Wednesday, November 28, 2007

Surgeon General's Misrepresentation of the Truth Leading to Public Distortion of the Science Regarding Secondhand Smoke

According to an editorial published last week in the Wichita Eagle, the United States Surgeon General has concluded that even brief exposure to secondhand smoke can cause heart disease and lung cancer in nonsmokers.

The editorial states: "A landmark U.S. surgeon general's report in 2006 found that there is no risk-free level of exposure to secondhand smoke and that even brief exposure to tobacco smoke could cause heart disease and lung cancer in nonsmokers."

This means that if a nonsmoker is exposed even briefly to secondhand smoke, he or she is at increased risk of developing heart disease and lung cancer. Walk into a smoky bar for 30 minutes and you could walk away with more than a light buzz - you could walk away with heart disease and lung cancer, according to the Surgeon General as cited in the Wichita Eagle.

For the record, the 2006 Surgeon General's report states nothing of the sort. Nowhere does it conclude that brief exposure to secondhand smoke is sufficient to cause heart disease and/or lung cancer in nonsmokers. What the report concludes is that chronic exposure to secondhand smoke can cause heart disease and lung cancer in nonsmokers.

However, in his public relations materials (i.e., propaganda) surrounding the release of the report, the Surgeon General did indeed state that brief exposure to secondhand smoke can cause heart disease and lung cancer in nonsmokers.

Here is what the Surgeon General's report concluded regarding the effects of secondhand smoke exposure on heart disease and lung cancer:

"The evidence is sufficient to infer a causal relationship between secondhand smoke exposure and lung cancer among lifetime nonsmokers. ... The pooled evidence indicates a 20 to 30 percent increase in the risk of lung cancer from secondhand smoke exposure associated with living with a smoker. ... The evidence is sufficient to infer a causal relationship between exposure to secondhand smoke and increased risks of coronary heart disease morbidity and mortality among both men and women."

Here is what the Surgeon General's press release stated:

"Even brief exposure to secondhand smoke has immediate adverse effects on the cardiovascular system and increases risk for heart disease and lung cancer, the report says."

And here is what the Surgeon General stated in his remarks to the media:

"Breathing secondhand smoke for even a short time can damage cells and set the cancer process in motion. Brief exposure can have immediate harmful effects on blood and blood vessels, potentially increasing the risk of a heart attack."

Here is what the Surgeon General stated in an accompanying fact sheet:

"Breathing secondhand smoke for even a short time can have immediate adverse effects on the cardiovascular system, interfering with the normal functioning of the heart, blood, and vascular systems in ways that increase the risk of heart attack."

And here is what the Surgeon General says in an accompanying brochure:

"Even a short time in a smoky room causes your blood platelets to stick together. Secondhand smoke also damages the lining of your blood vessels. In your heart, these bad changes can cause a deadly heart attack."

The Rest of the Story

To try to piece together what is going on here for you, these are the facts as I see them:

1. The Surgeon General's report concluded (correctly, in my opinion) that chronic exposure to secondhand smoke produces a small elevation in risk (relative risk of approximately 1.3 for spouses of smokers) for heart disease and lung cancer among nonsmokers.

2. The Surgeon General completely misrepresented the conclusions of his own report in disseminating his public relations materials surrounding the release of the report. While his report documented an increased risk of heart disease and lung cancer associated with chronic secondhand smoke exposure, it provided no evidence of an increased risk of the development of heart disease or lung cancer associated with brief exposure to secondhand smoke. Yet the Surgeon General clearly claimed that brief exposure does cause such an increased risk of both heart disease and lung cancer.

3. The Wichita Eagle has completely distorted the science regarding the acute cardiovascular effects of secondhand smoke. Their claims about the effects of brief exposure to secondhand smoke are not only wrong, but scientifically implausible, and absurd.

4. However, it appears that the Wichita Eagle is not solely or perhaps at all responsible for this scientific error. Instead, it appears that the Eagle was simply quoting what the Surgeon General stated in his press release.

The rest of the story, then, is that the Surgeon General's misrepresentation of the scientific evidence regarding secondhand smoke in his own report has led to a gross distortion of the science to the public. This has occurred almost a year and a half following the release of the initial report. And it is likely to continue to occur.

It appears that the Surgeon General's deceptive and arguably inaccurate propaganda regarding the effects of brief secondhand smoke exposure, which conflicted with the conclusions in his own report, continue to result in a public misperception of the health risks of secondhand smoke exposure.

In many ways, I don't blame newspapers for this. When the Surgeon General makes a statement, it seems reasonable (or used to at least) to believe that what he says is reasonably accurate.

The blame seems to lie with the Surgeon General himself, and/or with the Surgeon General's office or associated offices that prepared the ancillary materials that accompanied the actual report.

I think there is only one way to fix the damage that has been done and to prevent further damage, and that is for the Centers for Disease Control and Prevention (CDC) to clarify (i.e., correct) the Surgeon General's statement. I think CDC has a responsibility to the public to do this.

I don't see how CDC can continue to remain silent in the face of this kind of distortion of the science regarding the dangers of secondhand smoke.

While I certainly hope that Wichita will enact a strong workplace smoking ban that includes all restaurants and bars, I hope that they don't enact it based on the mistaken belief that brief exposure to secondhand smoke is causing heart disease and lung cancer among Wichitans. The evidence that chronic exposure to secondhand smoke causes these diseases is sufficient to justify protecting all Wichita workers from the hazards of tobacco smoke exposure.

We don't need the Surgeon General's distortion of the truth to help support smoking bans. In fact, the deception only hurts the anti-smoking cause. It makes those of us who support smoking bans look like liars and it casts all of what we say - even our conclusions about the effects of chronic exposure - into public doubt.

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