What is the truth about the dangers of secondhand smoke? Why has it taken so long for people to understand them?<\/p>\n\n\n\n
In Merchants of Doubt<\/em>, Naomi Oreskes and Erik Conway look at the history of doubt-mongering surrounding the dangers of secondhand smoke. The merchants of doubt<\/a> attacked the Environmental Protection<\/a> Agency (EPA) for doing \u201cbad science.\u201d This had crucial implications for public awareness and policy.<\/p>\n\n\n\n Read more to learn about the truth and doubt surrounding the dangers of secondhand smoke.<\/p>\n\n\n\n\n\n\n\n In the 1970s, tobacco industry<\/a> scientists discovered that secondhand smoke could cause cancer. In fact, they discovered that secondhand smoke was actually <\/strong>more<\/em><\/strong> toxic than active smoke.<\/strong> This was partly because more toxic compounds develop when cigarettes burn at a lower temperature (smoldering) than at a higher temperature (while smoking).<\/p>\n\n\n\n The industry responded to this discovery by:<\/p>\n\n\n\n Mainstream science started to unearth the dangers of secondhand smoke in the 1980s<\/strong>:<\/p>\n\n\n\n The tobacco industry attacked both papers. They criticized the first because the offices were \u201csmoky,\u201d but scientists hadn\u2019t measured exactly how much smoke the workers were exposed to. <\/strong>(This is a hard thing to measure because smoke quickly disperses in the air.)<\/p>\n\n\n\n To deal with the second paper, they hired consultants to disprove Hirayama. One consultant accused Hirayama of making a critical statistical error,<\/strong> and the Tobacco Institute advertised the critic\u2019s work and got the press to cover it by calling for coverage of \u201cboth sides\u201d again. (Industry internal memos acknowledged that Hirayama\u2019s study was accurate, and he was an expert scientist.)<\/p>\n\n\n\n The industry received equal media coverage, but their tactics didn\u2019t fool the scientific community, and medical professionals and anti-tobacco activists pushed for regulation of smoking in public. <\/strong>States started restricting public smoking, the Civil Aviation<\/a> Board considering banning smoking on flights, and Congress considered advertising controls.<\/p>\n\n\n\n In 1986, a Surgeon General\u2019s report announced that secondhand smoke could cause health problems, including lung cancer, even in people who didn\u2019t smoke. Additionally, secondhand smoke was especially dangerous to young children.<\/strong> The Executive Summary of the report strongly advised policy action. Smoking was no longer something that only affected the smoker\u2014it could kill bystanders too.<\/p>\n\n\n\n These developments worried the industry because if people were no longer able to smoke in public places, they would smoke less. They responded by:<\/p>\n\n\n\n Tobacco company Philip Morris\u2019s leaders came up with four goals for secondhand smoke in 1991:<\/p>\n\n\n\n In 1992, the U.S. Environmental Protection Agency (EPA) reviewed the existing scientific studies on the dangers of secondhand smoke<\/strong> and released a report that concluded:<\/p>\n\n\n\n The EPA developed the report according to the \u201cweight of evidence approach\u201d\u2014which considers all evidence and determines what it points most strongly toward.<\/strong> This is useful because all studies have limitations, but looking at all of them will give the most accurate picture.<\/p>\n\n\n\n The merchants of doubt responded by weighing in on the EPA report and attacking mainstream science.<\/p>\n\n\n\n Enter Fred Seitz. Seitz started working on secondhand smoke in 1989, and to address the EPA report, he suggested that instead of challenging the evidence itself, the industry should cast doubt on the EPA\u2019s <\/strong>approach <\/em><\/strong>(weight-of-evidence). The industry would claim that examining all the evidence was a mistake and that it would be better to focus on the \u201cbest evidence.\u201d<\/strong><\/p>\n\n\n\n This wasn\u2019t inherently unreasonable. Some studies are <\/em>bad and don\u2019t deserve to be considered. However, a \u201cbest evidence\u201d approach could quickly turn into focusing only on the evidence that agrees with your position, and Seitz considered that the \u201cbest evidence\u201d to be studies with \u201cideal research designs.\u201d Ideal research designs are impossible in medical studies of humans, because the variables can\u2019t be completely controlled. The tobacco industry didn\u2019t think Seitz\u2019s ideas would be effective, and they went to work with Fred Singer instead.<\/strong><\/p>\n\n\n\n Singer\u2019s approach was to promote science that agreed with the industry\u2019s position as \u201csound science\u201d and to dismiss everything else as garbage. <\/strong>To effectively do this, he and the industry would have to:<\/p>\n\n\n\n In March 1993, Singer wrote an article called \u201cJunk Science at the EPA\u201d that accused the EPA of doing bad science by:<\/p>\n\n\n\n In 1993, the tobacco industry put out a book called Bad Science<\/em> aimed at fact-fighters that explained how to manufacture doubt. A large section was devoted to the 1992 EPA secondhand smoke report as a case study. The book stated that:<\/p>\n\n\n\n More generally, the book included:<\/p>\n\n\n\n In November 1993, the public relations firm APCO (on behalf of tobacco company Philip Morris) created The Advancement of Sound Science Coalition (TASSC) to promote \u201cjunk science.\u201d <\/strong>TASSC was a hit in several cities and attracted a lot of media attention. Among other things, TASSC:<\/p>\n\n\n\n By the 1990s, more and more Americans were turning away from smoking. Attacking scientific confidence limits was obscure and didn\u2019t attract much attention.<\/p>\n\n\n\n The industry also worked with other right-wing organizations, notably the Alexis de Tocqueville Institution, a think tank with the goal of promoting democracy. (Defending secondhand smoke fell under promoting democracy.) In 1994, the think tank released a report (written by Fred Singer and lawyer Kent Jeffreys) criticizing the EPA for a variety of issues, but most importantly, secondhand smoke.<\/strong> It claimed that:<\/p>\n\n\n\n 1. The EPA had asked the federal government to ban smoking.<\/strong> (The EPA hadn\u2019t, and there was no pending legislation about a ban). <\/p>\n\n\n\n 2. The EPA had violated scientific standards by assuming that the dose-response was linear<\/strong> (linear means that the risk rises proportionally with exposure). Singer and Jeffreys argued that the EPA should have assumed a \u201cthreshold effect,\u201d in which secondhand smoke only started harming people after they\u2019d been exposed to a certain amount. This argument could have come from two places:<\/p>\n\n\n\n The EPA defended themselves by:<\/p>\n\n\n\n Here are the details of the peer review rounds:<\/p>\n\n\n\n The first time the reviewers looked over the EPA report, they agreed with the report\u2019s conclusion that secondhand smoke should be considered a Class A carcinogen. <\/strong>They asked for the following revisions:<\/p>\n\n\n\n Revision #1: Make the conclusion<\/strong>\u2014the dangers of secondhand smoke are serious\u2014explicit because the current draft\u2019s conclusions were too weak<\/em>.<\/strong> The reviewers noted that while the epidemiology data showed only modest <\/em>health effects (they were modest because most people are only exposed to low amounts of secondhand smoke because it quickly disperses in the air), scientists had already confirmed that active smoking causes lung cancer. Since inhaling both active and passive smoke involves breathing in the same toxic chemicals, passive smoke must cause cancer too.<\/p>\n\n\n\n Revision #2: Include more discussion of how secondhand smoke affected children.<\/strong> The reviewers thought that the evidence showed stronger effects than the report stated, and they also thought that the effects on children were more serious than the lung cancer deaths.<\/p>\n\n\n\n The reviewers <\/strong>didn\u2019t<\/em><\/strong> ask for changes to any of the things Singer and the tobacco industry had claimed were bad science:<\/strong><\/p>\n\n\n\n Response to Critique #1: They didn\u2019t suggest using a threshold effect. <\/strong>This was because standard scientific practice (and the EPA\u2019s guidelines) is to assume a linear dose-response unless there\u2019s a lot of evidence to prove something else should be used. This is because of:<\/p>\n\n\n\n In fact, the reviewers commented that because the dose-response model applied to active smoke, it would likely apply to secondhand smoke too.<\/strong> <\/p>\n\n\n\n Response to Critique #2: They didn\u2019t suggest that a higher confidence level was needed<\/strong>. This was because the results were all consistent, and there was other evidence (such as the tar mice work) that suggested a connection was real and not just chance.<\/p>\n\n\n\n The EPA panel took five months to complete revisions based on the reviewers\u2019 comments and then sent revisions back to the reviewers for a second look. The reviewers still <\/em>thought the report was understated when it came to the risk to children.<\/p>\n\n\n\n The EPA\u2019s position was that to protect people, the government had to step in. The EPA had determined secondhand smoke could kill people, and it was inappropriate to give people the freedom to kill others.<\/p>\n\n\n\n In the 1990s, Russell Seitz (Fred Seitz\u2019s free-market-supporting cousin) defended secondhand smoke too. In a 1997 Forbes<\/em> article, he wrote that:<\/p>\n\n\n\nDiscovery of the Dangers of Secondhand Smoke<\/h2>\n\n\n\n
The MOD’s Response<\/h3>\n\n\n\n
Policy and Public Action<\/h3>\n\n\n\n
The MOD’s Response <\/h3>\n\n\n\n
Further Scientific Exploration<\/h3>\n\n\n\n
The MOD’s Response<\/h3>\n\n\n\n
Addressing the Environmental Protection Agency (EPA) Report<\/h4>\n\n\n\n
Attacking Science<\/h4>\n\n\n\n
Bad Science<\/em><\/h5>\n\n\n\n
The Advancement of Sound Science Coalition (TASSC)<\/h4>\n\n\n\n
Policy and Public Action<\/h3>\n\n\n\n
The MOD’s Response<\/h3>\n\n\n\n
The EPA\u2019s Response<\/h3>\n\n\n\n
The MOD’s Response<\/h3>\n\n\n\n