No Significant Statistical Correlation Between Smoking and Lung Cancer

I don't smoke (currently - I have in the past) and I am not posting this to encourage smoking. I am posting it because I have often on conversation brought up this fact generally to point out that we often accept datums that are presented to us via the news and commercials and "experts" that don't hold up under examination. They wind up as data "everybody knows..." - sometimes harmlessly - but some datums that wind up like this are products of calculated propaganda machines to fool us and push public policy initiatives which in the end errode our liberty and enrich or empower special interests.

Journal of Theoretics Vol.1-4 Oct/Nov 1999 Editorial Smoking Does Not Cause Lung Cancer (According to WHO/CDC Data)* By: James P. Siepmann, MD Yes, it is true, smoking does not cause lung cancer. It is only one of many risk factors for lung cancer. I initially was going to write an article on how the professional literature and publications misuse the language by saying "smoking causes lung cancer"1,2, but the more that I looked into how biased the literature, professional organizations, and the media are, I modified this article to one on trying to put the relationship between smoking and cancer into perspective. (No, I did not get paid off by the tobacco companies, or anything else like that.) When the tobacco executives testified to Congress that they did not believe that smoking caused cancer, their answers were probably truthful and I agree with that statement. Now, if they were asked if smoking increases the risk of getting lung cancer, then their answer based upon current evidence should have be "yes." But even so, the risk of a smoker getting lung cancer is much less than anyone would suspect. Based upon what the media and anti-tobacco organizations say, one would think that if you smoke, you get lung cancer (a 100% correlation) or at least expect a 50+% occurrence before someone uses the word "cause." Would you believe that the real number is <>Yes, a US white male (USWM) cigarette smoker has an 8% lifetime chance of dying from lung cancer but the USWM nonsmoker also has a 1% chance of dying from lung cancer (see Appendix A). In fact, the data used is biased in the way that it was collected and the actual risk for a smoker is probably less. I personally would not smoke cigarettes and take that risk, nor recommend cigarette smoking to others, but the numbers were less than I had been led to believe. I only did the data on white males because they account for the largest number of lung cancers in the US, but a similar analysis can be done for other groups using the CDC data. You don't see this type of information being reported, and we hear things like, "if you smoke you will die", but when we actually look at the data, lung cancer accounts for only 2% of the annual deaths worldwide and only 3% in the US.** When we look at the data over a longer period, such as 50 years as we did here, the lifetime relative risk is only 8 (see Appendix A). That means that even using the biased data that is out there, a USWM smoker has only an 8x more risk of dying from lung cancer than a nonsmoker. It surprised me too because I had always heard numbers like 20-40 times more risk. Statistics that are understandable and make sense to the general public, what a concept! The process of developing cancer is complex and multifactorial. It involves genetics, the immune system, cellular irritation, DNA alteration, dose and duration of exposure, and much more. Some of the known risk factors include genetics4,5,6, asbestos exposure7, sex8, HIV status9, vitamin deficiency10, diet11,12,13, pollution14 , shipbuilding15and even just plain old being lazy.16 When some of these factors are combined they can have a synergistic effect17, but none of these risk factors are directly and independently responsible for "causing" lung cancer! Look in any dictionary and you will find something like, "anything producing an effect or result."18 At what level of occurrence would you feel comfortable saying that X "causes" Y? For myself and most scientists, we would require Y to occur at least 50% of the time. Yet the media would have you believe that X causes Y when it actually occurs less than 10% of the time. As ludicrous as that is, the medical and lay press is littered with such pabulum and gobbledygook. Even as web literate physician, it took me over 50 hours of internet time to find enough raw data to write this article. I went through thousands of abstracts and numerous articles, only to find two articles that even questioned the degree of correlation between smoking and lung cancer (British lung cancer rates do not correlating to smoking rates)19,20and another two articles which questioned the link between second hand smoke (passive smoking) and lung cancer.21,22 Everywhere I looked, the information was hidden in terms like "odds ratio," "relative risk," or "annualized mortality rate." Most doctors probably could not accurately define and interpret them all these terms accurately, let alone someone outside the medical profession. The public relies on the media to interpret this morass of data, but instead they are given politically correct and biased views. If they would say that smoking increases the incidence of lung cancer or that smoking is a risk factor in the development of lung cancer, then I would agree. The purpose of this article is to emphasize the need to use language appropriately in both the medical and scientific literature (the media, as a whole, may be a lost cause). Everything in life has risk; just going to work each day has risk. Are we supposed to live our lives in bed, hiding under the blanket in case a tornado should come into our bedroom? We in science, have a duty to give the public accurate information and then let them decide for themselves what risk is appropriate. To do otherwise is a subtle imposition of our biases on the populace. We must embrace Theoretics as a discipline that strives to bring objectivity and logic back into science. Every article/study has some bias in it, the goal is to minimize such biases and present the facts in a comprehensible and logical manner. Unfortunately, most scientists have never taken a course in logic, and I'm sure that English class was not their favorite. Theoretics is a field of science which focuses on the use of logic and appropriate language in order to develop and communicate scientifically credible theories and ideas which will then have experimental implications. As someone whom I respect says, "Words mean things." Let us use language and logic appropriately in our research and in the way that we communicate information. * * * * * Yes, smoking is bad for you, but so is fast-food hamburgers, driving, and so on. We must weigh the risk and benefits of the behavior both as a society and as an individual based on unbiased information. Be warned though, that a society that attempts to remove all risk terminates individual liberty and will ultimately perish. Let us be logical in our endeavors and true in our pursuit of knowledge. Instead of fearful waiting for lung cancer to get me (because the media and much of the medical literature has falsely told me that smoking causes lung cancer), I can enjoy my occasional cigar even more now...now that I know the whole story. * * * * * The Untold Facts of Smoking (Yes, there is bias in science) or "I feel like the Fox Network" (a bastion of truth in a sea of liberalism) USWM smokers have a lifetime relative risk of dying from lung cancer of only 8 (not the 20 or more that is based on an annual death rate and therefore virtually useless). No study has ever shown that casual cigar smoker (<5> Lung cancer is not in even in the top 5 causes of death, it is only #9.** All cancers combined account for only 13% of all annual deaths and lung cancer only 2%.** Occasional cigarette use (<1> Certain types of pollution are more dangerous than second hand smoke.3 Second hand smoke has never been shown to be a causative factor in lung cancer. A WHO study did not show that passive (second hand) smoke statistically increased the risk of getting lung cancer. No study has shown that second hand smoke exposure during childhood increases their risk of getting lung cancer. In one study they couldn't even cause lung cancer in mice after exposing them to cigarette smoke for a long time.23 If everyone in the world stopped smoking 50 years ago, the premature death rate would still be well over 80% of what it is today.1 (But I thought that smoking was the major cause of preventable death...hmmm.) *This article was revised after errors in the data and calculations were noticed by Charles Rotter, Curtis Cameron and Jesse V. Silverman. This is the corrected version. A special thanks to both. **WHO data of member countries Keywords: lung cancer, mortality, tobacco, smoking, Theoretics, language, WHO, cigarette, cigar, logic. References (I back up my statements with facts, will those who respond do the same?) 1. Articles: Pisani P, Parkin DM, Bray F, Ferlay J, Estimates of the worldwide mortality from 25 cancers in 1990,Int J Cancer 1999 Sep 24;83(1):18-29; "Tobacco smoking and chewing are almost certainly the major preventable causes of cancer today." American Thoracic Society, Cigarette smoking and health.. , Am J Respir Crit Care Med; 153(2):861-5 1996; "Cigarette smoking remains the primary cause of preventable death and morbidity in the United States." Nordlund LA, Trends in smoking habits and lung cancer in Sweden, Eur J Cancer Prev 1998 Apr;7(2):109-16; "Tobacco smoking is the most important cause of lung cancer and accounts for about 80-90% of all cases of lung cancer among men and about 50-80% among women." JAMA 1997;278:1505-1508; "The chief cause of death included lung cancer, esophageal cancer and liver cancer. The death rate was higher for those who started smoking before age 25. If current smoking patterns persist, tobacco will eventually cause more than two million deaths each year in China." JAMA 1997;278:1500-1504; "We have demonstrated that smoking is a major cause of death in China...." Hecht SS hecht002@tc.umn.edu, Tobacco smoke carcinogens and lung cancer, J Natl Cancer Inst1999 Jul 21;91(14):1194-210; "The complexity of tobacco smoke leads to some confusion about the mechanisms by which it causes lung cancer." Sarna L, Prevention: Tobacco control and cancer nursing, Cancer Nurs 1999 Feb;22(1):21-8; "In the next century, tobacco will become the number-one cause of preventable death throughout the world, resulting in half a billion deaths." Liu BQ, Peto R, Chen ZM, Boreham J, Wu YP, Li JY, Campbell TC, Chen JS, Emerging tobacco hazards in China: 1. Retrospective proportional mortality study of one million deaths, BMJ 1998 Nov 21;317(7170):1411-22; "If current smoking uptake rates persist in China (where about two thirds of men but few women become smokers) tobacco will kill about 100 million...." Nordlund LA Trends in smoking habits and lung cancer in Sweden. Eur J Cancer Prev 1998 Apr;7(2):109-16; "Tobacco smoking is the most important cause of lung cancer and accounts for about 80-90% of all cases of lung cancer among men and about 50-80% among women." Skurnik Y, Shoenfeld Y Health effects of cigarette smoking, Clin Dermatol 1998 Sep-Oct;16(5):545-56 "Cigarette smoking, the chief preventable cause of illness and death in the industrialized nations." 2. Websites: JAMA Website: http://www.ama-assn.org/sci-pubs/sci-news/1996/snr0424.htm [link no longer active as of 2004]; "Yet huge obstacles remain in our path, and new roadblocks are being erected continuously," writes Ronald M. Davis, M.D., director of the Center for Health Promotion and Disease Prevention, Henry Ford Health System, Detroit, Mich., in urging a review of the effort against "the most important preventablecause of death in our society." JAMA Website: http://www.ama-assn.org/sci-pubs/sci-news/1997/snr1203.htm#joc6d99 [link no longer active as of 2004]; "According to the authors, tobacco use has been cited as the chief avoidable cause of death in the U.S., responsible for more than 420,000 deaths annually ...." JAMA Website: http://jama.ama-assn.org/issues/v281n2/ffull/jwm80010-2.html [link no longer active as of 2004]; "The researchers reported that deaths caused by tobacco...." 3. The World Health Report 1999, chapter 5 and Statistical Annex and CDC data (http://www.cdc.gov/scientific.htm). 4.Mutat Res 1998 Feb 26;398(1-2):43-54 Association of the NAT1*10 genotype with increased chromosome aberrations and higher lung cancer risk in cigarette smokers. Abdel-Rahman SZ, El-Zein RA, Z 5. Schwartz AG, Rothrock M, Yang P, Swanson GM, "Increased cancer risk among relatives of nonsmoking lung cancer cases," Genet Epidemiol 1999;17(1):1-15 6. Amos CI, Xu W, Spitz MR, Is there a genetic basis for lung cancer susceptibility?, Recent Results Cancer Res1999;151:3-12 7. Silica, asbestos, man-made mineral fibers, and cancer. Author Steenland K; Stayner L Cancer Causes Control, 8(3):491-503 1997 May 8. Lam S, leRiche JC, Zheng Y, Coldman A, MacAulay C, Hawk E, Kelloff G, Gazdar AF, Sex-related differences in bronchial epithelial changes associated with tobacco smoking, J Natl Cancer Inst 1999 Apr 21;91(8):691-6 9. Ignacio I. Wistuba, MD, Comparison of Molecular Changes in Lung Cancers in HIV-Positive and HIV-Indeterminate Subjects, JAMAVol. 279, pp. 1554-1559, May 20, 1998 10. Kumagai Y, Pi JB, Lee S, Sun GF, Yamanushi T, Sagai M, Shimojo N, Serum antioxidant vitamins and risk of lung and stomach cancers in Shenyang, Cancer Lett 1998 Jul 17;129(2):145-9 China. 11. Nyberg F, et al., Dietary factors and risk of lung cancer in never-smokers, Int J Cancer 1998 Nov 9;78(4):430-6 12. Sinha R, Kulldorff M, Curtin J, Brown CC, Alavanja MC, Swanson CA, "Fried, well-done red meat and risk of lung cancer in women." Cancer Causes Control 1998 Dec;9(6):621-30. 13. Young KJ, Lee PN, Statistics and Computing Ltd, Surrey, UK. Intervention studies on cancer, Eur J Cancer Prev 1999 Apr;8(2):91-103 14. Long-term inhalable particles and other air pollutants related to mortality in nonsmokers. Am J Respir Crit Care Med. 1999 Feb;159(2):373-82. 15. Blot WJ, Fraumeni JF, Lung Cancer Mortality in the US: Shipyard Correlations Source, Ann N Y Acad Sci; 330:313-315 1979 UI: 80659437 16. Lee IM, Sesso HD, Paffenbarger RS Jr, Physical activity and risk of lung cancer. Int J Epidemiol 1999 Aug;28(4):620-5 17. Kamp DW, Greenberger MJ, Sbalchierro JS, Preusen SE, Weitzman SA, Cigarette smoke augments asbestos-induced alveolar epithelial cell injury: role of free radicals, Free Radic Biol Med 1998 Oct;25(6):728-39 18. The Complete Reference Collection, 1996-9, Compton's. 19. Lee PN, Forey BA, Trends in cigarette consumption cannot fully explain trends in British lung cancer rates, J Epidemiol Community Health; 52(2):82-92 1998 20. Pandey M, Mathew A, Nair MK, Global perspective of tobacco habits and lung cancer: a lesson for third world countries. Eur J Cancer Prev 1999 Aug;8(4):271-9 21. Jahn O, [Passive smoking, a risk factor for lung carcinoma?], Wien Klin Wochenschr; 108(18):570-3 1996 22. Nilsson R, Environmental tobacco smoke and lung cancer: a reappraisal, Ecotoxicol Environ Saf; 34(1):2-17 1996 23. Finch GL, Nikula KJ, Belinsky SA, Barr EB, Stoner GD, Lechner JF, Failure of cigarette smoke to induce or promote lung cancer in the A/J mouse, Cancer Lett; 99(2):161-7 1996 Appendix A: US white male data3 For those of you who actually read the whole article... As long as I'm being controversial by presenting both sides of the story, do I dare tell you that a woman is three times more likely to die from an abortion than from delivering a baby (WHO data). Journal Home Page email: archive@journaloftheoretics.com © Journal of Theoretics, Inc. 1999 (Note: all submissions become the property of the journal) Discount domain name registration and web hosting www.netgonian.com. Philadelphia Web Development, Philadelphia Database Development, Philadelphia Systems Design

Economics 101

Cute and strangely relevant story forwarded to me by my mother…

Once upon a time in a place overrun with monkeys, a man appeared and announced to the villagers that he would buy monkeys for $10 each. The villagers, seeing that there were many monkeys around, went out to the forest, and started catching them.

The man bought thousands at $10 and as supply started to diminish, they became harder to catch, so the villagers stopped their effort.

The man then announced that he would now pay $20 for each one. This renewed the efforts of the villagers and they started catching monkeys again. But soon the supply diminished even further and they were ever harder to catch, so people started going back to their farms and forgot about monkey catching.

The man increased his price to $25 each and the supply of monkeys became so sparse that it was an effort to even see a monkey, much less catch one.

The man now announced that he would buy monkeys for $50! However, since he had to go to the city on some business, his assistant would now buy on his behalf.

While the man was away the assistant told the villagers. 'Look at all these monkeys in the big cage that the man has bought. I will sell them to you at

$35 each and when the man returns from the city, you can sell them to him for $50 each.

The villagers rounded up all their savings and bought all the monkeys. They never saw the man nor his assistant again and once again there were monkeys everywhere.

Now you have a better understanding of how the stock market works.

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Correspondence with Senator Casey (D) Pa on the Emergency Economic Stabalization Act

Dear Senator Casey,

My problem is not with taking action to stabilize the economy. It is the measure that will increase my health insurance cost with Mental Health Parity that for some reason was added to the bill despite its utter lack of relevance. This is what is wrong with Washington and Congress. Why did you sanction that? It is measures like this that make health care so expensive in this country.

I own a small business in Philadelphia providing computer support services. I would love that Congress also mandate that all businesses that have computers have to purchase a support agreement but that is simply not fair. In the same respect I don’t want my government to mandate what health services I have to pay for. This mandate means that now through my health insurance payments I will be forced to pay for the mental health treatments of others despite the fact that I would never pay for them myself. I have lost a cousin to psychiatric treatments and have seen my aunt’s husband – an accomplished surgeon and pianists – reduced to a paraplegic during his stays in mental health institutions. In my opinion Congress is now forcing me to pay for fraudulent and harmful medical services.

You may not agree and I certainly wouldn’t sanction removing your right to use and pay for those services if you find value in them. Similarly I would not force you to pay for something you don’t agree with but I expect the same respect in return.

Sincerely,

Yves A. Martin



From: Senator Robert P. Casey, Jr. [mailto:senator@casey.senate.gov]
Sent: Friday, October 03, 2008 1:05 PM
Subject: Response from Senator Casey



Dear Friend:

Thank you for taking the time to contact me regarding the proposal to stabilize the economy and our financial infrastructure. I appreciate hearing from all Pennsylvanians about the issues that matter most to them.

On Wednesday, October 1, the Senate passed H.R. 1424, the Emergency Economic Stabilization Act of 2008, a bill that will stabilize our credit markets, protect retirement and pension savings, modify troubled loans and protect taxpayers from paying for Wall Street's mistakes. After careful consideration, I decided to vote for this legislation.

This is a time of great economic uncertainty in our Nation's history. For many families in Pennsylvania and throughout the country, the recession has been part of their lives for many months now. Just this week we learned that the unemployment rate in Pennsylvania went from 5.4% to 5.8% in the month of August and for some parts of the state it went up far more than half a percentage point. We also learned that in the month of August the foreclosure rate in Pennsylvania went up by more than 60% from the previous year. The job loss and foreclosure rates are indicators of the economic trauma that many families have felt in Pennsylvania and across America.

Like you, I am not happy with the current crisis, and I'm angry about the climate of deregulation and deference to Wall Street over the last eight years that got us into this mess. However, failing to act will not simply punish those who brought us to this situation; it will punish everyone.

The Emergency Economic Stabilization Act of 2008 (EESA) provides up to $700 billion to the Secretary of the Treasury to buy mortgages and other assets that are clogging the balance sheets of financial institutions and making it difficult for working families, small businesses and other companies to access credit. After purchasing these assets, the Department of Treasury will hold them until markets for them recover. Treasury would then plan to sell these assets for a profit, recouping most or all of the $700 billion for the benefit of taxpayers.

You should know that Congress has significantly improved the original proposal presented by the Bush administration. In the version passed by the Senate, executives will be held accountable for their past decisions through limitations on compensation, prohibitions against golden parachutes or excessive retirement packages, and requirements that unearned bonuses be returned. As improved by the Senate, the legislation also requires participating companies to provide warrants and other forms of equity so that taxpayers will share in the profits if the stock of these companies goes up as a result of Treasury Department intervention.

The EESA also contains several provisions directed at stemming the tide of mortgage foreclosures thereby keeping families in their homes and addressing the root cause which has led to a loss of investor confidence and the freezing of credit markets. It would require the Treasury Department, where possible, to modify troubled loans to help American families keep their homes. It would also expand the HOPE for Homeowners program and require other federal agencies to modify loans that they own or control.

To ensure that Treasury isn't just getting a blank check, the legislation makes $250 billion available immediately, then requires the President to certify that additional funds are needed. The Treasury must report on the use of the funds and on progress in addressing the crisis. The bill establishes an Oversight Board so that the Treasury cannot act in an arbitrary manner and establishes a special inspector general to protect against waste, fraud and abuse.

The United States is in a financial crisis that could become worse than anything in a generation. In addition, our Nation's problems are already spreading into the global economy. If the federal government fails to take action right now, there is a real threat to small businesses and jobs, as well as mortgages, pensions and savings.

For all these reasons, I concluded that Congress must act now, and I decided to vote in favor of H.R. 1424. In the last two weeks, I have worked hard to be sure that this bill includes provisions to help families who are struggling. I've closely questioned and sent two detailed letters to Treasury Secretary Paulson, Federal Reserve Chairman Bernanke and also spoke to leading economists about this legislation.

Enactment of this legislation is only the first in a series of steps we must take to bring about economic recovery. We need to institute rigorous and aggressive regulation of players in the market place in order to prevent the abuses which caused our economic problems.

Again, thank you for sharing your thoughts with me. Please do not hesitate to contact me in the future about this or any other matter of importance to you.

If you have access to the Internet, I encourage you to visit my web site, http://casey.senate.gov. I invite you to use this online office as a comprehensive resource to stay up-to-date on my work in Washington, request assistance from my office or share with me your thoughts on the issues that matter most to you and to Pennsylvania.



Sincerely,
Bob Casey
United States Senator

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