"All that is old and already formed can continue to live only if it allows within itself the conditions of a new beginning."
So Long, Jim Crow; Hello, Jim Smoke
Posted 1:34 p.m., July 22, 2004
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I'm a nonsmoker. My dad, Philip Norman Featherly, died in 1985 at age 50 from emphysema, a grotesquely debilitating disease caused by the three- to four-pack-a-day habit that started in his early teens.
Most of my nine family members were smokers. Growing up, my home was awash in a foggy blue haze; cigarette butts and ashtrays made up a prominent part of the home decor. My twin brother began sneaking smokes in our shared bedroom when we were probably 12. The murky sound of fluid-filled lungs and draining sinuses nagged my sleep and disturbed my days.
I watched my father slowly drown in his own membranes and cough fractures into his ribcage, and it forever turned me off to cigarettes. (Perhaps perversely, I have been known to light up the occasional cigar--though, like Bill Clinton, I don't inhale).
You might figure me for one of those folks who would happily mount the trounce-the-smokers bandwagon that has seized the Twin Cities metro area and other areas of the nation. Guess again.
The New Segregation
The city of St. Paul and my home city of Bloomington have passed ordinances to chase smokers outside of just about any building where a crowd might gather--and soon Minneapolis will pass another such ban. St. Paul's Parks and Recreation Commission last week took the crusade to its logical extreme by voting 4-3 to ban cigarette smoking in public parks. (Danger! Secondhand breeze!)
The mayor in St. Paul, Randy Kelly, had the sense to refuse to accept the commission's recommendation. He also vetoed the city council's decision to ban smoking in bars and restaurants citywide, but an override is likely.
Yes, you might think I'd be on the side of the zealots. But, on this issue, I'm on Doug Grow's side. Grow is a columnist at the Star Tribune, who drew what I see as the right conclusion about the Parks and Recreation board's move--and the relationship of that step to our politics as a whole today.
This knee-jerk Park Commission action was a microcosm of 21st-century American politics. ... Leaders are listening to the zealots, from the U.S. Senate to the St. Paul Parks and Recreation Commission. ... The zealots are in control. And we have groups on the right and the left demanding to tell the rest of us how to live.
-- Doug Grow,
Star Tribune, July 20, 2004I'm not a scientist, and not particularly adept at scrutinizing scientific literature. Like everyone else, I see news story after news story relating alarming information that second-hand cigarette smoke is responsible for countless heart attacks, asthma in children, diseases in pets.
Personally, I thought a suitable compromise was in place as of the late '80s, when we started relegating people who wanted to smoke to remote corners of bars and restaurants. And despite occasional bum-outs when I would wind up seated next to someone belching out smoke, I was generally pretty satisfied with the arrangement. I felt both my health and my personal space were adequately being respected.
But our more progressive friends, good folks who just want everyone to live under the same codes of virtue and valor by which they conduct their own affairs, weren't satisfied with the customary separate-but-unequal public arrangements for smokers. They kept pushing. They wanted more.
Their cause won the upper hand in 1993, when the Environmental Protection Agency issued a report declaring second-hand smoke a Class A carcinogen that was responsible for 3,000 deaths a year. The movement hasn't really looked back since then.
Thing is, that EPA report was always controversial. It wasn't based on the agency's own research but on a "meta-analysis" of 11 previous studies. The agency's analysis supposedly shows that second-hand smoke caused a 19 percent increase in lung cancer risk. But coming from an epidemiological study that makes inferences based on associations among a compendium of disparate data, what you get really isn't much more than circumstantial evidence.
A judge in North Carolina later declared that the EPA study was seriously flawed. Was that judge in the pocket of the tobacco industry? Maybe. But what about the Congressional Research Service (CRS) report that repeated, even amplified, the judge's critique?
In the CRS report titled "Cigarette Taxes to Fund Health Care Reform: An Economic Analysis," researchers note that the EPA "made subjective judgments about the extent to which the studies suffered from statistical problems," and set aside studies that "fared poorly in this analysis."
Translation: by CRS reckoning, the EPA cherry-picked the data. Further, two major studies conducted after the EPA launched its survey were ignored. In fact, the CRS report complains, one of those two later studies, the one that had "the largest number of observations," uncovered "no overall increased risk of lung cancer among nonsmoking spouses of smokers."
Germany Hatches Doubt
Now that was a decade ago, and many studies have been done since, and the evidence continues to mount that second-hand smoke is dangerous. You've seen many of those reports. But among them, have you ever seen cited a massive study published in the American Journal of Epidemiology in 2002 that seems to debunk a serious link between worker morbidity and workplace exposure to second-hand smoke?
I didn't think so.
That study, "Mortality from Cancer and Other Causes among Airline Cabin Attendants in Germany, 1960-1997," surveyed nearly 21,000 airline cabin attendants over three decades. It looked for "standardized mortality ratios" (SMR) among more than 16,000 women and over 4,500 men, all of whom who were exposed to such workplace risk factors as cigarette smoke, ultraviolet radiation, onboard pesticides and other environmental elements.
You'd think with a survey size that big, the dangers of second-hand smoke would pop out demonstrably. So what kind of increased risk did the journal uncover? Well....
We found a rather remarkably low SMR for lung cancer among female cabin attendants and no increase for male cabin attendants, indicating that smoking and exposure to passive smoking may not play an important role in mortality in this group. Smoking during airplane flights was permitted in Germany until the mid-1990s, and smoking is still not banned on all charter flights.
-- "Mortality from Cancer and Other Causes among Airline Cabin Attendants in Germany, 1960-1997," American Journal of Epidemiology, 2002The SMR did not increase with duration of employment, the report states. In fact, among the women surveyed, the total number of deaths over then 37-year period (141) was a little lower than expected. And the number of deaths among men during the period surveyed was at the anticipated level. The only heightened risk factors identified for the employees were associated with AIDS and airline crashes.
So What Do I Know?
Answer: Not much. I admit freely that googling around for a few pieces of contradictory evidence about second-hand smoke makes me no expert.
But my point is, it's not unreasonable to be skeptical about all the risks we keep hearing about related to second-hand smoke. And given that, perhaps we should put the brakes on social policies that institutionalize prejudices against smokers, who are, after all, engaging in legal behavior.
Personally, I think it stands to reason that second-hand smoke probably poses some possible risk of causing harm. There is real clinical evidence surfacing, but nothing, despite the hype, that rises to the level of proof.
I also believe it is unlikely that, by absorbing the merest fraction of a percentage of the smoke that a smoker absorbs, that a nonsmoker runs anything more than a fraction of the health risk. And if it takes on average 20 years for a regular smoker to show signs of smoking-related disease, how many lifetimes would someone have to live being occasionally exposed to small doses of second-hand smoke before negative signs show up?
Remember, I grew up in a smoke-filled house. Yet I suffer from no respiratory or heart problems. I don't have asthma. And, if I need to, I can hold a whole note for just the longest time....
Serious questions remain about how genuinely risky it is to be around smokers. Maybe it's dangerous, maybe not. Maybe it really is best for government to ban smoking from public places. Or maybe the market can make that decision, meaning if you don't like folks lighting up, perhaps you can go somewhere else.
It's impossible to escape the impression that the anti-smoking movement feels like another form of enforced segregation, targeted at a subculture that, for whatever reason, big segments of our culture have targeted for derision, ridicule and alienation.
Maybe we ought to take a time out, and more carefully consider all these new Jim Smoke laws.
-- Kevin Featherly|
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Copyright 2004, by Kevin Featherly
