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“The reason why the threat from passive smoking is exaggerated has more to do with politics than public health.” – Simon Clark
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Simon Clark, director, FOREST.
The word “FOREST” may conjure images of pine trees or oaks. However, in this case it is an acronym, standing for “Freedom Organization for the Rights to Enjoy Smoking Tobacco” (forestonline.org). Based in the UK and being active internationally, FOREST was founded in 1979 and is funded by tobacco companies to lobby on behalf of smokers. It is important to note at this point that FOREST explicitly is not pro-smoking, but rather pro-choice, defending the right of individuals to smoke tobacco if they so choose. That is an important difference.
FOREST’s current director is Englishman Simon Clark. Looking back at a distinguished career as a magazine editor, political researcher, and PR executive, Clark joined the organization in 1999. He also is a life-long non-smoker! But, Clark always has been interested in “nanny-state issues,” seeing the smoking debate as part of the larger libertarian debate. “Tobacco is a perfectly legal product and some of the regulations introduced to restrict people’s right to smoke are going too far,” Clark told Tobacco Asia during a recent interview. Among the issues that occupy him are the scientifically often very flimsy claims that passive smoking (a.k.a. second-hand smoking) bore an enormous health risk to exposed individuals.
Tobacco Asia (TA): Governments and anti-tobacco lobbies frequently extol non-smokers’ risk in contracting tobacco-related diseases through passive smoking. What do you make of such claims?
Simon Clark (SC): A smoky, poorly ventilated environment can be unpleasant for everyone, smokers and non-smokers alike. But, it is hugely debatable whether smoking should be banned in all enclosed public places, as tests have shown that modern technology can remove over 90% of airborne [tobacco] fumes and particles, for example in a bar or pub. Either way, the suggestion that a significant number of non-smokers are at serious risk of harm from even long-term exposure to second-hand smoke is not supported by most of the evidence.
The reason why the threat from passive smoking is exaggerated has more to do with politics than public health. It arguably goes back to 1975 when [England’s former chief medical officer] Sir George Godber said it would be essential “to foster an atmosphere where it was perceived that active smokers would injure those around them, especially their family and any infants or young children.” Since then, every effort was made to encourage that perception. And while I don’t dispute the good intentions of some anti-smoking campaigners, there is no doubt in my mind that many are on a moral crusade to rid the world of smoking. For them, that end result justifies the means.
TA: But anti-smoking campaigners regularly cite “scientific studies” that allegedly prove passive smoking risks to be a reality…
SC: It is true that a handful of studies have suggested a link between environmental tobacco smoke (ETS) and lung cancer and heart disease. However, the results of most of these studies are not statistically significant and they do not stand up to close scrutiny. Most are flawed because it is extremely difficult to measure or even estimate the effects of passive smoking on non-smokers.
A truly scientific ETS study would randomly assign groups of non-smokers to being exposed or not exposed to ETS for a length of time adequate for the development of possible [smoking-related] diseases. Such a study would be unethical, of course, because it could conceivably result in harm to study participants. It would also be impractical because it would take decades to complete. Studies about [the impact of] second-hand smoking are therefore limited to retrospective surveys in populations of self-declared non-smokers who have been exposed to other people’s tobacco smoke in the course of their lives. What this means is that they are not experimental but purely observational, attempting to look back in time and observe what may have happened, not what actually did happen.
TA: So you are saying that most passive smoking risk studies are “phony”?
SC: I wouldn’t call the research into passive smoking phony, but it is clear that [many of them] are not in the realm of scientific fact but of subjective and fallible memory. As a result, most passive smoking studies should be treated with caution bordering on skepticism.
TA: Nevertheless, some studies concluded that the elimination of tobacco smoke from the environment – households, the workplace, even public spaces – have positive effects on people’s health. For example, the so-called “Helena study” claimed that a public smoking ban in the city of Helena, Montana, USA, led to a dramatic reduction in heart attacks. That surely proves something?
SC: Claims that smoking bans have dramatically reduced the number of heart attacks, sometimes within months of a ban being introduced, have appeared several times, but with little or no credible evidence to support them. The widely publicized “Helena study” claimed that just six months after indoor public smoking became illegal in Helena, the rate of heart attacks decreased by a scarcely credible 40%. In reality it generally takes years for heart conditions to develop in the first place, even in heavy smokers. The chances of the Helena smoking ban having had such an immediate and enormous impact seems highly implausible.
TA: Is that why the Helena study, which was never peer-reviewed, is today widely discredited 1, occasionally even ridiculed as the “Helena Miracle”?
SC: Yes. In 2009, writing for the online magazine Spiked, Christopher Snowdon commented, “One must bear in mind that around 10% to 15% of coronary heart disease cases are attributed to active smoking. That passive smoking could be responsible for a further 40% strains all credibility2.” Nevertheless, and despite its tiny sample size and flimsy conclusions, the “Helena Miracle” is still quoted today as “proof” of the positive impact of smoking bans.
TA: Are there any studies around which concluded that the risk of contracting diseases through passive smoking is in fact rather negligible?
SC: Yes, there are. A large study published in May 2003 by the British Medical Journal concluded that the link between ETS and coronary heart disease and lung cancer may be considerably weaker than was generally believed. The analysis, by James Enstrom of the University of California, Los Angeles and Geoffrey Kabat of New Rochelle, New York, found that exposure to ETS was not significantly associated with death from coronary heart disease or lung cancer at any time or at any level of exposure, although a small effect could not be ruled out3.
Then, in 2006, a UK parliamentary committee published a report on the management of risk. One of the subjects they looked at was passive smoking. The committee concluded that, “passive smoking is an example in which [government] policy demonstrates a disproportionate response to a relatively minor health problem, with insufficient regard to statistical evidence.”
And in 2013 it was reported that another large US study involving more than 76,000 [non-smoking] women had failed to find a conclusive link between lung cancer and second-hand smoke. According to [Britain’s] Daily Mail, “Researchers from Stanford University say their findings add to a body of evidence which shows that while smoking cigarettes is strongly linked to cancer, passive smoking is not.”4.
TA: So why do mainstream media routinely suppress such studies while giving the alleged passive smoking danger plenty of coverage despite evidence to the contrary?
SC: Like many politicians today, few journalists want to be accused of defending potentially unhealthy lifestyle choices. There is a view that the argument about passive smoking has been lost so why fight old battles? Another reason is that few journalists have the time or desire to check the claims about [the negligible impact of] passive smoking. It’s far easier to accept the word of public health “experts” and researchers whose comments nevertheless betray an underlying anti-smoking sentiment. Of course, some journalists and politicians know that claims about the threat of passive smoking are weak. They admit as much privately, but ignoring the truth seems to be acceptable if it helps to eradicate smoking.
TA: Daily life is full of health risks at every turn. So why this almost obsessive vilification of passive smoking?
SC: Most people are well aware that we have to take some risks in life. Even commuting to work presents all sorts of risks for life and limb. The real issue is where to draw the line on what constitutes acceptable risk and whether the pleasure of smoking, for example, should be allowed to outweigh the risks [associated with it]. There is a debate in science and public policy circles between those who champion a “zero-risk” approach and those who think it’s impractical and undesirable, especially in relation to individual liberty and the need for adults to take greater responsibility for their own health.
TA: In your opinion, what is the “endgame” that public health and anti-tobacco campaigners pursue with their apparently flawed ETS claims? After all, they are quite instrumental in breeding a growing number of increasingly belligerent non-smokers. “Extinguish your cigarette at once or I am going to sue you for damaging my health,” is a threat heard more and more frequently.
SC: The endgame is clear: governments and anti-smoking campaigners want to create a smoke-free world in which the use of combustible tobacco is confined to a tiny “pariah” rump of the population. This will be followed by a world in which all forms of recreational nicotine are prohibited to “save” us from possible addiction, regardless of whether we want to be saved or not.
To achieve that goal an environment of fear has been created in which the argument that adults have a right to smoke as long as they don’t harm anyone else is outweighed by the claim that there is no safe level of ETS. The suggestion that smokers are harming non-smokers is a carefully orchestrated means to an end, designed to turn even the more tolerant non-smokers against those who smoke.
The threat to vaping and reduced-risk products is equally clear. According to Jacob Grier, whose articles have appeared in Reason, The Daily Beast, The Washington Post, The Los Angeles Times and numerous other publications, the anti-smoking movement has a long history of exploiting dubious science for political gain. Today’s moral panic about vaping, especially in the United States, has its roots in the decades-long campaign to delegitimize the use of nicotine in pursuit of a complete ban on smoking in public5.
Grier rightly focuses on the arguments surrounding passive smoking. However, what he and others overlook is that many of today’s most prominent pro-vaping advocates are also the very same people who sold us the myth that thousands of non-smokers die each year from second-hand smoke. The irony of that deception is that the relentless scaremongering about second-hand smoke will almost certainly lead to vaping bans in public places, too, because as far as the public and many politicians are concerned there is little difference between tobacco smoke and e-cigarette vapor.
TA: This has been an eye-opening talk. Any final comments?
SC: Having been bombarded with anti-smoking propaganda for decades, many people wrongly believe that passive smoking must be harmful simply because it involves tobacco smoke. It matters little [to them] that second-hand smoke is massively diluted in the air as soon as it is exhaled. Yet public health campaigners are now calling for smoking bans in an increasing number of outdoor public places where the health risk from passive smoking is minimal if not zero. Justifying outdoor smoking bans by citing alleged health risks is not only factually incorrect, it’s also morally wrong.
In-Text References
1Heartstopping Discovery (Jacob Sullum, Reason, April 2003) https://reason.com/2003/04/04/heartstopping-discovery-2/
2The myth of the smoking ban health miracle (Christopher Snowdon, Spiked , September 2009)
https://www.spiked-online.com/2009/09/24/the-myth-of-the-smok-ing-ban-health-miracle/
3Passive smoking may not damage your health after all, says research
(Celia Hall, Daily Telegraph, May 2003)
https://www.telegraph.co.uk/news/worldnews/northamerica/
usa/1430287/Passive-smoking-may-not-damage-your-health-after-all-says-research.html
4There is NO clear link between passive smoking and lunch cancer, scientists claim (Daily Mail, December 2013)
https://www.dailymail.co.uk/health/article-2526495/No-clear-link-passive-smoking-lung-cancer-scientists-claim.html
5We used terrible science to justify smoking bans (Jacob Grier, Slate, February 2017)
https://slate.com/technology/2017/02/secondhand-smoke-isnt-as-bad-as-we-thought.html
Further reading
Warning: the health police can seriously addle your brain (Robert Matthews, Daily Telegraph, May 2003)
https://www.telegraph.co.uk/news/uknews/1430438/Warning-the-health-police-can-seriously-addle-your-brain.html
Passive smoking? It’s all lies, damn lies and statistics (Robert Matthews, Daily Telegraph, November 2004)
https://www.telegraph.co.uk/news/uknews/1477124/Passive-smok-ing-Its-all-lies-damn-lies-and-statistics.html
All done with passive smoke and mirrors (Christopher Booker, Sunday Telegraph, July 2007)
https://www.telegraph.co.uk/news/1556118/Christopher-Bookers-notebook.html