Why can't they just leave us alone?

[generic mutant]

So let's get back to the data.

There is a startling unanimity about the 1.3ish risk factor for coronary heart disease among different studies.

Many use different methodologies, and different data. Considering them together, I don't think you can hold that the risk factor is too low to reliably detect.

 

[kristin]

Not many dispassionate parties to rely on, are there... Up to you, we can talk about the people, or the methodology.

Carl V Phillips - TobaccoTactics
Carl V Phillips Countering Critics - TobaccoTactics

The two are not exclusive of each other. The second link is one of the authors of the study supporting his methodology, conclusions and reputation. If you are going to pretend that political and personal agenda only comes into play when its people arguing agsinst SHS harm, then you are telling me you choose to remain brainwashed and there is really no reason for me to continue our discussion.

 

[generic mutant]

We need a level playing field. If every time I post anything mentioning Glantz, people are going to argue to the person...

I'm perfectly happy to just talk about methodology.

You'll note that both the BMJ who published the Enstrom and Kabat paper, and the ACS, who provided the data, have disowned it completely.

“The study is fundamentally flawed.”
–British Medical Association

Enstrom and Kabat did not gather original data for their study. Instead, it drew on data from the ACS’s Cancer Prevention Study (CPS-I), and used only a small subset (approximately 10%) of the total CPS-I data. Researchers at ACS repeatedly warned Enstrom that the data from CPS-I could not be used to determine the health effects of secondhand smoke, and they spoke out against the study upon its release, stating that their data had been misused.

http://no-smoke.org/document.php?id=333

Their later papers depend for their anomalous result on the first.

In 2003, Enstrom and Kabat73 published in the British Medical Journal a second CIAR-funded analysis of CPS-I on SHS and tobacco-related mortality, examining never-smoking adults exposed to a smoking spouse, and concluded that no statistically significant associations with mortality existed. The tobacco industry publicized the Enstrom and Kabat work around the world.74 The study73 was criticized for repeating the same exposure misclassification error as that by LeVois and Layard,57 despite having been specifically warned by the American Cancer Society that it was inappropriate to use CPS-I for SHS studies.61 (An analysis of tobacco industry documents revealed that the British Medical Journal financial disclosure requirement was not adequate to give readers and reviewers an appreciation for the authors’ long-standing relationships with the tobacco industry and the fact that the study was a “special project” funded by industry lawyers and executives outside the peer review process.24) Both the California Environmental Protection Agency7 and the US Surgeon General8 subsequently discounted the Enstrom and Kabat study73 in their evaluations of the health effects of SHS because of the problem in CPS-I with exposure misclassification.

In a 2006 PM-funded meta-analysis of SHS and cardiovascular mortality, Enstrom and Kabat75 did conclude that SHS was associated with a statistically significant increase in cardiovascular mortality risk, albeit smaller than the consensus estimate (5%75 versus 25% to 30%8), in Inhalation Toxicology (Its editorial board includes Lorillard and RJR representatives76). This lower relative risk is due to the examination of only US cohort studies, including the 2 industry-funded CPS-I analyses57,73 despite the negative biases introduced by widespread exposure misclassification. (The CPS-I data set is large, so including these negative results will lower the pooled relative risk estimate.) The authors75 acknowledged that the non-US studies tended to report higher risks but have 1 sentence stating that inclusion of the non-US studies did not “materially alter” the summary relative risks for the US results, even though their results differed from the risk estimates produced by non–tobacco-funded sources by a factor of 6.

http://circ.ahajournals.org/content/116/16/1845.full

Do you have any other epidemiology disputing the consensus?

 

[Robino1]

Just a couple of quick questions and then I'm done.
Do you think vaping is harmful?
Do you think there is harm to others that are in the same room with vapers?
Are you Anti Nicotine and Tobacco?

If you answered no to those questions? Why try so hard to disprove those that are fighting for our vaping?

 

[generic mutant]

Just a couple of quick questions and then I'm done.
Do you think vaping is harmful?

We established earlier in the thread that nicotine may well be a "suspected carcinogen", though at a low rate [late edit, for posterity: it's also linked with heart disease, of course, and there's all kinds of contradictory information about Alzheimer's]. Other ingredients, like the wick or chemicals in the plastics, are vague unknowns. PG is linked with asthma. In the scheme of things, compared to a cigarette, probably basically harmless, but no direct long term data exists.

Flavours are the big unknown, because there's too much variation to say "it's safe" or "it isn't". I think we'd be very wise to only buy from reputable, large companies, and even then to take such scares as diketones seriously.

Do you think there is harm to others that are in the same room with vapers?

Insufficient data. At this stage I'm going to stick my neck out and say "not any more than a very small theatre fog machine". The link between nicotine users and sickness is small, so second hand nicotine is likely to be negligible.

Are you Anti Nicotine and Tobacco?

I don't really know what that means, as such. We're probably almost all "anti-tobacco" in a way, aren't we, having been through the painful process of trying to reject smoking addiction? You don't have to be old to have been systematically lied to by tobacco companies with near bottomless pockets with which they bought significant scientific and political influence. I think that should make you very sceptical of anything "pro-tobacco".

That said, weak stimulants are weak stimulants, and I'm no more anti-nicotine than I am anti-caffeine - I guzzle both all day For the record, I tried snus, but just can't stomach it. I think the data for snus seems to suggest it's "safe if you're a smoker, not safe if you're a non-smoker"...

If you answered no to those questions? Why try so hard to disprove those that are fighting for our vaping?

I came to this site looking for information about a safe nicotine delivery mechanism, and found lots of good stuff here, but a lot of zealotry too.

In this thread, Spike1964 implied that nicotine "doesn't give you cancer", I pointed out that that isn't certain, and it snowballed from there.

Personally, I just think we're best off knowing The Truth (tm).

 

[synthros]

You also have to remember that anyone who criticizes the anti-tobacco studies gets black listed, so there is a menacing environment in tobacco control - toll the line or get out. Anything from Glantz is pure junk. Seriously. Ask anyone in tobacco harm reduction. This guy was one of the first to try to get e-cigs banned. He is such an anti tobacco and nicotine zealot that it is impossible to consider his work unbiased. Most of the anti-tobacco research is funded by Big Pharma through shills. Think those studies will favor banning smoking so people buy gum or not?


Regarding the criticism: https://www.biomedcentral.com/1742-5573/4/13
and more importantly:
EP&I | Full text | Defending legitimate epidemiologic research: combating Lysenko pseudoscience (Note Glantz's heavy-handed involvement in the attack.)

Hey Kristin, thank you for posting this. It was a fascinating and infuriating read. Many of the references and links out of these were also fascinating. It's not the first time by a long shot that science has been co-opted by vested interests, you would think we'd begin to get past this ends justifies the means mentality, but no I suppose we're still just human after all. It's sad that money, publicity and stridency carry the day. Unfortunately exaggerated health scares are always well loved, it so often gives people the impression that they can exhibit some behavior that will give them a degree of control over their lives, illusory or not and people have always sought this. I have no interest in debating the poster in this thread anymore than I want to debate the next messianic that knocks on my door. Fortunately (or unfortunately), time will sort out and put paid to what is true and what isn't, would be nice to see it happen in my lifetime, well see. Thanks again for the links!
1-

 

[EddardinWinter]

"We" certainly did not "establish earlier in the thread that nicotine may well be a 'suspected carcinogen'". You originally stated it "caused pancreatic cancer". You have been forced to reduce those claims by preponderance of evidence to reduce you claim to it might be a suspected carcinogen. You have taken that position. I remain at the position of there is insufficient evidence to conclude that nicotine alone is even a 'suspected carcinogen'.

 

[zoiDman]

...

Personally, I just think we're best off knowing The Truth (tm).

The Truth is a Funny thing.

Sometimes people quest for it only to find that when it is Found, they Don’t like what it Is.

Other’s live Happy lives Completely Unaware of what is Going On around them.

And to make matters even more Confusing, the Truth for One Person can be Different than the Truth for Another. It seems that Perspective and Frame of Reference can Influence the Truth.

Or perhaps, Perspective and Frame of Reference Define what the Truth is?

 

[generic mutant]

...You originally stated it "caused pancreatic cancer".

Direct quotes only please, that's pretty much dishonest.

You have been forced to reduce those claims by preponderance of evidence to reduce you claim to it might be a suspected carcinogen. You have taken that position. I remain at the position of there is insufficient evidence to conclude that nicotine alone is even a 'suspected carcinogen'.

"Nicotine is not a suspected carcinogen" is a stronger statement than "Nicotine is a suspected carcinogen". I'm not suggesting that you only need one nutter to think nicotine is carcinogenic before you can lump it in, but there is a substantial body of research pointing to it being carcinogenic. To lump it in with the "nots" you would need to be able to basically say "none of the research suggesting it is a carcinogen is credible". Feel free if you like, it'll just paint you as an idealogue though.

I think part of the confusion earlier in the thread was people failing to grasp the distinction between NRT / snus and nicotine. Again, "there is an association between NRT and cancer" is a stronger statement than "nicotine is a suspected carcinogen". I never said the former, and you're on very shaky ground if you really want to contest the latter.

 

[generic mutant]

The Truth is a Funny thing.

Sometimes people quest for it only to find that when it is Found, they Don’t like what it Is.

Other’s live Happy lives Completely Unaware of what is Going On around them.

And to make matters even more Confusing, the Truth for One Person can be Different than the Truth for Another. It seems that Perspective and Frame of Reference can Influence the Truth.

Or perhaps, Perspective and Frame of Reference Define what the Truth is?

Up to a point, but either Elvis is dead or he isn't.

There's an incredibly large pile of data on the association between passive smoking and sickness. We either need to establish convincingly that it's all wrong, because stuff using better methodology trumps it, or we provisionally assume it's true.

That's science.

 

[Robino1]

Science...used to achieve an objective that fits what others want you to believe.

Fact: 30 years ago a doctor looked at a chest X-ray of mine and stated I had the beginning of emphysema. I've had several X-rays since, never mentioning that quacks diagnosis. Never once did anyone say there was any abnormality. The doctor who made the original statement had one agenda, to get me to stop smoking. I do not trust science. They will lie to purport their truths as they want you to see them.

Some of this may be on both sides of the issue. Irrefutable fact: many, many people can attest to the fact that vaping HAS increased their general health. Of which I am one. Another fact, I am and always have been a healthy person with the exception of contracting bronchitis at least once a year for the past 7 years. I have not gotten that ailment this year.

My husband, a non smoker/never smoked, has several allergies. Cig smoked bothered him but not to a degree that he was allergic. My vaping in no way bothers him. I even vape in the car with windows up.

I will continue to help in the push to keep vaping a viable alternative.

 

[zoiDman]

Up to a point, but either Elvis is dead or he isn't.

There's an incredibly large pile of data on the association between passive smoking and sickness. We either need to establish convincingly that it's all wrong, because stuff using better methodology trumps it, or we provisionally assume it's true.

That's science.

Science... Herein lies a Problem.

A pile of data Doesn’t establish the Truth. It doesn’t even establish Fact. It’s just a pile of Data.

There are Many ways to Assimilate Data. Some are Better than others if a Reflective Interpretation of the Results of Data is going to be applied to some Hypothesis.

There is also many times when Biases can be associated with the Collection of Data. Biases to yield a result to Satisfy a Cause/Agenda or a Funder.

If one bases a Belief or Position on Statistical Results, shouldn't one Question just how Accurate these results really are?

Because a Statistical Result used to make an Inference about a True Population is Only as good as the Method to which it was derived. And the Statistical Method is Only as good as the Data that was used. And the Data is Only as Good as the way it was collected.

Prue Talbot has generated a Pile of Data. Should we consider her work to be Relevant and Accurate? What she does is "Science". It is up to Reader of her work to make the decision whether it is Good Science or Bad Science.


Black and White concepts like Elvis being dead or not may be relatively easy to discern for Most people. But concepts like Risk or Harm or Safety are not so Universally Acceptable. And they are Very Difficult to Quantify using Numbers.

If 1 person out of 10 gets Cancer from using a Product, do YOU consider the Product to be Safe? How about 1 out of 1,000? Or 10,000? Or 100,000? Where do you Draw the Safety Line? And how do you know a Product causes this Cancer? A Study that has all the Potential Biases and built in chances of Error?

Here is the Perspective thing…

If you say something is Safe (or a Hazard) if it causes 1 out of 10,000 to get Cancer and I say that it should be 1 in 100,000, who is Right? Or maybe we are Both Right to ourselves? Or maybe Both Wrong to a Third Person.

This entire “Does Nicotine Cause Cancer” debate is great. And it has been going on since Day One. I just don’t think a Pile of Data makes a Very Convincing Argument either For or Against.

In My field, One Good Paper out Trumps 100 Bad Papers.

---

Just a Side Note:

Some researcher believe that Nicotine does Not cause the onset of certain types of Cancer. That these cancers occur naturally in the Human Population. But that the presence of Nicotine in the Blood Stream helps to promote Growth of these Cancers once they form. And Inhibits the body’s ability to Fight Off these Cancers. So in this case, whereas the Nicotine was Not the cause of the Cancer, it caused Harm by assisting in Cancer Growth.

If these researchers are correct, it puts a whole New Spin on the entire "Is Nicotine Safe" concept.

 

[kristin]

There is a dearth of published research supporting that SHS has no significant affect on lung cancer and heart disease because there is an embargo on such research coming from the mainstream publications and universities. You can read for yourself what happened to a respected researcher when he attempted to publish something that didn't agree with the ANTZ doctrine. If you refuse to believe that the character of "people" has a huge effect on the outcome of the research, then there is nothing more to talk about.

But I will say one more thing. If you want to believe that SHS raises risk by a RR of 1.3 (30%) then what does that mean in the real chances you will get lung cancer? You have to know what the chances are without that exposure first.

The American Lung Association reported that the incidence rate for lung cancer overall in 2006 was 0.631 out of 100 people (calculated from 63.1 per 100,000). That is about 0.6% risk of getting lung cancer in a year (just over 1/2 of 1%). This includes smokers and ex-smokers, which the CDC says make up at least 85% of lung cancer cases. So, that means only 15% of those cases are non-smokers. Which means 0.09 out of 100 people are non-smokers who get lung cancer. Therefore, non-smokers have only a 0.09% risk of getting lung cancer and that includes those who are exposed to SHS. Thus, banning smoking approximately lowers a 0.09% risk of lung cancer to a 0.063% risk. Or the other way around, SHS increases a 0.063% risk of lung cancer by 1.3 or 30% to a 0.09% risk. Put simply, 99.91 out of 100 people exposed to SHS will not get lung cancer because of the exposure.

When you are talking about a 0.09% risk for lung cancer absent smoking, it is almost impossible to exclude exposure to other carcinogens, such as diesel exhaust, general air pollution and radon as factors. People can report exposure to SHS, but they usually don't know when or to what extent they were exposed to other airborne carcinogens so it goes unreported. It is not "safe to assume" their SHS exposure was their only exposure to a risk factor, yet that is exactly what every study on the impact of SHS does.

 

[generic mutant]

@ zoiDman: All true enough.

1) Statisticians develop methods, some of them very advanced, to overcome these inherent difficulties. That doesn't mean they're foolproof. So yes, I fully accept that the conventional wisdom over passive smoking may be exaggerated, or flat out wrong. Even if there wasn't a single study contesting it, you wouldn't hear me saying "It's true, definitively, incontestable". That just isn't how epidemiology, or science generally, work.

The point is though that there's a massive array of studies, using different methodologies (and therefore having different weaknesses), using metaanalysis to strengthen their statistical power, all pointing to around the same figure.

I'm not saying "that means it's true", I'm just saying you need a pretty blinking solid argument to say "it isn't".

2) Acceptable risk for a given benefit has to be determined democratically, with expert advice, at least in a democracy. I don't need to have a *precisely defined* position on how dangerous second hand smoke is to say "It looks like it's dangerous at the population level, and it really isn't that hard to walk outside (even if it's raining, here in England, which it has been known to do now and again) when I want a cigarette and some of those who would be exposed to my second hand smoke wouldn't be doing so fully voluntarily (i.e. being reasonably informed about the risks, and not having undue duress, like fearing losing their job and not being able to get another one if they refused)."

I would vote accordingly, even as a smoker, because I don't believe health and safety can be left to the discretion of the manager. It's never worked like that, anywhere, because of the imbalance of power between employers and employees.

3) True, and it's also true that it might be metabolites of nicotine rather than nicotine per se causing problems. But in a practical, medical sense the mechanism is irrelevant, even if not in a scientific sense. If we can add nicotine to people and get more cancer, we need to try to quantify the risk and if it's large enough take reasonable steps to avoid it.

I understand that's the distinction between carcinogenesis and oncogenesis - carcinogenesis mutates DNA in a way that can lead to cancer, oncogenesis is the overall process of development of a cancerous tumour. To "Joe Bloggs", they both "Give you cancer".

 

[zoiDman]

@ zoiDman: All true enough.

...

So how do you sum up Your position, in 25 Words or Less Preferably, on e-Cigarettes?

 

[generic mutant]

@ Kristin

Re: absolute figures for deaths - the point isn't that it's a massive number, it's simply that for a large proportion of the population (those exposed at work), it's easily avoidable through a small sacrifice on the part of smokers. The other questions like "can you smoke in a car with children in" are much more complex, bringing in questions about the degree to which the state can legitimately interfere with private family life. As I said, I don't have a well defined position on that at all.

---

If there are methodological weaknesses in Enstrom and Kabat's papers, you would assume they would try to do follow up studies - there is a *massive* financial interest from their backers in establishing their position more solidly.

I simply can't believe that the global scientific system is so corrupt that they wouldn't be able to find anywhere to publish.

That said, I am reading their defense of their paper as we speak, so "I'll be back..."



This has been an interesting discussion, so thanks.

 

[generic mutant]

So how do you sum up Your position, in 25 Words or Less Preferably, on e-Cigarettes?

25 words? I might stretch that a bit...

My position is that smoking cigarettes is one of the most dangerous voluntary things people do (and apparently significantly dangerous for others too), and also extremely addictive. Any harm reduction strategies, or ways to escape the addiction, should be welcomed if they work well - and should probably be given the go-ahead even if they're somewhat dangerous (e.g. snus appears to be somewhat dangerous, and is illegal to sell here, though you can still get it. Even if it turns out to be definitely somewhat dangerous, I'd make it legal myself).

Fortunately, e-cigarettes don't look like they're that dangerous - they might be pretty close to benign. More research is definitely needed.

 

[zoiDman]

25 words? I might stretch that a bit...

My position is that smoking cigarettes is one of the most dangerous voluntary things people do (and apparently significantly dangerous for others too), and also extremely addictive. Any harm reduction strategies, or ways to escape the addiction, should be welcomed if they work well - and should probably be given the go-ahead even if they're somewhat dangerous (e.g. snus appears to be somewhat dangerous, and is illegal to sell here, though you can still get it. Even if it turns out to be definitely somewhat dangerous, I'd make it legal myself).

Fortunately, e-cigarettes don't look like they're that dangerous - they might be pretty close to benign. More research is definitely needed.

Sorry to put you on the Spot. But it was Necessary to support my Premise.

And that is that the Position you gave is what Most, if not Nearly ALL people, will/do Support. Where we start to Diverge is on things like “… if they work well” or “…even if they're somewhat dangerous”.

Putting a Quantitative Value that we All can agree on to How Well something Works or How Dangerous something is may be Impossible.

Hence, discussions/debates like this will Never have a clear Winning or Losing side.

 

[generic mutant]

...
Hence, discussions/debates like this will Never have a clear Winning or Losing side.

Absolutely. I didn't engage in this debate thinking "I'm right, you're all wrong, I can prove it!"

But we can gain interesting information from a debate like this - I've certainly learnt some things, and I hope some of my posts have made people think, or pointed them to new information, too.

 

[zoiDman]

...

But we can gain interesting information from a debate like this. ...

Yeah... That is sometimes the reason I will stay with a Thread when people are Posting things that I Don't agree with.