second assumption is crucial because only a fairly small proportion of smokers die before the age of 65. 

 

They did, however, find 757 smoking-related deaths amongst the 35-39 age group (really? Who are they?) who each 'cost' society £750,000 (!) by dying young.

 

Better still, they assumed that none of these smokers would have had a life on the dole or on incapacity benefit. As a result, they didn't have to face the awkward task of showing a smoker saving the state money by dying.

 

Nor do they mention any of the pensions, benefits, prescriptions, hip replacements, meals on wheels, geriatric care and operations that won't have to come out of the pot thanks to smokers dying prematurely. And that's a damn good job, because that amount alone would dwarf all the rest of the figures combined and lead the reader to the unpalatable, but truthful, conclusion that smokers are net contributors to the economy. 

 

Oh, and stick another £713 million for deaths from passive smoking, even though they only exist on an epidemiologist's lap-top.

 

Ker-ching! £4.8 billion

 

Then there's litter collection. Everyone in Britain pays to have the streets cleaned but, according to the Policy Exchange, smokers should pay twice. The cost of collecting cigarette butts is, they reckon, £342 million. Stick it on the price of fags.

 

Ker-ching! £0.3 billion

 

And what about those cigarette breaks? They must be costing the country a fortune, right? The Policy Exchange estimates that smokers spend 5 to 10 minutes smoking while at work. Just imagine all the wealth they could be creating in that time! It's not as if everyone takes a break at work, especially since two 15 minute work breaks are mandatory under European law. Nah, let's pretend it's unique to smokers and call it 'lost productivity'.

 

This is pure baloney, as Mark Wadsworth points out:

How on earth is a smoking break a 'cost to the taxpayer'? That's like saying that since most people don't work at weekends, weekends cost the economy about £400 billion per annum

Never mind. Call it a cost and let's get to that £10 billion. And let's slap another £2.5 billion on because smokers are supposedly absent from work for 33 hours more than nonsmokers each year. This 33 hour absenteeism might have nothing to do with smoking, and probably isn't. It might not even be true at all, but it's grist to the mill. Okay, someone else estimated that the cost was less than half of that, but let's go with the highest figure we can find. Hence...

 

Ker-ching! £5.4 billion

 

The only problem is the tobacco industry's undoubted contribution to the economy. British American Tobacco alone turned over £33.9 billion in 2008 and is a significant employer. Without smoking, these people won't have a job, won't pay tax and will be claiming benefits. The same is true of their suppliers, distributors and retailers. This is a tangible economic benefit and the Policy Exchange does not want benefits eating away at their figure. So how to skirt around it? 

Smoking impacts on business in a variety of ways, and, when viewing our current paradigm, losses should be considered alongside benefits.

Agreed. Off you go then.

Previous studies have demonstrated that, were people not to spend money on cigarettes, they would direct their expenditure elsewhere. Other leisure industries support greater workforce, and have a significantly lower tax profile. This leads to an aggregate increase in employment, with consequent economic benefits. Indeed, they estimate that the benefits of to be derived from leisure spending going elsewhere would significantly outweigh the detrimental effects.

In other words, ex-smokers will spend their money elsewhere, thereby helping other industries which will then create new vacancies for those redundant tobacco execs and newsagents to fill. Well, yes, probably. But there is no guarantee that those industries will be in the UK. 

 

More to the point, the fact that people might find work elsewhere (though doubtful with over 8 million unemployed) is not a reason to ignore the costs of unemployment. I don't seem to recall many people in the 1980s telling the miners that their plight didn't matter because new industries would emerge. Nor have I noticed UNISON telling their members not to worry about mass redundancies because the money saved will be spent elsewhere.

 

A cost is a cost. Any financial spreadsheet needs to show that.

For these reasons we exclude the role of business from our calculation.

How very convenient. We wouldn't want the "role of business" to intrude on an economic analysis, would we?

 

And that, my friends, is how the Policy Exchange does its sums. They get to a figure of over £13 billion and want a 5% increase in the price of cigarettes which, by a remarkable coincidence, is exactly what ASH were demanding two weeks ago. 

 

Its lead author, Henry Featherstone, seems to be rather chummy with ASH, as Dick Puddlecote has noted. He is already utilising the fallacious arguments of that 'charity', turning up with a false dichotomy at ConservativeHome where he accuses his many critics of "defending smoking"—ie. anyone who criticises the 'good guys' must be helping the 'bad guys'. 

 

It's not defending smoking, Henry, it's defending reason.

 

Funnily enough, I was at the Policy Exchange last night. They were talking bollocks then as well.

 

UPDATE:

 

Mark Littlewood (Institute of Economic Affairs) attacks the notion that it is our duty to maximise our productivity for the state here.

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Kicking up a stink

So I get back from The International Conference Against Prohibition, pick up a copy of The Metro at Gatwick Airport and what do I spy?

Thousands banned from using perfumes at work

Thousands of civil servants could kick up a stink after being warned by bosses not to wear strong perfumes or aftershaves—to avoid costly legal action.

The Metro has jumped the gun a little here. For its online edition the headline has been changed to the more subdued, but more accurate:

Please don't wear perfume, Detroit tells workers

City employees in Detroit are being urged not to wear perfume or deodorant—after a lawsuit from an employee who couldn't stand her colleague's perfume.

This is the case of Susan McBride, who has successfully sued her employer on the basis that she has Multiple Chemical Sensitivity (MCS) and that...

... her colleague not only wore a strong scent but also plugged in a room deodoriser which forced her to go home sick.

The trouble is that Multiple Chemical Sensitivity doesn't exist. No serious physician or scientist believes otherwise. MCS is a rather unusual 'disease' since it only seems to affect middle-aged, middle class women, mainly in North America. These are the same kind of people who believe they are "allergic" to tobacco smoke (a biological impossibility).

As I discussed in Velvet Glove, Iron Fist, it started in Halifax, Nova Scotia. I quoted Dr Ronald House of St Michael's Hospital (Toronto):

"The uproar is fascinating from a cultural view. But it isn't good medicine, it's folly—political pandering to a few rather strident activists." (p. 343)

Sound familiar?

And yet this woman won her lawsuit, largely because the City of Detroit was foolish enough to cave in to the "rather strident activists" in 2005, when Erin Weber won a similar lawsuit (also in Velvet Glove). And The Metro may well be right when it says that employers will bring in workplace bans on perfume for fear of litigation. This is precisely what happened with secondhand smoke long before the EPA produced its infamous junk meta-analysis, and where America leads, the UK follows.

And speaking of strident activists, The Metro published this letter yesterday:

Smoke out abusers

I simply can't let Steve Lustig's diatribe against Duncan Bannatyne for saying children were being abused by smokers (Metro, Fri), go unchallenged. He thinks it is 'an insult to the victims of genuine abuse' to lump them with victims of smoking parents.

How very quaint. I am 58 years old, yet I am still traumatised by the memory of my father lighting up in the car throughout my childhood, despite pleas from my two younger sisters and I to refrain. His lighting up war invariably followed by all three of us throwing up. The callous disregard from the long-term damage caused by secondary smoking) he inflicted in the pursuit of his selfish pleasure simply beggars belief. And yes, I call that abuse.

By all means smoke yourself into an early grave if that's what lights your fag end. But do it without imposing it on others. Duncan is a true hero.

Costas Andrew Cleater

This guy's father lit up in a car "throughout [his] childhood" and this was "invariably followed by all three of us throwing up"? That's a lot of throwing up, and a very heartless father. You have to wonder how much this story has been embellished over the years, or whether it's true at all. Presumably this fellow would have been happier if he had had the power to turn his father over to the police, as Bannatyne is demanding.

(There's an interesting Channel 4 documentary about Multiple Chemical Sensitivity—including a woman who thinks she's allergic to her own hair—here: Allergic to the 21st Sensitivity.)

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Thirdhand smoke roundup

An extended version of my article about the thirdhand smoke study is on the Free Society website today. Quick summary: they used 14 times as much nitrous acid and 15 times as much nicotine as would be found in a normal home to produce a few nanograms of a substance that isn't a carcinogen. Apart from that, great study.

Meanwhile, it's been interesting to see what the reaction has been to the whole story in the press and on the blogs.

Some fell for it hook, line and sinker. Bro WTF? thinks...

So not only do smokers ruin my ability from wearing [sic] my same “go-to” outfit two nights in a row amongst two separate groups of people because my clothes now smell like an incinerator, smokers are killing me long after they leave a room.

Live Well! is not alone in seizing on thirdhand smoke as another excuse to tax smokers...

I say raise cigarette taxes! Not only is it good for our health, it will be good for the states who will receive more tax revenue that they desperately need for school systems, roads, and other infrastructure projects.

Honors e/e genuinely seems to be worried by the threat and wants to go further than mere taxation... 

Until I read this I always felt like if people want to smoke they should be able to it was not hurting me and if I did not want to be around it I could walk away, but now I am not so sure. This study shows that not only are smokers hurting themselves but they are also hurting people who come into a building, get in a car, or visit there [sic] house after they have been smoking. If tobacco is so harmful to everyone maybe it should be ban [sic].

Woman's Day says smokers should take a few precautions...

If you still insist on smoking, smoke outdoors only. Just make sure you take a shower and wash your clothes afterwards—at least you can help protect someone else’s health.

See? Is that so much to ask?

A member of an Indiana anti-smoking group can't separate cause from effect but she has her own story to tell at the Star Press...

Then, last year, I became a victim of third-hand smoke -- the residual toxins that linger on the hair, skin and clothing of smokers. I had come into contact with a couple who smoked and their clothing had the strongest stench of tobacco I had ever experienced. Being a previous smoker myself, I know that smokers don't realize how awful they smell and many times try to cover up the signs of smoking by using sprays and colognes (which) only make it worse.

The result of my contact with third-hand smoke was initially a sinus headache, then coughing. I ended up using a week's worth of vacation time because I developed what is called community acquired pneumonia.

John Banzhaf of ASH (for it is he) takes some dodgy science and exaggerates it still further:

Interestingly, another very recent study shows that nicotine exhaled into the air is converted by other common indoor air pollutants into cancer-causing chemicals which can linger on clothing, furniture, draperies, etc. -- a new risk being termed "thirdhand smoke."

The risk could be comparable to that of smoking.

Check that last line. Good grief.

Back on planet Earth, and on Spiked, Rob Lyons thinks differently:

Yet even the junk science of secondhand smoke seems like the stuff of Nobel Prizes next to the new kid on the block: ‘third-hand smoke’. Now, claim researchers, you don’t even need to breathe smoke in, you simply need to be in contact with smokers or touch surfaces that have been in contact with their smoke to be at risk. If the dodgy research that produced the smoking ban was bullshit, the claims made for third-hand smoking are in a whole new category: ‘beyond bullshit’.

At The Examiner, Thomas McAdam was showing signs of - shock, horror - having actually read the study:

His “study” did not involve any clinical trials with actual human beings (or even actual mice or rats). He and his student assistants simply applied tobacco smoke to sheets of cellulose as a model indoor material, and determined that TSNAs detected on cellulose surfaces were 10 times higher than those originally present in the sample. That is, after spraying the cellulose sheets with nitrous acid.

And he has some information about the study's funding source:

Before you jump to the conclusion that Dr. Hugo is some sort of moron, you need to know about California’s Proposition 99. In November 1988, California voters approved Prop. 99, “The Tobacco Tax and Health Protection Act”, which instituted a 25¢-per-pack cigarette surtax. Part of this tax revenue is deposited into a Research Account, to be appropriated for research on tobacco-related disease, by the TRDRP. For the bizarre little study we have outlined above, Dr. Hugo Destaillats was awarded $704,901.00 by TRDRP and the taxpaying smokers of California. Maybe Dr. Hugo’s not such a moron after all.

And, finally, he points out that not only are people prepared to believe anything they're told, they're already hunting out fresh scares for themselves:

Within months, the neologism “third-hand smoke” was getting more than 3 million references in a Google search. (Interestingly, the term “fourth-hand smoke”—the theory that you can get cancer from simply watching a movie in which Humphrey Bogart is smoking—is now getting 56,600 Google references.) Stay tuned.

We'll leave the last word to Andrew Button at The Muse:

The point at which your activism goes from being an attempt to protect people from harm to a plot to make life harder for people with a weakness, is the point you should probably call it quits.

The thing is, big anti-tobacco is a thriving business, and they’re not going to stop on their own...

The anti-smoking movement of today is less about health, and more about discriminating against and controlling people.
Anti-smoking activists want a nanny state that protects people from themselves, and punishes behavior some people find aesthetically unappealing.

The state should not have the power to regulate what it doesn’t like arbitrarily, unless that behavior poses a real risk to other people.

Until people realize this, anti-smoking legislation is only going to get more restricting and oppressive

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Unbelievable ignorance

For my sins, I'm currently reading a book called All Consuming by one of Gordon Brown's former advisors, Neal Lawson. In a nutshell, the author attempts to exploit the recession to persuade readers to turn against the free market. 

The book is riddled with factual errors and outrageous statements, as you might expect. Here's one of each:

Even the new [railway stations] like Liverpool Street and St Pancras are just shopping malls attached to platforms and ticket offices. Everywhere and everything is an excuse to sell.

Victorians, on the other hand, made stations that were more sensual and authentic. It was a joy to be in them to sit and wait. Now there are so few seats that you have to buy a coffee just to sit down. 

The trains are not part of a grand public service but engines for private profit.

Er... not quite. The railways were very much "engines for private profit" in Victorian times, what with them being entirely run by private companies. Britain's rail network wasn't nationalised until 1948, when British Rail was created. They then proceeded to close down hundreds of miles of track, ripping down countless "sensual and authentic" Victorian stations in the process.

That, however, is merely an hors d'oeuvre for this piece of swivel-eyed lunacy:

Totalitarianism, the accusation levelled against Communism...

That's right, "levelled". As if the jury was still out.

... is a system of control that regulates every aspect of public and private life. Consumerism and Communism are two different versions of totalitarian societies: both offer a pseudo-vision of freedom but operate to systematically refine their dominance. 

Good grief. That could very easily be the most stupid thing I've ever read. 

Totalitarian Communism (is there any other kind?) involves secret police, murder, torture, mass starvation, no freedom of speech, no freedom of the press, no freedom of religion, a one party state, rationing, endless queueing and forced labour. Oh, and 100 million deaths.

Consumerism involves people sometimes buying things they don't really need.

I'll take the electric toothbrush over the Siberian concentration camp, if it's all the same to you.

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Where do these numbers come from?

The last time I commented on a Radio 5 show, the presenter read it and left a comment, so I shall be careful what I say about Richard Bacon's debate about outdoor smoking bans last night. I have no idea where Bacon stands on the smoking issue. Like most people, he probably has no strong view either way. Still, he makes quite the devil's advocate, generally making the opposing view rather more forcefully than the person invited to do it themselves.

You can listen to the show here for 7 days if you're in the UK. A few things struck me about it...

Firstly, of all the people who called in, only two supported banning smoking outdoors, and they were both tobacco control professionals. One worked for a charity which, I must confess, I have never heard of - Heart Research UK - and the second only owned up to working in tobacco control after he had been on the line for several minutes. 

Secondly, the passive smoking theory has been well and truly discarded in favour of overt paternalism and the tyranny of the majority. The Heart Research UK spokeswoman was openly prohibitionist in a way that no one would have dared before July 2007.

Thirdly, the BBC have titled this show 'Should smoking be banned in all public places?' How quickly definitions of 'public places' shift and slide.

Finally, and most importantly, I was amazed by the mangling of the basic facts. Perhaps those of us who follow these issues closely assume too much of the media but it was repeatedly said - by the presenter - that the smoking ban has made a million people give up smoking. I have never heard this figure even from ASH or the Department of Health. 

I read this in The Independent in June 2008:

The nationwide smoking ban has triggered the biggest fall in smoking ever seen in England, a report says today.

More than two billion fewer cigarettes were smoked and 400,000 people quit the habit since the ban was introduced a year ago, which researchers say will prevent 40,000 deaths over the next 10 years.

But then I read this in the Daily Mail earlier this year:

The ban on smoking in public has failed to increase the number of people quitting, a report revealed yesterday.

And then earlier this year:

The number of smokers giving up has barely increased since the ban, despite a hike in the amount spent by the NHS on quitting services.

Figures show that nearly a quarter fewer smokers gave up the habit between April and September last year compared to 2007 - the year the ban on smoking in public places was brought in.

I don't know how many people have stopped smoking since the ban but it certainly isn't anything like a million. The most reliable source is usually the Office of National Statistics, which said - in March 2009 - that adult smoking prevalence was 21%, down from 22% before the ban. Since there were 9.5 million smokers before the ban (although estimates differ) that reduction equates to around 432,000 successful quitters. 

A 1% drop in smoking prevalence over two years is very much in line with the long-term decline so it is tenuous to say that this drop was attributable to the smoking ban at all. In time, we may even see the Irish phenomenon happen here and have many more people smoking.

The other statistic cited was that smokers cost the NHS £10 billion. Again, I've never heard this figure before. I've remember the old £1.5 billion well. I'm aware that there is now a £2.7 billion figure being bandied around (which began circulating, strangely enough, after the anti-alcohol lobby started saying that booze was costing The Health £2.7 billion). But never £10 billion. Even a Google search failed to unearth a single internet crank giving that number, so where on earth did it come from?

I ask this as a serious question. The number of people who check their facts on government websites and medical journals is tiny compared to the listenership of the average radio show. Regular readers will know that I quibble with official statistics from time to time - and I realise that I'm whistling in the wind by doing so - but even the official sources must wonder why they bother when they hear numbers being plucked out of thin air on national radio.

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Banning flavoured cigarettes

If you are looking for a brief explanation of why banning flavoured cigarettes is a pointless exercise, Steve Chapman's article at Reason is highly recommend.

At least since 1994, when seven tobacco executives testified before Congress that they didn't think cigarettes were addictive, the public has not put great trust in those who sell carcinogens for a living. What Americans may not realize is that they also shouldn't believe the people who are supposed to protect us from tobacco.

Chapman also explains why the claim that 3,600 American children start smoking every day is disingenuous and misleading. Do go read it all...

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More shisha madness

Over at Sp!ked, Patrick Hayes discusses the BBC's hysterical report about shisha smoking. As Hayes points out, the widely reported claim that shisha is "400 to 450 times worse than having a cigarette" is only the latest in a series of ever-escaltaing projections.

At worst, Dr Wareing claimed, ‘shisha was 400 to 450 times worse than having a cigarette’.

Wareing’s shock must have come from the finding that shishas are even more dangerous than believed following a 2007 study suggesting it was ‘200 times worse than a cigarette’, or 100 times worse, depending on who reported the study’s findings. The Department of Health is now working hard on ‘how best to get the message - that it is dangerous - across to the consumer’, grappling with the fact that it’s not easy to slap a warning sticker on a shisha pipe.

The research, however, has come under fire from some quarters, notably Dr Kamal Chaouachi, a tobacco expert from Paris IX University, who criticises the fact that the data has not yet been ‘peer reviewed or published’. Dr Chaouachi points out that shisha smoking is typically not ‘chronic’, with users usually partaking only one-to-three times a week, and criticises the way the study singles out carbon monoxide, which is relatively quickly flushed out of the body, for study: ‘Carbon monoxide is only one chemical out of thousands in cigarettes, so one cannot compare. But even if we look only at that chemical, shisha is not “worse” than cigarette smoking. The BBC should apologise [for its report on these findings].’

Dr Chaouachi knows of what he speaks and it's good to see at least a few news sources reporting his comments (see also here and here). But he's still waiting for a full reply from the BBC. 

His comments about the shisha report can be read here, and an interview we conducted earlier in the year can be read here.

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