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Friday, January 23, 2004
By Steven
Milloy
Do smokers who reduce, but don’t quit
smoking, reduce their risk of smoking-related disease?
Reminiscent of past allegations of tobacco industry lying, the
anti-tobacco industry apparently doesn’t want smokers to know
the truth.
The situation recalls George Orwell’s book
"Animal Farm" in which the leaders of the animal revolt
against their human masters gradually took to acting, well,
just like the humans they deposed.
“Smokers who cut back the number of
cigarettes they smoke may not be reducing the cancer-causing
chemicals in their bodies as much as they hoped,” reported the
Washington Post this week.
The Post report was spurred by a study
conducted by University of Minnesota “researchers” and
published in the Jan. 21 issue of the Journal of the National
Cancer Institute.
The researchers studied a group of 153
smokers who reduced their smoking by 25 percent during the
first two weeks of the study, by 50 percent during weeks 2-4
and by 75 percent during weeks 4-26.
At weeks 4, 6, 8, 12 and 26 of the study,
the researchers tested urine samples of the smokers for the
presence of NNAL (search) and NNAL-Gluc (search), byproducts of a compound in
cigarette smoke called “NNK” that may (or may not) play a role
in the development of lung cancer.
As the smokers reduced the number of
cigarettes smoked per day, statistically significant
reductions in the levels of urinary NNAL and NNAL-Gluc were
reported by the researchers.
“However, the observed decreases were
generally modest, always proportionally less than the
reductions in cigarettes smoked per day, and sometimes
transient,” noted the researchers. Reducing the number of
cigarettes smoked per day, whether by 50 percent or by 75
percent, reportedly only reduced urinary levels of NNAL and
NNAL-Gluc by about 30 percent.
The researchers suggested that the
comparatively small reduction in urinary levels of NNAL and
NNAL-Gluc compared to the reduction in cigarettes smoked per
day may be due to the smokers’ “compensation” ― that is,
dragging longer and harder on every cigarette.
“The results indicate that some smokers may
benefit from reduced smoking, but for most the effects are
modest,” concluded the researchers.
The University of Minnesota group, led by
anti-tobacco activist-researcher Stephen Hecht (search), thereby teed up the study for its
real purpose ― a broader attack on the notion of “harm
reduction” with respect to tobacco use.
Harm reduction (search) is a strategy to reduce the
incidence of smoking-related heath effects by getting smokers
to smoke less, smoke “safer” cigarettes or transition to
“safer” products such as smokeless tobacco (search).
Though harm reduction would seem to be a
reasonable approach toward reducing the risk of
smoking-related health effects ― at least for those who insist
on meddling in the personal health and private lives of others
― anti-tobacco extremists oppose it. Their public posture is
that harm reduction doesn’t work.
The University of Minnesota study was
accompanied by a Journal of the National Cancer Institute
editorial hailing its results and concluding that there are
“certainly insufficient data to support the practice of
encouraging smokers to pursue reduced smoking as a harm
reduction strategy.”
That statement is demonstrably false.
Anyone who knows anything about the
research on smoking and health ― and presumably that would
include the authors of the study and editorial ― knows that
the risk of smoking-related disease increases with the number
of cigarettes smoked.
A good summary of such studies is presented
in the U.S. Environmental Protection Agency’s 1993 report on
secondhand smoke.
In trying to link secondhand smoke with
lung cancer based on data concerning smoking and lung cancer,
the EPA wrote, “A gradient of increasing risk for lung cancer
mortality with increasing number of cigarettes smoked per day
was established in [each of eight major studies].”
In an American Cancer Society study of over
one million persons, for example, less-than-a-pack-per-day
smokers had less than half the lung cancer risk of
two-pack-per-day smokers. People who smoked 1-9 cigarettes per
day had about half the lung cancer risk of people who smoked
10-19 cigarettes per day.
There is no question that fewer cigarettes
smoked per day reduces lung cancer risk.
The University of Minnesota study does not
change this fact for at least two reasons: (1) the researchers
did not study the impact of reduced smoking on health and so
cannot claim that it has no effect on health; and (2) what
they did study (urinary levels of the NNK metabolites) may not
even be biologically related to cancer risk in smokers and so
may be utterly meaningless in terms of health consequences.
The condemnation of harm reduction on the
basis of this study is so unjustified as to be blatantly
dishonest. Lying to smokers about the health effects of
smoking less is simply despicable ― and isn’t that one of the
anti-tobacco activists’ primary criticisms of the tobacco
industry?
Many people are going to smoke no matter
what. Rather than accept and work within this reality to
reduce the consequences of such smoking, the anti-tobacco
industry is taking an “our way (tobacco prohibition) or the
highway (more smoking-related disease)” approach.
It’s a disturbing attitude that seems to be
driven more by a blind hatred of the tobacco industry than
concern for the health of smokers.
Steven Milloy is the publisher of
JunkScience.com,
an adjunct scholar at the Cato Institute and the author
of Junk Science Judo:
Self-Defense Against Health Scares and
Scams (Cato Institute, 2001).
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