Does Smoking Harm Health?

Earlier this week I received the following email:

Is smoking really that bad for health through what you have discovered? Or is it really a crusade against smokers?

Ive heard the lung cancer argument is basically false and doesn’t really create much more risk in that regard

What about heart disease? Does it really cause heart difficulties?

Assessing whether or not smoking is bad for health is quite difficult, because of the numerous ailments and diseases blamed on it – acne, blindness, various cancers, impotence, dull skin, emphysema, and of course the supposed harms from secondhand and thirdhand smoke.

When viewed objectively, there are definite and noted benefits of smoking – a reduction in the risk of alzheimer’s and parkinson’s being perhaps the most discussed, but also increased cognitive function, vascular reuptake, reduced risk of preeclampsia, and so on. That said, given that even the over-consumption of something as vital and life-sustaining as water can harm or kill us, it stands to reason that smoking has the potential to inflict harm. If I were to smoke 100 cigarettes a day, I would expect to notice effects on my health, particularly a bad cough, increased mucous production and a shortness of breath.

None of those things equate to life-threatening or debilitating illness, though. There is, without question, a crusade against smokers and smoking, by people who earn a lot of money targeting the lifestyle choice. It is from this crusade we have cripplingly high taxes on tobacco, a display ban, a smoking ban, discussions on plain packaging (despite it having no effect on Australian smoking rates) and now a ban on smoking in a car with children, not to mention the vote last year to ban 10-packs and menthol cigarettes.

I am sceptical about the link between smoking and heart disease. To lift an excerpt from Chapter 8 of Smoke Screens:

The problem with risk factors is that the researchers decide which ones to assess, and which to include in the final report. Further, it cannot be overstated that correlation does not mean causation – after all, 100% of lung cancer victims inhale air, and 100% of heart disease victims eat food, but everyone knows we cannot link breathing to lung cancer and all food to heart disease. Moreover, how can researchers be sure that a particular risk factor was responsible for the heart attack? The only way to deduce a risk factor is by isolating it as the one variable to which anomalous results can be attributed. As such, risk factors are automatically and without fail biased by the researchers’ opinions, as they choose which to include, exclude, study, and, ultimately, whether to reveal their raw data or to alter it to match their hypothesis or premise.

Aside from the media-touted risks of diet, exercise and alcohol consumption, we know that bacteria can cause heart disease. We also know that, generally, non-smokers are more likely to be concerned about their overall health than smokers, thus it stands to reason that statistically smokers have a higher incidence of heart disease (and other disease).

In 1999, the British Medical Journal published the Monica Study, which, conducted by the WHO, was the largest cardiological study – and found no link between smoking and heart attacks. This was also the case with the MRFIT study, an intervention trial that found no link between smoking status and heart disease.

Of course, when it comes to smoking and harm the real gem in the anti-smokers’ arsenal is the apparently iron-clad link between smoking and lung cancer. Yet, again, the link isn’t as strong as we would be led to believe. We know, for instance, that the animal tests all failed to induce lung cancer from tobacco smoke, a point that has been mentioned in court. In more recent years researchers managed to ’cause’ lung cancer in animals from tobacco by using rodents genetically bred to develop cancer (A/J mice and F334 rats), which further highlights their inability to do so with normal animals.

We also know that we still have no known biological mechanism by which smoking causes lung cancer. After decades of research into the matter, all scientists have shown is a statistical link through epidemiology. As the adage explains, correlation doesn’t mean causation – it’s a good starting point for further research, and little more. After all, there’s a very strong statistical link between headaches and painkillers, which an uninformed mind could look at and determine painkillers cause headaches (when, of course, the truth is painkillers are taken because a headache is already present).

There’s also the inconvenient fact that the majority of smokers do not get lung cancer – when the public health messages first began in the 1950s they explained that 1 in 10, or 10%, of heavy smokers would get lung cancer. Today we’re told that the smoker that doesn’t get the disease is lucky – but in truth only about 10-15% of smokers contract the disease, and there’s no pre- or post-mortem testing to know if smoking caused the disease.

Whether or not smoking does or does not cause lung cancer or heart disease I cannot say. Our knowledge is based only on the information we have, and that could change tomorrow. However, the scientific link between smoking and these diseases is far weaker than the media and health organisations would like us to believe, and only a few years ago we were routinely told that smoking (and alcohol) was the leading cause of oral cancers – today we know HPV is the real cause behind the vast majority of oral cancers. Tomorrow we may learn of a viral cause behind the majority of lung cancers, too.

NB: Lung cancer and heart disease both have entire chapters devoted to their relevant research in the book, which can be purchased from the link in the menu above.

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