🚀 go-pugleaf

     It's been a while since I posted anything to alt.smokers,
but I see from a recent posting that Bruce Watson still remembers
that I questioned whether active smoking, as opposed to ETS, is
harmful to the smoker. Well, I haven't changed my mind.

     I have read and enjoyed the excellent essays posted by Joe
Dawson, R. Wagner, and others, which take the position that,
while active smoking may be harmful to the smokers, it doesn't
harm anybody else and, therefore, there is no public policy
reason to ban smoking. That makes a lot of sense, and I didn't
want to introduce an element of discord. Why question the
conventional wisdom when a better defense can be constructed
which doesn't do so?

     When I was a small boy, I had a collection of popular
medical books from the turn of the century. They all warned, in
ominous terms, that masturbation causes blindness.

     Suppose the year is 1890. A medical doctor disagrees with
the conventional wisdom and advises a young man that masturbation
is harmless. The young man goes out and masturbates.
Subsequently, he goes blind and, believing the blindness to be
the result of the doctor's advice, sues for malpractice. I am
hired as the doctor's defense lawyer. If I am smart, I won't
attack the conventional wisdom. Instead, I will put the victim on
trial. I will cross examine him: "Haven't you read all the books,
warning about the dangers of this evil practice? Haven't you seen
the articles in the newspapers, describing the consequences of
Onanism?  Haven't you heard sermons in church, warning of the
dangers of this vice? Young man, you knew the dangers, but you
took the risk!"

     It's the same with smoking. If somebody sues a tobacco
company because they get lung cancer and think it was caused by
smoking, the best defense is to concede that it was caused by
smoking, but argue that the plaintiff assumed the risk. That
doesn't mean, however, that there is any scientific support for
the premise that the cancer was caused by smoking. 

     I cannot, of course, prove that smoking does not cause lung
cancer or anything else. Nobody can prove a negative. Suppose
somebody comes into my office and asks me to find out whether
John Doe filed for bankruptcy, last year. I send a researcher to
the local bankruptcy court. If the researcher comes back with
copies of a bankruptcy petition signed by Mr. Doe, I have proven,
affirmatively, that he filed for bankruptcy. But if the
researcher comes back empty handed, I have proven nothing. Maybe
the researcher didn't look in the right court, or maybe the
researcher didn't look hard enough, or maybe the records were
lost. I cannot prove that something is not so.

     In science, however, the burden of proving an hypothesis
should be upon those who assert the hypothesis. In the years
leading up to the 1964 Surgeon General's Report, all sorts of
animal experiments were conducted, trying to induce lung cancer
in dogs, rabbits, etc., by exposing them to tobacco smoke and
tars. If these experiments had succeeded, there would be proof
that smoking causes lung cancer. All of the experiments, however,
failed!

     The experiments having failed, the SG's Committee was forced
to rely upon prospective studies, in which researchers studied a
population for a few years, and tried to relate smoking habits to
disease. There were seven of these studies, as follows:

     (1) British doctors, a questionnaire having been sent to all
members of the medical profession in the U.K. by Doll and Hill,
in 1956.

     (2) White American men in 9 states, enrolled by American
Cancer Association volunteers, each of whom enlisted 10 white
males between 50 and 60 years of age. Hammond and Horn, 1958.

     (3) Policy holders of U.S. Government Life Insurance
policies. Dorn, 1958.

     (4) Men, 35-64 in nine occupations in California which were
suspected of having a high occupational risk of lung cancer.
Dunn, Linden and Breslow, 1960.

     (5) California members of the American Legion and their
wives. Dunn, Buell, and Breslow.

     (6) Canadian War Veterans. Best, Josie and Walker, 1961.

     (7) American men in ten states, enrolled by volunteers from
the American Cancer society, each of whom was asked to enroll
about ten families containing at least one person over 45.
Hammond, 1963.

     There were several sources of bias immediately apparent in
the manner in which the surveys were conducted. It was obvious to
everyone, including the participants and their doctors why these
studies were being conducted, i.e., to prove that smoking causes
lung cancer. Thus, an element of detection bias was introduced. 

     There was also the matter of the selection of the survey
participants. Not all the holders of U.S. Government Life
Insurance policies participated; not all the British doctors
participated, etc. Taking the five studies for which it had data
on the non-response rate, the Committee concluded that the
average non-response rate was about 32%. Then, at page 116 of its
Report, the Committee made the following observation. Citing a
paper by Berkson, the Committee said, "The death rate in the
complete population (3.000) was 42% higher than the respondent
death rate. The non-smoker death rate was over 38 times as high
among non-respondents as among respondents (60.1221/1.553),
whereas among smokers it was only 1.8 times as high. [Berkson's]
calculations referred to an early year of the study, in which the
differential entry of ill persons among smokers and non-smokers
are likely to be most marked. Further, as we interpret his
writing, the example was intended as a warning against the type
of subtle bias that can arise whenever a study has a high
proportion of non respondents, rather than a claim that this
numerical estimate of the bias actually applied to these
studies."

     In short, the Committee was confronted with a red flag,
strongly suggesting a serious flaw, but dismissed it as
unimportant.

     One would think that, if there is a connection between lung
cancer and smoking, smokers who inhale would have a higher
incidence of lung cancer than those who don't. Two studies,
however, (Fischer, 1958; Doll and Petro, 1976) purported to show
exactly the opposite, i.e., that inhalers had a substantially lower
rate of lung cancer than those who did not inhale.
     
     One would also think that, since the amount of benzopyrene
(a known carcinogen) in pipe and cigar smoke far exceeds that in
cigarette smoke, and since the amount of particulate in cigar and
pipe smoke far exceeds that of cigarette smoke, pipe and cigar
smokers would drop dead like flies, as a result of their habits.
However, the Committee found that pipe smokers lived longer than
non smokers, and cigar smokers lived the same.

     One would also think that since the rate of smoking in Japan
is far, far higher than in the U.S., the lung cancer death rate
in Japan would far exceed the rate in this country. In fact,
however, the LCDR in Japan is one-third the U.S. rate, and the
Japanese have the highest life expectancies of any nation in the
world (no, it's not because the Japanese couldn't get cigarettes
during WWII; we couldn't get them here, either, during WWII; I
well remember people switching to corn cob pipes, to help the war
effort). 
     
     Months ago, I posted a challenge to the antis to cite me a
scientific paper, proving the smoking/lung cancer connection.
None was ever cited, because there isn't one. All that exist are
the studies I've cited, which were conducted under the auspices
of the Cancer Societies, for the purpose of proving a point.
Science, however, is not supposed to work that way. 

     Whenever I post these things, I get responses from people
who say their dad died from lung cancer, caused by his smoking,
and suggest that I should be brought up on treason charges for
suggesting that it's OK for people to smoke. I can only ask these
respondents to ask themselves: "Are you sure your dad wouldn't
have died, anyway?". Even before Sir Walter Raleigh brought
tobacco to Europe, people there died, from time to time. I know
plenty of people who didn't smoke a day in their lives, but died
from lung cancer, anyway. So do you, if you're honest with
yourself.
-- 
Lauren A. Colby (Larry)