Dangers of secondhand smoke

[Leisureguy]

Jobs are not so easy to find as all that. Public places (such as bars, restaurants, and the like) are work places, after all: they have employees, and they have as much right to a smoke-free work environment as office workers, don't they? (It's easy to say that they can just find a job at a non-smoking bar, but in practice that doesn't work.) Cities that have passed laws banning smoking in public places don't seem to find that it really causes much of a problem. You can read in many places about New York's move to non-smoking public places (and the benefits for staff).

Perhaps it is too obvious to say, but flatulence in elevators is not a health hazard. But you knew that, didn't you?

The draconian "forbid it altogether or allow it everywhere" --- do you really want to go with that as a general rule? It would certainly change the face of society.

On another note, I like the in-line spell checker function that seems to have appeared. --- Ah, that's not due to the forum, but due to Firefox 2.0, which I just installed. Very cool.

[ScottS]

Jobs are not so easy to find as all that. Public places (such as bars, restaurants, and the like) are work places, after all: they have employees, and they have as much right to a smoke-free work environment as office workers, don't they? (It's easy to say that they can just find a job at a non-smoking bar, but in practice that doesn't work.) Cities that have passed laws banning smoking in public places don't seem to find that it really causes much of a problem. You can read in many places about New York's move to non-smoking public places (and the benefits for staff).

Again, I can agree with the workplace laws, and as I suggested before, allowing smoking would entail hiring workers who are smokers.

Perhaps it is too obvious to say, but flatulence in elevators is not a health hazard. But you knew that, didn't you?

As a scientist, my read through of the articles pointed to suggests that most of the health problems found related to second hand smoke in public places are studying the workers in such places, who are clearly heavily exposed. I simply won't believe, sans proof, that the casual exposure of, say, a restaurant patron, to the occasional whiff of secondhand smoke is a real public health risk, and is thus not that far removed from elevator flatulence.

The draconian "forbid it altogether or allow it everywhere" --- do you really want to go with that as a general rule? It would certainly change the face of society.

Yes, it would be a change. I'm not suggesting it to make it happen, or even to say this is the way it should be. I'm suggesting it as a tool to point out some hypocrisy I believe is inherent in the "ban it in public places" approach. It's either bad, or its not. You mentioned, for example, that a person should have the right to smoke at home. Well, if one assumes that secondhand smoke is bad, isn't it bad for the kids in that household (who are probably exposed far worse than the restaurant patron I posited above, to the level where it probably is a health hazard-- demonstrably so, I think, in terms of asthma development)? If the government has the power to protect me in a restaurant from a hazard I am perfectly free to walk away from, why can't it protect a child who isn't free to walk away from the home? Why can't it force smokers to opt out of government health programs?

I'm just trying to pint out that this is pretty far from black and white, neither from the public health viewpoint, or the civil libertarian viewpoint.

[e5f]

Who here has suggested Prohibition of tobacco? .

American Cancer Society,
ACU,
Cancer Research and Provention Foundation,
WHO,
etc., etc., etc.

Make no mistake, they and other organizations would just as soon see tobacco banned as opposed to keep putting negative light on it.

I never said anyone here espoused those views. You misinterpreted my statements.

Thanks,
Merlyn

[e5f]

Certainly it makes sense to ban smoking in public places and in work places---why should a non-smoker willy nilly have to breathe smoke. But smoking in the privacy of your home? That should be your choice.

Why shouldn't I be worried about people smoking in their homes? Smokers clearly are clearly increasing the burden on my health care dollar. Why should I allow the smoker the choice of spending my money? .

Where, oh where, is your proof????? How can you possibly, completely, totally isolate tobacco smoke from all the other variables in a person's life, within the context of a fairly large sample of people over a long, protracted period of time, to state with absolute 100% certainty that the reason these people developed cancer was because they smoked?????

As a scientist, you should know that you CAN'T isolate this one variable to prove positively this thesis. As a matter of fact, those individuals who did develop cancer and were not exposed to first or second-hand smoke should blow this correlation completely out of the water, objectively speaking.

As for your last question, the simple answer is: because IT IS A LEGAL SUBSTANCE.

Thanks,
Merlyn

[e5f]

The draconian "forbid it altogether or allow it everywhere" --- do you really want to go with that as a general rule? It would certainly change the face of society.
.

Well it looks like that it how all of this is going to end up. Honestly, the pendulum has certainly swung 180 degrees. From having all smoke put upon everyone to having smokers demonized and now ostracized within society. All over a legal substance. And no one should overlook the effect that the government is having on this. They gleefully promote a "no smoking" policy in many, many parts of society from putting ads out throughout the country to providing money to the above mentioned organizations thru research grants for all of these studies. Using the legal system to demand payment from the same companies for so-called "costs on society". Billion and billions of dollars. And what do the governments do????? Why, they use those funds to pay for all types of programs that have no association with smoking or health or tobacco use at all. This is hypocritical.

No, the reality of the situation is that the governments are in no position to kill the "goose laying the golden eggs." Having grown accustomed to getting all of this money from the tobacco companies has allowed sloth to creep into the various governments. They are able to keep their pet project, pork barrel items paid for WITHOUT having to go to the taxpayer to fund them. Scott has indeed got it wrong. The governments, having successfully sued the tobacco industry for BILLIONS, is more than paying for any of their so-called "damage to society". They are paying for your roads, bridges, gov't workers, hospital upgrades and so on and so forth.

Thanks,
Merlyn

[MOSES]

Where, oh where, is your proof????? How can you possibly, completely, totally isolate tobacco smoke from all the other variables in a person's life, within the context of a fairly large sample of people over a long, protracted period of time, to state with absolute 100% certainty that the reason these people developed cancer was because they smoked?????

Ok. I'm in. I don't have proof on. At the moment I'm not gonna hit that one. I will say that I was not surprised about the debate over secondhand smoke. It seems there is a lot of legitimate debate over whether it causes negative impacts, especially when we move from people who are exposed constantly (bar employees, etc) to everyone else who just encounters it here and there. I am really dumpfounded that we are debating whether it causes cancer in smokers. I thought even the tobacco companies had long since given that one up. Like I said, I can't really address it directly though, since I don't have studies to back me up.

I will address some of your statements about science and methodology, though.

As a scientist, you should know that you CAN'T isolate this one variable to prove positively this thesis. As a matter of fact, those individuals who did develop cancer and were not exposed to first or second-hand smoke should blow this correlation completely out of the water, objectively speaking.

Look, I don't know if you have a lot or a little science training. But if a lot, you should probably know to be a little more precise in your statements. Yes, of course you are right, it is impossible to prove with 100% certainty that smoking causes cancer. When you start having to do statistical analysis, as you have to do with almost any study worth doing, it is virtually impossible to prove anything with 100% certainty. Most of the drugs commercial available to treat any illness cannot be proven effective with 100% certainty. You cannot prove ANYTHING hardly with that level of certainty.

You CAN demonstrate a level of probability, however. Also, causation is much harder than correlation, and not the same thing. I would hope we could agree that there is a high level of correlation between increased lung cancer and smoking. This, of course proves nothing. But the mostly likely reason for the correlation IS that smoking caused the cancer. Getting at causation is much more difficult. Eliminating other variables is the key to building a stronger link, though. As you suggest, this is hard. It is incorrect to suggest that a large sample of people is a problem, though. In fact, it is the key. The larger the sampler, the more successful isolation of variables is. Ultimately, you are right that 100% isolation of smoking is impossible, especially given the long term nature of the problem. It is a total fallacy, though, to suggest that this means that a causal link cannot be established with a very strong probability.

Oh, and to address a direct point, no, the fact that people who never smoked also develop lung cancer does NOT blow the correlation between lung cancer and smoking "right out of the water" as you put it. Surely, if you are going to be invoking science, you can't be serious. IF we assume that secondhand smoke was not involved either, in at least some of these people, all you have established is that smoking is not the only cause of lung cancer. Yes, we can all agree on that. The point is that the rate of cancer is several times higher in smokers. Now, the exact relationship is probably not known. But this fact at least suggests that smoking makes getting cancer a heck of a lot more likely.

The direct "cause" of cancer on a cellular level is a complicated issue. Last I checked, it was not really understood. Smoking may or may not directly cause a cell to mutate, and become cancerous. But that is not really the point. In a general sense, to say that smoking causes cancer, we only need to establish that smoking sets in motion something on the cellular level, probably by damaging the tissues in some way, which makes cancer more likely to occur. In other words, causing the cancer in at least an indirect sense.

And you are right, as I said, that establishing this with 100% certainty is almost certainly not possible, until we can map the exact mechanism. In the meantime, though, by statistical analysis, it is definitely possible to establish causation with some degree of certainty.

Whether this has been done, is another matter, that requires reference to, and analysis of, actual studies. Frankly, a good debate would require actually going over studies and analyzing the methodology, something we are likely neither adequately trained for, since there is some much skepticism here as to the results of studies, because of potential bias.

As for your last question, the simple answer is: because IT IS A LEGAL SUBSTANCE.

This is simpler. I believe his question was whether it SHOULD be allowed. Saying that it is a legal substance is no answer, as the real question is whether it should be legal.

-Mo

[ScottS]

Where, oh where, is your proof????? How can you possibly, completely, totally isolate tobacco smoke from all the other variables in a person's life, within the context of a fairly large sample of people over a long, protracted period of time, to state with absolute 100% certainty that the reason these people developed cancer was because they smoked?????

If you've been reading this thread, I'm the one who says that I'm not satisfied with the proof behind the ills of casual exposure to secondhand smoke and health risks, and many of the studies are summarized at the NIH CANCER SITE. That said, it would be putting a bag over your head to believe that there are no health risks involved with cigarette smoking. Cancer is one such risk. Many cases of emphysema are directly caused by smoking. I've known a few people with emphysema-- it can be a slow uncomfortable death. Some of the emphysema patients I've known even continued to smoke, but not one of them ever doubted the link between their smoking and their condition. This stuff is established about as close to a cause and effect as science can come-- the smoke paralyzes the cilia in your lungs, so they can't clean themselves, and then the lungs are gunked up by tar and other irritants. Very clear recipe for all sorts of problems. There are also very clear cardiovascular risks

As a scientist, you should know that you CAN'T isolate this one variable to prove positively this thesis. As a matter of fact, those individuals who did develop cancer and were not exposed to first or second-hand smoke should blow this correlation completely out of the water, objectively speaking.

You can't isolate such things perfectly, but you can draw perfectly valid conclusions based upon the statistics. The field is called epidemiology. The current numbers for tobacco are far from subtle-- smoking causes about 87% of lung cancer deaths, and most cancers of the mouth, esophagus, and bladder.

As for your last question, the simple answer is: because IT IS A LEGAL SUBSTANCE.

So was liquor before prohibition.

[e5f]

Where, oh where, is your proof????? How can you possibly, completely, totally isolate tobacco smoke from all the other variables in a person's life, within the context of a fairly large sample of people over a long, protracted period of time, to state with absolute 100% certainty that the reason these people developed cancer was because they smoked?????

Ok. I'm in. I don't have proof on. At the moment I'm not gonna hit that one. I will say that I was not surprised about the debate over secondhand smoke. It seems there is a lot of legitimate debate over whether it causes negative impacts, especially when we move from people who are exposed constantly (bar employees, etc) to everyone else who just encounters it here and there. I am really dumpfounded that we are debating whether it causes cancer in smokers. I thought even the tobacco companies had long since given that one up. Like I said, I can't really address it directly though, since I don't have studies to back me up.

I will address some of your statements about science and methodology, though.

As a scientist, you should know that you CAN'T isolate this one variable to prove positively this thesis. As a matter of fact, those individuals who did develop cancer and were not exposed to first or second-hand smoke should blow this correlation completely out of the water, objectively speaking.

Look, I don't know if you have a lot or a little science training. But if a lot, you should probably know to be a little more precise in your statements. Yes, of course you are right, it is impossible to prove with 100% certainty that smoking causes cancer. When you start having to do statistical analysis, as you have to do with almost any study worth doing, it is virtually impossible to prove anything with 100% certainty. Most of the drugs commercial available to treat any illness cannot be proven effective with 100% certainty. You cannot prove ANYTHING hardly with that level of certainty.

You CAN demonstrate a level of probability, however. Also, causation is much harder than correlation, and not the same thing. I would hope we could agree that there is a high level of correlation between increased lung cancer and smoking. This, of course proves nothing. But the mostly likely reason for the correlation IS that smoking caused the cancer. Getting at causation is much more difficult. Eliminating other variables is the key to building a stronger link, though. As you suggest, this is hard. It is incorrect to suggest that a large sample of people is a problem, though. In fact, it is the key. The larger the sampler, the more successful isolation of variables is. Ultimately, you are right that 100% isolation of smoking is impossible, especially given the long term nature of the problem. It is a total fallacy, though, to suggest that this means that a causal link cannot be established with a very strong probability.

Oh, and to address a direct point, no, the fact that people who never smoked also develop lung cancer does NOT blow the correlation between lung cancer and smoking "right out of the water" as you put it. Surely, if you are going to be invoking science, you can't be serious. IF we assume that secondhand smoke was not involved either, in at least some of these people, all you have established is that smoking is not the only cause of lung cancer. Yes, we can all agree on that. The point is that the rate of cancer is several times higher in smokers. Now, the exact relationship is probably not known. But this fact at least suggests that smoking makes getting cancer a heck of a lot more likely.

The direct "cause" of cancer on a cellular level is a complicated issue. Last I checked, it was not really understood. Smoking may or may not directly cause a cell to mutate, and become cancerous. But that is not really the point. In a general sense, to say that smoking causes cancer, we only need to establish that smoking sets in motion something on the cellular level, probably by damaging the tissues in some way, which makes cancer more likely to occur. In other words, causing the cancer in at least an indirect sense.

And you are right, as I said, that establishing this with 100% certainty is almost certainly not possible, until we can map the exact mechanism. In the meantime, though, by statistical analysis, it is definitely possible to establish causation with some degree of certainty.

Whether this has been done, is another matter, that requires reference to, and analysis of, actual studies. Frankly, a good debate would require actually going over studies and analyzing the methodology, something we are likely neither adequately trained for, since there is some much skepticism here as to the results of studies, because of potential bias.

As for your last question, the simple answer is: because IT IS A LEGAL SUBSTANCE.

This is simpler. I believe his question was whether it SHOULD be allowed. Saying that it is a legal substance is no answer, as the real question is whether it should be legal.

-Mo

Mo;Yes you are right. My typing isn't really my forte. Actually I don't like it at all so I try and use brevity whenever possible. Also I agree about the causality of the issue being extremely important. THAT should be what we are talking about. I just don't believe in the current popular mantra that "smoking CAUSES cancer". I don't believe that. As you mentioned, that is not proven so those statements should have the same amount of weight as "smoking is good for you".

If one has done any significant amount of research on the research that has been done already, one could quite clearly see that the cancer levels of cigarette smokers is higher than that of non smokers, BUT also cigar and pipe smokers as well. As a matter of fact, numerous studies have indeed found that the level of cancer detected among pipe smokers is statistically the same as the level of cancer among non-smokers. What does this tell us? Well, perhaps the fact that most cigarette smokers inhale the smoke as opposed to cigar or pipe smokers might suggest an answer. Even most insurance companies view cigar or pipe smoking different from cigarette smoking. Many provide premiums identical to those charged as non smokers. What does this tell us? I suppose it could be argued that the actuarials that work in the industry view pipe or cigar smoking similar in terms of risk to the company as a non smoker.

Why do I bring this up? Because I find that many tend to overlook the differences that have already been established between what type of smoking method affects the kinds of cancer that sometimes develop and lump ALL tobacco as bad, evil, satanic, (insert favourite descriptive term here)

My point simply is that the current political climate for trying to make ALL manner of smoking as difficult as possible to do could quite easily turn into another "witch hunt" of sorts by over-emphasizing perceived risks while ignoring any and all information pursuant to the contrary.

Thanks,
Merlyn

[e5f]

Where, oh where, is your proof????? How can you possibly, completely, totally isolate tobacco smoke from all the other variables in a person's life, within the context of a fairly large sample of people over a long, protracted period of time, to state with absolute 100% certainty that the reason these people developed cancer was because they smoked?????

If you've been reading this thread, I'm the one who says that I'm not satisfied with the proof behind the ills of casual exposure to secondhand smoke and health risks,

If what you are saying here happens to be true, how can you then turn around and state that smoking CAUSES about 87% of lung cancer deaths? Do you know if the victims were exposed to casual levels of smoke or were left mired in smoke-filled rooms? And what kind of smoke was this attributed to; first or second hand smoke? This might be interesting to find out. It's just these kind of questions one should pose as opposed to simply saying that "smoking causes cancer" and leaving it at that.

As for your last question, the simple answer is: because IT IS A LEGAL SUBSTANCE.

So was liquor before prohibition.

That does NOT mean it was the right thing to do!

Thanks,
Merlyn

[MOSES]

I just don't believe in the current popular mantra that "smoking CAUSES cancer". I don't believe that. As you mentioned, that is not proven so those statements should have the same amount of weight as "smoking is good for you".

Well, I do believe that, actually. I'll take that last comment as tongue in cheek, because I'm pretty sure you didn't misread my statements that badly, and generally are suggesting that.

The whole point of my post, of course, if that the fact that we cannot show causation 100% does NOT mean that "smoking causes cancer" is no more reliable a statement than "smoking is good for you." In fact, we can still be pretty darn sure (just not 100%) that smoking causes cancer.

If one has done any significant amount of research on the research that has been done already, one could quite clearly see that the cancer levels of cigarette smokers is higher than that of non smokers, BUT also cigar and pipe smokers as well. As a matter of fact, numerous studies have indeed found that the level of cancer detected among pipe smokers is statistically the same as the level of cancer among non-smokers. What does this tell us? Well, perhaps the fact that most cigarette smokers inhale the smoke as opposed to cigar or pipe smokers might suggest an answer. Even most insurance companies view cigar or pipe smoking different from cigarette smoking. Many provide premiums identical to those charged as non smokers. What does this tell us? I suppose it could be argued that the actuarials that work in the industry view pipe or cigar smoking similar in terms of risk to the company as a non smoker.

This is an interesting fact. Yes, I think the health risk are probably very different. I see two likely reasons. The first you point out: The way the smoke is delivered. Not inhaling = less in the lungs. This also fits with what I understand to be pretty well understood, that the cancers associated with pipe and cigars are not exactly the same as with cigs. Or more accurately, while the cancers are probably the same ones, the relative likelihood of each is very different, along with the overall likelihood of cancer.

The other thing is that most cigar and pipe smokers i've run into are occasional. At least a heck of a lot lest often than the average cigarette smoker. Not sure exactly why this is. But it would obviously decrease the harmful impact somewhat.

Why do I bring this up? Because I find that many tend to overlook the differences that have already been established between what type of smoking method affects the kinds of cancer that sometimes develop and lump ALL tobacco as bad, evil, satanic, (insert favourite descriptive term here)

Well, I do prefer being around pipe and cigar smokers. (Yes, in general I agree with you and others that forcing other to breath your smoke is rude, but when someone is rude, or I just catch a whiff...). Mostly this is aesthetic. I like the smell better. Interestingly, if you think about it, any health impact from secondhand smoke would be the same for pipe, cigar, and cigarette, despite the difference for the smoker. The smoker ingests the smoke differently. The secondhand person, though, is inhaling them all just the same. (Ignoring impacts of the fact that cigarette smoke is more processed, and has more additives, which may be a significant factor).

My point simply is that the current political climate for trying to make ALL manner of smoking as difficult as possible to do could quite easily turn into another "witch hunt" of sorts by over-emphasizing perceived risks while ignoring any and all information pursuant to the contrary.

Well, I agree that decisions should be informed. Lets leave it at that.

-Mo

[MOSES]

That does NOT mean it was the right thing to do!

Indeed. In fact, it would rather suggest that total prohibition of tobacco would be a horrible idea.

-Mo

[JP]

Bottom line for me is legislate this all the way, or don't legislate it at all.

There are those who are striving to achieve that goal, but perhaps the best to go about that is to sneak up on it. I compare this to Prohibition, which was "legislated all the way" and didn't work at all.

[ScottS]

That does NOT mean it was the right thing to do!

Thanks,
Merlyn

At one time, the recreational use of IV Morphine was legal, as was cocaine. Were they the right substances to ban? I'm sure at the time, some users objected.

[Leisureguy]

So far as banning substances, the organization Law Enforcement Against Prohibition supports no bans. Regulation, yes, taxation, treatment, education, etc., but not prohibition. On their site they give their reasons.

I believe that cigar and snuff (powdered tobacco) users more often have cancer in and around the mouth and jaw.