Monday, May 15, 2006

More Completely Fallacious Claims by Anti-Smoking Organizations; Now, Anyone Exposed to Secondhand Smoke Will Get Heart Disease

Whitman County (WA) Public Health Department, Tobacco Cessation Program: "A non-smoker exposed to cigarette smoke experiences hardening of arteries in as little as 30 minutes."

Smoke Free Gwinnett: "Nonsmokers exposed to secondhand smoke for just 30 minutes experience hardening of the arteries."

The Rest of the Story

These claims are particularly egregious violations of the public's trust, because they are blatantly false statements. They directly indicate to the public that just 30 minutes of exposure to secondhand smoke is enough to cause hardening of the arteries.

The Smoke Free Gwinnett is especially egregious because it actually suggests that any nonsmoker who is exposed to secondhand smoke for just 30 minutes will experience hardening of the arteries. This statement doesn't even tone down its distortion of the truth by suggesting that 30 minutes of exposure increases a nonsmoker's risk of atherosclerosis. Instead, it suggests that if you are exposed, you will experience hardening of the arteries.

The Whitman County statement also implies that a nonsmoker acutely exposed to secondhand smoke will get heart disease. It could take as little as 30 minutes (or perhaps it could take more), but according to the Tobacco Cessation Program in Whitman County, it is going to happen.

So far, these two statements have to take the cake for the most fallacious claims about the acute cardiovascular effects of secondhand smoke.

It is quite troubling to me that these claims just keep getting more and more fallacious, more and more ridiculous, and more and more irresponsible.

Here, we are actually suggesting to people that if they have ever been exposed to secondhand smoke for even a brief period of time (30 minutes or more), they now have heart disease. If this were true, most of the population would now have coronary artery disease and nearly all of us would have to go see a cardiologist tomorrow to have stress testing and possibly, cardiac catheterization to diagnose the extent of our coronary artery stenosis.

It doesn't take a rocket cardiologist to figure out that you simply can't get hardening of the arteries in 30 minutes. It takes a little longer than that - more like 30 years, although it occasionally can happen a bit more quickly than that. But not in 30 minutes. The process takes years.

How many smokers do you see dying of heart attacks in their 20's? The reason you don't observe smokers dying at that young age is that it takes more than 10 years to develop atherosclerosis from exposure to tobacco smoke - even with active smoking. Usually, we don't observe heart attacks in smokers until they reach at least 40 years of age, suggesting that it takes more on the order of at least 25-30 years for this process to occur.

While it is certainly true that 30 minutes of secondhand smoke exposure can cause endothelial dysfunction and platelet activation which signal the start of the atherosclerotic process, these changes are reversible and a nonsmoker will not develop hardening of the arteries from this single 30-minute exposure. It takes repeated exposure, over many years, for hardening of the arteries to occur.

It could be the case that these are honest mistakes and that there is no intent to distort the truth. But if that's the case, then our scientific credibility as a movement has to be put in question, because somehow we're not capable of communicating science accurately.

And this is no small mistake. It's completely erroneous information.

As public health professionals, I view it as our responsibility to be trustworthy in our public communications. The public, after all, relies on us for accurate information regarding their health risks.

Suggesting that anyone exposed to 30 minutes of secondhand smoke experiences hardening of the arteries is hardly a statement that the public should be relying upon. In fact, if the public did rely upon this statement, then there would be no reason for anyone to stop smoking. After all, if you already have heart disease from having had a sandwich in a smoky restaurant, what's the point of worrying about your own active smoking?

Frankly, it's getting quite ridiculous. This is a huge embarrassment to me as a tobacco control practitioner. And it's a huge embarrassment for the entire movement. You would think that we would be paying heed and entering into crisis mode to resolve this widespread and growing problem. But instead, our reaction is still denial that there is anything wrong and attacking the messenger for delivering this bad news.

It is that reaction which is most troubling to me, even more disturbing than the fallacious claims themselves. Because it suggests that not only are we irresponsibly making false statements to the public to support our agenda, but that we don't seem to care.

No comments: