'No Safe Level of Secondhand Smoke'?

Here is my USA Today "Opposing View" on the surgeon general's secondhand smoke report. They have titled it "The Science Is Not In," which is odd because my main points were:

1) The science probably will never be "in," if that means conclusive proof that long-term exposure to secondhand smoke causes lung cancer and heart disease, because low-level risks are very hard to confirm in epidemiological studies.

2) The science is irrelevant to the policy question of whether the government should dictate smoking rules on private property.

The USA Today editorial asserts that "only smoke-free environments prevent risk." Today's New York Times likewise claims the surgeon general's report concluded "there is no safe level of secondhand smoke," a position that contradicts the basic toxicological principle that the dose makes the poison. Since it is difficult even to measure the health consequences of long-term, relatively intense exposure to secondhand smoke among people living with smokers for decades, how could one possibly demonstrate an effect from, say, a few molecules? It's clear that the vast majority of people exposed to secondhand smoke suffer no noticeable injury, so in what sense is their exposure unsafe? "No safe level" is an article of faith, not a scientific statement.

In any case, contrary to what he Times and various other news outlets are saying, this assertion does not seem to appear in the surgeon general's report. The closest thing I could find was this discussion of respiratory hazards from Chapter 2:

The evidence for underlying mechanisms of respiratory injury from exposure to secondhand smoke suggests that a safe level of exposure may not exist, thus implying that any exposure carries some risk. For infants, children, and adults with asthma or with more sensitive respiratory systems, even very brief exposures to secondhand smoke can trigger intense bronchopulmonary responses that could be life threatening in the most susceptible individuals.

As far as I can tell, there is no blanket statement that any amount of tobacco smoke is inevitably harmful. In any case, as Mark Wernimont notes at Clearing the Air, the Occupational Safety and Health Administration does set acceptable levels for the chemicals in tobacco smoke. Wernimont cites several studies of real-world concentrations in environments where smoking is permitted, including one by the American Cancer Society, that found levels well below the OSHA limits. As I noted in my book For Your Own Good: The Anti-Smoking Crusade and the Tyranny of Public Health, two studies using personal air monitors conducted in the 1990s found that nonsmokers with the heaviest exposure to secondhand smoke were absorbing between 0.8 and 1.5 milligrams of "tar" a day. By comparison, a single regular Marlboro has an official (machine-measured) tar yield of 12 milligrams.

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  • Taktix||

    It can't be declared safe, because how are the bureaucrats supposed to get their cigarette tax money?

  • ||

    low-level risks are very hard to confirm in epidemiological studies

    This needs to be hammered home more. I have nothing against valiant epidemiologists striving mightily to quantify what they can, but some people over-interpret the studies that they read about in the paper. A single study comes out saying that some particular food, medication, recreational substance, exercise, environmental factor, etc. slightly increases/decreases the chances of something good/bad happening.

    Boom! Everybody in the media is talking about big lifestyle changes.

    Now, that's not to suggest that the study is worthless. Finding a small effect is an interesting result in its own right. It can be used to point out a direction for future research, or perhaps it can be used to debunk speculation that the effect is in fact quite large. Sometimes a small observed effect masks the fact that there's an interesting subset of the population for which the effect is actually large. So there are all sorts of good reasons to conduct, report, and follow up on studies that find small effects.

    But that doesn't mean that the rest of us should run out and make drastic changes in response.

  • ||

    There's a difference between claiming that any exposure to second hand smoke is harmful, no matter how small the dose (which would indeed be an act of faith), and refusing to establish a "safe" exposure limit simply because harm has not yet been observed at that level of exposure. This is simply an application of the principle of caution.

    Unlike people, toxins should be guilty until proven innocent.

  • Jennifer||

    To repeat a comment I made in yesterday's thread: considering how ubiquitous public smoking was from the 1920s through at least the 1970s, if secondhand smoke were as dangerous as they say then the majority of Americans above age 30 would be suffering from lung cancer and other secondhand-smoke-related problems right now.

  • ||

    Please. Not everyone dies of lung cancer that is exposed to toxic tobacco smoke. Kids growing up from their nicotine addicted parents had issues like asthma, ear infections and other breathing problems, if not succumbed to the destructive and expensive addiction itself. What role models they were, huh...

  • Dennis||

    The negative effects of SHS smoke are long-term. This has been prove by overwhelming scientific evidence.

  • ||

    The problem, Mark, is tahat toxicity is inherently dosage specific.
    This debate is about whether second hand smoke is toxic; taking your approach would require us to ban all chemical substances, since all have an LD50 > 0.

    hugs,
    Shirley Knott

  • ||

    As always, Sullum rocks. I have a question, though: what is tar yield? The amount of tar present in the cigarette, the amount of tar that will be deposited in a typical smoker's lungs, both or neither?

  • ||

    As always, Sullum rocks. I have a question, though: what is tar yield? The amount of tar present in the cigarette, the amount of tar that will be deposited in a typical smoker's lungs, both or neither?

  • ||

    As always, Sullum rocks. I have a question, though: what is tar yield? The amount of tar present in the cigarette, the amount of tar that will be deposited in a typical smoker's lungs, both or neither?

  • ||

    As always, Sullum rocks. I have a question, though: what is tar yield? The amount of tar present in the cigarette, the amount of tar that will be deposited in a typical smoker's lungs, both or neither?

  • ||

    As always, Sullum rocks. I have a question, though: what is tar yield? The amount of tar present in the cigarette, the amount of tar that will be deposited in a typical smoker's lungs, both or neither?

  • ||

    Dear Surgeon General Carmona,

    I'm going to have a glass of Scotch and a big Dominican cigar tonight after work.
    I'm smoking the cigar indoors, but my window will be wide open.

    Fuck you and your clown costume.

    Sincerely,
    Ed

  • ||

    There is no safe number of stairs to climb without wearing a helmet. Eventually you all will recognize that, perhaps after hearing some tragic story of a toddler that cracked his skull. By 2015, 39 stats will have laws requiring helmets for children under 12 who go up and down stairs. By 2022, helmets on stairs will be required for everyone in all states. It's for safety, you know.

  • ||

    "To repeat a comment I made in yesterday's thread: considering how ubiquitous public smoking was from the 1920s through at least the 1970s, if secondhand smoke were as dangerous as they say then the majority of Americans above age 30 would be suffering from lung cancer and other secondhand-smoke-related problems right now."

    Which "they" are you referring to? Most epidemiologists would agree that the relative excess mortality risk (due mainly to cancer and heart disease) attributable to second-hand smoke exposure is absolutely tiny in comparison to the same risks from active smoking, so small in fact that they are almost impossible to detect, even in the largest and longest epidemiological studies.

    So, no, you surely would not expect "the majority of Americans above age 30 would be suffering from lung cancer and other secondhand-smoke-related problems right now," even if it is true that second-hand smoke has the effects claimed for it by some epidemiologists.

  • ||

    "The Debate is over. The science is in"

    Has Al Gore had a faceover and a white suit transplant, or has the Surgeon General entered a fugal state in which he imagines regurgitating Al's talk show opening lines on climate change and the precautionary principle can pass for epidemiology?

  • ||

    Paul,

    In FTC protocol, "tar yield" means the dry weight of material deposited in a standardized filter of a cigaretter smoked by a standardized smoking machine.

  • Jennifer||

    Which "they" are you referring to?

    The "they" who claim secondhand smoke is so dangerous that it needs to be completely eradicated from society.

  • ||

    The hell with epidemiology. It's too hard to spell, much less let it interfere with our gut instincts. Now what I'd like to see is a double blind study of the long term effects of second hand smoke vs. second hand farts.

  • ||

    Wouldn't a second-hand fart be one that was ingested and re-farted?
    I could get behind a ban on that kind of behavior.

  • ||

    Unlike people, toxins should be guilty until proven innocent.

    But we aren't talking about controlling toxins, we are talking about controlling people.

  • ||

    If secondhand smoke was so harmful then why is my 80 year old mom so healthy and going strong after living for 35 years with my dad who smoked several packs a day?

    As a side note, my grandmother had a little hand-operated device for rolling her own cigarettes. As a kid I would help her roll her own filterless cigarettes. She lived well into her 70's.

  • ||

    Ed, second hand farts, like second hand smoke, are those that you don't create, but nonetheless smell. I've carving out an exemption for first hand farts as free expression (or at least punctuation.)

    The problem with a `...toxins guilty until proven innocent...' concept is in defining toxin. Too much oxygen in the bloodstream is fatal, as is too much water in the lungs. Many substances have a benefical effect at a certain exposure, and a detrimental effect at a different level. Defining zero as the appropriate level until proven otherwise smacks of the precautionary principle, which is a highly unprinicpled way of thinking.

  • ||

    "Now what I'd like to see is a double blind study of the long term effects of second hand smoke vs. second hand farts."

    Great idea, we just need to find a way to "blind" the subjects as to whether they are being exposed to the tobacco smoke or farts. Most people can tell the difference immediately.

  • ||

    I'd rather smell a bad cigar than a good fart any day.

  • Jennifer||

    Farts are methane gas, are they not? Poisonous. And a greenhouse gas to boot. Far more dangerous than secondhand cigarette smoke.

    If we really want to make America healthy, we should make it illegal for sick people to go out in public. How many colds have I suffered through that never would have happened if I hadn't been exposed to a secondhand virus? The flu kills more Americans every year than secondhand smoke, and yet sneezy people with runny noses walk through public places with impunity.

  • ||

    "If secondhand smoke was so harmful then why is my 80 year old mom so healthy and going strong after living for 35 years with my dad who smoked several packs a day?"

    Why do you think that your mother living to 80 is odd or unusual, even if it is true that second-hand smoke increases the risk of cancer and heart disease the way anti-smoking people claim? Even the studies which purport to find impacts of SHS on mortality and chronic disease find that they impacts are very small. Therefore there should only be small differences in the number of SHS-exposed and SHS-nonexposed people making it to, say, 80.

  • ||

    "Farts are methane gas, are they not?"

    No, most farts contain no methane.

  • ||

    And fwiw, "methane is not toxic by any route", according to Wikipedia anyway.

  • Jennifer||

    No, most farts contain no methane.

    Sure they do--that's why when kids light their farts, the flames are blue. Here's the explanation from the Straight Dope:

    I've just been reading up on the subject in the Harvard Medical School Health Letter. Harvard is a veritable gold mine when it comes to flatulence.

    Intestinal gas, we learn, is made up mostly of five gases: nitrogen, oxygen, carbon dioxide, hydrogen, and methane. The first two you get from swallowing air during eating, while the last three are generated in the large intestine. From this we may deduce that burps and belches, which emanate from the stomach, consist mostly of air. Hiccups and sneezes, of course, are wholly unrelated.

    Hydrogen and carbon dioxide are produced by bacteria nibbling on undigested food in the colon. The noble bean, for instance, contains complex sugars that cannot be broken down by the body's digestive juices. Upon arriving in the colon, these sugars are set upon vigorously by the resident microbes, and the resultant fermentation produces the cheerful calliope effect celebrated in such cinematic masterworks as Blazing Saddles. Methane, another digestive byproduct, is responsible for the unique blue flame that has absorbed the attentions of college freshmen for generations.

    http://www.straightdope.com/classics/a1_079.html

  • ||

    Harvard is a veritable gold mine when it comes to flatulence.

    True dat.

  • ||

    Jennifer,

    Don't forget the mercaptans.

  • James Anderson Merritt||

    Ayatolla Usoe said, "Too much oxygen in the bloodstream is fatal, as is too much water in the lungs."

    Look for these to be labeled as "pollutants" if current efforts to label carbon dioxide as such prove successful.

  • ||

    I now know more about farts than I ever wanted to know.
    But when can we expect to see the Surgeon General's warning on said smelly vapors?

  • ||

    As I understand it, those who experience birth have a 100% mortality rate.

  • ||

    Why do farts smell?

    So deaf people can enjoy them too.

    Eliminating farts would clearly be against the ADA...

    hugs,
    Shirley Knott

  • ||

    "No, most farts contain no methane." Sure they do--that's why when kids light their farts, the flames are blue. Here's the explanation from the Straight Dope:

    Nope, most farts contain no methane, as I stated, and the SD link provides no evidence to the contrary -- rather it simply points out what everyone already knows, that *some* farts do contain methane.

    One online source states that:

    According to Dr. James L. A. Roth, the author of Gastrointestinal Gas (Ch. 17 in Gastroenterology, v. 4, 1976) most people (2/3 of adults) pass farts that contain no methane. If both parents are methane producers, their children have a 95% chance of being producers as well. The reason for this is apparently unknown.
    http://www.heptune.com/farts.html

  • ||

    Why do farts smell?

    There are many compounds in farts that stink, a main one being hydrogen sulfide. Methane itself, of course, is odourless.

  • uncle sam||

    Smoking probably would not have become such an issue but for those inconsiderate smokers who insisted they could not enjoy their meal at a restaurant without a smoke for their dessert.

  • Ken Layne||

    Nice work on the USA Today rebuttal.

    I just read it downstairs in the casino restaurant here in Winnemucca, while having lunch in the huge non-smoking section (about 75% of the dining room) provided because lots of people don't want to eat in a cloud of cigarette smoke.

    "Nevada now ranks as the worst state in the nation for protecting nonsmokers," according to local fanatics who would like to change the laws, yet there are many hundreds of restaurants in Vegas, Reno and beyond that *choose* not to allow customers to smoke. Seems to work pretty well ...

  • ||

    No, most farts contain no methane.

    Just the kind of misinformation you'd expect to hear from someone who is sooooooooooo obviously in the pocket of Big Bean...

  • nk||

    I was going to post a serious comment until I saw how this thread had deteriorated into a discussion of flatulence. So, instead, I will post a story.

    A simple, unsophisticated guy, much like myself, is invited to a formal dinner. During the course of the dinner, the hostess breaks wind loudly. Immediately, the gentleman sitting to the left stands up and says "Excuse me". A little later, the hostess breaks wind again. Immediately, the gentleman sitting to the right stands up and says "Excuse me". This piques the unsophisticasted guy's curiosity. He asks the guy next to him, "Why did those two guys apologize for farting when everyone knows our hostess did it?" His neighbor says, "It's the gentlemanly thing to do, to save the lady from embarassment." A little bit later, the hostess breaks wind again. The unsophisticated guy immediately jumps up and says, "Sit down guys, this one's on me."

  • ||

    I didn't mean to take this thread far afield. I just find it odd that our nanny state is out to protect us from something that is not harmful, but perhaps disagreable -- second hand smoke, and I substituted another similarly offensive intrusion, and wondered why there is no parallel attempt to protect us there. Where is the $4 per can tax on beans? The collection of employees standing outside the building entrance in a cloud of flatulence that we must negotiate? Where are the "No Farting" signs, or even the "Thank You For Not Farting" ones?

    Now as to the methane in or out debate. I refer you to the respected Merck Manual http://www.merck.com/mrkshared/mmanual/section3/chapter32/32b.jsp and suggest, if you read nothing else, at least read the part at the bottom, which appeared in prior publications, was removed by management, and reinserted by popular (if juvenile) demand.

  • ||

    read the part at the bottom, which appeared in prior publications, was removed by management, and reinserted by popular (if juvenile) demand.

    Yes

  • ||

    "The science is irrelevant to the policy question of whether the government should dictate smoking rules on private property"

    I'd like to take issue with this point. If the science showed that secondhand smoke was as dangerous as plutonium dust in the air, surely this would be a pretty strong argument for a smoking ban? Similarly, if the science showed that secondhand smoke was a harmless but obnoxious habit (rather like, say, wearing shiny green suits), the argument would be pretty strongly against a ban.

  • ||

    If the science showed that secondhand smoke was as dangerous as plutonium dust in the air, the people first exposed (ie the smokers) would be dropping dead so fast that they'd hardly have time to harm anyone else.

  • Kevin Murphy||

    The problem with the quoted section is that there are countless substances which *some* individuals cannot be exposed to at all, without severe and possibly life-threatening reactions.

    Allergies are the most common of these, either by direct ingestion, skin contact or inhalation. Peanuts, latex, etc. Do we regulate these as well? Remember, rare as some of these conditions are so are the extreme conditions the SG mentions.

    I have an extreme reaction to Parmesan cheese. I cannot be near it. I will pass out, or worse. Should you be constrained by my allergy, or is it up to me to avoid it wherever possible? I think the latter, but then I'm not good at being a victim. Only once in my life (on a full airplane) have I had to tell someone to "please put that away." But I would have moved if I could, if only to make it stop quicker.

    But, again, what is the public policy suggestion if there are *some* people who have a severe problem with tobacco smoke? If it's "ban it", then, my, what a list we have to go through.

  • ||

    The SG's report is just recycling. It references the previous SG reports over and over again. Simple fact, this report is based in the same old tired set of studies including the EPA report that was OVERTURNED in court to to '"The Agency disregarded information and made findings based on selective information... deviated from its own risk assessment guidelines; failed to disclose important findings and reasoning; and left significant questions without answers... Gathering all relevant information, researching and disseminating findings were subordinate to EPA's demonstrating ETS was a Group A carcinogen"

    "In this case, EPA publicly committed to a conclusion before research had begun; adjusted established procedure and scientific norms to validate the Agency's public conclusion, and aggressively utilized the Act's authority to disseminate findings to establish a de facto regulatory scheme...

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