Time to change the diapers on Pediatrics Journal

Pediatrics cries wolf so often that it would be difficult to identify any real threats to child health within those pages. Not only do they construct visions of disaster out of little more than phone polls (that third hand smoke lunacy), generalize from ambiguous results (as will be elaborated on here) or just plain mislead (as in child poisonings from new nicotine products), this journal, as we have opined before, gives The Onion a good run for the money. For instance, where else would anyone take seriously the idea that paternal smoking around pregnant women could lead to subsequent obesity in the to-be-born children?

Just paging through the last couple of issues I found this article on the effect of breastfeeding on later academic achievement with the conclusions in the abstract as:

Predominant breastfeeding for 6 months or longer was positively associated with academic achievement in children at 10 years of age. However, the effectiveness of breastfeeding differed according to gender; the benefits were only evident for boys.

Notice that the result is just as much one of “predominant breastfeeding is not positively associated with academic achievement in girls”. I do not have access to the whole article so for all I know it actually negatively impacts females however the point is that a specific conclusion is being generalized without reason. It might be an interesting question as to why boys and not girls and the conclusion should have mentioned that.

But to the matter at hand, the latest movies cause smoking “evidence”. And let’s just state those conclusions right up front:

These findings imply that, beyond direct influences, the relationship between adolescents’ sensation seeking and parental R-rated movie restrictions in explaining smoking onset is bidirectional in nature. Finally, these findings highlight the relevance of motivating and supporting parents in limiting access to R-rated movies.

Note the word “bidirectional”. The definition for that is “moving or operating in two usually opposite directions” Not really the sort of thing you would want to encourage when suggesting behaviors. So what the conclusion actually is saying is that “we don’t know what causes what, we think they might both cause each other, but we have no problem using this to give advice”. But let’s delve just a little deeper into this intriguing study. And I quote:

We found that adolescents with lower levels of sensation seeking and those who reported R-rated movie restrictions were at lower risk for trying smoking. The results also revealed negative associations between adolescents’ levels of sensation seeking and later R-rated movie restrictions, which indicates that sensation-seeking adolescents are at higher risk for starting to smoke not only directly but also indirectly through changes in parenting. Sensation-seeking adolescents seem to influence their parents to become more indulgent regarding their movie viewing, which subsequently is related to higher risks for smoking.

Now, forgive me if I am wrong but I do see this being reprinted in the Journal of Results So Obvious That Only a Fool Needing to Pad the CV Would Submit It. And the results are: kids who are curious about things are more likely to act on that curiosity than kids who are not, and they are also more likely to pester their parents, and those parents are more likely to give in than parents who had never been pestered. (If following form, the next Pediatrics article about smoking precursors should encourage parents to administer growth inhibitors since aging is probably the single greatest determiner for later smoking).

But now, and I do apologize for going on and on about this, Pediatrics has turned its attention to caffeine consumption in youth. (I know, yes, these articles do not share the same authors but they do all get printed at this journal so I think it is not unfair to suggest that the journal is to blame, hence the title about changing diapers; the authors may provide the food but it is the journal that puts out the crap).

In this case, the study is not quite as bad as the media reports that follow though the authors do flap their lips a little more loosely as well once in the spotlight. The study reported that the findings indicated either that caffeine consumption led to disrupted sleep patterns or that children consumed caffeine in response to not sleeping well the night before. They were not sure which way this went but it still led to concluding that caffeine should be restricted, not because it was harmful but on the basis that the beverages had “detectable pharmacologic effects”. It does not sound like a bad idea in general not to ply your kids with pots of coffee or coke but I really do not see the above as actually supporting that.

By the way, the other grand finding in the study was (and they took pride in that this had not been widely documented) that children’s sleep patterns on the weekends varied from that of the school week. (Maybe this is what they mean when they talk about the great work of science being built up one small brick at a time!)

But come the media and we have the headline Caffeine Can Harm Children. And the quote:

“Parents should be aware of the potentially negative influence of caffeine on a child’s sleep quality and daily functioning,” Dr. Warzak asserts.

And as we know, when you put in the word potentially anything after is quite true. We could potentially fall into the sun tomorrow. Absolutely true.

Or more to the point: Pediatrics Journal could potentially tighten up their editorial policies. The journal has been around long enough to move on to potty training.

– Paul L. Bergen

Overly precautionary: tobacco policy needs to return to the real world

There has been a subtle yet crucial shift in ideology which has led tobacco policies astray.

Consider that the statement using tobacco can result in disease is markedly different from the statement using tobacco results in disease. The first recognizes that tobacco use is a risk factor and the second is a gross generalization. The second position might be more effective in countering initiation but it also ends up supporting a strong anti-harm reduction stance.

Stating simply that using tobacco leads to disease ceases to distinguish between the two and therefore the only reasonable action for removing the disease is to remove tobacco use. Saying it might result in disease leaves open the option for substitutions that have much lower risks.

We have come to a place where we expect smokers to get sick and die as a result. Those who don’t are considered anomalies and while many smokers do get sick as a result many who do not. The overwhelming “these things will kill me” characterization is more ideological and a mirror of the times than it is a statement of fact.

Once tobacco use is characterized as inexorably leading to disease you are left with the position that all tobacco use as immediately harmful, any level of exposure to that use (second hand and third had smoke) as harmful, all communing of smokers in public as harmful, all smoking in public as harmful, and also any use of any tobacco product of any kind as harmful and therefore tobacco harm reduction no longer has any place in the discussion.

Recently at SpikedOnline, Frank Furedi wrote about the shift in public thought to instead of using as worst case thinking as just one of many future scenarios using it as the prime policy driver.

Frequently, worst-case thinking displaces any genuine risk-assessment process. Risk assessment is based on an attempt to calculate the probability of different outcomes. Worst-case thinking – these days known as precautionary thinking – is based on an act of imagination. It imagines the worst-case scenario and demands that we take action on that basis. For example, earlier this year, the fear that particles in the ash cloud from the volcanic eruption in Iceland could cause aeroplane engines to shut down automatically mutated into the conclusion that they would. It was the fantasy of the worst case, rather than risk assessment, which led to the panicky official ban on air travel.

Implicitly, and sometimes explicitly, advocates of worst-case thinking argue that society should stop looking at risk in terms of a balance of probabilities. These critics of probabilistic thinking are calling for a radical break with past practices, on the grounds that today we simply lack the information to calculate probabilities effectively. Their rejection of the practice of calculating probabilities is motivated by a belief that the dangers we face are so overwhelming and catastrophic – the Millennium Bug, international terrorism, swine flu, climate change – that we cannot wait until we have all the information before we calculate their destructive effects. ‘Shut it down!’ is the default response. One of the many regrettable consequences of this outlook is that policies designed to deal with threats are increasingly based on feelings and intuition rather than on evidence or facts.

Human beings have always exercised caution when dealing with uncertainty. Today, however, caution has become politicised and has been turned into a dominant cultural norm.

The Furedi article helps to explain why tobacco use policy is fear driven rather than a process of finding the most reasonable solution to a problem. Can there be any other explanation of why a future possibility of all snus and e-cigarette users gravitating to smoking (without any evidence for this) carries more weight than the potential of reducing the risks for smokers now?

Take fear out of the equation and you are left with simply dealing with a behavior with existing and available safer alternatives which if adopted would remove virtually all of the associated health risks.

Tobacco harm reduction is already at work. Smokers are switching over despite the impediments erected by the anti-tobacco and anti-smoking organizations that lie about being concerned about the annual death toll.

-Paul L. Bergen

Potpourri: Nicotine related news and articles

Rather than post a full article today. it seemed appropriate to promote a couple of articles elsewhere worth reading and some short comments on a couple of recent news items.

First the articles.

1. I was going to critique another of the Tobacco Control envisioning “new ways” articles, the Hatsukami et al which suggested various avenues of research to determine whether (and they really had already concluded that the whether was only a polite way of saying when) nicotine reduction could be applied to tobacco products in order to wean off the population however Brad Rodu said as much as needed to be said on that, and said it very well. See Imagining Tobacco Without Nicotine at TobaccoTruth; from October 6th.

2. Over at VelvetGloveIronFist, Chris Snowdon has a close look at the contradictions embodied in the work of Stanton Glantz (from his earlier writings critiquing methodological errors endemic in the health literature to his later publications transgressing his own guidelines for evidential significance. See Stanton Glantz: Then and now from October 14.

Now the news items:

3. Is Iceland going Swedish?. Cigarette sales are down 13% and snus/smokeless sales are up 9% (see here at Iceland Review Online). Its a straight forward report with no editorializing which contrasts strongly with a similar smoking down/smokeless up story out of Washington back in August (see here for my comments on that story).

4. More support out of Maryland for nicotine being protective or ameliorative for Alzheimer’s Disease (AD). This is not really surprising since nicotine is strongly anti-inflammatory. It is a very good option since most of the drugs used to counter the effects of AD have fairly common and fairly aggravating side effects. The article is unusually calm in its discussion with only a passing mention of manipulating the drug in order to reduce the addictiveness.

What is beautiful about nicotine for this application is that given the typical AD sufferer being 65 or over, addiction is irrelevant (and in any case would be preferable to cognitive decline) and even if the most dangerous form of obtaining nicotine (smoking) were the administration, with the effects tending to lag far after the start of chronic use, the usual health concerns are almost negligible.

-Paul L. Bergen

If one small lie could stop someone from ever smoking?

Years ago at a conference I attended, we had a discussion going about how much misleading information was present in materials which were aimed at getting people to stop or not start smoking. One of the more persistent ideas was that nicotine was poisonous. But a doctor who worked at an addictions clinic said that he supported leaving that in place because they had found that that one characterization had been their most effective tool in getting smokers to stop and stay stopped.

Later that day, my colleague asked me if I could stop my daughter from ever trying smoking just by telling one lie, would I do it?

Its easy enough to just say no because of course not only might one lie lead to another but any one lie would make all other communications suspect. But we are talking about parental impulses here and as much as I believe that everyone has the right to make their own choices about these things, and that there are worse things she could be doing, the thought of her drawing smoke into her pristeen lungs is not a pleasant one. I still said no.

But this question of whether it is permissible to lie (or deliberately manipulate popular pre-existing false beliefs) if it serves the greater good will always be with us.

In tobacco harm reduction we think that the most important thing is that people who use or might use tobacco should know about the health risks and should be aware (and have available) all the safer nicotine alternatives. Smoking is a choice but it should be within the context of the knowledge that there are safer ways to get nicotine. I guess one way of looking at it is, though for some people smoking is the best nicotine option given their circumstances, for many smokers that is not the case, and with that in mind, a decline in the number of smokers is a positive development.

So we want people to have options, but we would like to see smoking become less common. And not because it is smoking but because of those avoidable diseases.

We really would like to see smokers move to using smokeless tobacco or e-cigarettes but we have not used the fears of 2nd hand and 3rd hand smoke to do so. You will see some vendors using these arguments but we have not. And the temptation is there because tapping into those misperceptions could be quite effective. But the problem is that we don’t believe that stuff and we also like to think that one of the strict dividing lines between the standard anti-smoking dogma and our own is one of paying attention to the evidence.

Its more than just a question of strategies.

If we are evidence bound it means that we have to ignore certain tools and it means that when the evidence changes we have to change as well. We have that slight overlap with the anti-smoking groups of wanting to see the numbers of smokers decline but for us it is because that would indicate a healthier population and for them it just seems to be an aim in itself. Since they are ready to use each and every tool to fight smoking (including vilification) their movement is safe from any changes in the science.

For instance, if a week from now, incontrovertible evidence came out that smoking had about the same risk as using smokeless tobacco or e-cigarettes, and people knew about it, we would be out of business.

Would they?

This is also about the larger ethical implications. If we do not base our actions on what we think is the true picture of the world, then by extension we sanction others to knowingly manipulate our beliefs and actions with false information.

-Paul L. Bergen

SCOOP! Leaked UPA Guidelines for Tobacco Reporting

-The following inadvertently ended up in my inbox via a BCC re a starting writer at a major newspaper who probably was not aware that it was intended to be confidential. There is little need to comment on this since it pretty well speaks for itself.-PLB.

United Press Association Guidelines for Tobacco Reporting

As a new reporter or perhaps as a more seasoned journalist considering taking on tobacco news, this field may at first glance seem daunting. After all, tobacco is not only a major global agricultural product and business concern but also has come to be a focus of both governments and health agencies as a major negative influence on public health. There is a great deal of research being done on and journals devoted to all aspects of tobacco.

But have no fear.

This guide will show you how to master tobacco issues with a few easy steps and create articles any editor will accept (as long as you remember to use that spell checker!) and you will find that in practice, this seemingly complicated area, requires no background knowledge or experience to adequately manage.

Included in this package you will find examples of actual articles that were accepted as well as verbatim passages which need to be included in almost every tobacco relating article to pass editorial muster and to qualify for eventual publication. These passages might seem inappropriate for some articles but history has shown that in almost every case including these passages greatly increases the likelihood that an article will be printed and just as importantly also sends a clear message to the reader that you are a trustworthy writer. As an added bonus, these passages will without any effort on your part other than cutting and pasting, add up to 150 words, and if you are being paid by the word, that is money for next to nothing.

The basic article template is as follows:

1. Don’t worry about the headline: that is not under your control.

2. In your first paragraph have some sort of generic lead into the theme which includes the phrase “tobacco use (or smoking) is the leading preventable cause of death (or disease)”. Though this is ubiquitous in tobacco related articles, paradoxically, it signals that you have done original research and that you are well versed in the topic at hand. (Including this phrase is not optional: you will have some freedom in the body of the article but if you omit this phrase, chances are good that an editor will simply refuse to read further.)

3. In the body, you can simply use your reportage skills and describe the events or issues. As already mentioned, the area of tobacco covers many aspects and oddly enough as long as you refer to death and disease, or express concerns about the motives of producers, it will be interpreted as thoughtful criticism. Even if the concern is for instance about a shortage of water affecting tobacco crops, a collection of historical corncob pipes or whether cigarette butts are a major source of litter, it will only help you to add something about the impact of tobacco use on public health.

This might now seem an over simplification when you will encounter lesser known aspects of the world of tobacco and tobacco use but through experience you will find that when it comes to tobacco, less is always more. If you have explored scientific or health issues in the past you will have had to interview experts for quotes and insight into topics you are new to. You may remember hours spent trolling through expert databases at universities trying to find out who knows anything about nanotechnology, or walking through endless buildings trying to find the professor or scientist everyone is pointing you toward. You will be relieved to find that when it comes to any tobacco issues, any person you use will be accepted as an expert if they happen to be employed in the anti-smoking industry. These people are capable and ready to comment on any tobacco related issues and do not exhibit any fear of helping you in areas that they have no background knowledge in.

One other note on sources. Tobacco issues are also unique in that it is the only area in which you can not only report the opinions of children and teenagers about something that has some factual basis but those opinions can be considered the equal of any evidence. In fact, in this area they are better than evidence, and add that needed human touch to the story. (For example, if you get quotes from children saying they are being targeted by tobacco companies, it means that tobacco companies are targeting them –if you have some background in science reporting this may seem odd but consider that federal agencies and renowned health organizations will use this as evidence).

4. Finally, the summarizing paragraph(s) should contain the phrase “every year over 400,000 people die as a result of tobacco use”. (The only acceptable substitution for this phrase is one which has a global rather than national figure).

The above holds true for all tobacco related articles but if you happen to be writing about any issue that encompasses or refers to second hand smoke in any way, you will need to include, not instead of but in addition to the above, the phrase “there is no safe level of exposure to second hand smoke”. As with the other phrases, there is no need to cite any source since, technically, they fall into the category of self evident truths.

A few general points about writing the article

Back in journalism school, no doubt you were told to show both sides of every story and while that is quite true in most areas, here it has a specific manifestation. If you are reporting anything that is optimistic (let’s say a decline in smoking rates) always follow up with a cautionary note of some kind (but smokeless tobacco use is up). The opposite however is not required. In tobacco, all news is bad news, even the good news.

Some writers have taken the position that as with other areas of journalism, changing the pattern will make them stand out, and they have written tobacco related articles and deliberately omitted the “leading preventable..” and “over 400,000…” phrases. Some of them have even written articles that suggest there may be some benefits to tobacco use or that there might be some downside to higher tobacco taxes. Some have written about the lucrative anti-smoking industry or how current policies actually work against public health. These seem like worthwhile areas for investigative journalism but be wary. Those writers have stood out but where they have stood out is on the unemployment line. Be creative if you like but follow the basic template because even if you get your unique approach by your editor, you will cause confusion in readers who have come to expect these touches no less than they expect good grammar.

Follow these basic guidelines and you will find tobacco reporting easy and quite remunerative. With every state and municipality wanting to report on their individual wars against smoking, and the continual growth in regulations (and even some of the challenges to those regulations, as well as the new products coming out, and the growing awareness of tobacco markets abroad, there is no end to things to write about. Big area, no end of stories, no research required, and this ready template – there is no better area to cover than tobacco.

-and here is one of the articles that was attached to the e-package (PLB).

Article example 1: Insulin produced in genetically modified tobacco plants

Despite tobacco use being the leading preventable cause of death, US researchers have successfully expressed the precursor protein of insulin in lettuce and tobacco plants. Moreover, feeding these genetically modified plants to mice that have a tendency to become diabetic protected the animals against inflammation of the pancreas.

Generating the proinsulin protein in plants is a low-cost alternative to standard production methods, Dr. Lendl Trott, from the University of Florida in Palmetto, and colleagues note in their report in the Plants and Biotechnology Review.

In the study, the scientists describe the creation of lettuce and tobacco chloroplast lines that produce a fusion protein consisting of a subunit of cholera toxin joined to human proinsulin. Giving powered tobacco leaf to diabetic mice helped preserve insulin-producing beta-cells in the pancreas, Trott’s team reports, and this was associated with lower levels of glucose in their urine and blood.

Children who saw the tobacco plants said that “they are scary looking” and “I think they want to hurt me”. The children’s conclusions indicated that the tobacco industry was taking advantage of an unforeseen loophole in marketing regulations so researchers are moving on to using genetically engineered lettuce instead. They add that in light of the encouraging results in animals, testing in humans is now underway.

Despite the potential for helping millions of diabetics, tobacco use is responsible for over 400,000 deaths every year in the United States alone. It is the main cause of lung cancer and a major cause of many more. Cigarette smoke contains over 4000 different chemicals. Deb MacIntosh, the receptionist at the Ohio Freedom for Non-smokers Association said that these scientists have offered no assurance that these plants cannot be cured and smoked. “They might help a few diabetics but just one of these plants if smoked could cause the deaths of many non-smokers. Everybody knows there is no safe level of second hand smoke. We know that stopping tobacco will stop those deaths so it is utterly irresponsible that anyone would engage in this kind of research”.

Another concerned expert, John Banzhaf at ASH-US offered to represent any relatives of diabetics who might have been exposed to this new threat. In the meanwhile, despite the children, scientists continue to research manufacturing proinsulin.

-Paul L. Bergen

E-cigarettes: Kids are the red herring in this debate

Up to about a year ago the usual news report on electronic cigarettes was unabashedly positive. Here was this great new product that smokers were finding to be a pleasurable substitute for cigarettes. The stories would feature smokers and their reports of improved breathing and in just about every case they would also mention how they had tried to quit before and failed. But here it was, the answer to everyone’s dreams.

You’d think that after all that lip flapping about how bad smoking is, how everyone really should quit, about that 2nd hand smoke, and even all that nonsense about cigarette butts clogging the streets, that e-cigarettes would have been welcomed with open arms. You’d think that health authorities would be falling over each other to tell any smokers who had not heard about this yet. But though many smokers have heard the good news every anti-smoking agency and activist seems determined to get this product banned. (And yes, we will concede the fact that its absolute safety is not determined yet but whether it is much safer than cigarettes, and whether the vapor is much less harmful than 2nd hand smoke is without a doubt).

Now, the average article might still contain one or two smokers talking about their quitting but the state sponsored fearmongers have taken central stage and making sure that everyone thinks more about these products being not 100% safe and less about them being safer than smoking. Kind of like saying “well, we have not looked really closely at that Coast Guard vessel yet so better stay on your sinking ship”. But just as criminal as that is, and because it seems to be the standard response from reason-challenged folks when up against the better mousetrap, its time to trot out the kids.

In this overall fairly balanced article from ABC News, Electronic Cigarettes: A Safer ‘Smoke’ or Another Bad Habit? E-Cigarettes Help Some Quit, but May Be Too Appealing to Teens, we have a couple of real gems.

The ease of concealing an e-cigarette habit (no smoke, no smell) may also make the product more appealing to teens, some argue, and certain brands of e-cigarettes have also been accused of marketing to kids by offering candy-like flavors such as chocolate, cherry, mocha, or almond.

Sure, they would be appealing to teens who are already smoking who would care about concealment but otherwise? And don’t get me started on the flavor issue…I am one of those insane grownups who likes chocolate and mocha, and I like those on just about everything you can add them to. I haven’t tried vaping chocolate but it sounds pretty cool. And it might just beat the hell out of plain old cigarettes, which can only be good.

Though he doesn’t know any teens who have latched onto the habit, Dr. Petros Levounis, director of the Addiction Institute of New York, says that “there is definitely reason for concern here.”

Because teens can get them online by pretending to satisfy the age restrictions many brands place on their websites, “I wouldn’t be surprised if this becomes a problem,” he says.

Yes, we really have to be concerned about those teens who might go online and lie about their age, have access to a lot more money than you need to buy cigarettes, go through a lot more hassle than getting a smoke from a friend or stealing it from their parents, actually smoke for some reason other than being a little edgy (because when you are a teenager I’m pretty sure smoking cigarettes is a bit more rebellious than those prissy safe ecigs). But, really, considering the idea that smoking might in fact be more harmful for developing bodies than for us older types, wouldn’t you rather they be vaping instead?

Even if e-cigarettes lack the toxicity of tobacco cigarettes, the nicotine in them is still a stimulant substance that you would want to keep out of the hands of minors, just as you would caffeine or alcohol, says Dr. Edwin Salsitz of the Division of Chemical Dependency at Beth Israel Medical Center.

And then, this. Caffeine is a pretty good example of something that is like nicotine and something that is preferred by adults but also that some kids gravitate towards (I know I did). Would you really be all that worried about your kids drinking coffee?

But the big point is this.

We were on the verge of the biggest public health revolution of all time. You would be hard pressed something bigger than vaping replacing smoking. But it seems this is is all worth throwing away at the thought of some kids using something analogous to coffee. In the words of the immortal Charlie Brown: Good Grief!

-Paul L. Bergen

Victim of the culture whores

I really dislike both Paris and Perez Hilton.

In fact, and though you may think I am being hyperbolic or fatuous, I really do think that culturally, they are corrosive elements, and personally, they diminish my quality of life. I would rather spend a day in a room blue with second hand smoke than a day in a room with either one of them.

Now I could join an anti-Hilton group, I could start a website devoted to disparaging them, and I could advocate for all public parks to be declared off limits to either one of them. But I don’t.

Because like most people, I am a reasonable human being.

Paris or Perez Hilton have just as much right to be in a public park as I do, even though I find their presence much more disturbing (and much more of a certain threat to my culture) than any number of smokers.

– Paul L. Bergen

Is Pediatrics the new Onion?

There are a few more laughs in the Onion usually but the Onion seems to have the firmer grasp on reality as well. But Pediatrics just keeps plugging along. Never a dull day when Winickoff and company are waxing wise. And what is the latest?

As reported in WebMD, the July print issue will feature a number of new insights into the risk parental smoking poses to child development. (These are not yet available online but I just cannot wait to report on this almost certainly important work.)

From study number one we have the following gem (to quote from WebMD): Mary-Jo Brion, PhD, of the University of Bristol, tells WebMD by email that babies exposed to smoke may be prone to rule breaking, such as lying, cheating, bullying, and disobedience.

From study number two we have: The study’s key finding, she says, is that paternal smoking clearly seems to be associated with higher childhood weight as assessed by body mass index. And -Jonathan P. Winickoff, MD, MPH, of Harvard Medical School, says the conclusion that paternal smoking also may influence “the developmental in utero origins of childhood obesity seems to be a novel finding.”

Novel, as in fiction?

Or from Doctors Lounge: Winickoff, co-author of the commentary, said it’s not true that smoking makes people skinnier. Instead, it boosts the weight around their bellies and hips, he explained. One theory is that secondhand smoke could do the same thing to those who are exposed, like the kids of dads who light up.

Alright, well that would explain why right along with the drop in smoking rates obesity is now at an all time low?

We’ll save the real analysis for when the articles become available.

You know, sometimes I feel a little bad about singling out Winickoff, but its just like that whack a weasel game, and his head just keeps popping up.

– Paul L. Bergen

Wichita smoking ban delay draws fire

Interesting things going on in Wichita these days which illustrate some inconsistencies in the anti-smoking movement.

First, to clarify my own position, I am old enough to have experienced life when there were few smoking restrictions. I much prefer how things are now in general. I enjoy being free of the smell of stale smoke in my clothing and when some places (including hospital television rooms) were so thick with blue smoke you could hardly see. This is much better.

But I do not hate being around smoking in public and even find it pleasant to a degree (almost nostalgic at times). I miss pipes terribly. They, the sweetest smelling smoke, ranked right up there with the smell of campfires and barbecues. And though I do not like really smoky bars, I prefer an atmosphere that is inclusive rather than exclusive.

Second hand smoking is not something that I have concerns about. I don’t like people smoking in my house because of the lingering smell, not because I think it will harm me. That being said, I enjoy the clean air around me, the non smoking in enclosed spaces, and feel overall this is an improvement. However, it is plain wrong that smoking has been curtailed on patios, public parks, various open air spaces, and that businesses cannot determine whether they should be smoke free.

Wichita plays into this because Kansas has a state law that bans indoor smoking with the exception of tobacco shops, already established private clubs, special rooms in adult care facilities and casinos. The only one of those exceptions that doesn’t make sense to me is casinos.

Everyone in tobacco shops is expressly there to voluntarily engage in tobacco-related activities so making those smoke free is absurd. If you have your own club you should have the right to make any rules that don’t harm others even if they are silly (people who disagree don’t need to join; I would not join a smoking club but these days, if anyone needs private clubs, it is smokers). With adult care facilities, the damage is probably already done and it is a poor sport that denies an eighty year old what might be one of their few remaining pleasures added to the fact that this is one population that has a harder time going somewhere else to smoke. But casinos are the one place where there is no special group. Maybe the reasoning is that gambling is degenerate and anyone doing it enters a state in which protection from other dangers is unwarranted. (But of course we all know that exemptions tend to come from lobbying and not from any reasoning in the traditional sense).

So then in the city of Wichita, a restraining order has been enacted impeding the state law which was going to take effect next week in the city. The restraint was on the grounds that in the city the state exemptions would not be applicable and therefore the law was more stringent on the local than the state level. Currently smoking is allowed in Wichita restaurants.

Now, I am not arguing so much against Wichita going smoke free though I would prefer that to be up to the discretion of the business owners. I like a smoke free restaurant but I do not like an alcohol free restaurant (the point is that I prefer to have the choice). And tavern and eatery owners should be able to decide which market they would like cater to.

What I find interesting in this affair are the comments of local activists in response to the restraining order. A representative from the local Lung Association said “It creates an uneven playing field for businesses, makes enforcement difficult, and does not protect the health of all people in Wichita.”

I won’t argue the last point because it is true however the first and second are intriguing for different reasons. The first because all along anti-tobacco groups have argued that there is no negative economic impact to going non smoking, and have gone so far as to censure research that examines that aspect (see Michael Marlowe’s Reflections of a Nonsmoking Scholar). The second point is amusing in that just like earlier arguments against e-smoking just because some people cannot tell the difference, they argue against the co-existence of smoking and nonsmoking areas because officials or complainers will have to check with the owners on the rules of the establishment before they can levy fines and hurl accusations.

– Paul L. Bergen

Royal College of Physicians on Passive Smoking and Children

The Royal College of Physicians have just released their new report called Passive Smoking and Children and have already come under fire from Michael Siegel over at Rest of the Story and Chris Snowdon at Velvet Glove (writing about this BBC report on the report).

This report was particularly discouraging to me because the RCP was one of the few authoritative health bodies that endorsed tobacco harm reduction. They appeared to be sensible.

As my colleague put it, and I paraphrase, “on the bright side you can think that even a misguided group still knows enough to recognize a good idea when they see it”. And while that is true enough, I am now thinking that possibly they supported tobacco harm reduction not on the evidence (though their report is well grounded in the writing) but more on disliking smoking so much. And I do mean disliking rather than being concerned about the health effects.

As these other writers point out, the RCP argues against even the sight of smoking. That is when you know someone has abandoned reason, picked up a torch and joined the mob.

-PLB