Stanton Glantz's Margin of Error

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Stanton Glantz has written a response to my criticism of his study claiming that Helena, Montana's smoking ban cut heart attacks in half. Among other things, he says the study was not really that small, because "there were over 500 cases included in the analysis." He seems to be referring to the total number of heart attacks in Helena and surrounding areas from 1998 through 2002. But the outcome measure was heart attacks per month in Helena, a very small, highly variable number that ranged from 1 to 13 during the study period.

In response to my suggestion that the effect he attributes to the ban is preposterously large, Glantz says, "The individual risk of heart attack associated with passive smoking is about 30%, which is within the 'margin or error' of the 60% drop we saw in Helena." The 30 percent figure is the increase in risk associated with long-term secondhand smoke exposure in some epidemiological studies. It is itself implausibly high–about one-third the increased risk from smoking, which involves much higher levels of exposure–and it tells us nothing about immediate effects like those Glantz is claiming.

In any case, even completely eliminating secondhand smoke could reduce heart attacks by 60 percent only if exposure to secondhand smoke more than doubled the risk–an increase of 150 percent, compared to the 30 percent figure from the studies to which Glantz alludes. That does seem to be a pretty big difference, no matter what Glantz's margin of error was. And it implies that exposure to secondhand smoke is more dangerous than smoking.

Perhaps realizing how ridiculous and inconsistent this claim is, Glantz hedges by arguing that "when you make workplaces smokefree, many smokers quit or cut down, which reduces their risks of heart attack." But as I pointed out in my column, this effect could not possibly account for a drop of the magnitude Glantz is claiming, even if every smoker in Helena quit.

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  1. If you do a search on Glantz’ name on the Tobacco.org site you get 205 entries detailing his crusade to ban smoking in the US and UK. It is ludicrous to believe he is capable of producing an unbiased study about anything having to do with tobacco.

    It was funny when he peddled his message in London and was referred to as the “arch-creep” by the British tabloids.

  2. Good for Jacob Sullum, he does a splendid job of telling it like it is. Maybe Glantz’s title should be Professor of Spin since he seems better at that than statistics.

  3. Can we officially call this “junk science” now? 🙂

  4. You’ll notice that in the interest of a free and open debate, there was no link to Sullum’s article.

  5. Three weeks ago, a local radio station ran a US Government anti-smoking PSA claiming “Some studies actually show second-hand smoke is more dangerous than first-hand smoke.”

    Common sense is never common.

  6. Yes, anonymous, I originally put in my comment that Glantz had not linked, but I realized that would only be valid if Glantz were the one who webbed the article, which I don’t know. I thought about saying that Tobacco.org had not linked, but figured there was an outside chance that they are not actually a group with an agenda and that they only serve as a forum for debate, thus eliminating any motive they had for not linking. So I said what I did, which I guess was not really clear.

  7. Uhhh, Jim N…the link to Jacob’s article is hyperlinked to the word criticism…

  8. Glantz reminds me of an old Peanuts cartoon:

    Linus: How can you tell how old a tree is?

    Lucy: By counting the leaves.

    Linus: How do you know all these facts, Lucy?

    Lucy: I make ’em up.

  9. Uhhh, EcoDude…Jim N is referring to the fact that there is no link in Glantz’ response to Jacob’s initial criticism.

  10. I send this Glantz an email, pointing out that his study group was much too limited to prove anything. I don’t have a response yet, and don’t really expect one.

    I suggested to Glantz that if he really wants to study the effects of a smoking ban, New York over 5 years (assuming the ban lasts that long, by no means a given) would make a good choice. Lots of everything, including hospitals, peoples, etc. If such a study could show some statistical relationship between the ban and some measurable health effect, that would be persuasive.

    Of course, he won’t do it. Too much risk that the study wouldn’t show what he wants it to. Why? Heart attacks–is much too complicated to be predicated significantly upon one factor. A large group will reveal this.

  11. When the war on tobacco is over, Glantz will go down in the annals of history right beside Baghdad Bob for the caliber of his absurd lies.

    He says that similar effects to what he “found” in Helena cannot be ascertained in other places like California, because the bans were not immediate?!? Preliminary results of the CDC’s NHANES shows reduction of non-smoker exposure to SHS resulted in a 75% reduction of mean cotinine (a metabolite of nicotine) levels in their tests.

    Also Helena, as well as ALL other places in the US, has already banned smoking in PUBLIC buildings. It’s absurd to say this miraculous and “immediate” decrease in acute myocardial infarction as Glantz alleges happened in Helena could go unnoticed in our nations’ hospitals for so long.

  12. Glantz has cancer

  13. Glantz in a Prof. of Applied Machanics (statistics) He’s far from being a Medical Professional. Well, maybe a professional moron.

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