UCSF Falsely claims tobacco use shortens life twice as much as diabetes

[Berylanna]

12-item index predicts odds of dying - SFGate

This point system was reported by UCSF in the AMA Journal

2 points for being a tobacco user
1 point for having diabetes

[Edit: fixed typo in numbers, and considering not posting in the middle of the night anymore]

AND they use this point system to decide if it is worth agressively monitoring someone for other diseases:

A colonoscopy, for example, might detect a small abnormal polyp that could develop into full-blown colon cancer in eight years, said Dr. Marisa Cruz, the lead author of the study. If that is the case, then it might not be worth the burden, risks and costs of close surveillance if the patient is likely to live five more years in the first place.

Read more: 12-item index predicts odds of dying - SFGate

I'll comment with something or other from CASAA's website.

[Edit: the best SHORT thing I could find for this particular situation was to just give the URL for the AAPHP's tobacco page. I'm aware that overall CASAA is better but I couldn't find something short-and-sweet this late at night. I'm tired.]

 

[Elnroth]

I like how obesity isn't up there. Nor do they differentiate between type I and type II diabetes.

 

[kristin]

I think you have the numbers reversed? They gave 2 points for tobacco and 1 for diabetes. Which you are totally right about being completely ridiculous. MAYBE smoking is 2 points, but smokefree shouldn't add points at all - unless they are accounting for the factor that tobacco users often have other stresses that affect health - lower incomes, inadequate health care, high stress, drink more, etc. But there is no science backing up a claim that smokeless tobacco users are at greater risk of death than people who ALREADY have diabetes!

 

[Berylanna]

I think you have the numbers reversed? They gave 2 points for tobacco and 1 for diabetes. Which you are totally right about being completely ridiculous. MAYBE smoking is 2 points, but smokefree shouldn't add points at all - unless they are accounting for the factor that tobacco users often have other stresses that affect health - lower incomes, inadequate health care, high stress, drink more, etc. But there is no science backing up a claim that smokeless tobacco users are at greater risk of death than people who ALREADY have diabetes!

Fixed my typo.

I can buy the "other stresses" argument except I'm seeing so much about people just throwing around "tobacco user" as a synonym for smoker, that I don't trust them to have looked at the numbers separately.

 

[kristin]

Fixed my typo.

I can buy the "other stresses" argument except I'm seeing so much about people just throwing around "tobacco user" as a synonym for smoker, that I don't trust them to have looked at the numbers separately.

Yeah, that was definitely a sarcastic comment. They most certainly were just lumping in ST with smoking. I would be shocked if they were considering those other factors because they don't even do that when they do smoking research!

 

[DaveP]

I wonder sometimes if doctors combine the availability and the need for diagnostic tests with their association with doctors who perform those tests. I can understand a test ordered based on symptoms and obvious tell tales through observation. I find it a little disturbing that doctors seem to think everyone needs a Colonoscopy just because it's technically possible. My doctor asks me every time if I have decided to have one and I tell him no. There's no history in my family that makes me think I need to be screened.

Several times a year I get one of those slick color brochures offering a vein and heart screening using ultrasound. Those usually come from hospitals and traveling diagnosticians. Sure, it is probably not a bad idea but it screams of entrepreneurial gamesmanship by those who advertise them. Hospitals are all about driving up patient participation. Sometimes, things are better left alone in the absence of symptoms. Dr Welby would turn over in his grave.

I am glad that my doctor condones my use of my ecig. He's open enough to the scant research to discern that it's no worse than wearing nic patches.

 

[rolygate]

The CDC, who are the agency tasked with obtaining tobacco-related epidemiology statistics, i.e. the national health stats for morbidity and mortality, deliberately obfuscate the stats in order that the low incidence of disease caused by oral tobacco cannot be seen. This is easily done, by placing all tobacco users in the same group, instead of separating out smokers and smokefree product users.

It is contrary to their agenda to reveal that smoking causes the problems, not tobacco.

Prof Rodu tells me that due to this policy it is impossible to isolate the national stats for oral tobacco users (in the USA). This is almost certainly the design objective of the CDC. In order to locate stats for smokefree product users, it is necessary to look at meta-analyses of clinical studies on US oral tobacco users, and also those in Sweden (individual studies are not reliable, as some studies, whatever the subject, are always going to produce results that class them as outliers*).

Such studies reveal that the risks of modern oral tobacco consumption, both in the USA and Sweden, are so low as to be impossible to reliably identify. Prof Lee, who is the main author of the large-scale meta-analyses (PN Lee), puts it like this: there is no statistically-identifiable elevation of risk.

In practice this means that risk is equal to or less than 1%, as that is about the lower limit for statistical methods in this area (one reason being that almost all users will previously have been smokers).


* One example of this is the Boffetta study that concluded Snus consumers have an elevated risk for pancreatic cancer. Peter Lee tore that to shreds, describing it (in so many words) as incompetent rubbish (search: boffetta - pn lee).

 

[Petrodus]

One of my favorite quotes

If honesty were suddenly introduced into American life,
the whole system would collapse !!
George Carlin

 

[Vocalek]

Fewer procedures for people who do not really need them also mean lower costs. One person abstaining from an extra colonoscopy might not save substantial money, but thousands of people making that choice every year could lead to considerable reductions.

Read more: 12-item index predicts odds of dying - SFGate

Cool! Now, instead of admitting that I abhor the though of being violated, I can just blame my reluctance to submit to the test on my benevolent concern for the rising costs of health care!

 

[Bill Godshall]

The 2 points is correct for "daily smokers", but not for "current tobacco users", which is defined as using any tobacco product in the past month.

In the US, there are about 33 million daily smokers (i.e. 14% of adults) who face huge disease risks (esp. for >1/2 pack/day smokers), and who (along with those who quit smoking in the past two decades) will comprise >99% of the estimated 3-4 million tobacco attributable deaths in the US this decade.

But there are also nearly 40 million other tobacco users (i.e. 17% of adults, including 10M smokeless users, 14M cigar smokers, 12M occasional cigarette smokers, 2-3M vapers and 1M pipe smokers) who face negligable if any disease risks, and who (all combined) will comprise <1% of tobacco attributable deaths.

Instead of telling the public the truth about these vastly different disease risks facing different tobacco products and their use, the US DHHS (CDC, FDA, US SG, USPHS, SAMHSA), WHO, ACS, AHA, ALA, Legacy, AMA, ADA, most state/local health departments, and many university researcher/activists have conspired (beginning 30 years ago with smokeless tobacco) to intentionally deceive the public to believe that any use of any tobacco product is as hazardous as smoking a pack of cigarettes per day.

This has become the front and center policy of Obama's DHHS, as virtually every regulation, report, press release and talking point includes "tobacco use is the leading cause of death" and that "we must end the tobacco epidemic" to "protect the children"

The prohibitionists and propagandists refuse to even tell smokers that smoking two packs per day is far more hazardous than smoking one cigarette per month (since both are defined as "current smoking"), or that reducing daily cigarette consumption reduces disease risks (because they don't want smokers to reduce consumption, but just to quit all tobacco instead).

That's also why DHHS and others rely solely on the rate of "current smoking" (i.e. 45 million smokers, 20% of adults), which includes 12M occassional (i.e. non daily) smokers, and why DHHS and others never mention (except in survey chart appendices) the rate of "daily smoking" (i.e. 33 million smokers, 14% of adults), which has continued to steadily decline during the past decade (unlike the "current smoking" rate, whose decline has stagnated in the past decade).

 

[rolygate]

Some interesting stats there, Bill. Can I ask where the daily smokers: 33m figure comes from, please?