23/12/08 Letter to the Prime Minister

Here is the letter I wrote and sent to the Prime Minister Gordon Brown, as well as to BBC Panorama, ITV, Channel 4, Channel 5, The Times, The Guardian, The Observer, The Conservatives and the Liberal Democrats.  I will provide any update I receive following the letter.

Dear Prime Minister,   I am writing to you regarding an issue about the smoking ban.  Having signed the e-petition to allow certain establishments to permit smoking, I received an e-mail containing the following:

“· 98 per cent of all premises compliant and smokefree;
· 76 per cent of people in support (and even 55 per cent of smokers in support); and
· 87 per cent of businesses said implementation had gone well or very well.”

Could you please divulge how the above statistics were obtained given there has not been a public vote on the smoking ban?  I have not been made aware of a vote – either before or since the ban was implemented – and neither has anyone else I know.

I am particularly questioning the second and third statistics pertaining to the number of people and businesses in favour of the ban.  Since the ban I have been very aware of the number of pubs closing and landlords blaming the smoking ban for their drop in custom.  The British Beer and Pub Association have stated that British pubs have been closing at a rate of five a day during the first six months of 2008, totalling 36 closures a week – a 33% increase from 2007.  A spokesperson for the association has stated that “Pubs are now closing nine times faster than in 2006 and 18 times faster than in 2005, the figures, compiled by market researcher CGA Strategy, show. A total of 1,409 pubs closed during 2007.”

Additionally, from people I have encountered personally and through using the internet to obtain opinions from people in different locations it has become obvious that the majority of people – including non-smokers – feel that a compromise should be reached whereby some establishments allow smoking and others do not, giving people the choice where to go.  An alternative to this could be to have separate, ventilated rooms within a pub specifically for smoking.  The general consensus appears to be that forcing approximately one-quarter of the British population onto the street for their legal habit is unfair and, in the absence of a public vote, undemocratic.  Is there a reason why other options were not explored, such as ventilated smoking rooms or separate smoking and non-smoking establishments?

From my research it appears that there have been two types of questionnaires obtaining the public view: those with closed-ended questions whereby the volunteer only gets to say ‘yes’ or ‘no’; and open-ended questionnaires whereby the volunteer is able to elaborate or state their views.  An ICM report for the BBC asked whether “the Government should ban smoking in enclosed public spaces such as pubs and restaurants” and 65% of people said yes.  An ICM for the Guardian asked if respondents approved or disapproved “of a ban on smoking in all enclosed public places, such as pubs, restaurants and offices?” 66% of people approved. A YouGov poll for KPMG found almost identical results – 64% supported a ban on smoking in pubs and restaurants. However, these were the closed-ended questions.  If you ask people how they would like to see smoking in pubs dealt with, and give them a list of possible options including things other than an outright ban, you get very different results. The Office of National Statistics carry out an annual poll that asks about attitudes to smoking. It shows that around 65% of people would like “restrictions” on smoking, but asked what sort of restrictions people would like to see only 31% say they would like a complete ban; most people prefer separate smoking and non-smoking areas.

Why is it that the respondents of the questionnaires who could only answer ‘yes’ or ‘no’ have been published when the questionnaires allowing people to state their views have been ignored?  Surely the fair and democratic response would be to implement measures catering for everyone – with a compromise.

Another point raised in the e-mail was this:

“The scientific and medical evidence is very clear that secondhand smoke kills and that there is no safe level of exposure.”

Firstly, where are the studies leading to this conclusion to be found?  There are many scientists (including the anti-smoker Dr Elizabeth Whelan of ASCH) who state that the evidence for passive smoking being dangerous is extremely underwhelming.  The relative risk for secondhand smoke is 1.14, less than candle smoke and much lower than what scientists consider a health problem: the Editor of the New England Journal of Medicine, Marcia Angell, says: “as a general rule of thumb, we are looking for a relative risk of 3 or more before we accept a paper for publication” and Robert Temple, the director of Drug Evaluation for the FDA, says: “my basic rule is that if the relative risk isn’t at least 3 or 4 forget it”.

I am also very curious as to how passive smoking deaths are counted, seeing as almost everyone has been exposed to tobacco smoke throughout their lives how can it be determined that passive smoke was responsible for the death?   Studies show that diet affects lung cancer far more than passive smoke.  In fact, the association between consumption of fruit and vegetables and rates of lung cancer is one of the strongest in epidemiology.  There have been 25 published papers, and 24 of those show a clear statistical inverse relationship: the more fruits and vegetables consumed, the lower the incidence of lung cancer.  The one remaining study found no association between diet and cancer.  None of the 25 provided negative results (that eating fruit and vegetables caused lung cancer).  The results amongst all of them are very consistent in showing that those who eat less fruits and vegetables have a 50% increased risk of lung cancer.

There are also 156 published studies on cancers of the colon, breast, stomach, bladder, pancreas and ovaries, 128 of which show a protective effect of fruits and vegetables over contracting those cancers.  Conversely, there are 63 studies of non-smoking women married to smoking males, only 9 of which show a statistically significant positive association.  52 of them found no link, and two show a negative association.  So, then, studies on smoking passive smoke causes lung cancer in women has only been successful 14% of the time, whilst studies showing a poor diet can increase the risk of lung cancer has been shown 96% of the time.

If there really is no safe level of exposure this would allude that tobacco smoke is far more dangerous than everything from sunshine to radiation – and if this were the case the death count would be incalculable. In addition to this, the American Cancer Society conducted a test on air quality and discovered that the air quality in smoking-permitted establishments is between 532 – 25,000 times safer than Occupational Safety and Health Administration regulations for clean air. The OSHA also has an online table of air contaminants: http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9992

A study by the Oak Ridge National Laboratory found that restaurant ventilation/filtration systems can make the air of a non-smoking section of a smoking restaurant as clean as the air of smoke-free restaurant.
http://www.data-yard.net/2/21/rtp.pdf

The longest-running and highest-quality second hand smoke study ever done, completed “too late” (2003) to be included in Surgeon General Carmona’s report, found no link between second hand smoke and lung cancer or heart disease:
http://www.bmj.com/cgi/content/full/326/7398/1057

Another Oak Ridge National Laboratory study of tavern workers in 16 major cities found that the tobacco smoke exposure of bar and restaurant workers to be minimal. No bartender was found to breathe more than the equivalent of a single cigarette per 40 hour work week. The average bartender breathed .1 of a cigarette per 40 hour week.
http://www.ornl.gov/info/press_releases/get_press_release.cfm?ReleaseNumber=mr20000203-00 http://www.ehponline.org/members/1999/Suppl-2/341-348jenkins/jenkins-full.html

“The Bogus ‘Science’ of Secondhand Smoke”, a recent Washington Post op-ed by cancer epidemiologist and toxicologist Gio Batta Gori, former deputy director of the National Cancer Institute’s Division of Cancer Cause and Prevention, calls smoking bans “odious and socially unfair” prohibitions based on “bogus” science and “dangerous, wanton conjectures.” Gori warns that the many of the second hand smoke studies the Surgeon General uses to claim second hand smoke life risk fail to control for important confounding variables, are based merely on “brief phone interviews”, and assume that people always tell the truth about their smoking histories. Gori further warns that the results of these second hand smoke studies are inconsistent:

“In addition, results are not consistently reproducible. The majority of studies do not report a statistically significant change in risk from second hand smoke exposure, some studies show an increase in risk, and astoundingly some show a reduction of risk.” http://www.washingtonpost.com/wpdyn/content/article/2007/01/29/AR2007012901158_pf.html
Furthermore, it is no secret that the Environmental Protection Agency’s 1993 report has been the basis for many of the numbers and accusations regarding passive smoke, and almost every subsequent study has been based on, or incorporated, the findings, premises and statistics from that report.  The problem here is that the EPA report has been discredited many times: in 1994 a Congressional inquiry into the EPA and its methods concluded that “The process at every turn has been characterized by both scientific and procedural irregularities. Those irregularities include conflicts of interest by both Agency staff involved in the preparation of the risk assessment and members of the Science Advisory Board panel selected to provide a supposedly independent evaluation of the document.”

An anti-tobacco federal judge interviewed a range of scientists for 4 years, and subsequently called the EPA report an outright “fraud” and overturned that conclusion and the report itself.  To quote the judge himself: “The Agency disregarded information and made findings based on selective information… deviated from its own risk assessment guidelines; failed to disclose important (opposing) findings and reasoning; and left significant questions without answers.”

And:

“Gathering all relevant information, researching and disseminating findings were subordinate to EPA’s demonstrating ETS was a Group A carcinogen… In this case, EPA publicly committed to a conclusion before research had begun;  adjusted established procedure and scientific norms to validate the Agency’s public conclusion, and aggressively utilized the Act’s authority to disseminate findings to establish a de facto regulatory scheme… and to influence public opinion… While so doing, [it] produced limited evidence, then claimed the weight of the Agency’s research evidence demonstrated ETS causes cancer.”

The U.S. Congressional Research Service said: “The statistical evidence does not appear to support a conclusion that there are substantial health effects of passive smoking…. Even at the greatest exposure levels….very few or even no deaths can be attributed to ETS.”

A United States Department of Energy Report found not only serious flaws in the EPA’s methodology, but also demolished the underlying studies, and, extremely damaging to the report, quoted the EPA’s prior critiques of the same studies.

In addition to this EPA report, a lot of people trust in the World Health Organisation.  However, their definitive and largest every study on passive smoke revealed that passive smoke posed no risk to either co-workers or spouses of smokers.

Yet another point raised at the end of the email was this:

 … according to a report by Professor Robert West of University College London, an additional 400,000 people have given up smoking since 1st July 2007 as a result of smokefree legislation.

This figure comes directly from a study funded by Cancer Research UK – an organisation which has a Tobacco Advisory Group who state that:

 The Tobacco Advisory Group (TAG) is a funding and policy-setting committee. Cancer Research UK has a number of priority tobacco control policy areas. Through the TAG we aim to complement our policy and campaigning work by funding related research and projects as well as funding other work of national and international significance.

and  


TAG particularly funds research and activities that support: Smokefree workplaces across the UK and internationally, and other measures to protect against second hand smoke exposure;

I feel that the government should have a much firmer basis for figures and the implementation of a blanket ban – against the majority of the public’s wishes – than the results of one study funded by an anti-smoking organisation.

Finally, the Scottish smoking ban was initially said to have been responsible for a decline in heart attacks.  However, the Scottish acute coronary syndrome rate has been declining for ten years and this year the incidence rate increased – for the first time in a decade. Given this, how can the ban still be considered a success?

In lieu of all this, could the studies that have been used please be divulged so that we, the public, can see for ourselves where this information is coming from?

Can it also be said why a blanket ban was the final decision and other avenues not explored, such as separate rooms, ventilation, or allowing the landlord to decide whether smoking – a legal activity – is permitted on his or her premises?

Finally, can it be explained how the statistics affirming that the majority of Britons are backing the ban are compiled given that no public vote has taken place?

I trust my questions can be answered.

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