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Smoking ban health miracles

April 15th, 2013 Posted in health, pseudo science by

Earlier this year a paper was published in a peer reviewed journal that was so contrived and so flawed that I had hoped it would convince any doubters that the evidence for miraculous immediate health effects from smoking bans is entirely the figment of activist’s febrile imaginations. Sadly, it appears that I was wrong and that true believers including David Cameron still cling to the notion that smoking bans “have had a pretty dramatic health effect”.  This delusion is shared by Anna Soubry who unforgivably and untruthfully claimed reductions in heart attacks and childhood asthma admissions as a result of the English smoking ban in evidence that she gave to the House of Lords (page 11).  The fact that she was standing next to the less than impartial Andrew Black at the time is no excuse as only someone without interest in truth or reality would take anything Black says at face value.

The “growing body of peer reviewed evidence” used to justify these counter-intuitive claims is an indictment of public health industry ethics and medical journal standards. This recent contribution claiming a 12% reduction is asthma admissions as a result of the smoking ban originates from Imperial College London which is cause for further concern because Imperial is a top UK research establishment and as such charges young people a small fortune to be educated by what one would hope are top academics.

The culprits behind this affront to science are Stanton Glantz and Christopher Millett. In case anyone is labouring under the illusion that these two are objective scientists, Glantz is a well-known anti-tobacco activist who together with Millett holds extreme views on smoking in movies. Glantz was recently mentioned in the US congress in relation to a $680,000 grant that he used to make the bizarre claim that the Tea Party was created 25 years ago by big tobacco. It is extraordinary that we ban tobacco company funded research on the basis of scientific objectivity but, by a widely accepted double standard, treat the output of blatantly biased activist obsessives as “scientific evidence” fit for Prime Ministers.

This paper is yet another example of torturing numbers to fit a theory. The authors produce a lot of complex statistical waffle to obscure the deception but their essentially simplistic claim can be illustrated using annual data for childhood asthma admissions from the same NHS source they use. In the figure below the blue bars are years pre-ban and the orange ones the year of the ban and one year later. The solid red line is a simple linear fit to the pre-ban data.

asthma 2002 2009

The claim that the ban reduced asthma admissions depends on showing that admissions rates were increasing pre-ban and that after the ban admissions were lower than predicted had that trend continued along the path illustrated by the dashed red line.  Millett uses the period 2002-2007 to model the “rising trend” in admissions but the NHS data goes back further and if we use all the available data the “trend” changes somewhat.

asthma 1998 2009

Cherry picking time periods is a common deception practiced by the public health industry together with taking advantage of coincidental variations in data series that happen to fit a theory or policy.

Those desperate to believe might argue that I am being too simplistic in that the “experts” took a more sophisticated approach and used monthly data. A 12% fall in admissions should not need sophisticated techniques to be apparent but it is true that 2007-08, the year of the ban, saw a big fall in admissions compared to the previous year. However, a look at NHS data for monthly admissions covering three years around the ban serves only to illustrate how the second element of the trick works.  asthma 2005 2008

If I asked a group of seven year olds which of the lines on the chart above was the odd one out, I would expect the majority to say the orange one. The orange line represents monthly admissions for the year before the ban. We can align the data on the month of July which was when the ban came in but it makes little difference. Admissions were low in the year the ban came into force but not unusually so. Both the alleged upward trend before the ban and the apparent fall in the year it was enacted work for the activists only because peak season admissions were unusually high in the year before the ban. That stroke of fortune combined with the cherry picked time frame form the basis of the deception.

This peer reviewed paper appears to be nothing more than a cheap trick, an abuse of academic freedom for political purposes. The authors admit to some of its flaws but this did not prevent them from issuing a carefully worded press release that inevitably led to a misleading claim being widely broadcast by a gullible and uncritical media. It even made BBC TV news! This is not an isolated incident. It forms part of a body of highly publicised but fundamentally flawed “research” that has led some politicians and at least one national leader to erroneously believe in unlikely health miracles associated with interventions such as smoking bans. This might well influence opinions when reviewing existing or considering additional interventions, which one can argue is the main purpose behind such publications and their attendant publicity.

Of course, those politicians obsessed with public health are never slow to accept even the most unconvincing “evidence” if it suits their prejudices. Despite widespread incredulity over the facile “evidence” underpinning the implausible notion that smoking bans produce big falls in heart attacks, Sarah Wollaston of minimum alcohol pricing fame has claimed that the UK smoking ban:

“…was a very good example of evidence-based policy. If you look at what has happened in terms of deaths of cardiac disease, it has been staggering. There’s been a huge drop … It surprised even the health experts.”

Wollaston exhibits blind faith in “evidence” that is of no better standard than the article reviewed here. Her need to believe does not make it true, or a good basis for policy.

I have contacted Pediatrics and asked how something so obviously contrived as the Millett paper could survive peer review. I was informed that it was reviewed by people who are “experts in their field”.  I wasn’t told what field, but expertise in either mathematics or ethics was apparently not considered necessary in this case. There are reasons why political stunts like this usually appear in medical journals rather than elsewhere in the literature and it is remarkable just how low some set the peer review bar. Peer review is supposed to be a minimum requirement able to identify fundamental methodological errors or false claims. Every time an article such as this is published in a “peer reviewed” journal, respect for this gold standard and science in general declines a little bit further. The collective damage is becoming significant and the implications extend way beyond smoking.

I have also contacted Imperial College press office but they have declined to comment on why they inflicted this press release on the general public. From direct experience I know that Imperial College employs many excellent lecturers and research scientists but based on this output I think that we should question what exactly young people are being taught for £9,000 a year and who is doing the teaching. Honesty, integrity and academic excellence are qualities that I would expect to see in those who benefit from the fees young people are now being asked to pay. I appear to be in a minority.

By Chris Oakley. Chris’ previous posts on Liberal Vision include: Minimum pricing – policy based evidenceAlcohol is Old News – Minimum Pricing for Digestives is the “Next Logical Step” , Soviet Style Alcohol Suppression Campaign Called for By Public Health Activists , Alcohol Taxation: The truth, the whole truth and nothing but the truth Lies, damn lies, statistics &… , The Department of Health is Watching You! , New bounty on smokers helps GPs balance their books.

7 Responses to “Smoking ban health miracles”

  1. harleyrider1978 Says:

    Research: Asthma found to be strongly associated to unhealthy Western dietary patterns

    Monday, April 15, 2013 by: David Gutierrez, staff writer
    http://www.naturalnews.com/039914_asthma_processed_foods_standard_American_diet.html


  2. harleyrider1978 Says:

    Smoking ban fails to halt lung cancer rise

    Monday 15th April 2013, 12:00PM BST

    EVIDENCE has emerged that Guernsey’s smoking ban in public and workplaces has struggled to contain lung cancer rates.

    Statistics released in the Channel Islands Cancer Registration Report showed that the number of new cases rose from 34 in 2006 – when the ban was introduced – up to 45 in 2008.

    The following year there was a slight drop to 43.

    But when European age-standardised rates were applied, it also showed that Guernsey’s lung cancer cases per 100,000 people was significantly higher than Jersey and the south west.

    The formula – which takes into account how many old or young people’s data was used to generate the figures – showed Guernsey’s 2009 lung cancer rate was 68 in every 100,000 people.

    By contrast, Jersey’s 2009 figure was 52 per 100,000 islanders while the south west’s was 53.
    http://www.thisisguernsey.com/news/2013/04/15/smoking-ban-fails-to-halt-lung-cancer-rise/


  3. Jason F Says:

    I am becoming increasingly incensed with the BBC in particular that reports, such as Glantz’s, just get regurgitated without any critical appraisal whatsoever. Whatever happened to journalism. We should expect more from the taxpayer funded BBC. If we can’t do better then frankly all we have is state-sponsored propaganda.

    Worse still however, is the blind regurgitation of this nonsense from the Minister of Health. With every day that passes it becomes clearer that Anna Soubry is not up to the job. Sacking a minister so soon after appointment is harsh – but necessary if she can’t actually do the job required.


  4. Chicken Little Says:

    Jason F. Good point about Soubry – she is clearly out of her depth. Rarely (ever?) has a Minster made such a fool of themselves so quickly (probably a record). It was a nice idea to appoint her – I personally had high hopes for her, but she is proving to be totally hapless.


  5. Jamie Williams Says:

    Fool or no fool, she is the person in the Government in charge of public health. That is terribly frightening if she has already turned into an evangelical health nut. What we need in government are Ministers who have a clear understanding of (a) science and (b) the issues surrounding any piece of legislation – not a patsy for the civil servants with their own cock-eyed agendas.

    Not only did the smoking ban kill off a large number of pubs, but by turning people out of the pubs onto the streets, it also put smoking into full public view millions of people. It also automatically created an association within children’s minds that smoking and drinking are inextricably linked “adult” activities, in a way that it never did before. Making smoking “cooler” than it previously was.

    Herding people out onto the streets to “save” bar staff, only to then worry about the impact this might have on kids on the streets seeing adults smoke outside pubs – is exactly the kind of counter-productive policy cock-ups you might expect from Labour. But surely we have learned by now that one policy action to protect one set of people, often has serious and unintended effects on another set.

    It seems pretty clear that if Government really is to have joined-up sensible policy, it must stop feeding the beast with £hundreds of thousands in cash. Then perhaps we will get accurate, unbiased scientific research, not just propaganda to justify the next research project.


  6. harleyrider1978 Says:

    The inconvenient truth is that the only studies of children of smokers suggest it is PROTECTIVE in contracting atopy in the first place. The New Zealand study says by a staggering factor of 82%.

    “Participants with atopic parents were also less likely to have positive SPTs between ages 13 and 32 years if they smoked themselves (OR=0.18), and this reduction in risk remained significant after adjusting for confounders.

    The authors write: “We found that children who were exposed to parental smoking and those who took up cigarette smoking themselves had a lower incidence of atopy to a range of common inhaled allergens.
    “These associations were found only in those with a parental history of asthma or hay fever.”

    They conclude: Our findings suggest that preventing allergic sensitization is not one of them.”
    The Journal of Allergy and Clinical Immunology
    Volume 121, Issue 1 , Pages 38-42.e3, January 2008
    http://www.jacionline.org/article/S00…(07)01954-9/abstract

    .
    This is a Swedish study.

    “Children of mothers who smoked at least 15 cigarettes a day tended to have lower odds for suffering from allergic rhino-conjunctivitis, allergic asthma, atopic eczema and food allergy, compared to children of mothers who had never smoked (ORs 0.6-0.7)

    CONCLUSIONS: This study demonstrates an association between current exposure to tobacco smoke and a low risk for atopic disorders in smokers themselves and a similar tendency in their children.”
    Clin Exp Allergy 2001 Jun;31(6):908-14
    http://www.data-yard.net/30/asthma.htm

    In 2008 this paper was produced in America and concludes that nictotine and hence active smoking and passive smoking leads to less asthma. It also gives the aetiology (causation) why nicotine and the biologial process that reduces asthma in recipients.

    The results unequivocally show that, even after multiple allergen sensitizations, nicotine dramatically suppresses inflammatory/allergic parameters in the lung including the following: eosinophilic/lymphocytic emigration; mRNA and/or protein expression of the Th2 cytokines/chemokines IL-4, IL-5, IL-13, IL-25, and eotaxin; leukotriene C4; and total as well as allergen-specific IgE. unequivocally show that, even after multiple allergen sensitizations, nicotine dramatically suppresses inflammatory/allergic parameters in the lung including the following: eosinophilic/lymphocytic emigration; mRNA and/or protein expression of the Th2 cytokines/chemokines IL-4, IL-5, IL-13, IL-25, and eotaxin; leukotriene C4; and total as well as allergen-specific IgE. ”

    http://www.jimmunol.org/cgi/content/a


  7. harleyrider1978 Says:

    This pretty well destroys the Myth of second hand smoke:

    http://vitals.nbcnews.com/_news/2013/01/28/16741714-lungs-from-pack-a-day-smokers-safe-for-transplant-study-finds?lite

    Lungs from pack-a-day smokers safe for transplant, study finds.

    By JoNel Aleccia, Staff Writer, NBC News.

    Using lung transplants from heavy smokers may sound like a cruel joke, but a new study finds that organs taken from people who puffed a pack a day for more than 20 years are likely safe.

    What’s more, the analysis of lung transplant data from the U.S. between 2005 and 2011 confirms what transplant experts say they already know: For some patients on a crowded organ waiting list, lungs from smokers are better than none.

    “I think people are grateful just to have a shot at getting lungs,” said Dr. Sharven Taghavi, a cardiovascular surgical resident at Temple University Hospital in Philadelphia, who led the new study………………………

    Ive done the math here and this is how it works out with second ahnd smoke and people inhaling it!

    The 16 cities study conducted by the U.S. DEPT OF ENERGY and later by Oakridge National laboratories discovered:

    Cigarette smoke, bartenders annual exposure to smoke rises, at most, to the equivalent of 6 cigarettes/year.

    146,000 CIGARETTES SMOKED IN 20 YEARS AT 1 PACK A DAY.

    A bartender would have to work in second hand smoke for 2433 years to get an equivalent dose.

    Then the average non-smoker in a ventilated restaurant for an hour would have to go back and forth each day for 119,000 years to get an equivalent 20 years of smoking a pack a day! Pretty well impossible ehh!


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