Friday, July 27, 2007

Almost Had Me

After the incredibly fun week of back and forth over Global Warming, my arch nemesis Orac posted a follow-up, in regards to my question on Second Hand Smoke. He wrote:

“Certainly indoor smoking bans at workplaces and in restaurants and bars are defensible on a scientific and public health basis.”

In full disclosure, I’ve been opposed to smoking bans, since day one. I’ve got myself in trouble a couple times being civilly disobedient, and once I even made the 10:00 News in Minnesota, leading a smoking rally. (BTW: I will be back in Minneapolis October 2 - 6, the week after the Minnesota State ban goes in effect .,.. Stay Tuned!). I also tend to spend more time talking politics with right wing people (since all my leftist friends refuse to do it anymore). My slant is admittedly going to be on the side of the tobacco companies. At least,I admit my bias.

It always frustrates me when people only see that bias. Of course there is the corporate position. A company that has enriched itself providing a legal product that people enjoy, is going to take the side of themselves and their customers. And people DO want cigarettes. There is this peculiar notion, that every person who smokes is hopelessly addicted, and would quit tomorrow if it were possible. That is simply not true. Some people just like smoking. They know its unhealthy, but which of us non-smokers is completely guiltless when it comes to other self destructive behaviors, like drinking, overeating, and a negligent exercise schedule?

On the other side of the debate, is a motivation far more insidious. It is a desire for power. Many people who see the debate as manipulated solely by tobacco money, never look at that angle, nor recognize that for some, power is far more seductive than profit. There was a very power-hungry person, who once advocated smoke free workplaces. He is the one who cannot be named. (Not because there are dark powers associated with the name, it is because current protocol dictates that the first person to invoke his name, automatically loses the debate ... spend a little time playing with you Googler, and I’m sure you’ll figure it out.) But I think it’s no coincidence that one of the worlds’ most infamous megalomaniacs, didn’t want people smoking around him.

The reason why I am suspicious of things like Second Hand Smoke, and Global Warming is not because I am anti-science. I actually enjoy science. I spent some time in college studying it, (and if I hadn’t decided I like beer and girls better, I might be studying it still.) Actually, I am anti regulation, and anytime somebody tells me that science has proven a need to regulate my life, I get really suspicious. When I asked Orac if he could send me some links to prove the negative health consequences of smoking, I was genuinely curious. He wasn’t the first person I asked. However he was the first person who provided me with some.

I stayed in the background throughout the debate, because I didn’t want to embarrass myself again. I also didn’t have to join in. Somehow, from out of ether, came a swarm of angry bloggers, ready to call Orac on the carpet. He had to write two follow-ups, one on relative risk, and another on the famous Helena Study. He even did a fourth article on the effects of smoking on Parkinson’s Disease. I looked at what he had to say, and what his multitudinous opponents had to say in return. It was highly educational.

Here’s what I learned: There are studies that suggest a health risk from second hand smoke. The risk factor depends on whether you’re looking at lung or cardiovascular, and whether the person lived with a smoker, or worked around a lot smokers. It varies from 1.2 to 1.3. (Notice, that there is no study to indicate that standing next to someone smoking at a bus stop, or in the house next door, will have ANY impact on your health.)

I had known that somewhat. But from what I had been told, any risk under 2.0, is negligible. Orac corrected those who suggested such a thing. Apparently there is no practice within epidemiology (the study of stuff like this) to discount such statistics. According to him, there has been a propaganda campaign (most probably orchestrated from inside the tobacco companies) to discredit SHS studies, and a list of suspicious quotes discrediting epidemiological studies under 2.0, has been circulating the Internet. I had to throw in the towel at this point. I’ve never studied Epidemiology, and I have to take his word for it. If he says a risk below 2.0 is significant, it is significant. I guess I was wrong.

I was going to write him a note telling him so, until I ran across this. Apparently, a recent study found there is an increased risk of developing cardiovascular disease for people who drink a can of pop every day. And look at that risk rate. Over 1.4. Now granted this is just one isolated study, and Orac stressed the need to look at isolated studies without a biologically plausible mechanism skeptically, but it really puts things in perspective. Apparently the risk of getting heart trouble from second hand smoke, is almost identical to drinking a can of pop every day. So working in a smoky bar, is as bad for you as a can of pop. In fact, since most people who work in bars have access to the soda gun, there is a good chance that every non-smoker in those SHS studies, drank a glass or two of pop every single day.

So have I changed my mind? Yes and no. I can no longer defend the statement; “There is no science finding adverse health consequences from second hand smoke.” But is there enough danger in second hand smoke, to pass sweeping legislation? Not really.

Especially since that legislation has resulted in the bankruptcy of hundreds of small business owners. I honestly don’t understand why every bar has to be non smoking. I think that owners, customers and employees are all capable of making such a decision on their own, whether they want to subject themselves to a slightly elevated risk of cancer and heart disease. Certainly when smokers were forced to decide between drinking at home, or going to a non-smoking bar, they just opted to stay home.

But I wouldn’t expect Orac to understand. Some people just don’t care about the plight of the average Joe. To them it’s just about the numbers. It’s why I often find myself butting heads with Statists. I care more about the impact of Global Warming legislation on the economy today, than I worry about a projected 23 inches of ocean rise. I am more concerned about the real loss incurred by bar owners, than some mythological non-smoking waitress, who couldn’t find work anywhere else. But these people let their egos run out of control, and presuppose they know more than the individual business owners.

Orac wrote: “ There's nothing inherent in the work required in bars or restaurants that demands exposure to SHS, other than tradition.”

It’s beyond tradition, it’s why many people go into a bar in the first place. A place to smoke and drink. What he said is almost as ridiculous as as saying: “There is no reason to add Tequilla to a Margarita, other than tradition.” or “I just don’t see why exotic dancers need to take all their clothes off.”

This whole argument started over a bit I did, about how scientists probably got beat up on the dodgeball court when they were kids. I was trying to illustrate how some nerdy kids will grow up bitter with a disregard for humanity, and they disguise this disregard as logic. Orac started this thread disputing my allegation.

He might think that a bar should be able to survive, just by providing a place to drink, but statistics prove otherwise. At least a hundred families in Minnesota have lost their life investment, and at least a thousand more people are now out looking for work. Meanwhile there has been a recession in the various industries surrounding food and beverage in the Twin Cities.
How could anyone think that is, an acceptable sacrifice? Or maybe nobody really does. Maybe they are just getting even for Dodgeball.

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  • (Notice, that there is no study to indicate that standing next to someone smoking at a bus stop, or in the house next door, will have ANY impact on your health.)
    Has it occurred to you that this is because such a study would be incredibly difficult to do ? - I mean, it is easy asking everybody coming in with lung or cardiovascular complaints if they are smoking or exposed to second hand at home or on the job - that is a legitimate question a physician can ask of someone with a problem, and likely they are getting an answer. However the question "did someone smoke near you at the bus-stop" in the last 3 years would not be accurately answerable for most people. As for the smoking neighbor - finding out if someones neighbors smoke would require massive invasive ( and likely illegal ') questioning of the general populace. It can't be done .
    The question if a smoking ban has an adverse effect on bars and restaurants : to really see how much a smoking ban affects the people in the hospitality business one has to compare normal failure rates before and after smoking bans. Here in Cologne I notice that some localities seem to change owners, name and interiors about once a year. A pub/bar/bistro that makes it through its 3rd year is a rarity. ( yes there are some - we do have a lot watering holes here ) A Simple list of closures after the ban does not prove a cause. ( other causes of closing a business are lack of customers or retiring or losing their license for other reasons. )
    I note that with the exception of retirees the owners might be motivated to claim the smoking ban is the cause, but hardly anyone can be expected to say: "I am not a good businessman, so I failed"

    I know that business losses were feared in Italy, france, Irelan - but at least as far as I know the failed to materialize. Germany is on the verge of getting a ban and I have mixed feelings about that on the one hand I prefer to sit in better air - try sitting on the 'smoke side' of a campfire to see if you prefer not to - on the other I am not in favor of total bans - if a better phrased ban causes special smoking longes to open then a ban might actually create jobs - a total ban will likely lead to some people huddling outside and adding to noise pollution in semi-residential areas or staying at home. ( as long as beer tastes much better in the bar and soccer is on large screen TV there the latter is less likely though - this is here and now , ymmv)

    By Anonymous a. schaefer, at 7:46 AM, July 30, 2007  

  • If you prefer to patronize only nonsmoking establishments, no change in the law is required for you to do so - only a change in the policies of some establishments to become nonsmoking. (In fact, some already are.) There's no reason the market can't support a mix of smoking and nonsmoking restaurants, bars, maybe even movie theaters.

    It's the jump to heavy-handed legal intervention over a problem that can sort itself out by consumers voting with their wallets that bothers me.

    By Blogger Chris, at 10:33 AM, July 30, 2007  

  • Tim,

    While I appreciate your compromise - that only some drinking establishments shut down while leaving those that prefer to permit smoking, there would be a lot of logistical issues remaining that would make it a nightmare. How many could remain smoking-permitted? Would that be a percentage of the total or an absolute number of establishments? How would they be regulated? And, overall, what's the point?

    Do people really need to smoke while they're drinking, or would a nicotine patch or some nicotine gum suffice? Clearly, these options would mediate the conflict here.

    By Anonymous nosugrefneb, at 9:08 AM, August 06, 2007  

  • nosugrefneb writes: "Do people really need to smoke while they're drinking...?"

    Here are some better questions:

    Do people really need a five dollar cup of cappuccino? A new generation of video games? An iPhone? Athletic shoes with wheels in the heels? Another season of American Idol? Paris Hilton?

    We don't have a bureaucracy that determines need before a business is granted permission to open. That's not how it works in America. This country is based on the idea of want, not need. If somebody wants something, they will pay money for it. Since money inevitably leads to profit, someone will always step in, and satisfy that want. (Sometimes those wants will be satisfied, even in spite of the law.)

    What a dark, cold, tasteless and colorless place this Nation would be, if we were only allowed that which we need.

    By Blogger Tim Slagle, at 10:27 AM, August 13, 2007  

  • Tim,

    I didn't ask you any of those questions. All I asked was whether people absolutely need to smoke while drinking. I don't smoke, so I'm asking.

    Of course, there's a fundamental difference in the questions you posed: Being in their immediate vicinity doesn't damage your health. An iPhone may get you run over, and New York actually has partly banned that; Paris Hilton may make you dumber, but you know what I'm getting at.

    You may have seen on my blog that I've been pushing smokeless tobacco. So, I'm honestly asking. Cigarettes have a lot more than nicotine in them that doesn't need to be there, and it's hurting everyone else when there's a perfectly good solution for both parties in smokeless tobacco.

    By Anonymous nosugrefneb, at 9:06 PM, August 13, 2007  

  • nosugrefneb ,

    Sorry, you're right, you didn't ask any of those questions. Pardon my unrequested pontification.

    Do smokers really need to smoke?


    It isn't just the nicotine. There's something really delightful about the whole process, of lighting a cigarette, and using an ashtray.

    Smokeless tobacco, and gums are great for nicotine withdrawl. But there's just something about the taste and smell of smoke that those options lack. And lighting a cigarette is almost like a ritual that's hard to get over. I know people who have quit, that still like to light matches in a bar when they drink

    Ever sit by a campfire? It's a lot more fun than watching a gas log, isn't it? It's kind of the same idea.

    By Blogger Tim Slagle, at 9:55 PM, August 13, 2007  

  • Got it, so it's an oral fixation/muscle memory thing. I don't think anyone's debating the difficulties that come with quitting smoking.

    But, how then do you explain the widespread phenomenon in Sweden over the last decade or so in which smoking has been drastically reduced in favor of smokeless tobacco products?

    Check out this paper; they say, "Many former smokers have switched to snus, far more males use snus than smoke, and snus sale amongst now evidently growing rapidly. As a result Sweden has the lowest level of tobacco related disease in males among OECD countries, and has reported male smoking prevalence that has now hit single digit percentages in parts of the country."

    I don't understand how that scenario could be a bad thing here. Seems like the Swedish have figured out how to quit smoking.

    By Anonymous nosugrefneb, at 11:55 AM, August 16, 2007  

  • I've heard about the snus before. I understand that they can help quitting smoking.

    But you didn't ask me whether smokeless tobacco could help people quit smoking (I think it can).

    You asked me whether people need to smoke in a bar.

    I quit cigarettes ten years ago, but sometimes when I drink I want to smoke. I've found that a pipe or cigar makes a great substitute. The difference is, I don't wake up the next day looking for a cigar. (Quite frankly that idea disgusts me.) I always used to want a cigarette the next day.

    So yeah, I know I like to smoke in a bar. I know of others, who only smoke cigarettes when they're in a bar. Smoking and drunking just go really well together.

    I'll agree that the Swedish are on to something. But I think you'll find, that here in America, the same forces that want to ban cigarettes in bars, are allied against smokeless tobacco as well.

    By Blogger Tim Slagle, at 12:32 PM, August 16, 2007  

  • "But I think you'll find, that here in America, the same forces that want to ban cigarettes in bars, are allied against smokeless tobacco as well."
    First off, I mostly agree, but there very clearly are different reasons. Some really, really don't like secondhand smoke and think that smoking, by itself, isn't too bad, except that it most definitely affects others around the smoker; some really, really don't like smoking for its harms to the primary smoker, and so smokeless tobacco wouldn't be an appropriate alternative in that case. My personal feeling is that if everyone who smoked instead used smokeless tobacco, there would be zero issue here. Smokeless tobacco doesn't release carcinogens into the air, and it's essentially analogous to having a beer (or a can of soda, for example). :) I personally don't care all that much about the harm people do to themselves, at least in a regulatory sense, as long as it doesn't have the potential to harm others around them (cigarettes, guns, and spinning around in public with arms extended come to mind here).

    My original question was not regarding whether people needed to smoke in a bar for the sake of having access to nicotine, but instead whether smoking would be the singular route to that access.

    To rephrase it, then, if you were in a bar and needed some nicotine, would it be that different if you were to use snus rather than light up?

    By Anonymous nosugrefneb, at 2:54 PM, August 16, 2007  

  • Sure.

    But I don't "need" nicotine. I can go for months without it.

    I LIKE smoking. From time to time I want a cigar.

    Snus aren't going to help people like me, who want to have a smoke with their drink. Allowing bars to get smoking licenses will.

    By Blogger Tim Slagle, at 3:06 PM, August 16, 2007  

  • I gotta say, Tim, that's an even more ridiculous reason for opposing a smoking ban than I expected. I can sympathize with physical addiction, but to be entirely opposed to such a pivotal public health initiative simply because you want to feel free to put something in your mouth occasionally is rather offensive and completely disrespectful.

    I'll offer another quote from the paper: "It is estimated that cigarette smoking resulted in the deaths of roughly 100 million people in the last century, and that at current trends in consumption will kill 10 times that many this century." I wonder how many of those are people who didn't even smoke.

    By Anonymous nosugrefneb, at 9:03 PM, August 16, 2007  

  • You've missed my point entirely. I do not oppose the ban for personal reasons. I so rarely smoke in a bar that a ban doesn't really affect my life one way or another.

    You asked if there was a need for smoking in a bar, and I told you why. Believe it or not, smokers aren't all helpless fiends trapped into an addiction by the evil tobacco corporations. Some people actually ENJOY smoking.

    i oppose smoking bans on the basis of property rights. I believe if somebody owns a bar, he can decide which legal activities his customers can engage in, while they're there.

    What is truly offensive , is the notion that public health is more important than property rights, and civil Liberties. And what is truly disrespectful, is this notion you have, that you are somehow responsible for the welfare of us smokers.

    And what is really ridiculous, is the amount of time I wasted trying to rationalize with you.

    By Blogger Tim Slagle, at 10:54 PM, August 16, 2007  

  • Fair enough. By the way, sorry for coming to your blog and attacking you. I get a little overzealous sometimes on the topic. I suppose we'll have to agree to disagree.

    Go Bears?

    By Anonymous nosugrefneb, at 4:25 AM, August 17, 2007  

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