Tuesday, October 13, 2009

Smoking & heart attacks, another suspect study

According to a meta-analysis conducted by Dr. David Meyers and his team at Kansas University Medical Center, smoking bans have an immediate impact on heart attacks, reducing admissions to hospital by as much as 26%. In addition, Meyers claims a nationwide smoking ban could prevent as many as 154,000 heart attacks annually.

Dr. Michael Siegel of Boston University School of Public Health disagrees with the conclusions of Meyers' study. In fact, he suggests that both the meta-analysis and the individual studies used to compile it are badly flawed junk science. Siegel is an anti-smoking advocate who strongly supports smoking bans. But, even he notes: “Nevertheless, I believe they should be supported based on valid scientific conclusions, not on junk science conclusions such as those in this article.”

As a smoker, and admittedly prone to bias in my interpretation of these “scientific studies”, I believe most of what is passed off as science by the anti-smoker crowd these days is junk; propaganda, pure and simple.

For example, one troublesome aspect of Meyers' study is the use of heart attack admissions as a gauge of the beneficial aspects of smoking bans. According to study authors, heart attacks were used as a measuring stick because, unlike cancer, they don’t take years to develop.

But, why measure only admissions to hospital?

The National Heart Lung and Blood Institute (NHLBI) website claims: “Of the people who die from heart attacks, about half die within an hour of the first symptoms and before they reach the hospital.”

If Meyers and his team counted only admissions, then they didn't account for the true incidence of heart attacks since roughly half would be DOA (Dead On Arrival). There would be no need to admit them for treatment. Was this a simple oversight; or a deliberate attempt to mislead? Was the possibility accounted for in some other way in the study?

Again, why measure only admissions?

The same NHLBI website claims: “Each year, about 1.1 million people in the United States have heart attacks, and almost half of them die. CAD (Coronary Artery Disease), which often results in a heart attack, is the leading killer of both men and women in the United States.”

The Womens Health Foundation sets the number of heart attacks at 1.5 million each year with 500,000 deaths.

But, if one-third to one-half of those experiencing a heart attack will die, why not simply count the number of deaths from heart attack? Wouldn't this give a far more meaningful statistic than admissions? After all, if smoking bans can prevent as many as 154,000 heart attacks annually, as claimed by Meyers, wouldn't that mean that one-third to one-half that number of heart attack deaths would also be prevented?

Is it really plausible that smoking bans could reduce the number of heart attack deaths by 50 to 75 thousand annually? Wouldn't that eliminate all deaths currently attributed to secondhand smoke?

Smokers, according to the anti-smoker cult, will die from heart attacks as a result of their smoking. Logic dictates that they will die whether they smoke in public or private, since it is the habit that allegedly kills and not the location where the habit is practiced.. So, is it logical to expect a decline in heart attack incidence among smokers without a corresponding decrease in smoking prevalence?

And, if a decrease in heart attack admissions can't be linked directly to either smoking or exposure to secondhand smoke, how can it be attributed to smoking bans?

According to study authors: "Heart attacks are caused in large part by blood clots. With 20 minutes or so of tobacco smoke exposure, people’s blood becomes hypercoagulable and sticky and clots easily, and bam, you have a heart attack."

That's right folks. Twenty minutes of exposure to secondhand smoke and non-smokers start dropping like flies. Can't you remember the bodies being removed en masse from bars, restaurants and the local legion hall before the smoking bans? Aren't non-smokers keeling over from the effects of exposure to SHS in those jurisdictions where bans have not yet been implemented?

Dr. Siegel points out that brief secondhand smoke exposure is likely to trigger a heart attack only in people with severe existing coronary artery disease, saying: “The same hypercoagulability and endothelial dysfunction is also caused by eating high-fat foods and even by mental stress. It doesn't follow that you are going to prevent this person from having a heart attack merely by asking them to avoid exposure to secondhand smoke.”

David Meyers says the research should put to rest the debate about the health benefits of smoking bans. “The argument — that this is bad science — has now been put definitively to rest.”

And, therein lies the problem.

If (when) this story is picked up by the national media, it is not likely to include a rebuttal from Dr. Siegel (or anyone else for that matter). In fact, media coverage is unlikely to contain any dissenting opinion on the study. The public will be left with the perception that it has been scientifically proven that smoking bans reduce the incidence of heart attacks. Dr. Siegel, and others who contest the findings of Meyers' study, will be branded denialists; their voices silenced.

The perception rather than the reality will become entrenched in the public mind. Which, I suspect, is exactly what was intended by the authors of the study. For it appears that this study is not simply bad science, but a propaganda effort deliberately designed to mislead the public. The anti-smoker cult wants desperately to justify the growing number of smoking bans around the world.

Concludes Dr. Siegel: “The rest of the story is that anti-tobacco researchers and groups are making ridiculous, highly exaggerated, and scientifically unsupported claims in order to try to justify smoking bans.”

Just one more question before I sign off. If researchers are willing to use this kind of dishonesty and deception to convince the public of the hazards of smoking and SHS exposure, just why in hell should anyone believe anything the public health community has to say on the subject?

The bullshit and bafflegab is coming thick and fast.

No comments: