On NYC Smoking Ban

(Letters)

June 17, 2011

Dear WV

I read with alarm your article “NYC: Anti-Smoking Totalitarianism” [WV No. 982, 10 June] as you outright deny the huge body of scientific evidence which shows a link between secondhand smoking (SHS) and increased risk of cancer and other diseases. In support of this position you quote a 20 year EPA report and a short, badly written, suspiciously non-specific Washington Post article written by Gio Batta Gori, a scientist who is fairly open about being a consultant for the tobacco industry and who makes clearly bogus claims such as study results not being consistently reproducible.

You go on to state that even for the studies which show a 19% increase in risk this is not statistically significant (!?). It’s been a few years since I studied statistics where as I recall 5% was a general rule but this would vary depending on the data. I believe in epidemiology because very large numbers of people involved even a 2 or 3% risk can mean the unnecessary deaths of thousands of people but they have big problems in detecting such small variance.

In the same issue of WV you quite rightly decry the cutting of safety precautions for construction workers. If accidents were to increase by 19% due to falling safety standards would you not regard these as “statistically significant”?

In addition you state “As for the 19 percent figure, a number this low in such a study could be explained by anything from pure chance to previous family history” which completely ignores the issue of biological plausibility—we already know smoking causes cancer and we already know there is a dose-response curve, the more you smoke the bigger the risk. So it seems likely that exposure to SHS would increase cancer risk, just at a much lower dose.

Does this mean the ICL should change its position on Bloomberg’s outdoor smoking ban? Absolutely not, the article makes some very good political points in that regard. Does it mean the ICL should change its position on the ban on indoor smoking in public buildings such as bars and restaurants? That’s more difficult to say.

As a former (pre-smoking ban) bar worker myself I spent up to 12 hours a day, 6 days a week in often extremely smokey environments so on the one hand I’m sympathetic to a ban which significantly reduces disease risk along with improving the working environment. On the other hand there is a real issue of individual liberty, the fact the bourgeois state will use any law it can to victimise workers and the oppressed, including smoking bans and the fact that millions of people who are addicted to smoking are now effectively ostracised from these environments which can hit older people particularly hard. Certainly I think smoking areas should be provided for people and good ventilation. And of course what we do in our own homes should be no business of the state.

In any case a political decision has to be based on the facts. And WV have got the facts spectacularly wrong in this case. I suggest you do more research, the 2006 Surgeon General’s report on involuntary exposure to tobacco smoke (http://www.surgeongeneral.gov/library/secondhandsmoke/index.html) would be a good place to start and there are literally hundreds of studies to examine on Pubmed.gov.

After all that I now feel like a cigarette...

Kind Regards,
Michael C.

WV replies:

Although conflicted on the issue of indoor smoking bans, Michael C. quite rightly expresses a healthy distrust of the anti-smoking zealots in government and beyond. At the same time, he admonishes us for denying “the huge body of scientific evidence” supposedly showing a link between secondhand smoke and increased risk of life-threatening diseases in our article. In fact, we reviewed such evidence, discussing the 1992 Environmental Protection Agency (EPA) report by name and “subsequent major studies that tried to find a health risk from secondhand smoke,” all of which showed “no statistically meaningful correlation.”

Unless such proof someday becomes available, we stand by our longstanding position, which we quoted in the article: “Medical evidence on the effects of ‘secondary smoke’ is inconclusive, and the obvious solution is to provide adequate ventilation for everyone.” However, we did also incorrectly write in regard to the effects of smoking that “for those who don’t, but are merely ‘exposed’ to those who do, nothing has been scientifically proved to show that they suffer from secondhand smoke.” Cigarette smoke is an irritant, as is all smoke; at issue is at what dose it may become toxic.

On this score, the EPA report, like that from the Surgeon General in 2006, mostly draws on studies of disease frequency in spouses of cigarette smokers. Where elevated risks of lung cancer were observed, the elevations were quite small. While an increased risk of 19 percent might sound like a person has a one in five chance of developing cancer, this is not the case. It refers to a risk that is initially extremely low increasing to one only marginally higher. To put it another way, buying a second lotto ticket will double your chances of winning, but the probability of hitting the big jackpot is still one in several billion.

Such a slight uptick in risk, even assuming it is the 30 percent from the 2006 report, cannot be attributed with any certainty to breathing in cigarette smoke. There are too many factors at play, from the presence of environmental pollutants to the difficulty of quantifying how much smoke actually has been inhaled. While it is true that Gio Batta Gori is in the hip pocket of Big Tobacco, his criticisms of the 2006 report that we cited in the article are unobjectionable—nor are they limited to friends of the tobacco industry in the medical community.

In addition, a lot of the studies over the years have failed to meet basic standards of “statistical significance.” This term has nothing to do with the common usage of the word “significant” but rather is a measure of whether a study’s results are due to pure chance. When evaluating the studies, it also should be kept in mind that correlation does not per se prove causality.

The wildly exaggerated and unscientific statements in the 2006 report do provide ample evidence of the ideological crusade at hand. For example, among its conclusions: “There is no risk-free level of exposure to secondhand smoke.” This makes a mockery of the most basic tenet of modern toxicology—“The dose makes the poison.” It’s as if there is no difference between exposure to radiation from a single X-ray and the fallout from a nuclear bomb. In the twisted minds of the Surgeon General and his army of moralistic fanatics, even ventilation is a curse, supposedly distributing smoke throughout a building rather than dissipating and removing it.

The materials publicizing the report also repeat another favorite canard of the prohibitionists: “Smoking is the single greatest avoidable cause of disease and death.” What pure bourgeois propaganda! The capitalist ruling class denies health care to tens of millions, kills untold numbers in its imperialist wars of depredation, starves the impoverished masses and daily puts the life and limb of industrial workers at risk as it squeezes out its profits.

Commenting on the outdoor smoking ban in NYC, the New England Journal of Medicine (23 June) noted, “Since smokers are more likely to be poor and therefore dependent on free public spaces for enjoyment and recreation, refusing to allow them to smoke in those places poses potential problems of fairness.” That’s putting it far too mildly. There is a strong class and race bias to this puritanism, as Michael C. notes. While working people can no longer enjoy a smoke on the beach, in a park or while strolling along a pedestrian mall in the Big Apple and office employees huddle outside trying to sneak a puff, those with money light up freely inside “doorman and rope” nightclubs where a bottle of liquor can go for hundreds of dollars. Oozing ruling-class arrogance, Mayor Bloomberg, the Surgeon General and their ilk push a cause that has nothing to do with health and everything to do with the wholesale regimentation of the populace and a drive to increase workplace productivity.