Research once again undermines reasons for quitting smoking

(Thanks to CMNissen for alerting me to this article.)

In the most recent issue of Chemical Research in Toxicology, there is a new article with the daunting title of Immediate Consequences of Cigarette Smoking: Rapid Formation of Polycyclic Aromatic Hydrocarbon Diol Epoxides (abstract here). To summarize, 12 subjects each smoked a cigarette laced with a phenanthrene derivative which could be monitored for its subsequent route to illustrate the formation of mutagenic and carcinogenic epoxides which could arise from smoking. The epoxides were detected and it was concluded that there existed “immediate negative health consequences of smoking, which should serve as a major warning to anyone contemplating initiating tobacco use”.

I do not dispute the findings themselves though I would not be surprised if you could come to the same apocalyptic conclusion if you carefully studied a single exposure to a campfire. What concerns me is that like the recent Surgeon General’s One Puff Can Kill You, this adds more, if you will forgive the phrase, fuel to the fire of treating exposures as an all or nothing issue rather than the more pragmatic approach of treating smoking and such activities as dose response.

Sure, one exposure could doom you but it is quite unlikely. But multiply that by a thousand or a million and it should worry you more. Logically, if one exposure is as bad as they imply, why quit after you’ve had your one cigarette? You are probably already coasting on empty. (Of course, just by looking around we see that the longer people smoke the more likely they will exhibit some negative consequence, and we also know that when people stop smoking, associated negative effects tend to diminish. And there is plenty of good rigorous evidence to back up this common knowledge.)

Anti-tobacco activists and researchers expend a lot of effort reducing this wildly varying practice known as smoking to an overly simplistic do or die scenario (or I guess in this case, do and die). This undermines tobacco harm reduction (when they exaggerate and otherwise misrepresent the harms of vastly safer alternatives) and also undermines their own cessation message because though quit or die seemed overly aggressive it pales beside the horrible spectre of quit and die (anyway).

But to be absolutely clear, this is not just about Hecht and company delivering yet another counterproductive or disturbing message. It is easy enough for a determined researcher to find risk in almost any exposure. Productive work occurs when you consider and then manage risks within the context of typical use and typical consequences.

-Paul L. Bergen