Blowing smoke over secondhand smoke

"What do you think about second hand smoke?" he asked me. I sensed ulterior motives behind the question, but I wasn't sure. I suspected that he was just looking for an argument.

"It's bad," I joked.

"Some have told me that the studies don't show any health problems from second hand smoke," he replied.

"I'm sure 'some' have," I retorted somewhat sarcastically.

"No, really, is there any evidence," he replied. "I'm open-minded about this topic."

Somehow I doubted this, but I figured, what the heck, and did a little reviewing. It makes for some interesting reading.

The question of whether second hand smoke (SHS) causes lung cancer or other health problems in people exposed to it on a chronic basis is a tough one to examine epidemiologically because, as with most studies of exposures, it's difficult to control for other factors. It's not like studying smoking as a cause for cancer, where it's relatively easy to examine the exposure. More importantly, whatever the effect of SHS may be, we can, based on the simple principle of dose-response, expect that it would produce considerably less profund of an effect than smoking itself, given the obvious difference between inhaling someone else's smoke at a bar and inhaling 10-30 cigarettes a day over the course of many years. Moreover, it should be remembered that the science behind whether SHS is a health risk is a distinct from the policy question of what we should do about it as far as indoor smoking bans go. Finally, when millions of people are exposed, small increased risks can lead to many, many additional cases of smoking-caused disease.

Before I get into the studies, as a background, I'd point out that the tobacco industry managed to try to deny and obfuscate for decades over the very real and now indisputable risk of health problems from smoking. How on earth did they manage to do this? One has to remember that most people who smoke will not get cancer. As hard as it is for many lay people to believe, it's true. A person who smokes two packs a day smoker for 40-50 years will have approximately a 20% chance of dying of lung cancer. True to a dose-response curve, that means people who smoke less (which is most smokers these days) will have even less of a chance of dying of cancer. That means that there are a lot of smokers who never develop lung cancer and a lot of smokers who never develop cardiovascular disease. Indeed, I once said that it's impossible to tell whether any individual smoker will or won't get lung cancer; I can only quote the odds. In any case, if it was possible for tobacco companies to obfuscate such a powerful and now indisputable epidemiological risk for so long, imagine how much easier it is to sow doubt over the considerably smaller elevation in risk due to SHS.

I realize that "skeptics" of the health dangers of SHS will immediately start spinning conspiracy theories, but an excellent source of information on the topic is the most recent Surgeon General's report, released about a year ago, entitled The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. I had thought of plowing through the literature myself without a guide until the hundreds of studies out there convinced me that it was such a massive undertaking that it would be hard to justify it for just one blog article. The report lists many, many studies that support the contention that SHS causes health problems and critically compares them to the fewer studies that don't support such a link. I realize that to those who don't accept the science indicating an increased health risk from passive smoke, invoking any government document will be viewed in much the same way as HIV/AIDS denialists view the NIH statement on the link between HIV and AIDS, but keep in mind that this document was a product of the Bush administration, hardly a champion of regulating human exposure to environmental toxins.

Also, such "skeptics" often forget or ignore a key element in making a connection, namely biological plausibility. We already know that smoking causes cancer and heart disease; it is thus plausible that exposure to secondhand smoke would be likely to cause cancer as well, just at a decreased rate because of its much lower dose. This is not like the arguments over mercury in thimerosal in vaccines, where not only is it not biologically plausible that mercury causes autism but the epidemiological evidence does not support such a link. Moreover, "skeptics" also often will point to single studies as "proof" that there is no connection between SHS and human disease. The problem is, for a complex epidemiological problem like whether SHS causes cancer or heart disease, no single study will ever definitively prove or disprove a link. The totality of evidence has to be examined critically. Many "skeptics" that SHS is a danger will cherry pick studies that didn't find a link, but usually those studies fail to find a link because of inadequate sample size or statistical power.

Because the issue at hand is smoke exposure in the workplace and in indoor spaces, I'm not going to focus so much on the well-known and well-documented harmful effects of smoking on children's respiratory health. The evidence for this is well-documented in Chapter 6 of the Surgeon General's report. Suffice it to say that children exposed to secondhand smoke are at increased risk for acute respiratory infections, more severe asthma, and a variety of other health conditions.

In adults, numerous studies support the existence of approximately a 25% elevated risk of lung cancer from those exposed to secondhand smoke chronically. The types of epidemiologic studies generally include studies of secondhand smoke exposure in the home, which usually take the form of studies looking at cancer rates in nonsmoking spouses of smokers. Criticisms of these studies generally takes the form of criticizing how well they control for other factors, given that spouses living together generally share more than just exposure to smoke. Even so, the better-controlled studies here consistently show elevated risk of lung cancer in nonsmoking spouses of smokers. There are at least 52 spousal smoking studies, and meta-analysis produces estimates of relative risk ranging from 1.15 to 1.43; i.e., a 15-43% elevation in lung cancer risk. These are summarized in Chapter 7 of the Surgeon General's report.

The second type fo study tends to look at smoking in the workplace. As of the Surgeon General's report, there were at least 25 such studies, of which seven were from the U.S., one from Canada, seven from Europe, and ten from Asia. The studies are fairly heterogeneous, but their conclusions are remarkably consistent for such a diverse bunch of epidemiological studies. Not all studies reached statistical significance, namely because of small numbers and inadequate statistical power, but they still came to similar estimates, with relative risks ranging from 1.12 to 1.32, with a pooled estimate of 1.22, or a 22% increased risk of lung cancer. More interestingly, there are studies that support not just a correlation between exposure to SHS and lung cancer but a dose-response effect (Hackshaw et al, 1997; Lubin 1999; Zhong et al, 2000; Brennan et al, 2004). When these studies are looked at, neither confounding factors, publication bias, nor misclassification errors account for the observed increased relative risk.

A number of studies have also looked at the risk of cardiovascular disease due to SHS. As summarized in Chapter 8 of the Surgeon General's report, they consistently show a roughly 30% increase in risk of cardiovascular events. This data is summarized well in Chapter 8 of the Surgeon General's report. Epidemiological links are supported also by a wealth of preclinical evidence showing the effect of SHS on vascular tone, endothelial cell function, platelet aggregation, and a number of other markers of vascular injury.

One study that is frequently cited by "skeptics" who don't accept that SHS can cause health problems is J. E. Enstrom and G. C. Kabat Br. Med. J. 326, 1057; 2003. This study failed to find a causal relation between SHS and tobacco-related mortality. There's just one problem. The study was crap, and the BMJ was forced to reveal that the authors had accepted money from tobacco companies and that the study had several fatal flaws. In an editorial in Nature recently, this fiasco was recounted:

But top scientists at the cancer society say they repeatedly warned Enstrom of possible deficiencies in his analysis -- particularly a 25-year gap in which exposure to second-hand smoke could not be verified. The society also says that when it gave Enstrom computerized records of study subjects, it was not aware that he was receiving funding from the tobacco industry. Later tobacco-related lawsuits revealed he had received money from industry funneled through an organization called the Center for Indoor Air Research. And court records show Enstrom previously did consulting and research for attorneys defending the tobacco companies R. J. Reynolds and Philip Morris.

Perhaps my favorite paper of all is one that I'm saving for last because if I started with it I might have been accused of "poisoning the well." This one, which appeared in JAMA in 1998, is revealing. It examined review articles, and, well, here's the abstract:

Why Review Articles on the Health Effects of Passive Smoking Reach Different Conclusions
Deborah E. Barnes, MPH; Lisa A. Bero, PhD

JAMA. 1998;279:1566-1570.

Objective.-- To determine whether the conclusions of review articles on the health effects of passive smoking are associated with article quality, the affiliations of their authors, or other article characteristics.

Data Sources.-- Review articles published from 1980 to 1995 were identified through electronic searches of MEDLINE and EMBASE and from a database of symposium proceedings on passive smoking.

Article Selection.-- An article was included if its stated or implied purpose was to review the scientific evidence that passive smoking is associated with 1 or more health outcomes. Articles were excluded if they did not focus specifically on the health effects of passive smoking or if they were not written in English.

Data Extraction.-- Review article quality was evaluated by 2 independent assessors who were trained, followed a written protocol, had no disclosed conflicts of interest, and were blinded to all study hypotheses and identifying characteristics of articles. Article conclusions were categorized by the 2 assessors and by one of the authors. Author affiliation was classified as either tobacco industry affiliated or not, based on whether the authors were known to have received funding from or participated in activities sponsored by the tobacco industry. Other article characteristics were classified by one of the authors using predefined criteria.

Data Synthesis.-- A total of 106 reviews were identified. Overall, 37% (39/106) of reviews concluded that passive smoking is not harmful to health; 74% (29/39) of these were written by authors with tobacco industry affiliations. In multiple logistic regression analyses controlling for article quality, peer review status, article topic, and year of publication, the only factor associated with concluding that passive smoking is not harmful was whether an author was affiliated with the tobacco industry (odds ratio, 88.4; 95% confidence interval, 16.4-476.5; P<.001>

Conclusions.-- The conclusions of review articles are strongly associated with the affiliations of their authors. Authors of review articles should disclose potential financial conflicts of interest, and readers of review articles should consider authors' affiliations when deciding how to judge an article's conclusions.

Indeed. Lest you think that this isn't still going on, it's instructive to take a look at a couple of more recent articles that demonstrate the tobacco industry's favored techniques for denying a link between SHS and health problems: namely, challenging causation of adverse health effects of passive smoking by citing limitations of epidemiologic research, raising methodological and statistical issues, and disputing biological plausibility.

The bottom line is that, although the effect of SHS is relatively small in epidemiological terms because it is a relative risk that is well under 2, namely a roughly 25% increased risk of lung cancer and heart disease, plus lower and less clear associations to a number of other cancers and diseases, it is real. It consistently shows up in multiple studies done using multiple different methods in many different countries. Moreover, even though it is relatively small, because of the sheer numbers of people exposed to SHS, it is most definitely significant. Indeed, in the case of heart disease, which is the most common cause of death, even an increase of risk due to SHS of only a few percent would be significant, although such a small increase would be almost impossible to detect in epidemiological studies. Consequently, a strong argument can be made for indoor smoking bans in the workplace. We may not be able to do much aside from education and the encouragement of smoking cessation to prevent the exposure of children and nonsmoking spouses to the dangers of SHS. Arguments on a public policy basis and a cost-benefit basis about whether banning indoor smoking makes sense, but arguments that the science doesn't show that SHS can cause lung cancer and cardiovascular disease and adults and a variety of health problems in children are nonstarters. The science doesn't support them (although ideologues will try to take advantage of controversies over the exact magnitude of the health risks posed by SHS). Indeed, even Penn Jillette has admitted that he was wrong about SHS in an episode of Bullsh*t! in which it was claimed that SHS was not a danger, although he was full of, well, Bullsh*t! when he stated that a "lot of this was very new."

No, it wasn't. The data at the time that original episode aired was quite strong. The newer data only confirm the older data available then.

That being said, there is a risk of going too far in legislating smoking bans. Certainly indoor smoking bans at workplaces and in restaurants and bars are defensible on a scientific and public health basis. However, outdoor smoking bans, such as I've heard about on many California beaches and a recent law passed by the Beverly Hills City Council to ban smoking in all outdoor eating areas, are just plain stupid and wrong-headed, at least if the rationale is to prevent SHS-caused health problems in the population. This is particularly true since such bans apply to sidewalk cafes, where, in my experience, the exhaust fumes from passing traffic tend to overwhelm any smoke that comes from cigarettes. It doesn't help the reasonable and scientifically supported cause of indoor workplace smoking bans to overstep and impose bans in cases where the science doesn't support it.

And here are some studies that I picked almost at random. If anyone doesn't think they're enough, you can review the Surgeon General's report for literally hundreds more, and I could post many more as well.

  1. de Waard F, Kemmeren JM, van Ginkel LA, Stolker AAM. Urinary cotinine and lung cancer risk in a female cohort. British Journal of Cancer 1995; 72(3):784-7.
  2. Johnson KC, Hu J, Mao Y, the Canadian Cancer Registries Epidemiology Research Group. Lifetime residential and workplace exposure to environmental tobacco smoke and lung cancer in never-smoking women, Canada 1994-97. International Journal of Cancer 2001;93(6):902-6.
  3. Zhong L, Goldberg MS, Gao YT, Jin F. A case-control study of lung cancer and environmental tobacco smoke among nonsmoking women living in Shanghai, China. Cancer Causes Control. 1999 Dec;10(6):607-16.
  4. Eisner MD, Wang Y, Haight TJ, Balmes J, Hammond SK, Tager IB. Secondhand smoke exposure, pulmonary function, and cardiovascular mortality. Ann Epidemiol. 2007 May;17(5):364-73.
  5. Venn A, Britton J. Exposure to secondhand smoke and biomarkers of cardiovascular disease risk in never-smoking adults. Circulation. 2007 Feb 27;115(8):990-5.
  6. Hill SE, Blakely T, Kawachi I, Woodward A. Mortality among lifelong nonsmokers exposed to secondhand smoke at home: cohort data and sensitivity analyses. Am J Epidemiol. 2007 Mar 1;165(5):530-40.
  7. Barnoya J, Glantz SA. Cardiovascular effects of secondhand smoke: nearly as large as smoking. Circulation. 2005 May 24;111(20):2684-98.
  8. Raupach T, Schafer K, Konstantinides S, Andreas S. Secondhand smoke as an acute threat for the cardiovascular system: a change in paradigm. Eur Heart J. 2006 Feb;27(4):386-92.
  9. Brennan P, Buffler PA, Reynolds P, Wu AH, Wichmann HE, Agudo A, Pershagen G, Jockel KH, Benhamou S, Greenberg RS, Merletti F, Winck C, Fontham ET, Kreuzer M, Darby SC, Forastiere F, Simonato L, Boffetta P. Secondhand smoke exposure in adulthood and risk of lung cancer among never smokers: a pooled analysis of two large studies. Int J Cancer. 2004 Mar;109(1):125-31.
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That was very interesting. I live in the UK where we've recently had a smoking ban introduced, and I have to say that I was one of those "in denial" (I smoke) about the scientific evidence for any actual harm caused by second-hand smoke; partly having seen the Penn and Teller Bullsh*t episode you mention. However, it would appear that I was wrong, and there is a link. Thank you.

Having said that, your comments regarding the distinction between health effect and policy decisions has shown itself to be true here in the UK. Whilst our country has only banned smoking in "enclosed or partially enclosed" areas, some companies and councils appear to be ignoring this. My local bus company has banned - under the auspices of the ban - smoking in, of all places, an open-air bus station. Your comment on car fumes sprung to my mind too.

I saw that P&T as well. While I enjoy the show, unfortunately they seem to be spreading as much BS as anyone else. They tend to bring on one expert, whom they agree with, to debunk another expert, who they don't agree with, rather than using evidence.

That being said, that P&T claims that the primary piece of evidence that SHS advocates use is an EPA study that actually claims there is no correlation, do you know which one this is and is that actually what it says?

I believe it was an old EPA report from 1993 (which is out of date now), but I may have to go back and look it up.

Did it claim no correlation due to poor methods?

I live in the first town in the US that implemented a ban on smoking in public buildings. Even though there isn't a ban on outdoor smoking, smokers here have caught on to the fact that it is not socially acceptable. I can go for weeks without some moron blowing smoke in my face. Even if there were no health benefits to banning smoking, the improvement in air quality inside and outside is remarkable. On the rare occasions that I travel to the midwest or east I am struck by how bad it is there.
We don't tolerate industry spewing fumes into the air anymore, so why should we tolerate it when individuals do it? One individual doesn't have the right to ruin the air quality for dozens of people around them. A ban on smoking at beaches and in town makes perfect sense to me.

A ban on smoking at beaches and in town makes perfect sense to me.

JScarry, there are a couple of problems with such widespread smoking bans. First, it is politically difficult to pass such a measure (let alone enforce it). Forcing the matter could generate a backlash against all anti-smoking measures as well.

The second problem I see is that forcing smokers into their homes will increase the exposure of some others (notably children) to SHS. Daddy might want to go outside to smoke, but if he is not allowed to he'll just end up smoking inside with the kids. (Sure, he could quit, but most people will take the path of least resistance and continue the habit.)

Where do you live that your bus company banned smoking at bus stops? I would like to move there. Or to where JScarry lives. I absolutely agree that I am thrilled with every new restriction on smoking totally irrespective of what its long-term health effects on non-smokers are. Frankly, I don't *care* if it will increase my risk of lung cancer in forty years (well, I do, but it doesn't actually change my position). It makes me sick *now*. Any exposure at all (yes, this includes when I'm stuck in a place outside, like a bus stop or outdoor cafe, and it's blowing in my face) and it hurts to breathe, I can't take a full breath, I have to either breathe through a sleeve over my nose and mouth or just flee. Enough exposure and I'll be coughing, sick, chest sore, for the rest of the day. That's a really unpleasant experience just so that the small minority who have chosen this vile habit aren't inconvenienced in their freedom to indulge it whenever and wherever they please.

I guess I'm just counting on the trend towards increasing social unacceptability continuing, as it's probably too much to hope for outdoor bans, even though I think they're perfectly justified irrespective of any health considerations. Also, I honestly think that if I were offered a job in a state without an indoor smoking ban, barring extraordinary circumstances, I would turn it down for that reason alone. If smoking is allowed in restaurants, I simply can't eat in restaurants. Why should I have to take that kind of restriction, versus the smokers just having to go without for an hour or so? I don't get it.

Regarding the tobacco industry's obfuscation of smoking's health issues, I wonder if there was probably too much focus on cancer, which is scary but doesn't get that many smokers, as you say.

I've known a lot more smokers with COPD than cancer, and its a nasty debilitating disease. I wonder what the incidence of COPD is, both severe and mild, and whether it also shows up in 2nd hand cases.

There are at least 52 spousal smoking studies, and meta-analysis produces estimates of relative risk ranging from 1.15 to 1.43; i.e., a 15-43% elevation in lung cancer risk

Is this meaningful epidemiologically? If it were not SHS then would these figures warrant futher investigation?

Should all activities or substances that produce risks at these levels be banned?

Even if there were no health benefits to banning smoking, the improvement in air quality inside and outside is remarkable

How is the air quality outside improved? Does industry continue to spew out toxins, traffic spew out exhaust?

Enough exposure and I'll be coughing, sick, chest sore, for the rest of the day

This seems an extreme reaction.

west
----

Banning smoking at bus stops??????
Well its a start I guess. However what are the long range effects of exposure to diesel hydrocarbon exhaust on human lung tissue?
I don't smoke, never have, but I have what I believe to be a reasonable perspective on second hand smoke from cigarettes. Its a matter of dosage. At least in California which appears to be more anti smoke or at least more proactive say versus the midwest is or was. As I have stated in a previous post, my involuntary exposure to secondhand cigarette smoke in my childhood was what I would call severe as compared to the second hand smoke issues of today (my employer has banned smoking while on company property altogether). It's been almost never since I have been exposed to the dosages I saw as a kid.
Zombie makes a very good point as well with COPD. My mother has just been diagnosed with Emphysema. She was a long term smoker. My grandfather died due to complications from emphysema (basically died of exhaustion in an attempt to continue to get enough volume of air- not a pretty sight). Grandfather may have had other issues with industrial fume exposure as well however. People need to look at the other serious emplications of long term smoking and second hand exposure (at least the second hand exposure most 45-65 year old non smokers were exposed to when they were children - which is more severe than that of today). I am more concerned with emphysema and other pulmonary health problems associated with exposures to more than just cigarette smoke (people working in garages, at airports, sitting at buss stops etc). Seems like emhysema and other lung problems causing tissue damage
for some are almost a promise rather than a risk.

By Uncle Dave (not verified) on 16 Jul 2007 #permalink

Lisa Bero also co-authored an interesting study showing that in its quest to discredit the science linking SHS and disease, Philip Morris successfully pushed for legislation that's proving useful to several different industries opposing regulation of their products.

The study authors found that Philip Morris sought the raw data from one of the researchers whose studies demonstrated that SHS exposure increases risk of lung cancer in nonsmokers; their plan was to reanalyze it and "prove it does not show any association between ETS and disease." When the researcher, Elizabeth Fontham, refused to give Philip Morris her data, the company successfully pushed for passage of the Data Access Act, which makes all data produced under federally funded research studies available by FOIA request.

While this kind of access seems reasonable, the effect has been that companies whose products are subject to regulation are able to obtain and re-analyze the data from studies used in setting regulations or guidelines (often yielding reanalyses that contradict the original studies' findings). Meanwhile, corporations and trade associations are under no obligation to release data from studies they've funded, so the playing field is tilted in their favor.

After the Data Access Act passed, Philip Morris successfully pushed for the Data Quality Act (or Information Quality Act), which allows companies and trade associations to challenge the information behind regulations and guidelines issued by federal agencies. So, the American Chemistry Council has challenged a Consumer Products Safety Council ban on arsenic-treated wood; the Salt Institute and Chamber of Commerce have challenged the NIH's recommendations on cutting salt consumption; logging groups have challenged Forest Service calculations justifying timber harvest restrictions, etc.

National Cancer Institute - "In epidemiologic research, relative risks of less than 2 are considered small and usually difficult to interpret. Such increases may be due to chance, statistical bias or effects of confounding factors that are sometimes not evident." - National Cancer Institute, "Abortion and possible risk for breast cancer: analysis and inconsistencies," October 26, 1994.

Sir Richard Doll - " ... when relative risk lies between 1 and 2 ... problems of interpretation may become acute, and it may be extremely difficult to disentangle the various contributions of biased information, confounding of two or more factors, and cause and effect."
"The Causes of Cancer," by Richard Doll, F.R.S. and Richard Peto. Oxford-New York, Oxford University Press, 1981, p. 1219.

WHO/IARC - "Relative risks of less than 2.0 may readily reflect some unperceived bias or confounding factor, those over 5.0 are unlikely to do so." - Breslow and Day, 1980, Statistical methods in cancer research, Vol. 1, The analysis of case control studies. Published by the World Health Organization, International Agency for Research on Cancer, Sci. Pub. No. 32, Lyon, p. 36
FDA - "Relative risks of 2 have a history of unreliability" - Robert Temple, M.D. Food and Drug Administration Journal of the American Medical Association (JAMA), Letters, September 8, 1999

FDA - "My basic rule is if the relative risk isn't at least 3 or 4, forget it." - Robert Temple, director of drug evaluation at the Food and Drug Administration.

Average cancer risk elevation for exposure to passive smoke: about 20% (relative risk=1.2)
Average cardiovascular disease risk elevation for exposure to passive smoke: about 30% (relative risk=1.3)

This is a contrived issue to force a specific behavior on a segment of the population. Why is using spit tobacco or spitless tobacco banned? Last I checked there was no SHS from it? It should concern all Americans when a group can massage data to prosecute an agenda that they believe is better for all. What's next? Privacy and freedom are American values, the SHS issue was invented to organize non-smokers against smokers and it has worked.
The diesel issue is real. Check the asthma rates in the Bronx NY.

Well I guess I'll expose my libertarian side (scary, who knew I had one?). I fully accept that SHS is probably dangerous in the way that Orac describes above. However, I have a problem legislating smoking in bars. I really don't see why when people make a choice to go to a bar and know it has smoking or chose to work at a bar and know it has smoking that there is a problem. I think that a business owner should be allowed to offer their bar as a smoking bar. If they chose to ban it in their bar then they have that choice as well. Are they going to stop allowing people to smoke in Pipe or cigar stores? Where I live the widespread banning of smoking is currently being implemented. One bar that I have frequented lost serious business because of the ban. There were reports that their business was down as much as 50% over certain times in the spring and summer (this is a beach bar) that are their most busy (no I can't supply numbers or a source even, just knowing the bartenders there so the estimate is likely to be at least somewhat high but a loss none the less).

Just so you know, I don't smoke I've had family members die directly as a result of their smoking habit. I'd be perfectly happy if no one ever smoked in my presence again but I also know I am making a choice when I go into a bar where people smoke. And some nights out I avoid the bars I know are more smoky than others.

/tucks his minor libertarian views back under the bed

Katie -

Portland, for one, has smoking bans inside bus shelters and on the light rail platforms. For those who want to argue that this is a ridiculous notion, keep in mind that first, these locations are not public property and that people who do not smoke, including children, have to use these facilities, if they wish to ride public trans. Quite honestly, health concerns aside, there is still no reason that they should have to be subjected to the stench of other people's smoke.

Smokers (such as myself) can thank rude, obnoxious smokers, who insist they should be able to smoke wherever, whenever they please. Instead of politely stepping away, or saving the rest of their cigarette for later, when someone politely asks them not to smoke around them, I have often seen them instead, blow smoke in someone's face or pretend they didn't here them. It is this stupid sense of selfish entitlement that has led to smoking bans in so many places. Yeah, it annoys me sometimes, especially when I am on an empty or sparse rail platform and really want to smoke. I am more than happy to stand way off, where my smoke won't bother anyone, putting it out if more people arrive, but alas, I could be ticketed for it now.

On the other hand, I was on a platform the other day with my son. Someone decided they should light up, right there next to my son and another family with an infant in tow, along with a couple other children. Did the jerk step to the side, or walk across the lot, where we're allowed to smoke, of course not. Instead he bristled at the very notion that we might not want him smoking around our kids. Even with the law to stop it, the a-holes just can't stand the idea that there are other people in the world, besides them, people who have no desire to partake of their nasty habits.

That said, some bans are getting way out of hand. The statewide ban in WA, is a great example. There it is now illegal to smoke within 25' of the door or windows that could be open, anywhere in public. In downtown Vancouver, I have seen people literally standing in the middle of the road to smoke, indeed I've done it myself. There comes a point where the bans become a more than acceptable infringement of rights. Unfortunately, it's hard to find a happy medium, with so many rude smokers out there.

"Author affiliation was classified as either tobacco industry affiliated or not, based on whether the authors were known to have received funding from or participated in activities sponsored by the tobacco industry."

Seems rather naive to assume that there are no other competing interest author affiliations on this topic. How about affiliations with major funders like pharmaceutical companies -- producers of Nicotine Replacement Therapies. Might they not have a financial stake in 'positive' SHS study outcomes?

Perhaps your "favorite" paper shows nothing more than that SHS is more about opinion than science?

GDF -

Which might be a reasonable argument, were that one paper, the only evidence offered. Alas it is not. Hell, short of any papers or studies supporting the dangers of second hand smoke, it just takes common sense to realize that, while the danger is obviously less to those inhaling SHS, the smoke doesn't magically become completely safe, after being filtered through the smoker.

Rev. BigDumbChimp -

I agree with you there. Several bars in WA have closed since the ban went into effect there.

Good point GDF. The Johnson and Johnson company makers of Nicorette and others makes millions from this. I believe the Robert Wood Johnson foundation is the main funder of most of this disinformation.

Those exposed to secondhand smoke chronically are indoors all the time, and therefore don't get enough sun and so are deficient in vitamin D. This lack of sun would be particularly acute in bar staff who work nights and sleep during the day, and the elderly who tend to be homebodies.

Since financial conflicts of interest were brought up, I can't help but note there are enormous financialconflicts of interest on the anti-Tobacco side.

I find it far more interesting the cases of long term smokers that live to the median age and never develop lung cancer or pulmonary disease.
Are there detailed studies of long term smoking test subjects with no incidence of lung cancer or emphysema? What studies have been done to evaluate thier ability to beat the odds? Granted it may be a tiny group, but it seems that we now know that cultures that routinely consume food high in Omega 3 fatty acids seem to have a lower HDL, LDL and incidence of heart disease. Seems statistically more interesting at this point to focus on the test cases that do not develop lung cancer. Do they may have a genetic disposition or other factor (vitamin D from solar radiation)that works to thier advantage.
I beleive the genetic marker for breast cancer was identified based in part on research of detailed family records within the Morman church (forgive me if I have mis-stated). Damn them Mormans for not smoking!
Seems like we have enough data supporting most of what we already know - smoking, as well as second hand smoke (I won't go into industrial byproduct exposure) increases your risk of heart disease and cancer (to name a few).
Why do we bother given this cultures significant downward swing in smoking proliferation anyway? It is now pretty much viewed in the western world as a universal taboo. Now you routinely see people snear when someone lights up. Is there interesting data that approaches identification of test subjects that beat the statistical probability.

By Uncle Dave (not verified) on 16 Jul 2007 #permalink

DuWayne -- I might agree with you if that one paper was just any one study. But the paper discussed was claiming to demonstrate bias in the review articles that were assessing all (or many) of the other primary studies. I was suggesting that there may be sources of bias (other than from the tobacco indusrty) in those review articles that assess the findings of the other studies. Heck, the fact that only the tobacco industry (and no other competing interest) was even considered as a source of bias in a paper about bias is... I won't say biased, how about... ironic?

So, we fall back on common sense. And what you say DOES make sense at first read. Except that there are lots of things that are harmful in large doses and harmless in large doses. Common sense tells us that. That's why we ask science to evaluate the SHS question. And then round and round we go again.

I have to say you can count me in with the BigDumbChimp. I'm a non-smoker but I've always accepted that if I go to a club or a bar, there's going to be smoke. I might not take a job in one for that reason. I would prefer some fairly stringent requirements for active ventillation (has anyone ever done a study on the effects of ventillation on SHS), esp if there were fat tax breaks to pay the bar/clubowner back. Basically I am more in favor of cool, fun nightspots being able to open than I am against SHS. I also have a JH Mill-style dislike of 'social disapproval' being codified into law. I'd even allow smoking in restaurants if they met very stringent ventillation requirements.

By Antiquated Tory (not verified) on 16 Jul 2007 #permalink

"Except that there are lots of things that are harmful in large doses and harmless in large doses"

should have read:

"Except that there are lots of things that are harmful in large doses and harmless in small doses."

Sorry!

Orac,

What do you make of the studies claiming increases in cardiovascular problems from acute rather than chronic SHS exposure? I noticed a couple of them in your citations but that you didn't cover it much in the post.

Antiquated Tory, most of the antismoking guns have pooh-poohed ventilation and all other reasonable measures. In fact, I once wrote a letter to the editor in my hometown suggesting that they require beefed-up ventilation/filtration as a way to calm people who wanted cleaner air and still allow for smoking venues. The editor changed what I wrote to apply *only* to bars that allow smoking. (ASHRAE recently came out with similar recommendations for buildings that allow smoking--but not for nonsmoking buldings!) Thanks to antismoking hype, society now believes that only people who smoke have the right to cleaner air. How's that for irony? By the way, you really should hear Norm Kjono's interview on "The Dangerous Doug Kendall Show". He actually cleaned the air to the point of being better than outdoor air even with people who smoke in the office--and he was accused of being a tobacco shill for his efforts! LOL!

In my lifetime, most of the people I've met who smoked were very considerate, but too many have become tired of derisive comments by antismokers--"filthy", "stinking", "stupid", "moron" are just a few that I've heard. Frankly, I can't blame such people for no longer caring and behaving as described by DuWayne.
;-(
Hopefully, drug companies will be held accountable and this hysteria will come to an end. I do believe that most people wish to be considerate and have consideration shown toward them--and I *know* that most people share my belief.

Concerning the original blog, the Enstrom/Kabat paper was primarily funded by the American Cancer Society until the results "went the wrong way". Enstrom found funding for the tail end of the 30 year study in an organization setup by a tobacco company. His methodology was better than the methodology in most antismoking/pharmaceutical studies. Even the WHO had two large, long-term studies showing either no-correlation or statistically significant negative correlation. (Same for Wu-Williams in 1990--a statistically significant negative correlation on the largest study to date and, like the WHO studies, not exactly done by tobacco shills.) The "cherry-picking" in meta-analysis was first noted in a decision by Judge Osteen about one of the flaws of the EPA report. (That EPA report had already been panned by three federal agencies on methodological grounds.) The Surgeon General has already admitted to making statements on public health just to satisfy "ideological" pressures. In fact, the Surgeon General pushed all forms of NRT and medication; see #4 on http://www.surgeongeneral.gov/tobacco/consquits.htm Persoanlly, I wouldn't recommend things like Chantix, which has been known to cause diabetes, or Zyban, which has had serious side effects.

I am quite amazed there is a dialog still going on as far as second hand smoke is concerned, the Surgeon General among many other nicotine industry promoters declared the matter settled despite the controversy, which will only grow with the suspicion created when propaganda replaces real science as a foundation for health related information.

The foundation of human rights and civil law rests in the precedent of a basic human right to factual information of the highest quality available. Those in the Health care community seem to have found a way of cherry picking what is relevant in those areas, and what is not, which leaves them as a collaborating collective, independently liable when reliable facts are eventually established.

I found the author although apparently well read on the subject, a little confused on the perceptions presented. Although fewer studies refute the level of harm those few are the largest ones which carry much more weight in statistical studies. I could cite the World Health Organization's own research or that of Enstrom and Kabat along with the 50 year research of Sir Doll evaluating doctors who smoked which all are significant, all involve substantial research groups and all seem to deny the ad agency spin promoted by some of the largest health organizations on the planet. It should be noted no research studies of any equal size have provided anything but a proof of the insignificance of ETS exposure. The Surgeon General's report was at the time it was released an embarasement to all the mentioned groups who found it entirely difficult to cozy up to a lot of the unsubstantiated rhetoric particularly in association with the pre release press statements.

Epidemiology is a calculation of a single dimensional phenomenon. It unfortunately has defined limitations particularly in respect to size of population group studied. The larger studies have to carry the final say a collective of cherry picked studies all agreeing to desired opinions by excluding the peer reviewed studies which do not agree with formed opinions in what is known as meta analysis promotes only politics and fraud. The odds tell us some research will not agree the non existence of those studies, is actually proof all are wrong and a result of bias in the model.

As with all things taking short cuts to find sucess will eventually find a higher cost unfortunately in this case we are toying with politics and only the children will suffer despite a truck load of good intentions.

By taking the low road of double talk and deceit encompassed in propaganda terms such as tough love and for the greater good we yield the high road to the Tobacco industry who is not being punished as generally believed, but growing profits by the actions to date. Where is the hurt and hate directed most predominantly, is among the most vulnerable in society the poor and the children. It is too bad when cults and fanatics rule, how much we all suffer as a result. After the last time they hung doctors at the Nuremberg trials apparently the lesson was lost.

When science has to resort to proclamations such as "hurricane force winds" and "outdoor smoke plumes raining down on unsuspecting victims" to sell broad opinions, the future of science is heading into a dark period where snake oil and blood letting become popular once more.

I find this a very interesting topic, but only for historical reasons.

I'm 36, and I've never had a workplace of any sort where smoking was allowed. Frankly, I find the idea of smoking in a workplace a bit old-fashioned - I think many people of my generation associate it with clerks working with green visors on their heads and other 19th century ideas :)

All restaurants and clubs, pubs etc. have had non-smoking areas as long as I can remember, and recently have banned all smoking inside altogether (at the behest of the owners who are worried about SHS effects on staff).

I can remember public transport having smoking carriages on long-distance trains, but that was at least 15 years ago.

Many people seem to not care about primarily about health effects - the general opinions seem to be that smoking is smelly and dirty, and why should the (rapidly shrinking - about 18%, IIRC) small minority who smoke stink the place up for the rest of us?

Oh, I'm Australian, from Sydney.

I've come to the conclusion that my problem with SHS isn't the tobacco itself, but additives to the cigarettes.

I can handle being around pipe smoke OK. I like being around pipe smokers, just so long as I don't have to kiss them.

I can handle being around people smoking American Spirit cigarettes just fine.

I can handle being within 3' of a lit Camel outdoors, or within 10' indoors, without too much distress.

But if anyone lights up a Marlboro within 50' of me indoors, or within 15' of me outdoors, I have a problem.

Remember the purpose of bar and restaurant cessation movements are not as much for the patrons, they are for the employees who are facing daily exposure. Businesses being businesses will likely do everything they can to accomodate a paying customer.
Most every work place that I know of has banned smoking indoors at a minimum these days. My employer doesn't allow it anywhere on property (about 30 acres of it). People have to much to go outside the gates of the plant.
I am fairly confident that if I as a non-smoker go about my normal lifestyle, I will have little threat in my life of second hand smoke, as opposed to say 15-20 years ago and beyond. I have a far greater danger of respitory illness from prolonged exhaust exposure from sitting in LA traffic for hours in a day.
Sheeessh! I gotta find another subject this ones giving me second hand information.

By Uncle Dave (not verified) on 16 Jul 2007 #permalink

Frankly, I can't blame such people for no longer caring and behaving as described by DuWayne.

Ah, so people who are mistreated have the right to mistreat others. Gotcha.

Anyway, I enjoy inhaling the fumes of burning human hair. I'm tired of people calling this dirty or disgusting and asking me to extinguish my haircigs. I have a right to my hobby/addiction/fetish. I am a victim!

No, Boris, I never said anything about people having the right to mistreat others. In fact, I said, "most people wish to be considerate and have consideration shown toward them." You have demonstrated the reason that I said "most".

You haven't "got" anything. I feel sorry for you.

DTB...

Not sure what you're talking about, to be honest.

I've never worked in a place (or even visited when consulting) which allowed smoking.

The blog you link to from 2.5 years or so ago is arguing against the ban that just came in at the start of this month on smoking in pubs/clubs etc.

I've never worked in such a place... I fail to see how it in any way relates to my statement.

First of all, excellent article even though I disagree with your conclusions: at least you've done some research beyond reading press releases.

My main criticisms are that you rely so much on the Surgeon General's Report as an unimpeachable resource and that you have accepted, seemingly without much research, the criticisms of the Enstrom/Kabat study.

Remember how important it is to the antismoking cause to support smoking bans. Realize how difficult these bans would be to achieve without widespread fear of secondary smoke. There's a lot of manipulation of facts and figures going on out there by the antismoking industry today: at least as much and maybe even more than was done by Big Tobacco in the 1950s and 60s. There's also coverup involved, from sources you might not normally think would engage in such things.

See: http://www.acsh.org/factsfears/newsID.990/news_detail.asp for an example of such "passive fraud".

Obviously the full argument is way too involved for a posting like this. But, to get a good solid taste of the kind of distortion and lies that are out there, go to my website at http://pasan.TheTruthIsALie.com and scroll down to the first "boxed" item, titled "Day of Defiance". It's a short and very easy to read document that includes a complete trashing of the health and economics arguments behind smoking bans: you'll be amazed at how some of these "studies" are distorted by the time they hit the evening news.

Smoking bans are bad laws based on lies, and a law based on lies is no law at all. I fully support the growing British defiance of their smoking ban: Free and concerned citizens should feel proud to stand up for freedom and defy the encroachments that lead to ever-more powerful and dictatorial government interference in private lives and businesses.

Michael J. McFadden
Author of Dissecting Antismokers' Brains

The primary message is found here;

"" In philosophy generally, empiricism is a theory of knowledge emphasizing the role of experience in the formation of ideas, while discounting the notion of innate ideas.

In the philosophy of science, empiricism is a theory of knowledge which emphasizes those aspects of scientific knowledge that are closely related to experience, especially as formed through deliberate experimental arrangements. It is a fundamental requirement of scientific method that all hypotheses and theories must be tested against observations of the natural world, rather than resting solely on "a priori" reasoning, intuition, or revelation."

Consistent positive correlations can only be recognized if we can absolutely assure the possibility of bias is less than the predicted result.

In ETS calculations it would be a real stretch of the imagination to presume confounding effect and linear regression is defined so precisely without defining the variations of the suspect cause, or the exposure levels?

The sheer arrogance of anyone in the profession to dispense frauds declaring the precision of the method has been honed to accuracy within a .3 increase which can only truly demonstrate dedication much more than accuracy or expertise,

The confounding base is the same so how can we test the accuracy of the theory when the confounders are all of common design.

The randomness of the modeling process as well as the data has all but been eliminated is it any surprise the results find similar numbers?

More incredible is the formation of conclusion which agrees the level of increased risk with the complexity of a single life's experience can be defined to a level E&K numbers are insignificant yet the .3 level is judged as significant proof?

The precision suggests impropriety and that impropriety is found in the collusion within the major group who demand recognition because of their station alone.

One cannot believe empirical proof can be demonstrated without confounding for the bias of education and collusive need. The unknowns exceed the level of accuracy yet to be discovered. Consensus discoveries among a dedicated group who can not determine which harm will result from exposures and seeks to combine all possible harms in one disease perspective, with an identical model utilized to detect them all. The results are reviewed separately despite the reality many times alternate diseases are found among the same observed individuals.

The WHO call for evidence produces only what is requested, and in the absence of studies demonstrating non-proof results. The process is known to be corrupt and that corruption is worn on the sleeves of those who support it.

Most damning of all; the modelers them selves unanimously agree the funding source could somehow produce results with predictable bias.

Who pays hundreds of millions of dollars for the promotion of smoking bans and creating fat pandemics, is the topic which needs evaluation in observing billions in profits earned enjoying apparent immunity of the same discretion as other funders. The public purse is largely augmenting the direct promotion of those same products and services openly.

Antagonists declare all the time no conflicts of interest despite the obvious fallacy in those declarations, yet no one seems to mind???

Antiquated Tory, DTB - When smoking bans were first suggested in New Zeland, the first thing that occured to me was ventilation. After all, the problem is the smoke, not the smokers.

I would attribute the tendency to overlook this solution less to a moral crusade (though for a minority that may be an explanation) but rather to a natural human tendency to examine only the alternatives that are placed in front of one, rather than seriously examining how to correct the root cause of a problem with the minimum fuss to everyone.

"The Bogus 'Science' of Secondhand Smoke", a recent Washington Post op-ed by cancer epidemiologist and toxicologist Gio Batta Gori, former deputy director of the National Cancer Institute's Division of Cancer Cause and Prevention, calls smoking bans "odious and socially unfair" prohibitions based on "bogus" science and "dangerous, wanton conjectures." Gori says that many of the secondhand smoke studies the Surgeon General uses to claim secondhand smoke life risk fail to control for important confounding variables, are based merely on "brief phone interviews", and assume that people always tell the truth about their smoking histories. Gori further warns that the results of these secondhand smoke studies are inconsistent:

"In addition, results are not consistently reproducible. The majority of studies do not report a statistically significant change in risk from secondhand smoke exposure, some studies show an increase in risk, and ¿ astoundingly ¿ some show a reduction of risk."
http://www.washingtonpost.com/wp-dyn/content/article/2007/01/29/AR20070…

As a bar patron who very much enjoys a smoke with his beer, Gori makes my loss of freedom due to smoking bans feel unnecessary.

Dr. James Enstrom has very ably defended his ETS research against the attacks of Stanton Glanz and the American Cancer Society. His big ETS cohort study certainly deserves a closer look than most journalists and public health officials have given it.

http://www.scientificintegrityinstitute.org/defense.html

By Bill Hannegan (not verified) on 16 Jul 2007 #permalink

Julia -

I used to smoke hand-rolled - and if people smoked normal cigarettes in my college room, I'd know about it for the next couple of days, despite the fact that I was smoking.

Although I can understand workplace/office smoking bans, my main problem with banning smoking in pubs (and, amazingly, private members clubs) is that in many pubs, the majority will be smokers; there is a big correlation between 'people who smoke' and 'people who go to pubs a lot'. I get the impression that the kind of people pushing for bans are the ones who go to bars and pubs only occasionally. After all, if the majority of bar patrons were annoyed by smoking, there would already have been a lot of non-smoking bars.. or much better ventilation.

By Andrew Dodds (not verified) on 16 Jul 2007 #permalink

Speaking as someone who has never smoked, I agree that the push for smoking bans oft has gone past the point of keeping the air clean for us non-smokers, becoming instead a moral crusade. I'm glad the inside dining area of restaurants are now smoke-free. But smokers are people, too. They should be free to light up in outside areas and tobacco stores.

Just to throw a wrench in things:
"Although I can understand workplace/office smoking bans"

then

"my main problem with banning smoking in pubs (and, amazingly, private members clubs) is that in many pubs"

Pubs/clubs are workplaces for the people that work there.

"A ban on smoking at beaches and in town makes perfect sense to me."

This is rather silly. Gas's dissipate so quickly I can't imagine that, unless someone is right next to you blowing smoke in your direction, that smoking in a large open area is any sport of problem.

Banning smoking due to health effects is a relatively good idea depending on the circumstances. However banning smoking because you find it unagreeable is simply unacceptable. If everyone could restrict another person from doing things that they found bothersome, nobody would be able to do anything.

Obnoxious , self-righteous, whining little fucks. My biggest fear is that if I quit smoking, I'll become on of you...Don't take that wrong. I have something to tell you non-smokers that I know for a fact that you don't know, and I feel it's my duty to pass on information at all times. Ready?.......Non-smokers die every day...Enjoy your evening. See, I know that you entertain this eternal life fantasy because you've chosen not to smoke, but let me be the 1st to POP that bubble and bring you hurtling back to reality....You're dead too.

- Bill Hicks

I still think it kind of disgusting that people believe that the owners of private businesses should be forced to ban smoking, when no one is similarly forced to go to a resturant that allows smoking. The argument that "well, I don't have enough non-smoking choices" is just pathetic. No one OWES you the choices you like. If you really want something, go out and start it yourself.

The job aspect is equally pathetic. No one is owed a job by a particular resturant either. If no one wants to work in a place that allows smoking, that's tough luck for the resturant owner: he'll have to raise his wages above those that don't allow it in order to attract workers. Or, more likely, we won't, because most people DON'T GIVE A SHIT.

And that's the real issue with these sorts of things, isn't it? It can't be about giving crusaders a choice, because they no one owes them the choice of their preference. And it can't be about saving employees from hazards, because they can save themselves/choose the level of risk they desire for the pay. The issue is rather that some people don't like the choices that OTHER people make: they have it in their heads that if someone exposes themselves to a risk, they must be stopped. Not merely educated about the risk so that they can make their own choices: they must be STOPPED. That's the sort of busybody crusading I just can't stomach.

Of course, somehow that idea has never caught on in a sensible way: there are all sorts of huge risks in modern life that get virtually no attention, perhaps because they aren't flashy enough.

Before I go on, I must say I totally support the UK ban on smoking in enclosed public places, mainly for the benefit of bar staff.

However, I do think a lot of the ad-hominems aimed at smokers are extremely similar to anti-gay-rights arguments made in the 1990s. E.g. "I don't care if it is harmless outside, I don't want a filthy smoker smoking near me". It's called tolerance people. I don't like the sight, taste, or smell of broccoli or of fish, but I don't campaign for eating them at bus stops to be a crime. Remember, if you try to outlaw things for no better reason than that you don't like them, then someone will soon find something you do that they don't like. If it's not a situation where it's a real health hazard, just let it go.

By Tom Evans (not verified) on 17 Jul 2007 #permalink

rrgabe23,

I've addressed your quotes here. At least two of them are examples of deceptive quote-mining, and it wouldn't surprise me if the rest are the same. You could prove me wrong by providing me the entire articles or book chapters from which the additional quotes are drawn, so that I can examine the context.

Moreover, thanks to Tim Lambert, I now know something that I didn't know before. First the thing that I did know before: Claiming that epidemiologists widely believe that relative risks less than 2 are to be discounted as totally unreliable is a load of B.S. It's not true, as my dissection of the quotes by Dr. Temple in my followup post demonstrate. What is true is that lower relative risks found in single studies should be treated with some skepticism and that it takes multiple studies to confirm them, which is what I basically said in this article and the one to which I linked earlier in this comment. What I did not know was that there was a concerted P.R. campaign by tobacco companies to push the false idea that epidemiologists automatically reject studies that show relative risks under 2 as being totally worthless.

Thanks for the tactical air support, Tim!

I'm going to delurk to give you an example on the kind of rude behavior smokers deal with all the time. I was in a major American city recently that has banned smoking indoors, though not on the street. A friend and I were walking back to our hotel after dinner and I had a cigarette on the way since I could not smoke once inside the hotel (understandably). As I approached the outdoor ashtray, which is quite a ways from the door, to properly dispose of the butt, a woman sitting next to the ashtray made a dirty face at me, started waving her newpaper violently around her, and said I was a dirty, rude smoker for bringing the cigarette so close to her. That was ridiculous. She was sitting next to an ashtray! There were other benches available without ashtrays, but I'm the bad guy for daring to use the proper receptacle rather than tossing my cigarette butt on the road (which I do hate, that's gross).

BTW I have never intentionally blown smoke in anyone's face, and I take great care not to smoke around children. Personally, indoor smoking bans don't bother me that much, but the blanket outdoor ones are ridiculous. I'd like to ban strong perfume because it irritates my nose and makes me sneeze, but I'm not going to.

I am totally opposed to smoking bans in bars and restaurants. (I'm just about on my one year anniversay of having quit.)

Don't want SHS? Don't go to the bar. Don't work there either. It's really that simple.

There is a poplular cigar bar here. Cigar sales were about 15% of their business before the ban, but now even they can't have indoor smoking because some asshole somewhere who doesn't smoke might want to go into a cigar bar. I'm sorry, but that is just ridiculous- it's a privately owned cigar bar frequented and staffed by adults who know the risks.

Frankly, I think of most non-smokers as whining hypocrites. They don't care about much air quality when they're driving their SUV five blocks to drop their obese, pre-diabetic children off at school. Or going out to the bar to consume alcohol, which is not exactly the healthiest of activities.

Orec,
So, Judge Osteen's finding in 1998 is false or some Big Tobacco conspiracy? Sure it was overturned, but not on the merits of the case. He still found that EPA massaged the data.
Judge Osteen determined that the EPA had "cherry picked" its data and had grossly manipulated "scientific procedure and scientific norms" in order to rationalize the agency's own preconceived conclusion that passive smoking caused 3,000 lung cancer deaths a year. In addition, Osteen ruled that the EPA had violated the Radon Act, which was the agency's authority for disseminating its "de facto regulatory scheme" that intended to prohibit passive smoking. The agency responded, embarrassingly, with an ad hominem attack on the judge, not on the cold logic of his arguments.
Still, the EPA was determined to prove that ETS was a serious carcinogen that justified stringent regulation. To do that, it simply set aside 19 of the original constellation of 30 ETS studies and then, defying all scientific standards, simply changed the "confidence levels" in the statistical analysis from 95 percent to 90 percent. When the highly manipulated smaller sample finally "confessed" that passive smoking was a health risk, the EPA proudly announced it had "proven" its preconceived conclusions.
And the sordid tale gets worse. The EPA chose to omit entirely from its analysis two recent U.S. ETS studies that had determined that passive smoking was NOT a statistically significant health risk. Worse for the EPA, including those studies with the "cherry-picked" 11 produces a result that shows no statistically significant health risks associated with passive smoking, even at reduced confidence levels. In short, even employing the EPA's own corrupt methodology, ETS was simply not a "Group A Carcinogen," as the agency had boldly asserted.
www.cato.org/dailys/9-28-98.html
I have also included Dr. Gio Batta Gori's Washington Post article. www.washingtonpost.com/wp-dyn/content/article/2007/01/29/AR200701290115…

It has been fashionable to ignore the weakness of "the science" on secondhand smoke, perhaps in the belief that claiming "the science is settled" will lead to policies and public attitudes that will reduce the prevalence of smoking. But such a Faustian bargain is an ominous precedent in public health and political ethics. Consider how minimally such policies as smoking bans in bars and restaurants really reduce the prevalence of smoking, and yet how odious and socially unfair such prohibitions are.

By any sensible account, the anachronism of tobacco use should eventually vanish in an advancing civilization. Why must we promote this process under the tyranny of deception?

Presumably, we are grown-up people, with a civilized sense of fair play, and dedicated to disciplined and rational discourse. We are fortunate enough to live in a free country that is respectful of individual choices and rights, including the right to honest public policies. Still, while much is voiced about the merits of forceful advocacy, not enough is said about the fundamental requisite of advancing public health with sustainable evidence, rather than by dangerous, wanton conjectures.

A frank discussion is needed to restore straight thinking in the legitimate uses of "the science" of epidemiology -- uses that go well beyond secondhand smoke issues. Today, health rights command high priority on many agendas, as they should. It is not admissible to presume that people expect those rights to be served less than truthfully.

By the way, I was in nevada recently and there is no smoking ban in the casino's in Primm Nevada. There are even the perverbial cigarette machines - I had to stop and stare at what was to me almost a museum exhibit. Quite a surprise to me, walking through the casino area with that distinct oder of new and stale cigarette smoke that has become one with the carpet and all other surfaces.

It is so anti smoking in most of California that going anywhere where there is more than one person smoking in an enclosed area is almost deja vu from my childhood of being in bars and wedding hall where a dense layer of smoke occupies the altitude 3 feet below the ceiling and up.

By Uncle Dave (not verified) on 17 Jul 2007 #permalink

BigDumpChimp and Antiquated Tory:

If everyone was able to choose whatever job they wanted, I would agree with you. But they can't. So.. you know.

Hank Roberts,

I was actually primarily refering to Barnoya and Glantz, who includes in the abstract "The effects of even brief (minutes to hours) passive smoking are often nearly as large (averaging 80% to 90%) as chronic active smoking. CONCLUSIONS: The effects of secondhand smoke are substantial and rapid, explaining the relatively large risks that have been reported in epidemiological studies."

If smoking only affected those that smoked, then I would have to agree that the bans on smoking have gotten extreme. But the damage they inflict goes much farther afield than just impacting the smoker, and I am not just talking about second hand smoke.

Secondhand smoke does seem to be the focus of this particular thread and as a non-smoker, this is what impacts my family most directly. I agree with the bans in restaurants and in pubs. The primary purpose of these places to the purchase of food and drink, not smoking. Customers and employees should not have to tolerate harmful smoke while they are eating or working. And, no, some people don't have the option of working elsewhere; those who think otherwise have yet to venture from their protected lives into the real world.

By the way, ventilation doesn't help if the smoker is at the table or stool next to you.

Another impact of smoking that is being ignored here is the cost of caring for uninsured individuals who contract a smoking-related disease. I have a distant relative who died of lung cancer after smoking 2 packs a day for his entire adult life. He did not have health insurance and did not bother going to the doctor until his family called an ambulance after he collapsed at home. He died in the hospital two days later after receiving only "comfort" care, not actual treatment as the cancer had progressed too far. Even so, the hospital bill was over $100,000. His family couldn't pay that and most was "forgiven" by the hospital... but not forgotten. Guess who actually foots the bill? Taxpayers. We are paying for all of those sick, uninsured smokers.

Finally, there is the issue of pollution to consider. Cigarette butts are all over the entrance ways to office buildings and stores now that people can't smoke inside. They are seen in parking lots, alongside curbs, in our parks and playgrounds and littered through the sand on our beaches. The nicotene can actually make animals sick and gets into our water supply. And it costs money to clean this stuff up.

So smoking, far from limiting its impact to the smoker, directly and negatively impacts all of us by harming our health directly, dirtying our environment, and by costing us money in terms of paying for the healthcare of the uninsured and the cost of cleaning the environmental damage. Its a filthy, harmful, expensive habit with absolutely no benefit other than that the smoker "likes it". Sorry. Their right to damage their body as they choose does not outweigh the extensive cost to the rest of us. I'm all for more bans and more public pressure to just get rid of the nasty things.

LCR,
You assume SHS in the small dosage one is exposed is harmful and that is the big question. The science is in conflict on this issue.
If a bar or resturant allows smoking you can go elsewhere. If the owner decides that is best for business to ban it, then so be it. The government should keep out.
As for cost, smokers pay over 7 billion a year in federal taxes. If you add in the MSA payments and state and local taxes and sales taxes it goes higher. As a matter of fact, in 2005 California collected over 3 billion. Smokers pay more than their share.
The bottom line is that you don't care if people smoke as long as it does not effect you. That is why the SHS issue was invented. It is way for the elite to dictate what they percieve as their correct lifestyle. Lastly, why is spit tobacco included in these bans?

LCR,
Is there any evidence to show that bans reduce the amount anyone smokes significantly enough to matter for their long term health? Or are they just finding other places to smoke?
If money is the problem, there area lot more wastes of my tax dollars going on than hospital aid for a smoker. Not to say I don't mind it going to that particular need, however given the amount of time and money that would be required to have any useful affect, it's fairly low on my list of concerns currently.

LCR, what's your stance on Fireplace, BBQ, Candle and Fire-Pit[found at Target stores, etc] smoke?

By SmokeisSmoke (not verified) on 17 Jul 2007 #permalink

LCR -

I think that a reasonable way to deal with exactly that issue, is to use the tax on tobacco, to defray the costs. This is an argument I use regularly, as a supporter of universal health care (sorry Orac, but I am a huge supporter of UHC). Indeed, as a civil libertarian who supports the legalization of illicit drugs, I think they should be legal and part of the significant tax that should accompany that legalization should go to the same defrayment. Alcohol too, should be similarly taxed, along with junk foods.

You assume SHS in the small dosage one is exposed is harmful and that is the big question. The science is in conflict on this issue.

No, it's not really, at least not over the issue of whether prolonged chronic exposure to SHS is harmful. The question is over how harmful SHS is and what health problems it causes, not over the question of whether it is harmful.

But I notice you didn't comment on my little deconstruction of those quote-mined quotes that you posted. Perhaps you'd do me the favor of providing me with the entire articles, press release, and chapter from which the quotes that I couldn't find online are drawn, so that I can examine the context of the quotes, as I did for Dr. Temple's. What? You don't have the entire context for those quotes? Then how do you know that the snippets are as damning in context as they seem? Get thee to a library or stop spreading such quote-mined snippets!

Nor, more interestingly, did you comment on Tim Lambert's revelation of how the whole "anyrelative risk less than 2 is crap" campaign was a product of the tobacco company propaganda and not based on any sound epidemiology. I suspected all along that something was up with that, given the consistency of the quotes that I found in your list and variations parroted by various anti-smoking ban sites, but I figured it was just talking points for ideologues rather than an actual disinformation campaign.

I recall the news when this study came out; all I've found at the moment is a clip from a news report, but it's there for someone who has a moment to find the cite.

Another nail in that pincushion, er, coffin.

"... Helena, Mont. The citizens of Helena voted in June 2002 to ban smoking in all public buildings -- including restaurants, bars and casinos. Soon after, doctors at the local hospital noticed that heart-attack admissions were dropping. So they, in conjunction with the University of California, San Francisco, did a study to measure the potential short-term effects of a smoking ban.

"Helena is a perfect place for such a study: relatively isolated, with enough people in the region (66,000) for a meaningful population sample, and only one cardiac-care hospital within a 60-mile radius. So it was easy to control the study sample and methodology: if you get a heart attack in Helena, there's only one place to go for treatment.

"The study showed two trends. First, there was no change in heart attack rates for patients who lived outside city limits. But for city residents, the rates plummeted by 58 percent in only six months...."

By Hank Roberts (not verified) on 17 Jul 2007 #permalink

rrgabe23 said: "The science is in conflict on this issue."

Ah, just like science is in conflict over evolutionary theory. Both statements are false.

My "bottom line" is that smoking affects us in so many different ways, that there is no form of it that does NOT affect me or my family in a negative fashion. And because there are no benefits to smoking, only costs, there is no logical reason why non-smokers should have to endure any of the repercussions of smoking.

Am I wrong? Are there any benefits to smoking?

apy said: "Is there any evidence to show that bans reduce the amount anyone smokes significantly enough to matter for their long term health? Or are they just finding other places to smoke?"

That may be true. But the bans benefit those that don't smoke and puts negative pressure on those that do by reducing their opportunities to smoke.

Not sure about your point on taxes. You don't have that much say where your taxes go, but if they aren't going to pay for uninsured smokers, then they are available to go to education and medical research funding instead.

To Smoke is Smoke: I like a good BBQ a well as the next person, as long as my dinner isn't ruined by secondhand smoke.

DuWayne: I agree. Tax cigarettes like crazy. Use it to defray the health care costs.

But that doesn't address the heart of the problem, which is this: This is a vice that has absolutely zero benefit to anyone, including the user. In a cost/benefit analisys, costs continue to rise as we find more and more harmful affects of smoking to users and to those around them. Benefits remain at zero. I'm not extreme enough to believe that outlawing cigarettes will have a good result, but I see no reason why those costs have to be tolerated by anyone who chooses NOT to smoke cigarettes. And every time someone says a ban is uncalled for, they are asking non-smokers to put up with the varied costs of smoking... and receive no benefit from it in return.

So... either explain to me why I should take on the costs of smoking or, alternatively, explain to me how smoking benefits our society and balances those resulting costs.

Interesting. Not so cut and dried on this one. Thanks for the links, I will definately take a look. But first:

Leni writes: "Don't want SHS? Don't go to the bar. Don't work there either. It's really that simple."

I couldn't agree more. If health is the motivation, why aren't there any laws being passed banning bathhouses? Many deadly diseases have been spread in bathhouses. And I'm quite certain that because of the nature of activities that occur there, there is a large threat of second hand exposure to bathhouse employees.

Interesting. Not so cut and dried on this one. Thanks for the links, I will definately take a look. But first:

Leni writes: "Don't want SHS? Don't go to the bar. Don't work there either. It's really that simple."

I couldn't agree more. If health is the motivation, why aren't there any laws being passed banning bathhouses? Many deadly diseases have been spread in bathhouses. And I'm quite certain that because of the nature of activities that occur there, there is a large threat of second hand exposure to bathhouse employees.

Interesting. Not so cut and dried on this one. Thanks for the links, I will definately take a look. But first:

Leni writes: "Don't want SHS? Don't go to the bar. Don't work there either. It's really that simple."

I couldn't agree more. If health is the motivation, why aren't there any laws being passed banning bathhouses? Many deadly diseases have been spread in bathhouses. And I'm quite certain that because of the nature of activities that occur there, there is a large threat of second hand exposure to bathhouse employees.

Ok, if enough studies are done that show a relative risk of 2 or less for abortion and breast cancer then you'll agree that it should be banned. What I get from you is if it fits the moment or the context then an RR of less than 2 is valid.
Most of these studies are done in a short period where persons are interviewed as to their exposure. They are not asked about other possible contributers(diesel, jet fuel, radon....).
Give me a break, who can remember, and are they asked about other possible exposures. Noooo! This was the case with Engstrom. The study was ignored because they used interview data for a 25 year period, but that's OK when your guys do the same. I also think the American Cancer Society was the original funder for about 27 of the 30 years. As soon as they found out the numbers wern't going to come out in their favor they yanked it sighting the above.
And where did you get the data saying the study was crap, from none other than ASH. Whose the cranker and miner?
What about the biggest cranker of all Stanton Glance? Tell us about the validity of the Helena heart Study. Whose the cranker? Again, you neglect to address cranks on the other side who mine specific facts that fit their context.
Oh you did not comment on Dr. Gori. There are some with the courage to speak the truth and not continue to pollute minds in order to change anothers lifestyle.
By the way, I don't smoke, but find this trend disturbing where perceived marginal risk can stigmitise a portion of the population.

LCR.
What are the benefits of jumping out of airplane or riding a motorcycle without a helment, drinking alcohol, over eating and on and on. All could have a negative impact on you and your family in many ways. One way is through health cost. Obesity trumps primary smoking as it relates to premature death and illness. We must make these fat people lose weight! They are also nasty and disgusting and most smell bad.
And lastly , you receive a great benefit from smokers. I will repeat, over 7 billion was paid to the federal govenment in taxes. To date MSA payments amount to over 218 billion. These are taxes you did not have to pay.
I agree, if it's so bad it should be outlawed. But we know that is not going to happen. The federal and state govs make 3 times more per pack than Big Tobacco. Did you see how they screamed when per MSA two companies won arbitration to lower payments because of reduced consumption? What about the lights case in Illinois, as soon as PM said they would declare bankruptcy it went away. Per MSA if you are in bankruptcy you do not pay.
Wake up, your government is in the tobacco business.

Public Health has been nothing but selective in their views of what constitutes racist and elitist impositions. They have research which defines groups for targeted activism described not only by race but with percentages of each who smoke or drink and what they weigh, including finite details such as what they smoke and drink. They have the economic figures which also define who will be most affected by the promoted hatred and punishments to force what can only be described as a fine Aryan lifestyle, on the rest of the world. By every indication those promotions are designed to affect the most vulnerable the most.

The UN and it's agencies have provided some of the most horrific lifestyle situations ever seen and prolonged them indefinitely with self importance sustained through the suffrage of others. They maintain the killing fields through the arrogance of black mail with development funds to force nations to adhere to industry demands to surrender their natural resources and offer up their people to human experimentation. Forcing others to live by the terms of unified and corrupted new world justice systems, which heavily favor not only the large industries but those who live beyond the reach of any form of justice by birthright alone.

Public health should be more honest and live by the same arrogance they demonstrate in the impositions applied to the little people and admit what it stands for is above all else a resurgence of the eugenics movement and the same small minded ideals which empowered Hitler.

If you want to express moral outrage of someone enjoying a legal product, look within and admit what Tobacco Control and public health promotes is no different than best babies contests and the Aryan brotherhoods vision of racial purity by the denormalization of others.

Sustainable development is exactly what it sounds like; permanent imposition a cog at a time, moving toward the enslavement of the non privileged class who don't measure up to the the ideals or the bigotry of a group flattering themselves with the name public health.

rrgabe23 said: "What are the benefits of jumping out of airplane or riding a motorcycle without a helment, drinking alcohol, over eating and on and on."

You don't recognize that all of these activities, while dangerous to the user, do not have the shared dangers to those around you that smoking has? Jumping out of airplanes? You could die. Riding without a helmet. You could die. Drinking alcohol? In moderation and responsibly used, minimal danger, and we have laws against dangerous use where others are impacted, such as drinking and driving. Overeating? Yes, you are right, and notice all of the laws and social movements coming out now regarding obesity? People are beginning to recognize how our society pays when people make bad choices that impact others around them. Choices like smoking.

"And lastly , you receive a great benefit from smokers...over 7 billion was paid to the federal govenment in taxes."

Where do those taxes go? How do those taxes benefit me directly? Do they at least pay for the healthcare of those affected by cigarette smoke? Or do they go to a pet project of my local congressman who, by the way, is receiving funding from tobacco companies?

"These are taxes you did not have to pay."

I would rather get rid of smoking and do without the tax revenue. We would be better for it in the long run.

"I agree, if it's so bad it should be outlawed. But we know that is not going to happen."

So lets just be quiet and let people have their harmful little habit. Nothing's going to happen anyway...

"Wake up, your government is in the tobacco business."

Like this is news? But you are arguing that something is too hard to do or impossible, so we just shouldn't bother? Just because a corrupt government is dealing dirty business with a corrupt industry is no argument for ignoring the basic fact that smoking is dangerous and costly. It won't be irradicated quickly, but the bans are chipping slowly away at these so-called "smoker's rights", rights which are so costly to us as a society.

"but the bans are chipping slowly away at these so-called "smoker's rights", rights which are so costly to us as a society."

Spoken like a true sheep who deserves to live in the world he is cheering for. You cheaply give up the rights many others died to preserve. You may surrender your own rights, you have nothing to say about mine you cowardly ingrate.

The chiming in of the glorious realization declaring what a community will no longer tolerate without even the slightest understanding of what communities are about, is merely the parroting of what the Robert Wood Johnson foundation told their paid stooges to recite.

It would be refreshing to converse with one of the industry stooges with something original to say at least something he could actually take credit for.

The stooges of the cigarette industry have nothing on the stooges of the addictive chewing gum or spit tobacco industries, fodder for late night comedy.

Your words can be found internationally in blogs and discussions similar to this one almost word for word and always recited in the same hateful tone. You are not talking about some imaginary army of villains you are talking about all of our neighbors and friends close to 25% of the population, who in your estimation do not deserve enough respect to be allowed the privacy of their own decisions.

There are a lot of immature minds attached to the anti smoker cult movement it is really too bad the lessons of our past and the horrors which developed by these careless mindsets are no longer properly discussed in education systems anymore. It seems we are going to be forced to learn some very painful lessons once more. Hopefully when they punish those responsible, they hang enough of them this time to make a more lasting impression.

"but the bans are chipping slowly away at these so-called "smoker's rights", rights which are so costly to us as a society."

Spoken like a true sheep who deserves to live in the world he is cheering for. You cheaply give up the rights many others died to preserve. You may surrender your own rights, you have nothing to say about mine you cowardly ingrate.

The chiming in of the glorious realization declaring what a community will no longer tolerate without even the slightest understanding of what communities are about, is merely the parroting of what the Robert Wood Johnson foundation told their paid stooges to recite.

It would be refreshing to converse with one of the industry stooges with something original to say at least something he could actually take credit for.

The stooges of the cigarette industry have nothing on the stooges of the addictive chewing gum or spit tobacco industries, fodder for late night comedy.

Your words can be found internationally in blogs and discussions similar to this one almost word for word and always recited in the same hateful tone. You are not talking about some imaginary army of villains you are talking about all of our neighbors and friends close to 25% of the population, who in your estimation do not deserve enough respect to be allowed the privacy of their own decisions.

There are a lot of immature minds attached to the anti smoker cult movement it is really too bad the lessons of our past and the horrors which developed by these careless mindsets are no longer properly discussed in education systems anymore. It seems we are going to be forced to learn some very painful lessons once more. Hopefully when they punish those responsible, they hang enough of them this time to make a more lasting impression.

"Freedom" or "Kevin" or whatever your name is,

As to be expected by someone who is reduced to name calling as a defense, you don't have a clue about what a "freedom" actually is.

You do not have the right to live as you please regardless of how your actions impact others. Our freedoms are already necessarily limited by the fact that our choices affect other people. We are not permitted to behave in such a way that harms the people around us.

As I said in an earlier post, if someone could figure out how to let people smoke without it harming others, then fine, go for it. Knock yourself out. But as soon as your choice to smoke negatively affects someone else, in terms of health or finances, then you are impinging on another individual's basic freedoms and that is not acceptable.

Your a big one on freedoms as long as we are talking about YOUR freedoms. Well, I have the freedom to speak up and denounce behaviors that are harming others like me. No amount of spittle or name calling from you will make that statement any less true.

"Your words can be found internationally in blogs and discussions similar to this one almost word for word and always recited in the same hateful tone."

"Hateful"? That must be the tone of your own post flying back into your face. I don't hate people who smoke, even if I don't agree with their choice to do so. With the addictive properties of cigarettes, smokers are almost (almost) as much a victim as non-smokers are in this deal. If I "hate" anything, it is the industries that profit from their addictions and helplessness, those same industries you claim I am a "stooge" for.

And my words can be found everywhere? Really? I'd love to an example of that... word for word.

"...you are talking about all of our neighbors and friends, who in your estimation do not deserve enough respect to be allowed the privacy of their own decisions."

Nope. They can go ahead and smoke. That's their decision. But their choice can not be allowed to negatively impact the lives of those around them, who have an equal right to make this decision and have chosen NOT to smoke. My decision not to smoke does not harm your health, your environment, or your wallet. Likewise your choice to smoke can not harm me.

LCR,
If a person without insurance wrecks his motorcycle or dies jumping out of an airplane or gets ill from drinking, we pay! Don't you get it? This won't stop at cigarettes. You already acknowledge that movements and laws are targeting the obese. Doesn't this trend disturb you?
I hope you don't have a fat kid.
It's simple, the SHS issue was contrived to stigmitize smokers and force a lifestyle change. This by an elitist minority who truly believe they know best for us all.
And yes you benefit from the taxes, if not simply by reducing yours and allowing you more income to spend on your family. In any case it goes to schools, road construction and anything else but what it was intended.
Everybody cost his neighbor at some time. Have you ever cheated on your taxes?

"No one OWES you the choices you like."

Then why are smokers such whiuners? Smoking IS dangerous to others. But beyond that, smoking is disgusting. Why should my clothes smell horrible so that you can satisfy your addiction in public. I'm sorry that you've been spoiled by society for so long, but take it like men--or at least like reasonable women.

"It's simple, the SHS issue was contrived to stigmitize smokers and force a lifestyle change."

Yes, conspiracy theories are often simple.

"If a person without insurance wrecks his motorcycle or dies jumping out of an airplane or gets ill from drinking, we pay! Don't you get it?"

Yes. Its glaringly obvious. But what YOU don't seem to recognize is that the actual numbers of individuals in those categories is tiny compared with the numbers of uninsured smokers.

Think about it just for a second and use jumping out of airplanes as an example. How many people, annually, are rich enough to afford to go parachuting but do not have health insurance and are actually injured (not immediatly killed) while jumping?

Compare that to smoking, which bridges across all socioeconomic lines, including the poor who can not pay for health insurance?

Which would have the greater impact on the medical community in terms of the number of individuals needing health care but possessing no health insurance?

And regardless of this comparison, it still doesn't take away the fact that smoking cigarettes results in a huge cost to our society, both in actual money and loss of life. If we suddenly had a spike in injured, uninsured parachutists, it wouldn't reduce the affect of the cost to smoking. Now... do you get it?

"I hope you don't have a fat kid."

If I had a "fat kid" (yuck, what language. You are obviously not a parent), I would be more worried about the health of my "fat kid" than the societal trends.

"...the SHS issue was contrived to stigmitize smokers and force a lifestyle change."

I'm sending you back to Orac on this one. This is false and he has debunked this already.

"And yes you benefit from the taxes, if not simply by reducing yours and allowing you more income to spend on your family."

Well, that's okay then. The money we get in taxes more than compensates for the loss of life and the misery this causes families. Both my grandfathers died painful, horrible deaths due to smoking, but I would rather have the money then to have had them around longer in my life or to not to have had them suffer so in their final days.

You don't understand. You still think that a few billion dollars balances the other costs. It doesn't.

"Everybody cost his neighbor at some time. Have you ever cheated on your taxes?"

No, I haven't. But I'm guessing you have?

And yes, we are all an *unintentional* burden upon society at some time. That is why our systems of support are set up to minimize the impact (though they could be better). My problem is when someone *intentionally* chooses a behavior that they know will likely make not only them but also others around them sick. That behavior is irresponsible and costly to boot.

What about the biggest cranker of all Stanton Glance? Tell us about the validity of the Helena heart Study. Whose the cranker? Again, you neglect to address cranks on the other side who mine specific facts that fit their context.

Whatever the flaws of the Helena study, they have been well hashed out in the scientific literature, and the study was never represented in the scientific literature as anything other than a relatively small preliminary study with provocative findings suggestive of an effect that needed a whole lot of confirmation. Indeed, the authors of the study were quite honest about the limitations of their study. In a section entitled "Weaknesses of the Study," they even pointed out themselves the discussion section of their article that the study was small, that it used historical controls, and that biomarkers for SHS exposure were not measured. There was no deception or "scam" involved. Indeed, the authors were quite cautious in their assessment of the results, as any objective reading of the paper, particularly the discussion section, will show.

What rrgabe23 seems upset about is not how the authors represented their results, but rather how the press represented them, and that is a different issue entirely. He needs to learn how to distinguish between what scientists say and what the press says and not to tar the investigators with that.

Well, we are finally down to the point. You don't care at all about SHS, you are one of those who wants to eliminate all smoking or any tobacco use. Tha is why you never can answer why spit tobacco or any smokeless tobacco should be banned. It is written in all the responses. Live the way we want or suffer the consequenses. Sounds rather 1930's Germany to me? All the buzz words are there That's the trend that bothers me.
You don't seem to be so dense that you don't get the point. Life is risky and in a truly free society we should be free to make personal choices.
You argue that smoking is different because of cost to society. How much does it cost and where did you get the data? I hope it was not from the all accurate "SAMMEC". This is the system that estimates the cost without really ever counting anything real. Oh by the way, it also estimtes death. This is the same system used to calculate the 53,000 deaths from SHS. Please name one person who has died from SHS? I've never been able to find one?
Who decides what or who is next, the all knowing health care community? It appears they are going after obesity.
Again, I don't smoke and never have. My sister died of small cell lung cancer at 49, she never smoked. However, she lived in New York City (diesel exhaust and radon). My mother died last year at 75 from large cell. She had not smoked in 40 years and no one in her house smoked. However, the death certificate listed primary smoking as the reason for death.
I am resigned that if enough people don't become aware of these trends it will be too late. A small elitist minority will have successfully stripped freedoms we have taken for granted.

Well, we are finally down to the point. You don't care at all about SHS, you are one of those who wants to eliminate all smoking or any tobacco use. Tha is why you never can answer why spit tobacco or any smokeless tobacco should be banned.

Whatever you're smoking, it must not be tobacco, because I have no idea how you got that out of anything I've written.

I never said anything one way or the other about eliminating smoking or smokeless tobacco, and it's largely irrelevant to the question of SHS. But, here, if it makes you happy, let me first refer you to the last paragraph of the article I wrote above, which you seem either not to have read:

That being said, there is a risk of going too far in legislating smoking bans. Certainly indoor smoking bans at workplaces and in restaurants and bars are defensible on a scientific and public health basis. However, outdoor smoking bans, such as I've heard about on many California beaches and a recent law passed by the Beverly Hills City Council to ban smoking in all outdoor eating areas, are just plain stupid and wrong-headed, at least if the rationale is to prevent SHS-caused health problems in the population. This is particularly true since such bans apply to sidewalk cafes, where, in my experience, the exhaust fumes from passing traffic tend to overwhelm any smoke that comes from cigarettes. It doesn't help the reasonable and scientifically supported cause of indoor workplace smoking bans to overstep and impose bans in cases where the science doesn't support it.

Smokeless tobacco would also be one of those cases, as well.

Now that that canard of yours has been dealt with, as for smoking itself, I wish people wouldn't do it, but I'm not in favor of banning it altogether. If you want to kill yourself slowly with your habit, go ahead. Just pay your way, so the burden of your foolish choice doesn't fall on me and other nonsmokers, and don't expose nonsmokers to the risk of inhaling your fumes.

But, hey, while we're on the subject of who's "ignoring" questions, perhaps you'd like to finally get around to actually commenting substantively on my deconstruction of that list of quote-mined quotes you posted early on in this comment thread. And, while you're at it, I'll point out again that the whole "relative risks less than 2 can be ignored" canard is, as Tim Lambert informed me, a propaganda campaign by the tobacco industry designed to cast doubt on the epidemiology of SHS.

Take your time. I have to go back to work now.

rrgabe23:

You and Kevin are big talkers when it comes to freedoms but essentially what you both say is that the freedoms of smokers outweigh the freedoms of non-smokers. Smokers must be free to choose to smoke if they wish, but non-smokers must tolerate the costs, because their freedom to live a life unburdened by these costs, to pursue their own version of "life, liberty and the pursuit of happiness", is less important than that of the smoker.

Hypocrites.

If smokers wish to smoke, and they can do so without placing undue burdens upon society as a result of their choices, then I don't have a problem with their choice. But, and I repeat this for what seems to be the umpteenth time, if their choice negatively affects other people, then they need to take responsibility for their actions.

People make questionable choices all the time and for the most part as citizens of a democratic country, we can do so even if this means we are hurting ourselves. But we have laws that prevent us from doing so when our choices hurt other people, laws that protect us from the choices others make. I suggest that this should apply to smoking as well.

You may have the right to hurt yourself. You have NEVER had the right to hurt me. You never had that freedom to begin with. You cannot lose what was never yours, so your fear of having your freedoms "stripped" by a "small elitist minority" are unfounded.

Orac,

I think rrgabe23 was attacking my last post, not yours.

Regarding smoking prohibitions in bars:

I agree with you there. Several bars in WA have closed since the ban went into effect there.

That's a problem for the affected owners, but also highlights a potential problem in the "minor libertarian" expectation that the market will provide options for those who wish to visit or to work at a nonsmoking bar. With the perception, reinforced by stories such as these, that bars will do poorly if they turn away smokers, who would choose to open a bar which doesn't allow smoking?

Although I can understand workplace/office smoking bans, my main problem with banning smoking in pubs (and, amazingly, private members clubs) is that in many pubs, the majority will be smokers; there is a big correlation between 'people who smoke' and 'people who go to pubs a lot'. I get the impression that the kind of people pushing for bans are the ones who go to bars and pubs only occasionally. After all, if the majority of bar patrons were annoyed by smoking, there would already have been a lot of non-smoking bars.. or much better ventilation.

There's a definite chicken-and-egg question there. If those who go to pubs regularly smokers because of a correlation between wanting to drink and wanting to smoke or because those who would rather not smoke avoid pubs for that reason? The former does seem somewhat plausible in considering that those making a particular effort for a healthy lifestyle might avoid both activities, but the latter is still a possibility. Purely subjectively, smoking seems to be enjoying less popularity than it did in years past, but at least occasional drinking seems very widespread. I'd need more data and time to try to untangle that situation, though.
Would there have been a lot of nonsmoking bars or better ventilation? I think that depends on whether a business owner perceives it as profitable to choose either of these options, not whether it would be beneficial for patrons or employees.
Disclosure: I don't drink and I try not to smoke, when I can reasonably avoid it. That might lead one to paint me as one of those ban-pushing busybodies you mention, except that I mostly just grumble about nearby smoking. Since arriving in Washington, I've been doing somewhat less of that.

wrg wrote:

Would there have been a lot of nonsmoking bars or better ventilation? I think that depends on whether a business owner perceives it as profitable to choose either of these options, not whether it would be beneficial for patrons or employees.

I think you are right that it would depend, nevertheless no one is forced to go into bars or work at them.

(No I'm not sheltered, to whoever it was that made that remark above. The menial labor performed in bars is performed in a million other service industry jobs, many of which are currently hiring. In any case, if we are talking about prevalence, then prevalence of people who "can't" get jobs anywhere else is no doubt extremely low. A smoking ban for those 3 losers is like a using a hammer on the proverbial mosquito.)

Further, non-smoking clubs, taverns and restaurants did exist before the bans. Especially in recent years with smoking being less popular and non smokers being more vocal about their preference, and in particular at restaurants. But instead of using their collective buying power to thoughtfully patronize smoke-free places, or to even encourage business to go smoke free, non-smokers vote for bans because they are in the majority and it's simpler to force businesses to conform to their wishes-even places they wouldn't go to if someone paid them.

Beside all this, most people do accept health risks when it comes to work. Chemical exposure, stress, repetitive injury, communicable disease infection, even death. A person who works at a bar is no different and they accept the risks of exposure to health risks and unpleasant things the same as everyone else who works does.

The only reason we're having this conversation now is because a lot of non-smokers want to go wherever they feel like and not have to smell smoke. Apparently, as I bitterly noted above, that means even places like cigar bars.

That said, I do agree with general bans on smoking in places where people who do not smoke must go, but I do not see why that should imply or require no smoking in any business ever.

If I open a private club and want to let people smoke there, why the hell shouldn't I be able to? Because I might import slave labor and chain them to the bar? Because my overweight, drunken patrons who want to smoke might impair their own health?

It really is just ridiculous.

Masterful work, Orac, and much-needed, and I hope this gets to Jacob Sullum, over at Reason, and Dennis Prager, too -- two high-profile smoking harm deniers. Sullum's work on drug laws I respect; Dennis Prager is a rude, irrational blowhard almost every time he opens his big, flapping maw.

Anyway, I just wanted to point out the special hell a nonsmoker in an apartment building goes through when a smoker suddenly moves in. This happened to me not long ago, and I was forced to move because of it. Move or risk the consequences. And thanks, I'll take higher rent and a less ideal location over increasing my chances of various unpleasant diseases.

P.S. I just watched a nonsmoking friend die of lung cancer. It was terrible, and she was one of the bravest people I know. All those blithe people sucking away on their cancer sticks should go to the floor in the hospital where lung cancer patients go to suffer and die. If that doesn't make you quit, you're a bigger ass than you are for smoking already -- one of the more anti-life common pursuits you could have.

Leni, an antismoking crusader I know who used to own a lounge, is allergic to tobacco smoke, and has worked selling and installing commercial ventilation/filtration systems, recently admitted to me that a couple CM-12s can make a bar that allows smoking tolerable for him, if not ideal. He expressed interest in writing legislation that substitutes enforced air quality standards for smoking bans. Why can't ventilation/filtration systems solve the ETS problem in bars and restaurants?

http://www.air-zone.com/smokeeater.html

By Bill Hannegan (not verified) on 19 Jul 2007 #permalink

LCR;
Your response seems more closely linked to the symptoms of denial and transference than any logical discussion. Your fear that exposure at any level to tobacco smoke is completely without substance it is a promoted fear based in predetermined epidemiological studies which were created to produce the bulk of your arguments. You claim if a way were devised where someone could smoke without affecting others you would support it, yet it has been suggested many times a simple sign on the door which works wonders in other environmental challenges simply is ridiculous and poorly conceived the primary reason? Because it allows people the freedom of choice.

How many of us blindly accept environmental issues being dealt with by a health department? Why does a health department with self described experts treat an addiction as a disease which can be cured only if the patient is forced to do so by threats financial pressure and hateful language? There is an abundance of physical research which demonstrates carcinogens and toxins can be reduced they are not because as they reason; if smokers thought a cigarette was safer they would not quit, so it is better to maintain the higher toxic content and declare there is no safe cigarette which allows a manufacturer to buy cheaper unregulated tobacco and save a fortune. How much of this affects what you who fear the smoke are exposed to? You find it more convenient, and probably a lot of fun to look down you nose at others who smoke or those who are over weight but what you are promoting is the low road and the very worst in the human condition. Racial purity and safety first have been used many times in history to promote slavery second. There are many ways we can accommodate everyone as we have always done in the past all that is required is a willingness to think as a compassionate community beyond the current herded sheep mentality, being sold for larger profits in turning us upon ourselves.
Don't stand too close to a fat person you might catch it, described as a pandemic? Give me a break.

Epidemiology is the preferred method of creating proof because at its core it amounts to no more than politics with a calculator.
The lifetime studies to produce proof bartenders required protection saw a lifetime exposure to an as yet undefined substance at levels far beyond what would be expected in normal life, results estimated an insignificant proof those bartenders could be affected by exposure to the smoke yet none of those studies considered despite knowing for decades inhalation of alcohol is a significant health risk with identical results, especially with chronic exposures.
Your contention the same risk would apply to anyone with extremely low by comparison casual exposures seems to need a little justification when you consider the timeline and biological observations of the past 50 years you simply have no case. Smoking decreased from 54% prevalence to 25% and exposures according to the surgeon general decreased by 75% when will the dead start to rise? More important when will the diseases associated stop climbing?
Most people don't realize numerically there is essentially the same number of smokers in North America today as there were 50 years ago we are told by the experts the effects of smoking are delayed by 20 to 30 years the evidence therefore suggests smoking is closer to harmless than to the numbers being promoted. The disease categories all followed the increased population almost exactly, if smoking played as large a role as we are being told the disease categories would have remained as stable as the numbers of smokers, meaning the bulk of those diseases are attributed much more to other factors.
You won't hear about that in your anti smoker playbook.
The same researchers who would be the first to dismiss a study with even the whiff of tobacco funding admit in their own dissertations their own studies are suspect for exactly the same conflicts. With openly admitted conflicted funds by the industries who sell alternative products or the charities that leech in the name of fantasies of cures they will never produce because they are not looking for anything beyond the next big sound bite.
We see the major fear mongers decrying a 30% increased risk above no risk to be significant and harmful to bartenders exposed chronically over a 45 year working lifetime. When recent research was done to determine the risk of pilots with only a 30 year working lifetime it was phrased a little differently. With a 75% increased risk they were told the results only showed an insignificant risk so low it is not considered worthy of mention and pilots should be comforted by the results described as a .75 increase above no risk 250 times the risk of chronic exposure to cigarette smoke. By direct comparison should the passengers on those planes be seeking other modes of transportation or is their all of a sudden an acceptable level of risk? A risk made acceptable because planes don't leave a disgusting smell on your clothes when voluntarily exposing your clothes to them. Perhaps the whole cigarette debate boils down to making cigarettes smell better their certainly is little above fanaticism driving smoking bans, if you allow yourself to let go of the hatred you are being sold with your own taxes.

Before the personal insults start to fly;

My statements are found in research from reliable sources of science the physical kind with one standard that of replication consistently. The bulk of what I have seen here is simply a regurgitation of the six o'clock news. Contrary to popular belief the news is brought to you as a result of industry advertising payments and not a sense of benevolence. An industry promoted in sales, as a consumer nothing affects your health and that of your family more than personal decisions. The decisions you make based not in fears but in your right to accuracy in what you are told.

Sir Doll [RIP] who first connected smoking to cancer was likely quite right in his calculated assessments although he determined the effect to be much less than we are told today. His research was originally focussed on the increasing use of asphalt as Cancers were virtually non existent prior to 1930 smoking was initially eliminated as a substantial factor because it had been around for quit a while. In fact when we smoked at the highest rates cancers were at the lowest rates for centuries.

Here is a scientific evaluation of that pursuit which was abandoned after industries who would obviously be affected, offered to fund a tobacco research paper instead. An analysis of what chemically should have been revisited in the 50 years since, despite Doll's other research, this pursuit inexplicably has never found the funding.

A description by a good friend and scientist who proved irrefutably in a significant research study pending publication [which the journals refuse to publish for political reasons alone] proof any such junk science studies claiming 40% decreased heart attacks are a benefit of smoking bans are ridiculous. I am citing his recent email to me because it explains the situation in plain English for those who do not understand the implications of science well, who should be well informed. The benefit here is you can check the statements yourself without the need for the experts, simple published chemistry with no political bias or contravention weighted in anyone's favor.

" If you examine an asphalt roadway, you will notice when it is freshly paved, it is black, and of uniform thickness. As trafic wears it out, you will notice the road surface becomes 'trenched' where most of the tires of the vehicles pass over it.

Now, asphalt has a density about equal to water, while the limestone mixed with it to make pavement has a density about 4 times water. This is important because it rules out the possibility that over time the stones are working their way up to the surface. This leaves the only other possibility to be that the asphalt component is actually wearing down, and that would have to be by a mechanism whereby very fine particles are being dispersed off of the tires and into the air.

Now, how is asphalt made? They take the first substance ever identified as a carcinogen, which is coal tar, and they melt it and blow air through it to harden it. What they are infact doing, is adding oxygen to it which makes it have more affinity for human tissue.

Now, ( and I'm sorry if I'm doing this backwards, but it seems the best way at the moment)... what is coal tar? Cola tar is polynucleraromatic hydocarbons. As you already know, these belong to the same class as the PAh's in tobacco or wood smoke. But there is a difference...the ones in coal tar are higher members of the PAH series. Let me explain. First, there is the benzene molecule, which has been shown a carcinogen. then napthalyene which is 2 fused benzenes, is slightly more carcinogenic. then anthracene which is 3 benzenes fused, which is more carcinogenic than napthalene. and so the series continues, each time another benzene is fused into a condensed ring with other benzene molecules, the result is more carcinogenic than it's predecessor.

Now, when you get to 5 benzenes fused, you have the PAH's in cig smoke.

Here's the main point, the coal tar compoenets contain fused rings consisting of even more fused rings than the pah's in cig smoke, so they are even more carcinogenic than the ones in cig smoke.

Now, remember, i said they blow air into the hot mix of coal tar to make asphalt? Here's what that does: it adds hydroxyl groups to the PAH's in coal tar.

Now, I have a book published by the American Chemical Society, titled Chemical carcinogens, symposium series #173, and it talks about the PAH's in cig smoke, and how they cause lung cancer, and it says that, in esence the PAh's themselves do not cause lung cancer, but there is an enzyme called arylhydrocarbon hydorxylase which converts the PAh's in cig smoke to dihydroxyPAh's which do cause smokers to get lung cancer. How do they know that? Simple...smokers who have inherited a gentic defect which limits production of arylhydrocarbon hydroxylase hardly even develop lung cancer.

But remember, i said during the process which converts coal tar to asphalt they blow in air which actually makes the dihydroxy derivatives? so really, aside from the fact these are already more carcinogenic, they make the dihydorxy deravitives for us, so that our bodies don't even need the enzyme to cause lung cancer.

and thanks to the guy driving in fornt of you, and the lack of devotion by our public health officials to actually find out what causes LC in nonsmokers, nonsmokers will continue to get lung cancer long after every source of secondhand smoke , and every smoker has been eliminated."

I can only add prior to 1960 diesel fuel use including the use in large trucks was rare. Diesel exhaust created a new record for generation of cancer tumors not in 30 years but a matter of days in a petri dish.

When we took lead out of gasoline the one part per million per cubic meter of air in a 24 hour period and known standard safe level was breached in benzene exposures universally, you likely have one part per hundred gallons in your gas tank right now. Prior to the change it was illegal to pump your own gas, now it is the norm. Gas bar attendants needed to be protected to reduce insurance liability to the oil companies, how do you feel with no protection when you gas up your own car? Do you know what diesel fuel smells like? If so you have already been exposed to dangerous toxic levels of a deadly carcinogen. Do you like the smell of gasoline on your clothes? I can assure you if you smell it your carrying around the equivalent of 30 to 50 trillion cigarettes by carcinogenic comparison.

Who's rights are you compromising?

Kevin,

"Your fear that exposure at any level to tobacco smoke is completely without substance it is a promoted fear based in predetermined epidemiological studies which were created to produce the bulk of your arguments."

I am in awe of your ability to pack so many false statements and unsupported assumptions into 1 inch of text, let alone the mountain's worth of text in your last post.

It comes down to this. We mainly differ on whether the research on SHS is valid.

You, to say the least, are skeptical and see conspiracy theories galore and attacks on personal freedom. Fine. You have your issues.

Here are my issues. From what I have read and heard and learned, there is enough evidence from the research to have a valid concern over exposure to SHS. I am the mother of three kids. It is not just me that I am worried about. I am worried about the health of my children and of their children. Given what we do know about SHS, it would be irresponsible of me, as a parent, to sit back and tolerate a situation that has a good chance of being harmful to them.

Do you see where I am coming from? I don't care about the "industry" or government conspiracies, or any of the other crap you are bringing up. I am watching out for my children.

So here are is the deal. If we go your route, if we say that the science is wrong and that smokers should have the right to blow smoke into the air of public places, and it turns out that you are wrong, guess who gets hurt? My family and other non-smokers like us.

So guess what? If doctors and scientist start saying that there is nothing to worry about, that SHS carries no risk, then I will rethink my position. But your words carry no weight with me. You are not a doctor or a researcher or anyone with the credentials worth trusting with the lives of my children. You are more concerned with the rights of smokers to suck carcinogens into their lungs than the public's health, which, given the absurdity of the argument, doesn't credit you with much wisdom. There is absolutely nothing YOU could say that would make me change my mind on this issue and risk the lives of my family.

LCR;

I appreciate your candor and no insult was ever implied to you directly, I assure you. Contrary to your preconception of me however I have done extensive research and I draw no bias from a protection of a right to smoke and blow carcinogens into the faces of others. Everyone has a right to feel safe in their environment and I do not challenge your right to feel safe or to protect your children.

I am simply objecting to the vilification of smokers and the hatred being proliferated in a huge cash grab frenzy, veiled in a hollow punishment of the Tobacco industry who continues to produce record profits from the process, while the victims [all of them including smokers] are dealt the bill for mistakes of the past. What is ominously absent from all tobacco discussions are the smokers themselves who are described as brain dead and intolerant as a result of their "Nasty Habit"

What is lost and my point here is, we are being lead by rhetoric to hate each other and while all the ills of the world are being attached to smoking how little we lobby against toxins and carcinogens which by comparison are actually much more harmful to us all. Bait and switch is the order of the day. Do you feel confident sitting with a stroller at a bus or train station? Science tells us due to the high concentration of diesel exhaust in the air the damage you do your children is severe.

The damage to your children's health is not your fault, it is the fault of those promoting the ban of smoking on the same platform who failed to tell you the whole story and lead you astray by careless exaggerations, for just money?

Smoking is a fact of life and will be with us for quite some time I fear. If the so concerned lobbies who seek to "help smokers quit" were interested in solutions who better to go to for advice than a smoker?

If you are concerned about your kids as I am sure you are and want to feel secure they won't start as others do in the rebellious teen years, try talking to a few smokers and understand why they started.

The current rubbish blaming the movies and pictures on the labels have little to do with it. Marketing and taxes played a huge roll in promoting smoking in the past. My four boys were delivered while I sat in waiting rooms where almost all the other dads puffed away along with the doctors who came out to deliver the news. And no this was not in a prehistoric era, actually [and almost unbelievably to some] less than 20 years ago.

Many kids start believe it or not to avoid those extra years added onto a non smokers life those extra 10 years taken from a lifetime smoker. Dependant years when we are forced by bodily limitations to depend on others. From where I sit, considering the majority of ever smokers moving into their twilight years, the intolerance being promoted in society of those who lived in a different world; their instincts were correct. I don't want to live so long as to be Dependant on a generation who is being taught to hate me either.

Thank you. This is much better than having stats and unfounded charges leveled at me.

But you have not recieved my message in its entirety, or perhaps I wasn't clear. I do not hate or villify smokers. I agree that they are also victims of this whole mess. I have family and friends that still smoke, this in spite of acknowledging the health risks. They are stuck. And I know why and when they started. More importantly, I understand why they can't stop. That is what I hate. Not the people. Its the cigarettes themselves and the attitudes in the tobacco industry who, given the choice between lives and profit, chose profit.

RE: the smoking bans. I don't really care about the reasons behind the smoking bans. Your arguements still don't make sense to me, but even if the origins of the bans are "impure", if they further limit the exposure my children receive to smoke and to cigarettes, then great.

People are not bad. Smoking is bad. It is a hazardous practice with absolutely no benefits to balance out its cost of lost lives. We, as a society, would be much better off without cigarettes, can we at least agree on that? Smokers need to understand that bans are not meant to villify them, they are meant (at least to me) to reduce the harm done by their addiction to others who choose not to smoke. I understand that the end result is often for smokers to feel like social pariahs... but while I am sorry for that, I don't feel sorry enough to tell them its okay if they smoke (its not... its horrible for multiple reasons) or to not support the bans. Smoking bans may only push a small percentage of smokers toward quitting, but by creating a negative social response to smoking, they may in the long term reduce the number of people that do START smoking. That, combined with protecting others from the harmful affects of smoking, can only be a good thing.

It should be okay to say that smoking is a bad thing, because it is. It should be okay to openly acknowledge that it is harmful, because it is. It is not the same thing as saying that the smokers themselves are bad. But while we walk on eggshells around smokers, afraid of making them feel bad about their addiction, we are creating the illusion that smoking is not so bad or not so dangerous. That illusion is a lie, and it is killing people. I won't be part of that.

Smoking is simply put something which a large number of people enjoy. With rewards equal to the amount they are wiling to pay for their pleasures. Similarly motto-cross racing or sky diving are enjoyable to some and unforgivable risk to others. In the evaluation of harm to others you are correct we do differ in opinion. Perhaps your perspective would be different if faced with all the facts available however it is your right to find that information or not as a personal choice, and I will not even think of challenging your opinion.

The perception smokers are being aided in all this is absolute self serving bunk by those searching to profit in all the wrong places. The cure becomes the poison when we encroach on the perspective smokers should be made to quit. I don't tell anyone what to eat for breakfast why should anyone tell me what I may do with my own purchases. Does it really set the table for promoting an ability to quit, with so much increased pressure to comply. If an addiction is to be halted it takes time and patience something in short supply of late if addictive chewing gum is the only plan available which meets non smokers approval. A product well known to decrease your chances of quiting and a child friendly gateway drug to primary smoking sold without restriction in most places with no age requirement.

The perspective all enclosed public spaces should be smoke free encroaches on the rights of those who own the property. Clients in a bar are being rewarded for accepting a risk of smoking by the food the people or what ever else enticed them to walk in the door. Similarly employees are paid for the risks of the job otherwise they would demand more pay, Breathing apparatus or simply go elsewhere so they may feel more secure. to state children will be harmed in a bar where they are not allowed to be, serves itself. To state all smokers should be denied employment housing and even the minimum of a shelter from the rain travels into the land of fanaticism.

As I stated earlier if there is a need and a will we can always find ways which respect all of community When we listen to the hate mongering from non government organizations participating at the World Health Organization and decide to penalize 25% of community with no compromises I have to observe this is not a view held by caring and empathetic communities it is a repetition of what we saw in 1930s Germany.

Here is a link to a book written by an active anti smoker advocate the parallels are to similar to simply dismiss as calling names to promote an opinion or foolish conspiracy theory.

http://www.haciendapub.com/edcor5.html

Here is another link for a little comical relief
http://www.davehitt.com/may99/modest.html

The mapping of the human genome with new equipment available was completed in a relatively short time. With the new information available it wont be long before the statement when asked what make smoking s9o dangerous may soon be answered allowing a cure for what ails you. This of course would mean a closing of the four largest charities.

We are on the verge of appointing the smoking issue to an appropriate agency which should actually be the EPA however the FDA will do. This will entail according to procedure the definition of tobacco smoke to be described in a scientific term or a number of descriptions for legitimate scientific evaluation. For too long 5000 or 4000 deadly ingredients simply mislead people and caused irresponsible tension in communities who should realize not all or even a relatively small percentage of the ingredients can be called deadly with no reference to description or dosage.

The great drawback to the pending legislation to regulate the product is sure to furrow a lot of public eyebrows; the bill was co authored by the campaign for tobacco free kids and Phillip Morris the largest manufacturer of cigarettes in the States. Greed as they say makes strange bedfellows and this is shaking up to be an orgy as the Cancer institute, The lung association and many other lobby groups who want continued guarantees to their share of the proceeds of propaganda belly up to the trough. Amendments to the bill include the tobacco industry would be prohibited from claiming the product was FDA approved when in reality it would have to be, or be removed from the shelf.

Anyone convinced to fear the smell of tobacco smoke any more than they fear roasting marshmallows, need to be mortified by the knowlege of who is diving the good ship???
[call it what you want it just doesn't matter]

Kevin,

"Perhaps your perspective would be different if faced with all the facts available however it is your right to find that information or not as a personal choice, and I will not even think of challenging your opinion."

Your pompousness is returning and, from what I've read in these threads, your version of "facts" is suspect.

"The cure becomes the poison when we encroach on the perspective smokers should be made to quit."

Strawman. I never said smokers should be made to quit. I said that bans may increase public pressure against smoking which may encourage a few to quit and, *more importantly*, discourage others from starting.

"The perspective all enclosed public spaces should be smoke free encroaches on the rights of those who own the property."

So the smoking bans cause restaurants to lose business? That would be the main reason for resisting such bans... money. Any supporting evidence? But then that would put pub and restaurant owners in the same bag as the tobacco industry which promotes smoking to begin with... using smoking to increase sales. Back to death for profit again.

And then you go back to your conspiracy theories again for the remainder of your post.

I don't care. Conspiracy theories may be your passion, but they don't protect my kids from SHS. That's my bottom line.

Smoking is harmful to the smoker and there is sufficient credible evidence that SHS is also harmful to suggest that non-smokers are at risk. That's it. It doesn't matter if "cures" for smoking are ineffective or addictive themselves. That doesn't take away from the damage smoking causes. Find better cures if that is your gripe. But none of this, NONE of this, credibly suggests that we, smokers, non-smokers and business-owners, would NOT benefit from the smoking bans.

LCR;

Why take such strong offense to what I believe, I am just another ignorant smoker, so who would listen, right? You have your imposing opinions and I don't object to your right to state them. As for conspiracy theories I have been accused of worse, in fact I was once offered a little tin hat by a dishwasher in Ottawa. Which I wear [tongue in cheek] with pride on occasion. I find it puzzling you find nothing wrong with forcing 80 year old people out in subzero temperatures to as you figure convince some [a few] but not all of them to quit, and the benefit would be?

Similarly if all inhabitants of a pub are smokers and the employees are too, who is protected by the bans? Or if i ride alone in a commercial vehicle I own, who is protected by prohibiting my smoking? or If I stop for a smoke under a highway overpass who is being protected by giving me a fine? The complete; "there is no way to accommodate others preferences" thing is old and entirely telling of those who support such measures.

You would make all these claims you wish to get rid of smoking entirely yet you would be the first to protest if prohibition was mentioned. Tambourine banging is a funny thing, even when stuck in through the side door as the ban fans are attempting to do here, the results of a prohibition and a pseudo-prohibition are the same. The sales of organized crime are skyrocketing and smoking among kids is climbing again for the first time in 50 years.

So when I call ban fans nicotine salespeople it is with good reason. Whether you spit chew or burn it it is still an addiction and this whole exercise is sold to the public as an effort to punish the industry and help smokers, remember? In actual practice this is not targeting an industry as claimed it is targeting their customers.

You seem comfortable with trading one addiction for another, hardly fair to the victims now is it? Would you buy addictive chewing gum for your kids? it is sold in exciting new flavors now to suit their tastes. I like the little cartoon devil, Such a nice touch and I know the kids love him almost as much as Barney.

Your children and their peers will still be used to promote profits and and health scare funding as life in the world goes on and the nicotine industry finds new markets, leaving you perfectly content the lords work has been done. As for the information I provided, if you choose to not believe what I wrote fair enough, if you want to demonstrate your assertion "your version of "facts" is suspect." [Lies]simply ask and I will demonstrate the proof.

Which points need proof in your mind which you can't find for yourself with a search?

I didn't insinuate you where a liar despite what I believe in what you stated. Keep it in mind you were the one to point a finger at me for the personal attacks who is attacking who and for what reason? Because I believe we can find solutions and you won't hear of it hardly a gracious attitude there?

Or do you have another reason to defend the bans beyond your obvious hatred of your neighbors who may smoke?

How does this;

"The perspective all enclosed public spaces should be smoke free encroaches on the rights of those who own the property."

become this;

"So the smoking bans cause restaurants to lose business?"

And precipitate this;

So the smoking bans cause restaurants to lose business? That would be the main reason for resisting such bans... money. Any supporting evidence?

Why should I provide proof for a statement you alone made?

Can someone explain to me how banning smoking in bars is protecting LCR's, or anyone's, children?

LCR wrote:

That doesn't take away from the damage smoking causes.

And it still doesn't give you a *right* to determine what other people do with their businesses. Especially ones you and your children won't even be going in, where nothing illegal is occurring, and where the possibility of it harming innocent, captive nonsmokers is precisely nil.

Amy
Calling a Jew a Denier is one of the lowest forms if ignorance whether intentional or not, the moderator should take note and remove your post.

A practice known as "baiting" rekindles the pain felt by an entire people due to the horrors of the death camps. Please try to be more sensitive this kind of language is entirely intolerant. Your political or social discourse with others does not excuse racist remarks.

Perhaps those who refer to smokers as wrong headed individuals should think more about the promotion of that phrase. Is there any support for individuality left in our PC perfect rulebook?

It stands to reason by taking a confrontational role as applied to smokers with spiteful and hateful remarks coupled with an inability to seek or even discuss common goals with a large segment of the population who smoke; you open wide the high road to your opponents who sell cigarettes while permanently denying your hopes of ever being seen in the light you seek. Nanny state, prohibitionists and fascist attachments to your campaign will only invigorate the sales of tobacco. If anyone cares or wishes to make a lasting impact wouldn't the desired reduction of cigarette use, as opposed to the reinvigoration of a market in decline be a more desired effect?

In the same way cigarettes were made sexy in the past through the bad boy image. Tobacco control now points at smoking as an extreme addiction which reinforces in smokers the futility of trying to quit and in kids the reading between the lines smokers get a high or rush which makes it worth the danger. If we know a quarter of the population smokes we have to assume there is a reason. So as a show of bravery Kids will experiment and show off in front of others who will admire the daring personality and want to follow. By making such a promotion and targeting kids TC is actually making them a lot more aware of smoking and will likely lead a lot of kids toward taking that first cigarette.

This phrase sums up the current public perception of Public Health. Is this part and parcel of the strategy to success? I think not.

"Of all tyrannies a tyranny exercised for the good of its victim may be the most oppressive. It may be better to live under robber barons than under omnipotent moral busybodies. The robber baron's cruelty may sometimes sleep, his cupidity may at some point be satiated, but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience. - C.S. Lewis. "

Food for thought;
http://tobaccocontrol.bmj.com/cgi/eletters/14/suppl_2/ii3#499

http://tobaccocontrol.bmj.com/cgi/reprint/14/suppl_2/ii38

http://tobaccocontrol.bmj.com/cgi/content/full/14/suppl_2/ii3?ijkey=515…

http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1497534&blobtype=…

If anyone is really interested choose from below all available through medical journals and in general agreement with the current state of TC; as a shambles of disorganized all rules are off unethical hate mongering and disinformation relayed to the public as official science and health information. It seems in Tobacco Control the sound bite rules and their are no other rules which are applicable beyond the next catchy utterances.

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36. Lasser K, Boyd JW, Woolhandler S, et al. Smoking and mental illness: a population-based prevalence study. JAMA 2000;284:2606ââ¬"10.[Abstract/Free Full Text]

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38. Remier DK. Poor smokers, poor quitters, and cigarette tax regressivity. Am J Public Health 2004;94:225ââ¬"9.[Abstract/Free Full Text]

39.Beauchamp DE. Public health as social justice. Inquiry 1976;13:3ââ¬"14.[Medline]

40. Healton C, Nelson K. Reversal of misfortune: viewing tobacco as a social justice issue. Am J Public Health 2004;94:186ââ¬"91.[Free Full Text]

41. Churchill LR. What ethics can contribute to health policy. In: Danis R, Clancy C, Churchill LR, eds. Ethical dimensions of health policy. Oxford: Oxford University Press, 2002:51ââ¬"64.

Calling a Jew a Denier is one of the lowest forms if ignorance whether intentional or not, the moderator should take note and remove your post.

Oh, please.

I routinely battle Holocaust deniers here. I'm even part of an organization that exists to do that; so I know of what I speak. The term "denier" or "denialist" is used for many things other than Holocaust deniers. I will grant you that my choice of word would have been "smoking harm denialist" rather than "denier" simply because using "denier" allows people like you to get all up in arms, but you're going way overboard in your hyperbolic and emotional claim that Amy's remark was "racist" or somehow "accusing a Jew of being a Holocaust denier."

Of course, that's a good technique of "baiting" too.

Orac;

I was quite serious.

I have seen this type of trash all to many times and can assure you it is targeting and transparent. An opportunistic use of unnecessary language. The term when making obviously venomous comments against a very dedicated lifetime humanitarian was gratuitous and self serving and adds nothing to a civilized debate.

Think about it and the way it was used before you point at "my kind" as though that were an acceptable insult as well.

It seems promoted hatred for anyone who stands in the way of the anti smoker movement allows its partners to broaden what is acceptable in order to dictate what is not. A form of bigotry and certainly hypocrisy as well.

There is no secret; lobby tactics which seek to avoid discussion and target individuals is at the heart of this. Those with no ability to debate a topic simply and gratuitously attack the person, avoiding the explanation or embarrassment available in what was presented.

Dr. Michael Siegel called this a tactic which was part of a brainwashing of individuals involved in tobacco control. The much quoted long time advocate was the target of the same strategy for asking others to simply stay factual with what was presented, to the point he was shut out of a movement he helped put on the map. Just goes to show how dedicated some may become, to a point they loose all sense of a moral compass which has served them well in the past.

Please don't defend the use of this phrase in the context of an acceptable insult especially when it is targeted, other than that one point I found your arguments thought out and quite worthy. Open discussions even when we agree to disagree serve us all.

Amy
Calling a Jew a Denier is one of the lowest forms if ignorance whether intentional or not, the moderator should take note and remove your post.

A practice known as "baiting" rekindles the pain felt by an entire people due to the horrors of the death camps. Please try to be more sensitive this kind of language is entirely intolerant. Your political or social discourse with others does not excuse racist remarks.

You never know who's a Heeb from names in America, do you? I attended Temple Beth El, in Birmingham, Michigan, which, despite your clear shortage in gray matter, you might be able to deduce is not a outlet of the Catholic church. Of course, this is immaterial as is any reference to the Holocaust.

You're a science-denier, and clearly you haven't a scientific leg to stand on, and you know it, so you're pulling out the persecution complex.

Pathetic.

All the italics didn't come out.

This entire bit is a quote of the pathetic denier man:

"Amy
Calling a Jew a Denier is one of the lowest forms if ignorance whether intentional or not, the moderator should take note and remove your post.

A practice known as "baiting" rekindles the pain felt by an entire people due to the horrors of the death camps. Please try to be more sensitive this kind of language is entirely intolerant. Your political or social discourse with others does not excuse racist remarks."

P.S. Jews aren't a race, asshat.

Go ahead do your little dances I'm laughing too although not with but at you. You call me a denier of the science yet all I have seen from any of you is rhetoric and supposition. The wisdom of the studies you celebrate if the researcher has any sense at all, are ripe with plausable deniability included. The limitations of the research announced allows an escape route should the power hungry sober up and look for someone to blame. When lifetime worst case exposures research which demonstrates insignificant chance is exaggerated to state 3000 may die of second hand smoke and is further exagerated against the wishes of the author to attach it to a definitive statement by those to ignorant to know better, then further exaggerated to claim casual exposures will cause the same chance of harm, you can't really be presenting that trash talk as science?

You are talking hyperbally and suposition to support the bulk of your statements the cannon of proof is known to be a plastic cannon by the very excuses Thun used to defame E&K. Yet studies which used the same data were used generously in the meta analysis which you hold up again as definitive proof? Too foolish for words.

I presented a lot of information and not a word to challenge what I gave you other than personal slag which washes right off. You claim to have some science to demonstrate casual exposure to second hand smoke is more dangerous than toasting marshmallows with the kids, where is it? Not the political trash being bandied around growing with every utterance, the real stuff where are the bodies and a few of their names?

You follow the sheep in front and really don't know where the information comes from, or what validity sustains it, just that it is right because you heard it on the news and suits your needs no matter how foolish the information you spew makes you look. To explain your immovable faith in the information provided you live in a world of fear cloaked in denial that you may be used as pawns by others who will remain wealthier and a lot more intelligent.

But hey I'm just a conspiracy nut. L O L

Everyone's an expert yet no one seems to have an ability to stand behind what they preach and debate it in public I have always found that telling of a con artist Silence but unwarranted faith in the word. Thought to be "Science" because they don't understand it beyond what they hear from the press releases.

If you would like to challenge what I presented bring it on the tactic of calling a human rights advocate disgraceful names, is the best you can muster? I suspect if it was your rights being ignored you would be licking his boots and using his words to cry for the protection of your interests and those of the "iddy biddy children" to quote Rush who in a surprising turn is actually speaking out against your cult activities.

The regime of George will soon be at an end, some of your cult may soon be looking for work because if the USA is to retain any sense of integrity on the world stage real science will have to be unchained at least long enough to punish a few scapegoats.

The best part of fads? people grow tired of them and move on. The level of noise from those who looked at what was being supported as intelligent thought, grows louder and the jokes on late night grow more frequent. Kennedy will soon present his bill and the Health departments relying on propaganda as their claim to fame will loose control, how about that.

So wallow in your ignorance for your allotted time, I won't be crawling down there with you. I don't walk in fear of your kind or live my life by the limitations of fear. You are to be pitied, if you can find enough of us left to offer you even that once the screw turns.

99,000 lives will be saved by smoking bans, the immortals will soon walk among us. Y2K will end life as we know it? Global warming will transform Canada into a tropical climate?

Right on, I'm still waiting...

Go ahead do your little dances I'm laughing too although not with but at you. You call me a denier of the science yet all I have seen from any of you is rhetoric and supposition. The wisdom of the studies you celebrate if the researcher has any sense at all, are ripe with plausible deniability included. The limitations of the research announced allows an escape route should the power hungry sober up and look for someone to blame. When lifetime worst case exposures research which demonstrates insignificant chance is exaggerated to state 3000 may die of second hand smoke and is further exaggerated against the wishes of the author to attach it to a definitive statement by those to ignorant to know better, then further exaggerated to claim casual exposures will cause the same chance of harm, you can't really be presenting that trash talk as science?

You are talking hyperbole and supposition to support the bulk of your statements the cannon of proof is known to be a plastic cannon, by the very excuses Thun used to defame E&K. Yet studies which used the same data were used generously in the meta analysis which you hold up again as definitive proof? Too foolish for words.

I presented a lot of information and not a word to challenge what I gave you other than personal slag which washes right off. You claim to have some science to demonstrate casual exposure to second hand smoke is more dangerous than toasting marshmallows with the kids, where is it? Not the political trash being bandied around growing with every utterance, the real stuff where are the bodies and a few of their names?

You follow the sheep in front and really don't know where the information comes from, or what validity sustains it, just that it is right because you heard it on the news and suits your needs no matter how foolish the information you spew makes you look. To explain your immovable faith in the information provided you live in a world of fear cloaked in denial that you may be used as pawns by others who will remain wealthier and a lot more intelligent.

But hey I'm just a conspiracy nut. L O L

Everyone's an expert yet no one seems to have an ability to stand behind what they preach and debate it in public I have always found that telling of a con artist Silence but unwarranted faith in the word. Thought to be "Science" because they don't understand it beyond what they hear from the press releases.

If you would like to challenge what I presented bring it on the tactic of calling a human rights advocate disgraceful names, is the best you can muster? I suspect if it was your rights being ignored you would be licking his boots and using his words to cry for the protection of your interests and those of the "iddy biddy children" to quote Rush who in a surprising turn is actually speaking out against your cult activities.

The regime of George will soon be at an end, some of your cult may soon be looking for work because if the USA is to retain any sense of integrity on the world stage real science will have to be unchained at least long enough to punish a few scapegoats.

The best part of fads? people grow tired of them and move on. The level of noise from those who looked at what was being supported as intelligent thought, grows louder and the jokes on late night grow more frequent. Kennedy will soon present his bill and the Health departments relying on propaganda as their claim to fame will loose control, how about that.

So wallow in your ignorance for your allotted time, I won't be crawling down there with you. I don't walk in fear of your kind or live my life by the limitations of fear. You are to be pitied, if you can find enough of us left to offer you even that once the screw turns.

99,000 lives will be saved by smoking bans, the immortals will soon walk among us. Y2K will end life as we know it? Global warming will transform Canada into a tropical climate?

Right on, I'm still waiting...

I know there are no professional Tobacco Control advocates reading this blog and doubt if anyone else could help.
Being just a smoker and conspiracy nut as defined. Could anyone help me out with the difficult words in trying to understand what this guy is saying?

It may help in sorting out our disagreements or not...
Try to help if for nothing else for the kids sake, the iddy biddy kids remember?

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1447193

"Such formulations, while intended to redress imbalances in power underlying conditions of vulnerability, do not necessarily recognize the mutuality of the researcher-subject relationship,26 inherent in newer conceptions of public participation32,33 and community agency in determining need34 in public health. The process of "speaking for others," so central to IRB processes in relation to vulnerable groups,17 is coming under increasing criticism in development-related analyses of public heath where the "need for people to negotiate their own inclusion"33 is critical to the success of the new public health.

For example, Eckenwiler17 defines vulnerability in terms of threats to self-development, self-determination, and equality that exist independent of research and suggests that variables other than those "traditionally" cited in research codes (gender, disability, children, poverty, etc.) should be considered within the ambit of vulnerability, based on an analysis of the participant's own experiences and their particularity. Similarly, Zion et al.26 define vulnerability in terms of the lack of basic rights and freedoms required for participants' free choices. Brody25 has argued that failure to make informed consent meaningful has occurred because of a preoccupation with autonomy as a right rather than as a value, resulting in an ethical principle that generates no obligation on the part of the researcher to help the participant make autonomous decisions.

Institutional review processes, therefore, need to develop new ways to recognize and strengthen the agency of individuals, groups, and communities, whom institutional review has thus far only viewed as candidates for protection.35 As in broader public health policy, rather than "doing things for or to the poor, [ethical review should] start strengthening the capacities of the poor to do things themselves."36 By asking difficult but appropriate questions of researchers relating to the role their research will play in facilitating empowerment of vulnerable groups, ethical review should aim to strengthen the connection between autonomy and freedom."

Lets narrow the focus a little and entertain my preoccupation with conspiracy shall we?

"Brody25 has argued that failure to make informed consent meaningful has occurred because of a preoccupation with autonomy as a right rather than as a value, resulting in an ethical principle that generates no obligation on the part of the researcher to help the participant make autonomous decisions.

Institutional review processes, therefore, need to develop new ways to recognize and strengthen the agency of individuals, groups, and communities, whom institutional review has thus far only viewed as candidates for protection.35 As in broader public health policy, rather than "doing things for or to the poor, [ethical review should] start strengthening the capacities of the poor to do things themselves "

To the untrained eye this could provide actual confirmation smokers as a group are the current subjects of human experimentation.

Don't start to laugh just yet, it would appear non smokers are being observed as well. Without information or consent which presents a moral dilemma concerning autonomy. Just musing of course.

Not so funny anymore?

Wait there is a section discussing
""the science""

Oh please, say it ain't so, my conspiracy nut eyes are bleeding...

Moreover, one of the implications of the biomedical community's embrace of the randomized controlled trial as the core criterion for any public health evidence base is that other kinds of research, better suited to empowering vulnerable communities and groups, may be systematically neglected. For example, participatory action research37,38 and social epidemiology39 are research methods more attuned to assessing community harms and benefits and empowering study subjects. In examining challenges facing public health in developing countries, the strongest evidence for people-driven development in public health is often to be found in case studies,33 replete with internally subjective assessments of success.

Yet such evidence rarely meets traditional standards for scientific objectivity.

If ethical review processes are to take seriously the participation of those who are labeled vulnerable, it has to address the passivity imposed on subjects by the objectification of participants inherent in many research designs.

PARTIALITY AND POWER

Linked to the positivist framework of most biomedical research is the view that ethical review requires careful assessment by an impartial external agency. However, commentators have observed that, in reality, the very process of ethical review is often replete with partiality17 and--in Africa, for example--the colonial legacy leaves significant potential for personal bias.23 Moreover, decisions of IRBs take place in the context of significant differences in interests among stakeholders, which include governments, funders, academic institutions, researchers, and communities, both within countries and between countries.26 These interests, depending on the particular context, are expressed through uneven power relations between stakeholders,40 between stakeholders and IRBs, between IRBs and researchers in developed and developing countries,and even within IRBs.

Concerning the large ETS cohort study by Enstrom/Kabat, Orac wrote: "There's just one problem. The study was crap, and the BMJ was forced to reveal that the authors had accepted money from tobacco companies and that the study had several fatal flaws."

In fairness, Orac should comment on Enstrom's defense of his study against these charges.

http://www.scientificintegrityinstitute.org/defense.html

By Bill Hannegan (not verified) on 21 Jul 2007 #permalink

Kevin,

Please, don't give me that "appeal to other ways of knowing" silliness and obvious attempt to apply postmodernism (with the whole "colonial" and "power" thing to science. I've commented on such misapplication of PoMo to science before:

Bill;
You provided an excellent counter argument to those who will only see the views of one authority as valid. The world is an assortment of billions of balanced perspectives to decree no one else has a valid point is not discussion but authority. E&K brought forward their evidence and were chastised not in view of the work itself, but for their insolence in apparently opposing what was allowed to be discovered. The RRs at the BMJ as is pointed out in the vast majority are personal attacks and not related to the research in the least. Can we all say PROJECTION?

http://en.wikipedia.org/wiki/Psychological_projection

Here is another perspective which could be considered if such views were allowed to be considered in challenging personal denials. Just think of it as self improvement allowing yourself to be open to new ideas. This editorial is removed from the original Blog perspective, one of the growing number of alternate journalist views in the anti smoker debate. As people are starting to awaken from the slumber which allowed the promoted hatred of smokers to rise to it's current levels, objectively which could easily be described as fanaticism.

http://www.newmediajournal.us/staff/caruba/07202007.htm

Ah, I found the article from which kevin is drawing his quotes. Here it is:

Leslie London, MD, MB ChB, MMed (Comm Health).Ethical Oversight of Public Health Research: Can Rules and IRBs Make a Difference in Developing Countries? July 2002, Vol 92, No. 7 | American Journal of Public Health 1079-1084.

Now that I've read the article, it's at best irrelevant to the question of secondhand smoking and whether it causes health problems, because it is discussing randomized clinical trials and the ethics of doing them in developing countries. I can only conclude that kevin cited those paragraphs, though, as a lame attempt to claim somehow that IRBs aren't objective enough and that that's a reason to cast doubt on SHS research. Otherwise, I can't see the relevance of the article.

Orac;
What is described as science here, is altogether loose and irresponsible language.

Science although the directional phase can be determined in unbiased case studies, which provide in a single dimension only a few clues. It is no secret the studies can be easily guided to produce any desired result you seek. The idea being it is useless to cheat at solitaire and if you really seek knowledge Epi is only a tool to shorten the task, although not really well suited to complete it.

The whole of the process involves time line and biological evaluations as well. Science [real science] has one measure reproducible consistently, ETS evaluation has demonstrated anything but. Smoking is multidimensional and many of the determinants have yet to be discovered or analyzed. The effects of ETS are even more remote. The use of directional studies with regressive numbers which are not or could they ever be consistent considering the millions of possible recipes which could now be called tobacco or the exposure levels as they exist through how many different personal lives.

Inconsistent factors can not produce consistent results even if those numbers appear to reflect a very small increase in effect overall. The odds of the promoted illusion we see are astronomically opposed to have ever occurred purely by random chance. Use of the selective research as a foundation of absolute fact is irresponsible and putting the cart before the horse as politicians will, to establish self importance. This is dangerous because once established as a norm the practice will continue in other fields of debate.

The general public is not schooled in these methods and can be manipulated easily in relying on government as reliable source of information. Smoking bans provide an excellent case study as to how easily science can be manipulated to achieve common goals.

Do you in real life fear the mere smell of tobacco smoke as is being promoted? I highly doubt it. The so called researchers who will swear tobacco smoke safe levels should be placed below the level of Dioxins actually sat in smoke filled bars for days taking measurements. Does that promote confidence that they believe what they spew? or they are more likely to be producing information for the public to suit goals they wish to achieve. Has it occurred to you what would happen if those manipulations were used to promote goals you do not support? How do you put the genie back in the bottle without destroying your own credibility by admitting you did the same thing?

When I say; foolish if you fear the smoke more than roasting marshmallows with the kids. I say that with the confidence of real science which tells me you are subjected along with the marshmallows to almost an identical toxins list only in much higher quantities, of what you fear the most.

Unless what you fear the most is the Nicotine which would of course be much more ethical. Fear of the addiction is being taught as fear of those who are addicted which is morally inept.

BTW Orac;
The principles discussed are of a formation of international health policies which are not restricted to the third world.
The references to shortcomings are referenced in many instances as not being central or unique to only those populations.

To quote from the article;

" The concept of vulnerability of study populations, and the corollary obligations of the researchers, is central to

the well-grounded fear

of the exploitation of study subjects--particularly in, but not limited to, developing countries."

Entirely relevant to the subject matter at hand in my view.

Oh, please. Smokers, particularly in the U.S. and the rest of the developed world, are hardly "vulnerable" populations, certainly not in the way this article was discussing.

Now we are getting into semantics of whether the lowest of the socioeconomic scale in developed countries are considered vulnerable?

The thought you put forward initially was whether the validity of the research methodology is relevant to the discussion of ETS harm evaluations.

You seem to be eliminating the possibility out of hand, the methods are subject to partiality despite the observations. I can demonstrate similar observations from a number of sources if you don't like my choice of information which was provided deliberately due to a need for a highly credible source to appease the critics predictable responses.

The criticism of case research was stated as;

"replete with internally subjective assessments of success.

Yet such evidence rarely meets traditional standards for scientific objectivity. "

Take a look through the random list provided at the top of the blog and tell me [if assessed objectively] if you could find one of them which does not suffer the same criticism. The goal is usually found in the tittle and success is claimed in subjective opinions in the conclusions with supportive language throughout.

Irrefutable evidence? Science?
Sorry, I just don't see it.

Political arguments?
Not hard to see at all.

If you look further into the study you will find the specifics of the criticism and again the studies above all fail the unbiased objectivity test.

Again from the report;

"Financial incentives to researchers and whole institutions may be sufficiently powerful to shape entire research agendas in the developing world, and the developed world. Thus, while an idealized view of IRBs holds that their decisionmaking is always independent of influence, the reality may often be very different.

Some critics have argued that impartiality in ethical review is simply not possible and that claims for impartiality are in fact part of the problem. What enables differences in power to persist, and to insert themselves into institutional review, is largely the lack of explicit recognition of these diverse and often powerful sectoral interests by the review process."

Orec;
To be fair your conclusions and mine differ not for the reasons you assume. In actual fact at the time I did the bulk of my research which will likely develop eventually into a book on the subject.

I had quit smoking for over two years. More recently I have returned to smoking however I don't feel in the least uncomfortable or ill at ease with smoking as I once did, which largely facilitated my quiting. I simply gave it another try and now I likely enjoy smoking much more than I once did, despite the opinions of others who should really have no say in my personal choices.

You look at research and articles and compound your beliefs in those which find agreement with your views. I use a simple method to separate the objective views from the rhetoric.

And old rule many don't think about much anymore.

Consider the source and follow the money. It really is just that simple.

Give it a try and see if things develop differently.

The format of the studies in citations to compound internal balance and promotion suffer the same problem how many of us even look at the sources of funding and what is gained in advocacy? Sure Tobacco money is tainted but why is the funding of competitors or others who for various reasons will profit from promotions simply not worthy of evaluation?

The name Robert Wood Johnson Foundation comes to the surface far too often to claim no conflicts exist. They are directly conflicted, yet no one seems to mind. it is exactly that failure to support consistent procedures which takes credibility from the entire discussion which plays right back into the hands of the Tobacco industry who after all are seen as more open and honest than those who are dedicated to the dominance of the addictive Nicotine market.

kevin -

To be honest, you had me with you there, while simply defending the right of bar owners to allow smoking in their establishments. I am not at all supportive of bans on smoking in bars. I can even get behind restaurants allowing smoking, if they so choose, as long as allowances are made for non-smoking employees and they have high-quality air filtration in the smoking section. Even though I am a strong supporter of the smoking bans my local public trans authority placed on the light rail platforms and bus shelters. And in spite of the fact that, as a smoker, it has been more than three years, since I have smoked a cigarette indoors. I am all for small businesses having some leeway in regards to these sorts of regulations.

But you lost me, about the time you started making the insane assertion that it is essentially impossible for science to support public policy decisions. That somehow it is impossible to achieve any sort of objectivity when politics are involved, thus we should just discount any assertions made, that are based on scientific evidence. Honestly, I understand why you were "awarded" a tinfoil hat, it's just sad that you seem to be proud of it. You sound very much like a near and dear friend of mine, who believes very firmly that their is a joint U.S./UN/extra-terrestrial base on the dark side of the moon. While I love him dearly, he is clearly insane. While I can't say your assertions quite reach the level of his, they (and you) clearly can be taken no more seriously than his.

Duwayne;

You misread something which gave you a completely wrong impression of what i wrote.

Take another look will you?

FYI

More conspiracies revealed.

New York Times
http://www.nytimes.com/2007/07/17/health/17tobacco.html?ei=5090&en=6958…

The Cato institute
http://www.cato.org/view_ddispatch.php?viewdate=20070717

Bill Would Give FDA Control Over Tobacco

"The Senate health committee is scheduled on Wednesday to consider a bill that would for the first time allow the Food and Drug Administration to regulate cigarettes," reports The New York Times. "The bill now has 52 sponsors in the Senate, and a top House Republican predicted it would pass there by 2 to 1. Health advocates are predicting that, after more than a decade of debate, this may be the year tobacco regulation is made law."

http://www.cato.org/pubs/regulation/regv30n2/v30n2-merccomm.pdf

In "Bootleggers, Baptists, and Tobacco Regulation," in the summer 2007 edition of Regulation Magazine, Joseph A. Rotondi, writes: "FDA chairman Andrew von Eschenbach opposes this legislation. Altria, the largest U.S. cigarette producer with 51 percent of the market, supports it. This seeming paradox grows from and is explained by tobacco roads paved with 'bootlegger-Baptist' coalitions.

"The current bill in Congress has support from Baptists such as the Campaign for Tobacco-Free Kids and the American Heart Association, former FDA chairman Kessler, and 77 percent of American voters. Even the Southern Baptist Convention's president wants the legislation. In contrast, current FDA chairman von Eschenbach seems to have learned from the mistakes of FCC, FTC, and FDA chairmen past. FDA regulation will likely be dominated by the most politically connected tobacco companies, which will be able to increase or at least maintain market share as regulation does what it usually does when bootleggers and Baptists connect: cut competition."

Jacob Grier, editor, jgrier@cato.org

The big deal?

Phillip Morris and the campaign for Tobacco free Kids along with the major health charities all make a regulation deal not a legislation deal as smokers will face enforced with guns and jails, but regulation a civil matter enforced with minor fines and rule books, to keep the fattened cigarette cash cow milking, keeping smoking a profit based reality for the foreseeable future.

Sorry about the "Iddy Biddy children" who will suffer just a little longer. Likely well into old age before this cow runs dry. Who would have thought cigarettes, an FDA approved product. Like lambs to the slaughter, the rest of Tobacco Control just got had. Big Tobacco influence wins again game set and match.

No more complaints?

THE SMOKING DEBATE IS OVER AND THE CONTROLLED FASCIST SYMPATHIZERS LOST.

I declare this blog conquered by self absorbed smokers, who now will move on and claim the rest of the planet.

The bill is in the mail.

kevin apparently mistakes burying the comments in verbiage to the point where they bore the hell out of everyone with their specious arguments for "victory."

As I said in an earlier post, if someone could figure out how to let people smoke without it harming others, then fine, go for it. Knock yourself out.

Excellent! I propose a large sign on the door of any privately-owned establishment that states smoking is permitted within. Non-smokers may freely choose not to enter. Prospective employees may be handed the pamphlet of your choice before they accept or decline to work there. Problem solved.

But as soon as your choice to smoke negatively affects someone else, in terms of health or finances, then you are impinging on another individual's basic freedoms and that is not acceptable.

Forcing an establishment to prohibit smoking also impinges on basic freedoms, and has a negative finacial impact on many businesses.

I don't see what's so special about this one "risk" that adults cannot choose to accept it, and the risks can be reduced even further with ventilation and filtration.

Every time I drive my own car, I risk injury or death. I also risk the health of others. Cars are convenient, not necessary. My health is risked every time someone uses a cleaning product or fragrance, or cooks food. My health is risked every time someone uses the toilet without washing their hands, or sneezes without covering up.

How much of this can we legislate to "protect" ourselves?

Your [sic] a big one on freedoms as long as we are talking about YOUR freedoms. Well, I have the freedom to speak up and denounce behaviors that are harming others like me.

Absolutely. I will defend your right to do so at the top of my voice. I will draw the line at legislating your rights while denying those of others.

Not one of the anti-ban people above has demanded smoking be forced on anyone through law. They, and I, believe that business owners have the right to choose their own policies. If a bar chooses to prohibit smoking, the smokers can simply go somewhere else. If a bar chooses to allow smoking, the non-smokers can simply go somehwere else.

See how nicely that would work?

You have a measure of responsibility for your own comfort. If someone is annoying me, I move away. That's how civilized society works. Non-smokers believe they can stand in one spot in the great outdoors and demand not to be annoyed. Take a few steps. You'll be a lot happier for it.

" kevin apparently mistakes burying the comments in verbiage to the point where they bore the hell out of everyone with their specious arguments for "victory."

Yea, I hear you, getting punked in your own house with nothing intelligent to offer as a defense must be embarrassing.

Admit it, your only a looser because your arguments carry no weight a spewing of hollow eggs.

Fear mongers and terrorist are more fearful than those they attempt to intimidate, always fearful of the day others figure them out and walk away.

I hope you and the rest of the health scare cult get off so easily.

New American government policies are decided in Bangkok?
Now that is poetic justice.

LMAO self absorbed Americans deserve every bit of it.

Here are the new words to the oath of elegance,
I hope you choke on them Orec;

3 July 2007
Committee recommends adoption of Article 8 guidelines
Nations at international tobacco control conference seize opportunity to protect people from second-hand smoke and save lives
Bangkok, 3 July 2007 - Nations attending a conference of the World Health Organization tobacco control treaty today unanimously recommended the adoption of guidelines that will help governments adopt stringent smoke-free laws. It is expected that the full conference will quickly approve the guidelines, which are based on the principles that second-hand smoke kills, that there is no safe level of exposure to second-hand smoke, and that all people - especially workers - deserve to be protected from second-hand smoke.

"For millions of lives to be saved governments must implement these guidelines immediately," said Shoba John, chair of the Global Smoke-free Partnership, and board member of the Framework Alliance on Tobacco Control.

"We applaud the parties to the treaty for unanimously acknowledging that second-hand smoke kills and taking positive measures to address this threat to global health."

The Framework Convention on Tobacco Control (FCTC) is the world's first treaty addressing a public health issue. When approved by the full conference in the next few days, these guidelines will provide a vital tool for governments and tobacco control advocates to formulate and implement smoking bans based on best available practice. In countries like Ireland - the first nation to adopt 100% smoke-free laws - accumulated evidence shows that smoke free laws in indoor work areas, restaurants, bars, and public transit systems quickly improve the health of workers exposed to second-hand smoke, and help smokers quit.

"Uruguay was the first country in Latin America to go 100% smoke-free," said Eduardo Bianco head of the Uruguay delegation. "We are pleased that our efforts to help develop these guidelines will result in millions of lives saved around the world."

"In Kenya, the tobacco industry has consistently interfered with legislation designed to protect our people and workers from second-hand smoke," said Dr AE Ogwell, Kenya's chief delegate and head of international health relations in Kenya's health ministry. "Now that the parties to the tobacco control treaty have formally adopted these guidelines, they will prove to be an important tool in our fight to protect Kenyans from smoking related illnesses."

Second-hand smoke contains some 4,000 chemicals, at least 69 of which are known to cause cancer. Second-hand smoke contains toxic gases and fine particles that damage the heart and lungs.

These guidelines will provide the first official guidance on how best to protect people from second-hand smoke. The guidelines provide unequivocal, evidence-based instructions that designated smoking areas or rooms, and ventilation systems designed to remove tobacco smoke - measures often adopted to make indoor smoking bans more politically acceptable - do not protect people from second-hand smoke.

Zieg Hiel ,Zieg Hiel ,Zieg Hiel

You know kevin, you could have gone for an understated victory dance. One that at the very least entertained while it "informed".

But instead you went for the "Sieg Heil"... which you kinda misspelled, by the way. I mean, it's not like I don't misspell things, but I guess I'd want to know that my insanely out of proportion Nazi victory chant was at least spelled correctly.

Oh whell.

kevin outdoes himself in complete and utter idiocy. He can't even spell Sieg Heil, which adds to the hilarity!

Most amusingly, he's now sounding not unlike a New World Order conspiracy theorist type who thinks that the U.N. runs the world (with the help of the Illuminati, of course) and enforces its will through black helicopters and David Icke-style lizard people placed in high places. As a result, any sort of international cooperation or alliances (such as the U.N., NATO, or EU) must be incipient fascism. Of course, treaties that are dedicated to doing something he opposes (like preventing exposure to SHS) are the worst of all, apparently.

Orec;
I will leave it to you to correct the spelling of the terms you are more comfortable with, the reality of the extreme unquantifiable dangers of second hand smoke, sounds even more difficult to grasp than the proposition your laughing at, in light of the rekindled evidence all of which which Hitler presented first. Of course he had a lot of other strange notions as well.

http://www.haciendapub.com/edcor5.html

When governments turn communities upon themselves to argue about who's rights should dominate, both sides loose rights in process and the government increases it's right to use the example to diminish even more of your freedom. Compared to growing up in the 60s kids today are being cheated of a lot more than you will ever know.

When you cheer the taking of others rights, you give away your own in the process. Now that fat is declared contagious how much will it cost? paying for the Pan American strategy taxing unhealthy foods and providing 300% tax credits to industries who advertise healthy foods, which is the media payoff to keep the cheer leading section happy. Just like cigarettes food including red meat will be restricted to those who can afford it.

[Google CSPI} Basic Food you now take for granted is to be taxed abusively and without end because the little detail of what is healthy has not been resolved yet and new lobbies are forming every day, taking us one step closer to the daily measured helping of communal porridge [Yum].

Read just a little, you don't want to overdo it the first time out, the education despite the risk would do you a lot of good. Get out of your Mom's basement once in a while and discover the real world, all is not as you may believe, it is certainly not accurately described in the press, who sell their opinions and infomercials to the highest bidder.

Do you run away in fear whenever someone lights a smoke?

Who is the fool?

http://www.nycclash.com/CaseAgainstBans/Appendix.html#Glantz

If spelling mistakes are the bulk of your concern the rest will be over your head anyway, and you deserve exactly the kind of government you promote. You certainly are doing no service to the community applauding the hatred and exclusions promoted by UN agencies.

If you enjoy a drink from time to time, enjoy it while you can in removing smokers from the bars you enabled the removing of alcohol too. It is coming to a newsroom near you soon watch for it. New research to describe the deadly effects of second hand evaporating alcohol, those bartenders need more protection. according to public health aka the Galton institute [a private organization 137 years old and still dedicated to genetic purity.] It is estimated borrowing from figures calculated by Dr. Michael Siegal 220 bartenders die annually from the deadly effects of environmental alcohol[He had to allot them somewhere].

The world health organization estimates by the year 2015 ten million will die from the deadly effects of the alcohol pandemic. Don't stand to close to a drunk you may be affected. Soon we will see the fruits of effective lobbying and drinkers will be forced to stand outside if they wish to continue their nasty habit. The smokers will be permitted to smoke close to them and let the bodies lay where they fall.

http://www.spiked-online.com/index.php?/site/article/3673/

Insider stack tip...

Get out the piggy bank and call your broker.

Now that Philip Morris and stakeholder partners Senator Kennedy, The campaign for tobacco free kids, The American Cancer society and the heart and lung foundation will be successful in presenting their co-authored bill, PM market share will quickly rise and will show substantial gains in the next reported sales quarter.

Don't forget me in your will. LOL

Orec;

Your comprehension skills are outrageous, your mind does strange things when confronted with the big words or concepts you don't understand.

Not much wonder your such a willing victim.

This stuff is, and you would have to agree just a little childish and by that perspective entirely predictable, you can do better.

conspiracy theorist type who thinks that the U.N. runs the world (with the help of the Illuminati, of course) and enforces its will through black helicopters and David Icke-style lizard people placed in high places. As a result, any sort of international cooperation or alliances (such as the U.N., NATO, or EU) must be incipient fascism. Of course, treaties that are dedicated to doing something he opposes (like preventing exposure to SHS) are the worst of all, apparently.

This stuff is, and you would have to agree just a little childish and by that perspective entirely predictable, you can do better.

Indeed I can do better. It's just that you're not worth the effort. I came to that conclusion right after your idiotic "Zeig Heil" routine. Actually, I came to that conclusion before that.

By the way, I read Robert Proctor's book, The Nazi War on Cancer many months ago. I'm guessing that either you haven't or you're parrotting representations of it from crank sources. Let's put it this way. Just because the Nazis were the first to make the link between cigarette smoking and lung cancer and tried to discourage smoking does not mean that efforts to ban indoor smoking is a sign of incipient Nazi-ism or fascism. The Nazis collected taxes on cigarettes; that doesn't mean collecting taxes on cigarettes is a sign of incipient fascism. The Nazis had a rather interesting charitable program called the Winter Charity (Winterhilfswerk), where they collected money to distribute to those not well off. (Its slogan was "None shall starve nor freeze" and was designed to provide food and fuel to indigent Germansy.) That doesn't mean that running a charity is a sign of incipient fascism.

In other words, just because the Nazis did something does not mean that our doing the same thing is necessarily a sign of Nazi-ism or fascism.

Kevin -

It seems remarkable to me, that you have managed to not only not convince those who disagree with you on the smoking bans, but have managed to turn those who do agree against you as well. Indeed, your behavior on this thread is nigh on pathological. Not to mention rather ironic, as you have managed to invoke the specter of fascism inappropriately on the site that is home to the Hitler Zombie, who will be coming to eat your brains. Mmmmmm, brains. . .

Childish enough for you? You may be thinking so, but I would seriously recommend breaking out the Zombie survival guide quick now. Not that it will do you any good.

DuWayne;
You mistake me for a spoiled baby who wants the world to change just so I can have a smoke with my beer. That is what groups like Forces are all about, satisfying the needs of specialized emotions. They operate in promoting a fan base, dealing with the effects of junk science hoping to turn the public back with carefully considered debates in respect to smoking issues alone, while remaining with the rest of the inspired public, almost too fearful to address the real causes of their constant disdain, in spite of the abundance of information available in plain view, which defines the origin of "the new Public Health" AKA the Galton Institute and it's ties to the UN agencies from which they operate.

I am not looking for fans or profits so the criticism is irrelevant. To be fair Forces has some entirely valid points which others in their "right headed, forward going" world in keeping with promoted confidence, are too timid to examine much less explain. Science was much more civilized before politicians were allowed to sell their wares in the classroom, back when educators knew better.

I just simply don't like ignorance being used as a tool. You may not agree with a word I say which is your right consistently, in respecting the same right I have a right to my own opinions. When all I see is personal shots in defaming my opinions I see no reason to change, promoting the basic instinct to join in the mudslinging, which can be done for amusement however it gets old as you move along.

If the idea is to sell your conclusions through mud slinging all that is really promoted is more mud slinging.

Al Gore and The rest of the fascist movement more popular among Left leaning bleeding heart Liberals are no more than hypocrites not able to stand up to the live and let live that supposedly solidified them as a credible voice. Socialism seems to be consistent, no matter who is in charge, the track record in failures is also entirely consistent in producing poverty and organized crime as it's primary commodities.

The science they spew is so fragile and meticulously crafted it can not stand up to criticism. In fact it is believed it should be vigorously defended against anything resembling opposing opinion. The thinking now is get "right headed" or be denounced with character assassinations. The "Science" can not stand on it's own it needs protection to survive.

That would make you sort of the same protectors of the status quo as those formerly known as extreme right wing Conservatives wouldn't it? The new Dinosaurs who can't accommodate new ideas or perspectives entirely resistant to change.

Definitely Not Open to new perspectives and be what you spew is self described as "progressive?
Start to look at what is currently being parroted and see if any substance exists. If you look objectively you may be surprised.

For starters grab the Gore movie and make some notes of what he is selling in the numbers and compare the numbers to the original worst case dispensed in the hockey stick theory, It takes hundreds of years for changes to happen yet Gore sees the changes in a matter of months, things have gotten so much worse. You may notice Gore although he is being promoted as a rock star is actually only another cash oriented politician, finding popularity in gross exaggeration.

In Canada we have a billboard campaign with the Keebler elf of Kyoto, declaring "you can do it" selling compact florescent light bulbs for the billion light sockets in North America. What no one realizes is the large quantity of mercury in these bulbs will produce thousands of gallons of pure mercury and tons of phosphorus chemicals in the land fills. The numbers say to dispose of one light bulb at acceptable levels it takes 14,000 cubic meters of earth The over one billion light sockets in North America alone could take mercury levels on the whole continent above known safe levels.

Why the campaign urgency now? To maximize the profits in front of LED lamps being stalled in the production process until maximum profits from the fluorescents are seen, and the new environmental demands include selling LEDS. This pitch from the clown prince of the CBC, David Suzuki the Canadian version of Al Gore, is sold to his victims as the most prominent environmental expert in Canada. Where did our credibility go if he is the best we can do?

Point being and not as Orec mistakenly concluded and assigned to me, the Nazis were about propaganda more predominantly than anything else, That unrestricted credibility which gave them the power to do unbelievable things in defense against community risk factors.

Something else Orec neglected to notice. The battle between Public Health and the Tobacco Industry dates back quite a ways. Those who supported Eugenics and rule by industry and those who supported freedom to exist were divided along the same lines. The Tobacco industries were once politically aligned with the allied forces in opposition to human rights abuses, today they are deionized by Public Health lobbies [the eugenicists] for the same reasons, now calling smokers child abusers and murderers as they once described the Jews.

People need to break away from the unearned confidence found in media presentations, Media releases of new research is targeting you, through the press for good reason you have to be more suspicious of these promotions, because if it is in the news you can be pretty confident those who purchased the promotion are much more focussed on profit margins [meaning your cash] than in your well being. You don't agree? How do the studies get funded and why are they funded more important by who are they funded?

Politics today is about the taking of personal rights by comparing the rights of one group to the rights of another. and growing power through sales strategies or spin doctors Industry has always been restricted from false advertising Politicians for the most part are above the limitations of law.

Orec;
Here is something to kick around in your interpretations of Post modernist debates appropriately more commonly assigned to poetry classes as a great excuse for pot smoking. antidisestablishmentarianism at least had a reality base.

10 years ago the industry convention circuits were abuzz with inclusion as a business model. The right brain vs left brain analysis and elimination of middle management in corporate power structures.

Industry had finally discovered the power of community the top down corporate structures were inefficient because decisions were at the approval of a small management team at the top, who relied on a small but very expensive middle management base. Communities were evolved with discussions and controversy delivering wisdom based common sense formed in the experience of thousands of years of trial and error.

The majority of the employee base was under utilized if used at all in creating solutions to even the most minute problems found in day to day operations. Even ISO certifications were limited in their ability to deal with unique problems which more often than not when dealt with in traditional process increased costs significantly above what should be warranted.

The most significant process developed to cure corporate woes was the inclusion process of "brain storming" taking advantage in very short time frames of perspectives from many sources and the narrowing down of those ideas, to a solution to deal with virtually any problem which may arise. The inclusions of the floor sweepers gave ownership of the success of a company, to all members who felt empowered and through that empowerment a responsible to help a company succeed. In short; working with me not not for me.

Realizing this was a more efficient model most of the largest corporate entities on the planet set out to downsize, not the workers but the middle mangers, who's duties would fall to the workers, and save billions in the process.

This was found to be so efficient the idea came forward almost by accident. If community replication was so powerful wouldn't it be justified to swap positions and let them adapt to a top down management system and take the advantage away; Hello Globalization and the phrase "It takes a village to raise a child". When in a more accurate perspective that village has been replaced by the UN management team and Public Health agencies are being installed every where to do the middle management jobs modeled after the Taliban with the watchers on the corner. The rest of us? irrelevant.

The rest is post propaganda ideology. That is where you come in. everything which does not compute or is not consistent with the Borg appropriations process, is obviously conspiracy theory.

wrg wrote:

That's a problem for the affected owners, but also highlights a potential problem in the "minor libertarian" expectation that the market will provide options for those who wish to visit or to work at a nonsmoking bar. With the perception, reinforced by stories such as these, that bars will do poorly if they turn away smokers, who would choose to open a bar which doesn't allow smoking?

Well, there's the thing. At the time the WA smoking ban was imposed, in December 2005, 85% of restaurants and bars were already non-smoking, and their number was on the rise. Several months before the ban was imposed, a sports bar several blocks away (I live in greater Olympia) converted to non-smoking, and a month or two after that, another place opened a mile away, also non-smoking, and soon became the hottest spot in town (still is). As a result, the bars which took a hit from the ban were those whose major (or only) selling point was that they were among the few places left where you could smoke while wrecking your liver.

Another thing is that WA has some of the most onerous laws in the US regulating owners and employees of establishments serving alcohol. I hold an alcohol server's permit, and during the training course, the instructor told us that there the demand for alcohol servers outstrips the supply, so any licensed bartender can practically choose where he want to work.

As a result, even prior to the ban, no alcohol server had to work in a smoky environment if they didn't want to. So in WA, at least, the indoor smoking ban really wasn't necessary.

Frankly, I think the pressure to implement a state-wide indoor smoking ban was diven at least in part to cover up for the embarassing failure of the Pierce County ban that preceded it. Smokers started going to King County or the Indian reservations to drink instead, and it hurt a lot of bars in Tacoma and vicinity (Tacoma's more blue-collar than Seattle or Olympia, which means more smokers). So how better to stop the flight of the smokers than by making the ban state-wide?

If you want to see a bunch of hard core smokers defending their addiction and their supposed right to smoke wherever they want, see the Smoking Forum at http://www.topix.net/forum/health/smoking
Some of the tobacco company rhetoric that the smokers have memorized is scary.

Apparently Skeptic Magazine have turned into Second Hand Smoke Denialists. Read the article here:

http://www.nycclash.com/Zion-Skeptic-Science_And_SHS.PDF

With the stuff the Tobacco Control advocates pulled, is it any wonder that the science of Epidemiology and the medical sciences in general are losing credibility? Perhaps Orac and MarkH are the denialists. Orac ever wonder why people are finding it easy to believe unproven alternative medicine?

Orac I have in the past warned about the dangers of Tobacco Control turning Epidemioloty into junk science. There are three new journal articles that you may wish to read and comment on.

http://www.epi-perspectives.com/content/pdf/1742-5573-4-13.pdf

http://www.epi-perspectives.com/content/pdf/1742-5573-4-11.pdf

http://www.epi-perspectives.com/content/pdf/1742-5573-4-12.pdf

Care to comment. Sorry if this gets post multiple times as it keeps failing.

I saw that article and was appalled at how bad it was.( I wonder if someone should tell Skeptic Magazine that the website is violating their copyright.)

However, they fail to note that in the same issue a strong rebuttal article was published.

I would be more interested in hearing your comments about the journal articles. Are you going to say that you are appalled and leave it a that?