Talk:Tobacco and health/Archive 1

Archive 1

Sources?

Seems like about 2/3 of the article has no real references or sources other than "common knowledge" or original research. Perhaps a bit more documentation is in order? Gront 04:23, 24 July 2006 (UTC)

Pediatrics is a peer reviewed journal that has some information. Perhaps someone could review the article and update some of the references. —Preceding unsigned comment added by 72.224.160.250 (talk • contribs)

The above comment is now almost a year old - but I (and I'm sure many others) would be very happy to look for sources if people want to put {{fact|date=June 2007}} tags in the article by unsourced claims. Nmg20 10:40, 1 June 2007 (UTC)

---

The section "a critical view of the antosmoking movement" appear just a pretext to plug one's pet web site. This seen inconsistent with Wikkipedia guidelines. End

Agreed. Removed. Welshy 04:56, 4 February 2006 (UTC)

Removal of bias

I will remove all bias that I perceive in this article by this time tomorrow. This is a note for people to be prepared. Thanks Welshy 04:58, 4 February 2006 (UTC)

Contradictions

Is it really necessary to put a bunch of self-contradicting information about benefits of smoking? I don't wish to argue or shoot down anyone's posts, but I didn't think an encyclopedia was suppossed to mislead or confuse people about if smoking can "offer protection against Alzheimer's Disease" or "help cure asthma." I can't see that coming from any credible sources and people with asthma generally have to stay away from smokey areas to avoid asthma attacks, don't they? I believe the companies created a bias that smoking was "good for you" a few decades back, until it that it caused deadly diseases became public knowledge. At this time, they tried their best to cover up and discredit the scientific evidence. Perhaps this is where it came from...

Ugh - I hadn't seen that asthma nonsense in there. No qualified physician in the world would tell an asthmatic to smoke, and it's total nonsense. However, the reduction in Alzheimer's has been demonstrated statistically, and it is therefore a health effect of smoking - although it should be pointed out that it likely exists only as a function of the death of tobacco smokers prior to the onset of AD...! Nmg20 22:45, 4 September 2006 (UTC)

Actually, I think the Alzheimer's thing is funny. I suppose killing yourself before you get old enough for Alzheimer's works if you're that desperate to avoid it. Smokeresearcher 17:35, 9 September 2006 (UTC)

In my humble opinion - there must be some positive effects of smoking. I think the article should offer the truth - even if it contradicts some of the bad effects of smoking. I don't think that the overall effects are going to make anyone change their minds about it - but on the other side - this article shouldn't turn into a "smoking is bad and here are all the reason it kills you". It should be an objective and concise article on the topic that can be as nuetral as possible with well researched information from a variety of sources which are not simply about why it's bad. In my opinion wikipedia should not be a part of the nanny state - but rather as objective as possible. Phreakster 1998 03:03, 9 April 2007 (UTC)

I sort of agree. I don't think the article should turn into anything unless that's what the evidence suggests. I agree at the moment it presents a lot of evidence that - to use your words - "smoking is bad and here are all the reasons it kills you" - but that's because there's a hell of a lot of evidence out there for that position. Equally, it does have a section on the beneficial effects of smoking, and I've worked hard to ensure that side of the story is represented. At the moment, though, I don't think there's any good news that isn't already in the article - but by all means post new articles suggesting there is if you have 'em. Nmg20 17:29, 11 April 2007 (UTC)

As long as it's made obvious that the weight of such benefits are canceled out by the overwhelming negative effects, and that such benefits are no justification to start or continue smoking, I think it's fair to cite the articles. As a side note- mentioning that schizophrenics use a lot of tobacco certainly might be true-but is it really a benefit? Does it make them less symptomatic, or is it just comorbid (they're more prone to addiction,etc)? Moving this into a section about smoker demographics might make more sense.

Better numbers needed

This article is extremely vague when it comes to the actual risks of smoking. Nowhere can I find an actual number that says "Smokers are at X amount of risk of lung cancer if they smoke X amount of cigarettes every day over X amount of years, whereas nonsmokers are at X amount of risk over that same period." This is the definitive number that is needed. Surely it's out there. Aplomado ^talk 01:11, 3 September 2006 (UTC)

Actually, I understand that it's an inexact science and therefore no such numbers are known or would be accurate if they were. Someone can die less than a decade after starting to smoke and someone else could live long enough to get Alzheimer's; it's like Russian Roulette. I'd go looking for them otherwise... Smokeresearcher 17:42, 9 September 2006 (UTC)

I suspect we could get halfway there, and it would be worth doing. We start by assuming median amount of tobacco use (however much that is) and assume that our reference man doesn't quit until he dies. It looks like the median adult tobacco user smokes about one pack of cigarettes each day.[1] So what we want is to find, for this hypothetically average smoker, how much excess morbidity and mortality he is likely to suffer, at least for the major medical problems.

It would be great if the article could begin with something simple, like "In addition to the normal health risks faced by every person, one in X smokers will have a heart attack caused by their tobacco use, one in Y will develop emphysema, and one in Z will develop lung cancer. All of these medical problems could have been avoided by not using tobacco." 70.137.168.254 23:57, 11 September 2007 (UTC)

It looks like you are suggesting that using tobacco is the only cause of these maladies. Frotz 00:00, 12 September 2007 (UTC)

400,000 premature deaths?

http://www.cato.org/pubs/regulation/regv21n4/lies.pdf

The above link is a look at the much thrown out 400,000 number that is bandies about as "common knowledge." Looks at actual ages and causes. Of note: Half of this number of death occurs post normal life expectancy. This comment was added by User:67.37.205.166 at 22:14 on 6th September 2006. Four tildes, like this ~~~~ will sign your name and datestamp.

I can't seem to open this link (I need a new reader), sorry about that. It seems to have a file name of "lies" and such name-callling articles may be biased (I wish I could be completely sure by looking). I'm not a professional, but I'm sure the people at the Centers for Disease Control know what they're talking about. By the way, it was 440,000 per year. The 1,205 is from dividing 440,000 by 365 days per year. In part because these types of statistics can change over the years, anti-tobacco groups tend to use 1,200 (or 400,000) as their estimate. Thanks for asking before doing anything. Smokeresearcher 14:57, 19 September 2006 (UTC)

Worth a looksie anways. According to the file, these "smoking" deaths include SIDS cases (cause still unknown) and deaths from housefires. Also death from heart disease in people over 80 etc. Interesting read. 67.37.205.166 01:38, 20 September 2006 (UTC)TomH

Whatever the merits of the article - and I quite like the title! - it's utterly POV, and wouldn't be published in its current form anywhere reputable. That it includes the line "propaganda parades as fact" is slightly ironic for an article which contains no original research and resorts to a rather strange alcohol-drugs-n-car-accidents-are-worse argument in an attempt presumably to make smoking seem safe. Put it this way - it's just possible that bizarre statistic about whole milk is true - but it's not referenced, and until I've seen another source for it, I'd take it with a big pinch of salt. Nmg20 07:12, 20 September 2006 (UTC)

"Unable"

Regarding the caption on the photo of a person smoking, I realize it is difficult to quit smoking, but it is inaccurate and frankly POV to say that many smokers are "unable" to quit smoking. Anyone can quit smoking. It's hard, but no one is "unable." It's important that this article not turn into "TheTruth.com"-esque propaganda. Aplomado ^talk 03:11, 9 September 2006 (UTC)

I could be wrong, but I'm quite sure that not even theTruth.com would use such a phrase that would turn people away from quitting. They are roughly about minimizing the number of people who smoke in this country, not about scaring people away from tobacco by saying you can never quit. They use things like the famous "body bag" or "s'plode" commercials (aimed primarily at youth) to demonstrate their view on the topic and hope that people will see such deadly products to be as ludicrous as they do and thus not use them. I think they even offer resources to help people quit... Smokeresearcher 05:04, 22 October 2006 (UTC)

Vandalism

There has recently been a bit of vandalism on this article by some non-registered users. Does anyone know how to protect a page from non-registered users or also believe it should be protected? Smokeresearcher 06:23, 19 October 2006 (UTC)

I'm not sure we need to protect it yet, although I agree the childishness has been on the up recently. I think if we did need to ask for it to be protected the first step would be to list it at Wikipedia:Requests for page protection and then to list the relevant IPs / Users at Wikipedia:Administrator intervention against vandalism. Nmg20 08:29, 19 October 2006 (UTC)

Severe anti-smoker bias

This article is something else and reads like an anti-smoking propaganda brochure claiming that all smokers are hopeless addicted to nicotine and will suffer miserable withdrawal symptoms. Come on, people, that is just patently false. There is no evidence at all to suggest that the vast majority of smokers suffer from such symptoms, or even that the vast majority of smokers smoke more than one or two packs a day every single day, which would be required in order to feel and observe any noticeable "addictive" effect. metaspheres 06:32, 12 November 2006 (UTC)

I believe a recent study claims that secondhand smoke has not been shown to be a danger. The study however seems to be hard to find - any link known to it. Interesting that lung cancer was almost unknown before WW1 - I believe that is about the time that radiation contaminated fertilizer started to be used. In the 1800s, I believe the average man smoked at least 1 cigar per day. Chewing was very big, cigarettes were commmon ( roll your own ) as were pipes and don't forget snuff. Still no cancer until commercial fertilizer made the scene. Strange that noone has ever suggested not using the fertilizer - tobacco ( nor any other of your food needs radiation to grow - I believe it is used because it is cheap and all comes from one deposit in Florida ). 50% of lung cancer is natural - why nonsmokers still get half the lung cancer nowadays. A real question is why are they getting cancer when preWW1 noone got it. Lots of basic research still needs to be done. This comment was added by User:159.105.80.92 at 12:08 on 16th November 2006. Four tildes, like this ~~~~ will sign your name and datestamp.

Is this article more credible than the Surgeon General's report on secondhand smoke? The rest of your comment is interesting; I heard somewhere that much of the cancer caused by cigarettes is due to the radioactive particles in them. As for the lapse between smoking and cancer, smoking became popular around the 1930s (Richard Kluger's Ashes to Ashes. p. 113) and people don't just suddenly drop dead from smoking; it takes time, a painfully slow death, if you will. Would you care to cite where you found 50% of lung cancer deaths to be natural? It can take decades for someone to die from smoking; a significant amount of time, but soon enough to matter if you want to have grandchildren or retire. As for the types of smoking, that belongs in the tobacco smoking article. Maybe you could stick the chewing tobacco in its own page if your information isn't already there. This article is strictly for the health effects of tobacco products, not for the history of tobacco smoking or the various types of tobacco products. --Smokeresearcher 18:39, 16 November 2006 (UTC)

One article, ( I am not sure if it is the one I wanted - I believe the study I read was from a major university ), the 1998 WHO study, is used as a source for the Surgeon General's report. The strength of the WHO study was the use, and presentation, of statistics. Unfortunately, it was also its weakness - the final results were all over the place ( kids exposed to ETS were less likely to get cancer, etc). WHO, it appears, tried to bury their own study, supposedly the best ever done - actually it was a mess ( lots of little surveys added together trying to arrive at an answer and tripping at the last ditch). I tried to get the beginning dates and ending dates of the study to see if they had tried to "pospone" the release ( couldn't find them - 1988 to 1998 were the end points but all other dates were very cagey). The Surgeon General is weak on statistics - at least these people learn - of course I only browsed the 709 page "report". But the amount of use of the 1998 WHO report looks odd, I can't be the only person in the world who has read the Europen papers savaging of that report ( if it wasn't for the internet this report would have died on some libary shelf). I can't find the 50% number, something I heard, probably wrong ( I may have confused the two major types of lung cancer - large and small cell - with being equal in occurence. This comment was added by User:159.105.80.92 at 12:08 on 16 November 2006. Four tildes, like this ~~~~ will sign your name and datestamp.

I think the most interesting report I have seen, was a tobacco timeline that confirms that up to 1920 most surgeons had never, and never would, see a case of lung cancer in their careers. Knowing how much tobacco was grown and smoked from 1492 on, and how many of these people lived to old age, it seems impossible that lung cancer was unknown if it was caused by just plain ole tobacco. Something besides tobacco happened around 1900. Something in the tobacco and/or something else in the environment ( gas fumes, etc?). This comment was added by User:159.105.80.92 at 18:53 on 17 November 2006. Four tildes, like this ~~~~ will sign your name and datestamp.

If 170,000 get lung cancer each year then about 85% means 144,500 caused by smoking - well they are breathing down polonium so not unexpected. However, 15% means 25,500 which should be 0 (pre1900 numbers). Secondhand smoking appears a weak attempt to explain away the 25,500 - if aa smoking stopped is there a guess as to whether the number would reach 0. I think we may be being redirected as to why we are getting cancer like rats in a cage - isn't it better to have it be our own fault than gas fumes, high compreesion engines, plastic, electromagnetism, etc. - most people die of lung cancer when they are old and who would want to give up TV and cars to save some old guys who don't have long anyway. This comment was added by User:159.105.80.92 at 19:21, 17 November 2006. Four tildes, like this ~~~~ will sign your name and datestamp.

That "something" that happened to start causing cancer was the major companies we have in the U.S. today. They added a number of harmful chemicals to cigarettes (around 60 carcinogetic) in attempt to keep people smoking (like nicotine and ammonia). Their triumph was around that time-frame (see above soure), and began to fade away when people started realizing the health hazards that smoking caused. --Smokeresearcher 01:27, 19 November 2006 (UTC)

"Most" and "old" are perspective. Could you cite some more specific numbers? I've heard of enough cases where someone who I wouldn't consider that old died, leaving behind families and many years that are important to these "old" people. --Smokeresearcher 01:27, 19 November 2006 (UTC)

Please keep in mind that lung cancer isn't the only way people die from smoking. For example, if a smoker only "puffs" on the cigarette, never breathing the smoke into his/her lungs, then this smoker will much more likely get some sort of oral cancer. It is also believed to cause a bunch of other diseases including throat cancer, emphysema or diseases of the heart, kidney. This would explain why the gap between your lung cancer statistic and the secondhand smoke statistic is so great. Oh yes, if you didn't understand the report, that was just the full scientific version. I got it here, so you are more than welcome to read over (or even listen to) simpler versions or pieces of the full version divided by chapter. --Smokeresearcher 01:27, 19 November 2006 (UTC)

Nothing seems to be able to explain away the statement that "before WW1 lung cancer was unknown". The first explanation I use to hear was that old time doctors didn't recognize lung cancer. However, doctors whose careers straddled that time period confirm that they only saw it in their later years. Other explanations likewise fall on thier faces. This crusade seems to have sailed without too much science behind it. This comment was added by User:159.105.80.92 at 18:24 on 21st November 2006. Four tildes, like this ~~~~ will sign your name and datestamp.

Big words from someone who hasn't posted a single link. 216.64.249.59 18:00, 30 November 2006 (UTC)

One thing to consider about lung cancer before World War I was short life expectancy. Check this article for the quote "Life expectancy at birth in the United States in 1901 was 49 years." Lung cancer usually shows up later in life, so could be why no one noticed it much pre WW1 rather than some radioactive fertilizer. Just a thought, and no, I don't have any links to a study.Gront 08:54, 20 December 2006 (UTC)

Link to wiki - polonium articles are interesting. Everyone has it in their tissues - smokers or non-smokers. Lots of circling in wiki seems to answer most of my questions - smoking is worse than eating carrots, but surprisingly, not that much safer. Get rid of the polonium rich fertilizer ( not impossible ) and this problem would go away. the back to the earth hippies were right, they just didn't know why. The above comment was added at 13:31 on 4 December 2006 by User:159.105.80.219

I'm still going to stick to the carrots myself. Nmg20 14:36, 4 December 2006 (UTC)

At least carrots are (somewhat) natural, unlike some of the additives in cigarettes and they're nutritious. <laughs> Somehow, I don't see a tobacco diet helping all that much. Correct me if I'm mistaken... --Smokeresearcher 22:32, 4 December 2006 (UTC)

Somewhere in wiki - polonium? article - I read that smokers have 1.72pCi per kilo and non-smokers have .76pCi per kilo. Carrots may be safer but don't eat too much - do fat people get more cancer ( if yes I bet it is because they eat more ( twice the food consumption could double the pCi of a non-smoker to 1.52). This comment was added by User:159.105.80.219 at 8:44 on 7th December 2006. Four tildes, like this ~~~~ will sign your name and datestamp.

Undue wieght for radioactivity

The first subsection under "Primary risks" and the longest single subsection of the article is "Radioactive components of tobacco." This susection, citing few references, gives the strong impression that lead and polonium are chief among the causes of cancer in smokers. The first sentence of the concluding paragraph is "Some researchers suggest that the degree of carcinogenicity of these radioactive elements is sufficient to account for most, if not all, cases of lung cancer related to smoking."

Is this correct? I thought that tobacco per se did not contain any radioactive components and the only reason that such things as polonium manages to get into tobacco is through the types of fertilizers and/or pesticides used on them. This is, therefore, not a problem associated with tobacco, but a problem associated with the use of (optional) chemicals during the growing of tobacco. Its a bit like saying "an ingredient of tomatoes is pesticides". SimonUK 10:08, 4 August 2007 (UTC)

This seems to be a major case of WP:NPOV#undue weight, because "Levels of polonium-210 in tobacco smoke are not believed to be great enough to significantly impact lung cancer in smokers" [2], and ""It has been estimated that about 1% of the lung cancer risk associated with cigarette smoking could be ascribed to polonium-210. "[3] -- Chondrite 07:33, 5 December 2006 (UTC)

Does the polonium build up in tissue over time? Seems to be the agricultural industry's dream come true to have fertilizer not be a major cause. —The preceding unsigned comment was added by 159.105.80.219 (talk)

I added the statement "However, the view that polonium 210 is responsible for many cases of cancer in tobacco smokers is not widely accepted. " with references, but this does not correct the undue weight given to radioactivity. In order to achieve NPOV, the article needs to discuss well-known and widely accepted carcinogens (such as PAH) and reduce the space/emphasis given to radioactivity. Chondrite 20:28, 7 December 2006 (UTC)

Vitamins

I understand that tobacco smoking depletes vitamins C (and B?) - is it true, and anyone care to address it in the article?--Shtove 18:36, 12 December 2006 (UTC)

MSA

I added some stuff to the Master Settlement Agreement article and am a little dubious about the preexisting rather large section from libertarian think tanks. Anyone want to take a look? I've also started work on an article on the Mr. Butts affair. 67.117.130.181 11:19, 18 December 2006 (UTC)

Benefits of Smoking

Bias is well expressed by each benefit being followed by a corresponding risk which has already been stated in earlier sections. A section isn't created to contradict its own main idea.

Removal of bias?

What happened to the removal of bias thing? The negative effects of smoking tobacco are stated as pure fact, while the positive affects are all listed as 'uncertain' or 'unreliable'. Timb 12:37, 28 January 2007 (UTC)

The positive effects are listed as such because they *are* - e.g. it's possible the protective effect seen in Alzheimer's is due to smokers dying before they get it, and there's conflicting evidence from the studies which have looked at it. Those where the evidence is convincing (ulcerative colitis chiefly) are listed as such - although they should perhaps have the proviso that the risks outweigh the benefits.

Removing bias is not about giving equal weight to opposing viewpoints. It's giving due weight to the different viewpoints - so the large-scale, long-term, replicated studies demonstrating the dangers of smoking get a lot more weight than the smaller-scale, shorter-term, unreplicated studies demonstrating its benefits. Nmg20 11:43, 28 January 2007 (UTC)

why not calling the article "the danger of smoking?

in the hebrew wikipedia there is a vote in a trying of some pro smoking members to change the name of the article form "the dangers of smoking" (free translation) to "Health effects of tobacco smoking" as it is here. why it is not the same as in hebrew is it because of "politicaly correct"ism or just unwilling to confront the smokers? Avibliz 19:28, 13 February 2007 (UTC)

I believe it's because the WP:NPOV policy. 131.111.24.187 18:58, 16 March 2007 (UTC)

WP:NPOV. The hebrew version's title should be in line with this one, really. 219.78.67.153 11:51, 28 August 2007 (UTC)

graph out of date

is there a more recent graph showing the correlation? the data in that one is over 30 years old.. 131.111.24.187 18:58, 16 March 2007 (UTC)

The data is old, certainly, but it's not out of date! It's taken from a huge, longitudinal study which demonstrated that with an increase in smoking over almost a century, the incidence of lung cancer also increased. A more recent graph would not be able to demonstrate this because levels of smoking haven't changed nearly as dramatically over the past thirty years. Nmg20 22:09, 16 March 2007 (UTC)

Adding new section.

I would like to propose a new section (2.0 in the current scheme) dealing specifically with the health concerns of pipe smoking. I have compiled a number of sources from medical tests, journals, etc. Right now there is little about this particular practice. Any objections? Any suggestions? Thanks.

Go for it. To my mind it would fit best with the sections on Low Tar/Light cigarettes and Cigars (currently 1.3 and 1.4) - but that would involve hiving those out into their own subsection. Either way, it'll be good to see pipes in there! Nmg20 20:49, 19 March 2007 (UTC)

OK. I've added it after the last section. Please feel free to move it up, etc. from there. Thanks.

Surgeon General calling for a ban?

I wonder if there should be some mention of the US Surgeon General calling for a total ban of tobacco products in 2003? [4] —The preceding unsigned comment was added by 66.191.19.42 (talk) 21:01, 19 March 2007 (UTC).

Mental Health Issues

Perhaps an article on the mental health issues regarding smoking should be added [5][6]. Any comments.

I think we'd have to go back to the original articles (peer-reviewed, published in respected scientific journals, etc.) to add anything definitive - and I haven't read them, although they look like they're available for free on pubmed if anyone has time to go through them:

Murphy JM et al. Cigarette smoking in relation to depression: historical trends from the Stirling County Study. Am J Psychiatry. 2003 Sep;160(9):1663-9. PMID 12944343

Schmitz N, Kruse J, Kugler J. Disabilities, quality of life, and mental disorders associated with smoking and nicotine dependence. Am J Psychiatry. 2003 Sep;160(9):1670-6. PMID 12944344

I'll read them when I get time if no one else manages to! Nmg20 15:16, 28 March 2007 (UTC)

Richard Dadd spent five days smoking a hookah in Egypt in 1842 and then underwent a personality change. He decided to kill the Pope but instead killed his father (see here also - [7]) Is this an instance of nicotine-induced psychosis? 45 minutes of Hookah smoking is equivalent to over 200 cigarettes according to the wikipedia page.Malick78 07:45, 15 June 2007 (UTC)

I'd say it's unlikely, and without a medical or even journalistic source, certainly inappropriate to add to the article. Nmg20 09:02, 15 June 2007 (UTC)

Seems incredibly unlikely and is probably a coincidence. Nonethelesss, there is a body of medical evidence that suggests mental health issues related to smoking (see above). Some mention of this should probably be added with proper sources. 68.118.72.97 16:49, 15 June 2007 (UTC)

If anyone has sources, then yep we should add this - probably worth including the "disclaimer" that people with mental illnesses often smoke as a form of self-medication (e.g. Kumari V, Postma P. 2005 PMID 15964073), i.e. any link may be association rather than cause.

Grover Cleveland

Probably a minor point, but what the hell:

Grover Cleveland was diagnosed in 1893 with cancer of the left jaw, which was frequently remarked upon by the press and public as the side where he usually had a cigar clamped.

I'm not denying the diagnosis, but that cancer operation was kept under wraps when it was performed. The Grover Cleveland article says the surgeons at the operation did not confirm the details until 1917. Do we have any contemporary citations for the press speculating about the effect of the cigar on his mouth (which would have been very prescient of them)?--Idols of Mud 18:42, 12 August 2007 (UTC)

You've assumed that the speculation took place in 1893. It could well have been that everyone was talking about it in 1917, when the information was confirmed. 70.137.168.254 23:37, 11 September 2007 (UTC)

The cost on our health-care system

Would someone please find out how much public health-care money is wasted to care for the health of smokers? Maybe in the millions, or billions of dollars range?--Louiechefei28848888 03:10, 23 September 2007 (UTC)

Severe Bias

Sorry all you anti-smoking bigots. This article is pure speculation. The little actual fact in this article defies belief and is already covered in other articles. I'm nominating this for merging, and have added a disputed tag. If anyone wishes to object to this being merged let me know tonight at the latest.

Per suggestion of one of the wiki moderators I will go through (adding now) reference by reference to show how this article is biased. Please write back if you dispute any of this. —Preceding unsigned comment added by Naacats (talk • contribs) 19:12, 23 September 2007 (UTC)

Reference 1: WHO - The world health origination is clearly an anti-smoking organization. Look on their own page on tobacco, and you can see that they are clearly biased on this issue: http://www.who.int/tobacco/en/

Reference 2: CDC - Pretty much the same story as the WHO. The CDC has publicly acknowledged being funded by the pharmaceutical industry, and has additionally admitted to being an anti-smoking organization.

The CDC is a government agency. They are funded by you and me. Well maybe not me because I'm not American. As for being an anti-smoking organization, are they that way because the science backs up that point of view, or for some other reason? Cite sources please, with the same level of rigour you are now demanding of the opposing side.

-- Dethme0w 19:33, 23 September 2007 (UTC)

Yes the CDC is a government agency. I don't argue that point (it's clear fact). That does not change the fact that they are biased in their opinions.

Lets start with the basics on the CDC and their history with smoking (forgive me if I don't source properly here- i'm still getting the hang of wikipedia). Many of my points are being taken from a FORCES international article on the CDC, although I have verified the information presented (checked quotes from the MMWR, NCI etc.) and added many points of my own as well.

The highly sensationalized number of smoking-related deaths (418,000) comes from the CDC, in a publication: The CDC's August 27, 1993 Morbidity and Mortality Weekly Report (MMWR).

The relative risks (RR) reported in the MMWR are based on smoking-related data from an unpublished American Cancer Society study called Cancer Prevention Study-II (CPS-II).

The diseases listed on the MMWR are "known to be caused by or associated with smoking in adults," (quoted from the MMWR)

"Associated with" means "occurs together with." It does not imply causality. "For instance, according to the Sudden Infant Death Syndrome Alliance, SIDS is associated with being born twins or triplets. This does not mean that being born twins or triplets causes SIDS." (Quoted from FORCES International)

The MMWR also list many diseases that clearly are not caused by smoking. (pneumonia and influenza for example)

Another point about the MMWR, is that just shy of 1/2 of the relative risks reported in the MMWR are less than 2

"For example, under Cardiovascular Diseases, the relative risks for Ischemic Heart Disease for persons 65 years or older are: 1.9 (male current smokers), 1.3 (male former smokers), 1.7 (female current smokers), and 1.2 (female former smokers).

According to the National Cancer Institute, " ... relative risks of less than 2 are considered small and are usually difficult to interpret ... Such increases may be due to chance, statistical bias, or effects of confounding factors that are sometimes not evident." (NCI release, 10-26-94, as reported in the Competitive Enterprise Institute newsletter, CEI Update, February 1995, p.8).

Sir Richard Doll, one of the first researchers to report a link between active smoking and lung cancer, says that " ... when the relative risk lies between 1 and 2 ... problems of interpretation may become acute, and it may be extremely difficult to disentangle the various contributions of biased information, confounding of two or more factors, and cause and effect." (The Causes of Cancer," by Richard Doll, F.R.S. and Richard Peto. Oxford-New York, Oxford University Press, 1981, p. 1219).

CPS-II did not consider confounding factors such as diet, alcohol, occupation, socioeconomic status, etc. Therefore, as stated in the MMWR, the estimates "in this report are not adjusted for confounders (e.g. alcohol), which may lower the estimates for laryngeal and certain upper gastrointestinal cancers." In other words, if confounders were considered, the estimates would no doubt be lower.

Dr. Ernst Wynder of the American Health Foundation says you have "clearly got to think about fat as a confounder to tobacco consumption." (The Toxicology Forum, Annual Summer Meeting, 1993. Given Institute of Pathobiology, Aspen, Colorado. Transcrip p. 308.

According to Dr. Wynder, smokers have a lower intake of fresh fruits and vegetables than nonsmokers, consume more fat and more red meat, and have a higher serum cholesterol because of the high fat intake.

Dr. Michael Siegel, who is employed in the CDC's Office on Smoking and Health, says that one of the most important things to consider in lung cancer risk is diet. (Michael Siegel, M.D., MPH, "Involuntary Smoking in the Restaurant Workplace, " JAMA, July 28, 1993, Vol. 270, No. 4, p. 492.

CDC's Ann Malarcher says that "many factors ... are causally related to cardiovascular disease ... They include, but are not limited to, cigarette smoking, hypertension, elevated serum cholesterol, obesity, genetics, diabetes, physical inactivity, socio economic status and diet." (Correspondence from Ann Malarcher, Ph. D., Epidemiologist, Office on Smoking And Health, CDC, September 25, 1995).

If "many factors" are causally related to cardiovascular disease, why did the CDC examine just one: smoking?

And if diet is one of the most important things to consider in lung cancer risk, as Dr. Michael Siegel and others say it is, why did the CDC not consider it?

How does the CDC know that smoking caused 1,294 deaths from cervical cancer if other risk factors such as early and frequent sexual intercourse, multiple sexual partners, pregnancy at an early age, and the presence of sexually transmitted diseases ( to name a few) were not considered?" (Direct quote from FORCES international article)

http://www.forces.org/evidence/pharma/pdf/fedspharm.pdf - This is a good article to read as well - it outlines the link between pharmaceutical companies and the NHI - many of the same points can be raised about the CDC (if needed i'll go dig and find some examples)

Theres a lot more I could cite, but this should be enough for now.

Naacats 21:06, 23 September 2007 (UTC)

I'd just like to point out that Naacats is crusading against even less controversial claims in smoking right now with very similar arguments.

Peter ^Isotalo 12:39, 24 September 2007 (UTC)

"crusading" ? Hardly. I'm merely trying to fix some facts. Yes I'm using a similar argument. And it holds true on both pages - both need to be fixed. Naacats 22:20, 24 September 2007 (UTC)

An organisation which posts as its mission statement "FORCES International is an organisation in support of human rights and - in particular, but not limited to – the defence of those who expect from life the freedom to smoke, eat, drink and, in general, to enjoy personal lifestyle choices without restrictions and state interference." is NPOV by default. The attempts by the tobacco industry to align smoking with human rights are well-documented on wikipedia.

More pertinently, the article you've googled to post here is occasionally wrong and almost invariably outright misleading. For instance:

(1) Association and causation. Yes, association doesn't prove causality - but the example FORCES give is instructive. Multiple births do not cause SIDS in the sense that not all such children get SIDS and children who are not twins/triplets/etc do die from it. However, there is something about being a multiple birth which can lead to SIDS - perhaps due to imbalances in oxygen or nutrient supply in utero, perhaps due to the birth process, perhaps due to vulnerability to some post-birth environmental factor (Kinney's triple risk model covers this). Until and unless we understand in full what these are, we cannot say one cause the other in the sense that A leads inexorably to B - but we can say that one causes the other in the sense that in some children (people) A leads to B in the presence of other unknown factors. At an individual level, being a twin birth doesn't cause SIDS - but at a population level it does: more multiple birth children will get SIDS than singleton births.

(2) Pneumonia and influenza absolutely are caused by smoking and here the mechanism is well understood - paralysis of the cilia lining the respiratory tree makes it harder for the body to cough pathogens up. What's more, the wikipedia articles on both highlight this with references: influenza cites Murin S, Bilello K (2005). "Respiratory tract infections: another reason not to smoke.". Cleve Clin J Med 72 (10): 916-20. PMID 16231688, and pneumonia Almirall J, Bolibar I, Balanzo X, Gonzalez CA. Risk factors for community-acquired pneumonia in adults: A population-based case-control study. Eur Respir J. 1999;13:349. PMID 10065680. Yes, each requires the presence of pathogens, but at a population level smoking is causative.

(3) Relative risk has been covered here and elsewhere numerous times before. It should be sufficient to say that every one of the sources FORCES tries to muster to claim RR <2 is not significant disagree with FORCES conclusions: the National Cancer Institute, Richard Doll (who was knighted for proving smoking caused cancer!). The wikipedia article on relative risk explains that this was part of a tactic the tobacco industry used to attempt to undermine the health risks of smoking (PMID 11684591), that it's one which epidemiologists everywhere criticised culminating in an the article just linked in the American Journal of Public Health, and that the industry abandoned such tactics when it became clear no epidemiological organisation agreed with them (PMID 11684593). All this information is already on Wikipedia, and not bothering to check the info available right here on the subjects you are claiming expertise on, and resorting instead to an uncritical reposting of an article from a pro-smoking website, is pretty poor science.

(4) The information on Richard Doll is laughably ill-informed. Doll proved beyond a shadow of a doubt that smoking causes lung cancer - that's why he won all the awards listed on his wikipedia page and why it opens "he was the first in the modern world to prove that smoking caused lung cancer". Again, you should assume wikipedia is a better source of impartial information than smoking lobby websites.

(5) Either FORCES or you say in relation to the CPS-II study that "In other words, if confounders were considered, the estimates would no doubt be lower" based on the MMWR saying "confounders (e.g. alcohol), which may lower the estimates for laryngeal and certain upper gastrointestinal cancer". The absence of controls for co-founders may lower the estimates is not the same as would no doubt lower the estimates. You're claiming that statistical analysis you haven't done of data you've never seen would provide a result you have no proof whatever for - or in other words, you're making things up.

(6) Two people (Wynder, Siegel) saying in a non-peer-reviewed forum that we should consider diet in the pathogenesis of tobacco-related illnesses has no effect on existing evidence - they are right, we should, but we should examine them to explain more of the regression models typically used in analysis. You / FORCES attempt to portray this as undermining the link between smoking and illness- and again, that is a distortion of what was actually said.

(7) Similarly, saying "many factors are causally related to cardiovascular disease" (Malarcher) is undeniably true. Nowhere, however, does Malarcher say what you or FORCES go on to imply, which is that examining one cause of cardiovascular disease is somehow suspect. In addition, may I assume from your quoting Malarcher that you are happy with her description of cigarette smoking as "causally related" to heart disease? Again, you are attempting to warp the views of those who have openly supported the causative nature of tobacco smoking on a variety of illnesses to suit your goals - using a sort of unholy combination of NPOV and original research.

Not one word of what you've posted above justifies an amendment to the article. WP:Cite has clear guidelines on what you need to do to make such claims - find independently peer-reviewed articles supporting them. FORCES is, under this criteria, utterly laughable. Nmg20 12:51, 25 September 2007 (UTC)

I'm working on getting you that information (unfortunetly due to all the antismoking propeganda its harder for me to get my sources than it is for you)- I also have a LOT more to argue about on this page. The POV tag needs to stay up - We haven't even begun this discussion yet, and by wikis rules a POV tag needs to remain until the dispute is resolved. Peter please stop removing it. Naacats 11:22, 26 September 2007 (UTC) (As its 4:30 AM right now I'm going to bed - I'll post more when I get up)Naacats 11:27, 26 September 2007 (UTC)

It is no harder for you to find sources than anyone else - pubmed is an open resource, although you occasionally need subscriptions to the relevant journals to read the full versions of articles, the abstracts are free to view. Would you like to explain how exactly "antismoking propeganda (sic)" is making it harder for you to read?

And may I take your failure to address any of the points above, and your comment that you've plenty more to argue about, that you concede the points I raised?

I have removed the spurious expert tag you added once you realised putting the pov tag back in would breach the three-revert rule. You haven't said anywhere what aspects of that section you feel merit the attention of a specialist - and as the person responsible for adding the majority of the references to it, I'd be fascinated to hear why you think they need attention.

In summary, until you come up with some evidence to support your views, you need to stop adding whatever tag takes your fancy to this and other articles - do your research first, present it here, then change the article. Nmg20 17:32, 26 September 2007 (UTC)

Re: User:Naacats

We're having the same absurd debates over at the smoking article talk page. If you'd like to catch up on those too, or help us defend what has been graded a fine article by the review team, the crap starts here: Talk:Smoking#Request_for_comments, and goes all the way to the bottom. My sympathies to you. TeamZissou 05:48, 26 September 2007 (UTC)

As a general notification, I have proposed a topic ban of Naacats (talk · contribs) from smoking-related articles for tendentious POV-pushing, off-wiki solicitation of meatpuppets, etc. The discussion can be found at the community sanction noticeboard. MastCell ^Talk 18:34, 26 September 2007 (UTC)

Health Effects in 'Young' People

Have there been any studies about the effect on the health of people who smoke until they are 25/30? I have been looking for them, but so far none seem to imply any perment damage.--159.92.57.11 13:25, 16 October 2007 (UTC)

I don't have studies to hand, but we're certainly told as medical students that if you quit reasonably young, health outcomes in surviving former-smokers and never-smokers 5-10 years later are identical. I'll try to source that later. 159.92.101.58 15:00, 16 October 2007 (UTC)

I was talking to a very experienced doctor earlier today and he was saying that, although no studies have been conducted, since they'd be in neither big tobacco's nor a government's interest, there is no obvious link between smoking and then stopping before roughly 25 years old, or smoking up to approx. 5 cigarettes a day, and cancer. This might be worth pointing out. --159.92.57.11 00:01, 19 October 2007 (UTC)

Interesting though this is, without a published source it shouldn't go in the article - there are plenty of studies conducted by very experienced doctors, after all, which are done because they're in the interests of medicine rather than those of government or big business. That said there may well be something demonstrating this, in which case yup, it should go in. Nmg20 11:35, 19 October 2007 (UTC)

I fear that it might not be in medicine's interest to have a study claiming that smoking was safe up to a point. However, I shall try to find a 'verifiable' source. --159.92.57.11 01:46, 30 October 2007 (UTC)

Ah, proof by assertion of conspiracy. MastCell ^Talk 03:13, 30 October 2007 (UTC)

I would hardly rate that as a conspiracy. It would be if they supressed reports, but not performing a study because it would actively harm peoples' health hardly amounts to a conspiracy. --J.StuartClarke 13:59, 31 October 2007 (UTC)

True; I was referring to the anonymous IP's comments above, in which he suggested that such studies would not be in "the government's interest" because they might show that smoking a little bit is safe. MastCell ^Talk 15:59, 31 October 2007 (UTC)

Thinking about it though, the studies would be exceptionally difficult to perform. You would have to find people who smoked up the about the age of 25, and have a control group with smokers who continue smoking and another group of people who never smoked, and moniter all three groups for the entirity of their lives. I can't really see this being a particually easy experiment to moniter either. --J.StuartClarke 23:55, 14 November 2007 (UTC)

Epidemiology of smoking

The statement "About 5,900 of the study participants are still alive and only 134 of them still smoke." seems a bit misleading as we are given no information about the ages of survey participants. The earlier statement about life expectancy covers the results without the need for the extra and statistically irrelevant statement. (121.45.153.133 09:38, 2 November 2007 (UTC))

Articles: Health effects of tobacco smoking and Tobacco smoking

There is discussion over on Talk:Tobacco smoking about length and NPOV disputes regarding the excessive, though detailed and well sourced, info regarding smoking and health issues. Seeing as there is already a Health effects of tobacco smoking page. I was wondering if anyone might want to take a gander at the page for info that might be more at home over here? I was thinking perhaps the "Health effects" section and this article could be merged, allowing the Tobacco smoking article to provide a shorter summary. Any thoughts? Phyesalis 09:25, 9 November 2007 (UTC)

Renamed, copyedit and POV

I have renamed this article "tobacco and health" (was "Health effects of tobacco smoking") because it could easily include other forms of tobacco use compared to smoking. The ongoing controversy on Snus, for instance, could easily be discussed here. Overlap with articles such as passive smoking needs to be addressed. JFW | T@lk 15:22, 9 December 2007 (UTC)

Agree. Phyesalis (talk) 16:26, 9 December 2007 (UTC)

If we're already moving articles around, why not move the whole thing to health effects of smoking? Granted that it still be mostly about tobacco smoking, it could also discuss smoking in general, just like smoking went from a mere dab page to a proper article.

Peter ^Isotalo 16:40, 9 December 2007 (UTC)

I don't think the new article title is really an improvement. The health effects of smoking tobacco and dipping tobacco are basically unrelated since the inhaling of smoke is the major public health problem, not the chemical properties of tobacco. Making such a direct connection between the two is highly misleading. I would really appreciate if I could get some comments on my proposal about making the article substance-neutral instead of narrowing it down even further on tobacco.

Peter ^Isotalo 07:46, 28 December 2007 (UTC)

It does seem strange that an article entitled tobacco and health has numerous subheadings about 'smoking and...'. I appreciate there's work to be done, but to me if we're going to keep the new title we need some health effects of tobacco-which-isn't-smoked pretty soon! Nmg20 (talk) 11:53, 28 December 2007 (UTC)

I think that's a rather bad idea because it's very likely that we'll just wind up with an article about the health effects of just smoking anyway. Overall, the idea that smoking and dipping tobacco should somehow be associated with one another seems very far-fetched. It smacks more of anti-tobacco campaigning than anything else. I still think this article should limit itself to smoking, but expand the scope to more than just tobacco.

Peter ^Isotalo 13:02, 28 December 2007 (UTC)

I don't feel especially strongly either way. There are arguments for separating them out, where they could be linked by "For the health effects of...see..." lines, and arguments for keeping them together. Tobacco is, for instance, carcinogenic in whatever form - smokers get lung cancer, chewers get oral cancer - and although that point could be made in separate articles, it does need made. Doing so is, to my mind, just accurately representing the data that are out there rather than "campaigning", but as I say I don't have strong views on whether it's done in one article or several. Nmg20 (talk) 13:25, 28 December 2007 (UTC)

I haven't made a concerted effort to read up on the topic, but my impression from the debate here in Sweden, where snus is very popular, is that the authorities are exaggerating the health hazards beyond all reason. They're basically trying to equate it almost directly with smoking and strenously deny any benefit when comparing snus to cigarattes, which is as mind-boggingly stupid as it is stubborn. I've read that dipping tobacco is cancerogenic, but rather mildly so. And cancer is just one of several health hazards when it comes to smoking, hazards that are not an issue when using snus.

Peter ^Isotalo 15:05, 28 December 2007 (UTC)

I'm always wary of claims of shadowy authorities doing anything, but I quite agree that the one form of tobacco use is less hazardous than the other. Nmg20 (talk) 15:40, 28 December 2007 (UTC)

Swedish authorities aren't the least bit shadowy about these things, but they are very, very moralistic about just about any type of drug use. If anything, check out the Swedish alcohol monopoly. I just think that the most relevant common denominator here is the inhalation of smoke, not the properties of tobacco.

Peter ^Isotalo 19:33, 28 December 2007 (UTC)

Health Benefits Section

There appears to be something wrong with the Health Benefits section. Part of it is missing, as is it's heading. The way it reads now makes it appear that it's part of the section just before it. 71.92.157.57 (talk) 16:31, 24 December 2007 (UTC)

Thanks for pointing that out. I've (slightly harshly) reverted the most recent edit to fix it - there was a missing </ref>, so the article moved everything left down as a footnote...! The info added is probably fine, but not without a decent, peer-reviewed article ref to back it up. Nmg20 (talk) 19:29, 24 December 2007 (UTC)

Thanks for the fix. It looks like the site cited has the references at the bottom of the page. It appears some of the information was obtained from the American Cancer Society and the World Health Organization (WHO). Either way, I'm sure some peer-reviewed studies can be dug up on the subject. 68.116.99.152 (talk) 00:44, 27 December 2007 (UTC)

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