Policy by public opinion poll according to ASH Scotland

The lull in anti-smoking legislation will soon be over, and Sheila Duffy will soon stop reminding the incoming government of its obligations to children and get down to some serious work. Her latest effort claims:

Our polling shows that the public are aware that there are risks to children’s health from exposure to tobacco smoke with a huge 88% saying that they think second hand smoke increases the risk to a child’s health ...

The agenda has clearly moved to children (adults are no longer exposed in the workplace), meaning we can expect restrictions on smoking in homes and cars. The reasoning is superbly executed ... most people think smoke endangers children, therefore policy must be 'x'. (Are most people right? We should be told, but not only by Sheila Duffy.) More:

This is not necessarily about getting smokers who look after children to quit. Rather it is about informing people about the harms caused by tobacco smoke and showing parents and carers that the best way of protecting their children from the harm caused by second hand smoke is to not smoke around them.

So they are not even bothered about getting adults to quit any more. They are after 'harm reduction', which means nicotine replacement therapy in ASH Scotland's language. This means that they may have absorbed the wisdom imparted by the likes of Tim Coleman that NRT doesn't work for most people once they have left the clinic. That is, it doesn't work as a quit smoking tool, but it can still be used to relieve temporary discomfort.

Ms Duffy then goes on to recommend a 'social marketing campaign' covering the dangers of passive smoke exposure to children. What happened to public information campaigns? The term 'social marketing' is itself instructive, as marketing is a form of deliberate persuasion. The messenger is quite uncritical of the message: it has been taken for granted as fact, removed from the realm of objectivity, and given to the marketers to deliver to the public.

ASH Scotland has yet to start pushing for third-hand smoke awareness, but it's only a matter of time. Third-hand smoke is discussed clearly by Chris Snowdon here; he quotes author Winickoff from a private email regarding his study on third-hand smoke:

Basically, the study found that IF you believe that thirdhand smoke is harmful to infants and children, then you were much more likely to have a home smoking ban.

Not much science there either really, is there? More logic, really, and certainly doesn't address the issue whether third-hand smoke is a danger to children, or an issue that would make it advisable to wear a face mask when changing bed linen. The line of argument is identical to Sheila Duffy's. If enough people believe it's dangerous, there is no need to prove it any more.

ASH Scotland opens page on research into third-hand smoke

Thanks to auntieban (commenting on the previous post) I visited ASH Scotland's page on 'latest research on second-hand smoke'. It's now entitled:

Second-hand and Third-hand smoke 2010

Third-hand smoke was discovered in a telephone poll and has already become a tool for further denormalising smokers. Just one of the titles featured on this page of 'research', 'when smokers move out and non-smokers move in' (Matt, Quintana et al., Tobacco Control, 2010), is enough to make the skin crawl, especially to any smoker seeking to rent living space, and especially on the other side of the Atlantic.

I am reminded of the famous raid on Tommy Sheridan's home, when the police accused his wife of the theft of whisky miniatures. The police saw the miniatures during their lengthy raid on the Sheridans' property and thought they would charge her with stealing them. She was suspended by her employer British Airways before BA checked its own records and discovered that the miniatures had not been stolen. But by that time Gail Sheridan's name had been dragged into the mud. No issue, no evidence, no crime, but ill will and gullibility lead to a sordid outcome.

The genesis of the third-hand smoke phenomenon is described by Chris Snowdon here: an intriguing story of researchers manipulating the evidence: 

Having come up empty-handed using a real-life smoking environment, the researchers had resorted to using nicotine vapour on cellulose substrates in an experiment that could not be replicated outside of a laboratory. Even then, they had not found NNN in any of the experiments and the only TSNA to appear in any quantity was NNA. This posed a problem because NNA doesn’t actually cause cancer, as the authors admit: “NNA carcinogenicity has not been reported.”

 In a nutshell, people are making a fuss about something because there is a market for fuss, and a market means money. There's money in making a fuss about nothing. This is what makes ASH Scotland so powerful.

American public health charity calls for moderation in tobacco education

Although the USA largely subscribes to the idea that passive smoking kills, the American Council on Science and Health (like Michael Siegel) criticises more extreme claims made by other public health bodies. It takes the following example (which also typifies the kind of claim often criticised by Michael Siegel), claiming that it risks rendering all tobacco education too incredible to be taken seriously.

The report states, “[T]here is no safe level of exposure to tobacco smoke and that smoke causes damage immediately to the cardiovascular system. Even low levels of tobacco exposure lead to disease and death, including heart attack, stroke, weakened immune system, and asthma attacks.” 

 “Has the Lung Association damaged its credibility in making such a dramatic, unqualified assertion?” asks Dr Elizabeth Whelan of ACSH, not for the first time. This body does not shrink from criticising the Surgeon General's report, which includes similar claims about secondary smoke, and calls for a zero tolerance policy towards tobacco smoke:

Upon reading this statement, ACSH’s Dr. Gilbert Ross is left wondering whether basic toxicology and cancer-causation principles were considered in the drafting of the Surgeon General report. “Whether indirect exposure to tobacco smoke leads to disease is a matter of dose — the amount of smoke it takes to trigger adverse health outcomes such as heart disease or cancer — but the question of dose-response and exposure levels never made it into the report.” 

ACSH stops short of recommending spending much time exposed to tobacco smoke, but their suggestion to observe dose:reponse principles could be well observed by other bodies, especially in the United States, where they take the concept of third hand smoke seriously. University of Berkeley, California, scientists have pretty much dispensed with any such principles in their study of third hand smoke, as tobacco researcher and author Chris Snowdon writes here.

Noting that ASH Scotland has managed to set up an anti-smoking conference offering Learning Outcomes in (for want of a better expression) anti-smoking propaganda, I wonder how long before Scottish National Certificate qualifications are issued in Junk Science for being able to describe the damage to children from third hand smoke? What an outcome that would be for a small country with a proud educational record.

Or perhaps we will start to take science seriously again instead!

Trade warns of more illegal tobacco trading if display ban goes ahead

The daily news bulletin of ASH Scotland on Wednesday included several links to Scottish papers and the trade press reporting the warnings of the trade that the display ban will cause smuggling to grow. A further version of the story appeared yesterday south of the border.

Sheila Duffy can't see the problem with the display ban:

Throughout the debate over removing tobacco displays, a measure intended to protect young people from tobacco promotion, the tobacco industry has tried to divert attention away from the important health issues at stake by exaggerating fears based on unfounded claims.

The reality is that there is no substance to these claims. There is no reason to think that adult smokers who currently buy their product legally from responsible retailers will suddenly switch to illegal sources because the product is no longer on display. Smokers will be able to go on buying what they normally buy, where they normally buy it. Why would they suddenly go somewhere else?

What about price?

'Putting tobacco under the counter will make smokers feel like they’re doing something illegal when they buy tobacco from a shop' [says a shopkeeper]. 'If they think that, they might as well get it from a smuggler who sells it at half the price I can.'

There's also the stigma and the sheer bloody inconvenience, to say nothing of the fact that tobacco sales will slow down queues, to the (real or imagined) annoyance of other shoppers.

The English version of the story states that Andrew Lansley, Health Secretary, has been swayed by a rise in smoking rates in Canada since the display ban was introduced there. I hope the Scottish Health & Sport Committee is paying attention!

Sheila's attitude to the retail trade is extraordinary. It is part of her faith that tobacconists, who sell tobacco every day for many more hours every day than she spends working for ASH Scotland, rely completely on the manufacturers for knowledge of the tobacco trade. As for this:

This [the idea that a ban on displays would encourage the black market] looks to me like a classic case of tobacco industry smoke and mirrors. They spread misinformation and alarm amongst retailers, survey the concerns they create, and present the results as if they were genuine evidence.

A direct description of the way the scare of Third Hand Smoke was created.

No smoking, or no treatment!

The text below is lifted from the comment thread in the blog of David Milliband. The post discusses 'bold plans to save Britain's pubs', which concern regulation of the beer tie. Arguments are advanced in the blog about whether this will help pubs. Milliband does not consider the smoking ban worth touching in this context.

Is this comment typical of modern medical professionals?

Just prior to the smoking ban being enacted in 2007, I and other like minded people got together and set up an anti-smoking patrol watch in our local community. I have organised and run this watch with much success to date.

We gather photographic and camcorder evidence of anyone flouting the law of smoking in public places. We approached our local dentists and GPs, who then told us that anyone who smoked illegally would be refused treatment should their names appear on their patients’ lists. We also have the full support of our local police Superintendent – who agreed that this strategy would help in time to reduce smoking within our community. So far we have had no come back about Freedom of Information.

After several prosecutions we have seen the tide turning, but still need to remain vigilant on behalf of all our residents, after all it’s their health that’s at stake.

You have to remember that over 30,000 people are killed each year by SHS (second hand smoke), and this figure is rising year on year. We are still unclear about how many are affected each year by THS (third hand smoke), although there is good epidemiological evidence to show how dangerous it is to the health of young children.

I wrote to the then health secretary at the time Patricia Hewitt, who fully supported our efforts and asked to be kept up to date with our progress, which of course we did. I would like to see this kind of programme being rolled out across the country.

We are also supported by ASH UK, ASH Scotland, BHF and of course CRUK.

Dr Steven Johnson GP

[emphasis added]

Is there any other crime in the criminal justice system judged so adversely that it would merit the withdrawal of medical treatment? It is just not ethical for medics to pick on a specific group of (alleged) lawbreakers and deny treatment. I find it absolutely shocking that this comment has gone uncensored on the blog of a contender to the Labour Party leadership.

This story relates the intentions of NHS Grampian to treat smokers similarly – to punish them for flouting the legislation.

Withdrawing treatment on any other than clinical grounds must be considered very dangerous territory.

'No Government Funding of Smoking Cessation'

This has become a Facebook page with effect from three months ago. Its membership has grown steadily (now at 169) but is one of a number of facebook pages and other internet outlets that express disquiet with current tobacco policies: not only in Scotland and the UK, but right from the World Health Organisation. Their Framework Convention for Tobacco Control is an international agreement that requires participants to ban smoking and promote pharmaceutical methods of smoking cessation.

We set up this page prior to organising the demonstration at Glasgow's 2010 UK National Smoking Cessation Conference. We felt that this conference represents huge costs on the NHS throughout the UK, attracting delegates whose major focus of work is smoking cessation. Since cuts to all public health services are now a present threat, we felt that smoking cessation was an area of public health provision that the NHS could well do without.

We have also covered international stories on this page, such as a call for research applications to study (so-called) Third Hand Smoke in California. The money available for this was $US 3.75 millions, money raised by state taxes on tobacco in California, and directed towards research that will inevitably lead to further restrictions on tobacco use – this time with the premise that dropped cigarette butts will lead to contamination of the water supply and to wildlife when it rains.

Closer to home, another source of tobacco control funding is Cancer Research UK, whose list of funding projects is impressive (even extending to projects overseas), but surely begs the question whether they are a UK medical charity or an offshoot of the World Health Organisation.

If you're on Facebook please join up and share! Also look for ASH to ASHES, Anti-Smoking Exposed - Tobacco Control Out of Control, and (NEW!) The Resistance.