DNC News


DNC NEWS: Secondhand Smoke Revisited

January 28, 2005

Subject: A second look at the Montana study which linked secondhand smoke with heart attacks and a newer study which links second hand smoke with lowered cognitive skills.


I was startled this week by a belligerent letter that arrived via email from Michael J. McFadden, the apparent mastermind behind a smoker's rights website located at: www.TheTruthIsALie.com


Mr. McFadden expressed great distress at a newsletter I wrote last year about a study published in the British Medical Journal about the marked decrease in heart attacks recorded during the six month period in which a smoking ban existed in the city of Helena , Montana . [i] A copy of the full text of this study is available at: http://bmj.bmjjournals.com/cgi/content/abstract/328/7446/977?ijkey=92f6d31ab169221ba90b2d913f3d08e789b6f2e4&keytype2=tf_ipsecsha


Not wanting to spread false information, and prompted by Mr. McFadden's clear threat of legal action, I have set aside some time this weekend to reconsider this second hand smoke issue. Mr. McFadden appears to have taken umbrage at three separate issues in my newsletter. A copy of his missive can be found at: http://denvernaturopathic.com/news/smokingthreat.html


In reading Mr. McFadden's letter I detect three clear points of contention:

  1. On the web where the original study is published online, the British Medical Journal has a link to responses to the study written by those critical of the information presented. I did not mention these dissenting views. Mr. McFadden appears upset that I did not mention these opposing viewpoints. You can read these comments at: http://bmj.bmjjournals.com/cgi/eletters/328/7446/977 Among these comments are two letters from Mr. McFadden which I suspect he would like you to read.
  2. Mr. McFadden in his letter states that, “….data charts of the study used in its initial presentations showed that the real decline in heart attacks only occurred during the first THREE months of the ban... not throughout the entire six month period... and that they pretty much bounced back up to the normal range DURING those last three months of the ban, not after as stated in your piece.” If this is true, it is an interesting detail, which I apologize for overlooking. Now that I am aware of it, I do not find that it detracts from the statistically significant change seen on average for the full six month period.
  3. Most important and what appears to have prompted Mr. McFadden's furor the most is that I apparently mistakenly referred to his website as a “Tobacco Industry” website rather than what he claims to be, a Smoker's Rights proponent. I will take his word that he has no financial connections with the tobacco industry. Such an assumption on my part I think should be excused. A recent article in the September, 2004 Preventive Medicine, chronicles Phillip Morris's escapades in shifting public opinion through seemingly independent voices such as Mr. McFadden's. [ii]


Feel free to peruse Mr. McFadden's website, if you will.


All this thinking about secondhand smoke perked my interest and probably prompted me to take notice of a new study published in January's Environmental Health Perspectives. In the article Kimberly Yolton and her colleagues at the Cincinnati Children's Hospital report on their work. They shifted through data on 4, 399 nonsmoking children and adolescents between 6 and 16 and compared smoke exposure and performance on cognitive tests. The tests examined math skills, visual perception of spatial relationships, recognition of printed words and short term memory. Exposure to second hand smoke was estimated based on blood concentrations of cotinine, a by product of nicotine. Smoker's blood contains more than 100 ng/ml of cotinine. Children who had the highest exposure with blood levels of 3-15ng/ml scored about 10% below the least exposed group of children in three of the four tests. Smoke exposure lowered scores in reading, math, and spatial relations but did not appear to effect memory. These findings suggest that more than 33 million children are at risk of at least minor mental deficits from second hand smoke. [iii]


Now of course the obvious criticism that comes to mind reading through this data is that perhaps we are simply looking at the simple fact that smoking is a dumb thing to do, dumb people smoke and have dumb kids. The researchers did rule out several known influences on children's cognitive skills, including lead exposure, family income, and parental education but other factors such as alcohol and illicit drug use by parents was not evaluated and could explain the difference. I will not be surprised to see dissenting views on these comments from Mr. McFadden. Nevertheless a 10% drop in mental function in children should be cause for alarm in any democratic society which depends on its membership to direct its future course.


The website version of this article contains abstracts of the articles mentioned and can be found along with many of our other past newsletters, at www.DenverNaturopathic.com






[i] BMJ  2004;328:977-980 (24 April), doi:10.1136/bmj.38055.715683.55 (published 5 April 2004 )

Reduced incidence of admissions for myocardial infarction associated with public smoking ban: before and after study

Richard P Sargent, Robert M Shepard,

Correspondence to: S Glantz glantz@medicine.ucsf.edu


Objective To determine whether there was a change in hospital admissions for acute myocardial infarction while a local law banning smoking in public and in workplaces was in effect.

Design Analysis of admissions from December 1997 through November 2003 using Poisson analysis.

Setting Helena , Montana , a geographically isolated community with one hospital serving a population of 68 140.


Participants All patients admitted for acute myocardial infarction.

Main outcome measures Number of monthly admissions for acute myocardial infarction for people living in and outside Helena .

Results During the six months the law was enforced the number of admissions fell significantly (- 16 admissions, 95% confidence interval - 31.7 to - 0.3), from an average of 40 admissions during the same months in the years before and after the law to a total of 24 admissions during the six months the law was effect. There was a non-significant increase of 5.6 (- 5.2 to 16.4) in the number of admissions from outside Helena during the same period, from 12.4 in the years before and after the law to 18 while the law was in effect.

Conclusions Laws to enforce smoke-free workplaces and public places may be associated with an effect on morbidity from heart disease.


[ii] Prev Med. 2004 Sep;39(3):568-80.   

Turning free speech into corporate speech: Philip Morris' efforts to influence U.S. and European journalists regarding the U.S. EPA report on secondhand smoke.


Muggli ME, Hurt RD , Becker LB.


Tobacco Document Consultancy, St. Paul , MN 55105 , USA .


Background. Previously secret internal tobacco company documents show that the tobacco industry launched an extensive multifaceted effort to influence the scientific debate about the harmful effects of secondhand smoke. Integral to the industry's campaign was an effort to derail the Environmental Protection Agency's (EPA) risk assessment on environmental tobacco smoke (ETS) by recruiting a network of journalists to generate news articles supporting the industry's position and pushing its public relations messages regarding the ETS issue. Methods. Searches of previously secret internal tobacco industry records were conducted online and at the Minnesota Tobacco Document Depository. In addition, searches on the World Wide Web were conducted for each National Journalism Center alumnus. Lexis-Nexis(R) was used to locate news stories written by the journalists cited in this paper. Results. Philip Morris turned to its public relations firm Burson Marsteller to "build considerable reasonable doubt em leader particularly among consumers" about the "scientific weaknesses" of the EPA report. A Washington , DC , media and political consultant Richard Hines was a key player in carrying out Burson Marsteller's media recommendations of "EPA bashing" for Philip Morris. In March 1993, Philip Morris' vice president of corporate affairs policy and administration reported to Steve Parrish, vice president and general counsel of Philip Morris, that their consultant was "responsible for a number of articles that have appeared in em leader major news publications regarding EPA and ETS." In addition to placing favorable stories in the press through its consultant, Philip Morris sought to expand its journalist network by financially supporting a U.S. school of journalism; the National Journalism Center (NJC). Philip Morris gleaned "about 15 years worth of journalists at print and visual media throughout the country em leader to get across [its] side of the story" resulting in "numerous pieces consistent with our point of view." The company planned to "design innovative strategies to communicate [its] position on ETS through education programs targeting policy makers and the media" via the NJC. Finally, journalists associated with think tanks that were financially supported by Philip Morris wrote numerous articles critical of the EPA. Conclusions. This is the first report, from the tobacco industry's own documents, to show the extent to which the tobacco industry has gone to influence the print media on the issue of the health effects of secondhand smoke. Unfortunately, what we report here is that even journalists can fall victim to well-orchestrated and presented public relations efforts regardless of their scientific validity. It is not clear how various professional media organizations oversee the ethical conduct of their members. Certainly, on the topic of the health effects of secondhand smoke, more scrutiny is warranted from these organizations for articles written by their members lest the public be misinformed and thus ill served.


PMID: 15313097 [PubMed - in process]



[iii] Environ Health Perspect. 2005 Jan;113(1):98-103.   

Exposure to environmental tobacco smoke and cognitive abilities among U.S. children and adolescents.


Yolton K, Dietrich K, Auinger P, Lanphear BP, Hornung R.


Cincinnati Children's Environmental Health Center, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA. kimberly.yolton@cchmc.org


We used the Third National Health and Nutrition Examination Survey (NHANES III), conducted from 1988 to 1994, to investigate the relationship between environmental tobacco smoke (ETS) exposure and cognitive abilities among U.S. children and adolescents 6-16 years of age. Serum cotinine was used as a biomarker of ETS exposure. Children were included in the sample if their serum cotinine levels were less than or equal to 15 ng/mL, a level consistent with ETS exposure, and if they denied using any tobacco products in the previous 5 days. Cognitive and academic abilities were assessed using the reading and math subtests of the Wide Range Achievement Test-Revised and the block design and digit span subtests of the Wechsler Intelligence Scale for Children-III. Analyses were conducted using SUDAAN software. Of the 5,365 6- to 16-year-olds included in NHANES III, 4,399 (82%) were included in this analysis. The geometric mean serum cotinine level was 0.23 ng/mL (range, 0.035-15 ng/mL); 80% of subjects had levels < 1 ng/mL. After adjustment for sex, race, region, poverty, parent education and marital status, ferritin, and blood lead concentration, there was a significant inverse relationship between serum cotinine and scores on reading (beta = -2.69, p = 0.001), math (beta = -1.93, p = 0.01), and block design (beta = -0.55, p < 0.001) but not digit span (beta = -0.08, p = 0.52). The estimated ETS-associated decrement in cognitive test scores was greater at lower cotinine levels. A log-linear analysis was selected as the best fit to characterize the increased slope in cognitive deficits at lower levels of exposure. These data, which indicate an inverse association between ETS exposure and cognitive deficits among children even at extremely low levels of exposure, support policy to further restrict children's exposure.


PMID: 15626655 [PubMed - in process]


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