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frank_davis


Frank Davis

Banging on about the Smoking Ban


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The Mediaeval Mind
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frank_davis
I dropped into the River this afternoon, and was told a sad story. One of the regulars said that someone he knew had just been given two weeks to live. She was only 39, and riddled with cancer.

'Imagine it,' he said, rolling his eyes. 'Two weeks to put your affairs in order!'

'It started in her throat,' he added.

'Was she a smoker?' I asked.

'No. She didn't smoke. And she didn't drink either.'

And I began wondering yet again what was causing all this cancer, if it wasn't smoking or drinking or any of the other 'lifestyle' risk factors. Sir Richard Doll claimed that 90% of lung cancers were caused by smoking. 60 years on, we still have no better idea.

Smoking was hit upon as a convenient culprit. And it's remained the prime suspect ever since. Over the subsequent 60 years, antismoking has grown up to become a lucrative industry. Yet all that was found in 1950 was that, in an era when most people smoked, most people with lung cancer were smokers. What a surprise! Various figures get bandied about on the prevalence of smoking back then. That 60% of men smoked. Or 80% of them. But in the British Hospitals study conducted by Doll and Hill in the late 1940s, and published in 1950, 98% of all the patients in the study - lung cancer or other - were smokers. And when the subsequent Doll and Hill British Doctors study began a year later, 87% of the doctors were smokers. From these two snapshots from that time, it rather looks as if 90% or more men were smokers back then.

Since then, smoking has been in steady decline. In half a century, it's fallen from something like 90% to 25% or less. But lung cancer rates kept on rising for most of that period.

If this might have suggested to some people that there might be something wrong with the smoking hypothesis, the response of the antismoking zealots was to vastly magnify the threat. Whereas Richard Doll and Ernst Wynder had largely dismissed any danger posed by secondhand smoke, the next generation of zealots seized upon it to extend and enhance the threat. Smokers weren't just killing themselves, but were killing everybody else as well. If lung cancer rates kept on rising as smoking rates fell, it was because secondhand smoke in the vicinity of smokers was just as lethal as firsthand smoke. And if never-smokers in smoke-free environments continued to get lung cancer, it could only be because they encountered the thirdhand residues of smoking on the walls of buildings or the clothes of smokers, and this residue was yet more lethal still. The more remote the threat of tobacco smoke became, the greater its toxic powers were multiplied so as to compensate.

There is a mediaeval mindset underpinning such a tenacious belief. A wicked witch has been casting evil spells upon people, and she is tried and burned. But the blight on their lives continues, and so suspicion falls on her previously unsuspected daughters. And they are tried and burned too. But the blight only grows worse. And so suspicion falls upon her house and her possessions, and they are burned too.

Another mediaeval belief is that sickness is a punishment for sin. Smoking, along with drinking and debauchery, had long been held to be a sinful practice. What more apposite than to discover that the sin of smoking was attended by an appropriately divinely ordained punishment, in the form of lung cancer?

In fact modern 'lifestyle' medicine is simply this ancient dogma renovated and re-branded for a new age. Words like 'sin' and 'punishment' are no longer employed. Its practitioners no longer brandish crucifixes and bibles. But the gist of its message remains the same: the patient is to blame for his disease.

Such mediaevalism may well be simply what always emerges when reason falters or fails. Medical rationality has yet to explain cancer and many other diseases. And while the bright fire of reason slowly advances, it pushes up against a surrounding darkness inhabited by the spirits and hobgoblins and witches and succubi of the mediaeval mind. For every patient scientist like Snow or Pasteur or Fleming, there are always dozens of Dolls and Godbers and Liam Donaldsons, the modern descendants of witch doctors with bones thrust through their noses, dancing ecstatically around their pinioned sacrificial victims. Unable to advance in reason, we fall back on superstition.

One might even say that other modern beliefs have a similar mediaeval structure. We are told that we are to blame for heating up the planet, and that we must repent and wear sackcloth and ashes, as a carbon penance for our sins, for otherwise a divine retribution of global fire will be upon our children and our children's children, yea even unto the seventh generation.

It was all present this afternoon at the River. After firsthand smoking as a cause of the unfortunate young woman's cancer had been dispensed with, the spectre of secondhand smoking was conjured up in its place. If it wasn't one form of smoking, it had to be another. Anything else was inconceivable.

'Who was that comedian who reckoned he'd got lung cancer from playing for years in smoky clubs?' the regular asked. 'The name's on the tip my tongue. Roy... Roy Castle!'

'Yes,' I replied, 'That was indeed his own wild guess how he got it.'

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"The more remote the threat of tobacco smoke became, the greater its toxic powers were multiplied so as to compensate."

Very nicely put - because these are the same people who make a big song and dance about homeopathy being rubbish. And here they are using its very principles in support of their own ideas!

You're right! I hadn't noticed that homeopathy connection before. The more something is diluted, the more potent it becomes.

The Snifferati

(Anonymous)
'The more something is diluted, the more potent it's effect becomes' on the mind, perhaps?

I do think that people are starting to wake up, albeit it at a painfully slow rate. The problem with being so fixated about one thing, such as anti-smokers are, is that the further away from the truth they have to go to keep up the interest (and, in anti-smokers’ cases, the funding), the less it resonates with the public, because it increasingly moves away from the evidence of their own eyes, ears and personal experiences and becomes so far-fetched and tortuous that even previous “believers” start to doubt the “cause.” The conflict between the zealots’ ever-more desperate exhortations about how the world is, and the public’s experience of how it actually is leads inexorably towards a collision between ideals and reality where the “facts” supporting the ideals simply cannot be stretched and twisted any further in order to bear any semblance of similarity to the reality which is daily experienced by the general public. Perhaps inevitably, therefore, reality always wins, and such movements simply collapse under the weight of many years of increasingly bizarre and exaggerated claims.

One notable example of this is in the anti-smokers’ failure to win the battle for the hearts and minds of the general public around the issue of weight gain after giving up smoking. Have you noticed how quiet they always tend to be on this subject? Even with all the current talk about the "obesity epidemic" the fact that obesity has risen pretty much at the same rate as smoking has declined is never mentioned. There have been several gallant efforts to “prove” that smokers weigh more than their non-smoking counterparts, or that weight gain after giving up smoking is merely a temporary condition and that all that extra fat just melts away after few months. But somehow this idea has never taken root in the public’s consciousness and such “studies” have usually been swiftly buried or forgotten. Why? Well, it’s because people can see, and often know personally, countless others who have given up the smokes only to turn virtually overnight into wobbling lard-buckets whereas previously they were active, lively people of, usually, average weight. The other anti-smoking myth which never quite took off, incidentally, was the “smoking causes impotence” one. Again, it was the kind of lie which people saw through immediately because it was so clerly at variance with their own experiences. Ladies of my generation – children of the 1970’s and all that that entailed – would definitely have known if there was a “performance” variation between smoking and non-smoking men and, believe me, there was not!

And, as more and more clean-living, non-smoking people such as your acquaintance fall ill with all those terrible “smoking-related” diseases, and the efforts to link those diseases to tobacco smoke, against all the odds and no matter how obscure and tenuous that link might have to be, the less people will believe in the entire “smoking kills” message. Many more non-smokers will have to die from “smoking related” illnesses before the penny finally drops, of course – the public have never been known for being that quick on the uptake – but ironically, in this respect, through their “success” in coercing so many people into giving up smoking, the anti-smoking movement themselves may have sown the seeds of their own undoing and, indeed, may well have accelerated the process.

Yes, I think that people are beginning to wake up too. Painfully slowly, as you say.

At the River yesterday, the regular who told me that story, and who appealed to the sainted ghost of Roy Castle to explain it, ended up saying that it was probably pot luck whether you got these dreadful diseases or not.

Frank

A few facts:

Roy Castle died of lung cancer, his death certificate does not say passive smoking.

RC was not a non smoker, he smoked cigars.

In his early career RC did a comedy act in variety shows, his props were made from asbestos.

RC only spent a few years in smoky clubs, he moved on to films and TV, unlike thousands of club acts, many of whom are still going strong.

Lung Cancer did not appear with smoking, in 1900 before smoking was a widespread social activity, 10% of cancers were of the lung. Everyone dies of cancer if heart failure does not get them first.

Roy Castle did not die from passive smoking, he died from lung cancer.

timbone

It's strange how everybody seems to know about Roy Castle though. Somehow or other, it's got lodged in the public consciousness - perhaps because he was a popular entertainer.

But the suggestion being made in the River was not that he died of passive smoking, but of lung cancer brought on by passive smoking. All lung cancer is seen as being caused by smoking: if it's not active smoking, then it must be passive smoking. QED.

But were 10% of all cancers in 1900 lung cancers? My understanding is that lung cancer was almost unknown before 1900, and it only began to be recognised as an epidemic in the 1920s. The epidemic may have been an artefact of improved diagnoses, of course. Either way, the new fad of smoking cigarettes, popularised in the trenches of WWI, rapidly became the prime suspect.

Frank

Roy Castle famously sang: "dedication, dedication, dedication, that's what you need!" When what he really needed was radiation for his medication.

Unfortunately I lost the article written by a doctor with my last computer. I will try and find it again. As far as I remember, it stated that when the Doll research beagan, they were comparing medical records dating back to 1901. The figures from 1901 to 1952 for lung cancer had soared from 10% to a much higher figure.
I will try to find it again.
It also mentioned the unresolved debate as to whether it was cigarettes or diesel which had caused the epidemic, or a combination of both.

Found it. http://www.journaloftheoretics.com/Editorials/Vol-1/e1-4.htm
timbone

The article you reference (which I've read before) doesn't mention Doll. And it doesn't mention diesel either.

Frank

Sorry, my mistake. Like I say, I lost a lot of data when my last computer had a tragic end - serves me right for not backing up more often. I was in a rush this morning, but I also remembered this one, which you have no doubt seen - http://www.second-opinions.co.uk/diesel_lung_cancer.html
I am still trying to find the article which had the information I referred to, failing that, I will conceed my mistake and admit that age has caught up with me.

timbone

Well, you may be right about the incidence of lung cancer. It's just that I haven't read that anywhere.

Frank

Hi Frank

Is this any use?

Hueper 1956
In fact the first observations on an appreciable rise in the frequency of lung cancer were reported from the highly industrialized cities of densely populated Saxony during the first two decades of this century.
Some years later it was found that high lung cancer rates existed for the population of the industrialized territory of the Ruhr valley, while they were below average for the agricultural region of the Main valley.
http://www.chestjournal.org/cgi/reprint/30/2/141

Bessy Braddock, Labour MP
for Liverpool Exchange, favoured an environmental explanation, and therefore found the urban–rural divide a barrier to acceptance of the
smoking–lung cancer connection.

‘In view of the fact that cigarette and pipe smoking goes on all over the country, it is folly to say that it is the main cause of lung cancer.’
http://fds.oup.com/www.oup.co.uk/pdf/0-19-926030-3.pdf

the Cigarette - Enemy or Red Herring?

"The other theory is that the increase in lung cancer has been due to motor exhaust fumes; which are known to contain carcinogens, especially those of the diesel engine. I estimate roughly that the petrol engine is only about 6 % as dangerous as the diesel, and that if one adds.6 % of the petrol used to the diesel fuel consumed on the road's in each year, one gets a graph of the huge rise in carcinogenic pollution of the atmosphere in Britain in the last 50 years .

If the curve of the rise in male lung cancer mortality is plotted beside it, one can see that there is a close relationship between them.
I believe that this correlation is more than mere coincidence.
The diesel' theory needs to be thoroughly investigated' by a crash programme of research, and the cigarette theory needs to be checked and the figures on which it is based audited by independent statisticians.

The cigarette theory has been used as a red herring to distract attention from the horrible pollution of'the atmosphere by the diesel engine. all we've had up till now has been a flood of propaganda and the virtual suppression of all criticisim and discussion."
http://tobaccodocuments.org/lor/00622096-2098.html

Figures from 1910 onwards.

Rose



Hi Rose,

It may be what Tim Bone was talking about. He'll have to answer that.

The first Doll and Hill study - the 1950 London Hospitals study - was criticised on the grounds that it dealt with an urban population, and there were moves afoot to run a rural study. This was never done.

Neither, for that matter, was the London Hospitals study fully completed. There was supposed to be a subsequent paper considering all the other data they collected. That wasn't done either. And it's seems to me to be extremely remiss of Doll and Hill that this is so.

But I more and more think that the point of the study (and of the subsequent British Doctors study) was to frame tobacco, simply by looking at tobacco and nothing else. Thereafter, tobacco was kept tightly in the frame, and all alternative hypotheses were discounted.

Frank

"Perhaps, however, the most damaging element of the Doll study is an admission that he made when the study was finally terminated, in 2001.

Writing in the December, 2001, issue of the British Medical Journal, Doll explained that the study was "devised by Sir Austin Bradford Hill to achieve maximum publicity for the critical link between smoking and lung cancer".

In short it was never intended as a serious scientific study to test the hypothesis that smoking may cause lung cancer. From the beginning, it was just propaganda - well intended, perhaps, but propaganda none-the-less. "
http://www.lcolby.com/b-chap7.htm

Doesn't surprise me.

War of words
Richard Doll
"Robert Proctor is correct in thinking that few people know much about the public health measures of Hitler's physicians (Opinion, 19 June, p 4, but he is wrong to imply that scientists have been ignorant of the medical research of the period.

Opinions may differ about its quality and the conclusions that could be drawn from it, but it is just plain wrong to say that "Richard Doll . . . knew nothing of the Schairer and Schöniger article until he [Proctor] sent him a copy in 1997".

I published its findings in an article on the causes of lung cancer in Advances in Cancer Research, vol 3, p 9 in 1955 and have invariably referred to it in appropriate circumstances ever since."
http://www.newscientist.com/article/mg16321956.100


Hueper 1957 in a court case
A That is right, reputable European journals and the possibility of the question was ventilated that smoking of cigarettes might have something to do with lung cancer.

Q How widespread was that?

A There were repeated publications on that subject.

Q Were those publications'available in the major cities of the United States?.

A Yes, if they would read them.

Q In other words, anyone who was a doctor or not could go to any medical library and find it and read such statements?

A, Yes, it was in general medical journals and readily accessable.
http://tobaccodocuments.org/industry_depositions/503243231-3367.html?zoom=750&ocr_position=above_foramatted&start_page=1

It clearly was

Franz H Muller 1939 published in JAMA
"The fact that about one third of the subjects surveyes smoked moderately or not at all indicates the presence of other cancerigenic factors besides smoking, such as influenza and industrial working conditions.
The great significance of the latter can be inferred from various indications but needs further study."
http://tobaccodocuments.org/ness/4164.html

Tobacco couldn't be more convenient, visually too.

Right, I'll stop cluttering up your blog and go back to the garden, its very sunny up here.



Doll knew about German research because Franz Muller 1939 is mentioned in the references of the London Hospitals study. Furthermore, the reference is to a German publication not an American one.

Schairer and Schoniger's paper (or the only one I've seen) was published in 1944 (I think) during the war, so Doll may not have seen that one until a lot later.

Frank

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