SUBJECT: SECOND-HAND SCIENCE

There have been 30-40 studies of ETS (Environmental Tobacco Smoke), some
sloppier than others. Results have been mixed. Some found relative risks (RR) on
the order of 2.5 (95% CI), *most* found none (RR< 1.2),a few even found negative
risk.

Since inconclusiveness wasn't the politically correct answer, Louis Sullivan &
Co. reached deep into the barrel and came up with a study conducted in Northern
China 'proving' that ETS it was killing 50,000 Americans per year (the number
has since been lowered several times, now stands at 2,000). I can't find that
study; vaguely remember reading that it had not even been published in a
peer-reviewed journal. Nonetheless it was the justification for the EPA's first
smoking ban.

Almost all these studies concentrate on non-smoking wives of smoking husbands,
as did that one. It found lung cancer rates of wives higher than the control
group. Based on the 50,000 figure, it must have found RR ~= 5.0, which is way
out of range of the other studies.

What it failed to consider, and the follow-up study revealed, was a difference
in cooking style between two socioeconomic groups. The wives of smokers fried
their food more than the control group. *Honest* researchers found a carcinogen
in airborne cooking oil which correlated very closely with their lung cancer.

Here's the scary part: the follow-up study was already in the hands of Louis
Sullivan's scientist/spokesman when he presented the flawed study as "scientific
proof" at a general news conference. The day before, when addressing a
scientific conference, he admitted the study was worthless.

Although the lie was not widely published in popular press (except National
Review Jul 19, 1993, v45n14, p. 15, "Second-hand science"), it was known to
epidemiologists. Embarrassed, the EPA dropped that study. Instead it picked 3-4
which did find a correlation, ignoring better studies which didn't. Since none
of the studies individually showed a high-enough correlation, the EPA COMBINED
THEM, even though their criteria and methodology were different.

Then, when the correlation still wasn't good enough, the EDA LOWERED THE
CONFIDENCE INDEX from 95% to 90%, which gave them an RR of 1.2. If this isn't
cooking the numbers, I don't know what is. One gets the impression they would
have lowered it to 85, 80 or whatever it took. Actually they didn't go low
enough; RR=1.2 is not enough to overcome unrecognized bias and noise in the
data. See Mantel & Haenszel, "Statistical aspects of the analysis of data from
retrospective studies of disease", J Natl Cancer Inst. 1959;22:719-748, which
suggests a minimum RR of 1.5 to be considered meaningful.

Is this science? It was the sole justification for declaring ETS a Class A
carcinogen and an impending 'emergency' ban on smoking in all indoor places.

Let's look at one of the reports the EPA *did* use: "Environmental Tobacco Smoke
and Lung Cancer Risk in Nonsmoking Women", Stockwell et al, J Natl Cancer Inst.
1992;84:18:1417-1421. It finds a 2.4 Odds Ratio (I assume that's the same as RR)
in women who reported > 40 years of exposure in adulthood or > 22 years in
childhood and adolescence. It says "We found no statistically significant
increase in risk associated with exposure to ETS at work or during social
activities." -- exactly what it's being used to ban. Nor did it find any
correlation in adult exposure less than 40 years. It cites several other studies
including this: "A study of lifetime nonsmoking women in Hong Kong by Koo et al
showed that exposure to ETS was associated with elevated risk of squamous cell
and large-cell carcinomas."

Ok, let's look at "Measurements of Passive Smoking and Estimates of Lung Cancer
Risk Among Non-smoking Chinese Females", Koo et al, Int. J. Cancer,
1987;39:162-169. It is an interesting read. Contrary to the cite it concludes
"In our analysis of *all* never-smoked cases, the lack of a dose-response
pattern, and an almost consistent drop in RR at the highest doses of exposure
would seem to lead little, or only weak support for the passive smoking linkage
with lung cancer ... the effects of passive smoking might be so weak that they
are easily overshadowed by other environmental factors such as diet or exposure
to inhaled gaseous/particulate matter from other sources."

Quite a difference from Stockwell's characterization, eh? Typical findings in
the Koo study look like this:

Cig/day by husband:                    Adjusted RR
0                                             1.00
1-10                                          2.33
11-20                                         1.74
21+                                           1.19

By period of life:
No exposure                                   1.00
Childhood only                                2.07
Adulthood only                                1.68
Both childhood and adulthood                  0.64 !

Mean hours of exposure per day (>25 years)
< 1.5                                         1.47

> 1.5                                         1.07

These are not atypical. Other studies have found the same inverse effect to
dosage.

Now let's look at another EPA-friendly study in the headlines: Trichopoulos et
al, "Active and passive smoking and pathological indicators of lung cancer risk
in an autopsy study", JAMA,
1992;268:1697-1701. The abstract, widely quoted in the popular press,claims it
was based on "hundreds of people". It was actually based on 30 autopsies
performed in Athens. The published report does not contain *any data* to support
its primary conclusion: a link between passive smoking and lung cancer. Is this
science? Moreover, the report contradicts its own abstract when it says
"overall, the results of the present investigation ... cannot facilitate the
resolution of this important and controversial issue."

For those interested: after reading the report I suggest reading JAMA,1993;
270:14:1689-1691 (also 1742) for letters to the editor containing well-reasoned
rebuttal.

Meanwhile, on the grunt front, Indoor Air Review ("The Newspaper of the Indoor
Air Quality Industry", 4520 East-West Highway (#610), Bethesda,Md 20814,
$72/yr), which I read regularly, is strangely non-commital on the dangers of
ETS. Articles and advertisements are not bashful about opining on other dangers:
asbestos, radon, sick building syndrome (SDS,molds), CO2 and carpeting (which
they consider another false issue). They see ETS as a prospect for employment
but not a serious problem. Oddly, I've never seen a single ad for an ETS
monitor, although there are numerous ads for other monitors.

On the legal front, courts largely see it as a social change, refusing to
recognize non-smokers' alleged 'rights' nor grant awards for injury.

Why the perceived need to prove a link? Because it gives anti-smokers 'standing'
-- a rational interest. Otherwise they'd just be imposing their personal
preference on others against their will. In fact, that's exactly what they're
doing.

In summary: this is Political Correctness and Neo-Puritanism at its worst. I
expect politicians to lie and pander. I expect the public to be unsophisticated
and paranoid. I can live with lazy & sloppy research,errors in interpretation.
What bothers me is scientists who prostitute their objectivity for a few shekels
of grant money and the approbation of like-minded peers.
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--- timEd-B10
 * Origin:  Classical Liberal BBS, Victoria BC  (1:340/47)
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