View Comments |
Print This Post
| 
by Elizabeth M. Whelan | May 31st, 2006
Distorting the health risks of various modes of tobacco usage may cause more harm than it prevents.
In recognition of World No Tobacco Day, May 31, 2006, the World Heath Organization (WHO) published a lengthy document entitled "Tobacco: Deadly In Any Form or Disguise." The publication misleads at least as much as it informs, and distorting the health risks of various modes of tobacco usage may cause more harm than it prevents.
To understand the WHO disinformation campaign on tobacco, one has to know and accept the fact that tobacco products are not always inherently dangerous to health. The dangers of tobacco are directly related to the how the product is used — and how often.
Generally speaking, before cigarettes were introduced (which happened mainly in the first two decades of the twentieth century, with a huge surge in use after WWI), tobacco was used in a relatively safe manner. With pipes, cigars, and "chew," the health risks were real but in most cases small. Certainly there were exceptions (yes, the premature death of President Ulysses Grant was directly attributable to his habitual use of cigars), but in most cases tobacco in the pre-cigarette days did not cause substantial morbidity and mortality — and it rarely caused systemic diseases like lung cancer, emphysema, and heart disease. The fact that portable matches were not widely available until early in the twentieth century limited the use of pipes and cigars, which were most likely lit by fires and candles after dinner.
The cigarette and pocket matches changed all of that. Cigarettes could be smoked during all waking hours — and they were inhaled, dramatically increasing the risk of systemic diseases in the lungs, cardiovascular system, and beyond.
Thus for the WHO to prepare a purportedly educational document stating that all tobacco is harmful in any form without mentioning dose (frequency of use) and form (cigarettes versus other forms of tobacco) is irresponsible and outrageous.
The publication blatantly tells the occasional cigar and/or pipe users that any use of this product puts him/her at risk of lung and oral cancers. Surely, if one smokes cigars in the same way as one does
cigarettes — round the clock, regularly inhaling — one assumes the same risks as a cigarette smoker. But smoking a celebratory cigar or occasionally smoking a pipe pose very little health risk. WHO never
states that truth.
WHO condemns all forms of smokeless tobacco, lamenting that this product is used widely in Scandinavia and increasingly in the United States. What the health agency did not reveal is that the use of smokeless tobacco in Sweden and other countries — as a form of harm reduction for addicted cigarette smokers — led to a precipitous decline in lung cancer. WHO omits data showing that encouraging a switch from cigarettes to smokeless can save countless lives among those who are addicted to smoking and have not been able to quit with other approaches. WHO rejecting smokeless as a means of harm reduction is saying to the smoker: quit or die — you have no alternative.
The document is shameless in other ways as well. For example, seeking to terrify people about cigarettes, the agency reproduces an Australian anti-smoking ad blaring the message that there are toxic chemicals in cigarettes, citing specifically DDT, ammonia (which they helpfully remind us is a floor cleaner), acetone ("a paint stripper"), methanol ("rocket fuel"), and arsenic ("white ant poison"). This is outrageous. It is not the mere presence of the trace levels of chemicals that make cigarettes deadly — it is the lighting, burning, and inhalation that wreaks havoc with health. Why WHO felt compelled to use baseless hype to scare us is a mystery given that there is already overwhelming and irrefutable evidence from countless epidemiological studies confirming the unprecedented health hazards of cigarette smoking.
WHO threatens the credibility of the whole public health profession. Physicians and scientists who know better should demand that WHO correct the record, emphasizing the unique and spectacular dangers of
cigarette smoking — and the much less significant risks of other forms of tobacco use — presenting risks on a spectrum from negligible risk to severe risk. The best way to lose an argument is to overstate it. And by telling consumers that there is no safe level of exposure to tobacco WHO has indeed lost its argument.
Thanks for telling us that there is more to the story.
Is there hard proof that cigarette smoking CAUSES cancer?
As a statistician, I am keenly aware of the difference between the terms causation versus correlation.
Can you suggest a link for a curious researcher to examine the evidence of the link between cigarette smoking and its health effects? I suspect the link is one of correlation rather than causation. Though I would not discount the strength of correlation (providing the strength is statistically valid and significant), and would support efforts to inform the public of the risks, I would also advocate that if the link is not causation, then the public should be informed accordingly.
.
Comment by J.C.H. | May 31, 2006
Eliazabeth Whelan is correct.
Just as the WHO has wisely opposed moralistic abstinence only sex campaigns to prevent HIV and other sexually transmissible diseases, the WHO also should oppose abstinence only anti-tobacco campaigns.
The WHO has an ethical duty to tell cigarette smokers the truth about the risks of different tobacco products, and to respect the autonomy of smokers to sharply reduce their health risks by switching to smokeless tobacco or nicotine drugs.
Comment by Bill Godshall | May 31, 2006
Thank you, Dr. Whelan, for mentioning the potential for alternative nicotine products, such as smokeless tobacco, to be used as reduced-harm alternatives to smoking. For those interested in more information about this, please see our new website, http://www.TobaccoHarmReduction.org. There we provide more details to encourage those who cannot or will not stop using nicotine to seek a less harmful alternative to cigarettes. We launched that website today, World No Tobacco Day, to empahsize that we agree with the WHO's mission of trying to help people avoid smoking, but that we strongly disagree with their message that all tobacco is equally bad. In fact, smokeless tobacco is about 99% less harmful than smoking.
Carl V. Phillips, Associate Professor, University of Alberta School of Public Health, Edmonton, Canada
Comment by Carl V Phillips | May 31, 2006
Mr. Godshall,
Are you being ironic? First you dismiss moralistic abstinence-only sex campaigns, then you go on to support your own position by using words like "should," "ethical duty," and "truth." Your post reeks of moralism, just a different flavor from those you criticize.
Why should anyone accept your morality above someone elses? On what basis do you assert your moral superiority and dismiss the morals of others?
Comment by Rich Sherlock | May 31, 2006
Kudos to you for not falling for anti-tobacco's money-fueled whims. Seems the WHO has forgotten the many more millions around the world dying of malaria simply because they are mostly concentrated in third world (read: not as much $$$) countries whose governments are unable to fill the WHO's misbegotten coffers. Go ahead, say that I work for Philip Morris because I don't lol.
Comment by Dave | May 31, 2006
Dr. Whelan notes, " It is not the mere presence of the trace levels of chemicals that make cigarettes deadly — it is the lighting, burning, and inhalation that wreaks havoc with health. Why WHO felt compelled to use baseless hype to scare us is a mystery "
Dr. Whelan, it should not be a mystery to you at all. You're quite aware of, and largely in disagreement with, the scare campaigns aimed at secondary smoke which serve as a justification for smoking bans. Without hyping the almost imaginary trace expsoures to scary sounding things like arsenic, antismoking campaigners would be unable to terrify voters and politicians into passing things such as total bar bans and Seattle's wacky 25 foot rule. You mention arsenic in particular and that happens to be one element of smoke that I've analyzed in depth under the ETS segment of my web page at http://www.Antibrains.com
The basic reality is that an ordinary nonsmoker exposed to other's smoke would need to sit around for over 150,000 cigarette's worth to absorb the same amount of arsenic that the government has declared to be "safe" in a large glass of drinking water.
Michael J. McFadden
Author of "Dissecting Antismokers' Brains"
http://TheTruthIsALie.com
Comment by Michael J. McFadden | June 1, 2006
Dear Mr. McFadden:
I am not certain just what kind of response can be made to your book, "Dissecting Antismokers Brains", but it is
obvious that you get a lot of enjoyment from it's publication. Sorry to disappoint you, most of the people I know
have a personal reason for how we are. You can read about us at S.A.F.E. by doing a google search for us, it helps
to use my name in the search medium 'Albert J. Benson S.A.F.E. Stories' which will bring up the reason for our being,
to help educate people who do not smoke as to why they are so ill. Yes, it is not always easy to determine as to why
we become ill, since smoking has been so common a practice, it is not easy to rationalize such a serious illness from
something that is so common. Even some doctors do not know this, but fortunately most do.
If you do a google search for 'S.A.F.E. Smokefree Air For Everyone', you will bring up our web page which has a lot
of information about how to protect your loved ones, the children and others who don't smoke. I noticed recently
that our 'S.A.F.E. Stories' won't always come up unless the title is accessed as written. Hopefully you will have a
better opinion of people who have a problem with second hand smoke.
Sincerely,
Albert J. Benson
Comment by Albert J. Benson | June 2, 2006
So, if I sprinkle your hair with DDT and place a few drops of acetone in your coffee (though not enough to kill you) that's okay?
Tobacco DOES contain these chemicals, chemicals which harm, regardless of how much or how often they are used. Though the frequency may increase the likelihood of severe damage, who would willingly put ANY dangerous chemicals in their bodies unless they were uninformed, uncaring, or addicted?
The WHO is advocating abstinence from tobacco. You don't have to give up smoking if you don't want to, that's not the point. The point is to educate those who do not know exactly what is being put into their bodies, to tell them the truth, and to, if possible, persuade them that they are harming themselves.
The frequency of use issue is irrelevant. No smoking, no risk AT ALL of any of these chemicals entering your body. To suggest otherwise is irresponsible.
Incidentally, your essay is very well written.
Comment by alex | June 2, 2006
Everyone wants to rag on abstinence programs, but I can assure you that it is 100% effective in all cases. Does it mean that it will assure you a long and happy life? Not necessarily. But if a person dies at 40 of lung cancer and has never smoked, you can say with certainty that smoking did not kill him. If you haven't had sex, you will not become a teen pregnancy statistic. This argument is like advocating certain types of self-mutilation, after all, you're not very likely at all to die from minor cuts to your forearm, as long as you do it in moderation. Of course, if you don't do it at all, your chances of dying from self-mutilation become zero. So what is it that this argument seeks to accomplish? To advocate the use of certain types of materials that *could* kill you, but don't necessarily *have* to? Moderation isn't the key to everything. Walking on nail beds in moderation is still stupid, jumping from a moving car in moderation is still stupid, and Russian Roulette in moderation still isn't great odds. I think the point is: why chance it if you don't have to?
Comment by Patrick Mulligan | June 4, 2006
i agree with this article completely. something people don't understand is that smoking is enjoyable.
seriously, it isn't something you just do for the sake of doing it. and if you do it occasionally, like me,
then there isn't much of a problem, especially if it's chew. and another thing: tobacco usage isn't disgusting,
period. that includes chew. movies amke it out to be gross, but it really isn't. it dosen't smell bad(not
the right kind anyway), it can taste good. so what the hell. leave us tobacco users alone for once.
Comment by daniel | June 22, 2006