The one disease these groups have obviously overlooked which seems to be exacerbated by second hand smoke is hypocondra.
Dr. Siegel writes:
The shame of this all is that our credibility is going to take a big hit from all of this. In the name of trying to marginally increase the scare value of our message in the short-term, we are risking the long-term credibility of the movement.
"Your" credibility was shot long ago. "Your" movement lost all credibility a long time ago. (1988 in my experience) You just happen to finally be acknowleging that fact.
Shoddy science has taken over, and it has apparently infiltrated all the way up to the top. It's not even clear to me that anyone cares about the scientific integrity of the movement.
I hate to be the bearer of bad news, but the anti-smoker cartel has been using shoddy science (and other lies) for years. (back to 1988 in my experience)
It's not clear to me exactly how this all happens. The language of the claims seems quite similar, so perhaps it just takes one organization to make the claim and then other organizations follow, without carefully checking the validity of the claim before making it themselves.
Please, Dr. Siegel, do not consider your readers and bloggers to be so ignorant to believe such a claim. I have posted here on your blog, as well as elsewhere, about my experiences with members of the anti-smoker cartel who just spout the talking points of your side and will brook no debate about the "science." Even when they have no clue what I, or they are even talking about.
More likely it came from Command and Control-- the ACS or the AHA-- or Banzaf and Glantz-- who sent it out to the many-tentacled network as a Talking Point. We already know the "Grass Roots" are growing grass in their brains (plutonium, anyone?) and will swallow whatever they're fed and then excrete it onto a press release.
;
DR. Siegel,
I have to wonder if this claim about emphysemia can be traced back, in part to the Enstrom/ Kabat study you blogged recently. That possibility was first discussed in professor George davey Smith's letter to the editor which appeared in the same issue of the BMJ as the E/K study. Some researchers are now claiming the E/K study did find a weak link between SHS and COPD. It is then only a short step of word play to translate this to mean "emphysemia", one of the subcategories of COPD. Dave K
Dr Siegel Wrote:
Why don't we just take the slightest bit of evidence about every possible association that secondhand smoke may have and tell the public that secondhand smoke causes that disease?
Here's another one.....
http://news.yahoo.com/s/ap/
20060...ronmental_risks
Excerpt:
Study: ADHD cases linked to lead, smoking
By LINDSEY TANNER, AP Medical Writer Tue Sep 19, 5:53 AM ET
CHICAGO - About one-third of attention deficit cases among U.S. children may be linked with tobacco smoke before birth or to lead exposure afterward, according to provocative new research.
Even levels of lead the government considers acceptable appeared to increase a child's risk of having attention deficit hyperactivity disorder, the study found.
It builds on previous research linking attention problems, including ADHD, with childhood lead exposure and smoking during pregnancy, and offers one of the first estimates for how much those environmental factors might contribute.
"It's a landmark paper that quantifies the number of cases of ADHD that can be attributed to very important environmental exposures," said Dr. Leo Trasande, assistant director of the Center for Children's Health and the Environment at Mount Sinai School of Medicine in New York.
Copied over in part from my comment on another other thread:
First, smoking rates have been in decline for years. Many more women smoked while pregnant in the 1960s before this was proven to be detrimental to a fetus. If prenatal exposure to tobacco was as large a risk factor as this research claims, we would have expected to see an "epidemic" of ADHD in earlier generations, more so than in today's children.
Similarly, exposure to lead has also been in decline for years.
[...]
However, pinning one third of all cases of ADHD on two unproven risk factors would be irresponsible. Before ADHD can be considered a preventable disorder, a proven cause, not a hypothetical one, must be found. - http://www.acsh.org/factsfears/ n...news_detail.asp
Walt H. - I do believe you have finally found the one disease the Anti's wont claim is caused by SHS.
Congratulations, where do we send the trophy? 
Hypochondria - LOL, good one.
Dr. Siegel,
Allina Hospitals and Clinics says that SHS causes asthma and impotence.
Any comment?
The TC people have become like the White Queen...
After much practice, they're now able to think up as many as six impossible things before breakfast.
What a load of rubbish these antis keep spewing out,everyone knows BREATHING IS THE ROOT CAUSE OF ALL LUNG DISEASE.
Stephen asked what I think about the claims that SHS causes asthma and impotence.
I believe there is pretty strong evidence that it causes asthma. However, there is not sufficient evidence to conclude that it causes impotence. The evidence on that is, shall I say, impotent.
California is suing some of the big auto companies for making cars that contribute to global warming.
http://news.yahoo.com/s/nm/
20060...onment_autos_dc
(In case anyone's not aware of this, the "global warming" hype is another example of shoddy science being used to support an activist agenda.)
This is the link to the searchable bibliography of all studies used in the 2006 SG report.
http://apps.nccd.cdc.gov/sgri/
when Enstrom is entered as a search term, you will find a report where other authors concluded from E/K's 2003 BMJ study that SS increases risk of COPD, but no mention that the original E/K study found no link to lung cancer, or CVD.
I think this is serving as the basis for the claim SHS causes emphysemia. Dave K
"other authors concluded from E/K's 2003 BMJ study that SS increases risk of COPD, but no mention that the original E/K study found no link to lung cancer, or CVD."
You mean they condemn the E/K study but use the data that fits the agenda? Great!
I don't know why California is suing the car companies. Everybody knows it's secondhand smoke that causes global warming.
"However, there is not sufficient evidence to conclude that it causes impotence."
I can only confirm. No evidence at all, unless I look in the wrong place. 
When will rhis 'lack of credibility' kick in?
This disinformation has spread rapidly without apparently being checked. Does no one in these organizations have any integrity?
feeling badly let down by the health and scientific communities.
west
(Julie, I heard on the radio a scientist say Mobil should stop funding 'Anti climate change' research groups because they mislead the public and go against the scientific concensus.)
When will rhis 'lack of credibility' kick in?
This disinformation has spread rapidly without apparently being checked. Does no one in these organizations have any integrity?
feeling badly let down by the health and scientific communities.
west
(Julie, I heard on the radio a scientist say Mobil should stop funding 'Anti climate change' research groups because they mislead the public and go against the scientific concensus.)
Oops double post. Silly ppc, 'we apologise for the inconvienience'
west
....
Why would tobacco control let facts stand in their way?
Afterall, they accepted a lot of pharmaceutical money.....there are a lot of expectations tied to accepting that funding.
http://
cleanairquality.blogspot....secondhand.html
Why don't we just take the slightest bit of evidence about every possible association that secondhand smoke may have and tell the public that secondhand smoke causes that disease?
Oops! Didn't this approach already start with the SAMMEC program which calculates the number of 'smoking related deaths'?
Dr Siegel,you say there is pretty strong evidence that SHS causes asthma,but why is there not a generation of asthmatics ? Asthma is on the increase globally,is it really a case that SHS is covering the world ,is SHS the real cause of global warming ?Ok i am being a little facetious but surely the incidence of asthma would have been at its height during the fifties,sixties,seventies when the prevelance of smoking was astronomically high compared with now.If you stick with your view that Ii believe defies logic,do you believe it may have something to do the chemicals now added to cigarettes ? and would you surmise it will get worse as even more chemicals are added to make cigarettes fire safe etc ?Surely the chemical world we live in produces far more possibilities than the disappearing incidence of SHS ?
I believe there is pretty strong evidence that it causes asthma.
LOL -
I believe in the tooth fairy - I have strong evidence. If you leave a tooth under a pillow in my house, there's money in it's place when you wake up in the morning.
Ok - seriously - what evidence are you referring to? Studies indicating "increased risk"?
good points, si.
Just heard it on the NEWS. Smoking increases your risk of getting HIV too!
I echo Margaret's question Dr. Siegel. What strong evidence is there that proves SHS CAUSES asthma? AND if there is strong evidence that it does, how do you explain us baby boomers NOT having asthma in the numbers that kids today do?
Triggering a reaction is NOT causing asthma, nor is increased risk an absolute. Especially today with all the pollution levels as high as they are, all the chemicals in our food and water supply, etc.
To be honest here, Doc, I'm surprised that you, as a medical professional, limit your views the way you do. You are so enmeshed in your anti-tobacco research, you seem to have failed to take everything else into account. At least that's how it appears from my seat in the nose-bleed section.
Margaret, I'm telling you, any day now, they will proclaim ingrown toenails and papercuts are CAUSED by SHS and/or smoking. Wait. It's coming. hehehehehe
Sometimes I just wish someone would put a bullet through my head to put me out of everyone's misery.........this is totally beyond pathetic.
I'm with Margaret too. SHS as a cause of asthma when smoking isn't?
The Canadian Lung Association had this on their website in 2001 when I saved it: Asthma is not caused by smoking. (Their emphasis)
I wrote the American Lung Association and asked why the USA website didn't say that. That instead they wrote in a way to imply it did. I got a response from Elizabeth Lancet, MPH, who said:
"The American Lung Association is not saying that smoking causes asthma, but that asthma is exacerbated by the habit."
A study I found interesting was "Intergenerational 20 year trends in the prevalence of asthma and hay fever in adults: the Midspan family study surveys of parents and offspring."
Design: Two epidemiological surveys 20 years apart. Identical questions were asked about asthma, hay fever, and respiratory symptoms at each survey.
Results: In never smokers, age and sex standardised prevalences of asthma and hay fever were 3.0% and 5.8% respectively in 1972-6, and 8.2% and 19.9% in 1996. In ever smokers, the corresponding values were 1.6% and 5.4% in 1972-6 and 5.3% and 15.5% in 1996.
If I read that correctly it looks like smokers are less likely to get asthma.
Those are some examples that smoking doesn't cause asthma. How do we leap to SHS causes asthma (not saying it's never been said)? Even the guy who wrote that chapter for the 1992 EPA report has since recanted his statement. He said that was the politically correct way to think back then.
Dr. Seigel the Health Canada site (gov't site) has a whole section dedicated to this topic, impotence! They even mention this on a cigarette pack!
Hey they only needed to find one doctor to buy into the theory, so they can publicize it!
Care to see the picture on the pack?
The facts behind this label
Impotence and Smoking
Impotence, or erectile dysfunction, is twice as likely to occur in smokers than non-smokers. Exposure to second-hand smoke is a significant factor in becoming impotent.(4)
What is Impotence?
http://www.hc-sc.gc.ca/hl-vs/tob...it/
index_e.html
(4)Feldman, H.A., Johannes, C.B., Derby, C.A., Kleinman, K.P., Mohr, B.A., Araujo, A.B, McKinlay, J.B. Erectile Dysfunction and Coronary Risk Factors: Prospective Results from the Massachusetts Male Aging Study. Preventative Medicine 2000; 30:328-338.
They cover themselves pretty good when it comes to emphasema They only say:
"Exposure to SHS during childhood is associated with increased risk of developing emphysema as an adult."
http://www.hc-sc.gc.ca/ahc-asc/
m...05_03bk2_e.html
They only use the emphasema danger so that the bans can be encouraged. There was a full media campaign that showed a lady with oxygen tubes going to her nose. Then the tag line that: If she had known that his smoking could have caused her emphasema. She wouldn't of let her husband smoke in the house.
Yes the lies go all the way to the top!
Gee, can we women blame menopause on SHS?
Walt H,
Nobody's mentioned the piles. I know a guy who claims he gets messages on his suppositories, and the messages tell him: SHS.
Can't beat evidence like that.
Asthma may, in the not-too-distant future, be removed from the arsenal of the antis. British scientists have identified a deficiency in the lining of the lungs of people with asthma that renders them particularly susceptible to coughs and colds, and the first new treatments for 30 years are likely to result. Not only that, but possibly one day even a vaccine.
If that happens, boo-hoo for the rabids.
Dr Siegel--
I have a (far from complete) bibliography of studies showing asthma is NOT caused by ETS , and I've posted here (somewhere) at least some of that evidence.
I wonder if you'd do a full search on the subject with a newly-open mind (perhaps doing a search via google scholar and perhaps even beginning with the stuff that's been posted here when the subject last arose) and see if you're still convinced of a causal connection.
I mean now that you're aware of how science can be twisted, why not take a fresh look?
:
One more (off-topic) and I'll shut up for now.
Wendy's seems to be fighting back. Motto (or whatever you call it) on their french fries packaging (those semi-cone-shaped things) reads, "Do what tastes right." It's tm'd.
On the back it's "Do a lip burning, tongue scorching, endorphin releasing, oh my goodness, where's the icy cold drink, Spicy Chicken Sandwich. Do what tastes right."
I gotta tell ya, it warms my heart. Yes, I know: it's irresponsible commercial crap. But it still warms my heart (the enemy of my enemy is my friend).
I hold no hope, but someday, we may even take back the world. (Fat chance.)
about a week ago i was taken to task on this board for criticizing dr. siegel for NOT responding to questions and concerns i (we) may have advocating the purported dangers of SHS. while i do indeed appreciate this blog and the ability to carry on a sensible and intelligent conversation about tobacco and tobacco control, i must say i feel that the allegation that smoking and SHS CAUSES asthma has not been adequately addressed by dr. siegel. every child i know that has asthma is a non-ssmoker and comes from a non-smoking family. while several adults i know that have asthma do in fact smoke, the clear majority are non-smokers. others have raised excellent questions on the topic. i would like to see dr. siegel back up his claim rather than remain silent on the issue. where's the beef?
I know California kids have a lot higher asthma rate than Mississippi kids... Guess which are exposed to more SHS????
also 2003 adult self reported prevalence: CA = 9% OR=10% VT= 9%MA=11%, Nj=7' MS=7%, SC= 6%
source, BRFSS, 2003
Seems places with smoking bans have more asthma.
The most comprehensive review of the evidence relating secondhand smoke and asthma is contained in Chapter 6 of the California Office of Health Hazard Assessment's report: http://www.oehha.ca.gov/air/
envi...p3partb2005.pdf.
The report notes that:
"Numerous studies have evaluated the impact of ETS exposure on childhood asthma induction (Chilmonczyk et al., 1993). The 1997 Cal/EPA report included a meta-analysis of 37 studies
conducted between 1975 and 1995 that evaluated ETS exposure as a risk factor for induction of childhood asthma. The pooled RR for asthma was 1.44 (95% CI 1.27-1.64). These data
supported a causal association between ETS and new onset of childhood asthma cases (Cal EPA, 1997). Recent studies, including an updated meta-analysis by OEHHA (submitted for publication and abstract included below), continue to support a causal role of ETS in childhood asthma induction. The studies are presented below and in Tables 6.30 – 6.32. They are
separated by study type: cross-sectional, case-control, and prospective cohort."
After reviewing each of the studies in detail, the report concludes that there is indeed a causal relationship between secondhand smoke exposure and asthma induction.
If you read the report carefully, however, you'll note that it did NOT conclude that there is any relationship between secondhand smoke and impotence, as being claimed by some anti-smoking groups.
Also, it did NOT conclude that there is any relationship between secondhand smoke and emphysema, as I revealed yesterday is being claimed by at least 25 anti-smoking groups.
And of course, it did not conclude that brief secondhand smoke exposure causes heart disease or heart attacks, as many anti-smoking groups are claiming (at least 80).
A pooled RR of 1.44 is "causal"????????
Since when?
Why then, if this is to believed, has the number of childhood astham cases skyrocketed in recent years while smoking and exposure experiences have drastically declined? Why is it that every child I know that has asthma (and having an 8yo brings me into lots of contact with lots of children) comes from a smokefree environment without smoking parents?
So I was right.
SHS is not proven to be a 'cause' of asthma it's a "risk factor for induction". Duh. If one concedes that smoke from any source can exacerbate asthma it could be that mild asthma is more likely to be diagnosed in someone exposed to smoke.
Thanks for the link to the study. Very interesting. A little confusing with the use of OR, %age and probability. [Good for Margaret though ].
ref table 6.30 from link provided by Michael Siegel.
Of the about 57 reported ranged results, about 32 (more than half)reported an included Odds Ratio of 1 or less. Doesn't 1 or less mean not likely?
(Not being a statatician, see above), the best controlled study (acording to the table - Wang) Gave an OR of 1.08 with a range of 1.05-1.12. Can someone help put this into context please?
thanks
west
----
I'm no scientist West, but the only word to describe an OR of 1.08 is.....meaningless.
But, if you want a selection:
absurd, aimless, big zero, blank, double-talk, doublespeak, empty, feckless, fustian, futile, good-for-nothing, hollow, hot air, inane, inconsequential, insignificant, insubstantial, nonsensical, nothing, nugatory, nutmeg, pointless, purportless, purposeless, senseless, trifling, trivial, unimportant, unmeaning, unpurposed, useless, vacant, vague, vain, valueless, vapid, worthless
Colin what about CRAP.
Nice but can we now have the answers to the numerous questions as to why asthma just does not correlate to the historical elements.If this report was presented by the tobacco side it would have been kicked into touch so fast it would never see the light of day,BUT of course it was by the public health side and ssssssssooooooooo must be true.Anyone got a bucket ?
Si, I was just being polite....
Ah yes, the same CalEPA that also makes the link between ETS and breast cancer. And claims that smoke outdoors is a "toxic contaminant." thus birthing Calabasas.
Aside from the fact that their summaries of these new (post 99) studies are singularly uninformative as to actual methodology, startlingly lacking in any caveats and cautions which are usually SOP, that few mention what confounders were considered (or not) if any, that almost all of the risks lack statistical significance, and are at any rate low and subject to bias, I also note they listed none of the "new" (post '99) studies on my exculpatory list. (isn't that special.) I'll have to go back and re-read what they used in 1997.
But meanwhile of course there's an elephant in the room as shown by other studies: that doctors, upon learning that either parent smokes, are much more likely to say the kid has asthma. Another kind of bias. And one that either overmedicates (and psychologically harms) smokers' kids, or overlooks and undertreats the children of nonsmokers.
Colin when faced with this sort of science i was being polite too by the using the word crap LOL.
Colin/si thanks. Putting it all together with other comments this means that the evidence is ambiguous then.
In 2004 we had Global asthma rates soar with this quote 'Experts at the conference said they are baffled by what causes asthma'
Checking world asthma rates, it would seem that Russia and China have low rates, the UK, USA, Canada and Australia have high rates. The problem though is smoking.
'Indoor pollution from cooking and heating using open fires in poorly ventilated homes is a major risk factor for asthma in Southern Asia and China, but perhaps the greatest problem in Russia, Eastern Europe, China and Southern Asia is smoking. Russia is the fourth-largest cigarette market in the world, while one third of all cigarettes are smoked in China and 75% of men in Vietnam are currently smokers.'World Asthma Day 2005
Now onto 2006...
New study in the Journal of Allergy and Clinical Immunology Challenge with environmental tobacco smoke exacerbates allergic airway disease in human beings". (You may have to alter your cookie acceptance to follow the link) I could only get the abstract though it is interesting. This 2006 study by Dr David Diaz-Sanchez (UCLA School of Medicine) et al states 'Despite widespread perceptions that environmental tobacco smoke (ETS)is a potent risk factor for allergic airway disease, epidemiologic studies studying this have been equivocal. There is a clear need for experimental studies to address these questions.'
Strange to make this statment if it was already known to be 'causal'. They conclude 'These studies provide the first experimental evidence that secondhand smoke can exacerbate allergic responses in human beings.'
The study does seem to show ETS is a factor in exacerbating, though not causing, allergic response. Without access to the full study it is difficult to make any comment on what they actually did. (Level of ETS used and was it comparable with any normal levels of exposure). Food for thought.
Yet I think the debate about this is probably irrelevant since all this has already been decided. As well as alcohol and food.
Now the really scary part....
(See next post)
The scary part...or does the science matter any more?
On my travels around the inet I stopped by WHO Europe Delegates adopt a strategy on non communicable diseases. I wanted to find out what this strategy was and in the process found the answer to the 2007 question asked a while ago. I came across a 2nd draft at European strategy prevention control non communicable diseases. In this document there is an action plan (pages 18 and 19), some highlights...
Advertising, promotion & sponsorship
-Prohibit all forms of direct and indirect advertising of tobacco products and smoking, including promotion, “brand-stretching” and sponsorship
- Avoid glorifying the effects of alcohol and using young people in alcohol advertisements and prohibit the drinks industry from sponsoring sports and young people’s leisure timeactivities
- Restrict promotion of foods that are energy-dense and/or high in added salt, fat and sugar, particularly to children through sponsorship of educational and sports activities
Protection of people against Environmental tobacco smoke
- Make all public places smoke-free, including public transport and workplaces, bars and restaurants, and ban smoking in all educational institutions and health care delivery premises
Use of Taxation
- Use price and taxation as an effective measure to reduce demand
- Prohibit all tax-free and duty-free sales of tobacco products
- Develop a taxation policy that ensures a high real price of alcohol and tobacco products above the average rates of inflation, with higher taxes on alcoholic beverages with a higher alcohol content and the provision of non-alcoholic beverages at low prices
- Develop a taxation policy which promotes sustainable and cleaner transport, with incentives for shifts to walking, cycling and use of public transporto Explore food taxes as a means of influencing food consumption and behaviour
Funding health programmes
- Use alcohol and tobacco taxes to fund control activities including health education, research and support to health services at both local and national levels
The UK govt is certainly going a long way to meet this WHO plan. There is probably a similar plan for the US.
Progress to be reported back in 2007 (The 2007 connection). The final draft is basically the same with some different language Final
So the debate is over, buy a bike and pay your taxes. Apologies to those who already knew all this.
be well
west
----
west, scary, this WHO document.
Health as a right extends not only to timely and appropriate health care but also to the underlying determinants of health.
A health-promoting Europe free of preventable noncommunicable disease, premature death and avoidable
disability.
The ultimate goal must be eternal life ... at any price.
My mother-in-law left us a few days ago at the age of 91. In the past 2 years, she has told us over and over again that she wanted to leave this world, because she was tired of living, although she was still able to take short walks and play cards with friends.
benpal, I have heard others, close to the end of life, express similar sentiments. I hope she passed on peacefully.
Life is for living, being controlled in the way the WHO want seems, apparently paradoxicaly, very unhealthy. (IMHO)
west
....
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