Debate Rages Over Second-Hand Smoke

Published June 1, 2004

Looking for a surer method of being ripped apart than entering a lion’s den covered with catnip? Conduct the most exhaustive, longest-running study on second-hand smoke and death. Find no connection. And then, rather than being politically correct and hiding your data in a vast warehouse next to the Ark of the Covenant, publish it in one of the world’s most respected medical journals.

That’s what research professor James Enstrom of UCLA and professor Geoffrey Kabat of the State University of New York, Stony Brook did in May 2003: They reported in the British Medical Journal that their 39-year study of 35,561 Californians who had never smoked showed no “causal relationship between exposure to environmental tobacco smoke (ETS) and tobacco-related mortality.” (They also noted “a small effect” can’t be ruled out.)

At this writing, the Enstrom/Kabat work has generated more than 140 responses on the Journal‘s Web site at If made into a movie, those responses might well be called “The Howling.” Many are mere slurs several grades below even sophomoric.

Ban the Facts

Some respondents demanded the Journal retract the study because, as one put it, the “tobacco industry will use it.” (It didn’t.) Another made the rather draconian call to ban all use of statistics in science, lest they be put to such wicked purposes as this.

“It is astounding how much of the criticism springs from (personal attacks) rather than from scientific criticism of the study itself,” observed one of the few supportive writers. Said another: “As a publisher of the leading Austrian medical online news service, I feel quite embarrassed following the debate on this article. Many postings look more like a witch hunt than a scientific debate.”

Sadly, one of the most pathetic responses came from Dr. Michael Thun, vice president for epidemiology and surveillance research at the American Cancer Society (ACS). The ACS launched the study and formerly collaborated with the authors.

Thun claimed everybody in the 1950s and 1960s should be deemed a second-hand smoker, since smoking was so pervasive back then. That logic puts the wife of a two-pack-a-day husband in the same category as someone who once stumbled into a smoky bar. It negates all environmental tobacco smoke (ETS) studies based on spousal exposure–including those studies that better serve Thun’s purposes.

Based on the subjects’ own recollection decades later in the UCLA study, spousal smoking was indeed a good indicator of their total exposure to second-hand smoke.

Ignore the Facts

One refrain running through the attacks is, “Why take seriously a study that contradicts what everyone already knows?”

The answer is simple: Because “what everyone knows” is wrong. It’s the UCLA study that’s most consistent with other research.

A 1999 Environmental Health Perspectives survey of 17 ETS-heart disease studies found only five that were statistically significantly positive. (“Statistical significance” refers to whether an increased or decreased risk falls outside the bounds of what could be expected by chance.) Remarkably, Michael Thun was lead author of that study.

In 2002, an analysis of 48 studies addressing a possible ETS link to lung cancer found only 10 that were significantly positive, one that was significantly negative, and 37 that, like the Enstrom and Kabat work, were insignificant either way.

How can research find second-hand smoke to be so benign, when research shows active tobacco smoking to be so dangerous? Perhaps in part because “the dose makes the poison.” We are constantly bombarded by substances proven to be carcinogens, but in tiny amounts the body usually easily fends them off. Second-hand smoke falls into this category.

A New England Journal of Medicine study found that even back in 1975–when having smoke puffed into your face was ubiquitous in restaurants, cocktail lounges, and transportation lounges–the concentration was equal to merely 0.004 cigarettes an hour. In scientific terminology, that’s a “tiny amount.”

Defund Sound Science

Unable to find significant fault with the UCLA study itself, critics repeatedly harped on what Enstrom and Kabat had clearly acknowledged: that some of the funding for the study came from the tobacco industry. As the researchers explained, the University of California’s Tobacco-Related Disease Research Program, established specifically to support such research, nevertheless ceased funding for the project, and no sources outside the tobacco industry were willing to step up to the plate.

The big bucks go to those who “discover” ETS causes everything from pimples to piles. Government agencies and private organizations alike have sent tens of millions of dollars into the coffers of groups promoting ETS as a killer–even going so far as to fund research aimed at showing second-hand smoke to be more harmful than active smoking! Meanwhile, Big Tobacco has essentially extinguished its efforts on ETS, reserving new spending and political capital for other fights.

So give the British Medical Journal and Enstrom and Kabat an “F” for political correctness. But give them an “A” for honesty and courage.

Michael Fumento is a senior fellow at the Hudson Institute and author of BioEvolution: How Biotechnology Is Changing Our World (Encounter Books). His email address is [email protected].

For more information …

on second-hand smoke and other tobacco-related issues, visit The Heartland Institute’s online Smoker’s Lounge at