Monday, December 27, 2010

Quarterfinalists for 2010 Tobacco Control "Lie of the Year Award"

Here are the 8 quarterfinalists for the 2010 Tobacco Control Lie of the Year Award:

1. Free & Clear


The Lie: "Using an integrated mix of medication support, phone-based cognitive behavioral coaching and web-based learning and support tools the Quit For Life Program produces an average quit rate of 45% for employers, making it 9 times more effective than quitting “cold turkey.”"

The Rest of the Story: What Free & Clear does not tell the consumer is that the quit rates reported on the site are known not to be accurate, as they are based only on survey responders and ignore respondents who are lost to follow-up, who we know are most likely those who have failed to quit smoking. In my view, this is fraudulent marketing, because it the company is knowingly providing a quit rate that is invalid -- essentially by definition the true quit rate is substantially lower than that which is being advertised.

2. United States Surgeon General's Office

The Lie: (1) "Even brief exposure to secondhand smoke can cause cardiovascular disease and could trigger acute cardiac events, such as heart attack."; (2) "Inhaling even the smallest amount of tobacco smoke can also damage your DNA, which can lead to cancer."

The Rest of the Story: It is simply not true that even brief exposure to secondhand smoke can cause cardiovascular disease. Luckily, it takes many years of exposure before the process of atherosclerosis (hardening of the arteries) can occur. Fortunately as well, inhaling the smallest amount of tobacco smoke does not lead to cancer. While the Surgeon General is correct in asserting that the tiniest amount of tobacco smoke can damage your DNA, it simply is not true that someone who inhales the tiniest amount of tobacco smoke may well develop cancer because of it. There is certainly no evidence to support such a statement.

3. Americans for Nonsmokers' Rights

The Lie: (1) "there are virtually no health disparities between active and passive smoking."; (2) "The risks of heart disease associated with secondhand smoke are twice what were previously thought and are virtually indistinguishable from those associated with active smoking."; (3) "Just thirty minutes of exposure to secondhand smoke can cause heart damage similar to that of habitual smokers."

The Rest of the Story: ANR's claim that there are virtually no health disparities between active and passive smoking is a lie. If ANR were being truthful in claiming that passive smoking has virtually the same level of health effects as active smoking, then there would be tens of thousands more deaths from secondhand smoke than we currently observe. How can ANR can claim that there are virtually no health disparities between active and passive smoking? That implies that active smoking is virtually no more dangerous than exposure to secondhand smoke. We know this is not true, because there is a dose-response relationship between tobacco smoke exposure and lung cancer. The relative risk of lung cancer among active smokers is about 17, while the relative risk of lung cancer among passive smokers is about 1.3. Even if we restrict ourselves to the risk of heart disease, the scientific evidence simply doesn't support the conclusion that the risk of heart disease is "virtually" the same for active and passive smokers. If ANR were to inform an active smoker that his risk of heart disease was no different than that of a passive smoker, it would essentially represent malpractice, because unless this smoker is an extremely light smoker, the information is undeniably false.

The statement that brief exposure to secondhand smoke causes heart damage in nonsmokers similar to that observed in active smokers is also a lie. Nonsmokers exposed briefly to secondhand smoke do not suffer heart damage similar to that of habitual smokers. In fact, they do not suffer heart damage at all. Brief tobacco smoke exposure does not cause heart damage. What is does cause is endothelial damage (reversible vascular injury to the cells that line the coronary arteries). Heart damage refers to actual damage to the heart muscle, such as one sustains after myocardial ischemia or a heart attack. Believe me, the subjects in the Otsuka experiment did not suffer heart damage. If they did, they could sue the university for causing this damage. The IRB would never approved the study if it was even thought that the tobacco smoke exposure might cause heart damage. ANR is disseminating a lie that distorts the truth and makes brief tobacco smoke exposure sound much worse that it actually is.

4. Florida Department of Health

The Lie: "Non-smokers exposed to secondhand smoke for just 30 minutes experience hardening of the arteries."

The Rest of the Story: Obviously, this claim is a lie. It is impossible for a person to develop hardening of the arteries in just 30 minutes. Even an active smoker needs to smoke for many years before developing hardening of the arteries. You don't have 17 year old smokers walking around with hardening of the arteries.

5. Maricopa County Department of Public Health

The Lie: "Nonsmokers exposed to secondhand smoke for just 30 minutes experience hardening of the arteries."

The Rest of the Story: Just as with the lie from the Florida Department of Health, the study used to support this claim is also the Otsuka study. However, once again, that study did not show that nonsmokers exposed to secondhand smoke for just 30 minutes experienced hardening of the arteries. It merely showed that they sustained vascular injury in terms of endothelial damage. The subjects in the Otsuka experiment certainly did not experience hardening of the arteries. The Institutional Review Board would never have approved such a study if there was even a possibility that the subjects would develop atherosclerotic heart disease as a result of the 30 minute tobacco smoke exposure. Obviously, this claim is a lie. It is impossible for a person to develop hardening of the arteries in just 30 minutes. Even an active smoker needs to smoke for many years before developing hardening of the arteries. You don't have 17 year old smokers walking around with hardening of the arteries.

6. Breathe California of Sacramento-Emigrant Trails

The Lie: "Smoking kills about 340 young people a day."

The Rest of the Story: According to Breathe California of Sacramento-Emigrant Trails, then, smoking kills more than 124,000 young people every year. Obviously, this is not true.

7. FDA and U.S. Department of Health and Human Services

The Lie: "Almost 90 percent of adult smokers start smoking as teenagers. These flavored cigarettes are a gateway for many children and young adults to become regular smokers."; "Flavored cigarettes attract and allure kids into lifetime addiction. FDA's ban on these cigarettes will break that cycle for the more than 3,600 young people who start smoking daily."

The Rest of the Story: It is demonstrably false that flavored cigarettes are a gateway to cigarette smoking, that they contribute significantly to addiction of youths to tobacco, that the tobacco industry uses these flavored cigarettes to hook children, and that the FDA ban on candy-flavored cigarettes will have any impact whatsoever on youth smoking. (This is with the exception of menthol, the one flavoring which is actually used by the tobacco companies to hook kids, but which is exempt from the flavoring ban.) In fact, prior to the implementation of the law, not a single flavored cigarette brand (other than menthol cigarettes) produced by one of the major tobacco companies - including Philip Morris, Reynolds American, or Lorillard - was on the market. And the overall market share of flavored cigarettes among youth smokers was less than 0.1%. The truth is that nearly every youth who is addicted to tobacco smokes one of the major cigarette brands - including Marlboro, Camel, Newport, Kool, Winston, Parliament, and Basic. None of these are flavored cigarettes (again, with the exception of menthol, which I'll get to shortly). The truth is that the predominant gateway to youth smoking is non-flavored cigarettes (excluding menthol). The removal of flavored cigarettes from the market by the FDA will have no impact whatsoever on youth smoking. The only thing that would have had an impact is the removal of the non-flavored cigarettes - like Camels, Marlboros, and Newports - which are smoked by greater than 85% of all youth smokers.

8. American Cancer Society

The Lie: "The American Cancer Society, along with the broader public health community, fought the tobacco industry for more than a decade to get this historic legislation passed."

The Rest of the Story: The statement is simply not true. The biggest supporter of the FDA tobacco legislation, and a contributor of enormous lobbying expenditures in support of the bill, was none other than Philip Morris, the nation's largest tobacco company. Why does the American Cancer Society have to continue to lie like this? Why are they seemingly incapable of telling the American people the truth: that Philip Morris supported this bill?

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