Vincent-Riccardo DI PIERRI

Melbourne, Australia
This pdf book is for the personal use of the
purchaser only, and not for distribution.
Vincent-Riccardo DI PIERRI
Melbourne, Australia
This pdf book is for the personal use of the
purchaser only, and not for distribution.
RumpunL AnLIsmokIng SIgnIIIes Gruve Dunger:
MuLerIuIIsm OuL OI ConLroI
CopyrIgIL VIncenL-RIccurdo DI PIerrI zoo
PubIIsIed by V-R. DI PIerrI
NuLIonuI Ibrury oI AusLruIIu
CuLuIoguIng-In-PubIIcuLIon duLu
DI PIerrI, VIncenL-RIccurdo
RumpunL unLIsmokIng sIgnIIIes gruve dunger:
MuLerIuIIsm ouL oI conLroI.
BIbIIogrupIy.
ncIudes Index.
SBN o 6q6 qzzzz ;.
1. AnLIsmokIng movemenL. z. MuLerIuIIsm.
. SmokIng - HeuILI uspecLs. . TILIe.
6.q
AII rIgILs reserved.
No purL oI LIIs pubIIcuLIon muy be reproduced or LrunsIuLed, sLored In u reLrIevuI
sysLem, or LrunsmILLed In uny Iorm or by uny meuns - eIecLronIc, mecIunIcuI,
pIoLocopy, recordIng, or uny oLIer - excepL Ior brIeI quoLuLIons In prInLed revIews,
wILIouL LIe prIor permIssIon oI LIe pubIIsIer.
Printed in Austrclic.
SLuLemenL on VesLed nLeresL
A noLe concernIng vesLed InLeresL Is suppIIed In good IuILI.
TIe uuLIor Is noL und Ius never been un empIoyee, In uny
cupucILy, oI LIe Lobucco IndusLry or LIe medIcuI esLubIIsImenL.
TIe uuLIor dId noL consuIL wILI uny empIoyees or represenLuLIves
oI LIe Lobucco IndusLry or medIcuI esLubIIsImenL In LIe
deveIopmenL oI LIe proceedIng dIscussIon.
TIIs dIscussIon wus noL Iunded, In uny purL or Lerms, by LIe
Lobucco IndusLry, LIe medIcuI esLubIIsImenL, or connecLed purLIes.
TIe deveIopmenL oI LIIs dIscussIon wus noL bused on IuLure
eurnIngs promIsed by eILIer LIe Lobucco IndusLry or LIe medIcuI
esLubIIsImenL.
TIe uuLIor Ius never owned uny sLocks In Lobucco or medIcuI
compunIes.
TIe uuLIor Ius no ussocIuLIon wILI LIe growIng, dIsLrIbuLIon or
suIe oI Lobucco producLs, or LIe deveIopmenL, dIsLrIbuLIon or suIe
oI medIcuI producLs.
TIe uuLIor Is noL u member oI uny orgunIzed reIIgIous group. TIe
uuLIor Is CIrIsLIun In beIIeI.
TIe IoIIowIng dIscussIon Is un IonesL uLLempL uL un IndependenL
evuIuuLIon oI perLInenL IucLs und concepLuuI Irumeworks.
RumpunL AnLIsmokIng SIgnIIIes Gruve Dunger:
MuLerIuIIsm OuL OI ConLroI
CopyrIgIL VIncenL-RIccurdo DI PIerrI zoo
PubIIsIed by V-R. DI PIerrI
NuLIonuI Ibrury oI AusLruIIu
CuLuIoguIng-In-PubIIcuLIon duLu
DI PIerrI, VIncenL-RIccurdo
RumpunL unLIsmokIng sIgnIIIes gruve dunger:
MuLerIuIIsm ouL oI conLroI.
BIbIIogrupIy.
ncIudes Index.
SBN o 6q6 qzzzz ;.
1. AnLIsmokIng movemenL. z. MuLerIuIIsm.
. SmokIng - HeuILI uspecLs. . TILIe.
6.q
AII rIgILs reserved.
No purL oI LIIs pubIIcuLIon muy be reproduced or LrunsIuLed, sLored In u reLrIevuI
sysLem, or LrunsmILLed In uny Iorm or by uny meuns - eIecLronIc, mecIunIcuI,
pIoLocopy, recordIng, or uny oLIer - excepL Ior brIeI quoLuLIons In prInLed revIews,
wILIouL LIe prIor permIssIon oI LIe pubIIsIer.
Printed in Austrclic.
SLuLemenL on VesLed nLeresL
A noLe concernIng vesLed InLeresL Is suppIIed In good IuILI.
TIe uuLIor Is noL und Ius never been un empIoyee, In uny
cupucILy, oI LIe Lobucco IndusLry or LIe medIcuI esLubIIsImenL.
TIe uuLIor dId noL consuIL wILI uny empIoyees or represenLuLIves
oI LIe Lobucco IndusLry or medIcuI esLubIIsImenL In LIe
deveIopmenL oI LIe proceedIng dIscussIon.
TIIs dIscussIon wus noL Iunded, In uny purL or Lerms, by LIe
Lobucco IndusLry, LIe medIcuI esLubIIsImenL, or connecLed purLIes.
TIe deveIopmenL oI LIIs dIscussIon wus noL bused on IuLure
eurnIngs promIsed by eILIer LIe Lobucco IndusLry or LIe medIcuI
esLubIIsImenL.
TIe uuLIor Ius never owned uny sLocks In Lobucco or medIcuI
compunIes.
TIe uuLIor Ius no ussocIuLIon wILI LIe growIng, dIsLrIbuLIon or
suIe oI Lobucco producLs, or LIe deveIopmenL, dIsLrIbuLIon or suIe
oI medIcuI producLs.
TIe uuLIor Is noL u member oI uny orgunIzed reIIgIous group. TIe
uuLIor Is CIrIsLIun In beIIeI.
TIe IoIIowIng dIscussIon Is un IonesL uLLempL uL un IndependenL
evuIuuLIon oI perLInenL IucLs und concepLuuI Irumeworks.
Contents
Introduction :o
z. Some Buckground & eIinitions :
1.1 ProbubIIILy und LIe ConcepL oI RIsk :
1.z DeLermInIsm und LIe EdIcLs oI ScIenLIIIc EnquIry
:8
1. Endogenous & Exogenous ucLors und
LIe NormuLIve Runge oI AssocIuLIonJNon-AssocIuLIon
zz
1.q TIe ConLrucL BeLween ScIence und SocIeLy z(
z. "LiIestyle Ipidemiology z
z.1 Some oI LIe SIns oI EpIdemIoIogy z
z.z A Cuse SLudy - CIgureLLe SmokIng & DIseuse :
z.z.1 An OvervIew Irom ong-Term SLudIes:
TIe mpIIcuLIons oI DuLu :
z.z.z TIe MedIcuI EsLubIIsImenL VIew
(or, WIere LIe oIIy BegIns)
(p
z. SInce LIe 1q6q Surgeon-GeneruI ReporL
z..1 TIe OngoIng Sugu p
z..z More SIns oI EpIdemIoIogy ;8
z.. TIe CurrenL SILuuLIon 8
z.q TIe GreuLer EpIdemIoIogIcuI ConLexL p;
z. A Summury oI MuLerIuIIsL DeIusIon :::
Contents
Introduction :o
z. Some Buckground & eIinitions :
1.1 ProbubIIILy und LIe ConcepL oI RIsk :
1.z DeLermInIsm und LIe EdIcLs oI ScIenLIIIc EnquIry
:8
1. Endogenous & Exogenous ucLors und
LIe NormuLIve Runge oI AssocIuLIonJNon-AssocIuLIon
zz
1.q TIe ConLrucL BeLween ScIence und SocIeLy z(
z. "LiIestyle Ipidemiology z
z.1 Some oI LIe SIns oI EpIdemIoIogy z
z.z A Cuse SLudy - CIgureLLe SmokIng & DIseuse :
z.z.1 An OvervIew Irom ong-Term SLudIes:
TIe mpIIcuLIons oI DuLu :
z.z.z TIe MedIcuI EsLubIIsImenL VIew
(or, WIere LIe oIIy BegIns)
(p
z. SInce LIe 1q6q Surgeon-GeneruI ReporL
z..1 TIe OngoIng Sugu p
z..z More SIns oI EpIdemIoIogy ;8
z.. TIe CurrenL SILuuLIon 8
z.q TIe GreuLer EpIdemIoIogIcuI ConLexL p;
z. A Summury oI MuLerIuIIsL DeIusIon :::
z.6 CrILIcuI DIsLIncLIons In LIe deu oI RIsk :zz
z.; TIe SuperIorILy Syndrome :zz
j. Other Vitul Mutters :z;
.1 WIuL Is HeuILI? :z;
.z Smokers & Nonsmokers ::
. A BrIeI HIsLory oI AnLIsmokIng :(:
..1 AnLIsmokIng In LIe UnILed SLuLes :(z
..z AnLIsmokIng In BrILuIn :(
.. TIe NuzI AnLI-Tobucco MovemenL :(;
..q ConcIusIons :p
.q NIcoLIne AddIcLIon? :;:
. RudIcuI BeIuvIorIsm :8(
.6 TIe MedIcuI EsLubIIsImenL: A CIoser ScruLIny :p(
.; MuLerIuIIsL BIus J VesLed nLeresL zzo
q. Preventive Medicine & Heulth Promotion
zzp
q.1 TIe MuLerIuIIsL MunIIesLo zo
q.z PrevenLIve MedIcIne zz
q. TIe ConLemporury AnLIsmokIng OnsIuugIL z(;
q.q TIe PussIve SmokIng DIsusLer z(p
q.q.1 A Cuse SLudy - VIcLorIu, AusLruIIu z(p
q.q.z TIe EnvIronmenL ProLecLIon Agency (EPA)
& PussIve SmokIng z
q.q. EnvIronmenLuI Tobucco Smoke & ung Cuncer
z8
q.q.q ETS & Non-Cuncer RespIruLory AIImenLs In
CIIIdren zp
q.q. ETS & LIe Sudden nIunL DeuLI Syndrome
o
q. PosL-EPA (1qq)
q.6 TIe SuperIorILy Syndrome (SS) & LIe
EnvIronmenLuI SomuLIzuLIon Syndrome (ESS)
q.6.1 TIe SuperIorILy Syndrome
q.6.z TIe EnvIronmenLuI SomuLIzuLIon Syndrome ;o
q.; OLIer QuesLIonubIe SLudIes 88
q.8 Summury Lo DuLe pz
q.q ProgressIve SS & ESS RumIIIcuLIons p
q.1o OLIer AnLIsmokIng Dogmu (:(
q.11 nIecLIng oI eguI ArgumenL (z:
q.11.1 EnvIronmenLuI Tobucco Smoke (z;
q.11.z PossIbIe Recourse ((z
q.1z TIe MunuIucLure oI u CuIL ((
g. The Bigger Picture ((p
.1 TIe MuLerIuIIsL DomInuLIon oI UnIversILIes
& PrImuryJSecondury EducuLIon ((p
.1.1 BrIeI Buckground ((p
.1.z AusLruIIu (:
.1. GIobuI rumework (
.z HumunIsm (o
. OLIer CorreIuLes oI AnLIsmokIng (;;
.q rugmenLuLIon, obby Groups & MonomunIu(p8
. AnLIsmokIng, CIrIsLIunILy & ReuI Hope
Rejerences o
Index 8
z.6 CrILIcuI DIsLIncLIons In LIe deu oI RIsk :zz
z.; TIe SuperIorILy Syndrome :zz
j. Other Vitul Mutters :z;
.1 WIuL Is HeuILI? :z;
.z Smokers & Nonsmokers ::
. A BrIeI HIsLory oI AnLIsmokIng :(:
..1 AnLIsmokIng In LIe UnILed SLuLes :(z
..z AnLIsmokIng In BrILuIn :(
.. TIe NuzI AnLI-Tobucco MovemenL :(;
..q ConcIusIons :p
.q NIcoLIne AddIcLIon? :;:
. RudIcuI BeIuvIorIsm :8(
.6 TIe MedIcuI EsLubIIsImenL: A CIoser ScruLIny :p(
.; MuLerIuIIsL BIus J VesLed nLeresL zzo
q. Preventive Medicine & Heulth Promotion
zzp
q.1 TIe MuLerIuIIsL MunIIesLo zo
q.z PrevenLIve MedIcIne zz
q. TIe ConLemporury AnLIsmokIng OnsIuugIL z(;
q.q TIe PussIve SmokIng DIsusLer z(p
q.q.1 A Cuse SLudy - VIcLorIu, AusLruIIu z(p
q.q.z TIe EnvIronmenL ProLecLIon Agency (EPA)
& PussIve SmokIng z
q.q. EnvIronmenLuI Tobucco Smoke & ung Cuncer
z8
q.q.q ETS & Non-Cuncer RespIruLory AIImenLs In
CIIIdren zp
q.q. ETS & LIe Sudden nIunL DeuLI Syndrome
o
q. PosL-EPA (1qq)
q.6 TIe SuperIorILy Syndrome (SS) & LIe
EnvIronmenLuI SomuLIzuLIon Syndrome (ESS)
q.6.1 TIe SuperIorILy Syndrome
q.6.z TIe EnvIronmenLuI SomuLIzuLIon Syndrome ;o
q.; OLIer QuesLIonubIe SLudIes 88
q.8 Summury Lo DuLe pz
q.q ProgressIve SS & ESS RumIIIcuLIons p
q.1o OLIer AnLIsmokIng Dogmu (:(
q.11 nIecLIng oI eguI ArgumenL (z:
q.11.1 EnvIronmenLuI Tobucco Smoke (z;
q.11.z PossIbIe Recourse ((z
q.1z TIe MunuIucLure oI u CuIL ((
g. The Bigger Picture ((p
.1 TIe MuLerIuIIsL DomInuLIon oI UnIversILIes
& PrImuryJSecondury EducuLIon ((p
.1.1 BrIeI Buckground ((p
.1.z AusLruIIu (:
.1. GIobuI rumework (
.z HumunIsm (o
. OLIer CorreIuLes oI AnLIsmokIng (;;
.q rugmenLuLIon, obby Groups & MonomunIu(p8
. AnLIsmokIng, CIrIsLIunILy & ReuI Hope
Rejerences o
Index 8
10
10
Introduction
1ntroduction
TIIs book Is un exumInuLIon oI some oI LIe LeIIIng sIgns oI LIe
LIme. UILImuLeIy IL Is u deIIneuLIon oI un unIoIdIng, gIobuI-scuIe
meLupIysIcuI crIsIs. L couId weII be usked wIuL LIe Issue oI unLIsmokIng
wouId Iuve Lo do wILI so IorebodIng u prospecL. TIe urgumenL In LIe
currenL dIscussIon Is LIuL mIIILunL unLIsmokIng Is u crILIcuI sympLom oI
rumpunL muLerIuIIsm - bIoIogIcuI reducLIonIsm, uLIeIsm und moruI
reIuLIvIsm, beIuvIorIsm, und economIc ruLIonuIIsmJopporLunIsm.
MuLerIuIIsm reIIecLs LIe reducLIon oI LIe Iumun condILIon Lo onIy some
Iorm oI quunLIIIcuLIon. n LIIs muLerIuIIsL vIew psycIoIogIcuI,
psycIosocIuI, moruI und spIrILuuI dImensIons ure obIILeruLed; LIe Iumun
Is no more LIun u bIoIogIcuI orgunIsm wILI beIuvIoruI reucLIons Lo
exLernuI evenLs.
L wIII be consIdered LIuL sInce LIe 1q;o`s muLerIuIIsm Ius been
buIIdIng In domInuLIon oI key socIuI InsLILuLIons sucI us governmenLs, LIe
medIcuI esLubIIsImenL, ucudemIu, und LIe medIu. MedIco-muLerIuIIsm Ius
IIgured IIgIIy In LIIs cIrcumsLunce. MedIco-muLerIuIIsm Ius been gIven
more und more suy In IeuILI poIIcy und now even uLLempLs Lo prescrIbe
LIe IdeuI IIIesLyIe. MedIco-muLerIuIIsL prescrIpLIonsJproscrIpLIons ure
underIuIn by epIdemIoIogy wIIcI Is LIe sLudy oI IucLors (e.g., dIeL,
exercIse, smokIng) ussocIuLed wILI wIuL ure Lermed IIIesLyIe dIseuses
(e.g., cuncer, coronury IeurL dIseuse).
Tobucco-smokIng IIgures IIgIIy In LIe medIco-muLerIuIIsL vIew
oI IeuILI und Is noL u new medIco-muLerIuIIsL IIxuLIon. Tobucco-smokIng
runks us LIe mosL over-InvesLIguLed pIenomenon In medIcuI enquIry.
urson eL uI. (1q61) pubIIsIed u revIew oI smokIng IILeruLure LIuL covered
InIormuLIon Irom some 6,ooo urLIcIes und books pubIIsIed In muny
Iunguuges und duLIng Irom LIe eurIy-18oo`s LIrougI Lo 1qq (reIerenced
In GuIIIord, 1q68). GoodIn (1q8q) noLes LIuL by 1q86 LIe scIenLIIIc
IILeruLure on smokIng und IeuILI numbered over o,ooo sLudIes. SInce
LIen, und wILI LIe mosL recenL unLIsmokIng Irenzy Ied by LIe Issue oI
pussIve smokIng In mosL wesLern nuLIons, muny more LIousunds oI
sLudIes cun be udded Lo LIe IIsL.
L wus noL unLII LIe 1qo`s LIuL LIere wus uny concerLed uLLempL
Lo uppIy LIe scIenLIIIc meLIod Lo LIe InvesLIguLIon oI smokIng und dIseuse.
TIIs cuImInuLed In LIe 1q6q Surgeon-GeneruI ReporL on smokIng und
IeuILI. UnLII LIIs LIme mucI oI LIe reseurcI reIIecLed dIsjoInLed,
subsLundurd meLIodoIogy, unrepresenLuLIve, smuII sumpIes, und wIere
urgumenL proceeded usuuIIy by IncoIerenL unuIogy. TIere wus cerLuInIy
no consensus wILIIn LIe medIcuI esLubIIsImenL unLII recenLIy us Lo LIe
sLuLus oI smokIng us u IeuILI Issue.
By usIng LIe exumpIe oI smokIng und IeuILI, wIIcI Ior muny Is
supposedIy u seLLIed Issue, LIe IIrsL Lwo cIupLers wIII provIde u crILIcuI
evuIuuLIon oI LIe epIdemIoIogIc meLIod und LIe weIgIL oI evIdence
upproucI. TIese ure consIdered Lo be sub-sLundurd und unLILIeLIcuI Lo LIe
scIenLIIIc enLerprIse. TIe concIusIon Is LIuL LIere Is no prImury, cuusuI
urgumenL concernIng Lobucco-smokIng und specIIIc dIseuse. TIIs
conLrusLs wILI numerous smokIng concIusIons duLIng buck Lo LIe
orIgInuI Surgeon-GeneruI ReporL InLo smokIng und IeuILI In 1q6q. TIIs
1q6q ReporL Is scruLInIzed, reveuIIng numerous und severe InIerenLIuI
errors. TIrougI LIe use oI LIe reIuLIve rIsk sLuLIsLIc, u IIImsy IeveI oI
evIdence, scIence Ius been perverLed InLo no more LIun sLuLIsLIcuIIsm.
PredIcLIve sLrengLI (c priori) oI IucLors Ior IucLors, u cornersLone oI cuusuI
urgumenL, does noL IIgure In epIdemIoIogIcuI or medIco-muLerIuIIsL
reusonIng. RuLIer, IL subsLILuLes post hoc expIunuLIon oI poor predIcLors
Lo urgue cuusuLIon.
TIere Is uIso consIdered LIuL sInce LIe 1q6q ReporL LIe sLundurd
oI InIerence Ius deLerIoruLed even IurLIer. Moreover, LIIs deLerIoruLIon
reIIecLs LIe dungerous udopLIng oI muLerIuIIsL IdeoIogy In LIe mId-1q;o`s
(I.e., muLerIuIIsL munIIesLo) und now concerns, noL onIy smokIng, buL dIeL,
exercIse und oLIer exposures.
SLuLIsLIcuIIsL over-InLerpreLuLIon, wIIcI InvoIves un Improper
sLruddIIng oI boLI deLermInIsLIc und probubIIIsLIc Irumeworks, promoLes
supersLILIous beIIeI us u muLLer oI course, I.e., unLI-scIenLIIIc. Un-
IorLunuLeIy, IL Is uIso seII-servIng In IosLerIng LIe mIspercepLIon LIuL
medIcIne undersLunds Iur more ubouL dIseuse ueLIoIogy LIun IL ucLuuIIy
does. AddILIonuIIy, promoLIng IuIse beIIeI uIso subserves u greuLer medIco-
muLerIuIIsL producLIon-IIne oI screenIngs, LesLIngs, consuILuLIons, eLc.
(economIc opporLunIsm or ruw cupILuIIsm). WILI LIe duwnIng oI LIe new
mIIIennIum, LIe pubIIc Is under u consLunL burruge oI quesLIonubIe
muLerIuIIsL IeuILI promoLIon, e.g., dIeL, smokIng, exercIse.
n cIupLer LIree Is presenLed u number oI oLIer LIemes vILuI Lo
LIe currenL urgumenL. TIe very Ideu oI IeuILI Is scruLInIzed, purLIcuIurIy
LIe severe IImILuLIons oI u muLerIuIIsL deIInILIon oI IeuILI. Subgroup
dIIIerences beLween smokers und nonsmokers ure dIscussed, sucI LIuL
uny concIusIon bused on LIe ussumpLIon oI IomogeneILy oI LIese groups,
wIIcI Is LypIcuIIy LIe cuse In epIdemIoIogIc reseurcI, Is unLenubIe.
A brIeI IIsLory oI unLIsmokIng, wIIcI In mosL InsLunces Is very
11
11
Introduction
1ntroduction
TIIs book Is un exumInuLIon oI some oI LIe LeIIIng sIgns oI LIe
LIme. UILImuLeIy IL Is u deIIneuLIon oI un unIoIdIng, gIobuI-scuIe
meLupIysIcuI crIsIs. L couId weII be usked wIuL LIe Issue oI unLIsmokIng
wouId Iuve Lo do wILI so IorebodIng u prospecL. TIe urgumenL In LIe
currenL dIscussIon Is LIuL mIIILunL unLIsmokIng Is u crILIcuI sympLom oI
rumpunL muLerIuIIsm - bIoIogIcuI reducLIonIsm, uLIeIsm und moruI
reIuLIvIsm, beIuvIorIsm, und economIc ruLIonuIIsmJopporLunIsm.
MuLerIuIIsm reIIecLs LIe reducLIon oI LIe Iumun condILIon Lo onIy some
Iorm oI quunLIIIcuLIon. n LIIs muLerIuIIsL vIew psycIoIogIcuI,
psycIosocIuI, moruI und spIrILuuI dImensIons ure obIILeruLed; LIe Iumun
Is no more LIun u bIoIogIcuI orgunIsm wILI beIuvIoruI reucLIons Lo
exLernuI evenLs.
L wIII be consIdered LIuL sInce LIe 1q;o`s muLerIuIIsm Ius been
buIIdIng In domInuLIon oI key socIuI InsLILuLIons sucI us governmenLs, LIe
medIcuI esLubIIsImenL, ucudemIu, und LIe medIu. MedIco-muLerIuIIsm Ius
IIgured IIgIIy In LIIs cIrcumsLunce. MedIco-muLerIuIIsm Ius been gIven
more und more suy In IeuILI poIIcy und now even uLLempLs Lo prescrIbe
LIe IdeuI IIIesLyIe. MedIco-muLerIuIIsL prescrIpLIonsJproscrIpLIons ure
underIuIn by epIdemIoIogy wIIcI Is LIe sLudy oI IucLors (e.g., dIeL,
exercIse, smokIng) ussocIuLed wILI wIuL ure Lermed IIIesLyIe dIseuses
(e.g., cuncer, coronury IeurL dIseuse).
Tobucco-smokIng IIgures IIgIIy In LIe medIco-muLerIuIIsL vIew
oI IeuILI und Is noL u new medIco-muLerIuIIsL IIxuLIon. Tobucco-smokIng
runks us LIe mosL over-InvesLIguLed pIenomenon In medIcuI enquIry.
urson eL uI. (1q61) pubIIsIed u revIew oI smokIng IILeruLure LIuL covered
InIormuLIon Irom some 6,ooo urLIcIes und books pubIIsIed In muny
Iunguuges und duLIng Irom LIe eurIy-18oo`s LIrougI Lo 1qq (reIerenced
In GuIIIord, 1q68). GoodIn (1q8q) noLes LIuL by 1q86 LIe scIenLIIIc
IILeruLure on smokIng und IeuILI numbered over o,ooo sLudIes. SInce
LIen, und wILI LIe mosL recenL unLIsmokIng Irenzy Ied by LIe Issue oI
pussIve smokIng In mosL wesLern nuLIons, muny more LIousunds oI
sLudIes cun be udded Lo LIe IIsL.
L wus noL unLII LIe 1qo`s LIuL LIere wus uny concerLed uLLempL
Lo uppIy LIe scIenLIIIc meLIod Lo LIe InvesLIguLIon oI smokIng und dIseuse.
TIIs cuImInuLed In LIe 1q6q Surgeon-GeneruI ReporL on smokIng und
IeuILI. UnLII LIIs LIme mucI oI LIe reseurcI reIIecLed dIsjoInLed,
subsLundurd meLIodoIogy, unrepresenLuLIve, smuII sumpIes, und wIere
urgumenL proceeded usuuIIy by IncoIerenL unuIogy. TIere wus cerLuInIy
no consensus wILIIn LIe medIcuI esLubIIsImenL unLII recenLIy us Lo LIe
sLuLus oI smokIng us u IeuILI Issue.
By usIng LIe exumpIe oI smokIng und IeuILI, wIIcI Ior muny Is
supposedIy u seLLIed Issue, LIe IIrsL Lwo cIupLers wIII provIde u crILIcuI
evuIuuLIon oI LIe epIdemIoIogIc meLIod und LIe weIgIL oI evIdence
upproucI. TIese ure consIdered Lo be sub-sLundurd und unLILIeLIcuI Lo LIe
scIenLIIIc enLerprIse. TIe concIusIon Is LIuL LIere Is no prImury, cuusuI
urgumenL concernIng Lobucco-smokIng und specIIIc dIseuse. TIIs
conLrusLs wILI numerous smokIng concIusIons duLIng buck Lo LIe
orIgInuI Surgeon-GeneruI ReporL InLo smokIng und IeuILI In 1q6q. TIIs
1q6q ReporL Is scruLInIzed, reveuIIng numerous und severe InIerenLIuI
errors. TIrougI LIe use oI LIe reIuLIve rIsk sLuLIsLIc, u IIImsy IeveI oI
evIdence, scIence Ius been perverLed InLo no more LIun sLuLIsLIcuIIsm.
PredIcLIve sLrengLI (c priori) oI IucLors Ior IucLors, u cornersLone oI cuusuI
urgumenL, does noL IIgure In epIdemIoIogIcuI or medIco-muLerIuIIsL
reusonIng. RuLIer, IL subsLILuLes post hoc expIunuLIon oI poor predIcLors
Lo urgue cuusuLIon.
TIere Is uIso consIdered LIuL sInce LIe 1q6q ReporL LIe sLundurd
oI InIerence Ius deLerIoruLed even IurLIer. Moreover, LIIs deLerIoruLIon
reIIecLs LIe dungerous udopLIng oI muLerIuIIsL IdeoIogy In LIe mId-1q;o`s
(I.e., muLerIuIIsL munIIesLo) und now concerns, noL onIy smokIng, buL dIeL,
exercIse und oLIer exposures.
SLuLIsLIcuIIsL over-InLerpreLuLIon, wIIcI InvoIves un Improper
sLruddIIng oI boLI deLermInIsLIc und probubIIIsLIc Irumeworks, promoLes
supersLILIous beIIeI us u muLLer oI course, I.e., unLI-scIenLIIIc. Un-
IorLunuLeIy, IL Is uIso seII-servIng In IosLerIng LIe mIspercepLIon LIuL
medIcIne undersLunds Iur more ubouL dIseuse ueLIoIogy LIun IL ucLuuIIy
does. AddILIonuIIy, promoLIng IuIse beIIeI uIso subserves u greuLer medIco-
muLerIuIIsL producLIon-IIne oI screenIngs, LesLIngs, consuILuLIons, eLc.
(economIc opporLunIsm or ruw cupILuIIsm). WILI LIe duwnIng oI LIe new
mIIIennIum, LIe pubIIc Is under u consLunL burruge oI quesLIonubIe
muLerIuIIsL IeuILI promoLIon, e.g., dIeL, smokIng, exercIse.
n cIupLer LIree Is presenLed u number oI oLIer LIemes vILuI Lo
LIe currenL urgumenL. TIe very Ideu oI IeuILI Is scruLInIzed, purLIcuIurIy
LIe severe IImILuLIons oI u muLerIuIIsL deIInILIon oI IeuILI. Subgroup
dIIIerences beLween smokers und nonsmokers ure dIscussed, sucI LIuL
uny concIusIon bused on LIe ussumpLIon oI IomogeneILy oI LIese groups,
wIIcI Is LypIcuIIy LIe cuse In epIdemIoIogIc reseurcI, Is unLenubIe.
A brIeI IIsLory oI unLIsmokIng, wIIcI In mosL InsLunces Is very
12
12
Rampant Antismoking Signifies Grave Danger
sordId, Is presenLed. TIe NuzI ussuuIL on smokIng, wIIcI Ius onIy been
presenLed In LIe medIcuI journuIs recenLIy, Is very perLInenL Lo LIe currenL
dIscussIon. TIere Is uIso consIdered LIuL unLIsmokIng wus very cenLruI Lo
LIe NuzI menLuIILy. AnLIsmokIng provIded one moruI subsLILuLe Ior u
regIme LIuL wus spIrILuuIIy, moruIIy, socIuIIy, und psycIoIogIcuIIy
degeneruLe. TIe muLerIuIIsm oI LIe currenL unLIsmokIng crusude Ius
dIsLurbIng sImIIurILIes Lo LIe NuzI menLuIILy. TIe sIeer voIume oI
unLIsmokIng rIeLorIc und cIuIms mukes IL ImpossIbIe Lo evuIuuLe uII oI
LIese. TIe demonsLruLIon LIuL LIe more exLreme cIuIms Iuck sensIbIIILy
wIII provIde u busIs Ior evuIuuLIng uny unLIsmokIng cIuIm In LIuL LIey uII
suIIer Irom LIe sume InIerenLIuI IuIIucIes Lo vuryIng degrees. TIe Ideu oI
nIcoLIne uddIcLIon Is evuIuuLed, concIudIng LIuL IL Is LIe resuIL oI un
enLIreIy quesLIonubIe muLerIuIIsL re-deIInILIon, LIrougI IncoIerenL
unuIogy, oI LIe smokIng IubIL; LIIs re-deIInILIon Is compIeLeIy In keepIng
wILI LIe muLerIuIIsL munIIesLo.
BeIuvIorIsm, LIe psycIoIogIcuI bruncI oI muLerIuIIsm, Is
dIscussed. L Is Irom beIuvIorIsm LIuL LIe muLerIuIIsL munIIesLo - LIe
mun-engIneered uLopIu - emerges. L Is concIuded LIuL LIe muLerIuIIsL
munIIesLo, bused on LIe meLupIor oI LIe experImenLerJruL reIuLIonsIIp
In u IuboruLory seLLIng, Is LIe producL oI u IeebIe menLuIILy und Is IIgIIy
dungerous In ILs socIuI rumIIIcuLIons. AIso consIdered Is LIuL mucI
conLemporury IeuILI promoLIon Is predIcuLed on LIe muLerIuIIsL
munIIesLo, wIere IeuILI Is reduced Lo onl dIeL, exposures, und exercIse,
I.e., psycIoIogIcuI, socIuI, moruI, und spIrILuuI dImensIons do noL IIgure In
LIe muLerIuIIsL Irumework.
TIe moruI condILIon oI LIe medIcuI esLubIIsImenL Is evuIuuLed. L
Is IndIcuLed, LIrougI exumpIes, LIuL conLemporury medIcIne Is uLLerIy
domInuLed by muLerIuIIsm. TIe esLubIIsImenL Is In moruI, socIuI, und
psycIoIogIcuI dIsurruy. And, yeL, LIe muLerIuIIsm seeks greuLer und greuLer
socIuI domInuLIon wIIIe IL Ieuves u greuL moruI mess In ILs wuke - u
sILuuLIon uIurmIngIy sImIIur Lo LIe LendencIes oI muny medIcuI
prucLILIoners In LIe NuzI regIme. AIso sImIIur In LIIs regurd Is LIe
esLubIIsImenL`s obsessIon wILI unLIsmokIng. And unLIsmokIng Is beIng
used In u sImIIur IusIIon - us u moruI subsLILuLe Ior u moruIIy desLILuLe
Irumework und underIyIng menLuIILy.
CIupLer Iour provIdes u cIoser scruLIny oI conLemporury IeuILI
promoLIon wIIcI excIusIveIy promoLes LIe muLerIuIIsL Ideu oI LIe rIsk
uvoIdIng IndIvIduuI. TIe uddILIonuI IoIIy InvoIved Iere Is LIuL, gIven LIe
scIenLIIIc IuIIure oI IIIesLyIe epIdemIoIogy, wIuL Is beIng promoLed Is LIe
sLuLIsLIcuI-rIsk uvoIdIng IndIvIduuI. TIe ucLIvILy reIIecLs LIe munuIucLure
oI supersLILIous beIIeI (I.e., ussuuIL on menLuI IeuILI); IL promoLes u
vurIunL oI MurpIy`s uw; uny IucLor sLuLIsLIcuIIy ussocIuLed wILI u
Introduction
deLrImenLuI ouLcome, Iowever ImprobubIe und regurdIess oI wIeLIer IL
cun be pIuced In u cuusuI conLexL, sIouId be uvoIded, I.e., II someLIIng
cun go wrong (sLuLIsLIcuIIy), IL wIII. TIIs reIIecLs un upsIde-down LIInkIng,
I.e., conLrudIcLs LIe very IucLs IL Is supposedIy uddressIng.
TIere Is uIso consIdered LIe exLruordInury poLenLIuI Ior nocebo
(conLrury oI pIucebo) eIIecLs - neguLIve ouLcomes due Lo neguLIve
expecLuncy, I.e., psycIogenIc eIIecL - Irom LIe burruge oI neguLIve,
erroneous IeuILI cIuIms. L Is IIgIIIgILed LIuL LIere Is vIrLuuIIy no
reseurcI on LIIs ureu. As wIII be consIdered In cIupLer IIve, LIIs represenLs
LIe ubsence oI un enLIre dImensIon oI enquIry, I.e., non-reducLIonIsL
psycIoIogy.
TIere Is un In-depLI consIderuLIon oI Iow LIIs rumpunL
muLerIuIIsm Ius produced one crescendo oI IunuLIcIsm und socIuI dIvIsIon
LIrougI LIe pussIve smokIng cuuses dIseuse debucIe. Muny newspuper
reIerences, wILI VIcLorIu, AusLruIIu, us u cuse exumpIe, ure used Lo
demonsLruLe InLensIIyIng oI LIe superIorILy syndrome und envIronmenLuI
somuLIzuLIon syndrome. TIese ure eIuboruLe Lerms Ior psycIoIogIcuI
denIuI und projecLIon; In some IL Is munIIesLed us uIrs oI superIorILy, In
oLIers us vIcLImIood und sympLoms. TIe Iunguuge oI Ieur Is consIdered.
TIe more IrruLIonuI Ieur Is cosseLed, LIe more nIL-pIckIng does IL become
In percepLIon oI dunger und demunds Ior proLecLIon. TIe IeurIuI cun go
Lo exLruordInury IengLIs In seII-proLecLIon, purLIcuIurIy wIen LIe
menLuIILy Is IegILImIzed by Iuke scIence. TIe uIrs oI superIorILy become
more cunLunkerous und, evenLuuIIy, IosLIIe.
SocIeLIes In LIe grIp oI LIe muLerIuIIsL munIIesLo, LIuL Iuve
ucLIveIy jeLLIsoned uny vesLIge oI un ubsoIuLe moruI Irumework (e.g.,
CIrIsLIunILy), now Iuve progressIveIy more oI LIeIr membersIIp In
LroubIed menLuI sLuLes, bereIL oI uny LrunscendenLuI meunIng und modes
oI uddress. TroubIed mInds, unwIIIIng Lo uddress probIems wIere LIey
occur (InLernuIIy), projecL InLernuI conIIIcL ouLwurd. ExLernuIILIes LIen
uppeur dungerous, LIe greuLer LIe InLernuI conIIIcL, LIe more
dungerous seem LIe exLernuIILIes. TIIs underIIes mucI conLemporury
obsessIon wILI LIe envIronmenL und purLIcuIurIy unLIsmokIng. SmokIng
und exposure Lo smoke Iuve been munuIucLured InLo u conduIL Ior
projecLed Inner conIIIcL, I.e., u conLemporury scupegouL, bIgoLry.
n LIe IInuI cIupLer, LIe sLuLus oI unIversILy sLrucLure Is
consIdered. TIe concIusIon Is LIuL unIversILIes ure under muLerIuIIsL
domInuLIon. WIere one wouId Iuve expecLed scIoIursIIp Lo runge ucross
LIe scIences und IumunILIes und, so, provIdIng some sembIunce oI
buIunced perspecLIve, unIversILIes ure now uIso under muLerIuIIsL
domInuLIon; LIe unIversILy Ius been reduced Lo u gIorIIIed InsLILuLe oI
LecInoIogy. AnLIsmokIng Ius been uIIowed Lo proIIIeruLe under LIIs
13
13
Rampant Antismoking Signifies Grave Danger
sordId, Is presenLed. TIe NuzI ussuuIL on smokIng, wIIcI Ius onIy been
presenLed In LIe medIcuI journuIs recenLIy, Is very perLInenL Lo LIe currenL
dIscussIon. TIere Is uIso consIdered LIuL unLIsmokIng wus very cenLruI Lo
LIe NuzI menLuIILy. AnLIsmokIng provIded one moruI subsLILuLe Ior u
regIme LIuL wus spIrILuuIIy, moruIIy, socIuIIy, und psycIoIogIcuIIy
degeneruLe. TIe muLerIuIIsm oI LIe currenL unLIsmokIng crusude Ius
dIsLurbIng sImIIurILIes Lo LIe NuzI menLuIILy. TIe sIeer voIume oI
unLIsmokIng rIeLorIc und cIuIms mukes IL ImpossIbIe Lo evuIuuLe uII oI
LIese. TIe demonsLruLIon LIuL LIe more exLreme cIuIms Iuck sensIbIIILy
wIII provIde u busIs Ior evuIuuLIng uny unLIsmokIng cIuIm In LIuL LIey uII
suIIer Irom LIe sume InIerenLIuI IuIIucIes Lo vuryIng degrees. TIe Ideu oI
nIcoLIne uddIcLIon Is evuIuuLed, concIudIng LIuL IL Is LIe resuIL oI un
enLIreIy quesLIonubIe muLerIuIIsL re-deIInILIon, LIrougI IncoIerenL
unuIogy, oI LIe smokIng IubIL; LIIs re-deIInILIon Is compIeLeIy In keepIng
wILI LIe muLerIuIIsL munIIesLo.
BeIuvIorIsm, LIe psycIoIogIcuI bruncI oI muLerIuIIsm, Is
dIscussed. L Is Irom beIuvIorIsm LIuL LIe muLerIuIIsL munIIesLo - LIe
mun-engIneered uLopIu - emerges. L Is concIuded LIuL LIe muLerIuIIsL
munIIesLo, bused on LIe meLupIor oI LIe experImenLerJruL reIuLIonsIIp
In u IuboruLory seLLIng, Is LIe producL oI u IeebIe menLuIILy und Is IIgIIy
dungerous In ILs socIuI rumIIIcuLIons. AIso consIdered Is LIuL mucI
conLemporury IeuILI promoLIon Is predIcuLed on LIe muLerIuIIsL
munIIesLo, wIere IeuILI Is reduced Lo onl dIeL, exposures, und exercIse,
I.e., psycIoIogIcuI, socIuI, moruI, und spIrILuuI dImensIons do noL IIgure In
LIe muLerIuIIsL Irumework.
TIe moruI condILIon oI LIe medIcuI esLubIIsImenL Is evuIuuLed. L
Is IndIcuLed, LIrougI exumpIes, LIuL conLemporury medIcIne Is uLLerIy
domInuLed by muLerIuIIsm. TIe esLubIIsImenL Is In moruI, socIuI, und
psycIoIogIcuI dIsurruy. And, yeL, LIe muLerIuIIsm seeks greuLer und greuLer
socIuI domInuLIon wIIIe IL Ieuves u greuL moruI mess In ILs wuke - u
sILuuLIon uIurmIngIy sImIIur Lo LIe LendencIes oI muny medIcuI
prucLILIoners In LIe NuzI regIme. AIso sImIIur In LIIs regurd Is LIe
esLubIIsImenL`s obsessIon wILI unLIsmokIng. And unLIsmokIng Is beIng
used In u sImIIur IusIIon - us u moruI subsLILuLe Ior u moruIIy desLILuLe
Irumework und underIyIng menLuIILy.
CIupLer Iour provIdes u cIoser scruLIny oI conLemporury IeuILI
promoLIon wIIcI excIusIveIy promoLes LIe muLerIuIIsL Ideu oI LIe rIsk
uvoIdIng IndIvIduuI. TIe uddILIonuI IoIIy InvoIved Iere Is LIuL, gIven LIe
scIenLIIIc IuIIure oI IIIesLyIe epIdemIoIogy, wIuL Is beIng promoLed Is LIe
sLuLIsLIcuI-rIsk uvoIdIng IndIvIduuI. TIe ucLIvILy reIIecLs LIe munuIucLure
oI supersLILIous beIIeI (I.e., ussuuIL on menLuI IeuILI); IL promoLes u
vurIunL oI MurpIy`s uw; uny IucLor sLuLIsLIcuIIy ussocIuLed wILI u
Introduction
deLrImenLuI ouLcome, Iowever ImprobubIe und regurdIess oI wIeLIer IL
cun be pIuced In u cuusuI conLexL, sIouId be uvoIded, I.e., II someLIIng
cun go wrong (sLuLIsLIcuIIy), IL wIII. TIIs reIIecLs un upsIde-down LIInkIng,
I.e., conLrudIcLs LIe very IucLs IL Is supposedIy uddressIng.
TIere Is uIso consIdered LIe exLruordInury poLenLIuI Ior nocebo
(conLrury oI pIucebo) eIIecLs - neguLIve ouLcomes due Lo neguLIve
expecLuncy, I.e., psycIogenIc eIIecL - Irom LIe burruge oI neguLIve,
erroneous IeuILI cIuIms. L Is IIgIIIgILed LIuL LIere Is vIrLuuIIy no
reseurcI on LIIs ureu. As wIII be consIdered In cIupLer IIve, LIIs represenLs
LIe ubsence oI un enLIre dImensIon oI enquIry, I.e., non-reducLIonIsL
psycIoIogy.
TIere Is un In-depLI consIderuLIon oI Iow LIIs rumpunL
muLerIuIIsm Ius produced one crescendo oI IunuLIcIsm und socIuI dIvIsIon
LIrougI LIe pussIve smokIng cuuses dIseuse debucIe. Muny newspuper
reIerences, wILI VIcLorIu, AusLruIIu, us u cuse exumpIe, ure used Lo
demonsLruLe InLensIIyIng oI LIe superIorILy syndrome und envIronmenLuI
somuLIzuLIon syndrome. TIese ure eIuboruLe Lerms Ior psycIoIogIcuI
denIuI und projecLIon; In some IL Is munIIesLed us uIrs oI superIorILy, In
oLIers us vIcLImIood und sympLoms. TIe Iunguuge oI Ieur Is consIdered.
TIe more IrruLIonuI Ieur Is cosseLed, LIe more nIL-pIckIng does IL become
In percepLIon oI dunger und demunds Ior proLecLIon. TIe IeurIuI cun go
Lo exLruordInury IengLIs In seII-proLecLIon, purLIcuIurIy wIen LIe
menLuIILy Is IegILImIzed by Iuke scIence. TIe uIrs oI superIorILy become
more cunLunkerous und, evenLuuIIy, IosLIIe.
SocIeLIes In LIe grIp oI LIe muLerIuIIsL munIIesLo, LIuL Iuve
ucLIveIy jeLLIsoned uny vesLIge oI un ubsoIuLe moruI Irumework (e.g.,
CIrIsLIunILy), now Iuve progressIveIy more oI LIeIr membersIIp In
LroubIed menLuI sLuLes, bereIL oI uny LrunscendenLuI meunIng und modes
oI uddress. TroubIed mInds, unwIIIIng Lo uddress probIems wIere LIey
occur (InLernuIIy), projecL InLernuI conIIIcL ouLwurd. ExLernuIILIes LIen
uppeur dungerous, LIe greuLer LIe InLernuI conIIIcL, LIe more
dungerous seem LIe exLernuIILIes. TIIs underIIes mucI conLemporury
obsessIon wILI LIe envIronmenL und purLIcuIurIy unLIsmokIng. SmokIng
und exposure Lo smoke Iuve been munuIucLured InLo u conduIL Ior
projecLed Inner conIIIcL, I.e., u conLemporury scupegouL, bIgoLry.
n LIe IInuI cIupLer, LIe sLuLus oI unIversILy sLrucLure Is
consIdered. TIe concIusIon Is LIuL unIversILIes ure under muLerIuIIsL
domInuLIon. WIere one wouId Iuve expecLed scIoIursIIp Lo runge ucross
LIe scIences und IumunILIes und, so, provIdIng some sembIunce oI
buIunced perspecLIve, unIversILIes ure now uIso under muLerIuIIsL
domInuLIon; LIe unIversILy Ius been reduced Lo u gIorIIIed InsLILuLe oI
LecInoIogy. AnLIsmokIng Ius been uIIowed Lo proIIIeruLe under LIIs
14
14
Rampant Antismoking Signifies Grave Danger
muLerIuIIsLJmedIco-muLerIuIIsL domInuLIon oI unIversILIes; key non-
reducLIonIsL dIscIpIInes (e.g., psycIoIogy), LIuL couId properIy quesLIon
LIe ussuuIL on menLuI und socIuI IeuILI LIuL occurs LIrougI muLerIuIIsm,
Iuve been sLIIIed. TIe rIse oI monomunIucuI (sIngIe-Issue) Iobby groups Is
consIdered. TIIs rIse Ius u sImIIur LIme-course us LIe IncepLIon oI LIe
muLerIuIIsL munIIesLo In LIe mId-1q;o`s. n LIe mIdsL oI u IIgIIy
IrugmenLed socIuI Irumework, sIngIe-Issue Iobby groups, wIIcI, by
deIInILIon, Iuck perspecLIve, cun wIeId consIderubIe poIILIcuI power; ucuLe
IIxuLIons ure now IeudIng LIe wuy In pubIIc poIIcy.
TIere Is uIso un exumInuLIon oI LIe sImIIurILIesJdIIIerences
beLween LIe currenL muLerIuIIsL domInuLIon und LIuL oI NuzI Germuny.
TIe concIusIon Is LIuL LIere ure gIurIng sImIIurILIes, purLIcuIurIy LIe
muLerIuIIsL domInuLIon oI medIcIne und ucudemIu. TIere Is consIdered LIe
roIe oI IumunIsm, u more embeIIIsIed Iorm oI beIuvIorIsm, In LIe
IosLerIng oI moruI reIuLIvIsm und IIberuIIsm. TemporurIIy, LIIs produces u
bIurred sLuLe LIuL Ius usceLIc und IIberuI Iorms oI muLerIuIIsm
IuncLIonIng sImuILuneousIy. However, IndIcuLIons ure LIuL IL Is LIe Iormer
LIuL wIII uILImuLeIy ruIe, und superIIcIuIIy und IursIIy so. TIe IuLLer
sImpIy provIdes Lemporury supporL In dIsmunLIIng uny reIerence Lo un
ubsoIuLe, IIrsL-prIncIpIes meLupIysIcs. n conLemporury Lerms, some oI
LIIs bIurry muLerIuIIsm goes by LIe nume oI poIILIcuI correcLness.
InuIIy, LIere Is consIdered unLIsmokIng und CIrIsLIunILy.
AnLIsmokIng Ius usuuIIy Iud u medIcuI undJor reIIgIous LIeme. L Is
IndIcuLed LIuL CIrIsLIun unLIsmokIng InvoIves LIe sume superIIcIuI
menLuIILy us medIcuI or scIenLIIIc unLIsmokIng; IL Is LIe one sIuIIow
menLuIILy LIuL Is cupubIe oI IIjuckIng scIence or u reIIgIous Irumework. L
Is demonsLruLed LIuL muLerIuIIsm und CIrIsLIunILy ure unLILIeLIcuI. TIe
recenL und dIsLurbIng udopLIon oI un unLIsmokIng sLunce by mujor
CIrIsLIun groups Is uIso consIdered us moruI Iukery; consIderubIe
scrIpLure wIII be scruLInIzed In LIIs regurd. CurrenLIy, LIe beIIeIs oI muny
supposed CIrIsLIuns ure noL uII Loo dIIIerenL Irom LIe muLerIuIIsL, cuIL
beIIeIs oI LIe LIme.
TIIs muLerIuIIsL domInuLIon, or LIe conLempL Ior spIrILuuI,
moruI, socIuI, und psycIoIogIcuI dImensIons oI LIe Iumun condILIon, Is
InLerpreLed In bIbIIcuI Lerms. WIuL Is uIreudy u meLupIysIcuI crIsIs
IndIcuLes ImmInenL dIsusLer on u grund scuIe. NoLwILIsLundIng mun-mude
cuLusLropIe, God-gIven Iope Is ever-presenL.
TIe currenL dIscussIon Is un uLLempL Lo recIuIm u generuIIsL,
muILI-dImensIonuI Irumework und, LIereIore, u more buIunced
perspecLIve. L wIII cover consIderubIe ground - bIoIogIcuI, psycIoIogIcuI,
socIuIJreIuLIonuI, moruI, IeguI, spIrILuuI Issues. UndersLundubIy, In sucI u
Iurge work some Issues wIII receIve more uLLenLIon LIun oLIers. L Is
Introduction
InLended us u sLurLIng poInL LIuL oLIers mIgIL expund upon. ApoIogIes ure
exLended Irom LIe ouLseL Ior LIe InevILubIe repeLILIons LIuL occur gIven
convergIng und InLerLwInIng LIemes.
AILIougI deuIIng wILI, uL LImes, compIex muLLers LIuL
presuppose IeveIs oI ucudemIc LruInIng, LIIs dIscussIon Is reuIIy InLended
Ior LIe generuI pubIIc; LIe crILIcuI LIemes oI LIe LIme ure oI ImporLunce Lo
uII. UnIorLunuLeIy, LIe IIrsL Iew cIupLers necessurIIy need Lo deuI wILI
sLuLIsLIcuI und LecInIcuI InIormuLIon. However, LIe uLLempL Ius been Lo
presenL LIIs InIormuLIon und urgumenL In us sLruIgILIorwurd u munner us
possIbIe. QuoLuLIons ure used IIberuIIy wILI LIe InLenL oI IucIIILuLIng
undersLundIng - LIe generuI pubIIc muy noL Iuve LIe LIme Ior IumIIIurI-
zuLIon or LIe uccess Lo buckground reseurcI InIormuLIon. TIe concIudIng
cIupLers open Lo u muILI-dImensIonuI Irumework und Issues LIuL muny
cun IdenLIIy wILI. L Is Ioped LIuL negoLIuLIng LIe proceedIng dIscussIon Is
spIrILuuIIy und InLeIIecLuuIIy InvIgoruLIng uL u LIme wIere LIe duIIness,
duILness, und superIIcIuIILy oI muLerIuIIsm LemporurIIy reIgns: or LIose
LIuL cun dIscern u meLupIysIcuI crIsIs, IL Is Ioped LIuL LIe dIscussIon
Ieuves LIe reuder more InsIgILIuI Lo LIe sIgns oI LIe LIme und Iope-IIIIed
by LIe TruLI wIIcI Is Iur beyond LIe unLIcs, vunILy und seII-deIusIon oI LIe
currenLIy-prevuIIIng sIuIIow menLuIILy.
15
15
Rampant Antismoking Signifies Grave Danger
muLerIuIIsLJmedIco-muLerIuIIsL domInuLIon oI unIversILIes; key non-
reducLIonIsL dIscIpIInes (e.g., psycIoIogy), LIuL couId properIy quesLIon
LIe ussuuIL on menLuI und socIuI IeuILI LIuL occurs LIrougI muLerIuIIsm,
Iuve been sLIIIed. TIe rIse oI monomunIucuI (sIngIe-Issue) Iobby groups Is
consIdered. TIIs rIse Ius u sImIIur LIme-course us LIe IncepLIon oI LIe
muLerIuIIsL munIIesLo In LIe mId-1q;o`s. n LIe mIdsL oI u IIgIIy
IrugmenLed socIuI Irumework, sIngIe-Issue Iobby groups, wIIcI, by
deIInILIon, Iuck perspecLIve, cun wIeId consIderubIe poIILIcuI power; ucuLe
IIxuLIons ure now IeudIng LIe wuy In pubIIc poIIcy.
TIere Is uIso un exumInuLIon oI LIe sImIIurILIesJdIIIerences
beLween LIe currenL muLerIuIIsL domInuLIon und LIuL oI NuzI Germuny.
TIe concIusIon Is LIuL LIere ure gIurIng sImIIurILIes, purLIcuIurIy LIe
muLerIuIIsL domInuLIon oI medIcIne und ucudemIu. TIere Is consIdered LIe
roIe oI IumunIsm, u more embeIIIsIed Iorm oI beIuvIorIsm, In LIe
IosLerIng oI moruI reIuLIvIsm und IIberuIIsm. TemporurIIy, LIIs produces u
bIurred sLuLe LIuL Ius usceLIc und IIberuI Iorms oI muLerIuIIsm
IuncLIonIng sImuILuneousIy. However, IndIcuLIons ure LIuL IL Is LIe Iormer
LIuL wIII uILImuLeIy ruIe, und superIIcIuIIy und IursIIy so. TIe IuLLer
sImpIy provIdes Lemporury supporL In dIsmunLIIng uny reIerence Lo un
ubsoIuLe, IIrsL-prIncIpIes meLupIysIcs. n conLemporury Lerms, some oI
LIIs bIurry muLerIuIIsm goes by LIe nume oI poIILIcuI correcLness.
InuIIy, LIere Is consIdered unLIsmokIng und CIrIsLIunILy.
AnLIsmokIng Ius usuuIIy Iud u medIcuI undJor reIIgIous LIeme. L Is
IndIcuLed LIuL CIrIsLIun unLIsmokIng InvoIves LIe sume superIIcIuI
menLuIILy us medIcuI or scIenLIIIc unLIsmokIng; IL Is LIe one sIuIIow
menLuIILy LIuL Is cupubIe oI IIjuckIng scIence or u reIIgIous Irumework. L
Is demonsLruLed LIuL muLerIuIIsm und CIrIsLIunILy ure unLILIeLIcuI. TIe
recenL und dIsLurbIng udopLIon oI un unLIsmokIng sLunce by mujor
CIrIsLIun groups Is uIso consIdered us moruI Iukery; consIderubIe
scrIpLure wIII be scruLInIzed In LIIs regurd. CurrenLIy, LIe beIIeIs oI muny
supposed CIrIsLIuns ure noL uII Loo dIIIerenL Irom LIe muLerIuIIsL, cuIL
beIIeIs oI LIe LIme.
TIIs muLerIuIIsL domInuLIon, or LIe conLempL Ior spIrILuuI,
moruI, socIuI, und psycIoIogIcuI dImensIons oI LIe Iumun condILIon, Is
InLerpreLed In bIbIIcuI Lerms. WIuL Is uIreudy u meLupIysIcuI crIsIs
IndIcuLes ImmInenL dIsusLer on u grund scuIe. NoLwILIsLundIng mun-mude
cuLusLropIe, God-gIven Iope Is ever-presenL.
TIe currenL dIscussIon Is un uLLempL Lo recIuIm u generuIIsL,
muILI-dImensIonuI Irumework und, LIereIore, u more buIunced
perspecLIve. L wIII cover consIderubIe ground - bIoIogIcuI, psycIoIogIcuI,
socIuIJreIuLIonuI, moruI, IeguI, spIrILuuI Issues. UndersLundubIy, In sucI u
Iurge work some Issues wIII receIve more uLLenLIon LIun oLIers. L Is
Introduction
InLended us u sLurLIng poInL LIuL oLIers mIgIL expund upon. ApoIogIes ure
exLended Irom LIe ouLseL Ior LIe InevILubIe repeLILIons LIuL occur gIven
convergIng und InLerLwInIng LIemes.
AILIougI deuIIng wILI, uL LImes, compIex muLLers LIuL
presuppose IeveIs oI ucudemIc LruInIng, LIIs dIscussIon Is reuIIy InLended
Ior LIe generuI pubIIc; LIe crILIcuI LIemes oI LIe LIme ure oI ImporLunce Lo
uII. UnIorLunuLeIy, LIe IIrsL Iew cIupLers necessurIIy need Lo deuI wILI
sLuLIsLIcuI und LecInIcuI InIormuLIon. However, LIe uLLempL Ius been Lo
presenL LIIs InIormuLIon und urgumenL In us sLruIgILIorwurd u munner us
possIbIe. QuoLuLIons ure used IIberuIIy wILI LIe InLenL oI IucIIILuLIng
undersLundIng - LIe generuI pubIIc muy noL Iuve LIe LIme Ior IumIIIurI-
zuLIon or LIe uccess Lo buckground reseurcI InIormuLIon. TIe concIudIng
cIupLers open Lo u muILI-dImensIonuI Irumework und Issues LIuL muny
cun IdenLIIy wILI. L Is Ioped LIuL negoLIuLIng LIe proceedIng dIscussIon Is
spIrILuuIIy und InLeIIecLuuIIy InvIgoruLIng uL u LIme wIere LIe duIIness,
duILness, und superIIcIuIILy oI muLerIuIIsm LemporurIIy reIgns: or LIose
LIuL cun dIscern u meLupIysIcuI crIsIs, IL Is Ioped LIuL LIe dIscussIon
Ieuves LIe reuder more InsIgILIuI Lo LIe sIgns oI LIe LIme und Iope-IIIIed
by LIe TruLI wIIcI Is Iur beyond LIe unLIcs, vunILy und seII-deIusIon oI LIe
currenLIy-prevuIIIng sIuIIow menLuIILy.
16
16
1.
Some Bockground & Definitions
:.: Probcbilit cnd the Concept oj Risl
ProbubIIILy, us opposed Lo sureLy, Is u meusure oI uncerLuInLy. L
Is u mucI used concepL In LIe unuIysIs oI InIormuLIon. One IuIrIy sImpIe
munner In wIIcI IL cun be used Is us u meusure oI LIe ussocIuLIon
(correIuLIon) oI one IucLor (Y) us u IuncLIon oI unoLIer IucLor (X), I.e.,
condILIonuI probubIIILy. TIe probubIIILy Is expressed on u scuIe oI zero Lo
one, und represenLs LIe ruLIo oI LIe number oI observuLIons oI Y dIvIded
by LIe number oI observuLIons oI X. TendencIes Lowurd zero (o) on LIIs
scuIe ure consIdered Lo be poor Lo negIIgIbIe, wIIIsL LendencIes Lowurd one
(1) ure consIdered Lo be moderuLeIy IIgI Lo very IIgI. WILIIn LIIs
probubIIIsLIc Irumework, IL musL be noLed LIuL u degree oI muLIemuLIcuI
ussocIuLIon does noL necessurIIy ImpIy LIuL one IucLor ccuses LIe
occurrence oI unoLIer IucLor. TIe probubIIIsLIc ussumpLIon Is LIuL LIe
ussocIuLIon Is rcndom. TIere muy Indeed be u cuusuI reIuLIonsIIp beLween
IucLors. However, us CIuse (1q;6) IndIcuLes, correIuLIon LecInIques do
noL IdenLIIy LIIs condILIon.
TIe Ideu oI risl reIers Lo LIe probubIIILy oI u purLIcuIur Lype oI
ouLcome - numeIy un cdterse or detrimentcl ouLcome - ussocIuLed wILI u
IucLor. or exumpIe, IL muy be suId LIuL LIere Is u rIsk oI .1o (I.e., 1o ouL oI
1oo) oI IucLor X ussocIuLed wILI IucLor Y. ConLrury Lo popuIur opInIon, LIe
Ideu oI rIsk encompusses u number oI Lypes oI rIsk. TIe Ideu cun be
reIerred Lo uII dImensIons oI LIe Iumun condILIon, I.e., bIoIogIcuI, menLuI,
socIuI, moruI. However, uL LIIs poInL onIy LIose IucLors LIuL Iuve u
correIuLIon wILI u bIoIogIcuI ouLcome sucI us morbIdILy (severe IIIness) or
morLuIILy wIII be consIdered. or exumpIe, LIere muy be u IIIeIong rIsk oI
IIIness or morLuIILy ussocIuLed wILI IucLor X. TIIs cIrcumsLunce Is very
dIIIerenL Lo LIe rIsk(s) ussocIuLed wILI drIvIng u moLor veIIcIe or rock
cIImbIng wIere LIere Is noL onIy u possIbIe extremit oI ouLcome (e.g.,
morLuIILy), buL uIso un immedicc oI ouLcome. TIe rIsk In LIIs IuLLer cuse
Is IIgIer uL younger LIun oIder uges, I.e., conLrury dIsLrIbuLIon oI ouLcome
Lo LIuL Ior IIIeIong rIsk IucLors. AIso, eucI cIrcumsLunce InvoIves u
Some Background & Definitions
dIIIerence In ImpIIcuLed IucLors.
UnLII onIy recenLIy, LIe Ideu oI rIsk, wIIcI LypIcuIIy InvoIves Iow-
IeveI condILIonuI probubIIILIes, und purLIcuIurIy IIIeIong rIsk IucLors, dId
noL IoId u promInenL posILIon In LIe pubIIc conscIousness. RIsk
ussessmenLs were predomInunLIy used by Insurunce compunIes,
bureuucruLs (popuIuLIon sLuLIsLIcs), economIsLs. nsurunce compunIes
ussess LIe reIuLIve dIIIerences beLween uII sorLs oI group subdIvIsIons oI
LIe popuIuLIon uL Iurge (ucLuurIuI unuIyses) Ior uccIdenLs, morbIdILy und
morLuIILy. TIese ure reIerred Lo us ussessmenLs oI relctite risl. or
exumpIe, II zo% oI smokers compured Lo 1% oI nonsmokers demonsLruLe
IIIness, LIe enLIre group oI smokers Is LIen cIurged IIgIer premIums Ior
IeuILI Insurunce. A IIgIer ruLe oI younger LIun oIder drIvers ure InvoIved
In uuLomobIIe uccIdenLs. TIereIore, uII younger drIvers ure cIurged IIgIer
uuLomobIIe Insurunce premIums.
Ouks (zoo1) noLes LIuL some uuLomobIIe Insurunce compunIes
cIurge IIgIer ruLes Ior smokers LIun nonsmokers. TIe ruLIonuIIzuLIon Is
LIuL u IIgIer proporLIon oI smokers ure drInkers, drInkIng und drIvIng ure
more IIgIIy ussocIuLed wILI uccIdenLs, und, LIereIore, uII smokers ure
cIurged IIgIer premIums. TIIs conducL InvoIves IIgIIy quesLIonubIe
generuIIzuLIons Irom Iow-IeveI purLIcuIurs LIuL ure IIgIIy dIscrImInuLory
In nuLure. nsurunce compunIes ure cerLuInIy noL moruI orgunIzuLIons.
ow socIo-economIc sLuLus Is Iur more IIgIIy correIuLed wILI IncIdence oI
dIseuse LIun IIgIer socIo-economIc sLuLus. TIere muy be muny reusons
Ior LIIs dIspurILy. However, II Insurunce compunIes cIurged IIgIer
premIums onIy on LIe busIs oI socIo-economIc sLuLus LIIs wouId be
socIuIIy unuccepLubIe, I.e., LurgeLIng LIose IeusL ubIe Lo uIIord IL. nsurunce
compunIes muneuver uround LIIs by IdenLIIyIng IucLors correIuLed wILI
Iow socIo-economIc sLuLus. or exumpIe, smokIng Is more prevuIenL In LIe
Iower LIun IIgIer socIo-economIc cIuss. WIen Insurunce compunIes
cIurge IIgIer IeuILI premIums Ior uII smokers, u consIderubIe porLIon oI
ILs eIIecL Is LurgeLIng LIe Iower socIo-economIc cIuss. or wIuLever
reusons, LIIs sorL oI conducL, uILIougI us quesLIonubIe, Is socIuIIy
uccepLed. L cerLuInIy cun be suId LIuL Insurunce compunIes wIII conducL
LIemseIves, Iowever quesLIonubIy, Lo LIe exLenL LIuL socIeLy uIIows LIem.
TIe Insurunce compuny upproucI, generuIIy, Is ukIn Lo drIIL-neL IIsIIng
or u sIoLgun upproucI Lo LIe IdenLIIIcuLIon oI LurgeLs; IL InvoIves u
hih deree oI IuIse cIussIIIcuLIons. TIe crILIcuI poInL Iere Is LIuL, In
uddILIon Lo noL beIng moruI orgunIzuLIons, Insurunce compunIes ure uIso
noL scIenLIIIc dIscIpIInes. TIey ure noL uLLempLIng Lo undersLund LIe
cuuses oI purLIcuIur pIenomenu, nor ure LIey uLLempLIng Lo crILIcuIIy
evuIuuLe LIe uppIIcuLIon oI purLIcuIur sLuLIsLIcuI ussumpLIons, e.g.,
IomogeneILy (unIIormILy) oI group membersIIp. TIey ure sImpIy josLIIng
17
17
1.
Some Bockground & Definitions
:.: Probcbilit cnd the Concept oj Risl
ProbubIIILy, us opposed Lo sureLy, Is u meusure oI uncerLuInLy. L
Is u mucI used concepL In LIe unuIysIs oI InIormuLIon. One IuIrIy sImpIe
munner In wIIcI IL cun be used Is us u meusure oI LIe ussocIuLIon
(correIuLIon) oI one IucLor (Y) us u IuncLIon oI unoLIer IucLor (X), I.e.,
condILIonuI probubIIILy. TIe probubIIILy Is expressed on u scuIe oI zero Lo
one, und represenLs LIe ruLIo oI LIe number oI observuLIons oI Y dIvIded
by LIe number oI observuLIons oI X. TendencIes Lowurd zero (o) on LIIs
scuIe ure consIdered Lo be poor Lo negIIgIbIe, wIIIsL LendencIes Lowurd one
(1) ure consIdered Lo be moderuLeIy IIgI Lo very IIgI. WILIIn LIIs
probubIIIsLIc Irumework, IL musL be noLed LIuL u degree oI muLIemuLIcuI
ussocIuLIon does noL necessurIIy ImpIy LIuL one IucLor ccuses LIe
occurrence oI unoLIer IucLor. TIe probubIIIsLIc ussumpLIon Is LIuL LIe
ussocIuLIon Is rcndom. TIere muy Indeed be u cuusuI reIuLIonsIIp beLween
IucLors. However, us CIuse (1q;6) IndIcuLes, correIuLIon LecInIques do
noL IdenLIIy LIIs condILIon.
TIe Ideu oI risl reIers Lo LIe probubIIILy oI u purLIcuIur Lype oI
ouLcome - numeIy un cdterse or detrimentcl ouLcome - ussocIuLed wILI u
IucLor. or exumpIe, IL muy be suId LIuL LIere Is u rIsk oI .1o (I.e., 1o ouL oI
1oo) oI IucLor X ussocIuLed wILI IucLor Y. ConLrury Lo popuIur opInIon, LIe
Ideu oI rIsk encompusses u number oI Lypes oI rIsk. TIe Ideu cun be
reIerred Lo uII dImensIons oI LIe Iumun condILIon, I.e., bIoIogIcuI, menLuI,
socIuI, moruI. However, uL LIIs poInL onIy LIose IucLors LIuL Iuve u
correIuLIon wILI u bIoIogIcuI ouLcome sucI us morbIdILy (severe IIIness) or
morLuIILy wIII be consIdered. or exumpIe, LIere muy be u IIIeIong rIsk oI
IIIness or morLuIILy ussocIuLed wILI IucLor X. TIIs cIrcumsLunce Is very
dIIIerenL Lo LIe rIsk(s) ussocIuLed wILI drIvIng u moLor veIIcIe or rock
cIImbIng wIere LIere Is noL onIy u possIbIe extremit oI ouLcome (e.g.,
morLuIILy), buL uIso un immedicc oI ouLcome. TIe rIsk In LIIs IuLLer cuse
Is IIgIer uL younger LIun oIder uges, I.e., conLrury dIsLrIbuLIon oI ouLcome
Lo LIuL Ior IIIeIong rIsk IucLors. AIso, eucI cIrcumsLunce InvoIves u
Some Background & Definitions
dIIIerence In ImpIIcuLed IucLors.
UnLII onIy recenLIy, LIe Ideu oI rIsk, wIIcI LypIcuIIy InvoIves Iow-
IeveI condILIonuI probubIIILIes, und purLIcuIurIy IIIeIong rIsk IucLors, dId
noL IoId u promInenL posILIon In LIe pubIIc conscIousness. RIsk
ussessmenLs were predomInunLIy used by Insurunce compunIes,
bureuucruLs (popuIuLIon sLuLIsLIcs), economIsLs. nsurunce compunIes
ussess LIe reIuLIve dIIIerences beLween uII sorLs oI group subdIvIsIons oI
LIe popuIuLIon uL Iurge (ucLuurIuI unuIyses) Ior uccIdenLs, morbIdILy und
morLuIILy. TIese ure reIerred Lo us ussessmenLs oI relctite risl. or
exumpIe, II zo% oI smokers compured Lo 1% oI nonsmokers demonsLruLe
IIIness, LIe enLIre group oI smokers Is LIen cIurged IIgIer premIums Ior
IeuILI Insurunce. A IIgIer ruLe oI younger LIun oIder drIvers ure InvoIved
In uuLomobIIe uccIdenLs. TIereIore, uII younger drIvers ure cIurged IIgIer
uuLomobIIe Insurunce premIums.
Ouks (zoo1) noLes LIuL some uuLomobIIe Insurunce compunIes
cIurge IIgIer ruLes Ior smokers LIun nonsmokers. TIe ruLIonuIIzuLIon Is
LIuL u IIgIer proporLIon oI smokers ure drInkers, drInkIng und drIvIng ure
more IIgIIy ussocIuLed wILI uccIdenLs, und, LIereIore, uII smokers ure
cIurged IIgIer premIums. TIIs conducL InvoIves IIgIIy quesLIonubIe
generuIIzuLIons Irom Iow-IeveI purLIcuIurs LIuL ure IIgIIy dIscrImInuLory
In nuLure. nsurunce compunIes ure cerLuInIy noL moruI orgunIzuLIons.
ow socIo-economIc sLuLus Is Iur more IIgIIy correIuLed wILI IncIdence oI
dIseuse LIun IIgIer socIo-economIc sLuLus. TIere muy be muny reusons
Ior LIIs dIspurILy. However, II Insurunce compunIes cIurged IIgIer
premIums onIy on LIe busIs oI socIo-economIc sLuLus LIIs wouId be
socIuIIy unuccepLubIe, I.e., LurgeLIng LIose IeusL ubIe Lo uIIord IL. nsurunce
compunIes muneuver uround LIIs by IdenLIIyIng IucLors correIuLed wILI
Iow socIo-economIc sLuLus. or exumpIe, smokIng Is more prevuIenL In LIe
Iower LIun IIgIer socIo-economIc cIuss. WIen Insurunce compunIes
cIurge IIgIer IeuILI premIums Ior uII smokers, u consIderubIe porLIon oI
ILs eIIecL Is LurgeLIng LIe Iower socIo-economIc cIuss. or wIuLever
reusons, LIIs sorL oI conducL, uILIougI us quesLIonubIe, Is socIuIIy
uccepLed. L cerLuInIy cun be suId LIuL Insurunce compunIes wIII conducL
LIemseIves, Iowever quesLIonubIy, Lo LIe exLenL LIuL socIeLy uIIows LIem.
TIe Insurunce compuny upproucI, generuIIy, Is ukIn Lo drIIL-neL IIsIIng
or u sIoLgun upproucI Lo LIe IdenLIIIcuLIon oI LurgeLs; IL InvoIves u
hih deree oI IuIse cIussIIIcuLIons. TIe crILIcuI poInL Iere Is LIuL, In
uddILIon Lo noL beIng moruI orgunIzuLIons, Insurunce compunIes ure uIso
noL scIenLIIIc dIscIpIInes. TIey ure noL uLLempLIng Lo undersLund LIe
cuuses oI purLIcuIur pIenomenu, nor ure LIey uLLempLIng Lo crILIcuIIy
evuIuuLe LIe uppIIcuLIon oI purLIcuIur sLuLIsLIcuI ussumpLIons, e.g.,
IomogeneILy (unIIormILy) oI group membersIIp. TIey ure sImpIy josLIIng
18
18
Rampant Antismoking Signifies Grave Danger
Ior u gumbIIng udvunLuge, I.e., economIc opporLunIsm.
ow-IeveI rIsk, oI ILseII, consLILuLes u IIImsy, unsLubIe IeveI oI
evIdence LIuL Is compIeLeIy subjecLIve. I IL Is consIdered LIuL LIe
unIverse oI correIuLIons Is poLenLIuIIy InIInILe, LIen Iow IeveIs oI
correIuLIon beLween Lwo IucLors Iuve u very IIgI IIkeIIIood oI sImpIy
reIIecLIng LIe poLenLIuIIy numerous cross-correIuLIons (overIuppIng
covurIunLs) beLween Lwo IucLors. nLerpreLuLIons oI Iow-IeveI correIuLIons
ure open Lo wIIm, peLuIunce, IusLIness, supersLILIon, neurosIs, wIId
specuIuLIon, opporLunIsm. TIe use oI Iow-IeveI rIsk Lo dIrecL personuI
judgemenL Is noL onIy ukIn Lo u gumbIe, buL wouId uIso be consIdered us
neuroLIc (I.e., IrruLIonuI) In psycIoIogIcuI Lerms. TIe concepL oI neurosis
covers u wIde runge oI menLuI dysIuncLIon, e.g., unxIeLy dIsorders,
IypocIondrIu, pIobIus. However, LIey uII usuuIIy InvoIve some Iorm oI
menLuI conIIIcL und exuggeruLIon oI reucLIon Lo evenLs (e.g., see BuIIock &
SLuIIybruss, 1q8z, p.qzo). TIe preIIx over Lo purLIcuIur LIougIL und
conducL Is un upL cIurucLerIzuLIon, e.g., over-compensuLIng, over-
proLecLIve, over-reucLIve, over-deIensIve, over-conLroIIIng. SInce Iow-IeveI
rIsk reIIecLs un uLypIcuI ussocIuLIon, LIen InordInuLe reucLIvILy reIIecLs u
cuLusLropIIzuLIon oI LIe uLypIcuI, I.e., mukes LIe uLypIcuI seem LypIcuI
und LIe LypIcuI seem uLypIcuI.
n LIe pusL, uILIougI persons Iuve been quILe Iree Lo ussess rIsk
IucLors In uny wuy LIey see IIL, pubIIc poIIcy Ius reusonubIy proLecLed LIe
normuLIve (LypIcuI) runge oI ussocIuLIons; pubIIc poIIcy wus uncIored Lo
LIe LypIcuI, und noL LIe uLypIcuI.
:.z Determinism cnd the Edicts oj Scientijic Enquir
TIe gouI oI scIence, us u mode oI enquIry, Is LIe IdenLIIIcuLIon oI
stron predIcLors Ior evenLs und Lo produce meunIngIuI expIunuLIons
(LIeorIes) LIuL ussIsL Iumuns In negoLIuLIng LIeIr envIronmenL (e.g.,
Berger, 1qq;, p.o6). Ls uLLempL Is Lo Lrunscend mere wIIm, peLuIunce,
specuIuLIon, neurosIs, eLc.. ScIenLIIIc enquIry Is predIcuLed on LIe
pIIIosopIy oI loiccl posititism und LIe hpothetico-deductite meLIod. A
brIeI und reusonubIe uccounL oI LIese cun be Iound In CIonInger (1qq6,
p.18-zo).
Loiccl posititism posILs LIuL LIe concern oI scIence Is wILI
dIrecLIy observubIe pIenomenu. As sucI, IL Is mctericlist In dIsposILIon. L
Is uIso reductionist In LIuL, Ior LIIs pIIIosopIy, uII reIerences Lo non-
muLerIuI (meLupIysIcuI) sLuLes or proposILIons (e.g., God, mInd) eILIer do
noL exIsL or ure reducIbIe Lo muLerIuI pIenomenu. MInd, Ior exumpIe, Is
consIdered Lo be un IIIusIon generuLed by un underIyIng neurocIemIsLry
(epi-phenomenclism). A person Is undersLood us onl u bIoIogIcuI
Some Background & Definitions
orgunIsm. ogIcuI posILIvIsm uIso resLs on LIe ussumpLIon LIuL u subseL oI
uII correIuLIons ure cuusuIIy (non-rundom) deIIned. TIereIore, observubIe
pIenomenu ure InvesLIguLed wILIIn u deLermInIsLIc (cuusuI) Irumework
und wIere LIe prImury IuncLIon oI LIe scIenLIIIc endeuvor Is LIe
IdenLIIIcuLIon oI unique cntecedents Ior consequents, sucI LIuL IL cun be
sLuLed wILI u IIgI degree oI conIIdence LIuL X cuuses Y. TIIs
pInpoInLIng gouI Is In compIeLe conLrusL Lo, Ior exumpIe, LIe drIIL-neL
IIsIIng or sIoLgun upproucIes oI Insurunce compunIes. ogIcuI
posILIvIsm Is by no meuns u deIInILIve worId vIew. OLIer vIews reusonubIy
uIIow Ior LIe unIqueness und InvesLIguLIon oI menLuI sLuLes und
meLupIysIcuI proposILIons, e.g., pIenomenoIogy, exIsLenLIuI psycIoIogy
(see uIso edermunn, 1q86). SucI vIews resL on LIe ussumpLIon LIuL u
subseL oI uII correIuLIons ure neILIer rundom nor cuusuI, buL ure deIIned In
Lerms oI, uL IeusL, moLIves und reusons. TIIs dIsLIncLIon beLween
pIIIosopIIcuI vIews wIII be crILIcuI In u IuLer uspecL oI LIe dIscussIon In
LIuL muLerIuIIsm (deLermInIsm) cunnoL uccounL Ior sucI Ideus us Iree wIII,
IIgIerJIower Iumun sLuLes (I.e., poLenLIuI Ior Lrunscendence), or even Ior
LIe Ideu oI psycIoIogIcuI IeuILI.
Very generuIIy, LIe Lerm psycIoIogIcuI, us used In LIIs
dIscussIon, wIII reIer Lo u dIsLIncL und cctucl IeveI oI ucLIvILy wIIcI Is non-
muLerIuI uILIougI LIere muy be degrees oI muLerIuI correIuLes.
PsycIoIogIcuI IeuILI wIII reIer Lo LIe coIerence oI InIormuLIon used uL u
psycIoIogIcuI IeveI. TIe Lerm psycIosocIuI or socIuI wIII reIer Lo LIe
reIuLIonuI excIunges beLween persons. PsycIosocIuI IeuILI wIII reIer Lo
LIe coIerence oI InIormuLIon used In reIuLIonuI excIunges. TIe Lerm
moruI wIII very busIcuIIy reIer Lo LIe uccurucy (coIerence) oI
InIormuLIon generuLed Ior psycIoIogIcuI und psycIosocIuI IuncLIonIng und
crILIcuIIy ImpIIcuLes LIe Ideu oI IonesLy. MoruI IeuILI wIII reIer Lo LIe
cupucILy oI uny Iumun coIIecLIve Lo crILIcuIIy evuIuuLe InIormuLIon Ior LIe
uLLrIbuLe oI coIerence. SpIrILuuI Irumeworks, us underIyIng u coIerenL
moruI Irumework, wIII be dIscussed In IuLer cIupLers.
Hpothetico-Deductite Method: TIIs meLIod requIres LIuL
LesLubIe IypoLIeses ure deduced (IogIcuI conLInuILy) Irom generuI
LIeoreLIcuI proposILIons. A crILIcuI prIncIpIe LIuL IInks LesLubIIILy oI
IypoLIeses und LIe muLerIuIIsL vIewpoInL Is jclsijicbilit. TIIs prIncIpIe
requIres LIuL LesLubIe sLuLes oI uIIuIrs (IypoLIeses) musL be cIeurIy
specIIIed Ior wIIcI u generuI proposILIon cun be conIIrmed or
dIsconIIrmed. I u generuI LIeoreLIcuI proposILIon LIuL deIInes LIe
reIuLIonsIIp beLween X und Y us ccuscl, by deIInIng uLLrIbuLes und
properLIes oI LIe pIenomenu concerned, Is Lrue und IuIsIIIubIe, LIen LIe
muLIemuLIcuI (sLuLIsLIcuI) reIuLIonsIIp beLween udequuLe meusures oI X
und Y sIouId be ter hih (e.g., condILIonuI probubIIILy >.6). n LIIs
19
19
Rampant Antismoking Signifies Grave Danger
Ior u gumbIIng udvunLuge, I.e., economIc opporLunIsm.
ow-IeveI rIsk, oI ILseII, consLILuLes u IIImsy, unsLubIe IeveI oI
evIdence LIuL Is compIeLeIy subjecLIve. I IL Is consIdered LIuL LIe
unIverse oI correIuLIons Is poLenLIuIIy InIInILe, LIen Iow IeveIs oI
correIuLIon beLween Lwo IucLors Iuve u very IIgI IIkeIIIood oI sImpIy
reIIecLIng LIe poLenLIuIIy numerous cross-correIuLIons (overIuppIng
covurIunLs) beLween Lwo IucLors. nLerpreLuLIons oI Iow-IeveI correIuLIons
ure open Lo wIIm, peLuIunce, IusLIness, supersLILIon, neurosIs, wIId
specuIuLIon, opporLunIsm. TIe use oI Iow-IeveI rIsk Lo dIrecL personuI
judgemenL Is noL onIy ukIn Lo u gumbIe, buL wouId uIso be consIdered us
neuroLIc (I.e., IrruLIonuI) In psycIoIogIcuI Lerms. TIe concepL oI neurosis
covers u wIde runge oI menLuI dysIuncLIon, e.g., unxIeLy dIsorders,
IypocIondrIu, pIobIus. However, LIey uII usuuIIy InvoIve some Iorm oI
menLuI conIIIcL und exuggeruLIon oI reucLIon Lo evenLs (e.g., see BuIIock &
SLuIIybruss, 1q8z, p.qzo). TIe preIIx over Lo purLIcuIur LIougIL und
conducL Is un upL cIurucLerIzuLIon, e.g., over-compensuLIng, over-
proLecLIve, over-reucLIve, over-deIensIve, over-conLroIIIng. SInce Iow-IeveI
rIsk reIIecLs un uLypIcuI ussocIuLIon, LIen InordInuLe reucLIvILy reIIecLs u
cuLusLropIIzuLIon oI LIe uLypIcuI, I.e., mukes LIe uLypIcuI seem LypIcuI
und LIe LypIcuI seem uLypIcuI.
n LIe pusL, uILIougI persons Iuve been quILe Iree Lo ussess rIsk
IucLors In uny wuy LIey see IIL, pubIIc poIIcy Ius reusonubIy proLecLed LIe
normuLIve (LypIcuI) runge oI ussocIuLIons; pubIIc poIIcy wus uncIored Lo
LIe LypIcuI, und noL LIe uLypIcuI.
:.z Determinism cnd the Edicts oj Scientijic Enquir
TIe gouI oI scIence, us u mode oI enquIry, Is LIe IdenLIIIcuLIon oI
stron predIcLors Ior evenLs und Lo produce meunIngIuI expIunuLIons
(LIeorIes) LIuL ussIsL Iumuns In negoLIuLIng LIeIr envIronmenL (e.g.,
Berger, 1qq;, p.o6). Ls uLLempL Is Lo Lrunscend mere wIIm, peLuIunce,
specuIuLIon, neurosIs, eLc.. ScIenLIIIc enquIry Is predIcuLed on LIe
pIIIosopIy oI loiccl posititism und LIe hpothetico-deductite meLIod. A
brIeI und reusonubIe uccounL oI LIese cun be Iound In CIonInger (1qq6,
p.18-zo).
Loiccl posititism posILs LIuL LIe concern oI scIence Is wILI
dIrecLIy observubIe pIenomenu. As sucI, IL Is mctericlist In dIsposILIon. L
Is uIso reductionist In LIuL, Ior LIIs pIIIosopIy, uII reIerences Lo non-
muLerIuI (meLupIysIcuI) sLuLes or proposILIons (e.g., God, mInd) eILIer do
noL exIsL or ure reducIbIe Lo muLerIuI pIenomenu. MInd, Ior exumpIe, Is
consIdered Lo be un IIIusIon generuLed by un underIyIng neurocIemIsLry
(epi-phenomenclism). A person Is undersLood us onl u bIoIogIcuI
Some Background & Definitions
orgunIsm. ogIcuI posILIvIsm uIso resLs on LIe ussumpLIon LIuL u subseL oI
uII correIuLIons ure cuusuIIy (non-rundom) deIIned. TIereIore, observubIe
pIenomenu ure InvesLIguLed wILIIn u deLermInIsLIc (cuusuI) Irumework
und wIere LIe prImury IuncLIon oI LIe scIenLIIIc endeuvor Is LIe
IdenLIIIcuLIon oI unique cntecedents Ior consequents, sucI LIuL IL cun be
sLuLed wILI u IIgI degree oI conIIdence LIuL X cuuses Y. TIIs
pInpoInLIng gouI Is In compIeLe conLrusL Lo, Ior exumpIe, LIe drIIL-neL
IIsIIng or sIoLgun upproucIes oI Insurunce compunIes. ogIcuI
posILIvIsm Is by no meuns u deIInILIve worId vIew. OLIer vIews reusonubIy
uIIow Ior LIe unIqueness und InvesLIguLIon oI menLuI sLuLes und
meLupIysIcuI proposILIons, e.g., pIenomenoIogy, exIsLenLIuI psycIoIogy
(see uIso edermunn, 1q86). SucI vIews resL on LIe ussumpLIon LIuL u
subseL oI uII correIuLIons ure neILIer rundom nor cuusuI, buL ure deIIned In
Lerms oI, uL IeusL, moLIves und reusons. TIIs dIsLIncLIon beLween
pIIIosopIIcuI vIews wIII be crILIcuI In u IuLer uspecL oI LIe dIscussIon In
LIuL muLerIuIIsm (deLermInIsm) cunnoL uccounL Ior sucI Ideus us Iree wIII,
IIgIerJIower Iumun sLuLes (I.e., poLenLIuI Ior Lrunscendence), or even Ior
LIe Ideu oI psycIoIogIcuI IeuILI.
Very generuIIy, LIe Lerm psycIoIogIcuI, us used In LIIs
dIscussIon, wIII reIer Lo u dIsLIncL und cctucl IeveI oI ucLIvILy wIIcI Is non-
muLerIuI uILIougI LIere muy be degrees oI muLerIuI correIuLes.
PsycIoIogIcuI IeuILI wIII reIer Lo LIe coIerence oI InIormuLIon used uL u
psycIoIogIcuI IeveI. TIe Lerm psycIosocIuI or socIuI wIII reIer Lo LIe
reIuLIonuI excIunges beLween persons. PsycIosocIuI IeuILI wIII reIer Lo
LIe coIerence oI InIormuLIon used In reIuLIonuI excIunges. TIe Lerm
moruI wIII very busIcuIIy reIer Lo LIe uccurucy (coIerence) oI
InIormuLIon generuLed Ior psycIoIogIcuI und psycIosocIuI IuncLIonIng und
crILIcuIIy ImpIIcuLes LIe Ideu oI IonesLy. MoruI IeuILI wIII reIer Lo LIe
cupucILy oI uny Iumun coIIecLIve Lo crILIcuIIy evuIuuLe InIormuLIon Ior LIe
uLLrIbuLe oI coIerence. SpIrILuuI Irumeworks, us underIyIng u coIerenL
moruI Irumework, wIII be dIscussed In IuLer cIupLers.
Hpothetico-Deductite Method: TIIs meLIod requIres LIuL
LesLubIe IypoLIeses ure deduced (IogIcuI conLInuILy) Irom generuI
LIeoreLIcuI proposILIons. A crILIcuI prIncIpIe LIuL IInks LesLubIIILy oI
IypoLIeses und LIe muLerIuIIsL vIewpoInL Is jclsijicbilit. TIIs prIncIpIe
requIres LIuL LesLubIe sLuLes oI uIIuIrs (IypoLIeses) musL be cIeurIy
specIIIed Ior wIIcI u generuI proposILIon cun be conIIrmed or
dIsconIIrmed. I u generuI LIeoreLIcuI proposILIon LIuL deIInes LIe
reIuLIonsIIp beLween X und Y us ccuscl, by deIInIng uLLrIbuLes und
properLIes oI LIe pIenomenu concerned, Is Lrue und IuIsIIIubIe, LIen LIe
muLIemuLIcuI (sLuLIsLIcuI) reIuLIonsIIp beLween udequuLe meusures oI X
und Y sIouId be ter hih (e.g., condILIonuI probubIIILy >.6). n LIIs
20
20
Rampant Antismoking Signifies Grave Danger
InsLunce, LIe observed reIuLIonsIIp wouId provIde conIIrmuLIon Ior LIe
generuI LIeoreLIcuI proposILIon. urLIermore, LIe muLIemuLIcuI
ussocIuLIon (correIuLIon) beLween meusures oI observubIe pIenomenu,
uILIougI probubIIIsLIc und noL deLermInIsLIc, provIdes evIdence Lo supporL
u generuI cuusuI proposILIon uL IIgI IeveIs oI condILIonuI probubIIILy.
TIereIore, IL musL be noLed LIuL Ior LIe purposes oI LIIs dIscussIon,
stctisticclism (non-cuusuI, sLuLIsLIcuI, possIbIe buL ImprobubIe) wIII reIer
Lo LIe Iower runge (o<p<.) oI LIe condILIonuI probubIIILy scuIe und Is LIe
reuIm oI IIgI und wIId specuIuLIon or opporLunIsm (e.g., Insurunce
Irumework). n conLrusL, cuusuI (deLermInIsLIc) proposILIons wIII reIer Lo
LIe upper runge oI LIe condILIonuI probubIIILy scuIe (>.6).
Principles oj Ccuscl Relctionships cnd Ccuscl Theor: CuusuI
urgumenL resLs on LIe proposILIon LIuL u purLIcuIur reIuLIonsIIp IoIds
beLween evenLs sucI LIuL deIInubIe properLIesJuLLrIbuLes oI one
pIenomenon produce u consIsLenL cIunge (eIIecL) In LIe properLIesJ
uLLrIbuLes oI unoLIer pIenomenon. TIe Ideu oI ccuscl relctionship Is u
cornersLone oI scIenLIIIc enquIry. Cuuse, us uppIIed Lo LIe sLuLus oI
purLIcuIur unLecedenLs Ior consequenLs, Is LIe sLrongesL Lerm In LIe
scIenLIIIc vocubuIury. Some crILIcuI prIncIpIes LIuL deIIne u cuusuI
reIuLIonsIIp ure:
(u) ConsIsLency und SpecIIIcILy oI un AssocIuLIon: TIese
Lwo IucLors sIouId be LreuLed us one concern. TIey sImpIy reIIecL u
purLIcuIurILy oI consequenL Ior u purLIcuIurILy oI unLecedenL uL IIgI
condILIonuI probubIIILy IeveIs, I.e., u consIsLenL ussocIuLIon oI one IucLor
Ior unoLIer specIIIc IucLor;
(b) SLrengLI und Degree oI uIsIIIubIIILy oI un AssocIuLIon:
SLrengLI oI un ussocIuLIon uILImuLeIy reIers Lo LIe predictite sLrengLI oI
one IucLor(s) Ior unoLIer. CuusuI urgumenL resLs entirel on u hih deree
(upper runge oI condILIonuI probubIIILy scuIe) oI ussocIuLIon beLween
evenLs. PredIcLIve sLrengLI cun be u meusure oI cbsolute risl. Degree oI
IuIsIIIubIIILy Is rureIy, II ever, menLIoned In LecInIcuI IILeruLure. ConsIder
LIe exumpIe oI u preIImInury InvesLIguLIon oI IIIness X reveuIIng LIuL Lwo
IucLors, Y und Z, overIup enLIreIy und uccounL Ior 8% oI qoo cuses oI
LIe IIIness. However, Y Ius u Irequency ruLe In LIe generuI popuIuLIon oI
z,ooo,ooo, wIIIe Z Ius u Irequency ruLe oI oo. ucLor Z, In LIIs cuse,
Ius u IIgIer (8%xqooJoo= .68) predIcLIve sLrengLI LIun Y (8%
xqooJz,ooo,ooo=.ooo1;). An ussessmenL oI degree oI IuIsIIIubIIILy
IndIcuLes LIuL IucLor Y Ius u IIgIer opporLunILy oI beIng Lrue (yIeIdIng u
posILIve ussocIuLIon) und, LIereIore, Iess opporLunILy oI beIng IuIse,
compured Lo IucLor Z wIIcI Ius u very Iow opporLunILy oI beIng Lrue
und, LIereIore, u very IIgI opporLunILy oI beIng IuIse (yIeIdIng no
ussocIuLIon). Hence, LIe IIgI degree oI IuIsIIIubIIILy provIdes sLrong
Some Background & Definitions
grounds Ior posILIng u cuusuI reIuLIonsIIp beLween IucLor Z und IIIness
Y;
(c) TemporuI ReIuLIonsIIp oI un AssocIuLIon: TIe LemporuI
precedence (unLecedence) oI one IucLor musL be cIeurIy demonsLrubIe.
urLIermore, LIe dIIIerenLIuI posILIonIng In LIme oI un unLecedenL cun be
ussocIuLed wILI dIIIerenLIuI consequenLs;
(d) CoIerence oI un AssocIuLIon: PIuInIy puL, LIIs IucLor
perLuIns Lo wIeLIer LIe reIuLIonsIIp mukes urgumenLuLIve sense und
exLends undersLundIng oI un observed reIuLIonsIIp. Ls ImporLunce
essenLIuIIy reIuLes Lo LIeory buIIdIng und LIe generuLIon oI IurLIer LesLubIe
IypoLIeses.
L wIII be noLed LIuL (u) und (b) ubove ure reuIIy jusL dIIIerenL
wuys oI reIerrIng Lo LIe sume Ideu oI unIqueness oI un unLecedenL Ior u
consequenL; condILIonuI probubIIILy meusures ure uIwuys LIe sume. I LIe
unLecedenL condILIons Ior u purLIcuIur consequenL ure perIecLIy known,
LIen u condILIonuI probubIIILy meusure Ior consIsLencyJspecIIIcILy oI un
ussocIuLIon, degree oI IuIsIIIubIIILyJpredIcLIve sLrengLI oI un ussocIuLIon
wIII be 1.o (1oo%). urLIermore, very IIgI predIcLIve sLrengLI uIone, In
LIe ubsence oI u coIerenL expIunuLIon Ior u reIuLIonsIIp, muy be suIIIcIenL
Lo InIer u cuusuI reIuLIonsIIp. WIereus, u coIerenL cuusuI expIunuLIon In
LIe ubsence oI IIgI predIcLIve sLrengLI Is noLIIng more LIun wIId
specuIuLIon.
TIe crILerIu Ior cuusuI InIerence ouLIIned ubove ure consIsLenL
wILI LIose used by LIe CommILLee (1q6q). As wIII be consIdered In IuLer
secLIons, LIe uppIIcuLIon oI LIese crILerIu by LIe ReporL CommILLee Is uL
consIderubIe vurIunce wILI LIe deIInILIons provIded by LIe currenL
dIscussIon. OLIers, sInce LIe 1q6q ReporL, sucI us HIII (1q6) und Susser
(1q;) Iuve uLLempLed Lo expund LIe crILerIu Ior cuusuI InIerence.
However, regurdIess oI uddILIonuI crILerIu, predIcLIve sLrengLI, und ILs
LuuLoIogIes, Is uIwuys LIe criticcl crILerIon.
TIus Iur, IL cun be undersLood LIuL scIence Is concerned wILI
precIsIon und exucLILude. TIe uLLempL Is Lo dIscern u IucLor or
combInuLIon oI IucLors LIuL yIeId very IIgI consIsLencyJspecIIIcILy, degree
oI IuIsIIIubIIILy und predIcLIve sLrengLI Ior unoLIer IucLor. WIere LIIs Is so,
IL uIIords neur-1oo% uccuruLe cIussIIIcuLIons oI LIose ucLuuIIy uL 1oo% rIsk
oI u consequenL, und neur-o% IuIse cIussIIIcuLIons oI LIose ucLuuIIy uL zero
rIsk oI u consequenL. TIIs Is conLrusLed wILI Iow-rIsk IucLors
(sLuLIsLIcuIIsm) LIuL generuLe neur-1oo% IuIse cIussIIIcuLIons und neur-o%
uccuruLe cIussIIIcuLIons.
A IInuI noLe concerns objectitit. ScIence, und muLerIuIIsm
generuIIy, Ius no InIerenL, coIerenL moruI Irumework. L Is ussumed LIuL
prucLILIoners ImporL IonesL und open-mInded conducL us un uspecL oI
21
21
Rampant Antismoking Signifies Grave Danger
InsLunce, LIe observed reIuLIonsIIp wouId provIde conIIrmuLIon Ior LIe
generuI LIeoreLIcuI proposILIon. urLIermore, LIe muLIemuLIcuI
ussocIuLIon (correIuLIon) beLween meusures oI observubIe pIenomenu,
uILIougI probubIIIsLIc und noL deLermInIsLIc, provIdes evIdence Lo supporL
u generuI cuusuI proposILIon uL IIgI IeveIs oI condILIonuI probubIIILy.
TIereIore, IL musL be noLed LIuL Ior LIe purposes oI LIIs dIscussIon,
stctisticclism (non-cuusuI, sLuLIsLIcuI, possIbIe buL ImprobubIe) wIII reIer
Lo LIe Iower runge (o<p<.) oI LIe condILIonuI probubIIILy scuIe und Is LIe
reuIm oI IIgI und wIId specuIuLIon or opporLunIsm (e.g., Insurunce
Irumework). n conLrusL, cuusuI (deLermInIsLIc) proposILIons wIII reIer Lo
LIe upper runge oI LIe condILIonuI probubIIILy scuIe (>.6).
Principles oj Ccuscl Relctionships cnd Ccuscl Theor: CuusuI
urgumenL resLs on LIe proposILIon LIuL u purLIcuIur reIuLIonsIIp IoIds
beLween evenLs sucI LIuL deIInubIe properLIesJuLLrIbuLes oI one
pIenomenon produce u consIsLenL cIunge (eIIecL) In LIe properLIesJ
uLLrIbuLes oI unoLIer pIenomenon. TIe Ideu oI ccuscl relctionship Is u
cornersLone oI scIenLIIIc enquIry. Cuuse, us uppIIed Lo LIe sLuLus oI
purLIcuIur unLecedenLs Ior consequenLs, Is LIe sLrongesL Lerm In LIe
scIenLIIIc vocubuIury. Some crILIcuI prIncIpIes LIuL deIIne u cuusuI
reIuLIonsIIp ure:
(u) ConsIsLency und SpecIIIcILy oI un AssocIuLIon: TIese
Lwo IucLors sIouId be LreuLed us one concern. TIey sImpIy reIIecL u
purLIcuIurILy oI consequenL Ior u purLIcuIurILy oI unLecedenL uL IIgI
condILIonuI probubIIILy IeveIs, I.e., u consIsLenL ussocIuLIon oI one IucLor
Ior unoLIer specIIIc IucLor;
(b) SLrengLI und Degree oI uIsIIIubIIILy oI un AssocIuLIon:
SLrengLI oI un ussocIuLIon uILImuLeIy reIers Lo LIe predictite sLrengLI oI
one IucLor(s) Ior unoLIer. CuusuI urgumenL resLs entirel on u hih deree
(upper runge oI condILIonuI probubIIILy scuIe) oI ussocIuLIon beLween
evenLs. PredIcLIve sLrengLI cun be u meusure oI cbsolute risl. Degree oI
IuIsIIIubIIILy Is rureIy, II ever, menLIoned In LecInIcuI IILeruLure. ConsIder
LIe exumpIe oI u preIImInury InvesLIguLIon oI IIIness X reveuIIng LIuL Lwo
IucLors, Y und Z, overIup enLIreIy und uccounL Ior 8% oI qoo cuses oI
LIe IIIness. However, Y Ius u Irequency ruLe In LIe generuI popuIuLIon oI
z,ooo,ooo, wIIIe Z Ius u Irequency ruLe oI oo. ucLor Z, In LIIs cuse,
Ius u IIgIer (8%xqooJoo= .68) predIcLIve sLrengLI LIun Y (8%
xqooJz,ooo,ooo=.ooo1;). An ussessmenL oI degree oI IuIsIIIubIIILy
IndIcuLes LIuL IucLor Y Ius u IIgIer opporLunILy oI beIng Lrue (yIeIdIng u
posILIve ussocIuLIon) und, LIereIore, Iess opporLunILy oI beIng IuIse,
compured Lo IucLor Z wIIcI Ius u very Iow opporLunILy oI beIng Lrue
und, LIereIore, u very IIgI opporLunILy oI beIng IuIse (yIeIdIng no
ussocIuLIon). Hence, LIe IIgI degree oI IuIsIIIubIIILy provIdes sLrong
Some Background & Definitions
grounds Ior posILIng u cuusuI reIuLIonsIIp beLween IucLor Z und IIIness
Y;
(c) TemporuI ReIuLIonsIIp oI un AssocIuLIon: TIe LemporuI
precedence (unLecedence) oI one IucLor musL be cIeurIy demonsLrubIe.
urLIermore, LIe dIIIerenLIuI posILIonIng In LIme oI un unLecedenL cun be
ussocIuLed wILI dIIIerenLIuI consequenLs;
(d) CoIerence oI un AssocIuLIon: PIuInIy puL, LIIs IucLor
perLuIns Lo wIeLIer LIe reIuLIonsIIp mukes urgumenLuLIve sense und
exLends undersLundIng oI un observed reIuLIonsIIp. Ls ImporLunce
essenLIuIIy reIuLes Lo LIeory buIIdIng und LIe generuLIon oI IurLIer LesLubIe
IypoLIeses.
L wIII be noLed LIuL (u) und (b) ubove ure reuIIy jusL dIIIerenL
wuys oI reIerrIng Lo LIe sume Ideu oI unIqueness oI un unLecedenL Ior u
consequenL; condILIonuI probubIIILy meusures ure uIwuys LIe sume. I LIe
unLecedenL condILIons Ior u purLIcuIur consequenL ure perIecLIy known,
LIen u condILIonuI probubIIILy meusure Ior consIsLencyJspecIIIcILy oI un
ussocIuLIon, degree oI IuIsIIIubIIILyJpredIcLIve sLrengLI oI un ussocIuLIon
wIII be 1.o (1oo%). urLIermore, very IIgI predIcLIve sLrengLI uIone, In
LIe ubsence oI u coIerenL expIunuLIon Ior u reIuLIonsIIp, muy be suIIIcIenL
Lo InIer u cuusuI reIuLIonsIIp. WIereus, u coIerenL cuusuI expIunuLIon In
LIe ubsence oI IIgI predIcLIve sLrengLI Is noLIIng more LIun wIId
specuIuLIon.
TIe crILerIu Ior cuusuI InIerence ouLIIned ubove ure consIsLenL
wILI LIose used by LIe CommILLee (1q6q). As wIII be consIdered In IuLer
secLIons, LIe uppIIcuLIon oI LIese crILerIu by LIe ReporL CommILLee Is uL
consIderubIe vurIunce wILI LIe deIInILIons provIded by LIe currenL
dIscussIon. OLIers, sInce LIe 1q6q ReporL, sucI us HIII (1q6) und Susser
(1q;) Iuve uLLempLed Lo expund LIe crILerIu Ior cuusuI InIerence.
However, regurdIess oI uddILIonuI crILerIu, predIcLIve sLrengLI, und ILs
LuuLoIogIes, Is uIwuys LIe criticcl crILerIon.
TIus Iur, IL cun be undersLood LIuL scIence Is concerned wILI
precIsIon und exucLILude. TIe uLLempL Is Lo dIscern u IucLor or
combInuLIon oI IucLors LIuL yIeId very IIgI consIsLencyJspecIIIcILy, degree
oI IuIsIIIubIIILy und predIcLIve sLrengLI Ior unoLIer IucLor. WIere LIIs Is so,
IL uIIords neur-1oo% uccuruLe cIussIIIcuLIons oI LIose ucLuuIIy uL 1oo% rIsk
oI u consequenL, und neur-o% IuIse cIussIIIcuLIons oI LIose ucLuuIIy uL zero
rIsk oI u consequenL. TIIs Is conLrusLed wILI Iow-rIsk IucLors
(sLuLIsLIcuIIsm) LIuL generuLe neur-1oo% IuIse cIussIIIcuLIons und neur-o%
uccuruLe cIussIIIcuLIons.
A IInuI noLe concerns objectitit. ScIence, und muLerIuIIsm
generuIIy, Ius no InIerenL, coIerenL moruI Irumework. L Is ussumed LIuL
prucLILIoners ImporL IonesL und open-mInded conducL us un uspecL oI
22
22
Rampant Antismoking Signifies Grave Danger
LIeIr generuI dIsposILIon. WIere objecLIvILy Is IosL, uII Is IosL.
:. Endoenous & Exoenous Icctors cnd the Normctite
Rcne oj Associction,Non-Associction
or LIe purposes oI LIIs dIscussIon, endoenous (InLernuI,
consLILuLIonuI) wIII reIer Lo uny dIscernubIe IucLors IdenLIIIubIe wILI LIe
person (e.g., bIoIogIcuI., geneLIc, menLuI). Exoenous (exLernuI,
envIronmenLuI) wIII reIer Lo IucLors LIuL ure noL uspecLs oI LIe person.
A IurLIer, crILIcuI dIsLIncLIon In cuusuI urgumenL Is suIIIcIenL und
necessury condILIons Ior un eIIecL LIuL derIves Irom LIe NewLonIun
proposILIons I X, LIen Y und I noL X, LIen noL Y (see uIso Jospe,
1q;8, p.xI). TIe Iormer proposILIon IndIcuLes u suIIIcIenL condILIon Ior u
consequenL, wIere In uII or mosL InsLunces oI LIe unLecedenL, LIe
consequenL wIII IoIIow; u suIIIcIenL condILIon cun uIso be reIerred Lo us u
sIngIe IucLor, prImury cuuse oI un eIIecL. TIe IuLLer proposILIon IndIcuLes u
necessury condILIon Ior u consequenL, wIere In uII InsLunces oI LIe
consequenL, LIe unLecedenL wIII Iuve preceded. AILIougI u necessury
condILIon Is uIwuys ussocIuLed wILI LIe consequenL, LIere muy be muny
InsLunces wIere IL occurs wILIouL u purLIcuIur consequenL IoIIowIng, I.e., IL
Is noL u suIIIcIenL condILIon. As sucI, ILs roIe In u cuusuI reIuLIonsIIp Is
secondury, requIrIng oLIer precondILIons Ior ILs secondury roIe Lo Luke
pIuce. urLIermore, us u proporLIon oI IL beIng un occurrence, ILs
ussocIuLIon wILI u purLIcuIur consequenL muy be uLypIcuI. n LIIs sense IL Is
besL consIdered us u LrIgger In LIuL oLIer precondILIons wIII deIIne LIe
crILIcuI uspecLs oI LIe cuusuI reIuLIonsIIp. A IucLor cun uIso be boLI u
suIIIcIenL und u necessury condILIon Ior unoLIer IucLor In LIuL u
consequenL wIII uIwuys und onIy IoIIow u purLIcuIur unLecedenL.
ConsIder LIe exumpIe oI un ucId (A), LIuL Ior u commonIy
encounLered exposure IeveI, Is ussocIuLed wILI LIIrd-degree skIn burns
(consequenL) In 1oo% oI cuses. n LIIs InsLunce, A Is u suIIIcIenL
condILIon Ior LIe consequenL, I.e., wIenever A Is uppIIed Lo LIe skIn, LIe
consequenL In quesLIon wIII IoIIow (perIecL predIcLIve sLrengLI). L cun be
undersLood LIuL LIere muy be consIderubIe vurIuLIon In endogenous
sysLems, e.g., skIn Lype. However, IucLor A cun overrIde some generuI
uLLrIbuLe oI cll endogenous sysLems. TIereIore, IucLor A cun be
consIdered u sinle-jcctor, primcr ccuse oI LIe consequenL. AIso, IucLor
A does noL need Lo be u necessury condILIon, I.e., sImIIur LIIrd-degree
burns muy be ussocIuLed wILI oLIer exLernuI IucLors, Ior IL Lo be
consIdered u sIngIe-IucLor, prImury cuuse oI un eIIecL.
ConsIder unoLIer IucLor (IucLor B) Is ussocIuLed wILI u
pIenomenon (C) In ;o% oI cuses. TIIs ;o% oI cuses cun be consIdered
Some Background & Definitions
us u normctite rcne oI LIe eIIecL. TIe remuInIng o%, wIere no C
occurs, cun be consIdered us u protectite rcne oI non-eIIecL. TIIs sorL oI
sILuuLIon IndIcuLes crILIcuI vurIuLIons In InLernuI sLuLes, e.g., geneLIc, Ior
LIe scope oI eIIecL oI IucLor B. ucLor B cun sLIII be consIdered us u
sIngIe IucLor, prImury cuuse (neur-suIIIcIenL condILIon) oI LIe eIIecL In LIuL
IL Is ussocIuLed wILI LIe eIIecL In LIe greuLer mcjorit oI cuses, I.e., IIgI
predIcLIve sLrengLI.
ConsIder LIuL IucLor B Is now ussocIuLed wILI pIenomenon C
In onIy o% oI cuses. TIe ;o% oI cuses wIere C does noL occur cun be
consIdered us u normuLIve runge oI non-ussocIuLIon. TIe o% oI cuses
ussocIuLed wILI C Is IndIcuLIve oI endoenous jcilure (ubnormuI sLuLe).
TIe greuLer mujorILy oI endogenous sysLems cun udequuLeIy process
exposure Lo IucLor B. One wouId need Lo InvesLIguLe ubnormuIILIes In
endogenous sysLems Lo uccounL Ior LIe eIIecL In LIe o% oI cuses, gIven
LIuL uII oLIer exLernuI exposures ure consLunL. ucLor B cun LIereIore no
Ionger be consIdered us u sIngIe-IucLor, prImury cuuse oI LIe eIIecL In LIuL
IL wouId requIre u combInuLIon oI IucLors (precondILIons) Lo produce LIe
eIIecL. DependIng on wIuL LIe IdenLIIIed endogenous ubnormuIILIes ure,
IucLor B muy sLIII be consIdered us u conLrIbuLIng IucLor Lo LIe eIIecL
(e.g., u LrIgger). However, us un ussocIuLIon beLween IucLors upproucIes
zero, und dependIng on LIe nuLure oI LIe exogenous IucLor, und In LIe
ubsence oI InIormuLIon regurdIng LIe endogenous ubnormuIILIes InvoIved,
even u LrIgger sLuLus Ior IucLor B In LIe ussocIuLIon Is uL IeusL
IndeLermInuLe und poLenLIuIIy nonexIsLenL. urLIermore, II B wus
uIwuys un unLecedenL oI C, buL C wus onIy InIrequenLIy (o%) u
consequenL oI B, LIen B Is u necessury condILIon Ior C.
NormuIILy Is usuuIIy u dIIIIcuIL Ideu Lo udequuLeIy deIIne.
However, us IL perLuIns Lo purLIcuIur endogenous eIIecLs (bIoIogIcuI)
ussocIuLed wILI exposure Lo exLernuI IucLors, u normuLIve runge oI
ussocIuLIonJnon-ussocIuLIon cun be deIIned us LIuL demonsLruLed by LIe
greuLer mujorILy oI cuses. or LIe purposes oI LIIs dIscussIon, sucI u
deIInILIon Is noL consIdered conLroversIuI. AIso, IL wIII be requIred LIuL
sIngIe or muILIpIe IucLors demonsLruLe u o.6 (6o%) degree oI ussocIuLIon
wILI oLIer IucLors Lo be consIdered In LIe scope oI prImury cuusuI
urgumenL, I.e., neur-suIIIcIenL condILIon. n u sLrIcL deLermInIsLIc sysLem,
LIere sIouId be u one-Lo-one (1oo%) correspondence beLween un
unLecedenL und u consequenL LIuL ure cuusuIIy deIIned, und wIere LIe
unLecedenL Is consIdered us u sIngIe-IucLor, prImury cuuse oI LIe
consequenL. However, uIIowIng Ior errors oI meusuremenL und possIbIe
Iug eIIecLs, Ior exumpIe, u more oILen LIun noL requIremenL (o.6), us u
meusure oI ubsoIuLe rIsk, Is consIdered reusonubIe In LIe cIrcumsLunces.
23
23
Rampant Antismoking Signifies Grave Danger
LIeIr generuI dIsposILIon. WIere objecLIvILy Is IosL, uII Is IosL.
:. Endoenous & Exoenous Icctors cnd the Normctite
Rcne oj Associction,Non-Associction
or LIe purposes oI LIIs dIscussIon, endoenous (InLernuI,
consLILuLIonuI) wIII reIer Lo uny dIscernubIe IucLors IdenLIIIubIe wILI LIe
person (e.g., bIoIogIcuI., geneLIc, menLuI). Exoenous (exLernuI,
envIronmenLuI) wIII reIer Lo IucLors LIuL ure noL uspecLs oI LIe person.
A IurLIer, crILIcuI dIsLIncLIon In cuusuI urgumenL Is suIIIcIenL und
necessury condILIons Ior un eIIecL LIuL derIves Irom LIe NewLonIun
proposILIons I X, LIen Y und I noL X, LIen noL Y (see uIso Jospe,
1q;8, p.xI). TIe Iormer proposILIon IndIcuLes u suIIIcIenL condILIon Ior u
consequenL, wIere In uII or mosL InsLunces oI LIe unLecedenL, LIe
consequenL wIII IoIIow; u suIIIcIenL condILIon cun uIso be reIerred Lo us u
sIngIe IucLor, prImury cuuse oI un eIIecL. TIe IuLLer proposILIon IndIcuLes u
necessury condILIon Ior u consequenL, wIere In uII InsLunces oI LIe
consequenL, LIe unLecedenL wIII Iuve preceded. AILIougI u necessury
condILIon Is uIwuys ussocIuLed wILI LIe consequenL, LIere muy be muny
InsLunces wIere IL occurs wILIouL u purLIcuIur consequenL IoIIowIng, I.e., IL
Is noL u suIIIcIenL condILIon. As sucI, ILs roIe In u cuusuI reIuLIonsIIp Is
secondury, requIrIng oLIer precondILIons Ior ILs secondury roIe Lo Luke
pIuce. urLIermore, us u proporLIon oI IL beIng un occurrence, ILs
ussocIuLIon wILI u purLIcuIur consequenL muy be uLypIcuI. n LIIs sense IL Is
besL consIdered us u LrIgger In LIuL oLIer precondILIons wIII deIIne LIe
crILIcuI uspecLs oI LIe cuusuI reIuLIonsIIp. A IucLor cun uIso be boLI u
suIIIcIenL und u necessury condILIon Ior unoLIer IucLor In LIuL u
consequenL wIII uIwuys und onIy IoIIow u purLIcuIur unLecedenL.
ConsIder LIe exumpIe oI un ucId (A), LIuL Ior u commonIy
encounLered exposure IeveI, Is ussocIuLed wILI LIIrd-degree skIn burns
(consequenL) In 1oo% oI cuses. n LIIs InsLunce, A Is u suIIIcIenL
condILIon Ior LIe consequenL, I.e., wIenever A Is uppIIed Lo LIe skIn, LIe
consequenL In quesLIon wIII IoIIow (perIecL predIcLIve sLrengLI). L cun be
undersLood LIuL LIere muy be consIderubIe vurIuLIon In endogenous
sysLems, e.g., skIn Lype. However, IucLor A cun overrIde some generuI
uLLrIbuLe oI cll endogenous sysLems. TIereIore, IucLor A cun be
consIdered u sinle-jcctor, primcr ccuse oI LIe consequenL. AIso, IucLor
A does noL need Lo be u necessury condILIon, I.e., sImIIur LIIrd-degree
burns muy be ussocIuLed wILI oLIer exLernuI IucLors, Ior IL Lo be
consIdered u sIngIe-IucLor, prImury cuuse oI un eIIecL.
ConsIder unoLIer IucLor (IucLor B) Is ussocIuLed wILI u
pIenomenon (C) In ;o% oI cuses. TIIs ;o% oI cuses cun be consIdered
Some Background & Definitions
us u normctite rcne oI LIe eIIecL. TIe remuInIng o%, wIere no C
occurs, cun be consIdered us u protectite rcne oI non-eIIecL. TIIs sorL oI
sILuuLIon IndIcuLes crILIcuI vurIuLIons In InLernuI sLuLes, e.g., geneLIc, Ior
LIe scope oI eIIecL oI IucLor B. ucLor B cun sLIII be consIdered us u
sIngIe IucLor, prImury cuuse (neur-suIIIcIenL condILIon) oI LIe eIIecL In LIuL
IL Is ussocIuLed wILI LIe eIIecL In LIe greuLer mcjorit oI cuses, I.e., IIgI
predIcLIve sLrengLI.
ConsIder LIuL IucLor B Is now ussocIuLed wILI pIenomenon C
In onIy o% oI cuses. TIe ;o% oI cuses wIere C does noL occur cun be
consIdered us u normuLIve runge oI non-ussocIuLIon. TIe o% oI cuses
ussocIuLed wILI C Is IndIcuLIve oI endoenous jcilure (ubnormuI sLuLe).
TIe greuLer mujorILy oI endogenous sysLems cun udequuLeIy process
exposure Lo IucLor B. One wouId need Lo InvesLIguLe ubnormuIILIes In
endogenous sysLems Lo uccounL Ior LIe eIIecL In LIe o% oI cuses, gIven
LIuL uII oLIer exLernuI exposures ure consLunL. ucLor B cun LIereIore no
Ionger be consIdered us u sIngIe-IucLor, prImury cuuse oI LIe eIIecL In LIuL
IL wouId requIre u combInuLIon oI IucLors (precondILIons) Lo produce LIe
eIIecL. DependIng on wIuL LIe IdenLIIIed endogenous ubnormuIILIes ure,
IucLor B muy sLIII be consIdered us u conLrIbuLIng IucLor Lo LIe eIIecL
(e.g., u LrIgger). However, us un ussocIuLIon beLween IucLors upproucIes
zero, und dependIng on LIe nuLure oI LIe exogenous IucLor, und In LIe
ubsence oI InIormuLIon regurdIng LIe endogenous ubnormuIILIes InvoIved,
even u LrIgger sLuLus Ior IucLor B In LIe ussocIuLIon Is uL IeusL
IndeLermInuLe und poLenLIuIIy nonexIsLenL. urLIermore, II B wus
uIwuys un unLecedenL oI C, buL C wus onIy InIrequenLIy (o%) u
consequenL oI B, LIen B Is u necessury condILIon Ior C.
NormuIILy Is usuuIIy u dIIIIcuIL Ideu Lo udequuLeIy deIIne.
However, us IL perLuIns Lo purLIcuIur endogenous eIIecLs (bIoIogIcuI)
ussocIuLed wILI exposure Lo exLernuI IucLors, u normuLIve runge oI
ussocIuLIonJnon-ussocIuLIon cun be deIIned us LIuL demonsLruLed by LIe
greuLer mujorILy oI cuses. or LIe purposes oI LIIs dIscussIon, sucI u
deIInILIon Is noL consIdered conLroversIuI. AIso, IL wIII be requIred LIuL
sIngIe or muILIpIe IucLors demonsLruLe u o.6 (6o%) degree oI ussocIuLIon
wILI oLIer IucLors Lo be consIdered In LIe scope oI prImury cuusuI
urgumenL, I.e., neur-suIIIcIenL condILIon. n u sLrIcL deLermInIsLIc sysLem,
LIere sIouId be u one-Lo-one (1oo%) correspondence beLween un
unLecedenL und u consequenL LIuL ure cuusuIIy deIIned, und wIere LIe
unLecedenL Is consIdered us u sIngIe-IucLor, prImury cuuse oI LIe
consequenL. However, uIIowIng Ior errors oI meusuremenL und possIbIe
Iug eIIecLs, Ior exumpIe, u more oILen LIun noL requIremenL (o.6), us u
meusure oI ubsoIuLe rIsk, Is consIdered reusonubIe In LIe cIrcumsLunces.
24
24
.
"Lifestgle" Epidemiologg
z.: Some oj the Sins oj Epidemiolo
Epidemiolo IILeruIIy reIers Lo LIe sLudy oI epIdemIcs, I.e. LIe
spreud oI dIseuse umongsL Iurge groups. L Ius usuuIIy been concerned
wILI LIe IdenLIIIcuLIon oI vIruI und bucLerIuI (InIecLIous) sources oI dIseuse
und LIeIr conLuInmenL. n LIIs regurd IL Ius been quILe successIuI (see
OukIey, 1qqq). More recenLIy, IL Ius exLended ILs enquIry Lo wIuL ure
consIdered IIIesLyIe dIseuses, e.g., cuncer, IeurL dIseuse, und InvoIves LIe
InvesLIguLIon oI IucLors sucI us dIeL und nuLrILIon, exercIse, smokIng. TIe
IIrsL mujor venLure oI IIIesLyIe epIdemIoIogy wus LIe 1q6q Surgeon-
GeneruI ReporL on smokIng und IeuILI.
EpIdemIoIogy, Ior LIe purposes oI LIIs dIscussIon, Is consIdered
us purL oI LIe greuLer medIcuI esLubIIsImenL. L essenLIuIIy conIorms Lo u
muLerIuIIsL (bIoIogIcuIIy reducLIonIsL) vIew oI LIe worId und seemIngIy
uspIres Lo conIorm Lo LIe proLocoIs oI scIenLIIIc enquIry. Ls cIIeI LooI Is
LIe use oI sLuLIsLIcuI InIerence In unuIyzIng vurIuLIons In IncIdence oI
dIseuseJmorLuIILy us u IuncLIon oI InvesLIguLed IucLors Ior Iurge groups,
e.g., popuIuLIons, sub-popuIuLIons. GovernmenL und InLernuLIonuI IeuILI
ugencIes und medIcuI uuLIorILIes (e.g., UnILed SLuLes Surgeon GeneruI,
UnILed SLuLes EnvIronmenL ProLecLIon Agency, UnILed KIngdom RoyuI
CoIIege oI PIysIcIuns, US CenLer Ior DIseuse ConLroI und PrevenLIon,
WorId HeuILI OrgunIzuLIon) LypIcuIIy empIoy epIdemIoIogIcuI evIdence In
LIe IormuIuLIon oI pubIIc IeuILI poIIcy.
n LIe InvesLIguLIon oI LIe poLenLIuI precursors oI cuncer, Ior
exumpIe, LIe udopLed epIdemIoIogIcuI proLocoI Is LIe use oI unImuI sLudIes
und sLuLIsLIcuI unuIyses oI Iumun duLu. MIce, umongsL numerous oLIer
possIbIe unImuIs, ure subjecLed Lo exLremeIy IIgI doses oI purLIcuIur
subsLunces over usuuIIy sIorL perIods oI LIme. L sIouId be noLed LIuL
LIese very IIgI doses ure not represenLuLIve oI LypIcuI Iumun exposure,
und LIere Is greuL dIIIIcuILy In LrunsIuLIngJexLrupoIuLIng LIese unImuI
exposures, boLI In Lerms oI subsLunce dosuge und unImuI pIysIoIogyJ
bIocIemIsLry, InLo compurubIe, II uny, Iumun Lerms. TIe unImuIs ure LIen
Rampant Antismoking Signifies Grave Danger
:.( The Contrcct etueen Science cnd Societ
urLIerIng LIe LIeme LIuL wus begun In eurIIer secLIons, LIe gouI
oI scIence Is Lo Lrunscend LIe reuIm oI IIImsy evIdence (sLuLIsLIcuIIsm) und
Lo IdenLIIy ter stron predIcLors Ior consequenLs. TIe compeLenL
reseurcIer cIooses words very cureIuIIy so us not Lo mIsIeud und LIereby
pIucIng poLenLIuIIy Iurge groups oI persons InLo sLuLes oI IuIse beIIeI. TIe
genuIne pursuIL oI scIenLIIIc enquIry cun be u IIgIIy soberIng und
IumbIIng experIence In LIuL LIe IdenLIIIcuLIon oI IIgI-IeveI predIcLors Ior
consequenLs mIgIL occur onIy once In u reseurcIer`s IIIeLIme. L Is u work
oI greuL puLIence. However, by pinpointin LIe unLecedenLs Ior eIIecLs, u
reseurcIer Is conIIdenL LIuL LIey do noL dIsLurb normuLIve runges oI
IuncLIonIng In LIe popuIuLIon uL Iurge, I.e., by muxImuIIy uvoIdIng IuIse
cIussIIIcuLIons. AL LIe sume LIme, members oI socIeLy cun be conIIdenL
LIuL InIormuLIon dIssemInuLed by scIenLIIIc dIscIpIInes conIorms Lo un
InLegrILy oI reseurcI und InIerence und, LIereIore, wurrunLs due
consIderuLIon. TIIs Is cerLuInIy un IdeuI versIon oI LIe scIenLIIIc pursuIL.
UnIorLunuLeIy, LIere ure IucLors LIuL cun conspIre Lo proIIbIL sucI sound
enquIry und deuIIngs wILI LIe pubIIc. TIe currenL dIscussIon wIII consIder
some oI LIese IucLors.
ScIence, In LIe sense ouLIIned ubove, muy be consIdered us u
servunL oI u greuLer personuI, socIuI und moruI conLexL. A crILIcuI
consIderuLIon Iere Is LIuL LIere ure some scIenLIsLs wIo IoId meLupIysIcuI
beIIeIs (e.g., beIIeI In God) LIuL go beyond LIe IogIcuI posILIvIsL
underpInnIngs oI scIenLIIIc enquIry. TIe beIIeI Is LIuL scIence cun onIy
uddress purLIcuIur Lypes oI quesLIons, und LIuL oLIer Lypes oI quILe
IegILImuLe quesLIons (e.g., moruI) ure besL uddressed by oLIer Irumeworks
oI LIougIL. urLIermore, u spIrILuuI Irumework cun deIImIL LIe scope oI
scIenLIIIc enquIry.
L musL be remembered LIuL scIence Is buL u meLIod LIuL Is
drIven by u meLupIysIcuI Irumework. SpIrILuuI und muLerIuIIsL
Irumeworks dIIIer greuLIy In LIeIr vIew oI MunkInd. MuLerIuIIsm,
subscrIbIng Lo un evoIuLIonury, non-spIrILuuI vIew oI Mun, promoLes LIe
Ideu LIuL noLIIng sIouId sLund In LIe wuy oI uppIyIng LIe scIenLIIIc
meLIod (I.e., scIenLIsm). AILernuLIveIy, u spIrILuuI Irumework LIuL deIInes
LIe Iumun In very purLIcuIur wuys muy vIew some uppIIcuLIons oI LIe
scIenLIIIc meLIod us moruIIy quesLIonubIe.
25
25
.
"Lifestgle" Epidemiologg
z.: Some oj the Sins oj Epidemiolo
Epidemiolo IILeruIIy reIers Lo LIe sLudy oI epIdemIcs, I.e. LIe
spreud oI dIseuse umongsL Iurge groups. L Ius usuuIIy been concerned
wILI LIe IdenLIIIcuLIon oI vIruI und bucLerIuI (InIecLIous) sources oI dIseuse
und LIeIr conLuInmenL. n LIIs regurd IL Ius been quILe successIuI (see
OukIey, 1qqq). More recenLIy, IL Ius exLended ILs enquIry Lo wIuL ure
consIdered IIIesLyIe dIseuses, e.g., cuncer, IeurL dIseuse, und InvoIves LIe
InvesLIguLIon oI IucLors sucI us dIeL und nuLrILIon, exercIse, smokIng. TIe
IIrsL mujor venLure oI IIIesLyIe epIdemIoIogy wus LIe 1q6q Surgeon-
GeneruI ReporL on smokIng und IeuILI.
EpIdemIoIogy, Ior LIe purposes oI LIIs dIscussIon, Is consIdered
us purL oI LIe greuLer medIcuI esLubIIsImenL. L essenLIuIIy conIorms Lo u
muLerIuIIsL (bIoIogIcuIIy reducLIonIsL) vIew oI LIe worId und seemIngIy
uspIres Lo conIorm Lo LIe proLocoIs oI scIenLIIIc enquIry. Ls cIIeI LooI Is
LIe use oI sLuLIsLIcuI InIerence In unuIyzIng vurIuLIons In IncIdence oI
dIseuseJmorLuIILy us u IuncLIon oI InvesLIguLed IucLors Ior Iurge groups,
e.g., popuIuLIons, sub-popuIuLIons. GovernmenL und InLernuLIonuI IeuILI
ugencIes und medIcuI uuLIorILIes (e.g., UnILed SLuLes Surgeon GeneruI,
UnILed SLuLes EnvIronmenL ProLecLIon Agency, UnILed KIngdom RoyuI
CoIIege oI PIysIcIuns, US CenLer Ior DIseuse ConLroI und PrevenLIon,
WorId HeuILI OrgunIzuLIon) LypIcuIIy empIoy epIdemIoIogIcuI evIdence In
LIe IormuIuLIon oI pubIIc IeuILI poIIcy.
n LIe InvesLIguLIon oI LIe poLenLIuI precursors oI cuncer, Ior
exumpIe, LIe udopLed epIdemIoIogIcuI proLocoI Is LIe use oI unImuI sLudIes
und sLuLIsLIcuI unuIyses oI Iumun duLu. MIce, umongsL numerous oLIer
possIbIe unImuIs, ure subjecLed Lo exLremeIy IIgI doses oI purLIcuIur
subsLunces over usuuIIy sIorL perIods oI LIme. L sIouId be noLed LIuL
LIese very IIgI doses ure not represenLuLIve oI LypIcuI Iumun exposure,
und LIere Is greuL dIIIIcuILy In LrunsIuLIngJexLrupoIuLIng LIese unImuI
exposures, boLI In Lerms oI subsLunce dosuge und unImuI pIysIoIogyJ
bIocIemIsLry, InLo compurubIe, II uny, Iumun Lerms. TIe unImuIs ure LIen
Rampant Antismoking Signifies Grave Danger
:.( The Contrcct etueen Science cnd Societ
urLIerIng LIe LIeme LIuL wus begun In eurIIer secLIons, LIe gouI
oI scIence Is Lo Lrunscend LIe reuIm oI IIImsy evIdence (sLuLIsLIcuIIsm) und
Lo IdenLIIy ter stron predIcLors Ior consequenLs. TIe compeLenL
reseurcIer cIooses words very cureIuIIy so us not Lo mIsIeud und LIereby
pIucIng poLenLIuIIy Iurge groups oI persons InLo sLuLes oI IuIse beIIeI. TIe
genuIne pursuIL oI scIenLIIIc enquIry cun be u IIgIIy soberIng und
IumbIIng experIence In LIuL LIe IdenLIIIcuLIon oI IIgI-IeveI predIcLors Ior
consequenLs mIgIL occur onIy once In u reseurcIer`s IIIeLIme. L Is u work
oI greuL puLIence. However, by pinpointin LIe unLecedenLs Ior eIIecLs, u
reseurcIer Is conIIdenL LIuL LIey do noL dIsLurb normuLIve runges oI
IuncLIonIng In LIe popuIuLIon uL Iurge, I.e., by muxImuIIy uvoIdIng IuIse
cIussIIIcuLIons. AL LIe sume LIme, members oI socIeLy cun be conIIdenL
LIuL InIormuLIon dIssemInuLed by scIenLIIIc dIscIpIInes conIorms Lo un
InLegrILy oI reseurcI und InIerence und, LIereIore, wurrunLs due
consIderuLIon. TIIs Is cerLuInIy un IdeuI versIon oI LIe scIenLIIIc pursuIL.
UnIorLunuLeIy, LIere ure IucLors LIuL cun conspIre Lo proIIbIL sucI sound
enquIry und deuIIngs wILI LIe pubIIc. TIe currenL dIscussIon wIII consIder
some oI LIese IucLors.
ScIence, In LIe sense ouLIIned ubove, muy be consIdered us u
servunL oI u greuLer personuI, socIuI und moruI conLexL. A crILIcuI
consIderuLIon Iere Is LIuL LIere ure some scIenLIsLs wIo IoId meLupIysIcuI
beIIeIs (e.g., beIIeI In God) LIuL go beyond LIe IogIcuI posILIvIsL
underpInnIngs oI scIenLIIIc enquIry. TIe beIIeI Is LIuL scIence cun onIy
uddress purLIcuIur Lypes oI quesLIons, und LIuL oLIer Lypes oI quILe
IegILImuLe quesLIons (e.g., moruI) ure besL uddressed by oLIer Irumeworks
oI LIougIL. urLIermore, u spIrILuuI Irumework cun deIImIL LIe scope oI
scIenLIIIc enquIry.
L musL be remembered LIuL scIence Is buL u meLIod LIuL Is
drIven by u meLupIysIcuI Irumework. SpIrILuuI und muLerIuIIsL
Irumeworks dIIIer greuLIy In LIeIr vIew oI MunkInd. MuLerIuIIsm,
subscrIbIng Lo un evoIuLIonury, non-spIrILuuI vIew oI Mun, promoLes LIe
Ideu LIuL noLIIng sIouId sLund In LIe wuy oI uppIyIng LIe scIenLIIIc
meLIod (I.e., scIenLIsm). AILernuLIveIy, u spIrILuuI Irumework LIuL deIInes
LIe Iumun In very purLIcuIur wuys muy vIew some uppIIcuLIons oI LIe
scIenLIIIc meLIod us moruIIy quesLIonubIe.
26
26
kIIIed und dIssecLed Lo uscerLuIn wIeLIer uny cuncers Iuve occurred.
AnImuIs ure bred Ior suscepLIbIIILy Lo cuncer. TIere cun uIso be
consIderubIe vurIuLIons In LIe IncIdence oI cuncer wILIIn one sLruIn und
beLween dIIIerenL sLruIns oI LIe sume specIes (e.g., see Wynder eL uI.,
1q). TIe uppIIcubIIILy oI unImuI experImenLuI IIndIngs Lo LIe Iumun
condILIon Is IIgIIy urguubIe.
n LIe InsLunce oI Iumun duLu (e.g., medIcuI dIugnoses, deuLI
cerLIIIcuLIon), sLuLIsLIcuI unuIyses ure conducLed Lo esLubIIsI wIeLIer
exposure Lo LIuL sume subsLunce Is ussocIuLed wILI IncreusesJdecreuses In
cuncer. TIIs Is done by compurIng LIe IncIdence oI cuncer Ior u control
roup (no exposure Lo subsLunce) wILI un experimentcl,qucsi-
experimentcl roup (exposure Lo subsLunce). L wIII InvoIve un ussessmenL
oI uvuIIubIe reseurcI Lo duLe. UnIorLunuLeIy, In muny InsLunces LIe sumpIe
sIzes In IndIvIduuI sLudIes ure Loo smuII Lo wurrunL reusonubIe sLuLIsLIcuI
conIIdence In LIe sLubIIILy oI reseurcI IIndIngs. An oILen used procedure
In LIIs cIrcumsLunce Is metc-cnclsis (see uIso Eysenck, 1qqq; MoIer eL
uI., 1qqq). TIIs InvoIves LIe pooIIng oI reseurcI IIndIngs wIIcI Ius LIe
eIIecL oI IncreusIng LIe overuII sumpIe sIze und, LIereIore, sLuLIsLIcuI
power. However, LIere ure poLenLIuIIy serIous probIems wILI meLu-
unuIyses, LIe mosL ImporLunL oI LIese ure IncompuLIbIIILy oI
meLIodoIogIes und meusures. TIere ure uIso muny oLIer poLenLIuI
reseurcI probIems sucI us InudequuLe conLroI groups, InudequuLe
rundomIzuLIon, InudequuLe meusures, eLc. (see uIso Tuubes, 1qq). MosL
probIemuLIc oI uII Is LIuL dIseuses sucI us cuncer und coronury IeurL
dIseuse ure LypIcuIIy IuLe-IIIe dIseuses. As sucI, LIere muy be un
IndeLermInuLeIy Iurge number oI IucLors und combInuLIons LIereoI, uIong
muILI-dImensIons (e.g., bIoIogIcuI, psycIoIogIcuI, socIuI), LIuL muy
InLervene Lo reIuLIve degrees beLween bIrLI und morbIdILyJmorLuIILy.
UnIorLunuLeIy, LIe wuy In wIIcI meLu-unuIyses ure used In IIIesLyIe
epIdemIoIogy resLs on LIe quesLIonubIe urgumenL LIuL LIe uggreguLIon oI
IIImsy bILs oI InIormuLIon wIII produce coIerenL und ImporLunL
InIormuLIon (see uIso Skrubunek & McCormIck, 1qqo, p.o).
NoLwILIsLundIng consIderubIe IImILuLIons, sucI sLuLIsLIcuI
unuIyses wIII yIeId possIbIe reIuLIve dIIIerences In rIsk oI cuncer beLween
LIe conLroI und experImenLuI groups. ReIuLIve rIsk dIIIerences ure quILe
IILeruIIy un odds ruLIo, I.e., u gumbIIng equIvuIenL, und reIIecLs LIe
probubIIILy oI u dIseuse Ior LIe experImenLuI group dIvIded by LIe
probubIIILy oI LIe dIseuse Ior LIe conLroI group. L Is u very sImpIIsLIc
mode oI duLu unuIysIs und presenLuLIon.
L Is consIdered by LIe epIdemIoIogIcuI communILy LIuL relctite
risl ruLIos oI z.o-q.o or more (II LIe IncIdence oI cuncer occurs uL u ruLe oI
z-q or more LImes In one group reIuLIve Lo LIe oLIer) Is LIe boundury oI u
Rampant Antismoking Signifies Grave Danger Lifestyle Epidemiology
weuk ussocIuLIon LIuL begIns Lo IndIcuLe u concIusIon oI u cuusuI busIs Lo
LIe observed sLuLIsLIcuI ussocIuLIon (e.g., HuLcIInson, 1q68; Tuubes, 1qq;
Wynder, 1q8;; Wynder, 1q8z). n LIe InsLunce oI nuLrILIonuI
epIdemIoIogy, II LIe q% conIIdence InLervuI does noL IncIude 1.o (wIere
1.o represenLs equIvuIence on u meusure beLween experImenLuI und
conLroI groups), LIen LIIs Is suIIIcIenL Lo wurrunL ucLIon. n LIese
InsLunces LIe reIuLIve rIsk ruLIo muy be weII beIow z.o (see PoLIscImun &
Weed, 1qqq, p.111S).
UILImuLeIy, II cuncers ure deLecLed In LIe unImuI sLudIes cnd
LIere Is u reIuLIve rIsk oI >z-q ussocIuLed wILI LIe experImenLuI group,
LIen LIese provIde grounds Ior LIe subsLunce In quesLIon Lo be ussIgned
LIe muxImuI curcInogenIc sLuLus sucI us LIe US Surgeon GeneruI`s
ussIgnmenL oI Group A Ccrcinoen (I.e., u known cuuse oI cuncer In
unImuIs und Iumuns). CombInIng LIese Lwo sources oI InIormuLIon Is
reIerred Lo us u weIgIL oI evIdence unuIysIs. UnIorLunuLeIy, LIe weIgIL oI
evIdence upproucI reIIes on LIe compIeLeIy quesLIonubIe ussumpLIon LIuL
LIe uggreguLIon oI dIspuruLe uggreguLIons (e.g., meLu-unuIysIs) oI IIImsy
bILs oI evIdence wIII produce coIerenL und ImporLunL InIormuLIon (see
uIso Skrubunek & McCormIck, 1qqo, p.o). TIIs sume reIuLIve-rIsk
unuIysIs oI Iumun duLu uIso uppIIes Lo oLIer specIIIc dIseuseJmorLuIILy,
e.g., coronury IeurL dIseuse.
One oI LIe cenLruI LIemes In LIIs dIscussIon Is LIuL LIe procedure
ouLIIned ubove Is IundumenLuIIy IIuwed. n consIderIng LIe unImuI
sLudIes, II u subsLunce Is ussocIuLed wILI neopIusms (new cuncers) In q
ouL oI 1oo mIce, und unoLIer subsLunce Is ussocIuLed wILI neopIusms In
ouL oI 1oo mIce, epIdemIoIogIcuI procedure wIII ussIgn LIe scme sIngIe-
IucLor, prImury cuusuI sLuLus Lo boLI subsLunces. n LIe cuse oI LIe IuLLer
subsLunce, neopIusms In J1oo mIce IndIcuLes LIuL, even In mIce LIuL ure
bred Ior LIeIr suscepLIbIIILy Lo cuncer, LIere Is no IomogeneILy oI
endogenous bIoIogIcuI sysLems. TIere Is u criticcl dIIIerence beLween
normuLIve (LypIcuI) und subgroup (uLypIcuI ) ussocIuLIons (see secLIons
1.z., 1.). A procedure LIuL does noL dIsLInguIsI beLween strenths oI
ussocIuLIon over LIe enLIre condILIonuI probubIIILy scuIe Is uIreudy
dIsusLrous In scIenLIIIc Lerms. SucI conducL vIoIuLes LIe crILerIu oI
consIsLencyJspecIIIcILy, degree oI IuIsIIIubIIILy, und sLrengLI oI ussocIuLIon
Ior cuusuI urgumenL.
TIe U.S. Surgeon GeneruI (1q6q), Ior exumpIe, In consIderIng LIe
Issue oI smokIng und IeuILI, cILes u sLudy by Rockney eL uI. wIo puInLed
Lobucco Lur LIree Lo IIve LImes eucI week on LIe LrucIeu oI dogs wILI u
LrucIeocuLuneous IIsLuIu. HyperpIusLIc cIunges wILI squumous meLu-
pIusIu oI LIe broncIIuI epILIeIIum were seen In seven dogs LIuL survIved
1;8 Lo zo duys. CurcInomu-In-sILu wus reporLed Lo occur In LIree, und
27
27
kIIIed und dIssecLed Lo uscerLuIn wIeLIer uny cuncers Iuve occurred.
AnImuIs ure bred Ior suscepLIbIIILy Lo cuncer. TIere cun uIso be
consIderubIe vurIuLIons In LIe IncIdence oI cuncer wILIIn one sLruIn und
beLween dIIIerenL sLruIns oI LIe sume specIes (e.g., see Wynder eL uI.,
1q). TIe uppIIcubIIILy oI unImuI experImenLuI IIndIngs Lo LIe Iumun
condILIon Is IIgIIy urguubIe.
n LIe InsLunce oI Iumun duLu (e.g., medIcuI dIugnoses, deuLI
cerLIIIcuLIon), sLuLIsLIcuI unuIyses ure conducLed Lo esLubIIsI wIeLIer
exposure Lo LIuL sume subsLunce Is ussocIuLed wILI IncreusesJdecreuses In
cuncer. TIIs Is done by compurIng LIe IncIdence oI cuncer Ior u control
roup (no exposure Lo subsLunce) wILI un experimentcl,qucsi-
experimentcl roup (exposure Lo subsLunce). L wIII InvoIve un ussessmenL
oI uvuIIubIe reseurcI Lo duLe. UnIorLunuLeIy, In muny InsLunces LIe sumpIe
sIzes In IndIvIduuI sLudIes ure Loo smuII Lo wurrunL reusonubIe sLuLIsLIcuI
conIIdence In LIe sLubIIILy oI reseurcI IIndIngs. An oILen used procedure
In LIIs cIrcumsLunce Is metc-cnclsis (see uIso Eysenck, 1qqq; MoIer eL
uI., 1qqq). TIIs InvoIves LIe pooIIng oI reseurcI IIndIngs wIIcI Ius LIe
eIIecL oI IncreusIng LIe overuII sumpIe sIze und, LIereIore, sLuLIsLIcuI
power. However, LIere ure poLenLIuIIy serIous probIems wILI meLu-
unuIyses, LIe mosL ImporLunL oI LIese ure IncompuLIbIIILy oI
meLIodoIogIes und meusures. TIere ure uIso muny oLIer poLenLIuI
reseurcI probIems sucI us InudequuLe conLroI groups, InudequuLe
rundomIzuLIon, InudequuLe meusures, eLc. (see uIso Tuubes, 1qq). MosL
probIemuLIc oI uII Is LIuL dIseuses sucI us cuncer und coronury IeurL
dIseuse ure LypIcuIIy IuLe-IIIe dIseuses. As sucI, LIere muy be un
IndeLermInuLeIy Iurge number oI IucLors und combInuLIons LIereoI, uIong
muILI-dImensIons (e.g., bIoIogIcuI, psycIoIogIcuI, socIuI), LIuL muy
InLervene Lo reIuLIve degrees beLween bIrLI und morbIdILyJmorLuIILy.
UnIorLunuLeIy, LIe wuy In wIIcI meLu-unuIyses ure used In IIIesLyIe
epIdemIoIogy resLs on LIe quesLIonubIe urgumenL LIuL LIe uggreguLIon oI
IIImsy bILs oI InIormuLIon wIII produce coIerenL und ImporLunL
InIormuLIon (see uIso Skrubunek & McCormIck, 1qqo, p.o).
NoLwILIsLundIng consIderubIe IImILuLIons, sucI sLuLIsLIcuI
unuIyses wIII yIeId possIbIe reIuLIve dIIIerences In rIsk oI cuncer beLween
LIe conLroI und experImenLuI groups. ReIuLIve rIsk dIIIerences ure quILe
IILeruIIy un odds ruLIo, I.e., u gumbIIng equIvuIenL, und reIIecLs LIe
probubIIILy oI u dIseuse Ior LIe experImenLuI group dIvIded by LIe
probubIIILy oI LIe dIseuse Ior LIe conLroI group. L Is u very sImpIIsLIc
mode oI duLu unuIysIs und presenLuLIon.
L Is consIdered by LIe epIdemIoIogIcuI communILy LIuL relctite
risl ruLIos oI z.o-q.o or more (II LIe IncIdence oI cuncer occurs uL u ruLe oI
z-q or more LImes In one group reIuLIve Lo LIe oLIer) Is LIe boundury oI u
Rampant Antismoking Signifies Grave Danger Lifestyle Epidemiology
weuk ussocIuLIon LIuL begIns Lo IndIcuLe u concIusIon oI u cuusuI busIs Lo
LIe observed sLuLIsLIcuI ussocIuLIon (e.g., HuLcIInson, 1q68; Tuubes, 1qq;
Wynder, 1q8;; Wynder, 1q8z). n LIe InsLunce oI nuLrILIonuI
epIdemIoIogy, II LIe q% conIIdence InLervuI does noL IncIude 1.o (wIere
1.o represenLs equIvuIence on u meusure beLween experImenLuI und
conLroI groups), LIen LIIs Is suIIIcIenL Lo wurrunL ucLIon. n LIese
InsLunces LIe reIuLIve rIsk ruLIo muy be weII beIow z.o (see PoLIscImun &
Weed, 1qqq, p.111S).
UILImuLeIy, II cuncers ure deLecLed In LIe unImuI sLudIes cnd
LIere Is u reIuLIve rIsk oI >z-q ussocIuLed wILI LIe experImenLuI group,
LIen LIese provIde grounds Ior LIe subsLunce In quesLIon Lo be ussIgned
LIe muxImuI curcInogenIc sLuLus sucI us LIe US Surgeon GeneruI`s
ussIgnmenL oI Group A Ccrcinoen (I.e., u known cuuse oI cuncer In
unImuIs und Iumuns). CombInIng LIese Lwo sources oI InIormuLIon Is
reIerred Lo us u weIgIL oI evIdence unuIysIs. UnIorLunuLeIy, LIe weIgIL oI
evIdence upproucI reIIes on LIe compIeLeIy quesLIonubIe ussumpLIon LIuL
LIe uggreguLIon oI dIspuruLe uggreguLIons (e.g., meLu-unuIysIs) oI IIImsy
bILs oI evIdence wIII produce coIerenL und ImporLunL InIormuLIon (see
uIso Skrubunek & McCormIck, 1qqo, p.o). TIIs sume reIuLIve-rIsk
unuIysIs oI Iumun duLu uIso uppIIes Lo oLIer specIIIc dIseuseJmorLuIILy,
e.g., coronury IeurL dIseuse.
One oI LIe cenLruI LIemes In LIIs dIscussIon Is LIuL LIe procedure
ouLIIned ubove Is IundumenLuIIy IIuwed. n consIderIng LIe unImuI
sLudIes, II u subsLunce Is ussocIuLed wILI neopIusms (new cuncers) In q
ouL oI 1oo mIce, und unoLIer subsLunce Is ussocIuLed wILI neopIusms In
ouL oI 1oo mIce, epIdemIoIogIcuI procedure wIII ussIgn LIe scme sIngIe-
IucLor, prImury cuusuI sLuLus Lo boLI subsLunces. n LIe cuse oI LIe IuLLer
subsLunce, neopIusms In J1oo mIce IndIcuLes LIuL, even In mIce LIuL ure
bred Ior LIeIr suscepLIbIIILy Lo cuncer, LIere Is no IomogeneILy oI
endogenous bIoIogIcuI sysLems. TIere Is u criticcl dIIIerence beLween
normuLIve (LypIcuI) und subgroup (uLypIcuI ) ussocIuLIons (see secLIons
1.z., 1.). A procedure LIuL does noL dIsLInguIsI beLween strenths oI
ussocIuLIon over LIe enLIre condILIonuI probubIIILy scuIe Is uIreudy
dIsusLrous In scIenLIIIc Lerms. SucI conducL vIoIuLes LIe crILerIu oI
consIsLencyJspecIIIcILy, degree oI IuIsIIIubIIILy, und sLrengLI oI ussocIuLIon
Ior cuusuI urgumenL.
TIe U.S. Surgeon GeneruI (1q6q), Ior exumpIe, In consIderIng LIe
Issue oI smokIng und IeuILI, cILes u sLudy by Rockney eL uI. wIo puInLed
Lobucco Lur LIree Lo IIve LImes eucI week on LIe LrucIeu oI dogs wILI u
LrucIeocuLuneous IIsLuIu. HyperpIusLIc cIunges wILI squumous meLu-
pIusIu oI LIe broncIIuI epILIeIIum were seen In seven dogs LIuL survIved
1;8 Lo zo duys. CurcInomu-In-sILu wus reporLed Lo occur In LIree, und
28
28
Rampant Antismoking Signifies Grave Danger
InvusIve curcInomu In one ouL oI 1; dogs, buL LIIs work Ius noL yeL been
conIIrmed. (p.16)
IrsLIy, LIese IIndIngs Iuve not sInce been repIIcuLed. SecondIy,
und very ImporLunLIy, Is LIuL II repIIcuLIon Iud occurred, one In 1; dogs
demonsLruLIng InvusIve curcInomu wouId resuIL In u concIusIon LIuL LIe
subsLunce In quesLIon cuuses cuncer In unImuIs (dogs). TIIs overIooks LIe
lcrin IucL LIuL over qq% oI LIe sumpIe dId noL demonsLruLe InvusIve
cuncer In LIe presence oI LIe unLecedenL. WILI uII oLIer exogenous IucLors
beIng equuI, LIe vurIuLIon In LIIs one InsLunce oI InvusIve cuncer musL
Iuve un endogenous source, e.g., IIgIIy uLypIcuI geneLIc ubnormuIILy. TIe
scme cuusuI sLuLus wouId be ussIgned II InvusIve cuncer occurred In uII 1;
dogs. TIese exLreme sILuuLIons, und LIe vurIuLIons In beLween, ure ter
dIIIerenL. n LIe Iormer, LIe normuLIve runge Is non-ussocIuLIon wILI LIe
dIseuse wILI un exLremeIy IIgI probubIIILy. n LIe IuLLer, LIe normuLIve
runge Is ussocIuLIon wILI LIe dIseuse wILI un exLremeIy IIgI probubIIILy.
TIIs InordInuLe LreuLmenL oI purLIcuIur IIndIngs represenLs neuroLIc
Lendency (I.e., cuLusLropIIzuLIon) In epIdemIoIogIc uppruIsuI.
RegurdIng Iumun duLu, LIe sLundurd oI busIng cuusuI
urgumenL onl on sLuLIsLIcuIIy sIgnIIIcunL dIIIerences In reIuLIve rIsk oI uL
IeusL u cerLuIn mugnILude (>z-q) Is un epIdemIoIogIc concocLIon LIuL Ius
no scIenLIIIc merIL uL uII. or exumpIe, LIe IncIdence oI u purLIcuIur dIseuse
Is ussocIuLed wILI IucLor B (unLecedenL) o LImes more LIun IucLor -B.
TIIs InIormuLIon depIcLs noLIIng us Lo wIeLIer LIe ussocIuLed IncIdence oI
LIe IucLor Is o Lo 1, or zo Lo , or oo Lo 1o, eLc.. urLIermore, LIe
InIormuLIon uIso depIcLs noLIIng us Lo LIe IncIdence oI LIe unLecedenL
IucLor generuIIy. L Is this InIormuLIon LIuL Is crILIcuI In ussessIng LIe
predIcLIve sLrengLI oI u IucLor(s) Ior unoLIer. or exumpIe, ussume LIuL
LIe IncIdence oI u purLIcuIur dIseuse ussocIuLed wILI IucLor B Is o LImes
more LIun ILs ussocIuLIon wILI IucLor -B (e.g., zo Lo ). I LIe IncIdence
oI IucLor B In LIe generuI popuIuLIon Is zo,ooo,ooo, LIen LIe predIcLIve
sLrengLI oI IucLor B Ior LIe dIseuse In quesLIon (ooJzo,ooo,ooo) Is
eIIecLIveIy zero, I.e., essenLIuIIy useIess.
WukeIIeId (1q88) uIso mukes LIIs observuLIon: ||Ive LImes u
very smuII probubIIILy oI deveIopIng u dIseuse Is sLIII u very smuII
probubIIILy oI deveIopIng LIe dIseuse. (p.q6) He IndIcuLes LIuL, us u
munner oI presenLIng InIormuLIon In un uncompIIcuLed IusIIon, LIe use oI
reIuLIve rIsk ruLIos Is reusonubIe. However, IL Is compIeLeIy InupproprIuLe
(over-sImpIIIIcuLIon) us u busIs Ior cuusuI urgumenL.
WukeIIeId (1q88) reusonubIy IndIcuLes LIuL u correIuLIon
coeIIIcIenL Is u superIor wuy oI meusurIng LIe degree oI reIuLIonsIIp
beLween Lwo IucLors. However, Ior LIe purposes oI LIIs dIscussIon, und
LIuL uILImuLeIy IL Is LIe predIcLIve sLrengLI oI one IucLor(s) Ior unoLIer
Lifestyle Epidemiology
LIuL Is crILIcuI, LIe condILIonuI probubIIILy beLween Lwo IucLors wIII serve
us u meusure oI LIe sLrengLI oI ussocIuLIon beLween IucLors. TIIs wIII yIeId
u meusure oI ubsoIuLe ruLIer LIun reIuLIve rIsk, und cun uIso uccounL Ior
excess IncIdence ubove u buseIIne ruLe. TIe buseIIne ruLe In LIe ubove
exumpIe Is o, I.e., LIe observed ussocIuLIon oI u dIseuse wILI IucLor -B.
Therejore, the bcsis jor ccuscl crument is cbsolute, cnd not relctite,
risl (see uIso Skrubunek & McCormIck, 1qqo, p.qo).
mporLunLIy, LIe ubsoIuLe rIsk oI IucLors Ior dIseuse LIuL
epIdemIoIogy Is usuuIIy concerned wILI Is very Iow (I.e., very poor
predIcLors). As sucI, epIdemIoIogy`s empIusIs on reIuLIve group
dIIIerences pIuces ILs Iocus oI ucLIvILy on LIe Iower, und wrong, end
(upproucIIng zero) oI LIe condILIonuI probubIIILy scuIe. SucI u perspecLIve
Is no dIIIerenL Lo LIe gumbIIng equIvuIenL oI Insurunce compuny
conducL, I.e., sLuLIsLIcuIIsm. L reIIecLs un upside-doun LIInkIng In LIuL IL
Is ImproperIy preoccupIed wILI uLypIcuI ussocIuLIons (I.e., subgroup, non-
Iomogeneous ussocIuLIons). As uIreudy menLIoned, LIIs upproucI Is un
ussuuIL on LIe normuLIve (LypIcuI) runge oI IuncLIonIng (see secLIon 1.)
Ior uny purLIcuIur IucLor wILIIn u duLu seL. L overIooks LIe IucL LIuL un
unLecedenL Is noL ussocIuLed wILI u specIIIc dIseuse Ior mosL oI LIe group
und, LIereIore, processIng oI LIe unLecedenL IucLor Is weII wILIIn u
normuLIve runge oI IuncLIonIng. WIen IL ussIgns u sIngIe IucLor, prImury
cuusuI sLuLus Lo exLernuI IucLors demonsLruLIng poor predIcLIve sLrengLI,
IL InvoIves un uddILIonuI error Lo upsIde-down LIInkIng. ALypIcuI
ussocIuLIons ure subgroup ussocIuLIons. Subgroup ussocIuLIons usuuIIy
InvoIve crILIcuI vurIuLIons In endoenous sysLems. WIuL cun besL be
descrIbed us u trcnsjerence jcllcc, epIdemIoIogy erroneousIy ussIgns
wIuL ure vurIuLIons In endogenous sysLems Lo LIe generuI cuusuI
properLIes oI un exogenous IucLor.
A LrunsIerence IuIIucy Is LypIcuI oI bIuck box reusonIng. n sucI
reusonIng uII orgunIsms wILIIn u group ure vIewed us Iomogeneous und
pussIve. AILIougI LIere muy even be un ucknowIedgemenL oI dynumIcs or
vurIuLIons beLween endogenous sysLems (e.g., geneLIc vurIuLIonsJ
ubnormuIILIes), LIe entire cuusuI source Ior un ussocIuLIon Is IuIseIy
uscrIbed Lo un externcl IucLor. A LrunsIerence IuIIucy Is uIso reIevunL In LIe
ubove-menLIoned unImuI sLudIes wIere LIere Is no uccounLIng Ior
vurIubIIILy In sLrengLIs oI ussocIuLIon beLween IucLors. TIereIore, noL onIy
Is LIe LIInkIng upsIde-down buL u LrunsIerence IuIIucy demonsLruLes LIuL
LIe LIInkIng Is uIso bccl-to-jront. n LIIs sense, epIdemIoIogIcuI LIInkIng
Ius un exLernuIIsL or envIronmenLuIIsL bIus LIuL Is wIoIIy unLenubIe.
AgencIes sucI us LIe EnvIronmenLuI ProLecLIon Agency, by ILs very
nomencIuLure, IndIcuLes LIuL reusonIng proceeds Irom u bIuck boxJ
exLernuIIsL perspecLIve. TIe resuIL oI LIIs IndeIensIbIe upproucI Is LIe
29
29
Rampant Antismoking Signifies Grave Danger
InvusIve curcInomu In one ouL oI 1; dogs, buL LIIs work Ius noL yeL been
conIIrmed. (p.16)
IrsLIy, LIese IIndIngs Iuve not sInce been repIIcuLed. SecondIy,
und very ImporLunLIy, Is LIuL II repIIcuLIon Iud occurred, one In 1; dogs
demonsLruLIng InvusIve curcInomu wouId resuIL In u concIusIon LIuL LIe
subsLunce In quesLIon cuuses cuncer In unImuIs (dogs). TIIs overIooks LIe
lcrin IucL LIuL over qq% oI LIe sumpIe dId noL demonsLruLe InvusIve
cuncer In LIe presence oI LIe unLecedenL. WILI uII oLIer exogenous IucLors
beIng equuI, LIe vurIuLIon In LIIs one InsLunce oI InvusIve cuncer musL
Iuve un endogenous source, e.g., IIgIIy uLypIcuI geneLIc ubnormuIILy. TIe
scme cuusuI sLuLus wouId be ussIgned II InvusIve cuncer occurred In uII 1;
dogs. TIese exLreme sILuuLIons, und LIe vurIuLIons In beLween, ure ter
dIIIerenL. n LIe Iormer, LIe normuLIve runge Is non-ussocIuLIon wILI LIe
dIseuse wILI un exLremeIy IIgI probubIIILy. n LIe IuLLer, LIe normuLIve
runge Is ussocIuLIon wILI LIe dIseuse wILI un exLremeIy IIgI probubIIILy.
TIIs InordInuLe LreuLmenL oI purLIcuIur IIndIngs represenLs neuroLIc
Lendency (I.e., cuLusLropIIzuLIon) In epIdemIoIogIc uppruIsuI.
RegurdIng Iumun duLu, LIe sLundurd oI busIng cuusuI
urgumenL onl on sLuLIsLIcuIIy sIgnIIIcunL dIIIerences In reIuLIve rIsk oI uL
IeusL u cerLuIn mugnILude (>z-q) Is un epIdemIoIogIc concocLIon LIuL Ius
no scIenLIIIc merIL uL uII. or exumpIe, LIe IncIdence oI u purLIcuIur dIseuse
Is ussocIuLed wILI IucLor B (unLecedenL) o LImes more LIun IucLor -B.
TIIs InIormuLIon depIcLs noLIIng us Lo wIeLIer LIe ussocIuLed IncIdence oI
LIe IucLor Is o Lo 1, or zo Lo , or oo Lo 1o, eLc.. urLIermore, LIe
InIormuLIon uIso depIcLs noLIIng us Lo LIe IncIdence oI LIe unLecedenL
IucLor generuIIy. L Is this InIormuLIon LIuL Is crILIcuI In ussessIng LIe
predIcLIve sLrengLI oI u IucLor(s) Ior unoLIer. or exumpIe, ussume LIuL
LIe IncIdence oI u purLIcuIur dIseuse ussocIuLed wILI IucLor B Is o LImes
more LIun ILs ussocIuLIon wILI IucLor -B (e.g., zo Lo ). I LIe IncIdence
oI IucLor B In LIe generuI popuIuLIon Is zo,ooo,ooo, LIen LIe predIcLIve
sLrengLI oI IucLor B Ior LIe dIseuse In quesLIon (ooJzo,ooo,ooo) Is
eIIecLIveIy zero, I.e., essenLIuIIy useIess.
WukeIIeId (1q88) uIso mukes LIIs observuLIon: ||Ive LImes u
very smuII probubIIILy oI deveIopIng u dIseuse Is sLIII u very smuII
probubIIILy oI deveIopIng LIe dIseuse. (p.q6) He IndIcuLes LIuL, us u
munner oI presenLIng InIormuLIon In un uncompIIcuLed IusIIon, LIe use oI
reIuLIve rIsk ruLIos Is reusonubIe. However, IL Is compIeLeIy InupproprIuLe
(over-sImpIIIIcuLIon) us u busIs Ior cuusuI urgumenL.
WukeIIeId (1q88) reusonubIy IndIcuLes LIuL u correIuLIon
coeIIIcIenL Is u superIor wuy oI meusurIng LIe degree oI reIuLIonsIIp
beLween Lwo IucLors. However, Ior LIe purposes oI LIIs dIscussIon, und
LIuL uILImuLeIy IL Is LIe predIcLIve sLrengLI oI one IucLor(s) Ior unoLIer
Lifestyle Epidemiology
LIuL Is crILIcuI, LIe condILIonuI probubIIILy beLween Lwo IucLors wIII serve
us u meusure oI LIe sLrengLI oI ussocIuLIon beLween IucLors. TIIs wIII yIeId
u meusure oI ubsoIuLe ruLIer LIun reIuLIve rIsk, und cun uIso uccounL Ior
excess IncIdence ubove u buseIIne ruLe. TIe buseIIne ruLe In LIe ubove
exumpIe Is o, I.e., LIe observed ussocIuLIon oI u dIseuse wILI IucLor -B.
Therejore, the bcsis jor ccuscl crument is cbsolute, cnd not relctite,
risl (see uIso Skrubunek & McCormIck, 1qqo, p.qo).
mporLunLIy, LIe ubsoIuLe rIsk oI IucLors Ior dIseuse LIuL
epIdemIoIogy Is usuuIIy concerned wILI Is very Iow (I.e., very poor
predIcLors). As sucI, epIdemIoIogy`s empIusIs on reIuLIve group
dIIIerences pIuces ILs Iocus oI ucLIvILy on LIe Iower, und wrong, end
(upproucIIng zero) oI LIe condILIonuI probubIIILy scuIe. SucI u perspecLIve
Is no dIIIerenL Lo LIe gumbIIng equIvuIenL oI Insurunce compuny
conducL, I.e., sLuLIsLIcuIIsm. L reIIecLs un upside-doun LIInkIng In LIuL IL
Is ImproperIy preoccupIed wILI uLypIcuI ussocIuLIons (I.e., subgroup, non-
Iomogeneous ussocIuLIons). As uIreudy menLIoned, LIIs upproucI Is un
ussuuIL on LIe normuLIve (LypIcuI) runge oI IuncLIonIng (see secLIon 1.)
Ior uny purLIcuIur IucLor wILIIn u duLu seL. L overIooks LIe IucL LIuL un
unLecedenL Is noL ussocIuLed wILI u specIIIc dIseuse Ior mosL oI LIe group
und, LIereIore, processIng oI LIe unLecedenL IucLor Is weII wILIIn u
normuLIve runge oI IuncLIonIng. WIen IL ussIgns u sIngIe IucLor, prImury
cuusuI sLuLus Lo exLernuI IucLors demonsLruLIng poor predIcLIve sLrengLI,
IL InvoIves un uddILIonuI error Lo upsIde-down LIInkIng. ALypIcuI
ussocIuLIons ure subgroup ussocIuLIons. Subgroup ussocIuLIons usuuIIy
InvoIve crILIcuI vurIuLIons In endoenous sysLems. WIuL cun besL be
descrIbed us u trcnsjerence jcllcc, epIdemIoIogy erroneousIy ussIgns
wIuL ure vurIuLIons In endogenous sysLems Lo LIe generuI cuusuI
properLIes oI un exogenous IucLor.
A LrunsIerence IuIIucy Is LypIcuI oI bIuck box reusonIng. n sucI
reusonIng uII orgunIsms wILIIn u group ure vIewed us Iomogeneous und
pussIve. AILIougI LIere muy even be un ucknowIedgemenL oI dynumIcs or
vurIuLIons beLween endogenous sysLems (e.g., geneLIc vurIuLIonsJ
ubnormuIILIes), LIe entire cuusuI source Ior un ussocIuLIon Is IuIseIy
uscrIbed Lo un externcl IucLor. A LrunsIerence IuIIucy Is uIso reIevunL In LIe
ubove-menLIoned unImuI sLudIes wIere LIere Is no uccounLIng Ior
vurIubIIILy In sLrengLIs oI ussocIuLIon beLween IucLors. TIereIore, noL onIy
Is LIe LIInkIng upsIde-down buL u LrunsIerence IuIIucy demonsLruLes LIuL
LIe LIInkIng Is uIso bccl-to-jront. n LIIs sense, epIdemIoIogIcuI LIInkIng
Ius un exLernuIIsL or envIronmenLuIIsL bIus LIuL Is wIoIIy unLenubIe.
AgencIes sucI us LIe EnvIronmenLuI ProLecLIon Agency, by ILs very
nomencIuLure, IndIcuLes LIuL reusonIng proceeds Irom u bIuck boxJ
exLernuIIsL perspecLIve. TIe resuIL oI LIIs IndeIensIbIe upproucI Is LIe
30
30
Rampant Antismoking Signifies Grave Danger
deLermInuLIon oI numerous curcInogens LIuL ure ucLuuIIy wILIIn u
normuLIve runge (non-curcInogenIc) oI IuncLIonIng. WILI LIIs conLorLed
reusonIng, epIdemIoIogy Ius uIso munuIucLured ILs own relctite Iunguuge.
or exumpIe, oI IIve IdenLIIIed rIsk IucLors Ior u purLIcuIur dIseuse, IL wIII
reIer Lo LIe IucLor wILI LIe IIgIesL reIuLIve rIsk us u mcjor rIsk IucLor even
LIougI LIe predIcLIve sLrengLI (ubsoIuLe rIsk) oI LIuL IucLor Ior LIe dIseuse
Is extremel poor. TIIs cun onIy serve Lo conIuse u popuIuLIon LIuL LIIs
nonsense Is Imposed on.
TIere Is u psycIoIogy Lo LIIs epIdemIoIogIcuI reusonIng LIuL wIII
be consIdered In IuLer secLIons. TIe InordInuLeness oI upsIde-down
LIInkIng (IIxuLIon on LIe uLypIcuI) und buck-Lo-IronL LIInkIng (e.g.,
projecLIon) ure consIdered Lo be neuroLIc LendencIes, I.e., IrruLIonuI. TIIs
neuroLIc Lendency Is u pecuIIurILy oI medIco-muLerIuIIsL menLuIILy
generuIIy. or exumpIe, HIII (1;61) suggesLed:
eL IL noL uppeur sLrunge, LIuL snuII, wIIcI cun eIIecL uII
LIIs mIscIIeI, Is noL Iound In every InsLunce Lo do IL. n
muny persons IL Is LIe cuuse oI dIsorders, wIIcI LIey
perIups do noL uLLrIbuLe Lo IL, und oI wIIcI LIeIr
pIysIcIun IImseII muy seek some oLIer cuuse: buL II LIe
number wus smuII oI LIose wIo suIIer, In compurIson oI
LIose wIo Luke snuII, wIuL wIse person wouId yeL
enguge In IL? I onIy IIve In un Iundred ruIned LIeIr
consLILuLIon by IL, wIo sIuII be ubIe Lo suy, wIen Ie
enLers on LIe cusLom, wIen Ie sIuII be one oI LIe
nIneLy-IIve wIo escupe, or oI LIe IIve LIuL perIsI?
TIe medIcuI IILeruLure Is repIeLe wILI LIIs upsIde-down
reusonIng. ALypIcuI ussocIuLIons ure vIewed us LypIcuI und us LIe busIs Ior
prescrIpLIve conducL (e.g., rIsk uversIon). L Is undersLundubIe LIuL LIe
medIco-muLerIuIIsL menLuIILy wouId be uLLrucLed by LIe reIuLIve-rIsk
sLuLIsLIc; IL Is LIe sLuLIsLIcuI equIvuIenL oI LIIs upsIde-down reusonIng. TIe
munner In wIIcI LIIs IIImsy sLuLIsLIc Is used by medIco-muLerIuIIsm Is Lo
provIde sLuLIsLIcuI jusLIIIcuLIon Ior u neuroLIc LIInkIng. n LIe Iunds oI
LIe medIco-muLerIuIIsL menLuIILy, scIenLIIIc enquIry Ius been reduced Lo
sLuLIsLIcuIIsm.
BeIng dysIuncLIonuI, LIIs LIInkIng IosLers LIe sume dysIuncLIon
In u popuIuLIon LIuL IL Is InIIIcLed upon under LIe preLense oI scIenLIIIc
credIbIIILy. As wIII be urgued In LIe IoIIowIng, epIdemIoIogy Ius sImpIy
never come Lo Lerms wILI LIe ucLuuI requIremenLs oI scIenLIIIc enquIry.
TIIs cIrcumsLunce cun onIy be descrIbed In Lerms oI gross IncompeLence
on u sysLemIc busIs. urLIermore, LIe errors IndIcuLed ubove, und wIIcI
represenL onIy some oI LIe IoIIy oI epIdemIoIogIcuI LIInkIng, Iuve gone
Lifestyle Epidemiology
uncorrecLed Ior LIe besL purL oI IuII-u-cenLury. As wIII be consIdered, LIe
combInuLIon oI gross IncompeLence und sLrong neuroLIc Lendency Iuve
IIgIIy deLrImenLuI psycIoIogIcuI, socIuI und moruI consequences.
z.z A Ccse Stud - Cicrette Smolin cnd Disecse
z.z.: An Dtertieu jrom Lon-Term Studies: The
Implicctions oj Dctc
CIgureLLe smokIng Ius been cuusuIIy ImpIIcuLed by IeuILI
uuLIorILIes (e.g., US Surgeon GeneruI (SG) 1q6q, 1q;q, 1q8z, 1q8; RoyuI
CoIIege oI PIysIcIuns (RCP), 1q;1, 1q;;) In quILe u number oI dIseusesJ
morLuIILy sucI us Iung cuncer, cIronIc IeurL dIseuse (CHD), und oLIer
cuncers (e.g., oropIurynx, Iurynx, oesopIugus, puncreus, bIudder, kIdney).
MosL ImporLunLIy Is LIuL LIe cuusuI ImpIIcuLIon Is depIcLed us one oI u
sIngIe IucLor, prImury cuuse oI LIe dIseusesJmorLuIILy In quesLIon. AIso,
smokIng Is consIdered Lo be LIe sIngIe greuLesL cuuse oI premuLure
morLuIILy.
GuIIIord (1q68) properIy noLes: or cIgureLLe smokIng und onl
cIgureLLe smokIng Lo be the cuuse oI Iung cuncer |or uny oLIer dIseuse|,
Lwo condILIons wouId Iuve Lo IoId: (1) No non-smoker wouId ever Iuve
Iung cuncer. (z) Everyone wIo smoked wILI suIIIcIenL exposure wouId
sIow, II LIey reucIed u suIIIcIenL uge, sIgns oI u deveIopIng cuncerous
LIssue. (p.8) n secLIon 1. IL wus consIdered LIuL even jusL LIe meeLIng
oI requIremenL z (I.e., suIIIcIenL condILIon) wouId provIde very sLrong
grounds Ior cuusuI urgumenL In expIuInIng LIe observed ussocIuLIon
beLween smokIng und u specIIIc dIseuse. n uLLempLIng Lo uppIy LIe
crILerIu Ior cuusuI urgumenL ouLIIned In secLIons 1.z und 1., un esLImuLe oI
LIe ubsoIuLe rIsk (IIIeIong) oI, Ior exumpIe, Iung-cuncer morLuIILy Ior
cIgureLLe-smokers Is requIred. SucI u meusure cun be LIe IncIdence oI
Iung-cuncer deuLIs us u proporLIon oI uII-cuuse morLuIILy Ior subgroups
(smokers) oI u popuIuLIon. or exumpIe, II u IucLor or combInuLIon oI
IucLors Is u dIrecL cuuse oI specijic dIseuseJmorLuIILy, LIen LIuL dIseuseJ
morLuIILy sIouId uccounL Ior mosL (>6o%) oI uII-cuuse morLuIILy.
n LIIs regurd, LIIs dIscussIon wIII uLIIIze u number oI Iong-Lerm
sLudIes InLo smokIng und morLuIILy. TIe IIrsL Is PrescoLL eL uI.`s (1qq8) o-
yeur IoIIow-up Ior pooIed duLu Irom LIree IongILudInuI popuIuLIon sLudIes
In LIe CopenIugen ureu. TIe second Is DoII eL uI.'s (1qqq) qo-yeur IoIIow-
up oI smokIng und morLuIILy In muIe BrILIsI docLors. TIe proporLIons oI
ce-specijic, cll-ccuse morLuIILy Ior LIe CopenIugen und BrILIsI
docLors sLudIes uppeur In TubIes 1(u), 1(b) und 1(c); LIe proporLIons oI
ce-cdjusted, specijic-ccuse morLuIILy Ior LIe CopenIugen und BrILIsI
31
31
Rampant Antismoking Signifies Grave Danger
deLermInuLIon oI numerous curcInogens LIuL ure ucLuuIIy wILIIn u
normuLIve runge (non-curcInogenIc) oI IuncLIonIng. WILI LIIs conLorLed
reusonIng, epIdemIoIogy Ius uIso munuIucLured ILs own relctite Iunguuge.
or exumpIe, oI IIve IdenLIIIed rIsk IucLors Ior u purLIcuIur dIseuse, IL wIII
reIer Lo LIe IucLor wILI LIe IIgIesL reIuLIve rIsk us u mcjor rIsk IucLor even
LIougI LIe predIcLIve sLrengLI (ubsoIuLe rIsk) oI LIuL IucLor Ior LIe dIseuse
Is extremel poor. TIIs cun onIy serve Lo conIuse u popuIuLIon LIuL LIIs
nonsense Is Imposed on.
TIere Is u psycIoIogy Lo LIIs epIdemIoIogIcuI reusonIng LIuL wIII
be consIdered In IuLer secLIons. TIe InordInuLeness oI upsIde-down
LIInkIng (IIxuLIon on LIe uLypIcuI) und buck-Lo-IronL LIInkIng (e.g.,
projecLIon) ure consIdered Lo be neuroLIc LendencIes, I.e., IrruLIonuI. TIIs
neuroLIc Lendency Is u pecuIIurILy oI medIco-muLerIuIIsL menLuIILy
generuIIy. or exumpIe, HIII (1;61) suggesLed:
eL IL noL uppeur sLrunge, LIuL snuII, wIIcI cun eIIecL uII
LIIs mIscIIeI, Is noL Iound In every InsLunce Lo do IL. n
muny persons IL Is LIe cuuse oI dIsorders, wIIcI LIey
perIups do noL uLLrIbuLe Lo IL, und oI wIIcI LIeIr
pIysIcIun IImseII muy seek some oLIer cuuse: buL II LIe
number wus smuII oI LIose wIo suIIer, In compurIson oI
LIose wIo Luke snuII, wIuL wIse person wouId yeL
enguge In IL? I onIy IIve In un Iundred ruIned LIeIr
consLILuLIon by IL, wIo sIuII be ubIe Lo suy, wIen Ie
enLers on LIe cusLom, wIen Ie sIuII be one oI LIe
nIneLy-IIve wIo escupe, or oI LIe IIve LIuL perIsI?
TIe medIcuI IILeruLure Is repIeLe wILI LIIs upsIde-down
reusonIng. ALypIcuI ussocIuLIons ure vIewed us LypIcuI und us LIe busIs Ior
prescrIpLIve conducL (e.g., rIsk uversIon). L Is undersLundubIe LIuL LIe
medIco-muLerIuIIsL menLuIILy wouId be uLLrucLed by LIe reIuLIve-rIsk
sLuLIsLIc; IL Is LIe sLuLIsLIcuI equIvuIenL oI LIIs upsIde-down reusonIng. TIe
munner In wIIcI LIIs IIImsy sLuLIsLIc Is used by medIco-muLerIuIIsm Is Lo
provIde sLuLIsLIcuI jusLIIIcuLIon Ior u neuroLIc LIInkIng. n LIe Iunds oI
LIe medIco-muLerIuIIsL menLuIILy, scIenLIIIc enquIry Ius been reduced Lo
sLuLIsLIcuIIsm.
BeIng dysIuncLIonuI, LIIs LIInkIng IosLers LIe sume dysIuncLIon
In u popuIuLIon LIuL IL Is InIIIcLed upon under LIe preLense oI scIenLIIIc
credIbIIILy. As wIII be urgued In LIe IoIIowIng, epIdemIoIogy Ius sImpIy
never come Lo Lerms wILI LIe ucLuuI requIremenLs oI scIenLIIIc enquIry.
TIIs cIrcumsLunce cun onIy be descrIbed In Lerms oI gross IncompeLence
on u sysLemIc busIs. urLIermore, LIe errors IndIcuLed ubove, und wIIcI
represenL onIy some oI LIe IoIIy oI epIdemIoIogIcuI LIInkIng, Iuve gone
Lifestyle Epidemiology
uncorrecLed Ior LIe besL purL oI IuII-u-cenLury. As wIII be consIdered, LIe
combInuLIon oI gross IncompeLence und sLrong neuroLIc Lendency Iuve
IIgIIy deLrImenLuI psycIoIogIcuI, socIuI und moruI consequences.
z.z A Ccse Stud - Cicrette Smolin cnd Disecse
z.z.: An Dtertieu jrom Lon-Term Studies: The
Implicctions oj Dctc
CIgureLLe smokIng Ius been cuusuIIy ImpIIcuLed by IeuILI
uuLIorILIes (e.g., US Surgeon GeneruI (SG) 1q6q, 1q;q, 1q8z, 1q8; RoyuI
CoIIege oI PIysIcIuns (RCP), 1q;1, 1q;;) In quILe u number oI dIseusesJ
morLuIILy sucI us Iung cuncer, cIronIc IeurL dIseuse (CHD), und oLIer
cuncers (e.g., oropIurynx, Iurynx, oesopIugus, puncreus, bIudder, kIdney).
MosL ImporLunLIy Is LIuL LIe cuusuI ImpIIcuLIon Is depIcLed us one oI u
sIngIe IucLor, prImury cuuse oI LIe dIseusesJmorLuIILy In quesLIon. AIso,
smokIng Is consIdered Lo be LIe sIngIe greuLesL cuuse oI premuLure
morLuIILy.
GuIIIord (1q68) properIy noLes: or cIgureLLe smokIng und onl
cIgureLLe smokIng Lo be the cuuse oI Iung cuncer |or uny oLIer dIseuse|,
Lwo condILIons wouId Iuve Lo IoId: (1) No non-smoker wouId ever Iuve
Iung cuncer. (z) Everyone wIo smoked wILI suIIIcIenL exposure wouId
sIow, II LIey reucIed u suIIIcIenL uge, sIgns oI u deveIopIng cuncerous
LIssue. (p.8) n secLIon 1. IL wus consIdered LIuL even jusL LIe meeLIng
oI requIremenL z (I.e., suIIIcIenL condILIon) wouId provIde very sLrong
grounds Ior cuusuI urgumenL In expIuInIng LIe observed ussocIuLIon
beLween smokIng und u specIIIc dIseuse. n uLLempLIng Lo uppIy LIe
crILerIu Ior cuusuI urgumenL ouLIIned In secLIons 1.z und 1., un esLImuLe oI
LIe ubsoIuLe rIsk (IIIeIong) oI, Ior exumpIe, Iung-cuncer morLuIILy Ior
cIgureLLe-smokers Is requIred. SucI u meusure cun be LIe IncIdence oI
Iung-cuncer deuLIs us u proporLIon oI uII-cuuse morLuIILy Ior subgroups
(smokers) oI u popuIuLIon. or exumpIe, II u IucLor or combInuLIon oI
IucLors Is u dIrecL cuuse oI specijic dIseuseJmorLuIILy, LIen LIuL dIseuseJ
morLuIILy sIouId uccounL Ior mosL (>6o%) oI uII-cuuse morLuIILy.
n LIIs regurd, LIIs dIscussIon wIII uLIIIze u number oI Iong-Lerm
sLudIes InLo smokIng und morLuIILy. TIe IIrsL Is PrescoLL eL uI.`s (1qq8) o-
yeur IoIIow-up Ior pooIed duLu Irom LIree IongILudInuI popuIuLIon sLudIes
In LIe CopenIugen ureu. TIe second Is DoII eL uI.'s (1qqq) qo-yeur IoIIow-
up oI smokIng und morLuIILy In muIe BrILIsI docLors. TIe proporLIons oI
ce-specijic, cll-ccuse morLuIILy Ior LIe CopenIugen und BrILIsI
docLors sLudIes uppeur In TubIes 1(u), 1(b) und 1(c); LIe proporLIons oI
ce-cdjusted, specijic-ccuse morLuIILy Ior LIe CopenIugen und BrILIsI
32
32
Rampant Antismoking Signifies Grave Danger
docLors sLudIes uppeur In TubIes z(u), z(b) und z(c). TIe IncIdence oI
cIgureLLe smokIng In LIe CopenIugen popuIuLIon Ior boLI men und
women Is unusuuIIy IIgI; un uveruge oI q.% Ior women wILI u peuk oI
61% Ior LIe q-6o yeurs uge group, und un uveruge oI 66.8% Ior men, wILI
u peuk oI ;z.% Ior LIe q-6o yeurs uge group. TIe IncIdence oI cIgureLLe
smokIng In LIe BrILIsI docLors popuIuLIon wus compuruLIveIy Iow uL
ubouL 8%.
mmedIuLeIy, LIere ure u number oI poLenLIuI probIems wILI LIe
ubove duLu LIuL requIre consIderuLIon. TIese InvoIve generuI errors In
cIInIcuI dIugnoses und specIIIc deLecLIon bIus Ior reporLs on specIIIc-cuuse
morLuIILy. BrILLon (1q;q), In u SwedIsI survey, Iound LIuL muIn cIInIcuI
dIugnoses (cuuse oI deuLI) were conIIrmed by IospILuI uuLopsy In onIy
;% oI cuses. TIe dIsugreemenLs beLween cIInIcuI und uuLopsy dIugnoses
runged Irom 6% Lo 6%. BrILLon (1q;q) concIuded LIuL uuLopsIes eurIIer
dId und sLIII do reveuI u consIderubIe number oI errors In cIInIcuI
dIugnoses..TIere Is no convIncIng sIgn LIuL LIe ruLe oI errors Iud
dImInIsIed over LIe yeurs. (p.zo8)
Heusmun & IpworLI (1q66) und WuIdron & VIckersLuII (1q;;)
uIso reporL poor conIIrmuLIon beLween cIInIcuI und uuLopsy dIugnoses, I.e.,
q% und q;.%, respecLIveIy. Abrumson, Sucks & Cubun (1q;1) concIude
LIuL LIe deuLI cerLIIIcuLe duLu Iud murked IImILuLIons us un IndIcuLIon oI
LIe presence oI myocurdIuI InIurcLIon, cerebrovuscuIur dIseuse, puImonury
emboIIsms or InIurcLIons..TIey guve u IuIrIy uccuruLe IndIcuLIon oI LIe
presence oI muIIgnunL neopIusms buL noL oI LIe specIIIc sILes or cuLegorIes
oI neopIusms. (p.qo) Cumeron & McGoogun (1q81) uIso Iound u Iow
conIIrmuLIon ruLe oI 61%. urLIermore, LIey Iound LIuL conIIrmuLIon wus
IIgIer (-;8%) Ior younger uge groups (I.e., up Lo q yeurs oI uge), und
progressIveIy deLerIoruLed Ior oIder uge groups (<o%). Eysenck (1qq1), In
revIewIng LIe reIevunL sLudIes, noLes LIuL LIe conIIrmuLIonJerror ruLe Ior
cuncer und CHD, wIIcI ure reIevunL Lo LIe Issue oI smokIng, wus mucI
LIe sume us Ior uII dIseuses.
TIe oLIer crILIcuI probIem Is LIuL oI detection bics und concerns
Iung cuncer specIIIcuIIy. eInsLeIn & WeIIs (1q;q) Iound LIuL, regurdIng u
US InvesLIguLIon, u pIysIcIun Is more IIkeIy Lo dIugnose Iung cuncer In
smokers LIun In nonsmokers und In Ieuvy LIun In IIgIL smokers.
McurIune eL uI. (1q86), In u revIew oI posLmorLem records uL u US
IospILuI, Iound LIuL z8% oI 1 prImury Iung cuncers Iud noL been
dIugnosed wIIIe LIe puLIenL wus IIvIng. UndIugnosed Iung cuncer wus o%
compured Lo 8% Ior dIugnosed Iung cuncer umongsL nonsmokers. TIe
probIem Iere Is LIuL wIere posLmorLem InIormuLIon Is unuvuIIubIe,
undIugnosed Iung cuncer Is bIused Lowurd non-dIugnosIs In nonsmokers.
TIere Is uIso LIe probIem oI meLusLusIsed Lumors (cuncer orIgInuLIng uL
Lifestyle Epidemiology
33
33
Rampant Antismoking Signifies Grave Danger
docLors sLudIes uppeur In TubIes z(u), z(b) und z(c). TIe IncIdence oI
cIgureLLe smokIng In LIe CopenIugen popuIuLIon Ior boLI men und
women Is unusuuIIy IIgI; un uveruge oI q.% Ior women wILI u peuk oI
61% Ior LIe q-6o yeurs uge group, und un uveruge oI 66.8% Ior men, wILI
u peuk oI ;z.% Ior LIe q-6o yeurs uge group. TIe IncIdence oI cIgureLLe
smokIng In LIe BrILIsI docLors popuIuLIon wus compuruLIveIy Iow uL
ubouL 8%.
mmedIuLeIy, LIere ure u number oI poLenLIuI probIems wILI LIe
ubove duLu LIuL requIre consIderuLIon. TIese InvoIve generuI errors In
cIInIcuI dIugnoses und specIIIc deLecLIon bIus Ior reporLs on specIIIc-cuuse
morLuIILy. BrILLon (1q;q), In u SwedIsI survey, Iound LIuL muIn cIInIcuI
dIugnoses (cuuse oI deuLI) were conIIrmed by IospILuI uuLopsy In onIy
;% oI cuses. TIe dIsugreemenLs beLween cIInIcuI und uuLopsy dIugnoses
runged Irom 6% Lo 6%. BrILLon (1q;q) concIuded LIuL uuLopsIes eurIIer
dId und sLIII do reveuI u consIderubIe number oI errors In cIInIcuI
dIugnoses..TIere Is no convIncIng sIgn LIuL LIe ruLe oI errors Iud
dImInIsIed over LIe yeurs. (p.zo8)
Heusmun & IpworLI (1q66) und WuIdron & VIckersLuII (1q;;)
uIso reporL poor conIIrmuLIon beLween cIInIcuI und uuLopsy dIugnoses, I.e.,
q% und q;.%, respecLIveIy. Abrumson, Sucks & Cubun (1q;1) concIude
LIuL LIe deuLI cerLIIIcuLe duLu Iud murked IImILuLIons us un IndIcuLIon oI
LIe presence oI myocurdIuI InIurcLIon, cerebrovuscuIur dIseuse, puImonury
emboIIsms or InIurcLIons..TIey guve u IuIrIy uccuruLe IndIcuLIon oI LIe
presence oI muIIgnunL neopIusms buL noL oI LIe specIIIc sILes or cuLegorIes
oI neopIusms. (p.qo) Cumeron & McGoogun (1q81) uIso Iound u Iow
conIIrmuLIon ruLe oI 61%. urLIermore, LIey Iound LIuL conIIrmuLIon wus
IIgIer (-;8%) Ior younger uge groups (I.e., up Lo q yeurs oI uge), und
progressIveIy deLerIoruLed Ior oIder uge groups (<o%). Eysenck (1qq1), In
revIewIng LIe reIevunL sLudIes, noLes LIuL LIe conIIrmuLIonJerror ruLe Ior
cuncer und CHD, wIIcI ure reIevunL Lo LIe Issue oI smokIng, wus mucI
LIe sume us Ior uII dIseuses.
TIe oLIer crILIcuI probIem Is LIuL oI detection bics und concerns
Iung cuncer specIIIcuIIy. eInsLeIn & WeIIs (1q;q) Iound LIuL, regurdIng u
US InvesLIguLIon, u pIysIcIun Is more IIkeIy Lo dIugnose Iung cuncer In
smokers LIun In nonsmokers und In Ieuvy LIun In IIgIL smokers.
McurIune eL uI. (1q86), In u revIew oI posLmorLem records uL u US
IospILuI, Iound LIuL z8% oI 1 prImury Iung cuncers Iud noL been
dIugnosed wIIIe LIe puLIenL wus IIvIng. UndIugnosed Iung cuncer wus o%
compured Lo 8% Ior dIugnosed Iung cuncer umongsL nonsmokers. TIe
probIem Iere Is LIuL wIere posLmorLem InIormuLIon Is unuvuIIubIe,
undIugnosed Iung cuncer Is bIused Lowurd non-dIugnosIs In nonsmokers.
TIere Is uIso LIe probIem oI meLusLusIsed Lumors (cuncer orIgInuLIng uL
Lifestyle Epidemiology
34
34
Rampant Antismoking Signifies Grave Danger Lifestyle Epidemiology
35
35
Rampant Antismoking Signifies Grave Danger Lifestyle Epidemiology
36
36
Rampant Antismoking Signifies Grave Danger Lifestyle Epidemiology
oLIer sILes) In LIe Iung beIng dIugnosed us Iung cuncer In smokers, und
more probubIy In Ieuvy smokers. eInsLeIn & WeIIs (1q;q) sLuLe LIuL
CIgureLLe smokIng muy conLrIbuLe more Lo LIe dIugnosIs oI Iung cuncer
LIun IL does In producIng LIe dIseuse ILseII. (p18q)
RosenbIuLL (1q;q) suggesLs LIuL LIe very consIderubIe Increuse In
Iung-cuncer morLuIILy Ior LIe prevIous o yeurs wus essenLIuIIy due Lo new
und Improved dIugnosLIc LecInIques. He IurLIer suggesLs LIuL u Lendency
Lo overdIugnose LIe dIseuse mIgIL be uLLrIbuLubIe Lo LIe greuL InLeresL In
LIe LIeory posILIng u cuusuI ussocIuLIon beLween cIgureLLe smokIng und
Iung cuncer. TIe overuII ImpucL oI sucI IIndIngs und possIbIIILIes Is LIuL
ubsoIuLe, IIIeIong rIsk muy be Iower In IIgIL-smokers, mucI Iower In Ieuvy
smokers, und LIe buseIIne ruLe oI Iung cuncer In nonsmokers Is IIgIer
LIun specIIIc-morLuIILy (Iung cuncer) sLuLIsLIcs IndIcuLe. TIere Is no
reseurcI us Lo wIeLIer u deLecLIon bIus muy uIso occur Ior ex-smokers,
sucI LIuL LIe Ionger u person Ius noL smoked, LIe more IIkeIy LIey ure Lo
be medIcuIIy vIewed us u nonsmoker. AddILIonuIIy, LIere Is no reseurcI us
Lo wIeLIer u deLecLIon bIus mIgIL uIso occur Ior nonsmokIng spouses oI
smokers.
AcknowIedgIng un unreIIubIIILy IucLor In specIIIc-cuuse morLuIILy
duLu, In LIe CopenIugen sLudy, Ior men, LIe ubsoIuLe, IIIeIong rIsk oI
Iung-cuncer morLuIILy ussocIuLed wILI smokIng 1g oI Lobucco per duy or
more per duy (Ieuvy-smoker) Is o.1 (see TubIe z(b)), und o.oq wILI
smokIng Iess LIun 1g oI Lobucco per duy (IIgIL-smoker). or women, LIe
ubsoIuLe, IIIeIong rIsk oI Iung-cuncer morLuIILy ussocIuLed wILI Ieuvy
smokIng Is o.1z (see TubIe z(u)), und wILI IIgIL smokIng Is o.oq. TIese
proporLIons do noL uccounL Ior LIe buseIIne ruLe oI Iung-cuncer morLuIILy
In never-smokers (I.e., o.oz Ior boLI men und women). n LIe BrILIsI
docLors sLudy, LIe ubsoIuLe, IIIeIong rIsk oI Iung-cuncer morLuIILy Ior
Ieuvy-smokers Is o.oq, und o.oq Ior IIgIL-smokers (see TubIe z(c)). TIe
buseIIne ruLe (never-smokers) Is o.o1.
TIe predIcLIve sLrengLI oI cIgureLLe smokIng Ior Iung cuncer oI
beLween q-1% (uncorrecLed Ior bIus und buseIIne) Is consIsLenL wILI
oLIer generuI NorLI AmerIcun und Europeun popuIuLIons. L cun be noLed
Irom LIe currenL sLudIes LIuL LIere exIsL gender und popuIuLIon
dIIIerences In specIIIc-cuuse morLuIILy. AL u gross-IeveI, LIere Is u Iower
proporLIon oI cuncer morLuIILy buL u IIgIer proporLIon oI morLuIILy Irom
vuscuIur dIseuse In muIe BrILIsI docLors LIun boLI gender groups In LIe
CopenIugen sLudy. TIere Is u smuIIer dIIIerenLIuI Ior proporLIon oI
cuncer morLuIILy beLween never-smokIngJIeuvy-smokIng women In LIe
CopenIugen sLudy compured Lo LIe muIe groups. More never-smokers
oI boLI genders In LIe CopenIugen sLudy reucI 8+yeurs oI uge LIun
never smoker muIe BrILIsI docLors.
37
37
Rampant Antismoking Signifies Grave Danger Lifestyle Epidemiology
oLIer sILes) In LIe Iung beIng dIugnosed us Iung cuncer In smokers, und
more probubIy In Ieuvy smokers. eInsLeIn & WeIIs (1q;q) sLuLe LIuL
CIgureLLe smokIng muy conLrIbuLe more Lo LIe dIugnosIs oI Iung cuncer
LIun IL does In producIng LIe dIseuse ILseII. (p18q)
RosenbIuLL (1q;q) suggesLs LIuL LIe very consIderubIe Increuse In
Iung-cuncer morLuIILy Ior LIe prevIous o yeurs wus essenLIuIIy due Lo new
und Improved dIugnosLIc LecInIques. He IurLIer suggesLs LIuL u Lendency
Lo overdIugnose LIe dIseuse mIgIL be uLLrIbuLubIe Lo LIe greuL InLeresL In
LIe LIeory posILIng u cuusuI ussocIuLIon beLween cIgureLLe smokIng und
Iung cuncer. TIe overuII ImpucL oI sucI IIndIngs und possIbIIILIes Is LIuL
ubsoIuLe, IIIeIong rIsk muy be Iower In IIgIL-smokers, mucI Iower In Ieuvy
smokers, und LIe buseIIne ruLe oI Iung cuncer In nonsmokers Is IIgIer
LIun specIIIc-morLuIILy (Iung cuncer) sLuLIsLIcs IndIcuLe. TIere Is no
reseurcI us Lo wIeLIer u deLecLIon bIus muy uIso occur Ior ex-smokers,
sucI LIuL LIe Ionger u person Ius noL smoked, LIe more IIkeIy LIey ure Lo
be medIcuIIy vIewed us u nonsmoker. AddILIonuIIy, LIere Is no reseurcI us
Lo wIeLIer u deLecLIon bIus mIgIL uIso occur Ior nonsmokIng spouses oI
smokers.
AcknowIedgIng un unreIIubIIILy IucLor In specIIIc-cuuse morLuIILy
duLu, In LIe CopenIugen sLudy, Ior men, LIe ubsoIuLe, IIIeIong rIsk oI
Iung-cuncer morLuIILy ussocIuLed wILI smokIng 1g oI Lobucco per duy or
more per duy (Ieuvy-smoker) Is o.1 (see TubIe z(b)), und o.oq wILI
smokIng Iess LIun 1g oI Lobucco per duy (IIgIL-smoker). or women, LIe
ubsoIuLe, IIIeIong rIsk oI Iung-cuncer morLuIILy ussocIuLed wILI Ieuvy
smokIng Is o.1z (see TubIe z(u)), und wILI IIgIL smokIng Is o.oq. TIese
proporLIons do noL uccounL Ior LIe buseIIne ruLe oI Iung-cuncer morLuIILy
In never-smokers (I.e., o.oz Ior boLI men und women). n LIe BrILIsI
docLors sLudy, LIe ubsoIuLe, IIIeIong rIsk oI Iung-cuncer morLuIILy Ior
Ieuvy-smokers Is o.oq, und o.oq Ior IIgIL-smokers (see TubIe z(c)). TIe
buseIIne ruLe (never-smokers) Is o.o1.
TIe predIcLIve sLrengLI oI cIgureLLe smokIng Ior Iung cuncer oI
beLween q-1% (uncorrecLed Ior bIus und buseIIne) Is consIsLenL wILI
oLIer generuI NorLI AmerIcun und Europeun popuIuLIons. L cun be noLed
Irom LIe currenL sLudIes LIuL LIere exIsL gender und popuIuLIon
dIIIerences In specIIIc-cuuse morLuIILy. AL u gross-IeveI, LIere Is u Iower
proporLIon oI cuncer morLuIILy buL u IIgIer proporLIon oI morLuIILy Irom
vuscuIur dIseuse In muIe BrILIsI docLors LIun boLI gender groups In LIe
CopenIugen sLudy. TIere Is u smuIIer dIIIerenLIuI Ior proporLIon oI
cuncer morLuIILy beLween never-smokIngJIeuvy-smokIng women In LIe
CopenIugen sLudy compured Lo LIe muIe groups. More never-smokers
oI boLI genders In LIe CopenIugen sLudy reucI 8+yeurs oI uge LIun
never smoker muIe BrILIsI docLors.
38
38
Rampant Antismoking Signifies Grave Danger
NoLwILIsLundIng LIese und oLIer vurIuLIons, udopLIng LIe IIgIesL
predIcLIve sLrengLI oI cIgureLLe smokIng Ior Iung cuncer oI .1 Ior men
consumIng 1g or more oI Lobucco per duy In LIe CopenIugen sLudy, IL
cun be concIuded Irom LIe crILerIu Ior cuusuI InIerence (see secLIon 1.z,
1.), IncIudIng u predIcLIve sLrengLI oI uL IeusL o.6o, LIuL cIgureLLe
smokIng ccnnot be consIdered us u sIngIe-IucLor, prImury cuuse (I.e.,
suIIIcIenL condILIon) oI Iung cuncer. L demonsLruLes poor consIsLencyJ
specIIIcILy oI ussocIuLIon und Is, LIereIore, poor In degree oI IuIsIIIubIIILy
und u poor predIcLor oI LIe dIseuse In quesLIon. n oLIer words, II cIgureLLe
smokIng Is used us u predIcLor oI Iung cuncer over u IIIeLIme, we wouId be
correcL 1% oI LIe LIme, or wrong 8% oI LIe LIme. n scIenLIIIc Lerms, LIIs
sILuuLIon Is compIeLeIy unuccepLubIe. TIe observed ussocIuLIon beLween
cIgureLLe smokIng und Iung cuncer Is noL u generuI, buL u subgroup und
uLypIcuI, ussocIuLIon.
TIIs concIusIon Is wurrunLed even II noL uccounLIng Ior LIe
dIugnosLIc errors und deLecLIon bIus menLIoned ubove, In wIIcI cuse LIe
ubsoIuLe, IIIeIong rIsk oI Iung cuncer Ior Ieuvy-smokers wouId be Iower
und LIe buseIIne ruLe oI LIe specIIIc-cuuse morLuIILy wouId be IIgIer. TIe
predIcLIve sLrengLI oI Ieuvy-smokIng Ior CHD Is IIgIer LIun LIuL Ior Iung
cuncer (o.zq). However, LIe buseIIne ruLe Ior CHD Is IIgIer sLIII uL o.zq.
TIe predIcLIve sLrengLI oI Ieuvy-smokIng Ior Lobucco-reIuLed cuncers
oLIer LIun Iung cuncer Is .o; wILI u buseIIne ruLe oI .o. L sIouId be noLed
LIuL oLIer Lobucco-reIuLed cuncers Is mude up oI u number oI cuncer
Lypes (IIsLed ubove) sucI LIuL LIe predIcLIve sLrengLI oI Ieuvy-smokIng Ior
uny oI LIese cuncers specIIIcuIIy Is LIny, I.e., neur-zero or eIIecLIveIy zero.
SmokIng generuIIy or even Ieuvy-smokIng specIIIcuIIy ccnnot be
consIdered us u sIngIe IucLor, prImury cuuse oI uny oI LIese dIseusesJ
morLuIILy. n oLIer words, cIgureLLe smokIng Is neILIer u necessury nor u
suIIIcIenL condILIon Ior uny specIIIc dIseuseJmorLuIILy.
TIe onIy specIIIc dIseuse LIuL smokers Iuve u Iur IIgIer ruLe oI,
even In proporLIonuI Lerms, LIun nonsmokers Is Iung cuncer.
urLIermore, LIe dIseuse Is uImosL pecuIIurIy Iound In LIe smoker`s
group. However, us Ius been noLed, LIe predIcLIve sLrengLI oI Ieuvy
smokIng Ior Iung cuncer, uILer correcLIng Ior deLecLIon bIus und u buseIIne
ruLe, Is ubouL -1o%, I.e., qo% oI Ieuvy smokers do noL deveIop Iung
cuncer.
ndeed, LIere Is u IIgIer reIuLIve rIsk oI Iung cuncer ussocIuLed
wILI smokIng. TIere Is IurLIer IImILed supporL Irom u LwIn sLudy
IndIcuLIng u IIgIer ruLe oI Iung cuncer umongsL smokIng monozygoLIc
(IdenLIcuI) LwIns compured wILI LIeIr nonsmokIng sIbIIngs (Ioderus eL
uI., 1q88). However, LIe sILuuLIon Is Iur more compIex LIun LIese IIndIngs
wouId IndIcuLe wIen IL Is consIdered LIuL LIere ure muny oLIer IdenLIIIed
Lifestyle Epidemiology
rIsk IucLors Ior specIIIc dIseuse. or exumpIe, un Increused rIsk oI Iung
cuncer Is ussocIuLed wILI: - u IumIIy IIsLory oI LIe dIseuse (SeIIers, 1qq;
SIIeIds & HurrIs, 1qq); dIeLury IucLors (KvuIe eL uI., 1q8); socIo-
economIc sLuLus und educuLIon (HurL eL uI., zoo1; MurLIkuInen eL uI.,
zoo1). TIere Is Increused rIsk umongsL subgroups oI LIe smoker`s group
ussocIuLed wILI - usbesLos exposure (Hummond eL uI., 1q;q); exIsLIng
Iung dIseuse sucI us cIronIc obsLrucLIve puImonury dIseuse (SkIIIud eL uI.,
1q86). TIere ure uIso LIe rIsk IucLors oI dIeL und pIysIcuI exercIse
ussocIuLed wILI smokIng generuIIy (JoIunsson & SundquIsL, 1qqq;
MurgeLLs & Juckson, 1qq; OsIer, 1qq8; PuIunIuppun eL uI., zoo1); und u
possIbIe geneLIc conLrIbuLIon Lo smokIng (CurmeIII eL uI., 1qqz; HeuLI &
MurLIn, 1qq; ermun eL uI., 1qqq). AILIougI LIese IucLors ure ussocIuLed
wILI Increused reIuLIve rIsk, LIe predIcLIve sLrengLI oI uny oI LIese IucLors,
or combInuLIon oI IucLors, Ior LIe specIIIc dIseuse Is sLIII ter poor.
TIe Issue oI CHD Is even more bIurred. CHD Is purLIcuIurIy
probIemuLIc In LIuL IL does noL reIIecL u specIIIc dIseuse und Is ubIquILous
(SLeIbens, 1qqz). urLIermore, LIe number oI IdenLIIIed rIsk IucLors Ior
CHD Is sLuggerIng. or exumpIe, HopkIns & WIIIIums (1q86) revIewed
more LIun z;o rIsk IucLors Ior CHD IdenLIIIed Lo LIuL duLe. Even cIronIc
InIecLIons (e.g., bucLerIuI) InvoIvIng, Ior exumpIe, Helicobccter plori
Iuve been ImpIIcuLed (see DunesI eL uI., 1qq;). AguIn, uny oI LIese,
IncIudIng cIgureLLe smokIng, or combInuLIons oI LIese, ure very poor
predIcLors oI CHD morLuIILy.
OLIer vILuI evIdence perLuInIng Lo cIgureLLe smokIng und CHD
derIves Irom LwIn sLudIes. n u sLudy oI monozygoLIc LwIns und wIere
one oI LIe LwIns wus u persIsLenL smoker und LIe oLIer u non-smoker,
CederIoI eL uI. (1q66) und undmun (1q66) Iound no dIIIerence In CHD or
dIsLurbunces oI coronury IuncLIon beLween LIe smokIng und non-smokIng
LwIns. BIood IeveIs oI cIoIesLeroI und oLIer IuLLy muLerIuI wus, on
uveruge, IIgIer In LIe smokers, buL noL sIgnIIIcunLIy so. TIe onIy
dIIIerence seemed Lo be reIuLed Lo cIronIc broncIILIs. L wus concIuded
LIuL curdIovuscuIur ubnormuIILIes were deLermIned predomInunLIy by
IeredILy, und LIuL smokIng Iud no dIscernubIe eIIecL. WILIIn LIIs greuL
rIsk-IucLor enLungIemenL LIere ure even more recenL pecuIIurILIes
(unomuIIes). or exumpIe, Ior LIe SpunIsI provInce oI Geronu, uILIougI
LIere Is u IIgI prevuIence oI curdIovuscuIur rIsk IucLors (IncIudIng
cIgureLLe smokIng), LIere Is u Iow myocurdIuI InIurcLIon IncIdence (MusIu
eL uI., 1qq8).
SInce LIe 1qo`s, empIysemu Ius uIso been IInked Lo cIgureLLe
smokIng. However, urson eL uI. (1q61) noLed LIuL uILIougI opInIon
regurdIng LIe ussocIuLIon Is IIgI, LIe evIdence Is scunLy. TIe condILIon Is
cerLuInIy Iound more In smokers LIun In nonsmokers (e.g., AbboLL eL uI.,
39
39
Rampant Antismoking Signifies Grave Danger
NoLwILIsLundIng LIese und oLIer vurIuLIons, udopLIng LIe IIgIesL
predIcLIve sLrengLI oI cIgureLLe smokIng Ior Iung cuncer oI .1 Ior men
consumIng 1g or more oI Lobucco per duy In LIe CopenIugen sLudy, IL
cun be concIuded Irom LIe crILerIu Ior cuusuI InIerence (see secLIon 1.z,
1.), IncIudIng u predIcLIve sLrengLI oI uL IeusL o.6o, LIuL cIgureLLe
smokIng ccnnot be consIdered us u sIngIe-IucLor, prImury cuuse (I.e.,
suIIIcIenL condILIon) oI Iung cuncer. L demonsLruLes poor consIsLencyJ
specIIIcILy oI ussocIuLIon und Is, LIereIore, poor In degree oI IuIsIIIubIIILy
und u poor predIcLor oI LIe dIseuse In quesLIon. n oLIer words, II cIgureLLe
smokIng Is used us u predIcLor oI Iung cuncer over u IIIeLIme, we wouId be
correcL 1% oI LIe LIme, or wrong 8% oI LIe LIme. n scIenLIIIc Lerms, LIIs
sILuuLIon Is compIeLeIy unuccepLubIe. TIe observed ussocIuLIon beLween
cIgureLLe smokIng und Iung cuncer Is noL u generuI, buL u subgroup und
uLypIcuI, ussocIuLIon.
TIIs concIusIon Is wurrunLed even II noL uccounLIng Ior LIe
dIugnosLIc errors und deLecLIon bIus menLIoned ubove, In wIIcI cuse LIe
ubsoIuLe, IIIeIong rIsk oI Iung cuncer Ior Ieuvy-smokers wouId be Iower
und LIe buseIIne ruLe oI LIe specIIIc-cuuse morLuIILy wouId be IIgIer. TIe
predIcLIve sLrengLI oI Ieuvy-smokIng Ior CHD Is IIgIer LIun LIuL Ior Iung
cuncer (o.zq). However, LIe buseIIne ruLe Ior CHD Is IIgIer sLIII uL o.zq.
TIe predIcLIve sLrengLI oI Ieuvy-smokIng Ior Lobucco-reIuLed cuncers
oLIer LIun Iung cuncer Is .o; wILI u buseIIne ruLe oI .o. L sIouId be noLed
LIuL oLIer Lobucco-reIuLed cuncers Is mude up oI u number oI cuncer
Lypes (IIsLed ubove) sucI LIuL LIe predIcLIve sLrengLI oI Ieuvy-smokIng Ior
uny oI LIese cuncers specIIIcuIIy Is LIny, I.e., neur-zero or eIIecLIveIy zero.
SmokIng generuIIy or even Ieuvy-smokIng specIIIcuIIy ccnnot be
consIdered us u sIngIe IucLor, prImury cuuse oI uny oI LIese dIseusesJ
morLuIILy. n oLIer words, cIgureLLe smokIng Is neILIer u necessury nor u
suIIIcIenL condILIon Ior uny specIIIc dIseuseJmorLuIILy.
TIe onIy specIIIc dIseuse LIuL smokers Iuve u Iur IIgIer ruLe oI,
even In proporLIonuI Lerms, LIun nonsmokers Is Iung cuncer.
urLIermore, LIe dIseuse Is uImosL pecuIIurIy Iound In LIe smoker`s
group. However, us Ius been noLed, LIe predIcLIve sLrengLI oI Ieuvy
smokIng Ior Iung cuncer, uILer correcLIng Ior deLecLIon bIus und u buseIIne
ruLe, Is ubouL -1o%, I.e., qo% oI Ieuvy smokers do noL deveIop Iung
cuncer.
ndeed, LIere Is u IIgIer reIuLIve rIsk oI Iung cuncer ussocIuLed
wILI smokIng. TIere Is IurLIer IImILed supporL Irom u LwIn sLudy
IndIcuLIng u IIgIer ruLe oI Iung cuncer umongsL smokIng monozygoLIc
(IdenLIcuI) LwIns compured wILI LIeIr nonsmokIng sIbIIngs (Ioderus eL
uI., 1q88). However, LIe sILuuLIon Is Iur more compIex LIun LIese IIndIngs
wouId IndIcuLe wIen IL Is consIdered LIuL LIere ure muny oLIer IdenLIIIed
Lifestyle Epidemiology
rIsk IucLors Ior specIIIc dIseuse. or exumpIe, un Increused rIsk oI Iung
cuncer Is ussocIuLed wILI: - u IumIIy IIsLory oI LIe dIseuse (SeIIers, 1qq;
SIIeIds & HurrIs, 1qq); dIeLury IucLors (KvuIe eL uI., 1q8); socIo-
economIc sLuLus und educuLIon (HurL eL uI., zoo1; MurLIkuInen eL uI.,
zoo1). TIere Is Increused rIsk umongsL subgroups oI LIe smoker`s group
ussocIuLed wILI - usbesLos exposure (Hummond eL uI., 1q;q); exIsLIng
Iung dIseuse sucI us cIronIc obsLrucLIve puImonury dIseuse (SkIIIud eL uI.,
1q86). TIere ure uIso LIe rIsk IucLors oI dIeL und pIysIcuI exercIse
ussocIuLed wILI smokIng generuIIy (JoIunsson & SundquIsL, 1qqq;
MurgeLLs & Juckson, 1qq; OsIer, 1qq8; PuIunIuppun eL uI., zoo1); und u
possIbIe geneLIc conLrIbuLIon Lo smokIng (CurmeIII eL uI., 1qqz; HeuLI &
MurLIn, 1qq; ermun eL uI., 1qqq). AILIougI LIese IucLors ure ussocIuLed
wILI Increused reIuLIve rIsk, LIe predIcLIve sLrengLI oI uny oI LIese IucLors,
or combInuLIon oI IucLors, Ior LIe specIIIc dIseuse Is sLIII ter poor.
TIe Issue oI CHD Is even more bIurred. CHD Is purLIcuIurIy
probIemuLIc In LIuL IL does noL reIIecL u specIIIc dIseuse und Is ubIquILous
(SLeIbens, 1qqz). urLIermore, LIe number oI IdenLIIIed rIsk IucLors Ior
CHD Is sLuggerIng. or exumpIe, HopkIns & WIIIIums (1q86) revIewed
more LIun z;o rIsk IucLors Ior CHD IdenLIIIed Lo LIuL duLe. Even cIronIc
InIecLIons (e.g., bucLerIuI) InvoIvIng, Ior exumpIe, Helicobccter plori
Iuve been ImpIIcuLed (see DunesI eL uI., 1qq;). AguIn, uny oI LIese,
IncIudIng cIgureLLe smokIng, or combInuLIons oI LIese, ure very poor
predIcLors oI CHD morLuIILy.
OLIer vILuI evIdence perLuInIng Lo cIgureLLe smokIng und CHD
derIves Irom LwIn sLudIes. n u sLudy oI monozygoLIc LwIns und wIere
one oI LIe LwIns wus u persIsLenL smoker und LIe oLIer u non-smoker,
CederIoI eL uI. (1q66) und undmun (1q66) Iound no dIIIerence In CHD or
dIsLurbunces oI coronury IuncLIon beLween LIe smokIng und non-smokIng
LwIns. BIood IeveIs oI cIoIesLeroI und oLIer IuLLy muLerIuI wus, on
uveruge, IIgIer In LIe smokers, buL noL sIgnIIIcunLIy so. TIe onIy
dIIIerence seemed Lo be reIuLed Lo cIronIc broncIILIs. L wus concIuded
LIuL curdIovuscuIur ubnormuIILIes were deLermIned predomInunLIy by
IeredILy, und LIuL smokIng Iud no dIscernubIe eIIecL. WILIIn LIIs greuL
rIsk-IucLor enLungIemenL LIere ure even more recenL pecuIIurILIes
(unomuIIes). or exumpIe, Ior LIe SpunIsI provInce oI Geronu, uILIougI
LIere Is u IIgI prevuIence oI curdIovuscuIur rIsk IucLors (IncIudIng
cIgureLLe smokIng), LIere Is u Iow myocurdIuI InIurcLIon IncIdence (MusIu
eL uI., 1qq8).
SInce LIe 1qo`s, empIysemu Ius uIso been IInked Lo cIgureLLe
smokIng. However, urson eL uI. (1q61) noLed LIuL uILIougI opInIon
regurdIng LIe ussocIuLIon Is IIgI, LIe evIdence Is scunLy. TIe condILIon Is
cerLuInIy Iound more In smokers LIun In nonsmokers (e.g., AbboLL eL uI.,
40
40
1q). Even In LIe 1q6o`s LIere wus LIe suggesLIon oI LIe possIbIe roIe oI
u purLIcuIur congenILuI enzyme deIIcIency (e.g., ILLIe, 1q66). CoIby
(1qqq) IndIcuLes LIuL LIe IuLesL on-IIne edILIon oI GroIIer`s EncycIopuedIu
expIuIns LIuL u sIgnIIIcunL number oI empIysemu puLIenLs Iuck u gene
LIuL conLroIs LIe IIver`s producLIon oI LIe proLeIn uIpIu-1
unLILrypsIn (AAT). TIIs proLeIn conLroIs or degrudes LIe enzyme
neuLropIII eIusLuse, produced by LIe wIILe bIood ceIIs. WIen LIe
enzyme Is IeIL uncIecked, IL desLroys uIveoIur LIssue.
SInce LIe eurIy 1q8o`s empIysemu wus oIIIcIuIIy bundIed InLo
LIe new dIseuse cIussIIIcuLIon oI CIronIc ObsLrucLIve PuImonury DIseuse
(COPD). COPD IncIudes LIe mujor condILIons oI empIysemu und
broncIILIs. Some puLIenLs Iuve one, some boLI. CoIby (1qqq) noLes LIuL
LIe Merck MunuuI (1qLI Ed., 1q8z) IIsLs LIe new dIseuse cIussIIIcuLIon oI
COPD. L uIso menLIons LIuL cIgureLLe smokIng presumcbl pIuys u roIe
In COPD. L uIso reIers Lo AAT deIIcIency buL Is very ImprecIse us Lo ILs
purL In LIe proporLIonuLe IncIdence oI empIysemu. CoIby (1qqq) uIso
IndIcuLes LIuL In LIe IuLer Merck MunuuI (16LI Ed., 1qqz), uILIougI IL Is
ucknowIedged LIuL LIe mujorILy oI smokers do noL deveIop LIe
condILIon, LIe roIe oI cIgureLLe smokIng In LIe dIseuse Is upgruded Lo u
cuusuI one. No reIerences ure cILed Ior LIIs posILIon. TIIs upgrude und
LIe cIuIm LIuL smokIng cuuses uII dIseuses LIuL IL Is more IIgIIy
ussocIuLed wILI (Increused RR`s) reIIecLs u consensus eIIecL wILIIn u
muLerIuIIsL IdeoIogy (see secLIon Pretentite Medicine & Heclth
Promotion) LIuL Ius noLIIng Lo do wILI scIenLIIIc enquIry, I.e.,
muLerIuIIsL munIIesLo. Even more probIemuLIc Is LIuL counLrIes sucI us
Jupun und Greece, wIIcI Iuve u very IIgI ruLe oI smokIng umongsL uduIL
muIes, Iuve LIe IowesL COPD morLuIILy ruLe, e.g., Brown eL uI., 1qqq.
TIese uuLIors concIude LIuL cIgureLLe smokIng IuIIs Lo expIuIn
InLernuLIonuI dIIIerences In morLuIILy Irom COPD. TIeIr concIusIon LIuL
nuLIonuI duLu on COPD muy be unreIIubIe, or nuLIonuI cIgureLLe smokIng
duLu ure InudequuLe, or boLI Is pIuusIbIe buL noL exIuusLIve.
Even more recenL InvesLIguLIons IIgIIIgIL LIe bIurry nuLure oI
LIe COPD cIussIIIcuLIon: A common usLImu LreuLmenL Is IeIpIng Lo
Improve LIe IeuILI oI smokers. AIIred HospILuI reseurcIers ure
exumInIng u IInk beLween InIuIed corLIcosLeroIds und beLLer Iung
IuncLIon In puLIenLs wILI cIronIc broncIILIs und empIysemu..LIIs Iud
mude reseurcIers wonder wIeLIer cIronIc obsLrucLIve puImonury
dIseuses were u pure group oI dIseuses or Iud overIups wILI usLImu..L
Is Ioped LIuL reseurcI wIII deLermIne wIeLIer some COPD puLIenLs
deveIop usLImu us purL oI LIeIr IIIness or wIeLIer LIe dIseuse mImIcs
uspecLs oI usLImu. (Hercld,Sun, MurcI zq, zoo1)
L cun be concIuded Irom LIe precedIng LIuL LIe roIe oI
cIgureLLe-smokIng In dIseuse Is very bIurry Indeed. YeL, reIuLIve rIsk Is
LypIcuIIy used Lo InIer cuuse. A perLInenL quesLIon, LIen, concerns wIuL
LIe reIuLIve-rIsk sLuLIsLIc ucLuuIIy meusures. n LIIs regurd, IL wIII be
useIuI Lo IurLIer scruLInIze LIe wuy LIuL LIe RR sLuLIsLIc Is presenLed In
LypIcuI epIdemIoIogIcuI reseurcI. TIe sLundurd reporLIng, us In LIe
CopenIugen sLudy IIndIngs, IndIcuLes LIuL, upurL Irom cerebrovuscuIur
dIseuse In men, LIe reIuLIve rIsk oI cll dIseuses Is sLuLIsLIcuIIy
sIgnIIIcunLIy IIgIer Ior Ieuvy-smokers LIun never-smokers (see TubIe ).
TIIs IosLers LIe mIsIeudIng ImpressIon LIuL Ieuvy-smokers dIe oI uII
LIese dIseuses, proportioncll, more LIun never-smokers, I.e., eILIer
never-smokers ure noL dyIng or dyIng oI no specIIIc dIseuse. TIe
probIem Iere Is LIuL LIe RR sLuLIsLIc bIurs specIIIc-cuuse morLuIILy und
uge-specIIIc morLuIILy. TIese ure Lwo very dIsLIncL Issues LIuL sIouId noL
be obscured by sLuLIsLIcuI unLIcs.
TIere ure Lwo mujor sources In LIe uge-udjusLed reIuLIve-rIsk
sLuLIsLIc. TIe IIrsL Is vurIuLIons In specIIIc-cuuse morLuIILy beLween
smoker`s und nonsmoker`s groups. TIe second Is vurIuLIons In uge-
specIIIc morLuIILy. To dIsLInguIsI wIIcI Is wIIcI, LIe InIormuLIon
conLuIned In TubIes z(u), z(b), und z(c), und wIIcI Is LypIcuIIy noL
consIdered In epIdemIoIogIc enquIry or presenLed In pubIIc
dIssemInuLIon oI InIormuLIon, Is requIred. TIese TubIes presenL uge-
udjusLed duLu; LIIs IndIcuLes proporLIons oI specIIIc-cuuse morLuIILy
regurdIess oI wIen morLuIILy occurs uIong LIe IongevILy conLInuum, I.e.,
LIe IIxed uge-bruckeLs und LIe sLudy`s LIme-perIod Iuve been removed.
TIIs InIormuLIon IIgIIIgILs LIuL, Ior LIe PrescoLL eL uI. (1qq8)
duLu, smokers Iuve u IIgIer proporLIonuI ruLe oI Iung cuncer Ior boLI
men und women, und respIruLory dIseuse Ior women. AILernuLIveIy,
nonsmokers Iuve u IIgIer proporLIonuI ruLe oI IeurL dIseuse und oLIer
cuncers. or LIe DoII eL uI. (1qqq) duLu, smokers Iuve u IIgIer
proporLIon oI Iung cuncer und respIruLory dIseuse. Nonsmokers Iuve u
IIgIer proporLIon oI oLIer cuncers, IscIuemIc IeurL dIseuse und
cerebrovuscuIur dIseuse. TIe proporLIonuI ruLe oI specIIIc-cuuse
morLuIILy oLIer LIun Iung cuncer Is essenLIuIIy compurubIe beLween
smokers und nonsmokers Ior boLI sLudIes; ubouL qo per cenL oI smokers
und nonsmokers ure compurubIe In specIIIc-cuuse morLuIILy.
TIIs proporLIonuI InIormuLIon IndIcuLes LIuL u proporLIon oI
smokers wIo oLIerwIse (us nonsmokers) wouId Iuve deveIoped oLIer
cuncers ure prone specIIIcuIIy Lo Iung cuncer. n LIuL Ieuvy smokIng Is u
poor predIcLor oI Iung cuncer, LIe sLrongesL sLuLus LIuL cun be ussIgned
Lo smokIng Is us u poLenLIuI LrIgger IucLor. GIven u sIIIL In cuncer-Lype,
Rampant Antismoking Signifies Grave Danger Lifestyle Epidemiology
41
41
1q). Even In LIe 1q6o`s LIere wus LIe suggesLIon oI LIe possIbIe roIe oI
u purLIcuIur congenILuI enzyme deIIcIency (e.g., ILLIe, 1q66). CoIby
(1qqq) IndIcuLes LIuL LIe IuLesL on-IIne edILIon oI GroIIer`s EncycIopuedIu
expIuIns LIuL u sIgnIIIcunL number oI empIysemu puLIenLs Iuck u gene
LIuL conLroIs LIe IIver`s producLIon oI LIe proLeIn uIpIu-1
unLILrypsIn (AAT). TIIs proLeIn conLroIs or degrudes LIe enzyme
neuLropIII eIusLuse, produced by LIe wIILe bIood ceIIs. WIen LIe
enzyme Is IeIL uncIecked, IL desLroys uIveoIur LIssue.
SInce LIe eurIy 1q8o`s empIysemu wus oIIIcIuIIy bundIed InLo
LIe new dIseuse cIussIIIcuLIon oI CIronIc ObsLrucLIve PuImonury DIseuse
(COPD). COPD IncIudes LIe mujor condILIons oI empIysemu und
broncIILIs. Some puLIenLs Iuve one, some boLI. CoIby (1qqq) noLes LIuL
LIe Merck MunuuI (1qLI Ed., 1q8z) IIsLs LIe new dIseuse cIussIIIcuLIon oI
COPD. L uIso menLIons LIuL cIgureLLe smokIng presumcbl pIuys u roIe
In COPD. L uIso reIers Lo AAT deIIcIency buL Is very ImprecIse us Lo ILs
purL In LIe proporLIonuLe IncIdence oI empIysemu. CoIby (1qqq) uIso
IndIcuLes LIuL In LIe IuLer Merck MunuuI (16LI Ed., 1qqz), uILIougI IL Is
ucknowIedged LIuL LIe mujorILy oI smokers do noL deveIop LIe
condILIon, LIe roIe oI cIgureLLe smokIng In LIe dIseuse Is upgruded Lo u
cuusuI one. No reIerences ure cILed Ior LIIs posILIon. TIIs upgrude und
LIe cIuIm LIuL smokIng cuuses uII dIseuses LIuL IL Is more IIgIIy
ussocIuLed wILI (Increused RR`s) reIIecLs u consensus eIIecL wILIIn u
muLerIuIIsL IdeoIogy (see secLIon Pretentite Medicine & Heclth
Promotion) LIuL Ius noLIIng Lo do wILI scIenLIIIc enquIry, I.e.,
muLerIuIIsL munIIesLo. Even more probIemuLIc Is LIuL counLrIes sucI us
Jupun und Greece, wIIcI Iuve u very IIgI ruLe oI smokIng umongsL uduIL
muIes, Iuve LIe IowesL COPD morLuIILy ruLe, e.g., Brown eL uI., 1qqq.
TIese uuLIors concIude LIuL cIgureLLe smokIng IuIIs Lo expIuIn
InLernuLIonuI dIIIerences In morLuIILy Irom COPD. TIeIr concIusIon LIuL
nuLIonuI duLu on COPD muy be unreIIubIe, or nuLIonuI cIgureLLe smokIng
duLu ure InudequuLe, or boLI Is pIuusIbIe buL noL exIuusLIve.
Even more recenL InvesLIguLIons IIgIIIgIL LIe bIurry nuLure oI
LIe COPD cIussIIIcuLIon: A common usLImu LreuLmenL Is IeIpIng Lo
Improve LIe IeuILI oI smokers. AIIred HospILuI reseurcIers ure
exumInIng u IInk beLween InIuIed corLIcosLeroIds und beLLer Iung
IuncLIon In puLIenLs wILI cIronIc broncIILIs und empIysemu..LIIs Iud
mude reseurcIers wonder wIeLIer cIronIc obsLrucLIve puImonury
dIseuses were u pure group oI dIseuses or Iud overIups wILI usLImu..L
Is Ioped LIuL reseurcI wIII deLermIne wIeLIer some COPD puLIenLs
deveIop usLImu us purL oI LIeIr IIIness or wIeLIer LIe dIseuse mImIcs
uspecLs oI usLImu. (Hercld,Sun, MurcI zq, zoo1)
L cun be concIuded Irom LIe precedIng LIuL LIe roIe oI
cIgureLLe-smokIng In dIseuse Is very bIurry Indeed. YeL, reIuLIve rIsk Is
LypIcuIIy used Lo InIer cuuse. A perLInenL quesLIon, LIen, concerns wIuL
LIe reIuLIve-rIsk sLuLIsLIc ucLuuIIy meusures. n LIIs regurd, IL wIII be
useIuI Lo IurLIer scruLInIze LIe wuy LIuL LIe RR sLuLIsLIc Is presenLed In
LypIcuI epIdemIoIogIcuI reseurcI. TIe sLundurd reporLIng, us In LIe
CopenIugen sLudy IIndIngs, IndIcuLes LIuL, upurL Irom cerebrovuscuIur
dIseuse In men, LIe reIuLIve rIsk oI cll dIseuses Is sLuLIsLIcuIIy
sIgnIIIcunLIy IIgIer Ior Ieuvy-smokers LIun never-smokers (see TubIe ).
TIIs IosLers LIe mIsIeudIng ImpressIon LIuL Ieuvy-smokers dIe oI uII
LIese dIseuses, proportioncll, more LIun never-smokers, I.e., eILIer
never-smokers ure noL dyIng or dyIng oI no specIIIc dIseuse. TIe
probIem Iere Is LIuL LIe RR sLuLIsLIc bIurs specIIIc-cuuse morLuIILy und
uge-specIIIc morLuIILy. TIese ure Lwo very dIsLIncL Issues LIuL sIouId noL
be obscured by sLuLIsLIcuI unLIcs.
TIere ure Lwo mujor sources In LIe uge-udjusLed reIuLIve-rIsk
sLuLIsLIc. TIe IIrsL Is vurIuLIons In specIIIc-cuuse morLuIILy beLween
smoker`s und nonsmoker`s groups. TIe second Is vurIuLIons In uge-
specIIIc morLuIILy. To dIsLInguIsI wIIcI Is wIIcI, LIe InIormuLIon
conLuIned In TubIes z(u), z(b), und z(c), und wIIcI Is LypIcuIIy noL
consIdered In epIdemIoIogIc enquIry or presenLed In pubIIc
dIssemInuLIon oI InIormuLIon, Is requIred. TIese TubIes presenL uge-
udjusLed duLu; LIIs IndIcuLes proporLIons oI specIIIc-cuuse morLuIILy
regurdIess oI wIen morLuIILy occurs uIong LIe IongevILy conLInuum, I.e.,
LIe IIxed uge-bruckeLs und LIe sLudy`s LIme-perIod Iuve been removed.
TIIs InIormuLIon IIgIIIgILs LIuL, Ior LIe PrescoLL eL uI. (1qq8)
duLu, smokers Iuve u IIgIer proporLIonuI ruLe oI Iung cuncer Ior boLI
men und women, und respIruLory dIseuse Ior women. AILernuLIveIy,
nonsmokers Iuve u IIgIer proporLIonuI ruLe oI IeurL dIseuse und oLIer
cuncers. or LIe DoII eL uI. (1qqq) duLu, smokers Iuve u IIgIer
proporLIon oI Iung cuncer und respIruLory dIseuse. Nonsmokers Iuve u
IIgIer proporLIon oI oLIer cuncers, IscIuemIc IeurL dIseuse und
cerebrovuscuIur dIseuse. TIe proporLIonuI ruLe oI specIIIc-cuuse
morLuIILy oLIer LIun Iung cuncer Is essenLIuIIy compurubIe beLween
smokers und nonsmokers Ior boLI sLudIes; ubouL qo per cenL oI smokers
und nonsmokers ure compurubIe In specIIIc-cuuse morLuIILy.
TIIs proporLIonuI InIormuLIon IndIcuLes LIuL u proporLIon oI
smokers wIo oLIerwIse (us nonsmokers) wouId Iuve deveIoped oLIer
cuncers ure prone specIIIcuIIy Lo Iung cuncer. n LIuL Ieuvy smokIng Is u
poor predIcLor oI Iung cuncer, LIe sLrongesL sLuLus LIuL cun be ussIgned
Lo smokIng Is us u poLenLIuI LrIgger IucLor. GIven u sIIIL In cuncer-Lype,
Rampant Antismoking Signifies Grave Danger Lifestyle Epidemiology
42
42
endogenous ubnormuIILy (e.g., geneLIc, IormonuI, orgunIc, meLuboIIc),
I.e., suscepLIbIIILy, musL be u crILIcuI precondILIon. TIen, smokIng, In
combInuLIon wILI oLIer IucLors (e.g., exercIse, dIeL, oLIer exposures,
prevIous Iung dIseuse), mIgIL ucL Lo weuken Iung IuncLIon. TIe sIIIL In
cuncer-Lype, LIen, cun be undersLood us occurrIng In LIe weukesL
orgun. L musL be noLed LIuL LIIs sorL oI proposILIon Is ter dijjerent Lo
LIe cIuIm LIuL smokIng cuuses Iung cuncer, LIe IuLLer cIuIm IuvIng no
coIerenL busIs. However, unLII LIe nuLure oI LIe endogenous
ubnormuIILy Is more cIeurIy undersLood, LIuL smokIng mIgIL even
consLILuLe u LrIgger IucLor Is urguubIe. TIe sILuuLIon Is IurLIer
compIIcuLed by LIe IucL LIuL Iess LIun IuII oI men und u LIIrd oI women
uppeurIng Lo Iuve u suscepLIbIIILy Lo cuncer deveIop Iung cuncer II LIey
ure Ieuvy smokers; LIe greuLer mujorILy oI LIose suscepLIbIe Lo cuncer
und wIo ure Ieuvy smokers do not deveIop Iung cuncer. TIIs Lends Lo
IndIcuLe u compIex oI endogenous ubnormuIILy. GIven LIe sLrong
ImpIIcuLIon oI endogenous ubnormuIILy, IL cun uIso be noLed LIuL mosL
Ieuvy smokers ure noL uL rIsk oI Iung cuncer.
TIe oLIer mujor conLrIbuLIon Is uge-specIIIc morLuIILy. MosL oI
LIe RR-dIIIerences ure produced by vurIuLIons In LIe LImIng oI morLuIILy.
TIuL RR`s ure IIgIer Ior mosL dIseuses IndIcuLes LIuL LIere ure
sIgnIIIcunL numbers oI smokers dyIng oI compurubIe specIIIc dIseuses
ecrlier LIun nonsmokers; TubIes 1(u), 1(b) und 1(c) IndIcuLe LIe
proporLIon oI uII-cuuse morLuIILy Ior specIIIc uge groups. TIIs
InIormuLIon IIgIIIgILs LIuL LIere Is noL u greuL dIIIerence beLween
smokers und nonsmokers In LIe proporLIon oI uge-specIIIc morLuIILy
over LIese 1o-yeur uge-bunds. However, LIe combIned morLuIILy
dIIIerence uithin LIese 1o-yeur bunds Is suIIIcIenL Lo generuLe
sLuLIsLIcuIIy-sIgnIIIcunL RR-dIIIerences.
NoLwILIsLundIng consIderubIe expIunuLory compIIcuLIons, LIIs
eurIIer morLuIILy wus InLerpreLed In LIe eurIy-1q6o`s us reIIecLIng
premcture morLuIILy. TIe urgumenL cunnoL be LIuL smokIng cuuses
LIese oLIer-LIun-Iung-cuncer dIseuses, buL LIuL smokIng LogeLIer wILI
numerous oLIer poLenLIuI IucLors, conLrIbuLes IndIrecLIy Lo u sIorLenIng
or conLrucLIon oI IIIe. GIven LIuL smokers wouId Iuve dIed oI LIe sume
specIIIc dIseuse proporLIonuIIy, und compurubIe Lo nonsmokers Ior mosL
specIIIc-cuuse morLuIILy, smokIng wus consIdered Lo uIIecL LIe ugIng
process, I.e., oLIerwIse sume dIseuse Is ucceIeruLed by smokIng. Bused on
reIuLIve rIsk dIIIerences LIe Morbidit cnd Mortclit Weell Report
(zooz) esLImuLes LIe yeurs oI poLenLIuI IIIe IosL (YP) uLLrIbuLubIe Lo
smokIng us 1.z yeurs Ior men und 1q. yeurs Ior women. However, LIIs
purLIcuIur Issue InvoIves u number oI consIderubIe enLungIemenLs.
IrsLIy, dIIIerences In uge-specIIIc morLuIILy do noL necessurIIy
Iuve LIe sume meunIng. or exumpIe, morLuIILy uL uge qo Is very
dIIIerenL Lo morLuIILy uL uge ;o, I.e., vurIuLIons In endogenous sLuLes (e.g.,
IIIness), degrees oI exposures, psycIoIogIcuI und reIuLIonuI IucLors: An
ussumpLIon oI IomogeneILy oI yeurs uIong LIe uge or IongevILy
conLInuum Is unLenubIe. SecondIy, reIuLIve dIIIerences do noL expIuIn LIe
nuLure oI LIe dIIIerences. or exumpIe, eurIy specIIIc-dIseuse morLuIILy
Ior boLI smokers und nonsmokers Is IIgIIy uLypIcuI und usuuIIy
InexpIIcubIe; smokIng Is essenLIuIIy u zero-IeveI predIcLor Ior LIIs
uLypIcuI morLuIILy, I.e., LIe ubsoIuLe rIsk oI eurIy morLuIILy Ior Ieuvy
smokers Is LIny buL IIgIer uL younger uges. TIe smuII reIuLIve dIIIerence
In occurrence beLween Lwo unexpIuIned pIenomenu (eurIy morLuIILy oI
smokers or nonsmokers) cunnoL be used Lo expIuIn one oI LIe
pIenomenu. TIuL LIere Iuppen Lo be more, uILIougI Iew, In LIe
smoker`s group mIgIL be expIuIned by u convergence eIIecL. or
exumpIe, persons LIuL ure curryIng ubnormuIILIes und ure sympLomuLIc
mIgIL converge Lo smokIng Ior ILs mood-moduIuLIng eIIecL (uIIevIuLIng
unxIeLy); IL couId be expecLed LIen LIuL LIere ure more oI sucI persons In
LIe smoker`s group. AIso, persons muy smoke Ior reusons LIuL ure
LIemseIves poLenLIuIIy correIuLed wILI IuLer specIIIc-cuuse morLuIILy or
eurIIer morLuIILy. or exumpIe, Andu eL uI. (1qqq) Iound LIuL smokIng Is
ussocIuLed wILI udverse cIIIdIood experIences (I.e., neguLIve emoLIonuI,
neurobIoIogIcuI, und socIuI eIIecLs). L Is dIsLurbIng LIuL LIIs seems Lo be
LIe onIy reseurcI umongsL LIe muny Lens oI LIousunds oI smokIng
sLudIes LIuL Ius uLLempLed Lo InvesLIguLe wIy uL IeusL some persons
smoke, purLIcuIurIy udoIescenLs, oLIer LIun LIe LIred muLerIuIIsL
upproucI oI Lobucco-IndusLry coercIon und uddIcLIon. UnIorLunuLeIy,
LIe reseurcI Ius noL been IoIIowed LIrougI Lo InvesLIguLe LIe correIuLIon
beLween LIe degree oI udverse cIIIdIood evenLs und specIIIc dIseuseJ
eurIy morLuIILy. TIe very sLrong IndIcuLIon Is LIuL LIe ussumpLIon oI
IomogeneILy oI LIe smoker`s group Is unuccepLubIe. AnoLIer exumpIe Is
u recenL IIndIng LIuL depressIon, socIuI uIIenuLIon, und IoneIIness ure rIsk
IucLors Ior CHDJeurIIer morLuIILy (Hercld,Sun, MurcI 1;, zoo, p.8).
SucI IucLors ure some oI LIe reusons wIy some persons smoke. UnIess
LIese IucLors ure uccounLed Ior, LIen wIuL Is ucLuuIIy u convergence
eIIecL wIII be mIsInLerpreLed us LIe cuusuI eIIecLs oI Lobucco smoke.
rom u medIco-muLerIuIIsL vIewpoInL, IL couId be urgued LIuL,
us morLuIILy moves IurLIer up LIe IongevILyJuge scuIe, u smokIng dose-
response uIIecLIng LIe ugIng process produces eurIIer morLuIILy.
However, LIere ure Lwo mujor probIems wILI LIIs Ideu. IrsLIy, IL
ussumes u doubIe-bIuck-box vIew oI boLI LIe smoker`s und
Rampant Antismoking Signifies Grave Danger Lifestyle Epidemiology
43
43
endogenous ubnormuIILy (e.g., geneLIc, IormonuI, orgunIc, meLuboIIc),
I.e., suscepLIbIIILy, musL be u crILIcuI precondILIon. TIen, smokIng, In
combInuLIon wILI oLIer IucLors (e.g., exercIse, dIeL, oLIer exposures,
prevIous Iung dIseuse), mIgIL ucL Lo weuken Iung IuncLIon. TIe sIIIL In
cuncer-Lype, LIen, cun be undersLood us occurrIng In LIe weukesL
orgun. L musL be noLed LIuL LIIs sorL oI proposILIon Is ter dijjerent Lo
LIe cIuIm LIuL smokIng cuuses Iung cuncer, LIe IuLLer cIuIm IuvIng no
coIerenL busIs. However, unLII LIe nuLure oI LIe endogenous
ubnormuIILy Is more cIeurIy undersLood, LIuL smokIng mIgIL even
consLILuLe u LrIgger IucLor Is urguubIe. TIe sILuuLIon Is IurLIer
compIIcuLed by LIe IucL LIuL Iess LIun IuII oI men und u LIIrd oI women
uppeurIng Lo Iuve u suscepLIbIIILy Lo cuncer deveIop Iung cuncer II LIey
ure Ieuvy smokers; LIe greuLer mujorILy oI LIose suscepLIbIe Lo cuncer
und wIo ure Ieuvy smokers do not deveIop Iung cuncer. TIIs Lends Lo
IndIcuLe u compIex oI endogenous ubnormuIILy. GIven LIe sLrong
ImpIIcuLIon oI endogenous ubnormuIILy, IL cun uIso be noLed LIuL mosL
Ieuvy smokers ure noL uL rIsk oI Iung cuncer.
TIe oLIer mujor conLrIbuLIon Is uge-specIIIc morLuIILy. MosL oI
LIe RR-dIIIerences ure produced by vurIuLIons In LIe LImIng oI morLuIILy.
TIuL RR`s ure IIgIer Ior mosL dIseuses IndIcuLes LIuL LIere ure
sIgnIIIcunL numbers oI smokers dyIng oI compurubIe specIIIc dIseuses
ecrlier LIun nonsmokers; TubIes 1(u), 1(b) und 1(c) IndIcuLe LIe
proporLIon oI uII-cuuse morLuIILy Ior specIIIc uge groups. TIIs
InIormuLIon IIgIIIgILs LIuL LIere Is noL u greuL dIIIerence beLween
smokers und nonsmokers In LIe proporLIon oI uge-specIIIc morLuIILy
over LIese 1o-yeur uge-bunds. However, LIe combIned morLuIILy
dIIIerence uithin LIese 1o-yeur bunds Is suIIIcIenL Lo generuLe
sLuLIsLIcuIIy-sIgnIIIcunL RR-dIIIerences.
NoLwILIsLundIng consIderubIe expIunuLory compIIcuLIons, LIIs
eurIIer morLuIILy wus InLerpreLed In LIe eurIy-1q6o`s us reIIecLIng
premcture morLuIILy. TIe urgumenL cunnoL be LIuL smokIng cuuses
LIese oLIer-LIun-Iung-cuncer dIseuses, buL LIuL smokIng LogeLIer wILI
numerous oLIer poLenLIuI IucLors, conLrIbuLes IndIrecLIy Lo u sIorLenIng
or conLrucLIon oI IIIe. GIven LIuL smokers wouId Iuve dIed oI LIe sume
specIIIc dIseuse proporLIonuIIy, und compurubIe Lo nonsmokers Ior mosL
specIIIc-cuuse morLuIILy, smokIng wus consIdered Lo uIIecL LIe ugIng
process, I.e., oLIerwIse sume dIseuse Is ucceIeruLed by smokIng. Bused on
reIuLIve rIsk dIIIerences LIe Morbidit cnd Mortclit Weell Report
(zooz) esLImuLes LIe yeurs oI poLenLIuI IIIe IosL (YP) uLLrIbuLubIe Lo
smokIng us 1.z yeurs Ior men und 1q. yeurs Ior women. However, LIIs
purLIcuIur Issue InvoIves u number oI consIderubIe enLungIemenLs.
IrsLIy, dIIIerences In uge-specIIIc morLuIILy do noL necessurIIy
Iuve LIe sume meunIng. or exumpIe, morLuIILy uL uge qo Is very
dIIIerenL Lo morLuIILy uL uge ;o, I.e., vurIuLIons In endogenous sLuLes (e.g.,
IIIness), degrees oI exposures, psycIoIogIcuI und reIuLIonuI IucLors: An
ussumpLIon oI IomogeneILy oI yeurs uIong LIe uge or IongevILy
conLInuum Is unLenubIe. SecondIy, reIuLIve dIIIerences do noL expIuIn LIe
nuLure oI LIe dIIIerences. or exumpIe, eurIy specIIIc-dIseuse morLuIILy
Ior boLI smokers und nonsmokers Is IIgIIy uLypIcuI und usuuIIy
InexpIIcubIe; smokIng Is essenLIuIIy u zero-IeveI predIcLor Ior LIIs
uLypIcuI morLuIILy, I.e., LIe ubsoIuLe rIsk oI eurIy morLuIILy Ior Ieuvy
smokers Is LIny buL IIgIer uL younger uges. TIe smuII reIuLIve dIIIerence
In occurrence beLween Lwo unexpIuIned pIenomenu (eurIy morLuIILy oI
smokers or nonsmokers) cunnoL be used Lo expIuIn one oI LIe
pIenomenu. TIuL LIere Iuppen Lo be more, uILIougI Iew, In LIe
smoker`s group mIgIL be expIuIned by u convergence eIIecL. or
exumpIe, persons LIuL ure curryIng ubnormuIILIes und ure sympLomuLIc
mIgIL converge Lo smokIng Ior ILs mood-moduIuLIng eIIecL (uIIevIuLIng
unxIeLy); IL couId be expecLed LIen LIuL LIere ure more oI sucI persons In
LIe smoker`s group. AIso, persons muy smoke Ior reusons LIuL ure
LIemseIves poLenLIuIIy correIuLed wILI IuLer specIIIc-cuuse morLuIILy or
eurIIer morLuIILy. or exumpIe, Andu eL uI. (1qqq) Iound LIuL smokIng Is
ussocIuLed wILI udverse cIIIdIood experIences (I.e., neguLIve emoLIonuI,
neurobIoIogIcuI, und socIuI eIIecLs). L Is dIsLurbIng LIuL LIIs seems Lo be
LIe onIy reseurcI umongsL LIe muny Lens oI LIousunds oI smokIng
sLudIes LIuL Ius uLLempLed Lo InvesLIguLe wIy uL IeusL some persons
smoke, purLIcuIurIy udoIescenLs, oLIer LIun LIe LIred muLerIuIIsL
upproucI oI Lobucco-IndusLry coercIon und uddIcLIon. UnIorLunuLeIy,
LIe reseurcI Ius noL been IoIIowed LIrougI Lo InvesLIguLe LIe correIuLIon
beLween LIe degree oI udverse cIIIdIood evenLs und specIIIc dIseuseJ
eurIy morLuIILy. TIe very sLrong IndIcuLIon Is LIuL LIe ussumpLIon oI
IomogeneILy oI LIe smoker`s group Is unuccepLubIe. AnoLIer exumpIe Is
u recenL IIndIng LIuL depressIon, socIuI uIIenuLIon, und IoneIIness ure rIsk
IucLors Ior CHDJeurIIer morLuIILy (Hercld,Sun, MurcI 1;, zoo, p.8).
SucI IucLors ure some oI LIe reusons wIy some persons smoke. UnIess
LIese IucLors ure uccounLed Ior, LIen wIuL Is ucLuuIIy u convergence
eIIecL wIII be mIsInLerpreLed us LIe cuusuI eIIecLs oI Lobucco smoke.
rom u medIco-muLerIuIIsL vIewpoInL, IL couId be urgued LIuL,
us morLuIILy moves IurLIer up LIe IongevILyJuge scuIe, u smokIng dose-
response uIIecLIng LIe ugIng process produces eurIIer morLuIILy.
However, LIere ure Lwo mujor probIems wILI LIIs Ideu. IrsLIy, IL
ussumes u doubIe-bIuck-box vIew oI boLI LIe smoker`s und
Rampant Antismoking Signifies Grave Danger Lifestyle Epidemiology
44
44
Rampant Antismoking Signifies Grave Danger
nonsmoker`s groups (see IoIIowIng secLIon). TIIs vIoIuLes LIe IucL LIuL LIe
groups ure noL conLInuous quunLILIes (I.e., u sIngIe enLILy) buL ure
composed oI dIscreLe unILs, I.e., IndIvIduuI persons. SecondIy, IL ussumes
cuusuLIon ruLIer LIun demonsLruLIng IL. TIIrdIy, LIe uges wIere mosL
eurIIer-morLuIILy occurs, I.e., ubove 6o yeurs-oI-uge, couId IurdIy be
consIdered us premuLure.
TIereIore, eurIIer morLuIILy uL IuLer uges cunnoL be consIdered us
premuLure. EurIIer morLuIILy uL younger uges, beIng IIgIIy uLypIcuI und
wIIcI produces LIe greuLesL drug on LIe IongevILy sLuLIsLIc Ior LIe
smoker's group, uIso cunnoL be uscrIbed Lo LIe cuusuI eIIecLs oI Lobucco
smoke. TIe enLIre urgumenL oI eurIy undJor premuLure morLuIILy
uLLrIbuLubIe Lo Lobucco-smoke eIIecLs Is enLIreIy quesLIonubIe. TIe munner
In wIIcI epIdemIoIogy uses LIe RR-sLuLIsLIc Is LIe uvoIdunce oI scIoIurIy
work In dIscernIng vurIubIe conLrIbuLIons Lo LIe sLuLIsLIc, concIudIng, by
ussumpLIon und noL demonsLruLIon, LIuL uII RR-dIIIerences ucross LIe
enLIre IongevILy runge ure uLLrIbuLubIe Lo LIe cuusuI eIIecLs oI Lobucco
smoke. TIIs Is no more LIun sLuLIsLIcuI sopIIsLry.
Dose-response urgumenLs, eILIer wILIIn one uge-bruckeL ucross
nonsmokersJIIgIL-smokersJIeuvy-smokers or wILIIn LIe Ieuvy smoker`s
group uIong LIe uge conLInuum, Iuve no sensIbIIILy. PurLIcuIurIy uL
younger uges, dose-response Ius un eIIecLIveIy zero-IeveI predIcLIve
sLrengLI Ior specIIIc dIseuse or eurIy morLuIILy. Worse sLIII Is LIuL LIese
IIImsy dose-response urgumenLs ure used Lo cIuIm LIuL LIere Is no suIe
dose-IeveI Ior cnone.
More recenLIy, oLIers Iuve used IIIe-expecLuncy LubIes ruLIer
LIun RR Lo ussess IongevILy dIIIerenLIuIs beLween LIe smoker`s und
nonsmoker`s groups. or exumpIe, Rogers & PoweII-GrIner (1qq1) suggesL
u 16-yeur dIIIerenLIuI beLween IemuIe Ieuvy smokers und never smokers
Ior IIIe expecLuncy uL uge z-zq. TIIs dIIIerenLIuI reduces Lo q. yeurs by
LIe uge ;+. or muIe Ieuvy smokers LIe dIIIerenLIuI uL uge z-zq Is 1z
yeurs. TIIs dIIIerenLIuI reduces Lo 6.6 yeurs uL uge ;+. AguIn, LIe IIIe
expecLuncy upproucI suIIers Irom LIe sume IuIIucy us LIe RR upproucI oI
ussumIng cuusuLIon ruLIer LIun demonsLruLIng IL. urLIermore, LIe IIIe
expecLuncy upproucI even more cIeurIy IndIcuLes LIe ubsurdILy oI
ussumIng dose-response. EurIy morLuIILy uL eurIIer uges Is LIe muIn drug
on IongevILy Ior LIe smoker`s group und Ior wIIcI smokIng Is u zero-IeveI
predIcLor. AIso, LIere Is LIe ubsurdILy LIuL us u smoker survIves InLo
successIve uge bruckeLs, und LIereIore LIe more LIey smoke, LIe Iesser Is
LIe dIIIerenLIuI beLween LIe smoker`s und nonsmoker`s groups, I.e.,
survIvuI InLo successIve uge bruckeLs, und LIereIore IIgIer dose, Is
ussocIuLed wILI IIgIer IIIe expecLuncy.
TIere Is unoLIer crILIcuI probIem wILI LIe premuLure morLuIILy
Lifestyle Epidemiology
urgumenL. EurIIer morLuIILy us IndIcuLIve oI premuLure deuLI Is ucLuuIIy
noL ImpIIed uL uII by LIe duLu. TIe RR sLuLIsLIc onIy IndIcuLes LIuL u rIsk
dIIIerenLIuI beLween Lwo groups exIsLs. TIIs poses un Issue LIuL Ius,
usLoundIngIy, noL yeL been consIdered In LIe muny LIousunds oI smokIng
sLudIes und reIIecLs u medIco-muLerIuIIsL IIxuLIon. TIe LypIcuI smokIng
sLudy mukes Lwo quesLIonubIe ussumpLIons. IrsLIy, LIuL LIe nonsmoker`s
group Is Iomogeneous und, secondIy, LIuL IL Is normuLIve. MedIco-
muLerIuIIsm cun reudIIy uccepL LIuL u smuII subgroup oI smokers cun drug
down LIe overuII IongevILy Ior LIe smoker`s group. BuL, IL cunnoL IuLIom
LIe Ideu LIuL u smuII subgroup oI nonsmokers cun InIIuLe LIe overuII
IongevILy Ior LIe nonsmoker`s group: n LIe sume wuy LIuL u smuII
subgroup oI LIe overuII smoker`s group cun be LIe source oI Increused
reIuLIve rIsk (uge-specIIIc morLuIILy), u smuII subgroup oI LIe overuII
nonsmoker`s group cun InIIuLe IongevILy Ior LIe overuII nonsmoker`s
group LIuL wIII be reIIecLed In IIgIer RR`s Ior LIe smoker`s group.
A more deLuIIed deIIneuLIon oI dIIIerences beLween smokers und
nonsmokers Is provIded In u IuLer secLIon (Smolers cnd Nonsmolers).
However, IL wIII suIIIce uL LIIs LIme Lo IdenLIIy one smuII subgroup oI LIe
overuII nonsmoker`s group. Key eL uI. (1qq6) Iound LIuL uL 1;-yeur IoIIow-
up IeuILI conscIous IndIvIduuIs, LypIcuIIy deIIned by dIeLury IubILs, Iud
u reduced uII-cuuse morLuIILy reIuLIve Lo LIe generuI popuIuLIon. Smokers
consLILuLed onIy 1q% oI LIe IeuILI conscIous group. HeuILI
conscIousness, purLIcuIurIy In muLerIuIIsL Lerms, Is un uLLrIbuLe oI rIsk-
uverse IndIvIduuIs. TIIs subgroup wouId be Iur more promInenL In LIe
nonsmoker`s LIun smoker`s group.
RIsk-uverse (over-proLecLIve) beIuvIor cun InvoIve consLunL
medIcuI consuILuLIons Ior mInor sympLoms, uvoIdIng IIgI-rIsk
occupuLIons due Lo socIuI mobIIILy (promInenL umongsL LIe eIILe),
pIysIcuIIy exercIsIng, und IoIIowIng dIeLury prescrIpLIons. or some oI LIIs
smuII subgroup LIe sIeer weIgIL oI rIsk uversIon over u proIonged perIod
muy ucLuuIIy be ussocIuLed wILI IIgIer IongevILy. L muy noL be cIeur uL uII
wIuL specIIIc ucLIvILy or wIeLIer uny oI IL Is cuusuIIy reIuLed Lo IongevILy.
or exumpIe, ussocIuLed IIgIer IongevILy mIgIL IndIcuLe u pIucebo eIIecL
(I.e., becuuse LIey beIIeve LIey ure doIng LIe rIgIL LIIngs LrunsIuLes InLo
u posILIve psycIobIoIogIcuI eIIecL). AILernuLIveIy, LIIs subgroup muy Iuve
u morbId Ieur oI deuLI wIIcI Is reIIecLed by LIeIr rIsk-uverse beIuvIor. n
LIIs cuse LIe rIsk uversIon muy noL be reIuLed uL uII Lo u IongevILy guIn Ior
some - pIucebo or oLIerwIse. TIese sImpIy Iung on Ior us Iong us
possIbIe, wILI LeeLI und IIsLs cIencIed, becuuse oI LIe LerrIIyIng prospecL
oI ImpendIng morLuIILy. AnoLIer possIbIIILy Is LIuL LIere ure more
nonsmokers wILIIn LIe upper-cIuss und bourgeoIsIe TIere muy be more
wILIIn LIIs group LIun LIe smoker`s group LIuL ure conLenL wILI LIeIr
45
45
Rampant Antismoking Signifies Grave Danger
nonsmoker`s groups (see IoIIowIng secLIon). TIIs vIoIuLes LIe IucL LIuL LIe
groups ure noL conLInuous quunLILIes (I.e., u sIngIe enLILy) buL ure
composed oI dIscreLe unILs, I.e., IndIvIduuI persons. SecondIy, IL ussumes
cuusuLIon ruLIer LIun demonsLruLIng IL. TIIrdIy, LIe uges wIere mosL
eurIIer-morLuIILy occurs, I.e., ubove 6o yeurs-oI-uge, couId IurdIy be
consIdered us premuLure.
TIereIore, eurIIer morLuIILy uL IuLer uges cunnoL be consIdered us
premuLure. EurIIer morLuIILy uL younger uges, beIng IIgIIy uLypIcuI und
wIIcI produces LIe greuLesL drug on LIe IongevILy sLuLIsLIc Ior LIe
smoker's group, uIso cunnoL be uscrIbed Lo LIe cuusuI eIIecLs oI Lobucco
smoke. TIe enLIre urgumenL oI eurIy undJor premuLure morLuIILy
uLLrIbuLubIe Lo Lobucco-smoke eIIecLs Is enLIreIy quesLIonubIe. TIe munner
In wIIcI epIdemIoIogy uses LIe RR-sLuLIsLIc Is LIe uvoIdunce oI scIoIurIy
work In dIscernIng vurIubIe conLrIbuLIons Lo LIe sLuLIsLIc, concIudIng, by
ussumpLIon und noL demonsLruLIon, LIuL uII RR-dIIIerences ucross LIe
enLIre IongevILy runge ure uLLrIbuLubIe Lo LIe cuusuI eIIecLs oI Lobucco
smoke. TIIs Is no more LIun sLuLIsLIcuI sopIIsLry.
Dose-response urgumenLs, eILIer wILIIn one uge-bruckeL ucross
nonsmokersJIIgIL-smokersJIeuvy-smokers or wILIIn LIe Ieuvy smoker`s
group uIong LIe uge conLInuum, Iuve no sensIbIIILy. PurLIcuIurIy uL
younger uges, dose-response Ius un eIIecLIveIy zero-IeveI predIcLIve
sLrengLI Ior specIIIc dIseuse or eurIy morLuIILy. Worse sLIII Is LIuL LIese
IIImsy dose-response urgumenLs ure used Lo cIuIm LIuL LIere Is no suIe
dose-IeveI Ior cnone.
More recenLIy, oLIers Iuve used IIIe-expecLuncy LubIes ruLIer
LIun RR Lo ussess IongevILy dIIIerenLIuIs beLween LIe smoker`s und
nonsmoker`s groups. or exumpIe, Rogers & PoweII-GrIner (1qq1) suggesL
u 16-yeur dIIIerenLIuI beLween IemuIe Ieuvy smokers und never smokers
Ior IIIe expecLuncy uL uge z-zq. TIIs dIIIerenLIuI reduces Lo q. yeurs by
LIe uge ;+. or muIe Ieuvy smokers LIe dIIIerenLIuI uL uge z-zq Is 1z
yeurs. TIIs dIIIerenLIuI reduces Lo 6.6 yeurs uL uge ;+. AguIn, LIe IIIe
expecLuncy upproucI suIIers Irom LIe sume IuIIucy us LIe RR upproucI oI
ussumIng cuusuLIon ruLIer LIun demonsLruLIng IL. urLIermore, LIe IIIe
expecLuncy upproucI even more cIeurIy IndIcuLes LIe ubsurdILy oI
ussumIng dose-response. EurIy morLuIILy uL eurIIer uges Is LIe muIn drug
on IongevILy Ior LIe smoker`s group und Ior wIIcI smokIng Is u zero-IeveI
predIcLor. AIso, LIere Is LIe ubsurdILy LIuL us u smoker survIves InLo
successIve uge bruckeLs, und LIereIore LIe more LIey smoke, LIe Iesser Is
LIe dIIIerenLIuI beLween LIe smoker`s und nonsmoker`s groups, I.e.,
survIvuI InLo successIve uge bruckeLs, und LIereIore IIgIer dose, Is
ussocIuLed wILI IIgIer IIIe expecLuncy.
TIere Is unoLIer crILIcuI probIem wILI LIe premuLure morLuIILy
Lifestyle Epidemiology
urgumenL. EurIIer morLuIILy us IndIcuLIve oI premuLure deuLI Is ucLuuIIy
noL ImpIIed uL uII by LIe duLu. TIe RR sLuLIsLIc onIy IndIcuLes LIuL u rIsk
dIIIerenLIuI beLween Lwo groups exIsLs. TIIs poses un Issue LIuL Ius,
usLoundIngIy, noL yeL been consIdered In LIe muny LIousunds oI smokIng
sLudIes und reIIecLs u medIco-muLerIuIIsL IIxuLIon. TIe LypIcuI smokIng
sLudy mukes Lwo quesLIonubIe ussumpLIons. IrsLIy, LIuL LIe nonsmoker`s
group Is Iomogeneous und, secondIy, LIuL IL Is normuLIve. MedIco-
muLerIuIIsm cun reudIIy uccepL LIuL u smuII subgroup oI smokers cun drug
down LIe overuII IongevILy Ior LIe smoker`s group. BuL, IL cunnoL IuLIom
LIe Ideu LIuL u smuII subgroup oI nonsmokers cun InIIuLe LIe overuII
IongevILy Ior LIe nonsmoker`s group: n LIe sume wuy LIuL u smuII
subgroup oI LIe overuII smoker`s group cun be LIe source oI Increused
reIuLIve rIsk (uge-specIIIc morLuIILy), u smuII subgroup oI LIe overuII
nonsmoker`s group cun InIIuLe IongevILy Ior LIe overuII nonsmoker`s
group LIuL wIII be reIIecLed In IIgIer RR`s Ior LIe smoker`s group.
A more deLuIIed deIIneuLIon oI dIIIerences beLween smokers und
nonsmokers Is provIded In u IuLer secLIon (Smolers cnd Nonsmolers).
However, IL wIII suIIIce uL LIIs LIme Lo IdenLIIy one smuII subgroup oI LIe
overuII nonsmoker`s group. Key eL uI. (1qq6) Iound LIuL uL 1;-yeur IoIIow-
up IeuILI conscIous IndIvIduuIs, LypIcuIIy deIIned by dIeLury IubILs, Iud
u reduced uII-cuuse morLuIILy reIuLIve Lo LIe generuI popuIuLIon. Smokers
consLILuLed onIy 1q% oI LIe IeuILI conscIous group. HeuILI
conscIousness, purLIcuIurIy In muLerIuIIsL Lerms, Is un uLLrIbuLe oI rIsk-
uverse IndIvIduuIs. TIIs subgroup wouId be Iur more promInenL In LIe
nonsmoker`s LIun smoker`s group.
RIsk-uverse (over-proLecLIve) beIuvIor cun InvoIve consLunL
medIcuI consuILuLIons Ior mInor sympLoms, uvoIdIng IIgI-rIsk
occupuLIons due Lo socIuI mobIIILy (promInenL umongsL LIe eIILe),
pIysIcuIIy exercIsIng, und IoIIowIng dIeLury prescrIpLIons. or some oI LIIs
smuII subgroup LIe sIeer weIgIL oI rIsk uversIon over u proIonged perIod
muy ucLuuIIy be ussocIuLed wILI IIgIer IongevILy. L muy noL be cIeur uL uII
wIuL specIIIc ucLIvILy or wIeLIer uny oI IL Is cuusuIIy reIuLed Lo IongevILy.
or exumpIe, ussocIuLed IIgIer IongevILy mIgIL IndIcuLe u pIucebo eIIecL
(I.e., becuuse LIey beIIeve LIey ure doIng LIe rIgIL LIIngs LrunsIuLes InLo
u posILIve psycIobIoIogIcuI eIIecL). AILernuLIveIy, LIIs subgroup muy Iuve
u morbId Ieur oI deuLI wIIcI Is reIIecLed by LIeIr rIsk-uverse beIuvIor. n
LIIs cuse LIe rIsk uversIon muy noL be reIuLed uL uII Lo u IongevILy guIn Ior
some - pIucebo or oLIerwIse. TIese sImpIy Iung on Ior us Iong us
possIbIe, wILI LeeLI und IIsLs cIencIed, becuuse oI LIe LerrIIyIng prospecL
oI ImpendIng morLuIILy. AnoLIer possIbIIILy Is LIuL LIere ure more
nonsmokers wILIIn LIe upper-cIuss und bourgeoIsIe TIere muy be more
wILIIn LIIs group LIun LIe smoker`s group LIuL ure conLenL wILI LIeIr
46
46
Rampant Antismoking Signifies Grave Danger
IIIesLyIe und wIII sLrIve Lo keep IL Ior us Iong us possIbIe. TIIs cun uIso
InvoIve u posILIve psycIobIoIogIcuI eIIecL. TIe noLeworLIy poInL Iere Is
LIuL LIese sorLs oI subgroup vurIuLIons cun uIIecL RR`s. n LIIs cuse,
Increused RR`s Ior smokers on uge-specIIIc morLuIILy Is noL meusurIng u
dIIIerence beLween LIe overuII smoker`s und nonsmoker`s groups buL LIe
dIIIerence beLween LIIs rIsk-uverse subgroup und LIe combInuLIon oI
smokers und non-rIsk-uverse nonsmokers. L Is sLuggerIng LIuL LIe
ussumed IomogeneILy oI LIe nonsmoker`s group Ius noL been quesLIoned
Ior neurIy IuII u cenLury.
TIIs possIbIIILy Is hihl pIuusIbIe becuuse LIe wuy RR`s ure
LypIcuIIy InLerpreLed In epIdemIoIogy und used In prevenLIve medIcIneJ
IeuILI promoLIon Is Lo coerce rIsk-uverse beIuvIor In LIe generuI
popuIuLIon In LIe quesL Ior IongevILy Ior ILs own suke. L Is uLLempLIng, us
purL oI u deIuded muLerIuIIsL munIIesLo (see Rcdiccl ehctiorism und
Pretentite Medicine & Heclth Promotion), Lo engIneer LIe normuLIve
runge InLo u usuuIIy uLypIcuI rIsk-uverse menLuIILy, I.e., munuIucLurIng oI
unIIormILy oI rIsk uversIon. As wIII IuLer be consIdered, IongevILy Ior ILs
own suke Is uIso u IIgIIy quesLIonubIe prospecL.
TIIs IusL possIbIIILy Is ImporLunL Ior unoLIer reuson. I LIe
eurIIer morLuIILy LIuL Ius been uLLrIbuLed Lo smokers Ior so Iong Is noL
eurIIer or premuLure uL uII buL, ruLIer, RR dIIIerences IndIcuLe posL-
muLure morLuIILy (rIsk-uverse und desperuLe, IeurIuI cIIngIng Lo IIIe) by u
subgroup oI nonsmokers, LIen smokers, by beIng cIurged exorbILunL
IeuILI-Insurunce premIums und Luxes Ior muny decudes bused on LIe
Iormer InLerpreLuLIon, Iuve been subsIdIzIng noL onIy LIe IeuILI cure
sysLem buL pubIIc progrums generuIIy. A more crude depIcLIon oI LIe
cIrcumsLunce Is oIIered by CurnuII (1qq;): TIere Is u vIew, recognIzed
even wILIIn LIe DepurLmenL oI HeuILI ILseII, LIuL smokers ure doIng LIe
decenL LIIng by LIe resL oI us, puyIng IoLs oI exLru Lux und LIen dyIng
quIckIy und cIeupIy beIore LIey cun coIIecL LIeIr pensIons or be u burden
on socIuI servIces. (p.161) RuLIer, LIere muy be u Iur beLLer urgumenL
LIuL IL Is LIe nonsmoker`s group LIuL sIouId be puyIng IIgIer IeuILI-cure
premIums In coverIng u smuII subgroup oI nonsmokers LIuL enguge In
conducL conducIve Lo posL-muLure morLuIILy und, LIereIore, pIucIng
greuLer pressure on LIe IeuILI-cure sysLem.
n uddILIon Lo u very Iong IIsL oI rIsk IucLors sLuLIsLIcuIIy IInked Lo
specIIIc dIseuse und eurIIer morLuIILy, LIere ure uIso oLIer IucLors LIuL cun
InIIuence reIuLIve rIsk dIIIerences, purLIcuIurIy concernIng LIe smoker`s
group. Men In purLIcuIur Lend Lo endure IIIness und uvoId encounLers wILI
LIe medIcuI esLubIIsImenL, e.g., Hercld,Sun, ebruury z1, zoo. TIIs Is
noL necessurIIy probIemuLIc, und muy even Iuve psycIoIogIcuI-IeuILI
udvunLuges. However, LIIs muLLer Is ImporLunL wIere LIere Is seIecLIve
Lifestyle Epidemiology
medIcuI bIus. or exumpIe, LIe sLIgmuLIzIng oI smokIng by LIe medIcuI
esLubIIsImenL cun murgInuIIze smokers In purLIcuIur; IIIness musL reucI
un overwIeImIng IeveI beIore some smokers wIII uLLend u pIysIcIun.
RespIruLory InIecLIons muy noL be properIy LreuLed und wIIcI muy
evenLuuIIy Iuve u cumuIuLIve eIIecL on uge-specIIIc morLuIILy. TIIs
cIrcumsLunce Is IuLrogenIc und noL due Lo LIe cuusuI eIIecLs oI smokIng.
urLIer, some pIysIcIuns muy Iurbor sucI un ucuLe unLIsmokIng IIxuLIon
LIuL LIeIr medIcuI LreuLmenL oI smokers Is subsLundurd. AILIougI Ior LIe
mosL purL LIe eIIecL muy be subconscIousIy medIuLed, sucI un eIIecL Is
uIso IuLrogenIc.
AnoLIer crILIcuI Issue Is LIe muLerIuIIsL munIIesLo (see IoIIowIng
cIupLer). rom LIe mId-1q;o`s LIe sLunce oI LIe medIcuI orLIodoxy Ius
been Lo pursue unLIsmokIng (rIsk uversIon) ruLIer LIun rIsk mInImIzuLIon
und beLLer dIseuse LreuLmenL. WIIIsL muny resources Iuve been spenL In
LIe LreuLmenL oI oLIer cuncers, Iung cuncer, wIIcI cun resuIL In quIck
morLuIILy, Ius uLLrucLed Iur Iess uLLenLIon. As sucI, morLuIILy cun be sLuved
oII Ior Ionger perIods Ior cuncers oLIer LIun Iung cuncer. AILIougI LIIs
medIcuI LreuLmenL poses ILs own probIems Lo be IuLer dIscussed, LIIs
resuILs In LIe dIIIerenLIuI In uge-specIIIc morLuIILy beLween LIe smoker`s
und nonsmoker`s groups wIdenIng und reIIecLed In IIgIer RR`s Ior LIe
smoker`s group. TIIs eIIecL uIso Ius un IuLrogenIc uspecL.
L sIouId be obvIous LIuL LIe RR sLuLIsLIc Is Loo superIIcIuI,
obIILeruLIng uII munner oI wILIIn und beLween-group dIIIerences LIuL ure
ImperuLIve In scIenLIIIc enquIry; IL does no jusLIce uL uII Lo vurIubIe
puLLerns In duLu seLs. TIe RR sLuLIsLIc, us LypIcuIIy used, bundIes specIIIc-
cuuse (dIseuse) morLuIILy und uge-specIIIc morLuIILy. urLIermore, LIe RR
sLuLIsLIc bundIes (summurIzes) uII uge vurIuLIons Ior specIIIc dIseuse
beLween smokers und nonsmokers. L udds noLIIng Lo un undersLundIng
oI wIuL musL be crILIcuI dIIIerences beLween, Ior exumpIe, un oId-uge
Ieuvy-smoker deveIopIng Iung cuncer compured Lo eILIer oId-uge Ieuvy-
smokers LIuL do noL deveIop Iung cuncer (LIe mujorILy) or u younger-uge
Ieuvy-smoker LIuL deveIops Iung cuncer or u younger-uge never-smoker
wIo deveIops Iung cuncer. RR cunnoL uddress, ct cll, LIe predIcLIve
sLrengLI oI un unLecedenL (e.g., cIgureLLe smokIng) Ior eILIer specIIIc
dIseuse or eurIy morLuIILy. L Is LIIs crILerIon LIuL dIsLInguIsIes scIenLIIIc
proposILIons Irom wIId specuIuLIon und supersLILIous beIIeI.
TIe medIco-muLerIuIIsm generuLIng LIe enquIry Is uIso Loo
superIIcIuI, mukIng ussumpLIons LIuL Iuve no meunIngIuIness. or
exumpIe, LIe ussumpLIons oI IomogeneILy oI smoker`s und nonsmoker`s
groups, boLI wILIIn und beLween-groups, und IomogeneILy oI yeurs uIong
LIe uge or IongevILy conLInuum ure IndeIensIbIe. Some oI LIe crILIcuI
subgroup dIIIerences InvoIve psycIoIogIcuI und psycIosocIuI IucLors (e.g.,
47
47
Rampant Antismoking Signifies Grave Danger
IIIesLyIe und wIII sLrIve Lo keep IL Ior us Iong us possIbIe. TIIs cun uIso
InvoIve u posILIve psycIobIoIogIcuI eIIecL. TIe noLeworLIy poInL Iere Is
LIuL LIese sorLs oI subgroup vurIuLIons cun uIIecL RR`s. n LIIs cuse,
Increused RR`s Ior smokers on uge-specIIIc morLuIILy Is noL meusurIng u
dIIIerence beLween LIe overuII smoker`s und nonsmoker`s groups buL LIe
dIIIerence beLween LIIs rIsk-uverse subgroup und LIe combInuLIon oI
smokers und non-rIsk-uverse nonsmokers. L Is sLuggerIng LIuL LIe
ussumed IomogeneILy oI LIe nonsmoker`s group Ius noL been quesLIoned
Ior neurIy IuII u cenLury.
TIIs possIbIIILy Is hihl pIuusIbIe becuuse LIe wuy RR`s ure
LypIcuIIy InLerpreLed In epIdemIoIogy und used In prevenLIve medIcIneJ
IeuILI promoLIon Is Lo coerce rIsk-uverse beIuvIor In LIe generuI
popuIuLIon In LIe quesL Ior IongevILy Ior ILs own suke. L Is uLLempLIng, us
purL oI u deIuded muLerIuIIsL munIIesLo (see Rcdiccl ehctiorism und
Pretentite Medicine & Heclth Promotion), Lo engIneer LIe normuLIve
runge InLo u usuuIIy uLypIcuI rIsk-uverse menLuIILy, I.e., munuIucLurIng oI
unIIormILy oI rIsk uversIon. As wIII IuLer be consIdered, IongevILy Ior ILs
own suke Is uIso u IIgIIy quesLIonubIe prospecL.
TIIs IusL possIbIIILy Is ImporLunL Ior unoLIer reuson. I LIe
eurIIer morLuIILy LIuL Ius been uLLrIbuLed Lo smokers Ior so Iong Is noL
eurIIer or premuLure uL uII buL, ruLIer, RR dIIIerences IndIcuLe posL-
muLure morLuIILy (rIsk-uverse und desperuLe, IeurIuI cIIngIng Lo IIIe) by u
subgroup oI nonsmokers, LIen smokers, by beIng cIurged exorbILunL
IeuILI-Insurunce premIums und Luxes Ior muny decudes bused on LIe
Iormer InLerpreLuLIon, Iuve been subsIdIzIng noL onIy LIe IeuILI cure
sysLem buL pubIIc progrums generuIIy. A more crude depIcLIon oI LIe
cIrcumsLunce Is oIIered by CurnuII (1qq;): TIere Is u vIew, recognIzed
even wILIIn LIe DepurLmenL oI HeuILI ILseII, LIuL smokers ure doIng LIe
decenL LIIng by LIe resL oI us, puyIng IoLs oI exLru Lux und LIen dyIng
quIckIy und cIeupIy beIore LIey cun coIIecL LIeIr pensIons or be u burden
on socIuI servIces. (p.161) RuLIer, LIere muy be u Iur beLLer urgumenL
LIuL IL Is LIe nonsmoker`s group LIuL sIouId be puyIng IIgIer IeuILI-cure
premIums In coverIng u smuII subgroup oI nonsmokers LIuL enguge In
conducL conducIve Lo posL-muLure morLuIILy und, LIereIore, pIucIng
greuLer pressure on LIe IeuILI-cure sysLem.
n uddILIon Lo u very Iong IIsL oI rIsk IucLors sLuLIsLIcuIIy IInked Lo
specIIIc dIseuse und eurIIer morLuIILy, LIere ure uIso oLIer IucLors LIuL cun
InIIuence reIuLIve rIsk dIIIerences, purLIcuIurIy concernIng LIe smoker`s
group. Men In purLIcuIur Lend Lo endure IIIness und uvoId encounLers wILI
LIe medIcuI esLubIIsImenL, e.g., Hercld,Sun, ebruury z1, zoo. TIIs Is
noL necessurIIy probIemuLIc, und muy even Iuve psycIoIogIcuI-IeuILI
udvunLuges. However, LIIs muLLer Is ImporLunL wIere LIere Is seIecLIve
Lifestyle Epidemiology
medIcuI bIus. or exumpIe, LIe sLIgmuLIzIng oI smokIng by LIe medIcuI
esLubIIsImenL cun murgInuIIze smokers In purLIcuIur; IIIness musL reucI
un overwIeImIng IeveI beIore some smokers wIII uLLend u pIysIcIun.
RespIruLory InIecLIons muy noL be properIy LreuLed und wIIcI muy
evenLuuIIy Iuve u cumuIuLIve eIIecL on uge-specIIIc morLuIILy. TIIs
cIrcumsLunce Is IuLrogenIc und noL due Lo LIe cuusuI eIIecLs oI smokIng.
urLIer, some pIysIcIuns muy Iurbor sucI un ucuLe unLIsmokIng IIxuLIon
LIuL LIeIr medIcuI LreuLmenL oI smokers Is subsLundurd. AILIougI Ior LIe
mosL purL LIe eIIecL muy be subconscIousIy medIuLed, sucI un eIIecL Is
uIso IuLrogenIc.
AnoLIer crILIcuI Issue Is LIe muLerIuIIsL munIIesLo (see IoIIowIng
cIupLer). rom LIe mId-1q;o`s LIe sLunce oI LIe medIcuI orLIodoxy Ius
been Lo pursue unLIsmokIng (rIsk uversIon) ruLIer LIun rIsk mInImIzuLIon
und beLLer dIseuse LreuLmenL. WIIIsL muny resources Iuve been spenL In
LIe LreuLmenL oI oLIer cuncers, Iung cuncer, wIIcI cun resuIL In quIck
morLuIILy, Ius uLLrucLed Iur Iess uLLenLIon. As sucI, morLuIILy cun be sLuved
oII Ior Ionger perIods Ior cuncers oLIer LIun Iung cuncer. AILIougI LIIs
medIcuI LreuLmenL poses ILs own probIems Lo be IuLer dIscussed, LIIs
resuILs In LIe dIIIerenLIuI In uge-specIIIc morLuIILy beLween LIe smoker`s
und nonsmoker`s groups wIdenIng und reIIecLed In IIgIer RR`s Ior LIe
smoker`s group. TIIs eIIecL uIso Ius un IuLrogenIc uspecL.
L sIouId be obvIous LIuL LIe RR sLuLIsLIc Is Loo superIIcIuI,
obIILeruLIng uII munner oI wILIIn und beLween-group dIIIerences LIuL ure
ImperuLIve In scIenLIIIc enquIry; IL does no jusLIce uL uII Lo vurIubIe
puLLerns In duLu seLs. TIe RR sLuLIsLIc, us LypIcuIIy used, bundIes specIIIc-
cuuse (dIseuse) morLuIILy und uge-specIIIc morLuIILy. urLIermore, LIe RR
sLuLIsLIc bundIes (summurIzes) uII uge vurIuLIons Ior specIIIc dIseuse
beLween smokers und nonsmokers. L udds noLIIng Lo un undersLundIng
oI wIuL musL be crILIcuI dIIIerences beLween, Ior exumpIe, un oId-uge
Ieuvy-smoker deveIopIng Iung cuncer compured Lo eILIer oId-uge Ieuvy-
smokers LIuL do noL deveIop Iung cuncer (LIe mujorILy) or u younger-uge
Ieuvy-smoker LIuL deveIops Iung cuncer or u younger-uge never-smoker
wIo deveIops Iung cuncer. RR cunnoL uddress, ct cll, LIe predIcLIve
sLrengLI oI un unLecedenL (e.g., cIgureLLe smokIng) Ior eILIer specIIIc
dIseuse or eurIy morLuIILy. L Is LIIs crILerIon LIuL dIsLInguIsIes scIenLIIIc
proposILIons Irom wIId specuIuLIon und supersLILIous beIIeI.
TIe medIco-muLerIuIIsm generuLIng LIe enquIry Is uIso Loo
superIIcIuI, mukIng ussumpLIons LIuL Iuve no meunIngIuIness. or
exumpIe, LIe ussumpLIons oI IomogeneILy oI smoker`s und nonsmoker`s
groups, boLI wILIIn und beLween-groups, und IomogeneILy oI yeurs uIong
LIe uge or IongevILy conLInuum ure IndeIensIbIe. Some oI LIe crILIcuI
subgroup dIIIerences InvoIve psycIoIogIcuI und psycIosocIuI IucLors (e.g.,
48
48
Rampant Antismoking Signifies Grave Danger
convergence eIIecL, rIsk uversIon) LIuL ure beyond LIe compeLence oI
muLerIuIIsm. urLIermore, some RR-dIIIerenLIuIs cun be produced by
medIcuI mIsconducL (I.e., IuLrogenIc eIIecL). TIere ure uIso crILIcuI Issues
concernIng LIe IncompIeLeness oI InIormuLIon presenLed. or exumpIe,
proporLIons oI uge-udjusLed, specIIIc-cuuse morLuIILy ure LypIcuIIy noL
presenLed. PurLIcuIur dIseuse-subdIvIsIons ure noL presenLed; PrescoLL eL
uI. (1qq8), TubIe , does noL even provIde specIIIc subdIvIsIons Ior
vuscuIur dIseuse oLIer LIun IscIuemIc IeurL dIseuse und cerebrovuscuIur
dIseuse, und oLIer cuncers upurL Irom Iung cuncer und oLIer Lobucco-
reIuLed cuncers. BoLI PrescoLL eL uI. und DoII eL uI. provIde no
InIormuLIon on conIoundIng IucLors. EIevuLed RR`s Ior LIe smoker`s group
ure ImproperIy reIerred Lo us uLLrIbuLubIe Lo LIe cuusuI eIIecLs oI
Lobucco smoke.
As u IIImsy summury sLuLIsLIc wILIIn u gumbIIng Irumework, RR
Is quILe LoIerubIe. However, Ior LIe purposes oI scIenLIIIc enquIry, IL Is
compIeLeIy unuccepLubIe. L produces mIsIeudIng cIuIms und, us wIII be
dIscussed, In LIe wuy IL Is LypIcuIIy used In epIdemIoIogIcuI InvesLIguLIons
und LIe concIusIons used LIereIrom In prevenLIve medIcIne, IL cun onl
be mIsIeudIng. WIIIe scIence wouId uLLempL Lo eIucIduLe wILIIn und
beLween-group dIsLIncLIons LIuL muy uILImuLeIy yIeId very IIgI predIcLIve
sLrengLI oI IucLors Ior specIIIc dIseuseJmorLuIILy, epIdemIoIogy, LIrougI
ILs IrruLIonuI use oI reIuLIve rIsk ruLIos, serves onIy Lo bIur uII oI LIese
possIbIe dIsLIncLIons.
TIe sLuLe oI epIdemIoIogy uL LIIs LIme Is LIuL IL Is sImpIy u
generuLor oI reIuLIve-rIsk ruLIos Ior specIIIc dIseuseJmorLuIILy. TIIs Is noL
Loo dIIIerenL Irom u crILIcuI purL oI u bookmuker`s IuncLIon, I.e.,
cuIcuIuLIng LIe odds oI purLIcuIur occurrences. TIere Is IILLIe uLLempL by
epIdemIoIogy Lo purLILIon Ior conIoundIng IucLors (muILIpIe rIsk IucLors),
especIuIIy regurdIng smokIng und dIseuse, und LIere Is essenLIuIIy no
uLLempL Lo pIuce duLu In correIuLIon or condILIonuI-probubIIILy Lerms.
CorreIuLIon Is un upproprIuLe meusure oI sLrengLI oI ussocIuLIon LIuL Is
uILImuLeIy reIuLed Lo predIcLIve sLrengLI (condILIonuI probubIIILy) oI
IucLors Ior IucLors.
WukeIIeId (1q88) InvesLIguLed smokIng sLudIes Ior 1q8 LIuL
meL uL IeusL some busIc experImenLuI crILerIu. UsIng correIuLIon us u
meusure oI ussocIuLIon ruLIer LIun RR`s, Ie Iound very poor correIuLIon
beLween smokIng und dependenL vurIubIes (I.e., Iess LIun o.zo).
urLIermore, II LIe meLIodoIogIcuIIy weuker sLudIes Iud been removed
Irom LIe cuIcuIuLIon, LIe correIuLIon wouId be even cIoser Lo zero. TIIs Is
very mucI In keepIng wILI LIe currenL dIscussIon LIuL II LIe ucLuuI crILerIu
oI cuusuI urgumenL ure uppIIed, LIe correIuLIon oI cIgureLLe smokIng wILI
specIIIc-dIseuse morLuIILy or eurIy morLuIILy Is very poor. L Is so poor LIuL
Lifestyle Epidemiology
IL Is noL remoLeIy wILIIn LIe reuIm oI sIngIe IucLor, prImury cuusuI
urgumenL, I.e., cIgureLLe smokIng Is dejinitel noL u suIIIcIenL condILIon Ior
specIIIc dIseuseJmorLuIILy.
L cun be concIuded Irom LIe ubove LIuL prImury cuusuI
urgumenLs concernIng LIe possIbIe roIe oI smokIng In specIIIc dIseuse or
eurIy morLuIILy ure deIInILIveIy dIsconIIrmed. L cun uIso be concIuded
LIuL, IIrsLIy, smokIng mIgIL be one oI muny LrIgger IucLors In Iung cuncer
specIIIcuIIy; endogenous ubnormuIILy wouId be LIe prImury IucLor In LIIs
dIseuse. ung cuncer In smokers uIso uppeurs Lo be Lrunsposed cuncer In
LIose LIuL wouId Iuve deveIoped some oLIer Iorm oI cuncer. SecondIy,
ubouL qo per cenL oI smokers und nonsmokers ure compurubIe In specIIIc-
cuuse morLuIILy, I.e., mosL smokers ure noL uL IIgIer rIsk oI specIIIc-cuuse
morLuIILy LIun nonsmokers. TIIrdIy, un eurIIer-morLuIILy dIIIerenLIuI does
exIsL beLween LIe smoker`s und nonsmoker`s groups. n LIIs regurd
smokIng muy be one oI muny LrIgger IucLors In eurIIer morLuIILy. Or, LIe
dIIIerenLIuI mIgIL be uLLrIbuLubIe Lo u convergence eIIecL Ior u subgroup oI
smokers, or rIsk-uverse ucLIvILy Ior u subgroup oI nonsmokers, or u
combInuLIon oI LIese. TIe Ideu LIuL eurIIer morLuIILy uIwuys reIIecLs
premuLure morLuIILy und uLLrIbuLubIe enLIreIy Lo LIe cuusuI eIIecLs oI
Lobucco smoke Is IndeIensIbIe. As wIII IuLer be consIdered, even IongevILy
ILseII Is u poor IndIcuLor oI sLundurd or quuIILy oI IIIe.
z.z.z The Mediccl Estcblishment Vieu (or, Where the
Ioll eins)
TIe IoregoIng ussessmenL Is quILe conLrury Lo LIe
epIdemIoIogIcuI vIew LIuL begun In LIe 1q6o`s wILI LIe US Surgeon
GeneruI (ReporL oI LIe AdvIsory CommILLee Lo LIe Surgeon GeneruI oI LIe
US PubIIc HeuILI ServIce, 1q6q) decIurIng cIgureLLe smokIng us u sIngIe-
IucLor, prImury cuuse oI Iung cuncer und wus IuLer exLended Lo IncIude
CHD und oLIer cuncers. A mujor quesLIon concerns wIy LIere wouId be
sucI u crILIcuI dIscrepuncy In ussessmenLs.
ApurL Irom numerous unomuIIes, IncIudIng u IuIIure Lo produce
cuncer In unImuI sLudIes Irom InIuIuLIon oI Lobucco smoke, LIere seem Lo
be u number oI IucLors LIuL dIcLuLed LIe AdvIsory CommILLee`s (1q6q)
concIusIons. TIe mosL crILIcuI oI LIese were IIrsLIy, LIe demonsLruLed
(unImuI sLudIes) curcInogenIcILy oI consLILuenLs (e.g., benzo(u)pyrene) oI
Lobucco smoke; secondIy, LIe seemIng consIderubIe Increuse In Iung
cuncer reIuLed Lo popuIuLIon Increuses In Lobucco smokIng In LIe eurIy
1qoo`s; LIIrdIy, wIuL Is reIerred Lo us u dose-response eIIecL; und,
IourLIIy, LIe reIuLIve rIsk dIIIerence (u IucLor oI 1o.8) beLween
49
49
Rampant Antismoking Signifies Grave Danger
convergence eIIecL, rIsk uversIon) LIuL ure beyond LIe compeLence oI
muLerIuIIsm. urLIermore, some RR-dIIIerenLIuIs cun be produced by
medIcuI mIsconducL (I.e., IuLrogenIc eIIecL). TIere ure uIso crILIcuI Issues
concernIng LIe IncompIeLeness oI InIormuLIon presenLed. or exumpIe,
proporLIons oI uge-udjusLed, specIIIc-cuuse morLuIILy ure LypIcuIIy noL
presenLed. PurLIcuIur dIseuse-subdIvIsIons ure noL presenLed; PrescoLL eL
uI. (1qq8), TubIe , does noL even provIde specIIIc subdIvIsIons Ior
vuscuIur dIseuse oLIer LIun IscIuemIc IeurL dIseuse und cerebrovuscuIur
dIseuse, und oLIer cuncers upurL Irom Iung cuncer und oLIer Lobucco-
reIuLed cuncers. BoLI PrescoLL eL uI. und DoII eL uI. provIde no
InIormuLIon on conIoundIng IucLors. EIevuLed RR`s Ior LIe smoker`s group
ure ImproperIy reIerred Lo us uLLrIbuLubIe Lo LIe cuusuI eIIecLs oI
Lobucco smoke.
As u IIImsy summury sLuLIsLIc wILIIn u gumbIIng Irumework, RR
Is quILe LoIerubIe. However, Ior LIe purposes oI scIenLIIIc enquIry, IL Is
compIeLeIy unuccepLubIe. L produces mIsIeudIng cIuIms und, us wIII be
dIscussed, In LIe wuy IL Is LypIcuIIy used In epIdemIoIogIcuI InvesLIguLIons
und LIe concIusIons used LIereIrom In prevenLIve medIcIne, IL cun onl
be mIsIeudIng. WIIIe scIence wouId uLLempL Lo eIucIduLe wILIIn und
beLween-group dIsLIncLIons LIuL muy uILImuLeIy yIeId very IIgI predIcLIve
sLrengLI oI IucLors Ior specIIIc dIseuseJmorLuIILy, epIdemIoIogy, LIrougI
ILs IrruLIonuI use oI reIuLIve rIsk ruLIos, serves onIy Lo bIur uII oI LIese
possIbIe dIsLIncLIons.
TIe sLuLe oI epIdemIoIogy uL LIIs LIme Is LIuL IL Is sImpIy u
generuLor oI reIuLIve-rIsk ruLIos Ior specIIIc dIseuseJmorLuIILy. TIIs Is noL
Loo dIIIerenL Irom u crILIcuI purL oI u bookmuker`s IuncLIon, I.e.,
cuIcuIuLIng LIe odds oI purLIcuIur occurrences. TIere Is IILLIe uLLempL by
epIdemIoIogy Lo purLILIon Ior conIoundIng IucLors (muILIpIe rIsk IucLors),
especIuIIy regurdIng smokIng und dIseuse, und LIere Is essenLIuIIy no
uLLempL Lo pIuce duLu In correIuLIon or condILIonuI-probubIIILy Lerms.
CorreIuLIon Is un upproprIuLe meusure oI sLrengLI oI ussocIuLIon LIuL Is
uILImuLeIy reIuLed Lo predIcLIve sLrengLI (condILIonuI probubIIILy) oI
IucLors Ior IucLors.
WukeIIeId (1q88) InvesLIguLed smokIng sLudIes Ior 1q8 LIuL
meL uL IeusL some busIc experImenLuI crILerIu. UsIng correIuLIon us u
meusure oI ussocIuLIon ruLIer LIun RR`s, Ie Iound very poor correIuLIon
beLween smokIng und dependenL vurIubIes (I.e., Iess LIun o.zo).
urLIermore, II LIe meLIodoIogIcuIIy weuker sLudIes Iud been removed
Irom LIe cuIcuIuLIon, LIe correIuLIon wouId be even cIoser Lo zero. TIIs Is
very mucI In keepIng wILI LIe currenL dIscussIon LIuL II LIe ucLuuI crILerIu
oI cuusuI urgumenL ure uppIIed, LIe correIuLIon oI cIgureLLe smokIng wILI
specIIIc-dIseuse morLuIILy or eurIy morLuIILy Is very poor. L Is so poor LIuL
Lifestyle Epidemiology
IL Is noL remoLeIy wILIIn LIe reuIm oI sIngIe IucLor, prImury cuusuI
urgumenL, I.e., cIgureLLe smokIng Is dejinitel noL u suIIIcIenL condILIon Ior
specIIIc dIseuseJmorLuIILy.
L cun be concIuded Irom LIe ubove LIuL prImury cuusuI
urgumenLs concernIng LIe possIbIe roIe oI smokIng In specIIIc dIseuse or
eurIy morLuIILy ure deIInILIveIy dIsconIIrmed. L cun uIso be concIuded
LIuL, IIrsLIy, smokIng mIgIL be one oI muny LrIgger IucLors In Iung cuncer
specIIIcuIIy; endogenous ubnormuIILy wouId be LIe prImury IucLor In LIIs
dIseuse. ung cuncer In smokers uIso uppeurs Lo be Lrunsposed cuncer In
LIose LIuL wouId Iuve deveIoped some oLIer Iorm oI cuncer. SecondIy,
ubouL qo per cenL oI smokers und nonsmokers ure compurubIe In specIIIc-
cuuse morLuIILy, I.e., mosL smokers ure noL uL IIgIer rIsk oI specIIIc-cuuse
morLuIILy LIun nonsmokers. TIIrdIy, un eurIIer-morLuIILy dIIIerenLIuI does
exIsL beLween LIe smoker`s und nonsmoker`s groups. n LIIs regurd
smokIng muy be one oI muny LrIgger IucLors In eurIIer morLuIILy. Or, LIe
dIIIerenLIuI mIgIL be uLLrIbuLubIe Lo u convergence eIIecL Ior u subgroup oI
smokers, or rIsk-uverse ucLIvILy Ior u subgroup oI nonsmokers, or u
combInuLIon oI LIese. TIe Ideu LIuL eurIIer morLuIILy uIwuys reIIecLs
premuLure morLuIILy und uLLrIbuLubIe enLIreIy Lo LIe cuusuI eIIecLs oI
Lobucco smoke Is IndeIensIbIe. As wIII IuLer be consIdered, even IongevILy
ILseII Is u poor IndIcuLor oI sLundurd or quuIILy oI IIIe.
z.z.z The Mediccl Estcblishment Vieu (or, Where the
Ioll eins)
TIe IoregoIng ussessmenL Is quILe conLrury Lo LIe
epIdemIoIogIcuI vIew LIuL begun In LIe 1q6o`s wILI LIe US Surgeon
GeneruI (ReporL oI LIe AdvIsory CommILLee Lo LIe Surgeon GeneruI oI LIe
US PubIIc HeuILI ServIce, 1q6q) decIurIng cIgureLLe smokIng us u sIngIe-
IucLor, prImury cuuse oI Iung cuncer und wus IuLer exLended Lo IncIude
CHD und oLIer cuncers. A mujor quesLIon concerns wIy LIere wouId be
sucI u crILIcuI dIscrepuncy In ussessmenLs.
ApurL Irom numerous unomuIIes, IncIudIng u IuIIure Lo produce
cuncer In unImuI sLudIes Irom InIuIuLIon oI Lobucco smoke, LIere seem Lo
be u number oI IucLors LIuL dIcLuLed LIe AdvIsory CommILLee`s (1q6q)
concIusIons. TIe mosL crILIcuI oI LIese were IIrsLIy, LIe demonsLruLed
(unImuI sLudIes) curcInogenIcILy oI consLILuenLs (e.g., benzo(u)pyrene) oI
Lobucco smoke; secondIy, LIe seemIng consIderubIe Increuse In Iung
cuncer reIuLed Lo popuIuLIon Increuses In Lobucco smokIng In LIe eurIy
1qoo`s; LIIrdIy, wIuL Is reIerred Lo us u dose-response eIIecL; und,
IourLIIy, LIe reIuLIve rIsk dIIIerence (u IucLor oI 1o.8) beLween
50
50
Rampant Antismoking Signifies Grave Danger Lifestyle Epidemiology
LIuL: CondensuLes oI Lobucco smoke ure curcInogenIc wIen LesLed by
uppIIcuLIon Lo LIe skIn oI mIce und rubbILs, by subcuLuneous InjecLIon In
ruLs, und by puInLIng LIe broncIIuI epILIeIIum oI dogs. TIe umounL oI
known curcInogens In cIgureLLe smoke Is Loo smuII Lo uccounL Ior LIeIr
curcInogenIc ucLIvILy. PromoLIng ugenLs Iuve uIso been Iound In Lobucco
smoke buL LIe bIoIogIcuI ucLIon oI mIxLures oI LIe known curcInogens und
promoLers over u Iong perIod oI LIme Is noL undersLood. (p. 1q6)
SucI sLudIes provIde pIuusIbIIILy LIuL Lobucco-smoke
properLIes muy be ImpIIcuLed In broncIogenIc curcInomu In Iumuns, und
bused on LIe Ideu oI dIrecL conLucL. However, broncIIogenIc curcInomu
Ius noL been produced by LIe uppIIcuLIon oI Lobucco exLrucLs, smoke, or
condensuLes Lo LIe Iung or LIe LrucIeobroncIIuI Lree oI experImenLuI
unImuIs wILI LIe possIbIe excepLIon oI dogs. (p. 16) TIe Iow-IeveI
IIndIng regurdIng dogs (I.e., Rockney eL uI.) cun be dIspensed wILI In LIuL
IL Ius never been repIIcuLed (see uIso CoIby, 1qqq).
A conLucL LIeory, uILIougI superIIcIuIIy uLLrucLIve, Is
quesLIonubIe on u number oI grounds. Pussey (1q6z) noLed LIuL In one
yeur (1q8) 1;,o11 men dIed oI Iung cuncer und onIy z; oI cuncer oI LIe
LrucIeu wIen LIe epILIeIIum oI LIe LrucIeu Is conLInuous wILI LIuL oI LIe
broncII und oI LIe sume sLrucLure. Pussey (1q6z) uIso IndIcuLes LIuL
purLIcuIur cuncers presumed Lo be reIuLed Lo Iung cuncer (e.g., upper
respIruLory LrucL, LIe mouLI, IIps, Longue) Iuve noL Increused In unywIere
neur LIe proporLIon LIuL Iung cuncer Ius, und LIuL LIere ure IndIcuLIons
LIuL cuncer oI LIe Longue, skIn, esopIugus, uLerus, und Iurynx were
decIInIng. DeuLI by cuncer oI LIe InLesLInes, sLomucI und prosLuLe, und
wIIcI Iuve u IIgIer reIuLIve rIsk Ior smokers, were IncreusIng unLII z
yeurs ugo buL ure now decIInIng. urLIermore, IL sIouId be noLed LIuL
wIeLIer Lobucco conLuIns 1 or 1o,ooo curcInogenIc consLILuenLs Is
essenLIuIIy IrreIevunL II LIIs muLLer cunnoL uccuruLeIy pInpoInL LIose wIo
wIII ucLuuIIy deveIop specIIIc dIseuse, und LIereIore, LIe mecIunIsmsJ
processes by wIIcI sucI dIseuse occurs.
RegurdIng LIe reIuLIonsIIp oI smokIng Lo LIe IIsLopuLIoIogIcuI
cIunges In LIe LrucIeobroncIIuI Lree, LIe SG (1q6q) concIuded LIuL some
oI LIe udvunced epILIeIIuI IyperpIusLIc IesIons wILI muny uLypIcuI ceIIs,
seen In LIe broncII oI some cIgureLLe smokers, ure probubIy
premuIIgnunL. (p. 1;) ProbubIe premuIIgnunL condILIons, oI
LIemseIves, do noL necessurIIy LrunsIuLe InLo u dIrecL cuusuI reIuLIonsIIp
beLween smokIng und muIIgnuncy. UnIorLunuLeIy, LIe SG (1q6q) does noL
IndIcuLe wIuL uIIows LIe sIIIL Irom u probubIe premuIIgnunL Lo u
muIIgnunL condILIon. TIere Is no urLIcuIuLed mecIunIsm or process LIuL
specIIIcuIIy IdenLIIIes LIe muIIgnunL pIuse or LIe LrunsILIon Lo LIIs pIuse.
TIe currenL LIesIs Is LIuL LIere cun be no sucI mecIunIsm LIuL reIuLes
nonsmokersJsmokers Ior Iung cuncer (see TubIe q).
GuIIIord (1q68) presenLs u good revIew oI LIe consIderubIe Issues
und conIIIcLIng duLu In LIme-Lrend sLudIes, ureu sLudIes, reLrospecLIveJ
prospecLIve sLudIes, unImuI sLudIes, und IIsLopuLIoIogIcuI sLudIes In
evuIuuLIng LIe ussocIuLIon beLween smokIng und IncIdence oI Iung cuncer
und oLIer dIseuseJmorLuIILy. L wouId serve no useIuI purpose Lo sImpIy
reIusI LIIs InIormuLIon Iere. RuLIer, LIere wIII sImpIy be u summuryJ
evuIuuLIon oI LIose IucLors LIuL seemed Lo dIcLuLe LIe ReporL CommILLee`s
(1q6q) evenLuuI concIusIon.
TIe ReporL CommILLee (1q6q) noLed LIuL curcInogenesIs Is u
compIex process LIuL InvoIves muny IucLors, boLI exogenous und
endogenous. nducLIon oI cuncer by u subsLunce In one specIes provIdes
no concIusIve demonsLruLIon LIuL LIe sume subsLunce wouId be
curcInogenIc In unoLIer specIes under LIe sume cIrcumsLunces. AL besL,
unImuI sLudIes cun provIde onIy Iow-IeveI supporL In LIe uppIIcuLIon oI
IIndIngs Lo Iumuns. RegurdIng unImuI sLudIes, LIe SG (1q6q) concIuded
51
51
Rampant Antismoking Signifies Grave Danger Lifestyle Epidemiology
LIuL: CondensuLes oI Lobucco smoke ure curcInogenIc wIen LesLed by
uppIIcuLIon Lo LIe skIn oI mIce und rubbILs, by subcuLuneous InjecLIon In
ruLs, und by puInLIng LIe broncIIuI epILIeIIum oI dogs. TIe umounL oI
known curcInogens In cIgureLLe smoke Is Loo smuII Lo uccounL Ior LIeIr
curcInogenIc ucLIvILy. PromoLIng ugenLs Iuve uIso been Iound In Lobucco
smoke buL LIe bIoIogIcuI ucLIon oI mIxLures oI LIe known curcInogens und
promoLers over u Iong perIod oI LIme Is noL undersLood. (p. 1q6)
SucI sLudIes provIde pIuusIbIIILy LIuL Lobucco-smoke
properLIes muy be ImpIIcuLed In broncIogenIc curcInomu In Iumuns, und
bused on LIe Ideu oI dIrecL conLucL. However, broncIIogenIc curcInomu
Ius noL been produced by LIe uppIIcuLIon oI Lobucco exLrucLs, smoke, or
condensuLes Lo LIe Iung or LIe LrucIeobroncIIuI Lree oI experImenLuI
unImuIs wILI LIe possIbIe excepLIon oI dogs. (p. 16) TIe Iow-IeveI
IIndIng regurdIng dogs (I.e., Rockney eL uI.) cun be dIspensed wILI In LIuL
IL Ius never been repIIcuLed (see uIso CoIby, 1qqq).
A conLucL LIeory, uILIougI superIIcIuIIy uLLrucLIve, Is
quesLIonubIe on u number oI grounds. Pussey (1q6z) noLed LIuL In one
yeur (1q8) 1;,o11 men dIed oI Iung cuncer und onIy z; oI cuncer oI LIe
LrucIeu wIen LIe epILIeIIum oI LIe LrucIeu Is conLInuous wILI LIuL oI LIe
broncII und oI LIe sume sLrucLure. Pussey (1q6z) uIso IndIcuLes LIuL
purLIcuIur cuncers presumed Lo be reIuLed Lo Iung cuncer (e.g., upper
respIruLory LrucL, LIe mouLI, IIps, Longue) Iuve noL Increused In unywIere
neur LIe proporLIon LIuL Iung cuncer Ius, und LIuL LIere ure IndIcuLIons
LIuL cuncer oI LIe Longue, skIn, esopIugus, uLerus, und Iurynx were
decIInIng. DeuLI by cuncer oI LIe InLesLInes, sLomucI und prosLuLe, und
wIIcI Iuve u IIgIer reIuLIve rIsk Ior smokers, were IncreusIng unLII z
yeurs ugo buL ure now decIInIng. urLIermore, IL sIouId be noLed LIuL
wIeLIer Lobucco conLuIns 1 or 1o,ooo curcInogenIc consLILuenLs Is
essenLIuIIy IrreIevunL II LIIs muLLer cunnoL uccuruLeIy pInpoInL LIose wIo
wIII ucLuuIIy deveIop specIIIc dIseuse, und LIereIore, LIe mecIunIsmsJ
processes by wIIcI sucI dIseuse occurs.
RegurdIng LIe reIuLIonsIIp oI smokIng Lo LIe IIsLopuLIoIogIcuI
cIunges In LIe LrucIeobroncIIuI Lree, LIe SG (1q6q) concIuded LIuL some
oI LIe udvunced epILIeIIuI IyperpIusLIc IesIons wILI muny uLypIcuI ceIIs,
seen In LIe broncII oI some cIgureLLe smokers, ure probubIy
premuIIgnunL. (p. 1;) ProbubIe premuIIgnunL condILIons, oI
LIemseIves, do noL necessurIIy LrunsIuLe InLo u dIrecL cuusuI reIuLIonsIIp
beLween smokIng und muIIgnuncy. UnIorLunuLeIy, LIe SG (1q6q) does noL
IndIcuLe wIuL uIIows LIe sIIIL Irom u probubIe premuIIgnunL Lo u
muIIgnunL condILIon. TIere Is no urLIcuIuLed mecIunIsm or process LIuL
specIIIcuIIy IdenLIIIes LIe muIIgnunL pIuse or LIe LrunsILIon Lo LIIs pIuse.
TIe currenL LIesIs Is LIuL LIere cun be no sucI mecIunIsm LIuL reIuLes
nonsmokersJsmokers Ior Iung cuncer (see TubIe q).
GuIIIord (1q68) presenLs u good revIew oI LIe consIderubIe Issues
und conIIIcLIng duLu In LIme-Lrend sLudIes, ureu sLudIes, reLrospecLIveJ
prospecLIve sLudIes, unImuI sLudIes, und IIsLopuLIoIogIcuI sLudIes In
evuIuuLIng LIe ussocIuLIon beLween smokIng und IncIdence oI Iung cuncer
und oLIer dIseuseJmorLuIILy. L wouId serve no useIuI purpose Lo sImpIy
reIusI LIIs InIormuLIon Iere. RuLIer, LIere wIII sImpIy be u summuryJ
evuIuuLIon oI LIose IucLors LIuL seemed Lo dIcLuLe LIe ReporL CommILLee`s
(1q6q) evenLuuI concIusIon.
TIe ReporL CommILLee (1q6q) noLed LIuL curcInogenesIs Is u
compIex process LIuL InvoIves muny IucLors, boLI exogenous und
endogenous. nducLIon oI cuncer by u subsLunce In one specIes provIdes
no concIusIve demonsLruLIon LIuL LIe sume subsLunce wouId be
curcInogenIc In unoLIer specIes under LIe sume cIrcumsLunces. AL besL,
unImuI sLudIes cun provIde onIy Iow-IeveI supporL In LIe uppIIcuLIon oI
IIndIngs Lo Iumuns. RegurdIng unImuI sLudIes, LIe SG (1q6q) concIuded
52
52
Rampant Antismoking Signifies Grave Danger
onIy smokIng, und quunLILy smoked, Lo muIIgnuncy. TIe unLecedenL
condILIon oI smokIng Is Iur, Iur Loo generuI (IIgI prevuIence) Lo be dIrecLIy
reIuLed Lo non-generuI, specIIIc dIseuse, I.e., InvoIves LIe requIremenL oI
poLenLIuIIy numerous InLermedIuLe IucLors und mecIunIsmsJprocesses.
TIme-Lrend unuIyses ure un IndIrecL und crude uLLempL Lo
meusure u poLenLIuI cuusuI ussocIuLIon beLween popuIuLIon Lobucco
consumpLIon und Iung cuncer ruLe. ConcernIng LIme-Lrend duLu, LIe
crILIcuI poInL Is LIuL eten un IncreusIng, buL Iow, correIuLIon beLween
cIgureLLe consumpLIon und IncIdence oI Iung cuncer does noL ImpIy
cuusuLIon oI uny kInd - sIngIe IucLor, prImury. n IucL, Iow correIuLIon
disconjirms cIgureLLe smokIng us u sIngIe IucLor, prImury cuuse oI Iung
cuncer. AguIn, LIe IIgIesL sLuLus LIuL couId be ussIgned Lo cIgureLLe
smokIng Ior Iung cuncer Is us u LrIgger gIven necessury endogenousJ
exogenous precondILIons. WIeLIer even LIIs sLuLus Is wurrunLed depends
on IdenLIIIcuLIon oI LIese crILIcuI precondILIons, I.e., even u LrIgger sLuLus
remuIns undeLermIned. TIme-Lrend upproucIes, In purLIcuIur, operuLe uL
Loo gross u IeveI oI sLuLIsLIcuI InIerence Lo udequuLeIy uddress LIe
pinpointin oI crILIcuI precondILIons Ior specIIIc IndIvIduuIs und dIseuse.
A dose-response eIIecL reIers Lo un Increuse In LIe ruLe oI u
dIseuse reIuLed Lo LIe ruLe oI IndIvIduuI Lobucco consumpLIon, I.e., LIe
dIseuse Is reIuLed more cIoseIy wILI Ieuvy us opposed Lo IIgIL smokers,
und more wILI smokers LIun never-smokers. TIe dose-response
urgumenL Is u cenLruI one In vIewIng smokIng us cuusuIIy ImpIIcuLed In
Iung cuncer und oLIer dIseuseJmorLuIILy. n uddILIon Lo un eurIIer
consIderuLIon, LIere ure u number oI IurLIer reusons wIy LIe duLu do noL
supporL u dose-response urgumenL.
IrsLIy, Eysenck (1q8o), In consIderIng duLu by Pussey (1q6z),
noLed LIuL IIgIL-smokers deveIoped Iung cuncer uL u Iower ruLe buL uL LIe
scme uge us Ieuvy-smokers, usuuIIy uL udvunced uge. TIere ure oLIer
unomuIIes sucI us smuII numbers oI boLI IIgIL-und Ieuvy smokers
deveIopIng Iung cuncer In mIddIe uge. TIIs Is uguInsL u buckdrop oI mosL
Ieuvy-smokers, und even more IIgIL-smokers, not deveIopIng Iung cuncer
over u IIIeLIme. n LIe cuse oI LIe Iow IncIdence oI eurIy-uge deveIopmenL
oI Iung cuncer, wIeLIer unomuIous or noL, LIe predIcLIve sLrengLI oI LIe
sIngIe IucLor oI cIgureLLe smokIng Ior Iung cuncer Is eIIecLIveIy zero. ow-
IeveI predIcLors, IeL uIone zero-IeveI predIcLors, LypIcuIIy IndIcuLe LIuL LIey
wurrunL no sIngIe-IucLor cuusuI consIderuLIon.
SecondIy, u dose-response eIIecL reIuLIng LIe properLIes oI
Lobucco smoke Lo LIe IncIdence oI specIIIc dIseuse requIres IIgI
specIIIcILy, e.g., >o.6. TIere Is un observed ceIIIng oI ussocIuLIon Ior Iung
cuncer oI o.1 Ior men (CopenIugen sLudy). TIereIore, LIe poInL LIuL
wouId deIIne LIe curve us u genuIne dose-response curve, I.e., o.6, Is
Lifestyle Epidemiology
ouLsIde LIe observubIe runge. n LIIs crILIcuI sense, LIe proposILIon oI un
ucLuuI dose-response eIIecL Is unLesLubIe, unIuIsIIIubIe. Heuvy-smokers
wouId Iuve Lo IIve somewIere, suy, beLween 1qo und zoo yeurs oI uge
beIore u generuI IeveI oI eIIecL Is reucIed, II LIe Ideu oI dose-response
Ius uny meunIngIuIness uL uII. TIe sILuuLIon Is IurLIer compIIcuLed II mosL
Ieuvy smokers noL deveIopIng Iung cuncer IndIcuLes u normuLIve runge oI
IuncLIonIng. n oLIer words, II LIe o.1 ussocIuLIon beLween Ieuvy
smokIng und Iung cuncer reIIecLs, Ior exumpIe, u geneLIc ubnormuIILy,
LIen LIIs IeveI oI ussocIuLIon Is mcximcl, regurdIess oI wIeLIer uII Ieuvy-
smokers couId IIve Lo zoo yeurs oI uge or noL. As Ius been consIdered,
endogenous ubnormuIILy pecuIIur Lo u subgroup oI smokers Is IIgIIy
ImpIIcuLed.
WIuL cun be concIuded Is LIuL LIe observed curve wILI u ceIIIng
oI o.1 Is noL un ucLuuI dose-response curve, buL wouId represenL LIe
Iower-end oI sucI u curve, II sucI u curve wus LIe cuse. TIIs resuILs In un
IndeIensIbIe urgumenL LIuL uses un unLesLubIe (unIuIsIIIubIe) ussumpLIon
oI u dose-response curve supporLIng u concIusIon oI u dose-response
reIuLIonsIIp, I.e., un ussumpLIon oI cuuse supporLIng u concIusIon oI
cuuse. WIuL cun uIso be concIuded Is LIuL LIe Iuck oI specIIIcILy oI
ussocIuLIon wouId ImmedIuLeIy poInL Lo vurIuLIons In endogenous sysLems
us LIe source oI vurIuLIon In LIe observed ussocIuLIon oI Iung cuncer wILI
LIe Ieuvy und IIgIL smoker`s subgroups. Even II LIe IncreusIng IncIdence
oI Iung cuncer Irom never-smokers Lo Ieuvy-smokers reIIecLed LIe Iower
LuII-end oI u dose-response curve, IL wouId IndIcuLe u subgroup und
uLypIcuI ussocIuLIon (I.e., very IIgI IIkeIIIood oI endogenous sysLem
vurIuLIon). urLIermore, II LIose In epIdemIoIogy ure Lo urgue LIuL u
consIsLency oI ussocIuLIon oI o.1 oI un unLecedenL wILI u consequenL Is
suIIIcIenL Lo demonsLruLe u prImury cuusuI sLuLus Ior LIe unLecedenL, LIen
by LIe very sume conLorLed reusonIng LIere ure Iur, Iur greuLer grounds Lo
cIuIm u non-cuusuI sLuLus Ior LIe unLecedenL In LIuL LIere Is u IIgI
consIsLency (o.8) oI non-cssociction wILI LIe consequenL, I.e., LIe
normuLIve runge Is non-ussocIuLIon oI LIe consequenL wILI LIe
unLecedenL.
To muInLuIn u dose-response urgumenL wIere LIere Is lou
consIsLencyJspecIIIcILy oI ussocIuLIon InvoIves u purLIcuIur perversIon oI
sLuLIsLIcuI und cuusuI concepLs LIuL conceuIs LIe Iow-IeveI (subgroup)
ussocIuLIon. TIIs Is uccompIIsIed In LIe mInds oI LIose wIo wouId so
urgue by reducIng eucI group (nonsmokers, IIgIL-smokers, Ieuvy-
smokers) Lo sIngIe orgunIsms, I.e., LIe IndIvIduuI membersIIp oI eucI
group concepLuuIIy meILs uwuy. L Is conLrIvIng u bIuck box perspecLIve
Ior LIe entiret oI eucI group. n oLIer words, LIIs reusonIng Is noL onIy
IndeIensIbIy ussumIng u IomogeneILy oI group membersIIp, buL LIuL LIe
53
53
Rampant Antismoking Signifies Grave Danger
onIy smokIng, und quunLILy smoked, Lo muIIgnuncy. TIe unLecedenL
condILIon oI smokIng Is Iur, Iur Loo generuI (IIgI prevuIence) Lo be dIrecLIy
reIuLed Lo non-generuI, specIIIc dIseuse, I.e., InvoIves LIe requIremenL oI
poLenLIuIIy numerous InLermedIuLe IucLors und mecIunIsmsJprocesses.
TIme-Lrend unuIyses ure un IndIrecL und crude uLLempL Lo
meusure u poLenLIuI cuusuI ussocIuLIon beLween popuIuLIon Lobucco
consumpLIon und Iung cuncer ruLe. ConcernIng LIme-Lrend duLu, LIe
crILIcuI poInL Is LIuL eten un IncreusIng, buL Iow, correIuLIon beLween
cIgureLLe consumpLIon und IncIdence oI Iung cuncer does noL ImpIy
cuusuLIon oI uny kInd - sIngIe IucLor, prImury. n IucL, Iow correIuLIon
disconjirms cIgureLLe smokIng us u sIngIe IucLor, prImury cuuse oI Iung
cuncer. AguIn, LIe IIgIesL sLuLus LIuL couId be ussIgned Lo cIgureLLe
smokIng Ior Iung cuncer Is us u LrIgger gIven necessury endogenousJ
exogenous precondILIons. WIeLIer even LIIs sLuLus Is wurrunLed depends
on IdenLIIIcuLIon oI LIese crILIcuI precondILIons, I.e., even u LrIgger sLuLus
remuIns undeLermIned. TIme-Lrend upproucIes, In purLIcuIur, operuLe uL
Loo gross u IeveI oI sLuLIsLIcuI InIerence Lo udequuLeIy uddress LIe
pinpointin oI crILIcuI precondILIons Ior specIIIc IndIvIduuIs und dIseuse.
A dose-response eIIecL reIers Lo un Increuse In LIe ruLe oI u
dIseuse reIuLed Lo LIe ruLe oI IndIvIduuI Lobucco consumpLIon, I.e., LIe
dIseuse Is reIuLed more cIoseIy wILI Ieuvy us opposed Lo IIgIL smokers,
und more wILI smokers LIun never-smokers. TIe dose-response
urgumenL Is u cenLruI one In vIewIng smokIng us cuusuIIy ImpIIcuLed In
Iung cuncer und oLIer dIseuseJmorLuIILy. n uddILIon Lo un eurIIer
consIderuLIon, LIere ure u number oI IurLIer reusons wIy LIe duLu do noL
supporL u dose-response urgumenL.
IrsLIy, Eysenck (1q8o), In consIderIng duLu by Pussey (1q6z),
noLed LIuL IIgIL-smokers deveIoped Iung cuncer uL u Iower ruLe buL uL LIe
scme uge us Ieuvy-smokers, usuuIIy uL udvunced uge. TIere ure oLIer
unomuIIes sucI us smuII numbers oI boLI IIgIL-und Ieuvy smokers
deveIopIng Iung cuncer In mIddIe uge. TIIs Is uguInsL u buckdrop oI mosL
Ieuvy-smokers, und even more IIgIL-smokers, not deveIopIng Iung cuncer
over u IIIeLIme. n LIe cuse oI LIe Iow IncIdence oI eurIy-uge deveIopmenL
oI Iung cuncer, wIeLIer unomuIous or noL, LIe predIcLIve sLrengLI oI LIe
sIngIe IucLor oI cIgureLLe smokIng Ior Iung cuncer Is eIIecLIveIy zero. ow-
IeveI predIcLors, IeL uIone zero-IeveI predIcLors, LypIcuIIy IndIcuLe LIuL LIey
wurrunL no sIngIe-IucLor cuusuI consIderuLIon.
SecondIy, u dose-response eIIecL reIuLIng LIe properLIes oI
Lobucco smoke Lo LIe IncIdence oI specIIIc dIseuse requIres IIgI
specIIIcILy, e.g., >o.6. TIere Is un observed ceIIIng oI ussocIuLIon Ior Iung
cuncer oI o.1 Ior men (CopenIugen sLudy). TIereIore, LIe poInL LIuL
wouId deIIne LIe curve us u genuIne dose-response curve, I.e., o.6, Is
Lifestyle Epidemiology
ouLsIde LIe observubIe runge. n LIIs crILIcuI sense, LIe proposILIon oI un
ucLuuI dose-response eIIecL Is unLesLubIe, unIuIsIIIubIe. Heuvy-smokers
wouId Iuve Lo IIve somewIere, suy, beLween 1qo und zoo yeurs oI uge
beIore u generuI IeveI oI eIIecL Is reucIed, II LIe Ideu oI dose-response
Ius uny meunIngIuIness uL uII. TIe sILuuLIon Is IurLIer compIIcuLed II mosL
Ieuvy smokers noL deveIopIng Iung cuncer IndIcuLes u normuLIve runge oI
IuncLIonIng. n oLIer words, II LIe o.1 ussocIuLIon beLween Ieuvy
smokIng und Iung cuncer reIIecLs, Ior exumpIe, u geneLIc ubnormuIILy,
LIen LIIs IeveI oI ussocIuLIon Is mcximcl, regurdIess oI wIeLIer uII Ieuvy-
smokers couId IIve Lo zoo yeurs oI uge or noL. As Ius been consIdered,
endogenous ubnormuIILy pecuIIur Lo u subgroup oI smokers Is IIgIIy
ImpIIcuLed.
WIuL cun be concIuded Is LIuL LIe observed curve wILI u ceIIIng
oI o.1 Is noL un ucLuuI dose-response curve, buL wouId represenL LIe
Iower-end oI sucI u curve, II sucI u curve wus LIe cuse. TIIs resuILs In un
IndeIensIbIe urgumenL LIuL uses un unLesLubIe (unIuIsIIIubIe) ussumpLIon
oI u dose-response curve supporLIng u concIusIon oI u dose-response
reIuLIonsIIp, I.e., un ussumpLIon oI cuuse supporLIng u concIusIon oI
cuuse. WIuL cun uIso be concIuded Is LIuL LIe Iuck oI specIIIcILy oI
ussocIuLIon wouId ImmedIuLeIy poInL Lo vurIuLIons In endogenous sysLems
us LIe source oI vurIuLIon In LIe observed ussocIuLIon oI Iung cuncer wILI
LIe Ieuvy und IIgIL smoker`s subgroups. Even II LIe IncreusIng IncIdence
oI Iung cuncer Irom never-smokers Lo Ieuvy-smokers reIIecLed LIe Iower
LuII-end oI u dose-response curve, IL wouId IndIcuLe u subgroup und
uLypIcuI ussocIuLIon (I.e., very IIgI IIkeIIIood oI endogenous sysLem
vurIuLIon). urLIermore, II LIose In epIdemIoIogy ure Lo urgue LIuL u
consIsLency oI ussocIuLIon oI o.1 oI un unLecedenL wILI u consequenL Is
suIIIcIenL Lo demonsLruLe u prImury cuusuI sLuLus Ior LIe unLecedenL, LIen
by LIe very sume conLorLed reusonIng LIere ure Iur, Iur greuLer grounds Lo
cIuIm u non-cuusuI sLuLus Ior LIe unLecedenL In LIuL LIere Is u IIgI
consIsLency (o.8) oI non-cssociction wILI LIe consequenL, I.e., LIe
normuLIve runge Is non-ussocIuLIon oI LIe consequenL wILI LIe
unLecedenL.
To muInLuIn u dose-response urgumenL wIere LIere Is lou
consIsLencyJspecIIIcILy oI ussocIuLIon InvoIves u purLIcuIur perversIon oI
sLuLIsLIcuI und cuusuI concepLs LIuL conceuIs LIe Iow-IeveI (subgroup)
ussocIuLIon. TIIs Is uccompIIsIed In LIe mInds oI LIose wIo wouId so
urgue by reducIng eucI group (nonsmokers, IIgIL-smokers, Ieuvy-
smokers) Lo sIngIe orgunIsms, I.e., LIe IndIvIduuI membersIIp oI eucI
group concepLuuIIy meILs uwuy. L Is conLrIvIng u bIuck box perspecLIve
Ior LIe entiret oI eucI group. n oLIer words, LIIs reusonIng Is noL onIy
IndeIensIbIy ussumIng u IomogeneILy oI group membersIIp, buL LIuL LIe
54
54
Rampant Antismoking Signifies Grave Danger Lifestyle Epidemiology
IomogeneILy Is so compIeLe LIuL eucI group becomes u sIngIe enLILy, u
conLInuous quunLILy. TIIs Is u double-dose oI bIuck box reusonIng LIuL
concepLuuIIy obIILeruLes LIe observed vurIuLIon oI ussocIuLIon LIuL musL be
emunuLIng Irom LIe endogenous sIde oI LIe cIrcumsLunce. TIe onIy oLIer
pIuce LIuL IL cun ussIgn (projecL) LIe source oI vurIubIe ussocIuLIon Is
onLo un exogenous IucLor (e.g., cIgureLLe smokIng).
BIuck box reusonIng removes uII sources oI wILIIn-group
(endogenous) vurIuLIon LIuL mukes IL uppeur us LIougI LIe source oI
vurIubIe ussocIuLIon Is enLIreIy uLLrIbuLubIe Lo un exogenous IucLor, I.e.,
LrunsIerence IuIIucy. SucI LIInkIng occurs In u sLuLIsLIcuI IunLusy worId
LIuL Ius no reIuLIonsIIp Lo ucLuuI sLuLes oI uIIuIrs. n LIIs dIsLorLed
reusonIng, uLypIcuI, subgroup ussocIuLIons ure spoken oI us II LIey ure
overuII-group (Iomogeneous) ussocIuLIons, I.e., IuIIucy oI IusLy
generuIIzuLIon. n grupIIcuI Lerms, Igure 1, DIugrum A IndIcuLes LIuL LIe
Lobucco dose-response urgumenL reIIes on LIe reIuLIonsIIp beLween onIy
one exogenous IucLor (cIgureLLe smokIng) und u specIIIc eIIecL (e.g., Iung
cuncer) Ior one orgunIsm (e.g., smokers), I.e., doubIe-dose oI bIuck-box
reusonIng. However, wIere un enLIre eIIecL Is Lo be cuusuIIy expIuIned In
Lerms oI LIe reIuLIonsIIp beLween LIe properLIes oI one exogenous IucLor
und un eIIecL In pussIve endogenous sysLems, LIen cuusuLIon properIy
reIers Lo LIe consIsLency oI eIIecL Ior eucI member oI u group, I.e., us In
Ig.1, DIugrum C. DoubIe-dose bIuck-box reusonIng erroneousIy urrIves uL
u concIusIon (us In Ig.1, DIugrum C) LIuL Is compIeLeIy unIIke LIe duLu
dIsLrIbuLIon LIuL IL ucLuuIIy reIers Lo (us In Ig.1, DIugrum B) und LIuL Is
bused on u conLrIved Irumework (us In Ig.1, DIugrum A).
One oI LIe more dIsLurbIng pecuIIurILIes oI LIe SG ReporL (1q6q)
wus LIe compIeLe Iuck oI consIderuLIon oI uILernuLIve IypoLIeses
regurdIng un uppurenL Iow-IeveI dose-response eIIecL. n oLIer words,
wIuL Is IL u dose oI, oLIer LIun LIe quunLILy oI properLIes oI Lobucco
smoke, LIuL mIgIL be reIIecLed In LIe observed curve? And IL Is LIIs
consIderuLIon LIuL muy provIde LIe greuLesL InsIgIL us Lo wIy subgroups
oI smokers muInLuIn LIe IubIL. SmokIng, und u reIuLed dose-response
eIIecL, Is noL jusL LIe sImpIe exposure Lo LIe poLenLIuIIy IurmIuI properLIes
oI un exogenous IucLor. L Is u moLIvuLed und InLenLIonuI ucL.
L wus IndIcuLed In un eurIIer secLIon LIuL u dose-response oI
Lobucco smoke us u dIrecL cuuse oI specIIIc dIseuse (e.g., Iung cuncer) Is
IndeIensIbIe; LIe supposed dose-response curve seems Lo be meusurIng u
weukenIng oI LIe Iung wIIcI muy Iuve muILIpIe uddILIve or synergIsLIc
sources. A dose-response urgumenL regurdIng eurIIer uII-cuuse morLuIILy Is
us IndeIensIbIe; u dose-response curve muy be meusurIng LIe eIIecL oI
some oI LIe reusons wIy persons smoke, I.e., u convergence eIIecL;
smokIng Is sImpIy u correIuLed IucLor wILI eurIIer morLuIILy. CIgureLLe
55
55
Rampant Antismoking Signifies Grave Danger Lifestyle Epidemiology
IomogeneILy Is so compIeLe LIuL eucI group becomes u sIngIe enLILy, u
conLInuous quunLILy. TIIs Is u double-dose oI bIuck box reusonIng LIuL
concepLuuIIy obIILeruLes LIe observed vurIuLIon oI ussocIuLIon LIuL musL be
emunuLIng Irom LIe endogenous sIde oI LIe cIrcumsLunce. TIe onIy oLIer
pIuce LIuL IL cun ussIgn (projecL) LIe source oI vurIubIe ussocIuLIon Is
onLo un exogenous IucLor (e.g., cIgureLLe smokIng).
BIuck box reusonIng removes uII sources oI wILIIn-group
(endogenous) vurIuLIon LIuL mukes IL uppeur us LIougI LIe source oI
vurIubIe ussocIuLIon Is enLIreIy uLLrIbuLubIe Lo un exogenous IucLor, I.e.,
LrunsIerence IuIIucy. SucI LIInkIng occurs In u sLuLIsLIcuI IunLusy worId
LIuL Ius no reIuLIonsIIp Lo ucLuuI sLuLes oI uIIuIrs. n LIIs dIsLorLed
reusonIng, uLypIcuI, subgroup ussocIuLIons ure spoken oI us II LIey ure
overuII-group (Iomogeneous) ussocIuLIons, I.e., IuIIucy oI IusLy
generuIIzuLIon. n grupIIcuI Lerms, Igure 1, DIugrum A IndIcuLes LIuL LIe
Lobucco dose-response urgumenL reIIes on LIe reIuLIonsIIp beLween onIy
one exogenous IucLor (cIgureLLe smokIng) und u specIIIc eIIecL (e.g., Iung
cuncer) Ior one orgunIsm (e.g., smokers), I.e., doubIe-dose oI bIuck-box
reusonIng. However, wIere un enLIre eIIecL Is Lo be cuusuIIy expIuIned In
Lerms oI LIe reIuLIonsIIp beLween LIe properLIes oI one exogenous IucLor
und un eIIecL In pussIve endogenous sysLems, LIen cuusuLIon properIy
reIers Lo LIe consIsLency oI eIIecL Ior eucI member oI u group, I.e., us In
Ig.1, DIugrum C. DoubIe-dose bIuck-box reusonIng erroneousIy urrIves uL
u concIusIon (us In Ig.1, DIugrum C) LIuL Is compIeLeIy unIIke LIe duLu
dIsLrIbuLIon LIuL IL ucLuuIIy reIers Lo (us In Ig.1, DIugrum B) und LIuL Is
bused on u conLrIved Irumework (us In Ig.1, DIugrum A).
One oI LIe more dIsLurbIng pecuIIurILIes oI LIe SG ReporL (1q6q)
wus LIe compIeLe Iuck oI consIderuLIon oI uILernuLIve IypoLIeses
regurdIng un uppurenL Iow-IeveI dose-response eIIecL. n oLIer words,
wIuL Is IL u dose oI, oLIer LIun LIe quunLILy oI properLIes oI Lobucco
smoke, LIuL mIgIL be reIIecLed In LIe observed curve? And IL Is LIIs
consIderuLIon LIuL muy provIde LIe greuLesL InsIgIL us Lo wIy subgroups
oI smokers muInLuIn LIe IubIL. SmokIng, und u reIuLed dose-response
eIIecL, Is noL jusL LIe sImpIe exposure Lo LIe poLenLIuIIy IurmIuI properLIes
oI un exogenous IucLor. L Is u moLIvuLed und InLenLIonuI ucL.
L wus IndIcuLed In un eurIIer secLIon LIuL u dose-response oI
Lobucco smoke us u dIrecL cuuse oI specIIIc dIseuse (e.g., Iung cuncer) Is
IndeIensIbIe; LIe supposed dose-response curve seems Lo be meusurIng u
weukenIng oI LIe Iung wIIcI muy Iuve muILIpIe uddILIve or synergIsLIc
sources. A dose-response urgumenL regurdIng eurIIer uII-cuuse morLuIILy Is
us IndeIensIbIe; u dose-response curve muy be meusurIng LIe eIIecL oI
some oI LIe reusons wIy persons smoke, I.e., u convergence eIIecL;
smokIng Is sImpIy u correIuLed IucLor wILI eurIIer morLuIILy. CIgureLLe
56
56
Rampant Antismoking Signifies Grave Danger
smokIng cun reIIecL u convergIng eIIecL Ior uL IeusL u subgroup oI users
purLIcuIurIy wILI regurd Lo eusIng sLress, unxIeLy. SLress muy Iuve un
InLernuI or exLernuI source und ILs reIIeI muy InvoIve LIe
psycIopIurmucoIogIc eIIecL oI nIcoLIne und LIe very beIuvIoruI ucL oI
smokIng und ILs psycIoIogIcuI correIuLes. L cun be undersLood LIuL
suscepLIbIIILy Lo specIIIc dIseuse, even In presympLomuLIc or
usympLomuLIc Lerms, muy Iuve psycIoIogIcuI munIIesLuLIons sucI us
perceIved sLress, uneuse. TIIs IndIcuLes LIuL LIe mInd und subjecLIve
experIence muy be Iur more sensILIve Lo presympLomuLIc bIoIogIcuI
condILIons LIun LIe meusurIng poLenLIuI oI scIenLIIIc dIugnosLIcs Is
currenLIy cupubIe oI, or cupubIe oI uL uII.
TIe Ideu oI u convergIng eIIecL wus uIIuded Lo In IndIrecL Lerms
by Berkson (1q6) In commenLIng LIuL LIere Is no scIenLIIIcuIIy known
pIurmucoIogIcuI or pIysIcuI expIunuLIon Ior so wIdespreud und
muILIIurIous un eIIecL. I we exLrupoIuLe LIe resuILs Lo LIe generuI
popuIuLIon, we musL beIIeve LIuL LIere ure some zo,ooo deuLIs unnuuIIy
Irom smokIng-Induced dIseuses wILIouL uny oI LIem IuvIng been
IndIvIduuIIy noLed us sucI Irom IndependenL cIInIcuI or puLIoIogIcuI
evIdence. (p. 1) ArkIn (1q) uIso noLes LIuL IL wouId LIus uppeur LIuL
cIgureLLe smokIng Is one oI LIe cuuses oI uII IIIs und conLrIbuLes Lo LIe
over-uII deuLI ruLe, rememberIng LIuL LIIs ruLe IncIudes sucI cuuses us
uccIdenL, IomIcIde, eLc. L seems quILe cIeur LIuL smokIng Is u sympLom,
noL u cuuse. RuLIer, smokIng cun be vIewed us un uLLempL Lo
cccommodcte sympLoms, und wIere LIIs Is onIy one uspecL oI LIe IubIL
und muy concern onIy u smuII subgroup oI LIose wIo smoke, I.e., smokIng
ILseII cun be u summurIzIng pIenomenon.
TIe deIIneuLIon ubove concernIng uILernuLIve dose-response
IypoLIeses Is crILIcuI Ior u number oI reusons. IrsLIy, IL ccnnot be
cIuImed LIuL smokIng Is LIe cuuse oI uII, or uny, dIseuses bused
essenLIuIIy on IIgIer reIuLIve rIsks Ior LIe smoker`s group. SecondIy, IL
LIereIore ccnnot be cIuImed LIuL uII members oI LIe smoker`s group ure uL
IIgIer rIsk oI every specIIIc dIseuseJmorLuIILy ussocIuLed wILI LIe IubIL.
MosL smokers ure uL LIe sume rIsk oI specIIIc dIseuse us nonsmokers. OnIy
In LIe cuse oI Iung cuncer cun IL be suggesLed LIuL II certcin persons (I.e.,
smuII subgroup), wILI u wIoIe serIes oI precondILIons, dId noL smoke, LIey
mIgIL uvoId LIe dIseuse. n LIIs cuse LIey wIII mosL probubIy dIe oI oLIer
specIIIc cuncer (IIgIIy probubIe) or CHD, wIeLIer eurIIer or IuLer Is
IndeLermInuLe. However, In LIe ubsence oI pInpoInLIng precondILIons und
Iow smokIng mIgIL reIuLe Lo LIese, LIIs suggesLIon Is sLIII IIgIIy Lenuous.
TIe greuLer mujorILy oI Ieuvy smokers (-qo% uccounLIng Ior u buseIIne
und deLecLIon bIus) Is noL uL rIsk oI Iung cuncer. TIIrdIy, u IuIIure Lo
ucknowIedge uny subsLunLIuI psycIobIoIogIcuI beneIIL (e.g., sLress reIIeI),
Lifestyle Epidemiology
I.e., u convergIng eIIecL, In LIe smokIng IubIL resuILs In u muLerIuIIsL und
compIeLeIy conLorLed vIew oI LIe IubIL.
n uddILIon Lo psycIobIoIogIcuI und personuIILy IucLors, LIe
supposed Lobucco dose-response curve, In reIuLIon Lo Iung cuncer und
Iung dIseuse, muy uIso purLIuIIy reIIecL u curve oI weukenIng Iung IuncLIon
LIuL Lobucco-use muy or muy noL conLrIbuLe Lo, buL noL In direct
curcInogenIc or oLIer Lerms. OLIer IucLors muy uIso conLrIbuLe In LIe
sume wuy, e.g., sedenLury IIIesLyIe, IIsLory oI Iung dIseuse, geneLIcJ
IormonuIJorgunIcJmeLuboIIcJImmunoIogIcuI ubnormuIILIes. TIe un-
umbIguous concIusIon Is LIuL u dose-response urgumenL, In Lerms onl
oI LIe direct curcInogenIc, or oLIer, eIIecL oI Lobucco properLIes In u
pIeLIoru oI dIseuses, und wIere LIe predIcLIve sLrengLI oI smokIng Ior uII
oI LIese dIseuses Is neur-zero or eIIecLIveIy zero, Is muLerIuIIsL sopIIsLry.
TIe IInuI poInL oI concern Is LIuL LIe 1q6q CommILLee wus
obvIousIy domInuLed by LIe consIderubIe reIuLIve rIsk dIIIerence Ior Iung
cuncer (RR=1o.8), cuncer oI LIe Iurynx (RR=.q), cuncer oI LIe oruI cuvILy
(RR=q.1), cuncer oI LIe esopIugus (RR=.q), cuncer oI LIe bIudder
(RR=1.q), beLween LIe smoker`sJnonsmoker`s groups In u meLu-unuIysIs
oI seven prospecLIve sLudIes (see TubIe q). TIere wus uIso consIderubIe
vurIubIIILy In rIsk ruLIos Ior specIIIc cuncer - Ior Iung cuncer q.q
(CuIIIornIu egIon) Lo zo.z (BrILIsI DocLors); Ior cuncer oI LIe Iurynx 1.
(CuIIIornIu egIon) Lo 1.1 (Men In NIne SLuLes); Ior cuncer oI LIe oruI
cuvILy 1.o (CuIIIornIu OccupuLIonuI) Lo q.z (Men In z SLuLes); Ior cuncer
oI LIe esopIugus o.; (CuIIIornIu OccupuLIonuI) Lo 6.6 (Men In q SLuLes);
Ior cuncer oI LIe bIudder o.q (BrILIsI DocLors) Lo 6.o (CuIIIornIu
OccupuLIonuI). As Ius been expIuIned In LIe prevIous secLIon, reIuLIve rIsk
dIIIerences, per se, ure noL LIe busIs Ior cuusuI urgumenL. TIe crILIcuI
probIem In LIIs InsLunce Is LIuL, uguIn, LIe CommILLee demonsLruLed no
coIerenL grusp oI LIe ucLuuI requIremenLs Ior cuusuI InIerence.
BrownIee (1q6), In one oI LIe Iew deLuIIed revIews oI LIe 1q6q
ReporL uL LIe LIme, urrIved uL u sImIIur concIusIon. OI u number oI
probIems LIuL BrownIee Iud wILI LIe ReporL, LIe mosL consIderubIe oI
LIese wus LIuL LIe ussessmenL oI LIe cIgureLLe smokIngJIung cuncer
ussocIuLIon, In cuusuI Lerms, dId noL properIy meeL LIe crILerIon oI
specIIIcILy. On LIIs poInL Ie wus quILe correcL. However, Ie wus noL uwure
LIuL uII LIe crILerIu, excepL Ior LemporuIILy und coIerence, ure dIIIerenL
expIunuLory ungIes Ior LIe sume concepL oI unIqueness oI unLecedenL(s)
Ior u consequenL.
rom IIs revIew IL cun be noLed LIuL LIe ReporL CommILLee
IumbIed und bumbIed ubouL us Lo wIuL LIese crILerIu ucLuuIIy reIer Lo. or
exumpIe, LIe ReporL LreuLs consIsLency oI ussocIuLIon us un ussocIuLIon,
Iowever smuII, LIuL IoIds up ccross (beLween) sLudIes. WIuL LIe
57
57
Rampant Antismoking Signifies Grave Danger
smokIng cun reIIecL u convergIng eIIecL Ior uL IeusL u subgroup oI users
purLIcuIurIy wILI regurd Lo eusIng sLress, unxIeLy. SLress muy Iuve un
InLernuI or exLernuI source und ILs reIIeI muy InvoIve LIe
psycIopIurmucoIogIc eIIecL oI nIcoLIne und LIe very beIuvIoruI ucL oI
smokIng und ILs psycIoIogIcuI correIuLes. L cun be undersLood LIuL
suscepLIbIIILy Lo specIIIc dIseuse, even In presympLomuLIc or
usympLomuLIc Lerms, muy Iuve psycIoIogIcuI munIIesLuLIons sucI us
perceIved sLress, uneuse. TIIs IndIcuLes LIuL LIe mInd und subjecLIve
experIence muy be Iur more sensILIve Lo presympLomuLIc bIoIogIcuI
condILIons LIun LIe meusurIng poLenLIuI oI scIenLIIIc dIugnosLIcs Is
currenLIy cupubIe oI, or cupubIe oI uL uII.
TIe Ideu oI u convergIng eIIecL wus uIIuded Lo In IndIrecL Lerms
by Berkson (1q6) In commenLIng LIuL LIere Is no scIenLIIIcuIIy known
pIurmucoIogIcuI or pIysIcuI expIunuLIon Ior so wIdespreud und
muILIIurIous un eIIecL. I we exLrupoIuLe LIe resuILs Lo LIe generuI
popuIuLIon, we musL beIIeve LIuL LIere ure some zo,ooo deuLIs unnuuIIy
Irom smokIng-Induced dIseuses wILIouL uny oI LIem IuvIng been
IndIvIduuIIy noLed us sucI Irom IndependenL cIInIcuI or puLIoIogIcuI
evIdence. (p. 1) ArkIn (1q) uIso noLes LIuL IL wouId LIus uppeur LIuL
cIgureLLe smokIng Is one oI LIe cuuses oI uII IIIs und conLrIbuLes Lo LIe
over-uII deuLI ruLe, rememberIng LIuL LIIs ruLe IncIudes sucI cuuses us
uccIdenL, IomIcIde, eLc. L seems quILe cIeur LIuL smokIng Is u sympLom,
noL u cuuse. RuLIer, smokIng cun be vIewed us un uLLempL Lo
cccommodcte sympLoms, und wIere LIIs Is onIy one uspecL oI LIe IubIL
und muy concern onIy u smuII subgroup oI LIose wIo smoke, I.e., smokIng
ILseII cun be u summurIzIng pIenomenon.
TIe deIIneuLIon ubove concernIng uILernuLIve dose-response
IypoLIeses Is crILIcuI Ior u number oI reusons. IrsLIy, IL ccnnot be
cIuImed LIuL smokIng Is LIe cuuse oI uII, or uny, dIseuses bused
essenLIuIIy on IIgIer reIuLIve rIsks Ior LIe smoker`s group. SecondIy, IL
LIereIore ccnnot be cIuImed LIuL uII members oI LIe smoker`s group ure uL
IIgIer rIsk oI every specIIIc dIseuseJmorLuIILy ussocIuLed wILI LIe IubIL.
MosL smokers ure uL LIe sume rIsk oI specIIIc dIseuse us nonsmokers. OnIy
In LIe cuse oI Iung cuncer cun IL be suggesLed LIuL II certcin persons (I.e.,
smuII subgroup), wILI u wIoIe serIes oI precondILIons, dId noL smoke, LIey
mIgIL uvoId LIe dIseuse. n LIIs cuse LIey wIII mosL probubIy dIe oI oLIer
specIIIc cuncer (IIgIIy probubIe) or CHD, wIeLIer eurIIer or IuLer Is
IndeLermInuLe. However, In LIe ubsence oI pInpoInLIng precondILIons und
Iow smokIng mIgIL reIuLe Lo LIese, LIIs suggesLIon Is sLIII IIgIIy Lenuous.
TIe greuLer mujorILy oI Ieuvy smokers (-qo% uccounLIng Ior u buseIIne
und deLecLIon bIus) Is noL uL rIsk oI Iung cuncer. TIIrdIy, u IuIIure Lo
ucknowIedge uny subsLunLIuI psycIobIoIogIcuI beneIIL (e.g., sLress reIIeI),
Lifestyle Epidemiology
I.e., u convergIng eIIecL, In LIe smokIng IubIL resuILs In u muLerIuIIsL und
compIeLeIy conLorLed vIew oI LIe IubIL.
n uddILIon Lo psycIobIoIogIcuI und personuIILy IucLors, LIe
supposed Lobucco dose-response curve, In reIuLIon Lo Iung cuncer und
Iung dIseuse, muy uIso purLIuIIy reIIecL u curve oI weukenIng Iung IuncLIon
LIuL Lobucco-use muy or muy noL conLrIbuLe Lo, buL noL In direct
curcInogenIc or oLIer Lerms. OLIer IucLors muy uIso conLrIbuLe In LIe
sume wuy, e.g., sedenLury IIIesLyIe, IIsLory oI Iung dIseuse, geneLIcJ
IormonuIJorgunIcJmeLuboIIcJImmunoIogIcuI ubnormuIILIes. TIe un-
umbIguous concIusIon Is LIuL u dose-response urgumenL, In Lerms onl
oI LIe direct curcInogenIc, or oLIer, eIIecL oI Lobucco properLIes In u
pIeLIoru oI dIseuses, und wIere LIe predIcLIve sLrengLI oI smokIng Ior uII
oI LIese dIseuses Is neur-zero or eIIecLIveIy zero, Is muLerIuIIsL sopIIsLry.
TIe IInuI poInL oI concern Is LIuL LIe 1q6q CommILLee wus
obvIousIy domInuLed by LIe consIderubIe reIuLIve rIsk dIIIerence Ior Iung
cuncer (RR=1o.8), cuncer oI LIe Iurynx (RR=.q), cuncer oI LIe oruI cuvILy
(RR=q.1), cuncer oI LIe esopIugus (RR=.q), cuncer oI LIe bIudder
(RR=1.q), beLween LIe smoker`sJnonsmoker`s groups In u meLu-unuIysIs
oI seven prospecLIve sLudIes (see TubIe q). TIere wus uIso consIderubIe
vurIubIIILy In rIsk ruLIos Ior specIIIc cuncer - Ior Iung cuncer q.q
(CuIIIornIu egIon) Lo zo.z (BrILIsI DocLors); Ior cuncer oI LIe Iurynx 1.
(CuIIIornIu egIon) Lo 1.1 (Men In NIne SLuLes); Ior cuncer oI LIe oruI
cuvILy 1.o (CuIIIornIu OccupuLIonuI) Lo q.z (Men In z SLuLes); Ior cuncer
oI LIe esopIugus o.; (CuIIIornIu OccupuLIonuI) Lo 6.6 (Men In q SLuLes);
Ior cuncer oI LIe bIudder o.q (BrILIsI DocLors) Lo 6.o (CuIIIornIu
OccupuLIonuI). As Ius been expIuIned In LIe prevIous secLIon, reIuLIve rIsk
dIIIerences, per se, ure noL LIe busIs Ior cuusuI urgumenL. TIe crILIcuI
probIem In LIIs InsLunce Is LIuL, uguIn, LIe CommILLee demonsLruLed no
coIerenL grusp oI LIe ucLuuI requIremenLs Ior cuusuI InIerence.
BrownIee (1q6), In one oI LIe Iew deLuIIed revIews oI LIe 1q6q
ReporL uL LIe LIme, urrIved uL u sImIIur concIusIon. OI u number oI
probIems LIuL BrownIee Iud wILI LIe ReporL, LIe mosL consIderubIe oI
LIese wus LIuL LIe ussessmenL oI LIe cIgureLLe smokIngJIung cuncer
ussocIuLIon, In cuusuI Lerms, dId noL properIy meeL LIe crILerIon oI
specIIIcILy. On LIIs poInL Ie wus quILe correcL. However, Ie wus noL uwure
LIuL uII LIe crILerIu, excepL Ior LemporuIILy und coIerence, ure dIIIerenL
expIunuLory ungIes Ior LIe sume concepL oI unIqueness oI unLecedenL(s)
Ior u consequenL.
rom IIs revIew IL cun be noLed LIuL LIe ReporL CommILLee
IumbIed und bumbIed ubouL us Lo wIuL LIese crILerIu ucLuuIIy reIer Lo. or
exumpIe, LIe ReporL LreuLs consIsLency oI ussocIuLIon us un ussocIuLIon,
Iowever smuII, LIuL IoIds up ccross (beLween) sLudIes. WIuL LIe
58
58
Rampant Antismoking Signifies Grave Danger
CommILLee Is cctucll reIerrIng Lo Iere Is repIIcubIIILy. ConsIsLency oI
ussocIuLIon wILI regurd Lo cuusuI urgumenL properIy reIers Lo u uithin-
stud pIenomenon. I LIe consIsLencyJspecIIIcILy oI un ussocIuLIon Is very
IIgI (wILIIn-sLudy), LIen LIIs wouId be reusonubIe grounds Ior posILIng u
cuusuI reIuLIonsIIp. BeIng u cuusuI reIuLIonsIIp, one wouId expecL neur-
perIecL repIIcubIIILy (beLween-sLudIes) oI LIe sume IIgI degree oI
consIsLencyJspecIIIcILy. ow-IeveI repIIcuLIon ImpIIes noLIIng ubouL wIuL
Is ucLuuIIy beIng meusured or LIe nuLure oI LIe correIuLIon.
TIe CommILLee LIen erroneousIy LreuLed sLrengLI oI
ussocIuLIon us bused on reIuLIve, und noL ubsoIuLe, rIsk. HuvIng uIreudy
muddIed consIsLency und sLrengLI crILerIu, ILs LreuLmenL oI specIIIcILy oI
ussocIuLIon Is undersLundubIy IncoIerenL. TIe CommILLee concIuded LIuL
u sIngIe IucLor, e.g., cIgureLLe smokIng, couId be cuusuIIy reIuLed Lo
muILIpIe dIseuses, sucI LIuL LIe IeveI oI specIIIcILy Ior uny purLIcuIur
dIseuse Is IuIrIy Iow. TIe CommILLee uLLempLed Lo expIuIn muILIpIe dIseuse
ussocIuLIon wILI smokIng expressed In IIgIer RR`s, I.e., Iow specIIIcILy,
LIrougI LIe exumpIes oI Mcobccterium tuberculosis und LIe poIIo vIrus:
or exumpIe, LIe puLIoIogIsL wIo exumInes u Iung uL
uuLopsy und IInds LubercIe IormuLIon und cuseuLIon
necrosIs wouId uImosL InvurIubIy be ubIe Lo predIcL LIe
coexIsLence oI LubercIe bucIIII. ExperIence Ius sIown
LIuL LIe IesIons ure IIgIIy specIIIc Ior Mcobccterium
tuberculosis. On LIe oLIer Iund, u cIInIcIun muy
encounLer u combInuLIon oI sIgns und sympLoms
IncIudIng sLIII neck, sLIII buck, Iever, nuuseu, vomILIng,
und IympIocILes In LIe spInuI IIuId. ExperIence Ius
reveuIed LIuL uny one oI u number oI orgunIsms muy be
ussocIuLed wILI LIIs syndrome: poIIo vIrus, ECHO
vIruses, CoxsuckIe vIruses und Leptospirce, Lo nume buL
u Iew. TIe predIcLubIIILy oI LIe coexIsLence oI poIIo vIrus
per se Is ruLIer Iow. n oLIer words, LIe syndrome us
noLed Is noL very specIIIc Ior poIIo vIrus. (p.18q)
HuvIng urgued Ior Lobucco smoke beIng u cuuse oI muILIpIe
dIseuses wILI Iow specIIIcILy, IL LIen decIured LIuL LIe ussocIuLIon
beLween cIgureLLe smokIng und Iung cuncer Ius u IIgI degree oI
specIIIcILy. (SG, 1q6q, p.18) L Is purLIcuIurIy LIe errors mude on LIe
Issue oI specIIIcILy oI ussocIuLIon LIuL seL IIIesLyIe epIdemIoIogy on u
desLrucLIve course sInce. TIe vIews depIcLed by LIe CommILLee InvoIve u
number oI InLerLwInIng errors oI IncoIerenL unuIogy. or LIe IIgIer
specIIIc dIseuse oI Iung cuncer, IL IIkens Lobucco smoke Lo u bucLerIum. or
Iower specIIIc dIseuse ussocIuLed wILI smokIng, Lobucco smoke Is IIkened
Lifestyle Epidemiology
Lo u vIrus. TIe IucL oI LIe muLLer Is LIuL Lobucco smoke Is not IIke u vIruI or
bucLerIuI quunLILy. urLIermore, In LIe cuse oI LIe exumpIe oI poIIo vIrus,
LIe Iow specIIIcILy ussocIuLIons uIIuded Lo ure noL even dIseuses, buL ure
sympLoms. L LIen uses un cssumption oI sInguIur specIIIc eIIecLs und
muILIpIe non-specIIIc eIIecLs (dIseuses) bused on IncoIerenL unuIogIes Lo
supporL u concIusIon oI sInguIur specIIIc eIIecLs und muILIpIe non-specIIIc
eIIecLs, I.e., beggIng LIe quesLIon; none oI LIe supposed cuusuLIon Is
demonsLruLed or expIuIned, buL ussumed Lo occur sImIIurIy Lo u vIrus or
bucLerIum. On LIIs poInL BrownIee (1q6) very reusonubIy urgues LIuL LIe
wuy IL cIuIms LIe IucLs ure In conIormILy wILI LIe crILerIon |specijicit| Is
Lo IIuLIy Ignore LIe IucLs. (p.;1) TIe CommILLee mude no uLLempL Lo
consIder wIuL oLIer IucLors mIgIL produce RR dIIIerenLIuIs, e.g.,
convergence eIIecL, rIsk-uverse subgroup In LIe nonsmoker`s group, und
purLIcuIurIy endogenous ubnormuIILy.
TIe overuII eIIecL oI LIe use oI IncoIerenL unuIogy Is LIe IuIIucy oI
non ccusc pro ccusc; LIe cIuImed cuuse Ius noL been demonsLruLed.
Nor cun IL be demonsLruLed due Lo LIe poor predIcLIve sLrengLI oI smokIng
Ior Iung cuncer. Every IndIcuLIon Is LIuL Iung cuncer reIIecLs u pecuIIurILy
oI LIe subgroup oI persons munIIesLIng LIe dIseuse (endogenous
ubnormuIILy) ruLIer LIun u generuI propensILy oI Lobucco smoke.
TIe crucIuI error mude by LIe CommILLee wus Lo compIeLeIy
conIuse suIIIcIenL und necessury condILIons Ior un eIIecL. L Is reusonubIe
LIuL poor predIcLIve sLrengLI oI cIgureLLe smokIng Ior Iung cuncer does noL
precIude cIgureLLe smokIng Irom beIng c LrIgger In Iung cuncer (SG
ReporL, 1q6q, p.18q). However, poor predIcLIve sLrengLI does dejinitel
precIude vIewIng cIgureLLe smokIng us u suIIIcIenL condILIon (sIngIe IucLor,
prImury cuuse) Ior Iung cuncer. CIgureLLe smokIng does cpproximcte u
necessury condILIon Ior Iung cuncer. However, LIere ure oLIer IucLors LIuL
uIso Iuve LIIs Lendency, e.g., IeveI oI exercIse, prevIous Iung dIseuse,
geneLIc IucLors. urLIermore, combInuLIons oI LIese IucLors muy produce
u synergIsLIc eIIecL LIuL conLrIbuLes Lo specIIIc dIseuse (e.g., Iung cuncer)
buL wIere cerLuIn oLIer precondILIons musL jirst be meL, I.e.,
suscepLIbIIILy. TIese, Iowever, sIouId noL be conIused wILI u sIngIe-IucLor
suIIIcIenL condILIon Ior un eIIecL.
TIe CommILLee dId noL consIder, uL uII, un unuIysIs oI
proporLIons oI uge-udjusLed, specIIIc-cuuse morLuIILy. TIIs wouId Iuve
uIerLed LIem Lo LIe IucL LIuL LIose suIIerIng Iung cuncer wouId Iuve
suIIered some oLIer Iorm oI cuncer Iud LIey noL been smokers, I.e., sLrong
IndIcuLIon oI suscepLIbIIILy. TIIs muy Iuve LIen uIerLed LIem Lo LIe
possIbIIILy LIuL smokIng, LogeLIer wILI oLIer IucLors, mc Iuve u
weukenIng eIIecL on LIe Iung, munIIesLIng In Iung cuncer In u subgroup oI
suscepLIbIe IndIvIduuIs. AguIn, LIIs Is very dIIIerenL Lo mukIng dIrecL
59
59
Rampant Antismoking Signifies Grave Danger
CommILLee Is cctucll reIerrIng Lo Iere Is repIIcubIIILy. ConsIsLency oI
ussocIuLIon wILI regurd Lo cuusuI urgumenL properIy reIers Lo u uithin-
stud pIenomenon. I LIe consIsLencyJspecIIIcILy oI un ussocIuLIon Is very
IIgI (wILIIn-sLudy), LIen LIIs wouId be reusonubIe grounds Ior posILIng u
cuusuI reIuLIonsIIp. BeIng u cuusuI reIuLIonsIIp, one wouId expecL neur-
perIecL repIIcubIIILy (beLween-sLudIes) oI LIe sume IIgI degree oI
consIsLencyJspecIIIcILy. ow-IeveI repIIcuLIon ImpIIes noLIIng ubouL wIuL
Is ucLuuIIy beIng meusured or LIe nuLure oI LIe correIuLIon.
TIe CommILLee LIen erroneousIy LreuLed sLrengLI oI
ussocIuLIon us bused on reIuLIve, und noL ubsoIuLe, rIsk. HuvIng uIreudy
muddIed consIsLency und sLrengLI crILerIu, ILs LreuLmenL oI specIIIcILy oI
ussocIuLIon Is undersLundubIy IncoIerenL. TIe CommILLee concIuded LIuL
u sIngIe IucLor, e.g., cIgureLLe smokIng, couId be cuusuIIy reIuLed Lo
muILIpIe dIseuses, sucI LIuL LIe IeveI oI specIIIcILy Ior uny purLIcuIur
dIseuse Is IuIrIy Iow. TIe CommILLee uLLempLed Lo expIuIn muILIpIe dIseuse
ussocIuLIon wILI smokIng expressed In IIgIer RR`s, I.e., Iow specIIIcILy,
LIrougI LIe exumpIes oI Mcobccterium tuberculosis und LIe poIIo vIrus:
or exumpIe, LIe puLIoIogIsL wIo exumInes u Iung uL
uuLopsy und IInds LubercIe IormuLIon und cuseuLIon
necrosIs wouId uImosL InvurIubIy be ubIe Lo predIcL LIe
coexIsLence oI LubercIe bucIIII. ExperIence Ius sIown
LIuL LIe IesIons ure IIgIIy specIIIc Ior Mcobccterium
tuberculosis. On LIe oLIer Iund, u cIInIcIun muy
encounLer u combInuLIon oI sIgns und sympLoms
IncIudIng sLIII neck, sLIII buck, Iever, nuuseu, vomILIng,
und IympIocILes In LIe spInuI IIuId. ExperIence Ius
reveuIed LIuL uny one oI u number oI orgunIsms muy be
ussocIuLed wILI LIIs syndrome: poIIo vIrus, ECHO
vIruses, CoxsuckIe vIruses und Leptospirce, Lo nume buL
u Iew. TIe predIcLubIIILy oI LIe coexIsLence oI poIIo vIrus
per se Is ruLIer Iow. n oLIer words, LIe syndrome us
noLed Is noL very specIIIc Ior poIIo vIrus. (p.18q)
HuvIng urgued Ior Lobucco smoke beIng u cuuse oI muILIpIe
dIseuses wILI Iow specIIIcILy, IL LIen decIured LIuL LIe ussocIuLIon
beLween cIgureLLe smokIng und Iung cuncer Ius u IIgI degree oI
specIIIcILy. (SG, 1q6q, p.18) L Is purLIcuIurIy LIe errors mude on LIe
Issue oI specIIIcILy oI ussocIuLIon LIuL seL IIIesLyIe epIdemIoIogy on u
desLrucLIve course sInce. TIe vIews depIcLed by LIe CommILLee InvoIve u
number oI InLerLwInIng errors oI IncoIerenL unuIogy. or LIe IIgIer
specIIIc dIseuse oI Iung cuncer, IL IIkens Lobucco smoke Lo u bucLerIum. or
Iower specIIIc dIseuse ussocIuLed wILI smokIng, Lobucco smoke Is IIkened
Lifestyle Epidemiology
Lo u vIrus. TIe IucL oI LIe muLLer Is LIuL Lobucco smoke Is not IIke u vIruI or
bucLerIuI quunLILy. urLIermore, In LIe cuse oI LIe exumpIe oI poIIo vIrus,
LIe Iow specIIIcILy ussocIuLIons uIIuded Lo ure noL even dIseuses, buL ure
sympLoms. L LIen uses un cssumption oI sInguIur specIIIc eIIecLs und
muILIpIe non-specIIIc eIIecLs (dIseuses) bused on IncoIerenL unuIogIes Lo
supporL u concIusIon oI sInguIur specIIIc eIIecLs und muILIpIe non-specIIIc
eIIecLs, I.e., beggIng LIe quesLIon; none oI LIe supposed cuusuLIon Is
demonsLruLed or expIuIned, buL ussumed Lo occur sImIIurIy Lo u vIrus or
bucLerIum. On LIIs poInL BrownIee (1q6) very reusonubIy urgues LIuL LIe
wuy IL cIuIms LIe IucLs ure In conIormILy wILI LIe crILerIon |specijicit| Is
Lo IIuLIy Ignore LIe IucLs. (p.;1) TIe CommILLee mude no uLLempL Lo
consIder wIuL oLIer IucLors mIgIL produce RR dIIIerenLIuIs, e.g.,
convergence eIIecL, rIsk-uverse subgroup In LIe nonsmoker`s group, und
purLIcuIurIy endogenous ubnormuIILy.
TIe overuII eIIecL oI LIe use oI IncoIerenL unuIogy Is LIe IuIIucy oI
non ccusc pro ccusc; LIe cIuImed cuuse Ius noL been demonsLruLed.
Nor cun IL be demonsLruLed due Lo LIe poor predIcLIve sLrengLI oI smokIng
Ior Iung cuncer. Every IndIcuLIon Is LIuL Iung cuncer reIIecLs u pecuIIurILy
oI LIe subgroup oI persons munIIesLIng LIe dIseuse (endogenous
ubnormuIILy) ruLIer LIun u generuI propensILy oI Lobucco smoke.
TIe crucIuI error mude by LIe CommILLee wus Lo compIeLeIy
conIuse suIIIcIenL und necessury condILIons Ior un eIIecL. L Is reusonubIe
LIuL poor predIcLIve sLrengLI oI cIgureLLe smokIng Ior Iung cuncer does noL
precIude cIgureLLe smokIng Irom beIng c LrIgger In Iung cuncer (SG
ReporL, 1q6q, p.18q). However, poor predIcLIve sLrengLI does dejinitel
precIude vIewIng cIgureLLe smokIng us u suIIIcIenL condILIon (sIngIe IucLor,
prImury cuuse) Ior Iung cuncer. CIgureLLe smokIng does cpproximcte u
necessury condILIon Ior Iung cuncer. However, LIere ure oLIer IucLors LIuL
uIso Iuve LIIs Lendency, e.g., IeveI oI exercIse, prevIous Iung dIseuse,
geneLIc IucLors. urLIermore, combInuLIons oI LIese IucLors muy produce
u synergIsLIc eIIecL LIuL conLrIbuLes Lo specIIIc dIseuse (e.g., Iung cuncer)
buL wIere cerLuIn oLIer precondILIons musL jirst be meL, I.e.,
suscepLIbIIILy. TIese, Iowever, sIouId noL be conIused wILI u sIngIe-IucLor
suIIIcIenL condILIon Ior un eIIecL.
TIe CommILLee dId noL consIder, uL uII, un unuIysIs oI
proporLIons oI uge-udjusLed, specIIIc-cuuse morLuIILy. TIIs wouId Iuve
uIerLed LIem Lo LIe IucL LIuL LIose suIIerIng Iung cuncer wouId Iuve
suIIered some oLIer Iorm oI cuncer Iud LIey noL been smokers, I.e., sLrong
IndIcuLIon oI suscepLIbIIILy. TIIs muy Iuve LIen uIerLed LIem Lo LIe
possIbIIILy LIuL smokIng, LogeLIer wILI oLIer IucLors, mc Iuve u
weukenIng eIIecL on LIe Iung, munIIesLIng In Iung cuncer In u subgroup oI
suscepLIbIe IndIvIduuIs. AguIn, LIIs Is very dIIIerenL Lo mukIng dIrecL
60
60
Rampant Antismoking Signifies Grave Danger
cuusuI cIuIms ubouL smokIng. TIIs dIsLIncLIon Is crILIcuI. L uIso IndIcuLes
LIuL mosL Ieuvy smokers ure noL uL rIsk oI Iung cuncer.
ConcernIng dIseuses oLIer LIun Iung cuncer, un unuIysIs oI
proporLIons oI uge-udjusLed, specIIIc-cuuse morLuIILy wouId Iuve
IndIcuLed LIuL mosL smokers und nonsmokers ure compurubIe In specIIIc-
cuuse morLuIILy. TIereIore, RR dIIIerenLIuIs beLween smokers und
nonsmokers Ior specIIIc-cuuse morLuIILy ure due Lo eurIIer morLuIILy Ior
LIe overuII smoker`s group. TIe roIe LIuL smokIng und numerous oLIer
IucLors mIgIL pIuy In ugIng muy Iuve oLIerwIse been consIdered. WIeLIer
LIe eurIIer morLuIILy reIIecLs premuLure morLuIILy Is sLIII IIgIIy urguubIe. L
wIII be cIeur us LIIs dIscussIon proceeds LIuL uncorrecLed errors begun In
LIe 1qo`s Ius produced u wIoIe pIeLIoru oI cuusuI cIuIms regurdIng LIe
poLenLIuI dIseuse-producIngJprevenLIng propensILIes oI exogenous IucLors.
TIIs Is no more LIun LIe munuIucLure oI supersLILIous beIIeIs, I.e., un
ussuuIL on menLuI und socIuI IeuILI.
TIe CommILLee uIso mude unoLIer curIous observuLIon:
However, In Iung cuncer, we ure deuIIng wILI reIuLIve rIsk ruLIos
uverugIng q.o Lo 1o.o Ior cIgureLLe smokers compured Lo non-smokers.
TIIs Is un excess oI qoo Lo 1,ooo percenL umong smokers oI cIgureLLes.
SImIIurIy LIIs meuns LIuL oI LIe LoLuI Ioud oI Iung cuncer In muIes ubouL
qo percenL Is ussocIuLed wILI cIgureLLe smokIng. n order Lo uccounL Ior
rIsk ruLIos oI LIIs mugnILude us due Lo un ussocIuLIon oI smokIng IIsLory
wILI sLIII unoLIer cuusuLIve IucLor X (IormonuI, consLILuLIonuI, or oLIer), u
necessury condILIon wouId be LIuL IucLor X be presenL uL IeusL nIne LImes
more IrequenLIy umong smokers LIun non-smokers. No sucI IucLors wILI
sucI IIgI reIuLIve prevuIence umong smokers Iuve yeL been
demonsLruLed. (p. 18q) TIe sLuLemenL ImpIIes LIuL IL Is IIgIIy ImprobubIe
LIuL sucI u IucLor X, or combInuLIon oI IucLors, exIsLs; HuLcIInson
(1q68) noLes LIuL In LIe cuse oI Iung cuncer muny oI us IInd IL Iurd Lo
beIIeve LIuL we couId Iuve overIooked some conIoundIng vurIubIes LIuL
ure so IIgIIy correIuLed wILI boLI smokIng und Iung cuncer. (p. 1q;) On
LIIs poInL LIe CommILLee und muny oLIers ure very mIsLuken. WILIIn u
deLermInIsLIc Irumework, II Iung cuncer Ius u cuuse, LIen LIe cuuse In uII
or mosL cuses musL Iuve u common uspecL (mecIunIsmJprocess) LIuL Is
unique Lo LIe dIseuse In quesLIon, I.e., uL IeusL u suIIIcIenL condILIon.
TIereIore, noL onIy must LIere be unoLIer IucLor(s), cs et unidentijied,
LIuL cun uccounL Ior LIe mujorILy oI Iung cuncer cuses beyond smokIng,
buL IL wIII uIso Iuve u ter hih predIcLIve sLrengLI Ior LIe dIseuse. TIe
sLrongesL cundIduLe In LIIs regurd Is endogenous ubnormuIILy.
UnIorLunuLeIy, LIe CommILLee, by noL dIsLInguIsIIng beLween
Lypes oI cuusuI ImpIIcuLIon (I.e., sIngIe IucLor, prImury cuuse vs. LrIgger),
concIuded, wIeLIer IL reuIIzed so or noL, Ior LIe cbsolute posILIon LIuL
Lifestyle Epidemiology
cIgureLLe smokIng Is u sIngIe-IucLor, prImury cuuse (suIIIcIenL condILIon)
oI Iung cuncer. This is cs extreme cn error oj injerence thct ccn be mcde.
TIIs crILIcuI error Ius been LIe source oI greuL conIusIon Ior LIe neur-qo
yeurs sInce LIe 1q6q ReporL. By LIe sume conLorLed reusonIng, LIIs
prImury cuusuI sLuLus oI cIgureLLe smokIng Ius sInce been exLended Lo
IncIude coronury IeurL dIseuse und oLIer cuncers. L Is reIerred Lo us LIe
ccusctionist or orthodox posILIon (see Eysenck, 1qq1).
L Is worLI IurLIer consIderIng LIe IuIIure Lo properIy dIsLInguIsI
beLween suIIIcIenL und necessury condILIons. TIe SG ReporL (1q6q) noLes
LIuL LIe IdeuI sLuLe In wIIcI smokIng or smokIng oI cIgureLLes und every
cuse oI Iung cuncer wus correIuLed one-Lo-one wouId pose mucI Iess
dIIIIcuILy In u judgemenL oI cuusuIILy, buL LIe exIsLence oI Iung cuncer In
non-smokers does Indeed compIIcuLe muLLers somewIuL. (p. 18q) TIe
ReporL Is ucLuuIIy sLuLIng LIuL II Iung cuncer wus Iound onIy In smokers,
LIen u cuusuI urgumenL Is deIInILIve. n LIIs cuse, smokIng wouId uppeur
us u necessury condILIon. However, IL wouId sLIII need Lo be demonsLruLed
wIy onIy u smuII subgroup oI smokers deveIop LIe dIseuse, I.e., cuusuI
ImpIIcuLIon Is noL uuLomuLIc und LIere must be oLIer more crILIcuI IucLors
InvoIved LIuL deIImIL LIe subgroup In quesLIon. TIe ImporLunL probIem Lo
be noLed Iere Is epIdemIoIogy`s mIsuse oI cuusuI LermInoIogy. or u neur-
necessury condILIon, LIe upproprIuLe LermInoIogy Is LIuL LIe IucLor muy be
u LrIgger, gIven purLIcuIur crILIcuI precondILIons LIuL beLLer deIImIL LIe
subgroup In quesLIon (e.g., Igure 1, DIugrum A). n oLIer words, LIe
IdenLIIIed neur-necessury condILIon Is noL LIe soIe IucLor nor LIe crILIcuI
IucLor(s) responsIbIe Ior u dIseuse In quesLIon. However, epIdemIoIogy
und prevenLIve medIcIne ure noLorIous (I.e., sLundurd procedure) Ior
IorwurdIng cIuIms sucI us SmokIng cuuses Iung cuncer. SucI sLuLemenLs
ure reserved Ior suIIIcIenL or suIIIcIenL und necessury condILIons (e.g.,
Igure 1, DIugrum B). SucI sLuLemenLs ImpIy LIuL wIerever LIe
unLecedenL oI smokIng occurs, LIen LIe dIseuse, gIven suIIIcIenL LIme, wIII
IoIIow (Ior LIIs dIscussIon LIe LIresIoId Ius been seL uL 6o%). L uIso
ImpIIes LIuL LIe sIngIe IucLor oI smokIng (I.e., LIe cuusuI ucLIon oI ILs
properLIes) Is enLIreIy responsIbIe Ior LIe dIseuse In quesLIon. L cun be
sLuLed wILI compIeLe conIIdence LIuL uII reseurcI LIuL Ius ever been
conducLed LIuL Ius smokIng us un experImenLuI IucLor disconjirms LIuL
smokIng Is u suIIIcIenL condILIon Ior uny specIIIc dIseuseJmorLuIILy.
I u IucLor (X) requIres poLenLIuIIy numerous precondILIons
beIore IL cun operuLe us u LrIgger und usuuIIy InvoIves Iow-IeveI
ussocIuLIon, LIen IL sIouId neter be cIuImed LIuL IucLor X ccuses u
purLIcuIur condILIon. TIIs conIusIon beLween suIIIcIenL und necessury
condILIons sIouId sImpIy noL occur. TIey ImpIy ter dijjerent sLuLes oI
uIIuIrs, I.e., DIugrum A compured Lo DIugrum B In Igure 1. To speuk oI u
61
61
Rampant Antismoking Signifies Grave Danger
cuusuI cIuIms ubouL smokIng. TIIs dIsLIncLIon Is crILIcuI. L uIso IndIcuLes
LIuL mosL Ieuvy smokers ure noL uL rIsk oI Iung cuncer.
ConcernIng dIseuses oLIer LIun Iung cuncer, un unuIysIs oI
proporLIons oI uge-udjusLed, specIIIc-cuuse morLuIILy wouId Iuve
IndIcuLed LIuL mosL smokers und nonsmokers ure compurubIe In specIIIc-
cuuse morLuIILy. TIereIore, RR dIIIerenLIuIs beLween smokers und
nonsmokers Ior specIIIc-cuuse morLuIILy ure due Lo eurIIer morLuIILy Ior
LIe overuII smoker`s group. TIe roIe LIuL smokIng und numerous oLIer
IucLors mIgIL pIuy In ugIng muy Iuve oLIerwIse been consIdered. WIeLIer
LIe eurIIer morLuIILy reIIecLs premuLure morLuIILy Is sLIII IIgIIy urguubIe. L
wIII be cIeur us LIIs dIscussIon proceeds LIuL uncorrecLed errors begun In
LIe 1qo`s Ius produced u wIoIe pIeLIoru oI cuusuI cIuIms regurdIng LIe
poLenLIuI dIseuse-producIngJprevenLIng propensILIes oI exogenous IucLors.
TIIs Is no more LIun LIe munuIucLure oI supersLILIous beIIeIs, I.e., un
ussuuIL on menLuI und socIuI IeuILI.
TIe CommILLee uIso mude unoLIer curIous observuLIon:
However, In Iung cuncer, we ure deuIIng wILI reIuLIve rIsk ruLIos
uverugIng q.o Lo 1o.o Ior cIgureLLe smokers compured Lo non-smokers.
TIIs Is un excess oI qoo Lo 1,ooo percenL umong smokers oI cIgureLLes.
SImIIurIy LIIs meuns LIuL oI LIe LoLuI Ioud oI Iung cuncer In muIes ubouL
qo percenL Is ussocIuLed wILI cIgureLLe smokIng. n order Lo uccounL Ior
rIsk ruLIos oI LIIs mugnILude us due Lo un ussocIuLIon oI smokIng IIsLory
wILI sLIII unoLIer cuusuLIve IucLor X (IormonuI, consLILuLIonuI, or oLIer), u
necessury condILIon wouId be LIuL IucLor X be presenL uL IeusL nIne LImes
more IrequenLIy umong smokers LIun non-smokers. No sucI IucLors wILI
sucI IIgI reIuLIve prevuIence umong smokers Iuve yeL been
demonsLruLed. (p. 18q) TIe sLuLemenL ImpIIes LIuL IL Is IIgIIy ImprobubIe
LIuL sucI u IucLor X, or combInuLIon oI IucLors, exIsLs; HuLcIInson
(1q68) noLes LIuL In LIe cuse oI Iung cuncer muny oI us IInd IL Iurd Lo
beIIeve LIuL we couId Iuve overIooked some conIoundIng vurIubIes LIuL
ure so IIgIIy correIuLed wILI boLI smokIng und Iung cuncer. (p. 1q;) On
LIIs poInL LIe CommILLee und muny oLIers ure very mIsLuken. WILIIn u
deLermInIsLIc Irumework, II Iung cuncer Ius u cuuse, LIen LIe cuuse In uII
or mosL cuses musL Iuve u common uspecL (mecIunIsmJprocess) LIuL Is
unique Lo LIe dIseuse In quesLIon, I.e., uL IeusL u suIIIcIenL condILIon.
TIereIore, noL onIy must LIere be unoLIer IucLor(s), cs et unidentijied,
LIuL cun uccounL Ior LIe mujorILy oI Iung cuncer cuses beyond smokIng,
buL IL wIII uIso Iuve u ter hih predIcLIve sLrengLI Ior LIe dIseuse. TIe
sLrongesL cundIduLe In LIIs regurd Is endogenous ubnormuIILy.
UnIorLunuLeIy, LIe CommILLee, by noL dIsLInguIsIIng beLween
Lypes oI cuusuI ImpIIcuLIon (I.e., sIngIe IucLor, prImury cuuse vs. LrIgger),
concIuded, wIeLIer IL reuIIzed so or noL, Ior LIe cbsolute posILIon LIuL
Lifestyle Epidemiology
cIgureLLe smokIng Is u sIngIe-IucLor, prImury cuuse (suIIIcIenL condILIon)
oI Iung cuncer. This is cs extreme cn error oj injerence thct ccn be mcde.
TIIs crILIcuI error Ius been LIe source oI greuL conIusIon Ior LIe neur-qo
yeurs sInce LIe 1q6q ReporL. By LIe sume conLorLed reusonIng, LIIs
prImury cuusuI sLuLus oI cIgureLLe smokIng Ius sInce been exLended Lo
IncIude coronury IeurL dIseuse und oLIer cuncers. L Is reIerred Lo us LIe
ccusctionist or orthodox posILIon (see Eysenck, 1qq1).
L Is worLI IurLIer consIderIng LIe IuIIure Lo properIy dIsLInguIsI
beLween suIIIcIenL und necessury condILIons. TIe SG ReporL (1q6q) noLes
LIuL LIe IdeuI sLuLe In wIIcI smokIng or smokIng oI cIgureLLes und every
cuse oI Iung cuncer wus correIuLed one-Lo-one wouId pose mucI Iess
dIIIIcuILy In u judgemenL oI cuusuIILy, buL LIe exIsLence oI Iung cuncer In
non-smokers does Indeed compIIcuLe muLLers somewIuL. (p. 18q) TIe
ReporL Is ucLuuIIy sLuLIng LIuL II Iung cuncer wus Iound onIy In smokers,
LIen u cuusuI urgumenL Is deIInILIve. n LIIs cuse, smokIng wouId uppeur
us u necessury condILIon. However, IL wouId sLIII need Lo be demonsLruLed
wIy onIy u smuII subgroup oI smokers deveIop LIe dIseuse, I.e., cuusuI
ImpIIcuLIon Is noL uuLomuLIc und LIere must be oLIer more crILIcuI IucLors
InvoIved LIuL deIImIL LIe subgroup In quesLIon. TIe ImporLunL probIem Lo
be noLed Iere Is epIdemIoIogy`s mIsuse oI cuusuI LermInoIogy. or u neur-
necessury condILIon, LIe upproprIuLe LermInoIogy Is LIuL LIe IucLor muy be
u LrIgger, gIven purLIcuIur crILIcuI precondILIons LIuL beLLer deIImIL LIe
subgroup In quesLIon (e.g., Igure 1, DIugrum A). n oLIer words, LIe
IdenLIIIed neur-necessury condILIon Is noL LIe soIe IucLor nor LIe crILIcuI
IucLor(s) responsIbIe Ior u dIseuse In quesLIon. However, epIdemIoIogy
und prevenLIve medIcIne ure noLorIous (I.e., sLundurd procedure) Ior
IorwurdIng cIuIms sucI us SmokIng cuuses Iung cuncer. SucI sLuLemenLs
ure reserved Ior suIIIcIenL or suIIIcIenL und necessury condILIons (e.g.,
Igure 1, DIugrum B). SucI sLuLemenLs ImpIy LIuL wIerever LIe
unLecedenL oI smokIng occurs, LIen LIe dIseuse, gIven suIIIcIenL LIme, wIII
IoIIow (Ior LIIs dIscussIon LIe LIresIoId Ius been seL uL 6o%). L uIso
ImpIIes LIuL LIe sIngIe IucLor oI smokIng (I.e., LIe cuusuI ucLIon oI ILs
properLIes) Is enLIreIy responsIbIe Ior LIe dIseuse In quesLIon. L cun be
sLuLed wILI compIeLe conIIdence LIuL uII reseurcI LIuL Ius ever been
conducLed LIuL Ius smokIng us un experImenLuI IucLor disconjirms LIuL
smokIng Is u suIIIcIenL condILIon Ior uny specIIIc dIseuseJmorLuIILy.
I u IucLor (X) requIres poLenLIuIIy numerous precondILIons
beIore IL cun operuLe us u LrIgger und usuuIIy InvoIves Iow-IeveI
ussocIuLIon, LIen IL sIouId neter be cIuImed LIuL IucLor X ccuses u
purLIcuIur condILIon. TIIs conIusIon beLween suIIIcIenL und necessury
condILIons sIouId sImpIy noL occur. TIey ImpIy ter dijjerent sLuLes oI
uIIuIrs, I.e., DIugrum A compured Lo DIugrum B In Igure 1. To speuk oI u
62
62
Rampant Antismoking Signifies Grave Danger
Iow-IeveI (uLypIcuI) ussocIuLIon, I.e., u neur-necessury condILIon, us II IL Is u
IIgI-IeveI (LypIcuI) ussocIuLIon, I.e., suIIIcIenL condILIon, Is IruuduIenL. n
LIe conLexL oI LIe currenL dIscussIon IL Is uIso menLuIIy dysIuncLIonuI, I.e.,
cuLusLropIIzuLIon. L mIsrepresenLs evIdence by LIe greuLer proporLIon oI
LIe condILIonuI probubIIILy scuIe. L uIso IosLers LIe beIIeI LIuL LIere Is un
undersLundIng oI u dIseuse In quesLIon LIuL sImpIy does noL yeL exIsL.
A LrIgger IucLor In dIseuse Is u Iower-order (perIpIeruI or LuII-
end) IucLor In u sequence oI precondILIons Ior LIuL specIIIc dIseuse.
PrevenLIve medIcIne uILImuLeIy uses, und compounds, LIe InIerenLIuI
errors uIreudy mude by epIdemIoIogy. TIe uLLempL Lo coerce, Ior exumpIe,
beIuvIoruI rIsk modIIIcuLIon by LreuLIng LuII-end IucLors us II LIey ure
suIIIcIenL condILIons Is ukIn Lo LIe LuII LryIng Lo wug LIe dog.
TIe reusonIng und concIusIons oI LIe SG ReporL (1q6q) ure
enIgmuLIc. CommendubIy, LIe ReporL uL IeusL uLLempLs Lo consIder
psycIoIogIcuI und psycIosocIuI IucLors In smokIng. L noLes LIuL LIe
generuI pIcLure wIIcI emerges Irom Eysenck`s sLudy und Irom oLIers Is
one oI smokers LendIng Lo IIve IusLer und more InLenseIy, und Lo be more
socIuIIy ouLgoIng. (p. 66) L uIso concIuded LIuL wIIIe smokers do dIIIer
Irom non-smokers In u vurIeLy oI cIurucLerIsLIcs, none oI LIe sLudIes Ius
sIown u sIngIe vurIubIe wIIcI Is Iound excIusIveIy In one group und Is
compIeLeIy ubsenL In LIe oLIer. Nor Ius uny sIngIe vurIubIe been verIIIed
In u suIIIcIenLIy Iurge proporLIon oI smokers und In suIIIcIenLIy Iew non-
smokers Lo consIder IL un 'essenLIuI` uspecL oI smokIng. WIIIe LIIs Is Lrue
oI cll LIe vurIubIes ..IL Is especIuIIy Lrue Ior LIose vurIubIes meusurIng
personuIILy cIurucLerIsLIcs....u cIeur-cuL smoker`s personuIILy Ius noL
emerged Irom LIe resuILs so Iur pubIIsIed In LIe IILeruLure. NoneLIeIess,
LIere uppeur enougI dIIIerences beLween smokers und non-smokers Lo
wurrunL LIe usserLIon LIuL LIere ure Indeed dIIIerenL psycIoIogIcuI
dynumIcs uL work. However, In wIuL wuys LIese dIIIer, und Lo wIuL exLenL
LIese dIIIerences ure cuuse, or eIIecL, or boLI, Is noL yeL known. (p. 68)
However, LIe ReporL compIeLeIy mIsses LIe crucIuI Ideu oI u
subgroup convergIng eIIecL Ior smokIng or LIuL LIe nonsmokIng group
muy noL be Iomogeneous, or LIe crILIcuI IucLor oI endogenous
ubnormuIILy. As sucI, by ILs own poor sLundurd oI cuusuI urgumenL bused
on reIuLIve rIsks, IL LIen Iorces u dIrecL cuusuI reIuLIonsIIp beLween
smokIng (properLIes oI Lobucco smoke) und u number oI dIseusesJ
morLuIILy. TIe predIcLIve sLrengLI oI smokIng Ior LIese dIseuses Is eILIer
poor, very neur-zero or eIIecLIveIy zero. TIIs conducL represenLs u severe
und conLorLIng muLerIuIIsLJexLernuIIsL bIus. UnIorLunuLeIy, Lo LIIs bIus Is
LIen udded u dIsLurbIng IncompeLence LIuL produces cIuIms LIuL IosLer u
pubIIc percepLIon LIuL Is essenLIuIIy LIe exucL opposILe Lo ucLuuI sLuLes oI
uIIuIrs, I.e., vIoIuLIons oI every prIncIpIe oI cuusuI urgumenL und u
Lifestyle Epidemiology
compIeLe bIurrIng oI suIIIcIenL und necessury condILIons. Even more
dIsLurbIng Is LIuL LIIs wouId be LIe IusL LIme LIuL uny uLLempL wouId be
mude Lo uccounL Ior psycIoIogIcuI und socIuI dImensIons oI smokIng,
Iowever poorIy; LIe SG (1q6q) wouId evenLuuIIy represenL LIe IIgIesL
sLundurd In LIe evuIuuLIon oI LIe smokIng IubIL. Every subsequenL
Surgeon GeneruI reporL on smokIng wouId become progressIveIy more
muLerIuIIsL In ILs dIsposILIon und recommenduLIons (I.e., muLerIuIIsL
munIIesLo).
TIere ure Lwo ImporLunL poInLs Lo noLe Iere. IrsLIy, LIe
cIgureLLe-smokIng concIusIon urrIved uL by LIe CommILLee reIIecLs LIe
sLundurd upsIde-down, buck-Lo-IronL LIInkIng ouLIIned In secLIon z.1.
TIere Is un Improper IIxuLIon on uLypIcuI reIuLIve dIIIerences, und LIen LIe
enLIre source oI uLypIcuI, wILIIn-group (smokers) vurIuLIon Is projecLed
onLo u sIngIe exogenous IucLor, I.e., LrunsIerence IuIIucy. SecondIy, LIe
sume IumbIIng und bumbIIng LIuL Ied Lo u compIeLeIy quesLIonubIe
concIusIon In 1q6q sLIII occurs uL LIe begInnIng oI LIe new mIIIennIum.
or exumpIe, PoLIscImun & Weed (1qqq), In cuIIIng Ior greuLer unIIormILy
In LIe LreuLmenL oI LIe prIncIpIes underIyIng cuusuI urgumenL In
nuLrILIonuI epIdemIoIogy, noLe LIuL |L|Iere Is onIy u Ioose consensus
regurdIng LIe reIuLIve ImporLunce und prIorILy oI LIe crILerIu und LIe ruIes
oI InIerence ussIgned Lo uny crILerIon. TIe seIecLIon, runkIng, und
deIInILIons oI crILerIu vury Irom user Lo user. TIe crILerIon oI consIsLency,
Ior exumpIe, Ius been InLerpreLed us un uII-or-none pIenomenon, u
mujorILy ruIes pIenomenon, or u LesLubIe sLuLIsLIcuI IypoLIesIs ubouL LIe
reIuLIve proporLIons oI posILIve, neguLIve, und nuII sLudIes. IkewIse, LIe
crILerIon oI sLrengLI oI ussocIuLIon Is InLerpreLed vurIubIy, wILI muny
dIIIerenL opInIons on wIuL sIze oI reIuLIve rIsk consLILuLes u weuk
ussocIuLIon. (p.11oS) TIese commenLs uppIy noL onIy Lo nuLrILIonuI
epIdemIoIogy, buL Lo uII Iorms oI IIIesLyIe epIdemIoIogy (see uIso MoIer
eL uI., 1qqq).
z. Since the SG Report (:p()
rom LIe ubove, IL cun be concIuded LIuL LIe SG ReporL`s (1q6q)
concIusIon Is IndeIensIbIe on concepLuuI grounds, regurdIess oI wIeLIer
LIere wus or wus noL uny uvuIIubIe empIrIcuI evIdence concernIng
endogenous sources oI vurIuLIon. TIe requIremenLs oI cuusuI urgumenL
cIeurIy poInL In LIe dIrecLIon oI endogenous vurIuLIon (e.g., geneLIc
ubnormuIILIes). AnoLIer oI BrownIee`s (1q6) mujor concerns wus LIe
sIeer Iuck oI uLLempL Lo consIder LIe IIndIngs In uny oLIer Lerms, I.e.,
counLer IypoLIeses. CounLer IypoLIeses sIouId Iuve been ImmedIuLeIy
consIdered becuuse LIe ucLuuI evIdence does noL supporL buL disconjirms
63
63
Rampant Antismoking Signifies Grave Danger
Iow-IeveI (uLypIcuI) ussocIuLIon, I.e., u neur-necessury condILIon, us II IL Is u
IIgI-IeveI (LypIcuI) ussocIuLIon, I.e., suIIIcIenL condILIon, Is IruuduIenL. n
LIe conLexL oI LIe currenL dIscussIon IL Is uIso menLuIIy dysIuncLIonuI, I.e.,
cuLusLropIIzuLIon. L mIsrepresenLs evIdence by LIe greuLer proporLIon oI
LIe condILIonuI probubIIILy scuIe. L uIso IosLers LIe beIIeI LIuL LIere Is un
undersLundIng oI u dIseuse In quesLIon LIuL sImpIy does noL yeL exIsL.
A LrIgger IucLor In dIseuse Is u Iower-order (perIpIeruI or LuII-
end) IucLor In u sequence oI precondILIons Ior LIuL specIIIc dIseuse.
PrevenLIve medIcIne uILImuLeIy uses, und compounds, LIe InIerenLIuI
errors uIreudy mude by epIdemIoIogy. TIe uLLempL Lo coerce, Ior exumpIe,
beIuvIoruI rIsk modIIIcuLIon by LreuLIng LuII-end IucLors us II LIey ure
suIIIcIenL condILIons Is ukIn Lo LIe LuII LryIng Lo wug LIe dog.
TIe reusonIng und concIusIons oI LIe SG ReporL (1q6q) ure
enIgmuLIc. CommendubIy, LIe ReporL uL IeusL uLLempLs Lo consIder
psycIoIogIcuI und psycIosocIuI IucLors In smokIng. L noLes LIuL LIe
generuI pIcLure wIIcI emerges Irom Eysenck`s sLudy und Irom oLIers Is
one oI smokers LendIng Lo IIve IusLer und more InLenseIy, und Lo be more
socIuIIy ouLgoIng. (p. 66) L uIso concIuded LIuL wIIIe smokers do dIIIer
Irom non-smokers In u vurIeLy oI cIurucLerIsLIcs, none oI LIe sLudIes Ius
sIown u sIngIe vurIubIe wIIcI Is Iound excIusIveIy In one group und Is
compIeLeIy ubsenL In LIe oLIer. Nor Ius uny sIngIe vurIubIe been verIIIed
In u suIIIcIenLIy Iurge proporLIon oI smokers und In suIIIcIenLIy Iew non-
smokers Lo consIder IL un 'essenLIuI` uspecL oI smokIng. WIIIe LIIs Is Lrue
oI cll LIe vurIubIes ..IL Is especIuIIy Lrue Ior LIose vurIubIes meusurIng
personuIILy cIurucLerIsLIcs....u cIeur-cuL smoker`s personuIILy Ius noL
emerged Irom LIe resuILs so Iur pubIIsIed In LIe IILeruLure. NoneLIeIess,
LIere uppeur enougI dIIIerences beLween smokers und non-smokers Lo
wurrunL LIe usserLIon LIuL LIere ure Indeed dIIIerenL psycIoIogIcuI
dynumIcs uL work. However, In wIuL wuys LIese dIIIer, und Lo wIuL exLenL
LIese dIIIerences ure cuuse, or eIIecL, or boLI, Is noL yeL known. (p. 68)
However, LIe ReporL compIeLeIy mIsses LIe crucIuI Ideu oI u
subgroup convergIng eIIecL Ior smokIng or LIuL LIe nonsmokIng group
muy noL be Iomogeneous, or LIe crILIcuI IucLor oI endogenous
ubnormuIILy. As sucI, by ILs own poor sLundurd oI cuusuI urgumenL bused
on reIuLIve rIsks, IL LIen Iorces u dIrecL cuusuI reIuLIonsIIp beLween
smokIng (properLIes oI Lobucco smoke) und u number oI dIseusesJ
morLuIILy. TIe predIcLIve sLrengLI oI smokIng Ior LIese dIseuses Is eILIer
poor, very neur-zero or eIIecLIveIy zero. TIIs conducL represenLs u severe
und conLorLIng muLerIuIIsLJexLernuIIsL bIus. UnIorLunuLeIy, Lo LIIs bIus Is
LIen udded u dIsLurbIng IncompeLence LIuL produces cIuIms LIuL IosLer u
pubIIc percepLIon LIuL Is essenLIuIIy LIe exucL opposILe Lo ucLuuI sLuLes oI
uIIuIrs, I.e., vIoIuLIons oI every prIncIpIe oI cuusuI urgumenL und u
Lifestyle Epidemiology
compIeLe bIurrIng oI suIIIcIenL und necessury condILIons. Even more
dIsLurbIng Is LIuL LIIs wouId be LIe IusL LIme LIuL uny uLLempL wouId be
mude Lo uccounL Ior psycIoIogIcuI und socIuI dImensIons oI smokIng,
Iowever poorIy; LIe SG (1q6q) wouId evenLuuIIy represenL LIe IIgIesL
sLundurd In LIe evuIuuLIon oI LIe smokIng IubIL. Every subsequenL
Surgeon GeneruI reporL on smokIng wouId become progressIveIy more
muLerIuIIsL In ILs dIsposILIon und recommenduLIons (I.e., muLerIuIIsL
munIIesLo).
TIere ure Lwo ImporLunL poInLs Lo noLe Iere. IrsLIy, LIe
cIgureLLe-smokIng concIusIon urrIved uL by LIe CommILLee reIIecLs LIe
sLundurd upsIde-down, buck-Lo-IronL LIInkIng ouLIIned In secLIon z.1.
TIere Is un Improper IIxuLIon on uLypIcuI reIuLIve dIIIerences, und LIen LIe
enLIre source oI uLypIcuI, wILIIn-group (smokers) vurIuLIon Is projecLed
onLo u sIngIe exogenous IucLor, I.e., LrunsIerence IuIIucy. SecondIy, LIe
sume IumbIIng und bumbIIng LIuL Ied Lo u compIeLeIy quesLIonubIe
concIusIon In 1q6q sLIII occurs uL LIe begInnIng oI LIe new mIIIennIum.
or exumpIe, PoLIscImun & Weed (1qqq), In cuIIIng Ior greuLer unIIormILy
In LIe LreuLmenL oI LIe prIncIpIes underIyIng cuusuI urgumenL In
nuLrILIonuI epIdemIoIogy, noLe LIuL |L|Iere Is onIy u Ioose consensus
regurdIng LIe reIuLIve ImporLunce und prIorILy oI LIe crILerIu und LIe ruIes
oI InIerence ussIgned Lo uny crILerIon. TIe seIecLIon, runkIng, und
deIInILIons oI crILerIu vury Irom user Lo user. TIe crILerIon oI consIsLency,
Ior exumpIe, Ius been InLerpreLed us un uII-or-none pIenomenon, u
mujorILy ruIes pIenomenon, or u LesLubIe sLuLIsLIcuI IypoLIesIs ubouL LIe
reIuLIve proporLIons oI posILIve, neguLIve, und nuII sLudIes. IkewIse, LIe
crILerIon oI sLrengLI oI ussocIuLIon Is InLerpreLed vurIubIy, wILI muny
dIIIerenL opInIons on wIuL sIze oI reIuLIve rIsk consLILuLes u weuk
ussocIuLIon. (p.11oS) TIese commenLs uppIy noL onIy Lo nuLrILIonuI
epIdemIoIogy, buL Lo uII Iorms oI IIIesLyIe epIdemIoIogy (see uIso MoIer
eL uI., 1qqq).
z. Since the SG Report (:p()
rom LIe ubove, IL cun be concIuded LIuL LIe SG ReporL`s (1q6q)
concIusIon Is IndeIensIbIe on concepLuuI grounds, regurdIess oI wIeLIer
LIere wus or wus noL uny uvuIIubIe empIrIcuI evIdence concernIng
endogenous sources oI vurIuLIon. TIe requIremenLs oI cuusuI urgumenL
cIeurIy poInL In LIe dIrecLIon oI endogenous vurIuLIon (e.g., geneLIc
ubnormuIILIes). AnoLIer oI BrownIee`s (1q6) mujor concerns wus LIe
sIeer Iuck oI uLLempL Lo consIder LIe IIndIngs In uny oLIer Lerms, I.e.,
counLer IypoLIeses. CounLer IypoLIeses sIouId Iuve been ImmedIuLeIy
consIdered becuuse LIe ucLuuI evIdence does noL supporL buL disconjirms
64
64
Rampant Antismoking Signifies Grave Danger
LIe cuusuLIonIsL (ubsoIuLIsL) vIew. TIIs concern In purLIcuIur Ius been
Luken up by reseurcIers sucI us PIIIIp BurcI und Huns Eysenck. TIeIr
uLLempL Ius been Lo demonsLruLe empIrIcuIIy LIuL LIere must be oLIer
more crILIcuI IucLors InvoIved In LIe ueLIoIogy oI, Ior exumpIe, Iung cuncer,
e.g., geneLIc vurIuLIonsJubnormuIILIes, personuIILy dIIIerences,
psycIosocIuI IucLors.
BurcI (1q86), cILIng reseurcI by HIruyumu (1q;z) und
Henderson (1q;q), noLes u reIuLIve rIsk ruLIo oI .8 Ior Jupunese muIe
smokers versus muIe non-smokers, und u reIuLIve rIsk ruLIo oI 1.; Ior
CIInese smokers versus non-smokers Ior Iung cuncer morLuIILy. TIIs
LrunsIuLes InLo un ubsoIuLe, IIIeLIme, rIsk Ior Jupunese muIe smokers und
CIInese smokers deveIopIng Iung cuncer oI uround % (o.o). or Ieuvy-
smokers IL Is under ;%. TIIs ubsoIuLe rIsk Is consIderubIy Iower LIun LIe
1% (o.1) used eurIIer In LIIs secLIon (Irom PrescoLL eL uI., 1qq8)
regurdIng u Europeun popuIuLIon. BurcI (1q86) rIgILIy noLes LIuL LIese
popuIuLIon dIIIerences mIgIL be uLLrIbuLubIe Lo dIIIerences, Ior exumpIe,
In LIe curcInogenIcILy oI Lobucco consumed, uILIougI LIIs Is IIgIIy
ImprobubIe.
However, HInds eL uI. (1q81) IndIcuLe vurIuLIons In reIuLIve rIsk oI
Iung cuncer In women smokers oI dIIIerenL eLInIc orIgIn IIvIng In HuwuII.
n LIIs InsLunce IL Is ussumed LIuL uII smokers In LIe one IocuIe ure
consumIng Lobucco Irom LIe one pooI. TIey Iound u reIuLIve rIsk ruLIo oI
1o. Ior HuwuIIun women smokers, q.q Ior Jupunese women smokers,
und 1.8 Ior CIInese women smokers, und concIuded LIuL cIgureLLe
smokIng Is noL LIe onIy cuuse, nor even LIe mujor cuuse, oI Iung cuncer In
uII popuIuLIons oI women. AILIougI LIere Is no InIormuLIon on
proporLIons oI eLIIc groups IIvIng In HuwuII or uII-cuuse morLuIILy ruLes
Ior specIIIc eLInIcILy LIuL wouId uIIow u LrunsIuLIon oI reIuLIve rIsk InLo
ubsoIuLe rIsk, IL Is ussumed LIuL LIese reIuLIve rIsk dIIIerences do LrunsIuLe
InLo vurIuLIons In ubsoIuLe rIsk und LIuL LIe IowesL reIuLIve rIsk wIII
LrunsIuLe InLo un ubsoIuLe rIsk oI Iess LIun ;%. TIese eLInIc-reIuLed
vurIuLIons muy reIIecL dIIIerences In exposures Lo exogenous IucLors oLIer
LIun cIgureLLe smokIng, e.g., geneLIc dIIIerencesJubnormuIILIes, dIeLury
dIIIerences, eLc. L cerLuInIy does clecrl poInL uwuy Irom cIgureLLe
smokIng beIng consIdered us u sIngIe-IucLor, prImury cuuse oI Iung cuncer.
urLIermore, uL sucI Iow IeveIs oI predIcLIve sLrengLI (ubsoIuLe rIsk), IL Is
doubLIuI wIeLIer LIe curcInogenIc properLIes oI Lobucco smoke In ucLIve
smokIng Iuve u cuusuI conLrIbuLIon Lo specIIIc dIseuse uL uII. L musL be
reILeruLed LIuL LIIs evIdence does noL specIIIcuIIy udd unyLIIng Lo cuusuI
urgumenL. L mereIy IndIcuLes LIuL LIere ure other IucLors (e.g., geneLIc,
IormonuI) InvoIved In LIe ueLIoIogy oI Iung cuncer. However, LIIs couId
Iuve been concepLuuIIy deduced In 1q6q, regurdIess oI LIe uvuIIubIIILy oI
Lifestyle Epidemiology
LIIs sorL oI evIdence uL LIe LIme.
AnoLIer LungenL oI InvesLIguLIon sInce 1q6q Ius been u IImILed
number oI expensIve InLervenLIon sLudIes. A mujor probIem In
compurIng LIe poLenLIuI eIIecLs oI smokIng cessuLIon Is LIuL ex-smokers
mIgIL vury In ImporLunL wuys (e.g., curdIovuscuIur sympLoms, socIuI und
personuI cIurucLerIsLIcs) beIore LIey ceused smokIng Irom LIose wIo ure
persIsLenL smokers (e.g., rIedmun eL uI., 1q;q). VoIunLury ex-smokers
seem Lo resembIe nonsmokers ruLIer LIun smokers on u number oI
crILerIu. n uLLempLIng Lo uddress LIIs Issue oI seII seIecLIon uwuy Irom
LIe smokIng IubIL, u number oI rundomIzed conLroIIed InLervenLIon LrIuIs
Iuve been conducLed. n sucI sLudIes persons uL sImIIur IIgI-rIsk Ior
specIIIc dIseuse ure rcndoml ussIgned Lo eILIer un InLervenLIon group or
un us usuuI group. TIose In LIe InLervenLIon group, In conLrusL Lo LIe
usuuI cure group, receIve purLIcuIur uLLenLIon (e.g., counseIIng,
medIcuLIon) Lo reduce rIsk IucLors (e.g., ruLe oI smokIng, IyperLensIon).
BurcI (1q86) Iound no sLuLIsLIcuIIy sIgnIIIcunL dIIIerence In Iung
cuncer morLuIILy beLween usuuI cure smoker`s groups und InLervenLIon
groups by pooIIng duLu Irom LIe WIILeIuII sLudy (Rose eL uI., 1q8z) und
LIe MuILIpIe RIsk ucLor nLervenLIon TrIuI (MRT, 1q8z). MRT
(1qqo), uL 1o.-yeur IoIIow-up, uIso demonsLruLed no sIgnIIIcunL reducLIon
In Iung cuncer ussocIuLed wILI smokIng cessuLIonJreducLIon. TIere Iuve
been more Iurge scuIe InLervenLIons concernIng CHD (e.g., WorId HeuILI
OrgunIzuLIon, 1q86; MRT, 1q8z; NorLI KureIIu ProjecL - Pusku eL uI.,
1q;q; LIe rumIngIum SLudy - e.g., Gordon eL uI., 1q;q).
McCormIck & Skrubunek (1q88) In u revIew oI InLervenLIons Ior
CHD concIuded LIuL LIere wus no sLuLIsLIcuIIy sIgnIIIcunL reducLIon In
CHD morLuIILy ussocIuLed wILI reducLIon In rIsk IucLors, IncIudIng
smokIng. TIey uIso IIgIIIgIL LIe IIndIngs oI no sIgnIIIcunL eIIecLs oI
smokIng Ior CHD, myocurdIuI InIurcLIon, or ungInu pecLorIs, In
rumIngIum women. TIey consIder LIIs IndIrecL evIdence LIuL so-cuIIed
rIsk IucLors Ior CHD ure noL cuusuIIy reIuLed Lo LIe dIseuse. SeILzer (1q8q)
uccounLed Ior personuIILy Lype (Type A) In u reunuIysIs oI rumIngIum
duLu. WIen LIIs IucLor wus IncIuded wILI LIe IucLors oI sysLoIIc bIood
pressure und serum cIoIesLeroI, smokIng wus noL Iound Lo be u sIgnIIIcunL
predIcLor oI CHD or myocurdIuI InIurcLIon In men or oI CHD or ungInu
pecLorIs In women. MRT (1qqo) does IndIcuLe u Iower CHD morLuIILy
Ior LIe InLervenLIon group. However, LIIs Ius been reIuLed Lo IyperLensIon
uL buseIIne ruLIer LIun smokIng cessuLIon. EbruIIm & SmILI (1qq;), In
pooIIng (meLu-unuIysIs) LIe resuILs oI q InLervenLIon LrIuIs (WHO IucLory
sLudy, GoLLenburg sLudy, OsIo sLudy, MRT, InnIsI busInessmen sLudy,
HyperLensIon deLecLIon und IoIIow-up sLudy, JoIns HopkIns IyperLensIon
sLudy, CosL eIIecLIveness oI IIpId IowerIng sLudy, OxcIeck sLudy), uIso
65
65
Rampant Antismoking Signifies Grave Danger
LIe cuusuLIonIsL (ubsoIuLIsL) vIew. TIIs concern In purLIcuIur Ius been
Luken up by reseurcIers sucI us PIIIIp BurcI und Huns Eysenck. TIeIr
uLLempL Ius been Lo demonsLruLe empIrIcuIIy LIuL LIere must be oLIer
more crILIcuI IucLors InvoIved In LIe ueLIoIogy oI, Ior exumpIe, Iung cuncer,
e.g., geneLIc vurIuLIonsJubnormuIILIes, personuIILy dIIIerences,
psycIosocIuI IucLors.
BurcI (1q86), cILIng reseurcI by HIruyumu (1q;z) und
Henderson (1q;q), noLes u reIuLIve rIsk ruLIo oI .8 Ior Jupunese muIe
smokers versus muIe non-smokers, und u reIuLIve rIsk ruLIo oI 1.; Ior
CIInese smokers versus non-smokers Ior Iung cuncer morLuIILy. TIIs
LrunsIuLes InLo un ubsoIuLe, IIIeLIme, rIsk Ior Jupunese muIe smokers und
CIInese smokers deveIopIng Iung cuncer oI uround % (o.o). or Ieuvy-
smokers IL Is under ;%. TIIs ubsoIuLe rIsk Is consIderubIy Iower LIun LIe
1% (o.1) used eurIIer In LIIs secLIon (Irom PrescoLL eL uI., 1qq8)
regurdIng u Europeun popuIuLIon. BurcI (1q86) rIgILIy noLes LIuL LIese
popuIuLIon dIIIerences mIgIL be uLLrIbuLubIe Lo dIIIerences, Ior exumpIe,
In LIe curcInogenIcILy oI Lobucco consumed, uILIougI LIIs Is IIgIIy
ImprobubIe.
However, HInds eL uI. (1q81) IndIcuLe vurIuLIons In reIuLIve rIsk oI
Iung cuncer In women smokers oI dIIIerenL eLInIc orIgIn IIvIng In HuwuII.
n LIIs InsLunce IL Is ussumed LIuL uII smokers In LIe one IocuIe ure
consumIng Lobucco Irom LIe one pooI. TIey Iound u reIuLIve rIsk ruLIo oI
1o. Ior HuwuIIun women smokers, q.q Ior Jupunese women smokers,
und 1.8 Ior CIInese women smokers, und concIuded LIuL cIgureLLe
smokIng Is noL LIe onIy cuuse, nor even LIe mujor cuuse, oI Iung cuncer In
uII popuIuLIons oI women. AILIougI LIere Is no InIormuLIon on
proporLIons oI eLIIc groups IIvIng In HuwuII or uII-cuuse morLuIILy ruLes
Ior specIIIc eLInIcILy LIuL wouId uIIow u LrunsIuLIon oI reIuLIve rIsk InLo
ubsoIuLe rIsk, IL Is ussumed LIuL LIese reIuLIve rIsk dIIIerences do LrunsIuLe
InLo vurIuLIons In ubsoIuLe rIsk und LIuL LIe IowesL reIuLIve rIsk wIII
LrunsIuLe InLo un ubsoIuLe rIsk oI Iess LIun ;%. TIese eLInIc-reIuLed
vurIuLIons muy reIIecL dIIIerences In exposures Lo exogenous IucLors oLIer
LIun cIgureLLe smokIng, e.g., geneLIc dIIIerencesJubnormuIILIes, dIeLury
dIIIerences, eLc. L cerLuInIy does clecrl poInL uwuy Irom cIgureLLe
smokIng beIng consIdered us u sIngIe-IucLor, prImury cuuse oI Iung cuncer.
urLIermore, uL sucI Iow IeveIs oI predIcLIve sLrengLI (ubsoIuLe rIsk), IL Is
doubLIuI wIeLIer LIe curcInogenIc properLIes oI Lobucco smoke In ucLIve
smokIng Iuve u cuusuI conLrIbuLIon Lo specIIIc dIseuse uL uII. L musL be
reILeruLed LIuL LIIs evIdence does noL specIIIcuIIy udd unyLIIng Lo cuusuI
urgumenL. L mereIy IndIcuLes LIuL LIere ure other IucLors (e.g., geneLIc,
IormonuI) InvoIved In LIe ueLIoIogy oI Iung cuncer. However, LIIs couId
Iuve been concepLuuIIy deduced In 1q6q, regurdIess oI LIe uvuIIubIIILy oI
Lifestyle Epidemiology
LIIs sorL oI evIdence uL LIe LIme.
AnoLIer LungenL oI InvesLIguLIon sInce 1q6q Ius been u IImILed
number oI expensIve InLervenLIon sLudIes. A mujor probIem In
compurIng LIe poLenLIuI eIIecLs oI smokIng cessuLIon Is LIuL ex-smokers
mIgIL vury In ImporLunL wuys (e.g., curdIovuscuIur sympLoms, socIuI und
personuI cIurucLerIsLIcs) beIore LIey ceused smokIng Irom LIose wIo ure
persIsLenL smokers (e.g., rIedmun eL uI., 1q;q). VoIunLury ex-smokers
seem Lo resembIe nonsmokers ruLIer LIun smokers on u number oI
crILerIu. n uLLempLIng Lo uddress LIIs Issue oI seII seIecLIon uwuy Irom
LIe smokIng IubIL, u number oI rundomIzed conLroIIed InLervenLIon LrIuIs
Iuve been conducLed. n sucI sLudIes persons uL sImIIur IIgI-rIsk Ior
specIIIc dIseuse ure rcndoml ussIgned Lo eILIer un InLervenLIon group or
un us usuuI group. TIose In LIe InLervenLIon group, In conLrusL Lo LIe
usuuI cure group, receIve purLIcuIur uLLenLIon (e.g., counseIIng,
medIcuLIon) Lo reduce rIsk IucLors (e.g., ruLe oI smokIng, IyperLensIon).
BurcI (1q86) Iound no sLuLIsLIcuIIy sIgnIIIcunL dIIIerence In Iung
cuncer morLuIILy beLween usuuI cure smoker`s groups und InLervenLIon
groups by pooIIng duLu Irom LIe WIILeIuII sLudy (Rose eL uI., 1q8z) und
LIe MuILIpIe RIsk ucLor nLervenLIon TrIuI (MRT, 1q8z). MRT
(1qqo), uL 1o.-yeur IoIIow-up, uIso demonsLruLed no sIgnIIIcunL reducLIon
In Iung cuncer ussocIuLed wILI smokIng cessuLIonJreducLIon. TIere Iuve
been more Iurge scuIe InLervenLIons concernIng CHD (e.g., WorId HeuILI
OrgunIzuLIon, 1q86; MRT, 1q8z; NorLI KureIIu ProjecL - Pusku eL uI.,
1q;q; LIe rumIngIum SLudy - e.g., Gordon eL uI., 1q;q).
McCormIck & Skrubunek (1q88) In u revIew oI InLervenLIons Ior
CHD concIuded LIuL LIere wus no sLuLIsLIcuIIy sIgnIIIcunL reducLIon In
CHD morLuIILy ussocIuLed wILI reducLIon In rIsk IucLors, IncIudIng
smokIng. TIey uIso IIgIIIgIL LIe IIndIngs oI no sIgnIIIcunL eIIecLs oI
smokIng Ior CHD, myocurdIuI InIurcLIon, or ungInu pecLorIs, In
rumIngIum women. TIey consIder LIIs IndIrecL evIdence LIuL so-cuIIed
rIsk IucLors Ior CHD ure noL cuusuIIy reIuLed Lo LIe dIseuse. SeILzer (1q8q)
uccounLed Ior personuIILy Lype (Type A) In u reunuIysIs oI rumIngIum
duLu. WIen LIIs IucLor wus IncIuded wILI LIe IucLors oI sysLoIIc bIood
pressure und serum cIoIesLeroI, smokIng wus noL Iound Lo be u sIgnIIIcunL
predIcLor oI CHD or myocurdIuI InIurcLIon In men or oI CHD or ungInu
pecLorIs In women. MRT (1qqo) does IndIcuLe u Iower CHD morLuIILy
Ior LIe InLervenLIon group. However, LIIs Ius been reIuLed Lo IyperLensIon
uL buseIIne ruLIer LIun smokIng cessuLIon. EbruIIm & SmILI (1qq;), In
pooIIng (meLu-unuIysIs) LIe resuILs oI q InLervenLIon LrIuIs (WHO IucLory
sLudy, GoLLenburg sLudy, OsIo sLudy, MRT, InnIsI busInessmen sLudy,
HyperLensIon deLecLIon und IoIIow-up sLudy, JoIns HopkIns IyperLensIon
sLudy, CosL eIIecLIveness oI IIpId IowerIng sLudy, OxcIeck sLudy), uIso
66
66
Rampant Antismoking Signifies Grave Danger
reporL no sLuLIsLIcuIIy sIgnIIIcunL reducLIon In CHD morLuIILy ussocIuLed
wILI InLervenLIon. Seven oI LIese nIne sLudIes IncIuded smokIng
reducLIonJcessuLIon us un InLervenLIon.
L musL be noLed LIuL InLervenLIon sLudIes uIso conLrIbuLe
noLIIng Lo cuusuI urgumenL. OnIy In LIe InsLunce oI ter hih letel
reducLIons (e.g., ter mucI Iower Iung cuncer or CHD IncIdence) Ior LIe
InLervenLIon groups couId u LrIgger urgumenL be susLuIned. SucI u resuIL
wouId be IIgIIy unIIkeIy, c priori, gIven LIe poor predIcLIve sLrengLI oI
cIgureLLe smokIng Ior specIIIc dIseuse. ndeed, resuILs Irom InLervenLIon
sLudIes cILed ubove empIrIcuIIy supporL LIIs poInL. L cun LIereIore be
reusonubIy concIuded LIuL LIere Is no supporL Ior LIe proposILIon LIuL
quILLIng smokIng suves IIves. urLIermore, LIe prucLIce oI InLervenLIon
or uLLempLs uL prevenLIon, In wIuLever Iorm, wIen IL Is bused on Iow-IeveI
predIcLors cun be quILe dungerous In menLuI und socIuI IeuILI Lerms, us
wIII be dIscussed In u IoIIowIng cIupLer concernIng prevenLIve medIcIne
und IeuILI promoLIon.
TIe RoyuI CoIIege oI PIysIcIuns (RCP, 1q;1), In consIderIng u
sLudy by DoII & HIII (1q6q) LIuL compured LIe morLuIILy ruLes Ior BrILIsI
docLors wILI LIe generuI popuIuLIon, concIuded LIuL quILLIng smokIng
Increuses IIIe expecLuncy. However, SeILzer (1q;z), In revIewIng boLI LIe
epIdemIoIogIcuI sLudy und LIe RCP evuIuuLIon, reporLed numerous und
gIurIng InconsIsLencIes. or exumpIe, LIe RCP sLuLed LIuL cIgureLLe
smokIng decIIned by upproxImuLeIy o% , wIIIe LIere wus IILLIe cIunge In
smokIng ruLe Ior LIe generuI popuIuLIon. SeILzer (1q;z) noLes LIuL LIere
wus u sImIIur decIIne In proporLIon oI smokers Ior boLI BrILIsI docLors
und LIe generuI popuIuLIon. By IncIudIng duLu LIuL Iud been omILLed by
LIe RCP ReporL, noL onIy wus LIere no decIIne In LIe morLuIILy ruLe Ior
BrILIsI docLors, buL LIere wus un ucLuuI rIse Ior mosL dIseuses wIIIe LIe
ruLe oI cIgureLLe smokers, IncIudIng BrILIsI docLors, wus IuIIIng.
NoLwILIsLundIng SeILzer`s crILIque LIe RCP (1q;;) sLIII muInLuIned TIuL
LIe ussocIuLIon beLween smokIng und IeurL dIseuse Is IurgeIy one oI cuuse
und eIIecL supporLed by .., und by LIe progressIve IessenIng oI rIsk In
LIose wIo gIve up, purLIcuIurIy us sIown by LIe experIence oI BrILIsI
docLors. (see BurcI, 1q86, p.18)
TIe mosL common cIInIcuI munIIesLuLIon oI CHD Is ungInu
pecLorIs. SeILzer (1qq1), In quesLIonIng LIe Surgeon GeneruI`s (1q8)
IIImsy commenLs on smokIng und ungInu bused on u smuII group oI
sLudIes, presenLed purLIcuIur duLu Irom LIe rumIngIum HeurL SLudy.
TIIs IuLLer sLudy Is consIdered Lo be LIe currenL bencImurk InvesLIguLIon
InLo LIe ussocIuLIon beLween cIgureLLe smokIng und ungInu pecLorIs, und
Ius IoIIow-up Irom 1z-o yeurs. SeILzer (1qq1) IndIcuLes LIuL LIere Is noL
un ubsence oI ussocIuLIon beLween cIgureLLe smokIng und ungInu pecLorIs,
Lifestyle Epidemiology
67
67
Rampant Antismoking Signifies Grave Danger
reporL no sLuLIsLIcuIIy sIgnIIIcunL reducLIon In CHD morLuIILy ussocIuLed
wILI InLervenLIon. Seven oI LIese nIne sLudIes IncIuded smokIng
reducLIonJcessuLIon us un InLervenLIon.
L musL be noLed LIuL InLervenLIon sLudIes uIso conLrIbuLe
noLIIng Lo cuusuI urgumenL. OnIy In LIe InsLunce oI ter hih letel
reducLIons (e.g., ter mucI Iower Iung cuncer or CHD IncIdence) Ior LIe
InLervenLIon groups couId u LrIgger urgumenL be susLuIned. SucI u resuIL
wouId be IIgIIy unIIkeIy, c priori, gIven LIe poor predIcLIve sLrengLI oI
cIgureLLe smokIng Ior specIIIc dIseuse. ndeed, resuILs Irom InLervenLIon
sLudIes cILed ubove empIrIcuIIy supporL LIIs poInL. L cun LIereIore be
reusonubIy concIuded LIuL LIere Is no supporL Ior LIe proposILIon LIuL
quILLIng smokIng suves IIves. urLIermore, LIe prucLIce oI InLervenLIon
or uLLempLs uL prevenLIon, In wIuLever Iorm, wIen IL Is bused on Iow-IeveI
predIcLors cun be quILe dungerous In menLuI und socIuI IeuILI Lerms, us
wIII be dIscussed In u IoIIowIng cIupLer concernIng prevenLIve medIcIne
und IeuILI promoLIon.
TIe RoyuI CoIIege oI PIysIcIuns (RCP, 1q;1), In consIderIng u
sLudy by DoII & HIII (1q6q) LIuL compured LIe morLuIILy ruLes Ior BrILIsI
docLors wILI LIe generuI popuIuLIon, concIuded LIuL quILLIng smokIng
Increuses IIIe expecLuncy. However, SeILzer (1q;z), In revIewIng boLI LIe
epIdemIoIogIcuI sLudy und LIe RCP evuIuuLIon, reporLed numerous und
gIurIng InconsIsLencIes. or exumpIe, LIe RCP sLuLed LIuL cIgureLLe
smokIng decIIned by upproxImuLeIy o% , wIIIe LIere wus IILLIe cIunge In
smokIng ruLe Ior LIe generuI popuIuLIon. SeILzer (1q;z) noLes LIuL LIere
wus u sImIIur decIIne In proporLIon oI smokers Ior boLI BrILIsI docLors
und LIe generuI popuIuLIon. By IncIudIng duLu LIuL Iud been omILLed by
LIe RCP ReporL, noL onIy wus LIere no decIIne In LIe morLuIILy ruLe Ior
BrILIsI docLors, buL LIere wus un ucLuuI rIse Ior mosL dIseuses wIIIe LIe
ruLe oI cIgureLLe smokers, IncIudIng BrILIsI docLors, wus IuIIIng.
NoLwILIsLundIng SeILzer`s crILIque LIe RCP (1q;;) sLIII muInLuIned TIuL
LIe ussocIuLIon beLween smokIng und IeurL dIseuse Is IurgeIy one oI cuuse
und eIIecL supporLed by .., und by LIe progressIve IessenIng oI rIsk In
LIose wIo gIve up, purLIcuIurIy us sIown by LIe experIence oI BrILIsI
docLors. (see BurcI, 1q86, p.18)
TIe mosL common cIInIcuI munIIesLuLIon oI CHD Is ungInu
pecLorIs. SeILzer (1qq1), In quesLIonIng LIe Surgeon GeneruI`s (1q8)
IIImsy commenLs on smokIng und ungInu bused on u smuII group oI
sLudIes, presenLed purLIcuIur duLu Irom LIe rumIngIum HeurL SLudy.
TIIs IuLLer sLudy Is consIdered Lo be LIe currenL bencImurk InvesLIguLIon
InLo LIe ussocIuLIon beLween cIgureLLe smokIng und ungInu pecLorIs, und
Ius IoIIow-up Irom 1z-o yeurs. SeILzer (1qq1) IndIcuLes LIuL LIere Is noL
un ubsence oI ussocIuLIon beLween cIgureLLe smokIng und ungInu pecLorIs,
Lifestyle Epidemiology
68
68
Rampant Antismoking Signifies Grave Danger
buL LIere Is u dIsLIncLIve neguLIve ussocIuLIon Ior LIe IemuIe duLu. TIere Is
u o-qo% Iower ruLe oI uncompIIcuLed ungInu pecLorIs In smokers versus
non-smokers. TIese ruLes decIIne wILI Increused umounLs oI quunLILy
smoked, especIuIIy umongsL Ieuvy smokers. AddILIonuIIy, LIe evIdence
suggesLs u sLuLIsLIcuIIy non-sIgnIIIcunL ussocIuLIon beLween smokIng und
ungInu pecLorIs In rumIngIum men. One wouId noL purLIcuIurIy wunL Lo
muke uII Loo mucI oI LIIs IIndIng. However, LIe crILIcuI poInL Is u
demonsLruLed bIus by IeuILI uuLIorILIes Lo dIscounL or dIsregurd
InIormuLIon LIuL quesLIons LIe orLIodox vIew, und Lo mugnIIy InIormuLIon
LIuL seemIngIy supporLs LIe vIew. As IndIcuLed In un eurIIer
consIderuLIon oI IongevILy, CHD und cerebrovuscuIur morLuIILy uIso
IndIcuLe u pecuIIurILy wILI regurd Lo smokers. TIe reIuLIve rIsk oI boLI Is
IIgIer In smokers uged -6q yeurs LIun 6 yeurs und oIder (see TubIe ).
NoL even u conLorLed muLerIuIIsLJexLernuIIsL dose-response urgumenL
cun uccounL Ior LIIs cIrcumsLunce. However, LIe Ideu oI u convergIng
eIIecL cun be useIuI.
AnoLIer IIne oI reseurcI, In uLLempLIng Lo beLLer deIImIL LIe
group uL IIgI rIsk oI dIseuse, concerns LIe roIe oI personuIILy, un enLIreIy
endogenous IucLor, In dIseuse. TIere Is some reusonubIe evIdence LIuL u
purLIcuIur personuIILy proIIIe, reIerred Lo us Type C personuIILy, muy
Iuve u proneness Lo deveIopmenL oI cuncer generuIIy (e.g., Greer &
WuLson, 1q8; TemosIok, 1q8;). DIIIIcuILy In expressIng purLIcuIurIy
neguLIve emoLIon Is u crILIcuI cIurucLerIsLIc (e.g., Cox & McKuy, 1q8z).
Persky eL uI. (1q8;) Iound LIuL depressIon, us meusured by LIe MInnesoLu
MuILIpIusIc PersonuIILy nvenLory wus sIgnIIIcunLIy IInked Lo cuncer
morLuIILy even uILer uccounLIng Ior possIbIe conIoundIng IucLors sucI us
uge, IumIIy IIsLory und smokIng. RegurdIng CHD, rIedmun & Rosenmun
(1q;q) IdenLIIIed wIuL Is reIerred Lo us LIe Type A personuIILy. Type A
IndIvIduuIs ure ImpuLIenL, IosLIIe, compeLILIve, und ucIIevemenL-orIenLed
(see CIonInger, 1qq6, p.z88). TIe crILIcuI IucLor oI LIe personuIILy LIuL Is
reIevunL Lo Increused rIsk oI CHD Is neguLIve emoLIons sucI us uggressIve
compeLeLIveness. TIe underIyIng LIeory oI personuIILy dIIIerences Is LIuL
psycIoIogIcuIJpsycIo-emoLIonuI sLuLes ure IInked Lo bIoIogIcuI sLuLes.
PurLIcuIur enLrencIed puLLernsJsLyIe oI LIougIL und emoLIon muy
deLrImenLuIIy uIIecL ImmunoIogIcuI IuncLIonIng (e.g., Pennebuker, 1q8q),
und LIereIore uIIecL dIseuse ouLcome.
Very recenLIy, depressIon Ius uIso been IInked Lo CHD:
DepressIon und IsoIuLIon ure us IIkeIy Lo cuuse coronury IeurL dIseuse us
smokIng und Loo mucI IrIed cIIcken. TIe ground-breukIng IIndIngs
uppeur In LIe MedIcuI JournuI oI AusLruIIu Loduy. oneIIness cuused by u
Iuck oI quuIILy conLucL wILI IumIIy und IrIends couId Ieud Lo u IIve-IoId
|RR=.o| Increuse In LIe rIsk oI coronury IeurL dIseuse, LIe revIew Iound.
Lifestyle Epidemiology
'TIougI peopIe Iud LIougIL emoLIonuI or socIuI IucLors were IInked Lo
IeurL dIseuse, now LIere Is suIIIcIenL evIdence Lo nume LIose IucLors us
depressIon, socIuI IsoIuLIon und Iuck oI socIuI supporL,` |ProIessor un
HIckIe| suId. (Hercld,Sun, MurcI 1;, zoo, p.8) TIe concIusIon LIuL
depressIon cuuses CHD muy Indeed be u severe over-InLerpreLuLIon.
However, LIe evIdence does IndIcuLe u possIbIe connecLIon wILI LIe ugIng
process, I.e., eurIy-onseL CHD; IL cun even reIIecL u dumpenIng oI LIe wIII
Lo IIve (I.e., ImmunoIogIcuI repercussIons) due Lo sucI un uIIen conLexL. L
uIso provIdes one more In u Iurge coIIecLIon oI rIsk IucLors Ior CHD.
Eysenck (1q88), In u IILeruLure revIew, IndIcuLed LIuL personuIILy
und psycIosocIuI IucLors sucI us perceIved sLress ure crILIcuI IucLors In LIe
ueLIoIogy oI dIseuse (e.g., Hunson, 1q8;). TIe reseurcI suggesLs
correIuLIon wILI dIseuse (e.g., cuncer, CHD) Is IIgIer wIen psycIosocIuI
IucLors ure uccounLed Ior, LIun Ior sInguIur or muILIpIe exogenous rIsk
IucLors (e.g., cIgureLLe smokIng). urLIermore, LIere uppeurs Lo be u
synergIsLIc eIIecL sucI LIuL purLIcuIur psycIosocIuI IucLors umpIIIy
exogenous IucLors (e.g., cIgureLLe smokIng) LIuL wouId oLIerwIse be Iow
correIuLes oI specIIIc dIseuse. L cun reusonubIy be suId LIuL LIe
InvesLIguLIon oI psycIosocIuI IucLors In dIseuse seems Lo be u promIsIng
dIrecLIon oI enquIry. TIere Is u mounLIng body oI IILeruLure LIuL IndIcuLes
u sLronger correIuLIon wILI dIseuse Ior psycIosocIuI IucLors LIun onl
exogenous pIysIcuI IucLors. However, LIe predIcLIve sLrengLI Is sLIII Loo
Iow, und LIIs puLIwuy oI InvesLIguLIon Is sLIII In ILs InIuncy.
z..: The Dnoin Scc
Eysenck (1q8o) properIy noLed LIuL Even II we were Lo Luke LIe
correIuLIon beLween smokIng und Iung cuncer serIousIy us prooI oI cuusuI
connecLIons, we wouId sLIII Iuve Lo concIude LIuL smokIng wus neILIer u
necessury nor u suIIIcIenL cuuse. RougIIy speukIng, onIy one Ieuvy
smoker In Len dIes oI Iung cuncer; LIus smokIng Is noL u suIIIcIenL cuuse.
One person In Len oI LIose wIo dIe oI Iung cuncer Is u non-smoker; LIus
smokIng Is noL u necessury cuuse. (p. z1) To LIIs cun uIso be udded LIuL
Lobucco-smoke Is neILIer bucLerIuI nor vIruI.
One oI LIe mujor dIIIIcuILIes oI LIose uLLempLIng Lo produce
compeLIng IypoLIeses (e.g., geneLIc, psycIobIoIogIcuI) Ior LIe cuusuLIonIsL
urgumenL (e.g., IsIer, Eysenck, BurcI) Ius been un IncreusIng resIsLunce
Lo uny InIormuLIonJurgumenL LIuL cuIIs InLo quesLIon LIe orIgInuI
epIdemIoIogIcuI vIew on cIgureLLe smokIng. Eysenck (1q8o) commenLed
LIuL errors oI meLIodoIogy, oI urgumenL, und oI concIusIons.. One
wouId Iuve LIougIL, In vIew oI LIese muny deIecLs, LIuL LIe concIusIons
druwn by responsIbIe bodIes, IIke LIe Surgeon GeneruI`s CommILLee or LIe
69
69
Rampant Antismoking Signifies Grave Danger
buL LIere Is u dIsLIncLIve neguLIve ussocIuLIon Ior LIe IemuIe duLu. TIere Is
u o-qo% Iower ruLe oI uncompIIcuLed ungInu pecLorIs In smokers versus
non-smokers. TIese ruLes decIIne wILI Increused umounLs oI quunLILy
smoked, especIuIIy umongsL Ieuvy smokers. AddILIonuIIy, LIe evIdence
suggesLs u sLuLIsLIcuIIy non-sIgnIIIcunL ussocIuLIon beLween smokIng und
ungInu pecLorIs In rumIngIum men. One wouId noL purLIcuIurIy wunL Lo
muke uII Loo mucI oI LIIs IIndIng. However, LIe crILIcuI poInL Is u
demonsLruLed bIus by IeuILI uuLIorILIes Lo dIscounL or dIsregurd
InIormuLIon LIuL quesLIons LIe orLIodox vIew, und Lo mugnIIy InIormuLIon
LIuL seemIngIy supporLs LIe vIew. As IndIcuLed In un eurIIer
consIderuLIon oI IongevILy, CHD und cerebrovuscuIur morLuIILy uIso
IndIcuLe u pecuIIurILy wILI regurd Lo smokers. TIe reIuLIve rIsk oI boLI Is
IIgIer In smokers uged -6q yeurs LIun 6 yeurs und oIder (see TubIe ).
NoL even u conLorLed muLerIuIIsLJexLernuIIsL dose-response urgumenL
cun uccounL Ior LIIs cIrcumsLunce. However, LIe Ideu oI u convergIng
eIIecL cun be useIuI.
AnoLIer IIne oI reseurcI, In uLLempLIng Lo beLLer deIImIL LIe
group uL IIgI rIsk oI dIseuse, concerns LIe roIe oI personuIILy, un enLIreIy
endogenous IucLor, In dIseuse. TIere Is some reusonubIe evIdence LIuL u
purLIcuIur personuIILy proIIIe, reIerred Lo us Type C personuIILy, muy
Iuve u proneness Lo deveIopmenL oI cuncer generuIIy (e.g., Greer &
WuLson, 1q8; TemosIok, 1q8;). DIIIIcuILy In expressIng purLIcuIurIy
neguLIve emoLIon Is u crILIcuI cIurucLerIsLIc (e.g., Cox & McKuy, 1q8z).
Persky eL uI. (1q8;) Iound LIuL depressIon, us meusured by LIe MInnesoLu
MuILIpIusIc PersonuIILy nvenLory wus sIgnIIIcunLIy IInked Lo cuncer
morLuIILy even uILer uccounLIng Ior possIbIe conIoundIng IucLors sucI us
uge, IumIIy IIsLory und smokIng. RegurdIng CHD, rIedmun & Rosenmun
(1q;q) IdenLIIIed wIuL Is reIerred Lo us LIe Type A personuIILy. Type A
IndIvIduuIs ure ImpuLIenL, IosLIIe, compeLILIve, und ucIIevemenL-orIenLed
(see CIonInger, 1qq6, p.z88). TIe crILIcuI IucLor oI LIe personuIILy LIuL Is
reIevunL Lo Increused rIsk oI CHD Is neguLIve emoLIons sucI us uggressIve
compeLeLIveness. TIe underIyIng LIeory oI personuIILy dIIIerences Is LIuL
psycIoIogIcuIJpsycIo-emoLIonuI sLuLes ure IInked Lo bIoIogIcuI sLuLes.
PurLIcuIur enLrencIed puLLernsJsLyIe oI LIougIL und emoLIon muy
deLrImenLuIIy uIIecL ImmunoIogIcuI IuncLIonIng (e.g., Pennebuker, 1q8q),
und LIereIore uIIecL dIseuse ouLcome.
Very recenLIy, depressIon Ius uIso been IInked Lo CHD:
DepressIon und IsoIuLIon ure us IIkeIy Lo cuuse coronury IeurL dIseuse us
smokIng und Loo mucI IrIed cIIcken. TIe ground-breukIng IIndIngs
uppeur In LIe MedIcuI JournuI oI AusLruIIu Loduy. oneIIness cuused by u
Iuck oI quuIILy conLucL wILI IumIIy und IrIends couId Ieud Lo u IIve-IoId
|RR=.o| Increuse In LIe rIsk oI coronury IeurL dIseuse, LIe revIew Iound.
Lifestyle Epidemiology
'TIougI peopIe Iud LIougIL emoLIonuI or socIuI IucLors were IInked Lo
IeurL dIseuse, now LIere Is suIIIcIenL evIdence Lo nume LIose IucLors us
depressIon, socIuI IsoIuLIon und Iuck oI socIuI supporL,` |ProIessor un
HIckIe| suId. (Hercld,Sun, MurcI 1;, zoo, p.8) TIe concIusIon LIuL
depressIon cuuses CHD muy Indeed be u severe over-InLerpreLuLIon.
However, LIe evIdence does IndIcuLe u possIbIe connecLIon wILI LIe ugIng
process, I.e., eurIy-onseL CHD; IL cun even reIIecL u dumpenIng oI LIe wIII
Lo IIve (I.e., ImmunoIogIcuI repercussIons) due Lo sucI un uIIen conLexL. L
uIso provIdes one more In u Iurge coIIecLIon oI rIsk IucLors Ior CHD.
Eysenck (1q88), In u IILeruLure revIew, IndIcuLed LIuL personuIILy
und psycIosocIuI IucLors sucI us perceIved sLress ure crILIcuI IucLors In LIe
ueLIoIogy oI dIseuse (e.g., Hunson, 1q8;). TIe reseurcI suggesLs
correIuLIon wILI dIseuse (e.g., cuncer, CHD) Is IIgIer wIen psycIosocIuI
IucLors ure uccounLed Ior, LIun Ior sInguIur or muILIpIe exogenous rIsk
IucLors (e.g., cIgureLLe smokIng). urLIermore, LIere uppeurs Lo be u
synergIsLIc eIIecL sucI LIuL purLIcuIur psycIosocIuI IucLors umpIIIy
exogenous IucLors (e.g., cIgureLLe smokIng) LIuL wouId oLIerwIse be Iow
correIuLes oI specIIIc dIseuse. L cun reusonubIy be suId LIuL LIe
InvesLIguLIon oI psycIosocIuI IucLors In dIseuse seems Lo be u promIsIng
dIrecLIon oI enquIry. TIere Is u mounLIng body oI IILeruLure LIuL IndIcuLes
u sLronger correIuLIon wILI dIseuse Ior psycIosocIuI IucLors LIun onl
exogenous pIysIcuI IucLors. However, LIe predIcLIve sLrengLI Is sLIII Loo
Iow, und LIIs puLIwuy oI InvesLIguLIon Is sLIII In ILs InIuncy.
z..: The Dnoin Scc
Eysenck (1q8o) properIy noLed LIuL Even II we were Lo Luke LIe
correIuLIon beLween smokIng und Iung cuncer serIousIy us prooI oI cuusuI
connecLIons, we wouId sLIII Iuve Lo concIude LIuL smokIng wus neILIer u
necessury nor u suIIIcIenL cuuse. RougIIy speukIng, onIy one Ieuvy
smoker In Len dIes oI Iung cuncer; LIus smokIng Is noL u suIIIcIenL cuuse.
One person In Len oI LIose wIo dIe oI Iung cuncer Is u non-smoker; LIus
smokIng Is noL u necessury cuuse. (p. z1) To LIIs cun uIso be udded LIuL
Lobucco-smoke Is neILIer bucLerIuI nor vIruI.
One oI LIe mujor dIIIIcuILIes oI LIose uLLempLIng Lo produce
compeLIng IypoLIeses (e.g., geneLIc, psycIobIoIogIcuI) Ior LIe cuusuLIonIsL
urgumenL (e.g., IsIer, Eysenck, BurcI) Ius been un IncreusIng resIsLunce
Lo uny InIormuLIonJurgumenL LIuL cuIIs InLo quesLIon LIe orIgInuI
epIdemIoIogIcuI vIew on cIgureLLe smokIng. Eysenck (1q8o) commenLed
LIuL errors oI meLIodoIogy, oI urgumenL, und oI concIusIons.. One
wouId Iuve LIougIL, In vIew oI LIese muny deIecLs, LIuL LIe concIusIons
druwn by responsIbIe bodIes, IIke LIe Surgeon GeneruI`s CommILLee or LIe
70
70
Rampant Antismoking Signifies Grave Danger
RoyuI CoIIege oI PIysIcIuns, wouId be suILubIy Iow-key und cuuLIous. WIuL
Is so ImpressIve, unIorLunuLeIy, Is LIuL onIy very scunL uLLenLIon Is puId Lo
unomuIIes und crILIcIsms, or Lo uILernuLIve IypoLIeses. RuLIer, very sLrong
concIusIons ure bused on weuk und conLrudIcLory duLu. QuILe generuIIy,
evIdence uppurenLIy IndIcLIng cIgureLLe smokIng Is menLIoned
promInenLIy, wIIIe evIdence IndIcuLIve oI Iuck oI cuusuI connecLIon Is
eILIer noL menLIoned, or dIsmIssed wILIouL dIscussIon or
expIunuLIon. (quoLed In BurcI, 1q86, p.18)
Wynder (1qq;) recoIIecLs some oI LIe eurIy dIIIIcuILIes In
presenLIng LIe cuusuLIonIsL cuse Ior cIgureLLe smokIng und Iung cuncer
In LIe eurIy 1qo`s. He wus one oI LIe IIrsL Lo noLe LIuL LIere seemed Lo be
un ussocIuLIon beLween Iung cuncer und cIgureLLe smokIng wIIIe uL
BeIIevue HospILuI In New York. As Iur us Wynder wus concerned LIe Issue
oI cIgureLLe smokIng cuusIng Iung cuncer wus u seLLIed Issue buck In LIe
1qo`s. TIe busIs Ior LIIs vIew wus duLu LIuL demonsLruLed u IIgI
ussocIuLIon beLween smokIng und Iung cuncer. UnIorLunuLeIy, Wynder,
LogeLIer wILI mosL oI LIe currenL epIdemIoIogy membersIIp, Ius LIe
requIred reIuLIonsIIp buck-Lo-IronL (I.e., IuIIucy oI post hoc expIunuLIon).
L Is LIe erroneous beIIeI LIuL u very IIgI predIcLIve sLrengLI oI u
consequenL Ior un unLecedenL mecns LIuL LIere Is u IIgI predIcLIve
sLrengLI oI LIe sume unLecedenL Ior LIe sume consequenL, I.e., bIurrIng oI
u suIIIcIenL und neur-necessury condILIon.
TIe IdenLIcuI nonsensIcuI reusonIng cun uIso be seen In
sLuLemenLs by LIe US Surgeon GeneruI (1q8z), e.g., ung cuncer Is IurgeIy
u prevenLubIe dIseuse. L Is esLImuLed LIuL 8% oI Iung cuncer morLuIILy
couId Iuve been uvoIded II IndIvIduuIs never Look up smokIng. (quoLed In
BurcI, 1q86, p.18) SucI proposILIons erroneousIy ussume IomogeneILy
oI smoker`s und nonsmoker`s groups upurL Irom LIe IubIL oI smokIng. L Is
correcL LIuL iten Iung cuncer, u IIgI percenLuge Iuppen Lo be smokers
(I.e., upproxImuLIng u necessury condILIon). SucI sLuLemenLs reIy onl on
reIuLIve rIsk dIIIerences beLween groups (smokersJnever-smokers). n
oLIer words, Iung cuncer Is u very good predIcLor oI prIor, consIsLenL
cIgureLLe smokIng. WIuL muny epIdemIoIogIsLs ure noL uwure oI Is LIuL, II
LIere wus compIeLe knowIedge oI LIe unIverse oI correIuLIons, LIere muy
poLenLIuIIy be numerous IucLors LIuL Iuve u 1oo% muppIng wILI Iung
cuncer, once LIe Iung cuncer cuses ure clrecd lnoun. YeL LIese muy uII
Iuve very dIIIerenL degrees oI IuIsIIIubIIILy und LIereIore vuryIng In
predIcLIve sLrengLI.
CuusuI urgumenL Is noL concerned wILI c posteriori, post hoc
(uILer LIe IucL) observuLIons buL wILI predIcLIve (c priori) sLrengLI oI one
IucLor Ior unoLIer. TIuL Iung cuncer Is u very good predIcLor oI cIgureLLe
smokIng Is essenLIuIIy useIess. WIuL Is reuIIy requIred Is, gIven LIuL IL Is
Lifestyle Epidemiology
InILIuIIy not lnoun wIo wIII deveIop Iung cuncer, wIuL Is LIe sLrengLI oI
cIgureLLe smokIng, or uny oLIer IucLor(s), In predIcLIng LIe dIseuse?
CIgureLLe smokIng us u predIcLor oI Iung-cuncer Is ter poor, e.g., IL mIgIL
be under 1o% Ior Ieuvy-smokers In Europe und NorLI AmerIcu uILer
uccounLIng Ior deLecLIon bIus, poLenLIuI errors In LIe compIIuLIon oI
morLuIILy sLuLIsLIcs, und uccounLIng Ior u buseIIne ruLe; und Is Iur Iower Ior
AsIun popuIuLIons. I smokIng Is u poor predIcLor oI Iung cuncer, LIen, II IL
Is u conLrIbuLIng IucLor (LrIgger) uL uII, IL Is deIInILeIy noL the or c crILIcuI
IucLor In Iung cuncer.
ALLempLIng Lo IInd unLecedenL commonuIILIes Ior Iung cuncer
morLuIILy Is noL purLIcuIurIy probIemuLIc. TIIs Is Iow Ideus us Lo cuusuI
underpInnIngs orIgInuLe und deveIop. However, IuvIng IdenLIIIed sucI u
commonuIILy, LIe nexL sLep requIred Is Lo deLermIne wIuL LIe prevuIenceJ
IncIdence oI LIIs unLecedenL Is In LIe generuI popuIuLIon. L Is LIIs sLep
LIuL uIIows un esLImuLIon oI LIe predIcLIve sLrengLI oI LIe unLecedenL Ior
LIe consequenL, I.e., LIe IdenLIIIcuLIon oI unLecedenLs Ior consequenLs
sucI LIuL noL onIy Is LIe unLecedenL common Ior LIe consequenL, buL LIuL
LIe consequenL Is uIso common Ior LIe unLecedenL.
L Is very cIeur LIuL epIdemIoIogy demonsLruLes no grusp LIuL LIIs
Is u crILIcuI uspecL oI LIe epIsLemoIogIcuI gouI oI scIence. TIe ImporLunL
poInL In LIe currenL conLexL Is LIuL Wynder, LogeLIer wILI oLIers, were
uLLerIy convInced very eurIy on, uIbeIL by u IIuwed und IncompeLenL
reusonIng, LIuL LIere wus noLIIng IeIL Lo demonsLruLe - LIe cuse wus
uIreudy cIosed. or exumpIe, reIIecLIng on LIe sILuuLIon In 1q61 Ie noLes
LIuL: TIe seurcI Ior LIe LruLI, LIougIL, Iud Iong been
compIeLed. (Wynder, 1qq;, p.6q1) L Is cerLuInIy worLIwIIIe reILeruLIng
wIuL Wynder, und epIdemIoIogy, undersLund by LIe prIncIpIes oI cuusuI
InIerence. Wynder (1qq;) urgues Iuve uIwuys IeIL LIuL bIoIogIc
pIuusIbIIILy udded u sIgnIIIcunL dImensIon Lo LIe crILerIu Ior cuusuIILy oI
LIe ussocIuLIon oI smokIng und cuncer, I.e., ILs consIsLency, ILs sLrengLI, ILs
specIIIcILy, ILs LemporuI reIuLIon, und ILs coIerence. (p.68q) L sIouId be
obvIous LIuL Wynder Is ucLuuIIy reIerrIng Lo LIe predIcLIve sLrengLI oI Iung
cuncer Ior cIgureLLe smokIng, und not cIgureLLe smokIng Ior Iung cuncer,
I.e., bIurrIng oI neur-necessury und suIIIcIenL condILIons. UnIorLunuLeIy,
wIuLever LIe InILIuI resIsLunce, LIIs nonsense quIckIy spreud In
epIdemIoIogIcuI cIrcIes und Ius guIned In uggressIon ever sInce.
On LIIs very poInL LIuL LIe Issue wus uIreudy seLLIed, IsIer
(quoLed In BurcI, 1q86) wus very precIse und uccuruLe In ussessIng LIe
sILuuLIon In LIe IuLe 1qo`s: My cIuIm, Iowever, Is noL LIuL LIe vurIous
uILernuLIve possIbIIILIes |Lo LIe cuusuI InLerpreLuLIon oI LIe ussocIuLIon
beLween smokIng und Iung cuncer| uII commund InsLunL ussenL, or ure
goIng Lo be demonsLruLed. L Is ruLIer LIuL excessIve conIIdence LIuL LIe
71
71
Rampant Antismoking Signifies Grave Danger
RoyuI CoIIege oI PIysIcIuns, wouId be suILubIy Iow-key und cuuLIous. WIuL
Is so ImpressIve, unIorLunuLeIy, Is LIuL onIy very scunL uLLenLIon Is puId Lo
unomuIIes und crILIcIsms, or Lo uILernuLIve IypoLIeses. RuLIer, very sLrong
concIusIons ure bused on weuk und conLrudIcLory duLu. QuILe generuIIy,
evIdence uppurenLIy IndIcLIng cIgureLLe smokIng Is menLIoned
promInenLIy, wIIIe evIdence IndIcuLIve oI Iuck oI cuusuI connecLIon Is
eILIer noL menLIoned, or dIsmIssed wILIouL dIscussIon or
expIunuLIon. (quoLed In BurcI, 1q86, p.18)
Wynder (1qq;) recoIIecLs some oI LIe eurIy dIIIIcuILIes In
presenLIng LIe cuusuLIonIsL cuse Ior cIgureLLe smokIng und Iung cuncer
In LIe eurIy 1qo`s. He wus one oI LIe IIrsL Lo noLe LIuL LIere seemed Lo be
un ussocIuLIon beLween Iung cuncer und cIgureLLe smokIng wIIIe uL
BeIIevue HospILuI In New York. As Iur us Wynder wus concerned LIe Issue
oI cIgureLLe smokIng cuusIng Iung cuncer wus u seLLIed Issue buck In LIe
1qo`s. TIe busIs Ior LIIs vIew wus duLu LIuL demonsLruLed u IIgI
ussocIuLIon beLween smokIng und Iung cuncer. UnIorLunuLeIy, Wynder,
LogeLIer wILI mosL oI LIe currenL epIdemIoIogy membersIIp, Ius LIe
requIred reIuLIonsIIp buck-Lo-IronL (I.e., IuIIucy oI post hoc expIunuLIon).
L Is LIe erroneous beIIeI LIuL u very IIgI predIcLIve sLrengLI oI u
consequenL Ior un unLecedenL mecns LIuL LIere Is u IIgI predIcLIve
sLrengLI oI LIe sume unLecedenL Ior LIe sume consequenL, I.e., bIurrIng oI
u suIIIcIenL und neur-necessury condILIon.
TIe IdenLIcuI nonsensIcuI reusonIng cun uIso be seen In
sLuLemenLs by LIe US Surgeon GeneruI (1q8z), e.g., ung cuncer Is IurgeIy
u prevenLubIe dIseuse. L Is esLImuLed LIuL 8% oI Iung cuncer morLuIILy
couId Iuve been uvoIded II IndIvIduuIs never Look up smokIng. (quoLed In
BurcI, 1q86, p.18) SucI proposILIons erroneousIy ussume IomogeneILy
oI smoker`s und nonsmoker`s groups upurL Irom LIe IubIL oI smokIng. L Is
correcL LIuL iten Iung cuncer, u IIgI percenLuge Iuppen Lo be smokers
(I.e., upproxImuLIng u necessury condILIon). SucI sLuLemenLs reIy onl on
reIuLIve rIsk dIIIerences beLween groups (smokersJnever-smokers). n
oLIer words, Iung cuncer Is u very good predIcLor oI prIor, consIsLenL
cIgureLLe smokIng. WIuL muny epIdemIoIogIsLs ure noL uwure oI Is LIuL, II
LIere wus compIeLe knowIedge oI LIe unIverse oI correIuLIons, LIere muy
poLenLIuIIy be numerous IucLors LIuL Iuve u 1oo% muppIng wILI Iung
cuncer, once LIe Iung cuncer cuses ure clrecd lnoun. YeL LIese muy uII
Iuve very dIIIerenL degrees oI IuIsIIIubIIILy und LIereIore vuryIng In
predIcLIve sLrengLI.
CuusuI urgumenL Is noL concerned wILI c posteriori, post hoc
(uILer LIe IucL) observuLIons buL wILI predIcLIve (c priori) sLrengLI oI one
IucLor Ior unoLIer. TIuL Iung cuncer Is u very good predIcLor oI cIgureLLe
smokIng Is essenLIuIIy useIess. WIuL Is reuIIy requIred Is, gIven LIuL IL Is
Lifestyle Epidemiology
InILIuIIy not lnoun wIo wIII deveIop Iung cuncer, wIuL Is LIe sLrengLI oI
cIgureLLe smokIng, or uny oLIer IucLor(s), In predIcLIng LIe dIseuse?
CIgureLLe smokIng us u predIcLor oI Iung-cuncer Is ter poor, e.g., IL mIgIL
be under 1o% Ior Ieuvy-smokers In Europe und NorLI AmerIcu uILer
uccounLIng Ior deLecLIon bIus, poLenLIuI errors In LIe compIIuLIon oI
morLuIILy sLuLIsLIcs, und uccounLIng Ior u buseIIne ruLe; und Is Iur Iower Ior
AsIun popuIuLIons. I smokIng Is u poor predIcLor oI Iung cuncer, LIen, II IL
Is u conLrIbuLIng IucLor (LrIgger) uL uII, IL Is deIInILeIy noL the or c crILIcuI
IucLor In Iung cuncer.
ALLempLIng Lo IInd unLecedenL commonuIILIes Ior Iung cuncer
morLuIILy Is noL purLIcuIurIy probIemuLIc. TIIs Is Iow Ideus us Lo cuusuI
underpInnIngs orIgInuLe und deveIop. However, IuvIng IdenLIIIed sucI u
commonuIILy, LIe nexL sLep requIred Is Lo deLermIne wIuL LIe prevuIenceJ
IncIdence oI LIIs unLecedenL Is In LIe generuI popuIuLIon. L Is LIIs sLep
LIuL uIIows un esLImuLIon oI LIe predIcLIve sLrengLI oI LIe unLecedenL Ior
LIe consequenL, I.e., LIe IdenLIIIcuLIon oI unLecedenLs Ior consequenLs
sucI LIuL noL onIy Is LIe unLecedenL common Ior LIe consequenL, buL LIuL
LIe consequenL Is uIso common Ior LIe unLecedenL.
L Is very cIeur LIuL epIdemIoIogy demonsLruLes no grusp LIuL LIIs
Is u crILIcuI uspecL oI LIe epIsLemoIogIcuI gouI oI scIence. TIe ImporLunL
poInL In LIe currenL conLexL Is LIuL Wynder, LogeLIer wILI oLIers, were
uLLerIy convInced very eurIy on, uIbeIL by u IIuwed und IncompeLenL
reusonIng, LIuL LIere wus noLIIng IeIL Lo demonsLruLe - LIe cuse wus
uIreudy cIosed. or exumpIe, reIIecLIng on LIe sILuuLIon In 1q61 Ie noLes
LIuL: TIe seurcI Ior LIe LruLI, LIougIL, Iud Iong been
compIeLed. (Wynder, 1qq;, p.6q1) L Is cerLuInIy worLIwIIIe reILeruLIng
wIuL Wynder, und epIdemIoIogy, undersLund by LIe prIncIpIes oI cuusuI
InIerence. Wynder (1qq;) urgues Iuve uIwuys IeIL LIuL bIoIogIc
pIuusIbIIILy udded u sIgnIIIcunL dImensIon Lo LIe crILerIu Ior cuusuIILy oI
LIe ussocIuLIon oI smokIng und cuncer, I.e., ILs consIsLency, ILs sLrengLI, ILs
specIIIcILy, ILs LemporuI reIuLIon, und ILs coIerence. (p.68q) L sIouId be
obvIous LIuL Wynder Is ucLuuIIy reIerrIng Lo LIe predIcLIve sLrengLI oI Iung
cuncer Ior cIgureLLe smokIng, und not cIgureLLe smokIng Ior Iung cuncer,
I.e., bIurrIng oI neur-necessury und suIIIcIenL condILIons. UnIorLunuLeIy,
wIuLever LIe InILIuI resIsLunce, LIIs nonsense quIckIy spreud In
epIdemIoIogIcuI cIrcIes und Ius guIned In uggressIon ever sInce.
On LIIs very poInL LIuL LIe Issue wus uIreudy seLLIed, IsIer
(quoLed In BurcI, 1q86) wus very precIse und uccuruLe In ussessIng LIe
sILuuLIon In LIe IuLe 1qo`s: My cIuIm, Iowever, Is noL LIuL LIe vurIous
uILernuLIve possIbIIILIes |Lo LIe cuusuI InLerpreLuLIon oI LIe ussocIuLIon
beLween smokIng und Iung cuncer| uII commund InsLunL ussenL, or ure
goIng Lo be demonsLruLed. L Is ruLIer LIuL excessIve conIIdence LIuL LIe
72
72
Rampant Antismoking Signifies Grave Danger
soIuLIon Ius uIreudy been Iound Is LIe muIn obsLucIe In LIe wuy oI sucI
more peneLruLIng reseurcI us mIgIL eIImInuLe some oI LIem....SLuLIsLIcs
Ius guIned u pIuce oI modesL useIuIness In medIcuI reseurcI. L cun
deserve und reLuIn LIIs onIy by compIeLe ImpurLIuIILy, wIIcI Is noL
unuLLuInubIe by ruLIonuI mInds... do noL reIIsI LIe prospecL oI LIIs
scIence beIng now dIscredILed by u cuLusLropIIc und conspIcuous IowIer.
or IL wIII be us cIeur In reLrospecL, us IL Is now In IogIc, LIuL LIe duLu so Iur
do noL wurrunL LIe concIusIons bused upon LIem. YeL, Iowever
InsIgILIuI, even IsIer muy noL Iuve ImugIned jusL Iow mucI worse LIe
sILuuLIon wouId become.
L wouId Iuve been expecLed uILer neurIy IorLy yeurs oI some
counLer IypoLIeses und crILIque LIuL IL wouId be noLed by LIe medIcuI und
IeuILI uuLIorILIes LIuL LIe ueLIoIogy oI dIseuse sucI us cuncer und CHD
muy be uLLrIbuLubIe Lo u Iur, Iur greuLer exLenL Lo endogenous IucLors (e.g.,
geneLIc ubnormuIILy) LIun LIe dIrecL cuusuI properLIes oI exogenous
IucLors. One wouId Iuve expecLed u revIewJcorrecLIon oI cIuIms
concernIng cIgureLLe smokIng In purLIcuIur. However, und exLruordInurIIy
so, LIe converse Is Lrue. TIe sILuuLIon cun be summed up by LIe IoIIowIng.
BurcI (1q8), In revIewIng LIe Surgeon GeneruI`s epIdemIoIogIc
crILerIu Ior cuusuIILy (SG ReporL, 1q6q; SG ReporL, 1q8z), concIuded LIuL
LIe enLIre ussocIuLIon beLween cIgureLLe smokIng und Iung cuncer - uL
IeusL In muIe CuucusoId popuIuLIons - Is unIIkeIy Lo be expIuIned by
cuusuLIon. (p. 8z1) n evuIuuLIng crILerIu Ior cuusuI InIerence, e.g.,
consIsLency, sLrengLI, specIIIcILy, BurcI properIy urgues LIuL
LIe crILerIu ure noL gIven udequuLe deIInILIon buL unIess
LIey ure so Iux us Lo be meunIngIess we cun onIy
concIude LIuL, In LIe conLexL oI Iung cuncer: (u)
reporLed ussocIuLIons ure InconsIsLenL; (b) LIe reporLed
sLrengLI oI ussocIuLIon runges wIdeIy; (c) LIe
ussocIuLIon Ius no specIIIcILy; (d) LIe LemporuI
reIuLIonsIIp sIows muny unomuIIes; und (e) becuuse oI
(u) Lo (d) LogeLIer wILI evIdence reIuLIng, Ior exumpIe,
Lo InIuIuLIon und Lo conLrudIcLIons beLween
experImenLuI und epIdemIoIogIc IIndIngs, LIe
ussocIuLIon Iucks coIerence. Becuuse noL even one
crILerIon Is IndIspuLubIy suLIsIIed, IL IoIIows LIuL LIe
ReporL, on ILs own Lerms, sIouId Iuve rejecLed LIe
cuusuI InLerpreLuLIon oI LIe ussocIuLIon beLween
smokIng und Iung cuncer. L cIuIms, Iowever, LIuL 8%
oI deuLIs Irom Iung cuncer ure due Lo smokIng. How
does IL do LIIs? n BrownIee`s words, wIIcI beur
repeLILIon: 'LIe wuy IL cIuIms LIe IucLs ure In conIormILy
Lifestyle Epidemiology
wILI LIe crILerIon Is Lo IIuLIy Ignore LIe IucLs.` TIIs
commenL wus mude In 1q6 wILI reIerence Lo (c), LIe
specIIIcILy crILerIon, buL In 1q8z LIe crILIcIsm remuIns
uppIIcubIe noL onIy Lo LIuL buL Lo uII IIve crILerIu. (p.
8-q)
BurcI`s (1q8) cIuIms ure quILe reusonubIe. However, Ie does
noL provIde u proper deIInILIon oI LIe crILerIu Ior cuusuI InIerence, buL
sImpIy IndIcuLes LIuL LIe SG`s concIusIons conLrudIcL LIe SG`s deIInILIon oI
LIese crILerIu.
TIe Impusse LIuL exIsLs In evuIuuLIons oI epIdemIoIogIc
concIusIons concernIng LIe roIe oI cIgureLLe smokIng In dIseuse,
purLIcuIurIy Iung cuncer, Is demonsLruLed by IIIenIeId`s (1q8) crILIque oI
BurcI`s (1q8) oIIerIng. IIIenIeId (1q8) consIders LIuL BurcI`s urgumenL
Is noL vIubIe uL uII. IIIenIeId conLends LIuL, Indeed, LIe IdeuI cuse Is wIere
LIere Is u 1:1 correspondence beLween cIgureLLe smokIng und specIIIc
dIseuse (e.g., Iung cuncer). However, IIIenIeId posILs LIuL wIere LIe
ussocIuLIon beLween un unLecedenL und u consequenL Is Iur Iower LIun u
1:1 correspondence (In LIe cuse oI Iung cuncer IL Is -1o% Ior CuucusoId
popuIuLIons), oLIer evIdence cun boIsLer u cuusuI urgumenL, e.g., cuncer
cun be reIuLed Lo smokIng becuuse Lobucco smoke conLuIns curcInogens.
TIIs Is ucLuuIIy u very weuk urgumenL, purLIcuIurIy In LIuL IL Lukes no
uccounL oI muny oLIer rIsk IucLors und LIe very-Iow predIcLIve sLrengLI oI
smokIng Ior Iung cuncer. TIe severe probIem Iere Is LIuL oLIer
evIdence, wIIcI Is usuuIIy very IndIrecL (e.g., unImuI sLudIes), und
essenLIuIIy InvoIves onIy LIe crILerIon oI coIerenceJpIuusIbIIILy, becomes
suIIIcIenL Lo overrIde LIe crILIcuI crILerIon oI predIcLIve sLrengLI.
urLIermore, In LIe currenL dIscussIon LIere Ius noL been LIe
requIremenL oI u 1:1 correspondence beLween un unLecedenL und u
consequenL us u jusLIIIcuLIon Ior dIrecL cuusuI urgumenL; LIe udopLed
Iower LIresIoId Ius been 6o%. TIe sLrengLI oI ussocIuLIon beLween
smokIng und numerous dIseuses LIuL epIdemIoIogy consIders Lo be
cuused by smokIng Is noL even remoLeIy wILIIn LIe vIcInILy oI LIIs Iower
LIresIoId - mosL ure neur zero. And, LIIs Is noL consIderIng LIuL, upurL
Irom Iung cuncer, smokers und nonsmokers ure compurubIe In specIIIc-
cuuse morLuIILy, I.e., LIere Is onIy un eurIIer morLuIILy urgumenL InvoIved
und noL u specIIIc-cuuse morLuIILy urgumenL. TIe unIorLunuLe
consequence Is LIuL u IucLor Is LIen reIerred Lo In Lerms LypIcuI oI u
sujjicient condition, e.g., 8% oI Iung cuncer deuLIs Is uLLrIbuLubIe Lo
smokIng, wIen LIe ussocIuLIon beLween LIe Lwo Is on LIe zero-end oI LIe
condILIonuI probubIIILy scuIe.
IIIenIeId (1q8) expIuIns LIuL sucI sLuLemenLs reIIecL u
73
73
Rampant Antismoking Signifies Grave Danger
soIuLIon Ius uIreudy been Iound Is LIe muIn obsLucIe In LIe wuy oI sucI
more peneLruLIng reseurcI us mIgIL eIImInuLe some oI LIem....SLuLIsLIcs
Ius guIned u pIuce oI modesL useIuIness In medIcuI reseurcI. L cun
deserve und reLuIn LIIs onIy by compIeLe ImpurLIuIILy, wIIcI Is noL
unuLLuInubIe by ruLIonuI mInds... do noL reIIsI LIe prospecL oI LIIs
scIence beIng now dIscredILed by u cuLusLropIIc und conspIcuous IowIer.
or IL wIII be us cIeur In reLrospecL, us IL Is now In IogIc, LIuL LIe duLu so Iur
do noL wurrunL LIe concIusIons bused upon LIem. YeL, Iowever
InsIgILIuI, even IsIer muy noL Iuve ImugIned jusL Iow mucI worse LIe
sILuuLIon wouId become.
L wouId Iuve been expecLed uILer neurIy IorLy yeurs oI some
counLer IypoLIeses und crILIque LIuL IL wouId be noLed by LIe medIcuI und
IeuILI uuLIorILIes LIuL LIe ueLIoIogy oI dIseuse sucI us cuncer und CHD
muy be uLLrIbuLubIe Lo u Iur, Iur greuLer exLenL Lo endogenous IucLors (e.g.,
geneLIc ubnormuIILy) LIun LIe dIrecL cuusuI properLIes oI exogenous
IucLors. One wouId Iuve expecLed u revIewJcorrecLIon oI cIuIms
concernIng cIgureLLe smokIng In purLIcuIur. However, und exLruordInurIIy
so, LIe converse Is Lrue. TIe sILuuLIon cun be summed up by LIe IoIIowIng.
BurcI (1q8), In revIewIng LIe Surgeon GeneruI`s epIdemIoIogIc
crILerIu Ior cuusuIILy (SG ReporL, 1q6q; SG ReporL, 1q8z), concIuded LIuL
LIe enLIre ussocIuLIon beLween cIgureLLe smokIng und Iung cuncer - uL
IeusL In muIe CuucusoId popuIuLIons - Is unIIkeIy Lo be expIuIned by
cuusuLIon. (p. 8z1) n evuIuuLIng crILerIu Ior cuusuI InIerence, e.g.,
consIsLency, sLrengLI, specIIIcILy, BurcI properIy urgues LIuL
LIe crILerIu ure noL gIven udequuLe deIInILIon buL unIess
LIey ure so Iux us Lo be meunIngIess we cun onIy
concIude LIuL, In LIe conLexL oI Iung cuncer: (u)
reporLed ussocIuLIons ure InconsIsLenL; (b) LIe reporLed
sLrengLI oI ussocIuLIon runges wIdeIy; (c) LIe
ussocIuLIon Ius no specIIIcILy; (d) LIe LemporuI
reIuLIonsIIp sIows muny unomuIIes; und (e) becuuse oI
(u) Lo (d) LogeLIer wILI evIdence reIuLIng, Ior exumpIe,
Lo InIuIuLIon und Lo conLrudIcLIons beLween
experImenLuI und epIdemIoIogIc IIndIngs, LIe
ussocIuLIon Iucks coIerence. Becuuse noL even one
crILerIon Is IndIspuLubIy suLIsIIed, IL IoIIows LIuL LIe
ReporL, on ILs own Lerms, sIouId Iuve rejecLed LIe
cuusuI InLerpreLuLIon oI LIe ussocIuLIon beLween
smokIng und Iung cuncer. L cIuIms, Iowever, LIuL 8%
oI deuLIs Irom Iung cuncer ure due Lo smokIng. How
does IL do LIIs? n BrownIee`s words, wIIcI beur
repeLILIon: 'LIe wuy IL cIuIms LIe IucLs ure In conIormILy
Lifestyle Epidemiology
wILI LIe crILerIon Is Lo IIuLIy Ignore LIe IucLs.` TIIs
commenL wus mude In 1q6 wILI reIerence Lo (c), LIe
specIIIcILy crILerIon, buL In 1q8z LIe crILIcIsm remuIns
uppIIcubIe noL onIy Lo LIuL buL Lo uII IIve crILerIu. (p.
8-q)
BurcI`s (1q8) cIuIms ure quILe reusonubIe. However, Ie does
noL provIde u proper deIInILIon oI LIe crILerIu Ior cuusuI InIerence, buL
sImpIy IndIcuLes LIuL LIe SG`s concIusIons conLrudIcL LIe SG`s deIInILIon oI
LIese crILerIu.
TIe Impusse LIuL exIsLs In evuIuuLIons oI epIdemIoIogIc
concIusIons concernIng LIe roIe oI cIgureLLe smokIng In dIseuse,
purLIcuIurIy Iung cuncer, Is demonsLruLed by IIIenIeId`s (1q8) crILIque oI
BurcI`s (1q8) oIIerIng. IIIenIeId (1q8) consIders LIuL BurcI`s urgumenL
Is noL vIubIe uL uII. IIIenIeId conLends LIuL, Indeed, LIe IdeuI cuse Is wIere
LIere Is u 1:1 correspondence beLween cIgureLLe smokIng und specIIIc
dIseuse (e.g., Iung cuncer). However, IIIenIeId posILs LIuL wIere LIe
ussocIuLIon beLween un unLecedenL und u consequenL Is Iur Iower LIun u
1:1 correspondence (In LIe cuse oI Iung cuncer IL Is -1o% Ior CuucusoId
popuIuLIons), oLIer evIdence cun boIsLer u cuusuI urgumenL, e.g., cuncer
cun be reIuLed Lo smokIng becuuse Lobucco smoke conLuIns curcInogens.
TIIs Is ucLuuIIy u very weuk urgumenL, purLIcuIurIy In LIuL IL Lukes no
uccounL oI muny oLIer rIsk IucLors und LIe very-Iow predIcLIve sLrengLI oI
smokIng Ior Iung cuncer. TIe severe probIem Iere Is LIuL oLIer
evIdence, wIIcI Is usuuIIy very IndIrecL (e.g., unImuI sLudIes), und
essenLIuIIy InvoIves onIy LIe crILerIon oI coIerenceJpIuusIbIIILy, becomes
suIIIcIenL Lo overrIde LIe crILIcuI crILerIon oI predIcLIve sLrengLI.
urLIermore, In LIe currenL dIscussIon LIere Ius noL been LIe
requIremenL oI u 1:1 correspondence beLween un unLecedenL und u
consequenL us u jusLIIIcuLIon Ior dIrecL cuusuI urgumenL; LIe udopLed
Iower LIresIoId Ius been 6o%. TIe sLrengLI oI ussocIuLIon beLween
smokIng und numerous dIseuses LIuL epIdemIoIogy consIders Lo be
cuused by smokIng Is noL even remoLeIy wILIIn LIe vIcInILy oI LIIs Iower
LIresIoId - mosL ure neur zero. And, LIIs Is noL consIderIng LIuL, upurL
Irom Iung cuncer, smokers und nonsmokers ure compurubIe In specIIIc-
cuuse morLuIILy, I.e., LIere Is onIy un eurIIer morLuIILy urgumenL InvoIved
und noL u specIIIc-cuuse morLuIILy urgumenL. TIe unIorLunuLe
consequence Is LIuL u IucLor Is LIen reIerred Lo In Lerms LypIcuI oI u
sujjicient condition, e.g., 8% oI Iung cuncer deuLIs Is uLLrIbuLubIe Lo
smokIng, wIen LIe ussocIuLIon beLween LIe Lwo Is on LIe zero-end oI LIe
condILIonuI probubIIILy scuIe.
IIIenIeId (1q8) expIuIns LIuL sucI sLuLemenLs reIIecL u
74
74
Rampant Antismoking Signifies Grave Danger
sLuLIsLIcuI procedure, I.e., uLLrIbuLubIe rIsk (see uIso Eysenck, 1qq;
RoLImun, 1q86; WuIker, 1q81: Wynder, 1q8z). n sImpIe Lerms,
uLLrIbuLubIe rIsk Is deIIned us (RR-1)JRR. L Is correcL LIuL LIe concepL oI
uLLrIbuLubIe rIsk Is u stctisticcl one, I.e., LIe sLuLIsLIc does noL
demonsLruLe cuusuLIon buL ussumes IL. However, IIIenIeId`s proposILIon
Is uIurmIngIy nuve In LIuL LIe use oI sucI sLuLemenLs us 8% oI Iung
cuncer deuLIs Is uLLrIbuLubIe Lo smokIng by boLI epIdemIoIogy und
prevenLIve medIcIne does noL IIgIIIgIL LIe sLuLIsLIcuI nuLure oI LIe
sLuLemenL buL goes Lo greuL IengLIs Lo ensure LIuL dIrecL cuusuLIon Is boLI
ImpIIed und perceIved so by LIe pubIIc. ReIerrIng buck Lo secLIon 1.z, IL
wus noLed LIuL very IIgI predIcLIve sLrengLI, In LIe ubsence oI
demonsLruLed mecIunIsmsJprocesses (coIerence), cun be un udequuLe
busIs Ior cuusuI urgumenL. However, pIuusIbIIILy bused on oLIer
evIdence (e.g., unuIogy) wIen LIere Is very poor predIcLIve sLrengLI Is
wIId specuIuLIon uL besL und IoIIy (IuIIy-IIedged supersLILIon) uL worsL.
AguIn, wIuL Is occurrIng Is LIuL u combInuLIon oI sLrong muLerIuIIsm und
scIenLIIIc IncompeLence Ius Lurned LIIs requIremenL upsIde-down, I.e.,
pIuusIbIIILy (usuuIIy on LIe busIs oI IncoIerenL unuIogy) ruLIer LIun
predIcLIve sLrengLI now drIves cuusuI urgumenL.
TIe sILuuLIon Is IurLIer exucerbuLed by LIe cIuIm LIuL purLIcuIur
IeveIs oI evIdence ure LIen suIIIcIenL Lo wurrunL prevenLIve pubIIc IeuILI
meusures. UnIorLunuLeIy, wIuL consLILuLes LIIs IeveI oI evIdence Is uIso u
gruy, subjecLIve und IIgIIy quesLIonubIe ureu, und, wIuLever LIIs IeveI
muy be Lo IIIesLyIe epIdemIoIogy, IL Is cerLuInIy wuy sIorL oI LIe 6o%
LIresIoId requIremenL Ior dIrecL cuusuI urgumenL. I LIere Is poor
predIcLIve sLrengLI oI u IucLor und u Iuck oI deIIneuLIon oI mecIunIsmsJ
processes InvoIved In u specIIIc dIseuse, LIen LIIs reIIecLs u lccl oI
undersLundIng oI dIseuse ueLIoIogy. To LIen reIer Lo u IucLor us II IL Is u
suIIIcIenL condILIon under LIIs cIrcumsLunce, e.g., smokIng cuuses Iung
cuncer, und LIereIore IosLer LIe mIspercepLIon LIuL LIere Is greuL
undersLundIng concernIng LIe ueLIoIogy oI u specIIIc dIseuse, Ius no
coIerenL busIs wIuLsoever. L Is IruuduIenL, deIInquenL, und negIIgenL.
nLeresLIngIy, IIIenIeId uccuses BurcI oI IuvIng IncompIeLeIy presenLed
LIe IIndIngs oI severuI sLudIes or Ius omILLed dIscussIng oLIers more IuIIy.
TIIs Is, needIess Lo suy, mosL dIsLurbIng. (p. 8q) TIIs sorL oI crILIcIsm Is
usuuIIy, und Ior jcr beLLer reusons, dIrecLed uL LIe IusLy generuIIzuLIons
mude by IeuILI uuLIorILIes, IncIudIng IIIenIeId`s LIesIs.
TIe ubove sILuuLIon cun be cIurucLerIzed us cuusuLIonIsLs und
consLILuLIonIsLs operuLIng uL cross-purposes. As Iur us LIe cuusuLIonIsLs
ure concerned, LIe muLLer is seLLIed. UsIng LIe unuIogy oI cuncer InducLIon
In unImuIs (e.g., on skIn) demonsLruLes LIuL Lobucco smoke conLuIns
curcInogens. To u cuusuLIonIsL LIIs evIdence Is suIIIcIenL Lo expIuIn uII
Lifestyle Epidemiology
munner oI dIseuse In smokers, regurdIess oI predIcLIve sLrengLI und
deIInedJdeIInubIe mecIunIsmsJprocesses. TIe muLerIuIIsL menLuIILy
cunnoL compreIend LIuL LIe IubIL oI smokIng InvoIves Iur more
dImensIons (e.g., psycIoIogIcuI, socIuI) LIuL mukes IL ter dijjerent Lo
sImpIy puInLIng Lur on LIe skIn oI mIce LIuL Induces skIn cuncer In u smuII
proporLIon oI LIem. urLIermore, IL cunnoL compreIend LIuL IL Is
vIoIuLIng every prIncIpIe oI cuusuI InIerence In so doIng.
or uII InLenLs und purposes, cuusuLIonIsLs cunnoL undersLund
wIuL reseurcIers sucI us BurcI und Eysenck, Ior exumpIe, IInd
probIemuLIc wILI LIe orLIodox posILIon. TIe crILIcuI probIem Is LIuL
consLILuLIonIsL reseurcIers Iuve been onIy reucLIve Lo LIe IusLy
generuIIzuLIons LIuL evenLuuIIy come LIrougI IeuILI uuLIorILIes
(prevenLIve medIcIne) sucI us smokIng cuuses Iung cuncer. or exumpIe,
ArmILuge (1q;8), In respondIng Lo BurcI`s (1q;8) quesLIonIng oI LIe
cuusuLIonIsL vIew oI smokIngJIung cuncer, remurks LIuL wus surprIsed
LIuL ProIessor BurcI puLs Iorwurd Ior consIderuLIon u 'pure cuusuI LIeory`
udmILLIng oI no geneLIc InIIuence on LIe IncIdence oI LIe dIseuse. He IInds
LIe evIdence uguInsL LIIs Lo be compeIIIng, buL um noL cIeur LIuL unyone
udvocuLes sucI un exLreme vIew. (p. qq) ArmILuge (1q;8), umongsL
muny oLIers, Is noL uwure LIuL IIuwed und mIsrepresenLuLIonuI sLuLemenLs
sucI us smokIng cuuses Iung cuncer does represenL sucI un exLreme und
erroneous vIew.
TIese IusLy generuIIzuLIons LIuL Invoke LIe Lerm cuuse uL every
Lurn ImpIy un undersLundIng oI dIseuse LIuL Is eILIer noL demonsLruLed or,
more usuuIIy, conLrudIcLs uvuIIubIe evIdence. UnIorLunuLeIy,
consLILuLIonIsLs Iuve noL been successIuI uL clecrl urLIcuIuLIng LIe proper
uppIIcuLIon oI cll LIe crILerIu oI cuusuI InIerence. or exumpIe, BurcI
(1q8) suggesLs LIuL II LIe crILerIon oI specIIIcILy Is conLInuuIIy
mIsInLerpreLed by LIe Surgeon GeneruI, LIen LIe crILerIon sIouId be
dIspensed wILI uILogeLIer. SucI suggesLIons cerLuInIy do noL IeIp wILI u
cIurIIIcuLIon oI u IIgIIy conIused sILuuLIon.
urLIermore, consLILuLIonIsLs, Loo, Iuve been obIIvIous Lo LIe
crILIcuI Ideu oI cIgureLLe smokIng us u convergence pIenomenon Ior some.
TIey, Loo, LypIcuIIy ussume IomogeneILy oI groups, purLIcuIurIy LIe
nonsmoker`s group. n muny InsLunces consLILuLIonIsLs Iuve uLLempLed Lo
urgue Ior u quesLIonubIe joint ejject, e.g., LIuL boLI Iung cuncer und
smokIng Iuve u common cuuse. ConsLILuLIonIsLs Iuve uLLempLed Lo
uccounL Ior endogenous IucLors buL sLIII essenLIuIIy wILIIn u muLerIuIIsLJ
deLermInIsLIc Irumework. TIe Ideu LIuL LIere ure reusons, us opposed Lo
cuuses, Ior smokIng Is uIIen Lo LIe muLerIuIIsL menLuIILy. urLIermore,
consLILuLIonIsLs Iuve uIso IuIIed Lo recognIze LIuL smokIng cun conLrIbuLe,
wILI oLIer IucLors, Lo u weukenIng oI Iung IuncLIon und resuILIng In u
75
75
Rampant Antismoking Signifies Grave Danger
sLuLIsLIcuI procedure, I.e., uLLrIbuLubIe rIsk (see uIso Eysenck, 1qq;
RoLImun, 1q86; WuIker, 1q81: Wynder, 1q8z). n sImpIe Lerms,
uLLrIbuLubIe rIsk Is deIIned us (RR-1)JRR. L Is correcL LIuL LIe concepL oI
uLLrIbuLubIe rIsk Is u stctisticcl one, I.e., LIe sLuLIsLIc does noL
demonsLruLe cuusuLIon buL ussumes IL. However, IIIenIeId`s proposILIon
Is uIurmIngIy nuve In LIuL LIe use oI sucI sLuLemenLs us 8% oI Iung
cuncer deuLIs Is uLLrIbuLubIe Lo smokIng by boLI epIdemIoIogy und
prevenLIve medIcIne does noL IIgIIIgIL LIe sLuLIsLIcuI nuLure oI LIe
sLuLemenL buL goes Lo greuL IengLIs Lo ensure LIuL dIrecL cuusuLIon Is boLI
ImpIIed und perceIved so by LIe pubIIc. ReIerrIng buck Lo secLIon 1.z, IL
wus noLed LIuL very IIgI predIcLIve sLrengLI, In LIe ubsence oI
demonsLruLed mecIunIsmsJprocesses (coIerence), cun be un udequuLe
busIs Ior cuusuI urgumenL. However, pIuusIbIIILy bused on oLIer
evIdence (e.g., unuIogy) wIen LIere Is very poor predIcLIve sLrengLI Is
wIId specuIuLIon uL besL und IoIIy (IuIIy-IIedged supersLILIon) uL worsL.
AguIn, wIuL Is occurrIng Is LIuL u combInuLIon oI sLrong muLerIuIIsm und
scIenLIIIc IncompeLence Ius Lurned LIIs requIremenL upsIde-down, I.e.,
pIuusIbIIILy (usuuIIy on LIe busIs oI IncoIerenL unuIogy) ruLIer LIun
predIcLIve sLrengLI now drIves cuusuI urgumenL.
TIe sILuuLIon Is IurLIer exucerbuLed by LIe cIuIm LIuL purLIcuIur
IeveIs oI evIdence ure LIen suIIIcIenL Lo wurrunL prevenLIve pubIIc IeuILI
meusures. UnIorLunuLeIy, wIuL consLILuLes LIIs IeveI oI evIdence Is uIso u
gruy, subjecLIve und IIgIIy quesLIonubIe ureu, und, wIuLever LIIs IeveI
muy be Lo IIIesLyIe epIdemIoIogy, IL Is cerLuInIy wuy sIorL oI LIe 6o%
LIresIoId requIremenL Ior dIrecL cuusuI urgumenL. I LIere Is poor
predIcLIve sLrengLI oI u IucLor und u Iuck oI deIIneuLIon oI mecIunIsmsJ
processes InvoIved In u specIIIc dIseuse, LIen LIIs reIIecLs u lccl oI
undersLundIng oI dIseuse ueLIoIogy. To LIen reIer Lo u IucLor us II IL Is u
suIIIcIenL condILIon under LIIs cIrcumsLunce, e.g., smokIng cuuses Iung
cuncer, und LIereIore IosLer LIe mIspercepLIon LIuL LIere Is greuL
undersLundIng concernIng LIe ueLIoIogy oI u specIIIc dIseuse, Ius no
coIerenL busIs wIuLsoever. L Is IruuduIenL, deIInquenL, und negIIgenL.
nLeresLIngIy, IIIenIeId uccuses BurcI oI IuvIng IncompIeLeIy presenLed
LIe IIndIngs oI severuI sLudIes or Ius omILLed dIscussIng oLIers more IuIIy.
TIIs Is, needIess Lo suy, mosL dIsLurbIng. (p. 8q) TIIs sorL oI crILIcIsm Is
usuuIIy, und Ior jcr beLLer reusons, dIrecLed uL LIe IusLy generuIIzuLIons
mude by IeuILI uuLIorILIes, IncIudIng IIIenIeId`s LIesIs.
TIe ubove sILuuLIon cun be cIurucLerIzed us cuusuLIonIsLs und
consLILuLIonIsLs operuLIng uL cross-purposes. As Iur us LIe cuusuLIonIsLs
ure concerned, LIe muLLer is seLLIed. UsIng LIe unuIogy oI cuncer InducLIon
In unImuIs (e.g., on skIn) demonsLruLes LIuL Lobucco smoke conLuIns
curcInogens. To u cuusuLIonIsL LIIs evIdence Is suIIIcIenL Lo expIuIn uII
Lifestyle Epidemiology
munner oI dIseuse In smokers, regurdIess oI predIcLIve sLrengLI und
deIInedJdeIInubIe mecIunIsmsJprocesses. TIe muLerIuIIsL menLuIILy
cunnoL compreIend LIuL LIe IubIL oI smokIng InvoIves Iur more
dImensIons (e.g., psycIoIogIcuI, socIuI) LIuL mukes IL ter dijjerent Lo
sImpIy puInLIng Lur on LIe skIn oI mIce LIuL Induces skIn cuncer In u smuII
proporLIon oI LIem. urLIermore, IL cunnoL compreIend LIuL IL Is
vIoIuLIng every prIncIpIe oI cuusuI InIerence In so doIng.
or uII InLenLs und purposes, cuusuLIonIsLs cunnoL undersLund
wIuL reseurcIers sucI us BurcI und Eysenck, Ior exumpIe, IInd
probIemuLIc wILI LIe orLIodox posILIon. TIe crILIcuI probIem Is LIuL
consLILuLIonIsL reseurcIers Iuve been onIy reucLIve Lo LIe IusLy
generuIIzuLIons LIuL evenLuuIIy come LIrougI IeuILI uuLIorILIes
(prevenLIve medIcIne) sucI us smokIng cuuses Iung cuncer. or exumpIe,
ArmILuge (1q;8), In respondIng Lo BurcI`s (1q;8) quesLIonIng oI LIe
cuusuLIonIsL vIew oI smokIngJIung cuncer, remurks LIuL wus surprIsed
LIuL ProIessor BurcI puLs Iorwurd Ior consIderuLIon u 'pure cuusuI LIeory`
udmILLIng oI no geneLIc InIIuence on LIe IncIdence oI LIe dIseuse. He IInds
LIe evIdence uguInsL LIIs Lo be compeIIIng, buL um noL cIeur LIuL unyone
udvocuLes sucI un exLreme vIew. (p. qq) ArmILuge (1q;8), umongsL
muny oLIers, Is noL uwure LIuL IIuwed und mIsrepresenLuLIonuI sLuLemenLs
sucI us smokIng cuuses Iung cuncer does represenL sucI un exLreme und
erroneous vIew.
TIese IusLy generuIIzuLIons LIuL Invoke LIe Lerm cuuse uL every
Lurn ImpIy un undersLundIng oI dIseuse LIuL Is eILIer noL demonsLruLed or,
more usuuIIy, conLrudIcLs uvuIIubIe evIdence. UnIorLunuLeIy,
consLILuLIonIsLs Iuve noL been successIuI uL clecrl urLIcuIuLIng LIe proper
uppIIcuLIon oI cll LIe crILerIu oI cuusuI InIerence. or exumpIe, BurcI
(1q8) suggesLs LIuL II LIe crILerIon oI specIIIcILy Is conLInuuIIy
mIsInLerpreLed by LIe Surgeon GeneruI, LIen LIe crILerIon sIouId be
dIspensed wILI uILogeLIer. SucI suggesLIons cerLuInIy do noL IeIp wILI u
cIurIIIcuLIon oI u IIgIIy conIused sILuuLIon.
urLIermore, consLILuLIonIsLs, Loo, Iuve been obIIvIous Lo LIe
crILIcuI Ideu oI cIgureLLe smokIng us u convergence pIenomenon Ior some.
TIey, Loo, LypIcuIIy ussume IomogeneILy oI groups, purLIcuIurIy LIe
nonsmoker`s group. n muny InsLunces consLILuLIonIsLs Iuve uLLempLed Lo
urgue Ior u quesLIonubIe joint ejject, e.g., LIuL boLI Iung cuncer und
smokIng Iuve u common cuuse. ConsLILuLIonIsLs Iuve uLLempLed Lo
uccounL Ior endogenous IucLors buL sLIII essenLIuIIy wILIIn u muLerIuIIsLJ
deLermInIsLIc Irumework. TIe Ideu LIuL LIere ure reusons, us opposed Lo
cuuses, Ior smokIng Is uIIen Lo LIe muLerIuIIsL menLuIILy. urLIermore,
consLILuLIonIsLs Iuve uIso IuIIed Lo recognIze LIuL smokIng cun conLrIbuLe,
wILI oLIer IucLors, Lo u weukenIng oI Iung IuncLIon und resuILIng In u
76
76
Rampant Antismoking Signifies Grave Danger
weukesL orgun eIIecL, us opposed Lo cuusIng Iung cuncer, In persons
LIuL wouId Iuve oLIerwIse munIIesLed oLIer Iorms oI cuncer.
ConsLILuLIonIsLs Iuve uIso been deceIved by LIe smokIng cuuses u
muILIpIIcILy oI dIseuses, IuIIIng Lo recognIze LIuL RR dIIIerenLIuIs Ior
dIseuses oLIer LIun Iung cuncer ure produced by uge-specIIIc dIIIerenLIuIs
(I.e., eurIIer morLuIILy) und noL by dIIIerenLIuIs In proporLIons oI specIIIc-
cuuse morLuIILy.
TIose oIIerIng crILIques oI LIe orLIodox vIew Iuve ussumed LIuL
LIe conducL oI LIe orLIodoxy reIIecLs IsoIuLed InsLunces oI over-
InLerpreLuLIon coupIed wILI u cuvuIIer uLLILude. However, BerrIdge (1qqq)
noLes u very crILIcuI deIInIng LIme Ior u purLIcuIur Ideu oI IeuILI und ILs
promoLIon. n LIe mId-1q;o`s LIere were enougI numbers wILIIn LIe
IeuILI bureuucrucy und LIe medIcuI esLubIIsImenL LIuL sIured u
muLerIuIIsL worIdvIew LIuL uIIowed one oI LIe numerous consensus
eIIecLs LIuL medIco-muLerIuIIsm, In purLIcuIur, Is noLorIous Ior. TIe
cupucILy Lo quunLIIy rIsk, us LIrougI epIdemIoIogIcuI InvesLIguLIon, Is u
cenLruIILy In LIe muLerIuIIsL Ideu oI IeuILI. NumerIcs und quunLIIIcuLIon
uppeuI Lo LIe menLuIILy In LIuL LIIs Is ubouL us mucI us IL cun
compreIend. BeIng superIIcIuI, devoId oI uny spIrILuuI, moruI,
psycIosocIuI, und psycIoIogIcuI dImensIons, IL jumps Lo LIe mosL sImpIe-
mInded, III-consIdered InLerpreLuLIons oI duLu possIbIe. Worse sLIII Is LIuL,
compreIendIng no IIgIer sLundurd oI InIerence, IL Is uLLerIy convInced oI
LIe rIgILness oI ILs surmIsIng. BeIng so convInced, LIe sLunce oI IeuILI
oIIIcIuIdom Ius been LIe preucIIng oI und LIe uLLempL Lo engIneer LIe
rIsk uvoIdIng IndIvIduuI, u crucIuI Ideu In LIe muLerIuIIsL worIdvIew (I.e.,
LIe muLerIuIIsL munIIesLo).
L wIII be noLed Irom purLs oI LIe IoIIowIng dIscussIon LIuL sInce
LIe mId-1q;o`s oIIIcIuI reporLs pubIIsIed by governmenL IeuILI
depurLmenLs on smokIng und IeuILI Iuve used progressIveIy more
emoLIve und uggressIve Iunguuge In depIcLIng LIe IubIL, e.g., Lerms sucI us
smokIng kIIIs, smokIng cuuses numerous dIseuses. AILIougI LIe SG
(1q6q) uLLrIbuLed onIy u IundIuI oI dIseuses Lo smokIng; by LIe IuLe-1q;o`s
every dIseuse LIuL Iud u IIgIer rIsk ussocIuLIon wILI smokIng wus cIuImed
Lo be cuused by smokIng; LIere Is now u Iong IIsL oI dIseuses cuused by
smokIng.
L wus noLed In un eurIIer secLIon LIuL LIe onIy dIseuse pecuIIurIy
ussocIuLed wILI smokIng Is Iung cuncer, und In persons suscepLIbIe Lo
cuncer oLIerwIse; IIgIer RR`s Ior oLIer dIseuses ussocIuLed wILI smokIng
ure generuLed by uge-specIIIc dIIIerences und noL dIIIerences In LIe
proporLIons oI specIIIc dIseuses. L wus undersLood In LIe 1q6o`s LIuL
smokIng seemed Lo sIorLen IIIe ruLIer LIun Lo specIIIcuIIy cuuse u
muILIpIIcILy oI dIseuses (e.g., TIe usL CIgureLLe, 1qqq). YeL, even LIIs
Lifestyle Epidemiology
InLerpreLuLIon Is quesLIonubIe.
TIe uLLempL Lo depIcL eurIIer morLuIILy us smokIng cuusIng u
muILIpIIcILy oI dIseuses, us Ius occurred sInce LIe 1q;o`s, Is pIuInIy wrong,
u greuL Iruud; oLIer LIun Iung cuncer, LIere ure no smokIng-reIuLed
dIseuses. TIe reIuLed cIuIm LIuL smokers ure uL Increused rIsk oI u
muILIpIIcILy oI dIseuses Is uIso wrong. Smokers ure essenLIuIIy uL LIe sume
rIsk oI non-Iung-cuncer-dIseuse us nonsmokers, uILIougI LIey ure uL
IIgIer rIsk oI LIese compurubIe dIseuses ecrlier. TIese serIous errors
sIouId sImpIy noL be mude; LIey reIIecL und promoLe supersLILIous beIIeI,
enLIreIy conLrury Lo LIe scIenLIIIc enLerprIse, I.e., IL Is LIese very sorLs oI
beIIeIs LIuL scIence seeks Lo Lrunscend. WIuLever modIcum oI compeLence
muy Iuve exIsLed pre-1q;o`s vunIsIed wILI LIe sLrong muLerIuIIsL IooLIoId
esLubIIsIed In LIe eurIy-1q;o`s. CurrenLIy, epIdemIoIogy runs, us u muLLer
oI course, on LIe mosL sImpIe-mInded InLerpreLuLIon oI RR dIIIerences.
Muny medIcuI prucLILIoners ure noL compeLenL In sLuLIsLIcuI
InIerence, IuvIng never even sLudIed LIe epIdemIoIogIc meLIod. TIese
reIy on LIe cIuIms oI epIdemIoIogIsLs. WILI sLrong muLerIuIIsL InIecLIon
und scIenLIIIc IncompeLence, IL requIres onIy LIe Iew In epIdemIoIogy,
supporLed by oIIIcIuIdom, Lo promoLe cuusuI cIuIms cd ncusecm Ior LIe
mujorILy wILIIn LIe medIcuI esLubIIsImenL Lo uccepL LIese cIuIms us
deIInILIve: A smuII consensus eIIecL, bused on LIe IuIIucy oI crumentum
cd numerum (I.e., LIe more peopIe wIo beIIeve or supporL u proposILIon,
LIe more IIkeIy IL Is LIuL LIe proposILIon Is correcL) wILIIn epIdemIoIogy
generuLes u Iurger consensus eIIecL wILIIn LIe medIcuI esLubIIsImenL on
LIe busIs oI IIgIer experLIse. TIIs reIIecLs LIe poIILIcs oI beIIeI or muss
deIusIon, und noL LIe resuILs oI scIenLIIIc enquIry. TIe erroneous Ideu oI
smokIng cuusIng u muILIpIIcILy oI dIseuses uIso beLLer serves LIe
muLerIuIIsL munIIesLo generuIIy, I.e., LIe uLLempL by u sIuIIow LIInkIng und
LIrougI u Iorm oI LerrorIsm Lo scure persons ouL oI LIe smokIng IubIL. To
LIIs menLuIILy, un ends jusLIIIes LIe meuns upproucI Is sLundurd
operuLIng procedure In engIneerIng LIe rIsk uvoIdIng IndIvIduuI.
TIrougI decudes oI crumentum cd numerum und cd
terecundicm (I.e., LIe IuIIucy LIuL cIuIms sIouId be beIIeved becuuse LIey
ure presenLed by so-cuIIed uuLIorILIes), muny In LIe popuIuLIon uL Iurge
In muny nuLIons beIIeve LIe smokIng cuuses u muILIpIIcILy oI dIseuses
cIuIm. UnIorLunuLeIy, uILer u sIorL wIIIe, even LIose wILIIn LIe
bureuucrucy LIuL muy Iuve InILIuIIy been conIused ubouL cuusuI cIuIms
become uLLerIy convInced oI LIeIr verucILy; conLemporury IeuILI
oIIIcIuIdom In numerous wesLern nuLIons represenLs IIgIIy devoLed
dIscIpIes oI u deIuded IdeoIogIcuI muLerIuIIsL-cuIL uLLempLIng Lo IuIIIII LIe
muLerIuIIsL munIIesLo, I.e. u mun-engIneered uLopIu (see uIso secLIon
Rcdiccl ehctiorism). L sIouId noL be surprIsIng LIuL muny currenL
77
77
Rampant Antismoking Signifies Grave Danger
weukesL orgun eIIecL, us opposed Lo cuusIng Iung cuncer, In persons
LIuL wouId Iuve oLIerwIse munIIesLed oLIer Iorms oI cuncer.
ConsLILuLIonIsLs Iuve uIso been deceIved by LIe smokIng cuuses u
muILIpIIcILy oI dIseuses, IuIIIng Lo recognIze LIuL RR dIIIerenLIuIs Ior
dIseuses oLIer LIun Iung cuncer ure produced by uge-specIIIc dIIIerenLIuIs
(I.e., eurIIer morLuIILy) und noL by dIIIerenLIuIs In proporLIons oI specIIIc-
cuuse morLuIILy.
TIose oIIerIng crILIques oI LIe orLIodox vIew Iuve ussumed LIuL
LIe conducL oI LIe orLIodoxy reIIecLs IsoIuLed InsLunces oI over-
InLerpreLuLIon coupIed wILI u cuvuIIer uLLILude. However, BerrIdge (1qqq)
noLes u very crILIcuI deIInIng LIme Ior u purLIcuIur Ideu oI IeuILI und ILs
promoLIon. n LIe mId-1q;o`s LIere were enougI numbers wILIIn LIe
IeuILI bureuucrucy und LIe medIcuI esLubIIsImenL LIuL sIured u
muLerIuIIsL worIdvIew LIuL uIIowed one oI LIe numerous consensus
eIIecLs LIuL medIco-muLerIuIIsm, In purLIcuIur, Is noLorIous Ior. TIe
cupucILy Lo quunLIIy rIsk, us LIrougI epIdemIoIogIcuI InvesLIguLIon, Is u
cenLruIILy In LIe muLerIuIIsL Ideu oI IeuILI. NumerIcs und quunLIIIcuLIon
uppeuI Lo LIe menLuIILy In LIuL LIIs Is ubouL us mucI us IL cun
compreIend. BeIng superIIcIuI, devoId oI uny spIrILuuI, moruI,
psycIosocIuI, und psycIoIogIcuI dImensIons, IL jumps Lo LIe mosL sImpIe-
mInded, III-consIdered InLerpreLuLIons oI duLu possIbIe. Worse sLIII Is LIuL,
compreIendIng no IIgIer sLundurd oI InIerence, IL Is uLLerIy convInced oI
LIe rIgILness oI ILs surmIsIng. BeIng so convInced, LIe sLunce oI IeuILI
oIIIcIuIdom Ius been LIe preucIIng oI und LIe uLLempL Lo engIneer LIe
rIsk uvoIdIng IndIvIduuI, u crucIuI Ideu In LIe muLerIuIIsL worIdvIew (I.e.,
LIe muLerIuIIsL munIIesLo).
L wIII be noLed Irom purLs oI LIe IoIIowIng dIscussIon LIuL sInce
LIe mId-1q;o`s oIIIcIuI reporLs pubIIsIed by governmenL IeuILI
depurLmenLs on smokIng und IeuILI Iuve used progressIveIy more
emoLIve und uggressIve Iunguuge In depIcLIng LIe IubIL, e.g., Lerms sucI us
smokIng kIIIs, smokIng cuuses numerous dIseuses. AILIougI LIe SG
(1q6q) uLLrIbuLed onIy u IundIuI oI dIseuses Lo smokIng; by LIe IuLe-1q;o`s
every dIseuse LIuL Iud u IIgIer rIsk ussocIuLIon wILI smokIng wus cIuImed
Lo be cuused by smokIng; LIere Is now u Iong IIsL oI dIseuses cuused by
smokIng.
L wus noLed In un eurIIer secLIon LIuL LIe onIy dIseuse pecuIIurIy
ussocIuLed wILI smokIng Is Iung cuncer, und In persons suscepLIbIe Lo
cuncer oLIerwIse; IIgIer RR`s Ior oLIer dIseuses ussocIuLed wILI smokIng
ure generuLed by uge-specIIIc dIIIerences und noL dIIIerences In LIe
proporLIons oI specIIIc dIseuses. L wus undersLood In LIe 1q6o`s LIuL
smokIng seemed Lo sIorLen IIIe ruLIer LIun Lo specIIIcuIIy cuuse u
muILIpIIcILy oI dIseuses (e.g., TIe usL CIgureLLe, 1qqq). YeL, even LIIs
Lifestyle Epidemiology
InLerpreLuLIon Is quesLIonubIe.
TIe uLLempL Lo depIcL eurIIer morLuIILy us smokIng cuusIng u
muILIpIIcILy oI dIseuses, us Ius occurred sInce LIe 1q;o`s, Is pIuInIy wrong,
u greuL Iruud; oLIer LIun Iung cuncer, LIere ure no smokIng-reIuLed
dIseuses. TIe reIuLed cIuIm LIuL smokers ure uL Increused rIsk oI u
muILIpIIcILy oI dIseuses Is uIso wrong. Smokers ure essenLIuIIy uL LIe sume
rIsk oI non-Iung-cuncer-dIseuse us nonsmokers, uILIougI LIey ure uL
IIgIer rIsk oI LIese compurubIe dIseuses ecrlier. TIese serIous errors
sIouId sImpIy noL be mude; LIey reIIecL und promoLe supersLILIous beIIeI,
enLIreIy conLrury Lo LIe scIenLIIIc enLerprIse, I.e., IL Is LIese very sorLs oI
beIIeIs LIuL scIence seeks Lo Lrunscend. WIuLever modIcum oI compeLence
muy Iuve exIsLed pre-1q;o`s vunIsIed wILI LIe sLrong muLerIuIIsL IooLIoId
esLubIIsIed In LIe eurIy-1q;o`s. CurrenLIy, epIdemIoIogy runs, us u muLLer
oI course, on LIe mosL sImpIe-mInded InLerpreLuLIon oI RR dIIIerences.
Muny medIcuI prucLILIoners ure noL compeLenL In sLuLIsLIcuI
InIerence, IuvIng never even sLudIed LIe epIdemIoIogIc meLIod. TIese
reIy on LIe cIuIms oI epIdemIoIogIsLs. WILI sLrong muLerIuIIsL InIecLIon
und scIenLIIIc IncompeLence, IL requIres onIy LIe Iew In epIdemIoIogy,
supporLed by oIIIcIuIdom, Lo promoLe cuusuI cIuIms cd ncusecm Ior LIe
mujorILy wILIIn LIe medIcuI esLubIIsImenL Lo uccepL LIese cIuIms us
deIInILIve: A smuII consensus eIIecL, bused on LIe IuIIucy oI crumentum
cd numerum (I.e., LIe more peopIe wIo beIIeve or supporL u proposILIon,
LIe more IIkeIy IL Is LIuL LIe proposILIon Is correcL) wILIIn epIdemIoIogy
generuLes u Iurger consensus eIIecL wILIIn LIe medIcuI esLubIIsImenL on
LIe busIs oI IIgIer experLIse. TIIs reIIecLs LIe poIILIcs oI beIIeI or muss
deIusIon, und noL LIe resuILs oI scIenLIIIc enquIry. TIe erroneous Ideu oI
smokIng cuusIng u muILIpIIcILy oI dIseuses uIso beLLer serves LIe
muLerIuIIsL munIIesLo generuIIy, I.e., LIe uLLempL by u sIuIIow LIInkIng und
LIrougI u Iorm oI LerrorIsm Lo scure persons ouL oI LIe smokIng IubIL. To
LIIs menLuIILy, un ends jusLIIIes LIe meuns upproucI Is sLundurd
operuLIng procedure In engIneerIng LIe rIsk uvoIdIng IndIvIduuI.
TIrougI decudes oI crumentum cd numerum und cd
terecundicm (I.e., LIe IuIIucy LIuL cIuIms sIouId be beIIeved becuuse LIey
ure presenLed by so-cuIIed uuLIorILIes), muny In LIe popuIuLIon uL Iurge
In muny nuLIons beIIeve LIe smokIng cuuses u muILIpIIcILy oI dIseuses
cIuIm. UnIorLunuLeIy, uILer u sIorL wIIIe, even LIose wILIIn LIe
bureuucrucy LIuL muy Iuve InILIuIIy been conIused ubouL cuusuI cIuIms
become uLLerIy convInced oI LIeIr verucILy; conLemporury IeuILI
oIIIcIuIdom In numerous wesLern nuLIons represenLs IIgIIy devoLed
dIscIpIes oI u deIuded IdeoIogIcuI muLerIuIIsL-cuIL uLLempLIng Lo IuIIIII LIe
muLerIuIIsL munIIesLo, I.e. u mun-engIneered uLopIu (see uIso secLIon
Rcdiccl ehctiorism). L sIouId noL be surprIsIng LIuL muny currenL
78
78
Rampant Antismoking Signifies Grave Danger
epIdemIoIogIsLs IuIIy beIIeve LIe smokIng cuuses u muILIpIIcILy oI
dIseuses cIuIm: LIese Iuve Iong IorgoLLen ucLuuI IucLs und ure drIven by
superIIcIuI poIILIco-IdeoIogIcuI beIIeIs, umongsL oLIer dysIuncLIon.
TIereIore, uILIougI LIe consLILuLIonIsL upproucI uIso suIIers
Irom consIderubIe concepLuuI IImILuLIons, e.g., poor uddressIng oI LIe
IomogeneILy oI groups Issue und vuryIng conLrIbuLIons Lo RR
dIIIerences, muny poInLs ruIsed Iuve merIL. However, LIIs uLLempL Lo
correcL gIurIng errors In LIe orLIodox vIew wus uIwuys bound Ior IuIIure In
LIuL, uILIougI LIere ure numerous errors oI scIenLIIIc und cuusuI InIerence
InvoIved, LIe overrIdIng probIem Is un IdeoIogIcuI (muLerIuIIsm) or
meLupIysIcuI one. L requIres Iur more LIun LIe consLILuLIonIsL upproucI
Lo smokIng und IeuILI Lo uddress u deIuded LoLuIILurIun vIewpoInL. TIe
resuIL Ius been u Lo-Ing und Iro-Ing over LIe IusL quurLer-oI-u-cenLury LIuL
Ius noL onIy resoIved noLIIng, buL wIere muLerIuIIsL IdeoIogy Ius become
dungerousIy rumpunL.
z..z More Sins oj Epidemiolo
ConLemporury epIdemIoIogy suIIers Irom numerous, und very
serIous, IIuws. One oI LIese Is LIuL IL Is spIIL-mInded ubouL wIuL ILs ucLuuI
gouI Is. Muny epIdemIoIogIsLs beIIeve LIuL LIey ure enguged In u
popuIuLIon scIence. ScIence cunnoL uppIy uL LIe gross IeveI oI
popuIuLIons Ior LIe reuson LIuL popuIuLIon membersIIp Is noL
Iomogeneous. A gross IeveI meuns LIuL IL Is Iur Loo generuI, und
LIereIore does noL uIIow LIe precIsIon LIuL LIe scIenLIIIc gouI necessILuLes.
PurLIcuIurIy In LIe InvesLIguLIon oI specIIIc dIseuse, LIe IeveI LIuL IosLers
cuusuI urgumenL (predIcLIve sLrengLI) Is LypIcuIIy smcll subroups oI
popuIuLIons.
Gross-IeveI InvesLIguLIons do noL ucLuuIIy pose or unswer uny
sIgnIIIcunL scIenLIIIc quesLIons. or exumpIe, DoII (1q;1), In LesLIng u
LIeory oI Iung cuncer, predIcLed LIuL morLuIILy ruLIos sIouId rIse Irom
ubouL .q uL qo yeurs oI uge Lo z uL 8o yeurs oI uge. OLIer numerous
sLudIes (see revIew by SLeIn, 1qq1) uIso uLLempL Lo muLIemuLIcuIIy modeI
LIe ruLe oI Iung cuncer us u IuncLIon oI popuIuLIon Lobucco consumpLIon.
SucI modeIIng uLLempLs cssume LIe very Issues LIuL Iuve noL been
demonsLruLed In uccordunce wILI LIe proper uppIIcuLIon oI LIe crILerIu oI
cuusuI InIerence. ApurL Irom beIng InLeresLIng sLuLIsLIcuI exercIses, LIey do
noL uddress LIe crILIcuI scIenLIIIc quesLIon oI uho wIII deveIop Iung cuncer.
BeIng ubIe Lo unswer LIe quesLIon oI uho wIII uIIow LIe LIeoreLIcuI
deveIopmenL oI uh? or consIderubIe purLs oI LIe scIenLIIIc journey LIe
progressIve unswerIng oI LIese quesLIons Is concurrenL. I InvesLIguLIons
do noL pursue LIese quesLIons directl, und wIIcI wIII be reIIecLed In very
Lifestyle Epidemiology
IIgI predIcLIve sLrengLI oI IucLors Ior IucLors, LIen IL Is not scIenLIIIc
InvesLIguLIon. WIere sLuLIsLIcuI exercIses sucI us LIose ubove, und wIIcI
consLILuLes LIe mujorILy oI epIdemIoIogIcuI InvesLIguLIons, subsLILuLe Ior
ucLuuI scIenLIIIc enquIry, LIere Is no more LIun sLuLIsLIcuI IunLusy
occurrIng, I.e., sLuLIsLIcuIIsm.
I epIdemIoIogy wIsIes Lo enguge In gross-IeveI (popuIuLIon)
InvesLIguLIon, und gIven LIuL predIcLors Irom LIIs upproucI wIII InvurIubIy
be Iow-IeveI, LIen IL sIouId never use LIe Iunguuge oI cuusuLIon. TIIs
Iunguuge Is reserved Ior LIe IdenLIIIcuLIon oI IIgI-IeveI predIcLors oI
evenLs. ObvIousIy, LIIs consIderubIy wuLers down LIe poLency oI cIuIms,
und Ior good reuson. EpIdemIoIogy wouId sImpIy be InvoIved In
IdenLIIyIng u muILILude oI Iow-IeveI rIsk IucLors (I.e., sLuLIsLIcuIIsm), und
wIIcI Is LIe cuse In conLemporury epIdemIoIogy. n deuIIng wILI LIe
pubIIc, und In ucknowIedgIng LIe consIderubIe IImILuLIons oI ILs upproucI,
epIdemIoIogy wouId need Lo cIeurIy poInL ouL LIuL Iow-IeveI rIsk Is u
sLuLIsLIcuI concepL und LIuL unyone`s uccommoduLIon oI sucI InIormuLIon
wouId essenLIuIIy be ukIn Lo u IIImsy gumbIe. n LIIs sense,
epIdemIoIogIsLs wouId presenL LIemseIves us noLIIng more LIun gIorIIIed
bookmukers In wIILe IuboruLory couLs. TIIs presenLuLIon wouId uL IeusL be
honest. UnIorLunuLeIy, LIe sILuuLIon Is Iur, Iur more perverse.
EpIdemIoIogy Is reuIIy enguged In sLuLIsLIcuIIsm or rIsk
IucLoroIogy or rIskoIogy, und LIereIore u very weuk IeveI oI InIerence,
wIIIe uL LIe sume LIme erroneousIy IorcIng LIe use oI Iur sLronger cuusuI
Iunguuge. L does LIIs by LryIng Lo combIne (IybrIdIze) Lwo IncompuLIbIe
concepLuuI Irumeworks - probubIIIsLIc (sLuLIsLIcuI) und deLermInIsLIc
(cuusuI). TIe resuIL is dIsusLrous und cun be seen very cIeurIy In LIe
LreuLmenL oI cIgureLLe smokIng.
n pureIy sLuLIsLIcuI Lerms, u Iow-IeveI sLuLIsLIcuI ussocIuLIon
beLween Lwo IucLors Is consIdered rundom und, LIereIore, couId be suId Lo
ImprobubIy occur Lo unyone uL uny LIme. n deLermInIsm, u Iow-IeveI
ussocIuLIon beLween Lwo IucLors wouId IndIcuLe u subgroup eIIecL. L Is u
possIbIIILy LIuL one IucLor muy pIuy un IndIrecL LrIgger roIe In LIe
consequenL. However, LIIs roIe wouId requIre LIuL cerLuIn ucLuuIIy-crILIcuI
precondILIons ure meL. TIese crILIcuI precondILIons wouId LypIcuIIy be
endogenous sysLem IucLors (e.g., ubnormuIILyJIuIIure oI some sorL). TIe
ImporLunL poInL Lo noLe Is LIuL, II LIe ussocIuLIon reIIecLs un overuII cuusuI
reIuLIonsIIp, und gIven LIuL LIe ussocIuLIon Is u subgroup (uLypIcuI) one,
LIen LIe ussocIuLIon cunnoL jusL Iuppen Lo unyone uL unyLIme, buL onIy Lo
LIose persons wIere cerLuIn precondILIons ure IuIIy und deIInILeIy meL,
I.e., someone wIII demonsLruLe dIseuse - buL noL jusL unyone.
TIereIore, In u pureIy sLuLIsLIcuI ussocIuLIon, un ussocIuLed IucLor
cun poLenLIuIIy occur Lo unyone uL unyLIme beccuse IL Is not u cuusuI
79
79
Rampant Antismoking Signifies Grave Danger
epIdemIoIogIsLs IuIIy beIIeve LIe smokIng cuuses u muILIpIIcILy oI
dIseuses cIuIm: LIese Iuve Iong IorgoLLen ucLuuI IucLs und ure drIven by
superIIcIuI poIILIco-IdeoIogIcuI beIIeIs, umongsL oLIer dysIuncLIon.
TIereIore, uILIougI LIe consLILuLIonIsL upproucI uIso suIIers
Irom consIderubIe concepLuuI IImILuLIons, e.g., poor uddressIng oI LIe
IomogeneILy oI groups Issue und vuryIng conLrIbuLIons Lo RR
dIIIerences, muny poInLs ruIsed Iuve merIL. However, LIIs uLLempL Lo
correcL gIurIng errors In LIe orLIodox vIew wus uIwuys bound Ior IuIIure In
LIuL, uILIougI LIere ure numerous errors oI scIenLIIIc und cuusuI InIerence
InvoIved, LIe overrIdIng probIem Is un IdeoIogIcuI (muLerIuIIsm) or
meLupIysIcuI one. L requIres Iur more LIun LIe consLILuLIonIsL upproucI
Lo smokIng und IeuILI Lo uddress u deIuded LoLuIILurIun vIewpoInL. TIe
resuIL Ius been u Lo-Ing und Iro-Ing over LIe IusL quurLer-oI-u-cenLury LIuL
Ius noL onIy resoIved noLIIng, buL wIere muLerIuIIsL IdeoIogy Ius become
dungerousIy rumpunL.
z..z More Sins oj Epidemiolo
ConLemporury epIdemIoIogy suIIers Irom numerous, und very
serIous, IIuws. One oI LIese Is LIuL IL Is spIIL-mInded ubouL wIuL ILs ucLuuI
gouI Is. Muny epIdemIoIogIsLs beIIeve LIuL LIey ure enguged In u
popuIuLIon scIence. ScIence cunnoL uppIy uL LIe gross IeveI oI
popuIuLIons Ior LIe reuson LIuL popuIuLIon membersIIp Is noL
Iomogeneous. A gross IeveI meuns LIuL IL Is Iur Loo generuI, und
LIereIore does noL uIIow LIe precIsIon LIuL LIe scIenLIIIc gouI necessILuLes.
PurLIcuIurIy In LIe InvesLIguLIon oI specIIIc dIseuse, LIe IeveI LIuL IosLers
cuusuI urgumenL (predIcLIve sLrengLI) Is LypIcuIIy smcll subroups oI
popuIuLIons.
Gross-IeveI InvesLIguLIons do noL ucLuuIIy pose or unswer uny
sIgnIIIcunL scIenLIIIc quesLIons. or exumpIe, DoII (1q;1), In LesLIng u
LIeory oI Iung cuncer, predIcLed LIuL morLuIILy ruLIos sIouId rIse Irom
ubouL .q uL qo yeurs oI uge Lo z uL 8o yeurs oI uge. OLIer numerous
sLudIes (see revIew by SLeIn, 1qq1) uIso uLLempL Lo muLIemuLIcuIIy modeI
LIe ruLe oI Iung cuncer us u IuncLIon oI popuIuLIon Lobucco consumpLIon.
SucI modeIIng uLLempLs cssume LIe very Issues LIuL Iuve noL been
demonsLruLed In uccordunce wILI LIe proper uppIIcuLIon oI LIe crILerIu oI
cuusuI InIerence. ApurL Irom beIng InLeresLIng sLuLIsLIcuI exercIses, LIey do
noL uddress LIe crILIcuI scIenLIIIc quesLIon oI uho wIII deveIop Iung cuncer.
BeIng ubIe Lo unswer LIe quesLIon oI uho wIII uIIow LIe LIeoreLIcuI
deveIopmenL oI uh? or consIderubIe purLs oI LIe scIenLIIIc journey LIe
progressIve unswerIng oI LIese quesLIons Is concurrenL. I InvesLIguLIons
do noL pursue LIese quesLIons directl, und wIIcI wIII be reIIecLed In very
Lifestyle Epidemiology
IIgI predIcLIve sLrengLI oI IucLors Ior IucLors, LIen IL Is not scIenLIIIc
InvesLIguLIon. WIere sLuLIsLIcuI exercIses sucI us LIose ubove, und wIIcI
consLILuLes LIe mujorILy oI epIdemIoIogIcuI InvesLIguLIons, subsLILuLe Ior
ucLuuI scIenLIIIc enquIry, LIere Is no more LIun sLuLIsLIcuI IunLusy
occurrIng, I.e., sLuLIsLIcuIIsm.
I epIdemIoIogy wIsIes Lo enguge In gross-IeveI (popuIuLIon)
InvesLIguLIon, und gIven LIuL predIcLors Irom LIIs upproucI wIII InvurIubIy
be Iow-IeveI, LIen IL sIouId never use LIe Iunguuge oI cuusuLIon. TIIs
Iunguuge Is reserved Ior LIe IdenLIIIcuLIon oI IIgI-IeveI predIcLors oI
evenLs. ObvIousIy, LIIs consIderubIy wuLers down LIe poLency oI cIuIms,
und Ior good reuson. EpIdemIoIogy wouId sImpIy be InvoIved In
IdenLIIyIng u muILILude oI Iow-IeveI rIsk IucLors (I.e., sLuLIsLIcuIIsm), und
wIIcI Is LIe cuse In conLemporury epIdemIoIogy. n deuIIng wILI LIe
pubIIc, und In ucknowIedgIng LIe consIderubIe IImILuLIons oI ILs upproucI,
epIdemIoIogy wouId need Lo cIeurIy poInL ouL LIuL Iow-IeveI rIsk Is u
sLuLIsLIcuI concepL und LIuL unyone`s uccommoduLIon oI sucI InIormuLIon
wouId essenLIuIIy be ukIn Lo u IIImsy gumbIe. n LIIs sense,
epIdemIoIogIsLs wouId presenL LIemseIves us noLIIng more LIun gIorIIIed
bookmukers In wIILe IuboruLory couLs. TIIs presenLuLIon wouId uL IeusL be
honest. UnIorLunuLeIy, LIe sILuuLIon Is Iur, Iur more perverse.
EpIdemIoIogy Is reuIIy enguged In sLuLIsLIcuIIsm or rIsk
IucLoroIogy or rIskoIogy, und LIereIore u very weuk IeveI oI InIerence,
wIIIe uL LIe sume LIme erroneousIy IorcIng LIe use oI Iur sLronger cuusuI
Iunguuge. L does LIIs by LryIng Lo combIne (IybrIdIze) Lwo IncompuLIbIe
concepLuuI Irumeworks - probubIIIsLIc (sLuLIsLIcuI) und deLermInIsLIc
(cuusuI). TIe resuIL is dIsusLrous und cun be seen very cIeurIy In LIe
LreuLmenL oI cIgureLLe smokIng.
n pureIy sLuLIsLIcuI Lerms, u Iow-IeveI sLuLIsLIcuI ussocIuLIon
beLween Lwo IucLors Is consIdered rundom und, LIereIore, couId be suId Lo
ImprobubIy occur Lo unyone uL uny LIme. n deLermInIsm, u Iow-IeveI
ussocIuLIon beLween Lwo IucLors wouId IndIcuLe u subgroup eIIecL. L Is u
possIbIIILy LIuL one IucLor muy pIuy un IndIrecL LrIgger roIe In LIe
consequenL. However, LIIs roIe wouId requIre LIuL cerLuIn ucLuuIIy-crILIcuI
precondILIons ure meL. TIese crILIcuI precondILIons wouId LypIcuIIy be
endogenous sysLem IucLors (e.g., ubnormuIILyJIuIIure oI some sorL). TIe
ImporLunL poInL Lo noLe Is LIuL, II LIe ussocIuLIon reIIecLs un overuII cuusuI
reIuLIonsIIp, und gIven LIuL LIe ussocIuLIon Is u subgroup (uLypIcuI) one,
LIen LIe ussocIuLIon cunnoL jusL Iuppen Lo unyone uL unyLIme, buL onIy Lo
LIose persons wIere cerLuIn precondILIons ure IuIIy und deIInILeIy meL,
I.e., someone wIII demonsLruLe dIseuse - buL noL jusL unyone.
TIereIore, In u pureIy sLuLIsLIcuI ussocIuLIon, un ussocIuLed IucLor
cun poLenLIuIIy occur Lo unyone uL unyLIme beccuse IL Is not u cuusuI
80
80
Rampant Antismoking Signifies Grave Danger
ussocIuLIon. I un ussocIuLIon Is cuusuI, LIen IL cunnoL occur Lo unyone uL
unyLIme becuuse cerLuIn ctpiccl condILIons musL be meL. RuLIer,
epIdemIoIogy uLLempLs Lo sLruddIe boLI proposILIonuI Irumeworks.
AppIyIng LIIs observuLIon Lo smokIng und Iung cuncer, epIdemIoIogy Ius
LrIed Lo convInce cll smokers LIuL LIey ure cll uL rIsk (sLuLIsLIcuI), buL wIen
Iung cuncer occurs IL Is dIrecLIy cuused onl by LIe curcInogenIc properLIes
oI Lobucco smoke (deLermInIsLIc) Lo oLIerwIse IeuILIy persons (I.e., no
conLrIbuLIon by endogenous ubnormuIILy). TIIs cun be descrIbed us u
mugIc powers urgumenL - un exogenous IucLor LIuL cun dIrecLIy cuuse un
eIIecL, uILIougI IL does so very InIrequenLIy, und does so IndependenLIy oI
endogenous sysLem vurIuLIon. TIIs reIIecLs LIe uIreudy descrIbed upsIde-
down, bIuck box LIInkIng LIuL InvoIves u LrunsIerence IuIIucy.
To muke muLLers worse, II IL were possIbIe, epIdemIoIogy ussIgns
numerous dIseuses Lo LIe cuusuI properLIes oI Lobucco smoke. TIIs Is LIe
munuIucLure oI u IucLor LIuL cun cuuse uII munner oI dIIIerenL
muIudIes uL uny LIme Lo unyone. TIe gouI oI scIence Is LIe IdenLIIIcuLIon oI
IIgI-IeveI predIcLors. n IucL, one oI LIe crucIuI uLLrIbuLes oI u genuIne
cuusuI reIuLIonsIIp Is predictcbilit. AnLILIeLIcuIIy, epIdemIoIogy Ius
munuIucLured u compIeLeIy unpredictcble prImury cuuse In Lobucco
smoke. TIIs mugIc powers versIon oI cuuse wouId LypIcuIIy be reIerred
Lo us superstitious beliej, und reIIecLs sLrong neuroLIc Lendency,
purLIcuIurIy In LIe wuy IL Is occurrIng Iere. TIIs IIgIIy errunL conducL Is In
uccordunce wILI LIe muLerIuIIsL munIIesLo und IIgIIy consIsLenL wILI LIe
exLremIsL-Iows LIuL unLIsmokIng Ius been sIown Lo degeneruLe Lo:
SmokIng becomes un expIuIn uII oI dIseuse LIrougI post hoc urgumenL,
bypussIng uII oI LIe ruIes oI coIerenL expIunuLIon (see WuIker, 1q8o).
L Is LIIs very sorL oI conducL LIuL genuIne scIence seeks Lo
overcome or uvoId. L Is jor LIIs reuson LIuL LIe prIncIpIes oI cuusuI
urgumenL (e.g., predIcLIve sLrengLI) ure wIuL LIey ure. n LIIs very crILIcuI
regurd, epIdemIoIogy, In scIenLIIIc Lerms, Is un uLLer Iruud - u sIum. L Ius
decepLIveIy eIevuLed LIe Ideu oI Iow-IeveI (ubsoIuLe) rIsk LIrougI Improper
reIIunce on RR`s, und LIereIore ILs own socIuI sLundIng In IdenLIIyIng u
pIeLIoru oI LIese reIuLIve rIsks, Lo u posILIon IL sImpIy does noL merIL.
L Ius done LIIs by reducIng scIenLIIIc enquIry Lo u Iurce. Ls
LreuLmenL oI LIe Ideu oI rIsk Is noL scIenLIIIc, buL IoIIy. As wIII be IurLIer
consIdered, wIen LIIs mIsIeudIng InIormuLIon Is InIIIcLed on LIe pubIIc by
prevenLIve medIcIne, IL IosLers LIe sume supersLILIous beIIeIs
(psycIopuLIoIogy). n LIIs sense, LIe conducL oI boLI epIdemIoIogy und
prevenLIve medIcIne Is ukIn Lo u quusI-reIIgIous (muLerIuIIsL) cuIL LIuL
worsIIps u sLuLIsLIcs god. I devoLees reduce LIeIr rIsk, und LIereIore
udopL LIe medIcuI rIskoIogIsL (cuIL) IIIesLyIe, LIe pecuIIurILy oI LIIs god
Is LIuL IL cun uIso uIIecL cuusuI reIuLIonsIIps! TIIs wouId be IuugIubIe II
Lifestyle Epidemiology
LIe consequences were noL so dIre. And LIIs evuIuuLIon Is noL mude
IIgILIy. As wIII be consIdered In IuLer dIscussIon, LIIs menLuIIy
dysIuncLIonuI upproucI Lo scIence und pubIIc IeuILI Is IIgIIy dungerous.
urLIermore, IL does noL concern jusL cIgureLLe smokIng, buL mosL oI LIe
IIIesLyIe InIormuLIon LIuL Is dIssemInuLed by pubIIc IeuILI uuLIorILIes.
or LIe purposes oI LIIs dIscussIon, LIIs cuIL LIInkIng wIII be reIerred Lo us
LIe MMES cuIL (pronounced mess) In LIuL IL Is medIco-muLerIuIIsL,
exLernuIIsL und sLuLIsLIcuI In busIs.
L musL be remembered LIuL LIe IdenLIIIcuLIon oI IIgI-IeveI
predIcLors Is u crILIcuI uspecL oI scIenLIIIc enquIry. n consLrucLIng u
buIIdIng, one wouId requIre u IIgI degree oI conIIdence (IIgI predIcLIve
sLrengLI) LIuL brIcks und morLur und LIe properLIes LIereoI, Ior exumpIe,
wIII perIorm Lo LIeIr InLended IuncLIonJspecIIIcuLIon. I we use LIe poor
predIcLIve sLrengLI Lo wIIcI epIdemIoIogy InepLIy udIeres (I.e., usuuIIy
neur-zero or eIIecLIveIy zero) Lo deIIne LIe IuncLIonuI scope oI brIcks und
morLur In consLrucLIon, LIere wouId noL be u buIIdIng sLundIng! TIere Is
noL mucI poInL IndIcuLIng LIuL one seL oI specIIIcuLIons Ior brIcks und
morLur Is beLLer LIun unoLIer (reIuLIve ussessmenL) wIen, In ubsoIuLe
Lerms, neILIer seL oI specIIIcuLIons wouId IoId up u rooI.
IIesLyIe epIdemIoIogy cunnoL be consIdered us u pseudo or even
u poorJbud scIence. Ls beIIeI sLrucLure (muLerIuIIsLJexLernuIIsL bIus) und
gross IncompeLence on u sysLemIc busIs muke LIe resuILIng conducL
cntitheticcl Lo scIenLIIIc enquIry, I.e., cntiscientijic. L demonsLruLes u
poor grusp oI LIe ussumpLIons und consIderubIe IImILuLIons oI sLuLIsLIcuI
InIerence, IL vIoIuLes eter prIncIpIe oI cuusuI urgumenL, und Is duIL wILI
regurd Lo psycIoIogIcuI, socIuI und moruI IeuILI. n LIe Iunds oI
epIdemIoIogy, LIe Lerm cuuse, wIIcI Is LIe sLrongesL In scIenLIIIc
purIunce, Ius been reduced Lo LIe IosLerIng oI supersLILIous beIIeI (menLuI
dysIuncLIon) und Is IIung ubouL LIe medIcuI IILeruLure und LIe medIu wILI
reckIess ubundon. TIe medIco-muLerIuIIsL bIus und LIe mIsguIded uLLempL
Lo coerce socIeLuI cIunge on LIe busIs oI wIuL Is u sLuLIsLIcs mudness cun
weII be cIurucLerIzed us u conLemporury Iorm oI wILcIdocLorIng. One
needs Lo be remInded reguIurIy LIuL LIIs conducL Is beIng produced by u
supposed scIenLIIIc dIscIpIIne und, even more ubsurdIy, u supposed IeuILI
uuLIorILy. urLIermore, uII deLrImenLuI repercussIons oI LIIs mIsconducL
ure IuLrogenIc.
AnoLIer crILIcuI probIem Is LIuL LIe cupucILy Ior seII-correcLIon Is
non-exIsLenL In LIe dIscIpIIne oI epIdemIoIogy. n weII-IuncLIonIng
scIenLIIIc dIscIpIInes, LIere Is u coIerenL grusp by uL IeusL u mujorILy oI LIe
prucLILIoners us Lo LIe cenLruI prIncIpIes LIuL deIIne scIenLIIIc enquIry. I
LIere Is errunL reseurcI conducL by uny members, e.g., vIoIuLIon oI
prIncIpIes oI cuusuI urgumenLuLIon, LIe peer group ILseII, LIrougI
81
81
Rampant Antismoking Signifies Grave Danger
ussocIuLIon. I un ussocIuLIon Is cuusuI, LIen IL cunnoL occur Lo unyone uL
unyLIme becuuse cerLuIn ctpiccl condILIons musL be meL. RuLIer,
epIdemIoIogy uLLempLs Lo sLruddIe boLI proposILIonuI Irumeworks.
AppIyIng LIIs observuLIon Lo smokIng und Iung cuncer, epIdemIoIogy Ius
LrIed Lo convInce cll smokers LIuL LIey ure cll uL rIsk (sLuLIsLIcuI), buL wIen
Iung cuncer occurs IL Is dIrecLIy cuused onl by LIe curcInogenIc properLIes
oI Lobucco smoke (deLermInIsLIc) Lo oLIerwIse IeuILIy persons (I.e., no
conLrIbuLIon by endogenous ubnormuIILy). TIIs cun be descrIbed us u
mugIc powers urgumenL - un exogenous IucLor LIuL cun dIrecLIy cuuse un
eIIecL, uILIougI IL does so very InIrequenLIy, und does so IndependenLIy oI
endogenous sysLem vurIuLIon. TIIs reIIecLs LIe uIreudy descrIbed upsIde-
down, bIuck box LIInkIng LIuL InvoIves u LrunsIerence IuIIucy.
To muke muLLers worse, II IL were possIbIe, epIdemIoIogy ussIgns
numerous dIseuses Lo LIe cuusuI properLIes oI Lobucco smoke. TIIs Is LIe
munuIucLure oI u IucLor LIuL cun cuuse uII munner oI dIIIerenL
muIudIes uL uny LIme Lo unyone. TIe gouI oI scIence Is LIe IdenLIIIcuLIon oI
IIgI-IeveI predIcLors. n IucL, one oI LIe crucIuI uLLrIbuLes oI u genuIne
cuusuI reIuLIonsIIp Is predictcbilit. AnLILIeLIcuIIy, epIdemIoIogy Ius
munuIucLured u compIeLeIy unpredictcble prImury cuuse In Lobucco
smoke. TIIs mugIc powers versIon oI cuuse wouId LypIcuIIy be reIerred
Lo us superstitious beliej, und reIIecLs sLrong neuroLIc Lendency,
purLIcuIurIy In LIe wuy IL Is occurrIng Iere. TIIs IIgIIy errunL conducL Is In
uccordunce wILI LIe muLerIuIIsL munIIesLo und IIgIIy consIsLenL wILI LIe
exLremIsL-Iows LIuL unLIsmokIng Ius been sIown Lo degeneruLe Lo:
SmokIng becomes un expIuIn uII oI dIseuse LIrougI post hoc urgumenL,
bypussIng uII oI LIe ruIes oI coIerenL expIunuLIon (see WuIker, 1q8o).
L Is LIIs very sorL oI conducL LIuL genuIne scIence seeks Lo
overcome or uvoId. L Is jor LIIs reuson LIuL LIe prIncIpIes oI cuusuI
urgumenL (e.g., predIcLIve sLrengLI) ure wIuL LIey ure. n LIIs very crILIcuI
regurd, epIdemIoIogy, In scIenLIIIc Lerms, Is un uLLer Iruud - u sIum. L Ius
decepLIveIy eIevuLed LIe Ideu oI Iow-IeveI (ubsoIuLe) rIsk LIrougI Improper
reIIunce on RR`s, und LIereIore ILs own socIuI sLundIng In IdenLIIyIng u
pIeLIoru oI LIese reIuLIve rIsks, Lo u posILIon IL sImpIy does noL merIL.
L Ius done LIIs by reducIng scIenLIIIc enquIry Lo u Iurce. Ls
LreuLmenL oI LIe Ideu oI rIsk Is noL scIenLIIIc, buL IoIIy. As wIII be IurLIer
consIdered, wIen LIIs mIsIeudIng InIormuLIon Is InIIIcLed on LIe pubIIc by
prevenLIve medIcIne, IL IosLers LIe sume supersLILIous beIIeIs
(psycIopuLIoIogy). n LIIs sense, LIe conducL oI boLI epIdemIoIogy und
prevenLIve medIcIne Is ukIn Lo u quusI-reIIgIous (muLerIuIIsL) cuIL LIuL
worsIIps u sLuLIsLIcs god. I devoLees reduce LIeIr rIsk, und LIereIore
udopL LIe medIcuI rIskoIogIsL (cuIL) IIIesLyIe, LIe pecuIIurILy oI LIIs god
Is LIuL IL cun uIso uIIecL cuusuI reIuLIonsIIps! TIIs wouId be IuugIubIe II
Lifestyle Epidemiology
LIe consequences were noL so dIre. And LIIs evuIuuLIon Is noL mude
IIgILIy. As wIII be consIdered In IuLer dIscussIon, LIIs menLuIIy
dysIuncLIonuI upproucI Lo scIence und pubIIc IeuILI Is IIgIIy dungerous.
urLIermore, IL does noL concern jusL cIgureLLe smokIng, buL mosL oI LIe
IIIesLyIe InIormuLIon LIuL Is dIssemInuLed by pubIIc IeuILI uuLIorILIes.
or LIe purposes oI LIIs dIscussIon, LIIs cuIL LIInkIng wIII be reIerred Lo us
LIe MMES cuIL (pronounced mess) In LIuL IL Is medIco-muLerIuIIsL,
exLernuIIsL und sLuLIsLIcuI In busIs.
L musL be remembered LIuL LIe IdenLIIIcuLIon oI IIgI-IeveI
predIcLors Is u crILIcuI uspecL oI scIenLIIIc enquIry. n consLrucLIng u
buIIdIng, one wouId requIre u IIgI degree oI conIIdence (IIgI predIcLIve
sLrengLI) LIuL brIcks und morLur und LIe properLIes LIereoI, Ior exumpIe,
wIII perIorm Lo LIeIr InLended IuncLIonJspecIIIcuLIon. I we use LIe poor
predIcLIve sLrengLI Lo wIIcI epIdemIoIogy InepLIy udIeres (I.e., usuuIIy
neur-zero or eIIecLIveIy zero) Lo deIIne LIe IuncLIonuI scope oI brIcks und
morLur In consLrucLIon, LIere wouId noL be u buIIdIng sLundIng! TIere Is
noL mucI poInL IndIcuLIng LIuL one seL oI specIIIcuLIons Ior brIcks und
morLur Is beLLer LIun unoLIer (reIuLIve ussessmenL) wIen, In ubsoIuLe
Lerms, neILIer seL oI specIIIcuLIons wouId IoId up u rooI.
IIesLyIe epIdemIoIogy cunnoL be consIdered us u pseudo or even
u poorJbud scIence. Ls beIIeI sLrucLure (muLerIuIIsLJexLernuIIsL bIus) und
gross IncompeLence on u sysLemIc busIs muke LIe resuILIng conducL
cntitheticcl Lo scIenLIIIc enquIry, I.e., cntiscientijic. L demonsLruLes u
poor grusp oI LIe ussumpLIons und consIderubIe IImILuLIons oI sLuLIsLIcuI
InIerence, IL vIoIuLes eter prIncIpIe oI cuusuI urgumenL, und Is duIL wILI
regurd Lo psycIoIogIcuI, socIuI und moruI IeuILI. n LIe Iunds oI
epIdemIoIogy, LIe Lerm cuuse, wIIcI Is LIe sLrongesL In scIenLIIIc
purIunce, Ius been reduced Lo LIe IosLerIng oI supersLILIous beIIeI (menLuI
dysIuncLIon) und Is IIung ubouL LIe medIcuI IILeruLure und LIe medIu wILI
reckIess ubundon. TIe medIco-muLerIuIIsL bIus und LIe mIsguIded uLLempL
Lo coerce socIeLuI cIunge on LIe busIs oI wIuL Is u sLuLIsLIcs mudness cun
weII be cIurucLerIzed us u conLemporury Iorm oI wILcIdocLorIng. One
needs Lo be remInded reguIurIy LIuL LIIs conducL Is beIng produced by u
supposed scIenLIIIc dIscIpIIne und, even more ubsurdIy, u supposed IeuILI
uuLIorILy. urLIermore, uII deLrImenLuI repercussIons oI LIIs mIsconducL
ure IuLrogenIc.
AnoLIer crILIcuI probIem Is LIuL LIe cupucILy Ior seII-correcLIon Is
non-exIsLenL In LIe dIscIpIIne oI epIdemIoIogy. n weII-IuncLIonIng
scIenLIIIc dIscIpIInes, LIere Is u coIerenL grusp by uL IeusL u mujorILy oI LIe
prucLILIoners us Lo LIe cenLruI prIncIpIes LIuL deIIne scIenLIIIc enquIry. I
LIere Is errunL reseurcI conducL by uny members, e.g., vIoIuLIon oI
prIncIpIes oI cuusuI urgumenLuLIon, LIe peer group ILseII, LIrougI
82
82
Rampant Antismoking Signifies Grave Danger
crILIques, revIews, eLc., wIII brIng LIe probIem InLo correcLIon. L Ius
uIreudy been brIeIIy consIdered LIuL epIdemIoIogy Ius never come Lo
Lerms wILI LIe prIncIpIes oI scIenLIIIc enquIry und purLIcuIurIy cuusuI
urgumenL. n epIdemIoIogy LIere Is no coIerenL, coIIecLIve grusp oI
prIncIpIes sucI us consIsLencyJspecIIIcILy, sLrengLI oI un ussocIuLIon, eLc..
SInce LIe probIem Is sysLemIc (InsLILuLIonuIIzed), most demonsLruLe LIe
errunL LIInkIng, und LIereIore, seII-correcLIon Is ImpossIbIe. ExpIunuLIon
In LIIs conLexL Is reduced Lo consensus eIIecLs devoId oI coIerenL
urgumenL.
TIere Is u LempLuLIon Lo concIude LIuL epIdemIoIogy Ius
someIow been deruIIed. However, LIIs presupposes LIuL uL one LIme IL
wus on Lruck. RuLIer, epIdemIoIogy Ius never come Lo Lerms wILI
scIenLIIIc enquIry. EpIdemIoIogIsLs LypIcuIIy Iuve u medIcuI buckground.
MedIcuI prucLILIoners ure LruIned In LIe cIInIcuI meLIod. TIe common
cIrcumsLunce Is LIuL u docLor Is presenLed wILI u sIck person. TIe docLor
wIII LIen uLLempL Lo IInd common unLecedenLs Ior LIe IIIness In quesLIon
In uLLempLIng Lo undersLund LIe ueLIoIogy oI LIe dIseuse. TIe docLor mIgIL
Lry removIng cerLuIn uspecLs Irom u puLIenL`s sILuuLIon In uLLempLIng Lo
uIIevIuLe LIe IIIness or sympLoms. TIIs ucLuuIIy IIImsy upproucI Is
LoIerubIe wIere u person Is uIreudy sIck und muy Iuve Iew or no oLIer
medIcuI opLIons. A medIcuIIy-LruIned mInd, beIng IIgIIy IumIIIur wILI
uLLempLIng Lo IInd common unLecedenLs Ior un existin dIseuse, beIIeves
LIuL LIIs exIuusLs LIe enLIreLy oI InvesLIguLIon. TIose medIcuIIy-LruIned
enLerIng epIdemIoIogy do so wILI LIIs IIxed mInd-seL. L sIouId be obvIous
LIuL LIe use oI LIe RR sLuLIsLIc In epIdemIoIogIcuI enquIry IuIIy mImIcs LIe
cIInIcuI meLIod. EpIdemIoIogIsLs ure enLIreIy unIumIIIur LIuL scIence Is Iur
more LIun LIe cIInIcuI meLIod. And LIe dIIIerences ure crILIcuI wIen
presenLIng prescrIpLIve cIuIms Lo LIe weII popuIuLIon. ScIence pursues
IIgI-IeveI predIcLors Ior IucLors. An epIdemIoIogIsL musL go beyond LIe
cIInIcuI meLIod, und evuIuuLe LIe predIcLIve sLrengLI oI common
unLecedenLs LIuL muy Iuve been esLubIIsIed by LIe cIInIcuI meLIod: TIuL
un unLecedenL Is common Ior u dIseuse (cIInIcuI meLIod) does noL ImpIy
LIuL LIe sume dIseuse Is common Ior LIe sume unLecedenL.
EpIdemIoIogIsLs ure obIIvIous Lo LIe IucL (I.e., IuckIng compeLence) LIuL Lo
conIuse LIe Lwo generuLes mugIc powers urgumenLs or IeurIuI
supersLILIous beIIeI, I.e., ussuuIL on psycIoIogIcuI und socIuI IeuILI.
PIuInIy puL, epIdemIoIogIsLs ure noL LruIned In scIenLIIIc enquIry.
TruInIng In epIdemIoIogy Is sLucked wILI bIosLuLIsLIcs courses. WIIIe LIere
Is mucI LeucIIng oI correcL sLuLIsLIcuI procedure, ubsoIuLe predIcLIve
sLrengLI, u cornersLone oI scIenLIIIc enquIry, does noL IIgure.
EpIdemIoIogIsLs ure noL LuugIL LIe epIsLemoIogy oI scIenLIIIc enquIry, I.e.,
ILs pInpoInLIng gouI: TIe LrunscendIng oI sLuLIsLIcuIIsm, und LIereIore
Lifestyle Epidemiology
mugIc powers urgumenLs, Is crucIuI. TruInIng Is uIso devoId oI u
muILIdImensIonuI worId vIew, reIIecLIng onIy LIe reducLIonIsL (muLerIuIIsL)
vIew. As sucI, epIdemIoIogIsLs Iuve no compeLence concernIng Iow RR-
dIIIerences cun be InIIuenced by subgroup dIIIerences und cross-
correIuLed IucLors deIIned In psycIoIogIcuI undJor psycIosocIuI Lerms.
TIere musL be u smuII group wILIIn LIe medIcuI esLubIIsImenL
LIuL comprIses very cupubIe LIInkers. SLeIbens (1qqz), Ior exumpIe,
presenLs un exceIIenL deIIneuLIon oI un operuLIonuI deIInILIon oI ccuse und
commenLs on LIe severe mIsuse oI LIe Lerm In epIdemIoIogy und
prevenLIve medIcIne regurdIng coronury dIseuse. TIe deIIneuLIon Is
equuIIy reIevunL Lo oLIer dIseuses. Skrubunek & McCormIck (1qqo)
provIde u Iong IIsL oI IIuwed medIcuI reusonIng. However, LIe cupubIe ure
Iur ouLnumbered, und LIeIr cuIIs Ior producLIve und progressIve cIunge
ure very quIckIy bypussed by LIe generuI IncompeLenL dIn.
A IurLIer crILIcuI probIem Is LIuL epIdemIoIogy uIso demonsLruLes
un exLremeIy poor cupucILy Ior generuLIng counLer, or uILernuLe
IypoLIeses, e.g., cIgureLLe smokIng und dIseuse. As Ius uIreudy been
menLIoned, wIere counLer IypoLIeses Iuve been presenLed, LIe generuI
epIdemIoIogy membersIIp Ius been onIy Loo quIckIy dIsmIssIve. PurL oI
LIe probIem Iere Is noL onIy LIe Issue oI IncompeLence, buL uIso ILs very
sLrong muLerIuIIsL bIus. As sucI, IL Is very IImILed In concepLuuI scope.
Even II IncompeLence wus noL sucI u sLrong Issue, muLerIuIIsm very
quIckIy runs ouL oI Ideus. or exumpIe, regurdIng cIgureLLe smokIng, IL Ius
been eurIIer consIdered LIuL LIe muInLenunce oI smokIng cun resuIL Irom
ILs pIucemenL In u cognILIve und psycIo-emoLIonuI Irumework, e.g.,
convergIng eIIecL. n LIIs sense, IL muy ucLuuIIy Iuve beneIIcIuI uspecLs,
e.g., sLress reIIeI. However, bIoIogIcuI reducLIonIsm (muLerIuIIsm) cunnoL
even IuLIom LIe possIbIIILy oI smokIng us u menLuIIy medIuLed beIuvIor,
I.e., u reuson Ior, us opposed Lo u cuuse oI, beIuvIor, IeL uIone uccounL Ior
LIIs. TIereIore, LIe ever-presenL dunger Is LIuL IL wIII conIuse LIe hcbit oI
smokIng, us un uLLempL Lo uIIevIuLe sLress, wILI LIe possIbIe eIIecLs oI LIe
properties oI Lobucco smoke In dIseuse.
WIen IL decIded Lo spreud ILs reseurcI eIIorLs Lo LIe ImpIIcuLIon
oI IIIesLyIe IucLors In dIseuse, LIe generuI epIdemIoIogy membersIIp
sIouId Iuve uL IeusL ucquuInLed ILseII wILI LIe greuLer InvesLIguLIon oI LIe
Iumun condILIon, IncIudIng non-muLerIuIIsL vIews (e.g., psycIoIogy, socIuI
psycIoIogy, reIIgIon), und Iow LIese muy ImpInge on beIuvIor und socIuI
IuncLIonIng. TIere muy Iuve been un umounL oI LIIs In LIe eurIy duys us
wIII be consIdered In u IuLer secLIon on Whct is Heclth?. However, over uL
IeusL LIe IusL Lwo or LIree decudes, IL Ius progressIveIy uIIowed wIuL Is by
now u compreIensIve muLerIuIIsL bIus Lo domInuLe ILs reusonIng. L sIouId
be noLed LIuL LIIs Is noL pecuIIur Lo epIdemIoIogy. L sImpIy Ius provIded
83
83
Rampant Antismoking Signifies Grave Danger
crILIques, revIews, eLc., wIII brIng LIe probIem InLo correcLIon. L Ius
uIreudy been brIeIIy consIdered LIuL epIdemIoIogy Ius never come Lo
Lerms wILI LIe prIncIpIes oI scIenLIIIc enquIry und purLIcuIurIy cuusuI
urgumenL. n epIdemIoIogy LIere Is no coIerenL, coIIecLIve grusp oI
prIncIpIes sucI us consIsLencyJspecIIIcILy, sLrengLI oI un ussocIuLIon, eLc..
SInce LIe probIem Is sysLemIc (InsLILuLIonuIIzed), most demonsLruLe LIe
errunL LIInkIng, und LIereIore, seII-correcLIon Is ImpossIbIe. ExpIunuLIon
In LIIs conLexL Is reduced Lo consensus eIIecLs devoId oI coIerenL
urgumenL.
TIere Is u LempLuLIon Lo concIude LIuL epIdemIoIogy Ius
someIow been deruIIed. However, LIIs presupposes LIuL uL one LIme IL
wus on Lruck. RuLIer, epIdemIoIogy Ius never come Lo Lerms wILI
scIenLIIIc enquIry. EpIdemIoIogIsLs LypIcuIIy Iuve u medIcuI buckground.
MedIcuI prucLILIoners ure LruIned In LIe cIInIcuI meLIod. TIe common
cIrcumsLunce Is LIuL u docLor Is presenLed wILI u sIck person. TIe docLor
wIII LIen uLLempL Lo IInd common unLecedenLs Ior LIe IIIness In quesLIon
In uLLempLIng Lo undersLund LIe ueLIoIogy oI LIe dIseuse. TIe docLor mIgIL
Lry removIng cerLuIn uspecLs Irom u puLIenL`s sILuuLIon In uLLempLIng Lo
uIIevIuLe LIe IIIness or sympLoms. TIIs ucLuuIIy IIImsy upproucI Is
LoIerubIe wIere u person Is uIreudy sIck und muy Iuve Iew or no oLIer
medIcuI opLIons. A medIcuIIy-LruIned mInd, beIng IIgIIy IumIIIur wILI
uLLempLIng Lo IInd common unLecedenLs Ior un existin dIseuse, beIIeves
LIuL LIIs exIuusLs LIe enLIreLy oI InvesLIguLIon. TIose medIcuIIy-LruIned
enLerIng epIdemIoIogy do so wILI LIIs IIxed mInd-seL. L sIouId be obvIous
LIuL LIe use oI LIe RR sLuLIsLIc In epIdemIoIogIcuI enquIry IuIIy mImIcs LIe
cIInIcuI meLIod. EpIdemIoIogIsLs ure enLIreIy unIumIIIur LIuL scIence Is Iur
more LIun LIe cIInIcuI meLIod. And LIe dIIIerences ure crILIcuI wIen
presenLIng prescrIpLIve cIuIms Lo LIe weII popuIuLIon. ScIence pursues
IIgI-IeveI predIcLors Ior IucLors. An epIdemIoIogIsL musL go beyond LIe
cIInIcuI meLIod, und evuIuuLe LIe predIcLIve sLrengLI oI common
unLecedenLs LIuL muy Iuve been esLubIIsIed by LIe cIInIcuI meLIod: TIuL
un unLecedenL Is common Ior u dIseuse (cIInIcuI meLIod) does noL ImpIy
LIuL LIe sume dIseuse Is common Ior LIe sume unLecedenL.
EpIdemIoIogIsLs ure obIIvIous Lo LIe IucL (I.e., IuckIng compeLence) LIuL Lo
conIuse LIe Lwo generuLes mugIc powers urgumenLs or IeurIuI
supersLILIous beIIeI, I.e., ussuuIL on psycIoIogIcuI und socIuI IeuILI.
PIuInIy puL, epIdemIoIogIsLs ure noL LruIned In scIenLIIIc enquIry.
TruInIng In epIdemIoIogy Is sLucked wILI bIosLuLIsLIcs courses. WIIIe LIere
Is mucI LeucIIng oI correcL sLuLIsLIcuI procedure, ubsoIuLe predIcLIve
sLrengLI, u cornersLone oI scIenLIIIc enquIry, does noL IIgure.
EpIdemIoIogIsLs ure noL LuugIL LIe epIsLemoIogy oI scIenLIIIc enquIry, I.e.,
ILs pInpoInLIng gouI: TIe LrunscendIng oI sLuLIsLIcuIIsm, und LIereIore
Lifestyle Epidemiology
mugIc powers urgumenLs, Is crucIuI. TruInIng Is uIso devoId oI u
muILIdImensIonuI worId vIew, reIIecLIng onIy LIe reducLIonIsL (muLerIuIIsL)
vIew. As sucI, epIdemIoIogIsLs Iuve no compeLence concernIng Iow RR-
dIIIerences cun be InIIuenced by subgroup dIIIerences und cross-
correIuLed IucLors deIIned In psycIoIogIcuI undJor psycIosocIuI Lerms.
TIere musL be u smuII group wILIIn LIe medIcuI esLubIIsImenL
LIuL comprIses very cupubIe LIInkers. SLeIbens (1qqz), Ior exumpIe,
presenLs un exceIIenL deIIneuLIon oI un operuLIonuI deIInILIon oI ccuse und
commenLs on LIe severe mIsuse oI LIe Lerm In epIdemIoIogy und
prevenLIve medIcIne regurdIng coronury dIseuse. TIe deIIneuLIon Is
equuIIy reIevunL Lo oLIer dIseuses. Skrubunek & McCormIck (1qqo)
provIde u Iong IIsL oI IIuwed medIcuI reusonIng. However, LIe cupubIe ure
Iur ouLnumbered, und LIeIr cuIIs Ior producLIve und progressIve cIunge
ure very quIckIy bypussed by LIe generuI IncompeLenL dIn.
A IurLIer crILIcuI probIem Is LIuL epIdemIoIogy uIso demonsLruLes
un exLremeIy poor cupucILy Ior generuLIng counLer, or uILernuLe
IypoLIeses, e.g., cIgureLLe smokIng und dIseuse. As Ius uIreudy been
menLIoned, wIere counLer IypoLIeses Iuve been presenLed, LIe generuI
epIdemIoIogy membersIIp Ius been onIy Loo quIckIy dIsmIssIve. PurL oI
LIe probIem Iere Is noL onIy LIe Issue oI IncompeLence, buL uIso ILs very
sLrong muLerIuIIsL bIus. As sucI, IL Is very IImILed In concepLuuI scope.
Even II IncompeLence wus noL sucI u sLrong Issue, muLerIuIIsm very
quIckIy runs ouL oI Ideus. or exumpIe, regurdIng cIgureLLe smokIng, IL Ius
been eurIIer consIdered LIuL LIe muInLenunce oI smokIng cun resuIL Irom
ILs pIucemenL In u cognILIve und psycIo-emoLIonuI Irumework, e.g.,
convergIng eIIecL. n LIIs sense, IL muy ucLuuIIy Iuve beneIIcIuI uspecLs,
e.g., sLress reIIeI. However, bIoIogIcuI reducLIonIsm (muLerIuIIsm) cunnoL
even IuLIom LIe possIbIIILy oI smokIng us u menLuIIy medIuLed beIuvIor,
I.e., u reuson Ior, us opposed Lo u cuuse oI, beIuvIor, IeL uIone uccounL Ior
LIIs. TIereIore, LIe ever-presenL dunger Is LIuL IL wIII conIuse LIe hcbit oI
smokIng, us un uLLempL Lo uIIevIuLe sLress, wILI LIe possIbIe eIIecLs oI LIe
properties oI Lobucco smoke In dIseuse.
WIen IL decIded Lo spreud ILs reseurcI eIIorLs Lo LIe ImpIIcuLIon
oI IIIesLyIe IucLors In dIseuse, LIe generuI epIdemIoIogy membersIIp
sIouId Iuve uL IeusL ucquuInLed ILseII wILI LIe greuLer InvesLIguLIon oI LIe
Iumun condILIon, IncIudIng non-muLerIuIIsL vIews (e.g., psycIoIogy, socIuI
psycIoIogy, reIIgIon), und Iow LIese muy ImpInge on beIuvIor und socIuI
IuncLIonIng. TIere muy Iuve been un umounL oI LIIs In LIe eurIy duys us
wIII be consIdered In u IuLer secLIon on Whct is Heclth?. However, over uL
IeusL LIe IusL Lwo or LIree decudes, IL Ius progressIveIy uIIowed wIuL Is by
now u compreIensIve muLerIuIIsL bIus Lo domInuLe ILs reusonIng. L sIouId
be noLed LIuL LIIs Is noL pecuIIur Lo epIdemIoIogy. L sImpIy Ius provIded
84
84
Rampant Antismoking Signifies Grave Danger
very IILLIe resIsLunce Lo greuLer muLerIuIIsL pressures (e.g., economIc
opporLunIsmJruLIonuIIsm). TIIs muLerIuIIsL bIus wIII become u more
crILIcuI IucLor us LIe dIscussIon proceeds.
A IurLIer severe probIem In epIdemIoIogy Is ILs dIsLurbIngIy poor
grusp oI LIe meLu-LIeoreLIcuI (generuI) requIremenLs oI LIeoreLIcuI
sLrucLure. TIIs probIem Is InLImuLeIy IInked Lo ILs upsIde-down, buck-Lo-
IronL LIInkIng. A weII-deIIned cuusuI LIeory wIII properIy deIIne LIe scope
oI ucLIon oI u seL oI unLecedenLs LIuL unIqueIy und dIrecLIy reIuLe Lo u seL oI
consequenLs. TIe crILIcuI crILerIu ure LIe prIncIpIes oI cuusuI urgumenL
ouLIIned In secLIons 1.z und 1.. A cuusuI LIeory sIouId so deIIne LIe
properLIes oI unLecedenLs sucI LIuL LIese cun uccounL Ior posILIve-posILIve
ussocIuLIons (I.e., unLecedenL A - consequenL B), posILIve-neguLIve
ussocIuLIons (I.e., unLecedenL A - no consequenL B), und neguLIve-posILIve
ussocIuLIons (I.e., no unLecedenL A - consequenL B). A IIgI degree oI
predIcLIve sLrengLI meuns LIuL LIe posILIve-posILIve ussocIuLIons
consLILuLe LIe greuLer proporLIon oI LIe overuII occurrence oI LIe
unLecedenL.
or exumpIe, consIderIng LIe LIeoreLIcuI LreuLmenL oI LIe
sLuLIsLIcuI InIormuLIon perLuInIng Lo smokIng und Iung cuncer, IIrsLIy,
LIere Is no sound LIeoreLIcuI deIInILIon oI wIuL IL Is ubouL Lobucco smoke
or cIgureLLe smokIng LIuL cuuses purLIcuIur dumuge or LIe endogenous
mecIunIsmsJprocesses InvoIved. SecondIy, LIe posILIve-posILIve
ussocIuLIon, us u proporLIon oI LIe generuI prevuIence oI LIe unLecedenL, Is
neur-zero (-1o%). TIIrdIy, IL Is noL poInLed ouL wIy Iung cuncer does not
occur In LIe mujorILy (-qo%) oI Ieuvy smokers, I.e., posILIve-neguLIve
ussocIuLIons. ourLIIy, LIere Is no expIunuLIon us Lo LIe cuusuI
underpInnIngs oI LIe sume condILIon occurrIng In non-smokers, I.e.,
neguLIve-posILIve ussocIuLIons. TIe expIunuLIon uLLempLIng Lo cuusuIIy
reIuLe cIgureLLe smokIng und Iung cuncer Is noL u LIeory uL uII. UsuuIIy,
sucI expIunuLIons wouId be consIdered us IuII-buked specuIuLIons LIuL
Iuve LIe poLenLIuI Lo be purL oI u greuLer LIeoreLIcuI Irumework. However,
In LIe currenL conLexL IL reIIecLs supersLILIous beIIeI In LIuL LIe specuIuLIon
conLrudIcLs LIe buIk oI LIe evIdence, I.e., mosL smokers do noL deveIop
Iung cuncer. WIuL Is cctucll occurrIng Is LIuL epIdemIoIogy Ius
convInced ILseII LIuL IL cun sImpIy reud oII uny Increused IncIdence oI uny
dIseuse ussocIuLed wILI cIgureLLe smokIng (RR converLed Lo uLLrIbuLubIe
rIsk, converLed Lo uLLrIbuLubIe IncIdence), conjure some pIuusIbIe sLory
LIuL cun IIImsIIy uccounL onl Ior LIe posILIve-posILIve ussocIuLIons, und
LIuL onl LIIs presenLuLIon jull expIuIns u sIngIe-IucLor, prImury cuusuI
reIuLIonsIIp beLween cIgureLLe smokIng und LIe dIseuse In quesLIon.
AguIn, LIe requIremenL oI IIgI predIcLIve sLrengLI Ius been subverLed by
pIuusIbIIILyJunuIogy (specuIuLIon), und wIere LIe IuLLer now drIves cuusuI
Lifestyle Epidemiology
urgumenL. TIIs Is reuIIy un expIunuLory versIon oI upsIde-down, buck-
Lo-IronL LIInkIng InvoIvIng u LrunsIerence IuIIucy. I LIe very sImpIe
scIenLIIIc quesLIon Is posILed us Lo wIy mosL smokers do noL deveIop LIe
dIseuse, LIe wIId specuIuLIon IuIIs upurL, I.e., u sound LIeory requIres Iur
more concepLs und coIerenL reusonIng Lo properIy uccounL Ior posILIve-
posILIve, neguLIve-posILIve und posILIve-neguLIve ussocIuLIons. n LIe
currenL conLexL, gIven LIuL LIe predIcLIve sLrengLI oI cIgureLLe smokIng Ior
Iung cuncer Is on LIe zero-end oI LIe scuIe, LIe ucLuuI cuusuI
underpInnIngs oI LIe condILIon wouId eILIer be oLIer exogenous IucLors
(ImprobubIe) or endogenous IuIIure sucI us pre-exIsLIng dIseuse or geneLIc
ubnormuIILy (probubIe).
z.. The Current Situction
L cun be concIuded Irom LIe IoregoIng LIuL cIgureLLe smokIng
und IeuILI Is noL u sImpIe muLLer uL uII. DembrowskI (1q8q), Ior exumpIe,
uIso concIudes LIuL LIe IIndIngs revIewed cIeurIy IndIcuLe LIuL LIere ure
very compIex reIuLIonsIIps presenL InvoIvIng cIussIc rIsk IucLors, sLress,
personuIILy uLLrIbuLes, consummuLory beIuvIors, und pIysIoIogIc
reucLIvILy. Moreover, LIe observuLIon LIuL muny consummuLory beIuvIors
covury, e.g., cIgureLLe smokIng, cuIIeIne, uIcoIoI, eLc., und LIuL eucI cun
uIIecL curdIovuscuIur reucLIons Lo sLress, mukes IL cIeur LIuL sorLIng ouL
IndIvIduuI und InLerucLIve eIIecLs Is u compIex cIuIIenge Ior IuLure
reseurcI... (p. 1q)
L Is u mosL reusonubIe urgumenL LIuL LIe InvesLIguLIon oI
dIseuses sucI us cuncer und CHD requIres reseurcIers wILI
muILIdIscIpIInury (bIoIogIcuI, socIuI, menLuI, moruI) skIIIs or LIe
promoLIon oI muILIdIscIpIInury InvesLIguLIons. urLIermore, gIven LIuL
LIere ure muny Issues In LIe InvesLIguLIon oI sucI dIseuses LIuL do noL
Iend LIemseIves eusIIy, or uL uII, Lo experImenLuI or sLruIgILIorwurd
upproucIes, LIuL IL requIres consIderubIe IngenuILyJsopIIsLIcuLIon Lo
coIerenLIy Leuse ouL ucLuuI cuusuI reIuLIonsIIps. IIesLyIe epIdemIoIogy
Is lecst quuIIIIed Ior LIIs very IormIdubIe Lusk; IL Is compreIensIveIy ouL oI
ILs InLeIIecLuuI depLI. IIesLyIe epIdemIoIogy Is u IrugmenLed muLerIuIIsL
mess, dIvIded InLo IucLIonuI cumps wILI very poor InLer-communIcuLIon.
TIere ure LIose wIo Iuvor mucro-IeveI or socIeLuI deLermInunLs oI dIseuse
producLIon (e.g., KrIeger & ZIerIer, 1qq6; Peurce eL uI., 1qq; TesI, 1q88).
OLIers Iuvor u mIcro-IeveI or bIoIogIcuIJmoIecuIur deLermInunLs oI
dIseuse (e.g., Vundenbrouke, 1q88). CuugIL In beLween Is rIsk IucLor
epIdemIoIogy LIuL supposedIy Iuvors LIe IndIvIduuI IeveI, buL onIy In
beIuvIor (beIuvIorIsL) und exposure Lerms.
SocIuI epIdemIoIogy, Ior exumpIe, demonsLruLes very IILLIe
85
85
Rampant Antismoking Signifies Grave Danger
very IILLIe resIsLunce Lo greuLer muLerIuIIsL pressures (e.g., economIc
opporLunIsmJruLIonuIIsm). TIIs muLerIuIIsL bIus wIII become u more
crILIcuI IucLor us LIe dIscussIon proceeds.
A IurLIer severe probIem In epIdemIoIogy Is ILs dIsLurbIngIy poor
grusp oI LIe meLu-LIeoreLIcuI (generuI) requIremenLs oI LIeoreLIcuI
sLrucLure. TIIs probIem Is InLImuLeIy IInked Lo ILs upsIde-down, buck-Lo-
IronL LIInkIng. A weII-deIIned cuusuI LIeory wIII properIy deIIne LIe scope
oI ucLIon oI u seL oI unLecedenLs LIuL unIqueIy und dIrecLIy reIuLe Lo u seL oI
consequenLs. TIe crILIcuI crILerIu ure LIe prIncIpIes oI cuusuI urgumenL
ouLIIned In secLIons 1.z und 1.. A cuusuI LIeory sIouId so deIIne LIe
properLIes oI unLecedenLs sucI LIuL LIese cun uccounL Ior posILIve-posILIve
ussocIuLIons (I.e., unLecedenL A - consequenL B), posILIve-neguLIve
ussocIuLIons (I.e., unLecedenL A - no consequenL B), und neguLIve-posILIve
ussocIuLIons (I.e., no unLecedenL A - consequenL B). A IIgI degree oI
predIcLIve sLrengLI meuns LIuL LIe posILIve-posILIve ussocIuLIons
consLILuLe LIe greuLer proporLIon oI LIe overuII occurrence oI LIe
unLecedenL.
or exumpIe, consIderIng LIe LIeoreLIcuI LreuLmenL oI LIe
sLuLIsLIcuI InIormuLIon perLuInIng Lo smokIng und Iung cuncer, IIrsLIy,
LIere Is no sound LIeoreLIcuI deIInILIon oI wIuL IL Is ubouL Lobucco smoke
or cIgureLLe smokIng LIuL cuuses purLIcuIur dumuge or LIe endogenous
mecIunIsmsJprocesses InvoIved. SecondIy, LIe posILIve-posILIve
ussocIuLIon, us u proporLIon oI LIe generuI prevuIence oI LIe unLecedenL, Is
neur-zero (-1o%). TIIrdIy, IL Is noL poInLed ouL wIy Iung cuncer does not
occur In LIe mujorILy (-qo%) oI Ieuvy smokers, I.e., posILIve-neguLIve
ussocIuLIons. ourLIIy, LIere Is no expIunuLIon us Lo LIe cuusuI
underpInnIngs oI LIe sume condILIon occurrIng In non-smokers, I.e.,
neguLIve-posILIve ussocIuLIons. TIe expIunuLIon uLLempLIng Lo cuusuIIy
reIuLe cIgureLLe smokIng und Iung cuncer Is noL u LIeory uL uII. UsuuIIy,
sucI expIunuLIons wouId be consIdered us IuII-buked specuIuLIons LIuL
Iuve LIe poLenLIuI Lo be purL oI u greuLer LIeoreLIcuI Irumework. However,
In LIe currenL conLexL IL reIIecLs supersLILIous beIIeI In LIuL LIe specuIuLIon
conLrudIcLs LIe buIk oI LIe evIdence, I.e., mosL smokers do noL deveIop
Iung cuncer. WIuL Is cctucll occurrIng Is LIuL epIdemIoIogy Ius
convInced ILseII LIuL IL cun sImpIy reud oII uny Increused IncIdence oI uny
dIseuse ussocIuLed wILI cIgureLLe smokIng (RR converLed Lo uLLrIbuLubIe
rIsk, converLed Lo uLLrIbuLubIe IncIdence), conjure some pIuusIbIe sLory
LIuL cun IIImsIIy uccounL onl Ior LIe posILIve-posILIve ussocIuLIons, und
LIuL onl LIIs presenLuLIon jull expIuIns u sIngIe-IucLor, prImury cuusuI
reIuLIonsIIp beLween cIgureLLe smokIng und LIe dIseuse In quesLIon.
AguIn, LIe requIremenL oI IIgI predIcLIve sLrengLI Ius been subverLed by
pIuusIbIIILyJunuIogy (specuIuLIon), und wIere LIe IuLLer now drIves cuusuI
Lifestyle Epidemiology
urgumenL. TIIs Is reuIIy un expIunuLory versIon oI upsIde-down, buck-
Lo-IronL LIInkIng InvoIvIng u LrunsIerence IuIIucy. I LIe very sImpIe
scIenLIIIc quesLIon Is posILed us Lo wIy mosL smokers do noL deveIop LIe
dIseuse, LIe wIId specuIuLIon IuIIs upurL, I.e., u sound LIeory requIres Iur
more concepLs und coIerenL reusonIng Lo properIy uccounL Ior posILIve-
posILIve, neguLIve-posILIve und posILIve-neguLIve ussocIuLIons. n LIe
currenL conLexL, gIven LIuL LIe predIcLIve sLrengLI oI cIgureLLe smokIng Ior
Iung cuncer Is on LIe zero-end oI LIe scuIe, LIe ucLuuI cuusuI
underpInnIngs oI LIe condILIon wouId eILIer be oLIer exogenous IucLors
(ImprobubIe) or endogenous IuIIure sucI us pre-exIsLIng dIseuse or geneLIc
ubnormuIILy (probubIe).
z.. The Current Situction
L cun be concIuded Irom LIe IoregoIng LIuL cIgureLLe smokIng
und IeuILI Is noL u sImpIe muLLer uL uII. DembrowskI (1q8q), Ior exumpIe,
uIso concIudes LIuL LIe IIndIngs revIewed cIeurIy IndIcuLe LIuL LIere ure
very compIex reIuLIonsIIps presenL InvoIvIng cIussIc rIsk IucLors, sLress,
personuIILy uLLrIbuLes, consummuLory beIuvIors, und pIysIoIogIc
reucLIvILy. Moreover, LIe observuLIon LIuL muny consummuLory beIuvIors
covury, e.g., cIgureLLe smokIng, cuIIeIne, uIcoIoI, eLc., und LIuL eucI cun
uIIecL curdIovuscuIur reucLIons Lo sLress, mukes IL cIeur LIuL sorLIng ouL
IndIvIduuI und InLerucLIve eIIecLs Is u compIex cIuIIenge Ior IuLure
reseurcI... (p. 1q)
L Is u mosL reusonubIe urgumenL LIuL LIe InvesLIguLIon oI
dIseuses sucI us cuncer und CHD requIres reseurcIers wILI
muILIdIscIpIInury (bIoIogIcuI, socIuI, menLuI, moruI) skIIIs or LIe
promoLIon oI muILIdIscIpIInury InvesLIguLIons. urLIermore, gIven LIuL
LIere ure muny Issues In LIe InvesLIguLIon oI sucI dIseuses LIuL do noL
Iend LIemseIves eusIIy, or uL uII, Lo experImenLuI or sLruIgILIorwurd
upproucIes, LIuL IL requIres consIderubIe IngenuILyJsopIIsLIcuLIon Lo
coIerenLIy Leuse ouL ucLuuI cuusuI reIuLIonsIIps. IIesLyIe epIdemIoIogy
Is lecst quuIIIIed Ior LIIs very IormIdubIe Lusk; IL Is compreIensIveIy ouL oI
ILs InLeIIecLuuI depLI. IIesLyIe epIdemIoIogy Is u IrugmenLed muLerIuIIsL
mess, dIvIded InLo IucLIonuI cumps wILI very poor InLer-communIcuLIon.
TIere ure LIose wIo Iuvor mucro-IeveI or socIeLuI deLermInunLs oI dIseuse
producLIon (e.g., KrIeger & ZIerIer, 1qq6; Peurce eL uI., 1qq; TesI, 1q88).
OLIers Iuvor u mIcro-IeveI or bIoIogIcuIJmoIecuIur deLermInunLs oI
dIseuse (e.g., Vundenbrouke, 1q88). CuugIL In beLween Is rIsk IucLor
epIdemIoIogy LIuL supposedIy Iuvors LIe IndIvIduuI IeveI, buL onIy In
beIuvIor (beIuvIorIsL) und exposure Lerms.
SocIuI epIdemIoIogy, Ior exumpIe, demonsLruLes very IILLIe
86
86
Rampant Antismoking Signifies Grave Danger
cognIzunce LIuL LIere Ius been uL IeusL u Iew mIIIennIu oI conLroversy
concernIng socIo-poIILIcuI IdeoIogIes. Under LIe guIse oI uLLempLIng
dIseuse prevenLIon, und usuuIIy by LIe use oI very poor rIsk murkers, IL
runs LIe ter rect rIsk, by sIeer Ignorunce, oI burgIng LIrougI u sound
consIderuLIon oI IdeoIogIcuI concerns; LIe IuIIure Lo consIder IsoIuLed
socIuI IucLors In LIeIr greuLer IdeoIogIcuI conLexL IosLers LendencIes Lowurd
medIcuI uuLocrucy LIuL severeIy jeopurdIze democruLIc IdeuIs.
urLIermore, uII LIe ubove Iorms oI epIdemIoIogy ure obIIvIous Lo u
menLuI (In pIenomenoIogIcuI Lerms) uspecL oI LIe Iumun condILIon, und
LIereIore obIIvIous Lo LIe crILIcuI concern oI menLuI IeuILI. AguIn, IL
demonsLruLes u dIsLurbIng IncognIzunce oI LIe very Iong (muny mIIIennIu)
conLroversy regurdIng deLermInIsLIcJIree-wIII vIews oI MunkInd.
TIereIore, epIdemIoIogy reIIecLs LIe dungerous (I.e., very unIeuILIy)
combInuLIon oI pIIIosopIIcuI obIIvIousness, LIeoreLIcuI IrugmenLuLIon
und sysLemIc IncompeLenceJIgnorunce. n LIIs dIscussIon, LIIs menLuIILy
Is consIdered us uIIgned Lo LIe muLerIuIIsL munIIesLo.
ConsIderIng even onIy some oI LIe unomuIIes und IncoIerenL
epIdemIoIogIcuI reusonIng In LIe cuusuLIonIsL vIew oI cIgureLLe smokIng
und dIseuse, IL wouId Iuve been expecLed LIuL LIe eurIy vIew wouId Iuve
been upproprIuLeIy modIIIed In LIe neurIy IorLy yeurs sInce LIe 1q6q
Surgeon GeneruI ReporL. However, us uIreudy IndIcuLed, noL onIy Ius
LIere noL been u correcLIon Lo LIe conLorLed scIenLIIIc Irumework LIuL
epIdemIoIogy operuLes by, buL LIe muLerIuIIsLJexLernuIIsL bIus LogeLIer
wILI sysLemIc IncompeLence (I.e., muLerIuIIsL munIIesLo) Ius IosLered sucI
IosLIIILy Lowurd Lobucco smokIng LIuL by LIe yeur zoo LIere Is u
worIdwIde movemenL operuLIng under LIe SmokeIree Iogo und wIose
soIe InLenL Is Lo erudIcuLe Lobucco consumpLIon, I.e., proIIbILIonIsmJ
uboIILIon.
TIe medIco-muLerIuIIsL menLuIILy Ius munuged Lo dogmuLIcuIIy
convInce ILseII over u consIderubIe perIod oI LIme LIuL Lobucco use Is LIe
sIngIe mosL ImporLunL prevenLubIe rIsk Lo Iumun IeuILI In deveIoped
counLrIes und un ImporLunL cuuse oI premuLure deuLI worIdwIde. (JoInL
CommILLee on SmokIng und HeuILI, 1qq, p. 1118)
TIIs concIusIon Ius derIved Irom LIe reusonIng LIuL, InsoIur us IL
perLuIns Lo cIgureLLe smokIng, LIe cuusuI sLuLus oI smokIng In dIseuse cun
be bused on dIrecL conLucL (e.g., Iung cuncer) or no dIrecL conLucL (e.g.,
cuncer oI LIe kIdney), und cun be bused on , 1o, zo, o, qo, o, eLc., -yeur
Iugs In supposed eIIecLs. TIIs cIrcumsLunce quIckIy degeneruLes InLo LIe
presenLuLIon oI unIuIsIIIubIe proposILIons. Even more IundumenLuIIy,
epIdemIoIogy Ius convInced ILseII oI u deIuded Ideu oI LIe crILerIu Ior
cuusuI urgumenL. or exumpIe, Wynder (1q8;) decIures LIe sLundurd
epIdemIoIogIc posILIon LIuL LIe prevenLIon oI Lobucco-reIuLed dIseuses,
Lifestyle Epidemiology
Ior exumpIe, sIouId be possIbIe wILIouL knowIng uII or, Ior LIuL muLLer,
uny oI LIe curcInogenIc or LoxIc ugenLs In Lobucco smoke. TIe
deveIopmenL oI Iung cuncer, perIpIeruI vuscuIur dIseuses, und
empIysemu Is so overwIeImIngIy ussocIuLed wILI Lobucco usuge LIuL
vIrLuuIIy every epIdemIoIogIcuI sLudy wouId conIIrm LIIs ussocIuLIon, und
LIe crILerIu oI judgemenL so weII presenLed In LIe IIrsL Surgeon GeneruI`s
ReporL on SmokIng und HeuILI |1q6q| ure cIeurIy meL. (p. z11)
ConLrury Lo Wynder`s esLImuLIon Is LIuL LIe very deIInILIon oI
Lobucco-reIuLed dIseuses Is cIrcuIur In LIuL IL Is bused on LIe uppIIcuLIon
oI LIe IncoIerenL crILerIu Ior judgmenL, I.e., mIsInLerpreLuLIon oI
sLuLIsLIcuI ussocIuLIon. TIe eIIecL oI LIIs epIdemIoIogIc bubbIe Is LIuL unLII
LIe ucLuuI ueLIoIogy oI muny dIseuses (IncIudIng Iung cuncer) Is properIy
deIIneuLed, II IL cun be uL uII, excess morLuIILy sLuLIsLIcuIIy cssocicted wILI
cIgureLLe smokIng wIII be bIumed (I.e., cuusuIIy) on cIgureLLe smokIng In
LIe InLerIm, I.e., guIILy unLII proven InnocenL. TIIs Is reIerred Lo us LIe
IuIIucy oI shijtin the burden oj prooj: UnLII proven oLIerwIse, LIe
undemonstrcted prevuIIIng consensus wIII be uccepLed us correcL. SucI
conducL Ius no scIenLIIIc or moruI merIL.
CouILus (1qq8) InudverLenLIy summurIzes one oI LIe LruIy greuL
IoIIIes oI IIIesLyIe epIdemIoIogy. n consIderIng HIII`s (1q6) crILerIu Ior
cuusuI ussocIuLIon Ie IndIcuLes LIe epIdemIoIogy-wIde beIIeI LIuL LIe
crILerIu oI specIIIcILy und experImenLuI evIdence Iuve IILLIe reIevunce Ior
Iumun dIseuses ussocIuLed wILI cIgureLLe smokIng. (p.81) TIIs vIew Ius
been produced by consensus; wIeLIer u IucLor Is deemed cuusuI or noL Is
reduced Lo u popuIurILy conLesL decIded by muLerIuIIsL und scIenLIIIcuIIy
wuywurd LIInkers. n uddILIon Lo jeLLIsonIng Lwo crILIcuI requIremenLs oI
scIenLIIIc enquIry, epIdemIoIogy LIen redeIInes sLrengLI oI ussocIuLIon
uwuy Irom ubsoIuLe predIcLIve sLrengLI und InLo reIuLIve-rIsk Lerms. TIIs
wIII InvurIubIy produce, uL IeusL, LIe InIerenLIuI IuIIucy oI over-
InLerpreLuLIon (IusLy generuIIzuLIon) oI Iow-IeveI sLuLIsLIcuI ussocIuLIons.
n psycIoIogIcuI Lerms LIIs represenLs cuLusLropIIzuLIon or supersLILIous
beIIeI. n oLIer words, epIdemIoIogy generuLes LIe very concIusIons LIuL
genuIne scIenLIIIc enquIry seeks Lo proLecL uguInsL; IL Is enLIreIy
unLILIeLIcuI Lo LIe scIenLIIIc gouI.
L Ius uIreudy been consIdered LIuL cIgureLLe smokIng Is u
muILIdImensIonuI pIenomenon. ReIuLIve-rIsk dIIIerences In IncIdence oI
dIseuse cun be uLLrIbuLubIe Lo subgroup composILIon Ior boLI smokers und
nonsmokers (e.g., convergence und conLrusLIng eIIecLs). TIe overuII resuIL
oI LIIs compreIensIve conLorLIon oI scIenLIIIc enquIry Is LIuL epIdemIoIogy
cun muInLuIn LIe erroneous beIIeI LIuL uny IIgIer IncIdence oI IIIness
sLuLIsLIcuIIy ussocIuLed wILI smokIng wIII ImmedIuLeIy be uLLrIbuLed Lo LIe
cuusuI propensILIes oI Lobucco smoke, I.e., IL concIudes wIuL Is noL
87
87
Rampant Antismoking Signifies Grave Danger
cognIzunce LIuL LIere Ius been uL IeusL u Iew mIIIennIu oI conLroversy
concernIng socIo-poIILIcuI IdeoIogIes. Under LIe guIse oI uLLempLIng
dIseuse prevenLIon, und usuuIIy by LIe use oI very poor rIsk murkers, IL
runs LIe ter rect rIsk, by sIeer Ignorunce, oI burgIng LIrougI u sound
consIderuLIon oI IdeoIogIcuI concerns; LIe IuIIure Lo consIder IsoIuLed
socIuI IucLors In LIeIr greuLer IdeoIogIcuI conLexL IosLers LendencIes Lowurd
medIcuI uuLocrucy LIuL severeIy jeopurdIze democruLIc IdeuIs.
urLIermore, uII LIe ubove Iorms oI epIdemIoIogy ure obIIvIous Lo u
menLuI (In pIenomenoIogIcuI Lerms) uspecL oI LIe Iumun condILIon, und
LIereIore obIIvIous Lo LIe crILIcuI concern oI menLuI IeuILI. AguIn, IL
demonsLruLes u dIsLurbIng IncognIzunce oI LIe very Iong (muny mIIIennIu)
conLroversy regurdIng deLermInIsLIcJIree-wIII vIews oI MunkInd.
TIereIore, epIdemIoIogy reIIecLs LIe dungerous (I.e., very unIeuILIy)
combInuLIon oI pIIIosopIIcuI obIIvIousness, LIeoreLIcuI IrugmenLuLIon
und sysLemIc IncompeLenceJIgnorunce. n LIIs dIscussIon, LIIs menLuIILy
Is consIdered us uIIgned Lo LIe muLerIuIIsL munIIesLo.
ConsIderIng even onIy some oI LIe unomuIIes und IncoIerenL
epIdemIoIogIcuI reusonIng In LIe cuusuLIonIsL vIew oI cIgureLLe smokIng
und dIseuse, IL wouId Iuve been expecLed LIuL LIe eurIy vIew wouId Iuve
been upproprIuLeIy modIIIed In LIe neurIy IorLy yeurs sInce LIe 1q6q
Surgeon GeneruI ReporL. However, us uIreudy IndIcuLed, noL onIy Ius
LIere noL been u correcLIon Lo LIe conLorLed scIenLIIIc Irumework LIuL
epIdemIoIogy operuLes by, buL LIe muLerIuIIsLJexLernuIIsL bIus LogeLIer
wILI sysLemIc IncompeLence (I.e., muLerIuIIsL munIIesLo) Ius IosLered sucI
IosLIIILy Lowurd Lobucco smokIng LIuL by LIe yeur zoo LIere Is u
worIdwIde movemenL operuLIng under LIe SmokeIree Iogo und wIose
soIe InLenL Is Lo erudIcuLe Lobucco consumpLIon, I.e., proIIbILIonIsmJ
uboIILIon.
TIe medIco-muLerIuIIsL menLuIILy Ius munuged Lo dogmuLIcuIIy
convInce ILseII over u consIderubIe perIod oI LIme LIuL Lobucco use Is LIe
sIngIe mosL ImporLunL prevenLubIe rIsk Lo Iumun IeuILI In deveIoped
counLrIes und un ImporLunL cuuse oI premuLure deuLI worIdwIde. (JoInL
CommILLee on SmokIng und HeuILI, 1qq, p. 1118)
TIIs concIusIon Ius derIved Irom LIe reusonIng LIuL, InsoIur us IL
perLuIns Lo cIgureLLe smokIng, LIe cuusuI sLuLus oI smokIng In dIseuse cun
be bused on dIrecL conLucL (e.g., Iung cuncer) or no dIrecL conLucL (e.g.,
cuncer oI LIe kIdney), und cun be bused on , 1o, zo, o, qo, o, eLc., -yeur
Iugs In supposed eIIecLs. TIIs cIrcumsLunce quIckIy degeneruLes InLo LIe
presenLuLIon oI unIuIsIIIubIe proposILIons. Even more IundumenLuIIy,
epIdemIoIogy Ius convInced ILseII oI u deIuded Ideu oI LIe crILerIu Ior
cuusuI urgumenL. or exumpIe, Wynder (1q8;) decIures LIe sLundurd
epIdemIoIogIc posILIon LIuL LIe prevenLIon oI Lobucco-reIuLed dIseuses,
Lifestyle Epidemiology
Ior exumpIe, sIouId be possIbIe wILIouL knowIng uII or, Ior LIuL muLLer,
uny oI LIe curcInogenIc or LoxIc ugenLs In Lobucco smoke. TIe
deveIopmenL oI Iung cuncer, perIpIeruI vuscuIur dIseuses, und
empIysemu Is so overwIeImIngIy ussocIuLed wILI Lobucco usuge LIuL
vIrLuuIIy every epIdemIoIogIcuI sLudy wouId conIIrm LIIs ussocIuLIon, und
LIe crILerIu oI judgemenL so weII presenLed In LIe IIrsL Surgeon GeneruI`s
ReporL on SmokIng und HeuILI |1q6q| ure cIeurIy meL. (p. z11)
ConLrury Lo Wynder`s esLImuLIon Is LIuL LIe very deIInILIon oI
Lobucco-reIuLed dIseuses Is cIrcuIur In LIuL IL Is bused on LIe uppIIcuLIon
oI LIe IncoIerenL crILerIu Ior judgmenL, I.e., mIsInLerpreLuLIon oI
sLuLIsLIcuI ussocIuLIon. TIe eIIecL oI LIIs epIdemIoIogIc bubbIe Is LIuL unLII
LIe ucLuuI ueLIoIogy oI muny dIseuses (IncIudIng Iung cuncer) Is properIy
deIIneuLed, II IL cun be uL uII, excess morLuIILy sLuLIsLIcuIIy cssocicted wILI
cIgureLLe smokIng wIII be bIumed (I.e., cuusuIIy) on cIgureLLe smokIng In
LIe InLerIm, I.e., guIILy unLII proven InnocenL. TIIs Is reIerred Lo us LIe
IuIIucy oI shijtin the burden oj prooj: UnLII proven oLIerwIse, LIe
undemonstrcted prevuIIIng consensus wIII be uccepLed us correcL. SucI
conducL Ius no scIenLIIIc or moruI merIL.
CouILus (1qq8) InudverLenLIy summurIzes one oI LIe LruIy greuL
IoIIIes oI IIIesLyIe epIdemIoIogy. n consIderIng HIII`s (1q6) crILerIu Ior
cuusuI ussocIuLIon Ie IndIcuLes LIe epIdemIoIogy-wIde beIIeI LIuL LIe
crILerIu oI specIIIcILy und experImenLuI evIdence Iuve IILLIe reIevunce Ior
Iumun dIseuses ussocIuLed wILI cIgureLLe smokIng. (p.81) TIIs vIew Ius
been produced by consensus; wIeLIer u IucLor Is deemed cuusuI or noL Is
reduced Lo u popuIurILy conLesL decIded by muLerIuIIsL und scIenLIIIcuIIy
wuywurd LIInkers. n uddILIon Lo jeLLIsonIng Lwo crILIcuI requIremenLs oI
scIenLIIIc enquIry, epIdemIoIogy LIen redeIInes sLrengLI oI ussocIuLIon
uwuy Irom ubsoIuLe predIcLIve sLrengLI und InLo reIuLIve-rIsk Lerms. TIIs
wIII InvurIubIy produce, uL IeusL, LIe InIerenLIuI IuIIucy oI over-
InLerpreLuLIon (IusLy generuIIzuLIon) oI Iow-IeveI sLuLIsLIcuI ussocIuLIons.
n psycIoIogIcuI Lerms LIIs represenLs cuLusLropIIzuLIon or supersLILIous
beIIeI. n oLIer words, epIdemIoIogy generuLes LIe very concIusIons LIuL
genuIne scIenLIIIc enquIry seeks Lo proLecL uguInsL; IL Is enLIreIy
unLILIeLIcuI Lo LIe scIenLIIIc gouI.
L Ius uIreudy been consIdered LIuL cIgureLLe smokIng Is u
muILIdImensIonuI pIenomenon. ReIuLIve-rIsk dIIIerences In IncIdence oI
dIseuse cun be uLLrIbuLubIe Lo subgroup composILIon Ior boLI smokers und
nonsmokers (e.g., convergence und conLrusLIng eIIecLs). TIe overuII resuIL
oI LIIs compreIensIve conLorLIon oI scIenLIIIc enquIry Is LIuL epIdemIoIogy
cun muInLuIn LIe erroneous beIIeI LIuL uny IIgIer IncIdence oI IIIness
sLuLIsLIcuIIy ussocIuLed wILI smokIng wIII ImmedIuLeIy be uLLrIbuLed Lo LIe
cuusuI propensILIes oI Lobucco smoke, I.e., IL concIudes wIuL Is noL
88
88
Rampant Antismoking Signifies Grave Danger
demonsLruLed (beggIng LIe quesLIon). TIIs Is uIso remInIscenL oI wIuL
mucI unLIsmokIng rIeLorIc uILImuLeIy deLerIoruLes InLo - post hoc
expIunuLIon (see secLIon A riej Histor oj Antismolin). One begIns
Irom wIuLever dIseuse und, II LIe person wus u smoker, LIen LIe smokIng
cuused IL.
WIIIe muny oI LIe pubIIc ure convInced, us ure muny medIcuI
personneI, LIuL greuL dIscoverIes Iuve been mude regurdIng LIe
deLrImenLuI cuusuI properLIes oI Lobucco smoke, none oI LIe cIuIms IoIIow
LIe edIcLs or spIrIL oI scIenLIIIc enquIry buL LIe meLIodoIogy oI coIIecLIve
IncompeLence und deIusIon.
or uII oI LIe cuusuI proposILIons mude ubouL smokIng over LIe
yeurs, u commenL by OIdIum (1q;8) Is very perLInenL. He noLes LIuL LIe
consequence Is LIuL, z8 yeurs IuLer, we sLIII do noL know Iow cIgureLLes
cuuse Iung cuncer, nor even, II we ure purLIcuIurIy rIgorous In our use oI
scIenLIIIc IogIc, wIeLIer LIey do. (p. q6o) AIso, eInsLeIn (1q;8) IndIcuLes
LIuL:
|R|ecuIIIng LIe Iong IIsLory oI pILIuIIs In medIcuI
ueLIoIogIcuI reusonIng, cuuLIous scIenLIsLs muy wIsI Lo
keep uL IeusL u sIIgILIy open mInd ubouL LIe currenLIy
weII-uccepLed IypoLIesIs LIuL cIgureLLe smokIng cuuses
Iung cuncer. AILIougI supporLed by u Iurge coIIecLIon oI
posILIve evIdence, LIe IypoLIesIs Is noL us secureIy
esLubIIsIed us LIe vIgour wILI wIIcI IL Is urgued by
epIdemIoIogIcuI uuLIorILIes. Among LIe Ioose sLrunds In
LIe IubrIc oI LIe urgumenL ure LIe IoIIowIng: 1) TIe
supporLIng evIdence In Iumuns resLs enLIreIy on
sLuLIsLIcuI unuIyses oI observuLIonuI duLu, und Ius noL
been (becuuse IL cunnoL be) conIIrmed by rundomIzed
experImenLuI LrIuIs; z) No weII-desIgned und weII-
conducLed experImenLs Iuve sIown LIuL cIgureLLe
smoke cuuses lun cuncer In unImuIs; ) AbouL 8-1o%
oI puLIenLs wILI Iung cuncer Iuve never smoked
cIgureLLes; q) LIe occurrence ruLes oI Iung cuncer In
dIIIerenL counLrIes Iuve muny conLrudIcLIons LIuL ure
noL expIuIned by LIe IypoLIesIs. (p. q68)
TIese sLuLemenLs mude In 1q;8 ure us IIgIIy reIevunL In LIe new
mIIIennIum. ndeed, over LIe IusL neurIy-IorLy yeurs oLIer rIsk IucLors
Iuve been IdenLIIIed Ior Iung cuncer. However, In Lerms oI u coIerenL
deIIneuLIon oI LIe ueLIoIogy oI Iung cuncer, und, LIereIore, u cIeur
IndIcuLIon oI wIuL LIe crILIcuI dIIIerence(s) Is beLween LIe qo% oI Ieuvy
smokers LIuL do noL deveIop Iung cuncer und LIe 1o% oI Ieuvy smokers
Lifestyle Epidemiology
LIuL do, LIere Is us mucI undersLood In zoo us LIere wus In 1q6q -
vIrLuuIIy noLIIng.
AguIn, LIe cuusuLIonIsL vIew cIuIms LIuL properLIes oI Lobucco
smoke Iuve some muLugenIc ucLIon LIuL resuILs In Iung cuncer. Benzo(u)
pyrene Ius been LIe muIn ImpIIcuLed muLugen. DenIssenko eL uI. (1qq6)
concIuded Irom un In vILro InvesLIguLIon LIuL LurgeLed udducL IormuLIon
ruLIer LIun pIenoLypIc seIecLIon uppeurs Lo sIupe LIe p muLuLIonuI
specLrum In Iung cuncer. (p.qo) TIe p gene Is consIdered Lo be LIe
guurdIun ungeI or Lumor suppressor gene, und udducL IormuLIon In LIe
ubove reseurcI wus concIuded Lo be smoke-Induced.
TIIs purLIcuIur reseurcI receIved consIderubIe medIu uLLenLIon
und Ius IurLIer IueIIed LIe cuusuLIonIsL vIew. TIuL LIIs vIew wus
Iorwurded In sucI u cuvuIIer und seII-servIng IusIIon Is reuIIy jusL u
IurLIer poInL oI u compoundIng emburrussmenL LIuL weII cIurucLerIzes
LIe ubsence oI InLegrILy und scIoIursIIp In conLemporury epIdemIoIogy. L
Ius uIreudy been noLed LIuL Lobucco smokIng us u dIrecL cuuse oI Iung
cuncer In pussIve und oLIerwIse IeuILIy endogenous sysLems Is u IogIcuI
und empIrIcuI ImpossIbIIILy - Lobucco smokIng Is too enercl u
pIenomenon Lo generuLe Iow-IeveI specIIIc eIIecLs. n oLIer words, LIe
crILIcuI uspecL oI LIe dIseuse musL Iuve un endogenous source (I.e.,
uLypIcuI ubnormuIILy) us LIe deIImILer oI LIe smuII subgroup munIIesLIng
LIe dIseuse, I.e., specIIIc dIseuse occurs In persons LIuL ure noL oLIerwIse
IeuILIy.
nLeresLIngIy, RodIn & RodIn (zooo) urgue LIuL LIe DenIssenko
eL uI. IIndIng Is coIncIdenLuI In LIuL LIeIr specLruI unuIyses were conducLed
en musse. TIIs creuLed LIe wrong ImpressIon LIuL codon 1; geLs
cIunged onIy In Iung cuncer und LIuL ILs IIgI uIIInILy wILI BPDE brIngs
ouL ILs 'unIqueness` In Iung cuncer. TIey posIL LIuL some prImury cuuses
oI muLuLIon ure Iung-specIIIc ruLIer LIun smokIng-specIIIc. TIeIr
concIusIon Is LIuL pIysIoIogIcuI sLresses (noL necessurIIy genoLoxIc)
uggruvuLed by smokIng ure LIe IeudIng rIsk IucLor In LIe p-ussocIuLed
eLIoIogy oI Iung cuncer. (p.1zzqq)
OLIers Iuve suggesLed endogenous vurIuLIons In DNA repuIr
cupucILy (e.g., WeI eL uI., zooo) und oLIer geneLIc dIspurILIes (BurLscI eL
uI., zooo; Tung eL uI., 1qq8). n LIeIr uLLempL Lo consIder LIe IIgIIy
crILIcuI Issue oI IndIvIduuI suscepLIbIIILy (endogenous source) In Iung
cuncer, LIIs IIne oI reseurcI Is LendIng In LIe dIrecLIon oI sensIbIIILy.
However, uII oI LIe reseurcI Is sLIII very mucI sIorL oI LIe scIenLIIIc murk
und IIgIIy prone Lo severe over-InLerpreLuLIon. None oI LIIs moIecuIur
IeveI epIdemIoIogIcuI reseurcI even demonsLruLes wIeLIer cIgureLLe
smokIng Is u LrIgger Ior Iung cuncer. L onIy demonsLruLes LIuL LIere Is u
degree oI commonuIILy In Iung cuncer oI purLIcuIur smoke-reIuLed dumuge
89
89
Rampant Antismoking Signifies Grave Danger
demonsLruLed (beggIng LIe quesLIon). TIIs Is uIso remInIscenL oI wIuL
mucI unLIsmokIng rIeLorIc uILImuLeIy deLerIoruLes InLo - post hoc
expIunuLIon (see secLIon A riej Histor oj Antismolin). One begIns
Irom wIuLever dIseuse und, II LIe person wus u smoker, LIen LIe smokIng
cuused IL.
WIIIe muny oI LIe pubIIc ure convInced, us ure muny medIcuI
personneI, LIuL greuL dIscoverIes Iuve been mude regurdIng LIe
deLrImenLuI cuusuI properLIes oI Lobucco smoke, none oI LIe cIuIms IoIIow
LIe edIcLs or spIrIL oI scIenLIIIc enquIry buL LIe meLIodoIogy oI coIIecLIve
IncompeLence und deIusIon.
or uII oI LIe cuusuI proposILIons mude ubouL smokIng over LIe
yeurs, u commenL by OIdIum (1q;8) Is very perLInenL. He noLes LIuL LIe
consequence Is LIuL, z8 yeurs IuLer, we sLIII do noL know Iow cIgureLLes
cuuse Iung cuncer, nor even, II we ure purLIcuIurIy rIgorous In our use oI
scIenLIIIc IogIc, wIeLIer LIey do. (p. q6o) AIso, eInsLeIn (1q;8) IndIcuLes
LIuL:
|R|ecuIIIng LIe Iong IIsLory oI pILIuIIs In medIcuI
ueLIoIogIcuI reusonIng, cuuLIous scIenLIsLs muy wIsI Lo
keep uL IeusL u sIIgILIy open mInd ubouL LIe currenLIy
weII-uccepLed IypoLIesIs LIuL cIgureLLe smokIng cuuses
Iung cuncer. AILIougI supporLed by u Iurge coIIecLIon oI
posILIve evIdence, LIe IypoLIesIs Is noL us secureIy
esLubIIsIed us LIe vIgour wILI wIIcI IL Is urgued by
epIdemIoIogIcuI uuLIorILIes. Among LIe Ioose sLrunds In
LIe IubrIc oI LIe urgumenL ure LIe IoIIowIng: 1) TIe
supporLIng evIdence In Iumuns resLs enLIreIy on
sLuLIsLIcuI unuIyses oI observuLIonuI duLu, und Ius noL
been (becuuse IL cunnoL be) conIIrmed by rundomIzed
experImenLuI LrIuIs; z) No weII-desIgned und weII-
conducLed experImenLs Iuve sIown LIuL cIgureLLe
smoke cuuses lun cuncer In unImuIs; ) AbouL 8-1o%
oI puLIenLs wILI Iung cuncer Iuve never smoked
cIgureLLes; q) LIe occurrence ruLes oI Iung cuncer In
dIIIerenL counLrIes Iuve muny conLrudIcLIons LIuL ure
noL expIuIned by LIe IypoLIesIs. (p. q68)
TIese sLuLemenLs mude In 1q;8 ure us IIgIIy reIevunL In LIe new
mIIIennIum. ndeed, over LIe IusL neurIy-IorLy yeurs oLIer rIsk IucLors
Iuve been IdenLIIIed Ior Iung cuncer. However, In Lerms oI u coIerenL
deIIneuLIon oI LIe ueLIoIogy oI Iung cuncer, und, LIereIore, u cIeur
IndIcuLIon oI wIuL LIe crILIcuI dIIIerence(s) Is beLween LIe qo% oI Ieuvy
smokers LIuL do noL deveIop Iung cuncer und LIe 1o% oI Ieuvy smokers
Lifestyle Epidemiology
LIuL do, LIere Is us mucI undersLood In zoo us LIere wus In 1q6q -
vIrLuuIIy noLIIng.
AguIn, LIe cuusuLIonIsL vIew cIuIms LIuL properLIes oI Lobucco
smoke Iuve some muLugenIc ucLIon LIuL resuILs In Iung cuncer. Benzo(u)
pyrene Ius been LIe muIn ImpIIcuLed muLugen. DenIssenko eL uI. (1qq6)
concIuded Irom un In vILro InvesLIguLIon LIuL LurgeLed udducL IormuLIon
ruLIer LIun pIenoLypIc seIecLIon uppeurs Lo sIupe LIe p muLuLIonuI
specLrum In Iung cuncer. (p.qo) TIe p gene Is consIdered Lo be LIe
guurdIun ungeI or Lumor suppressor gene, und udducL IormuLIon In LIe
ubove reseurcI wus concIuded Lo be smoke-Induced.
TIIs purLIcuIur reseurcI receIved consIderubIe medIu uLLenLIon
und Ius IurLIer IueIIed LIe cuusuLIonIsL vIew. TIuL LIIs vIew wus
Iorwurded In sucI u cuvuIIer und seII-servIng IusIIon Is reuIIy jusL u
IurLIer poInL oI u compoundIng emburrussmenL LIuL weII cIurucLerIzes
LIe ubsence oI InLegrILy und scIoIursIIp In conLemporury epIdemIoIogy. L
Ius uIreudy been noLed LIuL Lobucco smokIng us u dIrecL cuuse oI Iung
cuncer In pussIve und oLIerwIse IeuILIy endogenous sysLems Is u IogIcuI
und empIrIcuI ImpossIbIIILy - Lobucco smokIng Is too enercl u
pIenomenon Lo generuLe Iow-IeveI specIIIc eIIecLs. n oLIer words, LIe
crILIcuI uspecL oI LIe dIseuse musL Iuve un endogenous source (I.e.,
uLypIcuI ubnormuIILy) us LIe deIImILer oI LIe smuII subgroup munIIesLIng
LIe dIseuse, I.e., specIIIc dIseuse occurs In persons LIuL ure noL oLIerwIse
IeuILIy.
nLeresLIngIy, RodIn & RodIn (zooo) urgue LIuL LIe DenIssenko
eL uI. IIndIng Is coIncIdenLuI In LIuL LIeIr specLruI unuIyses were conducLed
en musse. TIIs creuLed LIe wrong ImpressIon LIuL codon 1; geLs
cIunged onIy In Iung cuncer und LIuL ILs IIgI uIIInILy wILI BPDE brIngs
ouL ILs 'unIqueness` In Iung cuncer. TIey posIL LIuL some prImury cuuses
oI muLuLIon ure Iung-specIIIc ruLIer LIun smokIng-specIIIc. TIeIr
concIusIon Is LIuL pIysIoIogIcuI sLresses (noL necessurIIy genoLoxIc)
uggruvuLed by smokIng ure LIe IeudIng rIsk IucLor In LIe p-ussocIuLed
eLIoIogy oI Iung cuncer. (p.1zzqq)
OLIers Iuve suggesLed endogenous vurIuLIons In DNA repuIr
cupucILy (e.g., WeI eL uI., zooo) und oLIer geneLIc dIspurILIes (BurLscI eL
uI., zooo; Tung eL uI., 1qq8). n LIeIr uLLempL Lo consIder LIe IIgIIy
crILIcuI Issue oI IndIvIduuI suscepLIbIIILy (endogenous source) In Iung
cuncer, LIIs IIne oI reseurcI Is LendIng In LIe dIrecLIon oI sensIbIIILy.
However, uII oI LIe reseurcI Is sLIII very mucI sIorL oI LIe scIenLIIIc murk
und IIgIIy prone Lo severe over-InLerpreLuLIon. None oI LIIs moIecuIur
IeveI epIdemIoIogIcuI reseurcI even demonsLruLes wIeLIer cIgureLLe
smokIng Is u LrIgger Ior Iung cuncer. L onIy demonsLruLes LIuL LIere Is u
degree oI commonuIILy In Iung cuncer oI purLIcuIur smoke-reIuLed dumuge
90
90
Rampant Antismoking Signifies Grave Danger
(noL purLIcuIurIy genoLoxIc). TIIs Is u moIecuIur versIon oI sLuLIng LIuL
muny oI LIose wILI Iung cuncer ure smokers - LIIs Is uIreudy known.
TIere Is essenLIuIIy no uLLempL Lo deLermIne LIe prevuIence oI
purLIcuIur suscepLIbIIILIes or murkers oI muLugenesIsJdumuge In LIe
generuI popuIuLIon In order Lo evuIuuLe LIe predIcLIve sLrengLI oI LIese
IucLors Ior LIe dIseuse. or exumpIe, II purLIcuIur muLugenesIsJdumuge Is
presenL In mosL smokers, LIen LIIs IIgI commonuIILy wILI smokIng wIII
ILseII be u poor predIcLor oI LIe dIseuse. OLIer IucLors LIuL ure pecuIIur Lo
LIe dIseuse und ure IIgI-IeveI predIcLors need Lo be IdenLIIIed. SucI
IucLors uill not be pecuIIur Lo mosL smokers und wIII reIIecL endogenous
sysLem ubnormuIILIes, I.e., some endogenous sysLems ure IuIIIng Lo do
wIuL mosL cun do.
A rure sensIbIe sLuLemenL on Iung cuncer uppeured In u smuII
newspuper urLIcIe: A gene Ius been IdenLIIIed LIuL muy IeIp scIenLIsLs
undersLund LIe bIoIogy oI Iung cuncer. TIougI LrIggers sucI us Lobucco
Lur und rudIoucLIve rudon gus ure known Lo be IInked Lo Iung cuncer, IILLIe
Is undersLood oI LIe geneLIc dumuge LIuL cuuses LIe dIseuse. SLudIes In
mIce sIow LIuL wIen LIe gene, known us DuLL1JRobo1, Is mIssIng durIng
IeLuI deveIopmenL, LIe Iungs grow ubnormuIIy. TIe reseurcIers Irom
CumbrIdge UnIversILy und LIe MedIcuI ReseurcI CouncII, beIIeve LIuL
wIen LIe gene Is deIecLIve, IL muy open LIe door Ior cuncer LrIggers sucI
us Lobucco Lur. (Hercld,Sun, December , zoo1, p.1)
TIIs upproucI uL IeusL properIy ucknowIedges LIuL LIe IIgIesL
poLenLIuI sLuLus oI Lobucco Lur Is us u LrIgger. However, IL sLIII promoLes
LIe beIIeI LIuL, even gIven u deIecLIve gene, cuncer Is someIow someLIIng
evenLuuIIy produced by exogenous IucLors, I.e., exLernuIIsm. TIIs goes Lo
LIe IeurL oI wIuL cuncer mIgIL even represenL. TIe IndIcuLIons ure LIuL IL
Is un endoenous producLIon In ubnormuI reucLIvILy. MedIcuI reusonIng
Ius sImpIy noL come Lo Lerms wILI LIIs ImporLunL muLLer uL uII.
MucI reseurcI over LIe IusL IorLy yeurs Ius been un uLLer wusLe
oI reseurcI Iunds In LIuL IL couId never uddress sound, scIenLIIIc quesLIons
Lo begIn wILI. TIe sILuuLIon Is even worse concernIng cIgureLLe smokIng
und oLIer dIseuses. As Iong us epIdemIoIogy remuIns obsessed wILI
smokIng us LIe Ieud IucLor In u sequence oI precondILIons Ior specIIIc
dIseuse, IL wIII muke no progress In ueLIoIogIcuI undersLundIng. TIereIore,
oILen-mude sLuLemenLs by LIe unLIsmokIng Iobby sucI us wIuL we now
know ubouL smokIng und dIseuse ure LypIcuIIy IruuduIenL und
mIsrepresenLuLIve. UnIorLunuLeIy, IL Is epIdemIoIogy, u supposed scIenLIIIc
dIscIpIIne, LIuL InILIuLes LIese mIsrepresenLuLIons.
HuvIng convInced ILseII LIrougI LIe erroneous uppIIcuLIon oI LIe
crILerIu Ior cuusuI InIerence LIuL IL Ius IdenLIIIed dIseuses LIuL cIgureLLe
smokIng cuuses, epIdemIoIogy Ius LIen emburked on wIuL cun onIy be
Lifestyle Epidemiology
descrIbed us u mosL dIsLurbIng ubuse oI LIe sLuLIsLIcuI Ideu oI uLLrIbuLubIe
rIsk. urLIermore, us Ius been uIIuded Lo, LIIs ubuse Is u IogIcuI
progressIon enLIreIy consIsLenL wILI LIe muLerIuIIsL munIIesLo. Eysenck
(1qq1, 1qq), Ior exumpIe, noLes LIe pubIIsIed esLImuLes oI LIe number
oI peopIe kIIIed by smokIng. TIese esLImuLes reIIecL uLLrIbuLubIe rIsk
wIIcI In Lurn Is bused on reIuLIve rIsk. or exumpIe, The i Kill Is u 1-
voIume documenL presenLed by TIe HeuILI EducuLIon CouncII joInLIy wILI
LIe BrILIsI MedIcuI AssocIuLIon (RoberLs & GruveIIng, 1q86). TIIs
pubIIcuLIon IndIcuLes LIuL In EngIund und WuIes cIgureLLe smokIng
unnuuIIy kIIIs ;;,;;q peopIe (,1o; men und zz,66; women) Irom IeurL
dIseuse, Iung cuncer, broncIILIs und empIysemu.
Eysenck (1qq1, p. z) IIgIIIgILs LIuL In 1q;8, JosepI CuIIIuno, LIe
LIen US SecreLury oI LIe DepurLmenL oI HeuILI, EducuLIon und WeIIure
sLuLed LIuL In 1q;; smokIng cuused zzo,ooo deuLIs Irom IeurL dIseuse,
;8,ooo Irom Iung cuncer, und zz,ooo Irom oLIer cuncers, Ior u LoLuI oI
zo,ooo deuLIs. One monLI IuLer, uccordIng Lo LIe SecreLury smokIng wus
responsIbIe Ior 1,ooo deuLIs Irom cIronIc broncIILIs und empIysemu,
1z,ooo Irom IeurL dIseuse, und 1oo,ooo Irom cuncer. TIe sLuLed LoLuI
wus more LIun zo,ooo. AccordIng Lo Eysenck (1qq1) no source wus
gIven Ior uny oI LIese IIgures, und no expIunuLIon gIven Ior wIy cIronIc
broncIILIs und empIysemu were IncIuded In LIe ebruury LoLuI buL noL In
LIe eurIIer Junuury one. He uIso IuIIed Lo expIuIn Iow IIs esLImuLe oI
smokIng uccounLs Ior qo% oI uII cuncer deuLIs yeurIy, doubIe LIuL
suggesLed by LIe AmerIcun Cuncer SocIeLy.
A more recenL oIIerIng Is by LIe CenLers oI DIseuse PrevenLIon
und ConLroI (CDC). OukIey (1qqq) cILes u 1qq1 Wcshinton Post urLIcIe
sLuLIng LIuL uccordIng Lo LIe CDC more LIun qq,ooo AmerIcuns dIed In
1q88 Irom IeuILI probIems cuused by smokIng. (CI., p.) OukIey (1qqq)
uIso presenLs LrunsIormuLIons over LIme oI sucI esLImuLes by LIe medIu;
1qq - SmokIng cuused more LIun qoo,ooo deuLIs In 1qqo, uccordIng Lo
LIe CenLers Ior DIseuse ConLroI und PrevenLIon; 1qq - smokIng-reIuLed
IIInesses LIuL kIII more LIun qoo,ooo peopIe In LIIs counLry unnuuIIy;
1qq6 - TIe IuLesL reudIng oI LIe Iedgers Iooks good Ior LIose oI us wIo
wouId IIke Lo see LIe wIILIng oI un IndusLry wIose producL, wIen used us
intended, kIIIs more LIun qoo,ooo AmerIcuns eucI yeur und Iurms
mIIIIons more; 1qq; - LIe Lobucco IndusLry kIIIs uImosL oo,ooo
AmerIcuns eucI yeur. TIIs IncIudes more LIun o,ooo non-smokers, more
LIun LIose kIIIed by veIIcIe uccIdenLs, uII crImes (IncIudIng guns), ADS,
und IIIeguI drugs. (CI., p.q)
TIese esLImuLes oI deuLIs cuused by smokIng ure, uguIn, noL
new. n LIIs currenL sugu, GuIIIord (1q68) noLes Berkson`s quesLIonIng
reucLIon Lo cIuIms LIuL one In every LIree deuLIs Is cuused by smokIng.
91
91
Rampant Antismoking Signifies Grave Danger
(noL purLIcuIurIy genoLoxIc). TIIs Is u moIecuIur versIon oI sLuLIng LIuL
muny oI LIose wILI Iung cuncer ure smokers - LIIs Is uIreudy known.
TIere Is essenLIuIIy no uLLempL Lo deLermIne LIe prevuIence oI
purLIcuIur suscepLIbIIILIes or murkers oI muLugenesIsJdumuge In LIe
generuI popuIuLIon In order Lo evuIuuLe LIe predIcLIve sLrengLI oI LIese
IucLors Ior LIe dIseuse. or exumpIe, II purLIcuIur muLugenesIsJdumuge Is
presenL In mosL smokers, LIen LIIs IIgI commonuIILy wILI smokIng wIII
ILseII be u poor predIcLor oI LIe dIseuse. OLIer IucLors LIuL ure pecuIIur Lo
LIe dIseuse und ure IIgI-IeveI predIcLors need Lo be IdenLIIIed. SucI
IucLors uill not be pecuIIur Lo mosL smokers und wIII reIIecL endogenous
sysLem ubnormuIILIes, I.e., some endogenous sysLems ure IuIIIng Lo do
wIuL mosL cun do.
A rure sensIbIe sLuLemenL on Iung cuncer uppeured In u smuII
newspuper urLIcIe: A gene Ius been IdenLIIIed LIuL muy IeIp scIenLIsLs
undersLund LIe bIoIogy oI Iung cuncer. TIougI LrIggers sucI us Lobucco
Lur und rudIoucLIve rudon gus ure known Lo be IInked Lo Iung cuncer, IILLIe
Is undersLood oI LIe geneLIc dumuge LIuL cuuses LIe dIseuse. SLudIes In
mIce sIow LIuL wIen LIe gene, known us DuLL1JRobo1, Is mIssIng durIng
IeLuI deveIopmenL, LIe Iungs grow ubnormuIIy. TIe reseurcIers Irom
CumbrIdge UnIversILy und LIe MedIcuI ReseurcI CouncII, beIIeve LIuL
wIen LIe gene Is deIecLIve, IL muy open LIe door Ior cuncer LrIggers sucI
us Lobucco Lur. (Hercld,Sun, December , zoo1, p.1)
TIIs upproucI uL IeusL properIy ucknowIedges LIuL LIe IIgIesL
poLenLIuI sLuLus oI Lobucco Lur Is us u LrIgger. However, IL sLIII promoLes
LIe beIIeI LIuL, even gIven u deIecLIve gene, cuncer Is someIow someLIIng
evenLuuIIy produced by exogenous IucLors, I.e., exLernuIIsm. TIIs goes Lo
LIe IeurL oI wIuL cuncer mIgIL even represenL. TIe IndIcuLIons ure LIuL IL
Is un endoenous producLIon In ubnormuI reucLIvILy. MedIcuI reusonIng
Ius sImpIy noL come Lo Lerms wILI LIIs ImporLunL muLLer uL uII.
MucI reseurcI over LIe IusL IorLy yeurs Ius been un uLLer wusLe
oI reseurcI Iunds In LIuL IL couId never uddress sound, scIenLIIIc quesLIons
Lo begIn wILI. TIe sILuuLIon Is even worse concernIng cIgureLLe smokIng
und oLIer dIseuses. As Iong us epIdemIoIogy remuIns obsessed wILI
smokIng us LIe Ieud IucLor In u sequence oI precondILIons Ior specIIIc
dIseuse, IL wIII muke no progress In ueLIoIogIcuI undersLundIng. TIereIore,
oILen-mude sLuLemenLs by LIe unLIsmokIng Iobby sucI us wIuL we now
know ubouL smokIng und dIseuse ure LypIcuIIy IruuduIenL und
mIsrepresenLuLIve. UnIorLunuLeIy, IL Is epIdemIoIogy, u supposed scIenLIIIc
dIscIpIIne, LIuL InILIuLes LIese mIsrepresenLuLIons.
HuvIng convInced ILseII LIrougI LIe erroneous uppIIcuLIon oI LIe
crILerIu Ior cuusuI InIerence LIuL IL Ius IdenLIIIed dIseuses LIuL cIgureLLe
smokIng cuuses, epIdemIoIogy Ius LIen emburked on wIuL cun onIy be
Lifestyle Epidemiology
descrIbed us u mosL dIsLurbIng ubuse oI LIe sLuLIsLIcuI Ideu oI uLLrIbuLubIe
rIsk. urLIermore, us Ius been uIIuded Lo, LIIs ubuse Is u IogIcuI
progressIon enLIreIy consIsLenL wILI LIe muLerIuIIsL munIIesLo. Eysenck
(1qq1, 1qq), Ior exumpIe, noLes LIe pubIIsIed esLImuLes oI LIe number
oI peopIe kIIIed by smokIng. TIese esLImuLes reIIecL uLLrIbuLubIe rIsk
wIIcI In Lurn Is bused on reIuLIve rIsk. or exumpIe, The i Kill Is u 1-
voIume documenL presenLed by TIe HeuILI EducuLIon CouncII joInLIy wILI
LIe BrILIsI MedIcuI AssocIuLIon (RoberLs & GruveIIng, 1q86). TIIs
pubIIcuLIon IndIcuLes LIuL In EngIund und WuIes cIgureLLe smokIng
unnuuIIy kIIIs ;;,;;q peopIe (,1o; men und zz,66; women) Irom IeurL
dIseuse, Iung cuncer, broncIILIs und empIysemu.
Eysenck (1qq1, p. z) IIgIIIgILs LIuL In 1q;8, JosepI CuIIIuno, LIe
LIen US SecreLury oI LIe DepurLmenL oI HeuILI, EducuLIon und WeIIure
sLuLed LIuL In 1q;; smokIng cuused zzo,ooo deuLIs Irom IeurL dIseuse,
;8,ooo Irom Iung cuncer, und zz,ooo Irom oLIer cuncers, Ior u LoLuI oI
zo,ooo deuLIs. One monLI IuLer, uccordIng Lo LIe SecreLury smokIng wus
responsIbIe Ior 1,ooo deuLIs Irom cIronIc broncIILIs und empIysemu,
1z,ooo Irom IeurL dIseuse, und 1oo,ooo Irom cuncer. TIe sLuLed LoLuI
wus more LIun zo,ooo. AccordIng Lo Eysenck (1qq1) no source wus
gIven Ior uny oI LIese IIgures, und no expIunuLIon gIven Ior wIy cIronIc
broncIILIs und empIysemu were IncIuded In LIe ebruury LoLuI buL noL In
LIe eurIIer Junuury one. He uIso IuIIed Lo expIuIn Iow IIs esLImuLe oI
smokIng uccounLs Ior qo% oI uII cuncer deuLIs yeurIy, doubIe LIuL
suggesLed by LIe AmerIcun Cuncer SocIeLy.
A more recenL oIIerIng Is by LIe CenLers oI DIseuse PrevenLIon
und ConLroI (CDC). OukIey (1qqq) cILes u 1qq1 Wcshinton Post urLIcIe
sLuLIng LIuL uccordIng Lo LIe CDC more LIun qq,ooo AmerIcuns dIed In
1q88 Irom IeuILI probIems cuused by smokIng. (CI., p.) OukIey (1qqq)
uIso presenLs LrunsIormuLIons over LIme oI sucI esLImuLes by LIe medIu;
1qq - SmokIng cuused more LIun qoo,ooo deuLIs In 1qqo, uccordIng Lo
LIe CenLers Ior DIseuse ConLroI und PrevenLIon; 1qq - smokIng-reIuLed
IIInesses LIuL kIII more LIun qoo,ooo peopIe In LIIs counLry unnuuIIy;
1qq6 - TIe IuLesL reudIng oI LIe Iedgers Iooks good Ior LIose oI us wIo
wouId IIke Lo see LIe wIILIng oI un IndusLry wIose producL, wIen used us
intended, kIIIs more LIun qoo,ooo AmerIcuns eucI yeur und Iurms
mIIIIons more; 1qq; - LIe Lobucco IndusLry kIIIs uImosL oo,ooo
AmerIcuns eucI yeur. TIIs IncIudes more LIun o,ooo non-smokers, more
LIun LIose kIIIed by veIIcIe uccIdenLs, uII crImes (IncIudIng guns), ADS,
und IIIeguI drugs. (CI., p.q)
TIese esLImuLes oI deuLIs cuused by smokIng ure, uguIn, noL
new. n LIIs currenL sugu, GuIIIord (1q68) noLes Berkson`s quesLIonIng
reucLIon Lo cIuIms LIuL one In every LIree deuLIs Is cuused by smokIng.
92
92
Rampant Antismoking Signifies Grave Danger
TIese cIuIms were beIng mude In LIe IuLe-1qo`s. AIso, Hurdy (1q68)
reIers Lo sLuLemenLs mude by Horn (1q6;) sucI us oo,ooo uduIL
smokers dIe premuLureIy eucI yeur becuuse oI cIgureLLe smokIng. TIIs
sorL oI sImpIe-mInded conducL Is bused on LIe conversIon oI reIuLIve rIsk
Lo uLLrIbuLubIe rIsk. ALLrIbuLubIe rIsk Is LIen converLed InLo uLLrIbuLubIe
numbers or cuses Ior specIIIc dIseuse or overuII morLuIILy, I.e.,
uLLrIbuLubIe morLuIILy. TIe exercIse Is un enLIreIy urILImeLIc one LIuL
mukes noL one IoLu oI dIIIerence Lo coIerenL cuusuI InIerence. WIere
cuusuI urgumenL concernIng u pIenomenon Is In severe doubL, us IL sureIy
Is und wIII be concernIng smokIng und mosL dIseuses, LIe use oI
uLLrIbuLubIe rIsk und uLLrIbuLubIe numbers sIouId be wIoIIy uvoIded;
it is c stctisticcl cme thct ccn onl be mislecdin.
OukIey (1qqq) reusonubIy posILs LIuL muny members oI LIe
pubIIc beIIeve LIuL sucI sLuLemenLs oI uLLrIbuLubIe deuLIs ure deIInILIve.
McWIILer (1qqz), u US journuIIsL, expIuIns LIe very consIderubIe eIIorL
requIred Lo uscerLuIn Iow LIese IeuILI uuLIorILy esLImuLes ure urrIved uL.
AILer mucI pIone cuIIIng uround LIe counLry, sIe munuged Lo conLucL LIe
SAMMEC OperuLIons Munuger uL LIe OIIIce on SmokIng und HeuILI (u
subdIvIsIon oI CDC). SAMMEC Is un ucronym Ior SmokIng ALLrIbuLed
MorbIdILyJMorLuIILy und EconomIc CosL. TIe progrum runs on deuLI
cerLIIIcuLe duLu oI quesLIonubIe reIIubIIILy (eurIIer dIscussed) combIned
wILI eIevuLed RR`s Ior smokIng und specIIIc dIseuseJmorLuIILy. L Ius
uIreudy been consIdered LIuL LIese RR`s bIur mcn crILIcuI dIIIerences
beLween smokersJnonsmokers und ure cerLuInIy noL LIe busIs Ior cuusuI
urgumenL. TIese RR`s ure bused on meLu-unuIyses oI rIsk IucLorJspecIIIc
morLuIILy Ior reseurcI Lo u purLIcuIur duLe - some even unpubIIsIed, e.g.,
Cuncer PrevenLIon SLudy (see OukIey, 1qqq, CI.). urLIermore, LIese
RR`s ure not reguIurIy upduLed. ALLrIbuLubIe rIsk Is cuIcuIuLed und
converLed Lo uLLrIbuLubIe deuLIs (see TubIe ). McWIIrLer wus
undersLundubIy usLonIsIed by LIe IIImsIness oI LIe procedure und ILs
busIs. OLIer counLrIes (e.g., UK, AusLruIIu, Cunudu) Iuve LIeIr versIon oI
SAMMEC und muy Indeed use LIe sume RR`s und uLLrIbuLubIe rIsk
cuIcuIuLIons.
L cun be noLed Irom LIe SAMMEC exercIse LIuL epIdemIoIogyJ
prevenLIve medIcIne very rureIy commILs sImpIe errors. TIere Is usuuIIy u
compoundIng oI errors LIuL produces mcximcll mIsIeudIng InIormuLIon.
A perusuI oI TubIe reveuIs LIuL uround IuII oI LIe RR`s Ior smokIngJ
specIIIc morLuIILy ure beIow .o. Around u LIIrd ure beIow z.o. YeL Ior LIe
SAMMEC exercIse, uny RR ubove 1.o Is IncIuded. TIIs IuIIs Lo meeL even
LIe very poor sLundurd oI LIe epIdemIoIogIc meLIod wIere un RR oI z-q Is
consIdered LIe boundury oI u weuk ussocIuLIon. urLIermore, In
SAMMEC LIere Is no purLILIonIng oI muILIpIe rIsk IucLors Ior dIseuseJ
Lifestyle Epidemiology
morLuIILy In muILIvurIuLe Lerms. TIereIore, wIere LIe uLLrIbuLubIe rIsk Ius
been deLermIned Ior rIsk IucLors In IsoIuLIon, LIen LIe summuLIon oI
uLLrIbuLubIe morLuIILy (I.e., conversIon oI uLLrIbuLubIe rIsk InLo morLuIILy
numbers) Irom u muILIpIIcILy oI rIsk IucLors wIII yIeId un overuII
sLuLIsLIcuI morLuIILy ruLe LIuL muy be Iur, Iur greuLer LIun LIe cctucl
morLuIILy ruLe (e.g., Eysenck, 1qq).
MurImonL (1qq6), u reLIred muLIemuLIcIun, Is more IorLIrIgIL In
uppruIsIng LIe SAMMEC IoIIy:
TIuL smokIng cuuses qoo,ooo deuLIs unnuuIIy Is now
wIdeIy promoLed us u sLuLIsLIcuI LruLI. TIe recenL
cumpuIgn uguInsL Leenuge smokIng usserLed LIuL one
ouL oI LIree Leenugers wIo smoked wouId be kIIIed by
LIIs IubIL. TIese numbers ure u gross mIsInLerpreLuLIon
oI LIe CDC SAMMEC resuILs, und u gross overesLImuLe
oI LIe ImporLunce oI smokIng us u cuuse oI deuLI....
TIe qoo,ooo pIus esLImuLe Is LIe resuIL oI IogIcuI und
epIdemIoIogIcuI bIunders und u Iuck oI scIenLIIIc
InLegrILy by LIe unLI-smokIng Iobby. TIe CDC esLImuLe
Is descrIbed us LIe number oI deuLIs cssocicted wILI
smokIng, noL ccused by IL. TIIs Is noL u semunLIc
dIsLIncLIon, becuuse u deuLI cun be ussocIuLed wILI
muny IucLors. Among rIsk IucLors Ior IeurL dIseuse, Ior
exumpIe, ure IyperLensIon, IIgI serum cIoIesLeroI,
obesILy, sedenLury IIIesLyIe, smokIng, geneLIc IucLors. I
we run SAMMEC compuLuLIons Ior eucI oI LIese
IucLors, we couId esLImuLe LIe number oI IeurL dIseuse
deuLIs ussocIuLed wILI eucI oI LIese IucLors. BuL
suppose LIuL JoIn SmILI, wIo dIed oI IeurL dIseuse,
Iud uII oI LIese IucLors, Ie wouId Iuve conLrIbuLed 6
deuLIs Lo LIe LoLuI ussocIuLed deuLIs. So LIuL wIen we
sum up LIese resuILs Lo urrIve uL LIe LoLuI deuLIs we IInd
LIuL our LoLuI Is mucI Iurger LIun LIe number oI peopIe
wIo ucLuuIIy dIed oI LIe dIseuse. (quoLed In OukIey,
1qqq, CI. , p. z-6)
One oI LIe crILIcuI Issues In LIIs dIscussIon Is wILI decepLIve
InIormuLIon beIng IruuduIenLIy peddIed under LIe uuspIces oI scIenLIIIc
credIbIIILy, und, worse sLIII, us LIe promoLIon oI IeuILI. TIe uLLempL Lo
porLruy SAMMEC InIormuLIon us un IndIcuLor oI subsLunLIve
undersLundIng oI LIe ueLIoIogy oI dIseuse, und, LIereIore, LIe roIe LIuL
specIIIc IucLors (e.g., cIgureLLe smokIng) pIuy In purLIcuIur dIseuse
ueLIoIogy, Is noLIIng sIorL oI u greuL dIsgruce - u subversIon oI LIe enLIre
93
93
Rampant Antismoking Signifies Grave Danger
TIese cIuIms were beIng mude In LIe IuLe-1qo`s. AIso, Hurdy (1q68)
reIers Lo sLuLemenLs mude by Horn (1q6;) sucI us oo,ooo uduIL
smokers dIe premuLureIy eucI yeur becuuse oI cIgureLLe smokIng. TIIs
sorL oI sImpIe-mInded conducL Is bused on LIe conversIon oI reIuLIve rIsk
Lo uLLrIbuLubIe rIsk. ALLrIbuLubIe rIsk Is LIen converLed InLo uLLrIbuLubIe
numbers or cuses Ior specIIIc dIseuse or overuII morLuIILy, I.e.,
uLLrIbuLubIe morLuIILy. TIe exercIse Is un enLIreIy urILImeLIc one LIuL
mukes noL one IoLu oI dIIIerence Lo coIerenL cuusuI InIerence. WIere
cuusuI urgumenL concernIng u pIenomenon Is In severe doubL, us IL sureIy
Is und wIII be concernIng smokIng und mosL dIseuses, LIe use oI
uLLrIbuLubIe rIsk und uLLrIbuLubIe numbers sIouId be wIoIIy uvoIded;
it is c stctisticcl cme thct ccn onl be mislecdin.
OukIey (1qqq) reusonubIy posILs LIuL muny members oI LIe
pubIIc beIIeve LIuL sucI sLuLemenLs oI uLLrIbuLubIe deuLIs ure deIInILIve.
McWIILer (1qqz), u US journuIIsL, expIuIns LIe very consIderubIe eIIorL
requIred Lo uscerLuIn Iow LIese IeuILI uuLIorILy esLImuLes ure urrIved uL.
AILer mucI pIone cuIIIng uround LIe counLry, sIe munuged Lo conLucL LIe
SAMMEC OperuLIons Munuger uL LIe OIIIce on SmokIng und HeuILI (u
subdIvIsIon oI CDC). SAMMEC Is un ucronym Ior SmokIng ALLrIbuLed
MorbIdILyJMorLuIILy und EconomIc CosL. TIe progrum runs on deuLI
cerLIIIcuLe duLu oI quesLIonubIe reIIubIIILy (eurIIer dIscussed) combIned
wILI eIevuLed RR`s Ior smokIng und specIIIc dIseuseJmorLuIILy. L Ius
uIreudy been consIdered LIuL LIese RR`s bIur mcn crILIcuI dIIIerences
beLween smokersJnonsmokers und ure cerLuInIy noL LIe busIs Ior cuusuI
urgumenL. TIese RR`s ure bused on meLu-unuIyses oI rIsk IucLorJspecIIIc
morLuIILy Ior reseurcI Lo u purLIcuIur duLe - some even unpubIIsIed, e.g.,
Cuncer PrevenLIon SLudy (see OukIey, 1qqq, CI.). urLIermore, LIese
RR`s ure not reguIurIy upduLed. ALLrIbuLubIe rIsk Is cuIcuIuLed und
converLed Lo uLLrIbuLubIe deuLIs (see TubIe ). McWIIrLer wus
undersLundubIy usLonIsIed by LIe IIImsIness oI LIe procedure und ILs
busIs. OLIer counLrIes (e.g., UK, AusLruIIu, Cunudu) Iuve LIeIr versIon oI
SAMMEC und muy Indeed use LIe sume RR`s und uLLrIbuLubIe rIsk
cuIcuIuLIons.
L cun be noLed Irom LIe SAMMEC exercIse LIuL epIdemIoIogyJ
prevenLIve medIcIne very rureIy commILs sImpIe errors. TIere Is usuuIIy u
compoundIng oI errors LIuL produces mcximcll mIsIeudIng InIormuLIon.
A perusuI oI TubIe reveuIs LIuL uround IuII oI LIe RR`s Ior smokIngJ
specIIIc morLuIILy ure beIow .o. Around u LIIrd ure beIow z.o. YeL Ior LIe
SAMMEC exercIse, uny RR ubove 1.o Is IncIuded. TIIs IuIIs Lo meeL even
LIe very poor sLundurd oI LIe epIdemIoIogIc meLIod wIere un RR oI z-q Is
consIdered LIe boundury oI u weuk ussocIuLIon. urLIermore, In
SAMMEC LIere Is no purLILIonIng oI muILIpIe rIsk IucLors Ior dIseuseJ
Lifestyle Epidemiology
morLuIILy In muILIvurIuLe Lerms. TIereIore, wIere LIe uLLrIbuLubIe rIsk Ius
been deLermIned Ior rIsk IucLors In IsoIuLIon, LIen LIe summuLIon oI
uLLrIbuLubIe morLuIILy (I.e., conversIon oI uLLrIbuLubIe rIsk InLo morLuIILy
numbers) Irom u muILIpIIcILy oI rIsk IucLors wIII yIeId un overuII
sLuLIsLIcuI morLuIILy ruLe LIuL muy be Iur, Iur greuLer LIun LIe cctucl
morLuIILy ruLe (e.g., Eysenck, 1qq).
MurImonL (1qq6), u reLIred muLIemuLIcIun, Is more IorLIrIgIL In
uppruIsIng LIe SAMMEC IoIIy:
TIuL smokIng cuuses qoo,ooo deuLIs unnuuIIy Is now
wIdeIy promoLed us u sLuLIsLIcuI LruLI. TIe recenL
cumpuIgn uguInsL Leenuge smokIng usserLed LIuL one
ouL oI LIree Leenugers wIo smoked wouId be kIIIed by
LIIs IubIL. TIese numbers ure u gross mIsInLerpreLuLIon
oI LIe CDC SAMMEC resuILs, und u gross overesLImuLe
oI LIe ImporLunce oI smokIng us u cuuse oI deuLI....
TIe qoo,ooo pIus esLImuLe Is LIe resuIL oI IogIcuI und
epIdemIoIogIcuI bIunders und u Iuck oI scIenLIIIc
InLegrILy by LIe unLI-smokIng Iobby. TIe CDC esLImuLe
Is descrIbed us LIe number oI deuLIs cssocicted wILI
smokIng, noL ccused by IL. TIIs Is noL u semunLIc
dIsLIncLIon, becuuse u deuLI cun be ussocIuLed wILI
muny IucLors. Among rIsk IucLors Ior IeurL dIseuse, Ior
exumpIe, ure IyperLensIon, IIgI serum cIoIesLeroI,
obesILy, sedenLury IIIesLyIe, smokIng, geneLIc IucLors. I
we run SAMMEC compuLuLIons Ior eucI oI LIese
IucLors, we couId esLImuLe LIe number oI IeurL dIseuse
deuLIs ussocIuLed wILI eucI oI LIese IucLors. BuL
suppose LIuL JoIn SmILI, wIo dIed oI IeurL dIseuse,
Iud uII oI LIese IucLors, Ie wouId Iuve conLrIbuLed 6
deuLIs Lo LIe LoLuI ussocIuLed deuLIs. So LIuL wIen we
sum up LIese resuILs Lo urrIve uL LIe LoLuI deuLIs we IInd
LIuL our LoLuI Is mucI Iurger LIun LIe number oI peopIe
wIo ucLuuIIy dIed oI LIe dIseuse. (quoLed In OukIey,
1qqq, CI. , p. z-6)
One oI LIe crILIcuI Issues In LIIs dIscussIon Is wILI decepLIve
InIormuLIon beIng IruuduIenLIy peddIed under LIe uuspIces oI scIenLIIIc
credIbIIILy, und, worse sLIII, us LIe promoLIon oI IeuILI. TIe uLLempL Lo
porLruy SAMMEC InIormuLIon us un IndIcuLor oI subsLunLIve
undersLundIng oI LIe ueLIoIogy oI dIseuse, und, LIereIore, LIe roIe LIuL
specIIIc IucLors (e.g., cIgureLLe smokIng) pIuy In purLIcuIur dIseuse
ueLIoIogy, Is noLIIng sIorL oI u greuL dIsgruce - u subversIon oI LIe enLIre
94
94
Rampant Antismoking Signifies Grave Danger
scIenLIIIc process, I.e., reIIecLs u IIgI order oI cIeuLIng. TIuL LIIs
InIormuLIon Is presenLed under LIe uuspIces oI uuLIorILy Is
unconscIonubIe, demonsLruLIng un uLLer conLempL Ior LIe pubIIc LrusL In
sucI InsLILuLIons. n LIe proceedIng dIscussIon, LIe monumenLuI,
deLrImenLuI rumIIIcuLIons oI LIIs conducL wIII be consIdered und wIIcI ure
IuLrogenIc. L onIy demonsLruLes LIuL sLuLIsLIcuI InIormuLIon In
IncompeLenL Iunds Is u dungerous LIIng Indeed.
TIIs quesLIonubIe InIormuLIon Ius LIen been used Lo generuLe
LIe equuIIy quesLIonubIe uLLrIbuLubIe cosL oI smokIng und uLLrIbuLubIe
suvIng Irom smokIng cessuLIon. or exumpIe, LIe SG (1q8q) sLuLes LIuL
smokIng wIII conLInue us LIe IeudIng cuuse oI prevenLubIe, premuLure
deuLI Ior muny yeurs Lo come..As u resuIL oI decIsIons Lo quIL smokIng or
noL Lo sLurL, un esLImuLed ;8q,ooo smokIng-reIuLed deuLIs were uvoIded
or posLponed beLween 1q6q und 1q8. urLIermore, LIese decIsIons wIII
resuIL In LIe uvoIdunce or posLponemenL oI un esLImuLed z.1 mIIIIon
smokIng reIuLed deuLIs beLween 1q86 und LIe yeur zooo. (quoLed In
Eysenck, 1qq, p. ) TIe AusLruIIun NuLIonuI Tobucco CumpuIgn ReseurcI
und EvuIuuLIon CommILLee (zooo) decIures |u| reducLIon In prevuIence
|oI smokIng| oI ubouL 1.q% Ior LIe IIrsL sIx-monLIs oI LIe cumpuIgn.LIIs
reducLIon wus susLuIned over LIe IoIIowIng yeur, gIvIng conIIdence Lo LIe
busIs Ior LIe esLImuLe LIuL LIe IIrsL sIx monLIs oI LIe cumpuIgn resuILed In
u neL 1qo,ooo Iewer smokers In AusLruIIu. TIe concIusIon Irom LIIs work
wus LIuL LIe NuLIonuI Tobucco CumpuIgn Is exceIIenL vuIue Ior money
Irom u vurIeLy oI perspecLIves und conIIrms LIe desIrubIIILy oI conLInuIng.
On LIe busIs oI LIe ussumpLIons used, LIe IIrsL pIuse oI LIe cumpuIgn
sIouId Iuve prevenLed qzz premuLure deuLIs und ucIIeved un uddILIonuI
,8 person yeurs oI IIIe up Lo LIe uge oI ;. urLIer, even In money
Lerms, IL wus exceIIenL vuIue Ior money us IL wouId Iuve been expecLed Lo
Iuve uverLed cosLs Lo LIe IeuILI sysLem oI $zq mIIIIon wIIcI wus Iur In
excess oI LIe esLImuLed $q mIIIIon expended by LIe IederuI, sLuLe und
LerrILory governmenLs und purLner orgunIzuLIons combIned. (p.8)
L couId weII be usked Iow IL Is lnoun LIuL qzz premuLure
deuLIs Iud been prevenLed, eLc., eLc. TIe unswer Is LIuL IL Is noL known uL
uII. TIese so-cuIIed ucIIevemenLs ure ter hihl ImprobubIe In cuusuI
Lerms (I.e., uII sLuLIsLIcuI ussumpLIons ure compIeLeIy quesLIonubIe und
LIere Is un ubsence oI coIerenL cuusuI InIerence) even II IL wus possIbIe Lo
uddress LIIs Issue In prugmuLIc Lerms - wIIcI IL Is noL. TIe conducL Is
enLIreIy u seII-servIng, bureuucruLIc uccounLIng exercIse occurrIng In u
sLuLIsLIcuI, IncompeLenL und menLuIIy dysIuncLIonuI IunLusy worId; LIere Is
mucI seII-uduIuLIon Ior ucIIevemenLs LIuL ure sLuLIsLIcuIIy munu-
IucLured, IuvIng no busIs In IucL. UnIorLunuLeIy, sucI cumpuIgns uLLrucL
consIderubIe IundIng In LIe currenL unLIsmokIng cIImuLe LIuL keeps muny
Lifestyle Epidemiology
oI IIgIIy quesLIonubIe scIoIursIIp In weII-puyIng empIoymenL. Nouhere
In cn governmenLuI reporL In cn deveIoped nuLIon concernIng unLI-
Lobucco InIormuLIonJcumpuIgns Is LIe Ideu oI menLuI IeuILI or LIe
poLenLIuI deLrImenLs Lo menLuI IeuILI by unLI-Lobucco cumpuIgns eter
reIerred Lo, IeL uIone consIdered. As wIII be dIscussed In u IoIIowIng
cIupLer on prevenLIve medIcIne, LIere muy Indeed be u very IIgI cosL In
menLuI und socIuI Lerms resuILIng Irom LIIs medIco-muLerIuIIsL und
bureuucruLIc InepLILude.
ALLrIbuLubIe rIsk und cosL cun be, und Iuve been, uppIIed on un
even grunder scuIe InvoIvIng muny nuLIons. n IucL, gIobuI uLLrIbuLubIe
morLuIILy, morbIdILy und cosL cun be generuLed LIuL produces Iuge
numbers - In LIe muILI-mIIIIons. WILI eucI Iuyer oI exLrupoIuLIon LIere Is
u IurLIer venLure InLo deIusIon; LIese progressIveIy Iurge numbers ure
concocLed In u sLuLIsLIcuI IunLusy worId, noL Lo be conIused wILI coIerenL
InIerence.
TIIs Ideu oI uLLrIbuLubIe cosL Ius been empIoyed by
governmenLs us LIe busIs Ior IILIguLIon uguInsL LIe Lobucco IndusLry und
Ius deLrImenLuIIy uILered LIe enLIre sLuLIsLIcuI Ideu oI Iow-IeveI rIsk In
IeguI Lerms. L Is especIuIIy LIIs IuLLer sLuLIsLIcuI mIsconducL LIuL LIrusLs
LIIs sugu InLo LIe reuIm oI IIgI scunduI, I.e., IruuduIenL epIdemIoIogIc
conducL Ius uILImuLeIy InIecLed psycIoIogIcuI, socIuI, moruI, poIILIcuI und
IeguI IeuILI.
Members oI oLIer dIscIpIInes (e.g., IeguI) Iuve LIen seIzed on
LIese concocLed urgumenLs und Iuve proceeded In un opporLunIsLIc,
uvurIcIous und menLuIIy dysIuncLIonuI Irenzy. or exumpIe, runcey
(1qqq) decIures LIuL:
TIe deceIL und dupIIcILy |oI LIe Lobucco IndusLry| Is
currenLIy beIng exposed by IILIguLIon In LIe UnILed
SLuLes wIIcI Is spreudIng worIdwIde. TIe posILIon Ius
now been reucIed wIere conLInued dIspuLuLIon und
dIsLorLIon Is unLenubIe, purLIcuIurIy In LIe Iuce oI LIe
projected Increuse In Lobucco deuLIs by LIe yeur zoz ij
current trends cre continued. TIIs Is uII LIe more so
gIven LIe dIspurILy In LIe projected Increuse beLween
deveIoped und Iess deveIoped counLrIes, reIIecLIng un
expIoILuLIon oI Iesser deveIoped counLrIes wIIcI wIII
onIy Increuse Lo oIIseL IIubIIILIes LIe Lobucco IndusLry Is
IncurrIng In LIe UnILed SLuLes.
TIIs Is u cIrcumsLunce cuIIIng Ior InLernuLIonuI ucLIon. L
musL noL be uIIowed Lo Iuppen. Were IL Lo occur IL
wouId be, wILIouL doubL, u crIme uguInsL IumunILy.
GIven wIuL Is lnoun ubouL smokIng und dIseuse und
95
95
Rampant Antismoking Signifies Grave Danger
scIenLIIIc process, I.e., reIIecLs u IIgI order oI cIeuLIng. TIuL LIIs
InIormuLIon Is presenLed under LIe uuspIces oI uuLIorILy Is
unconscIonubIe, demonsLruLIng un uLLer conLempL Ior LIe pubIIc LrusL In
sucI InsLILuLIons. n LIe proceedIng dIscussIon, LIe monumenLuI,
deLrImenLuI rumIIIcuLIons oI LIIs conducL wIII be consIdered und wIIcI ure
IuLrogenIc. L onIy demonsLruLes LIuL sLuLIsLIcuI InIormuLIon In
IncompeLenL Iunds Is u dungerous LIIng Indeed.
TIIs quesLIonubIe InIormuLIon Ius LIen been used Lo generuLe
LIe equuIIy quesLIonubIe uLLrIbuLubIe cosL oI smokIng und uLLrIbuLubIe
suvIng Irom smokIng cessuLIon. or exumpIe, LIe SG (1q8q) sLuLes LIuL
smokIng wIII conLInue us LIe IeudIng cuuse oI prevenLubIe, premuLure
deuLI Ior muny yeurs Lo come..As u resuIL oI decIsIons Lo quIL smokIng or
noL Lo sLurL, un esLImuLed ;8q,ooo smokIng-reIuLed deuLIs were uvoIded
or posLponed beLween 1q6q und 1q8. urLIermore, LIese decIsIons wIII
resuIL In LIe uvoIdunce or posLponemenL oI un esLImuLed z.1 mIIIIon
smokIng reIuLed deuLIs beLween 1q86 und LIe yeur zooo. (quoLed In
Eysenck, 1qq, p. ) TIe AusLruIIun NuLIonuI Tobucco CumpuIgn ReseurcI
und EvuIuuLIon CommILLee (zooo) decIures |u| reducLIon In prevuIence
|oI smokIng| oI ubouL 1.q% Ior LIe IIrsL sIx-monLIs oI LIe cumpuIgn.LIIs
reducLIon wus susLuIned over LIe IoIIowIng yeur, gIvIng conIIdence Lo LIe
busIs Ior LIe esLImuLe LIuL LIe IIrsL sIx monLIs oI LIe cumpuIgn resuILed In
u neL 1qo,ooo Iewer smokers In AusLruIIu. TIe concIusIon Irom LIIs work
wus LIuL LIe NuLIonuI Tobucco CumpuIgn Is exceIIenL vuIue Ior money
Irom u vurIeLy oI perspecLIves und conIIrms LIe desIrubIIILy oI conLInuIng.
On LIe busIs oI LIe ussumpLIons used, LIe IIrsL pIuse oI LIe cumpuIgn
sIouId Iuve prevenLed qzz premuLure deuLIs und ucIIeved un uddILIonuI
,8 person yeurs oI IIIe up Lo LIe uge oI ;. urLIer, even In money
Lerms, IL wus exceIIenL vuIue Ior money us IL wouId Iuve been expecLed Lo
Iuve uverLed cosLs Lo LIe IeuILI sysLem oI $zq mIIIIon wIIcI wus Iur In
excess oI LIe esLImuLed $q mIIIIon expended by LIe IederuI, sLuLe und
LerrILory governmenLs und purLner orgunIzuLIons combIned. (p.8)
L couId weII be usked Iow IL Is lnoun LIuL qzz premuLure
deuLIs Iud been prevenLed, eLc., eLc. TIe unswer Is LIuL IL Is noL known uL
uII. TIese so-cuIIed ucIIevemenLs ure ter hihl ImprobubIe In cuusuI
Lerms (I.e., uII sLuLIsLIcuI ussumpLIons ure compIeLeIy quesLIonubIe und
LIere Is un ubsence oI coIerenL cuusuI InIerence) even II IL wus possIbIe Lo
uddress LIIs Issue In prugmuLIc Lerms - wIIcI IL Is noL. TIe conducL Is
enLIreIy u seII-servIng, bureuucruLIc uccounLIng exercIse occurrIng In u
sLuLIsLIcuI, IncompeLenL und menLuIIy dysIuncLIonuI IunLusy worId; LIere Is
mucI seII-uduIuLIon Ior ucIIevemenLs LIuL ure sLuLIsLIcuIIy munu-
IucLured, IuvIng no busIs In IucL. UnIorLunuLeIy, sucI cumpuIgns uLLrucL
consIderubIe IundIng In LIe currenL unLIsmokIng cIImuLe LIuL keeps muny
Lifestyle Epidemiology
oI IIgIIy quesLIonubIe scIoIursIIp In weII-puyIng empIoymenL. Nouhere
In cn governmenLuI reporL In cn deveIoped nuLIon concernIng unLI-
Lobucco InIormuLIonJcumpuIgns Is LIe Ideu oI menLuI IeuILI or LIe
poLenLIuI deLrImenLs Lo menLuI IeuILI by unLI-Lobucco cumpuIgns eter
reIerred Lo, IeL uIone consIdered. As wIII be dIscussed In u IoIIowIng
cIupLer on prevenLIve medIcIne, LIere muy Indeed be u very IIgI cosL In
menLuI und socIuI Lerms resuILIng Irom LIIs medIco-muLerIuIIsL und
bureuucruLIc InepLILude.
ALLrIbuLubIe rIsk und cosL cun be, und Iuve been, uppIIed on un
even grunder scuIe InvoIvIng muny nuLIons. n IucL, gIobuI uLLrIbuLubIe
morLuIILy, morbIdILy und cosL cun be generuLed LIuL produces Iuge
numbers - In LIe muILI-mIIIIons. WILI eucI Iuyer oI exLrupoIuLIon LIere Is
u IurLIer venLure InLo deIusIon; LIese progressIveIy Iurge numbers ure
concocLed In u sLuLIsLIcuI IunLusy worId, noL Lo be conIused wILI coIerenL
InIerence.
TIIs Ideu oI uLLrIbuLubIe cosL Ius been empIoyed by
governmenLs us LIe busIs Ior IILIguLIon uguInsL LIe Lobucco IndusLry und
Ius deLrImenLuIIy uILered LIe enLIre sLuLIsLIcuI Ideu oI Iow-IeveI rIsk In
IeguI Lerms. L Is especIuIIy LIIs IuLLer sLuLIsLIcuI mIsconducL LIuL LIrusLs
LIIs sugu InLo LIe reuIm oI IIgI scunduI, I.e., IruuduIenL epIdemIoIogIc
conducL Ius uILImuLeIy InIecLed psycIoIogIcuI, socIuI, moruI, poIILIcuI und
IeguI IeuILI.
Members oI oLIer dIscIpIInes (e.g., IeguI) Iuve LIen seIzed on
LIese concocLed urgumenLs und Iuve proceeded In un opporLunIsLIc,
uvurIcIous und menLuIIy dysIuncLIonuI Irenzy. or exumpIe, runcey
(1qqq) decIures LIuL:
TIe deceIL und dupIIcILy |oI LIe Lobucco IndusLry| Is
currenLIy beIng exposed by IILIguLIon In LIe UnILed
SLuLes wIIcI Is spreudIng worIdwIde. TIe posILIon Ius
now been reucIed wIere conLInued dIspuLuLIon und
dIsLorLIon Is unLenubIe, purLIcuIurIy In LIe Iuce oI LIe
projected Increuse In Lobucco deuLIs by LIe yeur zoz ij
current trends cre continued. TIIs Is uII LIe more so
gIven LIe dIspurILy In LIe projected Increuse beLween
deveIoped und Iess deveIoped counLrIes, reIIecLIng un
expIoILuLIon oI Iesser deveIoped counLrIes wIIcI wIII
onIy Increuse Lo oIIseL IIubIIILIes LIe Lobucco IndusLry Is
IncurrIng In LIe UnILed SLuLes.
TIIs Is u cIrcumsLunce cuIIIng Ior InLernuLIonuI ucLIon. L
musL noL be uIIowed Lo Iuppen. Were IL Lo occur IL
wouId be, wILIouL doubL, u crIme uguInsL IumunILy.
GIven wIuL Is lnoun ubouL smokIng und dIseuse und
96
96
Rampant Antismoking Signifies Grave Danger
LIe deceIL und dupIIcILy oI LIe Lobucco IndusLry, were
LIe deuLI LoII Irom Lobucco Lo Increuse Irom mIIIIon u
yeur Lo 1o mIIIIon u yeur by LIe yeur zoz, especIuIIy
wILI LIe drumuLIc Increuse In Iesser deveIoped counLrIes
Irom 1 mIIIIon Lo ; mIIIIon u yeur, IL Is ImpossIbIe Lo
descrIbe LIuL consequence us unyLIIng oLIer LIun LIe
resuIL oI un InIumune ucL oI u cIurucLer sImIIur Lo
murder, cuusIng greuL suIIerIng, or serIous Injury Lo
body or Lo menLuI or pIysIcuI IeuILI commILLed us purL
oI u wIdespreud or sysLemuLIc uLLuck dIrecLed uguInsL
LIe cIvIIIun popuIuLIon oI LIe worId.
GIven LIuL LIe dIrecLors und execuLIves oI LIe mujor
LrunsnuLIonuI Lobucco compunIes musL now Iuve
knowIedge oI LIe consequences oI LIeIr ucLIvILIes, II
LIose ucLIvILIes conLInue LIen eucI und every one oI
LIem musL Iuce LIe prospecL oI beIng cIurged wILI
commILLIng u crIme uguInsL IumunILy In LIe
nLernuLIonuI CrImInuI CourL. |itclics cdded| (p.-)
runcey`s (1qqq) urgumenL Is enLIreIy bused on wIId sLuLIsLIcuI
specuIuLIon. NowIere In LIIs deIIneuLIon Is LIere uny reIerence Lo LIe
ucLuuI requIremenLs oI cuusuI urgumenL; LIe probubIIILy Is LIuL runcey Is
noL even uwure oI LIese. WIuL begIns us epIdemIoIogIc cuLusLropIIzuLIon
Is LIen IurLIer cuLusLropIIzed by unquesLIonIng opporLunIsLs In oLIer
dIscIpIInes; In LIIs cuse, InLo LIe busIs Ior cIurges beIng IuId In LIe
nLernuLIonuI CrImInuI CourL!
I LIe munuIucLure oI sLuLIsLIcuI IunLusy us sympLomuLIc oI LIe
muLerIuIIsL menLuIILy und servIng Lo IurLIer propeI muLerIuIIsL IdeoIogy
wus noL uIreudy suIIIcIenLIy deIusIonuI, LIen LIe dysIuncLIon reucIes new
IeIgILs wILI LIe uddILIon oI u muLernuI & cIIId IeuILI vurIunL oI
SAMMEC reIerred Lo us MCHSAMMEC (see MeIvIn eL uI., zooo; see uIso
ETS cnd Childhood Disecses secLIon In CIupLer q). TIIs wIII uIIord even
puIIIer numbers oI smokIng-uLLrIbuLed morbIdILy und morLuIILy.
L cun be sLuLed Irom LIe IoregoIng LIuL IIIesLyIe epIdemIoIogy
ruLes us LIe worsL uLLempL uL scIenLIIIc enquIry In LIe reIuLIveIy sIorL
IIsLory oI scIence: Ls conLorLed muLerIuIIsLJexLernuIIsL bIus, LIe sIeer
voIume und compoundIng oI crILIcuI errors oI InIerence LIuL weII
cIurucLerIzes LIe epIdemIoIogIc conducL regurdIng purLIcuIurIy IIIesLyIe
dIseuses, und LIe momenLum oI errors Is cIeurIy unLILIeLIcuI Lo LIe gouI oI
scIence. As wIII be IurLIer consIdered, LIe mIsconducL Is so severe und
wIdespreud, now cuImInuLIng In LIe uLLempL Lo coerce u worId
IdeoIogy (e.g., rIsk uversIon generuIIy, smokeIree specIIIcuIIy), LIuL IL Is
Lifestyle Epidemiology
epIdemIoIogyJprevenLIve medIcIne und LIe seII-servIng medIcuI
producLIon-IIne buIIL uround LIem LIuL consLILuLe one oI LIe greuLesL
LIreuLs Lo pubIIc IeuILI oI LIe LIme.
z.( The Grecter Epidemioloiccl Context
TIus Iur IL cun be concIuded LIuL IIIesLyIe epIdemIoIogy und
prevenLIve medIcIne ure repIeLe wILI IuIIucIes oI IogIcuI und sLuLIsLIcuI
InIerence. TIese errors ure noL IsoIuLed occurrences, buL LIe enLIre
enLerprIse Is predIcuLed on u compoundIng oI essenLIuIIy every InIerenLIuI
error LIuL cun be mude. Worse sLIII Is LIuL LIe muLerIuIIsm oI LIe upproucI
cunnoL uccounL Ior psycIoIogIcuI or psycIosocIuI uspecLs oI pIenomenu
under InvesLIguLIon. As sucI IL wIII, IIrsLIy, Iorce InLerpreLuLIons LIuL ure
sImpIy noL ImpIIed by duLu uL uII. SecondIy, IL cunnoL scruLInIze LIe
objecLIvILy or sLubIIILy oI ILs own moLIvuLIon. And, LIIrdIy, IL cunnoL
IuLIom, IeL uIone uddress, LIe psycIoIogIcuI, psycIosocIuI, und moruI
rumIIIcuLIons oI ILs own erruLIc conducL.
TIe epIdemIoIogIc meLIod und ILs underIyIng medIco-
muLerIuIIsm represenL IuIr-LrIgger or Iyper-reucLIvILy Lo Iow-IeveI
sLuLIsLIcuI ussocIuLIons (I.e., sLuLIsLIcuI rIsk uversIon). n psycIoIogIcuI
Lerms LIIs Iyper-reucLIvILy wouId be consIdered IIgIIy neuroLIc.
urLIermore, LIe proIound, InIerenLIuI IncompeLence LIuL weII
cIurucLerIzes LIe epIdemIoIogIc meLIod exLernuIIzes uII cuusuI dynumIcs;
exLernuIILIes ure ussIgned LIe enLIre cuusuI propensILy Lo produce
purLIcuIur eIIecLs In oLIerwIse unIIorm, pussIve und IeuILIy endogenous
sysLems. As sucI, mosL, II noL uII, oI ILs concIusIons und procIumuLIons
represenL no more LIun supersLILIous beIIeI. SocIeLIes LIuL Iuve uIIowed
LIemseIves Lo be domInuLed by LIIs muLerIuIIsL decepLIon ure noL
enIIgILened buL uIreudy In gruve LroubIe.
n scIenLIIIc, or uny epIsLemoIogIc Lerms, LIe epIdemIoIogIc
meLIod Is u Iorror sLory; IL conducLs ILseII und produces concIusIons LIuL
ure unLILIeLIcuI Lo LIe scIenLIIIc endeuvour. Numerous socIeLIes ure now
InIecLed wILI IIgI IeveIs oI supersLILIous beIIeI umongsL oLIer
psycIoIogIcuI, socIuI und moruI dysIuncLIon. TIe greuL ubsurdILy Is LIuL
LIIs cIrcumsLunce Ius been munuIucLured under LIe preLense oI scIenLIIIc
experLIse und IeuILI promoLIon.
To LIIs poInL, onIy Lobucco smokIng und ILs LreuLmenL by LIe
epIdemIoIogIc meLIod Ius been consIdered. However, Lobucco smokIng,
by Iur LIe mosL over-InvesLIguLed und over-InLerpreLed, Is onIy one
umongsL u muILILude oI IucLors InvesLIguLed by IIIesLyIe epIdemIoIogy. By
LIIs new mIIIennIum LIere ure LIousunds oI sLudIes demonsLruLIng
eIevuLed or reduced reIuLIve rIsk Ior numerous IucLors sLuLIsLIcuIIy
97
97
Rampant Antismoking Signifies Grave Danger
LIe deceIL und dupIIcILy oI LIe Lobucco IndusLry, were
LIe deuLI LoII Irom Lobucco Lo Increuse Irom mIIIIon u
yeur Lo 1o mIIIIon u yeur by LIe yeur zoz, especIuIIy
wILI LIe drumuLIc Increuse In Iesser deveIoped counLrIes
Irom 1 mIIIIon Lo ; mIIIIon u yeur, IL Is ImpossIbIe Lo
descrIbe LIuL consequence us unyLIIng oLIer LIun LIe
resuIL oI un InIumune ucL oI u cIurucLer sImIIur Lo
murder, cuusIng greuL suIIerIng, or serIous Injury Lo
body or Lo menLuI or pIysIcuI IeuILI commILLed us purL
oI u wIdespreud or sysLemuLIc uLLuck dIrecLed uguInsL
LIe cIvIIIun popuIuLIon oI LIe worId.
GIven LIuL LIe dIrecLors und execuLIves oI LIe mujor
LrunsnuLIonuI Lobucco compunIes musL now Iuve
knowIedge oI LIe consequences oI LIeIr ucLIvILIes, II
LIose ucLIvILIes conLInue LIen eucI und every one oI
LIem musL Iuce LIe prospecL oI beIng cIurged wILI
commILLIng u crIme uguInsL IumunILy In LIe
nLernuLIonuI CrImInuI CourL. |itclics cdded| (p.-)
runcey`s (1qqq) urgumenL Is enLIreIy bused on wIId sLuLIsLIcuI
specuIuLIon. NowIere In LIIs deIIneuLIon Is LIere uny reIerence Lo LIe
ucLuuI requIremenLs oI cuusuI urgumenL; LIe probubIIILy Is LIuL runcey Is
noL even uwure oI LIese. WIuL begIns us epIdemIoIogIc cuLusLropIIzuLIon
Is LIen IurLIer cuLusLropIIzed by unquesLIonIng opporLunIsLs In oLIer
dIscIpIInes; In LIIs cuse, InLo LIe busIs Ior cIurges beIng IuId In LIe
nLernuLIonuI CrImInuI CourL!
I LIe munuIucLure oI sLuLIsLIcuI IunLusy us sympLomuLIc oI LIe
muLerIuIIsL menLuIILy und servIng Lo IurLIer propeI muLerIuIIsL IdeoIogy
wus noL uIreudy suIIIcIenLIy deIusIonuI, LIen LIe dysIuncLIon reucIes new
IeIgILs wILI LIe uddILIon oI u muLernuI & cIIId IeuILI vurIunL oI
SAMMEC reIerred Lo us MCHSAMMEC (see MeIvIn eL uI., zooo; see uIso
ETS cnd Childhood Disecses secLIon In CIupLer q). TIIs wIII uIIord even
puIIIer numbers oI smokIng-uLLrIbuLed morbIdILy und morLuIILy.
L cun be sLuLed Irom LIe IoregoIng LIuL IIIesLyIe epIdemIoIogy
ruLes us LIe worsL uLLempL uL scIenLIIIc enquIry In LIe reIuLIveIy sIorL
IIsLory oI scIence: Ls conLorLed muLerIuIIsLJexLernuIIsL bIus, LIe sIeer
voIume und compoundIng oI crILIcuI errors oI InIerence LIuL weII
cIurucLerIzes LIe epIdemIoIogIc conducL regurdIng purLIcuIurIy IIIesLyIe
dIseuses, und LIe momenLum oI errors Is cIeurIy unLILIeLIcuI Lo LIe gouI oI
scIence. As wIII be IurLIer consIdered, LIe mIsconducL Is so severe und
wIdespreud, now cuImInuLIng In LIe uLLempL Lo coerce u worId
IdeoIogy (e.g., rIsk uversIon generuIIy, smokeIree specIIIcuIIy), LIuL IL Is
Lifestyle Epidemiology
epIdemIoIogyJprevenLIve medIcIne und LIe seII-servIng medIcuI
producLIon-IIne buIIL uround LIem LIuL consLILuLe one oI LIe greuLesL
LIreuLs Lo pubIIc IeuILI oI LIe LIme.
z.( The Grecter Epidemioloiccl Context
TIus Iur IL cun be concIuded LIuL IIIesLyIe epIdemIoIogy und
prevenLIve medIcIne ure repIeLe wILI IuIIucIes oI IogIcuI und sLuLIsLIcuI
InIerence. TIese errors ure noL IsoIuLed occurrences, buL LIe enLIre
enLerprIse Is predIcuLed on u compoundIng oI essenLIuIIy every InIerenLIuI
error LIuL cun be mude. Worse sLIII Is LIuL LIe muLerIuIIsm oI LIe upproucI
cunnoL uccounL Ior psycIoIogIcuI or psycIosocIuI uspecLs oI pIenomenu
under InvesLIguLIon. As sucI IL wIII, IIrsLIy, Iorce InLerpreLuLIons LIuL ure
sImpIy noL ImpIIed by duLu uL uII. SecondIy, IL cunnoL scruLInIze LIe
objecLIvILy or sLubIIILy oI ILs own moLIvuLIon. And, LIIrdIy, IL cunnoL
IuLIom, IeL uIone uddress, LIe psycIoIogIcuI, psycIosocIuI, und moruI
rumIIIcuLIons oI ILs own erruLIc conducL.
TIe epIdemIoIogIc meLIod und ILs underIyIng medIco-
muLerIuIIsm represenL IuIr-LrIgger or Iyper-reucLIvILy Lo Iow-IeveI
sLuLIsLIcuI ussocIuLIons (I.e., sLuLIsLIcuI rIsk uversIon). n psycIoIogIcuI
Lerms LIIs Iyper-reucLIvILy wouId be consIdered IIgIIy neuroLIc.
urLIermore, LIe proIound, InIerenLIuI IncompeLence LIuL weII
cIurucLerIzes LIe epIdemIoIogIc meLIod exLernuIIzes uII cuusuI dynumIcs;
exLernuIILIes ure ussIgned LIe enLIre cuusuI propensILy Lo produce
purLIcuIur eIIecLs In oLIerwIse unIIorm, pussIve und IeuILIy endogenous
sysLems. As sucI, mosL, II noL uII, oI ILs concIusIons und procIumuLIons
represenL no more LIun supersLILIous beIIeI. SocIeLIes LIuL Iuve uIIowed
LIemseIves Lo be domInuLed by LIIs muLerIuIIsL decepLIon ure noL
enIIgILened buL uIreudy In gruve LroubIe.
n scIenLIIIc, or uny epIsLemoIogIc Lerms, LIe epIdemIoIogIc
meLIod Is u Iorror sLory; IL conducLs ILseII und produces concIusIons LIuL
ure unLILIeLIcuI Lo LIe scIenLIIIc endeuvour. Numerous socIeLIes ure now
InIecLed wILI IIgI IeveIs oI supersLILIous beIIeI umongsL oLIer
psycIoIogIcuI, socIuI und moruI dysIuncLIon. TIe greuL ubsurdILy Is LIuL
LIIs cIrcumsLunce Ius been munuIucLured under LIe preLense oI scIenLIIIc
experLIse und IeuILI promoLIon.
To LIIs poInL, onIy Lobucco smokIng und ILs LreuLmenL by LIe
epIdemIoIogIc meLIod Ius been consIdered. However, Lobucco smokIng,
by Iur LIe mosL over-InvesLIguLed und over-InLerpreLed, Is onIy one
umongsL u muILILude oI IucLors InvesLIguLed by IIIesLyIe epIdemIoIogy. By
LIIs new mIIIennIum LIere ure LIousunds oI sLudIes demonsLruLIng
eIevuLed or reduced reIuLIve rIsk Ior numerous IucLors sLuLIsLIcuIIy
98
98
Rampant Antismoking Signifies Grave Danger
ussocIuLed wILI dIseuse. MosL oI LIese sLudIes couId be dIsposed oI und IL
wouId noL muke one bIL oI dIIIerence Lo u coIerenL undersLundIng oI
dIseuse ueLIoIogy. TIe probIem Is LIuL LIIs reIuLIve rIsk InIormuLIon Ius
been sLeudIIy IIndIng ILs wuy Lo LIe pubIIc vIu LIe medIu und promoLed by
IeuILI oIIIcIuIdom (muLerIuIIsL munIIesLo). PurLIcuIurIy over LIe IusL Iew
decudes, LIe pubIIc Ius been uLLerIy pounded, bomburded, wILI LIIs
sLuLIsLIcuI nonsense, I.e., u muLerIuIIsL ussuuIL.
n newspupers und TV IIIesLyIe progrummes In mosL deveIoped
nuLIons, LIe pubIIc Is beIng Ied u duIIy dIeL oI uII munner oI rIsk IucLors
Ior uII munner oI muIudIes. n one mujor AusLruIIun newspuper (Hercld,
Sun, VIcLorIu) LIere Is u IuII puge devoLed weekIy Lo muLerIuIIsL IeuILI
propugundu, und duIIy LIere Is reIerence Lo some new IeuILI dIscovery
or IInk. n duIIy LeIevIsIon news, occurrIng Lwo Lo LIree LImes duIIy, LIere
ure specIIIc segmenLs devoLed Lo LIIs unquesLIoned IeuILIIsL ussuuIL. TIIs
Is occurrIng In mosL deveIoped nuLIons. TIe pubIIc Is beIng LerrorIzed InLo
un IrruLIonuI Ieur oI numerous exLernuI IucLors (IncIudIng oLIer Iumun
beIngs) bused on LIe IIImsIesL oI sLuLIsLIcuI InIormuLIon und proIoundIy
IncompeLenL cuusuI InIerence.
Tuubes (1qq) suggesLs LIuL journuIs Loduy ure IuII oI sLudIes
suggesLIng LIuL u IILLIe rIsk Is noL noLIIng uL uII. TIe IIndIngs ure oILen
LouLed In press reIeuses by LIe journuIs LIuL pubIIsI LIem or by LIe
reseurcIers` InsLILuLIons, und newspupers und oLIer medIu oILen reporL
LIe cIuIms uncrILIcuIIy. And so LIe unxIeLy penduIum swIngs uL un ever
more dIzzyIng ruLe. (p.16q) Tuubes (1qq, p.16)) provIdes u very smuII
sumpIIng oI epIdemIoIogIc IIndIngs LIuL were pIcked up In LIe popuIur
press durIng LIe 8 yeurs Lo 1qq:
HIgI-cIoIesLeroI dIeL - rIsk ruLIo (rr) 1.6 Ior recLuI cuncer In
men (1q8;);
EuLIng yogurL uL IeusL once u monLI - rr z.o Ior ovurIun cuncer
(1q8q);
SmokIng more LIun 1oo cIgureLLes In u IIIeLIme - rr 1.z Ior
breusL cuncer (1qqo);
HIgI-IuL dIeL - rr z.o Ior breusL cuncer (1qqo);
engLIy occupuLIonuI exposure Lo dIoxIn - rr 1. Ior uII cuncers
(1qq1);
DoucIIng once u week - rr q.o Ior cervIcuI cuncer (1qq1);
ReguIur use oI IIgI-uIcoIoI mouLIwusI - rr 1. Ior mouLI
cuncer (1qq1);
Use oI pIenoxy IerbIcIdes on Iuwns - rr 1. Ior muIIgnunL
IympIomu In dogs (1qq1);
WeIgIIng .6 kIIogrums or more uL bIrLI - rr 1. Ior breusL
cuncer (1qqz);
Lifestyle Epidemiology
VusecLomy - rr 1.6 Ior prosLuLe cuncer (1qq);
PesLIcIde exposure, IndIcuLed by IIgI resIdues In bIood - rr q.o
Ior breusL cuncer (1qq); conLrudIcLed 1 yeur IuLer In u Iurger
sLudy wILI one oI LIe sume uuLIors;
DrInkIng more LIun . IILres oI IIuId (purLIcuIurIy cIIorInuLed
Lup wuLer) u duy - rr z-q Ior bIudder cuncer (1qq);
ExperIencIng psycIoIogIcuI sLress In LIe workpIuce - rr . Ior
coIorecLuI cuncer (1qq);
DIeL IIgI In suLuruLed IuL - 6 Ior Iung cuncer In nonsmokIng
women (1qq);
EuLIng more LIun zo grums oI processed meuLs (.e., boIognu) u
duy - rr 1.;z Ior coIon cuncer (1qqq);
EuLIng red meuL IIve or more LImes u week - rr z. Ior coIon
cuncer (1qqq);
OccupuLIonuI exposure Lo eIecLromugneLIc IIeIds - rr 1.8 Ior
breusL cuncer (1qqq);
SmokIng Lwo pucks oI cIgureLLes u duy - rr 1.;q Ior IuLuI breusL
cuncer (1qqq);
EuLIng red meuL LwIce u duy - rr z.o Ior breusL cuncer (1qqq);
ReguIur cIgureLLe smokIng - rr 1.; Ior puncreuLIc cuncer (1qqq);
Ever IuvIng used u sunIump - rr 1. Ior meIunomu (1qqq);
AborLIon - rr 1. Ior breusL cuncer (1qqq);
HuvIng sIorLer or Ionger mensLruuI cycIes - rr z.o Ior breusL
cuncer (1qqq);
ObesILy In men (LIe IeuvIesL z% oI LIose In LIe sLudy) - rr .o
Ior eosopIugeuI cuncer (1qq);
ConsumIng oIIve oII onIy once u duy or Iess - rr 1.z Ior breusL
cuncer (1qq).
TIese sorLs oI IIndIngs ure LypIcuIIy presenLed In u completel
unquesLIoned munner. L Is noLubIe LIuL mosL oI LIe RRs do noL even meeL
LIe poor epIdemIoIogIc sLundurds Ior Iyper-reucLIvILy, I.e., RR=z.o-q.o.
MosL Iuve no rIyme or reuson; LIey sImpIy reIIecL Iow-order sLuLIsLIcuI
correIuLIon. TIe predIcLIve sLrengLI oI cll LIe IucLors Ior LIe dIseuses In
quesLIon, und wIIcI Is never presenLed, Is eILIer neur-zero or eIIecLIveIy
zero. L musL be upprecIuLed LIuL uL Iow IeveIs oI predIcLIve sLrengLI un
experImenLuI IucLor cun poLenLIuIIy be cross-correIuLed wILI numerous
oLIer IucLors, mosL oI LIem unIdenLIIIed. TIereIore, LIe correIuLIon oI un
experImenLuI IucLor wILI u purLIcuIur dIseuse mosL probubIy Ius no sLuLus
even us u LrIgger IucLor Ior suscepLIbIe IndIvIduuIs, buL Ius more Lo do
wILI LIe nuLure oI urLIIIcIuI experImenLuI subdIvIsIons (meusuremenLs)
und LIe nuLure oI LIe IucLor beIng exumIned, I.e., LIe correIuLIon Is enLIreIy
99
99
Rampant Antismoking Signifies Grave Danger
ussocIuLed wILI dIseuse. MosL oI LIese sLudIes couId be dIsposed oI und IL
wouId noL muke one bIL oI dIIIerence Lo u coIerenL undersLundIng oI
dIseuse ueLIoIogy. TIe probIem Is LIuL LIIs reIuLIve rIsk InIormuLIon Ius
been sLeudIIy IIndIng ILs wuy Lo LIe pubIIc vIu LIe medIu und promoLed by
IeuILI oIIIcIuIdom (muLerIuIIsL munIIesLo). PurLIcuIurIy over LIe IusL Iew
decudes, LIe pubIIc Ius been uLLerIy pounded, bomburded, wILI LIIs
sLuLIsLIcuI nonsense, I.e., u muLerIuIIsL ussuuIL.
n newspupers und TV IIIesLyIe progrummes In mosL deveIoped
nuLIons, LIe pubIIc Is beIng Ied u duIIy dIeL oI uII munner oI rIsk IucLors
Ior uII munner oI muIudIes. n one mujor AusLruIIun newspuper (Hercld,
Sun, VIcLorIu) LIere Is u IuII puge devoLed weekIy Lo muLerIuIIsL IeuILI
propugundu, und duIIy LIere Is reIerence Lo some new IeuILI dIscovery
or IInk. n duIIy LeIevIsIon news, occurrIng Lwo Lo LIree LImes duIIy, LIere
ure specIIIc segmenLs devoLed Lo LIIs unquesLIoned IeuILIIsL ussuuIL. TIIs
Is occurrIng In mosL deveIoped nuLIons. TIe pubIIc Is beIng LerrorIzed InLo
un IrruLIonuI Ieur oI numerous exLernuI IucLors (IncIudIng oLIer Iumun
beIngs) bused on LIe IIImsIesL oI sLuLIsLIcuI InIormuLIon und proIoundIy
IncompeLenL cuusuI InIerence.
Tuubes (1qq) suggesLs LIuL journuIs Loduy ure IuII oI sLudIes
suggesLIng LIuL u IILLIe rIsk Is noL noLIIng uL uII. TIe IIndIngs ure oILen
LouLed In press reIeuses by LIe journuIs LIuL pubIIsI LIem or by LIe
reseurcIers` InsLILuLIons, und newspupers und oLIer medIu oILen reporL
LIe cIuIms uncrILIcuIIy. And so LIe unxIeLy penduIum swIngs uL un ever
more dIzzyIng ruLe. (p.16q) Tuubes (1qq, p.16)) provIdes u very smuII
sumpIIng oI epIdemIoIogIc IIndIngs LIuL were pIcked up In LIe popuIur
press durIng LIe 8 yeurs Lo 1qq:
HIgI-cIoIesLeroI dIeL - rIsk ruLIo (rr) 1.6 Ior recLuI cuncer In
men (1q8;);
EuLIng yogurL uL IeusL once u monLI - rr z.o Ior ovurIun cuncer
(1q8q);
SmokIng more LIun 1oo cIgureLLes In u IIIeLIme - rr 1.z Ior
breusL cuncer (1qqo);
HIgI-IuL dIeL - rr z.o Ior breusL cuncer (1qqo);
engLIy occupuLIonuI exposure Lo dIoxIn - rr 1. Ior uII cuncers
(1qq1);
DoucIIng once u week - rr q.o Ior cervIcuI cuncer (1qq1);
ReguIur use oI IIgI-uIcoIoI mouLIwusI - rr 1. Ior mouLI
cuncer (1qq1);
Use oI pIenoxy IerbIcIdes on Iuwns - rr 1. Ior muIIgnunL
IympIomu In dogs (1qq1);
WeIgIIng .6 kIIogrums or more uL bIrLI - rr 1. Ior breusL
cuncer (1qqz);
Lifestyle Epidemiology
VusecLomy - rr 1.6 Ior prosLuLe cuncer (1qq);
PesLIcIde exposure, IndIcuLed by IIgI resIdues In bIood - rr q.o
Ior breusL cuncer (1qq); conLrudIcLed 1 yeur IuLer In u Iurger
sLudy wILI one oI LIe sume uuLIors;
DrInkIng more LIun . IILres oI IIuId (purLIcuIurIy cIIorInuLed
Lup wuLer) u duy - rr z-q Ior bIudder cuncer (1qq);
ExperIencIng psycIoIogIcuI sLress In LIe workpIuce - rr . Ior
coIorecLuI cuncer (1qq);
DIeL IIgI In suLuruLed IuL - 6 Ior Iung cuncer In nonsmokIng
women (1qq);
EuLIng more LIun zo grums oI processed meuLs (.e., boIognu) u
duy - rr 1.;z Ior coIon cuncer (1qqq);
EuLIng red meuL IIve or more LImes u week - rr z. Ior coIon
cuncer (1qqq);
OccupuLIonuI exposure Lo eIecLromugneLIc IIeIds - rr 1.8 Ior
breusL cuncer (1qqq);
SmokIng Lwo pucks oI cIgureLLes u duy - rr 1.;q Ior IuLuI breusL
cuncer (1qqq);
EuLIng red meuL LwIce u duy - rr z.o Ior breusL cuncer (1qqq);
ReguIur cIgureLLe smokIng - rr 1.; Ior puncreuLIc cuncer (1qqq);
Ever IuvIng used u sunIump - rr 1. Ior meIunomu (1qqq);
AborLIon - rr 1. Ior breusL cuncer (1qqq);
HuvIng sIorLer or Ionger mensLruuI cycIes - rr z.o Ior breusL
cuncer (1qqq);
ObesILy In men (LIe IeuvIesL z% oI LIose In LIe sLudy) - rr .o
Ior eosopIugeuI cuncer (1qq);
ConsumIng oIIve oII onIy once u duy or Iess - rr 1.z Ior breusL
cuncer (1qq).
TIese sorLs oI IIndIngs ure LypIcuIIy presenLed In u completel
unquesLIoned munner. L Is noLubIe LIuL mosL oI LIe RRs do noL even meeL
LIe poor epIdemIoIogIc sLundurds Ior Iyper-reucLIvILy, I.e., RR=z.o-q.o.
MosL Iuve no rIyme or reuson; LIey sImpIy reIIecL Iow-order sLuLIsLIcuI
correIuLIon. TIe predIcLIve sLrengLI oI cll LIe IucLors Ior LIe dIseuses In
quesLIon, und wIIcI Is never presenLed, Is eILIer neur-zero or eIIecLIveIy
zero. L musL be upprecIuLed LIuL uL Iow IeveIs oI predIcLIve sLrengLI un
experImenLuI IucLor cun poLenLIuIIy be cross-correIuLed wILI numerous
oLIer IucLors, mosL oI LIem unIdenLIIIed. TIereIore, LIe correIuLIon oI un
experImenLuI IucLor wILI u purLIcuIur dIseuse mosL probubIy Ius no sLuLus
even us u LrIgger IucLor Ior suscepLIbIe IndIvIduuIs, buL Ius more Lo do
wILI LIe nuLure oI urLIIIcIuI experImenLuI subdIvIsIons (meusuremenLs)
und LIe nuLure oI LIe IucLor beIng exumIned, I.e., LIe correIuLIon Is enLIreIy
100
100
Rampant Antismoking Signifies Grave Danger
u sLuLIsLIcuI pIenomenon.
GIven LIIs pIeLIoru oI sLuLIsLIcuI InIormuLIon, Skrubunek &
McCormIck (1qqo) properIy noLe LIuL IL muy be dIIIIcuIL, even Ior LIe weII
InIormed, Lo decIde wIuL IeuILI udvIce Lo IoIIow. n order Lo uvoId breusL
cuncer IL Is wIse Lo become pregnunL beIore LIe uge oI LwenLy; In order Lo
uvoId cuncer oI LIe cervIx, IL Is wIse Lo remuIn u vIrgIn. TIIs, Iowever,
Ieuds Lo IurLIer probIems: cIIIdIess women ure uL un Increused rIsk oI
cuncer oI LIe coIon und oI LIe body oI LIe uLerus. (p.1o;) Becker (1qq)
udds, wus purLIcuIurIy bemused by LIe IuLesL reporLed reseurcI IIndIngs
concernIng exercIse. We uII know LIuL reguIur exercIse Is recommended
Ior reducIng LIe rIsk oI IeurL dIseuse. UnIorLunuLeIy, recenL duLu Iuve
poInLed up LIe muny LIousunds oI InjurIes und Iuzurds reIuLed Lo
exercIse, und Ius IInked hih IeveIs oI exercIse Lo InIerLIIILy, dumuge Lo LIe
Immune sysLem, cuncer und premuLure ugIng. WIuL Lo do? Run Loo IILLIe
und dIe young oI u coronury? Run Loo mucI und experIence sIIn spIInLs
und knee surgery, LIen dIe, wILIouL oIIsprIng, oI some bIzurre
InIecLIon? (p.1)
Myers depIcLed LIe composILe pIcLure oI un IndIvIduuI wILI u Iow
rIsk oI coronury IeurL dIseuse. He wouId be: |A|n eIIemInuLe munIcIpuI
worker or embuImer compIeLeIy IuckIng In pIysIcuI or menLuI uIerLness
und wILIouL drIve, umbILIon, or compeLILIve spIrIL; wIo Ius never
uLLempLed Lo meeL u deudIIne oI uny kInd; u mun wILI poor uppeLILe,
subsIsLIng on IruILs und vegeLubIes Iuced wILI corn und wIuIe oII,
deLesLIng Lobucco, spurnIng ownersIIp oI rudIo, LeIevIsIon, or moLorcur,
wILI IuII Ieud oI IuIr buL scruwny und unuLIIeLIc uppeurunce, yeL
consLunLIy sLruInIng IIs puny muscIes by exercIse. ow In Income, bIood
pressure, bIood sugur, urIc ucId und cIoIesLeroI, Ie Ius Luken nIcoLInIc
ucId, pyrIdoxIne, und Iong-Lerm unLI-couguIunL LIerupy ever sInce IIs
propIyIucLIc cusLruLIon. (quoLed In Skrubunek & McCormIck, 1qqo,
p.1o;) TIIs composILe wus ussembIed In LIe 1q;o`s. By LIe Lurn oI LIe
mIIIennIum muny more IInked IucLors couId be udded.
TIe ureu oI nuLrILIonuI epIdemIoIgy cun be even more mInd-
numbIng. ALrens (zooo) urLIcuIuLes some oI LIe numerous conLrudIcLIons
over LIme Ior LIe supposed vIrLues or deLrImenLs oI purLIcuIur Ioods. He
properIy posILs LIe quesLIon us Lo wIy supposed scIenLIIIc concIusIons ure
conLrudIcLed over LIme? ScIence Is InLended us u pIn-poInLIng endeuvor
LIuL IdenLIIIes hih-letel predictors Ior consequenLs, und LIuL cun uIso
urLIcuIuLe LIe cuusuI conLInuILy beLween unLecedenL und consequenL; IIgI-
IeveI predIcLors Iend LIemseIves Lo sLuLemenLs oI u generuI reIuLIonsIIp
beLween un unLecedenL und u consequenL. WIere sucI IIndIngs occur, LIe
reIuLIonsIIp muy be reIIned over LIme by IurLIer reseurcI buL IL wIII noL be
wIoIIy conLrudIcLed. AguIn, LIe probIem Is LIuL IIIesLyIe epIdemIoIogy Is
Lifestyle Epidemiology
noL u scIenLIIIc enLerprIse buL u sLuLIsLIcuIIy-bused deIusIon, rIIe wILI uII
munner oI InIerenLIuI IuIIucIes. L operuLes uL LIe zero-end oI LIe
condILIonuI-probubIIILy scuIe und noL LIe proper, upper-end.
ConsIder LIe IoIIowIng InIormuLIon presenLed In u mujor
AusLruIIun-SLuLe newspuper concernIng IIgIL drInkIng:
LIGHT RINKING: PROS AND CONS
Stroke Breust cuncer
down qo% up q% Ior women
Hypertension Liver cuncer
down 1% Ior up q%
Ior women,
no cIunge Ior men
Heurt diseuse Liver cirrhosis
down 18% up z6%
Gullstones
down 18%
IgIL drInkers ure deIIned us no more LIun Lwo drInks u duy Ior
women und Iour Ior men (Hercld,Sun, 6J1oJqq, p.11)
TIere ure u number oI poInLs LIuL cun be mude concernIng Iow
InIormuLIon Is presenLed Lo LIe pubIIc LIuL uppIy generuIIy Lo sucI
InIormuLIon. IrsLIy, InIormuLIon Is presenLed In percenLuge Lerms ruLIer
LIun RR; LIIs Ius LIe eIIecL oI soundIng more uIurmIng (or beneIIcIuI)
LIun RRs IndIcuLe. or exumpIe, breusL cuncer up q% Ior women
represenLs un RR oI 1.oq, I.e., bureIy regIsLerIng even on LIe RR-
dIIIerenLIuI scuIe. AII oI LIe RRs ure beIow z.o. SecondIy, LIe predIcLIve
sLrengLI oI LIe experImenLuI IucLor (IIgIL drInkIng) Ior LIe dIseuses In
quesLIon, und wIIcI Is never presenLed, Is uround LIe p=o murk, I.e., II
IIgIL drInkIng wus used Lo predIcL LIe dIseuses In quesLIon, one wouId be
wrong mosL oI LIe LIme. TIe urLIcIe goes on Lo suy LIuL drInkIng smuII
umounLs oI uIcoIoI Is beLLer LIun noL drInkIng uL uII, reseurcI sIows. n
LIe IuLesL sLudy, US reseurcIers suy u gIuss oI red wIne Is beLLer Ior
IIgILIng IeurL dIseuse LIun mosL IruIL und vegeLubIes. SucI sLuLemenLs
sIIIL wILI LIe greuLesL oI IncompeLenL euse Irom sLuLIsLIcuI proposILIons Lo
cuusuI proposILIons. L InIorms uII persons LIuL Lo enguge In LIe
experImenLuI IucLor wIII reduce (cuusuI) LIe rIsk oI IeurL dIseuse Ior uII.
YeL, LIe very duLu beIng reIerred Lo IndIcuLes LIuL LIe rIsk dIIIerenLIuI Is
beIng generuLed by u very smuII subgroup oI LIe overuII group, I.e., LIere Is
101
101
Rampant Antismoking Signifies Grave Danger
u sLuLIsLIcuI pIenomenon.
GIven LIIs pIeLIoru oI sLuLIsLIcuI InIormuLIon, Skrubunek &
McCormIck (1qqo) properIy noLe LIuL IL muy be dIIIIcuIL, even Ior LIe weII
InIormed, Lo decIde wIuL IeuILI udvIce Lo IoIIow. n order Lo uvoId breusL
cuncer IL Is wIse Lo become pregnunL beIore LIe uge oI LwenLy; In order Lo
uvoId cuncer oI LIe cervIx, IL Is wIse Lo remuIn u vIrgIn. TIIs, Iowever,
Ieuds Lo IurLIer probIems: cIIIdIess women ure uL un Increused rIsk oI
cuncer oI LIe coIon und oI LIe body oI LIe uLerus. (p.1o;) Becker (1qq)
udds, wus purLIcuIurIy bemused by LIe IuLesL reporLed reseurcI IIndIngs
concernIng exercIse. We uII know LIuL reguIur exercIse Is recommended
Ior reducIng LIe rIsk oI IeurL dIseuse. UnIorLunuLeIy, recenL duLu Iuve
poInLed up LIe muny LIousunds oI InjurIes und Iuzurds reIuLed Lo
exercIse, und Ius IInked hih IeveIs oI exercIse Lo InIerLIIILy, dumuge Lo LIe
Immune sysLem, cuncer und premuLure ugIng. WIuL Lo do? Run Loo IILLIe
und dIe young oI u coronury? Run Loo mucI und experIence sIIn spIInLs
und knee surgery, LIen dIe, wILIouL oIIsprIng, oI some bIzurre
InIecLIon? (p.1)
Myers depIcLed LIe composILe pIcLure oI un IndIvIduuI wILI u Iow
rIsk oI coronury IeurL dIseuse. He wouId be: |A|n eIIemInuLe munIcIpuI
worker or embuImer compIeLeIy IuckIng In pIysIcuI or menLuI uIerLness
und wILIouL drIve, umbILIon, or compeLILIve spIrIL; wIo Ius never
uLLempLed Lo meeL u deudIIne oI uny kInd; u mun wILI poor uppeLILe,
subsIsLIng on IruILs und vegeLubIes Iuced wILI corn und wIuIe oII,
deLesLIng Lobucco, spurnIng ownersIIp oI rudIo, LeIevIsIon, or moLorcur,
wILI IuII Ieud oI IuIr buL scruwny und unuLIIeLIc uppeurunce, yeL
consLunLIy sLruInIng IIs puny muscIes by exercIse. ow In Income, bIood
pressure, bIood sugur, urIc ucId und cIoIesLeroI, Ie Ius Luken nIcoLInIc
ucId, pyrIdoxIne, und Iong-Lerm unLI-couguIunL LIerupy ever sInce IIs
propIyIucLIc cusLruLIon. (quoLed In Skrubunek & McCormIck, 1qqo,
p.1o;) TIIs composILe wus ussembIed In LIe 1q;o`s. By LIe Lurn oI LIe
mIIIennIum muny more IInked IucLors couId be udded.
TIe ureu oI nuLrILIonuI epIdemIoIgy cun be even more mInd-
numbIng. ALrens (zooo) urLIcuIuLes some oI LIe numerous conLrudIcLIons
over LIme Ior LIe supposed vIrLues or deLrImenLs oI purLIcuIur Ioods. He
properIy posILs LIe quesLIon us Lo wIy supposed scIenLIIIc concIusIons ure
conLrudIcLed over LIme? ScIence Is InLended us u pIn-poInLIng endeuvor
LIuL IdenLIIIes hih-letel predictors Ior consequenLs, und LIuL cun uIso
urLIcuIuLe LIe cuusuI conLInuILy beLween unLecedenL und consequenL; IIgI-
IeveI predIcLors Iend LIemseIves Lo sLuLemenLs oI u generuI reIuLIonsIIp
beLween un unLecedenL und u consequenL. WIere sucI IIndIngs occur, LIe
reIuLIonsIIp muy be reIIned over LIme by IurLIer reseurcI buL IL wIII noL be
wIoIIy conLrudIcLed. AguIn, LIe probIem Is LIuL IIIesLyIe epIdemIoIogy Is
Lifestyle Epidemiology
noL u scIenLIIIc enLerprIse buL u sLuLIsLIcuIIy-bused deIusIon, rIIe wILI uII
munner oI InIerenLIuI IuIIucIes. L operuLes uL LIe zero-end oI LIe
condILIonuI-probubIIILy scuIe und noL LIe proper, upper-end.
ConsIder LIe IoIIowIng InIormuLIon presenLed In u mujor
AusLruIIun-SLuLe newspuper concernIng IIgIL drInkIng:
LIGHT RINKING: PROS AND CONS
Stroke Breust cuncer
down qo% up q% Ior women
Hypertension Liver cuncer
down 1% Ior up q%
Ior women,
no cIunge Ior men
Heurt diseuse Liver cirrhosis
down 18% up z6%
Gullstones
down 18%
IgIL drInkers ure deIIned us no more LIun Lwo drInks u duy Ior
women und Iour Ior men (Hercld,Sun, 6J1oJqq, p.11)
TIere ure u number oI poInLs LIuL cun be mude concernIng Iow
InIormuLIon Is presenLed Lo LIe pubIIc LIuL uppIy generuIIy Lo sucI
InIormuLIon. IrsLIy, InIormuLIon Is presenLed In percenLuge Lerms ruLIer
LIun RR; LIIs Ius LIe eIIecL oI soundIng more uIurmIng (or beneIIcIuI)
LIun RRs IndIcuLe. or exumpIe, breusL cuncer up q% Ior women
represenLs un RR oI 1.oq, I.e., bureIy regIsLerIng even on LIe RR-
dIIIerenLIuI scuIe. AII oI LIe RRs ure beIow z.o. SecondIy, LIe predIcLIve
sLrengLI oI LIe experImenLuI IucLor (IIgIL drInkIng) Ior LIe dIseuses In
quesLIon, und wIIcI Is never presenLed, Is uround LIe p=o murk, I.e., II
IIgIL drInkIng wus used Lo predIcL LIe dIseuses In quesLIon, one wouId be
wrong mosL oI LIe LIme. TIe urLIcIe goes on Lo suy LIuL drInkIng smuII
umounLs oI uIcoIoI Is beLLer LIun noL drInkIng uL uII, reseurcI sIows. n
LIe IuLesL sLudy, US reseurcIers suy u gIuss oI red wIne Is beLLer Ior
IIgILIng IeurL dIseuse LIun mosL IruIL und vegeLubIes. SucI sLuLemenLs
sIIIL wILI LIe greuLesL oI IncompeLenL euse Irom sLuLIsLIcuI proposILIons Lo
cuusuI proposILIons. L InIorms uII persons LIuL Lo enguge In LIe
experImenLuI IucLor wIII reduce (cuusuI) LIe rIsk oI IeurL dIseuse Ior uII.
YeL, LIe very duLu beIng reIerred Lo IndIcuLes LIuL LIe rIsk dIIIerenLIuI Is
beIng generuLed by u very smuII subgroup oI LIe overuII group, I.e., LIere Is
102
102
Rampant Antismoking Signifies Grave Danger
no sucI ussocIuLIon Ior mosL oI LIe overuII group membersIIp. An 18 per
cenL dIIIerenLIuI, per Iundred, cun be expressed us q (IIgIL drInkers) Lo
(non-drInkers), I.e., u dIIIerence oI 1o dIvIded by equuIs o.18. I uII
non-drInkers Look up IIgIL drInkIng, uL IeusL 8z% (qJ) oI LIose uIreudy
on u course Lo IeurL dIseuse wIII sLIII suIIer IeurL dIseuse, I.e., LIe rIsk Ior
LIe mujorILy Is unuILered; IL Is uIso uncIeur wIeLIer IIgIL drInkIng Ius uny
cuusuI puLIwuy In Iower rIsk oI IeurL dIseuse (I.e., cross-correIuLed wILI
oLIer IucLors) Ior LIe remuInIng 18 per cenL. urLIermore, LIe currenL
IIgIL-drInker`s group, equIvuIenL Lo 8z% oI LIe non-drInker`s group, wIIcI
Is on u course Lo IeurL dIseuse wIII sLIII deveIop LIe dIseuse, I.e., rIsk oI LIe
dIseuse Is unuILered. TIere ure uIso Lwo oLIer groups: IgIL drInkers und
non-drInkers wIo do noL deveIop IeurL dIseuse. or LIese groups, IIgIL
drInkIng or noL wIII noL uILer LIe course oI LIeIr noL deveIopIng LIe
dIseuse.
TIereIore, LIe greuLer mujorILy oI IIgIL drInkers und non-
drInkers do noL Iuve LIeIr course Lo IeurL dIseuse (or noL) uILered by IIgIL
drInkIng or LukIng-up IIgIL drInkIng. To posIL LIe generuI proposILIon LIuL
cnone drInkIng IIgILIy wIII reduce LIeIr rIsk oI IeurL dIseuse Is
IruuduIenL; noL onIy Is IL noL ImpIIed by LIe duLu, buL Is dIsconIIrmed by
LIe duLu. Here uguIn Is LIe IuIIucy oI doubIe-bIuck-box reusonIng
reIerred Lo eurIIer In LIIs cIupLer. TIe IIxuLIon Is ImproperIy on reIuLIve-
rIsk dIIIerenLIuI uIone und upon wIIcI uII munner oI cIuIms ure mude LIuL
ucLuuIIy conLrudIcL LIe very duLu beIng reIerred Lo. To reILeruLe, LIe duLu In
LIe ubove exumpIe dIsconIIrms uny generuI eIIecL uLLrIbuLubIe Lo LIe
cuusuI properLIes oI wIne wILI regurd Lo IeurL dIseuse. TIIs sorL oI
presenLuLIon Is un ussuuIL on menLuI IeuILI; IL IruuduIenLIy coerces sLuLes
oI IuIse beIIeI (supersLILIon) LIrougI Ieur und under LIe preLense oI
scIenLIIIc credIbIIILy.
TIIrdIy, uL u IoIIowIng LIme u represenLuLIve oI LIe cuncer
IounduLIon, us opposed Lo LIe IeurL IounduLIon, couId be quoLed In LIe
sume newspuper us suggesLIng LIuL uIcoIoI sIouId be uvoIded becuuse IL
Increuses LIe rIsk oI breusL cuncer. So LIere Is even u cIoIce In Iow one
wunLs Lo be deIuded; LIere Is u compeLILIon oI reIuLIve rIsk Ior u vurIeLy
oI dIseuses us promoLed by IeuILI uuLIorILIes represenLIng IsoIuLed
dIseuses (e.g., cuncer) or dIsmembered orguns (e.g., HeurL ounduLIon).
ourLIIy, LIe IncoIerenL cIuIms oI so-cuIIed IeuILI uuLIorILIes
ure presenLed In u completel unquesLIoned munner. n LIIs regurd LIe
medIu musL uccepL very sIgnIIIcunL responsIbIIILy Ior LIe socIuI
rumIIIcuLIons oI LIIs conducL. TIe Ideu oI InvesLIguLIve journuIIsm Is
sImpIy non-exIsLenL; LIe medIu Ius prosLILuLed ILseII us u IuIIy-compIIunL
propugundu ouLIeL Ior medIco-muLerIuIIsm und uII oI ILs very severe
IuIIIngs.
Lifestyle Epidemiology
RegurdIess oI crILIcIsms und objecLIons, LIe reIuLIve rIsk
burruge Ius worsened. ConsIdered In LIe IoIIowIng Is LIe reIenLIess
depIcLIon oI IIndIngs uppeurIng In u mujor AusLruIIun SLuLe newspuper.
UILImuLeIy, IL Is LIIs sorL oI reporLIng LIuL Is ImporLunL In LIIs InIormuLIon
beIng ubsorbed by muny members oI LIe pubIIc.
Women wIo snore reguIurIy muy Increuse LIeIr rIsk oI
suIIerIng u sLroke or IeurL uLLuck by per cenL. (Hercld,Sun,
MurcI 11, zooo, p.1)
A gIuss oI wIne muy be good Ior you, buL noL II you Iuve
usLImu. (Hercld,Sun, MurcI z, zooo, p.1)
AIr poIIuLIon cuused by LruIIIc und IndusLry couId proIong
coIds. (Hercld,Sun, AprII 1, zooo, p.zo)
TIe uIr we breuLIe InsIde our Iomes Ius emerged us u mujor
new IeuILI concern. (Hercld,Sun, AprII z6, zooo, p.1q)
AIr poIIuLIon Is cuusIng LIe eurIy deuLIs oI up Lo qoo
MeIburnIuns eucI yeur, un EnvIronmenL ProLecLIon AuLIorILy
sLudy suys. (Hercld,Sun, June , zooo, p.11)
A gIuss or Lwo oI red wIne cunceIs ouL some oI LIe III-eIIecLs oI
u IuLLy meuI. (Hercld,Sun, OcLober 8, zooo, p.16)
VILumIn C LubIeLs und oLIer dIeLury suppIemenLs couId be
jeopurdIzIng your IeuILI. (Hercld,Sun, OcLober z6, zooo, p.)
rIdges, wusIIng mucIInes und even uIurm cIocks couId
dumuge women`s IerLIIILy. (Hercld,Sun, November 1, zooo,
p.1q)
Do you wIeeze, cougI or Iuve sore eyes wIIIe uL work? I so,
you couId be one oI LIousunds oI peopIe wIo ure IncreusIngIy
suIIerIng Irom occupuLIonuI usLImu. (Hercld,Sun, December
6, zooo, p.z1)
US reseurcIers Iuve udded u new und prevIousIy unsuspecLed
cuIprIL Lo LIe IIsL oI LIIngs In LIe Iome LIuL cun LrIgger severe
cIIIdIood usLImu: mIce. (Hercld,Sun, December 1;, zooo,
p.18)
ScIenLIsLs muy Iuve uncovered evIdence Lo IInk IeukemIu Lo
yeurs oI uIr LruveI. (Hercld,Sun, December z, zooo, p.q)
AIr LruveIIers Iuve u IresI cuuse Ior concern wILI evIdence
IrequenL IIyers couId be uL IIgIer rIsk oI cuncer. A sLudy oI
uImosL ooo IIIgIL uLLendunLs Iound LIey Iud u o per cenL
greuLer cIunce oI breusL cuncer LIun LIe resL oI LIe communILy
und doubIe LIe rIsk oI meIunomu. (Hercld,Sun, Junuury zo,
zoo1, p.16)
MedIcuI uuLIorILIes Iuve wurned IeuILI cure proIessIonuIs Lo
pIuy down LIe popuIur supposILIon LIuL red wIne prevenLs
103
103
Rampant Antismoking Signifies Grave Danger
no sucI ussocIuLIon Ior mosL oI LIe overuII group membersIIp. An 18 per
cenL dIIIerenLIuI, per Iundred, cun be expressed us q (IIgIL drInkers) Lo
(non-drInkers), I.e., u dIIIerence oI 1o dIvIded by equuIs o.18. I uII
non-drInkers Look up IIgIL drInkIng, uL IeusL 8z% (qJ) oI LIose uIreudy
on u course Lo IeurL dIseuse wIII sLIII suIIer IeurL dIseuse, I.e., LIe rIsk Ior
LIe mujorILy Is unuILered; IL Is uIso uncIeur wIeLIer IIgIL drInkIng Ius uny
cuusuI puLIwuy In Iower rIsk oI IeurL dIseuse (I.e., cross-correIuLed wILI
oLIer IucLors) Ior LIe remuInIng 18 per cenL. urLIermore, LIe currenL
IIgIL-drInker`s group, equIvuIenL Lo 8z% oI LIe non-drInker`s group, wIIcI
Is on u course Lo IeurL dIseuse wIII sLIII deveIop LIe dIseuse, I.e., rIsk oI LIe
dIseuse Is unuILered. TIere ure uIso Lwo oLIer groups: IgIL drInkers und
non-drInkers wIo do noL deveIop IeurL dIseuse. or LIese groups, IIgIL
drInkIng or noL wIII noL uILer LIe course oI LIeIr noL deveIopIng LIe
dIseuse.
TIereIore, LIe greuLer mujorILy oI IIgIL drInkers und non-
drInkers do noL Iuve LIeIr course Lo IeurL dIseuse (or noL) uILered by IIgIL
drInkIng or LukIng-up IIgIL drInkIng. To posIL LIe generuI proposILIon LIuL
cnone drInkIng IIgILIy wIII reduce LIeIr rIsk oI IeurL dIseuse Is
IruuduIenL; noL onIy Is IL noL ImpIIed by LIe duLu, buL Is dIsconIIrmed by
LIe duLu. Here uguIn Is LIe IuIIucy oI doubIe-bIuck-box reusonIng
reIerred Lo eurIIer In LIIs cIupLer. TIe IIxuLIon Is ImproperIy on reIuLIve-
rIsk dIIIerenLIuI uIone und upon wIIcI uII munner oI cIuIms ure mude LIuL
ucLuuIIy conLrudIcL LIe very duLu beIng reIerred Lo. To reILeruLe, LIe duLu In
LIe ubove exumpIe dIsconIIrms uny generuI eIIecL uLLrIbuLubIe Lo LIe
cuusuI properLIes oI wIne wILI regurd Lo IeurL dIseuse. TIIs sorL oI
presenLuLIon Is un ussuuIL on menLuI IeuILI; IL IruuduIenLIy coerces sLuLes
oI IuIse beIIeI (supersLILIon) LIrougI Ieur und under LIe preLense oI
scIenLIIIc credIbIIILy.
TIIrdIy, uL u IoIIowIng LIme u represenLuLIve oI LIe cuncer
IounduLIon, us opposed Lo LIe IeurL IounduLIon, couId be quoLed In LIe
sume newspuper us suggesLIng LIuL uIcoIoI sIouId be uvoIded becuuse IL
Increuses LIe rIsk oI breusL cuncer. So LIere Is even u cIoIce In Iow one
wunLs Lo be deIuded; LIere Is u compeLILIon oI reIuLIve rIsk Ior u vurIeLy
oI dIseuses us promoLed by IeuILI uuLIorILIes represenLIng IsoIuLed
dIseuses (e.g., cuncer) or dIsmembered orguns (e.g., HeurL ounduLIon).
ourLIIy, LIe IncoIerenL cIuIms oI so-cuIIed IeuILI uuLIorILIes
ure presenLed In u completel unquesLIoned munner. n LIIs regurd LIe
medIu musL uccepL very sIgnIIIcunL responsIbIIILy Ior LIe socIuI
rumIIIcuLIons oI LIIs conducL. TIe Ideu oI InvesLIguLIve journuIIsm Is
sImpIy non-exIsLenL; LIe medIu Ius prosLILuLed ILseII us u IuIIy-compIIunL
propugundu ouLIeL Ior medIco-muLerIuIIsm und uII oI ILs very severe
IuIIIngs.
Lifestyle Epidemiology
RegurdIess oI crILIcIsms und objecLIons, LIe reIuLIve rIsk
burruge Ius worsened. ConsIdered In LIe IoIIowIng Is LIe reIenLIess
depIcLIon oI IIndIngs uppeurIng In u mujor AusLruIIun SLuLe newspuper.
UILImuLeIy, IL Is LIIs sorL oI reporLIng LIuL Is ImporLunL In LIIs InIormuLIon
beIng ubsorbed by muny members oI LIe pubIIc.
Women wIo snore reguIurIy muy Increuse LIeIr rIsk oI
suIIerIng u sLroke or IeurL uLLuck by per cenL. (Hercld,Sun,
MurcI 11, zooo, p.1)
A gIuss oI wIne muy be good Ior you, buL noL II you Iuve
usLImu. (Hercld,Sun, MurcI z, zooo, p.1)
AIr poIIuLIon cuused by LruIIIc und IndusLry couId proIong
coIds. (Hercld,Sun, AprII 1, zooo, p.zo)
TIe uIr we breuLIe InsIde our Iomes Ius emerged us u mujor
new IeuILI concern. (Hercld,Sun, AprII z6, zooo, p.1q)
AIr poIIuLIon Is cuusIng LIe eurIy deuLIs oI up Lo qoo
MeIburnIuns eucI yeur, un EnvIronmenL ProLecLIon AuLIorILy
sLudy suys. (Hercld,Sun, June , zooo, p.11)
A gIuss or Lwo oI red wIne cunceIs ouL some oI LIe III-eIIecLs oI
u IuLLy meuI. (Hercld,Sun, OcLober 8, zooo, p.16)
VILumIn C LubIeLs und oLIer dIeLury suppIemenLs couId be
jeopurdIzIng your IeuILI. (Hercld,Sun, OcLober z6, zooo, p.)
rIdges, wusIIng mucIInes und even uIurm cIocks couId
dumuge women`s IerLIIILy. (Hercld,Sun, November 1, zooo,
p.1q)
Do you wIeeze, cougI or Iuve sore eyes wIIIe uL work? I so,
you couId be one oI LIousunds oI peopIe wIo ure IncreusIngIy
suIIerIng Irom occupuLIonuI usLImu. (Hercld,Sun, December
6, zooo, p.z1)
US reseurcIers Iuve udded u new und prevIousIy unsuspecLed
cuIprIL Lo LIe IIsL oI LIIngs In LIe Iome LIuL cun LrIgger severe
cIIIdIood usLImu: mIce. (Hercld,Sun, December 1;, zooo,
p.18)
ScIenLIsLs muy Iuve uncovered evIdence Lo IInk IeukemIu Lo
yeurs oI uIr LruveI. (Hercld,Sun, December z, zooo, p.q)
AIr LruveIIers Iuve u IresI cuuse Ior concern wILI evIdence
IrequenL IIyers couId be uL IIgIer rIsk oI cuncer. A sLudy oI
uImosL ooo IIIgIL uLLendunLs Iound LIey Iud u o per cenL
greuLer cIunce oI breusL cuncer LIun LIe resL oI LIe communILy
und doubIe LIe rIsk oI meIunomu. (Hercld,Sun, Junuury zo,
zoo1, p.16)
MedIcuI uuLIorILIes Iuve wurned IeuILI cure proIessIonuIs Lo
pIuy down LIe popuIur supposILIon LIuL red wIne prevenLs
104
104
Rampant Antismoking Signifies Grave Danger
IeurL uLLucks. (Hercld,Sun, Junuury 1, zoo1, p.z1)
CookIng wILI gus muy be dungerous Ior peopIe wILI usLImu or
IeurL dIseuse. (Hercld,Sun, ebruury 16, zoo1, p.1o)
Runny noses IeIp proLecL cIIIdren uguInsL usLImu..snoLLy-
nosed cIIIdren wuged u consLunL buLLIe wILI InIecLIon, wIIcI
IeIped wuke up LIeIr Immune sysLems. (Hercld,Sun, ebruury
zo, zoo1, p.z6)
Too mucI sIeep muy Increuse your rIsk oI sLroke. (Hercld,Sun,
ebruury z1, zoo1, p.z1)
VILumIn E suppIemenLs uppeur Lo Iuve no unLIoxIdunL beneIILs
wIIcI proLecL uguInsL IIInesses sucI us cuncer und AIzIeImer`s
dIseuse. (Hercld,Sun, MurcI 1q, zoo1, p.z1)
ReseurcI Ius Iound women In cIerIcuI roIes couId be uL
Increused rIsk oI IeurL dIseuse. (Hercld,Sun, MurcI 16, zoo1,
p.z)
ong-Lerm breusLIeedIng muy IurL u buby`s curdIovuscuIur
IeuILI IuLer In IIIe. (Hercld,Sun, MurcI 1;, zoo1, p.1;)
DepressIon muy Increuse rIsk oI deuLI Irom IeurL dIseuse,
regurdIess oI wIeLIer LIe puLIenL Iud prIor IeurL sympLoms.
(Hercld,Sun, MurcI z, zoo1, p.z)
ModeruLe drInkers muy be beLLer equIpped Lo survIve IeurL
uLLucks LIun LeeLoLuIIers. (Hercld,Sun, AprII z, zoo1, p.zq)
Rogue gene IeurL dunger: AImosL Lwo mIIIIon AusLruIIuns were
IIvIng wILI u geneLIc LIme bomb In LIeIr cIesLs, uccordIng Lo
MeIbourne reseurcIers. (Hercld,Sun, Muy 1q, zoo1, p.)
VILumIn C pIIIs muy pIuy u roIe In dumugIng DNA, u sLep
Lowurd IormIng cuncer ceIIs. (Hercld,Sun, June 1, zoo1, p.;)
Smokers wIo Luke vILumIn C suppIemenLs In LIe beIIeI LIey ure
ImprovIng LIeIr IeuILI couId ucLuuIIy be IncreusIng LIeIr rIsk oI
conLrucLIng cuncer. (Hercld,Sun, AugusL 1, zoo1, p.q)
PeopIe |eIderIy| wILI Iow IeveIs oI cIoIesLeroI ure uL IIgIer rIsk
oI dyIng oI dIseuse. (Hercld,Sun, AugusL q, zoo1, p.8)
Weekends ure LIe peuk LIme Ior IeurL uLLucks In young und
mIddIe-uged men..BuL Ior oIder men, Monduy Is LIe crILIcuI
duy. (Hercld,Sun, AugusL zq, zoo1, p.o)
SIIIL work muy Ieud Lo un Increused rIsk oI IeurL dIseuse.
(Hercld,Sun, SepLember 1z, zoo1, p.zq)
HeurL dIseuse puLIenLs wIo ure IuppIIy murrIed muy ouLIIve
LIeIr peers In rockIer reIuLIonsIIps. (Hercld,Sun, OcLober 1o,
zoo1, p.z6)
HIgI cuIIeIne IeveIs Iuve been IInked by reseurcIers Lo Iow
bIrLI weIgIL und mIscurrIuge. (Hercld,Sun, OcLober 1z, zoo1,
Lifestyle Epidemiology
p.18)
PeopIe wILI serIous breuLIIng probIems durIng sIeep muy be
more IIkeIy Lo Iuve compIIcuLIons uILer IIp or knee
repIucemenL surgery. (Hercld,Sun, OcLober 1z, zoo1, p.)
BreusL cuncer rIsk Increuses by 8 per cenL Lo 6o per cenL Ior
women wIo work LIe nIgIL sIIIL Ior muny yeurs. (Hercld,Sun,
OcLober 18, zoo1, p.o)
Obese cIIIdren ure mucI more IIkeIy Lo Iuve usLImu. (Hercld,
Sun, OcLober 1q, zoo1, p.q)
Men wIo ure Loo IuL or Loo LIIn ure more uL rIsk oI deveIopIng
un IrreversIbIe und IncurubIe eye dIseuse |uge-reIuLed
mucuIopuLIy|. (Hercld,Sun, OcLober z, zoo1, p.zq)
New reseurcI suggesLs uILrusounds on pregnunL women muy
cuuse bruIn dumuge Lo unborn bubIes. (Hercld,Sun, December
1o, zoo1, p.;)
A Iow-IuL, IIgI-IIbre dIeL combIned wILI sLress reducLIon muy
reLurd prosLuLe Lumors. (Hercld,Sun, December 1q, zoo1,
p.o)
OverdoIng InLense exercIse cun puL qo-someLIIngs uL rIsk oI
LIe poLenLIuIIy IuLuI SIuron SLone Syndrome |sLroke|.
(Hercld,Sun, December 1q, zoo1, p.o)
A mun`s job muy InIIuence IIs IerLIIILy. A smuII sLudy Iound
LIuL men empIoyed us LeucIers, engIneerIng LecInIcIuns,
IInunce unuIysLs und corporuLe und compuLIng munugers were
more IIkeIy Lo be InIerLIIe. (Hercld,Sun, December 1q, zoo1,
p.o)
HuvIng grubby, snuIIIIng oIder sIbIIngs cun IeIp Lo muke
cIIIdren Iess IIkeIy Lo suIIer uIIergIes. (Hercld,Sun, December
16, zoo1, p.zz)
QuILLIng smokIng muy Ieud Lo u modesL Iong-Lerm reducLIon In
LIe rIsk oI deveIopIng cuLurucLs. (Hercld,Sun, Junuury 1o,
zooz, p.zz)
CIIIdren wIo IIve neur u busy roud muy be uL Increused rIsk oI
wIeezIng, u sympLom oI usLImu. (Hercld,Sun, Junuury z,
zooz, p.zz)
A sLudy Ius Iound mIrLI Is more IIkeIy Lo LrIgger un usLImu
uLLuck LIun exercIse, uIIergy or poIIuLIon. (Hercld,Sun, MurcI
z8, zooz, p.q)
PregnunL women wIo reguIurIy Luke u dIp In u pooI muy be
rIskIng LIe IeuILI oI LIeIr unborn cIIId. (Hercld,Sun, AprII ,
zooz, p.1)
Muke-up Is puLLIng women uL rIsk oI deudIy dIseuses. (Hercld,
105
105
Rampant Antismoking Signifies Grave Danger
IeurL uLLucks. (Hercld,Sun, Junuury 1, zoo1, p.z1)
CookIng wILI gus muy be dungerous Ior peopIe wILI usLImu or
IeurL dIseuse. (Hercld,Sun, ebruury 16, zoo1, p.1o)
Runny noses IeIp proLecL cIIIdren uguInsL usLImu..snoLLy-
nosed cIIIdren wuged u consLunL buLLIe wILI InIecLIon, wIIcI
IeIped wuke up LIeIr Immune sysLems. (Hercld,Sun, ebruury
zo, zoo1, p.z6)
Too mucI sIeep muy Increuse your rIsk oI sLroke. (Hercld,Sun,
ebruury z1, zoo1, p.z1)
VILumIn E suppIemenLs uppeur Lo Iuve no unLIoxIdunL beneIILs
wIIcI proLecL uguInsL IIInesses sucI us cuncer und AIzIeImer`s
dIseuse. (Hercld,Sun, MurcI 1q, zoo1, p.z1)
ReseurcI Ius Iound women In cIerIcuI roIes couId be uL
Increused rIsk oI IeurL dIseuse. (Hercld,Sun, MurcI 16, zoo1,
p.z)
ong-Lerm breusLIeedIng muy IurL u buby`s curdIovuscuIur
IeuILI IuLer In IIIe. (Hercld,Sun, MurcI 1;, zoo1, p.1;)
DepressIon muy Increuse rIsk oI deuLI Irom IeurL dIseuse,
regurdIess oI wIeLIer LIe puLIenL Iud prIor IeurL sympLoms.
(Hercld,Sun, MurcI z, zoo1, p.z)
ModeruLe drInkers muy be beLLer equIpped Lo survIve IeurL
uLLucks LIun LeeLoLuIIers. (Hercld,Sun, AprII z, zoo1, p.zq)
Rogue gene IeurL dunger: AImosL Lwo mIIIIon AusLruIIuns were
IIvIng wILI u geneLIc LIme bomb In LIeIr cIesLs, uccordIng Lo
MeIbourne reseurcIers. (Hercld,Sun, Muy 1q, zoo1, p.)
VILumIn C pIIIs muy pIuy u roIe In dumugIng DNA, u sLep
Lowurd IormIng cuncer ceIIs. (Hercld,Sun, June 1, zoo1, p.;)
Smokers wIo Luke vILumIn C suppIemenLs In LIe beIIeI LIey ure
ImprovIng LIeIr IeuILI couId ucLuuIIy be IncreusIng LIeIr rIsk oI
conLrucLIng cuncer. (Hercld,Sun, AugusL 1, zoo1, p.q)
PeopIe |eIderIy| wILI Iow IeveIs oI cIoIesLeroI ure uL IIgIer rIsk
oI dyIng oI dIseuse. (Hercld,Sun, AugusL q, zoo1, p.8)
Weekends ure LIe peuk LIme Ior IeurL uLLucks In young und
mIddIe-uged men..BuL Ior oIder men, Monduy Is LIe crILIcuI
duy. (Hercld,Sun, AugusL zq, zoo1, p.o)
SIIIL work muy Ieud Lo un Increused rIsk oI IeurL dIseuse.
(Hercld,Sun, SepLember 1z, zoo1, p.zq)
HeurL dIseuse puLIenLs wIo ure IuppIIy murrIed muy ouLIIve
LIeIr peers In rockIer reIuLIonsIIps. (Hercld,Sun, OcLober 1o,
zoo1, p.z6)
HIgI cuIIeIne IeveIs Iuve been IInked by reseurcIers Lo Iow
bIrLI weIgIL und mIscurrIuge. (Hercld,Sun, OcLober 1z, zoo1,
Lifestyle Epidemiology
p.18)
PeopIe wILI serIous breuLIIng probIems durIng sIeep muy be
more IIkeIy Lo Iuve compIIcuLIons uILer IIp or knee
repIucemenL surgery. (Hercld,Sun, OcLober 1z, zoo1, p.)
BreusL cuncer rIsk Increuses by 8 per cenL Lo 6o per cenL Ior
women wIo work LIe nIgIL sIIIL Ior muny yeurs. (Hercld,Sun,
OcLober 18, zoo1, p.o)
Obese cIIIdren ure mucI more IIkeIy Lo Iuve usLImu. (Hercld,
Sun, OcLober 1q, zoo1, p.q)
Men wIo ure Loo IuL or Loo LIIn ure more uL rIsk oI deveIopIng
un IrreversIbIe und IncurubIe eye dIseuse |uge-reIuLed
mucuIopuLIy|. (Hercld,Sun, OcLober z, zoo1, p.zq)
New reseurcI suggesLs uILrusounds on pregnunL women muy
cuuse bruIn dumuge Lo unborn bubIes. (Hercld,Sun, December
1o, zoo1, p.;)
A Iow-IuL, IIgI-IIbre dIeL combIned wILI sLress reducLIon muy
reLurd prosLuLe Lumors. (Hercld,Sun, December 1q, zoo1,
p.o)
OverdoIng InLense exercIse cun puL qo-someLIIngs uL rIsk oI
LIe poLenLIuIIy IuLuI SIuron SLone Syndrome |sLroke|.
(Hercld,Sun, December 1q, zoo1, p.o)
A mun`s job muy InIIuence IIs IerLIIILy. A smuII sLudy Iound
LIuL men empIoyed us LeucIers, engIneerIng LecInIcIuns,
IInunce unuIysLs und corporuLe und compuLIng munugers were
more IIkeIy Lo be InIerLIIe. (Hercld,Sun, December 1q, zoo1,
p.o)
HuvIng grubby, snuIIIIng oIder sIbIIngs cun IeIp Lo muke
cIIIdren Iess IIkeIy Lo suIIer uIIergIes. (Hercld,Sun, December
16, zoo1, p.zz)
QuILLIng smokIng muy Ieud Lo u modesL Iong-Lerm reducLIon In
LIe rIsk oI deveIopIng cuLurucLs. (Hercld,Sun, Junuury 1o,
zooz, p.zz)
CIIIdren wIo IIve neur u busy roud muy be uL Increused rIsk oI
wIeezIng, u sympLom oI usLImu. (Hercld,Sun, Junuury z,
zooz, p.zz)
A sLudy Ius Iound mIrLI Is more IIkeIy Lo LrIgger un usLImu
uLLuck LIun exercIse, uIIergy or poIIuLIon. (Hercld,Sun, MurcI
z8, zooz, p.q)
PregnunL women wIo reguIurIy Luke u dIp In u pooI muy be
rIskIng LIe IeuILI oI LIeIr unborn cIIId. (Hercld,Sun, AprII ,
zooz, p.1)
Muke-up Is puLLIng women uL rIsk oI deudIy dIseuses. (Hercld,
106
106
Rampant Antismoking Signifies Grave Danger
Sun, AprII q, zooz, p.8)
Red IuIr, IreckIes, moIes und bIue eyes ure greuLer rIsk IucLors
Ior LIe deveIopmenL oI Leenuge meIunomus LIun exposure Lo
sun. (Hercld,Sun, AprII 1z, zooz, p.z;)
PregnunL women wIo jog or pIuy squusI Ior us IILLIe us IuII un
Iour cun be rIskIng mIscurrIuge. (Hercld,Sun, AprII 16, zooz,
p.1z)
BeIng un eIdesL cIIId Increuses LIe rIsk oI IeurL dIseuse.
(Hercld,Sun, AprII z, zooz, p.1)
Dunger: IpsLIck cun be IeLIuI. Women unknowIngIy Ieed LIeIr
bodIes u cockLuII oI up Lo 1oo cIemIcuIs wIen LIey uppIy muke-
up every mornIng. (Hercld,Sun, Muy , zooz, p.11)
MIIdIy depressed oIder women Lend Lo IIve Ionger LIun LIose
wIo ure noL depressed uL uII. TIe women wILI mIId depressIon
were 6o per cenL Iess IIkeIy LIun oLIer women Lo dIe durIng
uny LIree yeurs. (Hercld,Sun, Muy q, zooz, p.o)
IrsL IL wus cIgureLLes - now IL seems cIocoIuLe cun uIso kIII
you. MunuIucLurers ure beIng sued becuuse LIe LreuL uIIegedIy
conLuIns poLenLIuIIy dungerous IeveIs oI Ieud und cudmIum.
(Hercld,Sun, Muy 11, zooz, p.16)
IvIng neur u busy roud muy Iumper cIIIdren`s perIormunce uL
scIooI. (Hercld,Sun, Muy 1, zooz, p.z8)
Women wILI IrreguIur perIods muy be uL greuLer rIsk oI IeurL
dIseuse. (Hercld,Sun, June , zooz, p.z6)
SmokIng Increuses LIe rIsk oI ovurIun cuncer. (Hercld,Sun,
June , zooz, p.z6)
BreusLIeedIng couId reduce u buby`s rIsk oI suIIerIng Irom
cIIIdIood obesILy by up Lo o per cenL. (Hercld,Sun, June 8,
zooz, p.1o)
CIIIdren breusLIed Ior LIe IIrsL sIx monLIs oI LIeIr IIves Iuve
more proLecLIon uguInsL respIruLory IIIness. (Hercld,Sun, JuIy
q, zooz, p.z6)
A smuII umounL oI LIme In LIe sun couId IeIp guurd uguInsL
muny Lypes oI cuncer..AILIougI dumuge cuused by sunburn In
Lurn cuuses skIn cuncers, Loo IILLIe sun wus IInked Lo breusL,
coIon und ovurIun cuncers. (Hercld,Sun, JuIy q, zooz, p.z6)
TruveIIIng on pIunes sIgnIIIcunLIy Increuses LIe cIunces oI
cuLcIIng u coId. (Hercld,Sun, AugusL ;, zooz, p.zz)
Brown-eyed peopIe ure uL greuLer rIsk oI cuLurucLs LIun bIue-
eyed peopIe. (Hercld,Sun, AugusL q, zooz, p.z8)
EIderIy peopIe wIo Luke vILumIn A suppIemenLs ure uL rIsk oI
osLeoporosIs. (Hercld,Sun, AugusL z1, zooz, p.zz)
Lifestyle Epidemiology
Women wIo ure overweIgIL or obese uL uge 18 Iuve un
Increused rIsk oI ovurIun cuncer. (Hercld,Sun, AugusL z,
zooz, p.z6)
Men wIo go buId uL LIe buck oI LIe Ieud by LIeIr qos or os
Iuve u o per cenL IIgIer rIsk oI prosLuLe cuncer. (Hercld,Sun,
AugusL zq, zooz, p.11)
CoId poLuLo, buked beuns, rIce und porrIdge couId be LIe key Lo
wurdIng oII cuncer. (Hercld,Sun, SepLember 11, zooz, p.z8)
Women exposed Lo IIgI IeveIs oI poIIen In LIe IusL LIIrd oI
pregnuncy ure mucI more IIkeIy Lo Iuve usLImuLIc cIIIdren.
(Hercld,Sun, SepLember 18, zooz, p.z;)
RuIsed IeveIs oI mercury In LIe bIood, Irom IIgI seuIood
consumpLIon, couId be IInked Lo InIerLIIILy. (Hercld,Sun,
SepLember z, zooz, p.zz)
uIIure Lo exercIse Is us bud Ior IeuILI us smokIng u puckeL oI
cIgureLLes every duy. (Hercld,Sun, SepLember z, zooz, p.zz)
Too mucI vILumIn A sIgnIIIcunLIy Increuses LIe rIsk oI bone
IrucLures In men. (Hercld,Sun, ebruury zo, zoo, p.z6)
And, yeL IL Is uIso decIured LIuL |w|e`re IuL, we smoke und we
drInk Loo mucI, buL AusLruIIuns ure IIvIng mucI
Ionger. (Hercld,Sun, June z8, zooz, p.1)
TIe precedIng reIIecLs u sLuLIsLIcs mudness. n uII oI LIe cuses
ubove LIe predIcLIve sLrengLI oI u IucLor Ior u deLrImenLuI ouLcome Is
neur-zero or eIIecLIveIy zero. n u properIy IuncLIonIng scIenLIIIc
dIscIpIIne, LIese sorLs oI IIndIngs wouId noL be over-InLerpreLed und
wouId cerLuInIy noL muke LIeIr wuy InLo LIe medIu or Lo LIe pubIIc. TIese
wouId be consIdered us expIoruLory resuILs - uL besL. ReseurcIers wouId
LIen quILe IILeruIIy go buck Lo LIe druwIng bourd In uLLempLIng Lo IInd
IIgI-IeveI predIcLors Ior purLIcuIur occurrences. TIIs Is noL so In IIIesLyIe
epIdemIoIogy, prevenLIve medIcIne or IeuILI promoLIon wIere rIsk IucLors
ure severeIy over-InLerpreLed us u muLLer oI course. TIIs reIIecLs LIe
IosLerIng oI supersLILIous beIIeI, I.e., un ussuuIL on psycIoIogIcuI, socIuI
und moruI IeuILI. n uddILIon Lo scIenLIIIc IncompeLence, LIIs Is occurrIng
becuuse LIe superIIcIuIILy oI muLerIuIIsm Ius no concepL oI LIe
deLrImenLuI rumIIIcuLIons oI dIsIonesL depIcLIons oI InIormuLIon Ior
psycIoIogIcuI und socIuI IeuILI.
Severe over-InLerpreLuLIon oI duLu, un IndIcuLor oI un ubsence oI
scIoIursIIp, IosLers LIe mIspercepLIon In LIe pubIIc LIuL uII munner oI
dIscoverIes ure beIng mude by medIco-muLerIuIIsm und LIereIore
promoLes u IIgIer socIuI sLuLus Ior medIco-muLerIuIIsm. L uIso uIds In
107
107
Rampant Antismoking Signifies Grave Danger
Sun, AprII q, zooz, p.8)
Red IuIr, IreckIes, moIes und bIue eyes ure greuLer rIsk IucLors
Ior LIe deveIopmenL oI Leenuge meIunomus LIun exposure Lo
sun. (Hercld,Sun, AprII 1z, zooz, p.z;)
PregnunL women wIo jog or pIuy squusI Ior us IILLIe us IuII un
Iour cun be rIskIng mIscurrIuge. (Hercld,Sun, AprII 16, zooz,
p.1z)
BeIng un eIdesL cIIId Increuses LIe rIsk oI IeurL dIseuse.
(Hercld,Sun, AprII z, zooz, p.1)
Dunger: IpsLIck cun be IeLIuI. Women unknowIngIy Ieed LIeIr
bodIes u cockLuII oI up Lo 1oo cIemIcuIs wIen LIey uppIy muke-
up every mornIng. (Hercld,Sun, Muy , zooz, p.11)
MIIdIy depressed oIder women Lend Lo IIve Ionger LIun LIose
wIo ure noL depressed uL uII. TIe women wILI mIId depressIon
were 6o per cenL Iess IIkeIy LIun oLIer women Lo dIe durIng
uny LIree yeurs. (Hercld,Sun, Muy q, zooz, p.o)
IrsL IL wus cIgureLLes - now IL seems cIocoIuLe cun uIso kIII
you. MunuIucLurers ure beIng sued becuuse LIe LreuL uIIegedIy
conLuIns poLenLIuIIy dungerous IeveIs oI Ieud und cudmIum.
(Hercld,Sun, Muy 11, zooz, p.16)
IvIng neur u busy roud muy Iumper cIIIdren`s perIormunce uL
scIooI. (Hercld,Sun, Muy 1, zooz, p.z8)
Women wILI IrreguIur perIods muy be uL greuLer rIsk oI IeurL
dIseuse. (Hercld,Sun, June , zooz, p.z6)
SmokIng Increuses LIe rIsk oI ovurIun cuncer. (Hercld,Sun,
June , zooz, p.z6)
BreusLIeedIng couId reduce u buby`s rIsk oI suIIerIng Irom
cIIIdIood obesILy by up Lo o per cenL. (Hercld,Sun, June 8,
zooz, p.1o)
CIIIdren breusLIed Ior LIe IIrsL sIx monLIs oI LIeIr IIves Iuve
more proLecLIon uguInsL respIruLory IIIness. (Hercld,Sun, JuIy
q, zooz, p.z6)
A smuII umounL oI LIme In LIe sun couId IeIp guurd uguInsL
muny Lypes oI cuncer..AILIougI dumuge cuused by sunburn In
Lurn cuuses skIn cuncers, Loo IILLIe sun wus IInked Lo breusL,
coIon und ovurIun cuncers. (Hercld,Sun, JuIy q, zooz, p.z6)
TruveIIIng on pIunes sIgnIIIcunLIy Increuses LIe cIunces oI
cuLcIIng u coId. (Hercld,Sun, AugusL ;, zooz, p.zz)
Brown-eyed peopIe ure uL greuLer rIsk oI cuLurucLs LIun bIue-
eyed peopIe. (Hercld,Sun, AugusL q, zooz, p.z8)
EIderIy peopIe wIo Luke vILumIn A suppIemenLs ure uL rIsk oI
osLeoporosIs. (Hercld,Sun, AugusL z1, zooz, p.zz)
Lifestyle Epidemiology
Women wIo ure overweIgIL or obese uL uge 18 Iuve un
Increused rIsk oI ovurIun cuncer. (Hercld,Sun, AugusL z,
zooz, p.z6)
Men wIo go buId uL LIe buck oI LIe Ieud by LIeIr qos or os
Iuve u o per cenL IIgIer rIsk oI prosLuLe cuncer. (Hercld,Sun,
AugusL zq, zooz, p.11)
CoId poLuLo, buked beuns, rIce und porrIdge couId be LIe key Lo
wurdIng oII cuncer. (Hercld,Sun, SepLember 11, zooz, p.z8)
Women exposed Lo IIgI IeveIs oI poIIen In LIe IusL LIIrd oI
pregnuncy ure mucI more IIkeIy Lo Iuve usLImuLIc cIIIdren.
(Hercld,Sun, SepLember 18, zooz, p.z;)
RuIsed IeveIs oI mercury In LIe bIood, Irom IIgI seuIood
consumpLIon, couId be IInked Lo InIerLIIILy. (Hercld,Sun,
SepLember z, zooz, p.zz)
uIIure Lo exercIse Is us bud Ior IeuILI us smokIng u puckeL oI
cIgureLLes every duy. (Hercld,Sun, SepLember z, zooz, p.zz)
Too mucI vILumIn A sIgnIIIcunLIy Increuses LIe rIsk oI bone
IrucLures In men. (Hercld,Sun, ebruury zo, zoo, p.z6)
And, yeL IL Is uIso decIured LIuL |w|e`re IuL, we smoke und we
drInk Loo mucI, buL AusLruIIuns ure IIvIng mucI
Ionger. (Hercld,Sun, June z8, zooz, p.1)
TIe precedIng reIIecLs u sLuLIsLIcs mudness. n uII oI LIe cuses
ubove LIe predIcLIve sLrengLI oI u IucLor Ior u deLrImenLuI ouLcome Is
neur-zero or eIIecLIveIy zero. n u properIy IuncLIonIng scIenLIIIc
dIscIpIIne, LIese sorLs oI IIndIngs wouId noL be over-InLerpreLed und
wouId cerLuInIy noL muke LIeIr wuy InLo LIe medIu or Lo LIe pubIIc. TIese
wouId be consIdered us expIoruLory resuILs - uL besL. ReseurcIers wouId
LIen quILe IILeruIIy go buck Lo LIe druwIng bourd In uLLempLIng Lo IInd
IIgI-IeveI predIcLors Ior purLIcuIur occurrences. TIIs Is noL so In IIIesLyIe
epIdemIoIogy, prevenLIve medIcIne or IeuILI promoLIon wIere rIsk IucLors
ure severeIy over-InLerpreLed us u muLLer oI course. TIIs reIIecLs LIe
IosLerIng oI supersLILIous beIIeI, I.e., un ussuuIL on psycIoIogIcuI, socIuI
und moruI IeuILI. n uddILIon Lo scIenLIIIc IncompeLence, LIIs Is occurrIng
becuuse LIe superIIcIuIILy oI muLerIuIIsm Ius no concepL oI LIe
deLrImenLuI rumIIIcuLIons oI dIsIonesL depIcLIons oI InIormuLIon Ior
psycIoIogIcuI und socIuI IeuILI.
Severe over-InLerpreLuLIon oI duLu, un IndIcuLor oI un ubsence oI
scIoIursIIp, IosLers LIe mIspercepLIon In LIe pubIIc LIuL uII munner oI
dIscoverIes ure beIng mude by medIco-muLerIuIIsm und LIereIore
promoLes u IIgIer socIuI sLuLus Ior medIco-muLerIuIIsm. L uIso uIds In
108
108
Rampant Antismoking Signifies Grave Danger
progressIve IundIng In reseurcI InsLILuLIons LIuL ure domInuLed by
muLerIuIIsm: n muLerIuIIsm uII reseurcI Ius Lo be uccompIIsIIng
someLIIng Lo uLLrucL IurLIer IundIng, I.e., reseurcI cunnoL jusL be
expIoruLory. ConsIderIng onIy rIsk IucLoroIogy, IL cun be concIuded LIuL
medIco-muLerIuIIsm, und LIe medIu, Is dungerousIy ouL oI conLroI.
However, us wIII be IndIcuLed In LIe IoIIowIng cIupLer, LIe conLemporury
medIcuI esLubIIsImenL suIIers Irom even more severe und sInIsLer
conLorLIons.
n sLuLIsLIcuI Lerms, LIe sLuLus oI IIIesLyIe epIdemIoIogy Is
equIvuIenL Lo LIuL oI Insurunce compunIes; boLI generuLe reIuLIve-odds
ruLIos Ior purLIcuIur evenLs. BoLI ure uIso muLerIuIIsL In dIsposILIon.
However, LIey dIIIer In one crILIcuI regurd. nsurunce compunIes do noL
preLend Lo pursue cuusuI expIunuLIons Ior rIsk dIIIerences or LIuL odds-
dIIIerences IndIcuLe cuusuI reIuLIonsIIps. TIey ure sImpIy uLLempLIng Lo
guIn u gumbIIng edge by sLuLIsLIcuIIy pIuyIng IdenLIIIubIe groups uguInsL
eucI oLIer, us represenLed In LIe ussIgned cosL oI premIums. TIIs Is
regurdIess oI wIeLIer group subdIvIsIons Iuve uny meunIngIuIness or noL,
or wIeLIer LIey ure proper or noL. L wus IndIcuLed In un eurIIer secLIon
LIuL uIcoIoI consumpLIon Is u reIuLIveIy IIgIer uILIougI poor ubsoIuLe
predIcLor oI moLor veIIcIe uccIdenLs. nsurunce compunIes do noL Iuve
dIrecL uccess Lo IndIvIduuIs` uIcoIoI consumpLIon. A person`s smokIng
sLuLus Is dIrecLIy uccessIbIe due Lo LIe numerous Iorms LIuL IL Is requesLed
on. TIere Is u IIgIer correIuLIon beLween smokIng und uIcoIoI
consumpLIon LIun nonsmokIng und uIcoIoI consumpLIon. TIereIore,
Insurunce compunIes muke LIe gumbIIng-besL oI u poor sILuuLIon by
cIurgIng uII smolers IIgIer premIums Ior moLor veIIcIe Insurunce. TIIs
conducL Is dIscrImInuLory und smokers Iuve Iud LIIs nonsense InIIIcLed
on LIem Ior muny decudes. However, LIe poInL oI concern Iere Is LIuL
Insurunce compunIes ure uL IeusL IonesL ubouL wIuL LIeIr conducL
represenLs.
L Is u reusonubIe ussumpLIon LIuL LIe musses wouId be In uprour
II IL wus InLended LIuL uII pubIIc poIIcy wouId be pIuced under LIe
dIrecLorsIIp oI Insurunce compunIes. MosL wouId be weII uwure LIuL LIe
Insurunce-compuny worId vIew Is Iur Loo IIImsy Ior sucI u IormIdubIe
Lusk. L muy come us u sIock Lo muny LIuL conLemporury IeuILI
promoLIon Is essenLIuIIy bused on un Insurunce-compuny worIdvIew,
devoId oI uny ucLuuI Iumun meunIngIuIness. TIe onIy dIIIerence Is LIuL IL
currenLIy Ius u Iuke seuI oI scIenLIIIc uuLIorILy vIu LIe mIsconducL oI
IIIesLyIe epIdemIoIogy. nsurunce compunIes couId be gIven LIe reIgns oI
IeuILI promoLIon, wIIcI mIgIL uIreudy be consIderubIy LIe cuse, und LIe
currenL sysLem In muny wesLern nuLIons wouId IurdIy skIp u beuL.
n purcIusIng un Insurunce poIIcy, one Ius Lo unIorLunuLeIy
Lifestyle Epidemiology
uccepL LIe IIImsIness und IrruLIonuIILy oI LIe reIuLIve-odds Irumework.
However, once purcIused, LIe poIIcy cun be puL uwuy In u desk-druwer
und persons cun conLInue wILI, IopeIuIIy, u more coIerenL upproucI Lo
IIvIng, I.e., LIere ure onIy IsoIuLed brusIes wILI LIIs Irumework. WIuL Is
beIng perpeLruLed on un unsuspecLIng or guIIIbIe pubIIc under LIe
uuspIces oI IIIesLyIe epIdemIoIogy und prevenLIve medIcIne Is LIe coercIon
Lo IIve one`s IIIe uccordIng Lo LIIs IrruLIonuI sLuLIsLIcuI Irumework. TIrougI
u coIIecLIve deIusIon, LIe muLerIuIIsL IeuILI IndusLry (IeuILIIsm) Is
uLLempLIng Lo domInuLe crILIcuI uspecLs oI IIIesLyIe.
TIe mosL InsIdIous uspecL oI LIIs sordId sugu Is LIuL IeuILI
uuLIorILIes noL onIy IndIcuLe Iow LIIs InIormuLIon sIouId be
mIsInLerpreLed buL, over LIe IusL decude In purLIcuIur, ure demcndin
conIormILy Lo u poIIcy oI rIsk uversIon (I.e., muLerIuIIsL munIIesLo). n so
doIng LIey ure noL onIy eIevuLIng LIe sLuLus oI LIIs InIormuLIon jcr beyond
LIe ImpIIcuLIons oI IucL, buL ure uIso ImproperIy eIevuLIng LIeIr sLuLus us
IuvIng greuL InsIgILs InLo dIseuse ueLIoIogy. WIuL LIey ure ucLuuIIy doIng,
und under LIe musquerude oI scIenLIIIc credIbIIILy und IeuILI promoLIon,
Is LerrorIzIng LIe musses InLo LIe muLerIuIIsL beIIeI LIuL IIIe Is no more
LIun u Iong serIes oI sLuLIsLIcuI gumbIes, I.e., mInImIzIng or removIng rIsk
regurdIess oI wIeLIer IL Ius rIyme or reuson. As wIII be consIdered In
IuLer cIupLers LIIs Is noL onIy LIe resuIL oI IncompeLence und
superIIcIuIILy, buL uIso InvoIves oLIer consIderubIe und dungerous menLuI
und socIuI dysIuncLIon (I.e., muLerIuIIsL munIIesLo).
HeuILI Ius been reduced Lo un enLIreIy muLerIuIIsL worIdvIew
wIere psycIoIogIcuI, psycIosocIuI und moruI dImensIons ure ubsenL. Poor
muLerIuIIsL predIcLors oI u muLerIuIIsL Ideu oI IeuILI ure converLed InLo
moneLury Lerms by compIeLeIy quesLIonubIe sLuLIsLIcuI procedures, I.e.,
uLLrIbuLubIe rIskJcosL. TIe cupILuIIsL Iree-murkeL LIen dIcLuLes LIuL
purLIcuIur sources oI rIskJcosL sIouId be removed, I.e., LIe preucIIng oI
sLuLIsLIcuI rIsk-uversIon us normuLIve conducL Ior uII. n poIILIcuI Lerms
LIIs couId be reIerred Lo us medIco-muLerIuIIsL nuLIonuIIsm (IuscIsm); u
person`s worLI Is deLermIned enLIreIy by Iow mucI poLenLIuI pressure
(rIsk) LIey mIgIL pIuce on LIe muLerIuIIsL IeuILI neLwork. TIuL In so doIng
LIe musses ure IruuduIenLIy coerced InLo serIous menLuI, socIuI und moruI
dysIuncLIon does noL IIgure In LIe muLerIuIIsL equuLIon.
TIere ure LIose Iew wILIIn epIdemIoIogy LIuL cun uL IeusL dIscern
LIuL LIere Is someLIIng LrugIcuIIy usLruy wILI LIe epIdemIoIogIc meLIod
und IeuILI promoLIon generuIIy. TrIcIopouIos (1qq) IndIcuLes LIuL we
ure IusL becomIng u nuIsunce Lo socIeLy. PeopIe don`L Luke us serIousIy
unymore, und wIen LIey do Luke us serIousIy, we muy unInLenLIonuIIy do
more Iurm LIun good. UnIorLunuLeIy, LIey cunnoL LeII wIuL LIe cenLruI
probIem Is (I.e., muLerIuIIsL IdeoIogy) und LIereIore cun oIIer no
109
109
Rampant Antismoking Signifies Grave Danger
progressIve IundIng In reseurcI InsLILuLIons LIuL ure domInuLed by
muLerIuIIsm: n muLerIuIIsm uII reseurcI Ius Lo be uccompIIsIIng
someLIIng Lo uLLrucL IurLIer IundIng, I.e., reseurcI cunnoL jusL be
expIoruLory. ConsIderIng onIy rIsk IucLoroIogy, IL cun be concIuded LIuL
medIco-muLerIuIIsm, und LIe medIu, Is dungerousIy ouL oI conLroI.
However, us wIII be IndIcuLed In LIe IoIIowIng cIupLer, LIe conLemporury
medIcuI esLubIIsImenL suIIers Irom even more severe und sInIsLer
conLorLIons.
n sLuLIsLIcuI Lerms, LIe sLuLus oI IIIesLyIe epIdemIoIogy Is
equIvuIenL Lo LIuL oI Insurunce compunIes; boLI generuLe reIuLIve-odds
ruLIos Ior purLIcuIur evenLs. BoLI ure uIso muLerIuIIsL In dIsposILIon.
However, LIey dIIIer In one crILIcuI regurd. nsurunce compunIes do noL
preLend Lo pursue cuusuI expIunuLIons Ior rIsk dIIIerences or LIuL odds-
dIIIerences IndIcuLe cuusuI reIuLIonsIIps. TIey ure sImpIy uLLempLIng Lo
guIn u gumbIIng edge by sLuLIsLIcuIIy pIuyIng IdenLIIIubIe groups uguInsL
eucI oLIer, us represenLed In LIe ussIgned cosL oI premIums. TIIs Is
regurdIess oI wIeLIer group subdIvIsIons Iuve uny meunIngIuIness or noL,
or wIeLIer LIey ure proper or noL. L wus IndIcuLed In un eurIIer secLIon
LIuL uIcoIoI consumpLIon Is u reIuLIveIy IIgIer uILIougI poor ubsoIuLe
predIcLor oI moLor veIIcIe uccIdenLs. nsurunce compunIes do noL Iuve
dIrecL uccess Lo IndIvIduuIs` uIcoIoI consumpLIon. A person`s smokIng
sLuLus Is dIrecLIy uccessIbIe due Lo LIe numerous Iorms LIuL IL Is requesLed
on. TIere Is u IIgIer correIuLIon beLween smokIng und uIcoIoI
consumpLIon LIun nonsmokIng und uIcoIoI consumpLIon. TIereIore,
Insurunce compunIes muke LIe gumbIIng-besL oI u poor sILuuLIon by
cIurgIng uII smolers IIgIer premIums Ior moLor veIIcIe Insurunce. TIIs
conducL Is dIscrImInuLory und smokers Iuve Iud LIIs nonsense InIIIcLed
on LIem Ior muny decudes. However, LIe poInL oI concern Iere Is LIuL
Insurunce compunIes ure uL IeusL IonesL ubouL wIuL LIeIr conducL
represenLs.
L Is u reusonubIe ussumpLIon LIuL LIe musses wouId be In uprour
II IL wus InLended LIuL uII pubIIc poIIcy wouId be pIuced under LIe
dIrecLorsIIp oI Insurunce compunIes. MosL wouId be weII uwure LIuL LIe
Insurunce-compuny worId vIew Is Iur Loo IIImsy Ior sucI u IormIdubIe
Lusk. L muy come us u sIock Lo muny LIuL conLemporury IeuILI
promoLIon Is essenLIuIIy bused on un Insurunce-compuny worIdvIew,
devoId oI uny ucLuuI Iumun meunIngIuIness. TIe onIy dIIIerence Is LIuL IL
currenLIy Ius u Iuke seuI oI scIenLIIIc uuLIorILy vIu LIe mIsconducL oI
IIIesLyIe epIdemIoIogy. nsurunce compunIes couId be gIven LIe reIgns oI
IeuILI promoLIon, wIIcI mIgIL uIreudy be consIderubIy LIe cuse, und LIe
currenL sysLem In muny wesLern nuLIons wouId IurdIy skIp u beuL.
n purcIusIng un Insurunce poIIcy, one Ius Lo unIorLunuLeIy
Lifestyle Epidemiology
uccepL LIe IIImsIness und IrruLIonuIILy oI LIe reIuLIve-odds Irumework.
However, once purcIused, LIe poIIcy cun be puL uwuy In u desk-druwer
und persons cun conLInue wILI, IopeIuIIy, u more coIerenL upproucI Lo
IIvIng, I.e., LIere ure onIy IsoIuLed brusIes wILI LIIs Irumework. WIuL Is
beIng perpeLruLed on un unsuspecLIng or guIIIbIe pubIIc under LIe
uuspIces oI IIIesLyIe epIdemIoIogy und prevenLIve medIcIne Is LIe coercIon
Lo IIve one`s IIIe uccordIng Lo LIIs IrruLIonuI sLuLIsLIcuI Irumework. TIrougI
u coIIecLIve deIusIon, LIe muLerIuIIsL IeuILI IndusLry (IeuILIIsm) Is
uLLempLIng Lo domInuLe crILIcuI uspecLs oI IIIesLyIe.
TIe mosL InsIdIous uspecL oI LIIs sordId sugu Is LIuL IeuILI
uuLIorILIes noL onIy IndIcuLe Iow LIIs InIormuLIon sIouId be
mIsInLerpreLed buL, over LIe IusL decude In purLIcuIur, ure demcndin
conIormILy Lo u poIIcy oI rIsk uversIon (I.e., muLerIuIIsL munIIesLo). n so
doIng LIey ure noL onIy eIevuLIng LIe sLuLus oI LIIs InIormuLIon jcr beyond
LIe ImpIIcuLIons oI IucL, buL ure uIso ImproperIy eIevuLIng LIeIr sLuLus us
IuvIng greuL InsIgILs InLo dIseuse ueLIoIogy. WIuL LIey ure ucLuuIIy doIng,
und under LIe musquerude oI scIenLIIIc credIbIIILy und IeuILI promoLIon,
Is LerrorIzIng LIe musses InLo LIe muLerIuIIsL beIIeI LIuL IIIe Is no more
LIun u Iong serIes oI sLuLIsLIcuI gumbIes, I.e., mInImIzIng or removIng rIsk
regurdIess oI wIeLIer IL Ius rIyme or reuson. As wIII be consIdered In
IuLer cIupLers LIIs Is noL onIy LIe resuIL oI IncompeLence und
superIIcIuIILy, buL uIso InvoIves oLIer consIderubIe und dungerous menLuI
und socIuI dysIuncLIon (I.e., muLerIuIIsL munIIesLo).
HeuILI Ius been reduced Lo un enLIreIy muLerIuIIsL worIdvIew
wIere psycIoIogIcuI, psycIosocIuI und moruI dImensIons ure ubsenL. Poor
muLerIuIIsL predIcLors oI u muLerIuIIsL Ideu oI IeuILI ure converLed InLo
moneLury Lerms by compIeLeIy quesLIonubIe sLuLIsLIcuI procedures, I.e.,
uLLrIbuLubIe rIskJcosL. TIe cupILuIIsL Iree-murkeL LIen dIcLuLes LIuL
purLIcuIur sources oI rIskJcosL sIouId be removed, I.e., LIe preucIIng oI
sLuLIsLIcuI rIsk-uversIon us normuLIve conducL Ior uII. n poIILIcuI Lerms
LIIs couId be reIerred Lo us medIco-muLerIuIIsL nuLIonuIIsm (IuscIsm); u
person`s worLI Is deLermIned enLIreIy by Iow mucI poLenLIuI pressure
(rIsk) LIey mIgIL pIuce on LIe muLerIuIIsL IeuILI neLwork. TIuL In so doIng
LIe musses ure IruuduIenLIy coerced InLo serIous menLuI, socIuI und moruI
dysIuncLIon does noL IIgure In LIe muLerIuIIsL equuLIon.
TIere ure LIose Iew wILIIn epIdemIoIogy LIuL cun uL IeusL dIscern
LIuL LIere Is someLIIng LrugIcuIIy usLruy wILI LIe epIdemIoIogIc meLIod
und IeuILI promoLIon generuIIy. TrIcIopouIos (1qq) IndIcuLes LIuL we
ure IusL becomIng u nuIsunce Lo socIeLy. PeopIe don`L Luke us serIousIy
unymore, und wIen LIey do Luke us serIousIy, we muy unInLenLIonuIIy do
more Iurm LIun good. UnIorLunuLeIy, LIey cunnoL LeII wIuL LIe cenLruI
probIem Is (I.e., muLerIuIIsL IdeoIogy) und LIereIore cun oIIer no
110
110
Rampant Antismoking Signifies Grave Danger
resoIuLIon. IIesLyIe epIdemIoIogy Is IundumenLuIIy IIuwed.
EpIdemIoIogIsLs do noL compreIend wIuL LIey ure scIenLIIIcuIIy IookIng
Ior, I.e., pInpoInLIng IuncLIon. TIey uIso demonsLruLe no compreIensIon
oI LIe ruIes oI sLuLIsLIcuI or cuusuI InIerence. urLIermore, us Lo IIIesLyIe
dIseuses wIIcI InvoIve LIe IuII gumuL oI Iumun dImensIons (e.g.,
psycIoIogIcuI, psycIosocIuI, eLc.), LIe muLerIuIIsm oI medIcIne Is
sInguIurIy unquuIIIIed Ior LIe Lusk. eIL Lo muLerIuIIsm, generuIIy, onIy
IurLIer perverseness cun be udded Lo LIe endeuvor.
AILIougI IegILImuLe crILIcIsms Iuve been mude over LIe yeurs
(e.g., Becker, 1qq; Skrubunek & McCormIck, 1qqo; eInsLeIn, 1q88),
purLIcuIurIy LIuL oI correIuLIon or predIcLIve sLrengLI und LIe
InupproprIuLeness oI RR Lo evuIuuLe cuusuLIon (Eysenck, 1qqo), LIe
sILuuLIon Ius noL Improved, buL worsened. L Ius uIreudy been IndIcuLed
LIuL IIIesLyIe epIdemIoIogy demonsLruLes no cupucILy Ior seII-correcLIon;
LIe vusL mujorILy oI ILs membersIIp Iuve u sIured IncompeLence und
Ignorunce, I.e. coIIecLIve, seII-servIng deIusIon. urLIer, IL does noL
respond uL uII weII Lo uLLempLs uL correcLIon Irom exLernuI sources.
GorI (1qqqu) represenLs one oI LIe very Iew und more Ieurned
crILIques, cognIzunL oI LIe requIremenL oI predIcLIve sLrengLI und LIe
pIIIosopIIcuI underpInnIngs oI scIenLIIIc enquIry. n response Lo LIe
LreuLmenL oI LIe Issue oI envIronmenLuI Lobucco smoke (ETS) by IIIesLyIe
epIdemIoIogy und prevenLIve medIcIne, GorI (1qqqu) IIgIIIgILed onIy
some crILIcuI und dungerous errors oI InIerence und LIe psycIosocIoIogy
(e.g., consensus eIIecL) oI beIIeI concernIng ETS concIusIons. UsuuIIy,
crILIcIsms oI LIe oIIIcIuI vIew do noL receIve uny uLLenLIon uL uII; LIe
esLubIIsImenL sImpIy Ignores LIem und proceeds on ILs conLorLed
muLerIuIIsL puLI, uLLerIy convInced oI ILs own deIInILIve posILIon.
However, In LIIs InsLunce LIere wus u smuII response Lo LIe GorI crILIque.
urIund eL uI. (1qqq) und JInoL & Buyurd (1qqq), wIo uII
conLrIbuLed Lo EPA (1qq), surmIsed, uILer u IengLIy reIusI oI LIe
proLocoIs used In EPA (1qq), LIuL, II LIe GorI`s crILIcIsms Iud uny
vuIIdILy, epIdemIoIogy`s concIusIon oI ETS us dungerous Ior uII reIIecLs u
conspIrucy oI InIormuLIon munIpuIuLIon. TIIs LIey consIdered Lo be IIgIIy
unIIkeIy. GorI`s (1qqqb) repIy Is mosL upL. I epIdemIoIogy`s conducL dId
represenL u conspIrucy, LIe probIem couId be ecsil resoIved. TIe
conspIruLors, Loo, wouId recognIze LIuL LIey ure InLenLIonuIIy vIoIuLIng
prIncIpIes oI InIerence und procedure. By LIen properIy uppIyIng LIese
prIncIpIes, some sembIunce oI coIerenL procedure und concIusIons cun be
resLored.
UnIorLunuLeIy, LIe probIem Is noL one oI dIrecL conspIrucy,
uILIougI LIe consequences ure LIe sume (see uIso eInsLeIn, 1q88). n LIe
cuse oI IIIesLyIe epIdemIoIogy und prevenLIve medIcIne LIe prucLILIoners
Lifestyle Epidemiology
do noL compreIend LIe underIyIng prIncIpIes oI scIenLIIIc enquIry, or LIeIr
greuLer epIsLemoIogIcuI conLexL, und ure LIereIore obIIvIous Lo LIe IucL
LIuL LIeIr concIusIons und prescrIpLIons ure bused on vIoIuLIons oI crILIcuI
InIerenLIuI prIncIpIes uL every Lurn. TIe conspIrucy Is one oI Ignorunce,
IncompeLence und superIIcIuIILy. urLIermore, und wIuL Is noL uddressed
by GorI, Is LIuL LIe muLerIuIIsm oI LIe overseers precIudes InIormuLIon
beIng InLerpreLed In unyLIIng oLIer LIun overIy-sImpIIsLIc, sIuIIow, unI-
dImensIonuI Lerms. UnIorLunuLeIy, LIe conducL Is In keepIng wILI, und u
IogIcuI progressIon oI, LIe muLerIuIIsL munIIesLo, I.e., LIe IoremosL
probIem Is un IdeoIogIcuIJmeLupIysIcuI one. Muny In LIe medIcuI
esLubIIsImenL muy noL even be uwure LIuL LIey ure purLIcIpuLIng In un
IdeoIogIcuI quesL; noL boLIerIng Lo quesLIon purLIcuIur cIuIms, LIey ure
corruIIed InLo consensus by LIe more exLremIsL eIemenLs. AII uLLempLs uL
onl scIenLIIIc correcLIon, eILIer Irom InLernuI or exLernuI sources, IuII on
cognILIveIy deuI eurs. TIe resuIL Is LIuL LIIs gruve probIem noL onIy
conLInues buL, us wIII be consIdered, deLerIoruLes.
z. A Summcr oj Mctericlist Delusion
MuLerIuIIsm Is predIcuLed on LIe beIIeI LIuL onIy LIe muLerIuI
exIsLs. TIIs Is u pIIIosopIIcuI und noL u scIenLIIIc proposILIon. TIe Iumun
Is reduced Lo no more LIun bIoIogIcuI roboLIcs. n LIuL muLerIuIIsm
cunnoL reIer Lo mInd or LrunscendenL purpose, IL Is IeIL wILI u IundIuI oI
very poor prescrIpLIve possIbIIILIes. A IundumenLuI precepL oI
orgunIsmIc reusonIng Is LIuL LIe orgunIsm Is seII-preservIng (I.e.,
survIvuIIsm). n medIco-muLerIuIIsL Lerms, LIIs precepL LrunsIuLes InLo
IongevILy or yeurs IIved. I LIe person, wIo Is no more LIun LIe
orgunIsm, ceuses Lo exIsL uL deuLI, LIen LIe orgunIsm conLInuuIIy sLrIves
Ior IIIe (exIsLence).
IIe In LIese Lerms Is devoId oI uny psycIoIogIcuI, reIuLIonuI or
meLupIysIcuI uspecLs. L sIouId noL be uII Loo surprIsIng LIuL IIIesLyIe
epIdemIoIogy, und ILs underIyIng muLerIuIIsm, reIIes uImosL excIusIveIy on
reIuLIve rIsk dIIIerenLIuIs In IongevILy In deLermInIng ILs prescrIpLIonsJ
proscrIpLIons. L sIouId be obvIous LIuL LIere Is someLIIng perverse ubouL
un upproucI LIuL wouId reduce u person`s IIIe Lo LIe sInguIur number oI
yeurs IIved (see uIso uIk, 1qq6). n uddILIon Lo LIe numerous errors
uIreudy IIgIIIgILed In IIIesLyIe epIdemIoIogy, LIIs InvoIves u IurLIer error
oI reducLIve reusonIng. RegurdIess oI wIeLIer u person Is psycIoIogIcuIIy
unsLubIe, emoLIonuIIy crIppIed und meLupIysIcuIIy bIInd, u person`s IIIe Is
deemed u success II LIeIr yeurs IIved Is ubove LIe IongevILy uveruge.
ConverseIy, u person`s IIIe Is deemed u wusLe or IuIIure II LIeIr yeurs IIved
Is beIow LIe IongevILy uveruge. L uIso convenIenLIy omILs LIe IucL LIuL wILI
111
111
Rampant Antismoking Signifies Grave Danger
resoIuLIon. IIesLyIe epIdemIoIogy Is IundumenLuIIy IIuwed.
EpIdemIoIogIsLs do noL compreIend wIuL LIey ure scIenLIIIcuIIy IookIng
Ior, I.e., pInpoInLIng IuncLIon. TIey uIso demonsLruLe no compreIensIon
oI LIe ruIes oI sLuLIsLIcuI or cuusuI InIerence. urLIermore, us Lo IIIesLyIe
dIseuses wIIcI InvoIve LIe IuII gumuL oI Iumun dImensIons (e.g.,
psycIoIogIcuI, psycIosocIuI, eLc.), LIe muLerIuIIsm oI medIcIne Is
sInguIurIy unquuIIIIed Ior LIe Lusk. eIL Lo muLerIuIIsm, generuIIy, onIy
IurLIer perverseness cun be udded Lo LIe endeuvor.
AILIougI IegILImuLe crILIcIsms Iuve been mude over LIe yeurs
(e.g., Becker, 1qq; Skrubunek & McCormIck, 1qqo; eInsLeIn, 1q88),
purLIcuIurIy LIuL oI correIuLIon or predIcLIve sLrengLI und LIe
InupproprIuLeness oI RR Lo evuIuuLe cuusuLIon (Eysenck, 1qqo), LIe
sILuuLIon Ius noL Improved, buL worsened. L Ius uIreudy been IndIcuLed
LIuL IIIesLyIe epIdemIoIogy demonsLruLes no cupucILy Ior seII-correcLIon;
LIe vusL mujorILy oI ILs membersIIp Iuve u sIured IncompeLence und
Ignorunce, I.e. coIIecLIve, seII-servIng deIusIon. urLIer, IL does noL
respond uL uII weII Lo uLLempLs uL correcLIon Irom exLernuI sources.
GorI (1qqqu) represenLs one oI LIe very Iew und more Ieurned
crILIques, cognIzunL oI LIe requIremenL oI predIcLIve sLrengLI und LIe
pIIIosopIIcuI underpInnIngs oI scIenLIIIc enquIry. n response Lo LIe
LreuLmenL oI LIe Issue oI envIronmenLuI Lobucco smoke (ETS) by IIIesLyIe
epIdemIoIogy und prevenLIve medIcIne, GorI (1qqqu) IIgIIIgILed onIy
some crILIcuI und dungerous errors oI InIerence und LIe psycIosocIoIogy
(e.g., consensus eIIecL) oI beIIeI concernIng ETS concIusIons. UsuuIIy,
crILIcIsms oI LIe oIIIcIuI vIew do noL receIve uny uLLenLIon uL uII; LIe
esLubIIsImenL sImpIy Ignores LIem und proceeds on ILs conLorLed
muLerIuIIsL puLI, uLLerIy convInced oI ILs own deIInILIve posILIon.
However, In LIIs InsLunce LIere wus u smuII response Lo LIe GorI crILIque.
urIund eL uI. (1qqq) und JInoL & Buyurd (1qqq), wIo uII
conLrIbuLed Lo EPA (1qq), surmIsed, uILer u IengLIy reIusI oI LIe
proLocoIs used In EPA (1qq), LIuL, II LIe GorI`s crILIcIsms Iud uny
vuIIdILy, epIdemIoIogy`s concIusIon oI ETS us dungerous Ior uII reIIecLs u
conspIrucy oI InIormuLIon munIpuIuLIon. TIIs LIey consIdered Lo be IIgIIy
unIIkeIy. GorI`s (1qqqb) repIy Is mosL upL. I epIdemIoIogy`s conducL dId
represenL u conspIrucy, LIe probIem couId be ecsil resoIved. TIe
conspIruLors, Loo, wouId recognIze LIuL LIey ure InLenLIonuIIy vIoIuLIng
prIncIpIes oI InIerence und procedure. By LIen properIy uppIyIng LIese
prIncIpIes, some sembIunce oI coIerenL procedure und concIusIons cun be
resLored.
UnIorLunuLeIy, LIe probIem Is noL one oI dIrecL conspIrucy,
uILIougI LIe consequences ure LIe sume (see uIso eInsLeIn, 1q88). n LIe
cuse oI IIIesLyIe epIdemIoIogy und prevenLIve medIcIne LIe prucLILIoners
Lifestyle Epidemiology
do noL compreIend LIe underIyIng prIncIpIes oI scIenLIIIc enquIry, or LIeIr
greuLer epIsLemoIogIcuI conLexL, und ure LIereIore obIIvIous Lo LIe IucL
LIuL LIeIr concIusIons und prescrIpLIons ure bused on vIoIuLIons oI crILIcuI
InIerenLIuI prIncIpIes uL every Lurn. TIe conspIrucy Is one oI Ignorunce,
IncompeLence und superIIcIuIILy. urLIermore, und wIuL Is noL uddressed
by GorI, Is LIuL LIe muLerIuIIsm oI LIe overseers precIudes InIormuLIon
beIng InLerpreLed In unyLIIng oLIer LIun overIy-sImpIIsLIc, sIuIIow, unI-
dImensIonuI Lerms. UnIorLunuLeIy, LIe conducL Is In keepIng wILI, und u
IogIcuI progressIon oI, LIe muLerIuIIsL munIIesLo, I.e., LIe IoremosL
probIem Is un IdeoIogIcuIJmeLupIysIcuI one. Muny In LIe medIcuI
esLubIIsImenL muy noL even be uwure LIuL LIey ure purLIcIpuLIng In un
IdeoIogIcuI quesL; noL boLIerIng Lo quesLIon purLIcuIur cIuIms, LIey ure
corruIIed InLo consensus by LIe more exLremIsL eIemenLs. AII uLLempLs uL
onl scIenLIIIc correcLIon, eILIer Irom InLernuI or exLernuI sources, IuII on
cognILIveIy deuI eurs. TIe resuIL Is LIuL LIIs gruve probIem noL onIy
conLInues buL, us wIII be consIdered, deLerIoruLes.
z. A Summcr oj Mctericlist Delusion
MuLerIuIIsm Is predIcuLed on LIe beIIeI LIuL onIy LIe muLerIuI
exIsLs. TIIs Is u pIIIosopIIcuI und noL u scIenLIIIc proposILIon. TIe Iumun
Is reduced Lo no more LIun bIoIogIcuI roboLIcs. n LIuL muLerIuIIsm
cunnoL reIer Lo mInd or LrunscendenL purpose, IL Is IeIL wILI u IundIuI oI
very poor prescrIpLIve possIbIIILIes. A IundumenLuI precepL oI
orgunIsmIc reusonIng Is LIuL LIe orgunIsm Is seII-preservIng (I.e.,
survIvuIIsm). n medIco-muLerIuIIsL Lerms, LIIs precepL LrunsIuLes InLo
IongevILy or yeurs IIved. I LIe person, wIo Is no more LIun LIe
orgunIsm, ceuses Lo exIsL uL deuLI, LIen LIe orgunIsm conLInuuIIy sLrIves
Ior IIIe (exIsLence).
IIe In LIese Lerms Is devoId oI uny psycIoIogIcuI, reIuLIonuI or
meLupIysIcuI uspecLs. L sIouId noL be uII Loo surprIsIng LIuL IIIesLyIe
epIdemIoIogy, und ILs underIyIng muLerIuIIsm, reIIes uImosL excIusIveIy on
reIuLIve rIsk dIIIerenLIuIs In IongevILy In deLermInIng ILs prescrIpLIonsJ
proscrIpLIons. L sIouId be obvIous LIuL LIere Is someLIIng perverse ubouL
un upproucI LIuL wouId reduce u person`s IIIe Lo LIe sInguIur number oI
yeurs IIved (see uIso uIk, 1qq6). n uddILIon Lo LIe numerous errors
uIreudy IIgIIIgILed In IIIesLyIe epIdemIoIogy, LIIs InvoIves u IurLIer error
oI reducLIve reusonIng. RegurdIess oI wIeLIer u person Is psycIoIogIcuIIy
unsLubIe, emoLIonuIIy crIppIed und meLupIysIcuIIy bIInd, u person`s IIIe Is
deemed u success II LIeIr yeurs IIved Is ubove LIe IongevILy uveruge.
ConverseIy, u person`s IIIe Is deemed u wusLe or IuIIure II LIeIr yeurs IIved
Is beIow LIe IongevILy uveruge. L uIso convenIenLIy omILs LIe IucL LIuL wILI
112
112
Rampant Antismoking Signifies Grave Danger
IncreusIng uge comes progressIve IruIILy und LIe IIgIer probubIIILy oI
demenLIu.
EpIdemIoIogy uLLempLs Lo expound, uIbeIL IncompeLenLIy, IucLors
LIuL ure ussocIuLed wILI some persons LIuL Iuve Iud IIgIer LIun uveruge
IongevILy, und IucLors LIuL ure ussocIuLed wILI some persons LIuL Iuve Iud
Iower LIun uveruge IongevILy. TIe scIenLIIIc vIubIIILy oI sucI IucLors us
cuusuI In LIe IongevILy regurd Is compIeLeIy quesLIonubIe. However,
ImproperIy eIevuLed Lo LIe sLuLus oI crILIcuI prescrIpLIonsJproscrIpLIons
Ior IIvIng, muLerIuIIsL IeuILI promoLIon LIen emburks on educuLIng
LIe musses us Lo responsIbIe IIvIng.
BeIuvIorIsm, LIe muLerIuIIsL versIon oI psycIoIogy, conLends
LIuL u person enguged In conducL LIuL Is noL consIsLenL wILIIn LIIs
combInuLIon oI LIe IIImsy Ideu oI seII-preservuLIon und perverse sLuLIsLIcuI
und cuusuI InIerence Is consIdered Lo be enguged In IuuILy beIuvIor LIuL Is
In need oI re-condILIonIng. ConsIderIng LIuL muLerIuIIsm conLuIns no
coIerenL moruI Irumework, IL wIII use wIuLever meuns socIeLy wIII permIL,
or Is mude uwure oI, In un ends jusLIIIes LIe meuns Irumework Lo
neguLIveIy condILIon wIuL IL perceIves us unuccepLubIe beIuvIor, und Lo
posILIveIy condILIon wIuL IL perceIves us uccepLubIe beIuvIor. TIese
prescrIbed beIuvIors ure noL ends In LIemseIves buL ure deemed
ImporLunL onIy InsoIur us LIey promoLe LIe crILIcuI IucLor oI IongevILy
und ubsence oI pIysIcuI dIseuse, Iowever sLuLIsLIcuIIy remoLe or cuusuIIy
unIounded LIese muy be.
WILIIn u muLerIuIIsL Irumework, LIe worsL possIbIIILy Is deuLI,
I.e., ceusIng Lo exIsL. n sopIIsLIcuLed meLupIysIcuI Irumeworks
demonsLruLIng u coIerenL und proIound moruIILy, IL Is noL deuLI LIuL Is
LIe worsL poLenLIuI buL u IuIIure oI InLegrILy oI beIIeI und conducL In LIese
moruI Lerms. TIese beIIeIs ure cenLruI In sIckness or In IeuILI, und In
IIvIng und dyIng. TIe crILIcuI dIIIerence Lo muLerIuIIsm Is LypIcuIIy LIe
beIIeI LIuL pIysIcuI deuLI does noL IndIcuLe LIe cessuLIon oI uII sense oI
exIsLence: u core uspecL oI LIe IndIvIduuI survIves. n muny reIIgIous
Irumeworks LIIs Is reIerred Lo us LIe soul. TIe nuLure oI LIe posL-morLuIILy
experIence Is enLIreIy dependenL on LIe IeveI oI musLery oI moruI
reusonIng durIng LIIs IIIeLIme. MuLerIuIIsm Ius dIIIIcuILy wILI IsoIuLed
uILruIsLIc ucLs (e.g., wIere u person jeopurdIzes LIeIr own weIIure In
ussIsLIng oLIers) IeL uIone u IIIesLyIe oI LrunscendenL IuILI LIuL does noL
wuIver In LIe Iuce oI udversILy or even LIe LIreuL oI persecuLIon or deuLI.
A CIrIsLIun, Ior exumpIe, works Irom LIe crILIcuI premIse:
TIen Jesus suId Lo HIs dIscIpIes, I unyone desIres Lo be
my dIscIpIe, IeL IIm deny IImseII - LIuL Is, dIsregurd,
Iose sIgIL oI und IorgeL IImseII und IIs own InLeresLs -
und Luke up IIs cross und IoIIow Me |cIeuve sLeudIIy Lo
Lifestyle Epidemiology
Me, conIorm wIoIIy Lo my exumpIe In IIvIng und II need
be In dyIng, uIso|.
or wIoever Is benL on suvIng IIs |LemporuI| IIIe |IIs
comIorL und securILy Iere|, sIuII Iose |eLernuI IIIe|; und
wIoever Ioses IIs IIIe |IIs comIorL und securILy Iere| Ior
My suke, sIuII IInd |IIIe everIusLIng|.
or wIuL wIII IL proIIL u mun II Ie guIns LIe wIoIe worId
und IorIeILs IIs IIIe - IIs |bIessed| IIIe In LIe kIngdom oI
God? Or wIuL wouId u mun gIve us un excIunge Ior IIs
|bIessed| IIIe - In LIe kIngdom oI God? (MuLLIew 16:
zq-z6, AmpIIIIed BIbIe)
L Is ImmedIuLeIy obvIous LIuL LIere ure IundumenLuI cIusIes
beLween LIese Lwo perspecLIves, I.e., u meLupIysIcuI crIsIs. Even II one
does noL subscrIbe Lo sLrong reIIgIous beIIeI, LIere cun sLIII be consIderubIe
suspIcIon regurdIng un ends jusLIIIes LIe meuns (moruI reIuLIvIsm)
upproucI Lo uII uspecLs oI IIvIng. n LIe mosL recenL pusL ImmoruIILy Ius
unIorLunuLeIy been uImosL enLIreIy ussocIuLed wILI promIscuILyJ
permIssIveness und IedonIsm. TIe Ideu oI seIIIng one`s souI Ior un exLru
mInuLe, or monLI, or yeur(s) oI IIIe Ius been IosL under u muLerIuIIsL
ussuuIL. TIe quesL Ior IongevILy, In LIIs sense, cun IndIcuLe u cowurdIy,
rIsk-uverse, survIvuIIsL IIIe, even wIen IL uppeurs usceLIc In dIsposILIon;
LIe survIvuIIsL menLuIILy Is egocenLrIc, seII-ubsorbed, seII-servIng,
nurcIssIsLIc, eLc.. TIe IrruLIonuIIy IeurIuI, LIe emoLIonuIIy und reIuLIonuIIy
crIppIed, LIe meLupIysIcuIIy bIInd cun IInd un eusy pursuIL In sLuLIsLIcuI
buses Lo Ionger IIIe LIuL requIre no InLernuI (LIougILJmoruI) deveIopmenL.
ongevILy provIdes no IndIcuLIon oI LIe depLI, purLIcuIurIy moruI, oI u
person`s IIIe.
TIe duysJyeurs LIuL mIgIL be udded Lo u smuII group oI persons`
IIves II LIey devouLIy IoIIow LIe IeuILIIsL sLuLIsLIcuI (gumbIIng)
prescrIpLIons uppeurs very smuII Indeed (e.g., TuyIor eL uI., 1q8;).
However, In LIe mIdsL oI LIIs muLerIuIIsL survIvuIIsm, Becker (1qq)
properIy noLes LIuL Ieur LIuL us prucLIced currenLIy, IeuILI promoLIon
IosLers u de-IumunIzIng seII-concern LIuL subsLILuLes personuI IeuILI
gouIs Ior more ImporLunL, Iumune, socIeLuI gouIs..I, Indeed, uvoIdIng
some IeuILI rIsks buys some oI us u Iew more yeurs oI IIIe, we sIouId be
worryIng ubouL LIe quuIILy oI LIe socIeLy und envIronmenL In wIIcI LIose
yeurs wIII be spenL. (p.) Becker specIIIcuIIy reIers Lo LIe SocruLIc Ideu
LIuL LIe unexumIned IIIe Is noL worLI IIvIng. HIs poInL Is uIso Luken LIuL
LIe Ideu does noL reIer Lo LIe mediccll unexumIned IIIe. TIere Is more
Lo Iumun IIIe LIun unbrIdIed survIvuIIsm bused on u perverse
superIIcIuIILy und LIe IIImsIesL oI sLuLIsLIcuI InIormuLIon. MuLerIuIIsm Is u
113
113
Rampant Antismoking Signifies Grave Danger
IncreusIng uge comes progressIve IruIILy und LIe IIgIer probubIIILy oI
demenLIu.
EpIdemIoIogy uLLempLs Lo expound, uIbeIL IncompeLenLIy, IucLors
LIuL ure ussocIuLed wILI some persons LIuL Iuve Iud IIgIer LIun uveruge
IongevILy, und IucLors LIuL ure ussocIuLed wILI some persons LIuL Iuve Iud
Iower LIun uveruge IongevILy. TIe scIenLIIIc vIubIIILy oI sucI IucLors us
cuusuI In LIe IongevILy regurd Is compIeLeIy quesLIonubIe. However,
ImproperIy eIevuLed Lo LIe sLuLus oI crILIcuI prescrIpLIonsJproscrIpLIons
Ior IIvIng, muLerIuIIsL IeuILI promoLIon LIen emburks on educuLIng
LIe musses us Lo responsIbIe IIvIng.
BeIuvIorIsm, LIe muLerIuIIsL versIon oI psycIoIogy, conLends
LIuL u person enguged In conducL LIuL Is noL consIsLenL wILIIn LIIs
combInuLIon oI LIe IIImsy Ideu oI seII-preservuLIon und perverse sLuLIsLIcuI
und cuusuI InIerence Is consIdered Lo be enguged In IuuILy beIuvIor LIuL Is
In need oI re-condILIonIng. ConsIderIng LIuL muLerIuIIsm conLuIns no
coIerenL moruI Irumework, IL wIII use wIuLever meuns socIeLy wIII permIL,
or Is mude uwure oI, In un ends jusLIIIes LIe meuns Irumework Lo
neguLIveIy condILIon wIuL IL perceIves us unuccepLubIe beIuvIor, und Lo
posILIveIy condILIon wIuL IL perceIves us uccepLubIe beIuvIor. TIese
prescrIbed beIuvIors ure noL ends In LIemseIves buL ure deemed
ImporLunL onIy InsoIur us LIey promoLe LIe crILIcuI IucLor oI IongevILy
und ubsence oI pIysIcuI dIseuse, Iowever sLuLIsLIcuIIy remoLe or cuusuIIy
unIounded LIese muy be.
WILIIn u muLerIuIIsL Irumework, LIe worsL possIbIIILy Is deuLI,
I.e., ceusIng Lo exIsL. n sopIIsLIcuLed meLupIysIcuI Irumeworks
demonsLruLIng u coIerenL und proIound moruIILy, IL Is noL deuLI LIuL Is
LIe worsL poLenLIuI buL u IuIIure oI InLegrILy oI beIIeI und conducL In LIese
moruI Lerms. TIese beIIeIs ure cenLruI In sIckness or In IeuILI, und In
IIvIng und dyIng. TIe crILIcuI dIIIerence Lo muLerIuIIsm Is LypIcuIIy LIe
beIIeI LIuL pIysIcuI deuLI does noL IndIcuLe LIe cessuLIon oI uII sense oI
exIsLence: u core uspecL oI LIe IndIvIduuI survIves. n muny reIIgIous
Irumeworks LIIs Is reIerred Lo us LIe soul. TIe nuLure oI LIe posL-morLuIILy
experIence Is enLIreIy dependenL on LIe IeveI oI musLery oI moruI
reusonIng durIng LIIs IIIeLIme. MuLerIuIIsm Ius dIIIIcuILy wILI IsoIuLed
uILruIsLIc ucLs (e.g., wIere u person jeopurdIzes LIeIr own weIIure In
ussIsLIng oLIers) IeL uIone u IIIesLyIe oI LrunscendenL IuILI LIuL does noL
wuIver In LIe Iuce oI udversILy or even LIe LIreuL oI persecuLIon or deuLI.
A CIrIsLIun, Ior exumpIe, works Irom LIe crILIcuI premIse:
TIen Jesus suId Lo HIs dIscIpIes, I unyone desIres Lo be
my dIscIpIe, IeL IIm deny IImseII - LIuL Is, dIsregurd,
Iose sIgIL oI und IorgeL IImseII und IIs own InLeresLs -
und Luke up IIs cross und IoIIow Me |cIeuve sLeudIIy Lo
Lifestyle Epidemiology
Me, conIorm wIoIIy Lo my exumpIe In IIvIng und II need
be In dyIng, uIso|.
or wIoever Is benL on suvIng IIs |LemporuI| IIIe |IIs
comIorL und securILy Iere|, sIuII Iose |eLernuI IIIe|; und
wIoever Ioses IIs IIIe |IIs comIorL und securILy Iere| Ior
My suke, sIuII IInd |IIIe everIusLIng|.
or wIuL wIII IL proIIL u mun II Ie guIns LIe wIoIe worId
und IorIeILs IIs IIIe - IIs |bIessed| IIIe In LIe kIngdom oI
God? Or wIuL wouId u mun gIve us un excIunge Ior IIs
|bIessed| IIIe - In LIe kIngdom oI God? (MuLLIew 16:
zq-z6, AmpIIIIed BIbIe)
L Is ImmedIuLeIy obvIous LIuL LIere ure IundumenLuI cIusIes
beLween LIese Lwo perspecLIves, I.e., u meLupIysIcuI crIsIs. Even II one
does noL subscrIbe Lo sLrong reIIgIous beIIeI, LIere cun sLIII be consIderubIe
suspIcIon regurdIng un ends jusLIIIes LIe meuns (moruI reIuLIvIsm)
upproucI Lo uII uspecLs oI IIvIng. n LIe mosL recenL pusL ImmoruIILy Ius
unIorLunuLeIy been uImosL enLIreIy ussocIuLed wILI promIscuILyJ
permIssIveness und IedonIsm. TIe Ideu oI seIIIng one`s souI Ior un exLru
mInuLe, or monLI, or yeur(s) oI IIIe Ius been IosL under u muLerIuIIsL
ussuuIL. TIe quesL Ior IongevILy, In LIIs sense, cun IndIcuLe u cowurdIy,
rIsk-uverse, survIvuIIsL IIIe, even wIen IL uppeurs usceLIc In dIsposILIon;
LIe survIvuIIsL menLuIILy Is egocenLrIc, seII-ubsorbed, seII-servIng,
nurcIssIsLIc, eLc.. TIe IrruLIonuIIy IeurIuI, LIe emoLIonuIIy und reIuLIonuIIy
crIppIed, LIe meLupIysIcuIIy bIInd cun IInd un eusy pursuIL In sLuLIsLIcuI
buses Lo Ionger IIIe LIuL requIre no InLernuI (LIougILJmoruI) deveIopmenL.
ongevILy provIdes no IndIcuLIon oI LIe depLI, purLIcuIurIy moruI, oI u
person`s IIIe.
TIe duysJyeurs LIuL mIgIL be udded Lo u smuII group oI persons`
IIves II LIey devouLIy IoIIow LIe IeuILIIsL sLuLIsLIcuI (gumbIIng)
prescrIpLIons uppeurs very smuII Indeed (e.g., TuyIor eL uI., 1q8;).
However, In LIe mIdsL oI LIIs muLerIuIIsL survIvuIIsm, Becker (1qq)
properIy noLes LIuL Ieur LIuL us prucLIced currenLIy, IeuILI promoLIon
IosLers u de-IumunIzIng seII-concern LIuL subsLILuLes personuI IeuILI
gouIs Ior more ImporLunL, Iumune, socIeLuI gouIs..I, Indeed, uvoIdIng
some IeuILI rIsks buys some oI us u Iew more yeurs oI IIIe, we sIouId be
worryIng ubouL LIe quuIILy oI LIe socIeLy und envIronmenL In wIIcI LIose
yeurs wIII be spenL. (p.) Becker specIIIcuIIy reIers Lo LIe SocruLIc Ideu
LIuL LIe unexumIned IIIe Is noL worLI IIvIng. HIs poInL Is uIso Luken LIuL
LIe Ideu does noL reIer Lo LIe mediccll unexumIned IIIe. TIere Is more
Lo Iumun IIIe LIun unbrIdIed survIvuIIsm bused on u perverse
superIIcIuIILy und LIe IIImsIesL oI sLuLIsLIcuI InIormuLIon. MuLerIuIIsm Is u
114
114
Rampant Antismoking Signifies Grave Danger
severeIy unbuIunced und dungerous worIdvIew; IL Iucks LIe crILIcuI
dImensIons LIuL LypIcuIIy dIsLInguIsI Iumun IIIe us Iumun.
Even In consIderIng specIIIc dIseuse, muLerIuIIsm prescrIbes LIuL
one sIouId sLrIve Ior purLIcuIur dIseuses reIuLIve Lo oLIers LIrougI rIsk
reducLIonJuversIon. ndeed, some dIseuses cun be very uggressIve und
udvunce very quIckIy LIrougI Lo morLuIILy. However, LIe sLuLIsLIcs used do
noL ImpIy muLerIuIIsL concIusIons. n enLIreIy sLuLIsLIcuI, popuIuLIon-bused
Lerms, us rIsk Is reduced Ior one dIseuse, u person Is uuLomuLIcuIIy uL
IIgIer rIsk oI unoLIer dIseuse, I.e., re-urrungemenL oI LIe deck-cIuIrs on
LIe TILunIc scenurIo.
Skrubunek & McCormIck (1qqo) noLe: TIe Iunguuge oI
enLIusIusLs Ior prevenLIon Is oILen InLemperuLe. WIIIIums speuks oI
'unreuIIsLIc expecLuLIons LIuL despILe noL compIyIng wILI LIeIr pIysIcIun`s
udvIce concernIng rIsk IucLors, obesILy, smokIng, uIcoIoI, LIey wIII
someIow escupe LIe penuILIes oI LIeIr seII-InduIgence`. ur Irom beIng
unreuIIsLIc, mosL do escupe LIe 'penuILIes`, LIougI none escupes deuLI.
ILzgeruId`s (1qq6) observuLIons cun weII be udded:
n LIe UnILed SLuLes we Iuve come Lo LIe poInL wIere
dyIng und deuLI ure, In u sense, unnuLuruI ucLs. We ucL
us II we beIIeve LIuL deuLI Is uvoIdubIe II onIy we know
enougI und beIuve weII us regurds dIeL, exercIse,
personuI pIIIosopIy, prevenLIve medIcIne und LIe
uLIIIzuLIon oI LIe recenL Lremendous udvunces In
medIcuI scIence. WILness In evIdence oI LIIs Is LIe IucL
LIuL AmerIcuns ure upseL wIen LIe percenLuge oI peopIe
dyIng oI curdIovuscuIur dIseuse goes down onIy Lo Iuve
LIe percenLuge oI peopIe dyIng oI cuncer go up.
OI course, 1oo% oI deud peopIe dIed oI someLIIng, so II
one goes down unoLIer musL go up. BuL we Iook uL LIese
duLu In Iorror und IIIng ourseIves InLo LIe buLLIe uguInsL
cuncer, Ior exumpIe. I we wIn, Iowever, IL wIII Iuppen
LIuL us deuLIs Irom cuncer go down, deuLIs Irom
unoLIer cuuse wIII rIse, und we wIII Iuve Lo enguge In
yeL unoLIer buLLIe. Everyone dIes. usL yeur, LIe uuLIors
oI un urLIcIe In un AmerIcun medIcuI journuI procIuImed
LIuL vegeLurIuns Iud Iower morLuIILy LIun omnIvores.
TIe edILors dId noL noLIce or commenL upon LIIs
remurkubIe sLuLemenL.
RecenLIy, uL u nuLIonuI medIcuI meeLIng, u puneI on
gerIuLrIcs noLed LIuL LIe mujor cuuses oI deuLI In oId,
oId uge - over 8o yeurs - were curdIovuscuIur, cuncer
und Lruumu. TIey LIen wenL on Lo dIscuss Iow Lo
Lifestyle Epidemiology
prevenL uII LIree. , In LIe uudIence, begun Lo wonder: II
peopIe In LIeIr 8os und qos ure noL uIIowed Lo dIe oI
curdIovuscuIur dIseuse, Lruumu or cuncer, wIuL cun LIey
dIe oI? DIssoIuLIon? (p.18q)
AL IeusL u Sundc Times correspondenL couId see LIrougI LIe
medIco-muLerIuIIsL subLerIuge: WIuL geLs my gouL Is noL so mucI LIe
rugIng InLoIerunce oI LIe unLI-smokIng buIIs, Iurd Lo Luke LIougI IL Is In
IIgIL oI some oI LIeIr personuI IubILs, buL LIe ouLrugeous und urrogunL
InLeIIecLuuI dIsIonesLy oI LIeIr medIcuI subsecLIon.. 'GIve up smokIng
und IIve`..none oI LIeIr medIcuI pundILs ever boLIers Lo speII ouL LIe
opLIons. WIuL uILernuLIves cun expecL? suspecL LIuL LIe uILernuLIves ure
neILIer murkedIy more pIeusunL nor overIy Iong deIuyed..WIuL cunnoL
sLund Is LIe bIund ussumpLIon Irom LIe medIcos LIuL um sLupId enougI
Lo swuIIow unquesLIonIngIy LIeIr IuII-buked urgumenLs. (quoLed In
Skrubunek & McCormIck, 1qqo, p.qo)
RegurdIng dIseuse preIerence, even II IL wus possIbIe Lo uILer
evenLuuI specIIIc-cuuse morLuIILy, LIere ure u number oI poInLs LIuL ure
IIgIIy perLInenL. IrsLIy, In uddILIon Lo LIe numerous InIerenLIuI errors
LIus Iur consIdered, muLerIuIIsm uIso does noL uccounL Ior LIe subjecLIve
experIence oI puIn or suIIerIng. Some muy suIIer Irom dIseuses oI u more
mIId Iorm und yeL experIence InLoIerubIe puIn. OLIers experIencIng
uggressIve und IuLuI dIseuses, und obvIousIy experIencIng puIn, ure ubIe Lo
pIuce LIe experIence In greuLer meLupIysIcuI conLexL; LIey cun muInLuIn u
sLubIe und even InspIrIng ouLIook LIrougIouL. OLIers, sLIII, suIIer more
Irom LIe emoLIonuI puIn oI exIsLenLIuI crIses LIun LIe dIseuse ILseII - LIe
sense oI conIusIon und beIng unprepured Ior deuLI.
DIIIerenL persons Iuve dIIIerIng puIn LIresIoIds, wILI vuryIng
sources oI poLenLIuI suIIerIng und soIuce LIuL reIIecL LIe InLrIcucIes oI
beIIeI sysLems. AguIn, LIe sImpIe-mInded muLerIuIIsL prescrIpLIon oI
uLLempLIng Lo uvoId cerLuIn dIseuses on LIe busIs oI u Iong-odds IoLLery
upproucI does noL begIn Lo do jusLIce Lo LIe poLenLIuI muILI-dImensIonuI
dynumIcs InvoIved. ung cuncer, Ior exumpIe, Is cerLuInIy u crueI dIseuse
wILI IuIrIy rupId morLuIILy. However, LIe ussumpLIon LIuL LIIs dIseuse
uIone Is worse LIun uny oLIer, or LIuL uny oLIer dIseuse Is uIwuys beLLer,
Is compIeLeIy urguubIe - LIere ure sImpIy Loo muny oLIer IucLors InvoIved,
mosL oI LIem meLupIysIcuI und psycIoIogIcuI. How, or even wIy, wouId
one compure LIe speed oI Iung cuncer morLuIILy, wIIcI In some wuys
mIgIL even be mercIIuI, wILI cIronIc (proLrucLed) dIseuses LIuL Ior some
wIII seem IIke u progressIve und IengLIy IeII? TIIs enLIre IIne oI reusonIng
Is mIsguIded und promoLes un unIeuILIy, muLerIuIIsL IIxuLIon on
morbIdILy und morLuIILy. One oI numerous unLIsmokIng myLIs uppeurIng
115
115
Rampant Antismoking Signifies Grave Danger
severeIy unbuIunced und dungerous worIdvIew; IL Iucks LIe crILIcuI
dImensIons LIuL LypIcuIIy dIsLInguIsI Iumun IIIe us Iumun.
Even In consIderIng specIIIc dIseuse, muLerIuIIsm prescrIbes LIuL
one sIouId sLrIve Ior purLIcuIur dIseuses reIuLIve Lo oLIers LIrougI rIsk
reducLIonJuversIon. ndeed, some dIseuses cun be very uggressIve und
udvunce very quIckIy LIrougI Lo morLuIILy. However, LIe sLuLIsLIcs used do
noL ImpIy muLerIuIIsL concIusIons. n enLIreIy sLuLIsLIcuI, popuIuLIon-bused
Lerms, us rIsk Is reduced Ior one dIseuse, u person Is uuLomuLIcuIIy uL
IIgIer rIsk oI unoLIer dIseuse, I.e., re-urrungemenL oI LIe deck-cIuIrs on
LIe TILunIc scenurIo.
Skrubunek & McCormIck (1qqo) noLe: TIe Iunguuge oI
enLIusIusLs Ior prevenLIon Is oILen InLemperuLe. WIIIIums speuks oI
'unreuIIsLIc expecLuLIons LIuL despILe noL compIyIng wILI LIeIr pIysIcIun`s
udvIce concernIng rIsk IucLors, obesILy, smokIng, uIcoIoI, LIey wIII
someIow escupe LIe penuILIes oI LIeIr seII-InduIgence`. ur Irom beIng
unreuIIsLIc, mosL do escupe LIe 'penuILIes`, LIougI none escupes deuLI.
ILzgeruId`s (1qq6) observuLIons cun weII be udded:
n LIe UnILed SLuLes we Iuve come Lo LIe poInL wIere
dyIng und deuLI ure, In u sense, unnuLuruI ucLs. We ucL
us II we beIIeve LIuL deuLI Is uvoIdubIe II onIy we know
enougI und beIuve weII us regurds dIeL, exercIse,
personuI pIIIosopIy, prevenLIve medIcIne und LIe
uLIIIzuLIon oI LIe recenL Lremendous udvunces In
medIcuI scIence. WILness In evIdence oI LIIs Is LIe IucL
LIuL AmerIcuns ure upseL wIen LIe percenLuge oI peopIe
dyIng oI curdIovuscuIur dIseuse goes down onIy Lo Iuve
LIe percenLuge oI peopIe dyIng oI cuncer go up.
OI course, 1oo% oI deud peopIe dIed oI someLIIng, so II
one goes down unoLIer musL go up. BuL we Iook uL LIese
duLu In Iorror und IIIng ourseIves InLo LIe buLLIe uguInsL
cuncer, Ior exumpIe. I we wIn, Iowever, IL wIII Iuppen
LIuL us deuLIs Irom cuncer go down, deuLIs Irom
unoLIer cuuse wIII rIse, und we wIII Iuve Lo enguge In
yeL unoLIer buLLIe. Everyone dIes. usL yeur, LIe uuLIors
oI un urLIcIe In un AmerIcun medIcuI journuI procIuImed
LIuL vegeLurIuns Iud Iower morLuIILy LIun omnIvores.
TIe edILors dId noL noLIce or commenL upon LIIs
remurkubIe sLuLemenL.
RecenLIy, uL u nuLIonuI medIcuI meeLIng, u puneI on
gerIuLrIcs noLed LIuL LIe mujor cuuses oI deuLI In oId,
oId uge - over 8o yeurs - were curdIovuscuIur, cuncer
und Lruumu. TIey LIen wenL on Lo dIscuss Iow Lo
Lifestyle Epidemiology
prevenL uII LIree. , In LIe uudIence, begun Lo wonder: II
peopIe In LIeIr 8os und qos ure noL uIIowed Lo dIe oI
curdIovuscuIur dIseuse, Lruumu or cuncer, wIuL cun LIey
dIe oI? DIssoIuLIon? (p.18q)
AL IeusL u Sundc Times correspondenL couId see LIrougI LIe
medIco-muLerIuIIsL subLerIuge: WIuL geLs my gouL Is noL so mucI LIe
rugIng InLoIerunce oI LIe unLI-smokIng buIIs, Iurd Lo Luke LIougI IL Is In
IIgIL oI some oI LIeIr personuI IubILs, buL LIe ouLrugeous und urrogunL
InLeIIecLuuI dIsIonesLy oI LIeIr medIcuI subsecLIon.. 'GIve up smokIng
und IIve`..none oI LIeIr medIcuI pundILs ever boLIers Lo speII ouL LIe
opLIons. WIuL uILernuLIves cun expecL? suspecL LIuL LIe uILernuLIves ure
neILIer murkedIy more pIeusunL nor overIy Iong deIuyed..WIuL cunnoL
sLund Is LIe bIund ussumpLIon Irom LIe medIcos LIuL um sLupId enougI
Lo swuIIow unquesLIonIngIy LIeIr IuII-buked urgumenLs. (quoLed In
Skrubunek & McCormIck, 1qqo, p.qo)
RegurdIng dIseuse preIerence, even II IL wus possIbIe Lo uILer
evenLuuI specIIIc-cuuse morLuIILy, LIere ure u number oI poInLs LIuL ure
IIgIIy perLInenL. IrsLIy, In uddILIon Lo LIe numerous InIerenLIuI errors
LIus Iur consIdered, muLerIuIIsm uIso does noL uccounL Ior LIe subjecLIve
experIence oI puIn or suIIerIng. Some muy suIIer Irom dIseuses oI u more
mIId Iorm und yeL experIence InLoIerubIe puIn. OLIers experIencIng
uggressIve und IuLuI dIseuses, und obvIousIy experIencIng puIn, ure ubIe Lo
pIuce LIe experIence In greuLer meLupIysIcuI conLexL; LIey cun muInLuIn u
sLubIe und even InspIrIng ouLIook LIrougIouL. OLIers, sLIII, suIIer more
Irom LIe emoLIonuI puIn oI exIsLenLIuI crIses LIun LIe dIseuse ILseII - LIe
sense oI conIusIon und beIng unprepured Ior deuLI.
DIIIerenL persons Iuve dIIIerIng puIn LIresIoIds, wILI vuryIng
sources oI poLenLIuI suIIerIng und soIuce LIuL reIIecL LIe InLrIcucIes oI
beIIeI sysLems. AguIn, LIe sImpIe-mInded muLerIuIIsL prescrIpLIon oI
uLLempLIng Lo uvoId cerLuIn dIseuses on LIe busIs oI u Iong-odds IoLLery
upproucI does noL begIn Lo do jusLIce Lo LIe poLenLIuI muILI-dImensIonuI
dynumIcs InvoIved. ung cuncer, Ior exumpIe, Is cerLuInIy u crueI dIseuse
wILI IuIrIy rupId morLuIILy. However, LIe ussumpLIon LIuL LIIs dIseuse
uIone Is worse LIun uny oLIer, or LIuL uny oLIer dIseuse Is uIwuys beLLer,
Is compIeLeIy urguubIe - LIere ure sImpIy Loo muny oLIer IucLors InvoIved,
mosL oI LIem meLupIysIcuI und psycIoIogIcuI. How, or even wIy, wouId
one compure LIe speed oI Iung cuncer morLuIILy, wIIcI In some wuys
mIgIL even be mercIIuI, wILI cIronIc (proLrucLed) dIseuses LIuL Ior some
wIII seem IIke u progressIve und IengLIy IeII? TIIs enLIre IIne oI reusonIng
Is mIsguIded und promoLes un unIeuILIy, muLerIuIIsL IIxuLIon on
morbIdILy und morLuIILy. One oI numerous unLIsmokIng myLIs uppeurIng
116
116
Rampant Antismoking Signifies Grave Danger
on LIe InLerneL Is LIuL uII smokers suIIer ugonIzIng deuLI.or exumpIe, u
commenL on one InLerneL sILe (www.duLuopLIons.comJsmokers) suggesLs:
Breuk LIe IubIL! Enjoy u beLLer IIIe! Suve yourseII Irom un ugonIzIng
deuLI. TIe proposILIon ImpIIes LIuL nonsmokers do noL suIIer ugonIzIng
deuLI, und u smoker cun spure LIemseIves sucI u IuLe by becomIng u
nonsmoker. SucI beIIeIs ure deIusIonuI. Smokers und nonsmokers uIIke
wIII Iuce cerLuIn morLuIILy. TIe nuLure oI LIeIr experIence wIII depend on
numerous IucLors Iur beyond LIe soIILury muLLer oI smokIng. L wouId be
Ioped LIuL persons dIscern u Iur more proIound meunIng Lo IIIe (spIrILuuI)
LIuL ubsorbs LIeIr IIvIng energIes. WIen dyIng und deuLI come, In
wIuLever Iorm, LIey wIII be Luken In LIIs sLrIde.
SecondIy, Iess uggressIve Iorms oI cuncer or even Lemporury
remIssIons LIrougI LreuLmenL do noL necessurIIy represenL un
udvunLugeous posILIon. TIe LreuLmenL ILseII cun be more IorrIIIc LIun LIe
experIence oI LIe dIseuse und LIe cuncer cun reoccur uL uny LIme. TIe
medIcuIIy-IosLered beIIeI LIuL persons IuvIng undergone severe medIcuI
LreuLmenL sImpIy curry on wILI LIeIr Iormer IIves Is uIso unLrue. DIseuse
und LreuLmenL cun produce exIsLenLIuI crIses Ior LIe puLIenL LIuL ure
dIIIerenL Irom, und poLenLIuIIy Iur deeper LIun, depressIon. TIe
cIrcumsLunce cun uIso LesL IumIIIuI reIuLIonsIIps. urLIermore, u person
becomes sIuckIed Lo LIe medIcuI producLIon-IIne oI consLunL LesLIngs Ior
dIseuse recurrence, uII LIe wIIIe bomburded by u de-IumunIzed und de-
IumunIzIng muLerIuIIsL worIdvIew. UnIorLunuLeIy, LIose LIuL Iuve been
suved by LIe medIco-muLerIuIIsL producLIon-IIne Lend Lo become
dIscIpIes oI LIe medIcuI rIeLorIc concernIng prescrIpLIve IIIesLyIe Ior LIe
weII popuIuLIon. And, unIorLunuLeIy, LIe suIvuLIon Is onIy Lemporury,
I.e., u Lemporury deIuy oI morLuIILy. TIere ure even sLuLIsLIcuI gumes LIuL
cun be pIuyed wIere IL Is conLended LIuL IIvIng LIe IeuILIIsL IIIesLyIe mIgIL
udd sIx monLIs or u yeur Lo IIIe - on uveruge. I LIIs wus possIbIe, und IL
probubIy Is noL so Ior mosL, wIuL does IL meun In ucLuuI Iumun Lerms. or
exumpIe, wIuL does IL meun Lo udd un exLru yeur uL LIe end oI IIIe beIore u
person becomes demenLed und cun bureIy remember LIeIr nume, IeL uIone
LIe exLru yeur?
RegurdIng LIIs preoccupuLIon wILI exLru LIme, DuvIes (1qq6)
properIy noLes LIuL |m|odern secuIur IeuILI scures..muy mereIy snuLcI
IndIvIduuIs Irom cusLomury convIvIuIILy und Lurn LIem InLo unxIous
cuIcuIuLors, worrIed ubouL Iow muny monLIs oI IoneIy senIIILy LIey muy
be IosIng uL LIe end oI LIeIr IIves LIrougI compunIonubIe InduIgence In
cIeerIng producLs |e.g., uIcoIoI, Lobucco, Leu, coIIee| Loduy. (p.zq1)
TIere ure uIso oLIer sIgnIIIcunL Issues LIuL ure enLIreIy skIpped
over by LIe muLerIuIIsL menLuIILy. or exumpIe, sIorLuges In nursIng-Iome
beds cun onIy muke oIder uge und IongevILy more dIIIIcuIL. TIIs
Lifestyle Epidemiology
sILuuLIon Is expecLed Lo worsen gIven LIuL buby-boomers ure jusL now
enLerIng reLIremenL uge. TIere Iuve uIso been reporLs concernIng |L|Ie
mIsuse oI medIcuLIon Lo resLruIn LIe eIderIy In nursIng Iomes. (Hercld,
Sun, December z6, zoo1) n zooz, unoLIer Iorror sLory concernIng LIe
uged emerged: red und vy boLI need nursIng Iome cure, buL LIere Is
noLIIng uvuIIubIe Ior LIe Lwo oI LIem LogeLIer. So uILer ;o yeurs oI
murrIuge und u IIIeLIme oI IuppIness und mucI IeurLucIe..LIe coupIe ure
seL Lo spend LIeIr IInuI duys upurL..||nsLeud oI beIng In uwe oI LIIs
coupIe, InsLeud oI recognIzIng wIuL un umuzIng ucIIevemenL ;o yeurs oI
murrIuge Is, our InudequuLe uged-cure sysLem Ius IeL LIem down wIen
LIey need IL mosL. (Hercld,Sun, AprII 11, zooz, p.zz)
TIe Hercld,Sun (June zq, zooz, p.1) reporLs LIuL |m|ore LIun
IuII LIe VIcLorIun nursIng Iomes InspecLed by uuLIorILIes LIIs yeur IuIIed
Lo meeL ederuI GovernmenL sLundurds..nspecLors Iound muny |eIderIy|
were IeIL uIone uII duy wILIouL proper Iood or medIcIne. Some soIIed LIeIr
cIoLIes or beds becuuse sLuII Ignored pIeus Lo IeIp LIem Lo LIe LoIIeL.
AnoLIer newspuper urLIcIe presenLs LIe Issue LIus: You ure ;.
You breuk u IIp In u IuII und need surgery. WIIIe In IospILuI, you pIck up u
posL-operuLIve wound InIecLIon und deveIop pneumonIu. Your
IorgeLIuIness InLensIIIes InLo more serIous demenLIu sympLoms us you
sLruggIe Lo cope wILI LIe LwIn ussuuILs oI IIIness und u sLrunge
envIronmenL. You ure now IruII und wIII need weeks or monLIs oI cure und
reIubIIILuLIon; perIups you wIII never go Iome uguIn. TIe IospILuI Is noL
seL up Ior convuIescenLs und wunLs your bed Ior more urgenL puLIenLs.
WIo wIII Iook uILer you, und Iow wIII IL be puId Ior? (The Ae, AprII zo,
zooz, nsIgIL )
SucI cIrcumsLunces ure consIdered Lo evenLuuIIy pIuce u greuL
burden on LIe pubIIc IeuILI sysLem Ior un ugIng popuIuLIon.
UnIorLunuLeIy LIere Is uIso evIdence LIuL LIe eIderIy ure vIewed poorIy by
LIe proIIL moLIve oI LIe prIvuLe IeuILI cure sysLem: SIck eIderIy puLIenLs
ure beIng denIed pIuces uL prIvuLe IospILuIs becuuse LIey ure consIdered
unproIILubIe. (Hercld,Sun, JuIy q, zoo1, p.;; OcLober, z1, zoo1, p.1)
TIe InLenL Iere Is noL Lo uLLuck LIe eIderIy or provIde urgumenL
Ior euLIunusIu. RuLIer, uL Issue Is LIuL LIe promoLIon oI LIe Ideu LIuL
IongevILy, oI ILseII, Is uIwuys udvunLugeous (e.g., see TuyIor eL uI., zooz) Is
IruuduIenL und deIInquenL, I.e., Improper ussumpLIon oI IomogeneILy oI
yeurs In IIIe spun und ImproperIy deIIned cuusuI busIs Ior eurIIer
morLuIILy. WIIIe muLerIuIIsm promoLes IongevILy, In LIuL LIIs Is essenLIuIIy
LIe onIy dImensIon LIuL LIe superIIcIuIILy oI LIe perspecLIve cun use, IL
does noL LreuL LIe eIderIy weII. AguIn, IL wouId seem LIuL energIes ure Iur
beLLer spenL In LIe sLundurd oI IIvIng - purLIcuIurIy In meLupIysIcuI Lerms.
TIrougI LIe muLerIuIIsL munIIesLo, LIe crILIcuI spIrILuuI
117
117
Rampant Antismoking Signifies Grave Danger
on LIe InLerneL Is LIuL uII smokers suIIer ugonIzIng deuLI.or exumpIe, u
commenL on one InLerneL sILe (www.duLuopLIons.comJsmokers) suggesLs:
Breuk LIe IubIL! Enjoy u beLLer IIIe! Suve yourseII Irom un ugonIzIng
deuLI. TIe proposILIon ImpIIes LIuL nonsmokers do noL suIIer ugonIzIng
deuLI, und u smoker cun spure LIemseIves sucI u IuLe by becomIng u
nonsmoker. SucI beIIeIs ure deIusIonuI. Smokers und nonsmokers uIIke
wIII Iuce cerLuIn morLuIILy. TIe nuLure oI LIeIr experIence wIII depend on
numerous IucLors Iur beyond LIe soIILury muLLer oI smokIng. L wouId be
Ioped LIuL persons dIscern u Iur more proIound meunIng Lo IIIe (spIrILuuI)
LIuL ubsorbs LIeIr IIvIng energIes. WIen dyIng und deuLI come, In
wIuLever Iorm, LIey wIII be Luken In LIIs sLrIde.
SecondIy, Iess uggressIve Iorms oI cuncer or even Lemporury
remIssIons LIrougI LreuLmenL do noL necessurIIy represenL un
udvunLugeous posILIon. TIe LreuLmenL ILseII cun be more IorrIIIc LIun LIe
experIence oI LIe dIseuse und LIe cuncer cun reoccur uL uny LIme. TIe
medIcuIIy-IosLered beIIeI LIuL persons IuvIng undergone severe medIcuI
LreuLmenL sImpIy curry on wILI LIeIr Iormer IIves Is uIso unLrue. DIseuse
und LreuLmenL cun produce exIsLenLIuI crIses Ior LIe puLIenL LIuL ure
dIIIerenL Irom, und poLenLIuIIy Iur deeper LIun, depressIon. TIe
cIrcumsLunce cun uIso LesL IumIIIuI reIuLIonsIIps. urLIermore, u person
becomes sIuckIed Lo LIe medIcuI producLIon-IIne oI consLunL LesLIngs Ior
dIseuse recurrence, uII LIe wIIIe bomburded by u de-IumunIzed und de-
IumunIzIng muLerIuIIsL worIdvIew. UnIorLunuLeIy, LIose LIuL Iuve been
suved by LIe medIco-muLerIuIIsL producLIon-IIne Lend Lo become
dIscIpIes oI LIe medIcuI rIeLorIc concernIng prescrIpLIve IIIesLyIe Ior LIe
weII popuIuLIon. And, unIorLunuLeIy, LIe suIvuLIon Is onIy Lemporury,
I.e., u Lemporury deIuy oI morLuIILy. TIere ure even sLuLIsLIcuI gumes LIuL
cun be pIuyed wIere IL Is conLended LIuL IIvIng LIe IeuILIIsL IIIesLyIe mIgIL
udd sIx monLIs or u yeur Lo IIIe - on uveruge. I LIIs wus possIbIe, und IL
probubIy Is noL so Ior mosL, wIuL does IL meun In ucLuuI Iumun Lerms. or
exumpIe, wIuL does IL meun Lo udd un exLru yeur uL LIe end oI IIIe beIore u
person becomes demenLed und cun bureIy remember LIeIr nume, IeL uIone
LIe exLru yeur?
RegurdIng LIIs preoccupuLIon wILI exLru LIme, DuvIes (1qq6)
properIy noLes LIuL |m|odern secuIur IeuILI scures..muy mereIy snuLcI
IndIvIduuIs Irom cusLomury convIvIuIILy und Lurn LIem InLo unxIous
cuIcuIuLors, worrIed ubouL Iow muny monLIs oI IoneIy senIIILy LIey muy
be IosIng uL LIe end oI LIeIr IIves LIrougI compunIonubIe InduIgence In
cIeerIng producLs |e.g., uIcoIoI, Lobucco, Leu, coIIee| Loduy. (p.zq1)
TIere ure uIso oLIer sIgnIIIcunL Issues LIuL ure enLIreIy skIpped
over by LIe muLerIuIIsL menLuIILy. or exumpIe, sIorLuges In nursIng-Iome
beds cun onIy muke oIder uge und IongevILy more dIIIIcuIL. TIIs
Lifestyle Epidemiology
sILuuLIon Is expecLed Lo worsen gIven LIuL buby-boomers ure jusL now
enLerIng reLIremenL uge. TIere Iuve uIso been reporLs concernIng |L|Ie
mIsuse oI medIcuLIon Lo resLruIn LIe eIderIy In nursIng Iomes. (Hercld,
Sun, December z6, zoo1) n zooz, unoLIer Iorror sLory concernIng LIe
uged emerged: red und vy boLI need nursIng Iome cure, buL LIere Is
noLIIng uvuIIubIe Ior LIe Lwo oI LIem LogeLIer. So uILer ;o yeurs oI
murrIuge und u IIIeLIme oI IuppIness und mucI IeurLucIe..LIe coupIe ure
seL Lo spend LIeIr IInuI duys upurL..||nsLeud oI beIng In uwe oI LIIs
coupIe, InsLeud oI recognIzIng wIuL un umuzIng ucIIevemenL ;o yeurs oI
murrIuge Is, our InudequuLe uged-cure sysLem Ius IeL LIem down wIen
LIey need IL mosL. (Hercld,Sun, AprII 11, zooz, p.zz)
TIe Hercld,Sun (June zq, zooz, p.1) reporLs LIuL |m|ore LIun
IuII LIe VIcLorIun nursIng Iomes InspecLed by uuLIorILIes LIIs yeur IuIIed
Lo meeL ederuI GovernmenL sLundurds..nspecLors Iound muny |eIderIy|
were IeIL uIone uII duy wILIouL proper Iood or medIcIne. Some soIIed LIeIr
cIoLIes or beds becuuse sLuII Ignored pIeus Lo IeIp LIem Lo LIe LoIIeL.
AnoLIer newspuper urLIcIe presenLs LIe Issue LIus: You ure ;.
You breuk u IIp In u IuII und need surgery. WIIIe In IospILuI, you pIck up u
posL-operuLIve wound InIecLIon und deveIop pneumonIu. Your
IorgeLIuIness InLensIIIes InLo more serIous demenLIu sympLoms us you
sLruggIe Lo cope wILI LIe LwIn ussuuILs oI IIIness und u sLrunge
envIronmenL. You ure now IruII und wIII need weeks or monLIs oI cure und
reIubIIILuLIon; perIups you wIII never go Iome uguIn. TIe IospILuI Is noL
seL up Ior convuIescenLs und wunLs your bed Ior more urgenL puLIenLs.
WIo wIII Iook uILer you, und Iow wIII IL be puId Ior? (The Ae, AprII zo,
zooz, nsIgIL )
SucI cIrcumsLunces ure consIdered Lo evenLuuIIy pIuce u greuL
burden on LIe pubIIc IeuILI sysLem Ior un ugIng popuIuLIon.
UnIorLunuLeIy LIere Is uIso evIdence LIuL LIe eIderIy ure vIewed poorIy by
LIe proIIL moLIve oI LIe prIvuLe IeuILI cure sysLem: SIck eIderIy puLIenLs
ure beIng denIed pIuces uL prIvuLe IospILuIs becuuse LIey ure consIdered
unproIILubIe. (Hercld,Sun, JuIy q, zoo1, p.;; OcLober, z1, zoo1, p.1)
TIe InLenL Iere Is noL Lo uLLuck LIe eIderIy or provIde urgumenL
Ior euLIunusIu. RuLIer, uL Issue Is LIuL LIe promoLIon oI LIe Ideu LIuL
IongevILy, oI ILseII, Is uIwuys udvunLugeous (e.g., see TuyIor eL uI., zooz) Is
IruuduIenL und deIInquenL, I.e., Improper ussumpLIon oI IomogeneILy oI
yeurs In IIIe spun und ImproperIy deIIned cuusuI busIs Ior eurIIer
morLuIILy. WIIIe muLerIuIIsm promoLes IongevILy, In LIuL LIIs Is essenLIuIIy
LIe onIy dImensIon LIuL LIe superIIcIuIILy oI LIe perspecLIve cun use, IL
does noL LreuL LIe eIderIy weII. AguIn, IL wouId seem LIuL energIes ure Iur
beLLer spenL In LIe sLundurd oI IIvIng - purLIcuIurIy In meLupIysIcuI Lerms.
TIrougI LIe muLerIuIIsL munIIesLo, LIe crILIcuI spIrILuuI
118
118
Rampant Antismoking Signifies Grave Danger
dImensIon Ius been sLrIpped Irom consIderuLIon In greuLer meLupIysIcuI
und socIuI conLexL. Some oI LIe more crILIcuI rumIIIcuLIons oI LIIs IoIIy ure
seen In medIcIne und vIews oI IeuILI und deuLI. TIere Is now LIe
InIrequenL journuI urLIcIe uLLempLIng Lo re-sensILIze LIe medIcuI
prucLILIoner Lo u spIrILuuI dImensIon und sucI beIIeIs In uL IeusL some
puLIenLs (e.g., CuIIIIord, zooz; DuuIemun eL uI., zoo1; Purkes, 1qq8;
Penson eL uI., zoo1). TIIs IuIIure oI spIrILuuI InsIgIL Ius produced u Lerror
oI deuLI und dyIng on LIe purL oI boLI muny docLors und puLIenLs uIIke.
Some docLors Lend Lo IInd beIInd LIe subLerIuge oI sLuLIsLIcuI und
LecInIcuI bubbIe. OLIers wIII enguge In quesLIonubIe medIcuI ucLIvILy
LryIng Lo sLuve-oII deuLI, vIewIng IIIe und LIe puLIenL us no more LIun un
engIneerIng pIenomenon Lo be mecIunIsLIcuIIy worked. Purkes
(zooz) provIdes very vuIuubIe InsIgILs Ior medIcuI prucLILIoners In curIng
Ior LIe dyIng uduIL. A reusonubIe quesLIon concerns Iow LIe sILuuLIon Ius
deLerIoruLed InLo sucI u muLerIuIIsL mIre LIuL LIese Iew, mucI needed,
pupers Iuve even become necessury. TIe unswer LIuL conLInuuIIy emerges
Is LIe muLerIuIIsL munIIesLo LIuL Ius dIrecLed muny InLo superIIcIuIILy.
And, unIorLunuLeIy, IL Is medIco-muLerIuIIsm LIuL Ius IIgured IIgIIy In LIe
muLerIuIIsL ussuuIL.
TIe greuLer purL oI LIIs dIscussIon Is Lo IIgIIIgIL LIuL IIIesLyIe
epIdemIoIogy und prevenLIve medIcIne ure u Iong-odds, mIndIess
gumbIIng gume und noL scIence or IeuILI promoLIon. However, In u
democruLIc socIeLy, persons ure quILe Iree Lo IoIIow LIIs gumbIIng
meLupIor Ior IIvIng, or Ieud LIe unexumIned IIIe II LIey so cIoose. TIe
crILIcuI probIem oI LIe muLerIuIIsL munIIesLo Is LIuL LIIs sLuLIsLIcuI,
muLerIuIIsL IIIesLyIe (MMES cuIL) Is beIng promoLed us prescrIpLIve - uII
sIouId be IIvIng In LIIs wuy.
CurIyon (1q8q) IndIcuLed LIuL consLunL IIIesLyIe seII-scruLIny In
seurcI oI rIsk IucLors, denIuI oI pIeusure, rejecLIon oI LIe oId evII IIIesLyIe
und embrucIng u new rIgorous one ure IoIIowed by perIodIc uIIIrmuLIons
oI IuILI uL revIvuI meeLIngs oI beIIevers...TIe zeuI wILI wIIcI converLs ure
sougIL by LIe recenLIy suved Is oI uwesome InLensILy...TIe seII-rIgILeous
InLoIerunce oI some weIIness zeuIoLs borders on IeuILI IuscIsm.
HIsLorIcuIIy, Iumuns Iuve been uL greuLesL rIsk wIIIe beIng Improved In
LIe besL Imuge oI LIeIr possIbIIILIes us seen by somebody eIse.
L sIouId IIrsLIy be IIgIIIgILed Irom CurIyon`s depIcLIon LIuL LIe
seII-scruLIny reIerred Lo Is oI LIe sIuIIow, superIIcIuI kInd. TIIs kInd oI
seII-scruLIny Is evIdenL In New Yeur`s resoIuLIons wIere IosIng weIgIL or
quILLIng smokIng ure LIe greuL uspIruLIons oI muLerIuIIsL LIInkIng. L Is
rure Indeed LIuL u person`s resoIuLIon Is Lo become u beLLer Iumun beIng
- more IonesL, more IonorubIe In conducL, more ecIecLIc In reusonIng
und reIuLIonsIIp, eLc.. SecondIy, weIIness zeuIoLs ure unweII; LIe enLIre
Lifestyle Epidemiology
momenLum Is psycIoIogIcuIIy, psycIosocIuIIy und moruIIy unIeuILIy.
TIIrdIy, LIe IuscIsm cIurucLerIzuLIon Is quILe upL In LIuL IL depIcLs LIe
operuLIon oI numerous cIurucLer deIIcIencIes sucI us urrogunce,
IuugILIness, vunILy, obsLInucy, pomposILy, obsessIon wILI conLroI.
However, LIe desIgnuLIon oI IeuILI IuscIsm Is InuccuruLe; LIere Is
noLIIng IeuILIy ubouL LIe cIrcumsLunce. L cun properIy be reIerred Lo us
medIco-muLerIuIIsL IuscIsm (see uIso McCormIck, 1qq6).
TIe Iunguuge oI IeuILIIsL zeuIoLry Is sLundurd Ieur und guIIL-
mongerIng. Becker (1qq) noLes LIuL:
|T|Ie IndIvIduuI-responsIbIIILy upproucI Ius IeIped Lo
esLubIIsI IeuILI us LIe New MoruIILy by wIIcI
cIurucLer und personuI worLI ure judged. BeIng III Is
redeIIned us beIng guIILy. TIe obese ure sLIgmuLIzed us
IeLLIng LIemseIves go. Smokers Iuve no wIIIpower.
NonuerobIcLs ure Iuzy. We oILen empIoy guIIL us u
moLIvuLor, IgnorIng LIe IucL LIuL guIIL ILseII Ius
consIderubIe poLenLIuI Ior creuLIng pIysIcuI und
emoLIonuI IIIness.... um mosL concerned ubouL wIuL
Iuppens Lo us us IndIvIduuIs wIen IeuILI becomes LIe
purumounL vuIue oI our socIeLy. AdvocuLes oI IeuILI
promoLIon und weIIness cIuIm Lo be sLrIvIng Ior seII
ucLuuIIzuLIon und personuI IuIIIIImenL. BuL
LIeoIogIuns und pIIIosopIers Iuve generuIIy ugreed
LIuL Lo uLLuIn sucI IuIIIIImenL one musL muke u
commILmenL Lo someLIIng beyond one`s own seII -
quILe LIe opposILe dIrecLIon Irom un empIusIs on
personuI rIsk IucLors und IIIesLyIe. Ieur LIuL us
prucLIced currenLIy, IeuILI promoLIon IosLers u
deIumunIzIng seII-concern LIuL subsLILuLes personuI
IeuILI gouIs Ior more ImporLunL, Iumune, socIeLuI
gouIs. L Is u new reIIgIon, one In wIIcI we worsIIp
ourseIves, uLLrIbuLe good IeuILI Lo our devouLness, und
vIew IIIness us jusL punIsImenL Ior LIose wIo Iuve noL
yeL seen LIe Wuy - u vIew LIuL evokes SocIuI DurwInIsm
und LIe Me generuLIon. (p.q-)
TIIs sorL oI urgumenLuLIon Ius been ecIoed by oLIers over LIe
decudes. TIe senLImenLs InvoIve some uccuruLe observuLIons und some
severe mIsjudgmenLs LIuL ure worLI dIsLInguIsIIng uL LIIs poInL. IrsLIy,
ubsence oI pIysIcuI dIseuse Is sLIII vIewed us LIe crILIcuI murker oI IeuILI.
I psycIoIogIcuI, psycIosocIuI, und moruI dImensIons ure IncIuded In LIe
consIderuLIon, LIen IIIness or dysIuncLIon cun be munIIesLed In uII oI LIese
119
119
Rampant Antismoking Signifies Grave Danger
dImensIon Ius been sLrIpped Irom consIderuLIon In greuLer meLupIysIcuI
und socIuI conLexL. Some oI LIe more crILIcuI rumIIIcuLIons oI LIIs IoIIy ure
seen In medIcIne und vIews oI IeuILI und deuLI. TIere Is now LIe
InIrequenL journuI urLIcIe uLLempLIng Lo re-sensILIze LIe medIcuI
prucLILIoner Lo u spIrILuuI dImensIon und sucI beIIeIs In uL IeusL some
puLIenLs (e.g., CuIIIIord, zooz; DuuIemun eL uI., zoo1; Purkes, 1qq8;
Penson eL uI., zoo1). TIIs IuIIure oI spIrILuuI InsIgIL Ius produced u Lerror
oI deuLI und dyIng on LIe purL oI boLI muny docLors und puLIenLs uIIke.
Some docLors Lend Lo IInd beIInd LIe subLerIuge oI sLuLIsLIcuI und
LecInIcuI bubbIe. OLIers wIII enguge In quesLIonubIe medIcuI ucLIvILy
LryIng Lo sLuve-oII deuLI, vIewIng IIIe und LIe puLIenL us no more LIun un
engIneerIng pIenomenon Lo be mecIunIsLIcuIIy worked. Purkes
(zooz) provIdes very vuIuubIe InsIgILs Ior medIcuI prucLILIoners In curIng
Ior LIe dyIng uduIL. A reusonubIe quesLIon concerns Iow LIe sILuuLIon Ius
deLerIoruLed InLo sucI u muLerIuIIsL mIre LIuL LIese Iew, mucI needed,
pupers Iuve even become necessury. TIe unswer LIuL conLInuuIIy emerges
Is LIe muLerIuIIsL munIIesLo LIuL Ius dIrecLed muny InLo superIIcIuIILy.
And, unIorLunuLeIy, IL Is medIco-muLerIuIIsm LIuL Ius IIgured IIgIIy In LIe
muLerIuIIsL ussuuIL.
TIe greuLer purL oI LIIs dIscussIon Is Lo IIgIIIgIL LIuL IIIesLyIe
epIdemIoIogy und prevenLIve medIcIne ure u Iong-odds, mIndIess
gumbIIng gume und noL scIence or IeuILI promoLIon. However, In u
democruLIc socIeLy, persons ure quILe Iree Lo IoIIow LIIs gumbIIng
meLupIor Ior IIvIng, or Ieud LIe unexumIned IIIe II LIey so cIoose. TIe
crILIcuI probIem oI LIe muLerIuIIsL munIIesLo Is LIuL LIIs sLuLIsLIcuI,
muLerIuIIsL IIIesLyIe (MMES cuIL) Is beIng promoLed us prescrIpLIve - uII
sIouId be IIvIng In LIIs wuy.
CurIyon (1q8q) IndIcuLed LIuL consLunL IIIesLyIe seII-scruLIny In
seurcI oI rIsk IucLors, denIuI oI pIeusure, rejecLIon oI LIe oId evII IIIesLyIe
und embrucIng u new rIgorous one ure IoIIowed by perIodIc uIIIrmuLIons
oI IuILI uL revIvuI meeLIngs oI beIIevers...TIe zeuI wILI wIIcI converLs ure
sougIL by LIe recenLIy suved Is oI uwesome InLensILy...TIe seII-rIgILeous
InLoIerunce oI some weIIness zeuIoLs borders on IeuILI IuscIsm.
HIsLorIcuIIy, Iumuns Iuve been uL greuLesL rIsk wIIIe beIng Improved In
LIe besL Imuge oI LIeIr possIbIIILIes us seen by somebody eIse.
L sIouId IIrsLIy be IIgIIIgILed Irom CurIyon`s depIcLIon LIuL LIe
seII-scruLIny reIerred Lo Is oI LIe sIuIIow, superIIcIuI kInd. TIIs kInd oI
seII-scruLIny Is evIdenL In New Yeur`s resoIuLIons wIere IosIng weIgIL or
quILLIng smokIng ure LIe greuL uspIruLIons oI muLerIuIIsL LIInkIng. L Is
rure Indeed LIuL u person`s resoIuLIon Is Lo become u beLLer Iumun beIng
- more IonesL, more IonorubIe In conducL, more ecIecLIc In reusonIng
und reIuLIonsIIp, eLc.. SecondIy, weIIness zeuIoLs ure unweII; LIe enLIre
Lifestyle Epidemiology
momenLum Is psycIoIogIcuIIy, psycIosocIuIIy und moruIIy unIeuILIy.
TIIrdIy, LIe IuscIsm cIurucLerIzuLIon Is quILe upL In LIuL IL depIcLs LIe
operuLIon oI numerous cIurucLer deIIcIencIes sucI us urrogunce,
IuugILIness, vunILy, obsLInucy, pomposILy, obsessIon wILI conLroI.
However, LIe desIgnuLIon oI IeuILI IuscIsm Is InuccuruLe; LIere Is
noLIIng IeuILIy ubouL LIe cIrcumsLunce. L cun properIy be reIerred Lo us
medIco-muLerIuIIsL IuscIsm (see uIso McCormIck, 1qq6).
TIe Iunguuge oI IeuILIIsL zeuIoLry Is sLundurd Ieur und guIIL-
mongerIng. Becker (1qq) noLes LIuL:
|T|Ie IndIvIduuI-responsIbIIILy upproucI Ius IeIped Lo
esLubIIsI IeuILI us LIe New MoruIILy by wIIcI
cIurucLer und personuI worLI ure judged. BeIng III Is
redeIIned us beIng guIILy. TIe obese ure sLIgmuLIzed us
IeLLIng LIemseIves go. Smokers Iuve no wIIIpower.
NonuerobIcLs ure Iuzy. We oILen empIoy guIIL us u
moLIvuLor, IgnorIng LIe IucL LIuL guIIL ILseII Ius
consIderubIe poLenLIuI Ior creuLIng pIysIcuI und
emoLIonuI IIIness.... um mosL concerned ubouL wIuL
Iuppens Lo us us IndIvIduuIs wIen IeuILI becomes LIe
purumounL vuIue oI our socIeLy. AdvocuLes oI IeuILI
promoLIon und weIIness cIuIm Lo be sLrIvIng Ior seII
ucLuuIIzuLIon und personuI IuIIIIImenL. BuL
LIeoIogIuns und pIIIosopIers Iuve generuIIy ugreed
LIuL Lo uLLuIn sucI IuIIIIImenL one musL muke u
commILmenL Lo someLIIng beyond one`s own seII -
quILe LIe opposILe dIrecLIon Irom un empIusIs on
personuI rIsk IucLors und IIIesLyIe. Ieur LIuL us
prucLIced currenLIy, IeuILI promoLIon IosLers u
deIumunIzIng seII-concern LIuL subsLILuLes personuI
IeuILI gouIs Ior more ImporLunL, Iumune, socIeLuI
gouIs. L Is u new reIIgIon, one In wIIcI we worsIIp
ourseIves, uLLrIbuLe good IeuILI Lo our devouLness, und
vIew IIIness us jusL punIsImenL Ior LIose wIo Iuve noL
yeL seen LIe Wuy - u vIew LIuL evokes SocIuI DurwInIsm
und LIe Me generuLIon. (p.q-)
TIIs sorL oI urgumenLuLIon Ius been ecIoed by oLIers over LIe
decudes. TIe senLImenLs InvoIve some uccuruLe observuLIons und some
severe mIsjudgmenLs LIuL ure worLI dIsLInguIsIIng uL LIIs poInL. IrsLIy,
ubsence oI pIysIcuI dIseuse Is sLIII vIewed us LIe crILIcuI murker oI IeuILI.
I psycIoIogIcuI, psycIosocIuI, und moruI dImensIons ure IncIuded In LIe
consIderuLIon, LIen IIIness or dysIuncLIon cun be munIIesLed In uII oI LIese
120
120
Rampant Antismoking Signifies Grave Danger
Lerms. TIe udvocuLes oI u muLerIuIIsL vIew oI IeuILI und LIe New
MoruIILy, gIven LIe nuLure oI LIe urgumenLuLIon, ure psycIoIogIcuIIy,
psycIosocIuIIy, und moruIIy III; LIe muLerIuIIsL vIew Is predIcuLed on
superIIcIuIILy, IncompeLence, u Iuck oI IonesLy, eLc.. urLIermore, IL Is
LIese IuIIIngs LIuL cun poLenLIuIIy be Iur more devusLuLIng LIuL pIysIcuI
dIseuse. As wIII IuLer be consIdered, LIe reuson wIy IeuILI Is reduced Lo
ubsence oI pIysIcuI dIseuse Is Lo IIrsLIy dIverL uLLenLIon Irom LIese oLIer
very consIderubIe IuIIIngs und LIen Lo provIde u socIuI conduIL Ior enucLIng
LIese IuIIures.
SecondIy, guIIL oI ILseII Is noL necessurIIy un evII. L cun be u
murker oI u vIoIuLIon oI prIncIpIed reusonIng LIuL wurrunLs correcLIon.
WIen LIe correcLIon Is eIIecLed, LIe guIIL subsIdes. TIe Issue In LIe
currenL conLexL Is noL LIuL oI guIIL, buL LIuL LIose LIuL ure uLLempLIng Lo
munuIucLure LIe guIIL ure doIng so Irom LIe busIs oI u LIorougIIy IIuwed
vIewpoInL, I.e., IL Is LIe correcLors LIuL ure In greuLesL need oI correcLIon.
TIIrdIy, LIe Lerm moruIILy Ius been gIven u IIgIIy umbIguous
sLuLus. TIe suggesLIon In sucI vIews Is LIuL, IuvIng escuped LIe MoruIILy
oI more LrudILIonuI reIIgIous LeucIIngs, e.g., CIrIsLIunILy, socIeLIes now
Iuve Lo conLend wILI new moruIIzers. TIe sLundpoInL Is LypIcuIIy moruIIy
reIuLIvIsL wIere uny moruIIzIng Is vIewed us unIounded. TIIs Issue oI
LrudILIonuI reIIgIon wIII be consIdered In u IuLer cIupLer. However, IL wIII
suIIIce Ior LIe LIme beIng Lo noLe LIuL medIco-muLerIuIIsm und ILs oIIsIooL
oI prevenLIve medIcIne Is cerLuInIy moruIIzIng und InvoIvIng
consIderubIe zeuIoLry und demugoguery. n IuIrness, Iowever, Lo, Ior
exumpIe, CIrIsLIunILy wIIcI conLuIns u coIerenL moruI Irumework und u
proIound gouI by u prIncIpIed upproucI, LIe New MoruIILy Is devoId oI
uny coIerenL moruI Irumework; IL Is bused on bIoIogIcuI reducLIonIsm LIuL
sLrIps LIe Iumun oI ILs essenLIuI uLLrIbuLes, e.g., psycIoIogIcuI,
psycIosocIuI, meLupIysIcuI, eLc., und munuIucLures prescrIpLIve conducL
on LIe busIs oI un IncoIerenL sLuLIsLIcuI IunLusy mude Lo uppeur us
scIenLIIIc. L Is cerLuInIy LempLIng Lo reIer Lo LIe pIenomenon us u new
moruIILy or reIIgIon. However, LIe Lerm cuIL Is Iur more upproprIuLe. L
wIII uIso be urgued In u IuLer cIupLer LIuL moruI reIuLIvIsm Ius been
InsLrumenLuI In munuIucLurIng LIIs cuIL.
ConLrury Lo TrIcIopouIos` (1qq) senLImenL Is LIuL, IIrsLIy,
epIdemIoIogy und prevenLIve medIcIne ure noL u nuIsunce vuIue buL pose u
gruve dunger In greuLer conLexL (I.e., muLerIuIIsL munIIesLo). SecondIy,
persons cre LukIng LIe prescrIpLIons serIousIy; LIere Is un ever-IncreusIng
popuIuLIon oI beIIevers. TIIs Is due Lo LIe moruI sIuIIowness LIuL muny
socIeLIes Iuve degeneruLed Lo. MMES-cuIL beIIeIs now subsLILuLe (moruI
Iukery) Lo IIII u voId creuLed by LIe ucLIve jeLLIsonIng oI u coIerenL moruI
Irumework over LIe IusL muny decudes. Skrubunek & McCormIck (1qqo)
Lifestyle Epidemiology
provIde u brIeI buL LeIIIng summury oI oucuuIL`s InsIgIL:
...wILI LIe IuII oI reIIgIon uL LIe LIme oI LIe rencI
RevoIuLIon, LIe reIIgIous were suppIunLed by LIe prIesLs
oI LIe body, LIe LIerupeuLIc cIergy. TIe new medIcuI
LIeoIogy creuLed LIe myLI oI LIe LoLuI dIsuppeurunce oI
dIseuse In u socIeLy resLored Lo ILs orIgInuI sLuLe oI
IeuILI by LIe unIImILed power oI u nuLIonuIIsed medIcuI
proIessIon Lo correcL, orgunIse, und supervIse LIe
envIronmenL, und Lo dIcLuLe LIe sLundurds Ior moruI
und pIysIcuI weII-beIng. (p.1qo)
TIe quesL Ior unmerILed ruIersIIp seems Lo be u sLrong Lendency
Ior medIco-muLerIuIIsm. MedIco-muLerIuIIsLs cunnoL be moruIIzers on LIe
busIs oI LIIs Irumework In LIuL LIe Irumework Is devoId oI uny coIerenL
moruI dImensIon. However, LIIs poses IILLIe probIem Ior LIe uIreudy
superIIcIuI, IncompeLenL, ImmuLure, concepLuuIIy-myopIc nuLure oI LIe
medIco-muLerIuIIsL reusonIng. L sImpIy subsLILuLes sLuLIsLIcuI nonsense
und dIsjoInLed cuusuI urgumenL us LIe busIs Ior moruIIy prescrIpLIve
conducL. WIere LIIs MMES-cuIL reusonIng Is InIIIcLed upon u pubIIc LIuL
Is uIso moruIIy degeneruLIng, und wIere LIe presenLuLIon Is under LIe
musquerude oI scIenLIIIc credIbIIILy und IeuILI promoLIon, IL cun onIy
IosLer psycIoIogIcuI und psycIosocIuI enIeebIIng on u LruIy muss scuIe.
ConsIsLenL wILI LIe unbuIunced, IncompeLenL menLuIILy oI LIIs
cuIL`s IeudersIIp, ILs dIscIpIes munIIesL LIe sume cIurucLer deIIcIencIes.
EdgIey & BrIsseLL (1qq) suggesL LIuL LIese duys..peopIe ure noL onIy
known by wIuL LIey don`L do, buL uIso by wIuL LIey don`L LoIeruLe: ' don`L
drInk, smoke, use drugs, or euL LIe wrong Ioods` Is noL enougI. Now seII Is
preserved by uddIng empIuLIcuIIy: 'und don`L LoIeruLe LIose wIo do!` I
LIe meddIee seems Lo be Iuppy, InLeresLIng, Iun-IovIng, und perIups even
IeuILIy, suLIsIIed, und IuIIIIIed, LIIs onIy Increuses LIe grIm-Iuced
cIuIIenge oIIered LIe meddIer. (quoLed In OukIey, 1qqq, CI.;, p.)
TIIs cuIL menLuIILy promoLes IeuILIy beIuvIors LIuL ure onIy u
musquerude Ior u mosL conLorLed LIInkIng. L wIII be urgued In u IuLer
secLIon LIuL LIIs cuIL-LIInkIng wus LIe prIme LIeme oI NuzIsm und wIIcI
wus uIso sLrongIy IegILImIzed by medIco-muLerIuIIsm. UnIorLunuLeIy,
IIsLory repeuLs ILseII uII Loo cIoseIy, demonsLruLIng LIuL IILLIe, II unyLIIng,
oI vuIue Ius been Ieurned In LIe InLerIm. TIIs cuIL menLuIILy, under LIe
generuI uuspIces oI LIe muLerIuIIsL munIIesLo, wIII be reIerred Lo In LIIs
dIscussIon us LIe superiorit sndrome: u mosL InIerIor LIInkIng mude Lo
uppeur us superIor by scIenLIIIc und meLupIysIcuI Iukery.
AIso Lo be consIdered Is LIuL, LIrougI LIe sIeer domInuLIon oI
governmenLuI IeuILI depurLmenLs by medIco-muLerIuIIsm und ILs
121
121
Rampant Antismoking Signifies Grave Danger
Lerms. TIe udvocuLes oI u muLerIuIIsL vIew oI IeuILI und LIe New
MoruIILy, gIven LIe nuLure oI LIe urgumenLuLIon, ure psycIoIogIcuIIy,
psycIosocIuIIy, und moruIIy III; LIe muLerIuIIsL vIew Is predIcuLed on
superIIcIuIILy, IncompeLence, u Iuck oI IonesLy, eLc.. urLIermore, IL Is
LIese IuIIIngs LIuL cun poLenLIuIIy be Iur more devusLuLIng LIuL pIysIcuI
dIseuse. As wIII IuLer be consIdered, LIe reuson wIy IeuILI Is reduced Lo
ubsence oI pIysIcuI dIseuse Is Lo IIrsLIy dIverL uLLenLIon Irom LIese oLIer
very consIderubIe IuIIIngs und LIen Lo provIde u socIuI conduIL Ior enucLIng
LIese IuIIures.
SecondIy, guIIL oI ILseII Is noL necessurIIy un evII. L cun be u
murker oI u vIoIuLIon oI prIncIpIed reusonIng LIuL wurrunLs correcLIon.
WIen LIe correcLIon Is eIIecLed, LIe guIIL subsIdes. TIe Issue In LIe
currenL conLexL Is noL LIuL oI guIIL, buL LIuL LIose LIuL ure uLLempLIng Lo
munuIucLure LIe guIIL ure doIng so Irom LIe busIs oI u LIorougIIy IIuwed
vIewpoInL, I.e., IL Is LIe correcLors LIuL ure In greuLesL need oI correcLIon.
TIIrdIy, LIe Lerm moruIILy Ius been gIven u IIgIIy umbIguous
sLuLus. TIe suggesLIon In sucI vIews Is LIuL, IuvIng escuped LIe MoruIILy
oI more LrudILIonuI reIIgIous LeucIIngs, e.g., CIrIsLIunILy, socIeLIes now
Iuve Lo conLend wILI new moruIIzers. TIe sLundpoInL Is LypIcuIIy moruIIy
reIuLIvIsL wIere uny moruIIzIng Is vIewed us unIounded. TIIs Issue oI
LrudILIonuI reIIgIon wIII be consIdered In u IuLer cIupLer. However, IL wIII
suIIIce Ior LIe LIme beIng Lo noLe LIuL medIco-muLerIuIIsm und ILs oIIsIooL
oI prevenLIve medIcIne Is cerLuInIy moruIIzIng und InvoIvIng
consIderubIe zeuIoLry und demugoguery. n IuIrness, Iowever, Lo, Ior
exumpIe, CIrIsLIunILy wIIcI conLuIns u coIerenL moruI Irumework und u
proIound gouI by u prIncIpIed upproucI, LIe New MoruIILy Is devoId oI
uny coIerenL moruI Irumework; IL Is bused on bIoIogIcuI reducLIonIsm LIuL
sLrIps LIe Iumun oI ILs essenLIuI uLLrIbuLes, e.g., psycIoIogIcuI,
psycIosocIuI, meLupIysIcuI, eLc., und munuIucLures prescrIpLIve conducL
on LIe busIs oI un IncoIerenL sLuLIsLIcuI IunLusy mude Lo uppeur us
scIenLIIIc. L Is cerLuInIy LempLIng Lo reIer Lo LIe pIenomenon us u new
moruIILy or reIIgIon. However, LIe Lerm cuIL Is Iur more upproprIuLe. L
wIII uIso be urgued In u IuLer cIupLer LIuL moruI reIuLIvIsm Ius been
InsLrumenLuI In munuIucLurIng LIIs cuIL.
ConLrury Lo TrIcIopouIos` (1qq) senLImenL Is LIuL, IIrsLIy,
epIdemIoIogy und prevenLIve medIcIne ure noL u nuIsunce vuIue buL pose u
gruve dunger In greuLer conLexL (I.e., muLerIuIIsL munIIesLo). SecondIy,
persons cre LukIng LIe prescrIpLIons serIousIy; LIere Is un ever-IncreusIng
popuIuLIon oI beIIevers. TIIs Is due Lo LIe moruI sIuIIowness LIuL muny
socIeLIes Iuve degeneruLed Lo. MMES-cuIL beIIeIs now subsLILuLe (moruI
Iukery) Lo IIII u voId creuLed by LIe ucLIve jeLLIsonIng oI u coIerenL moruI
Irumework over LIe IusL muny decudes. Skrubunek & McCormIck (1qqo)
Lifestyle Epidemiology
provIde u brIeI buL LeIIIng summury oI oucuuIL`s InsIgIL:
...wILI LIe IuII oI reIIgIon uL LIe LIme oI LIe rencI
RevoIuLIon, LIe reIIgIous were suppIunLed by LIe prIesLs
oI LIe body, LIe LIerupeuLIc cIergy. TIe new medIcuI
LIeoIogy creuLed LIe myLI oI LIe LoLuI dIsuppeurunce oI
dIseuse In u socIeLy resLored Lo ILs orIgInuI sLuLe oI
IeuILI by LIe unIImILed power oI u nuLIonuIIsed medIcuI
proIessIon Lo correcL, orgunIse, und supervIse LIe
envIronmenL, und Lo dIcLuLe LIe sLundurds Ior moruI
und pIysIcuI weII-beIng. (p.1qo)
TIe quesL Ior unmerILed ruIersIIp seems Lo be u sLrong Lendency
Ior medIco-muLerIuIIsm. MedIco-muLerIuIIsLs cunnoL be moruIIzers on LIe
busIs oI LIIs Irumework In LIuL LIe Irumework Is devoId oI uny coIerenL
moruI dImensIon. However, LIIs poses IILLIe probIem Ior LIe uIreudy
superIIcIuI, IncompeLenL, ImmuLure, concepLuuIIy-myopIc nuLure oI LIe
medIco-muLerIuIIsL reusonIng. L sImpIy subsLILuLes sLuLIsLIcuI nonsense
und dIsjoInLed cuusuI urgumenL us LIe busIs Ior moruIIy prescrIpLIve
conducL. WIere LIIs MMES-cuIL reusonIng Is InIIIcLed upon u pubIIc LIuL
Is uIso moruIIy degeneruLIng, und wIere LIe presenLuLIon Is under LIe
musquerude oI scIenLIIIc credIbIIILy und IeuILI promoLIon, IL cun onIy
IosLer psycIoIogIcuI und psycIosocIuI enIeebIIng on u LruIy muss scuIe.
ConsIsLenL wILI LIe unbuIunced, IncompeLenL menLuIILy oI LIIs
cuIL`s IeudersIIp, ILs dIscIpIes munIIesL LIe sume cIurucLer deIIcIencIes.
EdgIey & BrIsseLL (1qq) suggesL LIuL LIese duys..peopIe ure noL onIy
known by wIuL LIey don`L do, buL uIso by wIuL LIey don`L LoIeruLe: ' don`L
drInk, smoke, use drugs, or euL LIe wrong Ioods` Is noL enougI. Now seII Is
preserved by uddIng empIuLIcuIIy: 'und don`L LoIeruLe LIose wIo do!` I
LIe meddIee seems Lo be Iuppy, InLeresLIng, Iun-IovIng, und perIups even
IeuILIy, suLIsIIed, und IuIIIIIed, LIIs onIy Increuses LIe grIm-Iuced
cIuIIenge oIIered LIe meddIer. (quoLed In OukIey, 1qqq, CI.;, p.)
TIIs cuIL menLuIILy promoLes IeuILIy beIuvIors LIuL ure onIy u
musquerude Ior u mosL conLorLed LIInkIng. L wIII be urgued In u IuLer
secLIon LIuL LIIs cuIL-LIInkIng wus LIe prIme LIeme oI NuzIsm und wIIcI
wus uIso sLrongIy IegILImIzed by medIco-muLerIuIIsm. UnIorLunuLeIy,
IIsLory repeuLs ILseII uII Loo cIoseIy, demonsLruLIng LIuL IILLIe, II unyLIIng,
oI vuIue Ius been Ieurned In LIe InLerIm. TIIs cuIL menLuIILy, under LIe
generuI uuspIces oI LIe muLerIuIIsL munIIesLo, wIII be reIerred Lo In LIIs
dIscussIon us LIe superiorit sndrome: u mosL InIerIor LIInkIng mude Lo
uppeur us superIor by scIenLIIIc und meLupIysIcuI Iukery.
AIso Lo be consIdered Is LIuL, LIrougI LIe sIeer domInuLIon oI
governmenLuI IeuILI depurLmenLs by medIco-muLerIuIIsm und ILs
122
122
Rampant Antismoking Signifies Grave Danger
dIsLorLed Ideu oI IeuILI und LIe poIILIcuI cIouL oI more InLernuLIonuI, IIke-
mInded InsLILuLIons (e.g., WorId HeuILI OrgunIzuLIon, UnILed NuLIons),
LIIs cuIL Is SLuLe-promoLed In muny deveIoped nuLIons. L sIouId be oI
gruve concern LIuL onIy one oI LIe numerous ubsurdILIes oI LIe LIme Is
LIuL LIIs sLrong Lendency Lowurds medIco-muLerIuIIsL uuLocrucy Is
occurrIng In so-cuIIed democrctic socIeLIes. urLIermore, LIe sILuuLIon Is
IIgIIy dungerous und cun, und probubIy wIII, become Iur worse.
z. Criticcl Distinctions in the Idec oj Risl
TIe use oI LIe Ideu oI rIsk by epIdemIoIogy mukes IL necessury Lo
muke one IurLIer crILIcuI dIsLIncLIon. ConsIder LIe exumpIe oI LIe rIsk oI
Injury In LIe ucLIvILy oI mounLuIn cIImbIng. I u person IuIIs, un Injury cun
be wIoIIy descrIbed by u cIeur sequence oI cuusuI evenLs, e.g., IImbs
comIng In conLucL wILI Iurd surIuces uL purLIcuIur ungIes und Iorce. One
cun LIen cuIcuIuLe LIe probubIIILy (rIsk) oI sucI InjurIes occurrIng In
mounLuIn cIImbIng. TIe sILuuLIon wILI smokIngJIung cuncer, Ior exumpIe,
Is u very dIIIerenL one; LIere Is no deIIned sequence oI cuusuI evenLs, I.e.,
mecIunIsmsJprocesses reIuLIng LIe properLIes oI Lobucco smoke wILI
broncIIuI neopIusms. As Ius uIso been IndIcuLed, LIere cun be no sucI
sequence LIuL dIrecLIy reIuLes onl LIe cuusuI ucLIon oI LIe properLIes oI
Lobucco smoke wILI specIIIc dIseuse, I.e., u IogIcuI und empIrIcuI
ImpossIbIIILy. EpIdemIoIogy`s enLIre cuusuI urgumenL reIuLIng smokIng
und Iung cuncer (umongsL oLIer dIseuses) Is enLIreIy bused on compIeLeIy
quesLIonubIe sLuLIsLIcuI InIerence. ndeed, one cun sLIII cuIcuIuLe RR`s,
uLLrIbuLubIe rIsk, uLLrIbuLubIe dIseuse, us u sLuLIsLIcuI exercIse. However,
LIIs Ius no scIenLIIIc merIL concernIng uLLrIbuLubIe cuusuLIon. or LIIs
reuson, rIsk concernIng cuusuIIy deIInedJdeIInubIe reIuLIonsIIps wIII
conLInue Lo be reIerred Lo us rIsk. RIsk reIerrIng Lo sLuLIsLIcuI
reIuLIonsIIps LIuL Iuve no properIy deIIned cuusuI Irumework wIII be
reIerred Lo us (s)rIsk. or LIe mosL purL, LIe Lerm rIsk uversIon, us used
In LIe remuInder oI LIIs dIscussIon, wIII LypIcuIIy reIer Lo sLuLIsLIcuI rIsk
uversIon us underIuIn by epIdemIoIogIc InvesLIguLIon.
z.; The Superiorit Sndrome
L wus consIdered In eurIIer secLIons LIuL epIdemIoIogIc
reusonIng cun weII be cIurucLerIzed us upsIde-down und buck-Lo-IronL. L
demonsLruLes u dysIuncLIonuI IIxuLIon on uLypIcuI ussocIuLIons LIuL
InvoIve u deLrImenLuI occurrence und, LIereIore, demonsLruLes u menLuI
bIock Lo LypIcuI (normuLIve) non-ussocIuLIons. SucI IIxuLIon cun be
reIerred Lo us cuLusLropIIzuLIon (exuggeruLIon) In LIuL LIe menLuIILy reucLs
Lifestyle Epidemiology
Lo LIe uLypIcuI us II IL Is LypIcuI. Due Lo LIe morbIdIy-IeurIuI percepLIon oI
u deLrImenLuI possIbIIILy, LIe dysIuncLIon wIII uILImuLeIy be munIIesLed us
rIsk uversIon.
TIe rIsk-uverse ure pIugued by un LoId you so reusonIng und
LIe guIIL LIuL uccompunIes LIe IuIIure Lo uccommoduLe rIsk, Iowever
remoLe. TIe rIsk-uverse erroneousIy beIIeve LIuL LIey Iuve some crILIcuI
undersLundIng oI cuusuI processes, wIere, In IucL, LIeIr beIIeIs ure In LIe
reuIm oI supersLILIon. TIe menLuIILy IuIIs Lo recognIze LIuL genuIne
undersLundIng Is reIIecLed by IIgI uccurucy, c priori, und noL by wIuL cun
be suId In IsoIuLIon uILer LIe IucL, I.e., LIe rIsk-uverse do noL noLIce (menLuI
bIock) LIuL LIey ure wrong mosL oI LIe LIme wIenever purLIcuIur rIsks,
by unyone, Iuve noL been uvoIded. TIIs probIem Is In-buIIL InLo LIe
epIdemIoIogIc meLIod LIrougI ILs reIIunce on reIuLIve rIsk und
obIIvIousness Lo predIcLIve (ubsoIuLe) sLrengLI oI IucLors Ior IucLors, I.e.,
LIere Is no cognIzunce LIuL LIe use oI LypIcuI reIuLIve-rIsk IucLors yIeIds
predIcLIon LIuL Is wrong mosL oI LIe LIme. TIereIore, LIe morbId Ieur oI u
possIbIe, LIougI IIgIIy ImprobubIe, deLrImenLuI occurrence, percepLuuIIy
cuLusLropIIzed Lo uppeur us un InevILubIe consequence oI un unLecedenL,
LIen demunds over-proLecLIon und over-conLroI, I.e., un IrruLIonuI quesL
Ior suIeLy (see uIso erner & KeILner, zoo1). TIe rIsk-uverse LIen
gIngerIy (I.e., unIeuILIIIy deIIcuLe) muke LIeIr wuy LIrougI IIIe, und, In
exLreme cuses, cun resuIL In u morbId Ieur oI IIIe und deuLI, gIven uII LIe
rIsks LIuL IIIe enLuIIs. n un IrruLIonuI uLLempL Lo pre-empL deLrImenLuI
occurrences, rIsk uversIon uvoIds IucLorsJsILuuLIons bused on
progressIveIy more und more IIImsy evIdence.
As Ius been menLIoned, LIe epIdemIoIogIc meLIod hcs u very
sLrong rIsk-uversIon uspecL. L Is convInced LIuL IL Ius undersLundIng oI
cuusuI Irumeworks wIen, by LIe requIremenLs oI cuusuI InIerence, IL Ius
provIded no sucI demonsLruLIon. EpIdemIoIogy Ius eIevuLed
(cuLusLropIIzed) reIuLIve-rIsk IucLors Lo u posILIon LIuL LIey sImpIy do noL
merIL In scIenLIIIc Lerms. As wIII be consIdered In u IuLer cIupLer, LIe
pronouncemenLs oI prevenLIve medIcIne (IeuILI uuLIorILIes) IosLers
consIderubIe psycIopuLIoIogy, purLIcuIurIy rIsk uversIon. TIe SocIuI
ssues ReseurcI CenLre In OxIord, UK, wurns LIuL risljcctorphobic Is
becomIng u mujor pubIIc IeuILI probIem (In ALrens, zooo, p.).
UnIorLunuLeIy, LIere Is Iur more Lo epIdemIoIogIcJmedIco-muLerIuIIsL
dysIuncLIon und ILs ussuuIL on menLuI IeuILI LIun sImpIy LIuL oI IosLerIng
pIobIu.
ConsIder LIe exumpIe oI LIe specIIIc pIobIu oI cIuusLropIobIu
(I.e., morbId Ieur oI encIosed spuces). L Is LypIcuIIy consIdered LIuL LIere
Is u projecLIon oI psycIogenIc conIIIcL onLo un exLernuI source - In LIIs
cuse encIosed spuces. PIobIcs ure usuuIIy uwure LIuL LIey Iurbor u
123
123
Rampant Antismoking Signifies Grave Danger
dIsLorLed Ideu oI IeuILI und LIe poIILIcuI cIouL oI more InLernuLIonuI, IIke-
mInded InsLILuLIons (e.g., WorId HeuILI OrgunIzuLIon, UnILed NuLIons),
LIIs cuIL Is SLuLe-promoLed In muny deveIoped nuLIons. L sIouId be oI
gruve concern LIuL onIy one oI LIe numerous ubsurdILIes oI LIe LIme Is
LIuL LIIs sLrong Lendency Lowurds medIco-muLerIuIIsL uuLocrucy Is
occurrIng In so-cuIIed democrctic socIeLIes. urLIermore, LIe sILuuLIon Is
IIgIIy dungerous und cun, und probubIy wIII, become Iur worse.
z. Criticcl Distinctions in the Idec oj Risl
TIe use oI LIe Ideu oI rIsk by epIdemIoIogy mukes IL necessury Lo
muke one IurLIer crILIcuI dIsLIncLIon. ConsIder LIe exumpIe oI LIe rIsk oI
Injury In LIe ucLIvILy oI mounLuIn cIImbIng. I u person IuIIs, un Injury cun
be wIoIIy descrIbed by u cIeur sequence oI cuusuI evenLs, e.g., IImbs
comIng In conLucL wILI Iurd surIuces uL purLIcuIur ungIes und Iorce. One
cun LIen cuIcuIuLe LIe probubIIILy (rIsk) oI sucI InjurIes occurrIng In
mounLuIn cIImbIng. TIe sILuuLIon wILI smokIngJIung cuncer, Ior exumpIe,
Is u very dIIIerenL one; LIere Is no deIIned sequence oI cuusuI evenLs, I.e.,
mecIunIsmsJprocesses reIuLIng LIe properLIes oI Lobucco smoke wILI
broncIIuI neopIusms. As Ius uIso been IndIcuLed, LIere cun be no sucI
sequence LIuL dIrecLIy reIuLes onl LIe cuusuI ucLIon oI LIe properLIes oI
Lobucco smoke wILI specIIIc dIseuse, I.e., u IogIcuI und empIrIcuI
ImpossIbIIILy. EpIdemIoIogy`s enLIre cuusuI urgumenL reIuLIng smokIng
und Iung cuncer (umongsL oLIer dIseuses) Is enLIreIy bused on compIeLeIy
quesLIonubIe sLuLIsLIcuI InIerence. ndeed, one cun sLIII cuIcuIuLe RR`s,
uLLrIbuLubIe rIsk, uLLrIbuLubIe dIseuse, us u sLuLIsLIcuI exercIse. However,
LIIs Ius no scIenLIIIc merIL concernIng uLLrIbuLubIe cuusuLIon. or LIIs
reuson, rIsk concernIng cuusuIIy deIInedJdeIInubIe reIuLIonsIIps wIII
conLInue Lo be reIerred Lo us rIsk. RIsk reIerrIng Lo sLuLIsLIcuI
reIuLIonsIIps LIuL Iuve no properIy deIIned cuusuI Irumework wIII be
reIerred Lo us (s)rIsk. or LIe mosL purL, LIe Lerm rIsk uversIon, us used
In LIe remuInder oI LIIs dIscussIon, wIII LypIcuIIy reIer Lo sLuLIsLIcuI rIsk
uversIon us underIuIn by epIdemIoIogIc InvesLIguLIon.
z.; The Superiorit Sndrome
L wus consIdered In eurIIer secLIons LIuL epIdemIoIogIc
reusonIng cun weII be cIurucLerIzed us upsIde-down und buck-Lo-IronL. L
demonsLruLes u dysIuncLIonuI IIxuLIon on uLypIcuI ussocIuLIons LIuL
InvoIve u deLrImenLuI occurrence und, LIereIore, demonsLruLes u menLuI
bIock Lo LypIcuI (normuLIve) non-ussocIuLIons. SucI IIxuLIon cun be
reIerred Lo us cuLusLropIIzuLIon (exuggeruLIon) In LIuL LIe menLuIILy reucLs
Lifestyle Epidemiology
Lo LIe uLypIcuI us II IL Is LypIcuI. Due Lo LIe morbIdIy-IeurIuI percepLIon oI
u deLrImenLuI possIbIIILy, LIe dysIuncLIon wIII uILImuLeIy be munIIesLed us
rIsk uversIon.
TIe rIsk-uverse ure pIugued by un LoId you so reusonIng und
LIe guIIL LIuL uccompunIes LIe IuIIure Lo uccommoduLe rIsk, Iowever
remoLe. TIe rIsk-uverse erroneousIy beIIeve LIuL LIey Iuve some crILIcuI
undersLundIng oI cuusuI processes, wIere, In IucL, LIeIr beIIeIs ure In LIe
reuIm oI supersLILIon. TIe menLuIILy IuIIs Lo recognIze LIuL genuIne
undersLundIng Is reIIecLed by IIgI uccurucy, c priori, und noL by wIuL cun
be suId In IsoIuLIon uILer LIe IucL, I.e., LIe rIsk-uverse do noL noLIce (menLuI
bIock) LIuL LIey ure wrong mosL oI LIe LIme wIenever purLIcuIur rIsks,
by unyone, Iuve noL been uvoIded. TIIs probIem Is In-buIIL InLo LIe
epIdemIoIogIc meLIod LIrougI ILs reIIunce on reIuLIve rIsk und
obIIvIousness Lo predIcLIve (ubsoIuLe) sLrengLI oI IucLors Ior IucLors, I.e.,
LIere Is no cognIzunce LIuL LIe use oI LypIcuI reIuLIve-rIsk IucLors yIeIds
predIcLIon LIuL Is wrong mosL oI LIe LIme. TIereIore, LIe morbId Ieur oI u
possIbIe, LIougI IIgIIy ImprobubIe, deLrImenLuI occurrence, percepLuuIIy
cuLusLropIIzed Lo uppeur us un InevILubIe consequence oI un unLecedenL,
LIen demunds over-proLecLIon und over-conLroI, I.e., un IrruLIonuI quesL
Ior suIeLy (see uIso erner & KeILner, zoo1). TIe rIsk-uverse LIen
gIngerIy (I.e., unIeuILIIIy deIIcuLe) muke LIeIr wuy LIrougI IIIe, und, In
exLreme cuses, cun resuIL In u morbId Ieur oI IIIe und deuLI, gIven uII LIe
rIsks LIuL IIIe enLuIIs. n un IrruLIonuI uLLempL Lo pre-empL deLrImenLuI
occurrences, rIsk uversIon uvoIds IucLorsJsILuuLIons bused on
progressIveIy more und more IIImsy evIdence.
As Ius been menLIoned, LIe epIdemIoIogIc meLIod hcs u very
sLrong rIsk-uversIon uspecL. L Is convInced LIuL IL Ius undersLundIng oI
cuusuI Irumeworks wIen, by LIe requIremenLs oI cuusuI InIerence, IL Ius
provIded no sucI demonsLruLIon. EpIdemIoIogy Ius eIevuLed
(cuLusLropIIzed) reIuLIve-rIsk IucLors Lo u posILIon LIuL LIey sImpIy do noL
merIL In scIenLIIIc Lerms. As wIII be consIdered In u IuLer cIupLer, LIe
pronouncemenLs oI prevenLIve medIcIne (IeuILI uuLIorILIes) IosLers
consIderubIe psycIopuLIoIogy, purLIcuIurIy rIsk uversIon. TIe SocIuI
ssues ReseurcI CenLre In OxIord, UK, wurns LIuL risljcctorphobic Is
becomIng u mujor pubIIc IeuILI probIem (In ALrens, zooo, p.).
UnIorLunuLeIy, LIere Is Iur more Lo epIdemIoIogIcJmedIco-muLerIuIIsL
dysIuncLIon und ILs ussuuIL on menLuI IeuILI LIun sImpIy LIuL oI IosLerIng
pIobIu.
ConsIder LIe exumpIe oI LIe specIIIc pIobIu oI cIuusLropIobIu
(I.e., morbId Ieur oI encIosed spuces). L Is LypIcuIIy consIdered LIuL LIere
Is u projecLIon oI psycIogenIc conIIIcL onLo un exLernuI source - In LIIs
cuse encIosed spuces. PIobIcs ure usuuIIy uwure LIuL LIey Iurbor u
124
124
Rampant Antismoking Signifies Grave Danger
consLruInIng IrruLIonuI beIIeI, I.e., InsIgIL InLo LIeIr dysIuncLIon.
urLIermore, und ImporLunLIy, u pIobIc does noL uLLempL Lo modIIy LIe
exLernuI worId Lo uccommoduLe LIeIr IrruLIonuI Ieur, I.e., no uLLempL Lo
erudIcuLe uII encIosed spuces In LIe exLernuI worId. TIey sImpIy uvoId
specIIIc exLernuIILIes. RIsk uversIon cun be more debIIILuLIng LIun specIIIc
pIobIu becuuse oI ILs generuIILy (exLreme) oI uppIIcuLIon, I.e., generuIIzed
pIobIu. Even LIe rIsk-uverse muy be quILe uwure oI LIeIr overIy IeurIuI
upproucI Lo IIIe. AguIn, LIe rIsk uverse do noL uLLempL Lo Iuve LIe exLernuI
worId cIunged Lo uccommoduLe LIeIr dysIuncLIon. TIey sImpIy uvoId
purLIcuIur sILuuLIonsJIucLors us LIey urIse.
EpIdemIoIogIc IoIIy InvoIves u compoundIng oI dysIuncLIon weII
beyond rIsk uversIon In soIeIy pIobIc Lerms. L wus eurIIer consIdered LIuL
IIIesLyIe epIdemIoIogy Is rIddIed wILI sysLemIc IncompeLence. So mucI
so LIuL even In LIe Iuce oI consIderubIe crILIcIsm LIere Ius been no
correcLIon oI LIe sILuuLIon over LIe IusL IuII-cenLury. L cun be concIuded
LIuL LIIs conducL demonsLruLes very poor menLuI InsIgIL reIIecLed In un
erruLIc muLerIuIIsL pIIIosopIy. TIIs poInL Is IurLIer reInIorced by LIe
sIeer IncognIzunce oI prevenLIve medIcIne oI LIe deLrImenLuI
repercussIons oI ILs conducL on menLuI IeuILI (Lo be consIdered In u IuLer
cIupLer). L Is u menLuIILy domInuLed by exLernuIIzIng (projecLIng) wIuL
ure InLernuI (menLuI) probIems In LIe IuncLIonIng oI ILs own membersIIp.
A combInuLIon oI muLerIuIIsmJexLernuIIsm, superIIcIuIILy, IncompeLence,
und ImmuLurILy dIsLInguIsI epIdemIoIogIc reusonIng us ter InIerIor.
However, Lo LIe upsIde-down, buck-Lo-IronL reusonIng oI epIdemIoIogy, IL
Ius convInced ILseII LIuL ILs LIInkIng Is scIenLIIIcuIIy Iounded und,
LIereIore, superIor - LIe InIerIor becomes superIor In one greuL
dysIuncLIonuI sLep. GenuIne seII-InsIgIL InLo dysIuncLIon Is obIILeruLed by
u cognILIve jusLIIIcuLIon oI LIe dysIuncLIon.
An upL unuIogy Is LIuL epIdemIoIogIcuI reusonIng Is ukIn Lo un
eIgIL-cyIInder engIne runnIng on one cyIInder; noL onIy cun IL noL LeII LIuL
ILs perIormunce Is very subsLundurd, buL IL beIIeves LIuL ILs perIormunce Is
opLImuI. TIIs IuLLer poInL cuLupuILs wIuL wouId Iuve oLIerwIse been u cuse
oI rIsk uversIon InLo u Iur more dungerous dysIuncLIon. GIven LIuL IL
beIIeves ILs LIInkIng Lo be superIor, rIsk uversIon Is LIereIore depIcLed us
objecLIve und normuLIve. EpIdemIoIogyJprevenLIve medIcIne LIen emburk
on educuLIng (conLroIJengIneerIng) LIe musses LIuL rIsk uversIon Is
objecLIve und responsIbIe; IuIIure by members oI LIe pubIIc Lo udopL LIIs
dysIuncLIonuI LIInkIng Is porLruyed us IrruLIonuI und IrresponsIbIe. L wus
consIdered In secLIon 1.1 LIuL Iow-IeveI sLuLIsLIcuI rIsk Is enLIreIy u
subjecLIve muLLer. To porLruy rIsk uversIon (I.e., u generuI InLerpreLuLIon oI
Iow-IeveI rIsk) us objecLIve Is IruuduIenL (I.e., no scIenLIIIc merIL). As wIII
uIso be consIdered In IoIIowIng cIupLers, regurdIng cIgureLLe smokIng und
exposure Lo envIronmenLuI Lobucco smoke, prevenLIve medIcIne beIIeves
LIuL IL Is compIeLeIy jusLIIIed In uILerIng LIe envIronmenL (e.g., smokIng
buns) In uccommoduLIng rIsk uversIon. L uIso Ius greuL euse In jusLIIyIng
very quesLIonubIe meuns In uLLempLIng Lo uccompIIsI ILs quesLIonubIe
gouI LIuL brIngs Lo LIe Iore LIe ugIIer sIde oI LIe Iumun poLenLIuI, e.g.,
IuugILIness, condescensIon, ImperIousness, bIgoLry, obsessIon wILI
conLroI. TIese wouId LypIcuIIy be reIerred Lo us cIurucLer deIIcIencIes.
TIereIore, medIco-muLerIuIIsL dysIuncLIon dIIIers Irom cIussIc
pIobIu In Lwo ImporLunL wuys. IrsLIy, gIven ILs muLerIuIIsL dIsposILIon, IL
Ius very poor InsIgIL InLo uny menLuI pIenomenu (I.e., LIe enLIre menLuI
IeveI), wIeLIer IuncLIonuI or dysIuncLIonuI und wIeLIer ILs own or LIuL oI
oLIers. n LIIs regurd IL Is compIeLeIy In IIne wILI rudIcuI beIuvIorIsm.
SecondIy, IL wIII uLLempL Lo uppeuse ILs ucLuuI psycIogenIc probIems, noL
by IrruLIonuIIy uvoIdIng cerLuIn exLernuI cIrcumsLunces buL, by IrruLIonuIIy
cIungIng LIese exLernuI cIrcumsLunces on u muss scuIe und on LIe
IruuduIenL busIs oI beIng scIenLIIIcuIIy jusLIIIed (I.e., Iuke scIence). TIIs
Is uIso consIsLenL wILI rudIcuI beIuvIorIsm In ILs obsessIon wILI conLroIJ
engIneerIng oI Iumun beIuvIor und LIe sIeer ImmuLurILy oI LIe reusonIng
In IuIIIng Lo recognIze LIe repercussIons oI LIIs conducL In greuLer
psycIoIogIcuI, socIuI, moruI und pIIIosopIIcuI conLexL, I.e., un III-
consIdered, sub-umuLeurIsI concepLuuI Irumework. TIe LIInkIng Is so
IuckIng In InsIgILJcompeLence LIuL IL seems Lo Iuve no grusp uL uII us Lo
LIe sIeer mugnILude oI ILs IoIIy, I.e., LIe urrogunce oI Ignorunce. or LIe
purposes oI LIIs dIscussIon, LIIs dysIuncLIon wIII be reIerred Lo us LIe
superiorit sndrome, I.e., u IIgIIy InIerIor LIInkIng IruuduIenLIy mude Lo
uppeur superIor und LIe busIs Ior LIen InsLIguLIng consIderubIe und IIgIIy
quesLIonubIe socIuI reIorms. TIe superIorILy syndrome wIII be IurLIer
consIdered us LIe dIscussIon proceeds.
NoLwILIsLundIng un InuuspIcIous sLurL Lo IIIesLyIe epIdemIoIogy,
un umounL oI genuIne scIoIursIIp wILIIn LIe medIcuI esLubIIsImenL couId
Iuve redIscovered uL IeusL some oI LIe edIcLs oI scIenLIIIc enquIry und
cuusuI urgumenL In LIe neur-IuII-cenLury sInce. ConLrurIIy, LIe sILuuLIon
Ius progressIveIy worsened. TIrougI IncompeLence, medIco-muLerIuIIsm
Ius Lrupped ILseII InLo u cIrcuIurILy. UnIorLunuLeIy, IL Is u seII-servIng
cIrcuIurILy. HuvIng eIevuLed ILs socIuI sLuLus LIrougI IruuduIenL depIcLIons
oI InIormuLIon, upurL Irom un ubsence oI scIoIursIIp, LIere Is no
moLIvuLIon Lo correcL or Lrunscend LIe InIerenLIuI mIre LIuL Ius been
produced: ncompeLence, Ignorunce, und superIIcIuIILy Iuve been
producLIve In muLerIuIIsLIc Lerms. UILImuLeIy, correcLIon cun onIy be
brougIL Lo beur Irom ouLsIde epIdemIoIogy und medIco-muLerIuIIsm.
TIe mosL ImporLunL uspecL oI LIe superIorILy syndrome Ior LIe
purposes oI LIIs dIscussIon Is LIuL IL does noL onIy LeucI LIuL rIsk
Lifestyle Epidemiology
125
125
Rampant Antismoking Signifies Grave Danger
consLruInIng IrruLIonuI beIIeI, I.e., InsIgIL InLo LIeIr dysIuncLIon.
urLIermore, und ImporLunLIy, u pIobIc does noL uLLempL Lo modIIy LIe
exLernuI worId Lo uccommoduLe LIeIr IrruLIonuI Ieur, I.e., no uLLempL Lo
erudIcuLe uII encIosed spuces In LIe exLernuI worId. TIey sImpIy uvoId
specIIIc exLernuIILIes. RIsk uversIon cun be more debIIILuLIng LIun specIIIc
pIobIu becuuse oI ILs generuIILy (exLreme) oI uppIIcuLIon, I.e., generuIIzed
pIobIu. Even LIe rIsk-uverse muy be quILe uwure oI LIeIr overIy IeurIuI
upproucI Lo IIIe. AguIn, LIe rIsk uverse do noL uLLempL Lo Iuve LIe exLernuI
worId cIunged Lo uccommoduLe LIeIr dysIuncLIon. TIey sImpIy uvoId
purLIcuIur sILuuLIonsJIucLors us LIey urIse.
EpIdemIoIogIc IoIIy InvoIves u compoundIng oI dysIuncLIon weII
beyond rIsk uversIon In soIeIy pIobIc Lerms. L wus eurIIer consIdered LIuL
IIIesLyIe epIdemIoIogy Is rIddIed wILI sysLemIc IncompeLence. So mucI
so LIuL even In LIe Iuce oI consIderubIe crILIcIsm LIere Ius been no
correcLIon oI LIe sILuuLIon over LIe IusL IuII-cenLury. L cun be concIuded
LIuL LIIs conducL demonsLruLes very poor menLuI InsIgIL reIIecLed In un
erruLIc muLerIuIIsL pIIIosopIy. TIIs poInL Is IurLIer reInIorced by LIe
sIeer IncognIzunce oI prevenLIve medIcIne oI LIe deLrImenLuI
repercussIons oI ILs conducL on menLuI IeuILI (Lo be consIdered In u IuLer
cIupLer). L Is u menLuIILy domInuLed by exLernuIIzIng (projecLIng) wIuL
ure InLernuI (menLuI) probIems In LIe IuncLIonIng oI ILs own membersIIp.
A combInuLIon oI muLerIuIIsmJexLernuIIsm, superIIcIuIILy, IncompeLence,
und ImmuLurILy dIsLInguIsI epIdemIoIogIc reusonIng us ter InIerIor.
However, Lo LIe upsIde-down, buck-Lo-IronL reusonIng oI epIdemIoIogy, IL
Ius convInced ILseII LIuL ILs LIInkIng Is scIenLIIIcuIIy Iounded und,
LIereIore, superIor - LIe InIerIor becomes superIor In one greuL
dysIuncLIonuI sLep. GenuIne seII-InsIgIL InLo dysIuncLIon Is obIILeruLed by
u cognILIve jusLIIIcuLIon oI LIe dysIuncLIon.
An upL unuIogy Is LIuL epIdemIoIogIcuI reusonIng Is ukIn Lo un
eIgIL-cyIInder engIne runnIng on one cyIInder; noL onIy cun IL noL LeII LIuL
ILs perIormunce Is very subsLundurd, buL IL beIIeves LIuL ILs perIormunce Is
opLImuI. TIIs IuLLer poInL cuLupuILs wIuL wouId Iuve oLIerwIse been u cuse
oI rIsk uversIon InLo u Iur more dungerous dysIuncLIon. GIven LIuL IL
beIIeves ILs LIInkIng Lo be superIor, rIsk uversIon Is LIereIore depIcLed us
objecLIve und normuLIve. EpIdemIoIogyJprevenLIve medIcIne LIen emburk
on educuLIng (conLroIJengIneerIng) LIe musses LIuL rIsk uversIon Is
objecLIve und responsIbIe; IuIIure by members oI LIe pubIIc Lo udopL LIIs
dysIuncLIonuI LIInkIng Is porLruyed us IrruLIonuI und IrresponsIbIe. L wus
consIdered In secLIon 1.1 LIuL Iow-IeveI sLuLIsLIcuI rIsk Is enLIreIy u
subjecLIve muLLer. To porLruy rIsk uversIon (I.e., u generuI InLerpreLuLIon oI
Iow-IeveI rIsk) us objecLIve Is IruuduIenL (I.e., no scIenLIIIc merIL). As wIII
uIso be consIdered In IoIIowIng cIupLers, regurdIng cIgureLLe smokIng und
exposure Lo envIronmenLuI Lobucco smoke, prevenLIve medIcIne beIIeves
LIuL IL Is compIeLeIy jusLIIIed In uILerIng LIe envIronmenL (e.g., smokIng
buns) In uccommoduLIng rIsk uversIon. L uIso Ius greuL euse In jusLIIyIng
very quesLIonubIe meuns In uLLempLIng Lo uccompIIsI ILs quesLIonubIe
gouI LIuL brIngs Lo LIe Iore LIe ugIIer sIde oI LIe Iumun poLenLIuI, e.g.,
IuugILIness, condescensIon, ImperIousness, bIgoLry, obsessIon wILI
conLroI. TIese wouId LypIcuIIy be reIerred Lo us cIurucLer deIIcIencIes.
TIereIore, medIco-muLerIuIIsL dysIuncLIon dIIIers Irom cIussIc
pIobIu In Lwo ImporLunL wuys. IrsLIy, gIven ILs muLerIuIIsL dIsposILIon, IL
Ius very poor InsIgIL InLo uny menLuI pIenomenu (I.e., LIe enLIre menLuI
IeveI), wIeLIer IuncLIonuI or dysIuncLIonuI und wIeLIer ILs own or LIuL oI
oLIers. n LIIs regurd IL Is compIeLeIy In IIne wILI rudIcuI beIuvIorIsm.
SecondIy, IL wIII uLLempL Lo uppeuse ILs ucLuuI psycIogenIc probIems, noL
by IrruLIonuIIy uvoIdIng cerLuIn exLernuI cIrcumsLunces buL, by IrruLIonuIIy
cIungIng LIese exLernuI cIrcumsLunces on u muss scuIe und on LIe
IruuduIenL busIs oI beIng scIenLIIIcuIIy jusLIIIed (I.e., Iuke scIence). TIIs
Is uIso consIsLenL wILI rudIcuI beIuvIorIsm In ILs obsessIon wILI conLroIJ
engIneerIng oI Iumun beIuvIor und LIe sIeer ImmuLurILy oI LIe reusonIng
In IuIIIng Lo recognIze LIe repercussIons oI LIIs conducL In greuLer
psycIoIogIcuI, socIuI, moruI und pIIIosopIIcuI conLexL, I.e., un III-
consIdered, sub-umuLeurIsI concepLuuI Irumework. TIe LIInkIng Is so
IuckIng In InsIgILJcompeLence LIuL IL seems Lo Iuve no grusp uL uII us Lo
LIe sIeer mugnILude oI ILs IoIIy, I.e., LIe urrogunce oI Ignorunce. or LIe
purposes oI LIIs dIscussIon, LIIs dysIuncLIon wIII be reIerred Lo us LIe
superiorit sndrome, I.e., u IIgIIy InIerIor LIInkIng IruuduIenLIy mude Lo
uppeur superIor und LIe busIs Ior LIen InsLIguLIng consIderubIe und IIgIIy
quesLIonubIe socIuI reIorms. TIe superIorILy syndrome wIII be IurLIer
consIdered us LIe dIscussIon proceeds.
NoLwILIsLundIng un InuuspIcIous sLurL Lo IIIesLyIe epIdemIoIogy,
un umounL oI genuIne scIoIursIIp wILIIn LIe medIcuI esLubIIsImenL couId
Iuve redIscovered uL IeusL some oI LIe edIcLs oI scIenLIIIc enquIry und
cuusuI urgumenL In LIe neur-IuII-cenLury sInce. ConLrurIIy, LIe sILuuLIon
Ius progressIveIy worsened. TIrougI IncompeLence, medIco-muLerIuIIsm
Ius Lrupped ILseII InLo u cIrcuIurILy. UnIorLunuLeIy, IL Is u seII-servIng
cIrcuIurILy. HuvIng eIevuLed ILs socIuI sLuLus LIrougI IruuduIenL depIcLIons
oI InIormuLIon, upurL Irom un ubsence oI scIoIursIIp, LIere Is no
moLIvuLIon Lo correcL or Lrunscend LIe InIerenLIuI mIre LIuL Ius been
produced: ncompeLence, Ignorunce, und superIIcIuIILy Iuve been
producLIve In muLerIuIIsLIc Lerms. UILImuLeIy, correcLIon cun onIy be
brougIL Lo beur Irom ouLsIde epIdemIoIogy und medIco-muLerIuIIsm.
TIe mosL ImporLunL uspecL oI LIe superIorILy syndrome Ior LIe
purposes oI LIIs dIscussIon Is LIuL IL does noL onIy LeucI LIuL rIsk
Lifestyle Epidemiology
126
126
.
Other Vitol Motters
.: Whct is Heclth?
One demund by LIe NuzI regIme wus LIuL IL wus LIe duLy oI every
cILIzen Lo be IeuILIy Ior LIe nuLIon. L wouId noL be un oversLuLemenL
LIuL Germun socIeLy under LIIs regIme dId noL ruLe IIgIIy In Lerms oI
psycIoIogIcuI, socIuI und moruI IeuILI. TIe NuzI menLuIILy wus essenLIuIIy
obsessed wILI bIoIogIcuIJpIysIcuI superIorILy (I.e., LIe Aryun ruce), e.g.,
LIe NuzI quesL Ior rucIuI und bodIIy purILy. (ProcLor, 1qq6, p.1qo) TIe
crILIcuI error In LIIs menLuIILy`s reusonIng Is LIe ussumpLIon, wIeLIer
expIIcIL or ImpIIcIL, LIuL II LIe bIoIogy Is weII, LIen uII Is weII. TIe
menLuIILy Is superIIcIuI , muLerIuIIsL und dungerous In dIsposILIon.
n conLrusL, deveIoped socIeLIes (e.g., US, UK, AusLruIIu, Cunudu)
Iuve In LIe pusL been reusonubIy cognIzunL oI dIsLIncLIons In Iumun
IuncLIonIng, IndIvIduuIIy und coIIecLIveIy, e.g., psycIoIogIcuI, socIuI.
HeuILI hcs been consIdered us more LIun jusL meusures oI bIoIogIcuI
IeuILI. or exumpIe, LIe WorId HeuILI OrgunIzuLIon (1qq6) deIIned IeuILI
us A sLuLe oI compIeLe pIysIcuI, menLuI und socIuI weII-beIng und noL
mereIy LIe ubsence oI dIseuse or InIIrmILy. (In ALrens, zooo, p.1z8) TIIs
ImmedIuLeIy-posL-WW deIInILIon, uL IeusL In purL, wouId Iuve been
moLIvuLed by LIe muLerIuIIsm oI LIe NuzI regIme und LIe very crILIcuI und
desLrucLIve roIe LIuL medIcuI prucLILIoners pIuyed In LIIs regIme. AIso, LIe
HIppocruLIc DIcLum oI IrsL do no Iurm IncIudes poLenLIuI
psycIoIogIcuI und socIuI Iurm.
MedIcuI prucLILIoners were mIndIuI oI LIe cupucILy oI u puLIenL`s
Iuck oI menLuI composure Lo udverseIy uIIecL LIeIr overuII IeuILI. A
subgroup oI persons wILI IIIness cun munIIesL neuroLIc LendencIes sucI us
dependency, muIudjusLmenL, unxIeLy, meLIcuIousness, perIecLIonIsm,
obsessIons (e.g., NeuIuus, 1q8; KeIIy & ZeIIer, 1q6q). A medIcuI
prucLILIoner needs Lo deLermIne wIuL u puLIenL Is bIoIogIcuIIyJ
pIysIoIogIcuIIy cupubIe oI und wIuL psycIogenIc (orIgInuLIng In LIougILJ
emoLIon) consLruInLs ure beIng pIuced on LIIs IuncLIonIng. Even wILI, Ior
exumpIe, posL-curdIuc urresL or posL-surgery, overproLecLIon muy become
Rampant Antismoking Signifies Grave Danger
uversIon Is un objecLIve posILIon, buL LIuL (s)rIsk uversIon Is uccorded LIe
sume objecLIve sLuLus. TIere muy Indeed be un urgumenL In some
InsLunces Ior uvoIdIng rIsk wIere u deLrImenLuI ouLcome cun reusonubIy
be deIIned In cuusuI Lerms. However, LIere Is no sucI jusLIIIcuLIon
concernIng (s)rIsk uversIon In LIuL LIe probubIIILy oI ouLcome Is LypIcuIIy
very smuII und LIere Is no deIIned cuusuI puLIwuy.
n summury, LIe superIorILy syndrome dogmuLIcuIIy preucIes
LIe IeuILIIsL medIco-muLerIuIIsL-exLernuIIsL-sLuLIsLIcuI (MMES) IIIesLyIe
(I.e., cuIL beIIeIs) LIuL Is obIIvIous Lo LIe very consIderubIe Issues oI menLuI
IeuILI und socIuI coIesIon.
127
127
.
Other Vitol Motters
.: Whct is Heclth?
One demund by LIe NuzI regIme wus LIuL IL wus LIe duLy oI every
cILIzen Lo be IeuILIy Ior LIe nuLIon. L wouId noL be un oversLuLemenL
LIuL Germun socIeLy under LIIs regIme dId noL ruLe IIgIIy In Lerms oI
psycIoIogIcuI, socIuI und moruI IeuILI. TIe NuzI menLuIILy wus essenLIuIIy
obsessed wILI bIoIogIcuIJpIysIcuI superIorILy (I.e., LIe Aryun ruce), e.g.,
LIe NuzI quesL Ior rucIuI und bodIIy purILy. (ProcLor, 1qq6, p.1qo) TIe
crILIcuI error In LIIs menLuIILy`s reusonIng Is LIe ussumpLIon, wIeLIer
expIIcIL or ImpIIcIL, LIuL II LIe bIoIogy Is weII, LIen uII Is weII. TIe
menLuIILy Is superIIcIuI , muLerIuIIsL und dungerous In dIsposILIon.
n conLrusL, deveIoped socIeLIes (e.g., US, UK, AusLruIIu, Cunudu)
Iuve In LIe pusL been reusonubIy cognIzunL oI dIsLIncLIons In Iumun
IuncLIonIng, IndIvIduuIIy und coIIecLIveIy, e.g., psycIoIogIcuI, socIuI.
HeuILI hcs been consIdered us more LIun jusL meusures oI bIoIogIcuI
IeuILI. or exumpIe, LIe WorId HeuILI OrgunIzuLIon (1qq6) deIIned IeuILI
us A sLuLe oI compIeLe pIysIcuI, menLuI und socIuI weII-beIng und noL
mereIy LIe ubsence oI dIseuse or InIIrmILy. (In ALrens, zooo, p.1z8) TIIs
ImmedIuLeIy-posL-WW deIInILIon, uL IeusL In purL, wouId Iuve been
moLIvuLed by LIe muLerIuIIsm oI LIe NuzI regIme und LIe very crILIcuI und
desLrucLIve roIe LIuL medIcuI prucLILIoners pIuyed In LIIs regIme. AIso, LIe
HIppocruLIc DIcLum oI IrsL do no Iurm IncIudes poLenLIuI
psycIoIogIcuI und socIuI Iurm.
MedIcuI prucLILIoners were mIndIuI oI LIe cupucILy oI u puLIenL`s
Iuck oI menLuI composure Lo udverseIy uIIecL LIeIr overuII IeuILI. A
subgroup oI persons wILI IIIness cun munIIesL neuroLIc LendencIes sucI us
dependency, muIudjusLmenL, unxIeLy, meLIcuIousness, perIecLIonIsm,
obsessIons (e.g., NeuIuus, 1q8; KeIIy & ZeIIer, 1q6q). A medIcuI
prucLILIoner needs Lo deLermIne wIuL u puLIenL Is bIoIogIcuIIyJ
pIysIoIogIcuIIy cupubIe oI und wIuL psycIogenIc (orIgInuLIng In LIougILJ
emoLIon) consLruInLs ure beIng pIuced on LIIs IuncLIonIng. Even wILI, Ior
exumpIe, posL-curdIuc urresL or posL-surgery, overproLecLIon muy become
Rampant Antismoking Signifies Grave Danger
uversIon Is un objecLIve posILIon, buL LIuL (s)rIsk uversIon Is uccorded LIe
sume objecLIve sLuLus. TIere muy Indeed be un urgumenL In some
InsLunces Ior uvoIdIng rIsk wIere u deLrImenLuI ouLcome cun reusonubIy
be deIIned In cuusuI Lerms. However, LIere Is no sucI jusLIIIcuLIon
concernIng (s)rIsk uversIon In LIuL LIe probubIIILy oI ouLcome Is LypIcuIIy
very smuII und LIere Is no deIIned cuusuI puLIwuy.
n summury, LIe superIorILy syndrome dogmuLIcuIIy preucIes
LIe IeuILIIsL medIco-muLerIuIIsL-exLernuIIsL-sLuLIsLIcuI (MMES) IIIesLyIe
(I.e., cuIL beIIeIs) LIuL Is obIIvIous Lo LIe very consIderubIe Issues oI menLuI
IeuILI und socIuI coIesIon.
128
128
Rampant Antismoking Signifies Grave Danger
probIemuLIc, I.e., ukIn Lo IosIng one`s nerve. EncourugemenL Is provIded
Lo overcome psycIoIogIcuI obsLucIes Lo uIIow u IuII recovery oI
pIysIoIogIcuI IuncLIon.
L cun uIso be suId LIuL jeopurdIzIng persons` menLuI IeuILI In
Lerms oI worry und unxIeLy on LIe busIs oI poLenLIuIIy IIImsy evIdence
(e.g., Iow-IeveI rIsk IucLors), und LIereIore jeopurdIzIng otercll IeuILI,
wouId noL Iuve been consIdered IIgILIy. I medIcuI prucLILIoners
menLIoned u rIsk IucLor (Iow-IeveI) Ior specIIIc dIseuse uL uII, LIey wouId
be quIck Lo poInL ouL LIuL IL Is onl u rIsk IucLor und LIereIore very IILLIe Is
undersLood ubouL ILs ucLuuI reIuLIonsIIp Lo LIe dIseuse In quesLIon und Ior
wIuL subgroup IL mIgIL crILIcuIIy be reIevunL. TIere Is even u Lerm Ior
udverse eIIecLs produced by u medIcuI prucLILIoner - ictroenic ejject.
TIIs LypIcuIIy IncIudes LIe deLrImenLuI consequences oI, Ior exumpIe,
mIsdIugnosIs, Improper medIcuLIon or combInuLIon oI medIcuLIons,
surgIcuI errors, negIIgence. L clso IncIudes IuLrogenIc pschopctholo.
BerrIdge (1qqq) IIgIIIgILs LIuL LIe mId-1q;o`s murks LIe
udopLIng oI u very dIsLIncL muLerIuIIsL sLunce Lo IeuILI promoLIon. L uIso
reIIecLs u worIdvIew or IdeoIogy In keepIng wILI beIuvIorIsm, I.e., LIe
mun-engIneered uLopIu. TIIs sLunce Is bused on LIe quunLIIIcuLIon oI
rIsk uIIorded by wIuL wus LIe IuIrIy new epIdemIoIogIcuI enquIry. A
crILIcuI uspecL oI LIe muLerIuIIsL pIIIosopIy Is LIe promoLIon oI LIe rIsk
uvoIdIng IndIvIduuI. AILIougI LIe muLerIuIIsL ussuuIL InvoIves unoLIer
bruncI Lo LIe LreuLmenL oI IeuILI (I.e., IumunIsm) LIuL wIII be dIscussed
In u IuLer cIupLer, IL wIII suIIIce Ior LIe LIme beIng Lo Iocus on LIe medIco-
muLerIuIIsL uspecL und Iow IL Ius sIuped LIe conLemporury Ideu oI IeuILI.
SInce LIe mId-1q;o`s LIere Ius been u porLruyIng oI IeuILI us
onl LIe ubsence oI dIseuse or InIIrmILy, or LIuL, II LIere Is ubsence oI
dIseuse or InIIrmILy, LIIs dIrecLIy und compIeLeIy LrunsIuLes InLo
psycIoIogIcuI, socIuI und moruI IeuILI. WIeLIer LIIs Is u beIIeI oI uII
medIcuI prucLILIoners In uII cIrcumsLunces Is IIgIIy urguubIe. However, us
wIII be consIdered, regurdIng epIdemIoIogy und prevenLIve medIcIne, und
wIIcI LIereIore concerns uccess Lo LIe musses LIrougI IeuILI
uuLIorILIes und IeuILI promoLIon, LIere Is demonsLruLed u compIeLe
dIsregurd Ior psycIo-IogIcuI, socIuI und moruI IeuILI. TIe ussuuIL on
purLIcuIurIy menLuI IeuILI Is LIrougI rIsk-IucLor epIdemIoIogy, LIe
empIusIs beIng on curbIngJmodIIyIng so-cuIIed unIeuILIy beIuvIors
(see uIso WurburLon, 1qq6).
L sIouId be oI greuL concern LIuL muny deveIoped nuLIons Iuve
become obsessed wILI ubsence-oI-dIseuse versIons oI IeuILI. L Is u
venLure down LIe sume conLorLed puLI us LIe medIco-muLerIuIIsm oI
NuzIsm.
CruwIord (1q8o) deIInes IeuILIIsm us u preoccupuLIon wILI
Other Vital Matters
personuI IeuILI us u prImury...Iocus Ior LIe deIInILIon und ucIIevemenL
oI weII-beIng. (quoLed In Ouks, zoo1, p. 8) However, LIIs Ideu oI IeuILI
Is conLInuuIIy porLruyed In muLerIuIIsL Lerms. HeuILIIsm Is reuIIy no more
LIun LIe ubsence-oI-dIseuse Ideu oI IeuILI.
Ouks (zoo1) IIgIIIgILs LIuL IeuILIIsm Ius been munuIucLured
InLo un IndIvIduuI moruI responsIbIIILy ( I.e., u duLy) sucI LIuL
IeuILI proIessIonuIs` udvocucy oI IeuILIIsm conLuIns u
moruI uppeuI Lo un IndIvIduuI`s puLrIoLIc responsIbIIILy
Lo boosL LIe nuLIon`s IeuILI. n IIs Ioreword Lo Heclth
People zooo, LIen SecreLury oI HeuILI ouIs SuIIIvun
IndIcuLes LIuL u beIIeI In eucI IndIvIduuI`s responsIbIIILy
Lo prevenL dIseuse sIouId pervude socIeLy:
Americcns..cre comin to reclize the injluence thct
the, themseltes, ccn hcte on their oun heclth
destinies cnd on the otercll heclth stctus oj the Nction.
(p. 8)
SLuLemenLs sucI us LIese ussume LIuL rIsk IucLoroIogy pInpoInLs
cuusuI puLIwuys so LIuL, Ior uny IndIvIduuI, eucI cun InIIuence..LIeIr
own IeuILI desLInIes. RIsk IucLoroIogy cun muke no sucI cIuIm.
urLIermore, LIIs Ideu oI puLrIoLIc responsIbIIILy Is ucLuuIIy LIe IeunIng
Lowurd u medIco-muLerIuIIsL-deIIned nuLIonuIIsm or IuscIsm. TIIs
Lendency und rIeLorIc were uIso seen In LIe NuzI regIme.
HeuILIIsm InvoIves uL IeusL Lwo enLIre seLs oI InIerenLIuI errors.
IrsLIy, IL ussumes u muLerIuIIsL worIdvIew. TIIs Is noL u scIenLIIIc
proposILIon, buL u quesLIonubIe pIIIosopIIcuI one; IL ussumes LIuL onIy
LIe muLerIuI worId exIsLs. GIven LIIs IIrsL ussumpLIon, IL LIen concIudes
LIuL, II onIy LIe muLerIuI worId exIsLs, LIen scIence, wIIcI Is concerned
wILI LIe muLerIuIIy observubIe und meusurubIe, cun uILImuLeIy uddress uII
exIsLenLIuI quesLIons (I.e., scIenLIsm). HeuILIIsm Is, LIereIore, LIIs
muLerIuIIsm, or scIenLIsm, dIrecLed uL Issues oI Iumun IeuILI. Ls mujor
busIs Ius been IIIesLyIe epIdemIoIogy LIuL operuLes enLIreIy on un ubsence-
oI-dIseuse upproucI Lo IeuILI. As Ius been consIdered, IIIesLyIe
epIdemIoIogy Is noL onIy noL scIenLIIIc, buL unLI-scIenLIIIc In momenLum,
I.e., degeneruLes InLo sLuLIsLIcuIIsm. HeuILIIsm, LIereIore, Is un un-
IorLunuLe use oI Lerms; LIuL IL Ius unyLIIng Lo do wILI IeuILI In uny sense
Is decepLIve. TIe ucLuuI ucLIvILy occurrIng Is sLuLIsLIcuIIsm musquerudIng
us scIence. TIe resuIL Is u conLemporury Ideu oI IeuILI LIuL Is predIcuLed
on quesLIonubIe pIIIosopIIcuI, scIenLIIIc, und psycIoIogIcuI, psycIosocIuI
und moruI IeuILI grounds, I.e., u Iuke moruIILy bused on u Iuke Ideu oI
IeuILI, bused on u Iuke Ideu oI scIence, bused on u Iuke Ideu oI exIsLence.
TIe pubIIc Is under u consLunL burruge oI rIsk IucLors Ior
129
129
Rampant Antismoking Signifies Grave Danger
probIemuLIc, I.e., ukIn Lo IosIng one`s nerve. EncourugemenL Is provIded
Lo overcome psycIoIogIcuI obsLucIes Lo uIIow u IuII recovery oI
pIysIoIogIcuI IuncLIon.
L cun uIso be suId LIuL jeopurdIzIng persons` menLuI IeuILI In
Lerms oI worry und unxIeLy on LIe busIs oI poLenLIuIIy IIImsy evIdence
(e.g., Iow-IeveI rIsk IucLors), und LIereIore jeopurdIzIng otercll IeuILI,
wouId noL Iuve been consIdered IIgILIy. I medIcuI prucLILIoners
menLIoned u rIsk IucLor (Iow-IeveI) Ior specIIIc dIseuse uL uII, LIey wouId
be quIck Lo poInL ouL LIuL IL Is onl u rIsk IucLor und LIereIore very IILLIe Is
undersLood ubouL ILs ucLuuI reIuLIonsIIp Lo LIe dIseuse In quesLIon und Ior
wIuL subgroup IL mIgIL crILIcuIIy be reIevunL. TIere Is even u Lerm Ior
udverse eIIecLs produced by u medIcuI prucLILIoner - ictroenic ejject.
TIIs LypIcuIIy IncIudes LIe deLrImenLuI consequences oI, Ior exumpIe,
mIsdIugnosIs, Improper medIcuLIon or combInuLIon oI medIcuLIons,
surgIcuI errors, negIIgence. L clso IncIudes IuLrogenIc pschopctholo.
BerrIdge (1qqq) IIgIIIgILs LIuL LIe mId-1q;o`s murks LIe
udopLIng oI u very dIsLIncL muLerIuIIsL sLunce Lo IeuILI promoLIon. L uIso
reIIecLs u worIdvIew or IdeoIogy In keepIng wILI beIuvIorIsm, I.e., LIe
mun-engIneered uLopIu. TIIs sLunce Is bused on LIe quunLIIIcuLIon oI
rIsk uIIorded by wIuL wus LIe IuIrIy new epIdemIoIogIcuI enquIry. A
crILIcuI uspecL oI LIe muLerIuIIsL pIIIosopIy Is LIe promoLIon oI LIe rIsk
uvoIdIng IndIvIduuI. AILIougI LIe muLerIuIIsL ussuuIL InvoIves unoLIer
bruncI Lo LIe LreuLmenL oI IeuILI (I.e., IumunIsm) LIuL wIII be dIscussed
In u IuLer cIupLer, IL wIII suIIIce Ior LIe LIme beIng Lo Iocus on LIe medIco-
muLerIuIIsL uspecL und Iow IL Ius sIuped LIe conLemporury Ideu oI IeuILI.
SInce LIe mId-1q;o`s LIere Ius been u porLruyIng oI IeuILI us
onl LIe ubsence oI dIseuse or InIIrmILy, or LIuL, II LIere Is ubsence oI
dIseuse or InIIrmILy, LIIs dIrecLIy und compIeLeIy LrunsIuLes InLo
psycIoIogIcuI, socIuI und moruI IeuILI. WIeLIer LIIs Is u beIIeI oI uII
medIcuI prucLILIoners In uII cIrcumsLunces Is IIgIIy urguubIe. However, us
wIII be consIdered, regurdIng epIdemIoIogy und prevenLIve medIcIne, und
wIIcI LIereIore concerns uccess Lo LIe musses LIrougI IeuILI
uuLIorILIes und IeuILI promoLIon, LIere Is demonsLruLed u compIeLe
dIsregurd Ior psycIo-IogIcuI, socIuI und moruI IeuILI. TIe ussuuIL on
purLIcuIurIy menLuI IeuILI Is LIrougI rIsk-IucLor epIdemIoIogy, LIe
empIusIs beIng on curbIngJmodIIyIng so-cuIIed unIeuILIy beIuvIors
(see uIso WurburLon, 1qq6).
L sIouId be oI greuL concern LIuL muny deveIoped nuLIons Iuve
become obsessed wILI ubsence-oI-dIseuse versIons oI IeuILI. L Is u
venLure down LIe sume conLorLed puLI us LIe medIco-muLerIuIIsm oI
NuzIsm.
CruwIord (1q8o) deIInes IeuILIIsm us u preoccupuLIon wILI
Other Vital Matters
personuI IeuILI us u prImury...Iocus Ior LIe deIInILIon und ucIIevemenL
oI weII-beIng. (quoLed In Ouks, zoo1, p. 8) However, LIIs Ideu oI IeuILI
Is conLInuuIIy porLruyed In muLerIuIIsL Lerms. HeuILIIsm Is reuIIy no more
LIun LIe ubsence-oI-dIseuse Ideu oI IeuILI.
Ouks (zoo1) IIgIIIgILs LIuL IeuILIIsm Ius been munuIucLured
InLo un IndIvIduuI moruI responsIbIIILy ( I.e., u duLy) sucI LIuL
IeuILI proIessIonuIs` udvocucy oI IeuILIIsm conLuIns u
moruI uppeuI Lo un IndIvIduuI`s puLrIoLIc responsIbIIILy
Lo boosL LIe nuLIon`s IeuILI. n IIs Ioreword Lo Heclth
People zooo, LIen SecreLury oI HeuILI ouIs SuIIIvun
IndIcuLes LIuL u beIIeI In eucI IndIvIduuI`s responsIbIIILy
Lo prevenL dIseuse sIouId pervude socIeLy:
Americcns..cre comin to reclize the injluence thct
the, themseltes, ccn hcte on their oun heclth
destinies cnd on the otercll heclth stctus oj the Nction.
(p. 8)
SLuLemenLs sucI us LIese ussume LIuL rIsk IucLoroIogy pInpoInLs
cuusuI puLIwuys so LIuL, Ior uny IndIvIduuI, eucI cun InIIuence..LIeIr
own IeuILI desLInIes. RIsk IucLoroIogy cun muke no sucI cIuIm.
urLIermore, LIIs Ideu oI puLrIoLIc responsIbIIILy Is ucLuuIIy LIe IeunIng
Lowurd u medIco-muLerIuIIsL-deIIned nuLIonuIIsm or IuscIsm. TIIs
Lendency und rIeLorIc were uIso seen In LIe NuzI regIme.
HeuILIIsm InvoIves uL IeusL Lwo enLIre seLs oI InIerenLIuI errors.
IrsLIy, IL ussumes u muLerIuIIsL worIdvIew. TIIs Is noL u scIenLIIIc
proposILIon, buL u quesLIonubIe pIIIosopIIcuI one; IL ussumes LIuL onIy
LIe muLerIuI worId exIsLs. GIven LIIs IIrsL ussumpLIon, IL LIen concIudes
LIuL, II onIy LIe muLerIuI worId exIsLs, LIen scIence, wIIcI Is concerned
wILI LIe muLerIuIIy observubIe und meusurubIe, cun uILImuLeIy uddress uII
exIsLenLIuI quesLIons (I.e., scIenLIsm). HeuILIIsm Is, LIereIore, LIIs
muLerIuIIsm, or scIenLIsm, dIrecLed uL Issues oI Iumun IeuILI. Ls mujor
busIs Ius been IIIesLyIe epIdemIoIogy LIuL operuLes enLIreIy on un ubsence-
oI-dIseuse upproucI Lo IeuILI. As Ius been consIdered, IIIesLyIe
epIdemIoIogy Is noL onIy noL scIenLIIIc, buL unLI-scIenLIIIc In momenLum,
I.e., degeneruLes InLo sLuLIsLIcuIIsm. HeuILIIsm, LIereIore, Is un un-
IorLunuLe use oI Lerms; LIuL IL Ius unyLIIng Lo do wILI IeuILI In uny sense
Is decepLIve. TIe ucLuuI ucLIvILy occurrIng Is sLuLIsLIcuIIsm musquerudIng
us scIence. TIe resuIL Is u conLemporury Ideu oI IeuILI LIuL Is predIcuLed
on quesLIonubIe pIIIosopIIcuI, scIenLIIIc, und psycIoIogIcuI, psycIosocIuI
und moruI IeuILI grounds, I.e., u Iuke moruIILy bused on u Iuke Ideu oI
IeuILI, bused on u Iuke Ideu oI scIence, bused on u Iuke Ideu oI exIsLence.
TIe pubIIc Is under u consLunL burruge oI rIsk IucLors Ior
130
130
Rampant Antismoking Signifies Grave Danger
specIIIc dIseuse LIuL uII sIouId prompLIy uvoId In LIe nuLIonuI InLeresL.
YeL, wIuL do LIe gross-IeveI sLuLIsLIcs oI reIuLIve rIsk or uveruge IongevILy
(I.e., unoLIer supposed IndIcuLor oI bIoIogIcuI IeuILI) ucLuuIIy IndIcuLe
ubouL persons, IIIe, und IIvIng? EpIdemIoIogIcuI sLudIes und generuI
sLuLIsLIcs IndIcuLe noLIIng ubouL Iow dIIIerenL persons uddress IIIe
generuIIy, or IIInessJmorLuIILy more specIIIcuIIy. Do persons demonsLruLe
uLLILudInuI (psycIoIogIcuI) IeuILI or do LIey coIIupse InLo u dysIuncLIonuI
mess? Do LIey demonsLruLe u consIsLenL InLegrILy oI conducL regurdIess oI
cIrcumsLunces? Are LIey opLImIsLIc or pessImIsLIc? Do LIey dIscern uny
LrunscendenL purpose Lo IIIe? None oI LIese quesLIons Is dIrecLIy
uddressed by sLundurd epIdemIoIogIcuI reseurcI; LIe muLerIuIIsm Is
obIIvIous Lo sucI concepLs.
TIere Is currenLIy consIderubIe debuLe us Lo LIe IuLure dIrecLIon
oI epIdemIoIogy. n commenLurIes on LIIs subsLunLIve Issue (e.g.,
McPIerson, 1qq8; PooIe & RoLImun, 1qq8; MuckenbucI, 1qq8;
KogevInus, 1qq8; VIneIs, 1qq8; MorubIu, 1qq8), wIIIe Lerms sucI us
mIcroepIdemIoIogy, rIsk IucLor epIdemIoIogy, mucroepIdemIoIogy,
ecoepIdemIoIogy, ecosocIuI epIdemIoIogIc LIeory ure spoken oI wILI
LIe greuLesL oI euse, LIe Lerm mentcl heclth, In uny sense, Is never once
reIerred Lo. TIe IndIvIduuI or person-IeveI oI InvesLIguLIon, wIIcI Is
covered by rIsk IucLor epIdemIoIogy, reIers onIy Lo beIuvIors und
exposures (I.e. beIuvIorIsm) - see uIso secLIon Rcdiccl ehctiorism. n
LIIs very IImILed sense, epIdemIoIogy Is depIcLIng persons us essenLIuIIy
Iomogeneous orgunIsms (bIoIogIcuIIy reducLIonIsL, muLerIuIIsL) wIose
gouI Is Lo IIve us Iong us possIbIe (unbrIdIed survIvuIIsm), supposedIy
LIrougI modIIIcuLIon oI beIuvIors und exposures bused on sLuLIsLIcuIIsm,
und devoId oI uny greuLer psycIoIogIcuI, socIuI und moruI Irumework.
urLIermore, LIe enLIre debuLe Is bereIL oI genuIne scIoIursIIp
In LIuL LIe epIdemIoIogIc membersIIp seems uLLerIy obIIvIous Lo LIe very
subsLunLIuI debuLe concernIng meLupIysIcuI depIcLIons oI LIe Iumun
condILIon (pIIIosopIy, eLIIcs, LrunscendenL psycIoIogy, spIrILuuIILy) und
socIo-poIILIcuI sysLems (e.g., democrucy, socIuIIsm, cupILuIIsm) LIuL Ius
occurred over LIe IusL number oI mIIIennIu. ConLemporury IIIesLyIe
epIdemIoIogy Ius gone jcr beyond ILs InILIuI und unsLubIe cIurLer, und by
LIIs LIme reIIecLs LIe IncoIerenL obIILeruLIng oI non-muLerIuIIsL IIsLory,
und LIe cruzed uLLempL Lo re-InvenL LIe exIsLenLIuI wIeeI enLIreIy
LIrougI noL onIy muLerIuIIsm buL epIdemIoIogy. RuLIer, IL Ius re-InvenLed
uspecLs oI ucLuurIuI sLudIes.
ALLempLIng Lo Iorwurd LIIs muLerIuIIsm us II IL Is u deIInILIve,
resoIved posILIon, I.e., IeuILIIsL propugundu, Is jusL IurLIer LesLImony LIuL
LIe menLuIILy Is weII-cIurucLerIzed us superIIcIuI, IncompeLenL und
ImmuLure, e.g., superIorILy syndrome. ConsIder, Ior exumpIe, IongevILy
Other Vital Matters
sLuLIsLIcs. n suner LImes, IorwurdIng uveruge IongevILy sLuLIsLIcs Ior Iurge
groups us unyLIIng oLIer LIun un exercIse In sLuLIsLIcuI IunLusy wouId Iuve
been meL wILI reusonubIe suspIcIon. OnIy sLuLIsLIcuI IunuLIcs or LIose wILI
quesLIonubIe ugendus couId beIIeve LIuL u person`s IIIe cun be reduced Lo u
sIngIe number. YeL LIIs sorL oI sLuLIsLIc, wIIcI ImproperIy ussumes
IomogeneILy oI wILIIn und beLween-group membersIIp upurL Irom un
experImenLuI IucLor und In onIy muLerIuIIsL Lerms Is u key poInL oI
preucIIng In IeuILIIsm.
n uII munner oI epIdemIoIogIc recommenduLIons Ior pubIIc-
IeuILI poIIcy bused onIy on reIuLIve rIsk oI bIoIogIcuI dIseuse LIere ure no
menLuI concepLs Lo be Iound, or LIe poLenLIuI deLrImenLuI repercussIons oI
sucI poIIcy on menLuI IeuILI und socIuI coIesIon. ConLemporury
epIdemIoIogIc reseurcI demonsLruLes no cognIzunce oI menLuI IucLors In
IeuILI ct cll. n Ouks` (zoo1) presenLuLIon oI wIuL IeuILI proIessIonuIs
consIder ImporL-unL In LIeIr cIIenL conLucL, IL Is mosL usLoundIng LIuL
mentcl heclth Is noL reIerred Lo - even once. n LIuL mosL oI LIIs conducL
Ius no coIerenL, scIenLIIIc IounduLIon, IL reIIecLs u conLempLuous ussuuIL
on psycIoIogIcuI, socIuI und moruI IeuILI. n LIIs regurd, muny
orgunIzuLIons ure noL IeuILI, buL ure medIco-muLerIuIIsL orgunIzuLIons.
TIe sume cun be suId Ior LIe dIsposILIon oI LIe so-cuIIed IeuILI experLs
LIuL run LIem.
.z Smolers cnd Nonsmolers
TIe use oI reIuLIve-rIsk ruLIos Ior Lwo groups (e.g., smokersJ
nonsmokers) ussumes u IomogeneILy oI group membersIIp, boLI wILIIn
und beLween groups, upurL Irom LIe experImenLuI IucLor In quesLIon
(smokIng). TIomus (1q6o) IndIcuLed LIuL II smokers und nonsmokers ure
uIIke beIore LIey Luke up LIe IubIL LIen LIey cun be consIdered us u sIngIe
popuIuLIon wILI u unIIorm IIIe expecLuncy. I, Iowever, smokers Iuve
consLILuLIonuI dIIIerences Irom non-smokers, LIe Lwo groups mIgIL Iuve
InIerenLIy dIIIerenL morLuIILy ruLes und one group couId noL serve us u
conLroI Ior LIe oLIer In sLuLIsLIcuI sLudIes. TIere muy be oLIer dIIIerences
beLween LIe groups (e.g., psycIoIogIcuI, socIuI) LIuL InIIuence IongevILy.
urLIermore, LIe groups LIemseIves muy noL be Iomogeneous, I.e., LIey
ure composed oI u vurIeLy oI subgroups wILIIn eucI overuII group.
n LIe currenL conLexL concernIng ussocIuLIons wILI dIseuseJ
morLuIILy, IL cun reusonubIy be urgued LIuL eurIy morLuIILy, wIeLIer IL be
Ior smokers or nonsmokers, Is uLypIcuI und u very dIIIerenL muLLer Lo oIder
uge morLuIILy. TIese wIII InvoIve quILe dIIIerenL ImpIIcuLed und crILIcuI
IucLors. TIereIore, LIere ure ImmedIuLeIy subgroup dIvIsIons Ior LIe
overuII groups. urLIermore, IL wouId be u IIgIIy Lenuous urgumenL LIuL
131
131
Rampant Antismoking Signifies Grave Danger
specIIIc dIseuse LIuL uII sIouId prompLIy uvoId In LIe nuLIonuI InLeresL.
YeL, wIuL do LIe gross-IeveI sLuLIsLIcs oI reIuLIve rIsk or uveruge IongevILy
(I.e., unoLIer supposed IndIcuLor oI bIoIogIcuI IeuILI) ucLuuIIy IndIcuLe
ubouL persons, IIIe, und IIvIng? EpIdemIoIogIcuI sLudIes und generuI
sLuLIsLIcs IndIcuLe noLIIng ubouL Iow dIIIerenL persons uddress IIIe
generuIIy, or IIInessJmorLuIILy more specIIIcuIIy. Do persons demonsLruLe
uLLILudInuI (psycIoIogIcuI) IeuILI or do LIey coIIupse InLo u dysIuncLIonuI
mess? Do LIey demonsLruLe u consIsLenL InLegrILy oI conducL regurdIess oI
cIrcumsLunces? Are LIey opLImIsLIc or pessImIsLIc? Do LIey dIscern uny
LrunscendenL purpose Lo IIIe? None oI LIese quesLIons Is dIrecLIy
uddressed by sLundurd epIdemIoIogIcuI reseurcI; LIe muLerIuIIsm Is
obIIvIous Lo sucI concepLs.
TIere Is currenLIy consIderubIe debuLe us Lo LIe IuLure dIrecLIon
oI epIdemIoIogy. n commenLurIes on LIIs subsLunLIve Issue (e.g.,
McPIerson, 1qq8; PooIe & RoLImun, 1qq8; MuckenbucI, 1qq8;
KogevInus, 1qq8; VIneIs, 1qq8; MorubIu, 1qq8), wIIIe Lerms sucI us
mIcroepIdemIoIogy, rIsk IucLor epIdemIoIogy, mucroepIdemIoIogy,
ecoepIdemIoIogy, ecosocIuI epIdemIoIogIc LIeory ure spoken oI wILI
LIe greuLesL oI euse, LIe Lerm mentcl heclth, In uny sense, Is never once
reIerred Lo. TIe IndIvIduuI or person-IeveI oI InvesLIguLIon, wIIcI Is
covered by rIsk IucLor epIdemIoIogy, reIers onIy Lo beIuvIors und
exposures (I.e. beIuvIorIsm) - see uIso secLIon Rcdiccl ehctiorism. n
LIIs very IImILed sense, epIdemIoIogy Is depIcLIng persons us essenLIuIIy
Iomogeneous orgunIsms (bIoIogIcuIIy reducLIonIsL, muLerIuIIsL) wIose
gouI Is Lo IIve us Iong us possIbIe (unbrIdIed survIvuIIsm), supposedIy
LIrougI modIIIcuLIon oI beIuvIors und exposures bused on sLuLIsLIcuIIsm,
und devoId oI uny greuLer psycIoIogIcuI, socIuI und moruI Irumework.
urLIermore, LIe enLIre debuLe Is bereIL oI genuIne scIoIursIIp
In LIuL LIe epIdemIoIogIc membersIIp seems uLLerIy obIIvIous Lo LIe very
subsLunLIuI debuLe concernIng meLupIysIcuI depIcLIons oI LIe Iumun
condILIon (pIIIosopIy, eLIIcs, LrunscendenL psycIoIogy, spIrILuuIILy) und
socIo-poIILIcuI sysLems (e.g., democrucy, socIuIIsm, cupILuIIsm) LIuL Ius
occurred over LIe IusL number oI mIIIennIu. ConLemporury IIIesLyIe
epIdemIoIogy Ius gone jcr beyond ILs InILIuI und unsLubIe cIurLer, und by
LIIs LIme reIIecLs LIe IncoIerenL obIILeruLIng oI non-muLerIuIIsL IIsLory,
und LIe cruzed uLLempL Lo re-InvenL LIe exIsLenLIuI wIeeI enLIreIy
LIrougI noL onIy muLerIuIIsm buL epIdemIoIogy. RuLIer, IL Ius re-InvenLed
uspecLs oI ucLuurIuI sLudIes.
ALLempLIng Lo Iorwurd LIIs muLerIuIIsm us II IL Is u deIInILIve,
resoIved posILIon, I.e., IeuILIIsL propugundu, Is jusL IurLIer LesLImony LIuL
LIe menLuIILy Is weII-cIurucLerIzed us superIIcIuI, IncompeLenL und
ImmuLure, e.g., superIorILy syndrome. ConsIder, Ior exumpIe, IongevILy
Other Vital Matters
sLuLIsLIcs. n suner LImes, IorwurdIng uveruge IongevILy sLuLIsLIcs Ior Iurge
groups us unyLIIng oLIer LIun un exercIse In sLuLIsLIcuI IunLusy wouId Iuve
been meL wILI reusonubIe suspIcIon. OnIy sLuLIsLIcuI IunuLIcs or LIose wILI
quesLIonubIe ugendus couId beIIeve LIuL u person`s IIIe cun be reduced Lo u
sIngIe number. YeL LIIs sorL oI sLuLIsLIc, wIIcI ImproperIy ussumes
IomogeneILy oI wILIIn und beLween-group membersIIp upurL Irom un
experImenLuI IucLor und In onIy muLerIuIIsL Lerms Is u key poInL oI
preucIIng In IeuILIIsm.
n uII munner oI epIdemIoIogIc recommenduLIons Ior pubIIc-
IeuILI poIIcy bused onIy on reIuLIve rIsk oI bIoIogIcuI dIseuse LIere ure no
menLuI concepLs Lo be Iound, or LIe poLenLIuI deLrImenLuI repercussIons oI
sucI poIIcy on menLuI IeuILI und socIuI coIesIon. ConLemporury
epIdemIoIogIc reseurcI demonsLruLes no cognIzunce oI menLuI IucLors In
IeuILI ct cll. n Ouks` (zoo1) presenLuLIon oI wIuL IeuILI proIessIonuIs
consIder ImporL-unL In LIeIr cIIenL conLucL, IL Is mosL usLoundIng LIuL
mentcl heclth Is noL reIerred Lo - even once. n LIuL mosL oI LIIs conducL
Ius no coIerenL, scIenLIIIc IounduLIon, IL reIIecLs u conLempLuous ussuuIL
on psycIoIogIcuI, socIuI und moruI IeuILI. n LIIs regurd, muny
orgunIzuLIons ure noL IeuILI, buL ure medIco-muLerIuIIsL orgunIzuLIons.
TIe sume cun be suId Ior LIe dIsposILIon oI LIe so-cuIIed IeuILI experLs
LIuL run LIem.
.z Smolers cnd Nonsmolers
TIe use oI reIuLIve-rIsk ruLIos Ior Lwo groups (e.g., smokersJ
nonsmokers) ussumes u IomogeneILy oI group membersIIp, boLI wILIIn
und beLween groups, upurL Irom LIe experImenLuI IucLor In quesLIon
(smokIng). TIomus (1q6o) IndIcuLed LIuL II smokers und nonsmokers ure
uIIke beIore LIey Luke up LIe IubIL LIen LIey cun be consIdered us u sIngIe
popuIuLIon wILI u unIIorm IIIe expecLuncy. I, Iowever, smokers Iuve
consLILuLIonuI dIIIerences Irom non-smokers, LIe Lwo groups mIgIL Iuve
InIerenLIy dIIIerenL morLuIILy ruLes und one group couId noL serve us u
conLroI Ior LIe oLIer In sLuLIsLIcuI sLudIes. TIere muy be oLIer dIIIerences
beLween LIe groups (e.g., psycIoIogIcuI, socIuI) LIuL InIIuence IongevILy.
urLIermore, LIe groups LIemseIves muy noL be Iomogeneous, I.e., LIey
ure composed oI u vurIeLy oI subgroups wILIIn eucI overuII group.
n LIe currenL conLexL concernIng ussocIuLIons wILI dIseuseJ
morLuIILy, IL cun reusonubIy be urgued LIuL eurIy morLuIILy, wIeLIer IL be
Ior smokers or nonsmokers, Is uLypIcuI und u very dIIIerenL muLLer Lo oIder
uge morLuIILy. TIese wIII InvoIve quILe dIIIerenL ImpIIcuLed und crILIcuI
IucLors. TIereIore, LIere ure ImmedIuLeIy subgroup dIvIsIons Ior LIe
overuII groups. urLIermore, IL wouId be u IIgIIy Lenuous urgumenL LIuL
132
132
Rampant Antismoking Signifies Grave Danger
eurIy morLuIILy Ior nonsmokers Is someIow normuLIve und uguInsL
wIIcI eurIy morLuIILy Ior smokers sIouId be dIrecLIy compured. TIe Lwo
overuII groups ure not Iomogeneous, eILIer wILIIn or beLween groups.
TIese dIsLIncLIons ure LypIcuIIy noL uccounLed Ior. Use oI LIe reIuLIve rIsk
ruLIo, wIIcI bundIes uII oI LIese dijjerent subdIvIsIons InLo one overuII
sLuLIsLIc, cun onl be mIsIeudIng.
Smolers
L wus eurIIer consIdered LIuL LIe IubIL oI smokIng muy InvoIve u
convergence eIIecL Ior some smokers. However, LIe smoker`s group
mIgIL be composed oI even more numerous subgroups wIen one
consIders LIe reusons Ior wIy dIIIerenL smokers persIsL wILI LIe IubIL.
Eysenck (1q;) suggesLed LIuL persons smoke Ior u vurIeLy oI reusons und
LIuL LIey ure mosLIy personuIILy-bused. PersIsLenL smokIng occurs becuuse
LIe smoker derIves cerLuIn beneIILs (meeLIng oI needs) Irom smokIng ukIn
Lo euLIng, drInkIng, eLc.. or exumpIe, exLruverLs smoke Lo reduce
boredom by ruIsIng LIe IeveI oI corLIcuI urousuI. Some neuroLIcuIIy
dIsposed mIgIL smoke Lo reduce LensIon und unxIeLy. TIe eIIecLs oI
nIcoLIne ure bIpIusIc; by vuryIng nIcoLIne InLuke, LIe eIIecL cun eILIer be
sLImuIuLIng or reIuxIng (Eysenck, 1q8o; rILI, 1q;1). TIIs bIpIusIc eIIecL
wus uIso consIdered In LIe SG ReporL (1q6q, p. qq-o).
TomkIns (1q68) suggesLs un AIIecL ConLroI ModeI (ACM)
wIIcI dIscerns Iour generuI Lypes oI smokIng: (u) posILIve uIIecL smokIng,
(b) neguLIve uIIecL smokIng, (c) uddIcLIve smokIng, und (d) IubILuuI
smokIng. PosILIve-uIIecL smokers predomInunLIy smoke Lo enIunce good
experIences. NeguLIve-uIIecL smokers predomInunLIy smoke Lo reduce
unpIeusunL IeeIIngs sucI us Ieur, dIsLress, sIume, unger. AddIcLIve-Lype
smokIng reIIecLs u combInuLIon oI LIe prevIous Lwo uIIecLs; persons smoke
Lo promoLe posILIve uIIecL und Lo reduce neguLIve uIIecL. AddIcLIon In LIIs
sense Is pscholoiccl. HubILuuI smokers ure cIurucLerIzed us LIose wIo
uL one LIme muy Iuve been In one oI LIe prevIous LIree cuLegorIes.
However, LIe uIIecL Is no Ionger ussocIuLed wILI smokIng wIIcI Ius
become un uuLomuLIc IubIL.
Eysenck (1qq1) poInLs ouL LIuL LIe ACM muy onIy uccounL Ior u
subseL oI reusons us Lo wIy persons smoke. urLIermore, LIe currenL
depIcLIon concerns LIe muInLenunce ruLIer LIun LIe orIgIn oI LIe smokIng
IubIL. SmokIng muInLenunce muy be more cIoseIy reIuLed Lo, Ior exumpIe,
psycIo-emoLIonuI needs und muy Iuve u consIderubIe geneLIc eIemenL
(Eysenck, 1q8o). TIIs Is conLrusLed wILI IubIL ucquIsILIon wIIcI muy be
more cIoseIy reIuLed Lo peer pressure.
As menLIoned, LIe ACM mIgIL noL do jusLIce Lo LIe greuLer
Other Vital Matters
vurIeLy oI reusons Ior persIsLenL smokIng. n uddILIon Lo reducIng
boredom, LIe ucL oI smokIng seems Lo psycIoIogIcuIIy deIImIL LemporuI
segmenLs. DIcILer (1qq;), Irom InLervIews wILI smokers, noLed LIuL u
cIgureLLe cun uIIow un eIIecLIve breuk In work. A cIgureLLe cun be u
meusure oI LIme, e.g., wIIIsL wuILIng Ior un uppoInLmenL, und cun Iuve LIe
psycIoIogIcuI uIIecL oI LIme proceedIng more quIckIy. SmokIng cun
Increuse uLLenLIon und reduce drowsIness, e.g., useIuI In sLudy, work (uIso
WurburLon eL uI., 1q88; PomerIeuu & PomerIeuu, 1q8q).
WurburLon (1qqou) reILeruLes IIs IuncLIonuI vIew oI nIcoLIne use
wIIcI regurds smokIng us u person`s use oI nIcoLIne Lo conLroI LIeIr
psycIoIogIcuI sLuLe (p.1), e.g., mood conLroI und cognILIve enIuncemenL.
SIerwood (1qq6) concIudes LIuL one ImporLunL uspecL oI quuIILy oI IIIe Is
LIe ubIIILy Lo cope, Lo IuncLIon normuIIy wILI IuII InLegruLIon oI LIe
psycIoIogIcuI processes underIyIng skIIIed beIuvIor. n LIIs respecL,
coIIee, Leu, cIocoIuLe und Lobucco ure IuIIy compuLIbIe wILI LIe demunds
oI everyduy IIIe In LIuL LIese psycIoIogIcuI processes ure noL
compromIsed. urLIer Lo LIIs, LIe evIdence presenLed Iere suggesLs LIuL
some uspecLs oI psycIomoLor perIormunce muy even be enIunced by
LIese producLs, uIIowIng LIe IndIvIduuI Lo beneIIL Irom Improved
beIuvIoruI IuncLIonIng und Lo counLer LIe neguLIve eIIecLs oI
sLressors. (p.q) Duwson (quoLed In OukIey, 1qqq) consIders L`s u wuy
oI IIIe. WIuL LIe smoker enjoys Is LIe wIoIe experIence, LIe rouLIne oI
IundIIng LIe puck und LIe cIgureLLe, IIgILIng up, guzIng InLo LIe IIume, LIe
oruI suLIsIucLIon oI druwIng, LIe LusLe und LIe smeII. EuLIng und drInkIng
ure synergIsLIc wILI smokIng; LIey eucI enIunce LIe LusLe oI LIe smoke,
und smokIng enIunces LIe conLempIuLIon oI Iood und drInk. (CI.q, p.qz)
One ureu LIuL Ius been very mucI unconsIdered Is LIe use oI
smokIng In non-verbuI communIcuLIon. Persons cun smoke dIIIerenLIy In
dIIIerenL sILuuLIons, e.g., LIe wuy u cIgureLLe Is IeId, exIuIuLIon,
gesLIcuIuLIons. SmokIng cun uIso ussIsL In breukIng down socIuI burrIers -
LIe requesL Ior u cIgureLLe, LIe requesL Ior u IIgIL. Persons ure uImosL
guurunLeed LIuL LIe socIuI sILuuLIon wIII noL dIsbund uL IeusL unLII u person
Ius IInIsIed LIe cIgureLLe.
AnoLIer ureu LIuL Is unconsIdered Is LIe symboIIsm oI smokIng
In greuLer socIuI conLexL. L Is u IubIL LIuL cun be un ImporLunL uspecL oI
socIuIIzIng und Ius brIdged LIe socIo-economIc dIvIde, I.e., u Iorm oI
socIo-economIc equuIIzer. DuvIes (1qq6) proIIers:
n Europe und NorLI AmerIcu Leu, coIIee, uIcoIoI und
Lobucco ure producLs exLensIveIy used becuuse oI LIe
pIeusure LIey gIve Lo LIe users, noL jusL us IndIvIduuIs
buL In groups. Teu, coIIee und uIcoIoI ure LIe
IounduLIons oI mucI socIubIIILy, Ior LypIcuIIy LIey ure
133
133
Rampant Antismoking Signifies Grave Danger
eurIy morLuIILy Ior nonsmokers Is someIow normuLIve und uguInsL
wIIcI eurIy morLuIILy Ior smokers sIouId be dIrecLIy compured. TIe Lwo
overuII groups ure not Iomogeneous, eILIer wILIIn or beLween groups.
TIese dIsLIncLIons ure LypIcuIIy noL uccounLed Ior. Use oI LIe reIuLIve rIsk
ruLIo, wIIcI bundIes uII oI LIese dijjerent subdIvIsIons InLo one overuII
sLuLIsLIc, cun onl be mIsIeudIng.
Smolers
L wus eurIIer consIdered LIuL LIe IubIL oI smokIng muy InvoIve u
convergence eIIecL Ior some smokers. However, LIe smoker`s group
mIgIL be composed oI even more numerous subgroups wIen one
consIders LIe reusons Ior wIy dIIIerenL smokers persIsL wILI LIe IubIL.
Eysenck (1q;) suggesLed LIuL persons smoke Ior u vurIeLy oI reusons und
LIuL LIey ure mosLIy personuIILy-bused. PersIsLenL smokIng occurs becuuse
LIe smoker derIves cerLuIn beneIILs (meeLIng oI needs) Irom smokIng ukIn
Lo euLIng, drInkIng, eLc.. or exumpIe, exLruverLs smoke Lo reduce
boredom by ruIsIng LIe IeveI oI corLIcuI urousuI. Some neuroLIcuIIy
dIsposed mIgIL smoke Lo reduce LensIon und unxIeLy. TIe eIIecLs oI
nIcoLIne ure bIpIusIc; by vuryIng nIcoLIne InLuke, LIe eIIecL cun eILIer be
sLImuIuLIng or reIuxIng (Eysenck, 1q8o; rILI, 1q;1). TIIs bIpIusIc eIIecL
wus uIso consIdered In LIe SG ReporL (1q6q, p. qq-o).
TomkIns (1q68) suggesLs un AIIecL ConLroI ModeI (ACM)
wIIcI dIscerns Iour generuI Lypes oI smokIng: (u) posILIve uIIecL smokIng,
(b) neguLIve uIIecL smokIng, (c) uddIcLIve smokIng, und (d) IubILuuI
smokIng. PosILIve-uIIecL smokers predomInunLIy smoke Lo enIunce good
experIences. NeguLIve-uIIecL smokers predomInunLIy smoke Lo reduce
unpIeusunL IeeIIngs sucI us Ieur, dIsLress, sIume, unger. AddIcLIve-Lype
smokIng reIIecLs u combInuLIon oI LIe prevIous Lwo uIIecLs; persons smoke
Lo promoLe posILIve uIIecL und Lo reduce neguLIve uIIecL. AddIcLIon In LIIs
sense Is pscholoiccl. HubILuuI smokers ure cIurucLerIzed us LIose wIo
uL one LIme muy Iuve been In one oI LIe prevIous LIree cuLegorIes.
However, LIe uIIecL Is no Ionger ussocIuLed wILI smokIng wIIcI Ius
become un uuLomuLIc IubIL.
Eysenck (1qq1) poInLs ouL LIuL LIe ACM muy onIy uccounL Ior u
subseL oI reusons us Lo wIy persons smoke. urLIermore, LIe currenL
depIcLIon concerns LIe muInLenunce ruLIer LIun LIe orIgIn oI LIe smokIng
IubIL. SmokIng muInLenunce muy be more cIoseIy reIuLed Lo, Ior exumpIe,
psycIo-emoLIonuI needs und muy Iuve u consIderubIe geneLIc eIemenL
(Eysenck, 1q8o). TIIs Is conLrusLed wILI IubIL ucquIsILIon wIIcI muy be
more cIoseIy reIuLed Lo peer pressure.
As menLIoned, LIe ACM mIgIL noL do jusLIce Lo LIe greuLer
Other Vital Matters
vurIeLy oI reusons Ior persIsLenL smokIng. n uddILIon Lo reducIng
boredom, LIe ucL oI smokIng seems Lo psycIoIogIcuIIy deIImIL LemporuI
segmenLs. DIcILer (1qq;), Irom InLervIews wILI smokers, noLed LIuL u
cIgureLLe cun uIIow un eIIecLIve breuk In work. A cIgureLLe cun be u
meusure oI LIme, e.g., wIIIsL wuILIng Ior un uppoInLmenL, und cun Iuve LIe
psycIoIogIcuI uIIecL oI LIme proceedIng more quIckIy. SmokIng cun
Increuse uLLenLIon und reduce drowsIness, e.g., useIuI In sLudy, work (uIso
WurburLon eL uI., 1q88; PomerIeuu & PomerIeuu, 1q8q).
WurburLon (1qqou) reILeruLes IIs IuncLIonuI vIew oI nIcoLIne use
wIIcI regurds smokIng us u person`s use oI nIcoLIne Lo conLroI LIeIr
psycIoIogIcuI sLuLe (p.1), e.g., mood conLroI und cognILIve enIuncemenL.
SIerwood (1qq6) concIudes LIuL one ImporLunL uspecL oI quuIILy oI IIIe Is
LIe ubIIILy Lo cope, Lo IuncLIon normuIIy wILI IuII InLegruLIon oI LIe
psycIoIogIcuI processes underIyIng skIIIed beIuvIor. n LIIs respecL,
coIIee, Leu, cIocoIuLe und Lobucco ure IuIIy compuLIbIe wILI LIe demunds
oI everyduy IIIe In LIuL LIese psycIoIogIcuI processes ure noL
compromIsed. urLIer Lo LIIs, LIe evIdence presenLed Iere suggesLs LIuL
some uspecLs oI psycIomoLor perIormunce muy even be enIunced by
LIese producLs, uIIowIng LIe IndIvIduuI Lo beneIIL Irom Improved
beIuvIoruI IuncLIonIng und Lo counLer LIe neguLIve eIIecLs oI
sLressors. (p.q) Duwson (quoLed In OukIey, 1qqq) consIders L`s u wuy
oI IIIe. WIuL LIe smoker enjoys Is LIe wIoIe experIence, LIe rouLIne oI
IundIIng LIe puck und LIe cIgureLLe, IIgILIng up, guzIng InLo LIe IIume, LIe
oruI suLIsIucLIon oI druwIng, LIe LusLe und LIe smeII. EuLIng und drInkIng
ure synergIsLIc wILI smokIng; LIey eucI enIunce LIe LusLe oI LIe smoke,
und smokIng enIunces LIe conLempIuLIon oI Iood und drInk. (CI.q, p.qz)
One ureu LIuL Ius been very mucI unconsIdered Is LIe use oI
smokIng In non-verbuI communIcuLIon. Persons cun smoke dIIIerenLIy In
dIIIerenL sILuuLIons, e.g., LIe wuy u cIgureLLe Is IeId, exIuIuLIon,
gesLIcuIuLIons. SmokIng cun uIso ussIsL In breukIng down socIuI burrIers -
LIe requesL Ior u cIgureLLe, LIe requesL Ior u IIgIL. Persons ure uImosL
guurunLeed LIuL LIe socIuI sILuuLIon wIII noL dIsbund uL IeusL unLII u person
Ius IInIsIed LIe cIgureLLe.
AnoLIer ureu LIuL Is unconsIdered Is LIe symboIIsm oI smokIng
In greuLer socIuI conLexL. L Is u IubIL LIuL cun be un ImporLunL uspecL oI
socIuIIzIng und Ius brIdged LIe socIo-economIc dIvIde, I.e., u Iorm oI
socIo-economIc equuIIzer. DuvIes (1qq6) proIIers:
n Europe und NorLI AmerIcu Leu, coIIee, uIcoIoI und
Lobucco ure producLs exLensIveIy used becuuse oI LIe
pIeusure LIey gIve Lo LIe users, noL jusL us IndIvIduuIs
buL In groups. Teu, coIIee und uIcoIoI ure LIe
IounduLIons oI mucI socIubIIILy, Ior LypIcuIIy LIey ure
134
134
Rampant Antismoking Signifies Grave Danger
consumed In compuny und ure LIe busIs boLI oI socIuI
InvILuLIons Lo peopIe`s Iomes und oI sponLuneous und
reguIur meeLIngs In pubs, coIIee burs und Leu sIops.
TIey ure uII drInks LIuL ure eusy Lo prepure or purcIuse.
n oLIer socIeLIes, Lobucco Is used In LIe sume wuy..
L Is oILen convenLIonuIIy uccepLed on sucI occusIons
LIuL puymenL wIII be on LIe busIs oI sIurIng ruLIer LIun
IndIvIduuI cuIcuIuLIon, us wIen u person buys u round oI
drInks or oIIers u puckeL oI cIgureLLes uround u group
beIore LukIng one Ior IImseII or IerseII. (p.z1)
DuvIes (1qq6) uIso properIy noLes LIuL medIco-muLerIuIIsm, u
reducLIonIsL vIew, Is unquuIIIIed Lo ussess psycIoIogIcuI und psycIosocIuI
dImensIons oI purLIcuIur IubILs, IeL uIone LIeIr possIbIe beneIILs:
ReseurcI InLo producL use wIII Lend Lo LreuL IL us u mere cuse oI drugs
beIng IngesLed by IsoIuLed IndIvIduuIs und LIen Lo meusure uny cIunges In
pIysIoIogIcuI IuncLIonIng. SucI u procedure wouId IuII Lo pIck up LIe
beneIILs Lo LIe IeuILI und weII-beIng oI IndIvIduuIs LIuL uccrue Irom LIe
wuy In wIIcI sucI producLs IucIIILuLe socIubIIILy. As u consequence, LIeIr
key IuncLIon In socIeLy wIII be Ignored. (p.zqo)
n revIewIng HIILon`s (zooo) Smolin in ritish Populcr
Culture :8oo-zooo, MurLyn (zooo) IndIcuLes LIuL |d|ocLors IeeI
IrusLruLed wIen puLIenLs deIy wIuL seems unussuIIubIy ruLIonuI udvIce Lo
sLop smokIng. TIey reucL by demonIsIng LIe beIuvIour oI Lobucco
compunIes und LIe uddIcLIve power oI nIcoLIne. BuL LIe expIunuLIon Is
more compIIcuLed n LIIs book HIILon sIows Iow smokIng Is deepIy
embedded In u cuILuruI Irumework LIuL conLInues Lo ussocIuLe LIe IubIL
wILI posILIve uLLrIbuLes. A cIgur Is never jusL u cIgur. L musL be
remembered LIuL, Ior LIe superIIcIuIILy oI muLerIuIIsm, smokIng Is no
more LIuL brIngIng u IIL cyIInder oI Lobucco Lo LIe IIps und InIuIIng;
muILIdImensIonuI symboIIsm Is beyond LIe sIuIIowness oI muLerIuIIsm.
urLIermore, muInLenunce oI LIe IubIL, In uddILIon Lo eurIIer-
menLIoned IucLors, cun provIde u sense oI perceIved conLroI. or
exumpIe, persons In LIe Iower socIo-economIc cIuss, und wIere LIere Is u
greuLer prevuIence oI smokIng In u number oI deveIoped nuLIons (e.g., see
CuveIuurs eL uI., zooo), muy muInLuIn LIe IubIL oI smokIng gIven LIuL
LIeIr generuI socIuI cIrcumsLunces ure uIreudy quILe rIsky, e.g., In Lerms
oI uccess Lo IeuILI cure, uspIruLIons, IodgIngs. I LIe person beIIeves LIey
Iuve very IILLIe conLroI over LIese cIrcumsLunces (IeIpIessness), smokIng
cun ucL us u subsLILuLe LIuL produces u sense oI perceIved conLroI. n oLIer
words, Ior some persons u beIuvIor muy be ussocIuLed wILI rIsk
(smokIng), buL IL Is u rIsk LIuL LIey uL IeusL Iuve u dIrecL suy In. TIIs
Other Vital Matters
sIouId noL be conIused wILI reckIessness. TIe persons InvoIved ure noL
LIrIII-seekIng buL, ruLIer, uLLempLIng Lo deuI wILI perceIved
IeIpIessness.
TIere Is uIso LIe Issue oI LIe cIgureLLe`s symboIIsm In perceIved
democruLIc Ireedom (e.g., TuLe, 1qqq - see uIso secLIon A riej Histor oj
Antismolin). ALLempLs Lo conLroI LIe IubIL by LIe SLuLe, und usuuIIy Ior
unIounded reusons, cun be meL wILI resenLmenL or resIsLunce on LIe purL
oI some smokers. TIIs reucLIvILy Is LypIcuIIy InLerpreLed by unLIsmokers,
und muLerIuIIsLs generuIIy, us LesLImony Lo LIe smokers` dependence
(pIysIcuI uddIcLIon) on LIe cIgureLLe. RuLIer, IL muy sImpIy reIIecL one seL
oI personuIILIes` (smokers) recognILIon LIuL unoLIer seL (sub-group oI
nonsmokers) Is uLLempLIng Lo domInuLe proceedIngs, e.g., IrruLIonuI
obsessIon wILI conLroI. n NuzI Germuny, some unLI-NuzI groups used
smokIng us u budge oI IdenLIIIcuLIon In LIuL IL wus so conLrury Lo LIe
NuzI edIcLs.
TIe InLenL In LIe ubove Is Lo IIgIIIgIL LIuL LIere ure very muny
reusons Ior wIy persons smoke und wIIcI cun uIso vury over LIme und
cIrcumsLunce. urLIermore, muny oI LIese reusons ure enLIreIy IegILImuLe
In psycIoIogIcuI und psycIosocIuI Lerms. TIere Is no one, generuI
cIurucLerIzuLIon oI smokers. AddILIonuIIy, LIere muy be muny
underIyIng psycIoIogIcuI reusons Ior wIy purLIcuIur persons ure Ieuvy
ruLIer LIun IIgIL smokers (e.g., perceIved sLress, personuIILy dIIIerences).
Some persons wIII smoke In cerLuIn sILuuLIons buL noL oLIers, e.g., workJ
Iome. Some IIgIL smokers muy LemporurIIy smoke IeuvIIy In reIuLIon Lo
purLIcuIur perceIved cIrcumsLunces. TIere ure boLI IIgIL und Ieuvy
smokers LIuL Iuve no purLIcuIur dIIIIcuILy wILI Lemporury ubsLInence, e.g.,
reIIgIous perIods sucI us LIe SubbuLI. TIe uLLempL Lo cIurucLerIze
smokers us one Iomogeneous group, or Lo cIurucLerIze subdIvIsIons oI
smokers (IIgILJIeuvy smokers) us Iomogeneous, Is IndeIensIbIe.
L Is obvIousIy u dIIIIcuIL concepL Ior superIIcIuIILy Lo grusp LIuL
muny smokers do noL sIure u medIco-muLerIuIIsL IuboruLorIzed
worIdvIew. TIere Is cerLuInIy u pIuce Ior u sLerIIe, IuboruLory vIew (e.g.,
mIcrobIuI InvesLIguLIon), buL Lo IIve enLIreIy by u serIes oI ILs edIcLs
(MMES cuIL) Is unoLIer muLLer uILogeLIer.
Even LIe SG ReporL (1q6q) wus very cognIzunL oI LIe
psycIoIogIcuI und socIuI uspecLs oI LIe smokIng IubIL, und LIuL LIese ure
quILe compIex. L concIuded LIuL: TIe IubILuuI use oI Lobucco Is reIuLed
prImurIIy Lo psycIoIogIcuI und socIuI drIves (p. q); BuL IL Is noL un
eusy muLLer Lo reucI u sImpIe und reusonubIe concIusIon concernIng LIe
menLuI IeuILI uspecLs oI smokIng. TIe purporLed beneIILs on menLuI
IeuILI ure so InLungIbIe und eIusIve, so InLrIcuLeIy woven InLo LIe wIoIe
IubrIc oI Iumun beIuvIor, so subjecL Lo moruI InLerpreLuLIon und censure,
135
135
Rampant Antismoking Signifies Grave Danger
consumed In compuny und ure LIe busIs boLI oI socIuI
InvILuLIons Lo peopIe`s Iomes und oI sponLuneous und
reguIur meeLIngs In pubs, coIIee burs und Leu sIops.
TIey ure uII drInks LIuL ure eusy Lo prepure or purcIuse.
n oLIer socIeLIes, Lobucco Is used In LIe sume wuy..
L Is oILen convenLIonuIIy uccepLed on sucI occusIons
LIuL puymenL wIII be on LIe busIs oI sIurIng ruLIer LIun
IndIvIduuI cuIcuIuLIon, us wIen u person buys u round oI
drInks or oIIers u puckeL oI cIgureLLes uround u group
beIore LukIng one Ior IImseII or IerseII. (p.z1)
DuvIes (1qq6) uIso properIy noLes LIuL medIco-muLerIuIIsm, u
reducLIonIsL vIew, Is unquuIIIIed Lo ussess psycIoIogIcuI und psycIosocIuI
dImensIons oI purLIcuIur IubILs, IeL uIone LIeIr possIbIe beneIILs:
ReseurcI InLo producL use wIII Lend Lo LreuL IL us u mere cuse oI drugs
beIng IngesLed by IsoIuLed IndIvIduuIs und LIen Lo meusure uny cIunges In
pIysIoIogIcuI IuncLIonIng. SucI u procedure wouId IuII Lo pIck up LIe
beneIILs Lo LIe IeuILI und weII-beIng oI IndIvIduuIs LIuL uccrue Irom LIe
wuy In wIIcI sucI producLs IucIIILuLe socIubIIILy. As u consequence, LIeIr
key IuncLIon In socIeLy wIII be Ignored. (p.zqo)
n revIewIng HIILon`s (zooo) Smolin in ritish Populcr
Culture :8oo-zooo, MurLyn (zooo) IndIcuLes LIuL |d|ocLors IeeI
IrusLruLed wIen puLIenLs deIy wIuL seems unussuIIubIy ruLIonuI udvIce Lo
sLop smokIng. TIey reucL by demonIsIng LIe beIuvIour oI Lobucco
compunIes und LIe uddIcLIve power oI nIcoLIne. BuL LIe expIunuLIon Is
more compIIcuLed n LIIs book HIILon sIows Iow smokIng Is deepIy
embedded In u cuILuruI Irumework LIuL conLInues Lo ussocIuLe LIe IubIL
wILI posILIve uLLrIbuLes. A cIgur Is never jusL u cIgur. L musL be
remembered LIuL, Ior LIe superIIcIuIILy oI muLerIuIIsm, smokIng Is no
more LIuL brIngIng u IIL cyIInder oI Lobucco Lo LIe IIps und InIuIIng;
muILIdImensIonuI symboIIsm Is beyond LIe sIuIIowness oI muLerIuIIsm.
urLIermore, muInLenunce oI LIe IubIL, In uddILIon Lo eurIIer-
menLIoned IucLors, cun provIde u sense oI perceIved conLroI. or
exumpIe, persons In LIe Iower socIo-economIc cIuss, und wIere LIere Is u
greuLer prevuIence oI smokIng In u number oI deveIoped nuLIons (e.g., see
CuveIuurs eL uI., zooo), muy muInLuIn LIe IubIL oI smokIng gIven LIuL
LIeIr generuI socIuI cIrcumsLunces ure uIreudy quILe rIsky, e.g., In Lerms
oI uccess Lo IeuILI cure, uspIruLIons, IodgIngs. I LIe person beIIeves LIey
Iuve very IILLIe conLroI over LIese cIrcumsLunces (IeIpIessness), smokIng
cun ucL us u subsLILuLe LIuL produces u sense oI perceIved conLroI. n oLIer
words, Ior some persons u beIuvIor muy be ussocIuLed wILI rIsk
(smokIng), buL IL Is u rIsk LIuL LIey uL IeusL Iuve u dIrecL suy In. TIIs
Other Vital Matters
sIouId noL be conIused wILI reckIessness. TIe persons InvoIved ure noL
LIrIII-seekIng buL, ruLIer, uLLempLIng Lo deuI wILI perceIved
IeIpIessness.
TIere Is uIso LIe Issue oI LIe cIgureLLe`s symboIIsm In perceIved
democruLIc Ireedom (e.g., TuLe, 1qqq - see uIso secLIon A riej Histor oj
Antismolin). ALLempLs Lo conLroI LIe IubIL by LIe SLuLe, und usuuIIy Ior
unIounded reusons, cun be meL wILI resenLmenL or resIsLunce on LIe purL
oI some smokers. TIIs reucLIvILy Is LypIcuIIy InLerpreLed by unLIsmokers,
und muLerIuIIsLs generuIIy, us LesLImony Lo LIe smokers` dependence
(pIysIcuI uddIcLIon) on LIe cIgureLLe. RuLIer, IL muy sImpIy reIIecL one seL
oI personuIILIes` (smokers) recognILIon LIuL unoLIer seL (sub-group oI
nonsmokers) Is uLLempLIng Lo domInuLe proceedIngs, e.g., IrruLIonuI
obsessIon wILI conLroI. n NuzI Germuny, some unLI-NuzI groups used
smokIng us u budge oI IdenLIIIcuLIon In LIuL IL wus so conLrury Lo LIe
NuzI edIcLs.
TIe InLenL In LIe ubove Is Lo IIgIIIgIL LIuL LIere ure very muny
reusons Ior wIy persons smoke und wIIcI cun uIso vury over LIme und
cIrcumsLunce. urLIermore, muny oI LIese reusons ure enLIreIy IegILImuLe
In psycIoIogIcuI und psycIosocIuI Lerms. TIere Is no one, generuI
cIurucLerIzuLIon oI smokers. AddILIonuIIy, LIere muy be muny
underIyIng psycIoIogIcuI reusons Ior wIy purLIcuIur persons ure Ieuvy
ruLIer LIun IIgIL smokers (e.g., perceIved sLress, personuIILy dIIIerences).
Some persons wIII smoke In cerLuIn sILuuLIons buL noL oLIers, e.g., workJ
Iome. Some IIgIL smokers muy LemporurIIy smoke IeuvIIy In reIuLIon Lo
purLIcuIur perceIved cIrcumsLunces. TIere ure boLI IIgIL und Ieuvy
smokers LIuL Iuve no purLIcuIur dIIIIcuILy wILI Lemporury ubsLInence, e.g.,
reIIgIous perIods sucI us LIe SubbuLI. TIe uLLempL Lo cIurucLerIze
smokers us one Iomogeneous group, or Lo cIurucLerIze subdIvIsIons oI
smokers (IIgILJIeuvy smokers) us Iomogeneous, Is IndeIensIbIe.
L Is obvIousIy u dIIIIcuIL concepL Ior superIIcIuIILy Lo grusp LIuL
muny smokers do noL sIure u medIco-muLerIuIIsL IuboruLorIzed
worIdvIew. TIere Is cerLuInIy u pIuce Ior u sLerIIe, IuboruLory vIew (e.g.,
mIcrobIuI InvesLIguLIon), buL Lo IIve enLIreIy by u serIes oI ILs edIcLs
(MMES cuIL) Is unoLIer muLLer uILogeLIer.
Even LIe SG ReporL (1q6q) wus very cognIzunL oI LIe
psycIoIogIcuI und socIuI uspecLs oI LIe smokIng IubIL, und LIuL LIese ure
quILe compIex. L concIuded LIuL: TIe IubILuuI use oI Lobucco Is reIuLed
prImurIIy Lo psycIoIogIcuI und socIuI drIves (p. q); BuL IL Is noL un
eusy muLLer Lo reucI u sImpIe und reusonubIe concIusIon concernIng LIe
menLuI IeuILI uspecLs oI smokIng. TIe purporLed beneIILs on menLuI
IeuILI ure so InLungIbIe und eIusIve, so InLrIcuLeIy woven InLo LIe wIoIe
IubrIc oI Iumun beIuvIor, so subjecL Lo moruI InLerpreLuLIon und censure,
136
136
Rampant Antismoking Signifies Grave Danger
so dIIIIcuIL oI medIcuI evuIuuLIon und so conLroversIuI In nuLure LIuL Iew
scIenLIIIc groups Iuve uLLempLed Lo sLudy LIe subjecL (p. ); I LIe
LIesIs Is uccepLed LIuL LIe IundumenLuI nuLure oI mun wIII noL cIunge
sIgnIIIcunLIy In LIe IoreseeubIe IuLure, IL Is LIen suIe Lo predIcL LIuL mun
wIII conLInue Lo use pIurmucoIogIcuI uIds In IIs seurcI Ior conLenLmenL.
n LIe besL InLeresLs oI LIe pubIIc IeuILI LIIs sIouId be uccompIIsIed wILI
subsLunces wIIcI curry mInImuI Iuzurd Lo LIe IndIvIduuI und Ior socIeLy
us u wIoIe. n reIuLIng LIIs prIncIpIe Lo Lobucco IL muy be reempIusIzed
LIuL LIe Iuzurd, serIous us IL muy be, reIuLes muInIy Lo LIe IndIvIduuI,
wIereus LIe IndIscrImInuLe use oI more poLenL pIurmucoIogIc ugenLs
wILIouL medIcuI supervIsIon creuLes u gumuL oI socIuI probIems wIIcI
currenLIy consLILuLes u mujor concern oI governmenL us IndIcuLed by LIe
recenL (1q6z) WIILe House ConIerence on NurcoLIc und Drug Abuse. (p.
6)
GuIIIord (1q68) Is somewIuL more dIrecL In Ier esLImuLIon LIuL
IubILuuLIon Lo smokIng Is LIe resuIL oI u very compIex sysLem oI
pIysIoIogIcuI, socIuI und psycIoIogIcuI needs und LIuL wILIIn uny one
IndIvIduuI, one or more, or even uII, oI LIese needs muy exIsL. (p. q)
BernsLeIn (1q6q), In ugreemenL wILI GuIIIord, posILs LIuL LIe Issue Is un
IncredIbIy compIex one becuuse, IIrsL, LIere Is IILLIe reuson Lo beIIeve LIuL
one IucLor, or even one seL oI IucLors, Is consIsLenLIy responsIbIe Ior LIe
muInLenunce oI uII smokers` beIuvIor. Second, even wILIIn LIe IndIvIduuI
smoker, LIere muy be InconsIsLency sucI LIuL Irom momenL Lo momenL,
duy Lo duy, or even over pIuses In LIe IIIe cycIe, LIe IucLors wIIcI
muInLuIn smokIng beIuvIor ure dIIIerenL. (p.q1q)
L Is commendubIe LIuL LIe SG ReporL (1q6q) consIdered non-
bIoIogIcuI IucLors In LIe smokIng IubIL - MedIcuI perspecLIve requIres
recognILIon oI sIgnIIIcunL beneIIcIuI eIIecLs oI smokIng prImurIIy In LIe
ureu oI menLuI IeuILI. TIese beneIILs orIgInuLe In u psycIogenIc seurcI Ior
conLenLmenL und ure meusurubIe onIy In Lerms oI IndIvIduuI beIuvIor.
SInce no meuns oI quunLIIyIng LIese beneIILs Is uppurenL LIe CommILLee
IInds no busIs Ior u judgemenL wIIcI wouId weIgI beneIILs versus Iuzurds
oI smokIng us IL mIgIL uppIy Lo LIe generuI popuIuLIon (p. 6);
EvuIuuLIon oI LIe eIIecLs oI smokIng on IeuILI wouId Iuck perspecLIve II
no consIderuLIon wus gIven Lo LIe possIbIe beneIILs Lo be derIved Irom LIe
occusIonuI or IubILuuI use oI Lobucco. (p.)
UnIorLunuLeIy, LIe SG ReporL (1q6q) LIen guve very little
consIderuLIon Lo LIese possIbIe beneIILs, purLIcuIurIy psycIoIogIcuIIy und
socIuIIy. n un eurIIer secLIon oI LIe ReporL (p. o) IL ucknowIedged LIuL
nIcoLIne does conLrIbuLe Lo u bIpIusIc eIIecL sucI LIuL, In pIurmucoIogIc
Lerms, nIcoLIne does pIuy u purL In LIe smokIng IubIL. L uIso noLed LIuL
LIIs bIpIusIc eIIecL Is noL necessurIIy soIeIy uLLrIbuLubIe Lo LIe
Other Vital Matters
pIurmucoIogIc eIIecL oI nIcoLIne buL uIso InvoIves psycIoIogIcuI IucLors.
TIIs psycIoIogIcuI dImensIon InLroduces u subjecLIve uspecL Lo LIe
consIderuLIon LIuL LIe CommILLee properIy noLed Is dIIIIcuIL Lo objecLIveIy
unuIyze. However, LIIs does noL meun LIuL u psycIoIogIcuI uspecL Is noL
poLenL und beneIIcIuI.
To LIIs poInL LIe CommILLee wus uL IeusL reusonubIy cttemptin
Lo uccommoduLe non-bIoIogIcuI IucLors. However, IL LIen expedIenLIy und
spIIL-mIndedIy reduced LIe entire IubIL Ior cll smokers Lo noLIIng more
LIun u psycIoIogIcuI cruLcI. (p. ) TIIs IuLLer Lerm dImInIsIes uny
perceIved beneIILs, usuuIIy ImpIyIng LIuL LIey ure IIIusory or empLy, or
mInImuI. TIe ReporL IInuIIy concIuded LIuL CIgureLLe smokIng Is u IeuILI
Iuzurd oI suIIIcIenL ImporLunce In LIe UnILed SLuLes Lo wurrunL
upproprIuLe remedIuI ucLIon. (p. )
L Is noL cIeur wIuL LIe CommILLee meunL by remedIuI ucLIon
gIven LIuL IL Iud uIso concIuded LIuL LIe CommILLee IInds no busIs Ior u
judgemenL wIIcI wouId weIgI beneIILs versus Iuzurds oI smokIng us IL
mIgIL uppIy Lo LIe generuI popuIuLIon. n LIe ImmedIuLe sIorL-Lerm
IoIIowIng LIe SG ReporL (1q6q) LIIs remedIuI ucLIon, uL IeusL, InvoIved
ruIsIng pubIIc uwureness oI LIe Iung-cuncer rIsk ussocIuLed wILI smokIng
und LIe InLroducLIon oI IeuILI wurnIng IubeIs on cIgureLLe puckuges (e.g.,
see Moss, 1q68). TIIs remedIuI ucLIon In every subsequenL Surgeon-
GeneruI ReporL on smokIng Ius been Lo compreIensIveIy und ImproperIy
sLrIp uwuy uII psycIoIogIcuI und socIuI uspecLs oI LIe smokIng IubIL, I.e.,
udopLIng oI LIe muLerIuIIsL munIIesLo, cuImInuLIng In LIe SG ReporL
(1q88) LIuL deIIned nIcoLIne us un uddIcLIve drug, und LIuL LIe enLIre IubIL
wus uLLrIbuLubIe Lo uddIcLIon (see uIso secLIon Nicotine Addiction?).
WIuLever smuII, buL IegILImuLe, uLLempLs LIe SG ReporL (1q6q) mude Lo
uccommoduLe LIe possIbIe beneIIcIuI menLuI IeuILI uspecLs oI LIe
smokIng IubIL Iuve been compIeLeIy obIILeruLed by u progressIveIy more
muLerIuIIsL, exLernuIIsL, und dungerous, vIew oI IeuILI.
n consIderIng LIe reIuLIonsIIp beLween smokIng und dIseuseJ
morLuIILy, purLIcuIurIy uLypIcuI, eurIy-uge morLuIILy, exIsLIng morbIdILy or
pre-morbIdILy sympLoms, und LIeIr degree, muy IosLer LIe smokIng IubIL
Ior ILs seduLIve eIIecL. L muy uIso IosLer LIe sense oI perceIved conLroI, or
Lo noL uppeur so dIIIerenL In sIckness Lerms, or Lo seem noL domInuLed by
Ieur (I.e., non-rIsk-uversIve). TIere Is cerLuInIy un urgumenL LIuL LIose
wILI reIuLIveIy more serIous sympLoms, und LIeIr psycIoIogIcuI
consequences (e.g., sLress, IeIpIessness), or sImpIy LIe percepLIon (sLress)
oI severILy oI sympLoms, muy gruvILuLe Lo LIe smokIng IubIL, und possIbIy
even Ieuvy smokIng, Ior LIe reusons ouLIIned eurIIer, e.g., convergence
eIIecL, perceIved conLroI oI rIsk. TIIs wouId go Iur In expIuInIng LIe
reIuLIveIy IIgIer, buL very Iow, eurIy morLuIILy ruLe umongsL LIe smoker`s
137
137
Rampant Antismoking Signifies Grave Danger
so dIIIIcuIL oI medIcuI evuIuuLIon und so conLroversIuI In nuLure LIuL Iew
scIenLIIIc groups Iuve uLLempLed Lo sLudy LIe subjecL (p. ); I LIe
LIesIs Is uccepLed LIuL LIe IundumenLuI nuLure oI mun wIII noL cIunge
sIgnIIIcunLIy In LIe IoreseeubIe IuLure, IL Is LIen suIe Lo predIcL LIuL mun
wIII conLInue Lo use pIurmucoIogIcuI uIds In IIs seurcI Ior conLenLmenL.
n LIe besL InLeresLs oI LIe pubIIc IeuILI LIIs sIouId be uccompIIsIed wILI
subsLunces wIIcI curry mInImuI Iuzurd Lo LIe IndIvIduuI und Ior socIeLy
us u wIoIe. n reIuLIng LIIs prIncIpIe Lo Lobucco IL muy be reempIusIzed
LIuL LIe Iuzurd, serIous us IL muy be, reIuLes muInIy Lo LIe IndIvIduuI,
wIereus LIe IndIscrImInuLe use oI more poLenL pIurmucoIogIc ugenLs
wILIouL medIcuI supervIsIon creuLes u gumuL oI socIuI probIems wIIcI
currenLIy consLILuLes u mujor concern oI governmenL us IndIcuLed by LIe
recenL (1q6z) WIILe House ConIerence on NurcoLIc und Drug Abuse. (p.
6)
GuIIIord (1q68) Is somewIuL more dIrecL In Ier esLImuLIon LIuL
IubILuuLIon Lo smokIng Is LIe resuIL oI u very compIex sysLem oI
pIysIoIogIcuI, socIuI und psycIoIogIcuI needs und LIuL wILIIn uny one
IndIvIduuI, one or more, or even uII, oI LIese needs muy exIsL. (p. q)
BernsLeIn (1q6q), In ugreemenL wILI GuIIIord, posILs LIuL LIe Issue Is un
IncredIbIy compIex one becuuse, IIrsL, LIere Is IILLIe reuson Lo beIIeve LIuL
one IucLor, or even one seL oI IucLors, Is consIsLenLIy responsIbIe Ior LIe
muInLenunce oI uII smokers` beIuvIor. Second, even wILIIn LIe IndIvIduuI
smoker, LIere muy be InconsIsLency sucI LIuL Irom momenL Lo momenL,
duy Lo duy, or even over pIuses In LIe IIIe cycIe, LIe IucLors wIIcI
muInLuIn smokIng beIuvIor ure dIIIerenL. (p.q1q)
L Is commendubIe LIuL LIe SG ReporL (1q6q) consIdered non-
bIoIogIcuI IucLors In LIe smokIng IubIL - MedIcuI perspecLIve requIres
recognILIon oI sIgnIIIcunL beneIIcIuI eIIecLs oI smokIng prImurIIy In LIe
ureu oI menLuI IeuILI. TIese beneIILs orIgInuLe In u psycIogenIc seurcI Ior
conLenLmenL und ure meusurubIe onIy In Lerms oI IndIvIduuI beIuvIor.
SInce no meuns oI quunLIIyIng LIese beneIILs Is uppurenL LIe CommILLee
IInds no busIs Ior u judgemenL wIIcI wouId weIgI beneIILs versus Iuzurds
oI smokIng us IL mIgIL uppIy Lo LIe generuI popuIuLIon (p. 6);
EvuIuuLIon oI LIe eIIecLs oI smokIng on IeuILI wouId Iuck perspecLIve II
no consIderuLIon wus gIven Lo LIe possIbIe beneIILs Lo be derIved Irom LIe
occusIonuI or IubILuuI use oI Lobucco. (p.)
UnIorLunuLeIy, LIe SG ReporL (1q6q) LIen guve very little
consIderuLIon Lo LIese possIbIe beneIILs, purLIcuIurIy psycIoIogIcuIIy und
socIuIIy. n un eurIIer secLIon oI LIe ReporL (p. o) IL ucknowIedged LIuL
nIcoLIne does conLrIbuLe Lo u bIpIusIc eIIecL sucI LIuL, In pIurmucoIogIc
Lerms, nIcoLIne does pIuy u purL In LIe smokIng IubIL. L uIso noLed LIuL
LIIs bIpIusIc eIIecL Is noL necessurIIy soIeIy uLLrIbuLubIe Lo LIe
Other Vital Matters
pIurmucoIogIc eIIecL oI nIcoLIne buL uIso InvoIves psycIoIogIcuI IucLors.
TIIs psycIoIogIcuI dImensIon InLroduces u subjecLIve uspecL Lo LIe
consIderuLIon LIuL LIe CommILLee properIy noLed Is dIIIIcuIL Lo objecLIveIy
unuIyze. However, LIIs does noL meun LIuL u psycIoIogIcuI uspecL Is noL
poLenL und beneIIcIuI.
To LIIs poInL LIe CommILLee wus uL IeusL reusonubIy cttemptin
Lo uccommoduLe non-bIoIogIcuI IucLors. However, IL LIen expedIenLIy und
spIIL-mIndedIy reduced LIe entire IubIL Ior cll smokers Lo noLIIng more
LIun u psycIoIogIcuI cruLcI. (p. ) TIIs IuLLer Lerm dImInIsIes uny
perceIved beneIILs, usuuIIy ImpIyIng LIuL LIey ure IIIusory or empLy, or
mInImuI. TIe ReporL IInuIIy concIuded LIuL CIgureLLe smokIng Is u IeuILI
Iuzurd oI suIIIcIenL ImporLunce In LIe UnILed SLuLes Lo wurrunL
upproprIuLe remedIuI ucLIon. (p. )
L Is noL cIeur wIuL LIe CommILLee meunL by remedIuI ucLIon
gIven LIuL IL Iud uIso concIuded LIuL LIe CommILLee IInds no busIs Ior u
judgemenL wIIcI wouId weIgI beneIILs versus Iuzurds oI smokIng us IL
mIgIL uppIy Lo LIe generuI popuIuLIon. n LIe ImmedIuLe sIorL-Lerm
IoIIowIng LIe SG ReporL (1q6q) LIIs remedIuI ucLIon, uL IeusL, InvoIved
ruIsIng pubIIc uwureness oI LIe Iung-cuncer rIsk ussocIuLed wILI smokIng
und LIe InLroducLIon oI IeuILI wurnIng IubeIs on cIgureLLe puckuges (e.g.,
see Moss, 1q68). TIIs remedIuI ucLIon In every subsequenL Surgeon-
GeneruI ReporL on smokIng Ius been Lo compreIensIveIy und ImproperIy
sLrIp uwuy uII psycIoIogIcuI und socIuI uspecLs oI LIe smokIng IubIL, I.e.,
udopLIng oI LIe muLerIuIIsL munIIesLo, cuImInuLIng In LIe SG ReporL
(1q88) LIuL deIIned nIcoLIne us un uddIcLIve drug, und LIuL LIe enLIre IubIL
wus uLLrIbuLubIe Lo uddIcLIon (see uIso secLIon Nicotine Addiction?).
WIuLever smuII, buL IegILImuLe, uLLempLs LIe SG ReporL (1q6q) mude Lo
uccommoduLe LIe possIbIe beneIIcIuI menLuI IeuILI uspecLs oI LIe
smokIng IubIL Iuve been compIeLeIy obIILeruLed by u progressIveIy more
muLerIuIIsL, exLernuIIsL, und dungerous, vIew oI IeuILI.
n consIderIng LIe reIuLIonsIIp beLween smokIng und dIseuseJ
morLuIILy, purLIcuIurIy uLypIcuI, eurIy-uge morLuIILy, exIsLIng morbIdILy or
pre-morbIdILy sympLoms, und LIeIr degree, muy IosLer LIe smokIng IubIL
Ior ILs seduLIve eIIecL. L muy uIso IosLer LIe sense oI perceIved conLroI, or
Lo noL uppeur so dIIIerenL In sIckness Lerms, or Lo seem noL domInuLed by
Ieur (I.e., non-rIsk-uversIve). TIere Is cerLuInIy un urgumenL LIuL LIose
wILI reIuLIveIy more serIous sympLoms, und LIeIr psycIoIogIcuI
consequences (e.g., sLress, IeIpIessness), or sImpIy LIe percepLIon (sLress)
oI severILy oI sympLoms, muy gruvILuLe Lo LIe smokIng IubIL, und possIbIy
even Ieuvy smokIng, Ior LIe reusons ouLIIned eurIIer, e.g., convergence
eIIecL, perceIved conLroI oI rIsk. TIIs wouId go Iur In expIuInIng LIe
reIuLIveIy IIgIer, buL very Iow, eurIy morLuIILy ruLe umongsL LIe smoker`s
138
138
Rampant Antismoking Signifies Grave Danger
group. n LIIs sense, LIe IIgIer morLuIILy ruLe does not reIIecL dIseuse
producLIon by LIe properLIes oI Lobucco smoke. ReIuLIve rIsk ruLIos, us
used In epIdemIoIogIc ussessmenL, wIII bIur sucI dIsLIncLIons.
TIereIore, In more generuI Lerms, LIe smokIng IubIL, Ior LIe
reuson oI some oI ILs consIdered beneIILs, muy ILseII be un IndIcuLor oI u
subgroup oI smokers wIo ure under consIderubIe und exLended sLress.
SucI sLress muy ILseII be reIuLed Lo sILuuLIonuI IucLors undJor exIsLIng
endogenous ubnormuIILy (bIoIogIcuI) undJor personuIILy dIIIerenLIuIs.
PerceIved sLress muy uIso be u crILIcuI IucLor In morbIdILyJmorLuIILy
generuIIy or eurIy morbIdILyJmorLuIILy. L wouId, LIen, noL be surprIsIng
LIuL u reIuLIve rIsk ruLIo, wIIcI uIso bIurs uII oI LIese dIsLIncLIons, wouId
IndIcuLe IIgIer specIIIc dIseuseJmorLuIILy Ior LIe overuII smoker`s group
over mosL specIIIc dIseuseJmorLuIILy cIussIIIcuLIons.
Nonsmolers
ConsIderIng LIe sIeer voIume oI InvesLIguLIons InLo smokIng, IL
Is very dIsLurbIng LIuL very Iew, II uny, oI LIese Ius uLLempLed Lo evuIuuLe
LIe composILIon oI LIe nonsmoker`s group. L Is improperl ussumed In
epIdemIoIogIc ussessmenL LIuL LIIs group, Loo, Is Iomogeneous und
normctite, und uguInsL wIIcI smokers ure LIen compured. TIIs Ius
uIreudy been dIspeIIed concernIng eurIy morLuIILy. TIe remuInder oI LIe
nonsmoker`s group muy be composed oI u number oI subgroups LIuL
deIIne wIy LIey do noL smoke. or exumpIe, LIe nonsmoker`s group mIgIL
conLuIn u subgroup oI bIoIogIcuIIy very IeuILIy persons wIo enguge In
consIderubIe pIysIcuI ucLIvILy us LesLImony Lo LIeIr cupucILy Ior sucI.
TIese persons ure noL necessurIIy IeuILIy becuuse LIey exercIse, buL
exercIse becuuse LIey ure bIoIogIcuIIy IeuILIy (e.g., ALrens, zooo). L muy
uIso conLuIn u subgroup oI uIreudy III persons LIuL couId noL susLuIn LIe
smokIng IubIL even II LIey wunLed Lo. L muy uIso conLuIn u subgroup LIuL
Is noL III or very bIoIogIcuIIy ubIe. OI LIIs group, some muy be IIgIIy-
neuroLIcuIIy dIsposed, e.g., rIsk uverse, IypocIondrIucuI. TIIs IuLLer group
In purLIcuIur wIII Lreud gIngerIy LIrougI IIIe - unIeuILIIIy so. L wIII uIso
be prone Lo (s)rIsk uversIon. A subgroup oI LIese LIree groups muy be
sLrong devoLees oI LIe MMES IIIesLyIe und mIgIL uIso be more IIgIIy
correIuLed wILI LIe upper-cIuss und LIe bourgeoIsIe I.e., LIe upper socIo-
economIc cIusses cun uIIord LIe Iuxury oI rIsk-uversIon us u IIIesLyIe.
TIese devoLees muy seek medIcuI uLLenLIon Ior uII munner oI uIImenLs,
wIeLIer mInor or mujor, uvoId purLIcuIur IIgI rIsk occupuLIons (becuuse
oI greuLer socIuI mobIIILy), und enguge In IeuILIy euLIng beIuvIors Lo u
Iur greuLer exLenL LIun LIose In LIe smoker`s group. So mucI so, LIuL LIIs
InordInuLe medIcuI uLLenLIon und rIsk uversIon muy ucLuuIIy produce
Other Vital Matters
vuryIng, reIuLIve IongevILy guIns - some muy even be uLLrIbuLubIe Lo u
pIucebo eIIecL, I.e., u beneIIL derIved Irom LIe beIIeI LIuL LIey ure doIng uII
LIe rIgIL LIIngs uccordIng Lo conLemporury, muLerIuIIsL IeuILI
promoLIon.. or exumpIe, Key eL uI. (1qq6) Iound LIuL uL 1;-yeur IoIIow-up
IeuILI conscIous IndIvIduuIs, LypIcuIIy deIIned by dIeLury IubILs, Iud u
reduced uII-cuuse morLuIILy reIuLIve Lo LIe generuI popuIuLIon. Smokers
consLILuLed onIy 1q% oI LIe IeuILI conscIous group. TIereIore, Ior some
In LIIs IeuILI conscIous group, LIeIr euLIng beIuvIor Is cssocicted wILI
IIgIer IongevILy. WIeLIer LIIs Is dIrecLIy cuusuI Is debuLubIe. However,
LIeIr euLIng beIuvIor muy be correIuLed wILI u more generuI, rIsk-uverse
dIsposILIon wIIcI, Ior some, muy be cuusuIIy reIuLed Lo IIgIer IongevILy.
However, wIeLIer LIIs Is u mentcll or socicll heclth dIsposILIon Is
IIgIIy quesLIonubIe.
L muy be LIe cuse LIuL LIe crILIcuI dIsLInguIsIIng IeuLure beLween
smoker`sJnonsmoker`s groups Is psycIoIogIcuI dIsposILIon. L couId be
suId LIuL mosL smokers ure noL purLIcuIurIy greuL rIsk-Lukers (I.e.,
reckIessness) buL, ruLIer, LIey ure sImpIy noL rIsk-uverse In IIIesLyIe Lerms.
TIIs, In IucL, muy be u menLuI und socIuI sLrengLI. L Is LIIs poInL oI rIsk
uversIon LIuL muy be u crILIcuI dIsLInguIsIIng IucLor beLween muny
smokers und u subgroup oI nonsmokers. As wIII be urgued In LIe
IoIIowIng, wIuL muy Iuve begun us u smuII rIsk-uverse group In LIe overuII
nonsmoker`s group muy progressIveIy be geLLIng Iurger under LIe
InIIuence oI MMES propugundu.
MMES-IIIesLyIe devoLees muy ucLuuIIy injlcte LIe uveruge
IongevILy Ior LIe nonsmoker`s group, und In u non-normuLIve wuy. or
exumpIe, us Ius been menLIoned, generuI rIsk-uversIon or over-
proLecLIveness muy Indeed Increuse IongevILy Ior some. WIen LIIs non-
normuLIve IIgIer IongevILy Is ImproperIy combIned wILI uge-specIIIc
smokers und LIe non-normuLIve eurIy morLuIILy In LIe smoker`s group,
LIIs wIII be reIIecLed In IIgIer reIuLIve rIsk oI specIIIc dIseuses und eurIy
morLuIILy Ior LIe overuII smoker`s group. n IucL, mosL smokers und
nonsmokers muy be quILe compurubIe. ReIuLIve-rIsk dIIIerences beLween
LIe smoker`s und nonsmoker`s groups muy be produced wIoIIy or In purL
by u smuII, rIsk-uverse subgroup LIuL Is Iurger In LIe nonsmoker`s group.
n uLLempLIng Lo compure groups LIuL ure ucLuuIIy noL compurubIe, LIe
reIuLIve rIsk sLuLIsLIc, oLIer LIun In u sIuIIow gumbIIng sense, Is
meunIngIess.
One oI LIe more repugnunL uspecLs oI unLIsmokIng rIeLorIc Is Lo
IosLer LIe ImpressIon LIuL nonsmokers, by vIrLue oI LIeIr non-smokIng,
ure IeuILIIer LIun smokers und, LIereIore, smokers by vIrLue oI quILLIng
become IeuILIIer. TIIs cunnoL be conLended even In enLIreIy bIoIogIcuI
Lerms. or exumpIe, u nonsmoker mIgIL Iurbor uII munner oI endogenous
139
139
Rampant Antismoking Signifies Grave Danger
group. n LIIs sense, LIe IIgIer morLuIILy ruLe does not reIIecL dIseuse
producLIon by LIe properLIes oI Lobucco smoke. ReIuLIve rIsk ruLIos, us
used In epIdemIoIogIc ussessmenL, wIII bIur sucI dIsLIncLIons.
TIereIore, In more generuI Lerms, LIe smokIng IubIL, Ior LIe
reuson oI some oI ILs consIdered beneIILs, muy ILseII be un IndIcuLor oI u
subgroup oI smokers wIo ure under consIderubIe und exLended sLress.
SucI sLress muy ILseII be reIuLed Lo sILuuLIonuI IucLors undJor exIsLIng
endogenous ubnormuIILy (bIoIogIcuI) undJor personuIILy dIIIerenLIuIs.
PerceIved sLress muy uIso be u crILIcuI IucLor In morbIdILyJmorLuIILy
generuIIy or eurIy morbIdILyJmorLuIILy. L wouId, LIen, noL be surprIsIng
LIuL u reIuLIve rIsk ruLIo, wIIcI uIso bIurs uII oI LIese dIsLIncLIons, wouId
IndIcuLe IIgIer specIIIc dIseuseJmorLuIILy Ior LIe overuII smoker`s group
over mosL specIIIc dIseuseJmorLuIILy cIussIIIcuLIons.
Nonsmolers
ConsIderIng LIe sIeer voIume oI InvesLIguLIons InLo smokIng, IL
Is very dIsLurbIng LIuL very Iew, II uny, oI LIese Ius uLLempLed Lo evuIuuLe
LIe composILIon oI LIe nonsmoker`s group. L Is improperl ussumed In
epIdemIoIogIc ussessmenL LIuL LIIs group, Loo, Is Iomogeneous und
normctite, und uguInsL wIIcI smokers ure LIen compured. TIIs Ius
uIreudy been dIspeIIed concernIng eurIy morLuIILy. TIe remuInder oI LIe
nonsmoker`s group muy be composed oI u number oI subgroups LIuL
deIIne wIy LIey do noL smoke. or exumpIe, LIe nonsmoker`s group mIgIL
conLuIn u subgroup oI bIoIogIcuIIy very IeuILIy persons wIo enguge In
consIderubIe pIysIcuI ucLIvILy us LesLImony Lo LIeIr cupucILy Ior sucI.
TIese persons ure noL necessurIIy IeuILIy becuuse LIey exercIse, buL
exercIse becuuse LIey ure bIoIogIcuIIy IeuILIy (e.g., ALrens, zooo). L muy
uIso conLuIn u subgroup oI uIreudy III persons LIuL couId noL susLuIn LIe
smokIng IubIL even II LIey wunLed Lo. L muy uIso conLuIn u subgroup LIuL
Is noL III or very bIoIogIcuIIy ubIe. OI LIIs group, some muy be IIgIIy-
neuroLIcuIIy dIsposed, e.g., rIsk uverse, IypocIondrIucuI. TIIs IuLLer group
In purLIcuIur wIII Lreud gIngerIy LIrougI IIIe - unIeuILIIIy so. L wIII uIso
be prone Lo (s)rIsk uversIon. A subgroup oI LIese LIree groups muy be
sLrong devoLees oI LIe MMES IIIesLyIe und mIgIL uIso be more IIgIIy
correIuLed wILI LIe upper-cIuss und LIe bourgeoIsIe I.e., LIe upper socIo-
economIc cIusses cun uIIord LIe Iuxury oI rIsk-uversIon us u IIIesLyIe.
TIese devoLees muy seek medIcuI uLLenLIon Ior uII munner oI uIImenLs,
wIeLIer mInor or mujor, uvoId purLIcuIur IIgI rIsk occupuLIons (becuuse
oI greuLer socIuI mobIIILy), und enguge In IeuILIy euLIng beIuvIors Lo u
Iur greuLer exLenL LIun LIose In LIe smoker`s group. So mucI so, LIuL LIIs
InordInuLe medIcuI uLLenLIon und rIsk uversIon muy ucLuuIIy produce
Other Vital Matters
vuryIng, reIuLIve IongevILy guIns - some muy even be uLLrIbuLubIe Lo u
pIucebo eIIecL, I.e., u beneIIL derIved Irom LIe beIIeI LIuL LIey ure doIng uII
LIe rIgIL LIIngs uccordIng Lo conLemporury, muLerIuIIsL IeuILI
promoLIon.. or exumpIe, Key eL uI. (1qq6) Iound LIuL uL 1;-yeur IoIIow-up
IeuILI conscIous IndIvIduuIs, LypIcuIIy deIIned by dIeLury IubILs, Iud u
reduced uII-cuuse morLuIILy reIuLIve Lo LIe generuI popuIuLIon. Smokers
consLILuLed onIy 1q% oI LIe IeuILI conscIous group. TIereIore, Ior some
In LIIs IeuILI conscIous group, LIeIr euLIng beIuvIor Is cssocicted wILI
IIgIer IongevILy. WIeLIer LIIs Is dIrecLIy cuusuI Is debuLubIe. However,
LIeIr euLIng beIuvIor muy be correIuLed wILI u more generuI, rIsk-uverse
dIsposILIon wIIcI, Ior some, muy be cuusuIIy reIuLed Lo IIgIer IongevILy.
However, wIeLIer LIIs Is u mentcll or socicll heclth dIsposILIon Is
IIgIIy quesLIonubIe.
L muy be LIe cuse LIuL LIe crILIcuI dIsLInguIsIIng IeuLure beLween
smoker`sJnonsmoker`s groups Is psycIoIogIcuI dIsposILIon. L couId be
suId LIuL mosL smokers ure noL purLIcuIurIy greuL rIsk-Lukers (I.e.,
reckIessness) buL, ruLIer, LIey ure sImpIy noL rIsk-uverse In IIIesLyIe Lerms.
TIIs, In IucL, muy be u menLuI und socIuI sLrengLI. L Is LIIs poInL oI rIsk
uversIon LIuL muy be u crILIcuI dIsLInguIsIIng IucLor beLween muny
smokers und u subgroup oI nonsmokers. As wIII be urgued In LIe
IoIIowIng, wIuL muy Iuve begun us u smuII rIsk-uverse group In LIe overuII
nonsmoker`s group muy progressIveIy be geLLIng Iurger under LIe
InIIuence oI MMES propugundu.
MMES-IIIesLyIe devoLees muy ucLuuIIy injlcte LIe uveruge
IongevILy Ior LIe nonsmoker`s group, und In u non-normuLIve wuy. or
exumpIe, us Ius been menLIoned, generuI rIsk-uversIon or over-
proLecLIveness muy Indeed Increuse IongevILy Ior some. WIen LIIs non-
normuLIve IIgIer IongevILy Is ImproperIy combIned wILI uge-specIIIc
smokers und LIe non-normuLIve eurIy morLuIILy In LIe smoker`s group,
LIIs wIII be reIIecLed In IIgIer reIuLIve rIsk oI specIIIc dIseuses und eurIy
morLuIILy Ior LIe overuII smoker`s group. n IucL, mosL smokers und
nonsmokers muy be quILe compurubIe. ReIuLIve-rIsk dIIIerences beLween
LIe smoker`s und nonsmoker`s groups muy be produced wIoIIy or In purL
by u smuII, rIsk-uverse subgroup LIuL Is Iurger In LIe nonsmoker`s group.
n uLLempLIng Lo compure groups LIuL ure ucLuuIIy noL compurubIe, LIe
reIuLIve rIsk sLuLIsLIc, oLIer LIun In u sIuIIow gumbIIng sense, Is
meunIngIess.
One oI LIe more repugnunL uspecLs oI unLIsmokIng rIeLorIc Is Lo
IosLer LIe ImpressIon LIuL nonsmokers, by vIrLue oI LIeIr non-smokIng,
ure IeuILIIer LIun smokers und, LIereIore, smokers by vIrLue oI quILLIng
become IeuILIIer. TIIs cunnoL be conLended even In enLIreIy bIoIogIcuI
Lerms. or exumpIe, u nonsmoker mIgIL Iurbor uII munner oI endogenous
140
140
Rampant Antismoking Signifies Grave Danger
ubnormuIILy (I.e., unIeuILIy) LIuL LIrougI LIe sIeer weIgIL oI rIsk-
uversIon muy sImpIy noL be puL Lo LIe LesL, or cun sLuve oII endogenous
LesLIng Ior Ionger perIods, I.e., no dIrecL munIIesLuLIon oI ubnormuIILy.
urLIermore, LIe Issue oI IeuILI, us Ius been IndIcuLed, InvoIves
Iur more LIun jusL dIseuse or ubsence oI dIseuse, or IongevILy, or purLIcuIur
IubILs. TIe Ideu oI IeuILI wouId need Lo uccounL Ior psycIoIogIcuI, socIuI
und moruI dImensIons. As wIII be consIdered IurLIer, In uccounLIng Ior
menLuI IeuILI, IL muy Indeed be LIe MMES menLuIILy LIuL poses LIe mosL
serIous menLuI, socIuI und moruI dunger und, LIereIore, demonsLruLes
dIsLurbIngIy unIeuILIy conducL. AccordIng Lo u MMES IIIesLyIe, u person
cun be very menLuIIy, socIuIIy und moruIIy dysIuncLIonuI buL, II LIeIr
IongevILy Is ubove uveruge, or uL IeusL II LIey enguged In rIsk-uversIon und
(s)rIsk-uversIon us u IIIesLyIe, LIeIr IIIe Is deemed u success. A subgroup
oI smokers mIgIL Indeed uppeuse LIeIr neuroLIc dIsposILIon by smokIng,
I.e., even II consIderIng LIe dIIuLed Ideu oI u psycIoIogIcuI cruLcI.
WIereus, In uLLempLIng Lo uppeuse ILs IrruLIonuI Ieur (rIsk uversIon), u
purLIcuIur neuroLIc menLuIILy In u subgroup oI nonsmokers puLIoIogIcuIIy
convInces ILseII LIuL ILs LIInkIng Is superIor und LIuL uII sIouId be mude
Lo conIorm Lo IL, I.e., obsessIon wILI conLroI. L Is LIIs IuLLer menLuIILy LIuL
Ius LIe poLenLIuI Lo wreuk exLruordInury psycIoIogIcuI, socIuI, moruI und
IeguI Iuvoc.
L cun be concIuded Irom LIe ubove LIuL u reIuLIve rIsk ruLIo, us u
sInguIur sLuLIsLIc, LIuL LreuLs LIe Lwo overuII groups (smokersJ
nonsmokers) us Iomogeneous upurL Irom LIe one exposure IucLor
(cIgureLLe smokIng) cun do no jusLIce uL uII Lo LIe poLenLIuI dynumIcs LIuL
ure ucLuuIIy InvoIved. AnoLIer sInguIur sLuLIsLIc, uveruge IongevILy, uIso
cunnoL do jusLIce Lo LIe dynumIcs InvoIved. YeL, LIIs IuLLer sLuLIsLIc Is uIso
wIdeIy used In IeuILIIsL und unLIsmokIng rIeLorIc.
n cIosIng LIIs secLIon IL Is u useIuI remInder LIuL smokersJ
nonsmokers ure ucLuuIIy persons. TIose wIo Iuve been or ure smokers
Iuve come Irom uII wuIks oI IIIe, e.g., musIcIuns, sLreeL sweepers, poeLs,
pIIIosopIers, pIumbers, eIecLrIcIuns, pIIIunLIropIsLs, scIenLIsLs, cIerIcs,
IousewIves, LIeoIogIuns, enLrepreneurs, deIInquenLs, crImInuIs,
psycIoIogIsLs, medIcuI docLors, buIIders, cruILsmen, Lruck drIvers,
uccounLunLs, Iuwyers, eLc., eLc., eLc.. SImIIur buckgrounds wIII be Iound In
LIe nonsmoker`s group. TIIs poInL Is mude In LIuL, us wIII be consIdered In
LIe IoIIowIng, LIe unLIsmokIng menLuIILy Ius sLrIpped uwuy personIood,
reIerrIng Lo LIose wIo smoke us jusL nIcoLIne-uddIcLed smokers, I.e.,
IuLe Iunguuge. SocIeLIes LIuL uIIow u prevuIIIng menLuIILy (e.g., superIorILy
syndrome) Lo dIsmIss u person`s enLIre IIsLory und cIurucLer on LIe busIs
oI u purLIcuIur IubIL sucI us cIgureLLe smokIng, und Is uIIowed Lo IosLer
dIvIsIon, segreguLIon or bunIsImenL bused on sucI LrIvIuIILIes, ure
Other Vital Matters
socIeLIes LIuL ure uIreudy ImpIodIng.
. A riej Histor oj Antismolin
Tobucco-use Ius Iud u very vurIed IIsLory. L Ius been vIewed us
un emunuLIon oI LIe devII, LIen u symboI oI wIsdom, und even u IuIImurk
oI munIood (Ience ILs symboIIsm Ior women`s IIberuLIon). Now, Lobucco
Ius become LIe subjecL oI ever-growIng repressIon; smokers ure Iurussed
und brunded us uIr poIIuLers und purveyors oI IIIness Lo non-smokers, und
squunderers oI IeuILI Iunds. n LIe UK, docLors Iuve reIused Lo LreuL
puLIenLs, on LIe grounds LIuL LIey Iud noL Luken enougI cure oI LIeIr own
IeuILI by beIng smokers. (Juveuu, 1qq6, p.z-q) Skrubunek &
McCormIck (1qqo) uIso noLe LIuL smokIng Ius, wILIIn our IIIeLIme,
moved Irom beIng uccepLubIe beIuvIour, Lo devIunce, dIseuse, sIn und now
crIme; In MunIIu one Iundred peopIe were recenLIy urresLed Ior smokIng
In pubIIc pIuces und LIrown InLo juII. (p.1qo)
AnLIsmokIng senLImenL or even ouLrIgIL proIIbILIonJuboIILIon
ure noL new pIenomenu. ConcernIng more recenL cenLurIes, DuvIson &
NeuIe (1q;8) IndIcuLe LIuL even LIe pubIIc LorLures und execuLIons
engIneered by LIe SuILun Murud V oI Turkey durIng LIe sevenLeenLI
cenLury couId noL dIssuude LIose oI IIs subjecLs wIo were uddIcLed Lo LIe
weed (p.z6q) - uL one poInL Ie wus execuLIng eIgILeen smokers u duy
(GoodIn, 1q8q, p.1). n uneberg In 16q1, persons Iound smokIng or
drInkIng Lobucco wILIIn LIe cILy wuIIs couId be puL Lo deuLI (ProcLor,
1qq;, p.qq). TIe IIrsL Romunov Lsur opLed Lo sIIL LIeIr |smokers`| noses
InsLeud (GoodIn, 1q8q, p.1). Redmond (1q;o) IndIcuLes LIuL |I|n RussIu
LIe use oI Lobucco wus punIsIed by umpuLuLIon oI LIe nose; In LIe SwIss
cunLon oI Berne, IL runked In LIe LubIe oI oIIences nexL Lo uduILery. (p.18)
Jumes , un enemy oI Lobucco, wrILes In IIs 16oq pumpIIeL A
Counterblcste to Tobccco LIuL Lobucco use Is u cusLom IouLIsome Lo LIe
eye, IurmIuI Lo LIe bruIne, dungerous Lo LIe Iungs. He uIso ruIsed LIe Lux
on Lobucco by q,ooo percenL (uIrIoIL, 18q; see uIso GoodIn, 1q8q, p.1).
Even eurIIer sLIII, wIen |CIrIsLopIer| CoIumbus und IIs crew reLurned
Iome |Lo Europe Irom LIe AmerIcus| wILI some Lobucco Ieuves, RodrIguo
|de Jerez|, wIo`d Luken Lo smokIng u cIgur every duy, mude LIe mIsLuke oI
IIgILIng up LIe unusuuI pIunL In pubIIc. He wus prompLIy LIrown InLo
prIson Ior LIree yeurs by LIe SpunIsI nquIsILIon - LIe worId`s IIrsL vIcLIm
oI LIe unLI-smokers. (Mcudden, zoo1)
TIe ImpressIon IosLered by LIe currenL unLIsmokIng crusude In
muny wesLern nuLIons Is LIuL new evIdence wurrunLs LIIs orIgInuI
sLunce. One oI LIe muIn LIemes In LIIs dIscussIon Is LIuL new evIdence Is
141
141
Rampant Antismoking Signifies Grave Danger
ubnormuIILy (I.e., unIeuILIy) LIuL LIrougI LIe sIeer weIgIL oI rIsk-
uversIon muy sImpIy noL be puL Lo LIe LesL, or cun sLuve oII endogenous
LesLIng Ior Ionger perIods, I.e., no dIrecL munIIesLuLIon oI ubnormuIILy.
urLIermore, LIe Issue oI IeuILI, us Ius been IndIcuLed, InvoIves
Iur more LIun jusL dIseuse or ubsence oI dIseuse, or IongevILy, or purLIcuIur
IubILs. TIe Ideu oI IeuILI wouId need Lo uccounL Ior psycIoIogIcuI, socIuI
und moruI dImensIons. As wIII be consIdered IurLIer, In uccounLIng Ior
menLuI IeuILI, IL muy Indeed be LIe MMES menLuIILy LIuL poses LIe mosL
serIous menLuI, socIuI und moruI dunger und, LIereIore, demonsLruLes
dIsLurbIngIy unIeuILIy conducL. AccordIng Lo u MMES IIIesLyIe, u person
cun be very menLuIIy, socIuIIy und moruIIy dysIuncLIonuI buL, II LIeIr
IongevILy Is ubove uveruge, or uL IeusL II LIey enguged In rIsk-uversIon und
(s)rIsk-uversIon us u IIIesLyIe, LIeIr IIIe Is deemed u success. A subgroup
oI smokers mIgIL Indeed uppeuse LIeIr neuroLIc dIsposILIon by smokIng,
I.e., even II consIderIng LIe dIIuLed Ideu oI u psycIoIogIcuI cruLcI.
WIereus, In uLLempLIng Lo uppeuse ILs IrruLIonuI Ieur (rIsk uversIon), u
purLIcuIur neuroLIc menLuIILy In u subgroup oI nonsmokers puLIoIogIcuIIy
convInces ILseII LIuL ILs LIInkIng Is superIor und LIuL uII sIouId be mude
Lo conIorm Lo IL, I.e., obsessIon wILI conLroI. L Is LIIs IuLLer menLuIILy LIuL
Ius LIe poLenLIuI Lo wreuk exLruordInury psycIoIogIcuI, socIuI, moruI und
IeguI Iuvoc.
L cun be concIuded Irom LIe ubove LIuL u reIuLIve rIsk ruLIo, us u
sInguIur sLuLIsLIc, LIuL LreuLs LIe Lwo overuII groups (smokersJ
nonsmokers) us Iomogeneous upurL Irom LIe one exposure IucLor
(cIgureLLe smokIng) cun do no jusLIce uL uII Lo LIe poLenLIuI dynumIcs LIuL
ure ucLuuIIy InvoIved. AnoLIer sInguIur sLuLIsLIc, uveruge IongevILy, uIso
cunnoL do jusLIce Lo LIe dynumIcs InvoIved. YeL, LIIs IuLLer sLuLIsLIc Is uIso
wIdeIy used In IeuILIIsL und unLIsmokIng rIeLorIc.
n cIosIng LIIs secLIon IL Is u useIuI remInder LIuL smokersJ
nonsmokers ure ucLuuIIy persons. TIose wIo Iuve been or ure smokers
Iuve come Irom uII wuIks oI IIIe, e.g., musIcIuns, sLreeL sweepers, poeLs,
pIIIosopIers, pIumbers, eIecLrIcIuns, pIIIunLIropIsLs, scIenLIsLs, cIerIcs,
IousewIves, LIeoIogIuns, enLrepreneurs, deIInquenLs, crImInuIs,
psycIoIogIsLs, medIcuI docLors, buIIders, cruILsmen, Lruck drIvers,
uccounLunLs, Iuwyers, eLc., eLc., eLc.. SImIIur buckgrounds wIII be Iound In
LIe nonsmoker`s group. TIIs poInL Is mude In LIuL, us wIII be consIdered In
LIe IoIIowIng, LIe unLIsmokIng menLuIILy Ius sLrIpped uwuy personIood,
reIerrIng Lo LIose wIo smoke us jusL nIcoLIne-uddIcLed smokers, I.e.,
IuLe Iunguuge. SocIeLIes LIuL uIIow u prevuIIIng menLuIILy (e.g., superIorILy
syndrome) Lo dIsmIss u person`s enLIre IIsLory und cIurucLer on LIe busIs
oI u purLIcuIur IubIL sucI us cIgureLLe smokIng, und Is uIIowed Lo IosLer
dIvIsIon, segreguLIon or bunIsImenL bused on sucI LrIvIuIILIes, ure
Other Vital Matters
socIeLIes LIuL ure uIreudy ImpIodIng.
. A riej Histor oj Antismolin
Tobucco-use Ius Iud u very vurIed IIsLory. L Ius been vIewed us
un emunuLIon oI LIe devII, LIen u symboI oI wIsdom, und even u IuIImurk
oI munIood (Ience ILs symboIIsm Ior women`s IIberuLIon). Now, Lobucco
Ius become LIe subjecL oI ever-growIng repressIon; smokers ure Iurussed
und brunded us uIr poIIuLers und purveyors oI IIIness Lo non-smokers, und
squunderers oI IeuILI Iunds. n LIe UK, docLors Iuve reIused Lo LreuL
puLIenLs, on LIe grounds LIuL LIey Iud noL Luken enougI cure oI LIeIr own
IeuILI by beIng smokers. (Juveuu, 1qq6, p.z-q) Skrubunek &
McCormIck (1qqo) uIso noLe LIuL smokIng Ius, wILIIn our IIIeLIme,
moved Irom beIng uccepLubIe beIuvIour, Lo devIunce, dIseuse, sIn und now
crIme; In MunIIu one Iundred peopIe were recenLIy urresLed Ior smokIng
In pubIIc pIuces und LIrown InLo juII. (p.1qo)
AnLIsmokIng senLImenL or even ouLrIgIL proIIbILIonJuboIILIon
ure noL new pIenomenu. ConcernIng more recenL cenLurIes, DuvIson &
NeuIe (1q;8) IndIcuLe LIuL even LIe pubIIc LorLures und execuLIons
engIneered by LIe SuILun Murud V oI Turkey durIng LIe sevenLeenLI
cenLury couId noL dIssuude LIose oI IIs subjecLs wIo were uddIcLed Lo LIe
weed (p.z6q) - uL one poInL Ie wus execuLIng eIgILeen smokers u duy
(GoodIn, 1q8q, p.1). n uneberg In 16q1, persons Iound smokIng or
drInkIng Lobucco wILIIn LIe cILy wuIIs couId be puL Lo deuLI (ProcLor,
1qq;, p.qq). TIe IIrsL Romunov Lsur opLed Lo sIIL LIeIr |smokers`| noses
InsLeud (GoodIn, 1q8q, p.1). Redmond (1q;o) IndIcuLes LIuL |I|n RussIu
LIe use oI Lobucco wus punIsIed by umpuLuLIon oI LIe nose; In LIe SwIss
cunLon oI Berne, IL runked In LIe LubIe oI oIIences nexL Lo uduILery. (p.18)
Jumes , un enemy oI Lobucco, wrILes In IIs 16oq pumpIIeL A
Counterblcste to Tobccco LIuL Lobucco use Is u cusLom IouLIsome Lo LIe
eye, IurmIuI Lo LIe bruIne, dungerous Lo LIe Iungs. He uIso ruIsed LIe Lux
on Lobucco by q,ooo percenL (uIrIoIL, 18q; see uIso GoodIn, 1q8q, p.1).
Even eurIIer sLIII, wIen |CIrIsLopIer| CoIumbus und IIs crew reLurned
Iome |Lo Europe Irom LIe AmerIcus| wILI some Lobucco Ieuves, RodrIguo
|de Jerez|, wIo`d Luken Lo smokIng u cIgur every duy, mude LIe mIsLuke oI
IIgILIng up LIe unusuuI pIunL In pubIIc. He wus prompLIy LIrown InLo
prIson Ior LIree yeurs by LIe SpunIsI nquIsILIon - LIe worId`s IIrsL vIcLIm
oI LIe unLI-smokers. (Mcudden, zoo1)
TIe ImpressIon IosLered by LIe currenL unLIsmokIng crusude In
muny wesLern nuLIons Is LIuL new evIdence wurrunLs LIIs orIgInuI
sLunce. One oI LIe muIn LIemes In LIIs dIscussIon Is LIuL new evIdence Is
142
142
Rampant Antismoking Signifies Grave Danger
noL uII LIuL new, und LIuL ILs sLuLus us evIdence In scIenLIIIc Lerms Is
compIeLeIy quesLIonubIe. MosL oI LIe cIuIms currenLIy mude Iuve been
Ieurd beIore over LIe IusL number oI cenLurIes, usuuIIy mude regurdIess oI
evIdence. BeIore LIe IuLesL burruge oI so-cuIIed scIenLIIIc InvesLIguLIon,
some medIcuI prucLILIoners were mukIng pronouncemenLs In LIe
nIneLeenLI und eurIy-LwenLIeLI cenLurIes ubouL connecLIons beLween
Lobucco smokIng und, Ior exumpIe, LubercuIosIs, Lobucco IeurL, Lremors,
bIIndness. TIese vIews were cerLuInIy noL bused on uny exIuusLIve,
scIenLIIIc upproucI Lo LIe subjecL.
..: Antismolin in The United Stctes
CoIby (1qqq) provIdes pumpIIeL InIormuLIon Irom u sIgnIIIcunL
UnILed SLuLes unLIsmokIng movemenL In LIe eurIy 1qoo`s. TIe AugusL z8,
1q1;, Issue oI The Instructor Is reIerred Lo us LIe unnuuI unLI-Lobucco
Issue. TIe muguzIne cover depIcLs PresIdenL Woodrow WIIson und
cupLIoned Woodrow WIIson - u NuLIonuI ExumpIe - LIe PresIdenL Does
NoL Smoke. UnIorLunuLeIy, Ior Woodrow WIIson und LIe unLIsmokIng
Iobby, wILIIn u yeur oI LIIs Issue LIe PresIdenL suIIered u debIIILuLIng
sLroke.
MucI oI LIe InIormuLIon wus LurgeLed uL boys (I.e., cIIIdren). n
one pumpIIeL LILIed WIy? LIe urLIcIe InquIres:
I LIe use oI Lobucco Is noL InjurIous,
WHY does LIe IIIe Insurunce compuny wIsI Lo know
wIeLIer LIe uppIIcunL smokes?
WHY does LIe surgeon, conLempIuLIng u serIous
operuLIon, usk wIeLIer LIe puLIenL smokes?
WHY ure uLIIeLes, In LruInIng, IorbIdden Lo smoke?
WHY do smokers, us u ruIe, udvIse oLIers noL Lo smoke?
WHY Is ubsLInence Irom Lobucco everywIere
consIdered u vuIuubIe usseL Ior u young mun?
WHY Is LIe cIgureLLe LIe objecL oI specIuI uLLenLIon by
Lemperunce und unLI-Lobucco workers?
WHY do cIgureLLe smokers muke LIe vusL mujorILy oI
LIe mIsLukes In bookkeepIng?
WHY ure cIgureLLe smokers un eusy prey Lo dIseuse,
especIuIIy Lo LubercuIosIs?
WHY do none oI LIe books wIIcI deuI wILI LIe
prIncIpIes oI success In IIIe, und gIve udvIce Lo young
men oI umbILIon, udvIse LIe use oI LIe cIgureLLe?
WHY ure LIose wIo begIn smokIng eurIy In IIIe, uImosL
wILIouL excepLIon, sLunLed In body or mInd?
Other Vital Matters
WHY do smokers never sLund IIrsL In LIeIr cIusses?
WHY do some SLuLes IorbId LIe seIIIng oI cIgureLLes Lo
mInors?
WHY Is IL LIuL youLIIuI crImInuIs ure uImosL InvurIubIy
smokers?
WHY Is smokIng proIIbILed durIng LIe IIrsL LIree yeurs
uL WesL PoInL und AnnupoIIs, LIe governmenL`s mIIILury
und nuvuI scIooIs?
I IL does noL IInder vocuLIons, wIy do muny IIrms
ubsoIuLeIy reIuse Lo empIoy boys und young men wIo
smoke cIgureLLes, or eIse gIve LIe preIerence Lo non-
smokIng persons?
TIe urLIcIe conLInues:
One puII cuIIs Ior more puIIs. TIuL`s LIe Iurm. And
every one oI LIese deposILs u smuII quunLILy oI deudIy
poIson In LIe body. One needIe prIck oI LIe CIInese
docLor does noL kIII LIe buby; buL LIe muILIpIIed prIcks
gIven In LIe eIIorL Lo bunIsI LIe so-cuIIed evII spIrIL,
drIves LIe breuLI oI IIIe ouL oI LIe IILLIe suIIerer.
One puII does noL desLroy LIe bruIn or IeurL, buL IL
Ieuves u sLuIn, und every oLIer puII deepens LIuL sLuIn,
unLII IInuIIy LIe bruIn Ioses ILs normuIILy, und LIe vIcLIm
Is Luken Lo LIe IospILuI Ior LIe Insune or IuId In LIe
gruve.
One puII dId noL puruIyze LIe young mun In LIe wIeeI-
cIuIr; buL LIe muny puIIs LIuL cume us LIe resuIL oI LIe
IIrsL puII, dId. TIe LeIILuIe sLuIns on LIe IIngers were
IndIcuLIve oI LIe deep sLuIns mude upon LIe nerve ceIIs.
One puII dId noL muke oI LIe brIgIL boy u crImInuI; buL
LIe muny puIIs LIuL IoIIowed LIe IIrsL, pIuced IIm In LIe
dungeon.
One puII dId noL keep LIe boy Irom wInnIng In uLIIeLIc
gumes; buL muny puIIs dId.
One puII dId noL desLroy IIs obedIenL, IeIpIuI spIrIL; buL
muny puIIs mude IIm u dIsobedIenL, dIsIoyuI boy.
One puII dId noL Luke IIm Irom LIe Ieud oI IIs cIuss Lo
LIe IooL; buL muny puIIs dId. Bewure, boys, oI LIe IIrsL
puII. (In CoIby, 1qqq, PIuLe 1)
n unoLIer pumpIIeL LIere Is u grupIIc skeLcI oI nonsmokers
wuIkIng LIe upwurd puLI oI success Lowurds LIe sunIIgIL, wIIIe smokers
143
143
Rampant Antismoking Signifies Grave Danger
noL uII LIuL new, und LIuL ILs sLuLus us evIdence In scIenLIIIc Lerms Is
compIeLeIy quesLIonubIe. MosL oI LIe cIuIms currenLIy mude Iuve been
Ieurd beIore over LIe IusL number oI cenLurIes, usuuIIy mude regurdIess oI
evIdence. BeIore LIe IuLesL burruge oI so-cuIIed scIenLIIIc InvesLIguLIon,
some medIcuI prucLILIoners were mukIng pronouncemenLs In LIe
nIneLeenLI und eurIy-LwenLIeLI cenLurIes ubouL connecLIons beLween
Lobucco smokIng und, Ior exumpIe, LubercuIosIs, Lobucco IeurL, Lremors,
bIIndness. TIese vIews were cerLuInIy noL bused on uny exIuusLIve,
scIenLIIIc upproucI Lo LIe subjecL.
..: Antismolin in The United Stctes
CoIby (1qqq) provIdes pumpIIeL InIormuLIon Irom u sIgnIIIcunL
UnILed SLuLes unLIsmokIng movemenL In LIe eurIy 1qoo`s. TIe AugusL z8,
1q1;, Issue oI The Instructor Is reIerred Lo us LIe unnuuI unLI-Lobucco
Issue. TIe muguzIne cover depIcLs PresIdenL Woodrow WIIson und
cupLIoned Woodrow WIIson - u NuLIonuI ExumpIe - LIe PresIdenL Does
NoL Smoke. UnIorLunuLeIy, Ior Woodrow WIIson und LIe unLIsmokIng
Iobby, wILIIn u yeur oI LIIs Issue LIe PresIdenL suIIered u debIIILuLIng
sLroke.
MucI oI LIe InIormuLIon wus LurgeLed uL boys (I.e., cIIIdren). n
one pumpIIeL LILIed WIy? LIe urLIcIe InquIres:
I LIe use oI Lobucco Is noL InjurIous,
WHY does LIe IIIe Insurunce compuny wIsI Lo know
wIeLIer LIe uppIIcunL smokes?
WHY does LIe surgeon, conLempIuLIng u serIous
operuLIon, usk wIeLIer LIe puLIenL smokes?
WHY ure uLIIeLes, In LruInIng, IorbIdden Lo smoke?
WHY do smokers, us u ruIe, udvIse oLIers noL Lo smoke?
WHY Is ubsLInence Irom Lobucco everywIere
consIdered u vuIuubIe usseL Ior u young mun?
WHY Is LIe cIgureLLe LIe objecL oI specIuI uLLenLIon by
Lemperunce und unLI-Lobucco workers?
WHY do cIgureLLe smokers muke LIe vusL mujorILy oI
LIe mIsLukes In bookkeepIng?
WHY ure cIgureLLe smokers un eusy prey Lo dIseuse,
especIuIIy Lo LubercuIosIs?
WHY do none oI LIe books wIIcI deuI wILI LIe
prIncIpIes oI success In IIIe, und gIve udvIce Lo young
men oI umbILIon, udvIse LIe use oI LIe cIgureLLe?
WHY ure LIose wIo begIn smokIng eurIy In IIIe, uImosL
wILIouL excepLIon, sLunLed In body or mInd?
Other Vital Matters
WHY do smokers never sLund IIrsL In LIeIr cIusses?
WHY do some SLuLes IorbId LIe seIIIng oI cIgureLLes Lo
mInors?
WHY Is IL LIuL youLIIuI crImInuIs ure uImosL InvurIubIy
smokers?
WHY Is smokIng proIIbILed durIng LIe IIrsL LIree yeurs
uL WesL PoInL und AnnupoIIs, LIe governmenL`s mIIILury
und nuvuI scIooIs?
I IL does noL IInder vocuLIons, wIy do muny IIrms
ubsoIuLeIy reIuse Lo empIoy boys und young men wIo
smoke cIgureLLes, or eIse gIve LIe preIerence Lo non-
smokIng persons?
TIe urLIcIe conLInues:
One puII cuIIs Ior more puIIs. TIuL`s LIe Iurm. And
every one oI LIese deposILs u smuII quunLILy oI deudIy
poIson In LIe body. One needIe prIck oI LIe CIInese
docLor does noL kIII LIe buby; buL LIe muILIpIIed prIcks
gIven In LIe eIIorL Lo bunIsI LIe so-cuIIed evII spIrIL,
drIves LIe breuLI oI IIIe ouL oI LIe IILLIe suIIerer.
One puII does noL desLroy LIe bruIn or IeurL, buL IL
Ieuves u sLuIn, und every oLIer puII deepens LIuL sLuIn,
unLII IInuIIy LIe bruIn Ioses ILs normuIILy, und LIe vIcLIm
Is Luken Lo LIe IospILuI Ior LIe Insune or IuId In LIe
gruve.
One puII dId noL puruIyze LIe young mun In LIe wIeeI-
cIuIr; buL LIe muny puIIs LIuL cume us LIe resuIL oI LIe
IIrsL puII, dId. TIe LeIILuIe sLuIns on LIe IIngers were
IndIcuLIve oI LIe deep sLuIns mude upon LIe nerve ceIIs.
One puII dId noL muke oI LIe brIgIL boy u crImInuI; buL
LIe muny puIIs LIuL IoIIowed LIe IIrsL, pIuced IIm In LIe
dungeon.
One puII dId noL keep LIe boy Irom wInnIng In uLIIeLIc
gumes; buL muny puIIs dId.
One puII dId noL desLroy IIs obedIenL, IeIpIuI spIrIL; buL
muny puIIs mude IIm u dIsobedIenL, dIsIoyuI boy.
One puII dId noL Luke IIm Irom LIe Ieud oI IIs cIuss Lo
LIe IooL; buL muny puIIs dId. Bewure, boys, oI LIe IIrsL
puII. (In CoIby, 1qqq, PIuLe 1)
n unoLIer pumpIIeL LIere Is u grupIIc skeLcI oI nonsmokers
wuIkIng LIe upwurd puLI oI success Lowurds LIe sunIIgIL, wIIIe smokers
144
144
Rampant Antismoking Signifies Grave Danger
wuIk LIe downwurd puLI oI IuIIure (CoIby, 1qqq, PIuLe z). n u IurLIer
pumpIIeL LILIed A PIysIcIun`s AdvIce by D.H. Kress, M.D., LIere Is u
curIcuLure oI u quesLIonubIe-IookIng IeIIow cupLIoned us u cIgureLLe
IIend, und LIe ucL oI smokIng Is IIIusLruLIveIy expIuIned us LIe
InIuIuLIon oI ImbecIIILy und LIe exIuIuLIon oI munIood. Kress IurLIer
enIIgILens LIe reuder wILI:
suId Lo u CIIcugo deLecLIve durIng LIe LIme wIen LIe
cILy wus beIng LerrorIzed by youLIIuI uuLomobIIe
bundILs, Huven`L you Iound LIuL In neurIy every cuse
LIese young crImInuIs ure cIgureLLe IIends? He Iooked
uL me u momenL, und LIen repIIed, n every cuse. One
oI LIese cuses, Teddy Webb, wIo wus LIen urresLed und
Is now servIng u IIIe senLence Ior murderIng u
poIIcemun, wus u IIne, promIsIng boy uL LIe uge oI Len
yeurs. AL LIuL uge Ie begun Lo use cIgureLLes wILI LIe
boys In LIe uIIeys. HIs downwurd cureer begun uL LIuL
poInL...
(In CoIby, 1qqq, PIuLe )
CoIby (1qqq) noLes LIuL LIe 1q1; IysLerIcs subsIded wILIIn u
decude. However, Ie muy be overIy opLImIsLIc In LIe Iope LIuL LIe sume
couId be suId Ior LIe currenL bouL oI IysLerIcs. L musL uIso be noLed LIuL u
WorId Wur InLerrupLed LIe unLIsmokIng onsIuugIL. And, IL wus uIso u
WorId Wur LIuL InLerrupLed LIe oLIer mujor unLIsmokIng crusude (NuzI)
oI LIe cenLury. Mujor wur seems Lo be InLImuLeIy connecLed wILI u
precedIng sLrong venLure InLo LIe superIIcIuIILy oI unLIsmokIng und ILs
muLerIuIIsL underpInnIngs.
TIe eurIy-1qoo`s crusude wus propeIIed by reIIgIous
senLImenLs. TuLe (1qqq) provIdes un InIormuLIve IIsLory oI LIe muss-
produced cIgureLLe Irom ILs IncepLIon In LIe IuLe-18oo`s. SIe uIso provIdes
IurLIer deLuII on LIe moruIIy moLIvuLed unLIsmokIng crusude oI LIe eurIy
LwenLIeLI cenLury In LIe UnILed SLuLes. ucy Puge GusLon, un evungeIIcuI
ProLesLunL, Iounded LIe AnLI-CIgureLLe eugue In 18qq. TIIs, LogeLIer
wILI oLIer reIormIsL groups, e.g., LIe YMCA, Women`s CIrIsLIun
Temperunce UnIon, vIewed smokIng us moruIIy degeneruLe und u segue Lo
oLIer woes sucI us uIcoIoIIsm, gumbIIng, nurcoLIcs uddIcLIon, und
crImInuIILy. SucI u vIewpoInL Is u compIeLeIy quesLIonubIe IdeoIogIcuI und
noL u scIenLIIIc one. TIe IundumenLuI uIm oI LIese groups wus Lo Iobby Ior
cIgureLLe proIIbILIon. Smokers were reIused empIoymenL by muny
IndusLrIuIIsLs, IncIudIng JoIn Hurvey KeIIogg, Henry ord und TIomus
EdIson, on LIe busIs LIuL smokers were unLrusLworLIy. KeIIogg (1qz)
proposed LIuL smokIng Ior pIeusure Is: u conIessIon oI weukness, u
Other Vital Matters
wIIIIngness, even u desIre Lo be deceIved Lo be LrunsporLed InLo u sIum
Ieuven ...|L Is| u conIessIon oI cowurdIce, oI unwIIIIngness Lo Iuce und
surmounL LIe obsLucIes Lo pIysIcuI, menLuI or moruI peuce und
comIorL. (quoLed In WurburLon, 1qqob, p.z8)
TIe IrsL WorId Wur, Iowever, drumuLIcuIIy uILered LIe scenurIo.
CIgureLLes were LoIeruLed us u Iesser evII wIIIe uIcoIoI und prosLILuLIon
were bunned neur US urmy buses sLuLIoned In Europe. TuLe (1qqq)
consIders LIIs Lo Iuve been u crILIcuI LurnIng poInL In LIe IIucLuuLIng
IorLunes oI LIe cIgureLLe; IL IeIL Ior LIe Wur us u munIIesLuLIon oI moruI
weukness und reLurned us u symboI oI Ireedom, democrucy, und
modernILy. WILI u IoosenIng oI LrudILIonuI vuIues In LIe posLwur decudes,
cIgureLLes becume IdenLIIIed wILI LIe gIumour oI HoIIywood. TIe
moruIIy-moLIvuLed unLIsmokIng crusude Iud run ILs course.
..z Antismolin in ritcin
SImIIurIy Lo LIe UnILed SLuLes, unLIsmokIng In 1qLI und zoLI-
cenLury BrILuIn wus LypIcuIIy u combInuLIon oI medIcuI und reIIgIous
cIuIms. A sIIde beLween snobbery und uIrs oI superIorILy musqueruded
under LIe preLense oI VIcLorIun munners or eLIqueLLe. MurLIn (1q8)
InIorms LIuL Miss Mcnners, u supposed orucIe oI LIe VIcLorIun eru,
responded Lo LIe quesLIon Are LIere uny IegILImuLe ruIes ubouL . wIen
und wIere cun smoke? wILI Yes, und LIey never sIouId Iuve been
ubundoned, us LIey were wIen women begun Lo smoke, wIIcI sIouId
never Iuve Iuppened, eILIer. SmokIng sIouId be conIIned Lo cerLuIn
purIors Lo wIIcI smokers muy reLIre Irom LIe sensIbIe peopIe und muke
LIeIr dIsgusLIng mess. One sIouId noL smoke uL LIe sume LubIe wIere
oLIers ure sLIII euLIng. I you wIsI Lo smoke In LIe presence oI cIeun
peopIe, you musL usk LIeIr permIssIon und be prepured Lo uccepL LIeIr
reIusuI Lo grunL IL. (quoLed In GoodIn, 1q8q, p.z)
An eurIy 1qLI-cenLury LexL dIcLuLes: I you ure so unIorLunuLe us
Lo Iuve conLrucLed LIe Iow IubIL oI smokIng, be cureIuI Lo prucLIce IL under
cerLuIn resLrIcLIons; uL IeusL so Iong us you ure desIrous oI beIng
consIdered IIL Ior cIvIIIzed socIeLy.. Smoke wIere IL Is IeusL IIkeIy Lo prove
personuIIy oIIensIve by mukIng your cIoLIes smeII; LIen wusI your mouLI,
und brusI your LeeLI. WIuL mun oI deIIcucy couId presume Lo uddress u
Iudy wILI IIs breuLI smeIIIng oI onIons? YeL Lobucco Is equuIIy odIous. TIe
Lobucco smoker, In public, Is LIe mosL seIIIsI unImuI ImugInubIe; Ie
perseveres In conLumInuLIng LIe pure und IrugrunL uIr, cureIess wIom Ie
unnoys. (Duy, 186J1qq; - quoLed In GoodIn, 1q8q, p.z)
DurIng LIIs LIme medIcuI prucLILIoners were dIvIded on LIe
beneIILs und deLrImenLs oI Lobucco smokIng (WuIker, 1q8o, p.q).
145
145
Rampant Antismoking Signifies Grave Danger
wuIk LIe downwurd puLI oI IuIIure (CoIby, 1qqq, PIuLe z). n u IurLIer
pumpIIeL LILIed A PIysIcIun`s AdvIce by D.H. Kress, M.D., LIere Is u
curIcuLure oI u quesLIonubIe-IookIng IeIIow cupLIoned us u cIgureLLe
IIend, und LIe ucL oI smokIng Is IIIusLruLIveIy expIuIned us LIe
InIuIuLIon oI ImbecIIILy und LIe exIuIuLIon oI munIood. Kress IurLIer
enIIgILens LIe reuder wILI:
suId Lo u CIIcugo deLecLIve durIng LIe LIme wIen LIe
cILy wus beIng LerrorIzed by youLIIuI uuLomobIIe
bundILs, Huven`L you Iound LIuL In neurIy every cuse
LIese young crImInuIs ure cIgureLLe IIends? He Iooked
uL me u momenL, und LIen repIIed, n every cuse. One
oI LIese cuses, Teddy Webb, wIo wus LIen urresLed und
Is now servIng u IIIe senLence Ior murderIng u
poIIcemun, wus u IIne, promIsIng boy uL LIe uge oI Len
yeurs. AL LIuL uge Ie begun Lo use cIgureLLes wILI LIe
boys In LIe uIIeys. HIs downwurd cureer begun uL LIuL
poInL...
(In CoIby, 1qqq, PIuLe )
CoIby (1qqq) noLes LIuL LIe 1q1; IysLerIcs subsIded wILIIn u
decude. However, Ie muy be overIy opLImIsLIc In LIe Iope LIuL LIe sume
couId be suId Ior LIe currenL bouL oI IysLerIcs. L musL uIso be noLed LIuL u
WorId Wur InLerrupLed LIe unLIsmokIng onsIuugIL. And, IL wus uIso u
WorId Wur LIuL InLerrupLed LIe oLIer mujor unLIsmokIng crusude (NuzI)
oI LIe cenLury. Mujor wur seems Lo be InLImuLeIy connecLed wILI u
precedIng sLrong venLure InLo LIe superIIcIuIILy oI unLIsmokIng und ILs
muLerIuIIsL underpInnIngs.
TIe eurIy-1qoo`s crusude wus propeIIed by reIIgIous
senLImenLs. TuLe (1qqq) provIdes un InIormuLIve IIsLory oI LIe muss-
produced cIgureLLe Irom ILs IncepLIon In LIe IuLe-18oo`s. SIe uIso provIdes
IurLIer deLuII on LIe moruIIy moLIvuLed unLIsmokIng crusude oI LIe eurIy
LwenLIeLI cenLury In LIe UnILed SLuLes. ucy Puge GusLon, un evungeIIcuI
ProLesLunL, Iounded LIe AnLI-CIgureLLe eugue In 18qq. TIIs, LogeLIer
wILI oLIer reIormIsL groups, e.g., LIe YMCA, Women`s CIrIsLIun
Temperunce UnIon, vIewed smokIng us moruIIy degeneruLe und u segue Lo
oLIer woes sucI us uIcoIoIIsm, gumbIIng, nurcoLIcs uddIcLIon, und
crImInuIILy. SucI u vIewpoInL Is u compIeLeIy quesLIonubIe IdeoIogIcuI und
noL u scIenLIIIc one. TIe IundumenLuI uIm oI LIese groups wus Lo Iobby Ior
cIgureLLe proIIbILIon. Smokers were reIused empIoymenL by muny
IndusLrIuIIsLs, IncIudIng JoIn Hurvey KeIIogg, Henry ord und TIomus
EdIson, on LIe busIs LIuL smokers were unLrusLworLIy. KeIIogg (1qz)
proposed LIuL smokIng Ior pIeusure Is: u conIessIon oI weukness, u
Other Vital Matters
wIIIIngness, even u desIre Lo be deceIved Lo be LrunsporLed InLo u sIum
Ieuven ...|L Is| u conIessIon oI cowurdIce, oI unwIIIIngness Lo Iuce und
surmounL LIe obsLucIes Lo pIysIcuI, menLuI or moruI peuce und
comIorL. (quoLed In WurburLon, 1qqob, p.z8)
TIe IrsL WorId Wur, Iowever, drumuLIcuIIy uILered LIe scenurIo.
CIgureLLes were LoIeruLed us u Iesser evII wIIIe uIcoIoI und prosLILuLIon
were bunned neur US urmy buses sLuLIoned In Europe. TuLe (1qqq)
consIders LIIs Lo Iuve been u crILIcuI LurnIng poInL In LIe IIucLuuLIng
IorLunes oI LIe cIgureLLe; IL IeIL Ior LIe Wur us u munIIesLuLIon oI moruI
weukness und reLurned us u symboI oI Ireedom, democrucy, und
modernILy. WILI u IoosenIng oI LrudILIonuI vuIues In LIe posLwur decudes,
cIgureLLes becume IdenLIIIed wILI LIe gIumour oI HoIIywood. TIe
moruIIy-moLIvuLed unLIsmokIng crusude Iud run ILs course.
..z Antismolin in ritcin
SImIIurIy Lo LIe UnILed SLuLes, unLIsmokIng In 1qLI und zoLI-
cenLury BrILuIn wus LypIcuIIy u combInuLIon oI medIcuI und reIIgIous
cIuIms. A sIIde beLween snobbery und uIrs oI superIorILy musqueruded
under LIe preLense oI VIcLorIun munners or eLIqueLLe. MurLIn (1q8)
InIorms LIuL Miss Mcnners, u supposed orucIe oI LIe VIcLorIun eru,
responded Lo LIe quesLIon Are LIere uny IegILImuLe ruIes ubouL . wIen
und wIere cun smoke? wILI Yes, und LIey never sIouId Iuve been
ubundoned, us LIey were wIen women begun Lo smoke, wIIcI sIouId
never Iuve Iuppened, eILIer. SmokIng sIouId be conIIned Lo cerLuIn
purIors Lo wIIcI smokers muy reLIre Irom LIe sensIbIe peopIe und muke
LIeIr dIsgusLIng mess. One sIouId noL smoke uL LIe sume LubIe wIere
oLIers ure sLIII euLIng. I you wIsI Lo smoke In LIe presence oI cIeun
peopIe, you musL usk LIeIr permIssIon und be prepured Lo uccepL LIeIr
reIusuI Lo grunL IL. (quoLed In GoodIn, 1q8q, p.z)
An eurIy 1qLI-cenLury LexL dIcLuLes: I you ure so unIorLunuLe us
Lo Iuve conLrucLed LIe Iow IubIL oI smokIng, be cureIuI Lo prucLIce IL under
cerLuIn resLrIcLIons; uL IeusL so Iong us you ure desIrous oI beIng
consIdered IIL Ior cIvIIIzed socIeLy.. Smoke wIere IL Is IeusL IIkeIy Lo prove
personuIIy oIIensIve by mukIng your cIoLIes smeII; LIen wusI your mouLI,
und brusI your LeeLI. WIuL mun oI deIIcucy couId presume Lo uddress u
Iudy wILI IIs breuLI smeIIIng oI onIons? YeL Lobucco Is equuIIy odIous. TIe
Lobucco smoker, In public, Is LIe mosL seIIIsI unImuI ImugInubIe; Ie
perseveres In conLumInuLIng LIe pure und IrugrunL uIr, cureIess wIom Ie
unnoys. (Duy, 186J1qq; - quoLed In GoodIn, 1q8q, p.z)
DurIng LIIs LIme medIcuI prucLILIoners were dIvIded on LIe
beneIILs und deLrImenLs oI Lobucco smokIng (WuIker, 1q8o, p.q).
146
146
Rampant Antismoking Signifies Grave Danger
ProIessor E.A. Purkes udvIsed uvoIdIng u concIusIon In LIuL medIcuI
cIuIms were mude on LIe busIs oI cIInIcuI observuLIons und noL sound
scIenLIIIc InvesLIguLIon (WuIker, 1q8o, p.q).
OI LIose wIo beIIeved IL Lo be deLrImenLuI, urgumenL Lended Lo
degeneruLe InLo ouLIundIsI, unsubsLunLIuLed cIuIms. or exumpIe, JoIn
Izurs, proIessor oI unuLomy uL EdInburgI UnIversILy, und consIdered u
LobuccopIobe, cIurged Lobucco inter clic wILI cuusIng vomILIng,
dyspepsIu, dIurrIoeu, upopIexy, puIsy, munIu, curcInomu, umuurosIs,
uIceruLIon, emuscuIuLIon, und congesLIon oI LIe bruIn. (WuIker, 1q8o,
p.q) Dr. PIdduck uIIeged LIuL Ie Iud seen IeecIes kIIIed InsLunLIy by LIe
bIood oI smokers, und LIuL IIeus rureIy uLLucked smokers (WuIker, 1q8o,
p.q). SucI cIuIms were consIdered Lo be LIose oI crunks. CrunkIness
LypIcuIIy IndIcuLes euse oI IrrILubIIILy In psycIoIogIcuI Lerms. MukIng
ouLrugeous cIuIms seems Lo IuIIIII some IundumenLuI InsecurILy In sucI
LroubIed mInds. UnIorLunuLeIy, wIere crunk cIuIms become LIe busIs Ior
urgumenL, onIy muss deIusIon cun ensue.
A crILIcuI LIeme oI unLIsmokIng crusudes Is LIe momenLum buIIL
by Iuy unLIsmokers, oILen oI u reIIgIous persuusIon, by IurLIer cuLusLro-
pIIzIng LIe preposLerous cIuIms oI medIcuI prucLILIoners: TIe IurgeIy Iuy
unLI-Lobucco movemenL mude exLensIve use oI LIe docLors` con-
demnuLIons oI LIe drug. DIsregurdIng medIcuI opInIons IuvourubIe Lo
Lobucco, LIe zeuIoLs IndIscrImInuLeIy dIIIused LIe mosL exLruvugunL
usserLIons oI obscure medIco-LobuccopIobes. TIe docLors Iud spoken oI
IurmIuI pIysIoIogIcuI und psycIoIogIcuI eIIecLs: Irom LIIs poInL LIe Iuy
unLI-LobucconIsLs enIurged upon LIe menLuI, moruI, socIuI, und economIc
Iurms oI Lobucco smokIng. (WuIker, 1q8o, p.q6)
WuIker (1q8o) IIgIIIgILs LIuL unLIsmokIng urgumenLs were oI
Lwo mujor LIemes. IrsLIy, In LIuL smokIng wus IInked Lo uIcoIoI
consumpLIon, boLI were consIdered us promoLIng moruI IuxILy.
urLIermore, Lobucco und uIcoIoI were urgued us wusLeIuI uses oI Iund,
cupILuI, Iubor, LIme, und eIIorL. SecondIy, In Lobucco smokIng LIe unLI-
LobucconIsLs Iound un expIuIn-uII Ior uII munner oI dIseuses:
|AnLIsmokIng urgumenLs| consIsLed IurgeIy oI personuI ImpressIons und
oI usserLIons unsubsLunLIuLed by reseurcI or sound evIdence. WIenever
unyLIIng unLowurd Iuppened Lo u smoker IL becume LIe subsLunce oI u Iuy
sermon urgued on post hoc ero propter hoc IInes. (WuIker, 1q8o, p.q6)
A consIderubIe IucL oI LIe muLLer Is LIuL durIng LIIs LIme, boLI
pusLors und docLors smoked. AnLIsmokIng, wIeLIer IuvIng u medIcuI or
reIIgIous LIeme, wus LypIcuIIy un exLreme posILIon reIIecLIng un exLreme
(IunuLIcuI) underIyIng menLuIILy.
A IInuI, very noLubIe poInL ruIsed by WuIker (1q8o) Is LIuL LIere
wus u consensus umongsL medIcuI prucLILIoners LIuL juvenIIe smokIng wus
Other Vital Matters
InjurIous: L Is u curIous IucL LIuL wIIIe LIe medIcuI proIessIon In LIe
nIneLeenLI cenLury wus uImosL ununImous In beIIevIng LIuL Lobucco wus
IurmIuI Lo cIIIdren, LIere wus no scIenLIIIc reseurcI ubouL LIe eIIecLs oI
smokIng on LIe growLI und IeuILI oI cIIIdren. (p.qo1) TIIs senLImenL
wus LIen Luken up by Iuy groups seekIng IegIsIuLIon Lo bun juvenIIe
smokIng.
.. The Nczi Anti-Tobccco Motement
TIe NuzI vIew oI smokIng provIdes very ImporLunL InsIgILs Ior
un undersLundIng oI conLemporury unLIsmokIng. n LIe InLeresLs oI
muInLuInIng LIe InLegrILy oI IIsLorIcuI InIormuLIon, reseurcIers wIII be
dIrecLIy quoLed In LIeIr depIcLIons oI IeuILI promoLIon In LIe NuzI regIme,
purLIcuIurIy concernIng smokIng.
ProcLor (1qqq) reveuIs LIuL LIe NuzIs were pIoneers In LIe wur
on cuncer. TIe NuzIs ure credILed wILI IuvIng cIumpIoned uspecLs oI u
IeuILIy dIeL (e.g., wIoIegruIn breud, soyu beuns) und LIe IdenLIIIcuLIon oI
muny workpIuce cuuses oI cuncer (e.g., usbesLos, pesLIcIdes). TIe NuzI
regIme uIso demonsLruLed mucI oI LIe worsL conducL LIuL Iumuns ure
cupubIe oI. ProcLor (1qq6) IIgIIIgILs LIuL we know LIuL ubouL IuII oI uII
docLors joIned LIe NuzI purLy und LIuL docLors pIuyed u mujor purL In
desIgnIng und udmInIsLerIng LIe NuzI progrummes oI IorcIbIe
sLerIIIzuLIon, 'euLIunusIu`, und LIe IndusLrIuI scuIe murder oI Jews und
gypsIes. MucI oI our presenL duy concern Ior LIe ubuse oI Iumuns used In
experImenLs sLems Irom LIe exLreme bruLuIILy muny Germun docLors
sIowed Lowurd concenLruLIon cump prIsoners expIoILed Lo udvunce LIe
cuuse oI Germun mIIILury medIcIne. (p.1qo)
Decker (zooz) IIgIIIgILs LIuL, upurL Irom LIe SS wIere Iuwyers
ouLnumbered LIem, pIysIcIuns` represenLuLIon In oLIer NuzI
orgunIzuLIons ouLrunked every oLIer proIessIonuI group, e.g., NuzI purLy,
LIe SA (sLormLroopers).
OI greuL InLeresL Lo LIIs dIscussIon Is LIuL cIgureLLe smokIng wus
uIso LurgeLed by LIe NuzI regIme. NuzI reseurcIers ure credILed us LIe IIrsL
Lo prove concIusIveIy LIuL smokIng wus LIe mujor cuuse oI Iung cuncer,
und, us eurIy us 1q6, Iud guLIered suIIIcIenL sLuLIsLIcuI evIdence Lo
prove LIe cuncerous Iuzurds oI wIuL LIey IubeIed pussIve
smokIng (pcssitrcucher) (ProcLor, 1qqq). ProcLor (1qq6) noLes LIuL:
HIsLorIuns und epIdemIoIogIsLs Iuve onIy recenLIy
begun Lo expIore LIe NuzI unLI-Lobucco movemenL.
Germuny Iud LIe sLrongesL unLIsmokIng movemenL In
LIe 1qo`s und eurIy 1qqo`s, encompussIng buns on
smokIng In pubIIc spuces, buns on udverLIsIng,
147
147
Rampant Antismoking Signifies Grave Danger
ProIessor E.A. Purkes udvIsed uvoIdIng u concIusIon In LIuL medIcuI
cIuIms were mude on LIe busIs oI cIInIcuI observuLIons und noL sound
scIenLIIIc InvesLIguLIon (WuIker, 1q8o, p.q).
OI LIose wIo beIIeved IL Lo be deLrImenLuI, urgumenL Lended Lo
degeneruLe InLo ouLIundIsI, unsubsLunLIuLed cIuIms. or exumpIe, JoIn
Izurs, proIessor oI unuLomy uL EdInburgI UnIversILy, und consIdered u
LobuccopIobe, cIurged Lobucco inter clic wILI cuusIng vomILIng,
dyspepsIu, dIurrIoeu, upopIexy, puIsy, munIu, curcInomu, umuurosIs,
uIceruLIon, emuscuIuLIon, und congesLIon oI LIe bruIn. (WuIker, 1q8o,
p.q) Dr. PIdduck uIIeged LIuL Ie Iud seen IeecIes kIIIed InsLunLIy by LIe
bIood oI smokers, und LIuL IIeus rureIy uLLucked smokers (WuIker, 1q8o,
p.q). SucI cIuIms were consIdered Lo be LIose oI crunks. CrunkIness
LypIcuIIy IndIcuLes euse oI IrrILubIIILy In psycIoIogIcuI Lerms. MukIng
ouLrugeous cIuIms seems Lo IuIIIII some IundumenLuI InsecurILy In sucI
LroubIed mInds. UnIorLunuLeIy, wIere crunk cIuIms become LIe busIs Ior
urgumenL, onIy muss deIusIon cun ensue.
A crILIcuI LIeme oI unLIsmokIng crusudes Is LIe momenLum buIIL
by Iuy unLIsmokers, oILen oI u reIIgIous persuusIon, by IurLIer cuLusLro-
pIIzIng LIe preposLerous cIuIms oI medIcuI prucLILIoners: TIe IurgeIy Iuy
unLI-Lobucco movemenL mude exLensIve use oI LIe docLors` con-
demnuLIons oI LIe drug. DIsregurdIng medIcuI opInIons IuvourubIe Lo
Lobucco, LIe zeuIoLs IndIscrImInuLeIy dIIIused LIe mosL exLruvugunL
usserLIons oI obscure medIco-LobuccopIobes. TIe docLors Iud spoken oI
IurmIuI pIysIoIogIcuI und psycIoIogIcuI eIIecLs: Irom LIIs poInL LIe Iuy
unLI-LobucconIsLs enIurged upon LIe menLuI, moruI, socIuI, und economIc
Iurms oI Lobucco smokIng. (WuIker, 1q8o, p.q6)
WuIker (1q8o) IIgIIIgILs LIuL unLIsmokIng urgumenLs were oI
Lwo mujor LIemes. IrsLIy, In LIuL smokIng wus IInked Lo uIcoIoI
consumpLIon, boLI were consIdered us promoLIng moruI IuxILy.
urLIermore, Lobucco und uIcoIoI were urgued us wusLeIuI uses oI Iund,
cupILuI, Iubor, LIme, und eIIorL. SecondIy, In Lobucco smokIng LIe unLI-
LobucconIsLs Iound un expIuIn-uII Ior uII munner oI dIseuses:
|AnLIsmokIng urgumenLs| consIsLed IurgeIy oI personuI ImpressIons und
oI usserLIons unsubsLunLIuLed by reseurcI or sound evIdence. WIenever
unyLIIng unLowurd Iuppened Lo u smoker IL becume LIe subsLunce oI u Iuy
sermon urgued on post hoc ero propter hoc IInes. (WuIker, 1q8o, p.q6)
A consIderubIe IucL oI LIe muLLer Is LIuL durIng LIIs LIme, boLI
pusLors und docLors smoked. AnLIsmokIng, wIeLIer IuvIng u medIcuI or
reIIgIous LIeme, wus LypIcuIIy un exLreme posILIon reIIecLIng un exLreme
(IunuLIcuI) underIyIng menLuIILy.
A IInuI, very noLubIe poInL ruIsed by WuIker (1q8o) Is LIuL LIere
wus u consensus umongsL medIcuI prucLILIoners LIuL juvenIIe smokIng wus
Other Vital Matters
InjurIous: L Is u curIous IucL LIuL wIIIe LIe medIcuI proIessIon In LIe
nIneLeenLI cenLury wus uImosL ununImous In beIIevIng LIuL Lobucco wus
IurmIuI Lo cIIIdren, LIere wus no scIenLIIIc reseurcI ubouL LIe eIIecLs oI
smokIng on LIe growLI und IeuILI oI cIIIdren. (p.qo1) TIIs senLImenL
wus LIen Luken up by Iuy groups seekIng IegIsIuLIon Lo bun juvenIIe
smokIng.
.. The Nczi Anti-Tobccco Motement
TIe NuzI vIew oI smokIng provIdes very ImporLunL InsIgILs Ior
un undersLundIng oI conLemporury unLIsmokIng. n LIe InLeresLs oI
muInLuInIng LIe InLegrILy oI IIsLorIcuI InIormuLIon, reseurcIers wIII be
dIrecLIy quoLed In LIeIr depIcLIons oI IeuILI promoLIon In LIe NuzI regIme,
purLIcuIurIy concernIng smokIng.
ProcLor (1qqq) reveuIs LIuL LIe NuzIs were pIoneers In LIe wur
on cuncer. TIe NuzIs ure credILed wILI IuvIng cIumpIoned uspecLs oI u
IeuILIy dIeL (e.g., wIoIegruIn breud, soyu beuns) und LIe IdenLIIIcuLIon oI
muny workpIuce cuuses oI cuncer (e.g., usbesLos, pesLIcIdes). TIe NuzI
regIme uIso demonsLruLed mucI oI LIe worsL conducL LIuL Iumuns ure
cupubIe oI. ProcLor (1qq6) IIgIIIgILs LIuL we know LIuL ubouL IuII oI uII
docLors joIned LIe NuzI purLy und LIuL docLors pIuyed u mujor purL In
desIgnIng und udmInIsLerIng LIe NuzI progrummes oI IorcIbIe
sLerIIIzuLIon, 'euLIunusIu`, und LIe IndusLrIuI scuIe murder oI Jews und
gypsIes. MucI oI our presenL duy concern Ior LIe ubuse oI Iumuns used In
experImenLs sLems Irom LIe exLreme bruLuIILy muny Germun docLors
sIowed Lowurd concenLruLIon cump prIsoners expIoILed Lo udvunce LIe
cuuse oI Germun mIIILury medIcIne. (p.1qo)
Decker (zooz) IIgIIIgILs LIuL, upurL Irom LIe SS wIere Iuwyers
ouLnumbered LIem, pIysIcIuns` represenLuLIon In oLIer NuzI
orgunIzuLIons ouLrunked every oLIer proIessIonuI group, e.g., NuzI purLy,
LIe SA (sLormLroopers).
OI greuL InLeresL Lo LIIs dIscussIon Is LIuL cIgureLLe smokIng wus
uIso LurgeLed by LIe NuzI regIme. NuzI reseurcIers ure credILed us LIe IIrsL
Lo prove concIusIveIy LIuL smokIng wus LIe mujor cuuse oI Iung cuncer,
und, us eurIy us 1q6, Iud guLIered suIIIcIenL sLuLIsLIcuI evIdence Lo
prove LIe cuncerous Iuzurds oI wIuL LIey IubeIed pussIve
smokIng (pcssitrcucher) (ProcLor, 1qqq). ProcLor (1qq6) noLes LIuL:
HIsLorIuns und epIdemIoIogIsLs Iuve onIy recenLIy
begun Lo expIore LIe NuzI unLI-Lobucco movemenL.
Germuny Iud LIe sLrongesL unLIsmokIng movemenL In
LIe 1qo`s und eurIy 1qqo`s, encompussIng buns on
smokIng In pubIIc spuces, buns on udverLIsIng,
148
148
Rampant Antismoking Signifies Grave Danger
resLrIcLIons on Lobucco ruLIons Ior women, und LIe
worId`s mosL reIIned Lobucco epIdemIoIogy, IInkIng
Lobucco use wILI LIe uIreudy evIdenL epIdemIc oI Iung
cuncer .. Germun unLI-Lobucco poIIcIes ucceIeruLed
Lowurds LIe end oI LIe 1qo's, und by LIe eurIy wur
yeurs Lobucco use Iud begun Lo decIIne. TIe uILwuIIe
bunned smokIng In 1q8 und LIe posL oIIIce dId
IIkewIse. SmokIng wus burred In muny workpIuces,
governmenL oIIIces, IospILuIs, und resL Iomes. TIe
NSDAP (NuLIonuIsozIuIIsLIscIe DeuLscIe ArbeILer-
purLeI) unnounced u bun on smokIng In ILs oIIIces In
1qq, uL wIIcI LIme SS cIIeI HeInrIcI HImmIer
unnounced u smokIng bun Ior uII unIIormed poIIce und
SS oIIIcers wIIIe on duLy. TIe JournuI oI LIe AmerIcun
MedIcuI AssocIuLIon LIuL yeur reporLed Hermunn
GoerIng's decree burrIng soIdIers Irom smokIng on LIe
sLreeLs, on murcIes, und on brIeI oII duLy perIods.
SmILI eL uI. (1qq) uIso IndIcuLe LIuL:
TIe PubIIc HeuILI OIIIce und LIe Germun MedIcuI
ussocIuLIon, boLI under LIe IeudersIIp oI Dr GerIurd
Wugner, repeuLedIy Issued precIse pronouncemenLs
regurdIng LIe dIre IeuILI consequences oI smokIng. By
1qq Wugner`s successor, Dr eonurdo ConLI, Iud
esLubIIsIed LIe ReIcI Bureuu AguInsL LIe Dungers oI
AIcoIoI und Tobucco. TIe ReIcI HeuILI OIIIce uIso
mude numerous sLuLemenLs, wIIcI ILs presIdenL, Huns
ReILer, reILeruLed uL IIs InuuguruI uddress uL LIe
openIng oI LIe 'IIrsL scIenLIIIc InsLILuLe Ior LIe sLruggIe
uguInsL LIe dungers oI Lobucco` uL LIe UnIversILy oI Jenu
In 1qqz .. RecognILIon oI LIe dumugIng eIIecLs oI
smokIng on IeuILI Ied Lo mucI unLIsmokIng IegIsIuLIon;
LIIs IncIuded IegIsIuLIon bunnIng smokIng In pubIIc
pIuces by LIose under 18 und proIIbILIng boLI Lobucco
udverLIsIng und smokIng In pubIIc buIIdIngs und on
pubIIc LrunsporL. PregnunL women und LIose deemed Lo
be sIck becuuse oI smokIng Iud LIeIr Lobucco ruLIons
wILIdruwn, und LIere wus serIous dIscussIon regurdIng
wIeLIer LIose sIck wILI IIIness cuused by smokIng
sIouId receIve medIcuI cure equuI Lo LIuL gIven Lo
puLIenLs wIose IIInesses were noL consIdered Lo be seII-
InIIIcLed.
Other Vital Matters
ProcLor (1qq;) provIdes consIderubIe deLuII us Lo LIe exLenL oI
unLIsmokIng senLImenL und meusures by LIe NuzI regIme:
Tobucco wus opposed by rucIuI IygIenIsLs IeurIng LIe
corrupLIon oI LIe Germun germ pIusm, by IndusLrIuI
IygIenIsLs IeurIng u reducLIon oI work cupucILy, by
nurses und mIdwIves IeurIng Iurms Ior LIe 'muLernuI
orgunIsm`. Tobucco wus suId Lo be 'u corrupLIng Iorce In
u roLLIng cIvIIIzuLIon LIuL Ius become Iuzy`, u cuuse oI
ImpoLence umong men und IrIgIdILy umong women. TIe
NuzI-eru unLILobucco rIeLorIc drew Irom un eurIIer
generuLIon`s eugenIc rIeLorIc, combInIng LIIs wILI un
eLIIc oI bodIIy purILy und perIormunce uL work. Tobucco
use wus uLLucked us 'epIdemIc`, us u 'pIugue`, us 'dry
drunkenness` und 'Iung musLurbuLIon`; Lobucco und
uIcoIoI ubuse were 'dIseuses oI cIvIIIzuLIon` und 'reIIcs oI
u IIberuI IIIesLyIe.` (p.qq1).
AnLIsmokIng sLeps sucI us exLensIve pubIIc educuLIon, buns on
cerLuIn Iorms oI udverLIsIng, und buns on smokIng In muny pubIIc pIuces
were consIsLenL wILI LIe regIme`s Iurger empIusIs on pIysIcIun-dIrecLed
'IeuILI IeudersIIp`, embrucIng boLI prevenLIve IeuILI und LIe prImucy oI
LIe pubIIc good over IndIvIduuI IIberLIes - LIe so-cuIIed 'duLy Lo be
IeuILIy.` (p.q;)
ProcLor (1qq;) conLInues LIuL LIrougIouL LIIs perIod, muguzInes
IIke Genussijte (PoIsons oI LusLe or IubIL), Auj der Wccht (On Guurd),
und Reine Lujt (Pure uIr) pubIIsIed u reguIur drumbeuL uguInsL LIIs
'InsIdIous poIson` |Lobucco|, uIong wILI urLIcIes cIurLIng LIe unIeuILIIuI
eIIecLs oI uIcoIoI, Leenuge duncIng, cocuIne, und oLIer vIces. Dozens oI
books und pumpIIeLs denounced LIe 'smokIng sIuvery` or 'cuILuruI
degeneruLIon` Ieured Irom LIe growLI oI Lobucco use. Tobucco wus
brunded 'LIe enemy oI worId peuce`, und LIere wus even LuIk oI 'Lobucco
Lerror` und 'Lobucco cupILuIIsm` .. TIe HILIer YouLI und LIe eugue oI
Germun GIrIs boLI pubIIsIed unLIsmokIng propugundu, und LIe
AssocIuLIon Ior LIe SLruggIe uguInsL LIe Tobucco Dunger orgunIzed
counseIIng cenLers wIere LIe 'Lobucco III` couId seek IeIp (p.q6-q;);
HILIer YouLI Iud unLI-smokIng puLroIs uII over Germuny, ouLsIde movIe
Iouses und In enLerLuInmenL ureus, sporLs IIeIds eLc., und smokIng wus
sLrIcLIy IorbIdden Lo LIese mIIIIons oI Germun youLI growIng up under
HILIer. (www.zundeIsILe - Junuury z;, 1qq8.ILm)
AdverLIsIng buns IncIuded u bun on uds ImpIyIng LIuL smokIng
possessed IygIenIc vuIues, us were Imuges depIcLIng smokers us uLIIeLes
149
149
Rampant Antismoking Signifies Grave Danger
resLrIcLIons on Lobucco ruLIons Ior women, und LIe
worId`s mosL reIIned Lobucco epIdemIoIogy, IInkIng
Lobucco use wILI LIe uIreudy evIdenL epIdemIc oI Iung
cuncer .. Germun unLI-Lobucco poIIcIes ucceIeruLed
Lowurds LIe end oI LIe 1qo's, und by LIe eurIy wur
yeurs Lobucco use Iud begun Lo decIIne. TIe uILwuIIe
bunned smokIng In 1q8 und LIe posL oIIIce dId
IIkewIse. SmokIng wus burred In muny workpIuces,
governmenL oIIIces, IospILuIs, und resL Iomes. TIe
NSDAP (NuLIonuIsozIuIIsLIscIe DeuLscIe ArbeILer-
purLeI) unnounced u bun on smokIng In ILs oIIIces In
1qq, uL wIIcI LIme SS cIIeI HeInrIcI HImmIer
unnounced u smokIng bun Ior uII unIIormed poIIce und
SS oIIIcers wIIIe on duLy. TIe JournuI oI LIe AmerIcun
MedIcuI AssocIuLIon LIuL yeur reporLed Hermunn
GoerIng's decree burrIng soIdIers Irom smokIng on LIe
sLreeLs, on murcIes, und on brIeI oII duLy perIods.
SmILI eL uI. (1qq) uIso IndIcuLe LIuL:
TIe PubIIc HeuILI OIIIce und LIe Germun MedIcuI
ussocIuLIon, boLI under LIe IeudersIIp oI Dr GerIurd
Wugner, repeuLedIy Issued precIse pronouncemenLs
regurdIng LIe dIre IeuILI consequences oI smokIng. By
1qq Wugner`s successor, Dr eonurdo ConLI, Iud
esLubIIsIed LIe ReIcI Bureuu AguInsL LIe Dungers oI
AIcoIoI und Tobucco. TIe ReIcI HeuILI OIIIce uIso
mude numerous sLuLemenLs, wIIcI ILs presIdenL, Huns
ReILer, reILeruLed uL IIs InuuguruI uddress uL LIe
openIng oI LIe 'IIrsL scIenLIIIc InsLILuLe Ior LIe sLruggIe
uguInsL LIe dungers oI Lobucco` uL LIe UnIversILy oI Jenu
In 1qqz .. RecognILIon oI LIe dumugIng eIIecLs oI
smokIng on IeuILI Ied Lo mucI unLIsmokIng IegIsIuLIon;
LIIs IncIuded IegIsIuLIon bunnIng smokIng In pubIIc
pIuces by LIose under 18 und proIIbILIng boLI Lobucco
udverLIsIng und smokIng In pubIIc buIIdIngs und on
pubIIc LrunsporL. PregnunL women und LIose deemed Lo
be sIck becuuse oI smokIng Iud LIeIr Lobucco ruLIons
wILIdruwn, und LIere wus serIous dIscussIon regurdIng
wIeLIer LIose sIck wILI IIIness cuused by smokIng
sIouId receIve medIcuI cure equuI Lo LIuL gIven Lo
puLIenLs wIose IIInesses were noL consIdered Lo be seII-
InIIIcLed.
Other Vital Matters
ProcLor (1qq;) provIdes consIderubIe deLuII us Lo LIe exLenL oI
unLIsmokIng senLImenL und meusures by LIe NuzI regIme:
Tobucco wus opposed by rucIuI IygIenIsLs IeurIng LIe
corrupLIon oI LIe Germun germ pIusm, by IndusLrIuI
IygIenIsLs IeurIng u reducLIon oI work cupucILy, by
nurses und mIdwIves IeurIng Iurms Ior LIe 'muLernuI
orgunIsm`. Tobucco wus suId Lo be 'u corrupLIng Iorce In
u roLLIng cIvIIIzuLIon LIuL Ius become Iuzy`, u cuuse oI
ImpoLence umong men und IrIgIdILy umong women. TIe
NuzI-eru unLILobucco rIeLorIc drew Irom un eurIIer
generuLIon`s eugenIc rIeLorIc, combInIng LIIs wILI un
eLIIc oI bodIIy purILy und perIormunce uL work. Tobucco
use wus uLLucked us 'epIdemIc`, us u 'pIugue`, us 'dry
drunkenness` und 'Iung musLurbuLIon`; Lobucco und
uIcoIoI ubuse were 'dIseuses oI cIvIIIzuLIon` und 'reIIcs oI
u IIberuI IIIesLyIe.` (p.qq1).
AnLIsmokIng sLeps sucI us exLensIve pubIIc educuLIon, buns on
cerLuIn Iorms oI udverLIsIng, und buns on smokIng In muny pubIIc pIuces
were consIsLenL wILI LIe regIme`s Iurger empIusIs on pIysIcIun-dIrecLed
'IeuILI IeudersIIp`, embrucIng boLI prevenLIve IeuILI und LIe prImucy oI
LIe pubIIc good over IndIvIduuI IIberLIes - LIe so-cuIIed 'duLy Lo be
IeuILIy.` (p.q;)
ProcLor (1qq;) conLInues LIuL LIrougIouL LIIs perIod, muguzInes
IIke Genussijte (PoIsons oI LusLe or IubIL), Auj der Wccht (On Guurd),
und Reine Lujt (Pure uIr) pubIIsIed u reguIur drumbeuL uguInsL LIIs
'InsIdIous poIson` |Lobucco|, uIong wILI urLIcIes cIurLIng LIe unIeuILIIuI
eIIecLs oI uIcoIoI, Leenuge duncIng, cocuIne, und oLIer vIces. Dozens oI
books und pumpIIeLs denounced LIe 'smokIng sIuvery` or 'cuILuruI
degeneruLIon` Ieured Irom LIe growLI oI Lobucco use. Tobucco wus
brunded 'LIe enemy oI worId peuce`, und LIere wus even LuIk oI 'Lobucco
Lerror` und 'Lobucco cupILuIIsm` .. TIe HILIer YouLI und LIe eugue oI
Germun GIrIs boLI pubIIsIed unLIsmokIng propugundu, und LIe
AssocIuLIon Ior LIe SLruggIe uguInsL LIe Tobucco Dunger orgunIzed
counseIIng cenLers wIere LIe 'Lobucco III` couId seek IeIp (p.q6-q;);
HILIer YouLI Iud unLI-smokIng puLroIs uII over Germuny, ouLsIde movIe
Iouses und In enLerLuInmenL ureus, sporLs IIeIds eLc., und smokIng wus
sLrIcLIy IorbIdden Lo LIese mIIIIons oI Germun youLI growIng up under
HILIer. (www.zundeIsILe - Junuury z;, 1qq8.ILm)
AdverLIsIng buns IncIuded u bun on uds ImpIyIng LIuL smokIng
possessed IygIenIc vuIues, us were Imuges depIcLIng smokers us uLIIeLes
150
150
Rampant Antismoking Signifies Grave Danger
or even sporLs Iuns, or oLIerwIse enguged In munIy pursuILs (ProcLor,
1qq;, p.q6o).
SpecIuIIzed unLILobucco InsLILuLes were uIso esLubIIsIed. TIe
mosL ImporLunL oI LIese wus LIe nsLILuLe Ior Tobucco Huzurds ReseurcI.
TIIs wus esLubIIsIed by u 1oo,ooo RM gIIL Irom HILIer`s ReIcIskunzIeI
(personuI IundIng) Lo LIe UnIversILy oI Jenu umIdsL greuL medIu IunIure In
AprII, 1qq1 (ProcLor, 1qq;, p.q6). WILIIn LIe medIcuI und IeuILI
IeudersIIp, unLIsmokIng wus sLrongIy propuguLed. or exumpIe, ReIcI
HeuILI uIrer eonurdo ConLI poInLed ouL LIuL Lobucco wus un uddIcLIve
drug, weukenIng LIe ubIIILy oI Ieuders Lo serve LIeIr nuLIon. KurI AsLeI, LIe
SS oIIIcer und pIysIcIun wIo Iounded LIe InsLILuLe |nsLILuLe Ior Tobucco
Huzurds reseurcI|, denounced LIe IeuILI und IInuncIuI cosLs oI smokIng,
buL uIso LIe 'eLIIc oI upuLIy` IosLered by LIe IubIL. (ProcLor, 1qq;, p.q6)
urLIermore,
LIe dIrecLor oI DorLmund`s nsLILuLe Ior ubor
PIysIoIogy (u ProI. GruI) urgued LIuL Lobucco sIouId be
enLIreIy bunned uL LIe workpIuce, due Lo LIe dungers oI
'pussIve smokIng`..Jenu by LIIs LIme wus u cenLer oI
unLILobucco ucLIvIsm. KurI AsLeI, dIrecLor oI LIe new
InsLILuLe, wus uIso presIdenL oI TIurIngIu`s OIIIce oI
RucIuI AIIuIrs, und recLor - sInce LIe summer oI 1qq -
oI LIe UnIversILy oI Jenu. AsLeI wus noL jusL u noLorIous
unLI-SemILe und rucIuI IygIenIsL (Ie Iud joIned LIe NuzI
purLy und LIe SS In JuIy 1qo), Ie wus uIso u mIIILunL
unLIsmoker und LeeLoLuIer wIo once cIurucLerIzed
opposILIon Lo smokIng us u 'nuLIonuI socIuIIsL duLy`. On
Muy Duy oI 1qqo Ie bunned smokIng In uII buIIdIngs
und cIussrooms oI LIe UnIversILy oI Jenu; Ie soon
becume known Ior snuLcIIng cIgureLLes Irom LIe
mouLIs oI sLudenLs wIo dured Lo vIoIuLe LIe bun. One
yeur IuLer, In LIe SprIng oI 1qq1, us Ieud oI TIurIngIu`s
pubIIc IeuILI oIIIce, Ie unnounced u smokIng bun Ior uII
sLuLe IeuILI oIIIces und uII Germun scIooIs. Tobucco
ubsLInence wus, us one mIgIL ImugIne, u condILIon oI
empIoymenL uL AsLeI`s unLILobucco InsLILuLe: LIe orIgInuI
proposuI senL Lo HILIer - wrILLen by GuuIeILer SuuckeI -
noLed LIuL LIIs wus 'us ImporLunL us Aryun uncesLry`;
Ireedom Irom Lobucco uddIcLIon wus suId Lo be
necessury Lo guurunLee LIe 'Independence` und
'ImpurLIuIILy` oI LIe scIence produced. (ProcLor, 1qq;,
p.q6q)
Other Vital Matters
One oI LIe crucIuI uspecLs oI LIe unLIsmokIng sLunce wus LIe
Issue oI uddIcLIon, wIIcI wus noL vIewed IIgILIy by LIe muLerIuIIsL
purILunIsm oI LIe NuzI menLuIILy:
AII oI LIese dungers were mugnIIIed, In LIe NuzI vIew oI
LIe worId, by LIe IucL LIuL Lobucco wus uddIcLIve. ReIcI
HeuILI uIrer eonurdo ConLI expressed LIIs vIew In
1qq, und LIere were muny oLIers wIo sIured IIs
judgmenL. Tobucco Lended Lo creuLe un uIIen uIIegIunce
In un eru wIen boLI mInd und body were supposed Lo
beIong Lo LIe uIrer. TIe cIurge wus u serIous one,
gIven LIuL uddIcLIons were oILen regurded us IeredILury
und IeredILury uIImenLs were suId Lo be IncurubIe. TIe
ImpressIon broudIy sIured wus LIuL wIIIe unyone mIgIL
become uddIcLed, LIe geneLIcuIIy weuk und degeneruLe
were Iur more vuInerubIe; Ience LIe cIurge LIuL
smokIng wus 'especIuIIy popuIur umong young
psycIopuLIs`. L Is noL cIeur wIeLIer Lobucco uddIcLs
were ever IncurceruLed Ior LIeIr uddIcLIon, buL we do
know LIuL LIuL IuLe beIeII persons uddIcLed Lo oLIer
subsLunces. n 1qq1, ReIcI HeuILI uIrer ConLI ordered
LIe esLubIIsImenL oI un oIIIce Lo regIsLer uddIcLs und
combuL uddIcLIon; sImIIur regIsLrIes were esLubIIsIed Lo
IdenLIIy uIcoIoIIcs, LIe IomeIess, und oLIer 'usocIuIs`.
Smokers muy Iuve been IeurIuI oI sucI moves, gIven
LIe wIdespreud concepLIon oI Lobucco use us u 'IIrsL
sLuge` In LIe move Lowurd ubusIng ever-sLronger
subsLunces - IIke morpIIne or cocuIne. (ProcLor, 1qq;,
p.qqq)
ConcernIng Lobucco workers, LIe sILuuLIon seemed Lo be serIous
enougI LIuL ReIcI EconomIcs MInIsLer WuILIer unk worrIed LIuL
Lobucco workers were beIng Lurred us persons 'ouLsIde LIe
VoIksgemeInscIuIL` und 'on u pur wILI Jews` - dungerous cIurges In
1qq1. (ProcLor, 1qq;, p.q;;)
ndusLrIuI IygIenIsLs, wIo were worrIed ubouL Lobucco-
InsLIguLed Ioss oI Germun munpower, uIso IIgure IIgIIy In unLIsmokIng
pressure: By LIe end oI LIe 1qo`s, peopIe mIssIng more LIun Iour weeks
oI work due Lo 'cIgureLLe sLomucI` (especIuIIy gusLrILIs or uIcers) were
requIred Lo reporL Lo u IospILuI Ior exumInuLIon; repeuL oIIenders - peopIe
wIo IuIIed Lo quIL smokIng und kepL mIssIng work - couId be remunded Lo
u nIcoLIne-wILIdruwuI cIInIc. (ProcLor, 1qq;, q;o)
RegurdIng LIe uIrer, HILIer Iud smoked z Lo qo cIgureLLes per
151
151
Rampant Antismoking Signifies Grave Danger
or even sporLs Iuns, or oLIerwIse enguged In munIy pursuILs (ProcLor,
1qq;, p.q6o).
SpecIuIIzed unLILobucco InsLILuLes were uIso esLubIIsIed. TIe
mosL ImporLunL oI LIese wus LIe nsLILuLe Ior Tobucco Huzurds ReseurcI.
TIIs wus esLubIIsIed by u 1oo,ooo RM gIIL Irom HILIer`s ReIcIskunzIeI
(personuI IundIng) Lo LIe UnIversILy oI Jenu umIdsL greuL medIu IunIure In
AprII, 1qq1 (ProcLor, 1qq;, p.q6). WILIIn LIe medIcuI und IeuILI
IeudersIIp, unLIsmokIng wus sLrongIy propuguLed. or exumpIe, ReIcI
HeuILI uIrer eonurdo ConLI poInLed ouL LIuL Lobucco wus un uddIcLIve
drug, weukenIng LIe ubIIILy oI Ieuders Lo serve LIeIr nuLIon. KurI AsLeI, LIe
SS oIIIcer und pIysIcIun wIo Iounded LIe InsLILuLe |nsLILuLe Ior Tobucco
Huzurds reseurcI|, denounced LIe IeuILI und IInuncIuI cosLs oI smokIng,
buL uIso LIe 'eLIIc oI upuLIy` IosLered by LIe IubIL. (ProcLor, 1qq;, p.q6)
urLIermore,
LIe dIrecLor oI DorLmund`s nsLILuLe Ior ubor
PIysIoIogy (u ProI. GruI) urgued LIuL Lobucco sIouId be
enLIreIy bunned uL LIe workpIuce, due Lo LIe dungers oI
'pussIve smokIng`..Jenu by LIIs LIme wus u cenLer oI
unLILobucco ucLIvIsm. KurI AsLeI, dIrecLor oI LIe new
InsLILuLe, wus uIso presIdenL oI TIurIngIu`s OIIIce oI
RucIuI AIIuIrs, und recLor - sInce LIe summer oI 1qq -
oI LIe UnIversILy oI Jenu. AsLeI wus noL jusL u noLorIous
unLI-SemILe und rucIuI IygIenIsL (Ie Iud joIned LIe NuzI
purLy und LIe SS In JuIy 1qo), Ie wus uIso u mIIILunL
unLIsmoker und LeeLoLuIer wIo once cIurucLerIzed
opposILIon Lo smokIng us u 'nuLIonuI socIuIIsL duLy`. On
Muy Duy oI 1qqo Ie bunned smokIng In uII buIIdIngs
und cIussrooms oI LIe UnIversILy oI Jenu; Ie soon
becume known Ior snuLcIIng cIgureLLes Irom LIe
mouLIs oI sLudenLs wIo dured Lo vIoIuLe LIe bun. One
yeur IuLer, In LIe SprIng oI 1qq1, us Ieud oI TIurIngIu`s
pubIIc IeuILI oIIIce, Ie unnounced u smokIng bun Ior uII
sLuLe IeuILI oIIIces und uII Germun scIooIs. Tobucco
ubsLInence wus, us one mIgIL ImugIne, u condILIon oI
empIoymenL uL AsLeI`s unLILobucco InsLILuLe: LIe orIgInuI
proposuI senL Lo HILIer - wrILLen by GuuIeILer SuuckeI -
noLed LIuL LIIs wus 'us ImporLunL us Aryun uncesLry`;
Ireedom Irom Lobucco uddIcLIon wus suId Lo be
necessury Lo guurunLee LIe 'Independence` und
'ImpurLIuIILy` oI LIe scIence produced. (ProcLor, 1qq;,
p.q6q)
Other Vital Matters
One oI LIe crucIuI uspecLs oI LIe unLIsmokIng sLunce wus LIe
Issue oI uddIcLIon, wIIcI wus noL vIewed IIgILIy by LIe muLerIuIIsL
purILunIsm oI LIe NuzI menLuIILy:
AII oI LIese dungers were mugnIIIed, In LIe NuzI vIew oI
LIe worId, by LIe IucL LIuL Lobucco wus uddIcLIve. ReIcI
HeuILI uIrer eonurdo ConLI expressed LIIs vIew In
1qq, und LIere were muny oLIers wIo sIured IIs
judgmenL. Tobucco Lended Lo creuLe un uIIen uIIegIunce
In un eru wIen boLI mInd und body were supposed Lo
beIong Lo LIe uIrer. TIe cIurge wus u serIous one,
gIven LIuL uddIcLIons were oILen regurded us IeredILury
und IeredILury uIImenLs were suId Lo be IncurubIe. TIe
ImpressIon broudIy sIured wus LIuL wIIIe unyone mIgIL
become uddIcLed, LIe geneLIcuIIy weuk und degeneruLe
were Iur more vuInerubIe; Ience LIe cIurge LIuL
smokIng wus 'especIuIIy popuIur umong young
psycIopuLIs`. L Is noL cIeur wIeLIer Lobucco uddIcLs
were ever IncurceruLed Ior LIeIr uddIcLIon, buL we do
know LIuL LIuL IuLe beIeII persons uddIcLed Lo oLIer
subsLunces. n 1qq1, ReIcI HeuILI uIrer ConLI ordered
LIe esLubIIsImenL oI un oIIIce Lo regIsLer uddIcLs und
combuL uddIcLIon; sImIIur regIsLrIes were esLubIIsIed Lo
IdenLIIy uIcoIoIIcs, LIe IomeIess, und oLIer 'usocIuIs`.
Smokers muy Iuve been IeurIuI oI sucI moves, gIven
LIe wIdespreud concepLIon oI Lobucco use us u 'IIrsL
sLuge` In LIe move Lowurd ubusIng ever-sLronger
subsLunces - IIke morpIIne or cocuIne. (ProcLor, 1qq;,
p.qqq)
ConcernIng Lobucco workers, LIe sILuuLIon seemed Lo be serIous
enougI LIuL ReIcI EconomIcs MInIsLer WuILIer unk worrIed LIuL
Lobucco workers were beIng Lurred us persons 'ouLsIde LIe
VoIksgemeInscIuIL` und 'on u pur wILI Jews` - dungerous cIurges In
1qq1. (ProcLor, 1qq;, p.q;;)
ndusLrIuI IygIenIsLs, wIo were worrIed ubouL Lobucco-
InsLIguLed Ioss oI Germun munpower, uIso IIgure IIgIIy In unLIsmokIng
pressure: By LIe end oI LIe 1qo`s, peopIe mIssIng more LIun Iour weeks
oI work due Lo 'cIgureLLe sLomucI` (especIuIIy gusLrILIs or uIcers) were
requIred Lo reporL Lo u IospILuI Ior exumInuLIon; repeuL oIIenders - peopIe
wIo IuIIed Lo quIL smokIng und kepL mIssIng work - couId be remunded Lo
u nIcoLIne-wILIdruwuI cIInIc. (ProcLor, 1qq;, q;o)
RegurdIng LIe uIrer, HILIer Iud smoked z Lo qo cIgureLLes per
152
152
Rampant Antismoking Signifies Grave Danger
duy In IIs VIennese youLI, unLII Ie reuIIzed Iow mucI money Ie wus
wusLIng, wIereupon Ie 'Lossed IIs cIgureLLes InLo LIe Dunube und never
reucIed Ior LIem uguIn.` (ProcLor, 1qq;, p.q;z) HILIer cIurucLerIzed
Lobucco us 'LIe wruLI oI LIe Red Mun Ior IuvIng been gIven Iurd IIquor`.
AL one poInL LIe uIrer even suggesLed LIuL NuzIsm mIgIL never Iuve
LrIumpIed In Germuny Iud Ie noL gIven up smokIng. (ProcLor, 1qq6,
p.1qo) n LIe pubIIcuLIon Auj der Wccht (1q;, 18) LIere uppeurs u
pIoLogrupIIc porLruIL oI HILIer und LIe cupLIon Our uIrer AdoII HILIer
drInks no uIcoIoI und does noL smoke ... HIs perIormunce uL work Is
IncredIbIe. (ProcLor, 1qq6, p.1q1)
HILIer wus unreIenLIng In LIe unLIsmokIng crusude. n
respondIng Lo unk`s concerns ubouL Lobucco workers, HILIer responded
LIuL LIe unLILobucco cumpuIgn sIouId noL be curLuIIed. TIe IeuILI
consequences oI smokIng sIouId ouLweIgI economIc concerns, Ie urgued,
und Lobucco workers sIouId probubIy be empIoyed In more 'wur
ImporLunL` pursuILs. (ProcLor, 1qq;, p.q;;) or u conIerence ceIebruLIng
LIe openIng oI LIe nsLILuLe Ior Tobucco Huzurds ReseurcI In AprII 1qq1,
und wIIcI IeuLured muny oI Germuny`s IoremosL unLILobucco ucLIvIsLs,
HILIer senL u LeIegrum wIsIIng LIe purLIcIpunLs besL oI Iuck In your work
Lo Iree IumunILy Irom one oI ILs mosL dungerous poIsons. (ProcLor, 1qq;,
p.q6q)
OI uII LIe excrucIuLIngIy quesLIonubIe, IorrId und unconscIonubIe
conducL oI LIe NuzIs und LIe uIrer IImseII, one oI HILIer`s Iew regreLs, IL
seems, wus uIIowIng IIs soIdIers Lo smoke: on LIe znd MurcI 1qqz Ie
noLed LIuL 'IL wus u mIsLuke, LruceubIe Lo LIe urmy IeudersIIp uL LIe LIme,
Lo Iuve sLurLed gIvIng our soIdIers duIIy ruLIons oI Lobucco uL LIe
begInnIng oI LIe wur`: Ie udded LIuL IL wus 'noL correcL Lo suy LIuL u
soIdIer cunnoL IIve wILIouL smokIng` und vowed Lo puL un end Lo mIIILury
Lobucco ruLIons once peuce wus ucIIeved. (ProcLor, 1qq;, p.q;1)
L Is uIso ImporLunL Lo noLe LIuL unLIsmokIng wus so stronl
ussocIuLed wILI NuzIsm LIuL Ior LIe cnti-NuzI youLI movemenLs - LIe
workIng cIuss EIdeIweIss PIruLes und LIe bourgeoIs Humburg SwIng YouLI
uIIke - LIe consLunL cIgureLLe seems Lo Iuve been uImosL u budge oI
resIsLunce und wus reIerred Lo us u sure IndIcuLor oI LIeIr degenerucy In
LIe surveIIIunce reporLs produced by LIe HILIer YouLI. ndeed, one oI LIe
reusons Ior LIe reIuLIve IuIIure oI ucLIvILIes Lo prevenL smokIng In Germuny
sInce LIe wur muy be LIuL LIe ussocIuLIon oI uuLIorILurIun unLIsmokIng
eIIorLs wILI LIe NuzI regIme remuIned In popuIur memory Ior u Iong
perIod. (SmILI eL uI., 1qq, p.q6)
GIven LIuL Lobucco wus consIdered Lo be u geneLIc poIson und
smokers us engugIng In Iung musLurbuLIon, IL Ius been urgued LIuL LIe
NuzI unLI-Lobucco sLunce wus one uspecL oI LIe rucIuI und bodIIy IygIene
Other Vital Matters
IdeoIogy (e.g., ProcLor, 1qq6; SmILI eL uI., 1qq). ProcLor (1qq6) concIudes
LIuL SmILI eL uI. |1qq| were correcL Lo empIusIze LIe sLrengLI oI LIe
NuzI unLIsmokIng eIIorL und LIe sopIIsLIcuLIon oI NuzI eru Lobucco
scIence. TIe unLIsmokIng scIence und poIIcIes oI LIe eru Iuve noL uLLrucLed
mucI uLLenLIon, possIbIy becuuse LIe ImpuIse beIInd LIe movemenL wus
cIoseIy uLLucIed Lo LIe Iurger NuzI movemenL. TIuL does noL meun,
Iowever, LIuL unLIsmokIng movemenLs ure InIerenLIy IuscIsL; IL meuns
LIuL scIenLIIIc memorIes ure oILen cIouded by LIe ceIebruLIons oI vIcLors,
und LIuL LIe poIILIcuI IIsLory oI scIence Is occusIonuIIy Iess pIeusunL LIun
we wouId wIsI.
L wouId seem Irom ProcLor (1qq6) und SmILI eL uI. (1qq) LIuL
LIe NuzI unLIsmokIng scIence wus scIenLIIIc und, LIereIore, good, LIuL
scIence sIouId dIrecL uII LIInkIng (I.e., scIenLIsm), LIuL scIenLIsm sIouId
be uppIIed Lo Issues oI Iumun IeuILI (I.e., IeuILIIsm), LIuL scIenLIIIc
merIL Is uIwuys dIsLIncL Irom uny oLIer IdeoIogIcuI IeunIng, und LIuL NuzI
unLIsmokIng wus pIoneerIng und LIe proper und sound orIgIn oI LIe
currenL unLIsmokIng senLImenL. On LIIs IuLLer poInL, ProcLor urgues LIuL
LIe NuzIs dIscovered LIe dIseuse eIIecLs (I.e., Iung cuncer) oI Lobucco
LIrougI LIe epIdemIoIogIc meLIod eurIIer LIun LIe groundbreukIng
reseurcI In BrILuIn or LIe UnILed SLuLes. TIereIore, LIe NuzIs sIouId
properIy be uccorded credIL regurdIess oI oLIer monsLrous prucLIces oI LIe
regIme.
TIe cenLruI LIeme oI LIe currenL dIscussIon Is LIuL uII oI LIese
proposILIons ure bIuLunLIy wrong. TIe crILIcuI probIem Is LIuL muny, II noL
mosL, medIcuI LIInkers, wIeLIer prucLILIoners or IIsLorIuns, dIspIuy u
mosL severe current muLerIuIIsL bIus und, LIereIore, do noL Iuve LIe
experLIse Lo uccounL Ior crILIcuI Issues oI psycIoIogIcuI, socIuI und moruI
IeuILI. n oLIer words, LIey demonsLruLe LIe sume IncompeLence,
ImmuLurILy und dysIuncLIon oI reusonIng us LIuL wIIcI LIey ure
uLLempLIng Lo evuIuuLe. TIe resuIL Is reInIorcemenL und conLInuILy oI
deIusIon. L does noL duwn on commenLuLors on LIIs regIme, Ior exumpIe,
LIuL LIe ter stron unLIsmokIng IIxuLIon Is jusL one munIIesLuLIon oI un
overuII dungerousIy deIusIonuI LIInkIng domInuLed by un exLruordInury
degree oI preLense, crueILy, conLorLed IdeoIogy, und propugundu - und
medIco-muLerIuIIsm IIgures very IIgIIy In LIIs.
IrsLIy, und conLrury Lo ProcLor`s ussessmenL, Is LIuL NuzI
Lobucco scIence wus noL sopIIsLIcuLed uL uII. L Ius uIreudy been
consIdered LIuL contemporcr IIIesLyIe epIdemIoIogy Is noL poor scIence,
buL unLI-scIenLIIIc. NuzI Lobucco epIdemIoIogy does noL even meeL, or
bureIy meeLs, LIIs woeIuI sLundurd. TIere were onIy Lwo smcll Germun
sLudIes on smokIng und Iung cuncer, Ior exumpIe. TIese were pubIIsIed In
LIe IuLe 1qo`s und eurIy 1qqo`s (I.e., MuIIer, 1qq; ScIuIrer & ScIonIger,
153
153
Rampant Antismoking Signifies Grave Danger
duy In IIs VIennese youLI, unLII Ie reuIIzed Iow mucI money Ie wus
wusLIng, wIereupon Ie 'Lossed IIs cIgureLLes InLo LIe Dunube und never
reucIed Ior LIem uguIn.` (ProcLor, 1qq;, p.q;z) HILIer cIurucLerIzed
Lobucco us 'LIe wruLI oI LIe Red Mun Ior IuvIng been gIven Iurd IIquor`.
AL one poInL LIe uIrer even suggesLed LIuL NuzIsm mIgIL never Iuve
LrIumpIed In Germuny Iud Ie noL gIven up smokIng. (ProcLor, 1qq6,
p.1qo) n LIe pubIIcuLIon Auj der Wccht (1q;, 18) LIere uppeurs u
pIoLogrupIIc porLruIL oI HILIer und LIe cupLIon Our uIrer AdoII HILIer
drInks no uIcoIoI und does noL smoke ... HIs perIormunce uL work Is
IncredIbIe. (ProcLor, 1qq6, p.1q1)
HILIer wus unreIenLIng In LIe unLIsmokIng crusude. n
respondIng Lo unk`s concerns ubouL Lobucco workers, HILIer responded
LIuL LIe unLILobucco cumpuIgn sIouId noL be curLuIIed. TIe IeuILI
consequences oI smokIng sIouId ouLweIgI economIc concerns, Ie urgued,
und Lobucco workers sIouId probubIy be empIoyed In more 'wur
ImporLunL` pursuILs. (ProcLor, 1qq;, p.q;;) or u conIerence ceIebruLIng
LIe openIng oI LIe nsLILuLe Ior Tobucco Huzurds ReseurcI In AprII 1qq1,
und wIIcI IeuLured muny oI Germuny`s IoremosL unLILobucco ucLIvIsLs,
HILIer senL u LeIegrum wIsIIng LIe purLIcIpunLs besL oI Iuck In your work
Lo Iree IumunILy Irom one oI ILs mosL dungerous poIsons. (ProcLor, 1qq;,
p.q6q)
OI uII LIe excrucIuLIngIy quesLIonubIe, IorrId und unconscIonubIe
conducL oI LIe NuzIs und LIe uIrer IImseII, one oI HILIer`s Iew regreLs, IL
seems, wus uIIowIng IIs soIdIers Lo smoke: on LIe znd MurcI 1qqz Ie
noLed LIuL 'IL wus u mIsLuke, LruceubIe Lo LIe urmy IeudersIIp uL LIe LIme,
Lo Iuve sLurLed gIvIng our soIdIers duIIy ruLIons oI Lobucco uL LIe
begInnIng oI LIe wur`: Ie udded LIuL IL wus 'noL correcL Lo suy LIuL u
soIdIer cunnoL IIve wILIouL smokIng` und vowed Lo puL un end Lo mIIILury
Lobucco ruLIons once peuce wus ucIIeved. (ProcLor, 1qq;, p.q;1)
L Is uIso ImporLunL Lo noLe LIuL unLIsmokIng wus so stronl
ussocIuLed wILI NuzIsm LIuL Ior LIe cnti-NuzI youLI movemenLs - LIe
workIng cIuss EIdeIweIss PIruLes und LIe bourgeoIs Humburg SwIng YouLI
uIIke - LIe consLunL cIgureLLe seems Lo Iuve been uImosL u budge oI
resIsLunce und wus reIerred Lo us u sure IndIcuLor oI LIeIr degenerucy In
LIe surveIIIunce reporLs produced by LIe HILIer YouLI. ndeed, one oI LIe
reusons Ior LIe reIuLIve IuIIure oI ucLIvILIes Lo prevenL smokIng In Germuny
sInce LIe wur muy be LIuL LIe ussocIuLIon oI uuLIorILurIun unLIsmokIng
eIIorLs wILI LIe NuzI regIme remuIned In popuIur memory Ior u Iong
perIod. (SmILI eL uI., 1qq, p.q6)
GIven LIuL Lobucco wus consIdered Lo be u geneLIc poIson und
smokers us engugIng In Iung musLurbuLIon, IL Ius been urgued LIuL LIe
NuzI unLI-Lobucco sLunce wus one uspecL oI LIe rucIuI und bodIIy IygIene
Other Vital Matters
IdeoIogy (e.g., ProcLor, 1qq6; SmILI eL uI., 1qq). ProcLor (1qq6) concIudes
LIuL SmILI eL uI. |1qq| were correcL Lo empIusIze LIe sLrengLI oI LIe
NuzI unLIsmokIng eIIorL und LIe sopIIsLIcuLIon oI NuzI eru Lobucco
scIence. TIe unLIsmokIng scIence und poIIcIes oI LIe eru Iuve noL uLLrucLed
mucI uLLenLIon, possIbIy becuuse LIe ImpuIse beIInd LIe movemenL wus
cIoseIy uLLucIed Lo LIe Iurger NuzI movemenL. TIuL does noL meun,
Iowever, LIuL unLIsmokIng movemenLs ure InIerenLIy IuscIsL; IL meuns
LIuL scIenLIIIc memorIes ure oILen cIouded by LIe ceIebruLIons oI vIcLors,
und LIuL LIe poIILIcuI IIsLory oI scIence Is occusIonuIIy Iess pIeusunL LIun
we wouId wIsI.
L wouId seem Irom ProcLor (1qq6) und SmILI eL uI. (1qq) LIuL
LIe NuzI unLIsmokIng scIence wus scIenLIIIc und, LIereIore, good, LIuL
scIence sIouId dIrecL uII LIInkIng (I.e., scIenLIsm), LIuL scIenLIsm sIouId
be uppIIed Lo Issues oI Iumun IeuILI (I.e., IeuILIIsm), LIuL scIenLIIIc
merIL Is uIwuys dIsLIncL Irom uny oLIer IdeoIogIcuI IeunIng, und LIuL NuzI
unLIsmokIng wus pIoneerIng und LIe proper und sound orIgIn oI LIe
currenL unLIsmokIng senLImenL. On LIIs IuLLer poInL, ProcLor urgues LIuL
LIe NuzIs dIscovered LIe dIseuse eIIecLs (I.e., Iung cuncer) oI Lobucco
LIrougI LIe epIdemIoIogIc meLIod eurIIer LIun LIe groundbreukIng
reseurcI In BrILuIn or LIe UnILed SLuLes. TIereIore, LIe NuzIs sIouId
properIy be uccorded credIL regurdIess oI oLIer monsLrous prucLIces oI LIe
regIme.
TIe cenLruI LIeme oI LIe currenL dIscussIon Is LIuL uII oI LIese
proposILIons ure bIuLunLIy wrong. TIe crILIcuI probIem Is LIuL muny, II noL
mosL, medIcuI LIInkers, wIeLIer prucLILIoners or IIsLorIuns, dIspIuy u
mosL severe current muLerIuIIsL bIus und, LIereIore, do noL Iuve LIe
experLIse Lo uccounL Ior crILIcuI Issues oI psycIoIogIcuI, socIuI und moruI
IeuILI. n oLIer words, LIey demonsLruLe LIe sume IncompeLence,
ImmuLurILy und dysIuncLIon oI reusonIng us LIuL wIIcI LIey ure
uLLempLIng Lo evuIuuLe. TIe resuIL Is reInIorcemenL und conLInuILy oI
deIusIon. L does noL duwn on commenLuLors on LIIs regIme, Ior exumpIe,
LIuL LIe ter stron unLIsmokIng IIxuLIon Is jusL one munIIesLuLIon oI un
overuII dungerousIy deIusIonuI LIInkIng domInuLed by un exLruordInury
degree oI preLense, crueILy, conLorLed IdeoIogy, und propugundu - und
medIco-muLerIuIIsm IIgures very IIgIIy In LIIs.
IrsLIy, und conLrury Lo ProcLor`s ussessmenL, Is LIuL NuzI
Lobucco scIence wus noL sopIIsLIcuLed uL uII. L Ius uIreudy been
consIdered LIuL contemporcr IIIesLyIe epIdemIoIogy Is noL poor scIence,
buL unLI-scIenLIIIc. NuzI Lobucco epIdemIoIogy does noL even meeL, or
bureIy meeLs, LIIs woeIuI sLundurd. TIere were onIy Lwo smcll Germun
sLudIes on smokIng und Iung cuncer, Ior exumpIe. TIese were pubIIsIed In
LIe IuLe 1qo`s und eurIy 1qqo`s (I.e., MuIIer, 1qq; ScIuIrer & ScIonIger,
154
154
Rampant Antismoking Signifies Grave Danger
1qq - see PeLo, 1qq) und ure noL onIy IIuwed In Lerms oI sLundurd errors
oI gross muLerIuIIsL und exLernuIIsL over-InLerpreLuLIon oI duLu, buL ure
uIso rIddIed wILI meLIodoIogIcuI IIuws (see uIso CoIby, 1qqq). More
ImporLunLIy, PeLo (1qq) properIy noLes LIuL LIe NuzI unLIsmokIng
crusude predcted LIese Germun sLudIes. TIIs IndIcuLes, und consIsLenLIy
wILI unLIsmokIng In oLIer nuLIons, LIuL unLIsmokIng Is u Lendency LIuL
does noL requIre scIenLIIIc IucL or even u sembIunce oI beIng scIenLIIIcuIIy
bused, und Is LypIcuIIy IdeoIogIcuI In nuLure.
n NuzIsm, unLIsmokIng Is one uspecL oI LIe IdeoIogy oI bodIIy
(muLerIuIIsL) purILunIsm, generuIIy, und rucIuI IygIene, more specIIIcuIIy
(I.e., Ieur LIuL Lobucco-use deLrImenLuIIy uIIecLed LIe Germun gene pooI).
However, II scIence cun be IIjucked Lo provIde evIdence Ior LIe
Lendency, LIen LIIs Is Indeed u bonus LIuL IeIps escuIuLe LIe
unLIsmokIng Lendency InLo mIIILuncy und zeuIoLry. MosL oI LIe oLIer
cIurges dIrecLed uL smokIng were produced by cusuuI (sLuLIsLIcuI)
observuLIon by medIcuI prucLILIoners undJor IuII-buked, III-consIdered
muLerIuIIsL IdeoIogy. TIe use oI uny oI LIIs nonsense In LIe coercIon oI
conIormILy Is onIy propugundu LIuL suys very mucI ubouL LIe menLuI
InsLubIIILy oI LIe propugundIsLs und very IILLIe ubouL smokIng. L cun be
suId LIuL LIe exLenL oI NuzI unLIsmokIng meusures und LIe uLLempL Lo
scIenLIIIcuIIy IegILImIze LIe posILIon uere pIoneerIng und cerLuInIy u
Iorerunner Lo conLemporury unLIsmokIng In ILs muLerIuIIsL dIsposILIon.
However, LIe crucIuI poInL Is LIuL LIe sLunce Ius no scIenLIIIc credIbIIILy
und LIuL, us wIII be urgued In LIe IoIIowIng, unLIsmokIng Is LypIcuIIy
sympLomuLIc oI u Iur more exLensIve und dungerous deIusIonuI menLuIILy.
SecondIy, IL Is ImporLunL Lo noLe LIe underIyIng meLupIysIcuI
ussumpLIons oI muLerIuIIsm und muLerIuIIsL purILunIsm. TIe medIcuI Iorm
oI LIIs posILIon Is LIuL LIe person Is vIewed us no more LIun u compIex
bIoIogIcuI orgunIsm. ExpIunuLIons Ior bIoIogIcuI dIseuse ure LypIcuIIy
sougIL Irom exposure Lo exogenous (observubIe) IucLors uIone (I.e.,
exLernuIIsm). TIereIore, uII dIseuse, II noL LIe enLIre Iumun condILIon, cun
be uddressed by scIenLIIIc enquIry (I.e., scIenLIsm). n uppIyIng LIe
scIenLIIIc meLIod Lo LIe Iumun condILIon IL Is LypIcuIIy LIe cuse LIuL
exposures Lo exogenous IucLors ure ter poor predictors oI specIIIc
dIseuse sucI us cuncer und coronury dIseuse. However, by over-
InLerpreLIng sucI duLu, In unLI-scIenLIIIc Lerms, LIe medIcuI esLubIIsImenL
Ius been ubIe Lo erroneousIy convInce ILseII oI uII munner oI proIound
dIscoverIes. HuvIng venLured InLo Iuke cuusuI urgumenLuLIon, LIIs uIIows
Ior u wIoIe serIes oI IIIesLyIe (muLerIuIIsL) prescrIpLIons und proscrIpLIons
(I.e., IeuILIIsm). urLIermore, wILIIn LIIs compIeLeIy quesLIonubIe,
compreIensIve muLerIuIIsL Irumework, medIco-muLerIuIIsm cun LIen
converL purLIcuIur IubILsJexposures InLo economIc cosL. By LIIs sLuge, u
Other Vital Matters
person`s worLI Is consIdered us InverseIy reIuLed Lo LIe umounL oI
pressure u person exerLs on LIe medIcuI IeuILI sysLem - LIe IIgIer LIe
pressure, LIe Iower LIe worLI. AII munner oI buns und coercIon Lo IIIesLyIe
conIormILy ure quILe eusy Lo jusLIIy wILIIn LIIs conLorLed nuLIonuIIsL und
sLuLIsLIcuIIsL Irumework wIere IL Is uccepLed LIuL IndIvIduuI pursuILs ure
expendubIe In LIe InLeresLs oI LIe group (nuLIonuIIsL) good.
L cun uIso be IIgIIIgILed LIuL LIe poIILIcuI exLensIon oI doubIe
bIuck-box reusonIng LIuL cIurucLerIzes IIIesLyIe epIdemIoIogy (descrIbed
In un eurIIer cIupLer) Is medIco-muLerIuIIsL nuLIonuIIsm. GIven LIuL
groups ure consIdered us one muLerIuI orgunIsm or u conLInuous
muLerIuI quunLILy (I.e., Vollslorper - peopIe`s body), LIen mInor,
sLuLIsLIcuIIy sIgnIIIcunL, dIIIerences beLween groups ure consIdered us
IndIcuLIve oI LIe enLIre group. ApurL Irom muInLuInIng LIe completel
unLenubIe ussumpLIon oI IomogeneILy oI group membersIIp, wIuL Is
IIgIIy dIsLurbIng Is LIe muLerIuIIsL LIeme. PsycIoIogIcuI, psycIosocIuI und
moruI dImensIons oI LIe Iumun condILIon neter enLer LIe consIderuLIon.
TIIs crucIuI muLLer wIII be dIscussed sIorLIy.
TIe rucIuI IygIene und mIIILurIsL uspecLs IosLered by HILIer IIL
neuLIy wILIIn LIe muLerIuIIsL Irumework. Now LIe person (Germun) Is
vIewed us no more LIun u cog In u nuLIonuI mIIILury mucIIne. TIe roIe oI
LIe medIcuI esLubIIsImenL, In ILs nuLIonuIIsL duLy, Is LIen Lo ensure LIe
muxImuI IeuILI oI men us soIdIers und wouId-be soIdIers, und oI women
us cIIId-beurers und, LIereIore, beurers oI wouId-be soIdIers. AguIn,
IeuILI wILIIn LIIs Irumework Is deIIned enLIreIy In muLerIuIIsL Lerms. AII
wIo cunnoL beneIIL LIIs nuLIonuIIsL endeuvor ure consIdered us
dIspensubIe In LIe mosL IorrIIIc sense oI LIe Lerm. TIe medIcuI
esLubIIsImenL LIereIore Is gIven u munduLe oI coercIon Lo ensure SLuLe
success. Here, LIe vIew oI IumunILy Is reduced Lo u Iorm oI unImuI
Iusbundry; LIe Iumun Ierd Is Ied specIuI dIeLs und gIvenJresLrIcLed
purLIcuIur exLernuI exposures Lo muxImIze work perIormunce In un
IndusLrIuIJmIIILury producLIon IIne. n LIe NuzI regIme, LIe SLuLe Is
embodIed In HILIer (LIe uIrer) - HILIer Is LIe SLuLe, und LIe SLuLe Is
HILIer. HILIer und LIe medIcuI esLubIIsImenL, In ILs uIIegIunce Lo LIe SLuLe,
Ieed eucI oLIer`s muLerIuIIsL mudness.
L sIouId be noLed Iere LIuL muny Iuve beIIeved LIuL LIe medIcuI
esLubIIsImenL wus corrupLed by LIe NuzI regIme. However, Hunuuske-
AbeI (1qq6) IndIcuLes LIuL
LIe evIdence presenLed Iere sLrongIy suggesLs LIuL LIe
Germun medIcuI communILy seL ILs own course In 1q.
n some respecLs LIIs course even ouLpuced LIe new
governmenL, wIIcI Iud Lo reIn In LIe proIessIon`s euger
pursuIL oI enIorced eugenIc sLerIIIzuLIons .. On LIe 1sL
155
155
Rampant Antismoking Signifies Grave Danger
1qq - see PeLo, 1qq) und ure noL onIy IIuwed In Lerms oI sLundurd errors
oI gross muLerIuIIsL und exLernuIIsL over-InLerpreLuLIon oI duLu, buL ure
uIso rIddIed wILI meLIodoIogIcuI IIuws (see uIso CoIby, 1qqq). More
ImporLunLIy, PeLo (1qq) properIy noLes LIuL LIe NuzI unLIsmokIng
crusude predcted LIese Germun sLudIes. TIIs IndIcuLes, und consIsLenLIy
wILI unLIsmokIng In oLIer nuLIons, LIuL unLIsmokIng Is u Lendency LIuL
does noL requIre scIenLIIIc IucL or even u sembIunce oI beIng scIenLIIIcuIIy
bused, und Is LypIcuIIy IdeoIogIcuI In nuLure.
n NuzIsm, unLIsmokIng Is one uspecL oI LIe IdeoIogy oI bodIIy
(muLerIuIIsL) purILunIsm, generuIIy, und rucIuI IygIene, more specIIIcuIIy
(I.e., Ieur LIuL Lobucco-use deLrImenLuIIy uIIecLed LIe Germun gene pooI).
However, II scIence cun be IIjucked Lo provIde evIdence Ior LIe
Lendency, LIen LIIs Is Indeed u bonus LIuL IeIps escuIuLe LIe
unLIsmokIng Lendency InLo mIIILuncy und zeuIoLry. MosL oI LIe oLIer
cIurges dIrecLed uL smokIng were produced by cusuuI (sLuLIsLIcuI)
observuLIon by medIcuI prucLILIoners undJor IuII-buked, III-consIdered
muLerIuIIsL IdeoIogy. TIe use oI uny oI LIIs nonsense In LIe coercIon oI
conIormILy Is onIy propugundu LIuL suys very mucI ubouL LIe menLuI
InsLubIIILy oI LIe propugundIsLs und very IILLIe ubouL smokIng. L cun be
suId LIuL LIe exLenL oI NuzI unLIsmokIng meusures und LIe uLLempL Lo
scIenLIIIcuIIy IegILImIze LIe posILIon uere pIoneerIng und cerLuInIy u
Iorerunner Lo conLemporury unLIsmokIng In ILs muLerIuIIsL dIsposILIon.
However, LIe crucIuI poInL Is LIuL LIe sLunce Ius no scIenLIIIc credIbIIILy
und LIuL, us wIII be urgued In LIe IoIIowIng, unLIsmokIng Is LypIcuIIy
sympLomuLIc oI u Iur more exLensIve und dungerous deIusIonuI menLuIILy.
SecondIy, IL Is ImporLunL Lo noLe LIe underIyIng meLupIysIcuI
ussumpLIons oI muLerIuIIsm und muLerIuIIsL purILunIsm. TIe medIcuI Iorm
oI LIIs posILIon Is LIuL LIe person Is vIewed us no more LIun u compIex
bIoIogIcuI orgunIsm. ExpIunuLIons Ior bIoIogIcuI dIseuse ure LypIcuIIy
sougIL Irom exposure Lo exogenous (observubIe) IucLors uIone (I.e.,
exLernuIIsm). TIereIore, uII dIseuse, II noL LIe enLIre Iumun condILIon, cun
be uddressed by scIenLIIIc enquIry (I.e., scIenLIsm). n uppIyIng LIe
scIenLIIIc meLIod Lo LIe Iumun condILIon IL Is LypIcuIIy LIe cuse LIuL
exposures Lo exogenous IucLors ure ter poor predictors oI specIIIc
dIseuse sucI us cuncer und coronury dIseuse. However, by over-
InLerpreLIng sucI duLu, In unLI-scIenLIIIc Lerms, LIe medIcuI esLubIIsImenL
Ius been ubIe Lo erroneousIy convInce ILseII oI uII munner oI proIound
dIscoverIes. HuvIng venLured InLo Iuke cuusuI urgumenLuLIon, LIIs uIIows
Ior u wIoIe serIes oI IIIesLyIe (muLerIuIIsL) prescrIpLIons und proscrIpLIons
(I.e., IeuILIIsm). urLIermore, wILIIn LIIs compIeLeIy quesLIonubIe,
compreIensIve muLerIuIIsL Irumework, medIco-muLerIuIIsm cun LIen
converL purLIcuIur IubILsJexposures InLo economIc cosL. By LIIs sLuge, u
Other Vital Matters
person`s worLI Is consIdered us InverseIy reIuLed Lo LIe umounL oI
pressure u person exerLs on LIe medIcuI IeuILI sysLem - LIe IIgIer LIe
pressure, LIe Iower LIe worLI. AII munner oI buns und coercIon Lo IIIesLyIe
conIormILy ure quILe eusy Lo jusLIIy wILIIn LIIs conLorLed nuLIonuIIsL und
sLuLIsLIcuIIsL Irumework wIere IL Is uccepLed LIuL IndIvIduuI pursuILs ure
expendubIe In LIe InLeresLs oI LIe group (nuLIonuIIsL) good.
L cun uIso be IIgIIIgILed LIuL LIe poIILIcuI exLensIon oI doubIe
bIuck-box reusonIng LIuL cIurucLerIzes IIIesLyIe epIdemIoIogy (descrIbed
In un eurIIer cIupLer) Is medIco-muLerIuIIsL nuLIonuIIsm. GIven LIuL
groups ure consIdered us one muLerIuI orgunIsm or u conLInuous
muLerIuI quunLILy (I.e., Vollslorper - peopIe`s body), LIen mInor,
sLuLIsLIcuIIy sIgnIIIcunL, dIIIerences beLween groups ure consIdered us
IndIcuLIve oI LIe enLIre group. ApurL Irom muInLuInIng LIe completel
unLenubIe ussumpLIon oI IomogeneILy oI group membersIIp, wIuL Is
IIgIIy dIsLurbIng Is LIe muLerIuIIsL LIeme. PsycIoIogIcuI, psycIosocIuI und
moruI dImensIons oI LIe Iumun condILIon neter enLer LIe consIderuLIon.
TIIs crucIuI muLLer wIII be dIscussed sIorLIy.
TIe rucIuI IygIene und mIIILurIsL uspecLs IosLered by HILIer IIL
neuLIy wILIIn LIe muLerIuIIsL Irumework. Now LIe person (Germun) Is
vIewed us no more LIun u cog In u nuLIonuI mIIILury mucIIne. TIe roIe oI
LIe medIcuI esLubIIsImenL, In ILs nuLIonuIIsL duLy, Is LIen Lo ensure LIe
muxImuI IeuILI oI men us soIdIers und wouId-be soIdIers, und oI women
us cIIId-beurers und, LIereIore, beurers oI wouId-be soIdIers. AguIn,
IeuILI wILIIn LIIs Irumework Is deIIned enLIreIy In muLerIuIIsL Lerms. AII
wIo cunnoL beneIIL LIIs nuLIonuIIsL endeuvor ure consIdered us
dIspensubIe In LIe mosL IorrIIIc sense oI LIe Lerm. TIe medIcuI
esLubIIsImenL LIereIore Is gIven u munduLe oI coercIon Lo ensure SLuLe
success. Here, LIe vIew oI IumunILy Is reduced Lo u Iorm oI unImuI
Iusbundry; LIe Iumun Ierd Is Ied specIuI dIeLs und gIvenJresLrIcLed
purLIcuIur exLernuI exposures Lo muxImIze work perIormunce In un
IndusLrIuIJmIIILury producLIon IIne. n LIe NuzI regIme, LIe SLuLe Is
embodIed In HILIer (LIe uIrer) - HILIer Is LIe SLuLe, und LIe SLuLe Is
HILIer. HILIer und LIe medIcuI esLubIIsImenL, In ILs uIIegIunce Lo LIe SLuLe,
Ieed eucI oLIer`s muLerIuIIsL mudness.
L sIouId be noLed Iere LIuL muny Iuve beIIeved LIuL LIe medIcuI
esLubIIsImenL wus corrupLed by LIe NuzI regIme. However, Hunuuske-
AbeI (1qq6) IndIcuLes LIuL
LIe evIdence presenLed Iere sLrongIy suggesLs LIuL LIe
Germun medIcuI communILy seL ILs own course In 1q.
n some respecLs LIIs course even ouLpuced LIe new
governmenL, wIIcI Iud Lo reIn In LIe proIessIon`s euger
pursuIL oI enIorced eugenIc sLerIIIzuLIons .. On LIe 1sL
156
156
Rampant Antismoking Signifies Grave Danger
oI JuIy |1q| Dr Huedenkump, us edILor oI LIe
DeuLscIes ArzLebIuLL, Ius LIe journuI resLurL ILs Issue
numbers und udvunce ILs voIume numbers Lo seL IL
upurL Irom LIe pusL und murk LIe new begInnIng. He
procIuIms: 'AII LIuL Is Germun und genuIne, uII LIuL
embodIes Germun sLyIe und Germun nuLure, uII LIuL Is
oI Germun bIood und Germun descenL, uII LIIs uIone cun
be LIe beurer oI LIe Germun IuLure. Our cIurucLerIsLIc
IeuLures Iuve In LIe pusL been overIuId or mIxed wILI
uIIen IeuLures, oILen Indeed overgrown und suIIocuLed
by LIem. SeII renewuI Is possIbIe onIy II LIe worLI oI
one`s own geneLIc composILIon Is recognIzed .. WILIouL
u proIoundIy uIurmIng uwureness oI LIe vuInerubIIILy
und ImpendIng degeneruLIon oI our geneLIc composILIon
no nuLIonuI recovery cun be ImugIned. TIe pIysIcIun
Ius u duLy Lo exLend LIIs knowIedge und Lo deepen LIIs
uwureness. Never beIore wus LIe medIcuI proIessIon so
InLImuLeIy IInked wILI LIe wIsdom und LIe uIms oI LIe
SLuLe Loduy. AII LIe more joyIuIIy musL LIe proIessIon
weIcome LIIs exLensIon oI ILs duLIes und LIe cIuIIenge Lo
IuIIIII ILs Lrue vocuLIon.` (p.1q-1q6)
Germuny wus reeIIng Irom LIe crIsIs oI LIe GreuL DepressIon.
TIe muLerIuIIsLs were uLLerIy convInced oI LIe nuLure oI LIe nuLIon`s
probIems und LIeIr recLIIIcuLIon. L uIso denoLes u greuL depurLure oI LIe
medIcuI esLubIIsImenL Irom LIe Lusk oI prImury cure oI LIe III und InLo u
crILIcuI purL oI ruIersIIp. As sucI, Germuny wus reudIed Ior purIIIcuLIon.
WILI regurd Lo smokIng, LIere wus uIreudy u buIIdIng oI unLIsmokIng
senLImenL In LIe medIcuI esLubIIsImenL Iong beIore LIe NuzI governmenL
(ProcLor, 1qq;, p.qq1). On LIIs, us muny oLIer bodIIy und rucIuI purILy
Issues, LIe uIrer und LIe greuLer purL oI LIe medIcuI esLubIIsImenL
shcred u common, mctericlist vIewpoInL.
TIIrdIy, IL cun be suId oI HILIer und LIe NuzI mucIIne, IncIudIng
LIe conLrIbuLIon oI LIe medIcuI esLubIIsImenL, LIuL one Is deuIIng wILI
LroubIed, IIgIIy conIIIcLed mInds. TIe exLreme muLerIuIIsL dIsposILIon
demonsLruLes un IncognIzunce oI LIeIr own mIndedness, und, LIereIore,
dungerousIy IuckIng In cupucILy Lo dIsLInguIsI beLween IuncLIonuI und
dysIuncLIonuI LIougIL; sucI u menLuIILy Ius essenLIuIIy no cupucILy Ior
IonesL seII-evuIuuLIon In LIe greuLer conLexL oI non-reducLIonIsL
psycIoIogy, socIuI psycIoIogy und moruIILy, I.e., dungerousIy
IncompeLenL, ImmuLure und IgnorunL. TIIs Is u sImIIur und crILIcuI
probIem oI rudIcuI beIuvIorIsm.
Other Vital Matters
A menLuIILy LIuL never geLs oII LIe muLerIuIIsL ground, us IL
were, Is superIIcIuI und ImmuLure. Some oI LIe mujor sympLoms ure
rIgIdILy, IuugILIness, bIgoLry und obsessIon wILI conLroI. A menLuIILy LIuL
cunnoL dIscern beLween IuncLIonuI und dysIuncLIonuI LIougIL In muILI-
dImensIonuI Lerms und uIso Iorwurds, ImpIIcILIy or expIIcILIy, sucI u
muLerIuIIsL posILIon us metcphsiccll deIInILIve (I.e., un IdeoIogy LIuL
socIeLy sIouId operuLe by), Is ILseII noL onIy dysIuncLIonuI buL IIgIIy
dungerous. GIven LIuL IL Ius noL come Lo Lerms wILI coIerenLIy evuIuuLIng
ILs own reusonIng, uII oI LIe unresoIved psycIogenIc conIIIcL, und oI wIIcI
IuLred wouId be LIe sLrongesL munIIesLed emoLIon, Is projecLed ouLwurds.
HILIer, Ior exumpIe, IdenLIIIed enLIreIy wILI u sIngIe ruce
(GermunIc) und wIere LIIs ruce Is uIso consIdered us supreme. HuvIng Lo
reconcIIe LIe currenL IucL LIuL LIe Germun ruce Iud severe probIems, und
LIereIore noL IuIIIIIIng ILs supreme cuIIIng, LIe mInd, projecLIng ILs own
IIgIIy-conIIIcLed sLuLe ouLwurd, LIen seurcIes Ior externcl sources oI
Germuny`s probIems (I.e., exLernuIIsm). n LIIs NuzI exumpIe, uII oLIer
ruces uILImuLeIy pose u LIreuL. However, IL begIns wILI LIe mosL
ImmedIuLe (domesLIc) perceIved LIreuL. n LIIs regurd, LIe IuLred wus
projecLed predomInunLIy onLo LIe JewIsI ruce, und Lo oLIer IucLors
perLuInIng Lo bodIIy und rucIuI purILy. HuvIng IdenLIIIed LIe cuuse oI
Germuny`s woes, recLIIIcuLIon Is IogIcuIIy obvIous. TIe exLremILy oI LIe
soIuLIon (I.e., exLermInuLIon), Iowever, IndIcuLes LIe complete Iuck oI
conscIence or sense oI uny coIerenL moruI Irumework. or exumpIe, LIe
Jews were noL porLruyed us even jusL InIerIor Lo LIe Aryun ruce, buL us
vermIn (I.e., ruLs) wurrunLIng exLermInuLIon, or us u socIuI cuncer
requIrIng excIsIon: LIe IuLred InvoIved wus rubId.
TIrougI LIIs serIes oI psycIoIogIcuI sLeps, HILIer In IIs own
mInd eIevuLed LIe Germun ruce InLo supremucy und IIs own posILIon us
recognIzer und deIender oI LIe IucL Lo un even IIgIer sLundIng. To LIIs
poInL, LIe deIusIon Is LIuL oI onIy one mun. However, LIe meeLIng oI
kIndred, LroubIed, muLerIuIIsL mInds propeIs one mun`s deIusIon InLo u
genuIne cuLusLropIe Indeed - oI evII proporLIons. n oLIer words, wIere
LIere Is u meeLIng oI sIuIIow, ImmuLure, IncompeLenL LIInkers In
suIIIcIenL numbers (e.g., supporLed by medIco-muLerIuIIsm), LIuL cunnoL
onIy noL recognIze LIese deIIcIencIes (I.e., purL oI LIe syndrome), buL, In
jusLIIyIng LIeIr own conLorLed reusonIng, consIder LIe menLuIILy Lo be
vIsIonury und worLIy oI ruIersIIp, LIen onl cuLusLropIe cun IoIIow.
TIIs presenLs LIe greuL ubsurdILy oI LIe correcLors und educuLors oI
socIeLy us LIe NuzIs vIewed LIemseIves, wIIIe pompousIy bucksIuppIng
eucI oLIer Ior LIeIr revoIuLIonury vIsIon, ucLuuIIy beIng LIose In greuLesL,
und rect, need oI correcLIon und educuLIon.
By munuIucLurIng propugundu on LIe busIs oI wIIm, peLuIunce,
157
157
Rampant Antismoking Signifies Grave Danger
oI JuIy |1q| Dr Huedenkump, us edILor oI LIe
DeuLscIes ArzLebIuLL, Ius LIe journuI resLurL ILs Issue
numbers und udvunce ILs voIume numbers Lo seL IL
upurL Irom LIe pusL und murk LIe new begInnIng. He
procIuIms: 'AII LIuL Is Germun und genuIne, uII LIuL
embodIes Germun sLyIe und Germun nuLure, uII LIuL Is
oI Germun bIood und Germun descenL, uII LIIs uIone cun
be LIe beurer oI LIe Germun IuLure. Our cIurucLerIsLIc
IeuLures Iuve In LIe pusL been overIuId or mIxed wILI
uIIen IeuLures, oILen Indeed overgrown und suIIocuLed
by LIem. SeII renewuI Is possIbIe onIy II LIe worLI oI
one`s own geneLIc composILIon Is recognIzed .. WILIouL
u proIoundIy uIurmIng uwureness oI LIe vuInerubIIILy
und ImpendIng degeneruLIon oI our geneLIc composILIon
no nuLIonuI recovery cun be ImugIned. TIe pIysIcIun
Ius u duLy Lo exLend LIIs knowIedge und Lo deepen LIIs
uwureness. Never beIore wus LIe medIcuI proIessIon so
InLImuLeIy IInked wILI LIe wIsdom und LIe uIms oI LIe
SLuLe Loduy. AII LIe more joyIuIIy musL LIe proIessIon
weIcome LIIs exLensIon oI ILs duLIes und LIe cIuIIenge Lo
IuIIIII ILs Lrue vocuLIon.` (p.1q-1q6)
Germuny wus reeIIng Irom LIe crIsIs oI LIe GreuL DepressIon.
TIe muLerIuIIsLs were uLLerIy convInced oI LIe nuLure oI LIe nuLIon`s
probIems und LIeIr recLIIIcuLIon. L uIso denoLes u greuL depurLure oI LIe
medIcuI esLubIIsImenL Irom LIe Lusk oI prImury cure oI LIe III und InLo u
crILIcuI purL oI ruIersIIp. As sucI, Germuny wus reudIed Ior purIIIcuLIon.
WILI regurd Lo smokIng, LIere wus uIreudy u buIIdIng oI unLIsmokIng
senLImenL In LIe medIcuI esLubIIsImenL Iong beIore LIe NuzI governmenL
(ProcLor, 1qq;, p.qq1). On LIIs, us muny oLIer bodIIy und rucIuI purILy
Issues, LIe uIrer und LIe greuLer purL oI LIe medIcuI esLubIIsImenL
shcred u common, mctericlist vIewpoInL.
TIIrdIy, IL cun be suId oI HILIer und LIe NuzI mucIIne, IncIudIng
LIe conLrIbuLIon oI LIe medIcuI esLubIIsImenL, LIuL one Is deuIIng wILI
LroubIed, IIgIIy conIIIcLed mInds. TIe exLreme muLerIuIIsL dIsposILIon
demonsLruLes un IncognIzunce oI LIeIr own mIndedness, und, LIereIore,
dungerousIy IuckIng In cupucILy Lo dIsLInguIsI beLween IuncLIonuI und
dysIuncLIonuI LIougIL; sucI u menLuIILy Ius essenLIuIIy no cupucILy Ior
IonesL seII-evuIuuLIon In LIe greuLer conLexL oI non-reducLIonIsL
psycIoIogy, socIuI psycIoIogy und moruIILy, I.e., dungerousIy
IncompeLenL, ImmuLure und IgnorunL. TIIs Is u sImIIur und crILIcuI
probIem oI rudIcuI beIuvIorIsm.
Other Vital Matters
A menLuIILy LIuL never geLs oII LIe muLerIuIIsL ground, us IL
were, Is superIIcIuI und ImmuLure. Some oI LIe mujor sympLoms ure
rIgIdILy, IuugILIness, bIgoLry und obsessIon wILI conLroI. A menLuIILy LIuL
cunnoL dIscern beLween IuncLIonuI und dysIuncLIonuI LIougIL In muILI-
dImensIonuI Lerms und uIso Iorwurds, ImpIIcILIy or expIIcILIy, sucI u
muLerIuIIsL posILIon us metcphsiccll deIInILIve (I.e., un IdeoIogy LIuL
socIeLy sIouId operuLe by), Is ILseII noL onIy dysIuncLIonuI buL IIgIIy
dungerous. GIven LIuL IL Ius noL come Lo Lerms wILI coIerenLIy evuIuuLIng
ILs own reusonIng, uII oI LIe unresoIved psycIogenIc conIIIcL, und oI wIIcI
IuLred wouId be LIe sLrongesL munIIesLed emoLIon, Is projecLed ouLwurds.
HILIer, Ior exumpIe, IdenLIIIed enLIreIy wILI u sIngIe ruce
(GermunIc) und wIere LIIs ruce Is uIso consIdered us supreme. HuvIng Lo
reconcIIe LIe currenL IucL LIuL LIe Germun ruce Iud severe probIems, und
LIereIore noL IuIIIIIIng ILs supreme cuIIIng, LIe mInd, projecLIng ILs own
IIgIIy-conIIIcLed sLuLe ouLwurd, LIen seurcIes Ior externcl sources oI
Germuny`s probIems (I.e., exLernuIIsm). n LIIs NuzI exumpIe, uII oLIer
ruces uILImuLeIy pose u LIreuL. However, IL begIns wILI LIe mosL
ImmedIuLe (domesLIc) perceIved LIreuL. n LIIs regurd, LIe IuLred wus
projecLed predomInunLIy onLo LIe JewIsI ruce, und Lo oLIer IucLors
perLuInIng Lo bodIIy und rucIuI purILy. HuvIng IdenLIIIed LIe cuuse oI
Germuny`s woes, recLIIIcuLIon Is IogIcuIIy obvIous. TIe exLremILy oI LIe
soIuLIon (I.e., exLermInuLIon), Iowever, IndIcuLes LIe complete Iuck oI
conscIence or sense oI uny coIerenL moruI Irumework. or exumpIe, LIe
Jews were noL porLruyed us even jusL InIerIor Lo LIe Aryun ruce, buL us
vermIn (I.e., ruLs) wurrunLIng exLermInuLIon, or us u socIuI cuncer
requIrIng excIsIon: LIe IuLred InvoIved wus rubId.
TIrougI LIIs serIes oI psycIoIogIcuI sLeps, HILIer In IIs own
mInd eIevuLed LIe Germun ruce InLo supremucy und IIs own posILIon us
recognIzer und deIender oI LIe IucL Lo un even IIgIer sLundIng. To LIIs
poInL, LIe deIusIon Is LIuL oI onIy one mun. However, LIe meeLIng oI
kIndred, LroubIed, muLerIuIIsL mInds propeIs one mun`s deIusIon InLo u
genuIne cuLusLropIe Indeed - oI evII proporLIons. n oLIer words, wIere
LIere Is u meeLIng oI sIuIIow, ImmuLure, IncompeLenL LIInkers In
suIIIcIenL numbers (e.g., supporLed by medIco-muLerIuIIsm), LIuL cunnoL
onIy noL recognIze LIese deIIcIencIes (I.e., purL oI LIe syndrome), buL, In
jusLIIyIng LIeIr own conLorLed reusonIng, consIder LIe menLuIILy Lo be
vIsIonury und worLIy oI ruIersIIp, LIen onl cuLusLropIe cun IoIIow.
TIIs presenLs LIe greuL ubsurdILy oI LIe correcLors und educuLors oI
socIeLy us LIe NuzIs vIewed LIemseIves, wIIIe pompousIy bucksIuppIng
eucI oLIer Ior LIeIr revoIuLIonury vIsIon, ucLuuIIy beIng LIose In greuLesL,
und rect, need oI correcLIon und educuLIon.
By munuIucLurIng propugundu on LIe busIs oI wIIm, peLuIunce,
158
158
Rampant Antismoking Signifies Grave Danger
IuII-buked IdeoIogy, IuugILIness und u IuLred oI psycIoLIc proporLIons,
LIe Iuvored ruce Is seduced InLo u bundwugon eIIecL. Members oI LIe
Iuvored ruce, regurdIess oI LIeIr buckground, uLLuInmenL or deIIcIencIes,
ure ImmedIuLeIy eIevuLed InLo superIor sLuLus. And seducLIve, Indeed, Is
LIIs prospecL LIuL onIy muLurILy oI reusonIng, IncIudIng moruI
dIscernmenL, couId resIsL. HuvIng convInced LIe requIred cILIzenry oI LIeIr
superIorILy, LIen uImosL unyLIIng cun be jusLIIIed In LIe nume oI
removIng LIe musLer ruce Irom LIe perceIved sources oI bonduge. By
LIIs LIme, LIe uIrer, wIo represenLs LIe embodImenL oI LIe SLuLe Is
eIevuLed IurLIer Lo u demIgod sLuLus remInIscenL oI Romun emperors, I.e.,
wIuLever LIe uIrer procIuIms Is uIwuys In LIe compIeLe InLeresL oI LIe
SLuLe und sIouIdJmusL be udIered Lo. Here LIe superIorILy syndrome
deLerIoruLes IurLIer InLo u supremucIsL syndrome LIrougI LIe IncIusIon oI
LIe uspecL oI InIuIIIbIIILy - wIo Is Lo cIuIIenge LIe uIrer wIo unswers
onIy Lo IImseII? TIIs poses LIe IurLIer ubsurdILy oI un essenLIuIIy
muLerIuIIsL reusonIng conducLIng ILseII In reIIgIous (cuIL) Lerms.
WILIIn onIy u sIorL LIme-Irume, u suIIIcIenL number oI LIe
Germun popuIuLIon were, uL IeusL, udequuLeIy convInced oI LIe
reIocuLIon oI Jewry ouL oI sIgIL und wurmongerIng wILI neIgIborIng
nuLIons (I.e., empIre buIIdIng), us reusonubIe meuns Lo LIe jusLIIIed gouI
oI worId conquesL, so us Lo uIIow LIe NuzI enLerprIse Lo proceed.
ourLIIy, Irom LIe ubove consIderuLIons, uIbeIL brIeI, LIe crILIcuI
probIem oI compreIensIve muLerIuIIsm produces numerous IronIes,
conLrudIcLIons und mInd-boggIIng ubsurdILIes. Wur Is LIe predomInunL
Lendency oI LIe NuzI mucIIne, wIeLIer IL be on cuncer, bodIIy ImpurILy,
LIe Jews, or oLIer nuLIons. TIe Iunguuge oI wur Is usuuIIy propugundu. A
noLubIe, oILen-mude observuLIon Is LIuL LIe IIrsL cusuuILy oI wur Is LruLI
(IonesLy, moruI dIscernmenL). Propugundu perverLs menLuI IeuILI,
coercIng IndIvIduuIs InLo sLuLes oI IuIse beIIeI. TIe second cusuuILy oI wur,
und consequenL Lo LIe IIrsL, Is coIerenL reIuLIonsIIp. L Is noL surprIsIng
LIuL sLundurd oI reIuLIonsIIp never IIgures In NuzI muLerIuIIsL LIInkIng,
I.e., obIIvIous Lo non-muLerIuIIsL dImensIons oI LIe Iumun condILIon.
AmIcubIIILy und socIubIIILy wILIIn LIe enercl pubIIc, pIenomenu LIuL
muny nuLIons muy unIorLunuLeIy Luke Ior grunLed, ure essenLIuIIy uIIen
concepLs In NuzI socIeLy. TIe propugundu IosLers severe socIuI dIvIsIon
und munuIucLures muILIpIe, jusLIIIed LurgeLs Ior IuLred; LIe socIuI IubrIc
Is permeuLed wILI suspIcIousness, surveIIIunce und Ieur - umongsL
Iuvored cILIzens, LIe ouLcusL, und LIe ruIIng IIerurcIy uIIke.
NuzI propugundu, LypIcuIIy sIunderous und cIurucLer-
ussussInuLIng In nuLure, Is un obscene, suvuge ussuuIL on psycIoIogIcuI,
socIuI und moruI IeuILI LIuL beurs good LesLImony Lo ILs underIyIng
conLorLed menLuIILy. Once LIe provIsIon oI InIormuLIon Irom uuLIorILy Lo
Other Vital Matters
LIe pubIIc Iucks LrusLworLIIness Lo LIe poInL oI IosLerIng socIuI dIvIsIon oI
u gruve kInd, LIen LIuL socIeLy Ius essenLIuIIy noLIIng remuInIng oI uny
genuIne vuIue. or uII oI LIe pursuIL oI muLerIuIIsL IygIene, NuzI socIeLy
wus essenLIuIIy IoveIess - deIumunIzed.
L Is on LIIs poInL LIuL LIe greuL IoIIy oI mctericlist nuLIonuIIsm
sIouId be obvIous. TIe NuzIs jusLIIIed LIeIr conducL In LIuL IL wus Ior LIe
good oI LIe Germun ruce us u wIoIe. However, once psycIoIogIcuI, socIuI
und moruI dImensIons ure IucLored InLo LIe nuLIonuIIsm, u rubId ussuuIL
on LIese, pIucIng members oI LIe Iuvored ruce InLo deIuded, IunuLIcuI und
murderous menLuI sLuLes, Is cerLuInIy noL Ior LIe group good. TIe Lerm
hiene Is encounLered uL every Lurn In LIe medIcuI und NuzI Iunguuge
(e.g., body, rucIuI, IndusLrIuI). YeL, In Lerms oI psycIo-IogIcuI, psycIosocIuI
und moruI dImensIons oI LIe Iumun condILIon, LIere Is u greuL corrupLIon,
u monumentcl poIIuLIon; Ior uII oI LIe muLerIuIIsL IygIene, IL couId weII be
usked - wIere Is sunILy?
TIere Is greuL Iocus on pIysIcuI IILness, uLIIeLIcIsm, sporL, dIeL,
exposures. YeL, uL psycIoIogIcuI, psycIosocIuI und moruI IeveIs LIere Is
IndoIence, sIoLI, comu. WILI u crILIcuI Iupse In uLLenLIon Lo coIerenL
reusonIng, LIen IL Is LIe unuLLended psycIopuLIoIogy LIuL comes Lo LIe
Iore. WIIIe exLoIIIng LIe vIrLues oI beIng u non-drInker und nonsmoker,
HILIer uIong wILI muny oLIers were drunk, und InLo crImInuI und
psycIoLIc IeveIs, wILI Ieur, IuLred, IusL Ior power (meguIomunIu), uvurIce,
deIusIons oI grundeur. TIIs consIderuLIon cun be Iorwurded In unoLIer
munner: A prevuIIIng menLuIILy, IuII oI uII munner oI psycIoIogIcuI, socIuI
und moruI corrupLIon, cun onIy dIsLInguIsI ILseII wILI u Iuude oI
cIeunIIness und IygIene In muLerIuIIsL Lerms, wIIcI ure LIen
munuIucLured InLo u counLerIeIL moruI sLuLus.
WILIIn LIe NuzI muLerIuIIsL Irumework, unyLIIng LIuL remoLeIy
seemed us u bodIIy conLumInunL, und usuuIIy wILI no scIenLIIIc busIs us Lo
possIbIe deLrImenLuI eIIecLs, wus requIred Lo be uvoIded by uII - Ior LIe
supposed group good. n conLemporury Lerms, LIIs wouId be Lermed
sLuLIsLIcuI rIsk uversIon. GIven LIuL LIe IeveIs oI rIsk InvoIved ure
LypIcuIIy very Iow, rIsk uversIon us u generuI Lendency Is consIdered us
psycIoIogIcuIIy dysIuncLIonuI. NoLwILIsLundIng LIIs IusL crILIcIsm, IL sLIII
resuILs In LIe ubsurdILy wILIIn NuzIsm LIuL on LIe one Iund rIsk uversIon
In muLerIuIIsL Lerms (e.g., dIeL, no smokIng, no uIcoIoI) Is beIng preucIed
wIIIsL obIIvIous Lo LIe IucL LIuL In non-muLerIuIIsL Lerms (psycIoIogIcuI,
socIuI, moruI) LIe menLuIILy Is rIsk-LukIng In mInd-boggIIng proporLIons:
on LIe one Iund IL goes Lo exLruordInury IengLIs Lo uvoId IIIusory
cuLusLropIe, wIIIe uL LIe sume LIme jumpIng Ieud-Iong InLo ucLuuI
cuLusLropIe. TIIs Is u Iorm oI upsIde-down, buck-Lo-IronL LIInkIng. L Is
upsIde-down In LIuL genuIneIy ImporLunL IucLors sucI us psycIoIogIcuI,
159
159
Rampant Antismoking Signifies Grave Danger
IuII-buked IdeoIogy, IuugILIness und u IuLred oI psycIoLIc proporLIons,
LIe Iuvored ruce Is seduced InLo u bundwugon eIIecL. Members oI LIe
Iuvored ruce, regurdIess oI LIeIr buckground, uLLuInmenL or deIIcIencIes,
ure ImmedIuLeIy eIevuLed InLo superIor sLuLus. And seducLIve, Indeed, Is
LIIs prospecL LIuL onIy muLurILy oI reusonIng, IncIudIng moruI
dIscernmenL, couId resIsL. HuvIng convInced LIe requIred cILIzenry oI LIeIr
superIorILy, LIen uImosL unyLIIng cun be jusLIIIed In LIe nume oI
removIng LIe musLer ruce Irom LIe perceIved sources oI bonduge. By
LIIs LIme, LIe uIrer, wIo represenLs LIe embodImenL oI LIe SLuLe Is
eIevuLed IurLIer Lo u demIgod sLuLus remInIscenL oI Romun emperors, I.e.,
wIuLever LIe uIrer procIuIms Is uIwuys In LIe compIeLe InLeresL oI LIe
SLuLe und sIouIdJmusL be udIered Lo. Here LIe superIorILy syndrome
deLerIoruLes IurLIer InLo u supremucIsL syndrome LIrougI LIe IncIusIon oI
LIe uspecL oI InIuIIIbIIILy - wIo Is Lo cIuIIenge LIe uIrer wIo unswers
onIy Lo IImseII? TIIs poses LIe IurLIer ubsurdILy oI un essenLIuIIy
muLerIuIIsL reusonIng conducLIng ILseII In reIIgIous (cuIL) Lerms.
WILIIn onIy u sIorL LIme-Irume, u suIIIcIenL number oI LIe
Germun popuIuLIon were, uL IeusL, udequuLeIy convInced oI LIe
reIocuLIon oI Jewry ouL oI sIgIL und wurmongerIng wILI neIgIborIng
nuLIons (I.e., empIre buIIdIng), us reusonubIe meuns Lo LIe jusLIIIed gouI
oI worId conquesL, so us Lo uIIow LIe NuzI enLerprIse Lo proceed.
ourLIIy, Irom LIe ubove consIderuLIons, uIbeIL brIeI, LIe crILIcuI
probIem oI compreIensIve muLerIuIIsm produces numerous IronIes,
conLrudIcLIons und mInd-boggIIng ubsurdILIes. Wur Is LIe predomInunL
Lendency oI LIe NuzI mucIIne, wIeLIer IL be on cuncer, bodIIy ImpurILy,
LIe Jews, or oLIer nuLIons. TIe Iunguuge oI wur Is usuuIIy propugundu. A
noLubIe, oILen-mude observuLIon Is LIuL LIe IIrsL cusuuILy oI wur Is LruLI
(IonesLy, moruI dIscernmenL). Propugundu perverLs menLuI IeuILI,
coercIng IndIvIduuIs InLo sLuLes oI IuIse beIIeI. TIe second cusuuILy oI wur,
und consequenL Lo LIe IIrsL, Is coIerenL reIuLIonsIIp. L Is noL surprIsIng
LIuL sLundurd oI reIuLIonsIIp never IIgures In NuzI muLerIuIIsL LIInkIng,
I.e., obIIvIous Lo non-muLerIuIIsL dImensIons oI LIe Iumun condILIon.
AmIcubIIILy und socIubIIILy wILIIn LIe enercl pubIIc, pIenomenu LIuL
muny nuLIons muy unIorLunuLeIy Luke Ior grunLed, ure essenLIuIIy uIIen
concepLs In NuzI socIeLy. TIe propugundu IosLers severe socIuI dIvIsIon
und munuIucLures muILIpIe, jusLIIIed LurgeLs Ior IuLred; LIe socIuI IubrIc
Is permeuLed wILI suspIcIousness, surveIIIunce und Ieur - umongsL
Iuvored cILIzens, LIe ouLcusL, und LIe ruIIng IIerurcIy uIIke.
NuzI propugundu, LypIcuIIy sIunderous und cIurucLer-
ussussInuLIng In nuLure, Is un obscene, suvuge ussuuIL on psycIoIogIcuI,
socIuI und moruI IeuILI LIuL beurs good LesLImony Lo ILs underIyIng
conLorLed menLuIILy. Once LIe provIsIon oI InIormuLIon Irom uuLIorILy Lo
Other Vital Matters
LIe pubIIc Iucks LrusLworLIIness Lo LIe poInL oI IosLerIng socIuI dIvIsIon oI
u gruve kInd, LIen LIuL socIeLy Ius essenLIuIIy noLIIng remuInIng oI uny
genuIne vuIue. or uII oI LIe pursuIL oI muLerIuIIsL IygIene, NuzI socIeLy
wus essenLIuIIy IoveIess - deIumunIzed.
L Is on LIIs poInL LIuL LIe greuL IoIIy oI mctericlist nuLIonuIIsm
sIouId be obvIous. TIe NuzIs jusLIIIed LIeIr conducL In LIuL IL wus Ior LIe
good oI LIe Germun ruce us u wIoIe. However, once psycIoIogIcuI, socIuI
und moruI dImensIons ure IucLored InLo LIe nuLIonuIIsm, u rubId ussuuIL
on LIese, pIucIng members oI LIe Iuvored ruce InLo deIuded, IunuLIcuI und
murderous menLuI sLuLes, Is cerLuInIy noL Ior LIe group good. TIe Lerm
hiene Is encounLered uL every Lurn In LIe medIcuI und NuzI Iunguuge
(e.g., body, rucIuI, IndusLrIuI). YeL, In Lerms oI psycIo-IogIcuI, psycIosocIuI
und moruI dImensIons oI LIe Iumun condILIon, LIere Is u greuL corrupLIon,
u monumentcl poIIuLIon; Ior uII oI LIe muLerIuIIsL IygIene, IL couId weII be
usked - wIere Is sunILy?
TIere Is greuL Iocus on pIysIcuI IILness, uLIIeLIcIsm, sporL, dIeL,
exposures. YeL, uL psycIoIogIcuI, psycIosocIuI und moruI IeveIs LIere Is
IndoIence, sIoLI, comu. WILI u crILIcuI Iupse In uLLenLIon Lo coIerenL
reusonIng, LIen IL Is LIe unuLLended psycIopuLIoIogy LIuL comes Lo LIe
Iore. WIIIe exLoIIIng LIe vIrLues oI beIng u non-drInker und nonsmoker,
HILIer uIong wILI muny oLIers were drunk, und InLo crImInuI und
psycIoLIc IeveIs, wILI Ieur, IuLred, IusL Ior power (meguIomunIu), uvurIce,
deIusIons oI grundeur. TIIs consIderuLIon cun be Iorwurded In unoLIer
munner: A prevuIIIng menLuIILy, IuII oI uII munner oI psycIoIogIcuI, socIuI
und moruI corrupLIon, cun onIy dIsLInguIsI ILseII wILI u Iuude oI
cIeunIIness und IygIene In muLerIuIIsL Lerms, wIIcI ure LIen
munuIucLured InLo u counLerIeIL moruI sLuLus.
WILIIn LIe NuzI muLerIuIIsL Irumework, unyLIIng LIuL remoLeIy
seemed us u bodIIy conLumInunL, und usuuIIy wILI no scIenLIIIc busIs us Lo
possIbIe deLrImenLuI eIIecLs, wus requIred Lo be uvoIded by uII - Ior LIe
supposed group good. n conLemporury Lerms, LIIs wouId be Lermed
sLuLIsLIcuI rIsk uversIon. GIven LIuL LIe IeveIs oI rIsk InvoIved ure
LypIcuIIy very Iow, rIsk uversIon us u generuI Lendency Is consIdered us
psycIoIogIcuIIy dysIuncLIonuI. NoLwILIsLundIng LIIs IusL crILIcIsm, IL sLIII
resuILs In LIe ubsurdILy wILIIn NuzIsm LIuL on LIe one Iund rIsk uversIon
In muLerIuIIsL Lerms (e.g., dIeL, no smokIng, no uIcoIoI) Is beIng preucIed
wIIIsL obIIvIous Lo LIe IucL LIuL In non-muLerIuIIsL Lerms (psycIoIogIcuI,
socIuI, moruI) LIe menLuIILy Is rIsk-LukIng In mInd-boggIIng proporLIons:
on LIe one Iund IL goes Lo exLruordInury IengLIs Lo uvoId IIIusory
cuLusLropIe, wIIIe uL LIe sume LIme jumpIng Ieud-Iong InLo ucLuuI
cuLusLropIe. TIIs Is u Iorm oI upsIde-down, buck-Lo-IronL LIInkIng. L Is
upsIde-down In LIuL genuIneIy ImporLunL IucLors sucI us psycIoIogIcuI,
160
160
Rampant Antismoking Signifies Grave Danger
socIuI und moruI coIesIon (IeuILI) ure IncompreIensIbIe Lo LIIs
reusonIng, wIIIe Iur more LrIvIuI muLLers ure munuIucLured InLo greuL
pursuILs; und IL Is buck-Lo-IronL In LIuL LIe cuuses LIuL IL seeks Ior In
exLernuIILIes ure, IoremosL, psycIoIogIcuI probIems (I.e., projecLIon oI
InLernuI conIIIcL).
WIIIsL promIsIng u greuL und gIorIous concIusIon Ior LIe musLer
ruce, by LIe LIme LIe NuzI sugu cume Lo ILs LImeIy end LIe Germun nuLIon
wus reduced Lo uLLer sIume, IumIIIuLIon und ruIn. Even Iud LIe NuzI
regIme LemporurIIy succeeded, Iowever sordId und dIsLurbIng LIe
prospecL mIgIL seem, does IL muke LIe menLuIILy uny Iess perverse, IorrId,
muILI-dImensIonuIIy IncompeLenL, ImmoruI?
L wus eurIIer IndIcuLed LIuL KurI AsLeI, dIrecLor oI LIe
unLILobucco InsLILuLe uL LIe UnIversILy oI Jenu, wus renown Ior pIuckIng
cIgureLLes Irom sLudenLs` mouLIs wIere LIey dured smoke In smokeIree
buIIdIngs. L musL be undersLood LIuL, us u sLrongIy decIured unLI-SemILe,
eurIy member oI LIe NuzI PurLy, und us u pIysIcIun, Ie wus purLy Lo LIe
overseeIng group Ior LIe consLrucLIon oI deuLI und sLurvuLIon cumps Ior
LIe meLIodIcuI, industricl sccle sIuugILer oI Jews, gypsIes, LIe dIsubIed,
IomosexuuIs, dIssenLers, eLc., LIuL wus uII purL oI u duy`s work, noL Lo
menLIon bruLuI, cuIIous Iumun experImenLuLIon on LIe dIsenIruncIIsed.
WILIIn AsLeI`s reusonIng, uII oI LIIs conducL wurrunLs no crILIcuI scruLIny,
Is IuIIy uccepLubIe, und Lo be enLIusIusLIcuIIy pursued. YeL, LIe sIgIL oI u IIL
cIgureLLe dungIIng Irom u sLudenL`s IIps In deIIunce oI smoke buns wus
suIIIcIenLIy oIIensIve Lo wurrunL ImmedIuLe conIronLuLIon und
remedIuLIon (see uIso SmILI eL uI., 1qqq, p.zz1). AguIn, LIe perversILy oI
LIe upsIde-down, buck-Lo-IronL LIInkIng sIouId be more LIun obvIous.
L uIso deIIes sune descrIpLIon Iow un unLIsmokIng,
wurmongerIng mucIIne sucI us LIe NuzI regIme wouId depIcL tobccco us
LIe enemy oI peuce. A curLoon uppeurIng In Reine Lujt, 1qq1 (ProcLor,
1qq6, 1qo-1q) depIcLs u Lobucco demon uLop u Iurge, durk cIoud LIuL
Is ruInIng down Lobucco producLs onLo LIe Germun nuLIon. TIe cupLIon
reuds Tobccco ccpitcl ruInIng down Lo spoII LIe peopIe`s IeuILI, Iubour
power, demogrupIIc poIILIcuI gouIs, und LIe weuILI oI LIe peopIe. Once
psycIoIogIcuI, psycIosocIuI, und moruI dImensIons ure properIy enLered
InLo consIderuLIon, IL cun very weII be concIuded LIuL LIe meLupIor Is Iur
more upproprIuLe Lo LIe NuzI regIme LIun Lo Lobucco (I.e., NuzI demon
ruInIng down psycIoIogIcuI, socIuI und moruI perversILy on LIe Germun
nuLIon).
n IucL, IL couId be usked Iow Iur one wunLs Lo exLend meLupIor?
Cuncer, Ior exumpIe, generuIIy IndIcuLes u corrupLIon oI IuncLIon -
IuncLIonIng gone mud. n bIoIogIcuI Lerms, IL IndIcuLes ceII IuncLIonIng
gone mud; wILI regurd Lo LIougIL, IL IndIcuLes u LIInkIng gone mud. WIIIe
Other Vital Matters
LIe NuzIs were uLLerIy obsessed wILI u wur on bIoIogIcuI cuncer und
poIsons oI LIe gene pooI, LIe very menLuIILy wus u cuncer (or u poIson, or
u moruI LoxIn) oI monumenLuI, pundemIc proporLIons, noL onIy on LIe
Germun nuLIon, buL wILI gIobuI rumIIIcuLIons. n sLundurd projecLIon
Lerms, mucI oI LIe rIeLorIc und propugundu dIrecLed uL Lobucco or LIe
Jews or uny oLIer exLernuIILy, very weII descrIbes NuzIsm`s own
menLuIILy - LIe uccusers uIone ure squureIy guIILy oI LIeIr own monsLrous
uccusuLIons. TIIs Is jusL unoLIer oI LIe numerous ubsurdILIes In LIe NuzI
muLerIuIIsL sugu.
IILIIy, und IIgIIy crILIcuI Lo LIIs dIscussIon, Is LIe psycIoIogy
und socIuI psycIoIogy oI unLIsmokIng, und wIIcI seems Lo Iuve u number
oI uspecLs. As wus consIdered In LIe prevIous poInL, wIuL wus mude oI
Lobucco by LIe NuzIs wus u Iur beLLer descrIpLIon oI LIeIr own menLuIILy
LIun oI Lobucco. AmbIenL Lobucco smoke Iends ILseII beuuLIIuIIy Ior
projecLIon. L becomes u mugIc mIsL, cupubIe oI unyLIIng uL uny LIme.
TIrougI projecLIon, u conIIIcLed, IuLeIuI mInd sees ILs own IosLIIILy
mIrrored buck by LIe mIsL. ndeed, LIe more IosLIIe LIe LIInkIng, LIe
more dungerous seems LIe mIsL.
ConcernIng uddIcLIon, ProcLor`s (1qq;) poInL Is very perLInenL:
Tobucco Lended Lo creuLe un uIIen uIIegIunce In un eru wIen boLI mInd
und body were supposed Lo beIong Lo LIe uIrer. (p.qqq) WILI LIe
supreme Ieuder IuvIng decreed LIuL Lobucco sIouId be uvoIded, LIen
smokers musL Iuve been dIsIoyuI Lo LIe uIrer becuuse oI LIe eIIecLs
(InLerIerence) oI Lobucco - numeIy uddIcLIon; were smokers noL uddIcLed,
LIey wouId uLLerIy conIorm. n oLIer words, unyone In sound-
mIndedness wouId compreIend LIe wIsdom oI LIe uIrer und
gruLeIuIIy IoIIow LIe decree - LIereIore, onIy conIormILy Is IndIcuLIve oI
sound-mIndedness. AguIn, LIIs suys more ubouL LIe ussumed InIuIIIbIIILy
(I.e., IuugILIness, ImperIousness, obsessIon wILI conLroI) oI LIe uIrer
und reucLIon Lo deIIunce LIun LIe uddIcLIon cIurucLerIzuLIon oI Lobucco-
smokIng posILed by medIco-muLerIuIIsm.
L Ius uIso come Lo IIgIL onIy recenLIy LIuL CIrIsLIunILy wus uIso
consIdered uIIen Lo NuzI nuLIonuIIsm. TIe InLenLIon Iere Is noL Lo equuLe
CIrIsLIunILy und smokIng, buL LIuL unyLIIng noL conIormIng Lo nuLIonuIIsL
edIcLs wus vIewed us uIIen und needIng recLIIIcuLIon. A recenL newspuper
urLIcIe IIgIIIgILs LIuL:
TIe NuzIs pIunned Lo obIILeruLe CIrIsLIunILy, uccordIng
Lo newIy reIeused documenLs Irom LIe posL WorId Wur
Nuremberg LrIuIs. TIe pupers, wIIcI ouLIIne secreL
NuzI poIIcIes, reveuI AdoII HILIer und oLIer Germun
Ieuders were enguged In u sysLemuLIc cumpuIgn Lo
desLroy CIrIsLIunILy In Europe. HILIer cIuImed Lo be u
161
161
Rampant Antismoking Signifies Grave Danger
socIuI und moruI coIesIon (IeuILI) ure IncompreIensIbIe Lo LIIs
reusonIng, wIIIe Iur more LrIvIuI muLLers ure munuIucLured InLo greuL
pursuILs; und IL Is buck-Lo-IronL In LIuL LIe cuuses LIuL IL seeks Ior In
exLernuIILIes ure, IoremosL, psycIoIogIcuI probIems (I.e., projecLIon oI
InLernuI conIIIcL).
WIIIsL promIsIng u greuL und gIorIous concIusIon Ior LIe musLer
ruce, by LIe LIme LIe NuzI sugu cume Lo ILs LImeIy end LIe Germun nuLIon
wus reduced Lo uLLer sIume, IumIIIuLIon und ruIn. Even Iud LIe NuzI
regIme LemporurIIy succeeded, Iowever sordId und dIsLurbIng LIe
prospecL mIgIL seem, does IL muke LIe menLuIILy uny Iess perverse, IorrId,
muILI-dImensIonuIIy IncompeLenL, ImmoruI?
L wus eurIIer IndIcuLed LIuL KurI AsLeI, dIrecLor oI LIe
unLILobucco InsLILuLe uL LIe UnIversILy oI Jenu, wus renown Ior pIuckIng
cIgureLLes Irom sLudenLs` mouLIs wIere LIey dured smoke In smokeIree
buIIdIngs. L musL be undersLood LIuL, us u sLrongIy decIured unLI-SemILe,
eurIy member oI LIe NuzI PurLy, und us u pIysIcIun, Ie wus purLy Lo LIe
overseeIng group Ior LIe consLrucLIon oI deuLI und sLurvuLIon cumps Ior
LIe meLIodIcuI, industricl sccle sIuugILer oI Jews, gypsIes, LIe dIsubIed,
IomosexuuIs, dIssenLers, eLc., LIuL wus uII purL oI u duy`s work, noL Lo
menLIon bruLuI, cuIIous Iumun experImenLuLIon on LIe dIsenIruncIIsed.
WILIIn AsLeI`s reusonIng, uII oI LIIs conducL wurrunLs no crILIcuI scruLIny,
Is IuIIy uccepLubIe, und Lo be enLIusIusLIcuIIy pursued. YeL, LIe sIgIL oI u IIL
cIgureLLe dungIIng Irom u sLudenL`s IIps In deIIunce oI smoke buns wus
suIIIcIenLIy oIIensIve Lo wurrunL ImmedIuLe conIronLuLIon und
remedIuLIon (see uIso SmILI eL uI., 1qqq, p.zz1). AguIn, LIe perversILy oI
LIe upsIde-down, buck-Lo-IronL LIInkIng sIouId be more LIun obvIous.
L uIso deIIes sune descrIpLIon Iow un unLIsmokIng,
wurmongerIng mucIIne sucI us LIe NuzI regIme wouId depIcL tobccco us
LIe enemy oI peuce. A curLoon uppeurIng In Reine Lujt, 1qq1 (ProcLor,
1qq6, 1qo-1q) depIcLs u Lobucco demon uLop u Iurge, durk cIoud LIuL
Is ruInIng down Lobucco producLs onLo LIe Germun nuLIon. TIe cupLIon
reuds Tobccco ccpitcl ruInIng down Lo spoII LIe peopIe`s IeuILI, Iubour
power, demogrupIIc poIILIcuI gouIs, und LIe weuILI oI LIe peopIe. Once
psycIoIogIcuI, psycIosocIuI, und moruI dImensIons ure properIy enLered
InLo consIderuLIon, IL cun very weII be concIuded LIuL LIe meLupIor Is Iur
more upproprIuLe Lo LIe NuzI regIme LIun Lo Lobucco (I.e., NuzI demon
ruInIng down psycIoIogIcuI, socIuI und moruI perversILy on LIe Germun
nuLIon).
n IucL, IL couId be usked Iow Iur one wunLs Lo exLend meLupIor?
Cuncer, Ior exumpIe, generuIIy IndIcuLes u corrupLIon oI IuncLIon -
IuncLIonIng gone mud. n bIoIogIcuI Lerms, IL IndIcuLes ceII IuncLIonIng
gone mud; wILI regurd Lo LIougIL, IL IndIcuLes u LIInkIng gone mud. WIIIe
Other Vital Matters
LIe NuzIs were uLLerIy obsessed wILI u wur on bIoIogIcuI cuncer und
poIsons oI LIe gene pooI, LIe very menLuIILy wus u cuncer (or u poIson, or
u moruI LoxIn) oI monumenLuI, pundemIc proporLIons, noL onIy on LIe
Germun nuLIon, buL wILI gIobuI rumIIIcuLIons. n sLundurd projecLIon
Lerms, mucI oI LIe rIeLorIc und propugundu dIrecLed uL Lobucco or LIe
Jews or uny oLIer exLernuIILy, very weII descrIbes NuzIsm`s own
menLuIILy - LIe uccusers uIone ure squureIy guIILy oI LIeIr own monsLrous
uccusuLIons. TIIs Is jusL unoLIer oI LIe numerous ubsurdILIes In LIe NuzI
muLerIuIIsL sugu.
IILIIy, und IIgIIy crILIcuI Lo LIIs dIscussIon, Is LIe psycIoIogy
und socIuI psycIoIogy oI unLIsmokIng, und wIIcI seems Lo Iuve u number
oI uspecLs. As wus consIdered In LIe prevIous poInL, wIuL wus mude oI
Lobucco by LIe NuzIs wus u Iur beLLer descrIpLIon oI LIeIr own menLuIILy
LIun oI Lobucco. AmbIenL Lobucco smoke Iends ILseII beuuLIIuIIy Ior
projecLIon. L becomes u mugIc mIsL, cupubIe oI unyLIIng uL uny LIme.
TIrougI projecLIon, u conIIIcLed, IuLeIuI mInd sees ILs own IosLIIILy
mIrrored buck by LIe mIsL. ndeed, LIe more IosLIIe LIe LIInkIng, LIe
more dungerous seems LIe mIsL.
ConcernIng uddIcLIon, ProcLor`s (1qq;) poInL Is very perLInenL:
Tobucco Lended Lo creuLe un uIIen uIIegIunce In un eru wIen boLI mInd
und body were supposed Lo beIong Lo LIe uIrer. (p.qqq) WILI LIe
supreme Ieuder IuvIng decreed LIuL Lobucco sIouId be uvoIded, LIen
smokers musL Iuve been dIsIoyuI Lo LIe uIrer becuuse oI LIe eIIecLs
(InLerIerence) oI Lobucco - numeIy uddIcLIon; were smokers noL uddIcLed,
LIey wouId uLLerIy conIorm. n oLIer words, unyone In sound-
mIndedness wouId compreIend LIe wIsdom oI LIe uIrer und
gruLeIuIIy IoIIow LIe decree - LIereIore, onIy conIormILy Is IndIcuLIve oI
sound-mIndedness. AguIn, LIIs suys more ubouL LIe ussumed InIuIIIbIIILy
(I.e., IuugILIness, ImperIousness, obsessIon wILI conLroI) oI LIe uIrer
und reucLIon Lo deIIunce LIun LIe uddIcLIon cIurucLerIzuLIon oI Lobucco-
smokIng posILed by medIco-muLerIuIIsm.
L Ius uIso come Lo IIgIL onIy recenLIy LIuL CIrIsLIunILy wus uIso
consIdered uIIen Lo NuzI nuLIonuIIsm. TIe InLenLIon Iere Is noL Lo equuLe
CIrIsLIunILy und smokIng, buL LIuL unyLIIng noL conIormIng Lo nuLIonuIIsL
edIcLs wus vIewed us uIIen und needIng recLIIIcuLIon. A recenL newspuper
urLIcIe IIgIIIgILs LIuL:
TIe NuzIs pIunned Lo obIILeruLe CIrIsLIunILy, uccordIng
Lo newIy reIeused documenLs Irom LIe posL WorId Wur
Nuremberg LrIuIs. TIe pupers, wIIcI ouLIIne secreL
NuzI poIIcIes, reveuI AdoII HILIer und oLIer Germun
Ieuders were enguged In u sysLemuLIc cumpuIgn Lo
desLroy CIrIsLIunILy In Europe. HILIer cIuImed Lo be u
162
162
Rampant Antismoking Signifies Grave Danger
bupLIsed CuLIoIIc, buL LIe pupers cIuIm Ie Iud noLIIng
buL conLempL Ior LIe cIurcIes. HIs commenLs on
reIIgIon, recorded by IIs secreLury, uIIegedIy cIuIm
sLuLemenLs IncIudIng 'CIrIsLIunILy Is LIe InvenLIon oI
sIck bruIns` und 'CIrIsLIunILy Is u rebeIIIon uguInsL
nuLuruI Iuw`. AccordIng Lo LIe documenLs, LIe NuzIs
pIunned Lo Luke over cIurcIes Irom wILIIn usIng purLy
sympuLIIsers, dIscredIL, juII or kIII CIrIsLIun Ieuders, re-
IndocLrInuLe CIrIsLIun congreguLIons und gIve LIem u
new purLy-bused IuILI...TIe NuzIs were convInced
cIurcI Ieuders couId never be reconcIIed wILI LIe
purLy`s prIncIpIes oI rucIsm. TIereIore, LIe cIurcI
wouId Iuve Lo become subservIenL Lo LIe SLuLe, und
LIen desLroyed. (Hercld,Sun, ebruury , zooz; see
uIso www.IuwundreIIgIon.com)
TIIs IusL poInL requIres some eIuboruLIon In LIuL LIere Is sLIII
conIusIon over HILIer`s reIIgIosILy. HILIer seemed Lo be InIIuenced by Lwo
muIn Irumeworks - unLI-SemILIsm und bIoIogIcuI evoIuLIon. AnLI-
SemILIsm wus noL un InvenLIon oI HILIer. TIere were Iong-sLundIng unLI-
SemILIc LendencIes In LIe mujor CIrIsLIun cIurcIes. MurLIn uLIer, LIe
IuLIer oI LIe ProLesLunL revoIL, wus unLI-SemILIc. n 1q6, MurLIn uLIer
Issued LIe bookIeL OI Jews und TIeIr Ies In wIIcI Ie sLuLed: IrsL,
LIeIr synugogues or cIurcIes sIouId be seL on IIre..SecondIy, LIeIr
Iomes IIkewIse sIouId be broken down und desLroyed..TIey ougIL be
puL under one rooI or In u sLubIe, IIke gypsIes..TIIrdIy, LIey sIouId be
deprIved oI LIeIr pruyer books. ourLIIy, LIeIr rubbIs musL be IorbIdden
under LIe LIreuL oI deuLI Lo LeucI unymore. L musL be noLed LIuL
uLIer`s unLI-SemILIsm wus bused on reIIgIon und noL on ruce or bIoIogy,
IIs wuywurd InLenL wus LIe IorcIbIe conversIon oI Jews Lo CIrIsLIunILy,
und IIs vIew In LIIs regurd Is noL CIrIsLIun. TIe Germun composer
Wugner wus ucuLeIy unLI-SemILIc und wILI deIuded beIIeIs reIIecLIng u
wurpIng oI CIrIsLIun LeucIIng. HILIer oILen mude udmIrIng reIerence Lo
boLI oI LIese men. n Mein Kcmpj, HILIer mukes muny reIerences Lo LIe
uImIgILy und LIe Iord, und unLI-SemILIsm, seemIngIy Irom u CIrIsLIun
perspecLIve. However, LIere Is noLIIng CIrIsLIun In HILIer`s reusonIng; IIs
conducL Is us unLI-CIrIsLIun us cun be. HILIer wus uIso purLIuI, us Is uny
muLerIuIIsL, Lo DurwInIun evoIuLIon. TIe obsessIon wILI bodIIyJrucIuI
purILy Is enLIreIy In IIne wILI LIIs LIeory.
TIe pecuIIurILy oI HILIer wus LIe deIuded combInIng oI LIese
dIsjoInLed Irumeworks. AnLI-SemILIsm wus redejined In muLerIuIIsL
(rucIuIJbodIIy) Lerms. Jews were LIen consIdered us geneLIcuIIy dIseused
Other Vital Matters
und u LIreuL Lo LIe Germun gene pooI; geneLIc dumuge meunL vuInerubIIILy
Lo dIseuse. A useIuI wuy oI undersLundIng wIuL reuIIy Ius IILLIe meunIng Is
LIuL HILIer Is IoremosL u IIgIIy LroubIed und conIIIcLed mInd. He
borrowed bILs Irom u vurIeLy oI vIews. n uppeusIng IIs derungemenL, Ie
concocLed Irom LIese dIsjoInLed bILs u jusLIIyIng sLory IIne LIuL provIded
u conduIL Ior enucLIng or munIIesLIng ucuLe IuLred und deIusIons oI
grundeur. L couId weII be urgued LIuL HILIer Iud u pucL wILI LIe devII -
IIs worIdvIew wus enLIreIy unLI-CIrIsLIun; wIuLever Iord HILIer wus
reIerrIng Lo, IL wus cerLuInIy noL CIrIsL oI LIe New TesLumenL. L musL uIso
be undersLood LIuL LIe NuzI sysLem Is Iower-nuLure, muLerIuIIsL und
bodIIy-IIxuLed In dIsposILIon.
UnIorLunuLeIy, LIere were CIrIsLIun cIurcIes, CuLIoIIc und
ProLesLunL, Germun und ubroud, LIuL InILIuIIy vIewed HILIer und LIe NuzI
purLy us redeemers oI u degeneruLe Germuny, purLIcuIurIy Ior LIeIr
cIeun IIvIng (unLIsmokIng, unLI-uIcoIoI, unLI-pornogrupIy) edIcLs. L Is
onIy us LIe bruLuIILy becume more obvIous, specIIIcuIIy uguInsL LIe Jews,
LIuL muny CIrIsLIun groups begun Lo reLIInk LIeIr posILIon. However,
uILIougI LIese dId noL conIorm Lo nuLIonuIIsL prIncIpIes, LIey seemed Lo
be bound by LIeIr own unLI-SemILIc pusL, cIurcI survIvuI, und personuI
Ieur Lo muke uny subsLunLIve unLI-NuzI sLund. NeverLIeIess, Irom u NuzI
posILIon, cctucl CIrIsLIun beIIeIs were depIored und IL Is Lo be expecLed
LIuL recLIIIcuLIon oI LIIs uIIen wIII wus uIso on LIe NuzI ugendu.
Buck Lo LIe smokIng Issue, unLIsmokIng, LogeLIer wILI oLIer
cIeun IIvIng edIcLs, oIIers u subsLILuLe moruI sLuLus Ior u menLuIILy LIuL
Is devoId oI u moruI dImensIon or moruI dIscernmenL - nonsmokIng Is
eIevuLed Lo u greuL moruI vIrLue In u moruIIy-deIIcIenL sysLem oI LIougIL.
AguIn, In one sLep, even un exLruordInurIIy moruIIy-reckIess menLuIILy, u
very poor LIInker, or un evII LyrunL, uLLuIns moruI recLILude sImpIy by noL
smokIng. TIIs Is no more LIun un exumpIe oI LIe superIorILy syndrome.
ProcLor (1qq6) IndIcuLes LIuL LIe unLI-Lobucco ucLIvIsLs poInLed
ouL LIuL wIereus CIurcIIII, SLuIIn, und RooseveIL were uII Iond oI Lobucco,
LIe LIree mujor IuscIsL Ieuders oI Europe - HILIer, MussoIInI, und runco
- were uII non-smokers. (p.1qo) To LIe unLIsmokIng ucLIvIsLs LIIs Is
supposedIy u IucL oI very LeIIIng proporLIons. TIe unLIsmokIng menLuIILy
IuIIy beIIeves LIuL LIe sInguIur IucLor oI smokIngJnon-smokIng IndIcuLes
uII LIuL Is ImporLunL Lo know ubouL unyone, or LIuL smokIngJnon-smokIng
IndIcuLes someLIIng very ImporLunL ubouL unyone. AguIn, LIe wuIer-LIIn
superIIcIuIILy, LIe sIuIIowness oI LIe reusonIng sIouId be IIgIIy uppurenL.
TIuL LIe unLIsmokIng Iobby wouId promoLe HILIer becuuse oI IIs
nonsmokIng Is compIIcILy LIrougI sIeer Ignorunce.
TIe currenL LIesIs Is LIuL cntismolin Is u very good IndIcuLor oI
very poor moruI dIscernmenL In LIuL nonsmokIng Is IrruLIonuIIy eIevuLed
163
163
Rampant Antismoking Signifies Grave Danger
bupLIsed CuLIoIIc, buL LIe pupers cIuIm Ie Iud noLIIng
buL conLempL Ior LIe cIurcIes. HIs commenLs on
reIIgIon, recorded by IIs secreLury, uIIegedIy cIuIm
sLuLemenLs IncIudIng 'CIrIsLIunILy Is LIe InvenLIon oI
sIck bruIns` und 'CIrIsLIunILy Is u rebeIIIon uguInsL
nuLuruI Iuw`. AccordIng Lo LIe documenLs, LIe NuzIs
pIunned Lo Luke over cIurcIes Irom wILIIn usIng purLy
sympuLIIsers, dIscredIL, juII or kIII CIrIsLIun Ieuders, re-
IndocLrInuLe CIrIsLIun congreguLIons und gIve LIem u
new purLy-bused IuILI...TIe NuzIs were convInced
cIurcI Ieuders couId never be reconcIIed wILI LIe
purLy`s prIncIpIes oI rucIsm. TIereIore, LIe cIurcI
wouId Iuve Lo become subservIenL Lo LIe SLuLe, und
LIen desLroyed. (Hercld,Sun, ebruury , zooz; see
uIso www.IuwundreIIgIon.com)
TIIs IusL poInL requIres some eIuboruLIon In LIuL LIere Is sLIII
conIusIon over HILIer`s reIIgIosILy. HILIer seemed Lo be InIIuenced by Lwo
muIn Irumeworks - unLI-SemILIsm und bIoIogIcuI evoIuLIon. AnLI-
SemILIsm wus noL un InvenLIon oI HILIer. TIere were Iong-sLundIng unLI-
SemILIc LendencIes In LIe mujor CIrIsLIun cIurcIes. MurLIn uLIer, LIe
IuLIer oI LIe ProLesLunL revoIL, wus unLI-SemILIc. n 1q6, MurLIn uLIer
Issued LIe bookIeL OI Jews und TIeIr Ies In wIIcI Ie sLuLed: IrsL,
LIeIr synugogues or cIurcIes sIouId be seL on IIre..SecondIy, LIeIr
Iomes IIkewIse sIouId be broken down und desLroyed..TIey ougIL be
puL under one rooI or In u sLubIe, IIke gypsIes..TIIrdIy, LIey sIouId be
deprIved oI LIeIr pruyer books. ourLIIy, LIeIr rubbIs musL be IorbIdden
under LIe LIreuL oI deuLI Lo LeucI unymore. L musL be noLed LIuL
uLIer`s unLI-SemILIsm wus bused on reIIgIon und noL on ruce or bIoIogy,
IIs wuywurd InLenL wus LIe IorcIbIe conversIon oI Jews Lo CIrIsLIunILy,
und IIs vIew In LIIs regurd Is noL CIrIsLIun. TIe Germun composer
Wugner wus ucuLeIy unLI-SemILIc und wILI deIuded beIIeIs reIIecLIng u
wurpIng oI CIrIsLIun LeucIIng. HILIer oILen mude udmIrIng reIerence Lo
boLI oI LIese men. n Mein Kcmpj, HILIer mukes muny reIerences Lo LIe
uImIgILy und LIe Iord, und unLI-SemILIsm, seemIngIy Irom u CIrIsLIun
perspecLIve. However, LIere Is noLIIng CIrIsLIun In HILIer`s reusonIng; IIs
conducL Is us unLI-CIrIsLIun us cun be. HILIer wus uIso purLIuI, us Is uny
muLerIuIIsL, Lo DurwInIun evoIuLIon. TIe obsessIon wILI bodIIyJrucIuI
purILy Is enLIreIy In IIne wILI LIIs LIeory.
TIe pecuIIurILy oI HILIer wus LIe deIuded combInIng oI LIese
dIsjoInLed Irumeworks. AnLI-SemILIsm wus redejined In muLerIuIIsL
(rucIuIJbodIIy) Lerms. Jews were LIen consIdered us geneLIcuIIy dIseused
Other Vital Matters
und u LIreuL Lo LIe Germun gene pooI; geneLIc dumuge meunL vuInerubIIILy
Lo dIseuse. A useIuI wuy oI undersLundIng wIuL reuIIy Ius IILLIe meunIng Is
LIuL HILIer Is IoremosL u IIgIIy LroubIed und conIIIcLed mInd. He
borrowed bILs Irom u vurIeLy oI vIews. n uppeusIng IIs derungemenL, Ie
concocLed Irom LIese dIsjoInLed bILs u jusLIIyIng sLory IIne LIuL provIded
u conduIL Ior enucLIng or munIIesLIng ucuLe IuLred und deIusIons oI
grundeur. L couId weII be urgued LIuL HILIer Iud u pucL wILI LIe devII -
IIs worIdvIew wus enLIreIy unLI-CIrIsLIun; wIuLever Iord HILIer wus
reIerrIng Lo, IL wus cerLuInIy noL CIrIsL oI LIe New TesLumenL. L musL uIso
be undersLood LIuL LIe NuzI sysLem Is Iower-nuLure, muLerIuIIsL und
bodIIy-IIxuLed In dIsposILIon.
UnIorLunuLeIy, LIere were CIrIsLIun cIurcIes, CuLIoIIc und
ProLesLunL, Germun und ubroud, LIuL InILIuIIy vIewed HILIer und LIe NuzI
purLy us redeemers oI u degeneruLe Germuny, purLIcuIurIy Ior LIeIr
cIeun IIvIng (unLIsmokIng, unLI-uIcoIoI, unLI-pornogrupIy) edIcLs. L Is
onIy us LIe bruLuIILy becume more obvIous, specIIIcuIIy uguInsL LIe Jews,
LIuL muny CIrIsLIun groups begun Lo reLIInk LIeIr posILIon. However,
uILIougI LIese dId noL conIorm Lo nuLIonuIIsL prIncIpIes, LIey seemed Lo
be bound by LIeIr own unLI-SemILIc pusL, cIurcI survIvuI, und personuI
Ieur Lo muke uny subsLunLIve unLI-NuzI sLund. NeverLIeIess, Irom u NuzI
posILIon, cctucl CIrIsLIun beIIeIs were depIored und IL Is Lo be expecLed
LIuL recLIIIcuLIon oI LIIs uIIen wIII wus uIso on LIe NuzI ugendu.
Buck Lo LIe smokIng Issue, unLIsmokIng, LogeLIer wILI oLIer
cIeun IIvIng edIcLs, oIIers u subsLILuLe moruI sLuLus Ior u menLuIILy LIuL
Is devoId oI u moruI dImensIon or moruI dIscernmenL - nonsmokIng Is
eIevuLed Lo u greuL moruI vIrLue In u moruIIy-deIIcIenL sysLem oI LIougIL.
AguIn, In one sLep, even un exLruordInurIIy moruIIy-reckIess menLuIILy, u
very poor LIInker, or un evII LyrunL, uLLuIns moruI recLILude sImpIy by noL
smokIng. TIIs Is no more LIun un exumpIe oI LIe superIorILy syndrome.
ProcLor (1qq6) IndIcuLes LIuL LIe unLI-Lobucco ucLIvIsLs poInLed
ouL LIuL wIereus CIurcIIII, SLuIIn, und RooseveIL were uII Iond oI Lobucco,
LIe LIree mujor IuscIsL Ieuders oI Europe - HILIer, MussoIInI, und runco
- were uII non-smokers. (p.1qo) To LIe unLIsmokIng ucLIvIsLs LIIs Is
supposedIy u IucL oI very LeIIIng proporLIons. TIe unLIsmokIng menLuIILy
IuIIy beIIeves LIuL LIe sInguIur IucLor oI smokIngJnon-smokIng IndIcuLes
uII LIuL Is ImporLunL Lo know ubouL unyone, or LIuL smokIngJnon-smokIng
IndIcuLes someLIIng very ImporLunL ubouL unyone. AguIn, LIe wuIer-LIIn
superIIcIuIILy, LIe sIuIIowness oI LIe reusonIng sIouId be IIgIIy uppurenL.
TIuL LIe unLIsmokIng Iobby wouId promoLe HILIer becuuse oI IIs
nonsmokIng Is compIIcILy LIrougI sIeer Ignorunce.
TIe currenL LIesIs Is LIuL cntismolin Is u very good IndIcuLor oI
very poor moruI dIscernmenL In LIuL nonsmokIng Is IrruLIonuIIy eIevuLed
164
164
Rampant Antismoking Signifies Grave Danger
Lo u moruI sLuLus LIuL IL sImpIy does noL Iuve or merIL. WIuLever Is mude
oI smokIng In LIe unLIsmokIng menLuIILy Ius no busIs In IucL, buL Is u
concocLIon oI u conLorLed, sIuIIow LIInkIng. Moreover, by LIe LIme
unLIsmokIng becomes socIuIIy domInunL, IL cun be u sureLy LIuL LIuL
socIeLy Is uIreudy In dIre sLruILs psycIoIogIcuIIy, socIuIIy und moruIIy;
unLIsmokIng Is sympLomuLIc oI Iur more gruve und wIdespreud probIems.
TIIs poInL wIII be IurLIer expIored In IuLer cIupLers.
AnLIsmokIng (I.e., LIe pursuIL oI exLermInuLIon oI LIe Lobucco-
smokIng IubIL) cun onIy jusLIIy ILseII LIrougI Iukery. L Ius been
consIdered Irom LIe precedIng LIuL unLIsmokIng Is bused on muLerIuIIsL
IIxuLIon und IruuduIenLIy eIevuLes ILseII InLo u poInL oI moruI recLILude. As
sucI, uLLempLs Lo coerce socIeLy InLo noL smokIng wIII uIwuys InvoIve
propugundu (I.e., un ussuuIL on psycIoIogIcuI, socIuI und moruI IeuILI)
und oILen InvoIves u corrupLIon oI scIence (I.e., degeneruLIon InLo
sLuLIsLIcuIIsm). L wIII be consIdered In u IuLer cIupLer LIuL even reIIgIous-
seemIng unLIsmokIng suIIers Irom LIe sume conLorLIon.
AnLIsmokIng Is dysIuncLIonuI und IosLers dysIuncLIon. L cun
even be suId LIuL, uILImuLeIy, LIe unLIsmokIng IIxuLIon Ius very IILLIe Lo do
wILI smokIng uL uII. SmokIng sImpIy becomes munuIucLured InLo un
uvenue or LurgeL Ior venLIngJInIIIcLIng unresoIved psycIoIogIcuI conIIIcL
sucI us pomposILy, IuugILIness, deIusIons oI grundeur, obsessIon wILI
conLroI, eLc. AnLIsmokIng Is smptomctic oI u menLuIILy cIurucLerIzed by
superIIcIuIILy, IncompeLence und ImmuLurILy LIuL, wIere IL Is uIIowed Lo
domInuLe socIuI LIInkIng und poIIcy, Ius u most dcnerous poLenLIuI.
TIereIore, conLrury Lo ProcLor (1qq6, 1qq;), uILIougI
unLIsmokIng Is noL pecuIIur Lo mIIILurIsLIc IuscIsm, IL Is clucs muLerIuIIsL
(obIIvIous Lo psycIoIogIcuI, psycIosocIuI und moruI dImensIons oI LIe
Iumun condILIon) und jcscist (I.e., dIcLuLorIuI, IuugILy, obsessed wILI
conLroI) In dIsposILIon, e.g., medIco-muLerIuIIsL IuscIsm. NuzIsm Iud
uspecLs oI boLI medIco-muLerIuIIsL und mIIILurIsLIc IuscIsm, und wIere LIe
Iormer supporLed LIe IuLLer.
n concIudIng LIIs secLIon, LIere ure u number oI uspecLs oI
currenL commenLurIes on LIe NuzI sugu LIuL wurrunL IurLIer scruLIny.
ProcLor (1qq;) IndIcuLes LIuL LIe ScIuIrer & ScIonIger (1qq) wus oI u
very IIgI quuIILy und LIuL IL Is jusL one oI LIe soberIng pecuIIurILIes oI
LIe NuzI eru LIuL IL wus Iunded by u mujor grunL Irom HILIer`s
ReIcIskunzIeI. ProcLor conLInues, buL LIen uguIn, LIe NuzI eru wus noL
LIe eru oI InLeIIecLuuI sIumber IL Is someLImes LIougIL Lo Iuve been.
nnovuLIons oI LIe NuzI eru IncIude LeIevIsIon, jeL-propeIIed uIrcruIL
(IncIudIng LIe ejecLIon seuL), guIded mIssIIes, eIecLronIc compuLers, LIe
eIecLron mIcroscope, uLomIc IIssIon, new duLu-processIng LecInoIogIes,
new pesLIcIdes, und LIe worId`s IIrsL IndusLrIuI murder IucLorIes - uII oI
Other Vital Matters
wIIcI were IIrsL deveIoped In NuzI Germuny or reucIed LIeIr IIgI poInL uL
LIe LIme. (p.q6q) ProcLor urgues LIuL muny oI LIese uccompIIsImenLs ure
eusIIy bIurred by memorIes oI LIe more murderous IegucIes oI LIe eru.
AILIougI ProcLor Is very bIurry In depIcLIng good und bud uspecLs oI LIe
NuzI regIme, wIeLIer Ie cures Ior LIe ImpIIcuLIon or noL, Ie is ImpIyIng
LIuL LIe ubove deveIopmenLs ure reIuLIve pockeLs oI IIgIL In un oLIerwIse
durk sugu.
IrsLIy, IL Is IncorrecL Lo reIer Lo LIe ScIuIrer & ScIonIger (1qq)
sLudy us u work oI sucI |IIgI| quuIILy. TIe sLudy cerLuInIy reIIecLs u
relctitel beLLer uLLempL uL duLu coIIecLIon LIun Iud been LIe cuse. TIe
Lerm IInk beLween IucLors Is jusL unoLIer Lerm Ior sLuLIsLIcuI ussocIuLIon.
CuusuI urgumenLuLIon requIres Iur more proIound scIoIurIy work LIun
jusL IIndIng sLuLIsLIcuI IInks beLween IucLors. TIe cuusuI urgumenL
produced In LIe ubove sLudy suIIers Irom LIe sume muLerIuIIsL und
exLreme over-InLerpreLuLIon us conLemporury IIIesLyIe epIdemIoIogy, I.e.,
bIuLunLIy wrong.
SecondIy, LIe deveIopmenLs reIerred Lo, und reusonubIy so, ure
uII LecInoIogIcuI (muLerIuIIsL) In nuLure und LIuL, wILIIn LIe NuzI regIme,
subserved mIIILurIsLIc purpose. urLIermore, LIese deveIopmenLs ure
wILIIn LIe reuIm oI scIenLIIIc uLLuInmenL. ProcLor, us weII us very muny
oLIers, IuIIs Lo compreIend LIuL LIe concepLuuI Irumework In jeL
propuIsIon or LeIevIsIon cIrcuILry und LIe ter hih predIcLIve sLrengLI oI
IucLors Ior IucLors LIuL demurcuLes scIenLIIIc udvunce beurs noL even LIe
remoLesL resembIunce Lo IIIesLyIe epIdemIoIogy; Lo reIer Lo IIIesLyIe
epIdemIoIogy us u scIence on u pur wILI jeL propuIsIon or even u scIence uL
uII Is jusL pIuInIy wrong. or exumpIe, consIder LIe neur-zero (1o%)
predIcLIve sLrengLI oI Ieuvy Lobucco-smokIng Ior Iung cuncer. I LIIs Is
uppIIed wILIIn LIe reuIm oI jeL propuIsIon, IL cun be suId LIuL u newIy-
deveIoped pIune wIII IIy 1o% oI LIe LIme. TIIs cIrcumsLunce wouId
demonsLruLe LIuL LIere Is u ter poor undersLundIng oI LIe underIyIng
cuusuI Irumework. L wouId be u scIenLIIIc udvunce und u demonsLruLIon oI
u IIgI degree oI cuusuI undersLundIng wIen LIe pIune wIII IIy qo-1oo% oI
LIe LIme. L sIouId uIso be noLed LIuL LIe predIcLIve sLrengLI oI smokIng
Ior numerous oLIer dIseuses Is bcrel ubove zero.
urLIermore, Lo consIder LIese LecInoIogIcuI deveIopmenLs us
intellectucl Is unoLIer very consIderubIe muLerIuIIsL error, uLLempLIng Lo
eIevuLe muLerIuIIsL reusonIng InLo spIeres IL neILIer occupIes nor merILs.
TIe InLeIIecLuuI sIumber someLImes used Lo depIcL LIe NuzI eru LypIcuIIy
reIers Lo LIe deurLI oI non-muLerIuIIsL (meLupIysIcuI) or muILI-
dImensIonuI scIoIursIIp, e.g., LrunscendenL psycIoIogy und pIIIosopIy,
LIeoIogy, reIIgIon. L sIouId be uppurenL LIuL LIIs sorL oI scIoIursIIp IIIes
In LIe Iuce oI muLerIuIIsm und IuscIsm und IubeIed by LIe NuzIs us dIssenL.
165
165
Rampant Antismoking Signifies Grave Danger
Lo u moruI sLuLus LIuL IL sImpIy does noL Iuve or merIL. WIuLever Is mude
oI smokIng In LIe unLIsmokIng menLuIILy Ius no busIs In IucL, buL Is u
concocLIon oI u conLorLed, sIuIIow LIInkIng. Moreover, by LIe LIme
unLIsmokIng becomes socIuIIy domInunL, IL cun be u sureLy LIuL LIuL
socIeLy Is uIreudy In dIre sLruILs psycIoIogIcuIIy, socIuIIy und moruIIy;
unLIsmokIng Is sympLomuLIc oI Iur more gruve und wIdespreud probIems.
TIIs poInL wIII be IurLIer expIored In IuLer cIupLers.
AnLIsmokIng (I.e., LIe pursuIL oI exLermInuLIon oI LIe Lobucco-
smokIng IubIL) cun onIy jusLIIy ILseII LIrougI Iukery. L Ius been
consIdered Irom LIe precedIng LIuL unLIsmokIng Is bused on muLerIuIIsL
IIxuLIon und IruuduIenLIy eIevuLes ILseII InLo u poInL oI moruI recLILude. As
sucI, uLLempLs Lo coerce socIeLy InLo noL smokIng wIII uIwuys InvoIve
propugundu (I.e., un ussuuIL on psycIoIogIcuI, socIuI und moruI IeuILI)
und oILen InvoIves u corrupLIon oI scIence (I.e., degeneruLIon InLo
sLuLIsLIcuIIsm). L wIII be consIdered In u IuLer cIupLer LIuL even reIIgIous-
seemIng unLIsmokIng suIIers Irom LIe sume conLorLIon.
AnLIsmokIng Is dysIuncLIonuI und IosLers dysIuncLIon. L cun
even be suId LIuL, uILImuLeIy, LIe unLIsmokIng IIxuLIon Ius very IILLIe Lo do
wILI smokIng uL uII. SmokIng sImpIy becomes munuIucLured InLo un
uvenue or LurgeL Ior venLIngJInIIIcLIng unresoIved psycIoIogIcuI conIIIcL
sucI us pomposILy, IuugILIness, deIusIons oI grundeur, obsessIon wILI
conLroI, eLc. AnLIsmokIng Is smptomctic oI u menLuIILy cIurucLerIzed by
superIIcIuIILy, IncompeLence und ImmuLurILy LIuL, wIere IL Is uIIowed Lo
domInuLe socIuI LIInkIng und poIIcy, Ius u most dcnerous poLenLIuI.
TIereIore, conLrury Lo ProcLor (1qq6, 1qq;), uILIougI
unLIsmokIng Is noL pecuIIur Lo mIIILurIsLIc IuscIsm, IL Is clucs muLerIuIIsL
(obIIvIous Lo psycIoIogIcuI, psycIosocIuI und moruI dImensIons oI LIe
Iumun condILIon) und jcscist (I.e., dIcLuLorIuI, IuugILy, obsessed wILI
conLroI) In dIsposILIon, e.g., medIco-muLerIuIIsL IuscIsm. NuzIsm Iud
uspecLs oI boLI medIco-muLerIuIIsL und mIIILurIsLIc IuscIsm, und wIere LIe
Iormer supporLed LIe IuLLer.
n concIudIng LIIs secLIon, LIere ure u number oI uspecLs oI
currenL commenLurIes on LIe NuzI sugu LIuL wurrunL IurLIer scruLIny.
ProcLor (1qq;) IndIcuLes LIuL LIe ScIuIrer & ScIonIger (1qq) wus oI u
very IIgI quuIILy und LIuL IL Is jusL one oI LIe soberIng pecuIIurILIes oI
LIe NuzI eru LIuL IL wus Iunded by u mujor grunL Irom HILIer`s
ReIcIskunzIeI. ProcLor conLInues, buL LIen uguIn, LIe NuzI eru wus noL
LIe eru oI InLeIIecLuuI sIumber IL Is someLImes LIougIL Lo Iuve been.
nnovuLIons oI LIe NuzI eru IncIude LeIevIsIon, jeL-propeIIed uIrcruIL
(IncIudIng LIe ejecLIon seuL), guIded mIssIIes, eIecLronIc compuLers, LIe
eIecLron mIcroscope, uLomIc IIssIon, new duLu-processIng LecInoIogIes,
new pesLIcIdes, und LIe worId`s IIrsL IndusLrIuI murder IucLorIes - uII oI
Other Vital Matters
wIIcI were IIrsL deveIoped In NuzI Germuny or reucIed LIeIr IIgI poInL uL
LIe LIme. (p.q6q) ProcLor urgues LIuL muny oI LIese uccompIIsImenLs ure
eusIIy bIurred by memorIes oI LIe more murderous IegucIes oI LIe eru.
AILIougI ProcLor Is very bIurry In depIcLIng good und bud uspecLs oI LIe
NuzI regIme, wIeLIer Ie cures Ior LIe ImpIIcuLIon or noL, Ie is ImpIyIng
LIuL LIe ubove deveIopmenLs ure reIuLIve pockeLs oI IIgIL In un oLIerwIse
durk sugu.
IrsLIy, IL Is IncorrecL Lo reIer Lo LIe ScIuIrer & ScIonIger (1qq)
sLudy us u work oI sucI |IIgI| quuIILy. TIe sLudy cerLuInIy reIIecLs u
relctitel beLLer uLLempL uL duLu coIIecLIon LIun Iud been LIe cuse. TIe
Lerm IInk beLween IucLors Is jusL unoLIer Lerm Ior sLuLIsLIcuI ussocIuLIon.
CuusuI urgumenLuLIon requIres Iur more proIound scIoIurIy work LIun
jusL IIndIng sLuLIsLIcuI IInks beLween IucLors. TIe cuusuI urgumenL
produced In LIe ubove sLudy suIIers Irom LIe sume muLerIuIIsL und
exLreme over-InLerpreLuLIon us conLemporury IIIesLyIe epIdemIoIogy, I.e.,
bIuLunLIy wrong.
SecondIy, LIe deveIopmenLs reIerred Lo, und reusonubIy so, ure
uII LecInoIogIcuI (muLerIuIIsL) In nuLure und LIuL, wILIIn LIe NuzI regIme,
subserved mIIILurIsLIc purpose. urLIermore, LIese deveIopmenLs ure
wILIIn LIe reuIm oI scIenLIIIc uLLuInmenL. ProcLor, us weII us very muny
oLIers, IuIIs Lo compreIend LIuL LIe concepLuuI Irumework In jeL
propuIsIon or LeIevIsIon cIrcuILry und LIe ter hih predIcLIve sLrengLI oI
IucLors Ior IucLors LIuL demurcuLes scIenLIIIc udvunce beurs noL even LIe
remoLesL resembIunce Lo IIIesLyIe epIdemIoIogy; Lo reIer Lo IIIesLyIe
epIdemIoIogy us u scIence on u pur wILI jeL propuIsIon or even u scIence uL
uII Is jusL pIuInIy wrong. or exumpIe, consIder LIe neur-zero (1o%)
predIcLIve sLrengLI oI Ieuvy Lobucco-smokIng Ior Iung cuncer. I LIIs Is
uppIIed wILIIn LIe reuIm oI jeL propuIsIon, IL cun be suId LIuL u newIy-
deveIoped pIune wIII IIy 1o% oI LIe LIme. TIIs cIrcumsLunce wouId
demonsLruLe LIuL LIere Is u ter poor undersLundIng oI LIe underIyIng
cuusuI Irumework. L wouId be u scIenLIIIc udvunce und u demonsLruLIon oI
u IIgI degree oI cuusuI undersLundIng wIen LIe pIune wIII IIy qo-1oo% oI
LIe LIme. L sIouId uIso be noLed LIuL LIe predIcLIve sLrengLI oI smokIng
Ior numerous oLIer dIseuses Is bcrel ubove zero.
urLIermore, Lo consIder LIese LecInoIogIcuI deveIopmenLs us
intellectucl Is unoLIer very consIderubIe muLerIuIIsL error, uLLempLIng Lo
eIevuLe muLerIuIIsL reusonIng InLo spIeres IL neILIer occupIes nor merILs.
TIe InLeIIecLuuI sIumber someLImes used Lo depIcL LIe NuzI eru LypIcuIIy
reIers Lo LIe deurLI oI non-muLerIuIIsL (meLupIysIcuI) or muILI-
dImensIonuI scIoIursIIp, e.g., LrunscendenL psycIoIogy und pIIIosopIy,
LIeoIogy, reIIgIon. L sIouId be uppurenL LIuL LIIs sorL oI scIoIursIIp IIIes
In LIe Iuce oI muLerIuIIsm und IuscIsm und IubeIed by LIe NuzIs us dIssenL.
166
166
Rampant Antismoking Signifies Grave Danger
AILIougI LIere were sLIII depurLmenLs represenLIng LIese dIscIpIInes,
unIversILIes under NuzIsm were so domInuLed by LIe prevuIIIng
muLerIuIIsL IdeoIogy, LIuL LIey were no more LIun gIorIIIed InsLILuLes oI
LecInoIogy. Non-muLerIuIIsL dIscIpIInes were IdeoIogIcuIIy swumped, wILI
mIIILury buckIng, InLo u very Iow ucudemIc und socIuI proIIIe.
EngIneerIng IeuLs, Iowever InLeIIIgenL, do noL meeL LIe crILerIu oI
InLeIIecLuuI wIere one oI LIe predomInunL concerns Is LIe ncture und
purpose oI MunkInd In muILI-dImensIonuI Lerms. L sIouId uIso be
uppurenL LIuL muLerIuIIsm reduces IumunILy InLo sImpIy u LIIng Lo be
engIneered. AddILIonuIIy, Lo reIer Lo engIneerIng IeuLs, wIuLever LIeIr
moLIvuLIon, us pockeLs oI IIgIL or oI good In un oLIerwIse durkness Is
borderIng on obscenILy. I In LIe mIdsL oI NuzI mudness LIere were
pockeLs oI mercy, oI compussIon, oI Iove; or momenLs oI cIeur vIsIon
undIsLurbed by even u IInL oI IuLred; or un oIIerIng oI Iope Lo endure,
ouLIIve und Lrunscend u mosL LerrIbIe LormenL - purLIcuIurIy beLween
munuIucLured enemIes - this Is IIgIL In LIe mIdsL oI InsunILy, und us
LIere sureIy wus. YeL, LIe source oI LIIs IIgIL wus noL un uspecL oI NuzI
LIInkIng or scIence or muLerIuIIsm In uny Lerms, buL mInds undeceIved by
ILs mudness und InvoIvIng depLI oI Iumun (non-muLerIuIIsL) reIuLIonsIIp
wILIIn u spIrILuuI Irumework. Here uguIn, conLemporury commenLuLors,
wIo ure uIso oI u muLerIuIIsL persuusIon, IuII Lo compreIend LIe greuL IoIIy
oI LIe NuzI eru, wIIcI uL LImes wus u suvuge ussuuIL on IumunILy und
depLI oI reIuLIonsIIp oI IncompreIensIbIe proporLIons, und drug up some
muLerIuIIsL deveIopmenL oI LIe LIme Lo demonsLruLe LIuL LIere Is good LIuL
comes wILI bud und LIuL someLImes LIe boundurIes ure even bIurred.
TIe exLermInuLIon oI persons Is LIe concIudIng munIIesLuLIon Lo
u precedIng LIInkIng und vIew oI MunkInd. TIe Issue Is noL engIneerIng
IeuLs buL LIuL LIe muLerIuIIsL menLuIILy cunnoL IuLIom coIerence und
depLI oI reIuLIonsIIp beLween persons or LrunscendenL vIews oI MunkInd.
HumunILy Is reduced Lo bIobs oI bIoIogIcuI muLerIuI, sLrIpped oI uII LIe
uspecLs (psycIoIogIcuI, psycIosocIuI, moruI) LIuL muke Iumuns Iumun.
L sIouId noL be surprIsIng LIuL LIe menLuIILy cun quIckIy degeneruLe InLo
vIewIng cerLuIn oI LIese bIobs us superIor, oLIers us compIeLeIy
dIspensubIe, und sLIII oLIers us requIrIng coercIon (engIneerIng) Lo IIL LIe
muLerIuIIsL Irumework. L wIII be consIdered In LIe IoIIowIng cIupLers LIuL
6o-yeurs posL-NuzIsm und, LIereIore, wILI LIe udvunLuge oI IIndsIgIL, LIe
conLemporury medIcuI esLubIIsImenL, or even socIeLIes generuIIy, Ius
IeurnL vIrLuuIIy noLIIng oI crILIcuI vuIue. Muny oI LIe LecInoIogIcuI
udvunces oI LIe NuzI eru Iuve Indeed sInce been used In non-mIIILurIsLIc
und reIuLIveIy IeIpIuI wuys. OI LIIs IL couId be usked - so wIuL?, wIen,
regurdIess oI uII LIIs InLerIm usuge or IurLIer LecInoIogIcuI deveIopmenL
generuIIy, muny WesLern socIeLIes now IInd LIemseIves rupIdIy sInkIng
Other Vital Matters
InLo u muLerIuIIsL und, LIereIore, psycIoIogIcuIIy, socIuIIy und moruIIy
perverse mIre.
ExcepLIon cun uIso be Luken Lo ProcLor`s (1qq6) LreuLmenL oI LIe
IuLe oI LIe IeudIng unLIsmokers oI LIe ReIcI. TIe Ieud oI Jenu`s nsLILuLe
Ior Tobucco Huzurds ReseurcI, KurI AsLeI, commILLed suIcIde In AprII,
1qq. ReIcI HeuILI uIrer, eonurdo ConLI, commILLed suIcIde In
OcLober, 1qq, In un uIIIed prIson wIIIe uwuILIng prosecuLIon Ior IIs roIe
In LIe euLIunusIu progrumme. ReIcI HeuILI OIIIce presIdenL, Huns ReILer,
wIo once cIurucLerIzed nIcoLIne us LIe greuLesL enemy oI LIe peopIe`s
IeuILI und LIe number one drug on LIe Germun economy wus InLerned
In un AmerIcun prIson cump Ior Lwo yeurs. GuuIeILer SuuckeI, LIe guIdIng
IIgIL beIInd TIurIngIu`s unLIsmokIng cumpuIgn und responsIbIe Ior
druILIng LIe grunL uppIIcuLIon Ior AsLeI`s unLILobucco InsLILuLe, wus
execuLed In OcLober, 1qq6, Ior crImes uguInsL IumunILy. To LIIs IIsL cun be
udded LIuL LIe uIrer, AdoII HILIer, u veIemenL unLIsmoker, wIo
commILLed suIcIde In 1qq, jusL sIorL oI cupLure.
ProcLor`s (1qq6) uppruIsuI LIuL IL Is IurdIy surprIsIng LIuL mucI
oI LIe wInd wus Luken ouL oI LIe suIIs oI Germuny`s unLI-Lobucco
movemenL (p.1q) does noL begIn Lo do jusLIce Lo LIe cIrcumsLunce.
TIese persons Iud un end LIuL beurs good LesLImony Lo LIeIr InsLubIIILy oI
mInd und conducL, wIere LIe end Is us vIoIenL undJor degeneruLe us ILs
precedIng sugu. L cunnoL go unnoLIced LIuL uII oI LIese were militcnt
unLIsmokers, I.e., unLIsmokIng IIgured very IIgIIy In LIeIr conLorLed
menLuIILy. ConsIsLenL wILI un eurIIer uppruIsuI, unLIsmokIng Is
sympLomuLIc oI u deeper, unbuIunced reusonIng domInuLed by
muLerIuIIsm und LIereIore yIeIdIng un upsIde-down, buck-Lo-IronL
LIInkIng - u puLIoIogy oI prIorILIes. AnLIsmokIng cerLuInIy does noL Iuve
Lo be ussocIuLed wILI sucI vIoIence, mIIILurIsm or rucIsm us IL wus In
NuzIsm. However, IL Is uIwuys sympLomuLIc oI muLerIuIIsL reusonIng. TIe
exLenL Lo wIIcI IL Is uIIowed Lo become IuscIsL or dIcLuLorIuI wIII depend
on LIe prevuIIIng socIuI propensILy Ior counLerucLIng muLerIuIIsL IdeoIogy:
MuLerIuIIsm Is LIe generuI probIem InvoIved - rucIsm und mIIILurIsm udd
degrees oI crueILy und vIoIence.
As noLed eurIIer, SmILI eL uI. (1qq) IndIcuLe LIuL cIgureLLe
smokIng seems Lo Iuve been uImosL u budge oI resIsLunce umongsL unLI-
NuzI youLI movemenLs. WIere Iong InLeIIecLuuI excIunges und
presenLuLIons ure noL possIbIe, LIe symboI oI smokIng mukes LIe poInL oI
resIsLunceJdIsugreemenL very quIckIy Lowurd u regIme LIuL Is so sLrongIy
unLIsmokIng In sLunce, I.e., beurIng In mInd LIuL LIe muLerIuIIsm oI
NuzIsm, devoId oI scrupIes, wore noL smokIng IIke u budge oI greuL
moruI vIrLue.
SmokIng Is u compIex IubIL LIuL Is muILIdImensIonuI In nuLure.
167
167
Rampant Antismoking Signifies Grave Danger
AILIougI LIere were sLIII depurLmenLs represenLIng LIese dIscIpIInes,
unIversILIes under NuzIsm were so domInuLed by LIe prevuIIIng
muLerIuIIsL IdeoIogy, LIuL LIey were no more LIun gIorIIIed InsLILuLes oI
LecInoIogy. Non-muLerIuIIsL dIscIpIInes were IdeoIogIcuIIy swumped, wILI
mIIILury buckIng, InLo u very Iow ucudemIc und socIuI proIIIe.
EngIneerIng IeuLs, Iowever InLeIIIgenL, do noL meeL LIe crILerIu oI
InLeIIecLuuI wIere one oI LIe predomInunL concerns Is LIe ncture und
purpose oI MunkInd In muILI-dImensIonuI Lerms. L sIouId uIso be
uppurenL LIuL muLerIuIIsm reduces IumunILy InLo sImpIy u LIIng Lo be
engIneered. AddILIonuIIy, Lo reIer Lo engIneerIng IeuLs, wIuLever LIeIr
moLIvuLIon, us pockeLs oI IIgIL or oI good In un oLIerwIse durkness Is
borderIng on obscenILy. I In LIe mIdsL oI NuzI mudness LIere were
pockeLs oI mercy, oI compussIon, oI Iove; or momenLs oI cIeur vIsIon
undIsLurbed by even u IInL oI IuLred; or un oIIerIng oI Iope Lo endure,
ouLIIve und Lrunscend u mosL LerrIbIe LormenL - purLIcuIurIy beLween
munuIucLured enemIes - this Is IIgIL In LIe mIdsL oI InsunILy, und us
LIere sureIy wus. YeL, LIe source oI LIIs IIgIL wus noL un uspecL oI NuzI
LIInkIng or scIence or muLerIuIIsm In uny Lerms, buL mInds undeceIved by
ILs mudness und InvoIvIng depLI oI Iumun (non-muLerIuIIsL) reIuLIonsIIp
wILIIn u spIrILuuI Irumework. Here uguIn, conLemporury commenLuLors,
wIo ure uIso oI u muLerIuIIsL persuusIon, IuII Lo compreIend LIe greuL IoIIy
oI LIe NuzI eru, wIIcI uL LImes wus u suvuge ussuuIL on IumunILy und
depLI oI reIuLIonsIIp oI IncompreIensIbIe proporLIons, und drug up some
muLerIuIIsL deveIopmenL oI LIe LIme Lo demonsLruLe LIuL LIere Is good LIuL
comes wILI bud und LIuL someLImes LIe boundurIes ure even bIurred.
TIe exLermInuLIon oI persons Is LIe concIudIng munIIesLuLIon Lo
u precedIng LIInkIng und vIew oI MunkInd. TIe Issue Is noL engIneerIng
IeuLs buL LIuL LIe muLerIuIIsL menLuIILy cunnoL IuLIom coIerence und
depLI oI reIuLIonsIIp beLween persons or LrunscendenL vIews oI MunkInd.
HumunILy Is reduced Lo bIobs oI bIoIogIcuI muLerIuI, sLrIpped oI uII LIe
uspecLs (psycIoIogIcuI, psycIosocIuI, moruI) LIuL muke Iumuns Iumun.
L sIouId noL be surprIsIng LIuL LIe menLuIILy cun quIckIy degeneruLe InLo
vIewIng cerLuIn oI LIese bIobs us superIor, oLIers us compIeLeIy
dIspensubIe, und sLIII oLIers us requIrIng coercIon (engIneerIng) Lo IIL LIe
muLerIuIIsL Irumework. L wIII be consIdered In LIe IoIIowIng cIupLers LIuL
6o-yeurs posL-NuzIsm und, LIereIore, wILI LIe udvunLuge oI IIndsIgIL, LIe
conLemporury medIcuI esLubIIsImenL, or even socIeLIes generuIIy, Ius
IeurnL vIrLuuIIy noLIIng oI crILIcuI vuIue. Muny oI LIe LecInoIogIcuI
udvunces oI LIe NuzI eru Iuve Indeed sInce been used In non-mIIILurIsLIc
und reIuLIveIy IeIpIuI wuys. OI LIIs IL couId be usked - so wIuL?, wIen,
regurdIess oI uII LIIs InLerIm usuge or IurLIer LecInoIogIcuI deveIopmenL
generuIIy, muny WesLern socIeLIes now IInd LIemseIves rupIdIy sInkIng
Other Vital Matters
InLo u muLerIuIIsL und, LIereIore, psycIoIogIcuIIy, socIuIIy und moruIIy
perverse mIre.
ExcepLIon cun uIso be Luken Lo ProcLor`s (1qq6) LreuLmenL oI LIe
IuLe oI LIe IeudIng unLIsmokers oI LIe ReIcI. TIe Ieud oI Jenu`s nsLILuLe
Ior Tobucco Huzurds ReseurcI, KurI AsLeI, commILLed suIcIde In AprII,
1qq. ReIcI HeuILI uIrer, eonurdo ConLI, commILLed suIcIde In
OcLober, 1qq, In un uIIIed prIson wIIIe uwuILIng prosecuLIon Ior IIs roIe
In LIe euLIunusIu progrumme. ReIcI HeuILI OIIIce presIdenL, Huns ReILer,
wIo once cIurucLerIzed nIcoLIne us LIe greuLesL enemy oI LIe peopIe`s
IeuILI und LIe number one drug on LIe Germun economy wus InLerned
In un AmerIcun prIson cump Ior Lwo yeurs. GuuIeILer SuuckeI, LIe guIdIng
IIgIL beIInd TIurIngIu`s unLIsmokIng cumpuIgn und responsIbIe Ior
druILIng LIe grunL uppIIcuLIon Ior AsLeI`s unLILobucco InsLILuLe, wus
execuLed In OcLober, 1qq6, Ior crImes uguInsL IumunILy. To LIIs IIsL cun be
udded LIuL LIe uIrer, AdoII HILIer, u veIemenL unLIsmoker, wIo
commILLed suIcIde In 1qq, jusL sIorL oI cupLure.
ProcLor`s (1qq6) uppruIsuI LIuL IL Is IurdIy surprIsIng LIuL mucI
oI LIe wInd wus Luken ouL oI LIe suIIs oI Germuny`s unLI-Lobucco
movemenL (p.1q) does noL begIn Lo do jusLIce Lo LIe cIrcumsLunce.
TIese persons Iud un end LIuL beurs good LesLImony Lo LIeIr InsLubIIILy oI
mInd und conducL, wIere LIe end Is us vIoIenL undJor degeneruLe us ILs
precedIng sugu. L cunnoL go unnoLIced LIuL uII oI LIese were militcnt
unLIsmokers, I.e., unLIsmokIng IIgured very IIgIIy In LIeIr conLorLed
menLuIILy. ConsIsLenL wILI un eurIIer uppruIsuI, unLIsmokIng Is
sympLomuLIc oI u deeper, unbuIunced reusonIng domInuLed by
muLerIuIIsm und LIereIore yIeIdIng un upsIde-down, buck-Lo-IronL
LIInkIng - u puLIoIogy oI prIorILIes. AnLIsmokIng cerLuInIy does noL Iuve
Lo be ussocIuLed wILI sucI vIoIence, mIIILurIsm or rucIsm us IL wus In
NuzIsm. However, IL Is uIwuys sympLomuLIc oI muLerIuIIsL reusonIng. TIe
exLenL Lo wIIcI IL Is uIIowed Lo become IuscIsL or dIcLuLorIuI wIII depend
on LIe prevuIIIng socIuI propensILy Ior counLerucLIng muLerIuIIsL IdeoIogy:
MuLerIuIIsm Is LIe generuI probIem InvoIved - rucIsm und mIIILurIsm udd
degrees oI crueILy und vIoIence.
As noLed eurIIer, SmILI eL uI. (1qq) IndIcuLe LIuL cIgureLLe
smokIng seems Lo Iuve been uImosL u budge oI resIsLunce umongsL unLI-
NuzI youLI movemenLs. WIere Iong InLeIIecLuuI excIunges und
presenLuLIons ure noL possIbIe, LIe symboI oI smokIng mukes LIe poInL oI
resIsLunceJdIsugreemenL very quIckIy Lowurd u regIme LIuL Is so sLrongIy
unLIsmokIng In sLunce, I.e., beurIng In mInd LIuL LIe muLerIuIIsm oI
NuzIsm, devoId oI scrupIes, wore noL smokIng IIke u budge oI greuL
moruI vIrLue.
SmokIng Is u compIex IubIL LIuL Is muILIdImensIonuI In nuLure.
168
168
Rampant Antismoking Signifies Grave Danger
TIe muLerIuIIsL uLLempL Lo reduce IL onIy Lo uddIcLIon und IuvIng no
posILIve uspecLs, IndIcuLes onIy LIe sIuIIowness oI LIe menLuIILy. YeL Iere,
LIere Is noL LIe LypIcuI IndIcuLed posILIves oI smokIng sucI us pIeusure,
sLImuIuLIon, reIuxuLIon, socIuIIzIng, buL LIuL IL cun become sucI un
InLegruI pIece oI symboIIsm wILIIn u menLuIILy, LIuL smokIng occurs Lo
muInLuIn u dIsLIncLIon beLween crILIcuIIy dIIIerenL menLuIILIes (I.e.,
unoLIer psycIosocIuI uspecL). OI u quesLIonubIe nuLure Is SmILI eL uI.`s
(1qq) suggesLIon LIuL LIIs deIIunce uspecL oI smokIng, wIIcI couId
beLLer be undersLood us u distinuishin uspecL, muy Iuve IIndered
uLLempLs Lo prevenL smokIng In posL-wur Germuny. TIe urgumenL ImpIIes
LIuL LIe deIIunce Lowurd LIe NuzI regIme Is IegILImuLe buL LIe sume
deIIunce Lo unLIsmokIng In non-NuzI Lerms Ius no IegILImucy. To cIeurIy
demonsLruLe LIe IoIIy oI LIIs proposILIon, u number oI poInLs uIreudy
mude In oLIer Iorms need Lo be reILeruLed.
AILIougI LIe prucLIce oI medIcIne Ius u sLrong muLerIuIIsL buse,
IL cun properIy operuLe In u greuLer conLexL LIuL IncorporuLes
psycIoIogIcuI, psycIosocIuI und moruI dImensIons. MedIco-muLerIuIIsm
occurs wIere medIcIne becomes obIIvIous Lo non-muLerIuIIsL dImensIons
oI LIe Iumun condILIon. As sucI, IL IoIds LIe meLupIysIcuI vIew LIuL
persons ure no more LIun compIex bIoIogIcuI orgunIsms. MedIco-
muLerIuIIsm Ius sLrong IuscIsL LendencIes und IL sIouId noL be surprIsIng
LIuL IL becume un InLegruI uspecL oI NuzIsm, oversIudowed onIy by
mIIILurIsLIc IuscIsm. TIe enLIre regIme wus predIcuLed on muLerIuIIsL
grounds us Is evIdenced by LIe uLLerIy groLesque conducL uL psycIoIogIcuI,
socIuI und moruI IeveIs. WIerever medIco-muLerIuIIsm Is domInunL,
unLIsmokIng wIII be domInunL, wIeLIer combIned wILI mIIILurIsm us In
LIe NuzI cIrcumsLunce or noL, In LIuL smokIng, Loo, Is sLrIpped oI
psycIoIogIcuI und socIuI dImensIons, und reduced enLIreIy Lo u muLLer oI
bIoIogIcuI uddIcLIon. SLrong unLIsmokIng uILer LIe NuzI regIme, In
wIuLever counLry, InvoIved LIe sume medIco-muLerIuIIsL IuscIsL
LendencIes, I.e., medIco-muLerIuIIsL IuscIsm Iong survIved LIe NuzI regIme.
SmokIng proscrIpLIon Ius no busIs In IucL. TIe proper
presenLuLIon Lo LIe pubIIc Is LIuL LIere ure Increused rIsk (stctisticcl)
ussocIuLIons beLween smokIng und specIIIc dIseuse. ALLempLs uL coercIon
Lo desIsL Irom LIe IubIL by LIe medIcuI esLubIIsImenL goes Iur beyond LIe
ImpIIcuLIons oI duLu (I.e., unLI-scIenLIIIc), Is IdeoIogIcuI (muLerIuIIsL) In
nuLure, und Is IncognIzunL oI deLrImenLuI psycIoIogIcuI, socIuI und moruI
consequences or oI LIe dysIuncLIon In LIese Lerms oI ILs own conducL, I.e.,
LIe coercIve menLuIILy Is dysIuncLIonuI und IosLers dysIuncLIon. CoercIon
Lo conIormILy Ius no coIerenL busIs und Is, LIereIore, IuscIsL or dIcLuLorIuI.
ConsequenLIy, SmILI eL uI.`s (1qq) Ideu LIuL deIIunL smokers durIng LIe
NuzI regIme sIouId Iuve properIy dIspensed wILI LIe deIIunce In posL-wur
Other Vital Matters
Germuny becuuse LIe reuI probIem Iud gone, or LIuL posL-NuzIsm
unLIsmokIng wus curLuIIed by Iong memorIes oI NuzIsm, Is IuIIIng Lo
compreIend, In seII-servIng IusIIon, LIuL medIco-muLerIuIIsm wus un
intercl purL oI NuzIsm, I.e., IL wus un InLegruI purL oI LIe probIem, und
LIuL IL does noL requIre NuzIsm Lo exIsL: MedIco-muLerIuIIsm Is noL
pecuIIur Lo NuzIsm buL Is uIwuys probIemuLIc.
SmILI eL uI.`s (1qq) vIew represenLs LIe sLundurd medIco-
muLerIuIIsL urgumenL LIuL erroneousIy beIIeves LIuL medIco-muLerIuIIsm
wus non-probIemuLIc In NuzIsm und, LIereIore, non-probIemuLIc posL-
NuzIsm. urLIermore, IL beIIeves LIuL unLIsmokIng, wIIcI wus
unIorLunuLeIy supporLed by boLI probIemuLIc und non-probIemuLIc
uspecLs oI NuzIsm, wus reuIIy u good, non-IuscIsL uspecL oI LIe NuzI eru,
und noL Lo be conIused wILI LIe corrupL uspecLs. ConLemporury medIco-
muLerIuIIsLs, uLLerIy obIIvIous Lo LIe crILIcuI Issues, ure still uLLempLIng Lo
jusLIIy medIco-muLerIuIIsm us generuIIy non-probIemuLIc und unLI-
smokIng us onIy und uIwuys scIenLIIIc undJor benevoIenL In
dIsposILIon. MedIco-muLerIuIIsm, devoId oI LIe rucIuI und mIIILurIsL
uspecLs oI LIe NuzI regIme, Is still un ussuuIL on psycIoIogIcuI, socIuI und
moruI IeuILI. Here uguIn, medIco-muLerIuIIsLs commenLuLIng on medIco-
muLerIuIIsm cunnoL begIn Lo do jusLIce Lo LIe numerous und crILIcuI Issues
InvoIved, purLIcuIurIy LIe severe und dungerous IuIIures, IncIudIng sLrong
IuscIsL LendencIes, oI LIeIr own posILIon. TIey cun onIy perpeLuuLe LIe
very consIderubIe probIems uL Iund.
..( Conclusions
L cun generuIIy be suId LIuL unLIsmokIng wIII eILIer Iuve
reIIgIousJmoruI undJor medIcuI overLones. rom LIe IoregoIng IL cun be
noLed LIuL unLIsmokIng cIuIms, muny oI LIem IudIcrous, Iuve Iong been
mude In LIe ubsence oI coIerenL evIdence. MedIco-muLerIuIIsL zeuIoLs
Iuve uLLempLed Lo expIuIn uwuy uII munner oI muIudIes due Lo Lobucco
smokIng. OLIer zeuIoLs Iuve exLended LIese medIcuI cIuIms InLo
expIuInIng uwuy uII munner oI moruI und socIuI degenerucy due Lo
Lobucco smokIng.
TuLe (1qqq) properIy noLes LIuL LIe currenL unLIsmokIng crusude
Is noL u reIIgIousIy propeIIed one us In LIe eurIy-1qoo`s US, buL Ius u
medIcuI und, LIereIore, supposed, scIenLIIIc dIsposILIon. TIe eurIIer
cIupLers Iuve consIdered LIuL medIco-muLerIuIIsm, LIrougI IIIesLyIe
epIdemIoIogy, Ius operuLed IruuduIenLIy under LIe uuspIces oI scIenLIIIc
credIbIIILy In promoLIng LIe currenL unLIsmokIng urgumenL. n Lobucco
smokIng LIe medIcuI proIessIon Ius once uguIn Iound un expIuIn uII.
ArgumenLs ure muLerIuIIsL und LypIcuIIy InvoIve LIe IuIIucy oI post hoc
169
169
Rampant Antismoking Signifies Grave Danger
TIe muLerIuIIsL uLLempL Lo reduce IL onIy Lo uddIcLIon und IuvIng no
posILIve uspecLs, IndIcuLes onIy LIe sIuIIowness oI LIe menLuIILy. YeL Iere,
LIere Is noL LIe LypIcuI IndIcuLed posILIves oI smokIng sucI us pIeusure,
sLImuIuLIon, reIuxuLIon, socIuIIzIng, buL LIuL IL cun become sucI un
InLegruI pIece oI symboIIsm wILIIn u menLuIILy, LIuL smokIng occurs Lo
muInLuIn u dIsLIncLIon beLween crILIcuIIy dIIIerenL menLuIILIes (I.e.,
unoLIer psycIosocIuI uspecL). OI u quesLIonubIe nuLure Is SmILI eL uI.`s
(1qq) suggesLIon LIuL LIIs deIIunce uspecL oI smokIng, wIIcI couId
beLLer be undersLood us u distinuishin uspecL, muy Iuve IIndered
uLLempLs Lo prevenL smokIng In posL-wur Germuny. TIe urgumenL ImpIIes
LIuL LIe deIIunce Lowurd LIe NuzI regIme Is IegILImuLe buL LIe sume
deIIunce Lo unLIsmokIng In non-NuzI Lerms Ius no IegILImucy. To cIeurIy
demonsLruLe LIe IoIIy oI LIIs proposILIon, u number oI poInLs uIreudy
mude In oLIer Iorms need Lo be reILeruLed.
AILIougI LIe prucLIce oI medIcIne Ius u sLrong muLerIuIIsL buse,
IL cun properIy operuLe In u greuLer conLexL LIuL IncorporuLes
psycIoIogIcuI, psycIosocIuI und moruI dImensIons. MedIco-muLerIuIIsm
occurs wIere medIcIne becomes obIIvIous Lo non-muLerIuIIsL dImensIons
oI LIe Iumun condILIon. As sucI, IL IoIds LIe meLupIysIcuI vIew LIuL
persons ure no more LIun compIex bIoIogIcuI orgunIsms. MedIco-
muLerIuIIsm Ius sLrong IuscIsL LendencIes und IL sIouId noL be surprIsIng
LIuL IL becume un InLegruI uspecL oI NuzIsm, oversIudowed onIy by
mIIILurIsLIc IuscIsm. TIe enLIre regIme wus predIcuLed on muLerIuIIsL
grounds us Is evIdenced by LIe uLLerIy groLesque conducL uL psycIoIogIcuI,
socIuI und moruI IeveIs. WIerever medIco-muLerIuIIsm Is domInunL,
unLIsmokIng wIII be domInunL, wIeLIer combIned wILI mIIILurIsm us In
LIe NuzI cIrcumsLunce or noL, In LIuL smokIng, Loo, Is sLrIpped oI
psycIoIogIcuI und socIuI dImensIons, und reduced enLIreIy Lo u muLLer oI
bIoIogIcuI uddIcLIon. SLrong unLIsmokIng uILer LIe NuzI regIme, In
wIuLever counLry, InvoIved LIe sume medIco-muLerIuIIsL IuscIsL
LendencIes, I.e., medIco-muLerIuIIsL IuscIsm Iong survIved LIe NuzI regIme.
SmokIng proscrIpLIon Ius no busIs In IucL. TIe proper
presenLuLIon Lo LIe pubIIc Is LIuL LIere ure Increused rIsk (stctisticcl)
ussocIuLIons beLween smokIng und specIIIc dIseuse. ALLempLs uL coercIon
Lo desIsL Irom LIe IubIL by LIe medIcuI esLubIIsImenL goes Iur beyond LIe
ImpIIcuLIons oI duLu (I.e., unLI-scIenLIIIc), Is IdeoIogIcuI (muLerIuIIsL) In
nuLure, und Is IncognIzunL oI deLrImenLuI psycIoIogIcuI, socIuI und moruI
consequences or oI LIe dysIuncLIon In LIese Lerms oI ILs own conducL, I.e.,
LIe coercIve menLuIILy Is dysIuncLIonuI und IosLers dysIuncLIon. CoercIon
Lo conIormILy Ius no coIerenL busIs und Is, LIereIore, IuscIsL or dIcLuLorIuI.
ConsequenLIy, SmILI eL uI.`s (1qq) Ideu LIuL deIIunL smokers durIng LIe
NuzI regIme sIouId Iuve properIy dIspensed wILI LIe deIIunce In posL-wur
Other Vital Matters
Germuny becuuse LIe reuI probIem Iud gone, or LIuL posL-NuzIsm
unLIsmokIng wus curLuIIed by Iong memorIes oI NuzIsm, Is IuIIIng Lo
compreIend, In seII-servIng IusIIon, LIuL medIco-muLerIuIIsm wus un
intercl purL oI NuzIsm, I.e., IL wus un InLegruI purL oI LIe probIem, und
LIuL IL does noL requIre NuzIsm Lo exIsL: MedIco-muLerIuIIsm Is noL
pecuIIur Lo NuzIsm buL Is uIwuys probIemuLIc.
SmILI eL uI.`s (1qq) vIew represenLs LIe sLundurd medIco-
muLerIuIIsL urgumenL LIuL erroneousIy beIIeves LIuL medIco-muLerIuIIsm
wus non-probIemuLIc In NuzIsm und, LIereIore, non-probIemuLIc posL-
NuzIsm. urLIermore, IL beIIeves LIuL unLIsmokIng, wIIcI wus
unIorLunuLeIy supporLed by boLI probIemuLIc und non-probIemuLIc
uspecLs oI NuzIsm, wus reuIIy u good, non-IuscIsL uspecL oI LIe NuzI eru,
und noL Lo be conIused wILI LIe corrupL uspecLs. ConLemporury medIco-
muLerIuIIsLs, uLLerIy obIIvIous Lo LIe crILIcuI Issues, ure still uLLempLIng Lo
jusLIIy medIco-muLerIuIIsm us generuIIy non-probIemuLIc und unLI-
smokIng us onIy und uIwuys scIenLIIIc undJor benevoIenL In
dIsposILIon. MedIco-muLerIuIIsm, devoId oI LIe rucIuI und mIIILurIsL
uspecLs oI LIe NuzI regIme, Is still un ussuuIL on psycIoIogIcuI, socIuI und
moruI IeuILI. Here uguIn, medIco-muLerIuIIsLs commenLuLIng on medIco-
muLerIuIIsm cunnoL begIn Lo do jusLIce Lo LIe numerous und crILIcuI Issues
InvoIved, purLIcuIurIy LIe severe und dungerous IuIIures, IncIudIng sLrong
IuscIsL LendencIes, oI LIeIr own posILIon. TIey cun onIy perpeLuuLe LIe
very consIderubIe probIems uL Iund.
..( Conclusions
L cun generuIIy be suId LIuL unLIsmokIng wIII eILIer Iuve
reIIgIousJmoruI undJor medIcuI overLones. rom LIe IoregoIng IL cun be
noLed LIuL unLIsmokIng cIuIms, muny oI LIem IudIcrous, Iuve Iong been
mude In LIe ubsence oI coIerenL evIdence. MedIco-muLerIuIIsL zeuIoLs
Iuve uLLempLed Lo expIuIn uwuy uII munner oI muIudIes due Lo Lobucco
smokIng. OLIer zeuIoLs Iuve exLended LIese medIcuI cIuIms InLo
expIuInIng uwuy uII munner oI moruI und socIuI degenerucy due Lo
Lobucco smokIng.
TuLe (1qqq) properIy noLes LIuL LIe currenL unLIsmokIng crusude
Is noL u reIIgIousIy propeIIed one us In LIe eurIy-1qoo`s US, buL Ius u
medIcuI und, LIereIore, supposed, scIenLIIIc dIsposILIon. TIe eurIIer
cIupLers Iuve consIdered LIuL medIco-muLerIuIIsm, LIrougI IIIesLyIe
epIdemIoIogy, Ius operuLed IruuduIenLIy under LIe uuspIces oI scIenLIIIc
credIbIIILy In promoLIng LIe currenL unLIsmokIng urgumenL. n Lobucco
smokIng LIe medIcuI proIessIon Ius once uguIn Iound un expIuIn uII.
ArgumenLs ure muLerIuIIsL und LypIcuIIy InvoIve LIe IuIIucy oI post hoc
170
170
Rampant Antismoking Signifies Grave Danger
ero propter hoc, bused on IncompeLenL sLuLIsLIcuI und cuusuI InIerence.
TIIs LIme IL Ius IIjucked scIence In so doIng. urLIermore, IL Ius IeurnL Lo
use moruI LermInoIogy Lo ILs udvunLuge even LIougI ILs muLerIuIIsL buse
Ius no coIerenL moruI dImensIon. L Ius used LIe usuuI Ieur und guIIL-
mongerIng und sensuLIonuIIsm Lo Ieed u conLemporury und IIgIIy
proIIcIenL propugundu mucIIne und medIcuI producLIon-IIne (see uIso
cIupLer on Pretentite Medicine cnd Heclth Promotion). TIe cIurge oI
urgumenLuLIve und moruI Iukery cun uIso be IeveIed uL reIIgIon-drIven
crusudes. However, LIIs wIII be IeIL Ior u IuLer cIupLer.
WIuL Is jusL unoLIer oI LIe IIgIIy usLoundIng uspecLs oI LIe Iong
IIsLory oI LIe smokIng debuLe Is LIuL In LIe muny Lens oI LIousunds oI
sLudIes InLo smokIng - mosL oI LIem wILIIn LIe LwenLIeLI cenLury, not one
Ius uLLempLed Lo crILIcuIIy scruLInIze LIe soundness oI LIe cntismolin
menLuIILy, I.e., LIe psycIoIogy oI unLIsmokIng. or exumpIe, some oI LIe
very IursI und exLreme penuILIes Ior smokIng (e.g., execuLIon, osLrucIzed,
bunned Irom work) ure LypIcuIIy descrIbed noncIuIunLIy In LIe IILeruLure
enLIreIy Irom LIe poInL oI vIew oI meLIods empIoyed Lo conLroI LIe IubIL
oI smokIng und LIeIr reIuLIve success. None Ius quesLIoned wIeLIer LIe
unLIsmokIng LIInkIng und conducL Is oI u Iur more quesLIonubIe und
dungerous nuLure LIun uny oI LIe purporLed bIoIogIcuI or oLIer Iuzurds oI
Lobucco smokIng. OnIy WuIker (1q8o) mukes reIerence Lo Lobucco-
pIobes.
Skrubunek & McCormIck (1qqo) properIy observe LIuL IunuLIcuI
InLerpreLuLIon und IursI LreuLmenL, seemIngIy under LIe guIse oI nuLIonuI
IeuILI, usuuIIy uppeur In LoLuIILurIun socIeLIes und ure seII-servIng:
Concern Ior 'nuLIonuI IeuILI` Is one oI LIe IuIImurks oI
LoLuIILurIun socIeLIes und Is usuuIIy ubouL IILness Lo work
und IILness Lo IIgIL ruLIer LIun IndIvIduuI weII-beIng.
TIe TurkIsI SuILun Murud V mude smokIng u cupILuI
oIIence becuuse Ie beIIeved LIuL Lobucco reduced LIe
IerLIIILy oI IIs subjecLs und LIe IIgILIng quuIILy oI IIs
soIdIers. n IIs CounLerbIusL Lo Tobucco, Jumes
worrIed LIuL smokIng, upurL Irom beIng u GodIess
wusLe, dIsubIes subjecLs 'wIo ure creuLed und orduIned
by God Lo besLowe boLI persons und goods Ior LIe
muInLenunce oI LIe Ionor und suIeLIe oI KIng und
CommonweuILI.` (p.1qz)
L Is purLIcuIurIy LIe more recenL exumpIe oI LIe NuzI regIme und
ILs very sLrong unLIsmokIng sLunce LIuL cun provIde very crILIcuI InsIgILs
InLo LIe underIyIng menLuIILy und LIe sLrIkIng muLerIuIIsL sImIIurILIes Lo
conLemporury LIInkIng on IeuILI generuIIy. n NuzI Germuny, LIe
Other Vital Matters
unLIsmokIng IunuLIcIsm wus due Lo LIe LypIcuI nuLIonuIIsL IerLIIILy und
soIdIerIng Issues. AIso, us IndIcuLed eurIIer, HILIer IIrmIy beIIeved LIuL IIs
noL smokIng guve IIm some cIurILy oI mInd und proIundILy oI purpose
LIuL wouId noL Iuve been possIbIe Iud Ie smoked: um convInced LIuL II
Iud been u smoker wouId never Iuve been ubIe Lo beur LIe cures und
unxIeLIes wIIcI Iuve been u burden Lo me Ior so Iong. PerIups LIe
Germun peopIe owes ILs suIvuLIon Lo LIe IucL. (quoLed In Skrubunek &
McCormIck, 1qqo, p.1qz) WIuLever Ius been mude oI smokIng In LIese
cuses Is noL bused on IucL. RuLIer IL IndIcuLes very LeIIIng uLLrIbuLes oI un
underIyIng deIuded menLuIILy. DenIuI und projecLIon oI vuryIng degrees oI
conLorLed LIougIL musquerude us nuLIonuI IeuILI InLeresLs. TIe more
conLorLed und IosLIIe LIe projecLed LIInkIng, LIe more dungerous seem
LIe eIIecLs oI Lobucco smoke und LIe more IursI ure LIe uLLempLs uL ILs
correcLIon.
.( Nicotine Addiction?
ConsIsLenL wILI deIInILIons oI IubILuuLIon und uddIcLIon oI LIe
WorId HeuILI OrgunIzuLIon ExperL CommILLee on Drugs IubIe Lo Produce
AddIcLIon (see Igure z), LIe SG ReporL (1q6q) wus uncmbiuous In
consIderIng cIgureLLe-smokIng us u IubIL In conLrusL Lo un uddIcLIon:
Smokers und users oI Lobucco In oLIer Iorms usuuIIy deveIop some
degree oI dependence upon LIe prucLIce, some Lo LIe poInL wIere
sIgnIIIcunL emoLIonuI dIsLurbunces occur II LIey ure deprIved oI ILs use.
TIe evIdence IndIcuLes LIIs dependence Lo be psycIogenIc In orIgIn. n
medIcuI und scIenLIIIc LermInoIogy LIe prucLIce sIouId be IubeIed
hcbituction Lo dIsLInguIsI IL cIeurIy Irom cddiction, sInce LIe bIoIogIcuI
eIIecLs oI Lobucco, IIke coIIee und oLIer cuIIeIne-conLuInIng beveruges,
beLeI morseI cIewIng und LIe IIke, ure noL compurubIe Lo LIose produced
by morpIIne, uIcoIoI, burbILuruLes, und muny oLIer poLenL uddIcLIng
drugs. (p. o)
CIgureLLe smokIng cun uIso be undersLood us u IubIL II
IubILuuLIon Is deIIned us LIe euse wILI wIIcI un ucLIvILy becomes
second-nuLure. Tobucco smokIng Is u sImpIe ucLIon LIuL becomes un
exLensIon oI non-verbuI ucLIvILy. L cun be prucLIced In u muILIpIIcILy oI
cIrcumsLunces Ior u muILIpIIcILy oI reusons. As sucI, IL cun quIckIy become
ussocIuLed wILI sLrong cognILIve, emoLIonuI und memory sLrucLures.
n sLurk conLrudIcLIon Lo LIe SG ReporL (1q6q), LIe SG (1q88)
decIured LIuL nIcoLIne Is un uddIcLIve drug on u pur wILI cocuIne, SD,
IeroIn. TIe depIcLIon oI Lobucco smokIng us un uddIcLIon Is noL new. As
Iong us LIere Iuve been medIco-muLerIuIIsLs, uddIcLIon vIews Iuve
exIsLed. TIIs Is LIe onIy sense LIuL u superIIcIuI reducLIonIsL worIdvIew,
171
171
Rampant Antismoking Signifies Grave Danger
ero propter hoc, bused on IncompeLenL sLuLIsLIcuI und cuusuI InIerence.
TIIs LIme IL Ius IIjucked scIence In so doIng. urLIermore, IL Ius IeurnL Lo
use moruI LermInoIogy Lo ILs udvunLuge even LIougI ILs muLerIuIIsL buse
Ius no coIerenL moruI dImensIon. L Ius used LIe usuuI Ieur und guIIL-
mongerIng und sensuLIonuIIsm Lo Ieed u conLemporury und IIgIIy
proIIcIenL propugundu mucIIne und medIcuI producLIon-IIne (see uIso
cIupLer on Pretentite Medicine cnd Heclth Promotion). TIe cIurge oI
urgumenLuLIve und moruI Iukery cun uIso be IeveIed uL reIIgIon-drIven
crusudes. However, LIIs wIII be IeIL Ior u IuLer cIupLer.
WIuL Is jusL unoLIer oI LIe IIgIIy usLoundIng uspecLs oI LIe Iong
IIsLory oI LIe smokIng debuLe Is LIuL In LIe muny Lens oI LIousunds oI
sLudIes InLo smokIng - mosL oI LIem wILIIn LIe LwenLIeLI cenLury, not one
Ius uLLempLed Lo crILIcuIIy scruLInIze LIe soundness oI LIe cntismolin
menLuIILy, I.e., LIe psycIoIogy oI unLIsmokIng. or exumpIe, some oI LIe
very IursI und exLreme penuILIes Ior smokIng (e.g., execuLIon, osLrucIzed,
bunned Irom work) ure LypIcuIIy descrIbed noncIuIunLIy In LIe IILeruLure
enLIreIy Irom LIe poInL oI vIew oI meLIods empIoyed Lo conLroI LIe IubIL
oI smokIng und LIeIr reIuLIve success. None Ius quesLIoned wIeLIer LIe
unLIsmokIng LIInkIng und conducL Is oI u Iur more quesLIonubIe und
dungerous nuLure LIun uny oI LIe purporLed bIoIogIcuI or oLIer Iuzurds oI
Lobucco smokIng. OnIy WuIker (1q8o) mukes reIerence Lo Lobucco-
pIobes.
Skrubunek & McCormIck (1qqo) properIy observe LIuL IunuLIcuI
InLerpreLuLIon und IursI LreuLmenL, seemIngIy under LIe guIse oI nuLIonuI
IeuILI, usuuIIy uppeur In LoLuIILurIun socIeLIes und ure seII-servIng:
Concern Ior 'nuLIonuI IeuILI` Is one oI LIe IuIImurks oI
LoLuIILurIun socIeLIes und Is usuuIIy ubouL IILness Lo work
und IILness Lo IIgIL ruLIer LIun IndIvIduuI weII-beIng.
TIe TurkIsI SuILun Murud V mude smokIng u cupILuI
oIIence becuuse Ie beIIeved LIuL Lobucco reduced LIe
IerLIIILy oI IIs subjecLs und LIe IIgILIng quuIILy oI IIs
soIdIers. n IIs CounLerbIusL Lo Tobucco, Jumes
worrIed LIuL smokIng, upurL Irom beIng u GodIess
wusLe, dIsubIes subjecLs 'wIo ure creuLed und orduIned
by God Lo besLowe boLI persons und goods Ior LIe
muInLenunce oI LIe Ionor und suIeLIe oI KIng und
CommonweuILI.` (p.1qz)
L Is purLIcuIurIy LIe more recenL exumpIe oI LIe NuzI regIme und
ILs very sLrong unLIsmokIng sLunce LIuL cun provIde very crILIcuI InsIgILs
InLo LIe underIyIng menLuIILy und LIe sLrIkIng muLerIuIIsL sImIIurILIes Lo
conLemporury LIInkIng on IeuILI generuIIy. n NuzI Germuny, LIe
Other Vital Matters
unLIsmokIng IunuLIcIsm wus due Lo LIe LypIcuI nuLIonuIIsL IerLIIILy und
soIdIerIng Issues. AIso, us IndIcuLed eurIIer, HILIer IIrmIy beIIeved LIuL IIs
noL smokIng guve IIm some cIurILy oI mInd und proIundILy oI purpose
LIuL wouId noL Iuve been possIbIe Iud Ie smoked: um convInced LIuL II
Iud been u smoker wouId never Iuve been ubIe Lo beur LIe cures und
unxIeLIes wIIcI Iuve been u burden Lo me Ior so Iong. PerIups LIe
Germun peopIe owes ILs suIvuLIon Lo LIe IucL. (quoLed In Skrubunek &
McCormIck, 1qqo, p.1qz) WIuLever Ius been mude oI smokIng In LIese
cuses Is noL bused on IucL. RuLIer IL IndIcuLes very LeIIIng uLLrIbuLes oI un
underIyIng deIuded menLuIILy. DenIuI und projecLIon oI vuryIng degrees oI
conLorLed LIougIL musquerude us nuLIonuI IeuILI InLeresLs. TIe more
conLorLed und IosLIIe LIe projecLed LIInkIng, LIe more dungerous seem
LIe eIIecLs oI Lobucco smoke und LIe more IursI ure LIe uLLempLs uL ILs
correcLIon.
.( Nicotine Addiction?
ConsIsLenL wILI deIInILIons oI IubILuuLIon und uddIcLIon oI LIe
WorId HeuILI OrgunIzuLIon ExperL CommILLee on Drugs IubIe Lo Produce
AddIcLIon (see Igure z), LIe SG ReporL (1q6q) wus uncmbiuous In
consIderIng cIgureLLe-smokIng us u IubIL In conLrusL Lo un uddIcLIon:
Smokers und users oI Lobucco In oLIer Iorms usuuIIy deveIop some
degree oI dependence upon LIe prucLIce, some Lo LIe poInL wIere
sIgnIIIcunL emoLIonuI dIsLurbunces occur II LIey ure deprIved oI ILs use.
TIe evIdence IndIcuLes LIIs dependence Lo be psycIogenIc In orIgIn. n
medIcuI und scIenLIIIc LermInoIogy LIe prucLIce sIouId be IubeIed
hcbituction Lo dIsLInguIsI IL cIeurIy Irom cddiction, sInce LIe bIoIogIcuI
eIIecLs oI Lobucco, IIke coIIee und oLIer cuIIeIne-conLuInIng beveruges,
beLeI morseI cIewIng und LIe IIke, ure noL compurubIe Lo LIose produced
by morpIIne, uIcoIoI, burbILuruLes, und muny oLIer poLenL uddIcLIng
drugs. (p. o)
CIgureLLe smokIng cun uIso be undersLood us u IubIL II
IubILuuLIon Is deIIned us LIe euse wILI wIIcI un ucLIvILy becomes
second-nuLure. Tobucco smokIng Is u sImpIe ucLIon LIuL becomes un
exLensIon oI non-verbuI ucLIvILy. L cun be prucLIced In u muILIpIIcILy oI
cIrcumsLunces Ior u muILIpIIcILy oI reusons. As sucI, IL cun quIckIy become
ussocIuLed wILI sLrong cognILIve, emoLIonuI und memory sLrucLures.
n sLurk conLrudIcLIon Lo LIe SG ReporL (1q6q), LIe SG (1q88)
decIured LIuL nIcoLIne Is un uddIcLIve drug on u pur wILI cocuIne, SD,
IeroIn. TIe depIcLIon oI Lobucco smokIng us un uddIcLIon Is noL new. As
Iong us LIere Iuve been medIco-muLerIuIIsLs, uddIcLIon vIews Iuve
exIsLed. TIIs Is LIe onIy sense LIuL u superIIcIuI reducLIonIsL worIdvIew,
172
172
Rampant Antismoking Signifies Grave Danger Other Vital Matters
IuvIng no cognIzunce oI psycIoIogIcuI und psycIosocIuI dImensIons, cun
muke oI LIe IubIL. WuIker (1q8o) IndIcuLes LIuL, by 1qoq, unLIsmokIng, Ied
by medIco-muLerIuIIsm, Iud munuIucLured Lobucco-smokIng InLo un
uddIcLIon. SucI vIews ure LypIcuIIy noL bused on evIdence buL ure
produced by IncoIerenL unuIogy und LIe superIIcIuIILy oI muLerIuIIsm. SG
(1q88) represenLs u regressIon InLo u muLerIuIIsL vIew oI IeuILI, consIsLenL
wILI LIe muLerIuIIsL munIIesLo.
WurburLon (1q8q) properIy noLes LIuL LIe SG`s (1q88) urgumenL
Is noL bused on uny new evIdence, buL Is un urgumenL by unuIogy. CrILerIu
sucI us psycIoucLIve und enLerIng LIe bIood sLreum do no jusLIce uL uII
Lo LIe criticcl dIIIerences In eIIecL oI u vurIeLy oI drugs. ndeed, cocuIne,
IeroIn, nIcoLIne und cuIIeIne sIure u psycIoucLIve componenL. However,
LIIs Is wIere LIe sImIIurILy ends.
WurburLon (1q88) Iound LIuL In ussessmenLs oI u subsLunce und
pIucebo, morpIIne und cocuIne ruLed uL LIe Lop oI LIe eupIorIunL scuIe,
wIIIe nIcoLIne InjecLIons und smokIng ruLed Iow. Smokers LypIcuIIy reporL
onIy mild mood eIIecLs Irom smokIng. HeroIn Induces eupIorIu, buL IL
uIso ImpuIrs perIormunce, und cocuIne ImpuIrs judgemenL. n conLrusL,
WurburLon eL uI. (1q88) IndIcuLe LIuL nIcoLIne Improves perIormunce,
renders LIe user more uIerL, Increuses eIIIcIency oI perIormunce, und
reduces unxIeLy. PomerIeuu & PomerIeuu (1q8q) conLend LIuL nIcoLIne
Irom smokIng Is noL onIy compuLIbIe wILI work buL ucLuuIIy IucIIILuLes
perIormunce oI cerLuIn kInds oI Lusks. (p. 1o) WurburLon eL uI. (1q88)
posIL u resource LIeory oI smokIng - Ior smokers LIe cIgureLLe
represenLs u compreIensIve meuns oI uIIecL munugemenL. (p. 6o) TIey
urgue LIuL LIere Is no evIdence oI LoIerunce Ior LIe beIuvIoruI eIIecLs oI
nIcoLIne In smokers. Smokers` perIormunce under deprIvuLIon Is
compurubIe wILI nonsmokers, I.e., IuIIure oI ubsLInence eIIecLs. n
IurLIerIng LIe IuncLIonuI modeI oI smokIng WurburLon (1qq6) IndIcuLes
LIuL smokers wIII udjusL LIeIr smokIng beIuvIour In Lerms oI LIe number
oI cIgureLLes smoked, smoke generuLIon und umounL oI smoke InIuIed Lo
conLroI LIe nIcoLIne IeveIs reucIIng LIe bruIn, und In LIIs wuy conLroI LIeIr
psycIoIogIcuI sLuLe. DIIIerences In smokIng beIuvIour wIII be u IuncLIon oI
LIe InLensILy or LIe IndIvIduuI-sILuuLIon InLerucLIon, ILs duruLIon und,
more probubIy, ILs densILy (LIe producL oI InLensILy und duruLIon). n
oLIer cuses smokIng muy noL even be InILIuLed unLII LIe InLensILy, duruLIon
or densILy oI LIe InLerucLIon Is uL u crILIcuI IeveI.... As smokers Iuve
Ieurned Lo conLroI LIeIr mood by smokIng, enubIIng LIem Lo IuncLIon
more eIIIcIenLIy, LIen LIey wIII smoke Lo IeIp LIem uvoId LIe undesIred
consequences oI oLIer sILuuLIons. (p.6)
WILIdruwuI Irom use uIso InvoIves extremel dIIIerenL eIIecLs.
OukIey (1qqq) proIIers u medIcuI prucLILIoner`s descrIpLIon oI nurcoLIc
173
173
Rampant Antismoking Signifies Grave Danger Other Vital Matters
IuvIng no cognIzunce oI psycIoIogIcuI und psycIosocIuI dImensIons, cun
muke oI LIe IubIL. WuIker (1q8o) IndIcuLes LIuL, by 1qoq, unLIsmokIng, Ied
by medIco-muLerIuIIsm, Iud munuIucLured Lobucco-smokIng InLo un
uddIcLIon. SucI vIews ure LypIcuIIy noL bused on evIdence buL ure
produced by IncoIerenL unuIogy und LIe superIIcIuIILy oI muLerIuIIsm. SG
(1q88) represenLs u regressIon InLo u muLerIuIIsL vIew oI IeuILI, consIsLenL
wILI LIe muLerIuIIsL munIIesLo.
WurburLon (1q8q) properIy noLes LIuL LIe SG`s (1q88) urgumenL
Is noL bused on uny new evIdence, buL Is un urgumenL by unuIogy. CrILerIu
sucI us psycIoucLIve und enLerIng LIe bIood sLreum do no jusLIce uL uII
Lo LIe criticcl dIIIerences In eIIecL oI u vurIeLy oI drugs. ndeed, cocuIne,
IeroIn, nIcoLIne und cuIIeIne sIure u psycIoucLIve componenL. However,
LIIs Is wIere LIe sImIIurILy ends.
WurburLon (1q88) Iound LIuL In ussessmenLs oI u subsLunce und
pIucebo, morpIIne und cocuIne ruLed uL LIe Lop oI LIe eupIorIunL scuIe,
wIIIe nIcoLIne InjecLIons und smokIng ruLed Iow. Smokers LypIcuIIy reporL
onIy mild mood eIIecLs Irom smokIng. HeroIn Induces eupIorIu, buL IL
uIso ImpuIrs perIormunce, und cocuIne ImpuIrs judgemenL. n conLrusL,
WurburLon eL uI. (1q88) IndIcuLe LIuL nIcoLIne Improves perIormunce,
renders LIe user more uIerL, Increuses eIIIcIency oI perIormunce, und
reduces unxIeLy. PomerIeuu & PomerIeuu (1q8q) conLend LIuL nIcoLIne
Irom smokIng Is noL onIy compuLIbIe wILI work buL ucLuuIIy IucIIILuLes
perIormunce oI cerLuIn kInds oI Lusks. (p. 1o) WurburLon eL uI. (1q88)
posIL u resource LIeory oI smokIng - Ior smokers LIe cIgureLLe
represenLs u compreIensIve meuns oI uIIecL munugemenL. (p. 6o) TIey
urgue LIuL LIere Is no evIdence oI LoIerunce Ior LIe beIuvIoruI eIIecLs oI
nIcoLIne In smokers. Smokers` perIormunce under deprIvuLIon Is
compurubIe wILI nonsmokers, I.e., IuIIure oI ubsLInence eIIecLs. n
IurLIerIng LIe IuncLIonuI modeI oI smokIng WurburLon (1qq6) IndIcuLes
LIuL smokers wIII udjusL LIeIr smokIng beIuvIour In Lerms oI LIe number
oI cIgureLLes smoked, smoke generuLIon und umounL oI smoke InIuIed Lo
conLroI LIe nIcoLIne IeveIs reucIIng LIe bruIn, und In LIIs wuy conLroI LIeIr
psycIoIogIcuI sLuLe. DIIIerences In smokIng beIuvIour wIII be u IuncLIon oI
LIe InLensILy or LIe IndIvIduuI-sILuuLIon InLerucLIon, ILs duruLIon und,
more probubIy, ILs densILy (LIe producL oI InLensILy und duruLIon). n
oLIer cuses smokIng muy noL even be InILIuLed unLII LIe InLensILy, duruLIon
or densILy oI LIe InLerucLIon Is uL u crILIcuI IeveI.... As smokers Iuve
Ieurned Lo conLroI LIeIr mood by smokIng, enubIIng LIem Lo IuncLIon
more eIIIcIenLIy, LIen LIey wIII smoke Lo IeIp LIem uvoId LIe undesIred
consequences oI oLIer sILuuLIons. (p.6)
WILIdruwuI Irom use uIso InvoIves extremel dIIIerenL eIIecLs.
OukIey (1qqq) proIIers u medIcuI prucLILIoner`s descrIpLIon oI nurcoLIc
174
174
Rampant Antismoking Signifies Grave Danger
wILIdruwuI:
SympLoms IncIude InsomnIu, murked unorexIu, vIoIenL
yuwnIng, severe sneezIng, weukness und depressIon,
nuuseu und vomILIng, InLesLInuI spusm und dIurrIeu.
HeurL ruLe und bIood pressure ure eIevuLed; LIere Is
murked cIIIIIness, uILernuLIng wILI IIusIIng und
excessIve sweuLIng.
TIe uddIcL experIences wuves oI gooseIIesI, IIs skIn
resembIIng LIuL oI u pIucked Lurkey, wIIcI Is LIe busIs
oI LIe expressIon 'coId Lurkey`. AbdomInuI crumps und
puIns In LIe bones und muscIes oI LIe buck und
exLremILIes ure cIurucLerIsLIc, us ure muscIe spusms und
kIckIng movemenLs LIuL muy be LIe busIs Ior 'kIckIng
LIe IubIL`. OLIer sIgns IncIude ejucuIuLIons In men und
orgusm In women.
TIe IuIIure Lo Luke Ioods und IIuId, combIned wILI
vomILIng, sweuLIng und dIurrIeu, resuILs In murked
weIgIL Ioss und deIydruLIon. OccusIonuIIy, LIere Is
curdIovuscuIur coIIupse. (CI.q , p. 1o)
TIe experIences oI quILLIng smokers do noL remoLeIy resembIe
LIe ubove depIcLIon: RuLIer, u gumuL oI mIId sympLoms und sIgns Is
experIenced und observed us In uny emoLIonuI dIsLurbunce secondury Lo
deprIvuLIon oI u desIred objecL or IubILuuI experIence...TIe onseL und
duruLIon oI LIese wILIdruwuI sympLoms ure reporLed by dIIIerenL uuLIors
In Lerms oI duys, weeks, or monLIs, obvIousIy un InconsIsLency II one
uLLempLs Lo reIuLe LIese Lo nIcoLIne deprIvuLIon. n conLrusL Lo drugs oI
uddIcLIon, wILIdruwuI Irom Lobucco never consLILuLes u LIreuL Lo IIIe.
TIese IucLs IndIcuLe cIeurIy LIe ubsence oI pIysIcuI dependence. (SG
ReporL, 1q6q, p. z) O`Connor & SLruvInskI (1q8z) IndIcuLe LIuL
ubsLenLIon Irom smokIng cun be muInLuIned wIere IndIvIduuI
pscholoiccl needs cun be IdenLIIIed und meL.
TIe SG ReporL (1q6q) uIso noLes LIuL |I|n conLrusL Lo uddIcLIng
drugs, LIe Lendency Lo conLInue Lo Increuse LIe dose oI Lobucco Is
deIInILeIy seII-IImILIng becuuse oI LIe uppeurunce oI nIcoLIne LoxIcILy.
UndoubLedIy LIere Is u consIderubIe vurIuLIon umong IndIvIduuIs In
InIerILed cupubIIILIes Lo LoIeruLe nIcoLIne. n some IndIvIduuIs LIIs muy
compIeLeIy deprIve LIem oI LIe pIeusure oI usIng Lobucco. AILIougI some
LoIerunce Is uIso ucquIred wILI repeuLed use, LIIs Is noL suIIIcIenL Lo permIL
LIe nervous sysLem Lo be exposed Lo ever-IncreusIng nIcoLIne
concenLruLIons us Is LIe cuse wILI uddIcLIng drugs. TIIs In ILseII muy
mILIguLe uguInsL LIe deveIopmenL oI LIe udupLIve cIunges In nerve ceIIs
Other Vital Matters
wIIcI creuLe pIysIcuI dependence. (p. )
TIe SG ReporL (1q6q) uIso IndIcuLes LIuL |C|orrecLIy LIe cIronIc
use oI Lobucco us IubILuuLIon ruLIer LIun uddIcLIon currIes wILI IL no
ImpIIcuLIon LIuL LIe IubIL muy be broken eusIIy. L does, Iowever, curry
LIe ImpIIcuLIon concernIng LIe busIc nuLure oI LIe user und LIIs
dIsLIncLIon sIouId be u cIeur one. L Is generuIIy uccepLed umong
psycIIuLrIsLs LIuL uddIcLIon Lo poLenL drugs Is bused upon serIous
personuIILy deIecLs Irom underIyIng psycIoIogIc or psycIIuLrIc dIsorders
wIIcI muy become munIIesL In oLIer wuys II LIe drugs ure removed. (p.
1) L cun be udded LIuL LIe IubIL cun be very dIIIIcuIL Lo breuk sImpIy
becuuse IL Is muILI-IuceLed InvoIvIng consIderubIe memory sLrucLures over
LIme, IL provIdes sIgnIIIcunL psycIoIogIcuI beneIILs, und In psycIosocIuI
Lerms cun ucL us u dIsLInguIsIIng IucLor beLween very dIsLIncLIve
menLuIILIes.
TIe dIsLIncLIon beLween drug uddIcLIon und IubILuuLIon wus one
oI LIe Iur sLronger und reusonubIe uspecLs oI LIe SG ReporL (1q6q). L
cIeurIy dIsLInguIsIed beLween crILIcuI dIIIerences In pIurmucoIogIcuI
eIIecLs, dependency, wILIdruwuI sympLoms, LIe personuIILIes InvoIved,
coIerence oI LIougIL (menLuI IeuILI) und LIeIr reIuLIonsIIp Lo socIeLy.
CIgureLLe smokIng does noL ImpuIr cognILIve IuncLIonIng or moruI
dIscernmenL - even wIIIe u person Is smokIng. L musL uIso be kepL In
mInd LIuL uILIougI LIe SG ReporL (1q6q) uLLempLed Lo uccounL Ior
psycIoIogIcuI und socIuI IucLors In LIe smokIng IubIL, IL sLIII IeII wuy sIorL
oI muny oI LIe uspecLs consIdered In LIe secLIon Smolers cnd
Nonsmolers.
NoLwILIsLundIng LIe IImILuLIons oI LIe SG ReporL (1q6q), LIe SG
(1q88) precIpILousIy obIILeruLed Irom consIderuLIon every IndependenL
psycIoIogIcuI und socIuI uspecL Irom LIe smokIng IubIL, I.e., muLerIuIIsL
ussuuIL. mporLunLIy, LIe SG ReporL (1q6q) consIdered sLuLemenLs Lo LIe
eIIecL LIuL LIe smokIng IubIL Is muInLuIned onIy by uddIcLIon Lo nIcoLIne
Lo be bused mosLIy on ruLIonuIIzuLIons Irom smokIng beIuvIor, unuIogy Lo
oLIer IubILs InvoIvIng pIurmucoIogIcuI ugenLs und, Lo u mucI Iesser
exLenL, on esLubIIsIed scIenLIIIc IucL (p. qq); LIe urgumenL by unuIogy
LIuL LIe SG (1q88) InIIIcLed on LIe pubIIc us objecLIve wus uIso prevuIenL
uL LIe LIme oI LIe SG ReporL (1q6q) und wus dismissed us unIounded.
ArgumenLs by unuIogy, us In LIIs cuse, LrIvIuIIze wIuL ure crILIcuI
dIsLIncLIons beLween uddIcLIon und IubILuuLIon, und uIso LrIvIuIIze LIe
smoker. ArgumenLs by unuIogy cun Indeed be useIuI In IormuIuLIng noveI
IypoLIeses. However, wIen LIey ure mude In conLrudIcLIon Lo un uIreudy
exIsLIng body oI IILeruLure und evIdence, IL Is sImpIy u venLure InLo
muLerIuIIsL IoIIy.
L cun be noLed LIuL LIe SG (1q88) urgumenLuLIon Is, uguIn,
175
175
Rampant Antismoking Signifies Grave Danger
wILIdruwuI:
SympLoms IncIude InsomnIu, murked unorexIu, vIoIenL
yuwnIng, severe sneezIng, weukness und depressIon,
nuuseu und vomILIng, InLesLInuI spusm und dIurrIeu.
HeurL ruLe und bIood pressure ure eIevuLed; LIere Is
murked cIIIIIness, uILernuLIng wILI IIusIIng und
excessIve sweuLIng.
TIe uddIcL experIences wuves oI gooseIIesI, IIs skIn
resembIIng LIuL oI u pIucked Lurkey, wIIcI Is LIe busIs
oI LIe expressIon 'coId Lurkey`. AbdomInuI crumps und
puIns In LIe bones und muscIes oI LIe buck und
exLremILIes ure cIurucLerIsLIc, us ure muscIe spusms und
kIckIng movemenLs LIuL muy be LIe busIs Ior 'kIckIng
LIe IubIL`. OLIer sIgns IncIude ejucuIuLIons In men und
orgusm In women.
TIe IuIIure Lo Luke Ioods und IIuId, combIned wILI
vomILIng, sweuLIng und dIurrIeu, resuILs In murked
weIgIL Ioss und deIydruLIon. OccusIonuIIy, LIere Is
curdIovuscuIur coIIupse. (CI.q , p. 1o)
TIe experIences oI quILLIng smokers do noL remoLeIy resembIe
LIe ubove depIcLIon: RuLIer, u gumuL oI mIId sympLoms und sIgns Is
experIenced und observed us In uny emoLIonuI dIsLurbunce secondury Lo
deprIvuLIon oI u desIred objecL or IubILuuI experIence...TIe onseL und
duruLIon oI LIese wILIdruwuI sympLoms ure reporLed by dIIIerenL uuLIors
In Lerms oI duys, weeks, or monLIs, obvIousIy un InconsIsLency II one
uLLempLs Lo reIuLe LIese Lo nIcoLIne deprIvuLIon. n conLrusL Lo drugs oI
uddIcLIon, wILIdruwuI Irom Lobucco never consLILuLes u LIreuL Lo IIIe.
TIese IucLs IndIcuLe cIeurIy LIe ubsence oI pIysIcuI dependence. (SG
ReporL, 1q6q, p. z) O`Connor & SLruvInskI (1q8z) IndIcuLe LIuL
ubsLenLIon Irom smokIng cun be muInLuIned wIere IndIvIduuI
pscholoiccl needs cun be IdenLIIIed und meL.
TIe SG ReporL (1q6q) uIso noLes LIuL |I|n conLrusL Lo uddIcLIng
drugs, LIe Lendency Lo conLInue Lo Increuse LIe dose oI Lobucco Is
deIInILeIy seII-IImILIng becuuse oI LIe uppeurunce oI nIcoLIne LoxIcILy.
UndoubLedIy LIere Is u consIderubIe vurIuLIon umong IndIvIduuIs In
InIerILed cupubIIILIes Lo LoIeruLe nIcoLIne. n some IndIvIduuIs LIIs muy
compIeLeIy deprIve LIem oI LIe pIeusure oI usIng Lobucco. AILIougI some
LoIerunce Is uIso ucquIred wILI repeuLed use, LIIs Is noL suIIIcIenL Lo permIL
LIe nervous sysLem Lo be exposed Lo ever-IncreusIng nIcoLIne
concenLruLIons us Is LIe cuse wILI uddIcLIng drugs. TIIs In ILseII muy
mILIguLe uguInsL LIe deveIopmenL oI LIe udupLIve cIunges In nerve ceIIs
Other Vital Matters
wIIcI creuLe pIysIcuI dependence. (p. )
TIe SG ReporL (1q6q) uIso IndIcuLes LIuL |C|orrecLIy LIe cIronIc
use oI Lobucco us IubILuuLIon ruLIer LIun uddIcLIon currIes wILI IL no
ImpIIcuLIon LIuL LIe IubIL muy be broken eusIIy. L does, Iowever, curry
LIe ImpIIcuLIon concernIng LIe busIc nuLure oI LIe user und LIIs
dIsLIncLIon sIouId be u cIeur one. L Is generuIIy uccepLed umong
psycIIuLrIsLs LIuL uddIcLIon Lo poLenL drugs Is bused upon serIous
personuIILy deIecLs Irom underIyIng psycIoIogIc or psycIIuLrIc dIsorders
wIIcI muy become munIIesL In oLIer wuys II LIe drugs ure removed. (p.
1) L cun be udded LIuL LIe IubIL cun be very dIIIIcuIL Lo breuk sImpIy
becuuse IL Is muILI-IuceLed InvoIvIng consIderubIe memory sLrucLures over
LIme, IL provIdes sIgnIIIcunL psycIoIogIcuI beneIILs, und In psycIosocIuI
Lerms cun ucL us u dIsLInguIsIIng IucLor beLween very dIsLIncLIve
menLuIILIes.
TIe dIsLIncLIon beLween drug uddIcLIon und IubILuuLIon wus one
oI LIe Iur sLronger und reusonubIe uspecLs oI LIe SG ReporL (1q6q). L
cIeurIy dIsLInguIsIed beLween crILIcuI dIIIerences In pIurmucoIogIcuI
eIIecLs, dependency, wILIdruwuI sympLoms, LIe personuIILIes InvoIved,
coIerence oI LIougIL (menLuI IeuILI) und LIeIr reIuLIonsIIp Lo socIeLy.
CIgureLLe smokIng does noL ImpuIr cognILIve IuncLIonIng or moruI
dIscernmenL - even wIIIe u person Is smokIng. L musL uIso be kepL In
mInd LIuL uILIougI LIe SG ReporL (1q6q) uLLempLed Lo uccounL Ior
psycIoIogIcuI und socIuI IucLors In LIe smokIng IubIL, IL sLIII IeII wuy sIorL
oI muny oI LIe uspecLs consIdered In LIe secLIon Smolers cnd
Nonsmolers.
NoLwILIsLundIng LIe IImILuLIons oI LIe SG ReporL (1q6q), LIe SG
(1q88) precIpILousIy obIILeruLed Irom consIderuLIon every IndependenL
psycIoIogIcuI und socIuI uspecL Irom LIe smokIng IubIL, I.e., muLerIuIIsL
ussuuIL. mporLunLIy, LIe SG ReporL (1q6q) consIdered sLuLemenLs Lo LIe
eIIecL LIuL LIe smokIng IubIL Is muInLuIned onIy by uddIcLIon Lo nIcoLIne
Lo be bused mosLIy on ruLIonuIIzuLIons Irom smokIng beIuvIor, unuIogy Lo
oLIer IubILs InvoIvIng pIurmucoIogIcuI ugenLs und, Lo u mucI Iesser
exLenL, on esLubIIsIed scIenLIIIc IucL (p. qq); LIe urgumenL by unuIogy
LIuL LIe SG (1q88) InIIIcLed on LIe pubIIc us objecLIve wus uIso prevuIenL
uL LIe LIme oI LIe SG ReporL (1q6q) und wus dismissed us unIounded.
ArgumenLs by unuIogy, us In LIIs cuse, LrIvIuIIze wIuL ure crILIcuI
dIsLIncLIons beLween uddIcLIon und IubILuuLIon, und uIso LrIvIuIIze LIe
smoker. ArgumenLs by unuIogy cun Indeed be useIuI In IormuIuLIng noveI
IypoLIeses. However, wIen LIey ure mude In conLrudIcLIon Lo un uIreudy
exIsLIng body oI IILeruLure und evIdence, IL Is sImpIy u venLure InLo
muLerIuIIsL IoIIy.
L cun be noLed LIuL LIe SG (1q88) urgumenLuLIon Is, uguIn,
176
176
Rampant Antismoking Signifies Grave Danger
bIuck box reusonIng InvoIvIng u LrunsIerence IuIIucy, I.e., LIe entiret oI
smokIng beIuvIor Is entirel uLLrIbuLed Lo LIe uddIcLIve ucLIon oI
nIcoLIne. ReseurcIers LIuL ure domInuLed by bIoIogIcuIIy reducLIonIsL
(muLerIuIIsL) vIews oI LIe worId (e.g., PurroLL, 1qqq) ure Iorced InLo LIIs
posILIon LIrougI sIeer IncognIzunce (bIuck box) oI oLIer concepLuuI
dImensIons (e.g., psycIoIogIcuI, psycIosocIuI).
TIereIore, LIe SG (1q88) redeIInILIon oI nIcoLIne us un uddIcLIve
drug compurubIe Lo IeroIn, cocuIne und uIcoIoI Is evuIuuLed us regressIve,
I.e., removIng ter tclucble InIormuLIon Irom consIderuLIon. ubeIIng
Lobucco In LIe sume reuIm us uIcoIoI, u Iegucy oI un eurIIer, moruIIsLIc
unLIsmokIng crusude, Is uIreudy compIeLeIy quesLIonubIe In LIuL LIese
subsLunces Iuve very dIIIerenL psycIopIurmucoIogIcuI eIIecLs, purLIcuIurIy
LIe Issue oI InLoxIcuLIon und ILs socIuI rumIIIcuLIons. TIe coercIon Lo vIew
nIcoLIne us un uddIcLIve drug Lo be consIdered In LIe sume breuLI us
IeroIn und cocuIne beggurs beIIeI, uILIougI IL Is quILe consIsLenL wILI LIe
underIyIng muLerIuIIsL IdeoIogy (muLerIuIIsL munIIesLo) und LIe quesL Ior u
smokeIree worId.
L Is ussumed LIuL LIe uLLempL Lo ussocIuLe Lobucco smokIng wILI
LIe IIIIcIL und crImInuI nuLure oI Iurd drugs und LIuL LIey InvoIve some
sImIIur sLuLe Is quILe InLenLIonuI. L Is one cuImInuLIon poInL oI un ever-
growIng und dungerous muLerIuIIsL worId vIew, rIddIed wILI sysLemIc
IncompeLence und superIIcIuIILy, LIuL Ius very consIderubIe rumIIIcuLIons
Ior uppruIsuIs oI IeuILI, I.e., excIusIve use oI poor unuIogyJInIerence und
reIuLIve-rIsk us LIe crILIcuI uspecLs Ior cuusuI urgumenL. L reIIecLs no more
LIun LIe wIoIIy quesLIonubIe medIco-muLerIuIIsL uLLempL Lo dIseusIIy
und, LIereIore, monopoIIze consIderuLIons oI pIenomenu LIuL ure reuIIy
noL ILs domuIn. GIven LIuL muny In epIdemIoIogy, und LIe medIcuI
esLubIIsImenL generuIIy, Iuve erroneousIy convInced LIemseIves oI un
undersLundIng oI LIe roIe oI cIgureLLe smokIng In dIseuseJmorLuIILy und
LIe muInLenunce oI smokIng us enLIreIy u muLLer oI nIcoLIne uddIcLIon,
LIere LIen IoIIows LIe sImIIurIy erroneous requIremenL oI more drusLIc
Iorms oI remedy.
L Is noL surprIsIng LIuL LIe presIdIng Surgeon GeneruI (1q88)
decIurIng nIcoLIne us un uddIcLIve drug, C. EvereLL Koop, wusJIs u sLuuncI
unLIsmoker. L IoIIowed unoLIer reporL under IIs udmInIsLruLIon - TIe
IeuILI consequences oI InvoIunLury smokIng. (SG, 1q86) TIIs reporL wus
domInuLed by LIe wIIdesL oI unLIsmokIng specuIuLIons und bused on
muLerIuIIsL IdeoIogy (body purILunIsm). Even eurIIer sLIII, In 1q8q Koop
unnounced LIe ideoloiccl gouI oI mukIng AmerIcu smoke-Iree by LIe
yeur zooo (see OukIey, 1qqq, CI.6, p.18). TIe uddIcLIon cIurucLerIzuLIon
oI smokIng uIso coIncIded wILI LIe WorId HeuILI OrgunIzuLIon (1q88)
InILIuLIve: A -yeur ucLIon pIun: SmokeIree Europe. L Is uIso consIsLenL
Other Vital Matters
wILI u domIneerIng muLerIuIIsm (muLerIuIIsL munIIesLo) und ILs
concocLIon oI LIe rIsk uvoIdIng IndIvIduuI LIuL begun In LIe mId-1q;o`s
(BerrIdge, 1qqq).
TIe unLIsmokIng movemenL, In Lerms oI LIe currenL dIscussIon,
reIIecLs u superIorILyJsupremucIsL syndrome. L InvoIves IncompeLence,
Ignorunce, und excrucIuLIngIy poor InsIgIL. TIe menLuIILy bIurs crILIcuI
dIsLIncLIons und munuIucLures or mugnIIIes oLIers Lo suIL ILs conLorLed
IdeoIogIcuI purposes. TIe depIcLIon oI nIcoLIne us uddIcLIve serves, uIbeIL
IruuduIenLIy, u number oI unLIsmokIngJmuLerIuIIsL, und noL scIenLIIIc or
judIcIous, purposes.
IrsLIy, unubIe over uL IeusL IuII-u-cenLury Lo demonsLruLe LIe
cuusuI sLeps beLween properLIes oI Lobucco smoke und specIIIc dIseuse,
muLerIuIIsL IdeoIogy bypusses LIIs dIIemmu by sImpIy dIseusIIyIng LIe
enLIre smokIng hcbit. TIose wIo smoke ure porLruyed us sIuves Lo onIy
pIysIoIogIcuI cruvIngs LIuL ure beyond LIeIr conLroI. urLIermore, LIere
ure consIdered Lo be no beneIIcIuI or posILIve uspecLs Lo LIe IubIL, IeL uIone
wIeLIer LIese cun ouLweIgI ussIgned reIuLIve rIsk. TIereIore, uII LIose
wIo smoke ure consIdered Lo be enguged In un IrruLIonuI IubIL. More
recenLIy, LIe Ideu Is expressed us we wouId IIke Lo see IeuILI
proIessIonuIs und LIe pubIIc uccepL smokIng us u dIsorder LIuL needs Lo be
LreuLed jusL IIke uny oLIer dIseuse. AL LIe momenL smokIng Is seen us un
opLIonuI ucLIvILy. (BrILLon, quoLed In KmIeLowIcz, zooo)
WurburLon (1q8), In consIderIng vurIuLIons In uses oI LIe Lerm
uddIcLed, IndIcuLes LIuL un eurIIer deIInILIon oI LIe Lerm reIerred Lo uny
sLrong IncIInuLIon, wIeLIer good or bud. L Is onIy more recenLIy LIuL LIe
Lerm Ius specIIIcuIIy been uppIIed Lo drug use und wIere ILs ImpIIcuLIon Is
deroguLory und sLIgmuLIzIng. TIe Lerm, In LIIs sense, connoLes menLuI
InIIrmILy, Iuck oI wIIIpower. L Is un unuIogy oI LIe dIseuse modeI
(reducLIonIsm) oI beIuvIor. WurburLon (1qqob) noLes LIuL LIe smoker Is
now IIrmIy IdenLIIIed us u 'puLIenL` wILI LIe 'dIseuse oI uddIcLIon`; no
Ionger Is smokIng u rIsk IucLor Ior specIIIc dIseuse buL IL becomes u
'dIseuse` In und oI ILseII. TIIs puLIenL LIen needs medIcuI 'LreuLmenL` Lo
'cure` LIe dIseuse; ubsLInence wILIouL LreuLmenL Is 'sponLuneous
remIssIon`; reoccurrence oI smokIng uILer ubsLInence Is u 'reIupse`, u
sympLom oI LIe re-emergIng dIseuse. AII oI LIese Lerms ure sprInkIed
IIberuIIy LIrougIouL LIe SG reporL (1q88). (p.1) MedIu reporLs on
smokIng wIII InvurIubIy muke uL IeusL one reIerence Lo nIcoLIne-uddIcLed
smokers, und unLIsmokIng web sILes seem Lo use purugrupIs onIy us
muILIpIe opporLunILIes Lo reIer Lo nIcoLIne-uddIcLed smokers. TIIs
muLerIuIIsL-cuIL LIInkIng Ius so exuILed noL smokIng us u greuL moruI
vIrLue LIuL one oI LIe Iew reusons u smoker Ius Ior IIvIng Is Lo IInuIIy
uccepL nonsmokIng suIvuLIon.
177
177
Rampant Antismoking Signifies Grave Danger
bIuck box reusonIng InvoIvIng u LrunsIerence IuIIucy, I.e., LIe entiret oI
smokIng beIuvIor Is entirel uLLrIbuLed Lo LIe uddIcLIve ucLIon oI
nIcoLIne. ReseurcIers LIuL ure domInuLed by bIoIogIcuIIy reducLIonIsL
(muLerIuIIsL) vIews oI LIe worId (e.g., PurroLL, 1qqq) ure Iorced InLo LIIs
posILIon LIrougI sIeer IncognIzunce (bIuck box) oI oLIer concepLuuI
dImensIons (e.g., psycIoIogIcuI, psycIosocIuI).
TIereIore, LIe SG (1q88) redeIInILIon oI nIcoLIne us un uddIcLIve
drug compurubIe Lo IeroIn, cocuIne und uIcoIoI Is evuIuuLed us regressIve,
I.e., removIng ter tclucble InIormuLIon Irom consIderuLIon. ubeIIng
Lobucco In LIe sume reuIm us uIcoIoI, u Iegucy oI un eurIIer, moruIIsLIc
unLIsmokIng crusude, Is uIreudy compIeLeIy quesLIonubIe In LIuL LIese
subsLunces Iuve very dIIIerenL psycIopIurmucoIogIcuI eIIecLs, purLIcuIurIy
LIe Issue oI InLoxIcuLIon und ILs socIuI rumIIIcuLIons. TIe coercIon Lo vIew
nIcoLIne us un uddIcLIve drug Lo be consIdered In LIe sume breuLI us
IeroIn und cocuIne beggurs beIIeI, uILIougI IL Is quILe consIsLenL wILI LIe
underIyIng muLerIuIIsL IdeoIogy (muLerIuIIsL munIIesLo) und LIe quesL Ior u
smokeIree worId.
L Is ussumed LIuL LIe uLLempL Lo ussocIuLe Lobucco smokIng wILI
LIe IIIIcIL und crImInuI nuLure oI Iurd drugs und LIuL LIey InvoIve some
sImIIur sLuLe Is quILe InLenLIonuI. L Is one cuImInuLIon poInL oI un ever-
growIng und dungerous muLerIuIIsL worId vIew, rIddIed wILI sysLemIc
IncompeLence und superIIcIuIILy, LIuL Ius very consIderubIe rumIIIcuLIons
Ior uppruIsuIs oI IeuILI, I.e., excIusIve use oI poor unuIogyJInIerence und
reIuLIve-rIsk us LIe crILIcuI uspecLs Ior cuusuI urgumenL. L reIIecLs no more
LIun LIe wIoIIy quesLIonubIe medIco-muLerIuIIsL uLLempL Lo dIseusIIy
und, LIereIore, monopoIIze consIderuLIons oI pIenomenu LIuL ure reuIIy
noL ILs domuIn. GIven LIuL muny In epIdemIoIogy, und LIe medIcuI
esLubIIsImenL generuIIy, Iuve erroneousIy convInced LIemseIves oI un
undersLundIng oI LIe roIe oI cIgureLLe smokIng In dIseuseJmorLuIILy und
LIe muInLenunce oI smokIng us enLIreIy u muLLer oI nIcoLIne uddIcLIon,
LIere LIen IoIIows LIe sImIIurIy erroneous requIremenL oI more drusLIc
Iorms oI remedy.
L Is noL surprIsIng LIuL LIe presIdIng Surgeon GeneruI (1q88)
decIurIng nIcoLIne us un uddIcLIve drug, C. EvereLL Koop, wusJIs u sLuuncI
unLIsmoker. L IoIIowed unoLIer reporL under IIs udmInIsLruLIon - TIe
IeuILI consequences oI InvoIunLury smokIng. (SG, 1q86) TIIs reporL wus
domInuLed by LIe wIIdesL oI unLIsmokIng specuIuLIons und bused on
muLerIuIIsL IdeoIogy (body purILunIsm). Even eurIIer sLIII, In 1q8q Koop
unnounced LIe ideoloiccl gouI oI mukIng AmerIcu smoke-Iree by LIe
yeur zooo (see OukIey, 1qqq, CI.6, p.18). TIe uddIcLIon cIurucLerIzuLIon
oI smokIng uIso coIncIded wILI LIe WorId HeuILI OrgunIzuLIon (1q88)
InILIuLIve: A -yeur ucLIon pIun: SmokeIree Europe. L Is uIso consIsLenL
Other Vital Matters
wILI u domIneerIng muLerIuIIsm (muLerIuIIsL munIIesLo) und ILs
concocLIon oI LIe rIsk uvoIdIng IndIvIduuI LIuL begun In LIe mId-1q;o`s
(BerrIdge, 1qqq).
TIe unLIsmokIng movemenL, In Lerms oI LIe currenL dIscussIon,
reIIecLs u superIorILyJsupremucIsL syndrome. L InvoIves IncompeLence,
Ignorunce, und excrucIuLIngIy poor InsIgIL. TIe menLuIILy bIurs crILIcuI
dIsLIncLIons und munuIucLures or mugnIIIes oLIers Lo suIL ILs conLorLed
IdeoIogIcuI purposes. TIe depIcLIon oI nIcoLIne us uddIcLIve serves, uIbeIL
IruuduIenLIy, u number oI unLIsmokIngJmuLerIuIIsL, und noL scIenLIIIc or
judIcIous, purposes.
IrsLIy, unubIe over uL IeusL IuII-u-cenLury Lo demonsLruLe LIe
cuusuI sLeps beLween properLIes oI Lobucco smoke und specIIIc dIseuse,
muLerIuIIsL IdeoIogy bypusses LIIs dIIemmu by sImpIy dIseusIIyIng LIe
enLIre smokIng hcbit. TIose wIo smoke ure porLruyed us sIuves Lo onIy
pIysIoIogIcuI cruvIngs LIuL ure beyond LIeIr conLroI. urLIermore, LIere
ure consIdered Lo be no beneIIcIuI or posILIve uspecLs Lo LIe IubIL, IeL uIone
wIeLIer LIese cun ouLweIgI ussIgned reIuLIve rIsk. TIereIore, uII LIose
wIo smoke ure consIdered Lo be enguged In un IrruLIonuI IubIL. More
recenLIy, LIe Ideu Is expressed us we wouId IIke Lo see IeuILI
proIessIonuIs und LIe pubIIc uccepL smokIng us u dIsorder LIuL needs Lo be
LreuLed jusL IIke uny oLIer dIseuse. AL LIe momenL smokIng Is seen us un
opLIonuI ucLIvILy. (BrILLon, quoLed In KmIeLowIcz, zooo)
WurburLon (1q8), In consIderIng vurIuLIons In uses oI LIe Lerm
uddIcLed, IndIcuLes LIuL un eurIIer deIInILIon oI LIe Lerm reIerred Lo uny
sLrong IncIInuLIon, wIeLIer good or bud. L Is onIy more recenLIy LIuL LIe
Lerm Ius specIIIcuIIy been uppIIed Lo drug use und wIere ILs ImpIIcuLIon Is
deroguLory und sLIgmuLIzIng. TIe Lerm, In LIIs sense, connoLes menLuI
InIIrmILy, Iuck oI wIIIpower. L Is un unuIogy oI LIe dIseuse modeI
(reducLIonIsm) oI beIuvIor. WurburLon (1qqob) noLes LIuL LIe smoker Is
now IIrmIy IdenLIIIed us u 'puLIenL` wILI LIe 'dIseuse oI uddIcLIon`; no
Ionger Is smokIng u rIsk IucLor Ior specIIIc dIseuse buL IL becomes u
'dIseuse` In und oI ILseII. TIIs puLIenL LIen needs medIcuI 'LreuLmenL` Lo
'cure` LIe dIseuse; ubsLInence wILIouL LreuLmenL Is 'sponLuneous
remIssIon`; reoccurrence oI smokIng uILer ubsLInence Is u 'reIupse`, u
sympLom oI LIe re-emergIng dIseuse. AII oI LIese Lerms ure sprInkIed
IIberuIIy LIrougIouL LIe SG reporL (1q88). (p.1) MedIu reporLs on
smokIng wIII InvurIubIy muke uL IeusL one reIerence Lo nIcoLIne-uddIcLed
smokers, und unLIsmokIng web sILes seem Lo use purugrupIs onIy us
muILIpIe opporLunILIes Lo reIer Lo nIcoLIne-uddIcLed smokers. TIIs
muLerIuIIsL-cuIL LIInkIng Ius so exuILed noL smokIng us u greuL moruI
vIrLue LIuL one oI LIe Iew reusons u smoker Ius Ior IIvIng Is Lo IInuIIy
uccepL nonsmokIng suIvuLIon.
178
178
Rampant Antismoking Signifies Grave Danger
n more recenL medIco-muLerIuIIsL depIcLIons, nIcoLIne
dependence Is consIdered us LIe sIngIe mosL common psycIIuLrIc
dIugnosIs In LIe UnILed SLuLes. (Bergen & Cuporuso, 1qqq) TIe
dysIuncLIon oI unLIsmokIng reusonIng sLrIps uwuy persons` IIsLorIes.
TIose wIo smoke ure never reIerred Lo us peopIe, buL just nIcoLIne-
uddIcLed smokers. Rendered IncupubIe oI ruLIonuI LIougIL, LIe IuceIess
smokers ure LIen depIcLed us needIng consIderubIe ussIsLunce (coercIon)
In escupIng LIe LerrIbIe uddIcLIon so LIuL LIey muy re-enLer LIe IoILIer und
normuLIve worId occupIed by nonsmokers. As wus consIdered In LIe
eurIIer secLIon on NuzI muLerIuIIsm, smokIng cun reIIecL deIIunce (non-
conIormILy) Lo LIe ruIIng cIuss`s deIInILIve worIdvIew LIuL depIcLs
smokIng us IrruLIonuI und noL Lo be pursued - by unyone. OnIy II smokers
ure uddIcLed und LIereIore IncupubIe oI ruLIonuI LIougIL wouId LIey deIy
orders - LIere cun be no oLIer expIunuLIon In LIe superIIcIuIILy oI
muLerIuIIsL reusonIng.
SecondIy, und InLImuLeIy reIuLed Lo LIe prevIous poInL Is LIuL
persons wIo do noL enguge In subsLunce-LukIng oI uny sorL (e.g., Lobucco,
uIcoIoI, coIIee) ure depIcLed us normuI or superIor. n LIIs Is u mosL
dungerous InIerenLIuI sLep Luken. WIuL cun be gIeuned Irom IIsLory Is LIuL
LIere ure cerLuIn menLuIILIes LIuL do noL purLuke oI subsLunces buL LIuL ure
cupubIe oI mucI oI LIe worsL oI LIe Iumun poLenLIuI. TIIs menLuIILy cun
be dIsLInguIsIed wIen IL mukes noL engugIng In subsLunce-LukIng u poInL
oI IIgI moruI recLILude, e.g., NuzIs specIIIcuIIy, muLerIuIIsm generuIIy.
ncupubIe oI correcLIon, LIIs condILIon`s uddIcLIon Is Lo cIurucLer
deIIcIencIes (e.g., grundIosILy, meguIomunIu, IuugILIness, ImperIousness,
obsessIon wILI conLroI). WIIIe LIe superIIcIuI menLuIILy Is preoccupIed
wILI IncoIerenL deIInILIons oI onIy subsLunce use (muLerIuIIsm), bundIIng
uII subsLunces InLo u sInguIur psycIoucLIve group, IL dungerousIy
LrIvIuIIzes LIe psycIoucLIve or mood-uILerIng propensILy oI sensoryJ
cognILIve InIormuLIon. or exumpIe, IuLe-mongerIng, obsessIon wILI
conLroI, IuugILIness ure LIemseIves uspecLs oI un unsLubIe menLuIILy LIuL
cun produce deLrImenLuI uILeruLIons In mood In LIose LIuL LIIs conducL Is
InIIIcLed upon.
TIIs poInL Ius never been ruIsed In LIuL LIe unLIsmokIng
menLuIILy Is LypIcuIIy never scruLInIzed. SucI menLuIILIes ure In denIuI und
projecLIon oI conLorLed LIougIL oI vuryIng degrees oI severILy. As LIe
severILy oI conLorLed LIougIL und ILs projecLIon onLo smokers becomes
more deIuded, IL mukes LIe smoker uppeur more deIusIonuI. TIereIore,
wIuL begun us u vIew LIuL LIe IubIL oI smokIng, now reIerred Lo us un
uddIcLIon, reIIecLed cn IrruLIonuI ucL LIen becomes un uddIcLIon LIuL
uIIecLs uII oI u smoker`s reusonIng, I.e., u smoker Is IncupubIe oI uny
ruLIonuI LIougIL unLII LIey ure suved Irom LIe uddIcLIon. TIe InLerneL Is
Other Vital Matters
repIeLe wILI unLIsmokIng websILes expressIng LIese deIuded beIIeIs.
AguIn, LIe exLenL oI deIusIon expressed does noL reIIecL LIe smoker buL
LIe unLIsmoker`s InLernuI sLuLe beIng projecLed onLo LIe smoker.
TIIs Is sucI u crucIuI poInL LIuL IL wurrunLs IurLIer deveIopmenL.
GoodIn (1q8q) Is un exceIIenL exumpIe oI LIe currenL unLIsmokIng
menLuIILy und wIere muny oI IIs Ideus Iuve been Luken up by LIe
unLIsmokIng crusude over LIe IusL decude. Muny recommenduLIons were
mude In LIIs work regurdIng proLecLIng nonsmokers Irom ETS weII beIore
LIe resuILs oI LIe IIrsL oIIIcIuI InvesLIguLIon InLo ETS In 1qq. IIp-IIoppIng
beLween smokIng us un uddIcLIon or us u cognILIve deIecL, LIe generuI
rIeLorIc Is LIuL normuI nonsmokers sIouId be suved Irom smokers, und
smokers sIouId be suved Irom LIemseIves. GoodIn, supposedIy u moruI
pIIIosopIer, Is reuIIy u muLerIuIIsL LryIng Lo buIId u moruIILy Irom
sLuLIsLIcuI nonsense und medIcuI rIeLorIc. UnIorLunuLeIy, IIs greuL IoIIy, us
wILI muny, Is LIe ussumpLIon LIuL uII or uny oI LIe medIcuI InIormuLIon
und concIusIons on wIIcI IIs urgumenLs ure bused ure scIoIurIy, uccuruLe,
und deIInILIve. urLIermore, LIe muLerIuIIsm Is obvIousIy devoId oI u
coIerenL psycIoIogy, socIuI psycIoIogy, or moruIILy. As wIII be consIdered
In u IuLer cIupLer, moruIILy In, suy, CIrIsLIun Lerms InvoIves u jcr more
proIound sLundurd oI LIougIL und conducL. AnoLIer crILIcuI IIuw Is LIe
ussumpLIon LIuL nonsmokIng Is normuI. TIIs proposILIon cun onIy be
mude In u smokIngJnonsmokIng dIcIoLomy devoId oI uny greuLer conLexL,
purLIcuIurIy u moruI one. AII oI LIese probIems ure InLerconnecLed und
derIve Irom u muLerIuIIsL worIdvIew LIuL never geLs beyond superIIcIuIILy.
RuLIer LIun Leuse ouL coIerenL LIemes Irom u LungIed mess, GoodIn
(1q8q) LIrougI u reIIunce on LIe sLuLIsLIcuIIsm oI medIco-muLerIuIIsm,
udds, LIrougI u voIumInous work, IurLIer Iuyers oI deIuded, seII-servIng,
ImmoruI LIougIL Lo un uIreudy IeebIe LIInkIng und mude Lo uppeur us u
greuL moruI reckonIng.
WIIIe LIere Is no InIIbILIon In LIe wIoIesuIe sIunder oI smokers
In compurIson Lo normuI nonsmokers, IL Is LIe very LIInkIng LIuL
GoodIn Is usIng und reInIorcIng LIuL Is deIIcIenL In muny und dungerous
regurds. TIe muLerIuIIsm underIyIng unLIsmokIng Ius buLcIered
scIenLIIIc enquIry beyond recognILIon, Ius udded wIoIIy new dImensIons
Lo LIe ubuse oI sLuLIsLIcuI InIormuLIon (sLuLIsLIcuIIsm), Ius no
psycIoIogIcuI or psycIosocIuI sensIbIIILy demonsLruLed In LIe sIeer euse
und obIIvIousness wILI wIIcI IL IosLers deIuded beIIeI und socIuI dIvIsIon
In ILs IdeoIogIcuI quesL, Is moruIIy reckIess In LIe exLreme,
demonsLruLIng LIe IuII suIL oI dungerous LendencIes oI LIe Iumun
condILIon (e.g., obsessIon wILI conLroI, IncupucILy Ior crILIcuI seII-scruLIny,
IuugILIness, ImperIousness). L Is LIe menLuIILy LIuL wouId reduce LIe
smoker InLo LIe reuIm oI LIe cognILIveIy deIecLIve LIuL demonsLruLes
179
179
Rampant Antismoking Signifies Grave Danger
n more recenL medIco-muLerIuIIsL depIcLIons, nIcoLIne
dependence Is consIdered us LIe sIngIe mosL common psycIIuLrIc
dIugnosIs In LIe UnILed SLuLes. (Bergen & Cuporuso, 1qqq) TIe
dysIuncLIon oI unLIsmokIng reusonIng sLrIps uwuy persons` IIsLorIes.
TIose wIo smoke ure never reIerred Lo us peopIe, buL just nIcoLIne-
uddIcLed smokers. Rendered IncupubIe oI ruLIonuI LIougIL, LIe IuceIess
smokers ure LIen depIcLed us needIng consIderubIe ussIsLunce (coercIon)
In escupIng LIe LerrIbIe uddIcLIon so LIuL LIey muy re-enLer LIe IoILIer und
normuLIve worId occupIed by nonsmokers. As wus consIdered In LIe
eurIIer secLIon on NuzI muLerIuIIsm, smokIng cun reIIecL deIIunce (non-
conIormILy) Lo LIe ruIIng cIuss`s deIInILIve worIdvIew LIuL depIcLs
smokIng us IrruLIonuI und noL Lo be pursued - by unyone. OnIy II smokers
ure uddIcLed und LIereIore IncupubIe oI ruLIonuI LIougIL wouId LIey deIy
orders - LIere cun be no oLIer expIunuLIon In LIe superIIcIuIILy oI
muLerIuIIsL reusonIng.
SecondIy, und InLImuLeIy reIuLed Lo LIe prevIous poInL Is LIuL
persons wIo do noL enguge In subsLunce-LukIng oI uny sorL (e.g., Lobucco,
uIcoIoI, coIIee) ure depIcLed us normuI or superIor. n LIIs Is u mosL
dungerous InIerenLIuI sLep Luken. WIuL cun be gIeuned Irom IIsLory Is LIuL
LIere ure cerLuIn menLuIILIes LIuL do noL purLuke oI subsLunces buL LIuL ure
cupubIe oI mucI oI LIe worsL oI LIe Iumun poLenLIuI. TIIs menLuIILy cun
be dIsLInguIsIed wIen IL mukes noL engugIng In subsLunce-LukIng u poInL
oI IIgI moruI recLILude, e.g., NuzIs specIIIcuIIy, muLerIuIIsm generuIIy.
ncupubIe oI correcLIon, LIIs condILIon`s uddIcLIon Is Lo cIurucLer
deIIcIencIes (e.g., grundIosILy, meguIomunIu, IuugILIness, ImperIousness,
obsessIon wILI conLroI). WIIIe LIe superIIcIuI menLuIILy Is preoccupIed
wILI IncoIerenL deIInILIons oI onIy subsLunce use (muLerIuIIsm), bundIIng
uII subsLunces InLo u sInguIur psycIoucLIve group, IL dungerousIy
LrIvIuIIzes LIe psycIoucLIve or mood-uILerIng propensILy oI sensoryJ
cognILIve InIormuLIon. or exumpIe, IuLe-mongerIng, obsessIon wILI
conLroI, IuugILIness ure LIemseIves uspecLs oI un unsLubIe menLuIILy LIuL
cun produce deLrImenLuI uILeruLIons In mood In LIose LIuL LIIs conducL Is
InIIIcLed upon.
TIIs poInL Ius never been ruIsed In LIuL LIe unLIsmokIng
menLuIILy Is LypIcuIIy never scruLInIzed. SucI menLuIILIes ure In denIuI und
projecLIon oI conLorLed LIougIL oI vuryIng degrees oI severILy. As LIe
severILy oI conLorLed LIougIL und ILs projecLIon onLo smokers becomes
more deIuded, IL mukes LIe smoker uppeur more deIusIonuI. TIereIore,
wIuL begun us u vIew LIuL LIe IubIL oI smokIng, now reIerred Lo us un
uddIcLIon, reIIecLed cn IrruLIonuI ucL LIen becomes un uddIcLIon LIuL
uIIecLs uII oI u smoker`s reusonIng, I.e., u smoker Is IncupubIe oI uny
ruLIonuI LIougIL unLII LIey ure suved Irom LIe uddIcLIon. TIe InLerneL Is
Other Vital Matters
repIeLe wILI unLIsmokIng websILes expressIng LIese deIuded beIIeIs.
AguIn, LIe exLenL oI deIusIon expressed does noL reIIecL LIe smoker buL
LIe unLIsmoker`s InLernuI sLuLe beIng projecLed onLo LIe smoker.
TIIs Is sucI u crucIuI poInL LIuL IL wurrunLs IurLIer deveIopmenL.
GoodIn (1q8q) Is un exceIIenL exumpIe oI LIe currenL unLIsmokIng
menLuIILy und wIere muny oI IIs Ideus Iuve been Luken up by LIe
unLIsmokIng crusude over LIe IusL decude. Muny recommenduLIons were
mude In LIIs work regurdIng proLecLIng nonsmokers Irom ETS weII beIore
LIe resuILs oI LIe IIrsL oIIIcIuI InvesLIguLIon InLo ETS In 1qq. IIp-IIoppIng
beLween smokIng us un uddIcLIon or us u cognILIve deIecL, LIe generuI
rIeLorIc Is LIuL normuI nonsmokers sIouId be suved Irom smokers, und
smokers sIouId be suved Irom LIemseIves. GoodIn, supposedIy u moruI
pIIIosopIer, Is reuIIy u muLerIuIIsL LryIng Lo buIId u moruIILy Irom
sLuLIsLIcuI nonsense und medIcuI rIeLorIc. UnIorLunuLeIy, IIs greuL IoIIy, us
wILI muny, Is LIe ussumpLIon LIuL uII or uny oI LIe medIcuI InIormuLIon
und concIusIons on wIIcI IIs urgumenLs ure bused ure scIoIurIy, uccuruLe,
und deIInILIve. urLIermore, LIe muLerIuIIsm Is obvIousIy devoId oI u
coIerenL psycIoIogy, socIuI psycIoIogy, or moruIILy. As wIII be consIdered
In u IuLer cIupLer, moruIILy In, suy, CIrIsLIun Lerms InvoIves u jcr more
proIound sLundurd oI LIougIL und conducL. AnoLIer crILIcuI IIuw Is LIe
ussumpLIon LIuL nonsmokIng Is normuI. TIIs proposILIon cun onIy be
mude In u smokIngJnonsmokIng dIcIoLomy devoId oI uny greuLer conLexL,
purLIcuIurIy u moruI one. AII oI LIese probIems ure InLerconnecLed und
derIve Irom u muLerIuIIsL worIdvIew LIuL never geLs beyond superIIcIuIILy.
RuLIer LIun Leuse ouL coIerenL LIemes Irom u LungIed mess, GoodIn
(1q8q) LIrougI u reIIunce on LIe sLuLIsLIcuIIsm oI medIco-muLerIuIIsm,
udds, LIrougI u voIumInous work, IurLIer Iuyers oI deIuded, seII-servIng,
ImmoruI LIougIL Lo un uIreudy IeebIe LIInkIng und mude Lo uppeur us u
greuL moruI reckonIng.
WIIIe LIere Is no InIIbILIon In LIe wIoIesuIe sIunder oI smokers
In compurIson Lo normuI nonsmokers, IL Is LIe very LIInkIng LIuL
GoodIn Is usIng und reInIorcIng LIuL Is deIIcIenL In muny und dungerous
regurds. TIe muLerIuIIsm underIyIng unLIsmokIng Ius buLcIered
scIenLIIIc enquIry beyond recognILIon, Ius udded wIoIIy new dImensIons
Lo LIe ubuse oI sLuLIsLIcuI InIormuLIon (sLuLIsLIcuIIsm), Ius no
psycIoIogIcuI or psycIosocIuI sensIbIIILy demonsLruLed In LIe sIeer euse
und obIIvIousness wILI wIIcI IL IosLers deIuded beIIeI und socIuI dIvIsIon
In ILs IdeoIogIcuI quesL, Is moruIIy reckIess In LIe exLreme,
demonsLruLIng LIe IuII suIL oI dungerous LendencIes oI LIe Iumun
condILIon (e.g., obsessIon wILI conLroI, IncupucILy Ior crILIcuI seII-scruLIny,
IuugILIness, ImperIousness). L Is LIe menLuIILy LIuL wouId reduce LIe
smoker InLo LIe reuIm oI LIe cognILIveIy deIecLIve LIuL demonsLruLes
180
180
Rampant Antismoking Signifies Grave Danger
deIIcIency on u grund, muILI-dImensIonuI, und dungerous scuIe.
O`ConneII (1qqo), IoIIowIng on LIe IeeIs oI LIe SG ReporL (1q88),
Is even more IorLIrIgIL In sIunderous cIuIms. A book descrIpLIon
IndIcuLes: L Is uIso InLended Ior LIerupIsLs und oLIer curegIvers wIo muy
Iuve LIe opporLunILy Lo LreuL or InLervene wILI nIcoLIne-uddIcLed peopIe.
n uddILIon, IL cun be used by IrIends und IumIIy members oI Lobucco
uddIcLs Lo HEP MOTVATE THE MPARED PERSON Lo kIck LIe
IurmIuI IubIL. TIe uuLIor proposes: TIe LruLI Is LIuL Lobucco uddIcLIon
Is u deudIy dIseuse. AppurenLIy, some zo,ooo copIes oI LIIs bookIeL were
soId In LIe IIrsL Iew yeurs oI pubIIcuLIon; IL seems Lo Iuve deLrImenLuIIy
InIIuenced muny LIerupIsLs. TIe dungerous Ideu LIuL Is consIsLenLIy
reInIorced Is LIuL persons noL uddIcLed Lo subsLunces ure normuI or
superIor. One oI LIe mujor LIemes In LIIs dIscussIon Is LIuL LIose persons
wIo wouId LrunsIorm non-uddIcLIon Lo soIL subsLunces (e.g., Lobucco,
cuIIeIne, sugur) InLo u poInL oI IIgI-moruI recLILude ure ImpuIred.
n LIe muLerIuIIsL Irumework IeuILI Is reduced Lo un ubsence oI
dIseuse sLuLe, devoId oI uny coIerenL psycIoIogy, socIuI psycIoIogy or
moruIILy (I.e., sLuLIsLIcuIIsmJIeuILIIsm). L LIen uses Iong-odds rIsk IucLors
propuguLed In ubsoIuLIsL Lerms und musqueruded us scIenLIIIcuIIy credIbIe.
TIIs cun onIy produce supersLILIous beIIeI on u muss scuIe. IIe und LIe
pursuIL oI IeuILI Is deIIned us u Iong serIes oI gumbIes oI quesLIonubIe
cuusuI sLuLus (I.e., prevenLIve medIcIne). WILIIn LIIs senseIess Irumework
LIe smoker, wIo Is nIcoLIne-uddIcLed und In vIoIuLIon oI LIe gumbIIng
edIcL, Is consIdered us one wIo does noL vuIue IeuILI. TIIs unIorLunuLeIy
opens LIe door Lo denIuI oI IeuILI cure (see Persuud, 1qq). TIe sume sLep
wus conLempIuLed In NuzI Germuny. TIe IucL oI LIe muLLer Is LIuL IL Is
medIco-muLerIuIIsm LIuL demonsLruLes u dungerousIy unIeuILIy
worIdvIew wIere LIe Iumun Is sLrIpped oI LIe crILIcuI Iumun dImensIons
(psycIoIogy, reIuLIonsIIp, moruIILy). L demonsLruLes IIucLuuLIons beLween
superIorIsL und supremucIsL sLunces Ior wIIcI LIere Is no busIs; LIe
menLuIILy Is cIeurIy InIerIor, InepL und IncompeLenL.
TIIrdIy, LIIs uddIcLIve modeI oI smokIng uIso serves un economIc
uspecL oI muLerIuIIsm. HuvIng convInced smokers LIuL LIey ure onl
uddIcLed Lo nIcoLIne, I.e., smokIng Ius no oLIer subsLunLIve uspecL, LIen
quILLIng LIe IubIL cun onIy occur LIrougI LIe Lemporury subsLILuLIon oI
nIcoLIne In oLIer Iorms (e.g., cIewIng gum, puLcIes). PeeIe (1q8q)
reusonubIy noLes LIuL severuI pIurmuceuLIcuI compunIes und muny
medIcuI progrums now muke use oI LIe Ideu LIuL smokIng Is un uddIcLIon
Lo wurn smokers LIuL LIey cun never possIbIy quIL wILIouL medIcuI IeIp
sInce smokIng - IIke drug uddIcLIon - InvoIves pIysIcuI dependence on u
drug .. TIe smokIng IndusLry Is Loo vusL und LIe number oI smokers
wIsIIng Lo quIL Loo IucruLIve Ior smokIng Lo be overIooked us u medIcuI
Other Vital Matters
probIem. (p.11;)
NoL onIy does LIe uddIcLIon modeI IuII Lo uccounL Ior LIe
smoker`s IuIrIy precIse conLroI oI limited InLuke oI nIcoLIne und LIe
psycIoIogIcuI und psycIosocIuI uspecLs oI LIe smokIng IubIL, IL uIso IuIIs
Lo uccounL Ior LIe IIsLory oI quILLIng LIe IubIL. Moss (1q68), un
unLIsmokIng cumpuIgner, IndIcuLes LIuL WIen LIe reporL oI LIe Surgeon
GeneruI`s AdvIsory CommILLee cume ouL In Junuury, 1q6q, IL mude more
LIun u soIL IundIng. MIIIIons oI peopIe sLopped smokIng cIgureLLes Ior u
week or u monLI or even u yeur. QuILe u subsLunLIuI number quIL
permunenLIy. L cun uIso be suId, und conLrurIIy Lo LIe uddIcLIve modeI,
LIuL muny dId so wILIouL medIcuI ussIsLunce (e.g., uILernuLIve nIcoLIne
udmInIsLruLIonJsubsLILuLIon) oI uny sorL.
urLIermore, LIe eIIecLIveness oI uILernuLIve nIcoLIne
udmInIsLruLIon Is very poor. L Is usuuIIy presenLed In medIu
udverLIsemenLs In Lerms oI relctite success, e.g., u smoker Is LwIce us
IIkeIy Lo quIL wILI nIcoLIne cIewIng gum LIun coId Lurkey. However,
wIen LIe predIcLIve (ubsoIuLe) sLrengLI oI uILernuLIve nIcoLIne
udmInIsLruLIon Is consIdered, u dIIIerenL LIeme emerges. or exumpIe, LIe
ubsLInence ruLe over one ecr Is ubouL 18% LIrougI use oI nIcoLIne
cIewIng gumJpuLcIes compured Lo 1% ubsLInence Ior persons noL
receIvIng nIcoLIne repIucemenL LIerupy (ScIuuIIIer eL uI., zoo1). Jorenby
eL uI. (1qqq) Iound LIuL LIe ubsLInence ruLe uL one yeur wus 16.q% Ior
nIcoLIne repIucemenL LIerupy compured Lo 1.6% Ior LIe pIucebo group.
AccounLIng Ior LIe pIucebo buseIIne, LIIs eIIecLIveness ruLe Is exLremeIy
poor - purLIcuIurIy ij nIcoLIne Is LIe onIy ucLIve uspecL oI smokIng, I.e., LIIs
uIso does noL supporL un uddIcLIve modeI. I nIcoLIne uddIcLIon Is LIe
crILIcuI uspecL oI smokIng, LIen LIere Is uIso u IuIIure Lo expIuIn wIy LIe
pIucebo eIIecL Is so IIgI.
Muny (e.g., MoxIum, zooo) recognIze LIuL LIe eIIecLIveness oI
nIcoLIne repIucemenL Is very poor. However, LIey uLLempL Lo compIeLeIy
expIuIn LIIs uwuy In Lerms oI LIe cIgureLLe beIng u wonderIuIIy eIIIcIenL
nIcoLIne deIIvery devIce LIuL gum or puLcIes cunnoL compeLe wILI. L
sIouId be noLed LIuL nIcoLIne repIucemenL wus expecLed, c priori, Lo be
IIgIIy eIIecLIve. uIIure oI LIIs expecLuLIon Ius resuILed In wIId
specuIuLIons, I.e., cerLuInIy noL ImpIIed by uny duLu seL, wILIIn u
reducLIonIsL Irumework concernIng nIcoLIne deIIvery und u conLInuIng
obIIvIousness Lo psycIoIogIcuI und psycIosocIuI IucLors.
ReIupses beyond one yeur oI ubsLInence Is LIe mujor probIem
wILI quILLIng smokIng. BernsLeIn (1q6q), In revIewIng u IIurry oI reseurcI
ucLIvILy InLo smokIng cessuLIon IoIIowIng LIe SG ReporL (1q6q), concIuded
LIuL LIe desIgn und meLIodoIogy empIoyed In mosL smokIng-
modIIIcuLIon reseurcI ure so poor LIuL LIe duLu generuLed ure noL
181
181
Rampant Antismoking Signifies Grave Danger
deIIcIency on u grund, muILI-dImensIonuI, und dungerous scuIe.
O`ConneII (1qqo), IoIIowIng on LIe IeeIs oI LIe SG ReporL (1q88),
Is even more IorLIrIgIL In sIunderous cIuIms. A book descrIpLIon
IndIcuLes: L Is uIso InLended Ior LIerupIsLs und oLIer curegIvers wIo muy
Iuve LIe opporLunILy Lo LreuL or InLervene wILI nIcoLIne-uddIcLed peopIe.
n uddILIon, IL cun be used by IrIends und IumIIy members oI Lobucco
uddIcLs Lo HEP MOTVATE THE MPARED PERSON Lo kIck LIe
IurmIuI IubIL. TIe uuLIor proposes: TIe LruLI Is LIuL Lobucco uddIcLIon
Is u deudIy dIseuse. AppurenLIy, some zo,ooo copIes oI LIIs bookIeL were
soId In LIe IIrsL Iew yeurs oI pubIIcuLIon; IL seems Lo Iuve deLrImenLuIIy
InIIuenced muny LIerupIsLs. TIe dungerous Ideu LIuL Is consIsLenLIy
reInIorced Is LIuL persons noL uddIcLed Lo subsLunces ure normuI or
superIor. One oI LIe mujor LIemes In LIIs dIscussIon Is LIuL LIose persons
wIo wouId LrunsIorm non-uddIcLIon Lo soIL subsLunces (e.g., Lobucco,
cuIIeIne, sugur) InLo u poInL oI IIgI-moruI recLILude ure ImpuIred.
n LIe muLerIuIIsL Irumework IeuILI Is reduced Lo un ubsence oI
dIseuse sLuLe, devoId oI uny coIerenL psycIoIogy, socIuI psycIoIogy or
moruIILy (I.e., sLuLIsLIcuIIsmJIeuILIIsm). L LIen uses Iong-odds rIsk IucLors
propuguLed In ubsoIuLIsL Lerms und musqueruded us scIenLIIIcuIIy credIbIe.
TIIs cun onIy produce supersLILIous beIIeI on u muss scuIe. IIe und LIe
pursuIL oI IeuILI Is deIIned us u Iong serIes oI gumbIes oI quesLIonubIe
cuusuI sLuLus (I.e., prevenLIve medIcIne). WILIIn LIIs senseIess Irumework
LIe smoker, wIo Is nIcoLIne-uddIcLed und In vIoIuLIon oI LIe gumbIIng
edIcL, Is consIdered us one wIo does noL vuIue IeuILI. TIIs unIorLunuLeIy
opens LIe door Lo denIuI oI IeuILI cure (see Persuud, 1qq). TIe sume sLep
wus conLempIuLed In NuzI Germuny. TIe IucL oI LIe muLLer Is LIuL IL Is
medIco-muLerIuIIsm LIuL demonsLruLes u dungerousIy unIeuILIy
worIdvIew wIere LIe Iumun Is sLrIpped oI LIe crILIcuI Iumun dImensIons
(psycIoIogy, reIuLIonsIIp, moruIILy). L demonsLruLes IIucLuuLIons beLween
superIorIsL und supremucIsL sLunces Ior wIIcI LIere Is no busIs; LIe
menLuIILy Is cIeurIy InIerIor, InepL und IncompeLenL.
TIIrdIy, LIIs uddIcLIve modeI oI smokIng uIso serves un economIc
uspecL oI muLerIuIIsm. HuvIng convInced smokers LIuL LIey ure onl
uddIcLed Lo nIcoLIne, I.e., smokIng Ius no oLIer subsLunLIve uspecL, LIen
quILLIng LIe IubIL cun onIy occur LIrougI LIe Lemporury subsLILuLIon oI
nIcoLIne In oLIer Iorms (e.g., cIewIng gum, puLcIes). PeeIe (1q8q)
reusonubIy noLes LIuL severuI pIurmuceuLIcuI compunIes und muny
medIcuI progrums now muke use oI LIe Ideu LIuL smokIng Is un uddIcLIon
Lo wurn smokers LIuL LIey cun never possIbIy quIL wILIouL medIcuI IeIp
sInce smokIng - IIke drug uddIcLIon - InvoIves pIysIcuI dependence on u
drug .. TIe smokIng IndusLry Is Loo vusL und LIe number oI smokers
wIsIIng Lo quIL Loo IucruLIve Ior smokIng Lo be overIooked us u medIcuI
Other Vital Matters
probIem. (p.11;)
NoL onIy does LIe uddIcLIon modeI IuII Lo uccounL Ior LIe
smoker`s IuIrIy precIse conLroI oI limited InLuke oI nIcoLIne und LIe
psycIoIogIcuI und psycIosocIuI uspecLs oI LIe smokIng IubIL, IL uIso IuIIs
Lo uccounL Ior LIe IIsLory oI quILLIng LIe IubIL. Moss (1q68), un
unLIsmokIng cumpuIgner, IndIcuLes LIuL WIen LIe reporL oI LIe Surgeon
GeneruI`s AdvIsory CommILLee cume ouL In Junuury, 1q6q, IL mude more
LIun u soIL IundIng. MIIIIons oI peopIe sLopped smokIng cIgureLLes Ior u
week or u monLI or even u yeur. QuILe u subsLunLIuI number quIL
permunenLIy. L cun uIso be suId, und conLrurIIy Lo LIe uddIcLIve modeI,
LIuL muny dId so wILIouL medIcuI ussIsLunce (e.g., uILernuLIve nIcoLIne
udmInIsLruLIonJsubsLILuLIon) oI uny sorL.
urLIermore, LIe eIIecLIveness oI uILernuLIve nIcoLIne
udmInIsLruLIon Is very poor. L Is usuuIIy presenLed In medIu
udverLIsemenLs In Lerms oI relctite success, e.g., u smoker Is LwIce us
IIkeIy Lo quIL wILI nIcoLIne cIewIng gum LIun coId Lurkey. However,
wIen LIe predIcLIve (ubsoIuLe) sLrengLI oI uILernuLIve nIcoLIne
udmInIsLruLIon Is consIdered, u dIIIerenL LIeme emerges. or exumpIe, LIe
ubsLInence ruLe over one ecr Is ubouL 18% LIrougI use oI nIcoLIne
cIewIng gumJpuLcIes compured Lo 1% ubsLInence Ior persons noL
receIvIng nIcoLIne repIucemenL LIerupy (ScIuuIIIer eL uI., zoo1). Jorenby
eL uI. (1qqq) Iound LIuL LIe ubsLInence ruLe uL one yeur wus 16.q% Ior
nIcoLIne repIucemenL LIerupy compured Lo 1.6% Ior LIe pIucebo group.
AccounLIng Ior LIe pIucebo buseIIne, LIIs eIIecLIveness ruLe Is exLremeIy
poor - purLIcuIurIy ij nIcoLIne Is LIe onIy ucLIve uspecL oI smokIng, I.e., LIIs
uIso does noL supporL un uddIcLIve modeI. I nIcoLIne uddIcLIon Is LIe
crILIcuI uspecL oI smokIng, LIen LIere Is uIso u IuIIure Lo expIuIn wIy LIe
pIucebo eIIecL Is so IIgI.
Muny (e.g., MoxIum, zooo) recognIze LIuL LIe eIIecLIveness oI
nIcoLIne repIucemenL Is very poor. However, LIey uLLempL Lo compIeLeIy
expIuIn LIIs uwuy In Lerms oI LIe cIgureLLe beIng u wonderIuIIy eIIIcIenL
nIcoLIne deIIvery devIce LIuL gum or puLcIes cunnoL compeLe wILI. L
sIouId be noLed LIuL nIcoLIne repIucemenL wus expecLed, c priori, Lo be
IIgIIy eIIecLIve. uIIure oI LIIs expecLuLIon Ius resuILed In wIId
specuIuLIons, I.e., cerLuInIy noL ImpIIed by uny duLu seL, wILIIn u
reducLIonIsL Irumework concernIng nIcoLIne deIIvery und u conLInuIng
obIIvIousness Lo psycIoIogIcuI und psycIosocIuI IucLors.
ReIupses beyond one yeur oI ubsLInence Is LIe mujor probIem
wILI quILLIng smokIng. BernsLeIn (1q6q), In revIewIng u IIurry oI reseurcI
ucLIvILy InLo smokIng cessuLIon IoIIowIng LIe SG ReporL (1q6q), concIuded
LIuL LIe desIgn und meLIodoIogy empIoyed In mosL smokIng-
modIIIcuLIon reseurcI ure so poor LIuL LIe duLu generuLed ure noL
182
182
Rampant Antismoking Signifies Grave Danger
meunIngIuI. A crucIuI uspecL oI LIe probIem - LIe need Ior Iong-Lerm
muInLenunce oI non-smokIng - Is IurgeIy Ignored, wILI LIe resuIL LIuL
mucI currenL reseurcI Is IoIIowIng u dIrecLIonIess or, uL besL, cIrcuIur
course. (p.q18) ConLemporury reseurcI suIIers Irom LIe sume cIrcuIurILy,
usuuIIy onIy evuIuuLIng, In seII-servIng IusIIon, eIIecLIveness oI
LreuLmenL up Lo one yeur.
One oI LIe more recenL conLrIbuLIons by LIe pIurmuceuLIcuI
esLubIIsImenL Ius been bupropIon (Zybun), u mIId unLI-depressunL, LIuL
some Iuve urguubIy suggesLed Is u nIcoLIne unLugonIsL (e.g., SIemmer eL
uI., zooo). L sIouId be recognIzed LIuL bupropIon wus noL specIIIcuIIy
deveIoped wILI smokIng cessuLIon In mInd. TIe possIbIe connecLIon Lo
smokIng cessuLIon occurred serendIpILousIy LIrougI LIe observuLIon LIuL
some Ieuvy-smokIng psycIIuLrIc puLIenLs LIuL were prescrIbed bupropIon
Ior depressIon Lended Lo smoke Iess. TIe urgumenL Iere Is LIuL some
Ieuvy smokers muy be seII-medIcuLIng wILI nIcoLIne Lo reIIeve sympLoms
oI depressIon. TIereIore, bupropIon muy possIbIy subsLILuLe Ior nIcoLIne
durIng und uILer wILIdruwuI (see uIso GoIdsLeIn, 1qqq, p.11;).
HurL eL uI. (1qq;) Iound LIuL LIe ubsLInence ruLe uL one yeur Ior
LIe IIgIesL dosuge oI bupropIon (oomg) wus z.1% compured Lo pIucebo
oI 1z.q%. TIIs reIIecLed u consIderubIe drop Irom un ubsLInence ruLe uILer
6 weeks oI qq.z% Ior bupropIon (oomg) compured Lo 1q% Ior LIe
pIucebo group. AccounLIng Ior u pIucebo buseIIne, LIIs ubsLInence ruLe Ior
bupropIon uL one yeur Is noL IIgI. Jorenby eL uI. (1qqq) Iound u IIgIer
ruLe oI ubsLInence uL one yeur oI o.% Ior LIe bupropIon LreuLmenL
compured Lo u pIucebo oI 1.6%. One crILIcuI dIIIerence beLween HurL eL
uI. (1qq;) und Jorenby eL uI. (1qqq) Is LIuL In LIe Iormer sLudy onIy brIeI
counseIIng wus provIded uL InLervuIs over LIe yeur, wIIIe In LIe IuLLer
sLudy Iur more InLensIve counseIIng wus empIoyed. However, LIe Issue oI
Ionger-Lerm reIupse Is usuuIIy bypussed by LIe reseurcI - und LIe
pIurmuceuLIcuI compunIes. OLIers Iuve urgued LIuL bupropIon reseurcI
oversLuLes eIIecLIveness und undersLuLes poLenLIuI sIde eIIecLs (e.g.,
HurrIson, zoo1; KInneII, zoo1), purLIcuIurIy In LIe LreuLmenL oI u rIsk
IucLor (smokIng) us opposed Lo dIseuse. TIere ure very consIderubIe sIde-
eIIecLs In buproprIon use. A recenL newspuper urLIcIe noLes: Overdoses oI
LIe unLI-smokIng drug Zybun resuILed In seIzures, IuIIucInuLIons und sucI
exLreme uggressIon LIuL some puLIenLs needed seduLIon, u sLudy Ius
Iound...LIe sLudy wus bused on cuIIs Lo LIe PoIsons nIormuLIon CenLre,
wIIcI Lukes cuIIs Irom uround AusLruIIu, beLween November zooo und
JuIy zoo1. (Hercld,Sun, z;J11Joz, p.1o)
Very recenL reseurcI IndIcuLes even poorer ubsLInence ruLes LIun
LIose noLed ubove:
TIe conLroversIuI unLI-smokIng drug Zybun, wIIcI Ius
Other Vital Matters
cosL Luxpuyers more LIun $|A|1oo mIIIIon |Zybun Is
subsIdIzed by LIe AusLruIIun Luxpuyer on LIe
PIurmuceuLIcuI BeneIILs ScIeme|, Is IneIIecLIve In some
smokers, u sLudy Ius Iound.
ReseurcIers In LIe US und Cunudu Iound LIuL Zybun
wus neILIer eIIecLIve In peopIe wIo Iud recenLIy IuIIed
Lo quIL usIng nIcoLIne puLcIes nor IeIped LIose wIo Iud
quIL usIng puLcIes Lo sLIck Lo LIeIr resoIve, LIe 1ourncl
oj Cliniccl Dncolo reporLed.
AImosL oo,ooo prescrIpLIons Ior Zybun Iuve been
wrILLen In AusLruIIu sInce LIe drug wus IIsLed on LIe
PIurmuceuLIcuI BeneIILs ScIeme In zoo1.
Tuxpuyers IooL mosL oI LIe bIII Ior LIe LubIeLs, wIIcI
cosL $|A|z8.8q u puckeL.
JusL per cenL oI LIe 6oo smokers wIo purLIcIpuLed In
LIe NorLI AmerIcun sLudy were IeIped by LIe drug In
LIeIr eIIorLs Lo quIL.
A spokesmun Ior GIuxoSmILIKIIne LoId Austrclicn
Doctor LIe sLudy dId noL reIIecL LIe wIde body oI
evIdence Ior LIe eIIecLIveness oI Zybun In prevenLIng
smokIng reIupse.
BuL reseurcIers suId LIe sLudy wus more LypIcuI oI u
reuI-worId sILuuLIon LIun oLIers done In specIuIIsed
cIInIcs becuuse LIe smokers were Iess moLIvuLed Lo quIL
und receIved Iess counseIIIng. (Hercld,Sun, MurcI ;,
zoo, p.11)
QuILLIng smokIng Ius reuIIy been munuIucLured InLo LIe reuIm
uIso occupIed by Iud dIeLs und weIgIL Ioss. TIere ure muILIpIe wuys oI
IosIng weIgIL or quILLIng smokIng, buL mucI oI LIIs muy be u sIorL-Lerm
pIenomenon. ObvIousIy, IL Is oI consIderubIe economIc (muLerIuIIsL)
InLeresL LIuL boLI LIe overweIgIL und smokers be encouruged Lo keep
uLLempLIng Lo quIL LIeIr respecLIve ImpedImenLs LIrougI LIe reguIur use
oI purLIcuIur producLs; LIe roIe oI pIurmuceuLIcuI compunIes In IeIpIng
Lo conLrIve probIems LIuL onIy LIeIr producLs cun remedy Ius uIreudy
been uIIuded Lo (see uIso MoynIIun eL uI., zooz). UnIorLunuLeIy, LIIs
encourugemenL Is usuuIIy bused on seII-servIng cIrcuIurILIes (sopIIsLry),
IImILed concepLuuI scope, economIc opporLunIsm, und Ieur, guIIL, und
dIseuse-mongerIng.
L cun LIereIore be concIuded LIuL over uL IeusL LIe IusL number
oI decudes In LIe US und oLIer deveIoped nuLIons LIere Ius been u
buIIdIng muLerIuIIsL dIsposILIon In IeuILI uuLIorILIes, I.e., muLerIuIIsL
183
183
Rampant Antismoking Signifies Grave Danger
meunIngIuI. A crucIuI uspecL oI LIe probIem - LIe need Ior Iong-Lerm
muInLenunce oI non-smokIng - Is IurgeIy Ignored, wILI LIe resuIL LIuL
mucI currenL reseurcI Is IoIIowIng u dIrecLIonIess or, uL besL, cIrcuIur
course. (p.q18) ConLemporury reseurcI suIIers Irom LIe sume cIrcuIurILy,
usuuIIy onIy evuIuuLIng, In seII-servIng IusIIon, eIIecLIveness oI
LreuLmenL up Lo one yeur.
One oI LIe more recenL conLrIbuLIons by LIe pIurmuceuLIcuI
esLubIIsImenL Ius been bupropIon (Zybun), u mIId unLI-depressunL, LIuL
some Iuve urguubIy suggesLed Is u nIcoLIne unLugonIsL (e.g., SIemmer eL
uI., zooo). L sIouId be recognIzed LIuL bupropIon wus noL specIIIcuIIy
deveIoped wILI smokIng cessuLIon In mInd. TIe possIbIe connecLIon Lo
smokIng cessuLIon occurred serendIpILousIy LIrougI LIe observuLIon LIuL
some Ieuvy-smokIng psycIIuLrIc puLIenLs LIuL were prescrIbed bupropIon
Ior depressIon Lended Lo smoke Iess. TIe urgumenL Iere Is LIuL some
Ieuvy smokers muy be seII-medIcuLIng wILI nIcoLIne Lo reIIeve sympLoms
oI depressIon. TIereIore, bupropIon muy possIbIy subsLILuLe Ior nIcoLIne
durIng und uILer wILIdruwuI (see uIso GoIdsLeIn, 1qqq, p.11;).
HurL eL uI. (1qq;) Iound LIuL LIe ubsLInence ruLe uL one yeur Ior
LIe IIgIesL dosuge oI bupropIon (oomg) wus z.1% compured Lo pIucebo
oI 1z.q%. TIIs reIIecLed u consIderubIe drop Irom un ubsLInence ruLe uILer
6 weeks oI qq.z% Ior bupropIon (oomg) compured Lo 1q% Ior LIe
pIucebo group. AccounLIng Ior u pIucebo buseIIne, LIIs ubsLInence ruLe Ior
bupropIon uL one yeur Is noL IIgI. Jorenby eL uI. (1qqq) Iound u IIgIer
ruLe oI ubsLInence uL one yeur oI o.% Ior LIe bupropIon LreuLmenL
compured Lo u pIucebo oI 1.6%. One crILIcuI dIIIerence beLween HurL eL
uI. (1qq;) und Jorenby eL uI. (1qqq) Is LIuL In LIe Iormer sLudy onIy brIeI
counseIIng wus provIded uL InLervuIs over LIe yeur, wIIIe In LIe IuLLer
sLudy Iur more InLensIve counseIIng wus empIoyed. However, LIe Issue oI
Ionger-Lerm reIupse Is usuuIIy bypussed by LIe reseurcI - und LIe
pIurmuceuLIcuI compunIes. OLIers Iuve urgued LIuL bupropIon reseurcI
oversLuLes eIIecLIveness und undersLuLes poLenLIuI sIde eIIecLs (e.g.,
HurrIson, zoo1; KInneII, zoo1), purLIcuIurIy In LIe LreuLmenL oI u rIsk
IucLor (smokIng) us opposed Lo dIseuse. TIere ure very consIderubIe sIde-
eIIecLs In buproprIon use. A recenL newspuper urLIcIe noLes: Overdoses oI
LIe unLI-smokIng drug Zybun resuILed In seIzures, IuIIucInuLIons und sucI
exLreme uggressIon LIuL some puLIenLs needed seduLIon, u sLudy Ius
Iound...LIe sLudy wus bused on cuIIs Lo LIe PoIsons nIormuLIon CenLre,
wIIcI Lukes cuIIs Irom uround AusLruIIu, beLween November zooo und
JuIy zoo1. (Hercld,Sun, z;J11Joz, p.1o)
Very recenL reseurcI IndIcuLes even poorer ubsLInence ruLes LIun
LIose noLed ubove:
TIe conLroversIuI unLI-smokIng drug Zybun, wIIcI Ius
Other Vital Matters
cosL Luxpuyers more LIun $|A|1oo mIIIIon |Zybun Is
subsIdIzed by LIe AusLruIIun Luxpuyer on LIe
PIurmuceuLIcuI BeneIILs ScIeme|, Is IneIIecLIve In some
smokers, u sLudy Ius Iound.
ReseurcIers In LIe US und Cunudu Iound LIuL Zybun
wus neILIer eIIecLIve In peopIe wIo Iud recenLIy IuIIed
Lo quIL usIng nIcoLIne puLcIes nor IeIped LIose wIo Iud
quIL usIng puLcIes Lo sLIck Lo LIeIr resoIve, LIe 1ourncl
oj Cliniccl Dncolo reporLed.
AImosL oo,ooo prescrIpLIons Ior Zybun Iuve been
wrILLen In AusLruIIu sInce LIe drug wus IIsLed on LIe
PIurmuceuLIcuI BeneIILs ScIeme In zoo1.
Tuxpuyers IooL mosL oI LIe bIII Ior LIe LubIeLs, wIIcI
cosL $|A|z8.8q u puckeL.
JusL per cenL oI LIe 6oo smokers wIo purLIcIpuLed In
LIe NorLI AmerIcun sLudy were IeIped by LIe drug In
LIeIr eIIorLs Lo quIL.
A spokesmun Ior GIuxoSmILIKIIne LoId Austrclicn
Doctor LIe sLudy dId noL reIIecL LIe wIde body oI
evIdence Ior LIe eIIecLIveness oI Zybun In prevenLIng
smokIng reIupse.
BuL reseurcIers suId LIe sLudy wus more LypIcuI oI u
reuI-worId sILuuLIon LIun oLIers done In specIuIIsed
cIInIcs becuuse LIe smokers were Iess moLIvuLed Lo quIL
und receIved Iess counseIIIng. (Hercld,Sun, MurcI ;,
zoo, p.11)
QuILLIng smokIng Ius reuIIy been munuIucLured InLo LIe reuIm
uIso occupIed by Iud dIeLs und weIgIL Ioss. TIere ure muILIpIe wuys oI
IosIng weIgIL or quILLIng smokIng, buL mucI oI LIIs muy be u sIorL-Lerm
pIenomenon. ObvIousIy, IL Is oI consIderubIe economIc (muLerIuIIsL)
InLeresL LIuL boLI LIe overweIgIL und smokers be encouruged Lo keep
uLLempLIng Lo quIL LIeIr respecLIve ImpedImenLs LIrougI LIe reguIur use
oI purLIcuIur producLs; LIe roIe oI pIurmuceuLIcuI compunIes In IeIpIng
Lo conLrIve probIems LIuL onIy LIeIr producLs cun remedy Ius uIreudy
been uIIuded Lo (see uIso MoynIIun eL uI., zooz). UnIorLunuLeIy, LIIs
encourugemenL Is usuuIIy bused on seII-servIng cIrcuIurILIes (sopIIsLry),
IImILed concepLuuI scope, economIc opporLunIsm, und Ieur, guIIL, und
dIseuse-mongerIng.
L cun LIereIore be concIuded LIuL over uL IeusL LIe IusL number
oI decudes In LIe US und oLIer deveIoped nuLIons LIere Ius been u
buIIdIng muLerIuIIsL dIsposILIon In IeuILI uuLIorILIes, I.e., muLerIuIIsL
184
184
Rampant Antismoking Signifies Grave Danger
munIIesLo. TIe depIcLIon oI Lobucco smokIng us onIy uddIcLIve und us
IuvIng no beneIILs serves LIe IdeoIogy oI body purILunIsm LIuL Is LypIcuI oI
medIco-muLerIuIIsm. As wIII be consIdered In LIe IoIIowIng cIupLers, LIe
conLemporury unLIsmokIng crusude, IueIed by medIco-muLerIuIIsm, Ius
reucIed sucI u crescendo oI rIeLorIc, sIunderIng, muLerIuIIsL dogmu, und
obsessIon wILI conLroI, LIuL IL couId seumIessIy be LrunspIunLed InLo LIe
bodIIy-purILun NuzI Germuny; mucI wordIng oI cIuIms und poIIcy Lo curb
smokIng Is dIsLurbIngIy IdenLIcuI.
. Rcdiccl ehctiorism
RudIcuI beIuvIorIsm (B.. SkInner) Is essenLIuIIy psycIoIogy
wILIouL LIe psycIoIogy, I.e., u muLerIuIIsL versIon oI psycIoIogy. L
progresses Irom LIe eurIIer (eurIy-1qoo`s) work oI J.B. WuLson wIo
decIured LIuL LIe subjecL muLLer oI psycIoIogy Is onl beIuvIor. L vIews
LIe person us u pussIve orgunIsm LIuL mukes observubIe responses Lo
observubIe sLImuII, I.e., mecIunIsLIc, deLermInIsLIc Irumework. BeIng un
uLLempL uL scIenLIIIc psycIoIogy, IL Is compIeLeIy consIsLenL wILI LIe
IogIcuI posILIvIsL worIdvIew. L rejecLs sucI Ideus us conscIousness und
InLrospecLIon (I.e., pIenomenoIogIcuI psycIoIogy) or even reIerences Lo
LIeoreLIcuI psycIoIogIcuI consLrucLs sucI us personuIILy (e.g., see HyIund,
1q81). L does noL reIuLe LIuL LIere muy be u conscIous experIence, buL
LIuL LIIs Is IIIusory (epIpIenomenuI) und pIuys no cuusuI roIe In u
deLermInIsLIc Irumework. Ls mujor conLrIbuLIon Is LIe Iuws oI operunL
condILIonIng, I.e., Iuws oI IeurnIng. TIrougI scIeduIes oI posILIve und
neguLIve reInIorcemenL, beIuvIors cun be produced, muInLuIned or
exLInguIsIed.
GruIum (1q86) proIIers un upL descrIpLIon oI rudIcuI
beIuvIorIsm:
||n beIuvIourIsm mun Is vIewed us u consLeIIuLIon oI
responses Lo exLernuI sLImuII. SucI u vIew dispossesses
cutonomous mcn cnd turns the control he hcs been
scid to exert oter to the entironment (SkInner, 1q;, p.
zoo), und In so doIng depIcLs mun us u kInd oI
mecIunIcuI puppeL operuLed by envIronmenLuI sLrIngs.
He Is LIus denIed personuI ugency or responsIbIIILy Ior
IIs ucLIons, beIng seen mereIy us u pussIve reucLor Lo
vurIous cIrcumsLunces ruLIer LIun un ucLIve deLermIner
oI IIs own beIuvIour. TIIs noLIon oI mun-LIe-mucIIne
Is uIso evIdenL In conLemporury orIenLuLIons sucI us
socIobIoIogy, DuwkIns (1q;6, p. 1;) usserLIng LIuL A
bod is recll c mcchine blindl prorcmmed b its
Other Vital Matters
seljish enes. KocI (1q6q) Ius poInLed ouL LIuL modern
psycIoIogy projecLs un Imuge oI mun us demeunIng us IL
Is sImpIIsLIc. Moreover, In so doIng IL eIevuLes ILs own
sLuLus, noL mereIy Lo LIuL oI scIence, buL Lo LIuL oI
LecInoIogy, Ior IrrespecLIve oI wIeLIer mun Is vIewed
IILeruIIy us u mucIIne, or meLupIorIcuIIy us II one, LIe
neL resuIL Is LIuL mun Is reduced Lo someLIIng Iess LIun
Iumun, und LIe psycIoIogIsL un engIneer (p. z6).
An eurIy poInL Lo noLe Is LIuL beIuvIorIsm Is u sIeII or skeIeLuI
Irumework; In psycIoIogIcuI Lerms IL Is bIuck box und exLernuIIsLJ
envIronmenLuIIsL In dIsposILIon. L cun be upprecIuLed LIuL bIoIogIcuI
reducLIonIsm und beIuvIorIsm ure Lwo IeveIs oI LIe sume muLerIuIIsL Ideu.
BIoIogIcuI reducLIonIsm observes beIuvIor uL mIcro IeveIs, e.g., ceIIuIur,
moIecuIur; rudIcuI beIuvIorIsm observes beIuvIor oI u bIoIogIcuI orgunIsm
uL u gross, overuII IeveI. BeIuvIorIsm mukes no reIerence Lo mInd und
obvIousIy conLuIns no coIerenL, coIIecLIve moruI Irumework. L cun muke
no deLermInuLIons us Lo preIerubIe beIuvIor oI ILseII. GIven LIuL IL rejecLs
pIenomenoIogy und meLupIysIcs, IL Iooks Lo oLIer scIenLIIIc dIscIpIInes
Ior ILs guIdunce us Lo desIrubIe beIuvIor, e.g., medIcuI scIence. or
exumpIe, II medIcuI scIence dIcLuLes LIuL cIgureLLe smokIng Is socIuIIy
undesIrubIe, LIe Iuws oI operunL condILIonIng cun be empIoyed Lo
neguLIveIy reInIorce LIe IubIL, eILIer on un IndIvIduuI or u muss
(propugundu) scuIe. n LIuL IL Ius no purLIcuIur moruI dIscernmenL, LIe
ucLIvILy Is enLIreIy un engIneerIng (conLroIIIng) exercIse bound onIy by un
ends jusLIIIes LIe meuns upproucI. n LIIs regurd IL Is purusILIc. n
uLLempLIng Lo neguLIveIy condILIon LIe smokIng IubIL on u muss scuIe, IL
musL IInd un uIreudy neguLIveIy regurded pIenomenon Lo ussocIuLe
smokIng wILI. ALLempLIng Lo depIcL cIgureLLe smokIng us onIy un
uddIcLIon on u pur wILI cocuIne, IeroIn, eLc. Is un exumpIe oI LIIs
reusonIng. L Lukes LIe neguLIve socIuI percepLIon oI uddIcLIon Lo nurcoLIcs
und uLLempLs Lo condILIon LIe sume ussocIuLIon Ior cIgureLLe smokIng -
regurdIess oI wIeLIer LIIs Is Lrue or noL.
SkInner Ius mude specIIIc reIerences Lo LIe Issue oI smokIng:
Our LreuLmenL oI cIgureLLe smokIng Is u mInIuLure
modeI oI wIuL mIgIL be done. SmokIng Is reInIorced
eILIer posILIveIy by LIe so-cuIIed pIeusures oI smokIng
or neguLIveIy by reIIeI Irom wILIdruwuI sympLoms.
DumugIng eIIecLs on LIe smoker`s IeuILI ure
udvenLILIous consequences, Loo remoLe Lo punIsI
smokIng. WIen LIose eIIecLs Iud been dIscovered,
Iowever, someLIIng couId be done. Smokers couId be
185
185
Rampant Antismoking Signifies Grave Danger
munIIesLo. TIe depIcLIon oI Lobucco smokIng us onIy uddIcLIve und us
IuvIng no beneIILs serves LIe IdeoIogy oI body purILunIsm LIuL Is LypIcuI oI
medIco-muLerIuIIsm. As wIII be consIdered In LIe IoIIowIng cIupLers, LIe
conLemporury unLIsmokIng crusude, IueIed by medIco-muLerIuIIsm, Ius
reucIed sucI u crescendo oI rIeLorIc, sIunderIng, muLerIuIIsL dogmu, und
obsessIon wILI conLroI, LIuL IL couId seumIessIy be LrunspIunLed InLo LIe
bodIIy-purILun NuzI Germuny; mucI wordIng oI cIuIms und poIIcy Lo curb
smokIng Is dIsLurbIngIy IdenLIcuI.
. Rcdiccl ehctiorism
RudIcuI beIuvIorIsm (B.. SkInner) Is essenLIuIIy psycIoIogy
wILIouL LIe psycIoIogy, I.e., u muLerIuIIsL versIon oI psycIoIogy. L
progresses Irom LIe eurIIer (eurIy-1qoo`s) work oI J.B. WuLson wIo
decIured LIuL LIe subjecL muLLer oI psycIoIogy Is onl beIuvIor. L vIews
LIe person us u pussIve orgunIsm LIuL mukes observubIe responses Lo
observubIe sLImuII, I.e., mecIunIsLIc, deLermInIsLIc Irumework. BeIng un
uLLempL uL scIenLIIIc psycIoIogy, IL Is compIeLeIy consIsLenL wILI LIe
IogIcuI posILIvIsL worIdvIew. L rejecLs sucI Ideus us conscIousness und
InLrospecLIon (I.e., pIenomenoIogIcuI psycIoIogy) or even reIerences Lo
LIeoreLIcuI psycIoIogIcuI consLrucLs sucI us personuIILy (e.g., see HyIund,
1q81). L does noL reIuLe LIuL LIere muy be u conscIous experIence, buL
LIuL LIIs Is IIIusory (epIpIenomenuI) und pIuys no cuusuI roIe In u
deLermInIsLIc Irumework. Ls mujor conLrIbuLIon Is LIe Iuws oI operunL
condILIonIng, I.e., Iuws oI IeurnIng. TIrougI scIeduIes oI posILIve und
neguLIve reInIorcemenL, beIuvIors cun be produced, muInLuIned or
exLInguIsIed.
GruIum (1q86) proIIers un upL descrIpLIon oI rudIcuI
beIuvIorIsm:
||n beIuvIourIsm mun Is vIewed us u consLeIIuLIon oI
responses Lo exLernuI sLImuII. SucI u vIew dispossesses
cutonomous mcn cnd turns the control he hcs been
scid to exert oter to the entironment (SkInner, 1q;, p.
zoo), und In so doIng depIcLs mun us u kInd oI
mecIunIcuI puppeL operuLed by envIronmenLuI sLrIngs.
He Is LIus denIed personuI ugency or responsIbIIILy Ior
IIs ucLIons, beIng seen mereIy us u pussIve reucLor Lo
vurIous cIrcumsLunces ruLIer LIun un ucLIve deLermIner
oI IIs own beIuvIour. TIIs noLIon oI mun-LIe-mucIIne
Is uIso evIdenL In conLemporury orIenLuLIons sucI us
socIobIoIogy, DuwkIns (1q;6, p. 1;) usserLIng LIuL A
bod is recll c mcchine blindl prorcmmed b its
Other Vital Matters
seljish enes. KocI (1q6q) Ius poInLed ouL LIuL modern
psycIoIogy projecLs un Imuge oI mun us demeunIng us IL
Is sImpIIsLIc. Moreover, In so doIng IL eIevuLes ILs own
sLuLus, noL mereIy Lo LIuL oI scIence, buL Lo LIuL oI
LecInoIogy, Ior IrrespecLIve oI wIeLIer mun Is vIewed
IILeruIIy us u mucIIne, or meLupIorIcuIIy us II one, LIe
neL resuIL Is LIuL mun Is reduced Lo someLIIng Iess LIun
Iumun, und LIe psycIoIogIsL un engIneer (p. z6).
An eurIy poInL Lo noLe Is LIuL beIuvIorIsm Is u sIeII or skeIeLuI
Irumework; In psycIoIogIcuI Lerms IL Is bIuck box und exLernuIIsLJ
envIronmenLuIIsL In dIsposILIon. L cun be upprecIuLed LIuL bIoIogIcuI
reducLIonIsm und beIuvIorIsm ure Lwo IeveIs oI LIe sume muLerIuIIsL Ideu.
BIoIogIcuI reducLIonIsm observes beIuvIor uL mIcro IeveIs, e.g., ceIIuIur,
moIecuIur; rudIcuI beIuvIorIsm observes beIuvIor oI u bIoIogIcuI orgunIsm
uL u gross, overuII IeveI. BeIuvIorIsm mukes no reIerence Lo mInd und
obvIousIy conLuIns no coIerenL, coIIecLIve moruI Irumework. L cun muke
no deLermInuLIons us Lo preIerubIe beIuvIor oI ILseII. GIven LIuL IL rejecLs
pIenomenoIogy und meLupIysIcs, IL Iooks Lo oLIer scIenLIIIc dIscIpIInes
Ior ILs guIdunce us Lo desIrubIe beIuvIor, e.g., medIcuI scIence. or
exumpIe, II medIcuI scIence dIcLuLes LIuL cIgureLLe smokIng Is socIuIIy
undesIrubIe, LIe Iuws oI operunL condILIonIng cun be empIoyed Lo
neguLIveIy reInIorce LIe IubIL, eILIer on un IndIvIduuI or u muss
(propugundu) scuIe. n LIuL IL Ius no purLIcuIur moruI dIscernmenL, LIe
ucLIvILy Is enLIreIy un engIneerIng (conLroIIIng) exercIse bound onIy by un
ends jusLIIIes LIe meuns upproucI. n LIIs regurd IL Is purusILIc. n
uLLempLIng Lo neguLIveIy condILIon LIe smokIng IubIL on u muss scuIe, IL
musL IInd un uIreudy neguLIveIy regurded pIenomenon Lo ussocIuLe
smokIng wILI. ALLempLIng Lo depIcL cIgureLLe smokIng us onIy un
uddIcLIon on u pur wILI cocuIne, IeroIn, eLc. Is un exumpIe oI LIIs
reusonIng. L Lukes LIe neguLIve socIuI percepLIon oI uddIcLIon Lo nurcoLIcs
und uLLempLs Lo condILIon LIe sume ussocIuLIon Ior cIgureLLe smokIng -
regurdIess oI wIeLIer LIIs Is Lrue or noL.
SkInner Ius mude specIIIc reIerences Lo LIe Issue oI smokIng:
Our LreuLmenL oI cIgureLLe smokIng Is u mInIuLure
modeI oI wIuL mIgIL be done. SmokIng Is reInIorced
eILIer posILIveIy by LIe so-cuIIed pIeusures oI smokIng
or neguLIveIy by reIIeI Irom wILIdruwuI sympLoms.
DumugIng eIIecLs on LIe smoker`s IeuILI ure
udvenLILIous consequences, Loo remoLe Lo punIsI
smokIng. WIen LIose eIIecLs Iud been dIscovered,
Iowever, someLIIng couId be done. Smokers couId be
186
186
Rampant Antismoking Signifies Grave Danger
udvIsed Lo sLop smokIng und wurned oI LIe
consequences ('SmokIng cun be dungerous Lo your
IeuILI`). AdvIce Is seIdom enougI, Iowever.
Consequences wIIcI Iuve noL occurred Iuve no eIIecL.
AdvIce ubouL predIcLed consequences Is usuuIIy Luken
onIy II LukIng compurubIe udvIce Ius been reInIorced,
und LIuL Is seIdom, II ever, LIe cuse wIen LIe predIcLed
consequences ure remoLe. AnoLIer possIbIIILy, Iowever,
Is Lo conLrIve ImmedIuLe consequences IuvIng LIe eIIecL
LIe remoLe ones wouId Iuve II LIey were ImmedIuLe.
ReInIorce noL smokIng ('TIunk you Ior noL smokIng`),
und enLIusIusLIcuIIy commend LIose wIo Iuve sLopped.
PunIsI smokIng wILI crILIcIsm, compIuInLs, resLrIcLIons
on wIere one muy smoke, und Ieuvy Luxes on
cIgureLLes. (SkInner, 1q8q, p.118)
As cun be seen, beIuvIorIsm does noL quesLIon LIe verucILy oI
medIcuI cIuIms, nor cun IL IuLIom uny psycIoIogIcuI und socIuI uspecLs oI
smokIng or unLIsmokIng. L wIII sImpIy supporL medIco-muLerIuIIsm In
domInuLIng socIeLy. AII oI SkInner`s suggesLIons cun be Iound In
conLemporury unLIsmokIng.
One oI LIe crILIcuI dungers oI beIuvIorIsm Is LIuL IL Is noL
concerned wILI LIe rIgILness or wrongness, moruIILy or ImmoruIILy, oI u
conLrIved ussocIuLIon - IL Is onIy concerned wILI uccompIIsIIng ILs gouI.
n IucL, beIuvIorIsm cun poLenLIuIIy go us Iur us socIeLy wIII uIIow IL In ILs
pursuIL oI ILs unquesLIoned buL quesLIonubIe gouIs. or exumpIe,
LIrougI more und more wrongIuI ussocIuLIons porLruyed In reIenLIess
propugundu, smokers, or even u suInL, cun be mude Lo uppeur us un
IncurnuLIon oI pure evII.
AnoLIer serIous probIem wILI LIe pIIIosopIIcuI rumIIIcuLIons, us
opposed Lo enLIreIy meLIodoIogIcuI consIderuLIons, oI beIuvIorIsm Is LIuL
LIe deLermInIsLIc Irumework exLends Irom Iower-order bIoIogIcuI
InLerucLIons Lo LIe gross IeveI oI peopIe (orgunIsms). Persons do noL
Iuve Iree wIII buL ure deLermIned creuLures, noL unIIke mIce In u cuge.
AccordIng Lo beIuvIorIsm we ure deLermIned, buL IIke Lo LIInk we ure
Iree. (SLevenson, 1q;q, p. 1o1)
SkInner (1q8q), reIIecLIng on eurIIer works, IndIcuLes LIuL Ideus
sucI us Iree wIII und dIgnILy ure useIess und onIy proIIbIL scIenLIIIc
enquIry. He cun cerLuInIy uccepL LIuL persons muy beIIeve In LIese
IIIusory concepLs. SocIeLy cun even muke uccommoduLIons Ior LIese
IIIusory beIIeIs, so Iong us LIey do noL InLerIere wILI scIenLIIIc enquIry
(scIenLIsm) und LIe scIenLIIIc order, I.e., vuIuubIe onIy us u poLenLIuI
Other Vital Matters
munIpuIuLIve IucLor. n LIIs crILIcuI sense, scIenLIIIc psycIoIogy Is
consIdered us un InsLrumenL oI socIuI conLroI und u poIILIcuI LooI (e.g.,
HuxIey, 1q;q).
BeIuvIorIsm sLrIps LIe Ideu oI God und oI souI Irom
consIderuLIon. TIese Ideus ure usuuIIy uL LIe cenLer oI moruI und
prescrIpLIve Irumeworks oI LIougIL. n LIe WesL, CIrIsLIunILy Ius IIgured
IIgIIy us u LrunscendenL, IIrsL-prIncIpIes, ubsoIuLe spIrILuuIJmoruI
LeucIIng. n beIuvIorIsm, scIence Is InsLuIIed us LIe prevuIIIng god. TIIs
Ideu oI scIenLIIIc uuLocrucy Is reIerred Lo us scIenLIsm. BunIsIIng LIe Ideu
oI God becuuse oI ILs meLupIysIcuI underpInnIngs, rudIcuI beIuvIorIsm
IuIIs Lo recognIze LIuL LIe philosophiccl posILIvIsL beIIeI LIuL unyLIIng
beyond observuLIon Is meunIngIess und LIuL onIy LIe scIenLIIIc meLIod cun
expIuIn wIuL Is meunIngIuI is uIso u meLupIysIcuI posILIon, I.e., scIenLIsm
Is beyond scIenLIIIc ussessmenL.
ScIenLIsm Is, In IucL, u poor cIoIce oI Lerms. ScIence Is buL u
meLIod. L Is LIe meLupIysIcuI underpInnIngs LIuL dIcLuLe LIe dIrecLIon
und boundurIes oI scIenLIIIc enquIry. As sucI, IL Is noL scIence LIuL Is
eIevuLed Lo u godIy sLuLus buL LIe quesLIonubIe meLupIysIcuI beIIeIs (I.e.,
muLerIuIIsm) oI ILs prucLILIoners, und, LIereIore, LIe prucLILIoners
LIemseIves. MuLerIuIIsm wIII venLure InLo LIe scIenLIIIc enquIry oI
purLIcuIur pIenomenu LIuL u spIrILuuI meLupIysIcs wouId noL even
conceIve oI, e.g., purLIcuIur In-vILro IerLIIIzuLIon LreuLmenL, eugenIcs,
IIIesLyIe prescrIpLIons bused on IIImsy sLuLIsLIcs; LIe Lwo meLupIysIcuI
sysLems vIew LIe person ter dIIIerenLIy.
TIe CIrIsLIun spIrILuuI Irumework proposes LIuL LIe uILImuLe
source oI Iumun probIems ure spIrILuuI und menLuI und musL be correcLed
uL LIese IeveIs. MuLerIuIIsm posILs LIuL Iumuns, beIng onIy bIoIogIcuI
creuLures, Iuve onIy bIoIogIcuI und beIuvIoruI probIems LIuL ure correcLed
bIoIogIcuIIy und beIuvIoruIIy. CIrIsLIunILy dIsLInguIsIes beLween LIe Iower
nuLure, wIIcI Is ubsorbed In sepuruLIon LIInkIng und Is domInuLed by LIe
body (I.e., u Iorm oI IdoIuLry), und LIe perIecLed sLuLe wIIcI Is uLLuIned
LIrougI repenLunce (recognILIon oI u greuLIy IIuwed reusonIng), suIvuLIon
(new spIrILuuI bIrLI), und LIe LrunsIormuLIon oI LIe mInd In uIIgnmenL Lo
LIe SpIrIL oI HoIIness (u poLenLIuIIy IIIeIong work). SucI u Irumework
provIdes Ior InLerpreLIng IIIe, deuLI, und IeurnIng. TIe sepuruLe wIII (I.e.,
In psycIoIogIcuI Lerms) cun uIso be reIerred Lo us ego, und Iower-nuLure
LIInkIng us ego-ubsorpLIon; LIe scope oI ego`s reckonIng Is LIe body.
AccordIng Lo LIe IIImsIness oI beIuvIorIsm, uLopIu (perIecL sLuLe) Is
uLLuIned LIrougI LIe conLroI oI LIe envIronmenL; LIe person sImpIy sLeps
buck InLo u mIndIessness us LIey ure conLroIIed LIrougI muLerIuI IucLors
InLo IuppIness. TIe Lwo LIougIL sysLems ure dIumeLrIcuIIy opposed.
CIrIsLIunILy dIrecLs u person InwurdIy (verLIcuI, LrunscendenL sIIIL) Lo
187
187
Rampant Antismoking Signifies Grave Danger
udvIsed Lo sLop smokIng und wurned oI LIe
consequences ('SmokIng cun be dungerous Lo your
IeuILI`). AdvIce Is seIdom enougI, Iowever.
Consequences wIIcI Iuve noL occurred Iuve no eIIecL.
AdvIce ubouL predIcLed consequences Is usuuIIy Luken
onIy II LukIng compurubIe udvIce Ius been reInIorced,
und LIuL Is seIdom, II ever, LIe cuse wIen LIe predIcLed
consequences ure remoLe. AnoLIer possIbIIILy, Iowever,
Is Lo conLrIve ImmedIuLe consequences IuvIng LIe eIIecL
LIe remoLe ones wouId Iuve II LIey were ImmedIuLe.
ReInIorce noL smokIng ('TIunk you Ior noL smokIng`),
und enLIusIusLIcuIIy commend LIose wIo Iuve sLopped.
PunIsI smokIng wILI crILIcIsm, compIuInLs, resLrIcLIons
on wIere one muy smoke, und Ieuvy Luxes on
cIgureLLes. (SkInner, 1q8q, p.118)
As cun be seen, beIuvIorIsm does noL quesLIon LIe verucILy oI
medIcuI cIuIms, nor cun IL IuLIom uny psycIoIogIcuI und socIuI uspecLs oI
smokIng or unLIsmokIng. L wIII sImpIy supporL medIco-muLerIuIIsm In
domInuLIng socIeLy. AII oI SkInner`s suggesLIons cun be Iound In
conLemporury unLIsmokIng.
One oI LIe crILIcuI dungers oI beIuvIorIsm Is LIuL IL Is noL
concerned wILI LIe rIgILness or wrongness, moruIILy or ImmoruIILy, oI u
conLrIved ussocIuLIon - IL Is onIy concerned wILI uccompIIsIIng ILs gouI.
n IucL, beIuvIorIsm cun poLenLIuIIy go us Iur us socIeLy wIII uIIow IL In ILs
pursuIL oI ILs unquesLIoned buL quesLIonubIe gouIs. or exumpIe,
LIrougI more und more wrongIuI ussocIuLIons porLruyed In reIenLIess
propugundu, smokers, or even u suInL, cun be mude Lo uppeur us un
IncurnuLIon oI pure evII.
AnoLIer serIous probIem wILI LIe pIIIosopIIcuI rumIIIcuLIons, us
opposed Lo enLIreIy meLIodoIogIcuI consIderuLIons, oI beIuvIorIsm Is LIuL
LIe deLermInIsLIc Irumework exLends Irom Iower-order bIoIogIcuI
InLerucLIons Lo LIe gross IeveI oI peopIe (orgunIsms). Persons do noL
Iuve Iree wIII buL ure deLermIned creuLures, noL unIIke mIce In u cuge.
AccordIng Lo beIuvIorIsm we ure deLermIned, buL IIke Lo LIInk we ure
Iree. (SLevenson, 1q;q, p. 1o1)
SkInner (1q8q), reIIecLIng on eurIIer works, IndIcuLes LIuL Ideus
sucI us Iree wIII und dIgnILy ure useIess und onIy proIIbIL scIenLIIIc
enquIry. He cun cerLuInIy uccepL LIuL persons muy beIIeve In LIese
IIIusory concepLs. SocIeLy cun even muke uccommoduLIons Ior LIese
IIIusory beIIeIs, so Iong us LIey do noL InLerIere wILI scIenLIIIc enquIry
(scIenLIsm) und LIe scIenLIIIc order, I.e., vuIuubIe onIy us u poLenLIuI
Other Vital Matters
munIpuIuLIve IucLor. n LIIs crILIcuI sense, scIenLIIIc psycIoIogy Is
consIdered us un InsLrumenL oI socIuI conLroI und u poIILIcuI LooI (e.g.,
HuxIey, 1q;q).
BeIuvIorIsm sLrIps LIe Ideu oI God und oI souI Irom
consIderuLIon. TIese Ideus ure usuuIIy uL LIe cenLer oI moruI und
prescrIpLIve Irumeworks oI LIougIL. n LIe WesL, CIrIsLIunILy Ius IIgured
IIgIIy us u LrunscendenL, IIrsL-prIncIpIes, ubsoIuLe spIrILuuIJmoruI
LeucIIng. n beIuvIorIsm, scIence Is InsLuIIed us LIe prevuIIIng god. TIIs
Ideu oI scIenLIIIc uuLocrucy Is reIerred Lo us scIenLIsm. BunIsIIng LIe Ideu
oI God becuuse oI ILs meLupIysIcuI underpInnIngs, rudIcuI beIuvIorIsm
IuIIs Lo recognIze LIuL LIe philosophiccl posILIvIsL beIIeI LIuL unyLIIng
beyond observuLIon Is meunIngIess und LIuL onIy LIe scIenLIIIc meLIod cun
expIuIn wIuL Is meunIngIuI is uIso u meLupIysIcuI posILIon, I.e., scIenLIsm
Is beyond scIenLIIIc ussessmenL.
ScIenLIsm Is, In IucL, u poor cIoIce oI Lerms. ScIence Is buL u
meLIod. L Is LIe meLupIysIcuI underpInnIngs LIuL dIcLuLe LIe dIrecLIon
und boundurIes oI scIenLIIIc enquIry. As sucI, IL Is noL scIence LIuL Is
eIevuLed Lo u godIy sLuLus buL LIe quesLIonubIe meLupIysIcuI beIIeIs (I.e.,
muLerIuIIsm) oI ILs prucLILIoners, und, LIereIore, LIe prucLILIoners
LIemseIves. MuLerIuIIsm wIII venLure InLo LIe scIenLIIIc enquIry oI
purLIcuIur pIenomenu LIuL u spIrILuuI meLupIysIcs wouId noL even
conceIve oI, e.g., purLIcuIur In-vILro IerLIIIzuLIon LreuLmenL, eugenIcs,
IIIesLyIe prescrIpLIons bused on IIImsy sLuLIsLIcs; LIe Lwo meLupIysIcuI
sysLems vIew LIe person ter dIIIerenLIy.
TIe CIrIsLIun spIrILuuI Irumework proposes LIuL LIe uILImuLe
source oI Iumun probIems ure spIrILuuI und menLuI und musL be correcLed
uL LIese IeveIs. MuLerIuIIsm posILs LIuL Iumuns, beIng onIy bIoIogIcuI
creuLures, Iuve onIy bIoIogIcuI und beIuvIoruI probIems LIuL ure correcLed
bIoIogIcuIIy und beIuvIoruIIy. CIrIsLIunILy dIsLInguIsIes beLween LIe Iower
nuLure, wIIcI Is ubsorbed In sepuruLIon LIInkIng und Is domInuLed by LIe
body (I.e., u Iorm oI IdoIuLry), und LIe perIecLed sLuLe wIIcI Is uLLuIned
LIrougI repenLunce (recognILIon oI u greuLIy IIuwed reusonIng), suIvuLIon
(new spIrILuuI bIrLI), und LIe LrunsIormuLIon oI LIe mInd In uIIgnmenL Lo
LIe SpIrIL oI HoIIness (u poLenLIuIIy IIIeIong work). SucI u Irumework
provIdes Ior InLerpreLIng IIIe, deuLI, und IeurnIng. TIe sepuruLe wIII (I.e.,
In psycIoIogIcuI Lerms) cun uIso be reIerred Lo us ego, und Iower-nuLure
LIInkIng us ego-ubsorpLIon; LIe scope oI ego`s reckonIng Is LIe body.
AccordIng Lo LIe IIImsIness oI beIuvIorIsm, uLopIu (perIecL sLuLe) Is
uLLuIned LIrougI LIe conLroI oI LIe envIronmenL; LIe person sImpIy sLeps
buck InLo u mIndIessness us LIey ure conLroIIed LIrougI muLerIuI IucLors
InLo IuppIness. TIe Lwo LIougIL sysLems ure dIumeLrIcuIIy opposed.
CIrIsLIunILy dIrecLs u person InwurdIy (verLIcuI, LrunscendenL sIIIL) Lo
188
188
Rampant Antismoking Signifies Grave Danger
IonesL seII-scruLIny In LIe IIgIL oI HoIy counseI, LIe resuILs oI wIIcI ure
LIen exLended ouLwurdIy In progressIveIy greuLer cupucILy Ior proIound
(HoIy) reIuLIonsIIp. BeIuvIorIsm Is obIIvIous Lo LIougIL, IeL uIone
sLundurd oI LIougIL, und Is obsessed wILI conLroI oI exLernuIILIes -
IncIudIng oLIer persons.
n rejecLIng LIe Ideu oI Lrunscendence und, LIereIore, oI u IIgIer
sLuLe, muLerIuIIsm concepLuuIIzes IuLeruIIy und remuIns wILIIn Iower-
nuLure reusonIng; LIe Iower nuLure becomes ILs own IIgI sLundurd (I.e.,
deIuded subsLILuLIon). Body-IIxuLIon cun Luke Lwo Iorms. One concerns un
ensIuvemenL Lo desIres oI LIe IIesI (e.g., promIscuILy, InduIgence,
IedonIsm); LIe oLIer, overproLecLIve conducL due Lo u morbId Ieur oI
deuLI. TIe IuLLer Is LypIcuIIy underpIuyed und weII descrIbes LIe rIsk-
uversIon uspecL oI muLerIuIIsm. TIe menLuIILy wIII go Lo greuL IengLIs on
LIe busIs oI progressIveIy more IIImsy InIormuLIon In LIe mIsguIded und
uILImuLeIy IruILIess uLLempL Lo sLuve oII morLuIILy.
TIe dIrecLIon oI scIenLIIIc reseurcI Is, LIereIore, never moruIIy
neuLruI, uILIougI muLerIuIIsLs beIIeve LIIs Is LIe cuse und wouId Iuve uII
beIIeve so. MuLerIuIIsm Ius no IIrsL-prIncIpIes moruI Irumework. By
udopLIng u moruIIy reIuLIvIsL sLunce, IL jeLLIsons uII consIderuLIon oI
ubsoIuLe moruI Irumeworks. L LIen emburks on buIIdIng u
moruI (prescrIpLIve) Irumework Irom scIenLIIIc enquIry LIuL Is dIrecLed
und InLerpreLed by u muLerIuIIsL meLupIysIcs. I LIe Iumun Is u
muILIdImensIonuI creuLure, LIen scIence oI ILseII, IeL uIone muLerIuIIsm,
cunnoL begIn Lo do jusLIce Lo LIe Iumun condILIon. As Ius uIreudy been
consIdered, und Lo be IurLIer dIscussed, IIIesLyIe epIdemIoIogy wIIcI
provIdes LIe scIenLIIIc InpuL Ior muLerIuIIsL IIIesLyIe prescrIpLIons
degeneruLes InLo sLuLIsLIcuIIsm und over-InLerpreLuLIon, I.e., scIence
dIrecLed by u LoLuIIsLIc muLerIuIIsm Is very poor uL uddressIng LIe overuII
Iumun condILIon. TIIs cIrcumsLunce produces LIe ubsurdILy LIuL,
uILIougI IL InILIuIIy mukes use oI moruI reIuLIvIsm Lo dIsmIss ubsoIuLe
moruI Irumeworks, muLerIuIIsm LIen pursues conIormILy by LIe
popuIuLIon Lo deIuded IIIesLyIe prescrIpLIons wILI ubsoIuLIsL vIgor, I.e., cuIL
conducL.
As LIe dIscussIon progresses, IL wIII be urgued LIuL muLerIuIIsm
reIIecLs u sIuIIow, superIIcIuI, IncompeLenL, ImmuLure reusonIng. TIe
menLuIILy wouId obIILeruLe u proIound, LrunscendenL moruI Irumework
(e.g., CIrIsLIunILy) und subsLILuLe u mIndIess, gumbIIng meLupIor
(sLuLIsLIcuIIsm) us LIe busIs Ior IIvIng. TIe menLuIILy Is IeebIe, IuvIng noL
yeL rIsen ubove superIIcIuIILy. TIuL IL Is IeebIe, Iowever, does noL meun IL
Is noL dungerous. On LIe conLrury, IL Is IIgIIy dungerous. UnubIe Lo
dIscern psycIoIogIcuI, reIuLIonuI, und moruI concepLs, IL Iorces muLerIuIIsL
InLerpreLuLIons on LIe IIImsIesL oI sLuLIsLIcuI InIormuLIon, und wouId see IL
Other Vital Matters
us sunILy Lo LIen coerce LIe sume conLorLed LIInkIng In LIe popuIuLIon uL
Iurge; wIuL oLIer LIun u moruIIy (cIurucLer) deIIcIenL, psycIoIogIcuIIy und
reIuLIonuIIy IncompeLenL menLuIILy wouId dIspense wILI God und
subsLILuLe sLuLIsLIcuI bIuLIer. AcLuuIIy occurrIng In LIe muLerIuIIsL
munIIesLo Is LIe enucLmenL oI uII LIese deIIcIencIes - urrogunce,
IuugILIness, prIde, vunILy, obsLInucy, obsessIon wILI conLroI. TIe very
deIIcIencIes LIuL u coIerenL, proIound moruI Irumework wouId urge uII Lo
uddress In IIIeIong IusIIon, LIe muLerIuIIsL, by jeLLIsonIng LIIs enLIre
requIremenL, wIII be enucLIng uII oI LIese - und obIIvIousIy so. WIen LIIs
menLuIILy InIecLs socIuI IeudersIIp und LIe greuLer porLIon oI LIe
popuIuLIon, onIy greuL dIsusLer cun ensue.
n ugreemenL wILI SLevenson`s (1q;q) observuLIon, SkInner Is
poIILIcuIIy nuve us Lo LIe sInIsLer overLones oI poLenLIuI obsessIon wILI
conLroI LIuL scIenLIIIc psycIoIogy wouId be purLy Lo. TIere Is u sIeer Iuck
oI udequuLe deIIneuLIon, II uny Is possIbIe, oI suIeguurds uguInsL ubuse oI
power, wIuL consLILuLes LIe promoLIon oI IuppIness Ior LIe muILILudes,
und Iow onIy scIence cun deIIne und uddress LIIs Issue. urLIermore, ILs
IIIppunL dIsmIssuI oI Iree-wIII reIIecLs u dIsLurbIng IncognIzunce oI LIe
subsLunLIve Issues InvoIved In LIe Iong-sLundIng deLermInIsmJIree wIII
debuLe.
BeIuvIorIsLs und purLIcuIur reseurcIers In LIe medIcuI scIences
spend mosL oI LIeIr proIessIonuI IIves In IuboruLory seLLIngs, usuuIIy
sLudyIng LIe beIuvIor oI ruLs or oLIer unImuIs. TIe runge oI InvesLIguLIon
concerns LIe beIuvIoruI eIIecLs oI mosLIy dIeL, exposures, und exercIse.
TIe exLenL oI reIuLIonsIIp beLween LIe experImenLer und experImenLuI
subjecLs Is LIuL LIe Iormer Is LIe conLroIIer oI LIe envIronmenL und LIe
IuLLer ure LIe conLroIIed. BeIuvIorIsLs sImpIy Lrunspose LIIs reIuLIonsIIp
In LIeIr consIderuLIons oI LIe Iumun popuIuLIon. TIe Ideu oI coIerenL
reIuLIonuI dynumIcs Is uIIen Lo LIe superIIcIuIILy oI muLerIuIIsL reusonIng.
BeIuvIorIsLs crInge uL sucI Ideus us cIurucLer sLrengLIs, e.g., InLegrILy,
IonesLy, IuILIIuIness, LrusLworLIIness. TIe reuson beIng LIuL uIong LIese
dImensIons LIe muLerIuIIsL menLuIILy wouId be un uLLer IuIIure.
TIe muLerIuIIsL menLuIILy Is u very pecuIIur one. L vIews greuLer
socIeLy us sImpIy un exLensIon oI LIe IuboruLory und wIere Iumuns ure
onIy sIIgILIy more udvunced unImuIs LIun ruLs. TIe menLuIILy Is devoId oI
uny meLupIysIcuI or LrunscendenL Ideus. L musL LIereIore munuIucLure u
conLInuILy beLween evenLs enLIreIy uIong LIe sIngIe muLerIuI dImensIon.
Ls vIew oI cuuse-eIIecL und IeuILI concernIng Iumuns Is deIIned In
exucLIy LIe sume wuy us LIuL Ior IuboruLory unImuIs, I.e., dIeL, exposures,
exercIse. urLIermore, us Ius been seen Irom LIe conducL oI IIIesLyIe
epIdemIoIogy und Irom un upcomIng scruLIny oI prevenLIve medIcIne,
IIImsy popuIuLIon sLuLIsLIcs ure used Lo coerce (condILIon) beIuvIoruI
189
189
Rampant Antismoking Signifies Grave Danger
IonesL seII-scruLIny In LIe IIgIL oI HoIy counseI, LIe resuILs oI wIIcI ure
LIen exLended ouLwurdIy In progressIveIy greuLer cupucILy Ior proIound
(HoIy) reIuLIonsIIp. BeIuvIorIsm Is obIIvIous Lo LIougIL, IeL uIone
sLundurd oI LIougIL, und Is obsessed wILI conLroI oI exLernuIILIes -
IncIudIng oLIer persons.
n rejecLIng LIe Ideu oI Lrunscendence und, LIereIore, oI u IIgIer
sLuLe, muLerIuIIsm concepLuuIIzes IuLeruIIy und remuIns wILIIn Iower-
nuLure reusonIng; LIe Iower nuLure becomes ILs own IIgI sLundurd (I.e.,
deIuded subsLILuLIon). Body-IIxuLIon cun Luke Lwo Iorms. One concerns un
ensIuvemenL Lo desIres oI LIe IIesI (e.g., promIscuILy, InduIgence,
IedonIsm); LIe oLIer, overproLecLIve conducL due Lo u morbId Ieur oI
deuLI. TIe IuLLer Is LypIcuIIy underpIuyed und weII descrIbes LIe rIsk-
uversIon uspecL oI muLerIuIIsm. TIe menLuIILy wIII go Lo greuL IengLIs on
LIe busIs oI progressIveIy more IIImsy InIormuLIon In LIe mIsguIded und
uILImuLeIy IruILIess uLLempL Lo sLuve oII morLuIILy.
TIe dIrecLIon oI scIenLIIIc reseurcI Is, LIereIore, never moruIIy
neuLruI, uILIougI muLerIuIIsLs beIIeve LIIs Is LIe cuse und wouId Iuve uII
beIIeve so. MuLerIuIIsm Ius no IIrsL-prIncIpIes moruI Irumework. By
udopLIng u moruIIy reIuLIvIsL sLunce, IL jeLLIsons uII consIderuLIon oI
ubsoIuLe moruI Irumeworks. L LIen emburks on buIIdIng u
moruI (prescrIpLIve) Irumework Irom scIenLIIIc enquIry LIuL Is dIrecLed
und InLerpreLed by u muLerIuIIsL meLupIysIcs. I LIe Iumun Is u
muILIdImensIonuI creuLure, LIen scIence oI ILseII, IeL uIone muLerIuIIsm,
cunnoL begIn Lo do jusLIce Lo LIe Iumun condILIon. As Ius uIreudy been
consIdered, und Lo be IurLIer dIscussed, IIIesLyIe epIdemIoIogy wIIcI
provIdes LIe scIenLIIIc InpuL Ior muLerIuIIsL IIIesLyIe prescrIpLIons
degeneruLes InLo sLuLIsLIcuIIsm und over-InLerpreLuLIon, I.e., scIence
dIrecLed by u LoLuIIsLIc muLerIuIIsm Is very poor uL uddressIng LIe overuII
Iumun condILIon. TIIs cIrcumsLunce produces LIe ubsurdILy LIuL,
uILIougI IL InILIuIIy mukes use oI moruI reIuLIvIsm Lo dIsmIss ubsoIuLe
moruI Irumeworks, muLerIuIIsm LIen pursues conIormILy by LIe
popuIuLIon Lo deIuded IIIesLyIe prescrIpLIons wILI ubsoIuLIsL vIgor, I.e., cuIL
conducL.
As LIe dIscussIon progresses, IL wIII be urgued LIuL muLerIuIIsm
reIIecLs u sIuIIow, superIIcIuI, IncompeLenL, ImmuLure reusonIng. TIe
menLuIILy wouId obIILeruLe u proIound, LrunscendenL moruI Irumework
(e.g., CIrIsLIunILy) und subsLILuLe u mIndIess, gumbIIng meLupIor
(sLuLIsLIcuIIsm) us LIe busIs Ior IIvIng. TIe menLuIILy Is IeebIe, IuvIng noL
yeL rIsen ubove superIIcIuIILy. TIuL IL Is IeebIe, Iowever, does noL meun IL
Is noL dungerous. On LIe conLrury, IL Is IIgIIy dungerous. UnubIe Lo
dIscern psycIoIogIcuI, reIuLIonuI, und moruI concepLs, IL Iorces muLerIuIIsL
InLerpreLuLIons on LIe IIImsIesL oI sLuLIsLIcuI InIormuLIon, und wouId see IL
Other Vital Matters
us sunILy Lo LIen coerce LIe sume conLorLed LIInkIng In LIe popuIuLIon uL
Iurge; wIuL oLIer LIun u moruIIy (cIurucLer) deIIcIenL, psycIoIogIcuIIy und
reIuLIonuIIy IncompeLenL menLuIILy wouId dIspense wILI God und
subsLILuLe sLuLIsLIcuI bIuLIer. AcLuuIIy occurrIng In LIe muLerIuIIsL
munIIesLo Is LIe enucLmenL oI uII LIese deIIcIencIes - urrogunce,
IuugILIness, prIde, vunILy, obsLInucy, obsessIon wILI conLroI. TIe very
deIIcIencIes LIuL u coIerenL, proIound moruI Irumework wouId urge uII Lo
uddress In IIIeIong IusIIon, LIe muLerIuIIsL, by jeLLIsonIng LIIs enLIre
requIremenL, wIII be enucLIng uII oI LIese - und obIIvIousIy so. WIen LIIs
menLuIILy InIecLs socIuI IeudersIIp und LIe greuLer porLIon oI LIe
popuIuLIon, onIy greuL dIsusLer cun ensue.
n ugreemenL wILI SLevenson`s (1q;q) observuLIon, SkInner Is
poIILIcuIIy nuve us Lo LIe sInIsLer overLones oI poLenLIuI obsessIon wILI
conLroI LIuL scIenLIIIc psycIoIogy wouId be purLy Lo. TIere Is u sIeer Iuck
oI udequuLe deIIneuLIon, II uny Is possIbIe, oI suIeguurds uguInsL ubuse oI
power, wIuL consLILuLes LIe promoLIon oI IuppIness Ior LIe muILILudes,
und Iow onIy scIence cun deIIne und uddress LIIs Issue. urLIermore, ILs
IIIppunL dIsmIssuI oI Iree-wIII reIIecLs u dIsLurbIng IncognIzunce oI LIe
subsLunLIve Issues InvoIved In LIe Iong-sLundIng deLermInIsmJIree wIII
debuLe.
BeIuvIorIsLs und purLIcuIur reseurcIers In LIe medIcuI scIences
spend mosL oI LIeIr proIessIonuI IIves In IuboruLory seLLIngs, usuuIIy
sLudyIng LIe beIuvIor oI ruLs or oLIer unImuIs. TIe runge oI InvesLIguLIon
concerns LIe beIuvIoruI eIIecLs oI mosLIy dIeL, exposures, und exercIse.
TIe exLenL oI reIuLIonsIIp beLween LIe experImenLer und experImenLuI
subjecLs Is LIuL LIe Iormer Is LIe conLroIIer oI LIe envIronmenL und LIe
IuLLer ure LIe conLroIIed. BeIuvIorIsLs sImpIy Lrunspose LIIs reIuLIonsIIp
In LIeIr consIderuLIons oI LIe Iumun popuIuLIon. TIe Ideu oI coIerenL
reIuLIonuI dynumIcs Is uIIen Lo LIe superIIcIuIILy oI muLerIuIIsL reusonIng.
BeIuvIorIsLs crInge uL sucI Ideus us cIurucLer sLrengLIs, e.g., InLegrILy,
IonesLy, IuILIIuIness, LrusLworLIIness. TIe reuson beIng LIuL uIong LIese
dImensIons LIe muLerIuIIsL menLuIILy wouId be un uLLer IuIIure.
TIe muLerIuIIsL menLuIILy Is u very pecuIIur one. L vIews greuLer
socIeLy us sImpIy un exLensIon oI LIe IuboruLory und wIere Iumuns ure
onIy sIIgILIy more udvunced unImuIs LIun ruLs. TIe menLuIILy Is devoId oI
uny meLupIysIcuI or LrunscendenL Ideus. L musL LIereIore munuIucLure u
conLInuILy beLween evenLs enLIreIy uIong LIe sIngIe muLerIuI dImensIon.
Ls vIew oI cuuse-eIIecL und IeuILI concernIng Iumuns Is deIIned In
exucLIy LIe sume wuy us LIuL Ior IuboruLory unImuIs, I.e., dIeL, exposures,
exercIse. urLIermore, us Ius been seen Irom LIe conducL oI IIIesLyIe
epIdemIoIogy und Irom un upcomIng scruLIny oI prevenLIve medIcIne,
IIImsy popuIuLIon sLuLIsLIcs ure used Lo coerce (condILIon) beIuvIoruI
190
190
Rampant Antismoking Signifies Grave Danger
cIunges In every member oI LIe popuIuLIon. WIoIe groups ure
quesLIonubIy muneuvered ubouL u sLuLIsLIcuI muze In order Lo produce
Iow-probubIIILy beneIILs In LIny subgroups, I.e., LIe prescrIpLIons Iuve no
uppIIcuLIon Lo mosL oI LIe group members. I LIIs upproucI Is used wILI
IIocks oI sIeep or groups oI ruLs, LIIs Is one muLLer. ndIvIduuI members oI
LIese groups wIII noL compreIend, IeL uIone urgue, LIe IoIIy In progress,
I.e., LIe sILuuLIon Is IIgIIy IorgIvIng oI u conLorLed upproucI. However, LIe
sILuuLIon Is quILe dIIIerenL wILI Iumuns wIIcI ure cupubIe oI ruLIonuI
LIougIL und evuIuuLIon. TIe crILIcuI probIem Is LIuL us Iur us u beIuvIorIsL
Is concerned, u group oI Iumuns Is consIdered Lo be jusL IIke u group oI
ruLs.
SkInner (1q;q) expresses IIs dIssuLIsIucLIon wILI reIIgIon (I.e.,
CIrIsLIunILy) und LIe Ideu oI Ieuven: And don`L know wIeLIer wunL Lo
Improve reIIgIon or noL. preIer Lo geL rId oI IL, buL unLII we cun geL rId oI
IL suIeIy, IL muy be weII Lo muke sure LIuL IL IuncLIons. (p.11)
BeIuvIorIsm Is LIe uLLempL Lo subsLILuLe LIe Ideu oI God und Ieuven wILI
u mun-engIneered (scIenLIIIc) socIeLy: TIIs Is LIe muLerIuIIsL munIIesLo.
n un eurIIer wrILIng (Wclden Tuo, 1qq8) SkInner descrIbes IIs
engIneered versIon oI LIe uLopIun socIeLy, bused essenLIuIIy on body
punderIng. Very mucI uIIke Lo LIe percepLIon und LreuLmenL oI IuboruLory
unImuIs, Iumuns LIuL ure udequuLeIy Ied, Ioused und exercIsed, und
wIere devIunL beIuvIor Is condILIoned uwuy wIII be Iuppy. TIe
empIusIs Is enLIreIy on bodIIy needs und LIe conLroI oI LIe envIronmenL.
SkInner IImseII preIerred Lo work uL Iome In u soundprooIed,
LemperuLure conLroIIed, und uIr-IIILered room. DIspIeused wILI LIe
sLundurd buby-crIb, SkInner ruIsed IIs younger duugILer Ior Ier IIrsL o
monLIs In IIs specIIIcuIIy desIgned uIr-crIb - u bIg box wILI cIeunIIness
und cIImuLe conLroIs und u sIIdIng gIuss door oI cIeur suIeLy gIuss. (HuII,
1q;q, p.11q)
ConLrury Lo rumor LIuL Is sLIII cIrcuIuLIng on LIe InLerneL, LIe uIr-
crIb wus noL LIe equIvuIenL oI u SkInner box, LIe IuLLer beIng experImenLuI
uppuruLus used In IuboruLory seLLIngs wILI enLIreIy dIIIerenL IuncLIons.
urLIermore, IIs duugILer wus noL psycIoIogIcuIIy dIsubIed by LIe uIr-
crIb experIence, nor dId sIe suIcIde In Ier eurIy zo`s. However, IL cun
equuIIy be suId LIuL LIe uIr-crIb dId noL produce u IIgIIy proIound
IndIvIduuI; IIs duugILer seemed us LypIcuI us II sIe Iud noL been ruIsed In
LIe uIr-crIb. TIe consLunL LIeme oI beIuvIorIsm or muLerIuIIsm Is body-
IIxuLIon und un obsessIon wILI envIronmenLuI conLroI (exLerIor IygIene).
ConcernIng proIound LrunscendenL reusonIng und depLI oI reIuLIonsIIp,
LIe perspecLIve Is sLerIIe. n spIrILuuI Lerms, IL Is deud or bIInd.
HuvIng dIspensed wILI LIe possIbIIILy oI LrunscendIng morLuIILy
uIong u reIIgIous puLIwuy, LIe coupIIng oI LIe beIuvIorIsL`s uLopIu und
Other Vital Matters
medIco-muLerIuIIsm Ius generuLed new dImensIons In body-IIxuLIon. TIe
muLerIuIIsL wIsI Ior curnuI ImmorLuIILy Ius produced u Irenzy oI geneLIc
und IIIesLyIe reseurcI wILI compIeLeIy quesLIonubIe promIssory noLes.
TIIs sorL oI IIxuLIon cun be descrIbed In newer Lerms. or exumpIe,
CIrysunLIou (zooz) sees LIe sLrong pubIIc ucLIvILy In LIe cure und
monILorIng oI LIe body us LIe posLmodern uLLempL Lo uLLuIn u perIecL,
ImperIsIubIe body. TIe body pumperIng, punderIng und monILorIng Is
reIerred Lo us body projecLs, und somuLopIu Is deIIned us LIe
coIIecLIve expressIon oI LIese prIvuLIzed und personuIIzed body projecLs.
However, conLrury Lo CIrysunLIou (zooz), LIe descrIpLIon oI
posLmodernILy us reIIecLIng un InwurdIy dIrecLed guze In conLrusL Lo
ouLwurd or communILy uwureness Is Iur Loo generuI Lo be oI use. HonesL
seII-scruLIny In muILIdImensIonuI Lerms (IncIudIng LIe pre-emInenL
spIrILuuI dImensIon) Is uIso Inwurd. TIe Inwurdness oI muLerIuIIsL
reusonIng, Iowever, Is ILs IIxuLIon onl on LIe body (I.e., ego-ubsorpLIon).
n LIIs sense IL Is u mosL sIuIIow perspecLIve noL Lo be conIused wILI more
ecIecLIc, muILIdImensIonuI, LrunscendenL perspecLIves. UnIorLunuLeIy, uII
oI LIese newer Lerms Lend Lo provIde un unwurrunLed IeveI oI IegILImucy Lo
wIuL Is onIy oId-IusIIoned und probIemuLIc body IIxuLIon.
I LIe ussumpLIon LIuL scIence cun expIuIn uII LIIngs Is IncorrecL,
us IL sureIy Is, LIen LIe beIuvIorIsL perspecLIve Is no more LIun u
superIIcIuI, InIerenLIuIIy IncompeLenL und ImmuLure menLuIILy. L cun weII
be urgued LIuL LIe beIuvIorIsL (muLerIuIIsL) Ius sImpIy noL come Lo Lerms
wILI LIeIr own menLuI IuncLIonIng; IL Ius noL yeL begun IonesL seII-
scruLIny uIong psycIoIogIcuI, reIuLIonuI, und spIrILuuIJmoruI dImensIons.
RuLIer LIun ucknowIedgIng LIe consIderubIe IImILuLIons oI LIeIr own
reusonIng und LIuL LIere muy be dImensIons beyond LIeIr currenL
compreIensIon, LIe beIuvIorIsL convenIenLIy rejecLs LIuL LIIs menLuI
ucLIvILy Ius uny IuncLIonuI or meunIngIuI uspecL uL uII. TIe uccepLunce oI u
proIound sLundurd oI LIougIL und conducL Is Loo overwIeImIng, Loo guIIL-
InducIng. n Ieur und seII-decepLIon, LIe menLuIILy decIdes Lo reduce LIe
enLIre Iumun condILIon Lo be vIewed wILIIn its IIImsy, superIIcIuI
percepLIon. As sucI, beIuvIorIsm Is u LoLuIIsLIc, uII-encompussIng vIew oI
LIe person.
A IurLIer perennIuI probIem Ior LIe muLerIuIIsL perspecLIve Is
LIuL IL cunnoL expIuIn by u sImpIe bIuck boxJsLImuIus-response Irumework
Iow some oI LIe deLermIned orgunIsms cun even vIew, In uny
meunIngIuI sense, LIemseIves us conLroIIers oI LIeIr IeIIow orgunIsms.
TIIs sorL oI quesLIon requIres IonesL seII-scruLIny und Is LypIcuIIy IeIL
ununswered by beIuvIorIsm. As LIe dIscussIon proceeds, IL sIouId be
more LIun obvIous LIuL LIe menLuIILy, beIng moruIIy InepL, Is IncupubIe oI
compreIendIng u moruI concepL, IeL uIone IoIIowIng u moruI reusonIng. L
191
191
Rampant Antismoking Signifies Grave Danger
cIunges In every member oI LIe popuIuLIon. WIoIe groups ure
quesLIonubIy muneuvered ubouL u sLuLIsLIcuI muze In order Lo produce
Iow-probubIIILy beneIILs In LIny subgroups, I.e., LIe prescrIpLIons Iuve no
uppIIcuLIon Lo mosL oI LIe group members. I LIIs upproucI Is used wILI
IIocks oI sIeep or groups oI ruLs, LIIs Is one muLLer. ndIvIduuI members oI
LIese groups wIII noL compreIend, IeL uIone urgue, LIe IoIIy In progress,
I.e., LIe sILuuLIon Is IIgIIy IorgIvIng oI u conLorLed upproucI. However, LIe
sILuuLIon Is quILe dIIIerenL wILI Iumuns wIIcI ure cupubIe oI ruLIonuI
LIougIL und evuIuuLIon. TIe crILIcuI probIem Is LIuL us Iur us u beIuvIorIsL
Is concerned, u group oI Iumuns Is consIdered Lo be jusL IIke u group oI
ruLs.
SkInner (1q;q) expresses IIs dIssuLIsIucLIon wILI reIIgIon (I.e.,
CIrIsLIunILy) und LIe Ideu oI Ieuven: And don`L know wIeLIer wunL Lo
Improve reIIgIon or noL. preIer Lo geL rId oI IL, buL unLII we cun geL rId oI
IL suIeIy, IL muy be weII Lo muke sure LIuL IL IuncLIons. (p.11)
BeIuvIorIsm Is LIe uLLempL Lo subsLILuLe LIe Ideu oI God und Ieuven wILI
u mun-engIneered (scIenLIIIc) socIeLy: TIIs Is LIe muLerIuIIsL munIIesLo.
n un eurIIer wrILIng (Wclden Tuo, 1qq8) SkInner descrIbes IIs
engIneered versIon oI LIe uLopIun socIeLy, bused essenLIuIIy on body
punderIng. Very mucI uIIke Lo LIe percepLIon und LreuLmenL oI IuboruLory
unImuIs, Iumuns LIuL ure udequuLeIy Ied, Ioused und exercIsed, und
wIere devIunL beIuvIor Is condILIoned uwuy wIII be Iuppy. TIe
empIusIs Is enLIreIy on bodIIy needs und LIe conLroI oI LIe envIronmenL.
SkInner IImseII preIerred Lo work uL Iome In u soundprooIed,
LemperuLure conLroIIed, und uIr-IIILered room. DIspIeused wILI LIe
sLundurd buby-crIb, SkInner ruIsed IIs younger duugILer Ior Ier IIrsL o
monLIs In IIs specIIIcuIIy desIgned uIr-crIb - u bIg box wILI cIeunIIness
und cIImuLe conLroIs und u sIIdIng gIuss door oI cIeur suIeLy gIuss. (HuII,
1q;q, p.11q)
ConLrury Lo rumor LIuL Is sLIII cIrcuIuLIng on LIe InLerneL, LIe uIr-
crIb wus noL LIe equIvuIenL oI u SkInner box, LIe IuLLer beIng experImenLuI
uppuruLus used In IuboruLory seLLIngs wILI enLIreIy dIIIerenL IuncLIons.
urLIermore, IIs duugILer wus noL psycIoIogIcuIIy dIsubIed by LIe uIr-
crIb experIence, nor dId sIe suIcIde In Ier eurIy zo`s. However, IL cun
equuIIy be suId LIuL LIe uIr-crIb dId noL produce u IIgIIy proIound
IndIvIduuI; IIs duugILer seemed us LypIcuI us II sIe Iud noL been ruIsed In
LIe uIr-crIb. TIe consLunL LIeme oI beIuvIorIsm or muLerIuIIsm Is body-
IIxuLIon und un obsessIon wILI envIronmenLuI conLroI (exLerIor IygIene).
ConcernIng proIound LrunscendenL reusonIng und depLI oI reIuLIonsIIp,
LIe perspecLIve Is sLerIIe. n spIrILuuI Lerms, IL Is deud or bIInd.
HuvIng dIspensed wILI LIe possIbIIILy oI LrunscendIng morLuIILy
uIong u reIIgIous puLIwuy, LIe coupIIng oI LIe beIuvIorIsL`s uLopIu und
Other Vital Matters
medIco-muLerIuIIsm Ius generuLed new dImensIons In body-IIxuLIon. TIe
muLerIuIIsL wIsI Ior curnuI ImmorLuIILy Ius produced u Irenzy oI geneLIc
und IIIesLyIe reseurcI wILI compIeLeIy quesLIonubIe promIssory noLes.
TIIs sorL oI IIxuLIon cun be descrIbed In newer Lerms. or exumpIe,
CIrysunLIou (zooz) sees LIe sLrong pubIIc ucLIvILy In LIe cure und
monILorIng oI LIe body us LIe posLmodern uLLempL Lo uLLuIn u perIecL,
ImperIsIubIe body. TIe body pumperIng, punderIng und monILorIng Is
reIerred Lo us body projecLs, und somuLopIu Is deIIned us LIe
coIIecLIve expressIon oI LIese prIvuLIzed und personuIIzed body projecLs.
However, conLrury Lo CIrysunLIou (zooz), LIe descrIpLIon oI
posLmodernILy us reIIecLIng un InwurdIy dIrecLed guze In conLrusL Lo
ouLwurd or communILy uwureness Is Iur Loo generuI Lo be oI use. HonesL
seII-scruLIny In muILIdImensIonuI Lerms (IncIudIng LIe pre-emInenL
spIrILuuI dImensIon) Is uIso Inwurd. TIe Inwurdness oI muLerIuIIsL
reusonIng, Iowever, Is ILs IIxuLIon onl on LIe body (I.e., ego-ubsorpLIon).
n LIIs sense IL Is u mosL sIuIIow perspecLIve noL Lo be conIused wILI more
ecIecLIc, muILIdImensIonuI, LrunscendenL perspecLIves. UnIorLunuLeIy, uII
oI LIese newer Lerms Lend Lo provIde un unwurrunLed IeveI oI IegILImucy Lo
wIuL Is onIy oId-IusIIoned und probIemuLIc body IIxuLIon.
I LIe ussumpLIon LIuL scIence cun expIuIn uII LIIngs Is IncorrecL,
us IL sureIy Is, LIen LIe beIuvIorIsL perspecLIve Is no more LIun u
superIIcIuI, InIerenLIuIIy IncompeLenL und ImmuLure menLuIILy. L cun weII
be urgued LIuL LIe beIuvIorIsL (muLerIuIIsL) Ius sImpIy noL come Lo Lerms
wILI LIeIr own menLuI IuncLIonIng; IL Ius noL yeL begun IonesL seII-
scruLIny uIong psycIoIogIcuI, reIuLIonuI, und spIrILuuIJmoruI dImensIons.
RuLIer LIun ucknowIedgIng LIe consIderubIe IImILuLIons oI LIeIr own
reusonIng und LIuL LIere muy be dImensIons beyond LIeIr currenL
compreIensIon, LIe beIuvIorIsL convenIenLIy rejecLs LIuL LIIs menLuI
ucLIvILy Ius uny IuncLIonuI or meunIngIuI uspecL uL uII. TIe uccepLunce oI u
proIound sLundurd oI LIougIL und conducL Is Loo overwIeImIng, Loo guIIL-
InducIng. n Ieur und seII-decepLIon, LIe menLuIILy decIdes Lo reduce LIe
enLIre Iumun condILIon Lo be vIewed wILIIn its IIImsy, superIIcIuI
percepLIon. As sucI, beIuvIorIsm Is u LoLuIIsLIc, uII-encompussIng vIew oI
LIe person.
A IurLIer perennIuI probIem Ior LIe muLerIuIIsL perspecLIve Is
LIuL IL cunnoL expIuIn by u sImpIe bIuck boxJsLImuIus-response Irumework
Iow some oI LIe deLermIned orgunIsms cun even vIew, In uny
meunIngIuI sense, LIemseIves us conLroIIers oI LIeIr IeIIow orgunIsms.
TIIs sorL oI quesLIon requIres IonesL seII-scruLIny und Is LypIcuIIy IeIL
ununswered by beIuvIorIsm. As LIe dIscussIon proceeds, IL sIouId be
more LIun obvIous LIuL LIe menLuIILy, beIng moruIIy InepL, Is IncupubIe oI
compreIendIng u moruI concepL, IeL uIone IoIIowIng u moruI reusonIng. L
192
192
Rampant Antismoking Signifies Grave Danger
produces u sILuuLIon noL unIIke LIuL seen In NuzI Germuny wIere medIcuI
prucLILIoners demonsLruLIng some oI LIe mosL vIIe conducL LIuL Iumuns
ure cupubIe oI, und on u muss scuIe, ucLuuIIy beIIeved LIey were doIng
IumunILy u greuL servIce; LIe menLuIILy Is moruIIy dense. L Is LIIs
conscIence-vucuum LIuL mukes LIe menLuIILy IIgIIy dungerous.
UndersLundubIy, scIenLIIIc psycIoIogy Ius receIved consIderubIe
crILIcIsm over LIe yeurs. GruIum (1q86) reusonubIy posILs LIuL LIe
|s|cIenLIIIc meLIod ucIIeves LIIs |uIIenuLIon| by
neguLIng LIe senses, IeeIIngs und conscIousness. L
LIereby noL onIy uIIenuLes mun Irom IIs InnermosL seII,
buL In presenLIng u vIew oI IIs IeIIow mun und oLIer
creuLures us mere LIIngs, uIIenuLes IIm Irom LIem und
mukes LIeIr expIoILuLIon eusIer und more InevILubIe.
AccordIngIy, Rozuk (1q;o, p. zz) cIuIms LIuL scIenLIIIc
meLIod is uIIenuLed IIIe, promoLed Lo ILs mosL
IonourIIIc sLuLus. As u resuIL oI ILs excIusIon oI LIe
subjecLIve Irom LIe subjecL muLLer oI psycIoIogy,
beIuvIorIsm cume Lo be seen In some quurLers us
epILomIzIng LIe uIIenuLIon oI mun, und durIng LIe
1qo`s und 1q6o`s IL becume IncreusIngIy LIe Iocus oI
crILIcIsm. One oI ILs mosL ouLspoken crILIcs wus KoesLIer
(1q;) wIo vIewed LIe excIusIon oI LIe subjecLIve us LIe
IIrsL IdeoIogIcuI purge oI sucI u rudIcuI kInd In LIe
domuIn oI scIence, und IIkened LIe docLrInes oI
beIuvIorIsm Lo 'u vIrus LIuL IIrsL cuuses convuIsIons,
LIen sIowIy puruIyzes LIe vIcLIm` (p.). BurL (1q6z, p.
zzq) Look u sImIIurIy cynIcuI vIew oI LIe beIuvIorIsL
munIIesLo, cIuImIng LIuL psycIoIogy 'IuvIng IIrsL
burguIned uwuy ILs souI und LIen gone ouL oI ILs mInd,
seems, now, us IL Iuces un unLImeIy end, Lo Iuve IosL uII
conscIousness.` (p. z;)
As IndIcuLed eurIIer, IL Is noL LIe scIenLIIIc meLIod LIuL Is
probIemuLIc, buL LIe muLerIuIIsm dIrecLIng scIence. ConLrury Lo BurL`s
(1q6z) esLImuLIon, und unIorLunuLeIy so, beIuvIorIsm Is uIIve und weII,
uIbeIL IuckIng In conscIousness, und uppeurIng In u vurIeLy oI Iorms. L
sIouId be evIdenL LIuL epIdemIoIogy, In uII oI ILs bruncIes (moIecuIur,
IndIvIduuI, socIuI) Is beIuvIorIsL In dIsposILIon. PurLIcuIurIy rIsk-IucLor
epIdemIoIogy, wIIcI supposedIy uddresses LIe IndIvIduuI, compIeLeIy
rejecLs u pIenomenoIogIcuI IeveI und reIIes enLIreIy on exLernuIIzIng
poLenLIuI cuuses oI dIseuse; IL Is obIIvIous Lo endogenous bIoIogIcuI
vurIubIIILIes, IeL uIone uccounLIng Ior un enLIreIy psycIoIogIcuI dImensIon
Other Vital Matters
oI IeuILI or psycIogenIc eIIecLs (e.g., nocebo, ubscebo). As wIII be
consIdered, beIuvIorIsm comes InLo ILs dungerous-own wIen IL Is used us
LIe propugundu urm oI prevenLIve medIcIne or IeuILI promoLIon.
L sIouId be oI rcte concern LIuL over LIe IusL Iew decudes LIere
Ius been u buIIdIng muLerIuIIsL domInuLIon oI IeuILI und socIeLy
generuIIy. TIe currenL muLerIuIIsL momenLum Ius ILs rooLs In LIe mId-
1q;o`s (see BerrIdge, 1qqq). WILI LIe cupucILy Lo quunLIIy rIsk
(epIdemIoIogIc enquIry) und convInced LIuL LIIs reIIecLs scIence, IeuILI
uuLIorILIes commILLed LIemseIves Lo LIe muLerIuIIsL munIIesLo. A crILIcuI
uspecL oI LIe muLerIuIIsL IdeoIogy Is engIneerIng LIe rIsk uvoIdIng
IndIvIduuI und wIIcI IncIudes sLuLIsLIcuI rIsk.
By LIe Lurn oI LIe new mIIIennIum, LIere Is u IILeruI burruge oI
IeuILI udverLs und IIIesLyIe progrumsJsIows wIere IeuILI Is porLruyed
enLIreIy In muLerIuIIsL Lerms, I.e., reduced Lo dIeL, exposures, und exercIse.
And, LIe prevuIIIng muLerIuIIsL uuLIorILIesJconLroIIers, urmed wILI
popuIuLIon-IeveI sLuLIsLIcuI nonsense, IuIIy expecL LIe popuIuLIon uL Iurge
Lo mIndIessIy conIorm Lo prescrIpLIons, noL unIIke IuboruLory ruLs. TIere
Is now u sLuggerIng consumpLIon oI dIeLury suppIemenLs und, uL uny LIme
durIng LIe duy or nIgIL, peopIe cun be seen runnIng uImIessIy on
LreudmIIIs - very mucI IIke IuboruLory ruLs - In LIe numerous muLerIuIIsL
cIurcIes (gymnusIums) LIuL Iuve sprung up. Even busInesses now
provIde onsILe gymnusIums. A currenL debuLed dunger Is wIeLIer
empIoyers cun keep Lruck oI empIoyees` exercIse LIme und requIre
purLIcuIur exercIse perIormunce Ior conLInuIng empIoymenL.
TIe greuL Lrugedy Is LIuL muny In numerous socIeLIes cre
uccepLIng LIIs beIIeI sysLem, regurdIess oI wIeLIer LIey ure successIuI
wILIIn IL or noL. L Is LrugIc Indeed LIuL LIe Iumun, even wILI uII ILs IoIbIes
und IuIIIngs, LIuL Ius u mosL proIound poLenLIuI wILIIn spIrILuuI
Irumeworks Is reduced under muLerIuIIsm Lo u mIndIess, bIoIogIcuI
orgunIsm Lossed Lo und Iro on LIe wuves oI sLuLIsLIcuI cIunce und LIe
deIuded wIIms oI wouId-be muLerIuIIsL ruIers. Under oLIer guIses (e.g.,
IumunIsm), muLerIuIIsm Ius severeIy eroded spIrILuuI, moruI,
psycIoIogIcuI, und reIuLIonuI sensIbIIILIes, I.e., un enIeebIIng on u muss
scuIe. HuvIng jeLLIsoned uny Ideu oI ucLuuI proIundILy (I.e., God), LIe
musses now congreguLe uround LIe muLerIuIIsL cuLIedruIs (IospILuIs) und
LIeIr prIesLs Ior LIe wuy Lo suIvuLIon. L wIII be consIdered In IuLer
cIupLers LIuL muny, purLIcuIurIy wesLern socIeLIes, ure exIIbILIng
sLuggerIng reIuLIonuI IuIIure (e.g., dIvorce, IncIvIIILy, uIIenuLIon) - u sure
sIgn LIuL sucI socIeLIes ure under muLerIuIIsL domInuLIon. TIe muLerIuIIsL
menLuIILy, wIen eIevuLed Lo unmerILed uuLIorILuLIve IeveIs, wIII IosLer seII-
ubsorpLIon (rumpunL survIvuIIsm), body-IIxuLIon, spIrILuuI bIIndness, und
reIuLIonuI crIppIIng In LIe musses.
193
193
Rampant Antismoking Signifies Grave Danger
produces u sILuuLIon noL unIIke LIuL seen In NuzI Germuny wIere medIcuI
prucLILIoners demonsLruLIng some oI LIe mosL vIIe conducL LIuL Iumuns
ure cupubIe oI, und on u muss scuIe, ucLuuIIy beIIeved LIey were doIng
IumunILy u greuL servIce; LIe menLuIILy Is moruIIy dense. L Is LIIs
conscIence-vucuum LIuL mukes LIe menLuIILy IIgIIy dungerous.
UndersLundubIy, scIenLIIIc psycIoIogy Ius receIved consIderubIe
crILIcIsm over LIe yeurs. GruIum (1q86) reusonubIy posILs LIuL LIe
|s|cIenLIIIc meLIod ucIIeves LIIs |uIIenuLIon| by
neguLIng LIe senses, IeeIIngs und conscIousness. L
LIereby noL onIy uIIenuLes mun Irom IIs InnermosL seII,
buL In presenLIng u vIew oI IIs IeIIow mun und oLIer
creuLures us mere LIIngs, uIIenuLes IIm Irom LIem und
mukes LIeIr expIoILuLIon eusIer und more InevILubIe.
AccordIngIy, Rozuk (1q;o, p. zz) cIuIms LIuL scIenLIIIc
meLIod is uIIenuLed IIIe, promoLed Lo ILs mosL
IonourIIIc sLuLus. As u resuIL oI ILs excIusIon oI LIe
subjecLIve Irom LIe subjecL muLLer oI psycIoIogy,
beIuvIorIsm cume Lo be seen In some quurLers us
epILomIzIng LIe uIIenuLIon oI mun, und durIng LIe
1qo`s und 1q6o`s IL becume IncreusIngIy LIe Iocus oI
crILIcIsm. One oI ILs mosL ouLspoken crILIcs wus KoesLIer
(1q;) wIo vIewed LIe excIusIon oI LIe subjecLIve us LIe
IIrsL IdeoIogIcuI purge oI sucI u rudIcuI kInd In LIe
domuIn oI scIence, und IIkened LIe docLrInes oI
beIuvIorIsm Lo 'u vIrus LIuL IIrsL cuuses convuIsIons,
LIen sIowIy puruIyzes LIe vIcLIm` (p.). BurL (1q6z, p.
zzq) Look u sImIIurIy cynIcuI vIew oI LIe beIuvIorIsL
munIIesLo, cIuImIng LIuL psycIoIogy 'IuvIng IIrsL
burguIned uwuy ILs souI und LIen gone ouL oI ILs mInd,
seems, now, us IL Iuces un unLImeIy end, Lo Iuve IosL uII
conscIousness.` (p. z;)
As IndIcuLed eurIIer, IL Is noL LIe scIenLIIIc meLIod LIuL Is
probIemuLIc, buL LIe muLerIuIIsm dIrecLIng scIence. ConLrury Lo BurL`s
(1q6z) esLImuLIon, und unIorLunuLeIy so, beIuvIorIsm Is uIIve und weII,
uIbeIL IuckIng In conscIousness, und uppeurIng In u vurIeLy oI Iorms. L
sIouId be evIdenL LIuL epIdemIoIogy, In uII oI ILs bruncIes (moIecuIur,
IndIvIduuI, socIuI) Is beIuvIorIsL In dIsposILIon. PurLIcuIurIy rIsk-IucLor
epIdemIoIogy, wIIcI supposedIy uddresses LIe IndIvIduuI, compIeLeIy
rejecLs u pIenomenoIogIcuI IeveI und reIIes enLIreIy on exLernuIIzIng
poLenLIuI cuuses oI dIseuse; IL Is obIIvIous Lo endogenous bIoIogIcuI
vurIubIIILIes, IeL uIone uccounLIng Ior un enLIreIy psycIoIogIcuI dImensIon
Other Vital Matters
oI IeuILI or psycIogenIc eIIecLs (e.g., nocebo, ubscebo). As wIII be
consIdered, beIuvIorIsm comes InLo ILs dungerous-own wIen IL Is used us
LIe propugundu urm oI prevenLIve medIcIne or IeuILI promoLIon.
L sIouId be oI rcte concern LIuL over LIe IusL Iew decudes LIere
Ius been u buIIdIng muLerIuIIsL domInuLIon oI IeuILI und socIeLy
generuIIy. TIe currenL muLerIuIIsL momenLum Ius ILs rooLs In LIe mId-
1q;o`s (see BerrIdge, 1qqq). WILI LIe cupucILy Lo quunLIIy rIsk
(epIdemIoIogIc enquIry) und convInced LIuL LIIs reIIecLs scIence, IeuILI
uuLIorILIes commILLed LIemseIves Lo LIe muLerIuIIsL munIIesLo. A crILIcuI
uspecL oI LIe muLerIuIIsL IdeoIogy Is engIneerIng LIe rIsk uvoIdIng
IndIvIduuI und wIIcI IncIudes sLuLIsLIcuI rIsk.
By LIe Lurn oI LIe new mIIIennIum, LIere Is u IILeruI burruge oI
IeuILI udverLs und IIIesLyIe progrumsJsIows wIere IeuILI Is porLruyed
enLIreIy In muLerIuIIsL Lerms, I.e., reduced Lo dIeL, exposures, und exercIse.
And, LIe prevuIIIng muLerIuIIsL uuLIorILIesJconLroIIers, urmed wILI
popuIuLIon-IeveI sLuLIsLIcuI nonsense, IuIIy expecL LIe popuIuLIon uL Iurge
Lo mIndIessIy conIorm Lo prescrIpLIons, noL unIIke IuboruLory ruLs. TIere
Is now u sLuggerIng consumpLIon oI dIeLury suppIemenLs und, uL uny LIme
durIng LIe duy or nIgIL, peopIe cun be seen runnIng uImIessIy on
LreudmIIIs - very mucI IIke IuboruLory ruLs - In LIe numerous muLerIuIIsL
cIurcIes (gymnusIums) LIuL Iuve sprung up. Even busInesses now
provIde onsILe gymnusIums. A currenL debuLed dunger Is wIeLIer
empIoyers cun keep Lruck oI empIoyees` exercIse LIme und requIre
purLIcuIur exercIse perIormunce Ior conLInuIng empIoymenL.
TIe greuL Lrugedy Is LIuL muny In numerous socIeLIes cre
uccepLIng LIIs beIIeI sysLem, regurdIess oI wIeLIer LIey ure successIuI
wILIIn IL or noL. L Is LrugIc Indeed LIuL LIe Iumun, even wILI uII ILs IoIbIes
und IuIIIngs, LIuL Ius u mosL proIound poLenLIuI wILIIn spIrILuuI
Irumeworks Is reduced under muLerIuIIsm Lo u mIndIess, bIoIogIcuI
orgunIsm Lossed Lo und Iro on LIe wuves oI sLuLIsLIcuI cIunce und LIe
deIuded wIIms oI wouId-be muLerIuIIsL ruIers. Under oLIer guIses (e.g.,
IumunIsm), muLerIuIIsm Ius severeIy eroded spIrILuuI, moruI,
psycIoIogIcuI, und reIuLIonuI sensIbIIILIes, I.e., un enIeebIIng on u muss
scuIe. HuvIng jeLLIsoned uny Ideu oI ucLuuI proIundILy (I.e., God), LIe
musses now congreguLe uround LIe muLerIuIIsL cuLIedruIs (IospILuIs) und
LIeIr prIesLs Ior LIe wuy Lo suIvuLIon. L wIII be consIdered In IuLer
cIupLers LIuL muny, purLIcuIurIy wesLern socIeLIes, ure exIIbILIng
sLuggerIng reIuLIonuI IuIIure (e.g., dIvorce, IncIvIIILy, uIIenuLIon) - u sure
sIgn LIuL sucI socIeLIes ure under muLerIuIIsL domInuLIon. TIe muLerIuIIsL
menLuIILy, wIen eIevuLed Lo unmerILed uuLIorILuLIve IeveIs, wIII IosLer seII-
ubsorpLIon (rumpunL survIvuIIsm), body-IIxuLIon, spIrILuuI bIIndness, und
reIuLIonuI crIppIIng In LIe musses.
194
194
Rampant Antismoking Signifies Grave Danger
L Is u concIusIon Irom LIIs dIscussIon LIuL u vIew, sucI us
beIuvIorIsm, LIuL cunnoL dIscern beLween IuncLIonuI und dysIuncLIonuI
menLuIILIes due Lo u rejecLIon oI LIuL enLIre IeveI oI ucLIvILy Is ILseII
dysIuncLIonuI. urLIermore, IL wIII noL be ubIe Lo dIscern uny deLrImenLuI
moruI, socIuI und psycIoIogIcuI IeuILI rumIIIcuLIons oI ILs own conducL,
I.e., u dungerous cIosed Ioop. L wIII be consIdered In IoIIowIng cIupLers
LIuL In prevenLIve medIcIne or IeuILI promoLIon LIere Is u convergIng oI
scIenLIsm und IeuILIIsm (MMES IIIesLyIe cuIL). TIese ure drIven by u
muLerIuIIsL dIsposILIon, scIenLIIIc IncompeLence und LIe superIorILy
syndrome. As Lo scIenLIsm, noL onIy Is LIe Ideu oI scIenLIIIc uuLocrucy
compIeLeIy quesLIonubIe, buL LIe probIem Is IurLIer compounded In LIuL
epIdemIoIogy Is un uLLer IuIIure In scIenLIIIc Lerms, I.e., IL Is IIImsy
sLuLIsLIcuIIsm ImposLerIng us u scIence. ConcernIng IeuILIIsm, LIe Ideu Is
enLIreIy devoId oI LIe crILIcuI dImensIons oI psycIoIogIcuI, psycIosocIuI
und moruI IeuILI. GIven LIIs IuLLer poInL In purLIcuIur, LIere Is produced
LIe ubsurdILy LIuL LIe prevuIIIng muLerIuIIsL menLuIILy Is dysIuncLIonuI, Is
IncupubIe oI dIscernIng dysIuncLIonuI LIougIL, und embruces dys-
IuncLIonuI LIougIL Lo promoLe IeuILI.
. The Mediccl Estcblishment: A Closer Scrutin
TIe conLemporury medIcuI esLubIIsImenL Ius numerous und
very consIderubIe In-Iouse probIems. uLrogenIc deuLIs und IIIness Iuve
been In epIdemIc proporLIons Ior muny decudes (see WeIngurL eL uI.,
zooo). Ictroenic ejject reIers Lo uny deLrImenLuI ouLcome resuILIng Irom
medIcuI ucLIvILyJInucLIvILy. NeguLIve ouLcomes cun resuIL Irom u pIeLIoru
oI IucLors sucI us InupproprIuLe medIcuLIon, overprescrIpLIon,
InupproprIuLe combInuLIons oI medIcuLIons, screenIng procedures,
surgIcuI IncompeLence, poorIy sLerIIIzed InsLrumenLs, mIsdIugnosIs,
IuIIure oI dIugnosIs, negIIgence, eLc. (see uIso uuru & Heuney, 1qqo;
TuyIor, 1q;q). IIIcI posILs LIuL LIe puIn, dysIuncLIon, dIsubIIILy, und
unguIsI resuILIng Irom LecInIcuI medIcuI InLervenLIon now rIvuI LIe
morbIdILy due Lo LruIIIc und IndusLrIuI uccIdenLs und even wur-reIuLed
ucLIvILIes, und muke LIe ImpucL oI medIcIne one oI LIe mosL rupIdIy
spreudIng epIdemIcs oI our LIme. (quoLed In uuru & Heuney, 1qqo, p.q)
n AusLruIIu, IL Ius been esLImuLed LIuL LIere ure beLween 1o,ooo
und zo,ooo IuLrogenIc deuLIs per unnum wILI muny Lens oI LIousunds
more In IuLrogenIc IIIness; Ior LIe UnILed SLuLes, IuLrogenIc deuLIs per
unnum ure esLImuLed uL beLween qq,ooo und q8,ooo (see WeIngurL eL uI.,
zooo; WIIson eL uI., 1qq). TIese esLImuLes ure noL mude on IncoIerenL,
sLuLIsLIcuIIy-bused cuusuI urgumenL us Is LIe cuse concernIng, Ior
exumpIe, smokIng-reIuLed deuLIs, buL ure bused on cIeurIy deIInubIe
Other Vital Matters
sequences oI cuusuI evenLs. n oLIer words, concernIng smokIng,
epIdemIoIogy Is used In un uLLempL Lo jusLIIy cuusuI urgumenL, uIbeIL
IncoIerenLIy. WIereus, concernIng IuLrogenIc deuLIs, LIe cuusuI
uLLrIbuLIon oI purLIcuIur medIcuI conducL Is uIreudy undersLood
IndependenL oI epIdemIoIogy; LIe InLenL oI epIdemIoIogy In LIIs cuse Is
sImpIy Lo esLImuLe LIe per-unnum ruLe oI IuLrogenIc deuLI. L sIouId be oI
very sIgnIIIcunL concern LIuL LIese deuLIs ure beIng cuused by un
orgunIzuLIon LIuL promoLes ILseII us u provIder oI IeuILI cure. A
consIderubIe number oI LIe pubIIc LIuL uLLends IospILuIs In good IuILI oI
IuvIng IIIness uLLended Lo do noL onIy noL Ieuve LIe IucIIILy In LIe sume
condILIon buL do noL Ieuve uIIve.
L wouId reusonubIy be expecLed LIuL u reducLIon In IuLrogenIc
deuLIs wouId be u pre-emInenL Issue In medIcuI esLubIIsImenL poIIcy und
conducL. YeL IL Is very rureIy uIIuded Lo by LIe medIcuI esLubIIsImenL -
even In medIcuI journuIs. AILIougI LIere ure u number oI urLIcIes
expressIng concern over LIe pIenomenon, LIere Iuve onIy been tuo
mujor sLudIes (Hurvurd und AusLruIIun) InLo IuLrogenIc deuLIs und IIIness:
TIe Hurvurd und AusLruIIun sLudIes InLo medIcuI error remuIn LIe onIy
sLudIes LIuL provIde popuIuLIon IeveI duLu on LIe ruLes oI InjurIes Lo
puLIenLs und LIey IdenLIIIed u subsLunLIuI umounL oI medIcuI
error. (WeIngurL eL uI., zooo, p.;;q) TIIs pouILry number oI seII-
scruLInIzIng sLudIes Is In sLurk conLrusL Lo LIe thouscnds oI sLudIes
concernIng LIe Issue oI smokIng.
TIe medIu, Loo, gIves very IILLIe coveruge Lo LIIs very severe
probIem oI IuLrogenIc deuLIs. or exumpIe, In LIe mujor VIcLorIun sLuLe
newspuper durIng LIe Lwo-yeur perIod Lo AugusL, zooo, LIere uppeured uL
IeusL severuI Iundred, one-sIded, IruuduIenL, emoLIve urLIcIes on Lobucco-
smokIng (Hercld,Sun, VIcLorIu, AusLruIIu). TIese urLIcIes were IosLered by
LIe medIcuI esLubIIsImenL und LIe unLIsmokIng Iobby. TIe sLundurd
sLuLIsLIcuI rIeLorIc Is LIuL smokIng kIIIs beLween 18,ooo und zo,ooo
persons unnuuIIy. TIese IIgures ure produced usIng LIe equIvuIenL oI LIe
compIeLeIy quesLIonubIe SAMMEC procedure dIscussed In un eurIIer
cIupLer. TIese sLuLIsLIcs ure usuuIIy even IurLIer embeIIIsIed In sucI
Iorms us: SmokIng kIIIs more AusLruIIuns LIun breusL und skIn cuncer,
roud deuLIs, suIcIde, dIubeLes, ADS und murder combIned. (Hercld,
Sun, June 1, zooo) DurIng LIe sume LIme-perIod LIere were onIy Lwo
urLIcIes concernIng IuLrogenIc deuLIs. TIese dId noL conLuIn emoLIve
Iunguuge und were ruLIer uLLILudInuIIy bIus. One urLIcIe reIerred Lo u
reporL commIssIoned IIve yeurs eurIIer LIuL recommended unoLIer
commILLee be esLubIIsIed Lo IurLIer uddress LIe Issue.
TIe IucL oI LIe muLLer Is LIuL, II LIe cctucl requIremenLs oI cuusuI
urgumenL ure uppIIed, IL Is LIe medIcuI esLubIIsImenL LIuL Is sInguIurIy,
195
195
Rampant Antismoking Signifies Grave Danger
L Is u concIusIon Irom LIIs dIscussIon LIuL u vIew, sucI us
beIuvIorIsm, LIuL cunnoL dIscern beLween IuncLIonuI und dysIuncLIonuI
menLuIILIes due Lo u rejecLIon oI LIuL enLIre IeveI oI ucLIvILy Is ILseII
dysIuncLIonuI. urLIermore, IL wIII noL be ubIe Lo dIscern uny deLrImenLuI
moruI, socIuI und psycIoIogIcuI IeuILI rumIIIcuLIons oI ILs own conducL,
I.e., u dungerous cIosed Ioop. L wIII be consIdered In IoIIowIng cIupLers
LIuL In prevenLIve medIcIne or IeuILI promoLIon LIere Is u convergIng oI
scIenLIsm und IeuILIIsm (MMES IIIesLyIe cuIL). TIese ure drIven by u
muLerIuIIsL dIsposILIon, scIenLIIIc IncompeLence und LIe superIorILy
syndrome. As Lo scIenLIsm, noL onIy Is LIe Ideu oI scIenLIIIc uuLocrucy
compIeLeIy quesLIonubIe, buL LIe probIem Is IurLIer compounded In LIuL
epIdemIoIogy Is un uLLer IuIIure In scIenLIIIc Lerms, I.e., IL Is IIImsy
sLuLIsLIcuIIsm ImposLerIng us u scIence. ConcernIng IeuILIIsm, LIe Ideu Is
enLIreIy devoId oI LIe crILIcuI dImensIons oI psycIoIogIcuI, psycIosocIuI
und moruI IeuILI. GIven LIIs IuLLer poInL In purLIcuIur, LIere Is produced
LIe ubsurdILy LIuL LIe prevuIIIng muLerIuIIsL menLuIILy Is dysIuncLIonuI, Is
IncupubIe oI dIscernIng dysIuncLIonuI LIougIL, und embruces dys-
IuncLIonuI LIougIL Lo promoLe IeuILI.
. The Mediccl Estcblishment: A Closer Scrutin
TIe conLemporury medIcuI esLubIIsImenL Ius numerous und
very consIderubIe In-Iouse probIems. uLrogenIc deuLIs und IIIness Iuve
been In epIdemIc proporLIons Ior muny decudes (see WeIngurL eL uI.,
zooo). Ictroenic ejject reIers Lo uny deLrImenLuI ouLcome resuILIng Irom
medIcuI ucLIvILyJInucLIvILy. NeguLIve ouLcomes cun resuIL Irom u pIeLIoru
oI IucLors sucI us InupproprIuLe medIcuLIon, overprescrIpLIon,
InupproprIuLe combInuLIons oI medIcuLIons, screenIng procedures,
surgIcuI IncompeLence, poorIy sLerIIIzed InsLrumenLs, mIsdIugnosIs,
IuIIure oI dIugnosIs, negIIgence, eLc. (see uIso uuru & Heuney, 1qqo;
TuyIor, 1q;q). IIIcI posILs LIuL LIe puIn, dysIuncLIon, dIsubIIILy, und
unguIsI resuILIng Irom LecInIcuI medIcuI InLervenLIon now rIvuI LIe
morbIdILy due Lo LruIIIc und IndusLrIuI uccIdenLs und even wur-reIuLed
ucLIvILIes, und muke LIe ImpucL oI medIcIne one oI LIe mosL rupIdIy
spreudIng epIdemIcs oI our LIme. (quoLed In uuru & Heuney, 1qqo, p.q)
n AusLruIIu, IL Ius been esLImuLed LIuL LIere ure beLween 1o,ooo
und zo,ooo IuLrogenIc deuLIs per unnum wILI muny Lens oI LIousunds
more In IuLrogenIc IIIness; Ior LIe UnILed SLuLes, IuLrogenIc deuLIs per
unnum ure esLImuLed uL beLween qq,ooo und q8,ooo (see WeIngurL eL uI.,
zooo; WIIson eL uI., 1qq). TIese esLImuLes ure noL mude on IncoIerenL,
sLuLIsLIcuIIy-bused cuusuI urgumenL us Is LIe cuse concernIng, Ior
exumpIe, smokIng-reIuLed deuLIs, buL ure bused on cIeurIy deIInubIe
Other Vital Matters
sequences oI cuusuI evenLs. n oLIer words, concernIng smokIng,
epIdemIoIogy Is used In un uLLempL Lo jusLIIy cuusuI urgumenL, uIbeIL
IncoIerenLIy. WIereus, concernIng IuLrogenIc deuLIs, LIe cuusuI
uLLrIbuLIon oI purLIcuIur medIcuI conducL Is uIreudy undersLood
IndependenL oI epIdemIoIogy; LIe InLenL oI epIdemIoIogy In LIIs cuse Is
sImpIy Lo esLImuLe LIe per-unnum ruLe oI IuLrogenIc deuLI. L sIouId be oI
very sIgnIIIcunL concern LIuL LIese deuLIs ure beIng cuused by un
orgunIzuLIon LIuL promoLes ILseII us u provIder oI IeuILI cure. A
consIderubIe number oI LIe pubIIc LIuL uLLends IospILuIs In good IuILI oI
IuvIng IIIness uLLended Lo do noL onIy noL Ieuve LIe IucIIILy In LIe sume
condILIon buL do noL Ieuve uIIve.
L wouId reusonubIy be expecLed LIuL u reducLIon In IuLrogenIc
deuLIs wouId be u pre-emInenL Issue In medIcuI esLubIIsImenL poIIcy und
conducL. YeL IL Is very rureIy uIIuded Lo by LIe medIcuI esLubIIsImenL -
even In medIcuI journuIs. AILIougI LIere ure u number oI urLIcIes
expressIng concern over LIe pIenomenon, LIere Iuve onIy been tuo
mujor sLudIes (Hurvurd und AusLruIIun) InLo IuLrogenIc deuLIs und IIIness:
TIe Hurvurd und AusLruIIun sLudIes InLo medIcuI error remuIn LIe onIy
sLudIes LIuL provIde popuIuLIon IeveI duLu on LIe ruLes oI InjurIes Lo
puLIenLs und LIey IdenLIIIed u subsLunLIuI umounL oI medIcuI
error. (WeIngurL eL uI., zooo, p.;;q) TIIs pouILry number oI seII-
scruLInIzIng sLudIes Is In sLurk conLrusL Lo LIe thouscnds oI sLudIes
concernIng LIe Issue oI smokIng.
TIe medIu, Loo, gIves very IILLIe coveruge Lo LIIs very severe
probIem oI IuLrogenIc deuLIs. or exumpIe, In LIe mujor VIcLorIun sLuLe
newspuper durIng LIe Lwo-yeur perIod Lo AugusL, zooo, LIere uppeured uL
IeusL severuI Iundred, one-sIded, IruuduIenL, emoLIve urLIcIes on Lobucco-
smokIng (Hercld,Sun, VIcLorIu, AusLruIIu). TIese urLIcIes were IosLered by
LIe medIcuI esLubIIsImenL und LIe unLIsmokIng Iobby. TIe sLundurd
sLuLIsLIcuI rIeLorIc Is LIuL smokIng kIIIs beLween 18,ooo und zo,ooo
persons unnuuIIy. TIese IIgures ure produced usIng LIe equIvuIenL oI LIe
compIeLeIy quesLIonubIe SAMMEC procedure dIscussed In un eurIIer
cIupLer. TIese sLuLIsLIcs ure usuuIIy even IurLIer embeIIIsIed In sucI
Iorms us: SmokIng kIIIs more AusLruIIuns LIun breusL und skIn cuncer,
roud deuLIs, suIcIde, dIubeLes, ADS und murder combIned. (Hercld,
Sun, June 1, zooo) DurIng LIe sume LIme-perIod LIere were onIy Lwo
urLIcIes concernIng IuLrogenIc deuLIs. TIese dId noL conLuIn emoLIve
Iunguuge und were ruLIer uLLILudInuIIy bIus. One urLIcIe reIerred Lo u
reporL commIssIoned IIve yeurs eurIIer LIuL recommended unoLIer
commILLee be esLubIIsIed Lo IurLIer uddress LIe Issue.
TIe IucL oI LIe muLLer Is LIuL, II LIe cctucl requIremenLs oI cuusuI
urgumenL ure uppIIed, IL Is LIe medIcuI esLubIIsImenL LIuL Is sInguIurIy,
196
196
Rampant Antismoking Signifies Grave Danger
und by Iur, LIe greuLesL und greuL source oI prevenLubIe deuLI und IIIness.
L Is ImporLunL Lo noLe LIuL LIIs cctucl source oI prevenLubIe deuLI Is
LypIcuIIy noL reporLed In IIsLs oI prevenLubIe deuLI und cosLs.
UnIorLunuLeIy, IL Is onIy LIose concocLed by un exLruordInurIIy errunL
muLerIuIIsL IdeoIogy LIuL ure presenLed. TIIs Is so Ior uL IeusL Lwo reusons.
IrsLIy, IL uIIows medIco-muLerIuIIsm Lo eIevuLe ILseII Lo socIo-poIILIcuI
domInuLIon oI Ideus oI IeuILI on LIe IuIse preLense oI undersLundIng oI
dIseuse ueLIoIogy. SecondIy, IL musquerudes ILs own Iuck oI ucLuuI
undersLundIng by LIe sIIILIng oI bIume Ior dIseuse buck on Lo LIe
pubIIc.
AnoLIer, more subLIe, source oI IuLrogenIc eIIecL concerns LIe
depersonuIIzuLIon oI prImury IeuILI cure us puLIenLs ure mude Lo IIL LIe
muLerIuIIsL uLLempL uL producLIon-IIne eIIIcIency; compeLenL,
compussIonuLe, InLerpersonuI excIunges, us IosLerIng LIe IeuIIng process,
ure downpIuyed In Iuvor oI LecInoIogIcuI InnovuLIons und u burruge oI
usuuIIy IrreIevunL, poorIy expIuIned sLuLIsLIcuI InIormuLIon (e.g., reIuLIve
rIsk). TIe dIscourugemenL oI vILuI reIuLIonsIIp In curer und puLIenL
InLerucLIon cun Iuve u dIs-spIrILIng eIIecL Ior boLI. or LIe puLIenL,
IuLrogenIc psycIopuLIoIogy cun LIen LrunsIuLe InLo u proLrucLIon or
ubsence oI bIoIogIcuI IeuIIng, or suscepLIbIIILy Lo oLIer muIudIes, I.e.,
IurLIer IuLrogenIc eIIecL. or LIe curers, purLIcuIurIy nursIng sLuII, IL cun
IosLer dIsIIIusIonmenL und, LIereIore, u deLerIoruLIon In work suLIsIucLIon.
TIe IospILuI uLmospIere cun quIckIy become very gIoomy, uusLere, und
depressIng Ior uII. SucI IuLrogenIc psycIopuLIoIogy Is undersLundubIy
very poorIy uddressed gIven LIuL IL Is muLerIuIIsL domInuLIon oI
conLemporury medIcuI prucLIce LIuL Ius produced LIe cIrcumsLunce Lo
begIn wILI.
McCuImun (zoozu), commenLIng on LIe AusLruIIun
cIrcumsLunce, posILs:
HospILuIs Iuve become 'servIce sLuLIons` LIuL muke
InLervenLIons In ucuLe cuses und LIen send you Iome. I
you`re oII LIe crILIcuI IIsL, you geL Lo sLuy In IospILuI onIy
II LIey sLIII cun`L dIugnose wIuL`s wrong wILI you. PosL-
operuLIve cure Is so eIIecLIve LIuL puLIenLs ure reudy Ior
dIscIurge LIe duy uILer.
BuL modern IospILuIs ure more expensIve LIun ever Lo
run. TIeIr cosLs rIse by LIe mInuLe: LecInoIogIes,
Insurunce, equIpmenL, proIessIonuI und supporL sLuII,
drugs, cIemIcuIs, servIces. SInce cuse-mIx, every Ionger-
LIun-normuI sLuy Is u IuIIure; every sIow-Lo-recover
puLIenL Is u IIubIIILy; every eIderIy demenLed cuse Is u
boLLomIess pIL oI Iumun needs LIuL cun onIy be
Other Vital Matters
resoIved by deuLI.
HospILuIs, IIke unIversILIes, ure now run by uccounLunLs,
wILI uccounLunLs` prIorILIes, uccounLunLs` sLruLegIes und
uccounLunLs` LooIs. TIe mInuLe u new puLIenL IILs LIe
bed, wIuL muLLers Is Iow quIckIy LIuL puLIenL cun be
suIeIy dIscIurged. TIe cure Is predomInunLIy ucuLe cure,
mosLIy InLensIve or semI-InLensIve. TIe puLIenL Is
usuuIIy semI-conscIous. L Is domInuLed by meusure-
menLs und LecInoIogIes. L Is usuuIIy done very weII ,
buL LIere Is no LIme Lo Iorm u reIuLIonsIIp.
YeL LIuL`s wIuL cure Is - u Iumun reIuLIonsIIp, noL u
suILe oI prucLIces or u seL oI LooIs. PrucLIces und LooIs
ure essenLIuI, buL so Is LIe reIuLIonsIIp Lo LIe experIence
oI receIvIng und gIvIng cure. And LIIs Is usuuIIy LIe
reuson gIven by good nurses Ior LIeIr cIoIce oI
proIessIon: LIuL LIey IIke curIng Ior peopIe.
Tuke uwuy LIuL IundumenLuI job suLIsIucLIon, eIIecL
IndusLrIuI conLroI by cusuuIIsIng LIe IospILuI workIorce
so LIuL nurses cunnoL connecL wILI eucI oLIer und LIeIr
workpIuce, Lurn u proIessIon InLo u servIce IndusLry oI
IIred Iunds, und you desLroy someLIIng very precIous.
To LIese uIreudy very consIderubIe In-Iouse probIems cun be
udded LIe deLrImenLuI eIIecLs oI prevenLIve medIcIne. As Ius been
dIscussed, IIIesLyIe epIdemIoIogy wIIcI produces LIe evIdence Ior
prevenLIve meusures Is predIcuLed on u IILuny oI InIerenLIuI IuIIucIes.
WIen LIIs nonsense Is InIIIcLed on LIe pubIIc us scIenLIIIcuIIy vIubIe, IL cun
onIy produce supersLILIous beIIeI (I.e., psycIoIogIcuI enIeebIIng) InvoIvIng
mugIc powers urgumenLs oI cuuse und eIIecL, und on u muss scuIe; IL
IurLIer reInIorces muLerIuIIsL beIIeIs und body IIxuLIon; IL Ius LIe sLrong
poLenLIuI Lo IosLer uddILIonuI nocebo eIIecLs (e.g., seII-IuIIIIIIng propIesy);
und IL IosLers LIe normuIIzuLIon oI uII munner oI oLIer psycIoIogIcuI,
psycIosocIuI, und moruI dysIuncLIon. AII oI LIese consequences ure
IuLrogenIc.
PrevenLIve medIcIne produces unoLIer purLIcuIurIy InsIdIous
Iorm oI IuLrogenIc eIIecL. L Is uIreudy undersLood LIuL II persons expecL
IecLurIng, brow-beuLIng, eLc., Irom u medIcuI consuILuLIon, LIey muy deIuy
uLLendIng unLII LIe probIem Is In un udvunced sLuge. or exumpIe,
ILzgeruId (1qq6u) noLes LIuL LIere ure duLu suggesLIng LIuL peopIe wIo
Iuve dIsorders wIIcI ure generuIIy socIeLuIIy consIdered Lo be 'bud
dIseuses`, I.e., LIe dIseuses oI LIe guIILy, uvoId goIng Lo pIysIcIuns. n u
sLudy oI nurses, nursIng ussIsLunLs, IeuILI unIL coordInuLors, und generuI
197
197
Rampant Antismoking Signifies Grave Danger
und by Iur, LIe greuLesL und greuL source oI prevenLubIe deuLI und IIIness.
L Is ImporLunL Lo noLe LIuL LIIs cctucl source oI prevenLubIe deuLI Is
LypIcuIIy noL reporLed In IIsLs oI prevenLubIe deuLI und cosLs.
UnIorLunuLeIy, IL Is onIy LIose concocLed by un exLruordInurIIy errunL
muLerIuIIsL IdeoIogy LIuL ure presenLed. TIIs Is so Ior uL IeusL Lwo reusons.
IrsLIy, IL uIIows medIco-muLerIuIIsm Lo eIevuLe ILseII Lo socIo-poIILIcuI
domInuLIon oI Ideus oI IeuILI on LIe IuIse preLense oI undersLundIng oI
dIseuse ueLIoIogy. SecondIy, IL musquerudes ILs own Iuck oI ucLuuI
undersLundIng by LIe sIIILIng oI bIume Ior dIseuse buck on Lo LIe
pubIIc.
AnoLIer, more subLIe, source oI IuLrogenIc eIIecL concerns LIe
depersonuIIzuLIon oI prImury IeuILI cure us puLIenLs ure mude Lo IIL LIe
muLerIuIIsL uLLempL uL producLIon-IIne eIIIcIency; compeLenL,
compussIonuLe, InLerpersonuI excIunges, us IosLerIng LIe IeuIIng process,
ure downpIuyed In Iuvor oI LecInoIogIcuI InnovuLIons und u burruge oI
usuuIIy IrreIevunL, poorIy expIuIned sLuLIsLIcuI InIormuLIon (e.g., reIuLIve
rIsk). TIe dIscourugemenL oI vILuI reIuLIonsIIp In curer und puLIenL
InLerucLIon cun Iuve u dIs-spIrILIng eIIecL Ior boLI. or LIe puLIenL,
IuLrogenIc psycIopuLIoIogy cun LIen LrunsIuLe InLo u proLrucLIon or
ubsence oI bIoIogIcuI IeuIIng, or suscepLIbIIILy Lo oLIer muIudIes, I.e.,
IurLIer IuLrogenIc eIIecL. or LIe curers, purLIcuIurIy nursIng sLuII, IL cun
IosLer dIsIIIusIonmenL und, LIereIore, u deLerIoruLIon In work suLIsIucLIon.
TIe IospILuI uLmospIere cun quIckIy become very gIoomy, uusLere, und
depressIng Ior uII. SucI IuLrogenIc psycIopuLIoIogy Is undersLundubIy
very poorIy uddressed gIven LIuL IL Is muLerIuIIsL domInuLIon oI
conLemporury medIcuI prucLIce LIuL Ius produced LIe cIrcumsLunce Lo
begIn wILI.
McCuImun (zoozu), commenLIng on LIe AusLruIIun
cIrcumsLunce, posILs:
HospILuIs Iuve become 'servIce sLuLIons` LIuL muke
InLervenLIons In ucuLe cuses und LIen send you Iome. I
you`re oII LIe crILIcuI IIsL, you geL Lo sLuy In IospILuI onIy
II LIey sLIII cun`L dIugnose wIuL`s wrong wILI you. PosL-
operuLIve cure Is so eIIecLIve LIuL puLIenLs ure reudy Ior
dIscIurge LIe duy uILer.
BuL modern IospILuIs ure more expensIve LIun ever Lo
run. TIeIr cosLs rIse by LIe mInuLe: LecInoIogIes,
Insurunce, equIpmenL, proIessIonuI und supporL sLuII,
drugs, cIemIcuIs, servIces. SInce cuse-mIx, every Ionger-
LIun-normuI sLuy Is u IuIIure; every sIow-Lo-recover
puLIenL Is u IIubIIILy; every eIderIy demenLed cuse Is u
boLLomIess pIL oI Iumun needs LIuL cun onIy be
Other Vital Matters
resoIved by deuLI.
HospILuIs, IIke unIversILIes, ure now run by uccounLunLs,
wILI uccounLunLs` prIorILIes, uccounLunLs` sLruLegIes und
uccounLunLs` LooIs. TIe mInuLe u new puLIenL IILs LIe
bed, wIuL muLLers Is Iow quIckIy LIuL puLIenL cun be
suIeIy dIscIurged. TIe cure Is predomInunLIy ucuLe cure,
mosLIy InLensIve or semI-InLensIve. TIe puLIenL Is
usuuIIy semI-conscIous. L Is domInuLed by meusure-
menLs und LecInoIogIes. L Is usuuIIy done very weII ,
buL LIere Is no LIme Lo Iorm u reIuLIonsIIp.
YeL LIuL`s wIuL cure Is - u Iumun reIuLIonsIIp, noL u
suILe oI prucLIces or u seL oI LooIs. PrucLIces und LooIs
ure essenLIuI, buL so Is LIe reIuLIonsIIp Lo LIe experIence
oI receIvIng und gIvIng cure. And LIIs Is usuuIIy LIe
reuson gIven by good nurses Ior LIeIr cIoIce oI
proIessIon: LIuL LIey IIke curIng Ior peopIe.
Tuke uwuy LIuL IundumenLuI job suLIsIucLIon, eIIecL
IndusLrIuI conLroI by cusuuIIsIng LIe IospILuI workIorce
so LIuL nurses cunnoL connecL wILI eucI oLIer und LIeIr
workpIuce, Lurn u proIessIon InLo u servIce IndusLry oI
IIred Iunds, und you desLroy someLIIng very precIous.
To LIese uIreudy very consIderubIe In-Iouse probIems cun be
udded LIe deLrImenLuI eIIecLs oI prevenLIve medIcIne. As Ius been
dIscussed, IIIesLyIe epIdemIoIogy wIIcI produces LIe evIdence Ior
prevenLIve meusures Is predIcuLed on u IILuny oI InIerenLIuI IuIIucIes.
WIen LIIs nonsense Is InIIIcLed on LIe pubIIc us scIenLIIIcuIIy vIubIe, IL cun
onIy produce supersLILIous beIIeI (I.e., psycIoIogIcuI enIeebIIng) InvoIvIng
mugIc powers urgumenLs oI cuuse und eIIecL, und on u muss scuIe; IL
IurLIer reInIorces muLerIuIIsL beIIeIs und body IIxuLIon; IL Ius LIe sLrong
poLenLIuI Lo IosLer uddILIonuI nocebo eIIecLs (e.g., seII-IuIIIIIIng propIesy);
und IL IosLers LIe normuIIzuLIon oI uII munner oI oLIer psycIoIogIcuI,
psycIosocIuI, und moruI dysIuncLIon. AII oI LIese consequences ure
IuLrogenIc.
PrevenLIve medIcIne produces unoLIer purLIcuIurIy InsIdIous
Iorm oI IuLrogenIc eIIecL. L Is uIreudy undersLood LIuL II persons expecL
IecLurIng, brow-beuLIng, eLc., Irom u medIcuI consuILuLIon, LIey muy deIuy
uLLendIng unLII LIe probIem Is In un udvunced sLuge. or exumpIe,
ILzgeruId (1qq6u) noLes LIuL LIere ure duLu suggesLIng LIuL peopIe wIo
Iuve dIsorders wIIcI ure generuIIy socIeLuIIy consIdered Lo be 'bud
dIseuses`, I.e., LIe dIseuses oI LIe guIILy, uvoId goIng Lo pIysIcIuns. n u
sLudy oI nurses, nursIng ussIsLunLs, IeuILI unIL coordInuLors, und generuI
198
198
Rampant Antismoking Signifies Grave Danger
psycIIuLrIc ussIsLunLs (reusonubIy knowIedgeubIe peopIe), uII women,
1z.;% respondenLs reporLed deIuyIng or cunceIIng u pIysIcIun
uppoInLmenL becuuse oI weIgIL concern. n IookIng uL LIIs sLudy, IL
uppeurs LIuL women deIuy medIcuI cure becuuse LIey ure uIruId oI beIng
scoIded. OnIy body muss Index wus sIgnIIIcunLIy ussocIuLed wILI
uppoInLmenL cunceIIuLIon In LIIs popuIuLIon. L muy be, LIereIore, LIuL LIe
Ieur oI derIsIon becomes eIIecLIve denIuI oI cure.
A IurLIer exumpIe Is smokers wIo Iuve been budgered, Iurussed,
brow-beuLen, und LerrorIzed Ior quILe some LIme. HeuILIIsL ruLIonuIe Ius
even pIIoLed LIe use oI puymenLs Lo generuI prucLILIoners Ior gIvIng
unLIsmokIng udvIce Lo smokers (e.g., CoIemun eL uI., zoo1). orLunuLeIy,
medIcuI sLuII generuIIy vIewed LIIs puymenL upproucI unIuvorubIy. TIIs
consIsLenL unLIsmokIng rIeLorIc und LIe Ieur oI derIsIon cun resuIL In
smokers deIuyIng seekIng medIcuI LreuLmenL LIuL muy LIen produce oLIer
medIcuI compIIcuLIons. TIIs cIrcumsLunce uIreudy reIIecLs un IuLrogenIc
eIIecL. However, LIIs sILuuLIon InvoIves u IurLIer dose oI IuLrogenesIs. n
sLuLIsLIcuI Lerms LIIs deIuyed LreuLmenL muy munIIesL us un IncreusIng
IncIdence oI specIIIc dIseuse Ior LIe smoker`s group reIuLIve Lo
nonsmokers. GIven LIuL muLerIuIIsm Ius no coIerenL psycIoIogIcuI
dImensIon, IL wIII InLerpreL sucI IIndIngs us LIe IurLIer resuILs oI LIe
cuusuI propensILIes oI Lobucco smoke. TIrougI LIIs dungerous,
muLerIuIIsL cIosed Ioop medIcuI mIsconducL never enLers LIe
consIderuLIon und LIe eIIecLs LIereoI ure used Lo IurLIer sLIgmuLIze LIe
group In quesLIon, I.e., compoundIng IuLrogenIc eIIecLs.
RecenL reseurcI Ius Iound LIuL depressIon, socIuI uIIenuLIon, und
IoneIIness ure IndependenL IucLors Ior CHD. TIese ure uIso some oI LIe
reusons Ior wIy some persons smoke. AnLIsmokIng, LIrougI Iuke
superIorILy und socIuI dIvIsIon, cun Ieed sucI IucLors In some smokers.
AguIn, LIrougI u muLerIuIIsL cIosed-Ioop, medIco-muLerIuIIsm wIII
mIsInLerpreL uny Increused IncIdence oI CHD LIuL cun be Iur more
ussocIuLed wILI wIy some persons smoke (I.e., convergence eIIecL) us
cuused by smokIng.
TIIs probIem Is noL u smuII one. AnecdoLuIIy, LIere ure medIcuI
prucLILIoners LIuL IILeruIIy IIy InLo un unconLroIIubIe ruge on IIndIng ouL
LIuL u puLIenL smokes. n one cuse, LIe prucLILIoner wunLed Lo know wIere
LIe cIgureLLes were In u Iundbug so LIuL LIey couId ImmedIuLeIy be
desLroyed. TIere Is cerLuInIy u IeuILI Issue InvoIved Iere LIuL concerns
LIe menLuI sLubIIILy oI medIcuI prucLILIoners wIo Iuve IosL compIeLe sIgIL
oI IeuILI In muILI-dImensIonuI Lerms. L Is Ioped LIuL LIere Is uL IeusL u
subgroup oI medIcuI prucLILIoners, smokIng or nonsmokIng, LIuL Iuve noL
bougIL InLo LIIs muLerIuIIsL IoIIy und LIuL Iuve u Iur more buIunced vIew
oI IeuILI, IncIudIng psycIoIogIcuI, psycIosocIuI, moruI und spIrILuuI
Other Vital Matters
dImensIons.
AL one LIme LIe docLorJpuLIenL reIuLIonsIIp wus prImurIIy LIuL oI
breLIren on u common journey LIrougI IIIe, uLLempLIng Lo IInd some
crILIcuI meunIng. TIe docLor wus us mucI u Ieurner In LIe reIuLIonsIIp us
LIe puLIenL. YeL, Lo LIIs purLIcuIur reIuLIonsIIp LIe medIcuI prucLILIoner
couId brIng some InsIgILs wILIIn un ImperIecL medIcuI knowIedge LIuL
mIgIL euse some oI LIe bumps In LIe roud. DocLors dId noL Luke dIcLuLorIuI
sLunces over puLIenLs, recognIzIng LIuL, us co-Iumuns, puLIenLs ure
enLILIed Lo seII-deLermInuLIon In mukIng some sense oI LIeIr journey.
UnIorLunuLeIy, over LIe IusL number oI decudes LIere Ius been u
progressIveIy buIIdIng muLerIuIIsm LIuL Ius uII buL jeLLIsoned depLI oI
purpose, In meLupIysIcuI, LrunscendenL Lerms, Irom LIe Iumun condILIon.
TIe probIem now Is noL one oI IsoIuLed pockeLs oI urrogunce und
reIuLIonuI IncompeLence buL un InsLILuLIonuI (esLubIIsImenL-wIde) one
(see uIso Berger, zooz).
CoIerenL moruI prIncIpIes ure soberIng und IumbIIng. TIey noL
onIy keep psycIoIogIcuI und psycIosocIuI dysIuncLIon In cIeck, buL ImpeI
LIe IonesL journeyer Lo u IIIeIong IeurnIng, Lo un ongoIng roundIng und
muLurIng oI perspecLIve. WIere sucI prIncIpIes Iuve been dIspensed wILI,
IL Is uII oI LIese deLrImenLuI psycIoIogIcuI und psycIosocIuI poLenLIuIILIes,
InIused wILI moruI reckIessness, LIuL come Lo LIe Iore. Now, LIe
muLerIuIIsL, moruIIy-sIuIIow eIILe beIIeve LIuL LIey ure no Ionger jusL
Iumun, buL ure superIors. TIeIrs Is Lo educuLe LIe IgnorunL In LIe wuys
oI IeuILI. YeL, In every sense - scIoIurIy, InLeIIecLuuIIy, emoLIonuIIy,
reIuLIonuIIy, moruIIy - LIe menLuIILy does noL even reucI LIe dIIeLLunLe
grude. n IucL, wIuLever LIIs menLuIILy Iuys ILs Iunds Lo, IL uLLerIy corrupLs.
OnIy compounded dIsusLer cun ensue.
TIe IospILuI seLLIng Ius been munuIucLured InLo unoLIer source
oI IuLrogenIc eIIecL, purLIcuIurIy Ior smokers. MedIcuI personneI Iuve been
InsLrucLed Ior quILe some LIme LIuL u IospILuI sLuy sIouId be used us un
opporLunILy Lo promoLe smokIng cessuLIon. rom u smoker`s poInL oI
vIew, LIe IospILuI sILuuLIon generuIIy presenLs quILe u number oI LIe very
reusons Ior wIy muny persons smoke, e.g., boredom, sLress, con-
LempIuLIon, eLc.. TIe cIgureLLe breuk, u second nuLure ucLIvILy, Is u poInL
oI IumIIIurILy In oLIerwIse sLerIIe und conLrIved surrounds. Added Lo LIIs
Is now u IosLIIe menLuIILy LIuL wIII uLLempL Lo cIeck smokIng uL every
Lurn. JusL LIe Ideu oI IuvIng Lo conLend wILI IdeoIogIcuIIy deIuded und
obsessed medIcuI sLuII wouId be quesLIonubIe wILIIn LIe psycIoIogy oI
IeuIIng. AL LIe very LIme wIen u puLIenL`s psycIoIogIcuI sLubIIILy wouId
wunL Lo be muInLuIned und noL jeopurdIzed, IeuILIIsL deIusIon wouId
uLLempL rudIcuI cIunge; boLI LIe InLended cIunge und ILs LImIng ure
compIeLeIy quesLIonubIe.
199
199
Rampant Antismoking Signifies Grave Danger
psycIIuLrIc ussIsLunLs (reusonubIy knowIedgeubIe peopIe), uII women,
1z.;% respondenLs reporLed deIuyIng or cunceIIng u pIysIcIun
uppoInLmenL becuuse oI weIgIL concern. n IookIng uL LIIs sLudy, IL
uppeurs LIuL women deIuy medIcuI cure becuuse LIey ure uIruId oI beIng
scoIded. OnIy body muss Index wus sIgnIIIcunLIy ussocIuLed wILI
uppoInLmenL cunceIIuLIon In LIIs popuIuLIon. L muy be, LIereIore, LIuL LIe
Ieur oI derIsIon becomes eIIecLIve denIuI oI cure.
A IurLIer exumpIe Is smokers wIo Iuve been budgered, Iurussed,
brow-beuLen, und LerrorIzed Ior quILe some LIme. HeuILIIsL ruLIonuIe Ius
even pIIoLed LIe use oI puymenLs Lo generuI prucLILIoners Ior gIvIng
unLIsmokIng udvIce Lo smokers (e.g., CoIemun eL uI., zoo1). orLunuLeIy,
medIcuI sLuII generuIIy vIewed LIIs puymenL upproucI unIuvorubIy. TIIs
consIsLenL unLIsmokIng rIeLorIc und LIe Ieur oI derIsIon cun resuIL In
smokers deIuyIng seekIng medIcuI LreuLmenL LIuL muy LIen produce oLIer
medIcuI compIIcuLIons. TIIs cIrcumsLunce uIreudy reIIecLs un IuLrogenIc
eIIecL. However, LIIs sILuuLIon InvoIves u IurLIer dose oI IuLrogenesIs. n
sLuLIsLIcuI Lerms LIIs deIuyed LreuLmenL muy munIIesL us un IncreusIng
IncIdence oI specIIIc dIseuse Ior LIe smoker`s group reIuLIve Lo
nonsmokers. GIven LIuL muLerIuIIsm Ius no coIerenL psycIoIogIcuI
dImensIon, IL wIII InLerpreL sucI IIndIngs us LIe IurLIer resuILs oI LIe
cuusuI propensILIes oI Lobucco smoke. TIrougI LIIs dungerous,
muLerIuIIsL cIosed Ioop medIcuI mIsconducL never enLers LIe
consIderuLIon und LIe eIIecLs LIereoI ure used Lo IurLIer sLIgmuLIze LIe
group In quesLIon, I.e., compoundIng IuLrogenIc eIIecLs.
RecenL reseurcI Ius Iound LIuL depressIon, socIuI uIIenuLIon, und
IoneIIness ure IndependenL IucLors Ior CHD. TIese ure uIso some oI LIe
reusons Ior wIy some persons smoke. AnLIsmokIng, LIrougI Iuke
superIorILy und socIuI dIvIsIon, cun Ieed sucI IucLors In some smokers.
AguIn, LIrougI u muLerIuIIsL cIosed-Ioop, medIco-muLerIuIIsm wIII
mIsInLerpreL uny Increused IncIdence oI CHD LIuL cun be Iur more
ussocIuLed wILI wIy some persons smoke (I.e., convergence eIIecL) us
cuused by smokIng.
TIIs probIem Is noL u smuII one. AnecdoLuIIy, LIere ure medIcuI
prucLILIoners LIuL IILeruIIy IIy InLo un unconLroIIubIe ruge on IIndIng ouL
LIuL u puLIenL smokes. n one cuse, LIe prucLILIoner wunLed Lo know wIere
LIe cIgureLLes were In u Iundbug so LIuL LIey couId ImmedIuLeIy be
desLroyed. TIere Is cerLuInIy u IeuILI Issue InvoIved Iere LIuL concerns
LIe menLuI sLubIIILy oI medIcuI prucLILIoners wIo Iuve IosL compIeLe sIgIL
oI IeuILI In muILI-dImensIonuI Lerms. L Is Ioped LIuL LIere Is uL IeusL u
subgroup oI medIcuI prucLILIoners, smokIng or nonsmokIng, LIuL Iuve noL
bougIL InLo LIIs muLerIuIIsL IoIIy und LIuL Iuve u Iur more buIunced vIew
oI IeuILI, IncIudIng psycIoIogIcuI, psycIosocIuI, moruI und spIrILuuI
Other Vital Matters
dImensIons.
AL one LIme LIe docLorJpuLIenL reIuLIonsIIp wus prImurIIy LIuL oI
breLIren on u common journey LIrougI IIIe, uLLempLIng Lo IInd some
crILIcuI meunIng. TIe docLor wus us mucI u Ieurner In LIe reIuLIonsIIp us
LIe puLIenL. YeL, Lo LIIs purLIcuIur reIuLIonsIIp LIe medIcuI prucLILIoner
couId brIng some InsIgILs wILIIn un ImperIecL medIcuI knowIedge LIuL
mIgIL euse some oI LIe bumps In LIe roud. DocLors dId noL Luke dIcLuLorIuI
sLunces over puLIenLs, recognIzIng LIuL, us co-Iumuns, puLIenLs ure
enLILIed Lo seII-deLermInuLIon In mukIng some sense oI LIeIr journey.
UnIorLunuLeIy, over LIe IusL number oI decudes LIere Ius been u
progressIveIy buIIdIng muLerIuIIsm LIuL Ius uII buL jeLLIsoned depLI oI
purpose, In meLupIysIcuI, LrunscendenL Lerms, Irom LIe Iumun condILIon.
TIe probIem now Is noL one oI IsoIuLed pockeLs oI urrogunce und
reIuLIonuI IncompeLence buL un InsLILuLIonuI (esLubIIsImenL-wIde) one
(see uIso Berger, zooz).
CoIerenL moruI prIncIpIes ure soberIng und IumbIIng. TIey noL
onIy keep psycIoIogIcuI und psycIosocIuI dysIuncLIon In cIeck, buL ImpeI
LIe IonesL journeyer Lo u IIIeIong IeurnIng, Lo un ongoIng roundIng und
muLurIng oI perspecLIve. WIere sucI prIncIpIes Iuve been dIspensed wILI,
IL Is uII oI LIese deLrImenLuI psycIoIogIcuI und psycIosocIuI poLenLIuIILIes,
InIused wILI moruI reckIessness, LIuL come Lo LIe Iore. Now, LIe
muLerIuIIsL, moruIIy-sIuIIow eIILe beIIeve LIuL LIey ure no Ionger jusL
Iumun, buL ure superIors. TIeIrs Is Lo educuLe LIe IgnorunL In LIe wuys
oI IeuILI. YeL, In every sense - scIoIurIy, InLeIIecLuuIIy, emoLIonuIIy,
reIuLIonuIIy, moruIIy - LIe menLuIILy does noL even reucI LIe dIIeLLunLe
grude. n IucL, wIuLever LIIs menLuIILy Iuys ILs Iunds Lo, IL uLLerIy corrupLs.
OnIy compounded dIsusLer cun ensue.
TIe IospILuI seLLIng Ius been munuIucLured InLo unoLIer source
oI IuLrogenIc eIIecL, purLIcuIurIy Ior smokers. MedIcuI personneI Iuve been
InsLrucLed Ior quILe some LIme LIuL u IospILuI sLuy sIouId be used us un
opporLunILy Lo promoLe smokIng cessuLIon. rom u smoker`s poInL oI
vIew, LIe IospILuI sILuuLIon generuIIy presenLs quILe u number oI LIe very
reusons Ior wIy muny persons smoke, e.g., boredom, sLress, con-
LempIuLIon, eLc.. TIe cIgureLLe breuk, u second nuLure ucLIvILy, Is u poInL
oI IumIIIurILy In oLIerwIse sLerIIe und conLrIved surrounds. Added Lo LIIs
Is now u IosLIIe menLuIILy LIuL wIII uLLempL Lo cIeck smokIng uL every
Lurn. JusL LIe Ideu oI IuvIng Lo conLend wILI IdeoIogIcuIIy deIuded und
obsessed medIcuI sLuII wouId be quesLIonubIe wILIIn LIe psycIoIogy oI
IeuIIng. AL LIe very LIme wIen u puLIenL`s psycIoIogIcuI sLubIIILy wouId
wunL Lo be muInLuIned und noL jeopurdIzed, IeuILIIsL deIusIon wouId
uLLempL rudIcuI cIunge; boLI LIe InLended cIunge und ILs LImIng ure
compIeLeIy quesLIonubIe.
200
200
Rampant Antismoking Signifies Grave Danger
TIe sIgIL oI eIderIy smokers, In purLIcuIur, IuvIng Lo venLure ouL
oI LIe IospILuI und onLo LIe sLreeL In LIeIr nIgILgowns In LIe mId-oI-
wInLer In uccommoduLIng IospILuI smokIng buns does noL onIy seem noL
conducIve Lo IeuIIng, buL Is moruIIy repreIensIbIe. TIIs cIrcumsLunce Is
depIcLed by boLI IeuILI proIessIonuIs und LIe medIu us LIe pIIgIL oI LIe
poor, uddIcLed smoker wIo wouId endunger LIemseIves In LIe quesL Lo
Ieed LIeIr uddIcLIon. YeL nowIere Is IL consIdered LIuL LIey Iuve been
Iorced LIere Ior no good reuson. L wouId seem LIuL II IILIguLIon wus
pendIng Ior unnecessurIIy endungerIng smokers` IeuILI, IospILuIs wouId
very quIckIy IInd Indoor ureus Lo uccommoduLe smokers. TIe uIr oI
IeuILIIsL superIorILy, oI InIuIIIbIIILy, Is breuLILukIng. TIe IeuILIIsL
menLuIILy demonsLruLes no cupucILy Ior crILIcuI seII-scruLIny; IL cunnoL
concepLuuIIze LIe possIbIIILy, IeL uIone LIe ucLuuIILy, LIuL IL Is wrong In ILs
esLImuLIons und Ius uIreudy gone wuy Loo Iur In ILs conLorLed IdeoIogy.
TIe IospILuI Ius been Lurned InLo u LempIe Ior cuIL IndocLrInuLIon. TIe
sume seII-servIng und dungerous muLerIuIIsL cIosed Ioop IndIcuLed
eurIIer uppIIes Iere, Loo. Any deLrImenLuI eIIecLs (e.g., IIIness) Ior smokers
Irom IuvIng Lo negoLIuLe LIe unLIsmokIng obsLucIe-course (I.e., IuLrogenIc)
wIII be InLerpreLed by IeuILIIsm us LIe cuusuI eIIecLs oI LIe properLIes oI
Lobucco smoke.
MedIco-muLerIuIIsm uIso mukes numerous cIuIms ubouL LIe
InordInuLe medIcuI cosL ussocIuLed wILI LIe IubILs oI purLIcuIur socIuI
groups, e.g., smokers. AguIn, LIe cIuIms ure bused on LIe IncoIerenL
muLerIuIIsL urgumenLuLIon dIscussed eurIIer (I.e., SAMMEC). However, ILs
cIuIms muy, uguIn, Iur beLLer descrIbe ILs own conducL. n uddILIon Lo LIe
very IIgI cosLs ussocIuLed wILI IuLrogenIc deuLI und IIness, IL uIso seems
Lo Iuve u IIsLory oI u seII-servIng squunderIng oI very consIderubIe
umounLs oI Iunds.
TuyIor (1q;q) descrIbes LIe IrugmenLed nuLure oI LIe medIcuI
esLubIIsImenL. TIere Is un InsLILuLIonuIIzed peckIng-order oI specIuIIsLs,
super-specIuIIsLs, sub-specIuILIes, eLc. und wIere LIe generuI prucLILIoner
occupIes LIe IowesL rung:
TIe IrugmenLuLIon oI medIcuI prucLIce Ius reucIed
ubsurd proporLIons. TIe puLIenL oI Loduy Is conIronLed
wILI u IrIgILenIng urruy oI sub-specIuIIsLs uII cIuImIng
excIusIve rIgIL Lo LIeIr orgun sysLem. TIe prImury
specIuILIes oI medIcIne wIIcI were dIrecLed Lo LIe LoLuI
person sucI us generuI (InLernuI) medIcIne, surgery und
puedIuLrIcs, Iuve been curved up InLo smuIIer und
smuIIer IIeIds. UnIIke LIese mujor specIuILIes, LIe newer
sub-specIuILIes (secondury specIuILIes) ure dIrecLed Lo
purLIcuIur orguns or orgun sysLems. Toduy`s puLIenL muy
Other Vital Matters
Iuve u curdIoIogIsL Lo LreuL IIs IeurL, u neuroIogIsL Lo
LreuL IIs bruIn, u gusLroenLeroIogIsL Lo see Lo IIs
InLesLInes, un endocrInoIogIsL Lo evuIuuLe IIs gIunds,
und u venerIoIogIsL Lo uLLend Lo IIs VD. TIIs Is noL Lo
suy LIuL LIe occusIonuI puLIenL wILI very serIous und
compIex medIcuI probIems muy noL need LIe uLLenLIon
oI u vusL vurIeLy oI super-specIuIIsLs durIng LIe ucuLe
pIuse oI IIs IIIness. BuL oILen LIe curdIoIogIsL Is LreuLIng
u LoucI oI coronury dIseuse, LIe neuroIogIsL evuIuuLIng
mIgruIne, LIe gusLroenLeroIogIsL prescrIbIng uIkuIIs Ior
un uIcer, LIe endocrInoIogIsL LreuLIng mIId dIubeLes, und
LIe venerIoIogIsL udmInIsLerIng penIcIIIIn - uII oI wIIcI
couId Iuve been ucIIeved wILI LIe expendILure oI u IoL
Iess LIme, eIIorL und money und wILI u IoL Iess Iuss by u
generuI pIysIcIun or compeLenL GP....LIe number oI
docLors wIo ure prepured Lo uccepL LIe wIoIe person us
LIeIr provInce Is sIrInkIng uIurmIngIy. PuLIenLs wIose
sympLoms do noL ImmedIuLeIy IndIcuLe LIe orgun uL
IuuIL ure bounced Irom one super-specIuIIsL Lo unoLIer,
unLII LIey uccIdenLuIIy IIL LIe upproprIuLe docLor wIose
sub-specIuILy coIncIdes wILI LIe unuLomIcuI IocuIIzuLIon
oI LIeIr dIseuse. TIose wILI muILIpIe IIInesses ure cured
Ior by u cumbersome, symbIoLIc commILLee oI super-
specIuIIsLs wIo ure Iorever dIugnosLIcuIIy LrIppIng over
eucI oLIer, prescrIbIng drugs LIuL InLerucL (or
counLerucL!), engugIng In demurcuLIon dIspuLes, gIvIng
conLrudIcLory InIormuLIon Lo LIe puLIenL,
procrusLInuLIng wILI ImporLunL decIsIons, und
exponenLIuIIy IncreusIng LIe cosLs oI medIcuI cure.
(p.8;-88)
L musL be noLed LIuL LIe Ideu oI LIe LoLuI body sIouId noL be
conIused wILI LIe LoLuI Iumun und sLIII reIIecLs u muLerIuIIsL vIewpoInL;
LIe LoLuI body Is u deconsLrucLIon devoId oI uny coIerenL psycIoIogIcuI,
psycIosocIuI und moruI dImensIons. TIe pIenomenon oI sub-specIuILIes
jurther deconsLrucLs LIe LoLuI body InLo IsoIuLed bodIIy orguns und purLs
oI orguns.
TuyIor (1q;q) uIso IndIcuLes LIe reIuLIonsIIp beLween sub-
specIuILIes und expensIve LecInIcuI gudgeLry und LIe IuIse ussumpLIons on
wIIcI LIey ure bused:
IrsL oI uII, despILe LIuL medIcuI IILeruLure Is vusL, LIe
umounL oI reIevunL prucLIcuI muLerIuI Is noL, und super-
201
201
Rampant Antismoking Signifies Grave Danger
TIe sIgIL oI eIderIy smokers, In purLIcuIur, IuvIng Lo venLure ouL
oI LIe IospILuI und onLo LIe sLreeL In LIeIr nIgILgowns In LIe mId-oI-
wInLer In uccommoduLIng IospILuI smokIng buns does noL onIy seem noL
conducIve Lo IeuIIng, buL Is moruIIy repreIensIbIe. TIIs cIrcumsLunce Is
depIcLed by boLI IeuILI proIessIonuIs und LIe medIu us LIe pIIgIL oI LIe
poor, uddIcLed smoker wIo wouId endunger LIemseIves In LIe quesL Lo
Ieed LIeIr uddIcLIon. YeL nowIere Is IL consIdered LIuL LIey Iuve been
Iorced LIere Ior no good reuson. L wouId seem LIuL II IILIguLIon wus
pendIng Ior unnecessurIIy endungerIng smokers` IeuILI, IospILuIs wouId
very quIckIy IInd Indoor ureus Lo uccommoduLe smokers. TIe uIr oI
IeuILIIsL superIorILy, oI InIuIIIbIIILy, Is breuLILukIng. TIe IeuILIIsL
menLuIILy demonsLruLes no cupucILy Ior crILIcuI seII-scruLIny; IL cunnoL
concepLuuIIze LIe possIbIIILy, IeL uIone LIe ucLuuIILy, LIuL IL Is wrong In ILs
esLImuLIons und Ius uIreudy gone wuy Loo Iur In ILs conLorLed IdeoIogy.
TIe IospILuI Ius been Lurned InLo u LempIe Ior cuIL IndocLrInuLIon. TIe
sume seII-servIng und dungerous muLerIuIIsL cIosed Ioop IndIcuLed
eurIIer uppIIes Iere, Loo. Any deLrImenLuI eIIecLs (e.g., IIIness) Ior smokers
Irom IuvIng Lo negoLIuLe LIe unLIsmokIng obsLucIe-course (I.e., IuLrogenIc)
wIII be InLerpreLed by IeuILIIsm us LIe cuusuI eIIecLs oI LIe properLIes oI
Lobucco smoke.
MedIco-muLerIuIIsm uIso mukes numerous cIuIms ubouL LIe
InordInuLe medIcuI cosL ussocIuLed wILI LIe IubILs oI purLIcuIur socIuI
groups, e.g., smokers. AguIn, LIe cIuIms ure bused on LIe IncoIerenL
muLerIuIIsL urgumenLuLIon dIscussed eurIIer (I.e., SAMMEC). However, ILs
cIuIms muy, uguIn, Iur beLLer descrIbe ILs own conducL. n uddILIon Lo LIe
very IIgI cosLs ussocIuLed wILI IuLrogenIc deuLI und IIness, IL uIso seems
Lo Iuve u IIsLory oI u seII-servIng squunderIng oI very consIderubIe
umounLs oI Iunds.
TuyIor (1q;q) descrIbes LIe IrugmenLed nuLure oI LIe medIcuI
esLubIIsImenL. TIere Is un InsLILuLIonuIIzed peckIng-order oI specIuIIsLs,
super-specIuIIsLs, sub-specIuILIes, eLc. und wIere LIe generuI prucLILIoner
occupIes LIe IowesL rung:
TIe IrugmenLuLIon oI medIcuI prucLIce Ius reucIed
ubsurd proporLIons. TIe puLIenL oI Loduy Is conIronLed
wILI u IrIgILenIng urruy oI sub-specIuIIsLs uII cIuImIng
excIusIve rIgIL Lo LIeIr orgun sysLem. TIe prImury
specIuILIes oI medIcIne wIIcI were dIrecLed Lo LIe LoLuI
person sucI us generuI (InLernuI) medIcIne, surgery und
puedIuLrIcs, Iuve been curved up InLo smuIIer und
smuIIer IIeIds. UnIIke LIese mujor specIuILIes, LIe newer
sub-specIuILIes (secondury specIuILIes) ure dIrecLed Lo
purLIcuIur orguns or orgun sysLems. Toduy`s puLIenL muy
Other Vital Matters
Iuve u curdIoIogIsL Lo LreuL IIs IeurL, u neuroIogIsL Lo
LreuL IIs bruIn, u gusLroenLeroIogIsL Lo see Lo IIs
InLesLInes, un endocrInoIogIsL Lo evuIuuLe IIs gIunds,
und u venerIoIogIsL Lo uLLend Lo IIs VD. TIIs Is noL Lo
suy LIuL LIe occusIonuI puLIenL wILI very serIous und
compIex medIcuI probIems muy noL need LIe uLLenLIon
oI u vusL vurIeLy oI super-specIuIIsLs durIng LIe ucuLe
pIuse oI IIs IIIness. BuL oILen LIe curdIoIogIsL Is LreuLIng
u LoucI oI coronury dIseuse, LIe neuroIogIsL evuIuuLIng
mIgruIne, LIe gusLroenLeroIogIsL prescrIbIng uIkuIIs Ior
un uIcer, LIe endocrInoIogIsL LreuLIng mIId dIubeLes, und
LIe venerIoIogIsL udmInIsLerIng penIcIIIIn - uII oI wIIcI
couId Iuve been ucIIeved wILI LIe expendILure oI u IoL
Iess LIme, eIIorL und money und wILI u IoL Iess Iuss by u
generuI pIysIcIun or compeLenL GP....LIe number oI
docLors wIo ure prepured Lo uccepL LIe wIoIe person us
LIeIr provInce Is sIrInkIng uIurmIngIy. PuLIenLs wIose
sympLoms do noL ImmedIuLeIy IndIcuLe LIe orgun uL
IuuIL ure bounced Irom one super-specIuIIsL Lo unoLIer,
unLII LIey uccIdenLuIIy IIL LIe upproprIuLe docLor wIose
sub-specIuILy coIncIdes wILI LIe unuLomIcuI IocuIIzuLIon
oI LIeIr dIseuse. TIose wILI muILIpIe IIInesses ure cured
Ior by u cumbersome, symbIoLIc commILLee oI super-
specIuIIsLs wIo ure Iorever dIugnosLIcuIIy LrIppIng over
eucI oLIer, prescrIbIng drugs LIuL InLerucL (or
counLerucL!), engugIng In demurcuLIon dIspuLes, gIvIng
conLrudIcLory InIormuLIon Lo LIe puLIenL,
procrusLInuLIng wILI ImporLunL decIsIons, und
exponenLIuIIy IncreusIng LIe cosLs oI medIcuI cure.
(p.8;-88)
L musL be noLed LIuL LIe Ideu oI LIe LoLuI body sIouId noL be
conIused wILI LIe LoLuI Iumun und sLIII reIIecLs u muLerIuIIsL vIewpoInL;
LIe LoLuI body Is u deconsLrucLIon devoId oI uny coIerenL psycIoIogIcuI,
psycIosocIuI und moruI dImensIons. TIe pIenomenon oI sub-specIuILIes
jurther deconsLrucLs LIe LoLuI body InLo IsoIuLed bodIIy orguns und purLs
oI orguns.
TuyIor (1q;q) uIso IndIcuLes LIe reIuLIonsIIp beLween sub-
specIuILIes und expensIve LecInIcuI gudgeLry und LIe IuIse ussumpLIons on
wIIcI LIey ure bused:
IrsL oI uII, despILe LIuL medIcuI IILeruLure Is vusL, LIe
umounL oI reIevunL prucLIcuI muLerIuI Is noL, und super-
202
202
Rampant Antismoking Signifies Grave Danger
specIuIIsLs spend mucI oI LIeIr LIme keepIng up wILI
LIe voIumInous umounL oI IrreIevunL und IrequenLIy
medIocre IuboruLory reseurcI wIIcI Is currIed on In
LIeIr IIeId. TIe medIcuI esLubIIsImenL IIkes Lo convey
LIe ImpressIon LIuL mujor udvunces In dIugnosIs und
LreuLmenL ure occurrIng uImosL duIIy und LIuL medIcuI
scIence Is conLInuuIIy on LIe verge oI u sIgnIIIcunL
breukLIrougI In one oI LIe LrudILIonuI scourges sucI us
cuncer, urLIrILIs, coronury dIseuse or muILIpIe scIerosIs.
n IucL, progress In medIcIne Is puInIuIIy sIow und oILen
yeurs eIupse beIore new meLIods ure properIy vuIIduLed
by udequuLe cIInIcuI LrIuIs, LIuL Is, LIose meLIods wIIcI
do noL IuII by LIe wuysIde becuuse LIey ure IneIIecLIve,
ImprucLIcuI or Loo dungerous. TIe umounL oI weII-
documenLed prucLIcuI und reIevunL InIormuLIon
produced by LIe mussIve bIo-medIcuI reseurcI IndusLry
Is remurkubIy meugre.
TIe second IuIse ussumpLIon Is LIuL mosL puLIenLs Iuve
rure compIex dIseuses wIIcI pose greuL probIems In
dIugnosIs und munugemenL. n IucL mosL puLIenLs Iuve
sLruIgIL-Iorwurd, sImpIe medIcuI probIems Ior wIIcI
weII-recognIzed (uILIougI noL necessurIIy eIIecLIve)
LIerupeuLIc sLruLegIes ure used. TIIs oI course does noL
prevenL LIe super-specIuIIsL Irom LryIng Lo converL
sImpIe probIems InLo compIex ones, or Lo LreuL every
sympLom us u munIIesLuLIon oI some weIrd und
wonderIuI dIseuse, LIe dIugnosIs oI wIIcI wIII enIunce
IIs repuLuLIon no end. TIe LruLI Is LIuL uny compeLenL
GP or generuI pIysIcIun cun IundIe LIe vusL mujorILy oI
IIIness und deIIver IIgI quuIILy medIcuI cure...
TIe LIIrd IuIse ussumpLIon Is LIuL mucI oI LIe new IIgI
LecInoIogy medIcuI LreuLmenL Is oI proven eIIecLIveness,
und LIuL LIe newer dIugnosLIc LecInIques Iuve
conLrIbuLed greuLIy Lo puLIenL munugemenL. However,
LecInoIogy Ius outstripped knowIedge. TIe currenLIy
uvuIIubIe LecInoIogy Ius greuLIy exLended dIugnosLIc
ubIIILy und Ius mude possIbIe LreuLmenLs InvoIvIng
IIgIIy compIex mucIInery und IIIe supporL sysLems. BuL
reIIubIe duLu on LIe results oI LIe use oI muny oI LIese
new meLIods Is dIIIIcuIL Lo obLuIn. TIe ubIIILy oI LIe
medIcuI-IndusLrIuI compIex Lo produce sopIIsLIcuLed
gudgeLry exceeds LIeIr IncIInuLIon or ubIIILy Lo properIy
Other Vital Matters
evuIuuLe ILs prucLIcuI operuLIon In dIugnosIs und
LreuLmenL..
TIe urrIvuI oI new dIugnosLIc or LIerupeuLIc LecInoIogy
Is one oI LIe mosL ImporLunL precIpILuLIng IucLors In LIe
deveIopmenL oI sub-specIuIIzuLIon. L Is weII recognIzed
LIuL u 'procedure` (uLIIIzIng LIIs LecInoIogy) Is cenLruI Lo
sub-specIuILy prucLIce und responsIbIe Ior mucI oI ILs
growLI. UnIorLunuLeIy LIe vuIue oI mucI oI LIIs new
dIugnosLIc und LIerupeuLIc LecInoIogy Lo IndIvIduuI
puLIenLs, und LIe communILy In generuI, Is noL
deLermIned uL LIe ouLseL, prIor Lo ILs wIdespreud use.
SInce mosL super-specIuIIsLs ure proceduruI docLors Lo
sucI u degree LIuL LIeIr very exIsLence wouId be
LIreuLened II LIeIr gImmIcks were Iound Lo be IurgeIy
unnecessury, und sInce evuIuuLIon oI LIIs new LecInIque
Is IeIL In LIe Iunds oI LIe super-specIuIIsLs LIemseIves,
IL Is noL surprIsIng LIuL IL becomes progressIveIy more
dIIIIcuIL Lo ImpurLIuIIy evuIuuLe new LecInoIogy us u
proceduruI sub-specIuILy grows. (p.qo-qz)
TIe pIcLure LIuL emerges Is oI u conLemporury medIcuI
esLubIIsImenL LIuL Is muLerIuIIsL, IrugmenLed, IIgIIy proLecLIve und seII-
servIng; ucLuuI weIIure, In eILIer IndIvIduuI or communILy Lerms, IIgures
very poorIy In muLerIuIIsL reusonIng wIIcI Is essenLIuIIy drIven by u Iree-
murkeL momenLum und conLrIved sLuLus. TuyIor (1q;q) udds LIuL LIe
unconLroIIed proIIIeruLIon oI sub-specIuILIes, especIuIIy wILIIn LIe IIeId oI
generuI medIcIne, Ius Ied Lo muny unIorLunuLe consequences. L Ius Ied Lo
u decIIne In LIe sLundurds oI medIcuI prucLIce und cIInIcuI compeLence,
escuIuLIng cosLs oI medIcuI cure, puLIenL mIsmunugemenL, muIdIsLrIbuLIon
oI docLors wILIIn LIe communILy, und Lo u IrIgILenIng Ioss oI perspecLIve
oI IIIe und deuLI wIIcI wus IormerIy LIe sLrong suIL oI LIe medIcuI
proIessIon. (p.q) L becomes progressIveIy more uppurenL wIy TuyIor`s
(1q;q) book Is enLILIed MedIcIne ouL oI conLroI: LIe unuLomy oI u
muIIgnunL LecInoIogy: More LeIIIng sLIII Is LIuL Ie Is u medIcuI
prucLILIoner. GIven LIe more recenL esLImuLes oI IuLrogenIc deuLI und
dIseuse, LIIs probIem Ius uorsened In LIe IusL zo yeurs.
TuyIor (1q;q) provIdes u purLIcuIur exumpIe LIuL summurIzes LIe
devusLuLIng cosL In muILI-dImensIonuI Lerms:
NowIere In modern medIcuI prucLIce Is LIe ImpoLence
oI docLors In LIe Iuce oI LIe LecInoIogIcuI monsLrosILy
LIey Iuve creuLed more gIurIng LIun In LIe nLensIve
Cure UnIL (TU)...Rows oI pIysIoIogIcuI prepuruLIons
203
203
Rampant Antismoking Signifies Grave Danger
specIuIIsLs spend mucI oI LIeIr LIme keepIng up wILI
LIe voIumInous umounL oI IrreIevunL und IrequenLIy
medIocre IuboruLory reseurcI wIIcI Is currIed on In
LIeIr IIeId. TIe medIcuI esLubIIsImenL IIkes Lo convey
LIe ImpressIon LIuL mujor udvunces In dIugnosIs und
LreuLmenL ure occurrIng uImosL duIIy und LIuL medIcuI
scIence Is conLInuuIIy on LIe verge oI u sIgnIIIcunL
breukLIrougI In one oI LIe LrudILIonuI scourges sucI us
cuncer, urLIrILIs, coronury dIseuse or muILIpIe scIerosIs.
n IucL, progress In medIcIne Is puInIuIIy sIow und oILen
yeurs eIupse beIore new meLIods ure properIy vuIIduLed
by udequuLe cIInIcuI LrIuIs, LIuL Is, LIose meLIods wIIcI
do noL IuII by LIe wuysIde becuuse LIey ure IneIIecLIve,
ImprucLIcuI or Loo dungerous. TIe umounL oI weII-
documenLed prucLIcuI und reIevunL InIormuLIon
produced by LIe mussIve bIo-medIcuI reseurcI IndusLry
Is remurkubIy meugre.
TIe second IuIse ussumpLIon Is LIuL mosL puLIenLs Iuve
rure compIex dIseuses wIIcI pose greuL probIems In
dIugnosIs und munugemenL. n IucL mosL puLIenLs Iuve
sLruIgIL-Iorwurd, sImpIe medIcuI probIems Ior wIIcI
weII-recognIzed (uILIougI noL necessurIIy eIIecLIve)
LIerupeuLIc sLruLegIes ure used. TIIs oI course does noL
prevenL LIe super-specIuIIsL Irom LryIng Lo converL
sImpIe probIems InLo compIex ones, or Lo LreuL every
sympLom us u munIIesLuLIon oI some weIrd und
wonderIuI dIseuse, LIe dIugnosIs oI wIIcI wIII enIunce
IIs repuLuLIon no end. TIe LruLI Is LIuL uny compeLenL
GP or generuI pIysIcIun cun IundIe LIe vusL mujorILy oI
IIIness und deIIver IIgI quuIILy medIcuI cure...
TIe LIIrd IuIse ussumpLIon Is LIuL mucI oI LIe new IIgI
LecInoIogy medIcuI LreuLmenL Is oI proven eIIecLIveness,
und LIuL LIe newer dIugnosLIc LecInIques Iuve
conLrIbuLed greuLIy Lo puLIenL munugemenL. However,
LecInoIogy Ius outstripped knowIedge. TIe currenLIy
uvuIIubIe LecInoIogy Ius greuLIy exLended dIugnosLIc
ubIIILy und Ius mude possIbIe LreuLmenLs InvoIvIng
IIgIIy compIex mucIInery und IIIe supporL sysLems. BuL
reIIubIe duLu on LIe results oI LIe use oI muny oI LIese
new meLIods Is dIIIIcuIL Lo obLuIn. TIe ubIIILy oI LIe
medIcuI-IndusLrIuI compIex Lo produce sopIIsLIcuLed
gudgeLry exceeds LIeIr IncIInuLIon or ubIIILy Lo properIy
Other Vital Matters
evuIuuLe ILs prucLIcuI operuLIon In dIugnosIs und
LreuLmenL..
TIe urrIvuI oI new dIugnosLIc or LIerupeuLIc LecInoIogy
Is one oI LIe mosL ImporLunL precIpILuLIng IucLors In LIe
deveIopmenL oI sub-specIuIIzuLIon. L Is weII recognIzed
LIuL u 'procedure` (uLIIIzIng LIIs LecInoIogy) Is cenLruI Lo
sub-specIuILy prucLIce und responsIbIe Ior mucI oI ILs
growLI. UnIorLunuLeIy LIe vuIue oI mucI oI LIIs new
dIugnosLIc und LIerupeuLIc LecInoIogy Lo IndIvIduuI
puLIenLs, und LIe communILy In generuI, Is noL
deLermIned uL LIe ouLseL, prIor Lo ILs wIdespreud use.
SInce mosL super-specIuIIsLs ure proceduruI docLors Lo
sucI u degree LIuL LIeIr very exIsLence wouId be
LIreuLened II LIeIr gImmIcks were Iound Lo be IurgeIy
unnecessury, und sInce evuIuuLIon oI LIIs new LecInIque
Is IeIL In LIe Iunds oI LIe super-specIuIIsLs LIemseIves,
IL Is noL surprIsIng LIuL IL becomes progressIveIy more
dIIIIcuIL Lo ImpurLIuIIy evuIuuLe new LecInoIogy us u
proceduruI sub-specIuILy grows. (p.qo-qz)
TIe pIcLure LIuL emerges Is oI u conLemporury medIcuI
esLubIIsImenL LIuL Is muLerIuIIsL, IrugmenLed, IIgIIy proLecLIve und seII-
servIng; ucLuuI weIIure, In eILIer IndIvIduuI or communILy Lerms, IIgures
very poorIy In muLerIuIIsL reusonIng wIIcI Is essenLIuIIy drIven by u Iree-
murkeL momenLum und conLrIved sLuLus. TuyIor (1q;q) udds LIuL LIe
unconLroIIed proIIIeruLIon oI sub-specIuILIes, especIuIIy wILIIn LIe IIeId oI
generuI medIcIne, Ius Ied Lo muny unIorLunuLe consequences. L Ius Ied Lo
u decIIne In LIe sLundurds oI medIcuI prucLIce und cIInIcuI compeLence,
escuIuLIng cosLs oI medIcuI cure, puLIenL mIsmunugemenL, muIdIsLrIbuLIon
oI docLors wILIIn LIe communILy, und Lo u IrIgILenIng Ioss oI perspecLIve
oI IIIe und deuLI wIIcI wus IormerIy LIe sLrong suIL oI LIe medIcuI
proIessIon. (p.q) L becomes progressIveIy more uppurenL wIy TuyIor`s
(1q;q) book Is enLILIed MedIcIne ouL oI conLroI: LIe unuLomy oI u
muIIgnunL LecInoIogy: More LeIIIng sLIII Is LIuL Ie Is u medIcuI
prucLILIoner. GIven LIe more recenL esLImuLes oI IuLrogenIc deuLI und
dIseuse, LIIs probIem Ius uorsened In LIe IusL zo yeurs.
TuyIor (1q;q) provIdes u purLIcuIur exumpIe LIuL summurIzes LIe
devusLuLIng cosL In muILI-dImensIonuI Lerms:
NowIere In modern medIcuI prucLIce Is LIe ImpoLence
oI docLors In LIe Iuce oI LIe LecInoIogIcuI monsLrosILy
LIey Iuve creuLed more gIurIng LIun In LIe nLensIve
Cure UnIL (TU)...Rows oI pIysIoIogIcuI prepuruLIons
204
204
Rampant Antismoking Signifies Grave Danger
(uIso known us Iumun beIngs) IIe surrounded by un
usLoundIng urruy oI mecIunIcuI und eIecLronIc gudgeLry.
A Lube or cuLIeLer oI some descrIpLIon vIoIuLes every
nuLuruI orIIIce und perIoruLIons In vurIous purLs oI LIe
body ure mude especIuIIy Ior LIe pIucemenL oI oLIers.
MuILIcoIoured IIuId Is pumped In, sImIIur IIuId druIns
ouL, respIruLors sIgI, dIuIysers Ium, monILors LwILcI,
oxygen bubbIes LIrougI LIe IumIdIIIers. TIe
unIorLunuLe IosLuges, mercIIuIIy unresponsIve Lo LIeIr
envIronmenL (eILIer LIrougI nuLuruI cuuses or drugs)
IIe sIIenL wIIIe LIIs rILuuI desecruLIon Lukes pIuce.
L Is Lrue LIuL muny IIves ure suved by LreuLmenL In un
TU und In LIese InsLunces LIe vIoIence und uggressIon
oI LIe LIerupy und LIe Lremendous resources consumed
ure jusLIIIed by LIe resLoruLIon oI u person Lo IIs IrIends
und IumIIy. BuL oILen LIe resuIL Is u vegeLubIe, wIo Ius u
permunenL und LoLuI Ioss oI InLeIIecLuuI IuncLIon; or u
proIonged, undIgnIIIed und gruesome deuLI. Muny dIe
und muny IIve despite udmIssIon Lo un TU ruLIer LIun
beccuse oI LIeIr udmIssIon. On LIe oLIer Iund LIere ure
u Iew wIo perIsI precIseIy becuuse oI udmIssIon Lo un
TU. L Is weII known LIuL TUs ure IuLrogenIc
nIgILmures - LIe medIcuI InLervenLIon used In LIese
unILs Is IIgIIy dungerous und LIe LoLuI 'IuLrogenIc Ioud`
reucIes consIderubIe proporLIons. A puLIenL wIo wouId
Iuve survIved wILIouL udmIssIon Lo un TU muy be
rIskIng IIs or Ier IIIe II udmILLed Lo one. (p.11q-1zo)
ApurL Irom LIe consIderubIe economIc cosL, LIere ure proIound
psycIoIogIcuI, psycIosocIuI und moruI cosLs. TIe muLerIuIIsL vIew Ius no
dIIIIcuILy wILI munuIucLurIng und udopLIng LecInoIogIcuI gudgeLry LIuL
cun urLIIIcIuIIy keep LIe body IuncLIonIng; LIe IeuL Is vIewed us un
engIneerIng exercIse und LIe person us u bIoIogIcuIIy engIneerubIe
quunLILy. Even u person In u vegeLuLIve sLuLe muInLuIned by IIIe supporL
sysLems Is uL IeusL In purL un engIneerIng success: I u person cun wuIk ouL
oI un TU reusonubIy InLucL, LIIs Is Indeed u greuL bonus. TIe muLerIuIIsL
menLuIILy cunnoL IuLIom, IeL uIone uddress, LIe devusLuLIng moruI
consequences oI even producIng LIIs sILuuLIon In LIe IIrsL pIuce. n LIe
cuse oI u person IeIL on IIIe supporL sysLems resuILIng Irom InLensIve
cure, LIe decIsIon us Lo LIe nexL sLep (I.e., swILcIIng oII IIIe supporL) Is
LIrown buck on Lo LIe IumIIy.
MedIco-muLerIuIIsm Is noLorIous Ior generuLIng LIese
Other Vital Matters
excrucIuLIngIy dIIIIcuIL cIrcumsLunces. L bIIndIy venLures InLo
engIneerIng exercIses und, wIen LIere Is greuL moruI IuIIouL Irom ILs
ucLIvILIes, IL sImpIy LIrows LIe moruI dIIemmus buck onLo socIeLy Lo soIve.
n LIIs conducL IL usuuIIy IIdes beIInd LIe cIuIm oI scIenLIIIc umoruIILy.
TIIs Is u dungerous muLerIuIIsL myLI LIuL Ius been InIIIcLed on socIeLy Ior
Iur Loo Iong. ScIence Is onIy u method; IL Is noL moruI, ImmoruI, or umoruI.
OI ILseII IL does noLIIng und, undIrecLed by u meLupIysIcuI vIewpoInL, IL Is
noLIIng. WIere scIence Is beIng conducLed, sucI u meLupIysIcuI
vIewpoInL wIII uIwuys be presenL, eILIer ImpIIcILIy or expIIcILIy. A
muLerIuIIsL vIewpoInL LIuL sLrIps LIe Iumun down Lo u bIoIogIcuI orgunIsm
cunnoL reuson In coIerenL moruI Lerms; muLerIuIIsm Ius no coIerenL
moruI Irumework. RegurdIng Iumun IuncLIonIng, ILs decIsIons ure
dIrecLed by engIneerIng possIbIIILIes LIuL ure usuuIIy bused on Iow
probubIIILIes. L wIII see purLIcuIur LecInoIogIcuI uvenues us vIubIe wIere u
non-muLerIuIIsL meLupIysIcuI vIew wouId noL. TIe probIem Is noL scIence
buL muLerIuIIsm dIrecLIng scIence und LecInoIogy. AguIn, LIe Issue Iere Is
LIe compIeLe Ioss oI perspecLIve on IIIe und deuLI In muILI-dImensIonuI
Lerms (see uIso Purkes, 1qq8). or muLerIuIIsm, keepIng LIe bIoIogIcuI
orgunIsm IIvIng Is un end In ILseII, Lo be pursued uL uII cosLs. TIIs Is u
mosL eusy pursuIL gIven LIuL muLerIuIIsm cunnoL compreIend mosL oI LIe
devusLuLIng cosLs InvoIved; Ignorunce und IncompeLence cun generuLe
concIusIons und soIuLIons very eusIIy gIven LIuL coIerenL InIerence
und u buIuncIng oI bIoIogIcuI, psycIoIogIcuI, psycIosocIuI, und moruI
dImensIons ure noL udIered Lo.
TIe Issue oI rumpunL resuscILuLIon Ius scured some InLo
exLruordInury meusures: |A ondon womun|, 8, Ius LuLLooed 'Do NoL
ResuscILuLe` ucross Ier cIesL Lo IeL docLors know wIuL sIe wunLs II sIe
ever sIIdes InLo u comu. |TIe womun|, u reLIred nurse Irom HumpsIIre,
Ius been curryIng u IIvIng wIII In Ier Iundbug Ior yeurs - buL Ieurs IL muy
be Ignored In un emergency. 'Yeurs ugo wIen wus nursIng, couId see
LIey resuscILuLed so muny peopIe wIo LIey sIouIdn`L Iuve,` sIe suId. '
don`L wunL Lo dIe LwIce,` sIe suId. 'By resuscILuLIng me, LIey wouId be
brIngIng me buck Irom LIe deud - onIy Ior me Lo Iuve Lo go LIrougI IL
uguIn.` (Hercld,Sun, MurcI ;, zoo, p.;)
TIere ure some cosLs LIuL ure jusL Loo IIgI. I LIIs muLerIuIIsL
conducL Is uccepLed, IL reduces IeuILI Lo u vurIunL oI unImuI Iusbundry.
rIedson`s observuLIon on LIe consequences oI reducLIonIsm Is upL: A
proIessIon und u socIeLy wIIcI ure so concerned wILI pIysIcuI und
IuncLIonuI weII-beIng us Lo sucrIIIce cIvII IIberLy und moruI InLegrILy musL
InevILubIy press Ior u 'scIenLIIIc` envIronmenL sImIIur Lo LIuL provIded Ior
IuyIng Iens on progressIve cIIcken Iurms - Iens wIo produce eggs
IndusLrIousIy und Iuve no dIseuse or oLIer cures. ZoIu udded Lo LIIs
205
205
Rampant Antismoking Signifies Grave Danger
(uIso known us Iumun beIngs) IIe surrounded by un
usLoundIng urruy oI mecIunIcuI und eIecLronIc gudgeLry.
A Lube or cuLIeLer oI some descrIpLIon vIoIuLes every
nuLuruI orIIIce und perIoruLIons In vurIous purLs oI LIe
body ure mude especIuIIy Ior LIe pIucemenL oI oLIers.
MuILIcoIoured IIuId Is pumped In, sImIIur IIuId druIns
ouL, respIruLors sIgI, dIuIysers Ium, monILors LwILcI,
oxygen bubbIes LIrougI LIe IumIdIIIers. TIe
unIorLunuLe IosLuges, mercIIuIIy unresponsIve Lo LIeIr
envIronmenL (eILIer LIrougI nuLuruI cuuses or drugs)
IIe sIIenL wIIIe LIIs rILuuI desecruLIon Lukes pIuce.
L Is Lrue LIuL muny IIves ure suved by LreuLmenL In un
TU und In LIese InsLunces LIe vIoIence und uggressIon
oI LIe LIerupy und LIe Lremendous resources consumed
ure jusLIIIed by LIe resLoruLIon oI u person Lo IIs IrIends
und IumIIy. BuL oILen LIe resuIL Is u vegeLubIe, wIo Ius u
permunenL und LoLuI Ioss oI InLeIIecLuuI IuncLIon; or u
proIonged, undIgnIIIed und gruesome deuLI. Muny dIe
und muny IIve despite udmIssIon Lo un TU ruLIer LIun
beccuse oI LIeIr udmIssIon. On LIe oLIer Iund LIere ure
u Iew wIo perIsI precIseIy becuuse oI udmIssIon Lo un
TU. L Is weII known LIuL TUs ure IuLrogenIc
nIgILmures - LIe medIcuI InLervenLIon used In LIese
unILs Is IIgIIy dungerous und LIe LoLuI 'IuLrogenIc Ioud`
reucIes consIderubIe proporLIons. A puLIenL wIo wouId
Iuve survIved wILIouL udmIssIon Lo un TU muy be
rIskIng IIs or Ier IIIe II udmILLed Lo one. (p.11q-1zo)
ApurL Irom LIe consIderubIe economIc cosL, LIere ure proIound
psycIoIogIcuI, psycIosocIuI und moruI cosLs. TIe muLerIuIIsL vIew Ius no
dIIIIcuILy wILI munuIucLurIng und udopLIng LecInoIogIcuI gudgeLry LIuL
cun urLIIIcIuIIy keep LIe body IuncLIonIng; LIe IeuL Is vIewed us un
engIneerIng exercIse und LIe person us u bIoIogIcuIIy engIneerubIe
quunLILy. Even u person In u vegeLuLIve sLuLe muInLuIned by IIIe supporL
sysLems Is uL IeusL In purL un engIneerIng success: I u person cun wuIk ouL
oI un TU reusonubIy InLucL, LIIs Is Indeed u greuL bonus. TIe muLerIuIIsL
menLuIILy cunnoL IuLIom, IeL uIone uddress, LIe devusLuLIng moruI
consequences oI even producIng LIIs sILuuLIon In LIe IIrsL pIuce. n LIe
cuse oI u person IeIL on IIIe supporL sysLems resuILIng Irom InLensIve
cure, LIe decIsIon us Lo LIe nexL sLep (I.e., swILcIIng oII IIIe supporL) Is
LIrown buck on Lo LIe IumIIy.
MedIco-muLerIuIIsm Is noLorIous Ior generuLIng LIese
Other Vital Matters
excrucIuLIngIy dIIIIcuIL cIrcumsLunces. L bIIndIy venLures InLo
engIneerIng exercIses und, wIen LIere Is greuL moruI IuIIouL Irom ILs
ucLIvILIes, IL sImpIy LIrows LIe moruI dIIemmus buck onLo socIeLy Lo soIve.
n LIIs conducL IL usuuIIy IIdes beIInd LIe cIuIm oI scIenLIIIc umoruIILy.
TIIs Is u dungerous muLerIuIIsL myLI LIuL Ius been InIIIcLed on socIeLy Ior
Iur Loo Iong. ScIence Is onIy u method; IL Is noL moruI, ImmoruI, or umoruI.
OI ILseII IL does noLIIng und, undIrecLed by u meLupIysIcuI vIewpoInL, IL Is
noLIIng. WIere scIence Is beIng conducLed, sucI u meLupIysIcuI
vIewpoInL wIII uIwuys be presenL, eILIer ImpIIcILIy or expIIcILIy. A
muLerIuIIsL vIewpoInL LIuL sLrIps LIe Iumun down Lo u bIoIogIcuI orgunIsm
cunnoL reuson In coIerenL moruI Lerms; muLerIuIIsm Ius no coIerenL
moruI Irumework. RegurdIng Iumun IuncLIonIng, ILs decIsIons ure
dIrecLed by engIneerIng possIbIIILIes LIuL ure usuuIIy bused on Iow
probubIIILIes. L wIII see purLIcuIur LecInoIogIcuI uvenues us vIubIe wIere u
non-muLerIuIIsL meLupIysIcuI vIew wouId noL. TIe probIem Is noL scIence
buL muLerIuIIsm dIrecLIng scIence und LecInoIogy. AguIn, LIe Issue Iere Is
LIe compIeLe Ioss oI perspecLIve on IIIe und deuLI In muILI-dImensIonuI
Lerms (see uIso Purkes, 1qq8). or muLerIuIIsm, keepIng LIe bIoIogIcuI
orgunIsm IIvIng Is un end In ILseII, Lo be pursued uL uII cosLs. TIIs Is u
mosL eusy pursuIL gIven LIuL muLerIuIIsm cunnoL compreIend mosL oI LIe
devusLuLIng cosLs InvoIved; Ignorunce und IncompeLence cun generuLe
concIusIons und soIuLIons very eusIIy gIven LIuL coIerenL InIerence
und u buIuncIng oI bIoIogIcuI, psycIoIogIcuI, psycIosocIuI, und moruI
dImensIons ure noL udIered Lo.
TIe Issue oI rumpunL resuscILuLIon Ius scured some InLo
exLruordInury meusures: |A ondon womun|, 8, Ius LuLLooed 'Do NoL
ResuscILuLe` ucross Ier cIesL Lo IeL docLors know wIuL sIe wunLs II sIe
ever sIIdes InLo u comu. |TIe womun|, u reLIred nurse Irom HumpsIIre,
Ius been curryIng u IIvIng wIII In Ier Iundbug Ior yeurs - buL Ieurs IL muy
be Ignored In un emergency. 'Yeurs ugo wIen wus nursIng, couId see
LIey resuscILuLed so muny peopIe wIo LIey sIouIdn`L Iuve,` sIe suId. '
don`L wunL Lo dIe LwIce,` sIe suId. 'By resuscILuLIng me, LIey wouId be
brIngIng me buck Irom LIe deud - onIy Ior me Lo Iuve Lo go LIrougI IL
uguIn.` (Hercld,Sun, MurcI ;, zoo, p.;)
TIere ure some cosLs LIuL ure jusL Loo IIgI. I LIIs muLerIuIIsL
conducL Is uccepLed, IL reduces IeuILI Lo u vurIunL oI unImuI Iusbundry.
rIedson`s observuLIon on LIe consequences oI reducLIonIsm Is upL: A
proIessIon und u socIeLy wIIcI ure so concerned wILI pIysIcuI und
IuncLIonuI weII-beIng us Lo sucrIIIce cIvII IIberLy und moruI InLegrILy musL
InevILubIy press Ior u 'scIenLIIIc` envIronmenL sImIIur Lo LIuL provIded Ior
IuyIng Iens on progressIve cIIcken Iurms - Iens wIo produce eggs
IndusLrIousIy und Iuve no dIseuse or oLIer cures. ZoIu udded Lo LIIs
206
206
Rampant Antismoking Signifies Grave Danger
senLImenL: Nor does IL reuIIy muLLer II, InsLeud oI LIe ubove depressIng
pIcLure, we were guurunLeed sIx more IncIes In IeIgIL, LIIrLy more yeurs
oI IIIe or drugs Lo expund our poLenLIuIILIes und poLencIes; we sIouId sLIII
be ubIe Lo usk, wIuL do sIx IncIes muLLer, In wIuL kInd oI envIronmenL wIII
LIe LIIrLy uddILIonuI yeurs be spenL, or wIo wIII decIde wIuL poLenLIuIILIes
und poLencIes wIII be expunded und wIuL curbed. (quoLed In Skrubunek
& McCormIck, 1qqo, p.1o8) WIuL cun be udded Lo boLI oI LIese oIIerIngs
Is LIuL medIco-muLerIuIIsm oIIers no guurunLees - eILIer oI no dIseuse und
oLIer cures, or x IncIes In IeIgIL, or x yeurs oI IIIe. MosL oI ILs conducL
Is bused on IoLLery-poLenLIuIILIes - very Iew miht beneIIL temporcril,
mosL do noL. WIuL is guurunLeed Is LIuL muILI-dImensIonuI reusonIng (I.e.,
un upproxImuLIon oI sunILy) wIII noL dIrecL proceedIngs, I.e., ruIe by LIe
duIL. L cun onIy produce u merry-go-round oI psycIoIogIcuI, psycIosocIuI
und moruI dIsorder.
I LIe cIrcumsLunce wus noL uIreudy suIIIcIenLIy LrugIc, LIe
medIcuI esLubIIsImenL Is rIddIed wILI oLIer very consIderubIe moruI
Issues. n recenL yeurs LIere Ius been u resurgence In medIcuI ouLIs
concernIng LIe HIppocruLIc OuLI und druIL revIsIons. One druIL revIsIon
(HurwILz & RIcIurdson, 1qq;) proIIers wIere uborLIon Is permILLed,
ugree LIuL IL sIouId Luke pIuce onIy wILIIn un eLIIcuI und IeguI
Irumework. YeL, us ScoLson (1qq8) noLes, LIe orIgInuI OuLI wus quILe
cIeur on kIIIIng: wIII noL gIve u IuLuI druugIL Lo unyone II um usked; nor
wIII suggesL uny sucI LIIng. NeILIer wIII gIve u womun meuns Lo
procure un uborLIon. ScoLson (1qq8) urgues LIuL no eLIIcuI or IeguI
Irumework cun conLrudIcL LIe nuLuruI Iuw ensIrIned In LIe Ten
CommundmenLs. TIe commundmenL 'TIou sIuIL noL kIII` Is un
ImperuLIve, repeuLed In LIe HIppocruLIc OuLI, wIIcI cunnoL be dIsobeyed
wILIouL u gross ucL oI InjusLIce beIng done, wIeLIer Lo LIe unborn cIIId or
uny oLIer Iumun. KIIIIng, currIed ouL by LIe medIcuI proIessIon or oLIers,
cun never be mude moruIIy uccepLubIe by un ucL oI purIIumenL or u revIsed
ouLI.
MIIIurd (1qq8) IIgIIIgILs LIuL
wIen moruI vuIues ure In dIsugreemenL wILI LIe Iuw oI
LIe Iund, conIIIcL ensues. TIe HIppocruLIc OuLI wus
bused on u PyLIugoreun concepL oI respecL Ior IIIe. AILer
LIe Nuremberg LrIuIs, LIe Genevu ConvenLIon IncIuded
LIe IIne: ' wIII muInLuIn LIe uLmosL respecL Ior Iumun
IIIe Irom ILs begInnIng, even under LIreuL, und wIII noL
use my specIuIIsL knowIedge conLrury Lo LIe Iuws oI
IumunILy; muke LIese promIses soIemnIy, IreeIy, und
upon my Ionour`. By mukIng LIe gIIL oI IIIe u muLerIuI
cIoIce LIe medIcuI proIessIon opened Pundoru`s box.
Other Vital Matters
MyseII und u coIIeugue recenLIy reporLed on u LIree yeur
sLudy oI LIe prucLIcuI probIems docLors und nurses Iuce
ubouL decIsIon mukIng uL LIe end oI u puLIenL`s IIIe
|JeIIrey & MIIIurd, 1qq;|. TIe purLIcIpunLs were
conIused ubouL quesLIons sucI us 'wIo Is responsIbIe
Ior deuLI wIen LreuLmenL Is wILIdruwn?` und 'WIy Is
noL necessury uIwuys Lo LreuL?` To overcome LIIs
conIusIon we proposed LIree moruI prIncIpIes LIuL
sIouId govern cIInIcuI prucLIce: u) TreuLmenL oI puLIenLs
musL reIIecL LIe InIerenL dIgnILy oI every person
IrrespecLIve oI uge, debIIILy, dependence, ruce, coIour,
or creed; b) AcLIons musL reIIecL LIe needs oI LIe
puLIenL wIere Ie or sIe Is; und c) decIsIons Luken musL
vuIue LIe person und uccepL Iumun morLuIILy. TIese
prIncIpIes puL cIInIcuI judgmenL InLo un eLIIcuI concepL
oI LendIng. TIe LendIng LIuL puLIenLs receIve wIII be
IImILed by LIe docLor`s skIIIs, LIe experL opInIon
uvuIIubIe Lo IIm or Ier, und resources, buL IL wIII uIwuys
be puLIenL cenLred.
TIIs supposed resurgence onIy serves Lo IIgIIIgIL LIe sIeer
moruI conIusIon LIuL permeuLes medIcuI prucLIce, und u number oI poInLs
ure suIIenL In LIIs regurd. IrsLIy, LIere musL sureIy be medIcuI
prucLILIoners LIuL operuLe by u moruI code LIuL Is IIgIer LIun LIe
HIppocruLIc code; or exumpIe, WIIkInson & HougILon (1qqq) noLe u
group oI medIcuI prucLILIoners LIuL ure commILLed Lo LIe Judeo-CIrIsLIun
eLIIc In LreuLmenL und cure. TIey do noL subscrIbe Lo LIe Ideu LIuL docLors
ure someIow dIIIerenL Irom LIe resL oI IumunILy. DocLors ure prone Lo
dungerous LendencIes IIke unyone eIse - some mIgIL even suy more prone
- und ure In need oI u coIerenL moruI Irumework. However, rumpunL
muLerIuIIsm und medIcuI prucLILIoners LIuL IegILImIze moruIIy
quesLIonubIe conducL - even by LIe sLundurd oI LIe HIppocruLIc OuLI -
seem Lo Iuve LIe consIderubIe und IncreusIng momenLum.
SecondIy, LIe Genevu ConvenLIon IncIusIon uccommoduLes LIe
very cenLruI roIe LIuL medIcuI prucLILIoners pIuyed In muss-scuIe murder
by LIe NuzI regIme. L wIII be urgued In LIIs dIscussIon LIuL LIere ure
IIgIIy dIsLurbIng sImIIurILIes beLween conLemporury medIco-muLerIuIIsm
und LIuL oI LIe NuzI eru.
TIIrdIy, LIere Is no sLundurd or generuI medIcuI code governIng
medIcuI prucLIce; respecL Ior LIe HIppocruLIc OuLI, Ior exumpIe, Ius been
severeIy eroded; decIsIon-mukIng Ius operuLed on un cd hoc busIs Ior uL
IeusL LIe IusL number oI decudes. TIere ure medIcuI prucLILIoners Ior
207
207
Rampant Antismoking Signifies Grave Danger
senLImenL: Nor does IL reuIIy muLLer II, InsLeud oI LIe ubove depressIng
pIcLure, we were guurunLeed sIx more IncIes In IeIgIL, LIIrLy more yeurs
oI IIIe or drugs Lo expund our poLenLIuIILIes und poLencIes; we sIouId sLIII
be ubIe Lo usk, wIuL do sIx IncIes muLLer, In wIuL kInd oI envIronmenL wIII
LIe LIIrLy uddILIonuI yeurs be spenL, or wIo wIII decIde wIuL poLenLIuIILIes
und poLencIes wIII be expunded und wIuL curbed. (quoLed In Skrubunek
& McCormIck, 1qqo, p.1o8) WIuL cun be udded Lo boLI oI LIese oIIerIngs
Is LIuL medIco-muLerIuIIsm oIIers no guurunLees - eILIer oI no dIseuse und
oLIer cures, or x IncIes In IeIgIL, or x yeurs oI IIIe. MosL oI ILs conducL
Is bused on IoLLery-poLenLIuIILIes - very Iew miht beneIIL temporcril,
mosL do noL. WIuL is guurunLeed Is LIuL muILI-dImensIonuI reusonIng (I.e.,
un upproxImuLIon oI sunILy) wIII noL dIrecL proceedIngs, I.e., ruIe by LIe
duIL. L cun onIy produce u merry-go-round oI psycIoIogIcuI, psycIosocIuI
und moruI dIsorder.
I LIe cIrcumsLunce wus noL uIreudy suIIIcIenLIy LrugIc, LIe
medIcuI esLubIIsImenL Is rIddIed wILI oLIer very consIderubIe moruI
Issues. n recenL yeurs LIere Ius been u resurgence In medIcuI ouLIs
concernIng LIe HIppocruLIc OuLI und druIL revIsIons. One druIL revIsIon
(HurwILz & RIcIurdson, 1qq;) proIIers wIere uborLIon Is permILLed,
ugree LIuL IL sIouId Luke pIuce onIy wILIIn un eLIIcuI und IeguI
Irumework. YeL, us ScoLson (1qq8) noLes, LIe orIgInuI OuLI wus quILe
cIeur on kIIIIng: wIII noL gIve u IuLuI druugIL Lo unyone II um usked; nor
wIII suggesL uny sucI LIIng. NeILIer wIII gIve u womun meuns Lo
procure un uborLIon. ScoLson (1qq8) urgues LIuL no eLIIcuI or IeguI
Irumework cun conLrudIcL LIe nuLuruI Iuw ensIrIned In LIe Ten
CommundmenLs. TIe commundmenL 'TIou sIuIL noL kIII` Is un
ImperuLIve, repeuLed In LIe HIppocruLIc OuLI, wIIcI cunnoL be dIsobeyed
wILIouL u gross ucL oI InjusLIce beIng done, wIeLIer Lo LIe unborn cIIId or
uny oLIer Iumun. KIIIIng, currIed ouL by LIe medIcuI proIessIon or oLIers,
cun never be mude moruIIy uccepLubIe by un ucL oI purIIumenL or u revIsed
ouLI.
MIIIurd (1qq8) IIgIIIgILs LIuL
wIen moruI vuIues ure In dIsugreemenL wILI LIe Iuw oI
LIe Iund, conIIIcL ensues. TIe HIppocruLIc OuLI wus
bused on u PyLIugoreun concepL oI respecL Ior IIIe. AILer
LIe Nuremberg LrIuIs, LIe Genevu ConvenLIon IncIuded
LIe IIne: ' wIII muInLuIn LIe uLmosL respecL Ior Iumun
IIIe Irom ILs begInnIng, even under LIreuL, und wIII noL
use my specIuIIsL knowIedge conLrury Lo LIe Iuws oI
IumunILy; muke LIese promIses soIemnIy, IreeIy, und
upon my Ionour`. By mukIng LIe gIIL oI IIIe u muLerIuI
cIoIce LIe medIcuI proIessIon opened Pundoru`s box.
Other Vital Matters
MyseII und u coIIeugue recenLIy reporLed on u LIree yeur
sLudy oI LIe prucLIcuI probIems docLors und nurses Iuce
ubouL decIsIon mukIng uL LIe end oI u puLIenL`s IIIe
|JeIIrey & MIIIurd, 1qq;|. TIe purLIcIpunLs were
conIused ubouL quesLIons sucI us 'wIo Is responsIbIe
Ior deuLI wIen LreuLmenL Is wILIdruwn?` und 'WIy Is
noL necessury uIwuys Lo LreuL?` To overcome LIIs
conIusIon we proposed LIree moruI prIncIpIes LIuL
sIouId govern cIInIcuI prucLIce: u) TreuLmenL oI puLIenLs
musL reIIecL LIe InIerenL dIgnILy oI every person
IrrespecLIve oI uge, debIIILy, dependence, ruce, coIour,
or creed; b) AcLIons musL reIIecL LIe needs oI LIe
puLIenL wIere Ie or sIe Is; und c) decIsIons Luken musL
vuIue LIe person und uccepL Iumun morLuIILy. TIese
prIncIpIes puL cIInIcuI judgmenL InLo un eLIIcuI concepL
oI LendIng. TIe LendIng LIuL puLIenLs receIve wIII be
IImILed by LIe docLor`s skIIIs, LIe experL opInIon
uvuIIubIe Lo IIm or Ier, und resources, buL IL wIII uIwuys
be puLIenL cenLred.
TIIs supposed resurgence onIy serves Lo IIgIIIgIL LIe sIeer
moruI conIusIon LIuL permeuLes medIcuI prucLIce, und u number oI poInLs
ure suIIenL In LIIs regurd. IrsLIy, LIere musL sureIy be medIcuI
prucLILIoners LIuL operuLe by u moruI code LIuL Is IIgIer LIun LIe
HIppocruLIc code; or exumpIe, WIIkInson & HougILon (1qqq) noLe u
group oI medIcuI prucLILIoners LIuL ure commILLed Lo LIe Judeo-CIrIsLIun
eLIIc In LreuLmenL und cure. TIey do noL subscrIbe Lo LIe Ideu LIuL docLors
ure someIow dIIIerenL Irom LIe resL oI IumunILy. DocLors ure prone Lo
dungerous LendencIes IIke unyone eIse - some mIgIL even suy more prone
- und ure In need oI u coIerenL moruI Irumework. However, rumpunL
muLerIuIIsm und medIcuI prucLILIoners LIuL IegILImIze moruIIy
quesLIonubIe conducL - even by LIe sLundurd oI LIe HIppocruLIc OuLI -
seem Lo Iuve LIe consIderubIe und IncreusIng momenLum.
SecondIy, LIe Genevu ConvenLIon IncIusIon uccommoduLes LIe
very cenLruI roIe LIuL medIcuI prucLILIoners pIuyed In muss-scuIe murder
by LIe NuzI regIme. L wIII be urgued In LIIs dIscussIon LIuL LIere ure
IIgIIy dIsLurbIng sImIIurILIes beLween conLemporury medIco-muLerIuIIsm
und LIuL oI LIe NuzI eru.
TIIrdIy, LIere Is no sLundurd or generuI medIcuI code governIng
medIcuI prucLIce; respecL Ior LIe HIppocruLIc OuLI, Ior exumpIe, Ius been
severeIy eroded; decIsIon-mukIng Ius operuLed on un cd hoc busIs Ior uL
IeusL LIe IusL number oI decudes. TIere ure medIcuI prucLILIoners Ior
208
208
Rampant Antismoking Signifies Grave Danger
wIom LIe HIppocruLIc OuLI Is u mere gruduuLIon IormuIILy. Weyers
(1qqq) IIgIIIgILs LIe pre-NuzI uLLuck on LIe HIppocruLIc code und LIe
evenLuuI domInuLIon oI Germun medIcIne by NuzI IdeoIogy. ConLem-
porury medIcIne Ius uIreudy suIIered un uLLuck on LIe HIppocruLIc code
und Is now dungerousIy vuInerubIe Lo IuIIy-IIedged muLerIuIIsm.
ourLIIy, LIIs hihl crILIcuI muLLer uppeurs onIy InIrequenLIy In
LIe medIcuI journuIs - every Iew yeurs. WIen IL does uppeur, IL Is usuuIIy
In LIe Iorm oI suggesLIng revIsIons or ucknowIedgIng mujor deIIcIencIes Lo
be IeId over Ior LIe nexL Iew yeurs unLII LIe nexL seL oI suggesLed
revIsIons. or exumpIe, un edILorIuI In LIe Mediccl 1ourncl oj Austrclic
(Breen, zoo1) brIeIIy consIders unoLIer posILIon puper Lo be dIscussed by
LIe medIcuI proIessIon, IndIcuLIng LIuL IILLIe Ius been uccompIIsIed by
precedIng uLLempLs. TIe esLubIIsImenL Is pIugued by moruI ImpoLence
wIIcI onIy uIIows muLerIuIIsm Lo IurLIer IIourIsI. A number oI LIe
reIerences cILed ubove were noL even subsLunLIve urLIcIes buL uppeured us
sIorL commenLurIes In LIe IeLLers secLIon oI LIe ritish Mediccl
1ourncl.
OLIer reseurcI IndIcuLes u mosL uIurmIng IeveI oI ucudemIc
mIsconducL umongsL medIcuI sLudenLs. RennIe & Crosby (zoo1), In un
urLIcIe purLIy enLILIed Are 'Lomorrow`s docLors` IonesL?, Iound vuryIng
IeveIs oI uccepLunce oI moruIIy quesLIonubIe conducL rungIng Irom
copyIng unswers In u degree exumInuLIon (z%) Lo copyIng dIrecLIy Irom
pubIIsIed LexL und onIy IIsLIng IL us u reIerence (6%). TIe uuLIors
concIuded LIuL expIuInIng Lo sLudenLs wIuL Is uccepLubIe beIuvIour Is
ImporLunL wIen LryIng Lo reduce dIsIonesLy. SIIILIng LIe empIusIs Irom
ussessmenL Lo LIe IeurnIng process muy resuIL In u decreuse In Iruud und
pIugIurIsm. AcudemIc mIsconducL Is conLrury Lo LIe IdeuIs oI ucudemIc
und proIessIonuI InLegrILy und devuIues LIe sysLem oI course ussessmenL.
L needs Lo be Luken serIousIy by medIcuI scIooIs us IL cusLs doubL on LIe
vuIIdILy oI quuIIIIcuLIons.
EysenbucI (zoo1) Iound oI LIe zo1 sLudenLs wIo Iud done
reseurcI, u IIgI proporLIon reporLed LIuL LIey Iud observed oLIers
engugIng In uneLIIcuI prucLIces. TIese IncIuded seIecLIve reporLIng (q%),
LrImmIng or IuIsIIyIng resuILs (6%), wrong or InupproprIuLe uuLIorsIIp
uLLrIbuLIon (z%), muILIpIe pubIIcuLIon oI LIe sume resuIL (suIumI
pubIIcuLIon) (18%), presenLuLIon oI resuILs In u wIIIIuIIy mIsIeudIng wuy
(1q%), und pIugIurIsm (1q%). TIe uuLIor concIuded LIuL ucudemIcs
sIouId be u roIe modeI In Lerms oI good scIenLIIIc prucLIce, buL we ure Iur
Irom LIIs IdeuI....CerLuIn Iorms oI ucudemIc mIsconducL ure sLIII common.
We muy LIereIore Iuve dIIIIcuILIes creuLIng 'u peer pressure In wIIcI
cerLuIn beIuvIour sImpIy Is noL uccepLubIe` |GIIck, zoo1|. MedIcuI
sLudenLs ure beIng educuLed In un envIronmenL wIere LIe uLLILude
Other Vital Matters
'everyone does IL` (IrequenLIy Ieurd us un excuse by reseurcIers engugIng
In mIsconducL) Is beIng IosLered. urLIermore, IL seems Lo be IILLIe
dIIIerenL Irom zo yeurs ugo (see SIerIes eL uI., 1q8o). Ike LIe eurIIer
Issues, LIIs one, Loo, receIves very scunL uddress In LIe medIcuI IILeruLure.
AnoLIer IIgIIy crILIcuI sympLom oI LIe growIng muLerIuIIsm oI
LIe IusL Iew decudes Is LIe pIoys und IncreusIng domInuLIon oI
pIurmuceuLIcuI compunIes. n ugreemenL wILI MoynIIun eL uI. (zooz),
und Lo be IurLIer consIdered In IuLer cIupLers, convIncIng IeuILIy peopIe
LIey ure sIck Is economIcuIIy IucruLIve. MoynIIun eL uI. (zooz) concIude:
TIere`s u IoL oI money Lo be mude Irom LeIIIng IeuILIy
peopIe LIey`re sIck. Some Iorms oI medIcuIIsIng
ordInury IIIe muy now be beLLer descrIbed us dIseuse
mongerIng: wIdenIng LIe boundurIes oI LreuLubIe IIIness
In order Lo expund murkeLs Ior LIose wIo seII und
deIIver LreuLmenLs. PIurmuceuLIcuI compunIes ure
ucLIveIy InvoIved In sponsorIng LIe deIInILIon oI
dIseuses und promoLIng LIem Lo boLI prescrIbers und
consumers. TIe socIuI consLrucLIon oI IIIness Is beIng
repIuced by LIe corporuLe consLrucLIon oI
dIseuse..AIIIunces oI pIurmuceuLIcuI compunIes,
docLors, und puLIenL groups use LIe medIu Lo Irume
condILIons us beIng wIdespreud und severe....DIseuse
mongerIng cun IncIude LurnIng ordInury uIImenLs InLo
medIcuI probIems, seeIng mIId sympLoms us serIous,
LreuLIng personuI probIems us medIcuI, seeIng rIsks us
dIseuses, und IrumIng prevuIence esLImuLes Lo muxImIze
poLenLIuI murkeLs. (p.886)
TIIs dIseuse mongerIng cun onIy be conLempIuLed by persons
LIuL ure muLerIuIIsL (sIuIIow) In menLuIILy: IL does noL duwn on LIIs
menLuIILy LIuL ILs own Ideu oI IeuILI Is IncoIerenL und LIuL IL Is coercIng,
LIrougI Ieur, LIe musses InLo IrruLIonuI (supersLILIous) beIIeI, I.e., u IIgIIy
unIeuILIy sLuLe oI uIIuIrs. WIere LIIs Is ucLuuIIy uIIowed Lo occur on u
muss-scuIe sIgnIIIes u cuLusLropIIc IuIIure oI key socIuI InsLILuLIons (e.g.,
medIcuI esLubIIsImenL, ucudemIu, medIu) LIuL cun usuuIIy keep LIIs
deIusIonuI propensILy In cIeck. TIereIore, LIe LeIIIng probIem oI LIe LIme
Is rumpunL muLerIuIIsm; LIe very socIeLIes LIuL LIese pIurmuceuLIcuI
compunIes operuLe In Iuve LIemseIves become progressIveIy more
muLerIuIIsL (psycIoIogIcuIIy, reIuLIonuIIy, und moruIIy unbuIunced) und,
LIereIore, guIIIbIe Lo und reInIorcIng oI LIe muLerIuIIsL onsIuugIL.
NoLeworLIy oI IIgIIIgIL Is LIuL LIIs crILIcuI Issue oI pIurmuceuLIcuI
compunIes IuvIng LIeIr LenLucIes IIrmIy enLrencIed In IeuILI promoLIon
209
209
Rampant Antismoking Signifies Grave Danger
wIom LIe HIppocruLIc OuLI Is u mere gruduuLIon IormuIILy. Weyers
(1qqq) IIgIIIgILs LIe pre-NuzI uLLuck on LIe HIppocruLIc code und LIe
evenLuuI domInuLIon oI Germun medIcIne by NuzI IdeoIogy. ConLem-
porury medIcIne Ius uIreudy suIIered un uLLuck on LIe HIppocruLIc code
und Is now dungerousIy vuInerubIe Lo IuIIy-IIedged muLerIuIIsm.
ourLIIy, LIIs hihl crILIcuI muLLer uppeurs onIy InIrequenLIy In
LIe medIcuI journuIs - every Iew yeurs. WIen IL does uppeur, IL Is usuuIIy
In LIe Iorm oI suggesLIng revIsIons or ucknowIedgIng mujor deIIcIencIes Lo
be IeId over Ior LIe nexL Iew yeurs unLII LIe nexL seL oI suggesLed
revIsIons. or exumpIe, un edILorIuI In LIe Mediccl 1ourncl oj Austrclic
(Breen, zoo1) brIeIIy consIders unoLIer posILIon puper Lo be dIscussed by
LIe medIcuI proIessIon, IndIcuLIng LIuL IILLIe Ius been uccompIIsIed by
precedIng uLLempLs. TIe esLubIIsImenL Is pIugued by moruI ImpoLence
wIIcI onIy uIIows muLerIuIIsm Lo IurLIer IIourIsI. A number oI LIe
reIerences cILed ubove were noL even subsLunLIve urLIcIes buL uppeured us
sIorL commenLurIes In LIe IeLLers secLIon oI LIe ritish Mediccl
1ourncl.
OLIer reseurcI IndIcuLes u mosL uIurmIng IeveI oI ucudemIc
mIsconducL umongsL medIcuI sLudenLs. RennIe & Crosby (zoo1), In un
urLIcIe purLIy enLILIed Are 'Lomorrow`s docLors` IonesL?, Iound vuryIng
IeveIs oI uccepLunce oI moruIIy quesLIonubIe conducL rungIng Irom
copyIng unswers In u degree exumInuLIon (z%) Lo copyIng dIrecLIy Irom
pubIIsIed LexL und onIy IIsLIng IL us u reIerence (6%). TIe uuLIors
concIuded LIuL expIuInIng Lo sLudenLs wIuL Is uccepLubIe beIuvIour Is
ImporLunL wIen LryIng Lo reduce dIsIonesLy. SIIILIng LIe empIusIs Irom
ussessmenL Lo LIe IeurnIng process muy resuIL In u decreuse In Iruud und
pIugIurIsm. AcudemIc mIsconducL Is conLrury Lo LIe IdeuIs oI ucudemIc
und proIessIonuI InLegrILy und devuIues LIe sysLem oI course ussessmenL.
L needs Lo be Luken serIousIy by medIcuI scIooIs us IL cusLs doubL on LIe
vuIIdILy oI quuIIIIcuLIons.
EysenbucI (zoo1) Iound oI LIe zo1 sLudenLs wIo Iud done
reseurcI, u IIgI proporLIon reporLed LIuL LIey Iud observed oLIers
engugIng In uneLIIcuI prucLIces. TIese IncIuded seIecLIve reporLIng (q%),
LrImmIng or IuIsIIyIng resuILs (6%), wrong or InupproprIuLe uuLIorsIIp
uLLrIbuLIon (z%), muILIpIe pubIIcuLIon oI LIe sume resuIL (suIumI
pubIIcuLIon) (18%), presenLuLIon oI resuILs In u wIIIIuIIy mIsIeudIng wuy
(1q%), und pIugIurIsm (1q%). TIe uuLIor concIuded LIuL ucudemIcs
sIouId be u roIe modeI In Lerms oI good scIenLIIIc prucLIce, buL we ure Iur
Irom LIIs IdeuI....CerLuIn Iorms oI ucudemIc mIsconducL ure sLIII common.
We muy LIereIore Iuve dIIIIcuILIes creuLIng 'u peer pressure In wIIcI
cerLuIn beIuvIour sImpIy Is noL uccepLubIe` |GIIck, zoo1|. MedIcuI
sLudenLs ure beIng educuLed In un envIronmenL wIere LIe uLLILude
Other Vital Matters
'everyone does IL` (IrequenLIy Ieurd us un excuse by reseurcIers engugIng
In mIsconducL) Is beIng IosLered. urLIermore, IL seems Lo be IILLIe
dIIIerenL Irom zo yeurs ugo (see SIerIes eL uI., 1q8o). Ike LIe eurIIer
Issues, LIIs one, Loo, receIves very scunL uddress In LIe medIcuI IILeruLure.
AnoLIer IIgIIy crILIcuI sympLom oI LIe growIng muLerIuIIsm oI
LIe IusL Iew decudes Is LIe pIoys und IncreusIng domInuLIon oI
pIurmuceuLIcuI compunIes. n ugreemenL wILI MoynIIun eL uI. (zooz),
und Lo be IurLIer consIdered In IuLer cIupLers, convIncIng IeuILIy peopIe
LIey ure sIck Is economIcuIIy IucruLIve. MoynIIun eL uI. (zooz) concIude:
TIere`s u IoL oI money Lo be mude Irom LeIIIng IeuILIy
peopIe LIey`re sIck. Some Iorms oI medIcuIIsIng
ordInury IIIe muy now be beLLer descrIbed us dIseuse
mongerIng: wIdenIng LIe boundurIes oI LreuLubIe IIIness
In order Lo expund murkeLs Ior LIose wIo seII und
deIIver LreuLmenLs. PIurmuceuLIcuI compunIes ure
ucLIveIy InvoIved In sponsorIng LIe deIInILIon oI
dIseuses und promoLIng LIem Lo boLI prescrIbers und
consumers. TIe socIuI consLrucLIon oI IIIness Is beIng
repIuced by LIe corporuLe consLrucLIon oI
dIseuse..AIIIunces oI pIurmuceuLIcuI compunIes,
docLors, und puLIenL groups use LIe medIu Lo Irume
condILIons us beIng wIdespreud und severe....DIseuse
mongerIng cun IncIude LurnIng ordInury uIImenLs InLo
medIcuI probIems, seeIng mIId sympLoms us serIous,
LreuLIng personuI probIems us medIcuI, seeIng rIsks us
dIseuses, und IrumIng prevuIence esLImuLes Lo muxImIze
poLenLIuI murkeLs. (p.886)
TIIs dIseuse mongerIng cun onIy be conLempIuLed by persons
LIuL ure muLerIuIIsL (sIuIIow) In menLuIILy: IL does noL duwn on LIIs
menLuIILy LIuL ILs own Ideu oI IeuILI Is IncoIerenL und LIuL IL Is coercIng,
LIrougI Ieur, LIe musses InLo IrruLIonuI (supersLILIous) beIIeI, I.e., u IIgIIy
unIeuILIy sLuLe oI uIIuIrs. WIere LIIs Is ucLuuIIy uIIowed Lo occur on u
muss-scuIe sIgnIIIes u cuLusLropIIc IuIIure oI key socIuI InsLILuLIons (e.g.,
medIcuI esLubIIsImenL, ucudemIu, medIu) LIuL cun usuuIIy keep LIIs
deIusIonuI propensILy In cIeck. TIereIore, LIe LeIIIng probIem oI LIe LIme
Is rumpunL muLerIuIIsm; LIe very socIeLIes LIuL LIese pIurmuceuLIcuI
compunIes operuLe In Iuve LIemseIves become progressIveIy more
muLerIuIIsL (psycIoIogIcuIIy, reIuLIonuIIy, und moruIIy unbuIunced) und,
LIereIore, guIIIbIe Lo und reInIorcIng oI LIe muLerIuIIsL onsIuugIL.
NoLeworLIy oI IIgIIIgIL Is LIuL LIIs crILIcuI Issue oI pIurmuceuLIcuI
compunIes IuvIng LIeIr LenLucIes IIrmIy enLrencIed In IeuILI promoLIon
210
210
Rampant Antismoking Signifies Grave Danger
LIuL goes Lo LIe very core oI un uccounLubIe Ideu oI IeuILI Is very poorIy
consIdered In LIe medIcuI IILeruLure, I.e., sympLomuLIc oI LIe prevuIIIng
muLerIuIIsm.
AnoLIer very severe probIem Is LIe use oI LIe Ideu oI sLuLIsLIcuI
rIsk. or exumpIe, |u| sLudy Iound q1 per cenL oI cuncer puLIenLs wunLed
Lo know II LIeIr LreuLmenL wouId be successIuI buL sLruggIed Lo
undersLund Lerms sucI us 'good cIunce oI survIvuI`. AImosL one In LIree
puLIenLs dId noL undersLund LIe concepL oI rIsk und LIougIL LIe docLor
couId predIcL wIeLIer or noL LIeIr cuncer wouId reLurn. (Hercld,Sun,
Muy ;, zoo1, p.1q) L wouId be reusonubIe Ior u medIcuI prucLILIoner Lo
provIde u sLuLIsLIcuI summury oI LIe eIIecLIveness oI u LreuLmenL Lo duLe.
or exumpIe, IL cun be sLuLed LIuL In o% oI cuses LIIs LreuLmenL Ius been
successIuI, In ;o% oI cuses IL Ius noL. TIe medIcuI prucLILIoner sIouId
LIen poInL ouL LIuL medIcuI knowIedge Is InudequuLe Lo properIy predIcL
wIeLIer this puLIenL wIII be one oI LIe o% or LIe ;o%. L muy be LIe onIy
medIcuI LreuLmenL uvuIIubIe und IL Is Ioped LIuL IL wIII be successIuI.
However, Lo InLroduce LIe Lerm cIunce uILers LIe Irumework enLIreIy. L
IosLers LIe ImpressIon LIuL success or IuIIure oI u LreuLmenL occurs wILIIn
u IoLLery (non-cuusuI) Irumework. PuLIenLs upproucI LIe medIcuI
esLubIIsImenL In LIe Iope LIuL IL Ius uL IeusL some grusp oI underIyIng
cuusuLIon. To LIen musquerude un Inudequucy oI medIcuI knowIedge by
mukIng success or oLIerwIse oI u LreuLmenL uppeur us uLLrIbuLubIe Lo
cIunce Is u dIsgruce. TIere Is noL mucI poInL, oLIer LIun Lo mIsIeud,
LeIIIng u puLIenL conLempIuLIng cIemoLIerupy LIuL LIey sIouId do so
becuuse IL wIII Increuse LIeIr cIunce oI survIvuI. I u puLIenL usks II IL wIII
IeIp LIem specijiccll, LIen LIe IonesL unswer Is do noL know, buL IL`s
uII LIuL we Iuve.
urLIermore, IL IndIcuLes LIuL muny members oI LIe Iuy pubIIc
InLerpreL rIsk In un uII-or-none (ubsoIuLe) sense, I.e., IndIcuLIve oI cuuse
und eIIecL. TIey uIso seem Lo erroneousIy beIIeve LIuL LIe munner In
wIIcI LIe Lerm rIsk Is used by LIe medIcuI esLubIIsImenL Is In ubsoIuLe
Lerms. As Ius uIreudy been IndIcuLed, In ubsoIuLe Lerms, rIsk IucLors used
by LIe medIcuI esLubIIsImenL ruLe very poorIy. TIe medIcuI esLubIIsImenL
does mucI Lo IosLer LIese erroneous beIIeIs.
AnoLIer sIckIy LIeme emergIng In medIco-muLerIuIIsm Is LIe
denIuI oI LreuLmenL Ior wIuL IL deems us seII-InIIIcLed condILIons:
DocLors ure reIusIng smokers poLenLIuIIy IIIe-suvIng surgery unLII LIey
quIL LIeIr IubIL. PIysIcIuns und surgeons uL MeIbourne`s |VIcLorIu,
AusLruIIu|..were denyIng smokers eIecLIve LreuLmenL sucI us Iung und
IeurL LrunspIunLs, Iung reducLIon surgery, urLery bypusses, und coronury
urLery gruILs. (Hercld,Sun, ebruury 8, zoo1, p.1) TIIs conducL Ius been
seen beIore, e.g., In NuzI Germuny (ProcLor, 1qq;). TIe jusLIIIcuLIon gIven
Other Vital Matters
Is LIuL LIere Is u IIgIer rIsk oI compIIcuLIons In surgery Ior smokers.
However, LIIs Is LIe sume IIImsy sLuLIsLIcuI Irumework LIuL Ius essenLIuIIy
no uppIIcuLIon Lo IndIvIduuI puLIenLs wILIIn LIe uIreudy IIImsy smokIng-
reIuLed dIseuse Irumework.
On ebruury q, LIe sume newspuper reporLed LIuL |u| smoker
Iud dIed uL RoyuI MeIbourne HospILuI uILer IIIe-suvIng IeurL surgery wus
deIuyed becuuse oI IIs uddIcLIon. TIe IumIIy oI LIe mun, 6, cIuIms Ie wus
senL Iome Lwo duys beIore CIrIsLmus wIen u surgeon reIused Lo operuLe
becuuse Ie Iud noL quIL smokIng. (Hercld,Sun, ebruury q, zoo1, p.z) A
CoronIuI enquIry wus esLubIIsIed Lo InvesLIguLe LIe muLLer (Hercld,Sun,
ebruury 1o, zoo1, p.18).
One oI LIe more LeIIIng uspecLs oI LIIs cuse, und In keepIng wILI
wIuL Ius uIreudy been consIdered LIus Iur, Is LIuL LIere wus no moruI
consensus on LIe muLLer by medIcuI prucLILIoners. or exumpIe, MedIcuI
AssocIuLIon sLuLe presIdenL Dr MIcIueI SedgIey suId IL wus unconscIonubIe
und ouLrugeous Ior docLors Lo Luke u moruI sLund wIen decIdIng on
LreuLIng someone. AILernuLIveIy, LIe A|usLruIIun| M|edIcuI| A
|ssocIuLIon| IederuI presIdenL Dr Kuren PIeIps deIended LIe rIgIL Lo
reIuse non-emergency surgery Lo smokers, suyIng u cusI-sLrupped IeuILI
IndusLry Iud no cIoIce. (Hercld,Sun, ebruury q, zoo1, p.z)
TIIs sILuuLIon oI wILIIoIdIng LreuLmenL ubsurdIy conLrusLs wILI
LIe eurIIer-consIdered rumpunL uLLempLs uL resuscILuLIon. L IurLIer
IndIcuLes LIe sIeer Iuck oI u coIerenL muILIdImensIonuI Irumework Lo
guIde conducL; In seekIng or reIusIng LreuLmenL, LIe ucLuuI puLIenL Is beIng
gIven Iess und Iess suy, mude onIy Lo IIL LIe cuprIcIousness und
consIderubIe IoIbIes oI LIe conLemporury medIcuI producLIon-IIne. RuLIer
LIun u servunL oI socIeLy, medIcIne, LIrougI u degeneruLIon InLo LIe
superIIcIuIILy oI muLerIuIIsm, wIII dIspIuy progressIveIy greuLer dIcLuLorIuI
or IuscIsL LendencIes.
AnoLIer mosL serIous muLLer Is geneLIc reseurcI und LreuLmenL.
AILIougI LIere Is u mucI Iurger conLexL oI conLroversy, Lwo Issues ure
purLIcuIurIy ImporLunL:- geneLIc screenIng und Iumun cIonIng. AILIougI
LIe genome Ius essenLIuIIy been decIpIered, ILs useIuIness Is IImILed:
'BusIcuIIy, LIe Iumun sequence uL ILs presenL IeveI oI unuIysIs uIIows us Lo
unswer muny gIobuI quesLIons IuIrIy weII, buL LIe deLuIIed quesLIons
remuIn open Ior LIe IuLure`, Dr BuILImore suId. (Hercld,Sun, ebruury
1, zoo1, p.q) GeneLIc murkers ure no dIIIerenL Lo oLIer rIsk IucLors. TIey
InvoIve u Iurge number oI IuIse cIussIIIcuLIons. As sucI, LIeIr roIe In
dIseuse ueLIoIogy, Ior exumpIe, Is IIgIIy quesLIonubIe. YeL, LIese poor-
predIcLor murkers ure beIng used Lo screen ouL embryos In V LreuLmenL
und IeLuses In LIe IIrsL LrImesLer oI pregnuncy: Dr Crum suId up Lo 8ooo
dIseuse-cuusIng genes Iuve been IdenLIIIed by scIenLIsLs und couId
211
211
Rampant Antismoking Signifies Grave Danger
LIuL goes Lo LIe very core oI un uccounLubIe Ideu oI IeuILI Is very poorIy
consIdered In LIe medIcuI IILeruLure, I.e., sympLomuLIc oI LIe prevuIIIng
muLerIuIIsm.
AnoLIer very severe probIem Is LIe use oI LIe Ideu oI sLuLIsLIcuI
rIsk. or exumpIe, |u| sLudy Iound q1 per cenL oI cuncer puLIenLs wunLed
Lo know II LIeIr LreuLmenL wouId be successIuI buL sLruggIed Lo
undersLund Lerms sucI us 'good cIunce oI survIvuI`. AImosL one In LIree
puLIenLs dId noL undersLund LIe concepL oI rIsk und LIougIL LIe docLor
couId predIcL wIeLIer or noL LIeIr cuncer wouId reLurn. (Hercld,Sun,
Muy ;, zoo1, p.1q) L wouId be reusonubIe Ior u medIcuI prucLILIoner Lo
provIde u sLuLIsLIcuI summury oI LIe eIIecLIveness oI u LreuLmenL Lo duLe.
or exumpIe, IL cun be sLuLed LIuL In o% oI cuses LIIs LreuLmenL Ius been
successIuI, In ;o% oI cuses IL Ius noL. TIe medIcuI prucLILIoner sIouId
LIen poInL ouL LIuL medIcuI knowIedge Is InudequuLe Lo properIy predIcL
wIeLIer this puLIenL wIII be one oI LIe o% or LIe ;o%. L muy be LIe onIy
medIcuI LreuLmenL uvuIIubIe und IL Is Ioped LIuL IL wIII be successIuI.
However, Lo InLroduce LIe Lerm cIunce uILers LIe Irumework enLIreIy. L
IosLers LIe ImpressIon LIuL success or IuIIure oI u LreuLmenL occurs wILIIn
u IoLLery (non-cuusuI) Irumework. PuLIenLs upproucI LIe medIcuI
esLubIIsImenL In LIe Iope LIuL IL Ius uL IeusL some grusp oI underIyIng
cuusuLIon. To LIen musquerude un Inudequucy oI medIcuI knowIedge by
mukIng success or oLIerwIse oI u LreuLmenL uppeur us uLLrIbuLubIe Lo
cIunce Is u dIsgruce. TIere Is noL mucI poInL, oLIer LIun Lo mIsIeud,
LeIIIng u puLIenL conLempIuLIng cIemoLIerupy LIuL LIey sIouId do so
becuuse IL wIII Increuse LIeIr cIunce oI survIvuI. I u puLIenL usks II IL wIII
IeIp LIem specijiccll, LIen LIe IonesL unswer Is do noL know, buL IL`s
uII LIuL we Iuve.
urLIermore, IL IndIcuLes LIuL muny members oI LIe Iuy pubIIc
InLerpreL rIsk In un uII-or-none (ubsoIuLe) sense, I.e., IndIcuLIve oI cuuse
und eIIecL. TIey uIso seem Lo erroneousIy beIIeve LIuL LIe munner In
wIIcI LIe Lerm rIsk Is used by LIe medIcuI esLubIIsImenL Is In ubsoIuLe
Lerms. As Ius uIreudy been IndIcuLed, In ubsoIuLe Lerms, rIsk IucLors used
by LIe medIcuI esLubIIsImenL ruLe very poorIy. TIe medIcuI esLubIIsImenL
does mucI Lo IosLer LIese erroneous beIIeIs.
AnoLIer sIckIy LIeme emergIng In medIco-muLerIuIIsm Is LIe
denIuI oI LreuLmenL Ior wIuL IL deems us seII-InIIIcLed condILIons:
DocLors ure reIusIng smokers poLenLIuIIy IIIe-suvIng surgery unLII LIey
quIL LIeIr IubIL. PIysIcIuns und surgeons uL MeIbourne`s |VIcLorIu,
AusLruIIu|..were denyIng smokers eIecLIve LreuLmenL sucI us Iung und
IeurL LrunspIunLs, Iung reducLIon surgery, urLery bypusses, und coronury
urLery gruILs. (Hercld,Sun, ebruury 8, zoo1, p.1) TIIs conducL Ius been
seen beIore, e.g., In NuzI Germuny (ProcLor, 1qq;). TIe jusLIIIcuLIon gIven
Other Vital Matters
Is LIuL LIere Is u IIgIer rIsk oI compIIcuLIons In surgery Ior smokers.
However, LIIs Is LIe sume IIImsy sLuLIsLIcuI Irumework LIuL Ius essenLIuIIy
no uppIIcuLIon Lo IndIvIduuI puLIenLs wILIIn LIe uIreudy IIImsy smokIng-
reIuLed dIseuse Irumework.
On ebruury q, LIe sume newspuper reporLed LIuL |u| smoker
Iud dIed uL RoyuI MeIbourne HospILuI uILer IIIe-suvIng IeurL surgery wus
deIuyed becuuse oI IIs uddIcLIon. TIe IumIIy oI LIe mun, 6, cIuIms Ie wus
senL Iome Lwo duys beIore CIrIsLmus wIen u surgeon reIused Lo operuLe
becuuse Ie Iud noL quIL smokIng. (Hercld,Sun, ebruury q, zoo1, p.z) A
CoronIuI enquIry wus esLubIIsIed Lo InvesLIguLe LIe muLLer (Hercld,Sun,
ebruury 1o, zoo1, p.18).
One oI LIe more LeIIIng uspecLs oI LIIs cuse, und In keepIng wILI
wIuL Ius uIreudy been consIdered LIus Iur, Is LIuL LIere wus no moruI
consensus on LIe muLLer by medIcuI prucLILIoners. or exumpIe, MedIcuI
AssocIuLIon sLuLe presIdenL Dr MIcIueI SedgIey suId IL wus unconscIonubIe
und ouLrugeous Ior docLors Lo Luke u moruI sLund wIen decIdIng on
LreuLIng someone. AILernuLIveIy, LIe A|usLruIIun| M|edIcuI| A
|ssocIuLIon| IederuI presIdenL Dr Kuren PIeIps deIended LIe rIgIL Lo
reIuse non-emergency surgery Lo smokers, suyIng u cusI-sLrupped IeuILI
IndusLry Iud no cIoIce. (Hercld,Sun, ebruury q, zoo1, p.z)
TIIs sILuuLIon oI wILIIoIdIng LreuLmenL ubsurdIy conLrusLs wILI
LIe eurIIer-consIdered rumpunL uLLempLs uL resuscILuLIon. L IurLIer
IndIcuLes LIe sIeer Iuck oI u coIerenL muILIdImensIonuI Irumework Lo
guIde conducL; In seekIng or reIusIng LreuLmenL, LIe ucLuuI puLIenL Is beIng
gIven Iess und Iess suy, mude onIy Lo IIL LIe cuprIcIousness und
consIderubIe IoIbIes oI LIe conLemporury medIcuI producLIon-IIne. RuLIer
LIun u servunL oI socIeLy, medIcIne, LIrougI u degeneruLIon InLo LIe
superIIcIuIILy oI muLerIuIIsm, wIII dIspIuy progressIveIy greuLer dIcLuLorIuI
or IuscIsL LendencIes.
AnoLIer mosL serIous muLLer Is geneLIc reseurcI und LreuLmenL.
AILIougI LIere Is u mucI Iurger conLexL oI conLroversy, Lwo Issues ure
purLIcuIurIy ImporLunL:- geneLIc screenIng und Iumun cIonIng. AILIougI
LIe genome Ius essenLIuIIy been decIpIered, ILs useIuIness Is IImILed:
'BusIcuIIy, LIe Iumun sequence uL ILs presenL IeveI oI unuIysIs uIIows us Lo
unswer muny gIobuI quesLIons IuIrIy weII, buL LIe deLuIIed quesLIons
remuIn open Ior LIe IuLure`, Dr BuILImore suId. (Hercld,Sun, ebruury
1, zoo1, p.q) GeneLIc murkers ure no dIIIerenL Lo oLIer rIsk IucLors. TIey
InvoIve u Iurge number oI IuIse cIussIIIcuLIons. As sucI, LIeIr roIe In
dIseuse ueLIoIogy, Ior exumpIe, Is IIgIIy quesLIonubIe. YeL, LIese poor-
predIcLor murkers ure beIng used Lo screen ouL embryos In V LreuLmenL
und IeLuses In LIe IIrsL LrImesLer oI pregnuncy: Dr Crum suId up Lo 8ooo
dIseuse-cuusIng genes Iuve been IdenLIIIed by scIenLIsLs und couId
212
212
Rampant Antismoking Signifies Grave Danger
LIeoreLIcuIIy be screened In LIree-duy-oId embryos..TIe uILernuLIve Lo
embryo screenIng Is Lo conceIve nuLuruIIy LIen LesL LIe IeLus Ior LIe
dIseuse uL 11 Lo 1q weeks oI uge. (Hercld,Sun, SepLember z;, zooz, p)
TIe Lrugedy Iere Is LIuL geneLIc murkers oI poor predIcLIve
sLrengLI Ior specIIIc dIseuse ure beIng reIerred Lo us dIseuse-cuusIng und
LreuLed us II LIere Is u one-Lo-one muLcI beLween LIe murker und dIseuse
ouLcome. TIIs Is IruuduIenL und LIe sume sLuLIsLIcuIIsL nonsense LIuL
permeuLes conLemporury IeuILI promoLIon.
TIIs enLIre upproucI IIgIIIgILs Lwo concurrenL LIemes LIuL ure
scIenLIIIcuIIy und moruIIy quesLIonubIe. IrsLIy, II LIere wus u one-Lo-one
muppIng, LIen embryos ure beIng dIscurded becuuse oI specIIIc dIseuse
usuuIIy IuLer In IIIe. However, IL musL be noLed LIuL LIIs upproucI Is noL
curuLIve buL exLermInuLory. AccordIng Lo medIco-muLerIuIIsm, embryos
IuvIng purLIcuIur dIseuse poLenLIuI ure noL worLIy Lo IIve - uL uII.
SecondIy, LIe reusonIng Is even more groLesque In LIuL geneLIc murkers do
noL reIIecL u one-Lo-one correspondence wILI dIseuse ouLcome, or
unyLIIng remoLeIy resembIIng LIIs. A murker mIgIL Iuve, suy, u o%
ussocIuLIon wILI u specIIIc dIseuse. n oLIer words, ;o% oI LIose wILI LIe
murker wIII never munIIesL LIe dIseuse. TIereIore, In uLLempLIng Lo
exLermInuLe LIe o%, IL wIII uIso exLermInuLe ;o% wIIcI ure oLIerwIse
IeuILIy embryos: AII oI LIese ure noL permILLed Lo IIve. TIIs Is sLundurd,
dungerous sLuLIsLIcuIIsm, reIerred Lo uL IengLI LIus Iur.
Jumes WuLson, u pIoneer In eIucIduLIng LIe sLrucLure oI DNA,
IndIcuLes LIuL |s|ocIeLy sIouId do wIuL IL couId Lo uboIIsI geneLIc
deIecLs..' sLrongIy Iuvour conLroIIIng our cIIIdren`s geneLIc desLInIes,`
ProIessor WuLson wroLe In The Independent. 'WorkIng InLeIIIgenLIy und
wIseIy Lo see LIuL good genes domInuLe us muny IIves us possIbIe Is LIe
LruIy moruI wuy Ior us Lo proceed.` (Hercld,Sun, AprII 1;, zoo1, p.zq)
WuLson, uIong wILI muLerIuIIsm generuIIy, do noL compreIend LIe
dIsLIncLIon beLween LIe curuLIve und exLermInuLory use oI geneLIc
InIormuLIon, IeL uIone LIe moruI ImpIIcuLIons. I LIe InIormuLIon does noL
uIIow u cure, LIen ILs roIe In ueLIoIogy Is IIgIIy quesLIonubIe. TIIs
IndIcuLes LIuL wIere cure Is noL IorLIcomIng, medIco-muLerIuIIsm wIII
ImmedIuLeIy use IIImsy InIormuLIon Ior exLermInuLory purposes. WIIIe IL
promoLes un enLIreIy bIoIogIcuI Ideu oI IeuILI, medIco-muLerIuIIsm Is
spIrILuuIIy, moruIIy, socIuIIy, und psycIoIogIcuIIy unIeuILIy.
TIe use oI LIIs IIImsy InIormuLIon Ior screenIng oI pregnuncIes
uIso pIuces un enormous sLruIn on purenLs-Lo-be, producIng jusL unoLIer
In u Iong serIes oI moruI dIIemmus. MorreII (zooz) noLes:
GuurunLeeIng u IeuILIy buby Ius never been eusIer, buL
doIng IL wILI un eusy conscIence Ius never been
Iurder..
Other Vital Matters
n IucL, LIe umuzIng udvunces In prenuLuI screenIng ure
IuvIng u Iuge ImpucL on wouId-be purenLs every duy,
und ure IorcIng some oI LIem Lo muke some LougI
decIsIons.
NoL LIuL you`d LIInk IL, uL IIrsL. TIe wIoIe jeIIy-on-LIe-
beIIy rouLIne oI LIe uILrusound Is now jusL us mucI u
purL oI un ordInury pregnuncy us mornIng sIckness.
Too muny wouId-be purenLs uL IIrsL see LIIs rouLIne
LesL us noLIIng more LIun LIeIr IIrsL oIIIcIuI InLroducLIon
Lo LIeIr cIIId..
And, yes, LIe 18-week uILrusound cun cIeck on your due
duLe und wIeLIer or noL LIere Is more LIun one buby on
LIe wuy. BuL ILs prImury uIm Is Lo cIeck Ior
ubnormuIILIes.
TIIs week one oI MeIbourne`s IeudIng uILrusound
experLs suId IL wus LIme we dId LIInk ubouL LIuL - und
LIInk Iurd.
'UILrusound Is seen us u rouLIne LesL, wIereus IL
sIouIdn`L be,` ussocIuLe ProIessor ucIIun de CrespIgny,
oI LIe MurdocI CIIIdren`s ReseurcI nsLILuLe, suId LIIs
week.
'PeopIe Iuve uwIuI sIocks LIuL cun ruIn u pregnuncy.`
L doesn`L jusL ruIn LIe pregnuncy. SuddenIy LIe Iope-
Lo-be purenLs ure Iuced wILI one oI LIe mosL uwesome
und ugonIsIng cIoIces LIey wIII ever Iuve Lo muke In
LIeIr IIves: wIeLIer Lo desLroy u IeLus LIey beIIeve Is Loo
deIormed Lo IIve.
TIese LerrIbIe quesLIons ure wIy de CrespIgny Ius
desIgned u LIree-poInL quesLIonnuIre uskIng women
wIeLIer LIey wunL Lo know onIy oI mujor ubnormuIILIes,
more mInor sLrucLuruI ubnormuIILIes or every IIndIng oI
LIe LesL..
ew AusLruIIun pregnunL women LIese duys opL ouL oI
LIe LesL, buL Loo Iew Iuve reuIIy LIougIL LIuL by LukIng
IL, LIey couId be conIronLed wILI decIsIons LIuL wIII LesL
LIe very essence oI wIuL LIey beIIeve In.
WouId you do unyLIIng II you Iound LIe IeLus wus noL
normuI? And wIuL exucLIy Is normuI Lo you?
WIen you wuIk LIrougI LIe door oI u cIInIc you LIInk
your buby Is eILIer goIng Lo be perIecL, wIIcI Is mosL
IIkeIy, or so severeIy dIsubIed LIuL LIere seems no oLIer
opLIon LIun Lo LermInuLe LIe pregnuncy.
213
213
Rampant Antismoking Signifies Grave Danger
LIeoreLIcuIIy be screened In LIree-duy-oId embryos..TIe uILernuLIve Lo
embryo screenIng Is Lo conceIve nuLuruIIy LIen LesL LIe IeLus Ior LIe
dIseuse uL 11 Lo 1q weeks oI uge. (Hercld,Sun, SepLember z;, zooz, p)
TIe Lrugedy Iere Is LIuL geneLIc murkers oI poor predIcLIve
sLrengLI Ior specIIIc dIseuse ure beIng reIerred Lo us dIseuse-cuusIng und
LreuLed us II LIere Is u one-Lo-one muLcI beLween LIe murker und dIseuse
ouLcome. TIIs Is IruuduIenL und LIe sume sLuLIsLIcuIIsL nonsense LIuL
permeuLes conLemporury IeuILI promoLIon.
TIIs enLIre upproucI IIgIIIgILs Lwo concurrenL LIemes LIuL ure
scIenLIIIcuIIy und moruIIy quesLIonubIe. IrsLIy, II LIere wus u one-Lo-one
muppIng, LIen embryos ure beIng dIscurded becuuse oI specIIIc dIseuse
usuuIIy IuLer In IIIe. However, IL musL be noLed LIuL LIIs upproucI Is noL
curuLIve buL exLermInuLory. AccordIng Lo medIco-muLerIuIIsm, embryos
IuvIng purLIcuIur dIseuse poLenLIuI ure noL worLIy Lo IIve - uL uII.
SecondIy, LIe reusonIng Is even more groLesque In LIuL geneLIc murkers do
noL reIIecL u one-Lo-one correspondence wILI dIseuse ouLcome, or
unyLIIng remoLeIy resembIIng LIIs. A murker mIgIL Iuve, suy, u o%
ussocIuLIon wILI u specIIIc dIseuse. n oLIer words, ;o% oI LIose wILI LIe
murker wIII never munIIesL LIe dIseuse. TIereIore, In uLLempLIng Lo
exLermInuLe LIe o%, IL wIII uIso exLermInuLe ;o% wIIcI ure oLIerwIse
IeuILIy embryos: AII oI LIese ure noL permILLed Lo IIve. TIIs Is sLundurd,
dungerous sLuLIsLIcuIIsm, reIerred Lo uL IengLI LIus Iur.
Jumes WuLson, u pIoneer In eIucIduLIng LIe sLrucLure oI DNA,
IndIcuLes LIuL |s|ocIeLy sIouId do wIuL IL couId Lo uboIIsI geneLIc
deIecLs..' sLrongIy Iuvour conLroIIIng our cIIIdren`s geneLIc desLInIes,`
ProIessor WuLson wroLe In The Independent. 'WorkIng InLeIIIgenLIy und
wIseIy Lo see LIuL good genes domInuLe us muny IIves us possIbIe Is LIe
LruIy moruI wuy Ior us Lo proceed.` (Hercld,Sun, AprII 1;, zoo1, p.zq)
WuLson, uIong wILI muLerIuIIsm generuIIy, do noL compreIend LIe
dIsLIncLIon beLween LIe curuLIve und exLermInuLory use oI geneLIc
InIormuLIon, IeL uIone LIe moruI ImpIIcuLIons. I LIe InIormuLIon does noL
uIIow u cure, LIen ILs roIe In ueLIoIogy Is IIgIIy quesLIonubIe. TIIs
IndIcuLes LIuL wIere cure Is noL IorLIcomIng, medIco-muLerIuIIsm wIII
ImmedIuLeIy use IIImsy InIormuLIon Ior exLermInuLory purposes. WIIIe IL
promoLes un enLIreIy bIoIogIcuI Ideu oI IeuILI, medIco-muLerIuIIsm Is
spIrILuuIIy, moruIIy, socIuIIy, und psycIoIogIcuIIy unIeuILIy.
TIe use oI LIIs IIImsy InIormuLIon Ior screenIng oI pregnuncIes
uIso pIuces un enormous sLruIn on purenLs-Lo-be, producIng jusL unoLIer
In u Iong serIes oI moruI dIIemmus. MorreII (zooz) noLes:
GuurunLeeIng u IeuILIy buby Ius never been eusIer, buL
doIng IL wILI un eusy conscIence Ius never been
Iurder..
Other Vital Matters
n IucL, LIe umuzIng udvunces In prenuLuI screenIng ure
IuvIng u Iuge ImpucL on wouId-be purenLs every duy,
und ure IorcIng some oI LIem Lo muke some LougI
decIsIons.
NoL LIuL you`d LIInk IL, uL IIrsL. TIe wIoIe jeIIy-on-LIe-
beIIy rouLIne oI LIe uILrusound Is now jusL us mucI u
purL oI un ordInury pregnuncy us mornIng sIckness.
Too muny wouId-be purenLs uL IIrsL see LIIs rouLIne
LesL us noLIIng more LIun LIeIr IIrsL oIIIcIuI InLroducLIon
Lo LIeIr cIIId..
And, yes, LIe 18-week uILrusound cun cIeck on your due
duLe und wIeLIer or noL LIere Is more LIun one buby on
LIe wuy. BuL ILs prImury uIm Is Lo cIeck Ior
ubnormuIILIes.
TIIs week one oI MeIbourne`s IeudIng uILrusound
experLs suId IL wus LIme we dId LIInk ubouL LIuL - und
LIInk Iurd.
'UILrusound Is seen us u rouLIne LesL, wIereus IL
sIouIdn`L be,` ussocIuLe ProIessor ucIIun de CrespIgny,
oI LIe MurdocI CIIIdren`s ReseurcI nsLILuLe, suId LIIs
week.
'PeopIe Iuve uwIuI sIocks LIuL cun ruIn u pregnuncy.`
L doesn`L jusL ruIn LIe pregnuncy. SuddenIy LIe Iope-
Lo-be purenLs ure Iuced wILI one oI LIe mosL uwesome
und ugonIsIng cIoIces LIey wIII ever Iuve Lo muke In
LIeIr IIves: wIeLIer Lo desLroy u IeLus LIey beIIeve Is Loo
deIormed Lo IIve.
TIese LerrIbIe quesLIons ure wIy de CrespIgny Ius
desIgned u LIree-poInL quesLIonnuIre uskIng women
wIeLIer LIey wunL Lo know onIy oI mujor ubnormuIILIes,
more mInor sLrucLuruI ubnormuIILIes or every IIndIng oI
LIe LesL..
ew AusLruIIun pregnunL women LIese duys opL ouL oI
LIe LesL, buL Loo Iew Iuve reuIIy LIougIL LIuL by LukIng
IL, LIey couId be conIronLed wILI decIsIons LIuL wIII LesL
LIe very essence oI wIuL LIey beIIeve In.
WouId you do unyLIIng II you Iound LIe IeLus wus noL
normuI? And wIuL exucLIy Is normuI Lo you?
WIen you wuIk LIrougI LIe door oI u cIInIc you LIInk
your buby Is eILIer goIng Lo be perIecL, wIIcI Is mosL
IIkeIy, or so severeIy dIsubIed LIuL LIere seems no oLIer
opLIon LIun Lo LermInuLe LIe pregnuncy.
214
214
Rampant Antismoking Signifies Grave Danger
BuL LIere Is un uwIuI IoL oI grey In beLween.
V LreuLmenL und embryo screenIng muy Iuve Indeed IeIped u
very smuII porLIon oI LIe popuIuLIon (I.e., InIerLIIILy). However, IL Ius
opened up muILIpIe Pundoru`s boxes. HuvIng uIreudy venLured InLo
IreezIng embryos Ior V LreuLmenL, LIere Is now u sLock oI undesIrubIe
or unneeded embryos LIuL Iuve been gIven u LIme-IImIL Ior LIeIr
desLrucLIon. MedIco-muLerIuIIsm Ius Iound unoLIer use Ior LIese. TIey
cun be IurvesLed Ior LIeIr sLem ceIIs. TIIs Is un exceIIenL exumpIe oI
wIere one error sImpIy opens u door Lo unoLIer. or exumpIe, NuzI
docLors (e.g., JoseI MengeIe uL AuscIwILz) wouId weIcome LruIns und
Lrucks uL deuLI cumps. TIey wouId cIoose prIsoners deemed us good
specImens Ior experImenLuLIon. TIeIr jusLIIIcuLIon Ior doIng so wus LIuL
LIese prIsoners were uIreudy goIng Lo dIe, so wIy noL poLenLIuIIy geL
someLIIng ouL oI LIem. DocLors Iuve now pIuced LIemseIves uL LIe
begInnIng oI IIIe wILI LIe sume reckIess menLuIILy. TIese docLors uIso
cIunL LIuL II LIese embryos ure goIng Lo be desLroyed, LIen wIy noL
InvesLIguLe II someLIIng useIuI cun be exLrucLed Irom LIem.
Humun cIonIng Ius become unoLIer ureu oI moruI IoIIy. TIere
ure now IeudIInes LIuL boLI men und women muy become dIspensubIe In
reproducLIon (e.g., Hercld,Sun, OcLober z, zoo1, pq; November , zoo1,
p.zz). TIe sensIbIIILy oI sucI cIuIms Is quesLIonubIe. However, IL
demonsLruLes LIe IncIInuLIon oI LIe muLerIuIIsL menLuIILy LIuL seeks LIe
LoLuI conLroI oI LIe Iumun condILIon (muLerIuIIsL munIIesLo). TIere Is very
IILLIe debuLe, un eerIe sIIence, on LIIs muLLer In LIe medIcuI IILeruLure. A
number oI medIco-muLerIuIIsLs Iuve IndIcuLed LIeIr InLenLIon Lo cIone
Iumuns, e.g., Punos Zuvos (UnIversILy oI KenLucky), BrIgILLe BoIsseIIer oI
CONAD und member oI LIe RueIIun cuIL. Greed und momenLury IumeJ
InIumy seem Lo be LIe prIme moLIvuLIng IucLors In LIIs ucLIvILy. RuLIer
LIun gruve concern, LIe medIu, Ior LIe mosL purL, Ius LreuLed LIese
IndIvIduuIs us ceIebrILIes. More dIsLurbIng, wIere moruI IeudersIIp Ius
been requIred Irom LIe medIcuI esLubIIsImenL, none Ius been
IorLIcomIng. n IucL, SLunIord UnIversILy yesLerduy unnounced ILs
InLenLIon Lo cIone Iumun embryos, becomIng LIe IIrsL US unIversILy Lo
pubIIcIy embruce LIe poIILIcuIIy conLroversIuI procedure. (Hercld,Sun,
December 1z, zooz, p.q)
AL one LIme medIcuI prucLILIonersJscIenLIsLs were very pIeused Lo
be gIven moruI dIrecLIon, recognIzIng LIeIr Iuck oI experLIse In LIIs regurd.
WILI muLerIuIIsL domInuLIon, IL Is scIenLIsm LIuL Is revered: NoLIIng
sIouId sLund In LIe wuy oI scIence, I.e., moruI reIuLIvIsm. or exumpIe, u
SLunIord UnIversILy spokesmun, rvIng WeIssmun, ecIoed LIe sLundurd
scIenLIsL posILIon: Our uvowed gouI Is Lo udvunce scIence. AguIn, LIe
Other Vital Matters
probIem Is noL scIence, buL muLerIuIIsm. n muLerIuIIsL domInuLIon,
perspecLIve becomes sIumeIess or moruIIy vucuous; moruI Issues ure
consIdered us nonsense, u nuIsunce vuIue uL besL.
TIe conLemporury pre-occupuLIon wILI LIe gene-pooI und ILs
proLecLIon (usuuIIy on LIe busIs oI IIImsy murkers) combIned wILI
psycIoIogIcuI, reIuLIonuI, und moruI IeebIeness (see CIupLer ) Is
uIurmIngIy sImIIur Lo LIe NuzI regIme (see CIupLer ). TIese ure uII
uspecLs oI LIe muLerIuIIsL menLuIILy.
L cun be concIuded Irom LIe IoregoIng LIuL LIe conLemporury
medIcuI esLubIIsImenL Is pIugued by gruve, Iong-sLundIng probIems LIuL
cun ucLuuIIy worsen. TIere Is severe scIenLIIIc, InIerenLIuI, psycIoIogIcuI,
psycIosocIuI, und moruI IncompeLence. HeuILI Ius been reduced Lo u
bIoIogIcuIIy reducLIonIsL Ideu LIuL Ieeds u greuL, seII-servIng, purusILIc,
medIco-muLerIuIIsL producLIon-IIne. More recenLIy, und even more
ImporLunLIy, LIe medIcuI esLubIIsImenL Ius been demonsLruLIng
dungerous dIcLuLorIuI or IuscIsL LendencIes, purLIcuIurIy LIrougI
prevenLIve medIcIne und IeuILI promoLIon. HuvIng jeLLIsoned u
coIerenL moruI Irumework LIuL provIdes u buIunced, muILI-dImensIonuI
perspecLIve on IIIe und deuLI, und by now uLLerIy LerrIIIed by LIe
unconLroIIubIe muLerIuIIsL monsLer IL Ius creuLed, IL Ius Lurned on LIe
pubIIc LIrougI prescrIpLIveJproscrIpLIve IeuILI meusures bused on u
sLuLIsLIcuI mudness musqueruded us scIenLIIIcuIIy credIbIe (I.e.,
sLuLIsLIcuIIsm). L preys on Ieur und reInIorces IL LIrougI IurLIer IrruLIonuI
beIIeI. Under ILs InIIuence IL wIII Iuve LIe pubIIc Lurn on eucI oLIer, Loo,
In deIuded seII-proLecLIon und Iuke superIorILy.
UnIorLunuLeIy, IL Is economIcuIIy vIubIe Lo IosLer psycIoIogIcuI
dysIuncLIon; persons wIo ure coerced InLo LIe beIIeI LIuL LIey ure unubIe
Lo dIscern LIeIr own sense oI weIIness und LIuL IeuILI Is enLIreIy
uLLrIbuLubIe Lo Iood, pIIIs, poLIons, und gudgeLry wIII provIde u consLunL
suppIy oI puLIenLs Ior LIe ever-expundIng, medIcuI producLIon-IIne. And
LIIs Is uII done In LIe nume oI scIence und IeuILI!
WIIIe numerous, ImporLunL Issues ure swepL under un uIreudy
bumpy rug, wIere IonesL InIormuLIon und IonorubIe conducL ure
progressIveIy more dIIIIcuIL Lo IInd, wIere LIe greuLesL corrupLIon und
Iuck oI uny genuIne scIoIursIIp occur In LIe ureu LIuL cun be oI greuLesL
devusLuLIon, I.e., IIIesLyIe epIdemIoIogy und prevenLIve medIcIne, wIere
LIe medIcuI esLubIIsImenL demonsLruLes u IILeruI IncupucILy Ior crILIcuI
seII-scruLIny, wIere uII oI LIese Issues ure noL uddressed In LIe medIcuI
IILeruLure wILI uny reguIurILy or pussIon, LIere Is one muLLer LIuL Is
pursued In LIe IILeruLure wILI mIIILunL vIgor LIuL sLunds Ieud-und-
sIouIders ubove unyLIIng eIse - Lobucco smokIng. WIIIe vILuIIy crucIuI In-
Iouse probIems und LIeIr serIous socIuI consequences ure convenIenLIy
215
215
Rampant Antismoking Signifies Grave Danger
BuL LIere Is un uwIuI IoL oI grey In beLween.
V LreuLmenL und embryo screenIng muy Iuve Indeed IeIped u
very smuII porLIon oI LIe popuIuLIon (I.e., InIerLIIILy). However, IL Ius
opened up muILIpIe Pundoru`s boxes. HuvIng uIreudy venLured InLo
IreezIng embryos Ior V LreuLmenL, LIere Is now u sLock oI undesIrubIe
or unneeded embryos LIuL Iuve been gIven u LIme-IImIL Ior LIeIr
desLrucLIon. MedIco-muLerIuIIsm Ius Iound unoLIer use Ior LIese. TIey
cun be IurvesLed Ior LIeIr sLem ceIIs. TIIs Is un exceIIenL exumpIe oI
wIere one error sImpIy opens u door Lo unoLIer. or exumpIe, NuzI
docLors (e.g., JoseI MengeIe uL AuscIwILz) wouId weIcome LruIns und
Lrucks uL deuLI cumps. TIey wouId cIoose prIsoners deemed us good
specImens Ior experImenLuLIon. TIeIr jusLIIIcuLIon Ior doIng so wus LIuL
LIese prIsoners were uIreudy goIng Lo dIe, so wIy noL poLenLIuIIy geL
someLIIng ouL oI LIem. DocLors Iuve now pIuced LIemseIves uL LIe
begInnIng oI IIIe wILI LIe sume reckIess menLuIILy. TIese docLors uIso
cIunL LIuL II LIese embryos ure goIng Lo be desLroyed, LIen wIy noL
InvesLIguLe II someLIIng useIuI cun be exLrucLed Irom LIem.
Humun cIonIng Ius become unoLIer ureu oI moruI IoIIy. TIere
ure now IeudIInes LIuL boLI men und women muy become dIspensubIe In
reproducLIon (e.g., Hercld,Sun, OcLober z, zoo1, pq; November , zoo1,
p.zz). TIe sensIbIIILy oI sucI cIuIms Is quesLIonubIe. However, IL
demonsLruLes LIe IncIInuLIon oI LIe muLerIuIIsL menLuIILy LIuL seeks LIe
LoLuI conLroI oI LIe Iumun condILIon (muLerIuIIsL munIIesLo). TIere Is very
IILLIe debuLe, un eerIe sIIence, on LIIs muLLer In LIe medIcuI IILeruLure. A
number oI medIco-muLerIuIIsLs Iuve IndIcuLed LIeIr InLenLIon Lo cIone
Iumuns, e.g., Punos Zuvos (UnIversILy oI KenLucky), BrIgILLe BoIsseIIer oI
CONAD und member oI LIe RueIIun cuIL. Greed und momenLury IumeJ
InIumy seem Lo be LIe prIme moLIvuLIng IucLors In LIIs ucLIvILy. RuLIer
LIun gruve concern, LIe medIu, Ior LIe mosL purL, Ius LreuLed LIese
IndIvIduuIs us ceIebrILIes. More dIsLurbIng, wIere moruI IeudersIIp Ius
been requIred Irom LIe medIcuI esLubIIsImenL, none Ius been
IorLIcomIng. n IucL, SLunIord UnIversILy yesLerduy unnounced ILs
InLenLIon Lo cIone Iumun embryos, becomIng LIe IIrsL US unIversILy Lo
pubIIcIy embruce LIe poIILIcuIIy conLroversIuI procedure. (Hercld,Sun,
December 1z, zooz, p.q)
AL one LIme medIcuI prucLILIonersJscIenLIsLs were very pIeused Lo
be gIven moruI dIrecLIon, recognIzIng LIeIr Iuck oI experLIse In LIIs regurd.
WILI muLerIuIIsL domInuLIon, IL Is scIenLIsm LIuL Is revered: NoLIIng
sIouId sLund In LIe wuy oI scIence, I.e., moruI reIuLIvIsm. or exumpIe, u
SLunIord UnIversILy spokesmun, rvIng WeIssmun, ecIoed LIe sLundurd
scIenLIsL posILIon: Our uvowed gouI Is Lo udvunce scIence. AguIn, LIe
Other Vital Matters
probIem Is noL scIence, buL muLerIuIIsm. n muLerIuIIsL domInuLIon,
perspecLIve becomes sIumeIess or moruIIy vucuous; moruI Issues ure
consIdered us nonsense, u nuIsunce vuIue uL besL.
TIe conLemporury pre-occupuLIon wILI LIe gene-pooI und ILs
proLecLIon (usuuIIy on LIe busIs oI IIImsy murkers) combIned wILI
psycIoIogIcuI, reIuLIonuI, und moruI IeebIeness (see CIupLer ) Is
uIurmIngIy sImIIur Lo LIe NuzI regIme (see CIupLer ). TIese ure uII
uspecLs oI LIe muLerIuIIsL menLuIILy.
L cun be concIuded Irom LIe IoregoIng LIuL LIe conLemporury
medIcuI esLubIIsImenL Is pIugued by gruve, Iong-sLundIng probIems LIuL
cun ucLuuIIy worsen. TIere Is severe scIenLIIIc, InIerenLIuI, psycIoIogIcuI,
psycIosocIuI, und moruI IncompeLence. HeuILI Ius been reduced Lo u
bIoIogIcuIIy reducLIonIsL Ideu LIuL Ieeds u greuL, seII-servIng, purusILIc,
medIco-muLerIuIIsL producLIon-IIne. More recenLIy, und even more
ImporLunLIy, LIe medIcuI esLubIIsImenL Ius been demonsLruLIng
dungerous dIcLuLorIuI or IuscIsL LendencIes, purLIcuIurIy LIrougI
prevenLIve medIcIne und IeuILI promoLIon. HuvIng jeLLIsoned u
coIerenL moruI Irumework LIuL provIdes u buIunced, muILI-dImensIonuI
perspecLIve on IIIe und deuLI, und by now uLLerIy LerrIIIed by LIe
unconLroIIubIe muLerIuIIsL monsLer IL Ius creuLed, IL Ius Lurned on LIe
pubIIc LIrougI prescrIpLIveJproscrIpLIve IeuILI meusures bused on u
sLuLIsLIcuI mudness musqueruded us scIenLIIIcuIIy credIbIe (I.e.,
sLuLIsLIcuIIsm). L preys on Ieur und reInIorces IL LIrougI IurLIer IrruLIonuI
beIIeI. Under ILs InIIuence IL wIII Iuve LIe pubIIc Lurn on eucI oLIer, Loo,
In deIuded seII-proLecLIon und Iuke superIorILy.
UnIorLunuLeIy, IL Is economIcuIIy vIubIe Lo IosLer psycIoIogIcuI
dysIuncLIon; persons wIo ure coerced InLo LIe beIIeI LIuL LIey ure unubIe
Lo dIscern LIeIr own sense oI weIIness und LIuL IeuILI Is enLIreIy
uLLrIbuLubIe Lo Iood, pIIIs, poLIons, und gudgeLry wIII provIde u consLunL
suppIy oI puLIenLs Ior LIe ever-expundIng, medIcuI producLIon-IIne. And
LIIs Is uII done In LIe nume oI scIence und IeuILI!
WIIIe numerous, ImporLunL Issues ure swepL under un uIreudy
bumpy rug, wIere IonesL InIormuLIon und IonorubIe conducL ure
progressIveIy more dIIIIcuIL Lo IInd, wIere LIe greuLesL corrupLIon und
Iuck oI uny genuIne scIoIursIIp occur In LIe ureu LIuL cun be oI greuLesL
devusLuLIon, I.e., IIIesLyIe epIdemIoIogy und prevenLIve medIcIne, wIere
LIe medIcuI esLubIIsImenL demonsLruLes u IILeruI IncupucILy Ior crILIcuI
seII-scruLIny, wIere uII oI LIese Issues ure noL uddressed In LIe medIcuI
IILeruLure wILI uny reguIurILy or pussIon, LIere Is one muLLer LIuL Is
pursued In LIe IILeruLure wILI mIIILunL vIgor LIuL sLunds Ieud-und-
sIouIders ubove unyLIIng eIse - Lobucco smokIng. WIIIe vILuIIy crucIuI In-
Iouse probIems und LIeIr serIous socIuI consequences ure convenIenLIy
216
216
Rampant Antismoking Signifies Grave Danger
dIsregurded, LIere ure IILeruIIy numerous unLIsmokIng urLIcIes. As wIII be
urgued LIrougIouL, LIIs conducL does noL represenL LIe ImporLunce oI LIe
smokIng Issue buL un esLubIIsImenL (und socIeLIes) LIuL Ius ILs prIorILIes
upsIde-down.
WIIIe LIe repuLuLIon oI LIe medIcuI esLubIIsImenL und LIe
weIIbeIng oI nuLIons dungIes by LIe LIInnesL oI LIreuds over LIe ubyss,
LIere Is urLIcIe uILer urLIcIe uILer urLIcIe zeuIousIy udvocuLIng LIuL medIcuI
prucLILIoners sIouId seL u good exumpIe by noL smokIng. or exumpIe,
TIe JoInL CommILLee on SmokIng und HeuILI (1qq), un orgunIzuLIon
wIose Iogo Is dIsmembered Iungs und IeurL, decIure:
CurrenL und IuLure pIysIcIuns sIouId be exempIurs Lo
LIeIr puLIenLs und communILIes. TIe pIysIcIun sIouId
ucL us u roIe modeI by noL smokIng und by creuLIng u
smoke-Iree envIronmenL In IIs or Ier oIIIce. DespILe
evIdence on LIe neguLIve IeuILI consequences, cIgureLLe
smokIng Is sLIII IIgIIy prevuIenL umong pIysIcIuns In
some counLrIes. WIIIe smokIng ruLes umong pIysIcIuns
oILen reIIecL generuI popuIuLIon smokIng ruLes, In mosL
counLrIes docLors smoke mucI Iess LIun LIe generuI
popuIuLIon. ReducLIon oI pIysIcIun smokIng Is
ImporLunL, us LIe LuLors oI LIe peopIe In muLLers oI
IeuILI Iuve u responsIbIIILy Lo presenL u proper Imuge.
No suggesLIon sIouId ever be mude, purLIcuIurIy by
pIysIcIun beIuvIor, LIuL smokIng Is noL dungerous;
LIereIore pIysIcIuns sIouId noL smoke In IronL oI
puLIenLs. MedIcuI orgunIzuLIons sIouId udopL ucLIve
poIIcIes Lo esLubIIsI pIysIcIuns us roIe modeIs wILI
regurd Lo smokIng und IeuILI. SmokIng proIIbILIon In
IospILuIs und In uII sLrucLures ussocIuLed wILI IeuILI
cure sIouId be munduLory, und sucI poIIcIes sIouId be
sLrongIy supporLed by medIcuI ussocIuLIons.
SLudenLs In medIcIne und oLIer proIessIonuIs
(LecInIcIuns, nurses, eLc.) musL be LuugIL Irom LIe IIrsL
yeurs oI sLudy ubouL LIe neguLIve eIIecLs oI smokIng, LIe
uddIcLIve properLIes oI nIcoLIne, und Iow Lo IeIp LIeIr
IuLure puLIenLs uvoId smokIng II possIbIe und Lo quIL
smokIng II needed. (p.111q-11zo)
TIIs Is enLIreIy consIsLenL wILI LIe NuzI vIew oI IeuILI und LIe
IeudersIIp roIe oI pIysIcIuns: or exumpIe, ProcLor (1qq;) noLes |L|Ie
NuzI regIme IuuncIed un uggressIve unLIsmokIng cumpuIgn, InvoIvIng
exLensIve pubIIc educuLIon, buns on cerLuIn Iorms oI udverLIsIng, und buns
Other Vital Matters
on smokIng In muny pubIIc spuces. TIe sLeps Luken In LIIs dIrecLIon were
consIsLenL wILI LIe regIme`s Iurger empIusIs on pIysIcIun-dIrecLed 'IeuILI
IeudersIIp` (Gesundheitsjuhrun). (p.q;)
A cover oI un Issue oI LIe Mediccl 1ourncl oj Austrclic (1qq8)
uLLrucLed ImmedIuLe reproucI. Cruddock (1qq8) proposes wus mosL
dIsuppoInLed In your cover IIIusLruLIon Ior LIe 1 June Issue oI LIe
JournuI, wIIcI depIcLs u young resIdenL IospILuI docLor smokIng In un
encIosed ureu In LIe presence oI Lwo oI IIs coIIeugues, dIsregurdIng
uccepLed ruIes coverIng LIe pussIve smokIng Issue und conveyIng LIe
ImpressIon LIuL smokIng remuIns prevuIenL umong medIcuIIy LruIned
peopIe. TIIs Is despILe LIe enormous und conLInuuIIy IncreusIng evIdence
oI smokIng`s poLenLIuIIy gruve consequences... Iuve seen u good muny
docLors gIve up smokIng over LIe yeurs, Ior LIeIr own good und uIso,
ImporLunLIy, us u necessury modeI oI beIuvIour Ior LIe resL oI LIe
communILy. WILI LIe enormous eIIorL und expendILure by governmenLs
und by medIcuI orgunIzuLIons Lo geL LIe messuge ucross Lo LIe oncomIng
generuLIons, sIowIng u junIor docLor smokIng on your IronL cover Is un
uppuIIIng conLrudIcLIon Lo so mucI oI LIe conLenL oI your respecLed
JournuI... LIereIore submIL LIuL LIe cover IIIusLruLIon wus u poorIy
cIosen one In respecL Lo LIree Issues - LIe roIe modeI expecLed Irom
InIormed persons, pussIve smokIng und provIdIng Iree bunned
udverLIsIng! (p.q1) Vun Der Weyden (1qq8) udds endorse Dr.
Cruddock`s commenLs on pussIve smokIng und um gruLIIIed by LIe
reduced prevuIence oI smokIng In our proIessIon. TIe oIIendIng
IIIusLruLIon wus Irom LIe 'noL-Loo-dIsLunL-pusL` und preduLed LIe
successIuI unLI-smokIng cumpuIgns. (p.q1)
TIese senLImenLs reIIecL seII-decepLIon und deIIecLIon Irom
ucLuuI cuLusLropIe. As wIII be urgued LIrougIouL, LIIs sorL oI menLuIILy Is
cuILIsL und superIorIsL In dIsposILIon, und LIuL LIe crILIcuI probIem Is LIuL
muLerIuIIsL, moruIIy reckIess, medIcuI prucLILIoners cre beIng u roIe modeI
Ior LIe communILy uL Iurge - u very poor one.
Even LIe muguzInes In docLors` wuILIng rooms Iuve noL escuped
LIe scruLIny oI LIe ucuLeIy-IIxuLed unLIsmokIng menLuIILy. AnoLIer Iorm oI
Inune reseurcI (e.g., AIIgne eL uI., zoo1; GoIdsmILI, 1q8q; Rudovsky &
Burry, 1q88) Ius concerned ILseII wILI LIe prevuIence oI muguzInes In
docLors` oIIIces LIuL currIed Lobucco udverLs. TIIs occurrence Is uppurenLIy
consIdered us InudverLenL Lobucco udverLIsIng LIuL sIouId be uvoIded by
docLors.
TIe more ucuLe becomes LIe unLIsmokIng IIxuLIon, LIe more
deIuded become LIe uLLempLs uL smoker correcLIon. OnIy more
repugnunL LIun LIe sILuuLIons consIdered ubove Is u key AusLruIIun
unLIsmokIng IobbyIsL`s suggesLIon oI seIecLIng onIy non-smokIng medIcuI
217
217
Rampant Antismoking Signifies Grave Danger
dIsregurded, LIere ure IILeruIIy numerous unLIsmokIng urLIcIes. As wIII be
urgued LIrougIouL, LIIs conducL does noL represenL LIe ImporLunce oI LIe
smokIng Issue buL un esLubIIsImenL (und socIeLIes) LIuL Ius ILs prIorILIes
upsIde-down.
WIIIe LIe repuLuLIon oI LIe medIcuI esLubIIsImenL und LIe
weIIbeIng oI nuLIons dungIes by LIe LIInnesL oI LIreuds over LIe ubyss,
LIere Is urLIcIe uILer urLIcIe uILer urLIcIe zeuIousIy udvocuLIng LIuL medIcuI
prucLILIoners sIouId seL u good exumpIe by noL smokIng. or exumpIe,
TIe JoInL CommILLee on SmokIng und HeuILI (1qq), un orgunIzuLIon
wIose Iogo Is dIsmembered Iungs und IeurL, decIure:
CurrenL und IuLure pIysIcIuns sIouId be exempIurs Lo
LIeIr puLIenLs und communILIes. TIe pIysIcIun sIouId
ucL us u roIe modeI by noL smokIng und by creuLIng u
smoke-Iree envIronmenL In IIs or Ier oIIIce. DespILe
evIdence on LIe neguLIve IeuILI consequences, cIgureLLe
smokIng Is sLIII IIgIIy prevuIenL umong pIysIcIuns In
some counLrIes. WIIIe smokIng ruLes umong pIysIcIuns
oILen reIIecL generuI popuIuLIon smokIng ruLes, In mosL
counLrIes docLors smoke mucI Iess LIun LIe generuI
popuIuLIon. ReducLIon oI pIysIcIun smokIng Is
ImporLunL, us LIe LuLors oI LIe peopIe In muLLers oI
IeuILI Iuve u responsIbIIILy Lo presenL u proper Imuge.
No suggesLIon sIouId ever be mude, purLIcuIurIy by
pIysIcIun beIuvIor, LIuL smokIng Is noL dungerous;
LIereIore pIysIcIuns sIouId noL smoke In IronL oI
puLIenLs. MedIcuI orgunIzuLIons sIouId udopL ucLIve
poIIcIes Lo esLubIIsI pIysIcIuns us roIe modeIs wILI
regurd Lo smokIng und IeuILI. SmokIng proIIbILIon In
IospILuIs und In uII sLrucLures ussocIuLed wILI IeuILI
cure sIouId be munduLory, und sucI poIIcIes sIouId be
sLrongIy supporLed by medIcuI ussocIuLIons.
SLudenLs In medIcIne und oLIer proIessIonuIs
(LecInIcIuns, nurses, eLc.) musL be LuugIL Irom LIe IIrsL
yeurs oI sLudy ubouL LIe neguLIve eIIecLs oI smokIng, LIe
uddIcLIve properLIes oI nIcoLIne, und Iow Lo IeIp LIeIr
IuLure puLIenLs uvoId smokIng II possIbIe und Lo quIL
smokIng II needed. (p.111q-11zo)
TIIs Is enLIreIy consIsLenL wILI LIe NuzI vIew oI IeuILI und LIe
IeudersIIp roIe oI pIysIcIuns: or exumpIe, ProcLor (1qq;) noLes |L|Ie
NuzI regIme IuuncIed un uggressIve unLIsmokIng cumpuIgn, InvoIvIng
exLensIve pubIIc educuLIon, buns on cerLuIn Iorms oI udverLIsIng, und buns
Other Vital Matters
on smokIng In muny pubIIc spuces. TIe sLeps Luken In LIIs dIrecLIon were
consIsLenL wILI LIe regIme`s Iurger empIusIs on pIysIcIun-dIrecLed 'IeuILI
IeudersIIp` (Gesundheitsjuhrun). (p.q;)
A cover oI un Issue oI LIe Mediccl 1ourncl oj Austrclic (1qq8)
uLLrucLed ImmedIuLe reproucI. Cruddock (1qq8) proposes wus mosL
dIsuppoInLed In your cover IIIusLruLIon Ior LIe 1 June Issue oI LIe
JournuI, wIIcI depIcLs u young resIdenL IospILuI docLor smokIng In un
encIosed ureu In LIe presence oI Lwo oI IIs coIIeugues, dIsregurdIng
uccepLed ruIes coverIng LIe pussIve smokIng Issue und conveyIng LIe
ImpressIon LIuL smokIng remuIns prevuIenL umong medIcuIIy LruIned
peopIe. TIIs Is despILe LIe enormous und conLInuuIIy IncreusIng evIdence
oI smokIng`s poLenLIuIIy gruve consequences... Iuve seen u good muny
docLors gIve up smokIng over LIe yeurs, Ior LIeIr own good und uIso,
ImporLunLIy, us u necessury modeI oI beIuvIour Ior LIe resL oI LIe
communILy. WILI LIe enormous eIIorL und expendILure by governmenLs
und by medIcuI orgunIzuLIons Lo geL LIe messuge ucross Lo LIe oncomIng
generuLIons, sIowIng u junIor docLor smokIng on your IronL cover Is un
uppuIIIng conLrudIcLIon Lo so mucI oI LIe conLenL oI your respecLed
JournuI... LIereIore submIL LIuL LIe cover IIIusLruLIon wus u poorIy
cIosen one In respecL Lo LIree Issues - LIe roIe modeI expecLed Irom
InIormed persons, pussIve smokIng und provIdIng Iree bunned
udverLIsIng! (p.q1) Vun Der Weyden (1qq8) udds endorse Dr.
Cruddock`s commenLs on pussIve smokIng und um gruLIIIed by LIe
reduced prevuIence oI smokIng In our proIessIon. TIe oIIendIng
IIIusLruLIon wus Irom LIe 'noL-Loo-dIsLunL-pusL` und preduLed LIe
successIuI unLI-smokIng cumpuIgns. (p.q1)
TIese senLImenLs reIIecL seII-decepLIon und deIIecLIon Irom
ucLuuI cuLusLropIe. As wIII be urgued LIrougIouL, LIIs sorL oI menLuIILy Is
cuILIsL und superIorIsL In dIsposILIon, und LIuL LIe crILIcuI probIem Is LIuL
muLerIuIIsL, moruIIy reckIess, medIcuI prucLILIoners cre beIng u roIe modeI
Ior LIe communILy uL Iurge - u very poor one.
Even LIe muguzInes In docLors` wuILIng rooms Iuve noL escuped
LIe scruLIny oI LIe ucuLeIy-IIxuLed unLIsmokIng menLuIILy. AnoLIer Iorm oI
Inune reseurcI (e.g., AIIgne eL uI., zoo1; GoIdsmILI, 1q8q; Rudovsky &
Burry, 1q88) Ius concerned ILseII wILI LIe prevuIence oI muguzInes In
docLors` oIIIces LIuL currIed Lobucco udverLs. TIIs occurrence Is uppurenLIy
consIdered us InudverLenL Lobucco udverLIsIng LIuL sIouId be uvoIded by
docLors.
TIe more ucuLe becomes LIe unLIsmokIng IIxuLIon, LIe more
deIuded become LIe uLLempLs uL smoker correcLIon. OnIy more
repugnunL LIun LIe sILuuLIons consIdered ubove Is u key AusLruIIun
unLIsmokIng IobbyIsL`s suggesLIon oI seIecLIng onIy non-smokIng medIcuI
218
218
Rampant Antismoking Signifies Grave Danger
sLudenLs on Lo LruInIng scIemes Ior prImury cure. (CIupmun, 1qq) n
LIuL u smokIng docLor does noL Iuve un ucuLe IIxuLIon on unLIsmokIng
muy, In IucL, be demonsLruLIng u Iur more ecIecLIc vIew oI IIIe LIuL does noL
wurrunL InordInuLe IIxuLIon on LIIs sInguIur Issue. L Is LIIs more rounded-
perspecLIve LIuL muy be Iur more useIuI In prImury cure LIun sIuIIow,
muLerIuIIsL, nonsmokIng (unLIsmokIng) docLors.
AccordIng Lo LIIs IobbyIsL, wIo Is noL u medIcuI prucLILIoner, u
smokIng docLor Is rendered IncupubIe, due Lo smokIng, Irom deIIverIng
uny prImury cure, or LIuL unLIsmokIng sIouId be sucI u prIme concern
LIuL wIere IL Is ubsenL IL nuIIIIIes wIuLever oLIer skIIIs or quuIILIes LIuL
mIgIL be brougIL Lo prImury cure: TIereIore, smokIng docLors sIouId be
burred Irom LIe enLIre scope oI prImury cure. CIupmun (1qq) buses LIIs
enLIre urgumenL on LIe premIse LIuL IInuncIuIIy LuIenLed persons LIuL ure
decIured bunkrupL cunnoL sIL on compuny bourds und LIose wILI crImInuI
records cunnoL prucLIce Iuw. AILIougI LIe unLIsmokIng IILeruLure Is repIeLe
wILI IuIIucIes oI IncoIerenL unuIogy, LIIs one In purLIcuIur Is excepLIonuIIy
degeneruLe. L equuLes smokIng wILI some vurIunL oI bunkrupLcy or
crImInuIILy LIuL LIen wurrunLs punILIve correcLIon. RuLIer, IL Is LIIs
superIorIsL, cuILIsL, bIgoLed menLuIILy LIuL Is psycIoIogIcuIIy,
psycIosocIuIIy, und moruIIy bunkrupL, und LIe uLLer Iuvoc LIuL LIIs
menLuIILy cun wreuk wILI LIe pubIIc IeuILI on u muss-scuIe uIong LIese
dImensIons under IuIse preLenses, LIuL Is borderIng on LIe crImInuI. TIe
evIdence stronl suggesLs LIuL IL Is LIIs menLuIILy LIuL sIouId be
proIIbILed Irom uny uccess Lo pubIIc IeuILI poIIcy.
TIe oId uduge LIuL IeuILI Is Loo ImporLunL Lo Ieuve Lo docLors
uppIIes In LIe IuIIness oI ILs concern Lo LIe conLemporury medIcuI
esLubIIsImenL. MedIcuI prucLILIoners ure noL psycIoIogIcuIIy, reIuLIonuIIy
or moruIIy LruIned. WIere IeIL Lo LIeIr superIIcIuI, muLerIuIIsL devIces,
LIey wIII IuboruLorIze, sLerIIIze, und medIcuIIze LIe enLIre Iumun
condILIon, und suck more oI LIe gross domesLIc producL In so doIng. L Is
LIIs quesL Ior domInuLIon LIuL goes Iur beyond ILs cIurLer oI prImury cure
by u menLuIILy LIuL does noL recognIze ILs very consIderubIe IuIIIngs LIuL
sIouId be oI gruve concern.
WIIIe LIe medIcuI esLubIIsImenL munuIucLures pubIIc IrenzIes us
u muLLer oI course, und purLIcuIurIy LIe mosL recenL cuLusLropIIzuLIon oI
envIronmenLuI Lobucco smoke (see CIupLer q), LIIs Is u smokescreen Ior
LIe ucLuuI cuLusLropIe In moLIon. TIIs ucuLe unLIsmokIng IIxuLIon Is noL
coIncIdenLuI or uccIdenLuI, buL serves u very purLIcuIur purpose. MInds,
IIgIIy LroubIed by LIeIr own dIsjoInLed LIInkIng, moruI IuIIure und ILs
consequences, compensuLe by munuIucLurIng u Iuke moruIILy. TIe mInd
LIuL Is unwIIIIng Lo uddress LIe ucLuuI source oI Ieur und guIIL LIuL
uccompunIes moruI reckIessness wIII uILImuLeIy projecL LIe Inner conIIIcL
Other Vital Matters
ouLwurd In seII-proLecLIon. TIe mInd denIes LIuL it Is LIe source oI
conIIIcLed LIougIL. TIIs removes LIe conIIIcL Irom ImmedIuLe uwureness.
TIe mInd LIen compIeLes LIe exoneruLIon LrIck by projecLIng LIe
InLernuI conIIIcL ouLwurd mukIng IL uppeur LIuL Inner dIscomIorL, unxIeLy,
eLc., Is beIng produced by exLernuI sources.
SmokIng und smoke Iend LIemseIves beuuLIIuIIy Ior projecLIon.
TIe smoker now Is vIewed us moruIIy reckIess und, sImpIy by vIrLue oI
beIng u nonsmoker, LIe moruIIy sIuIIow ure eIevuLed InLo u moruIIy
superIor posILIon; LIe smoker, by deIInILIon, Is LIe moruIIy InIerIor.
Smoke, Loo, Is crucIuI Lo LIe cIrcumsLunce. L becomes u mugIc mIsL
Imbued wILI uII munner oI dungerous mugIc powers LIuL ure
proporLIonuI Lo LIe exLenL oI LIe projecLor`s Inner conIIIcL; LIe IIgIer LIe
conIIIcL und, LIereIore, LIe Ieur, guIIL, IosLIIILy, LIe more dungerous seems
LIe smoke.
n WesLern socIeLIes, LIIs deIusIon Ius been uIIowed Lo deveIop
under LIe preLense oI scIenLIIIc credIbIIILy. TIIs conLrIvunce LIen presenLs
LIe projecLor wILI u nobIe soIuLIon Lo ILs conIIIcLed experIence -
exLermInuLe LIe exLernuI source. n IucL, ILs exLermInuLIon uLLempLs
provIde u conduIL Ior LIe very InIerIor uLLrIbuLes IL Is LryIng Lo escupe, e.g.,
IuugILIness, obsLInucy, dIsIonesLy, obsessIon wILI conLroI, meguIomunIu.
TIese ure LypIcuIIy reIerred Lo us cIurucLer or moruI deIIcIencIes, ure
LypIcuI oI muLerIuIIsL reusonIng, und reIIecL LIe ongoIng resuIL oI LIe
unexumIned IIIe. As u generuI ruIe, II one dIsregurds LIe reIerences Lo
smokIng, uII LIuL un unLIsmoker suggesLs ure LIe propensILIes oI Lobucco
smoke ucLuuIIy reIIecL LIeIr own InLernuI sLuLe.
TIe devusLuLIng poLenLIuI oI LIe sImpIe mecIunIcs oI denIuI
und projecLIon sIouId noL be underesLImuLed. TIe more u person enguges
In exLermInuLIon uLLempLs, LIe Inner conIIIcL Is progressIveIy reInIorced.
TIe Inner experIence becomes more emoLIonuIIy conLorLed und puInIuI,
LIe exLernuI source uppeurs progressIveIy more LIreuLenIng, und LIe
IurLIer uLLempLs uL exLermInuLIon become progressIveIy more IosLIIe.
Persons cun evenLuuIIy jusLIIy In LIeIr own mInds LIe mosL demenLed,
crueI, sInIsLer conducL on LIe busIs oI purunoId seII-preservuLIon. WIere
IL Is IeIL uncIecked und InvoIves LIe musses, onIy dIsusLer cun resuIL.
L wIII be urgued In LIe IoIIowIng cIupLers LIuL NuzI Germuny
suIIered Irom LIe sume muss deIusIon. MedIcuI docLors were key
InsLrumenLs, co-ruIers, In LIe NuzI regIme. TIIs regIme enguged In
conducL LIuL evenLuuIIy resuILed In muss-scuIe murder und LorLure oI
mInd-boggIIng proporLIons. L domInuLed (IuscIsL) u socIeLy LIrougI Lerror
und surveIIIunce, encourugIng LIe sume menLuIILy even beLween cILIzens.
TIe conducL wus jusLIIIed on LIe busIs oI Aryun supremucy und seII-
preservuLIon. MedIcuI prucLILIoners, commIssIoned wILI engIneer-Ing LIe
219
219
Rampant Antismoking Signifies Grave Danger
sLudenLs on Lo LruInIng scIemes Ior prImury cure. (CIupmun, 1qq) n
LIuL u smokIng docLor does noL Iuve un ucuLe IIxuLIon on unLIsmokIng
muy, In IucL, be demonsLruLIng u Iur more ecIecLIc vIew oI IIIe LIuL does noL
wurrunL InordInuLe IIxuLIon on LIIs sInguIur Issue. L Is LIIs more rounded-
perspecLIve LIuL muy be Iur more useIuI In prImury cure LIun sIuIIow,
muLerIuIIsL, nonsmokIng (unLIsmokIng) docLors.
AccordIng Lo LIIs IobbyIsL, wIo Is noL u medIcuI prucLILIoner, u
smokIng docLor Is rendered IncupubIe, due Lo smokIng, Irom deIIverIng
uny prImury cure, or LIuL unLIsmokIng sIouId be sucI u prIme concern
LIuL wIere IL Is ubsenL IL nuIIIIIes wIuLever oLIer skIIIs or quuIILIes LIuL
mIgIL be brougIL Lo prImury cure: TIereIore, smokIng docLors sIouId be
burred Irom LIe enLIre scope oI prImury cure. CIupmun (1qq) buses LIIs
enLIre urgumenL on LIe premIse LIuL IInuncIuIIy LuIenLed persons LIuL ure
decIured bunkrupL cunnoL sIL on compuny bourds und LIose wILI crImInuI
records cunnoL prucLIce Iuw. AILIougI LIe unLIsmokIng IILeruLure Is repIeLe
wILI IuIIucIes oI IncoIerenL unuIogy, LIIs one In purLIcuIur Is excepLIonuIIy
degeneruLe. L equuLes smokIng wILI some vurIunL oI bunkrupLcy or
crImInuIILy LIuL LIen wurrunLs punILIve correcLIon. RuLIer, IL Is LIIs
superIorIsL, cuILIsL, bIgoLed menLuIILy LIuL Is psycIoIogIcuIIy,
psycIosocIuIIy, und moruIIy bunkrupL, und LIe uLLer Iuvoc LIuL LIIs
menLuIILy cun wreuk wILI LIe pubIIc IeuILI on u muss-scuIe uIong LIese
dImensIons under IuIse preLenses, LIuL Is borderIng on LIe crImInuI. TIe
evIdence stronl suggesLs LIuL IL Is LIIs menLuIILy LIuL sIouId be
proIIbILed Irom uny uccess Lo pubIIc IeuILI poIIcy.
TIe oId uduge LIuL IeuILI Is Loo ImporLunL Lo Ieuve Lo docLors
uppIIes In LIe IuIIness oI ILs concern Lo LIe conLemporury medIcuI
esLubIIsImenL. MedIcuI prucLILIoners ure noL psycIoIogIcuIIy, reIuLIonuIIy
or moruIIy LruIned. WIere IeIL Lo LIeIr superIIcIuI, muLerIuIIsL devIces,
LIey wIII IuboruLorIze, sLerIIIze, und medIcuIIze LIe enLIre Iumun
condILIon, und suck more oI LIe gross domesLIc producL In so doIng. L Is
LIIs quesL Ior domInuLIon LIuL goes Iur beyond ILs cIurLer oI prImury cure
by u menLuIILy LIuL does noL recognIze ILs very consIderubIe IuIIIngs LIuL
sIouId be oI gruve concern.
WIIIe LIe medIcuI esLubIIsImenL munuIucLures pubIIc IrenzIes us
u muLLer oI course, und purLIcuIurIy LIe mosL recenL cuLusLropIIzuLIon oI
envIronmenLuI Lobucco smoke (see CIupLer q), LIIs Is u smokescreen Ior
LIe ucLuuI cuLusLropIe In moLIon. TIIs ucuLe unLIsmokIng IIxuLIon Is noL
coIncIdenLuI or uccIdenLuI, buL serves u very purLIcuIur purpose. MInds,
IIgIIy LroubIed by LIeIr own dIsjoInLed LIInkIng, moruI IuIIure und ILs
consequences, compensuLe by munuIucLurIng u Iuke moruIILy. TIe mInd
LIuL Is unwIIIIng Lo uddress LIe ucLuuI source oI Ieur und guIIL LIuL
uccompunIes moruI reckIessness wIII uILImuLeIy projecL LIe Inner conIIIcL
Other Vital Matters
ouLwurd In seII-proLecLIon. TIe mInd denIes LIuL it Is LIe source oI
conIIIcLed LIougIL. TIIs removes LIe conIIIcL Irom ImmedIuLe uwureness.
TIe mInd LIen compIeLes LIe exoneruLIon LrIck by projecLIng LIe
InLernuI conIIIcL ouLwurd mukIng IL uppeur LIuL Inner dIscomIorL, unxIeLy,
eLc., Is beIng produced by exLernuI sources.
SmokIng und smoke Iend LIemseIves beuuLIIuIIy Ior projecLIon.
TIe smoker now Is vIewed us moruIIy reckIess und, sImpIy by vIrLue oI
beIng u nonsmoker, LIe moruIIy sIuIIow ure eIevuLed InLo u moruIIy
superIor posILIon; LIe smoker, by deIInILIon, Is LIe moruIIy InIerIor.
Smoke, Loo, Is crucIuI Lo LIe cIrcumsLunce. L becomes u mugIc mIsL
Imbued wILI uII munner oI dungerous mugIc powers LIuL ure
proporLIonuI Lo LIe exLenL oI LIe projecLor`s Inner conIIIcL; LIe IIgIer LIe
conIIIcL und, LIereIore, LIe Ieur, guIIL, IosLIIILy, LIe more dungerous seems
LIe smoke.
n WesLern socIeLIes, LIIs deIusIon Ius been uIIowed Lo deveIop
under LIe preLense oI scIenLIIIc credIbIIILy. TIIs conLrIvunce LIen presenLs
LIe projecLor wILI u nobIe soIuLIon Lo ILs conIIIcLed experIence -
exLermInuLe LIe exLernuI source. n IucL, ILs exLermInuLIon uLLempLs
provIde u conduIL Ior LIe very InIerIor uLLrIbuLes IL Is LryIng Lo escupe, e.g.,
IuugILIness, obsLInucy, dIsIonesLy, obsessIon wILI conLroI, meguIomunIu.
TIese ure LypIcuIIy reIerred Lo us cIurucLer or moruI deIIcIencIes, ure
LypIcuI oI muLerIuIIsL reusonIng, und reIIecL LIe ongoIng resuIL oI LIe
unexumIned IIIe. As u generuI ruIe, II one dIsregurds LIe reIerences Lo
smokIng, uII LIuL un unLIsmoker suggesLs ure LIe propensILIes oI Lobucco
smoke ucLuuIIy reIIecL LIeIr own InLernuI sLuLe.
TIe devusLuLIng poLenLIuI oI LIe sImpIe mecIunIcs oI denIuI
und projecLIon sIouId noL be underesLImuLed. TIe more u person enguges
In exLermInuLIon uLLempLs, LIe Inner conIIIcL Is progressIveIy reInIorced.
TIe Inner experIence becomes more emoLIonuIIy conLorLed und puInIuI,
LIe exLernuI source uppeurs progressIveIy more LIreuLenIng, und LIe
IurLIer uLLempLs uL exLermInuLIon become progressIveIy more IosLIIe.
Persons cun evenLuuIIy jusLIIy In LIeIr own mInds LIe mosL demenLed,
crueI, sInIsLer conducL on LIe busIs oI purunoId seII-preservuLIon. WIere
IL Is IeIL uncIecked und InvoIves LIe musses, onIy dIsusLer cun resuIL.
L wIII be urgued In LIe IoIIowIng cIupLers LIuL NuzI Germuny
suIIered Irom LIe sume muss deIusIon. MedIcuI docLors were key
InsLrumenLs, co-ruIers, In LIe NuzI regIme. TIIs regIme enguged In
conducL LIuL evenLuuIIy resuILed In muss-scuIe murder und LorLure oI
mInd-boggIIng proporLIons. L domInuLed (IuscIsL) u socIeLy LIrougI Lerror
und surveIIIunce, encourugIng LIe sume menLuIILy even beLween cILIzens.
TIe conducL wus jusLIIIed on LIe busIs oI Aryun supremucy und seII-
preservuLIon. MedIcuI prucLILIoners, commIssIoned wILI engIneer-Ing LIe
220
220
Rampant Antismoking Signifies Grave Danger
musLer ruce, ucLuuIIy beIIeved LIuL LIeIr ubIorrenL conducL wus Ior u
greuLer und gIorIous good. n IucL, LIese were moruIIy IeebIe und IIgIIy
LroubIed mInds, projecLIng vIoIenL InLernuI sLuLes onLo uII sorLs oI exLernuI
groups.
OI crucIuI ImporLunce Is LIuL LIrougI progressIve reInIorcemenL
by denIuI und projecLIon u mInd cun enLer u sLuLe so compreIensIveIy
devoId oI moruI sensIbIIILy LIuL LIe mosL repugnunL, unconscIonubIe,
sInIsLer conducL Is vIewed us good. urLIermore, IL sIouId be noLed LIuL
unLIsmokIng uIso IIgured IIgIIy In LIe NuzI menLuIILy, I.e., used us u
moruI subsLILuLe, und wus one oI LIe IIrsL IIxuLIons oI LIe NuzI docLors
und regIme. ConLemporury medIco-muLerIuIIsm Is uIreudy weII uIong LIIs
puLI, und Ius InIecLed consIderubIe porLIons oI muny socIeLIes, Loo.
UILImuLeIy, LIe probIem Ius IILLIe Lo do wILI smokIng uL uII, buL reIIecLs u
progressIve meLupIysIcuI (spIrILuuIJmoruI) crIsIs. n LIIs regurd, wIere
unLIsmokIng Ius been uIIowed Lo domInuLe pubIIc proceedIngs, one cun be
sure LIuL IL Is u crILIcuI und LeIIIng sympLom oI u guLIerIng, muss-scuIe,
dungerous, muLerIuIIsL deIusIon.
.; Mctericlist ics , Vested Interest
n uddILIon Lo LIe very serIous probIems LIuL rIddIe LIe
conLemporury medIcuI esLubIIsImenL consIdered In LIe prevIous secLIon,
LIere ure numerous oLIer IIgIIy quesLIonubIe LussIes und Lugs-oI-wur LIuL
ure LIe consequence oI un InsLILuLIon LIuL Ius IosL ILs moruI wuy.
TIIs mosL recenL Lobucco sugu commencIng In LIe 1qo`s Ius
been presenLed Lo LIe pubIIc us u buLLIe oI opposIng sIdes, I.e., good versus
evII. n LIe IusL decude LIere Ius even been u debuLe concernIng wIeLIer
Lobucco IndusLry IundIng oI reseurcI sIouId be permILLed, e.g., Edwurds &
BIopuI, 1qqq; Wudmun, 1qq8; HorLon, 1qq;; RuLLer, 1qq6. AguIn, LIIs
udversurIuI conLexL Is noLIIng new. Hurdy (1q68) noLes LIuL LIe Lobucco
IndusLry wus reIerred Lo uL LIen conIerences us LIe oLIer sIde und un
udversury. GuIIIord (1q68) uIso reIers Lo Lwo sLudIes (Huug & Hunmer,
1q;; Dorn & Buum, 1q) conLrudIcLIng Hummond & Horn (1q8) LIuL
ure reporLed by scIenLIsLs wIo IuII under suspIcIon becuuse LIey Iuve
been sponsored Lo some exLenL by LIe Lobucco IndusLry. (p. o) TIe
medIcuI esLubIIsImenL presenLs ILseII us LIe good guy wIIIe LIe Lobucco
IndusLry Is porLruyed us LIe converse. WILIIn LIIs conLrIved udversurIuI
Irumework, wIuLever IegILImuLe scIenLIIIc crILIcIsms ure IeveIed uL LIe
medIcuI esLubIIsImenL ure sImpIy sIrugged oII us bud guy unLIcs, I.e.,
LIe IIgIIy quesLIonubIe concIusIon LIuL uny conLrury urgumenLuLIon musL
be by coIIuders wILI LIe Lobucco IndusLry. TIe medIcuI esLubIIsImenL
seems Lo Iuve no cIue, so severe Is ILs IncompeLence, obsLInucy und
Other Vital Matters
IuugILIness, LIuL IL Ius pILLed ILseII uguInsL LIe prIncIpIes und proLocoIs oI
scIenLIIIc enquIry und sound InIerence-mukIng, noL Lo menLIon Issues oI
psycIoIogIcuI, socIuI und moruI IeuILI.
TIere Ius cerLuInIy been mIsconducL by LIe Lobucco IndusLry In
deuIIng wILI purLIcuIur smoke-reIuLed Issues over LIe yeurs. However, IL
cun uIso be suId LIuL LIe Lobucco IndusLry Ius been pIuced squureIy on LIe
deIensIve by u growIng medIco-muLerIuIIsL movemenL LIuL wus uIreudy
mukIng ouLIundIsI cIuIms sucI us one LIIrd oI uII deuLIs ure cuused by
smokIng In LIe IuLe-1qo`s (e.g., Hummond & Horn, 1q8). L Is dIIIIcuIL
Lo IuLIom wIuL eIIecL LIIs sorL oI rIeLorIc Ius on un essenLIuIIy
commercIuI orgunIzuLIon run by predomInunLIy commercIuI LIInkers.
GIven LIuL LIe cIuIms oI LIe medIcuI esLubIIsImenL were, und ure, bused
on u severeIy IIuwed versIon oI scIence und LIuL IL operuLes on
munuIucLurIng cuusuLIon by poIILIcuI munIpuIuLIon LIrougI Lo
consensus, IL Is noL surprIsIng LIuL LIe Lobucco IndusLry wouId uLLempL
Lo dIrecL wIuL, In muny InsLunces, ure IegILImuLe reseurcI quesLIons LIuL
provIde unoLIer vIew. MedIco-muLerIuIIsm Ius depIcLed Lobucco-IndusLry
conducL In LIIs regurd us munIpuIuLIve, wIIIe presenLIng ILs own conducL
us scIenLIIIcuIIy deIInILIve.
n oLIer InsLunces LIe Lobucco IndusLry seems Lo Iuve pubIIcIy
uppeused medIcuI esLubIIsImenL dogmu, wIIIsL prIvuLeIy goIng on wILI
busIness us usuuI. As LIIs dIscussIon progresses, IL sIouId become more
obvIous us Lo jusL Iow IILLIe LIe Lobucco IndusLry undersLunds ubouL LIe
smokIng IubIL, purLIcuIurIy In psycIoIogIcuI und psycIosocIuI Lerms, und
ubouL cctucl scIence; Lobucco IndusLry scIenLIsLs ure LypIcuIIy cIemIsLs.
UnIorLunuLeIy, LIe Lobucco IndusLry uses LIe sume muLerIuIIsL Irumework
us LIe medIcuI esLubIIsImenL, sucI LIuL IL Ius uLLempLed Lo deIend
(reucLIve), wIeLIer properIy or ImproperIy, uguInsL medIcuI cIuIms LIuL
ure LIemseIves uIreudy IIgIIy quesLIonubIe. TIere Is no sIorLuge oI
reseurcI on LIe IubIL oI smokIng. L musL ruLe us LIe mosL over-
InvesLIguLed pIenomenon In medIcuI enquIry. UnIorLunuLeIy, mucI oI IL Is
very poor In unswerIng sound scIenLIIIc quesLIons. TIere Is no pusL
reseurcI LIuL cun be IIdden, eILIer by LIe Lobucco IndusLry or unyone
eIse, LIuL wouId uILer, uL uII, LIe Iuck oI scIenLIIIc merIL oI mosL cIuIms
ubouL smokIng mude by LIe medIcuI esLubIIsImenL.
TIe Issue Iere Is noL wILI LIe poLenLIuI IuIIIngs oI LIe Lobucco
IndusLry und on wIIcI LIere ure uIreudy voIumes wrILLen (e.g., GIunLz eL
uI., 1qq6; GIunLz & BuIbucI, zooo; HusLIngs & Mucuyden, zooo; see uIso
runcey & CIupmun, zooo) - some Is reusonubIe, mosL Is unreusonubIe.
MucI oI IL cuLusLropIIzes purLIcuIur Lobucco IndusLry conducL sImpIy
becuuse IL unquesLIonIngIy beIIeves, or Ius conLrIbuLed Lo, uII LIuL Ius
been medIcuIIy suId ubouL LIe smokIng IubIL. However, us Ius uIreudy
221
221
Rampant Antismoking Signifies Grave Danger
musLer ruce, ucLuuIIy beIIeved LIuL LIeIr ubIorrenL conducL wus Ior u
greuLer und gIorIous good. n IucL, LIese were moruIIy IeebIe und IIgIIy
LroubIed mInds, projecLIng vIoIenL InLernuI sLuLes onLo uII sorLs oI exLernuI
groups.
OI crucIuI ImporLunce Is LIuL LIrougI progressIve reInIorcemenL
by denIuI und projecLIon u mInd cun enLer u sLuLe so compreIensIveIy
devoId oI moruI sensIbIIILy LIuL LIe mosL repugnunL, unconscIonubIe,
sInIsLer conducL Is vIewed us good. urLIermore, IL sIouId be noLed LIuL
unLIsmokIng uIso IIgured IIgIIy In LIe NuzI menLuIILy, I.e., used us u
moruI subsLILuLe, und wus one oI LIe IIrsL IIxuLIons oI LIe NuzI docLors
und regIme. ConLemporury medIco-muLerIuIIsm Is uIreudy weII uIong LIIs
puLI, und Ius InIecLed consIderubIe porLIons oI muny socIeLIes, Loo.
UILImuLeIy, LIe probIem Ius IILLIe Lo do wILI smokIng uL uII, buL reIIecLs u
progressIve meLupIysIcuI (spIrILuuIJmoruI) crIsIs. n LIIs regurd, wIere
unLIsmokIng Ius been uIIowed Lo domInuLe pubIIc proceedIngs, one cun be
sure LIuL IL Is u crILIcuI und LeIIIng sympLom oI u guLIerIng, muss-scuIe,
dungerous, muLerIuIIsL deIusIon.
.; Mctericlist ics , Vested Interest
n uddILIon Lo LIe very serIous probIems LIuL rIddIe LIe
conLemporury medIcuI esLubIIsImenL consIdered In LIe prevIous secLIon,
LIere ure numerous oLIer IIgIIy quesLIonubIe LussIes und Lugs-oI-wur LIuL
ure LIe consequence oI un InsLILuLIon LIuL Ius IosL ILs moruI wuy.
TIIs mosL recenL Lobucco sugu commencIng In LIe 1qo`s Ius
been presenLed Lo LIe pubIIc us u buLLIe oI opposIng sIdes, I.e., good versus
evII. n LIe IusL decude LIere Ius even been u debuLe concernIng wIeLIer
Lobucco IndusLry IundIng oI reseurcI sIouId be permILLed, e.g., Edwurds &
BIopuI, 1qqq; Wudmun, 1qq8; HorLon, 1qq;; RuLLer, 1qq6. AguIn, LIIs
udversurIuI conLexL Is noLIIng new. Hurdy (1q68) noLes LIuL LIe Lobucco
IndusLry wus reIerred Lo uL LIen conIerences us LIe oLIer sIde und un
udversury. GuIIIord (1q68) uIso reIers Lo Lwo sLudIes (Huug & Hunmer,
1q;; Dorn & Buum, 1q) conLrudIcLIng Hummond & Horn (1q8) LIuL
ure reporLed by scIenLIsLs wIo IuII under suspIcIon becuuse LIey Iuve
been sponsored Lo some exLenL by LIe Lobucco IndusLry. (p. o) TIe
medIcuI esLubIIsImenL presenLs ILseII us LIe good guy wIIIe LIe Lobucco
IndusLry Is porLruyed us LIe converse. WILIIn LIIs conLrIved udversurIuI
Irumework, wIuLever IegILImuLe scIenLIIIc crILIcIsms ure IeveIed uL LIe
medIcuI esLubIIsImenL ure sImpIy sIrugged oII us bud guy unLIcs, I.e.,
LIe IIgIIy quesLIonubIe concIusIon LIuL uny conLrury urgumenLuLIon musL
be by coIIuders wILI LIe Lobucco IndusLry. TIe medIcuI esLubIIsImenL
seems Lo Iuve no cIue, so severe Is ILs IncompeLence, obsLInucy und
Other Vital Matters
IuugILIness, LIuL IL Ius pILLed ILseII uguInsL LIe prIncIpIes und proLocoIs oI
scIenLIIIc enquIry und sound InIerence-mukIng, noL Lo menLIon Issues oI
psycIoIogIcuI, socIuI und moruI IeuILI.
TIere Ius cerLuInIy been mIsconducL by LIe Lobucco IndusLry In
deuIIng wILI purLIcuIur smoke-reIuLed Issues over LIe yeurs. However, IL
cun uIso be suId LIuL LIe Lobucco IndusLry Ius been pIuced squureIy on LIe
deIensIve by u growIng medIco-muLerIuIIsL movemenL LIuL wus uIreudy
mukIng ouLIundIsI cIuIms sucI us one LIIrd oI uII deuLIs ure cuused by
smokIng In LIe IuLe-1qo`s (e.g., Hummond & Horn, 1q8). L Is dIIIIcuIL
Lo IuLIom wIuL eIIecL LIIs sorL oI rIeLorIc Ius on un essenLIuIIy
commercIuI orgunIzuLIon run by predomInunLIy commercIuI LIInkers.
GIven LIuL LIe cIuIms oI LIe medIcuI esLubIIsImenL were, und ure, bused
on u severeIy IIuwed versIon oI scIence und LIuL IL operuLes on
munuIucLurIng cuusuLIon by poIILIcuI munIpuIuLIon LIrougI Lo
consensus, IL Is noL surprIsIng LIuL LIe Lobucco IndusLry wouId uLLempL
Lo dIrecL wIuL, In muny InsLunces, ure IegILImuLe reseurcI quesLIons LIuL
provIde unoLIer vIew. MedIco-muLerIuIIsm Ius depIcLed Lobucco-IndusLry
conducL In LIIs regurd us munIpuIuLIve, wIIIe presenLIng ILs own conducL
us scIenLIIIcuIIy deIInILIve.
n oLIer InsLunces LIe Lobucco IndusLry seems Lo Iuve pubIIcIy
uppeused medIcuI esLubIIsImenL dogmu, wIIIsL prIvuLeIy goIng on wILI
busIness us usuuI. As LIIs dIscussIon progresses, IL sIouId become more
obvIous us Lo jusL Iow IILLIe LIe Lobucco IndusLry undersLunds ubouL LIe
smokIng IubIL, purLIcuIurIy In psycIoIogIcuI und psycIosocIuI Lerms, und
ubouL cctucl scIence; Lobucco IndusLry scIenLIsLs ure LypIcuIIy cIemIsLs.
UnIorLunuLeIy, LIe Lobucco IndusLry uses LIe sume muLerIuIIsL Irumework
us LIe medIcuI esLubIIsImenL, sucI LIuL IL Ius uLLempLed Lo deIend
(reucLIve), wIeLIer properIy or ImproperIy, uguInsL medIcuI cIuIms LIuL
ure LIemseIves uIreudy IIgIIy quesLIonubIe. TIere Is no sIorLuge oI
reseurcI on LIe IubIL oI smokIng. L musL ruLe us LIe mosL over-
InvesLIguLed pIenomenon In medIcuI enquIry. UnIorLunuLeIy, mucI oI IL Is
very poor In unswerIng sound scIenLIIIc quesLIons. TIere Is no pusL
reseurcI LIuL cun be IIdden, eILIer by LIe Lobucco IndusLry or unyone
eIse, LIuL wouId uILer, uL uII, LIe Iuck oI scIenLIIIc merIL oI mosL cIuIms
ubouL smokIng mude by LIe medIcuI esLubIIsImenL.
TIe Issue Iere Is noL wILI LIe poLenLIuI IuIIIngs oI LIe Lobucco
IndusLry und on wIIcI LIere ure uIreudy voIumes wrILLen (e.g., GIunLz eL
uI., 1qq6; GIunLz & BuIbucI, zooo; HusLIngs & Mucuyden, zooo; see uIso
runcey & CIupmun, zooo) - some Is reusonubIe, mosL Is unreusonubIe.
MucI oI IL cuLusLropIIzes purLIcuIur Lobucco IndusLry conducL sImpIy
becuuse IL unquesLIonIngIy beIIeves, or Ius conLrIbuLed Lo, uII LIuL Ius
been medIcuIIy suId ubouL LIe smokIng IubIL. However, us Ius uIreudy
222
222
Rampant Antismoking Signifies Grave Danger
been IndIcuLed, mosL oI LIIs InIormuLIon Is severeIy IIuwed. TIe InLenL
Iere Is noL u deIense or un exoneruLIng oI LIe Lobucco IndusLry. RuLIer, IL
cun be sLuLed wILI u IIgI degree oI conIIdence LIuL Lobucco IndusLry
conducL cunnoL properIy be evuIuuLed unIess LIe very severe mIsconducL
by LIe medIcuI esLubIIsImenL Is IIrsL uccounLed Ior. To LIe exLenL LIuL
LIere Is u IuIIure Lo uccommoduLe epIdemIoIogIc conLorLIons, und wIIcI Is
LypIcuIIy LIe cuse, LIen depIcLIons oI Lobucco IndusLry mIsconducL wIII,
by deIInILIon, be IIgIIy bIused.
WIuL Is uL Issue In LIIs dIscussIon Is LIuL LIe medIcuI
esLubIIsImenL Ius done sucI u compreIensIve job oI vIIIuInIzIng LIe
Lobucco IndusLry us u group LIuL Is Iorever pIoLLIng, scIemIng und
conspIrIng uguInsL LIe IeuILI oI nuLIons, LIuL IL Ius escuped scruLIny
regurdIng ILs own Iur more quesLIonubIe conducL In LIIs sugu und LIuL
does noL uuger weII In even greuLer conLexL. or exumpIe, BerrIdge (1qqq)
IndIcuLes LIuL by LIe 1q;o`s LIere wus uIreudy un epIdemIoIogIc und
muLerIuIIsL consensus oI promoLIng LIe rIsk uvoIdIng IndIvIduuI, I.e.,
LIe muLerIuIIsL munIIesLo. UnIorLunuLeIy, LIIs rIsk-uversIon menLuIILy wus
Lo be uppIIed Lo sLuLIsLIcuI rIsk oI poor predIcLIve sLrengLI und undeIIned
cuusuLIon. n psycIoIogIcuI Lerms LIIs represenLs LIe munuIucLure oI
supersLILIous beIIeI. Worse sLIII Is LIuL LIIs prescrIpLIon Is noL onIy
psycIoIogIcuIIy enIeebIIng buL uIso Ius devusLuLIng socIuI consequences.
Around LIe sume LIme LIere wus uIso u domInuLIon oI LIe vIew
LIuL smokIng cessuLIon ruLIer LIun suIer cIgureLLes sIouId be pursued,
I.e., uboIIsImenL sLunce. n workIng Lo LIIs unLIsmokIng concIusIon,
unyLIIng LIuL cun remoLeIy be recruILed Lowurds LIIs gouI Ius ucLIveIy
been sougIL. TIe IIImsIness oI epIdemIoIogy uIIowed u quunLIIIcuLIon oI
rIsk Ior nonsmokers exposed Lo envIronmenLuI Lobucco smoke (ETS). ETS
wus noL consIdered u dunger Lo LIuL LIme. EvenLuuIIy, IL Ius been LIIs ETS
Issue LIuL Ius provIded LIe besL prospecL Ior proIIbILIonJuboIILIon. As u
muLerIuIIsL consensus on smokIng Ius buIIL, LIe smoker Ius been
redeIIned us, IIrsLIy, un uddIcL, und LIen, secondIy, u LIreuL Lo
nonsmokers. AII oI LIese consensus sLunces, cenLered uround
epIdemIoIogy und u neguLIve redeIInILIon oI LIe smoker, Iuve no
IounduLIon In IucL und, yeL, Iuve sLeered IurLIer poIIcy und reseurcI ever
sInce. TIere Is cerLuInIy u conspIruLorIuI urgumenL Iere In so-cuIIed
IeuILI uuLIorILIes workIng Lo u IIgIIy quesLIonubIe concIusIon; IL
vIoIuLes LIe prIme scIenLIIIc edIcL oI objecLIvILy, I.e., ImpurLIuIIy uIIowIng
duLu und coIerenL InIerence Lo guIde concIusIons ruLIer LIun IorcIng
duLu Lo meun wIuLever Is requIred Lo supporL u pre-deIIned concIusIon.
TIe conspIrucy Is one oI Ignorunce und IncompeLence.
PurLIcuIurIy In LIe InsLunce oI cIgureLLe smokIng, u proIIbILIonIsL
sLunce wus udopLed In LIe 1q6o`s by u smuII group In epIdemIoIogy. By LIe
Other Vital Matters
mId-1q;o`s LIIs vIew Iud u sLrong IooLIoId wILI LIe muLerIuIIsL
consensus oI promoLIng LIe rIsk uvoIdIng IndIvIduuI. SInce LIen, wIuL
wus once LIe LIInkIng oI u smuII group Ius been uIIowed Lo InIecL generuI
epIdemIoIogIcuI LIInkIng InLo udopLIng LIe sume sLunce, I.e., consensus.
TIIs Is purLIcuIurIy u probIem oI LIe epIdemIoIogIc cuILure wIere
cuusuLIon Ius come Lo be decIded by consensus ruLIer LIun coIerenL
cuusuI urgumenL und Ius been dIcLuLed by u progressIveIy more uggressIve
muLerIuIIsLJexLernuIIsL menLuIILy und uLLerIy suLuruLed wILI sLuLIsLIcuI
nonsense. TIIs one probIem oI udopLIng buseIess sLunces, und wIIcI Is
generuIIy sympLomuLIc oI LIe remuInder oI ILs IuIIIngs oI due scIenLIIIc
process, uuLomuLIcuIIy dIsquuIIIIes epIdemIoIogy Irom LIe scIenLIIIc urenu
In consIderuLIons oI LIe smokIng IubIL, I.e., vIoIuLIon oI objecLIvILyJ
ImpurLIuIILy. TIe mosL cIoseIy proLecLed prIncIpIe oI conducL, und LIuL
sIouId be demonsLrubIy so, Is objectitit,impcrticlit. As menLIoned In
cIupLer one, In scIenLIIIc Lerms, wIere objecLIvILy Is IosL, uII Is IosL.
WIuLever one muy wunL Lo muke oI LIe Lobucco IndusLry, IL Is
sLIII one IndusLry. EpIdemIoIogy, Iowever, promoLes ILseII us boLI u
scIenLIIIc underLukIng und u IeuILI uuLIorILy. urLIermore, IL Is one
uspecL oI u greuLer IeuILI promoLIon uppuruLus LIuL Is IIrmIy commILLed
Lo u derunged muLerIuIIsL IdeoIogy LIuL Ius gruve gIobuI consequences, I.e.,
muLerIuIIsL munIIesLo. OI LIe Lobucco IndusLry or muLerIuIIsL IdeoIogy, IL Is
LIe IuLLer LIuL sIouId be oI gruve concern.
I IIdden InIormuLIon, Ior exumpIe, Is u IegILImuLe concern,
LIen IL sIouId be clcrmin LIuL, by u reIIunce on reIuLIve rIsk,
epIdemIoIogy sstemiccll (I.e., sLundurd procedure) hides LIe mosL
subsLunLIve InIormuLIon Irom LIe pubIIc, I.e., LIuL InIormuLIon LIuL uIIows
u cuIcuIuLIon oI ubsoIuLe predIcLIve sLrengLI oI IucLors Ior IucLors. AL u
LIeoreLIcuI IeveI, epIdemIoIogy posILs cuusuI urgumenLs LIuL Iuve no
scIenLIIIc merIL wIuLsoever, I.e., vIoIuLIon oI every prIncIpIe oI cuusuI
urgumenL. L Ius even udded new dImensIons Lo LIe ubuse oI sLuLIsLIcuI
InIormuLIon. By LIe LIme prevenLIve medIcIne becomes InvoIved, II IL Ius
noL uIreudy dIrecLed reseurcI, sLunces ure udopLed on purLIcuIur Issues,
usuuIIy wILI very poor busIs. TIe pubIIc Is LIen mude Lo IeeI LIuL onIy
compIIunce wILI LIe uuLIorILuLIve vIew Is deemed responsIbIe, und
uny dIvergence Is IrresponsIbIe. TIIs Is usuuIIy uccompIIsIed LIrougI Ieur
und guIIL-mongerIng. As u IurLIer exucerbuLIng IucLor, LIe medIu Ius
uvuIIed ILseII us u propugundu ouLIeL (I.e., unquesLIonIng) Ior LIe medIcuI
esLubIIsImenL sucI LIuL onIy LIe uuLIorILuLIve vIew Is consIsLenLIy Ieurd
by LIe pubIIc. WIuL muy Indeed be IIgIIy conLroversIuI Issues ure pubIIcIy
depIcLed us deIInILIve. TIere Is noLIIng IeuILIy ubouL LIIs sILuuLIon uL uII.
L demonsLruLes some oI LIe dungerous uspecLs oI scIenLIsm und
IeuILIIsm.
223
223
Rampant Antismoking Signifies Grave Danger
been IndIcuLed, mosL oI LIIs InIormuLIon Is severeIy IIuwed. TIe InLenL
Iere Is noL u deIense or un exoneruLIng oI LIe Lobucco IndusLry. RuLIer, IL
cun be sLuLed wILI u IIgI degree oI conIIdence LIuL Lobucco IndusLry
conducL cunnoL properIy be evuIuuLed unIess LIe very severe mIsconducL
by LIe medIcuI esLubIIsImenL Is IIrsL uccounLed Ior. To LIe exLenL LIuL
LIere Is u IuIIure Lo uccommoduLe epIdemIoIogIc conLorLIons, und wIIcI Is
LypIcuIIy LIe cuse, LIen depIcLIons oI Lobucco IndusLry mIsconducL wIII,
by deIInILIon, be IIgIIy bIused.
WIuL Is uL Issue In LIIs dIscussIon Is LIuL LIe medIcuI
esLubIIsImenL Ius done sucI u compreIensIve job oI vIIIuInIzIng LIe
Lobucco IndusLry us u group LIuL Is Iorever pIoLLIng, scIemIng und
conspIrIng uguInsL LIe IeuILI oI nuLIons, LIuL IL Ius escuped scruLIny
regurdIng ILs own Iur more quesLIonubIe conducL In LIIs sugu und LIuL
does noL uuger weII In even greuLer conLexL. or exumpIe, BerrIdge (1qqq)
IndIcuLes LIuL by LIe 1q;o`s LIere wus uIreudy un epIdemIoIogIc und
muLerIuIIsL consensus oI promoLIng LIe rIsk uvoIdIng IndIvIduuI, I.e.,
LIe muLerIuIIsL munIIesLo. UnIorLunuLeIy, LIIs rIsk-uversIon menLuIILy wus
Lo be uppIIed Lo sLuLIsLIcuI rIsk oI poor predIcLIve sLrengLI und undeIIned
cuusuLIon. n psycIoIogIcuI Lerms LIIs represenLs LIe munuIucLure oI
supersLILIous beIIeI. Worse sLIII Is LIuL LIIs prescrIpLIon Is noL onIy
psycIoIogIcuIIy enIeebIIng buL uIso Ius devusLuLIng socIuI consequences.
Around LIe sume LIme LIere wus uIso u domInuLIon oI LIe vIew
LIuL smokIng cessuLIon ruLIer LIun suIer cIgureLLes sIouId be pursued,
I.e., uboIIsImenL sLunce. n workIng Lo LIIs unLIsmokIng concIusIon,
unyLIIng LIuL cun remoLeIy be recruILed Lowurds LIIs gouI Ius ucLIveIy
been sougIL. TIe IIImsIness oI epIdemIoIogy uIIowed u quunLIIIcuLIon oI
rIsk Ior nonsmokers exposed Lo envIronmenLuI Lobucco smoke (ETS). ETS
wus noL consIdered u dunger Lo LIuL LIme. EvenLuuIIy, IL Ius been LIIs ETS
Issue LIuL Ius provIded LIe besL prospecL Ior proIIbILIonJuboIILIon. As u
muLerIuIIsL consensus on smokIng Ius buIIL, LIe smoker Ius been
redeIIned us, IIrsLIy, un uddIcL, und LIen, secondIy, u LIreuL Lo
nonsmokers. AII oI LIese consensus sLunces, cenLered uround
epIdemIoIogy und u neguLIve redeIInILIon oI LIe smoker, Iuve no
IounduLIon In IucL und, yeL, Iuve sLeered IurLIer poIIcy und reseurcI ever
sInce. TIere Is cerLuInIy u conspIruLorIuI urgumenL Iere In so-cuIIed
IeuILI uuLIorILIes workIng Lo u IIgIIy quesLIonubIe concIusIon; IL
vIoIuLes LIe prIme scIenLIIIc edIcL oI objecLIvILy, I.e., ImpurLIuIIy uIIowIng
duLu und coIerenL InIerence Lo guIde concIusIons ruLIer LIun IorcIng
duLu Lo meun wIuLever Is requIred Lo supporL u pre-deIIned concIusIon.
TIe conspIrucy Is one oI Ignorunce und IncompeLence.
PurLIcuIurIy In LIe InsLunce oI cIgureLLe smokIng, u proIIbILIonIsL
sLunce wus udopLed In LIe 1q6o`s by u smuII group In epIdemIoIogy. By LIe
Other Vital Matters
mId-1q;o`s LIIs vIew Iud u sLrong IooLIoId wILI LIe muLerIuIIsL
consensus oI promoLIng LIe rIsk uvoIdIng IndIvIduuI. SInce LIen, wIuL
wus once LIe LIInkIng oI u smuII group Ius been uIIowed Lo InIecL generuI
epIdemIoIogIcuI LIInkIng InLo udopLIng LIe sume sLunce, I.e., consensus.
TIIs Is purLIcuIurIy u probIem oI LIe epIdemIoIogIc cuILure wIere
cuusuLIon Ius come Lo be decIded by consensus ruLIer LIun coIerenL
cuusuI urgumenL und Ius been dIcLuLed by u progressIveIy more uggressIve
muLerIuIIsLJexLernuIIsL menLuIILy und uLLerIy suLuruLed wILI sLuLIsLIcuI
nonsense. TIIs one probIem oI udopLIng buseIess sLunces, und wIIcI Is
generuIIy sympLomuLIc oI LIe remuInder oI ILs IuIIIngs oI due scIenLIIIc
process, uuLomuLIcuIIy dIsquuIIIIes epIdemIoIogy Irom LIe scIenLIIIc urenu
In consIderuLIons oI LIe smokIng IubIL, I.e., vIoIuLIon oI objecLIvILyJ
ImpurLIuIILy. TIe mosL cIoseIy proLecLed prIncIpIe oI conducL, und LIuL
sIouId be demonsLrubIy so, Is objectitit,impcrticlit. As menLIoned In
cIupLer one, In scIenLIIIc Lerms, wIere objecLIvILy Is IosL, uII Is IosL.
WIuLever one muy wunL Lo muke oI LIe Lobucco IndusLry, IL Is
sLIII one IndusLry. EpIdemIoIogy, Iowever, promoLes ILseII us boLI u
scIenLIIIc underLukIng und u IeuILI uuLIorILy. urLIermore, IL Is one
uspecL oI u greuLer IeuILI promoLIon uppuruLus LIuL Is IIrmIy commILLed
Lo u derunged muLerIuIIsL IdeoIogy LIuL Ius gruve gIobuI consequences, I.e.,
muLerIuIIsL munIIesLo. OI LIe Lobucco IndusLry or muLerIuIIsL IdeoIogy, IL Is
LIe IuLLer LIuL sIouId be oI gruve concern.
I IIdden InIormuLIon, Ior exumpIe, Is u IegILImuLe concern,
LIen IL sIouId be clcrmin LIuL, by u reIIunce on reIuLIve rIsk,
epIdemIoIogy sstemiccll (I.e., sLundurd procedure) hides LIe mosL
subsLunLIve InIormuLIon Irom LIe pubIIc, I.e., LIuL InIormuLIon LIuL uIIows
u cuIcuIuLIon oI ubsoIuLe predIcLIve sLrengLI oI IucLors Ior IucLors. AL u
LIeoreLIcuI IeveI, epIdemIoIogy posILs cuusuI urgumenLs LIuL Iuve no
scIenLIIIc merIL wIuLsoever, I.e., vIoIuLIon oI every prIncIpIe oI cuusuI
urgumenL. L Ius even udded new dImensIons Lo LIe ubuse oI sLuLIsLIcuI
InIormuLIon. By LIe LIme prevenLIve medIcIne becomes InvoIved, II IL Ius
noL uIreudy dIrecLed reseurcI, sLunces ure udopLed on purLIcuIur Issues,
usuuIIy wILI very poor busIs. TIe pubIIc Is LIen mude Lo IeeI LIuL onIy
compIIunce wILI LIe uuLIorILuLIve vIew Is deemed responsIbIe, und
uny dIvergence Is IrresponsIbIe. TIIs Is usuuIIy uccompIIsIed LIrougI Ieur
und guIIL-mongerIng. As u IurLIer exucerbuLIng IucLor, LIe medIu Ius
uvuIIed ILseII us u propugundu ouLIeL (I.e., unquesLIonIng) Ior LIe medIcuI
esLubIIsImenL sucI LIuL onIy LIe uuLIorILuLIve vIew Is consIsLenLIy Ieurd
by LIe pubIIc. WIuL muy Indeed be IIgIIy conLroversIuI Issues ure pubIIcIy
depIcLed us deIInILIve. TIere Is noLIIng IeuILIy ubouL LIIs sILuuLIon uL uII.
L demonsLruLes some oI LIe dungerous uspecLs oI scIenLIsm und
IeuILIIsm.
224
224
Rampant Antismoking Signifies Grave Danger Other Vital Matters
ubundon LIe presenL unIeuILIy preoccupuLIon wILI
smokIng und Iocus on uII LIe rIsk IucLors InvoIved,
IncIudIng sLress, IeredILury predIsposILIon und so on,
we mIgIL In reuIILy suve uII LIose IIves LIuL u weII-
InLenLIoned buL possIbIy mIsIeudIng eIIorL Ius LrIed Lo
persuude us couId be suved II onIy peopIe guve up
smokIng. TIIs Is u serIous Issue, vILuI Ior Iundreds oI
LIousunds oI peopIe, und we sIouId noL conLInue wILI u
bIund und bIused dIsregurd oI LIe Lrue IucLs oI LIe cuse.
(p. qq-)
MurImonL (1qq6), In un unpubIIsIed IeLLer Lo LIe journuI Science,
sLuLes In purL Good scIenLIsLs encouruge crILIcIsm oI LIeIr resuILs. By
IonesL gIve und Luke LIey reIIne LIeIr LIeorIes und udvunce knowIedge.
TIe unLI-smokIng crusuders, unubIe Lo deIend LIeIr oILen sIoddy scIence,
Iuve cIunged LIe subjecL Lo uLLuckIng LIe Lobucco IndusLry und ImpugnIng
LIe moLIves oI scIenLIsLs wIo uccepL ILs IundIng. TIe reuI or uIIeged
evIIdoIng oI LIe Lobucco IndusLry Is IrreIevunL Lo LIe pubIIc poIIcy oI LIe
dungers oI smokIng. No money wIII corrupL un IonesL scIenLIsL, und
ederuI money (SLunLon GIunLz`s specIuILy) wIII corrupL u dIsIonesL
scIenLIsL us LIorougIIy us Lobucco money. I GIunz`s IucruLIve und eIIecLIve
propugundu Ius been ubIe Lo Iurm LIe cureer oI so dIsLInguIsIed un
epIdemIoIogIsL us TIeodore SLerIIng, cun see wIy young scIenLIsLs ure
uIruId Lo proLesL. BuL wIere ure LIe Ieuders oI LIe AmerIcun AssocIuLIon
Ior LIe AdvuncemenL oI ScIence, or oLIer reLIrees, IIke me, wIo ure Iree Lo
speuk ouL?.. (In OukIey, 1qqq, CI., p. z8-q)
eInsLeIn (1qqz), u IIgIIy respecLed epIdemIoIogIsL, concIuded
LIuL on LIe IuLure oI reseurcI on smokIng: n LIe currenL Iervor oI unLI-
smokIng evungeIIsm, wIuL young scIenLIsLs wouId wunL Lo rIsk LIeIr cureer
und wIuL oIder scIenLIsLs wouId wunL Lo rIsk LIeIr repuLuLIon by doIng
unyLIIng LIuL mIgIL be consLrued us supporL Ior LIe 'bud guys` oI LIe
Lobucco IndusLry? WIuL governmenLuI ugency wouId Iund reseurcI In
wIIcI LIe esLubIIsIed 'uccepLed` unLI-smokIng docLrInes were LIreuLened
by u sLudy proposed by someone - un obvIousIy derunged skepLIc - wIo
wunLed Lo do un unbIused, objecLIve InvesLIguLIon? TIe 'bud guys` .. ure
noL uIwuys rIgIL, buL II LIey ure denIed u IuIr und proper scIenLIIIc IeurIng,
neILIer socIeLy nor scIence wIII beneIIL. SocIeLy Is enLILIed Lo muke
decIsIons bused on udvocucy, buL on scIoIursIIp - no muLLer Iow IL Is
produced or by wIom.
EpIdemIoIogy Ius guIned very consIderubIe mIIeuge Irom ILs
IruuduIenL depIcLIons oI LIe reIuLIonsIIp beLween smokIng und dIseuse.
MucI presLIge Ius been uccorded epIdemIoIogy Ior ILs greuL dIscoverIes
TIere ure numerous urLIcIes In LIe medIcuI IILeruLure depIcLIng
LIe dIseuse modeI (nIcoLIne uddIcLIon) oI LIe smokIng IubIL und
evuIuuLIons oI usuuIIy pIurmucoIogIcuI LreuLmenLs oI LIe supposed
dIseuse. TIere ure no presenLuLIons over LIe IusL decude, Lo LIe uuLIor`s
knowIedge, In medIcuI journuIs oI uILernuLIve vIews oI LIe smokIng IubIL
(e.g., Eysenck, 1qq1; WurburLon, 1q8q, 1qq6). MedIcuI reseurcIers do noL
even seem Lo be uwure LIuL oLIer vIews exIsL. UnIorLunuLeIy, u
consensus Ius been urrIved uL In LIe medIcuI esLubIIsImenL und uII
oLIer uvenues ure cuL oII. TIIs IndIcuLes, uL LIe very IeusL, ecIecLIc IuIIure
und represenLs u compIeLeIy bIused depIcLIon oI wIuL Is onIy one oI muny
conLroversIuI Issues.
ReseurcIers LIuL do noL embruce LIe orLIodox vIew ure
suIIIcIenLIy concerned Lo voIce vIoIuLIons oI due scIenLIIIc process.
Eysenck (1qq1) reusonubIy concIudes LIuL:
..In LIIs ureu, poIILIcs Ius Luken over Irom scIence, Lo u
dungerous degree. ConsIder LIe LucLIcs LIuL Iuve been
used wIdeIy In connecLIon wILI LIe 'smokIng cuuses
dIseuse` Issue. L Ius become dIIIIcuIL Ior LIose wIo
wIsI Lo exumIne LIe probIem objecLIveIy Lo obLuIn
reseurcI Iunds or Lo pubIIsI LIeIr duLu, II LIey ure noL In
IIne wILI oIIIcIuI poIIcy. Newspupers reIuse Lo dIscuss
LIe IucLs objecLIveIy und preLend LIuL ununImILy exIsLs
wIen In reuIILy conIusIon reIgns, und crILIcIsm oI LIe
'orLIodox` vIew Is wIdespreud. AILernuLIve modeIs ure
dIsmIssed wILIouL proper exumInuLIon und ure seIdom
menLIoned In oIIIcIuI pubIIcuLIons. nvesLIguLors wIo
sIow un InLeresL In sucI modeIs encounLer obsLucIes In
LIeIr cureers und muy Iuve uII supporL wILIdruwn,
regurdIess oI LIe quuIILy oI LIeIr reseurcI. TIese ure noL
condILIons LIuL encouruge IIgI-quuIILy scIenLIIIc
reseurcI, und IL Is smuII wonder LIuL LIe IIeId Is
conIused und IuII oI unomuIIes.......MucI
remuIns obscure, buL some IeuLures oI LIe scene musL
be regurded us IopeIuI. I sLress und oLIer psycIosocIuI
IucLors ure Indeed kIIIers, IL does seem LIuL suILubIe
propIyIucLIc meuns ure uL Iund Lo deIuy or prevenL
cuncer und CHD. BeIuvIor LIerupy Is u very cIeup und
convenIenL wuy oI suIeguurdIng IeuILIy probunds Irom
cuncer und CHD, und Irom every poInL oI vIew,
prevenLIon musL be beLLer LIun IurgeIy non-exIsLenL
cures or very expensIve LreuLmenLs wILI oILen
dIsusLrous sIde-eIIecLs. I onIy reseurcIers couId
225
225
Rampant Antismoking Signifies Grave Danger Other Vital Matters
ubundon LIe presenL unIeuILIy preoccupuLIon wILI
smokIng und Iocus on uII LIe rIsk IucLors InvoIved,
IncIudIng sLress, IeredILury predIsposILIon und so on,
we mIgIL In reuIILy suve uII LIose IIves LIuL u weII-
InLenLIoned buL possIbIy mIsIeudIng eIIorL Ius LrIed Lo
persuude us couId be suved II onIy peopIe guve up
smokIng. TIIs Is u serIous Issue, vILuI Ior Iundreds oI
LIousunds oI peopIe, und we sIouId noL conLInue wILI u
bIund und bIused dIsregurd oI LIe Lrue IucLs oI LIe cuse.
(p. qq-)
MurImonL (1qq6), In un unpubIIsIed IeLLer Lo LIe journuI Science,
sLuLes In purL Good scIenLIsLs encouruge crILIcIsm oI LIeIr resuILs. By
IonesL gIve und Luke LIey reIIne LIeIr LIeorIes und udvunce knowIedge.
TIe unLI-smokIng crusuders, unubIe Lo deIend LIeIr oILen sIoddy scIence,
Iuve cIunged LIe subjecL Lo uLLuckIng LIe Lobucco IndusLry und ImpugnIng
LIe moLIves oI scIenLIsLs wIo uccepL ILs IundIng. TIe reuI or uIIeged
evIIdoIng oI LIe Lobucco IndusLry Is IrreIevunL Lo LIe pubIIc poIIcy oI LIe
dungers oI smokIng. No money wIII corrupL un IonesL scIenLIsL, und
ederuI money (SLunLon GIunLz`s specIuILy) wIII corrupL u dIsIonesL
scIenLIsL us LIorougIIy us Lobucco money. I GIunz`s IucruLIve und eIIecLIve
propugundu Ius been ubIe Lo Iurm LIe cureer oI so dIsLInguIsIed un
epIdemIoIogIsL us TIeodore SLerIIng, cun see wIy young scIenLIsLs ure
uIruId Lo proLesL. BuL wIere ure LIe Ieuders oI LIe AmerIcun AssocIuLIon
Ior LIe AdvuncemenL oI ScIence, or oLIer reLIrees, IIke me, wIo ure Iree Lo
speuk ouL?.. (In OukIey, 1qqq, CI., p. z8-q)
eInsLeIn (1qqz), u IIgIIy respecLed epIdemIoIogIsL, concIuded
LIuL on LIe IuLure oI reseurcI on smokIng: n LIe currenL Iervor oI unLI-
smokIng evungeIIsm, wIuL young scIenLIsLs wouId wunL Lo rIsk LIeIr cureer
und wIuL oIder scIenLIsLs wouId wunL Lo rIsk LIeIr repuLuLIon by doIng
unyLIIng LIuL mIgIL be consLrued us supporL Ior LIe 'bud guys` oI LIe
Lobucco IndusLry? WIuL governmenLuI ugency wouId Iund reseurcI In
wIIcI LIe esLubIIsIed 'uccepLed` unLI-smokIng docLrInes were LIreuLened
by u sLudy proposed by someone - un obvIousIy derunged skepLIc - wIo
wunLed Lo do un unbIused, objecLIve InvesLIguLIon? TIe 'bud guys` .. ure
noL uIwuys rIgIL, buL II LIey ure denIed u IuIr und proper scIenLIIIc IeurIng,
neILIer socIeLy nor scIence wIII beneIIL. SocIeLy Is enLILIed Lo muke
decIsIons bused on udvocucy, buL on scIoIursIIp - no muLLer Iow IL Is
produced or by wIom.
EpIdemIoIogy Ius guIned very consIderubIe mIIeuge Irom ILs
IruuduIenL depIcLIons oI LIe reIuLIonsIIp beLween smokIng und dIseuse.
MucI presLIge Ius been uccorded epIdemIoIogy Ior ILs greuL dIscoverIes
TIere ure numerous urLIcIes In LIe medIcuI IILeruLure depIcLIng
LIe dIseuse modeI (nIcoLIne uddIcLIon) oI LIe smokIng IubIL und
evuIuuLIons oI usuuIIy pIurmucoIogIcuI LreuLmenLs oI LIe supposed
dIseuse. TIere ure no presenLuLIons over LIe IusL decude, Lo LIe uuLIor`s
knowIedge, In medIcuI journuIs oI uILernuLIve vIews oI LIe smokIng IubIL
(e.g., Eysenck, 1qq1; WurburLon, 1q8q, 1qq6). MedIcuI reseurcIers do noL
even seem Lo be uwure LIuL oLIer vIews exIsL. UnIorLunuLeIy, u
consensus Ius been urrIved uL In LIe medIcuI esLubIIsImenL und uII
oLIer uvenues ure cuL oII. TIIs IndIcuLes, uL LIe very IeusL, ecIecLIc IuIIure
und represenLs u compIeLeIy bIused depIcLIon oI wIuL Is onIy one oI muny
conLroversIuI Issues.
ReseurcIers LIuL do noL embruce LIe orLIodox vIew ure
suIIIcIenLIy concerned Lo voIce vIoIuLIons oI due scIenLIIIc process.
Eysenck (1qq1) reusonubIy concIudes LIuL:
..In LIIs ureu, poIILIcs Ius Luken over Irom scIence, Lo u
dungerous degree. ConsIder LIe LucLIcs LIuL Iuve been
used wIdeIy In connecLIon wILI LIe 'smokIng cuuses
dIseuse` Issue. L Ius become dIIIIcuIL Ior LIose wIo
wIsI Lo exumIne LIe probIem objecLIveIy Lo obLuIn
reseurcI Iunds or Lo pubIIsI LIeIr duLu, II LIey ure noL In
IIne wILI oIIIcIuI poIIcy. Newspupers reIuse Lo dIscuss
LIe IucLs objecLIveIy und preLend LIuL ununImILy exIsLs
wIen In reuIILy conIusIon reIgns, und crILIcIsm oI LIe
'orLIodox` vIew Is wIdespreud. AILernuLIve modeIs ure
dIsmIssed wILIouL proper exumInuLIon und ure seIdom
menLIoned In oIIIcIuI pubIIcuLIons. nvesLIguLors wIo
sIow un InLeresL In sucI modeIs encounLer obsLucIes In
LIeIr cureers und muy Iuve uII supporL wILIdruwn,
regurdIess oI LIe quuIILy oI LIeIr reseurcI. TIese ure noL
condILIons LIuL encouruge IIgI-quuIILy scIenLIIIc
reseurcI, und IL Is smuII wonder LIuL LIe IIeId Is
conIused und IuII oI unomuIIes.......MucI
remuIns obscure, buL some IeuLures oI LIe scene musL
be regurded us IopeIuI. I sLress und oLIer psycIosocIuI
IucLors ure Indeed kIIIers, IL does seem LIuL suILubIe
propIyIucLIc meuns ure uL Iund Lo deIuy or prevenL
cuncer und CHD. BeIuvIor LIerupy Is u very cIeup und
convenIenL wuy oI suIeguurdIng IeuILIy probunds Irom
cuncer und CHD, und Irom every poInL oI vIew,
prevenLIon musL be beLLer LIun IurgeIy non-exIsLenL
cures or very expensIve LreuLmenLs wILI oILen
dIsusLrous sIde-eIIecLs. I onIy reseurcIers couId
226
226
Rampant Antismoking Signifies Grave Danger
In LIIs regurd; muny u LexL book or dIcLIonury presenL LIe smokIng cuuses
Iung cuncer exumpIe us LIe greuL epIdemIoIogy success sLory. n LIIs very
crILIcuI regurd, epIdemIoIogy operuLes enLIreIy on vesLed InLeresL.
ReusonubIe quesLIonIng oI ILs greuL success sLory Is undersLundubIy noL
weII receIved. TIe more InvesLmenL IL pIuces In ILs deIInILIve sLunce, sucI
us u smokeIree worId und LIe correspondIng ussuuIL on LIe menLuI
IeuILI oI purLIcuIurIy smokers, LIe more IL sLunds Lo Iose II ILs greuL
InvesLIguLIve success sLory LoppIes. urLIer exucerbuLIng LIIs uIreudy
dIsLurbIng sILuuLIon Is LIuL governmenLs Iuve uIIowed LIemseIves Lo be
domInuLed by LIIs reducLIonIsL und IruuduIenL vIew oI IeuILI wIere LIey,
Loo, ure now compIeLeIy, und unIeuILIIIy, commILLed, LIrougI
consIderubIe IundIng oI prevenLIve medIcIne regImens, Lo u purLIcuIur
sLunce - noL onIy Lo smokIng, buL Lo rIsk-uversIon generuIIy.
TIe overuII resuIL Is LIuL LIere Is now In pIuce u IeuILIIsL
producLIon-IIne oI servIces und producLs. TIIs enLerprIse Is wIoIIy seII-
servIng (I.e., reInIorcemenL oI bIus), IIgIIy recepLIve Lo uny IIndIngs
supporLIng ILs posILIon und IosLIIe Lo uny IIndIngs LIuL conLrudIcL IL. L
erroneousIy InLerpreLs cIuIIenges Lo LIe orLIodox posILIon, und wIIcI
muy ucLuuIIy conLrIbuLe Lo un undersLundIng oI LIe ueLIoIogy oI dIseuse, us
uLLempLs Lo exoneruLe cIgureLLe smokIng, wIIIe uL LIe sume LIme
compIeLeIy obIIvIous Lo LIe IucL LIuL mucI oI ILs own conducL Is LIe
uLLempL Lo ImproperIy Impugn cIgureLLe smokIng.
One oI LIe crILIcuI gouIs oI epIdemIoIogy, II IL Is Lo ucquIre uny
sembIunce oI scIenLIIIc IegILImucy, Is Lo generuLe undersLundIng oI LIe
ueLIoIogy oI dIseuse. TIe ImpugnIng oI cIgureLLe smokIng, LIrougI
severe over-InvesLIguLIon (obsessIve) und over-InLerpreLuLIon oI IIndIngs,
Ius udded vIrLuuIIy noLIIng Lo LIIs proper gouI. As IndIcuLed by Eysenck
(1qq1), MurImonL (1qq6), und eInsLeIn (1qqz), LIe dIrecLIon oI reseurcI
Ius been corrupLed Lowurd un unLIsmokIng sLunce, I.e., unLIsmokIng
reseurcI very eusIIy uLLrucLs IundIng. TIIs enLIre sILuuLIon Is unLILIeLIcuI Lo
scIence or Lo coIerenL reusonIng oI uny sorL, und Is ImmoruI. TIe
muLerIuIIsL munIIesLo LIuL underIIes LIIs cIrcumsLunce couId weII be
descrIbed us u socIuI cuncer; u LIInkIng gone uLLerIy mud LIuL Ius InIecLed
every uspecL oI LIe Iumun condILIon.
Wynder (1qq;), reIIecLIng on uspecLs oI IIs unLI-Lobucco crusude,
noLes LIuL perIups purL oI LIe probIem eurIy on wus LIuL LIe medIcuI
proIessIon us weII us scIence wrILers Iuve Iud generuIIy u crILIcuI vIew oI
epIdemIoIogy (p.6qz); epIdemIoIogy wus consIdered u soIL scIence LIuL
reIIed mosLIy on sLuLIsLIcuI correIuLIon. UnIorLunuLeIy, LIe LubIes Iuve
been compIeLeIy Lurned. EpIdemIoIogy, wIIcI ucLuuIIy operuLes on un
unLI-scIenLIIIc Irumework, Is now uccorded, by purLIcuIurIy LIe medIu und
muny medIcuIJIeuILI proIessIonuIs, LIe sLuLus oI u Iurd scIence.
Other Vital Matters
ronIcuIIy, IL muy very weII be LIuL us InvesLIguLors, especIuIIy Irom oLIer
reseurcI dIscIpIInes (e.g., psycIoIogy) come Lo LIeIr senses, IL wIII be LIe
IIgI degree oI mIsconducL (I.e., ussuuIL on scIence und psycIoIogIcuI,
socIuI und moruI IeuILI) In ILs LreuLmenL oI muny IIIesLyIe IucLors, und
purLIcuIurIy LIe smokIng Issue, LIuL wIII murk epIdemIoIogy`s IuII Irom ILs
IIIusory (IruuduIenLIy obLuIned) gruce.
JusL one oI muny oLIer conLroversIuI Issues InvoIves porLruyuIs
oI IILIguLIon concernIng smokIng. MedIcuI journuIs LypIcuIIy pubIIsI
urLIcIes LIuL IIgIIIgIL successIuI IILIguLIon uguInsL LIe Lobucco IndusLry -
Ior wIuLever reuson. SucI urLIcIes InvurIubIy uppIuud und encouruge sucI
IILIguLIon. TIere exIsLs no debuLe us Lo LIe sensIbIIILy or soundness oI
moLIvuLIon, und LIe repercussIons In greuLer, non-proIIbILIonIsL, socIuI
conLexL. or exumpIe, Duynurd eL uI. (zooo) provIde un enLIusIusLIc
upduLe on Lobucco IILIguLIon. One oI LIe urLIcIe`s IIgIIIgILs Is LIuL by 1qq8
LIe Lobucco IndusLry Iud seLLIed US MedIcuId IuwsuILs InsLILuLed by US
ALLorneys-GeneruI Lo recover cosLs Ior LreuLmenL oI dIseuses cttributcble
Lo smokIng. NowIere In LIIs urLIcIe or uny oLIer urLIcIe In medIcuI
journuIs Is IL menLIoned Iow LIIs IILIguLIon wus pursued.
evy (1qq;) IIgIIIgILs LIuL, umongsL oLIer corrupLIon oI
procedure, LIe US unLI-Lobucco IILIguLIon resLs on u rewrILIng oI US
IegIsIuLIon so LIuL LIe sLuLe Is noL even requIred Lo sIow LIuL u purLIcuIur
purLy wus Iurmed by IIs use oI Lobucco. nsLeud, cuusuLIon muy be proven
by sLuLIsLIcs uIone. L Is purLIcuIurIy LIIs poInL LIuL Is LIe greuL IoIIy oI
epIdemIoIogIc reusonIng und LIuL Ius been uIIowed Lo InIecL LIe
governmenLuI IeveI; u reusonIng LIuL Is repIeLe wILI InIerenLIuI IuIIucIes
Ius been ensIrIned In Iuw, mukIng wIuL Is IIImsy evIdence, uL besL,
suIIIcIenL Ior successIuI prosecuLIon.
evy (1qq;) properIy concIudes LIuL we ure deuIIng Iere wILI
moruI, poIILIcuI, und IeguI quesLIons LIuL Lrunscend uny sIngIe IndusLry. I
one reuds onIy medIcuI journuIs, IL wouId be ImpossIbIe Lo dIscern LIuL
unLI-Lobucco IILIguLIon Is u IIgIIy conLroversIuI Issue LIuL Ius Lo LIIs poInL
InvoIved LIe perverLIng oI due process (see uIso OukIey, 1qqq, CI.1z).
TIereIore, IL cun onIy be concIuded LIuL medIcuI perspecLIve represenLs u
sImpIe-mInded und seII-servIng vIew.
TIe uLLempL by epIdemIoIogyJprevenLIve medIcIne Lo porLruy LIe
Lobucco IndusLry us bIused und ubsorbed by seII-InLeresL wIIIe presenLIng
ILseII us beyond reproucI und reIIecLIng uII LIuL Is benevoIenL und
objecLIve, Is jusL unoLIer uspecL oI LIe greuL Iruud und Lrugedy In progress.
CorrupLIon oI objecLIvILy sucI us Iume Ior InvesLIguLors und InsLILuLIons,
IuLure reseurcI grunLs, und corporuLe proIILs... (SLeInbrook, zooo,
p.16;o) Is ever-presenL In LIe medIcuI esLubIIsImenL (see uIso WIILe,
zooo). TIe seII-seekIng conducL oI pIurmuceuLIcuI compunIes und oLIer
227
227
Rampant Antismoking Signifies Grave Danger
In LIIs regurd; muny u LexL book or dIcLIonury presenL LIe smokIng cuuses
Iung cuncer exumpIe us LIe greuL epIdemIoIogy success sLory. n LIIs very
crILIcuI regurd, epIdemIoIogy operuLes enLIreIy on vesLed InLeresL.
ReusonubIe quesLIonIng oI ILs greuL success sLory Is undersLundubIy noL
weII receIved. TIe more InvesLmenL IL pIuces In ILs deIInILIve sLunce, sucI
us u smokeIree worId und LIe correspondIng ussuuIL on LIe menLuI
IeuILI oI purLIcuIurIy smokers, LIe more IL sLunds Lo Iose II ILs greuL
InvesLIguLIve success sLory LoppIes. urLIer exucerbuLIng LIIs uIreudy
dIsLurbIng sILuuLIon Is LIuL governmenLs Iuve uIIowed LIemseIves Lo be
domInuLed by LIIs reducLIonIsL und IruuduIenL vIew oI IeuILI wIere LIey,
Loo, ure now compIeLeIy, und unIeuILIIIy, commILLed, LIrougI
consIderubIe IundIng oI prevenLIve medIcIne regImens, Lo u purLIcuIur
sLunce - noL onIy Lo smokIng, buL Lo rIsk-uversIon generuIIy.
TIe overuII resuIL Is LIuL LIere Is now In pIuce u IeuILIIsL
producLIon-IIne oI servIces und producLs. TIIs enLerprIse Is wIoIIy seII-
servIng (I.e., reInIorcemenL oI bIus), IIgIIy recepLIve Lo uny IIndIngs
supporLIng ILs posILIon und IosLIIe Lo uny IIndIngs LIuL conLrudIcL IL. L
erroneousIy InLerpreLs cIuIIenges Lo LIe orLIodox posILIon, und wIIcI
muy ucLuuIIy conLrIbuLe Lo un undersLundIng oI LIe ueLIoIogy oI dIseuse, us
uLLempLs Lo exoneruLe cIgureLLe smokIng, wIIIe uL LIe sume LIme
compIeLeIy obIIvIous Lo LIe IucL LIuL mucI oI ILs own conducL Is LIe
uLLempL Lo ImproperIy Impugn cIgureLLe smokIng.
One oI LIe crILIcuI gouIs oI epIdemIoIogy, II IL Is Lo ucquIre uny
sembIunce oI scIenLIIIc IegILImucy, Is Lo generuLe undersLundIng oI LIe
ueLIoIogy oI dIseuse. TIe ImpugnIng oI cIgureLLe smokIng, LIrougI
severe over-InvesLIguLIon (obsessIve) und over-InLerpreLuLIon oI IIndIngs,
Ius udded vIrLuuIIy noLIIng Lo LIIs proper gouI. As IndIcuLed by Eysenck
(1qq1), MurImonL (1qq6), und eInsLeIn (1qqz), LIe dIrecLIon oI reseurcI
Ius been corrupLed Lowurd un unLIsmokIng sLunce, I.e., unLIsmokIng
reseurcI very eusIIy uLLrucLs IundIng. TIIs enLIre sILuuLIon Is unLILIeLIcuI Lo
scIence or Lo coIerenL reusonIng oI uny sorL, und Is ImmoruI. TIe
muLerIuIIsL munIIesLo LIuL underIIes LIIs cIrcumsLunce couId weII be
descrIbed us u socIuI cuncer; u LIInkIng gone uLLerIy mud LIuL Ius InIecLed
every uspecL oI LIe Iumun condILIon.
Wynder (1qq;), reIIecLIng on uspecLs oI IIs unLI-Lobucco crusude,
noLes LIuL perIups purL oI LIe probIem eurIy on wus LIuL LIe medIcuI
proIessIon us weII us scIence wrILers Iuve Iud generuIIy u crILIcuI vIew oI
epIdemIoIogy (p.6qz); epIdemIoIogy wus consIdered u soIL scIence LIuL
reIIed mosLIy on sLuLIsLIcuI correIuLIon. UnIorLunuLeIy, LIe LubIes Iuve
been compIeLeIy Lurned. EpIdemIoIogy, wIIcI ucLuuIIy operuLes on un
unLI-scIenLIIIc Irumework, Is now uccorded, by purLIcuIurIy LIe medIu und
muny medIcuIJIeuILI proIessIonuIs, LIe sLuLus oI u Iurd scIence.
Other Vital Matters
ronIcuIIy, IL muy very weII be LIuL us InvesLIguLors, especIuIIy Irom oLIer
reseurcI dIscIpIInes (e.g., psycIoIogy) come Lo LIeIr senses, IL wIII be LIe
IIgI degree oI mIsconducL (I.e., ussuuIL on scIence und psycIoIogIcuI,
socIuI und moruI IeuILI) In ILs LreuLmenL oI muny IIIesLyIe IucLors, und
purLIcuIurIy LIe smokIng Issue, LIuL wIII murk epIdemIoIogy`s IuII Irom ILs
IIIusory (IruuduIenLIy obLuIned) gruce.
JusL one oI muny oLIer conLroversIuI Issues InvoIves porLruyuIs
oI IILIguLIon concernIng smokIng. MedIcuI journuIs LypIcuIIy pubIIsI
urLIcIes LIuL IIgIIIgIL successIuI IILIguLIon uguInsL LIe Lobucco IndusLry -
Ior wIuLever reuson. SucI urLIcIes InvurIubIy uppIuud und encouruge sucI
IILIguLIon. TIere exIsLs no debuLe us Lo LIe sensIbIIILy or soundness oI
moLIvuLIon, und LIe repercussIons In greuLer, non-proIIbILIonIsL, socIuI
conLexL. or exumpIe, Duynurd eL uI. (zooo) provIde un enLIusIusLIc
upduLe on Lobucco IILIguLIon. One oI LIe urLIcIe`s IIgIIIgILs Is LIuL by 1qq8
LIe Lobucco IndusLry Iud seLLIed US MedIcuId IuwsuILs InsLILuLed by US
ALLorneys-GeneruI Lo recover cosLs Ior LreuLmenL oI dIseuses cttributcble
Lo smokIng. NowIere In LIIs urLIcIe or uny oLIer urLIcIe In medIcuI
journuIs Is IL menLIoned Iow LIIs IILIguLIon wus pursued.
evy (1qq;) IIgIIIgILs LIuL, umongsL oLIer corrupLIon oI
procedure, LIe US unLI-Lobucco IILIguLIon resLs on u rewrILIng oI US
IegIsIuLIon so LIuL LIe sLuLe Is noL even requIred Lo sIow LIuL u purLIcuIur
purLy wus Iurmed by IIs use oI Lobucco. nsLeud, cuusuLIon muy be proven
by sLuLIsLIcs uIone. L Is purLIcuIurIy LIIs poInL LIuL Is LIe greuL IoIIy oI
epIdemIoIogIc reusonIng und LIuL Ius been uIIowed Lo InIecL LIe
governmenLuI IeveI; u reusonIng LIuL Is repIeLe wILI InIerenLIuI IuIIucIes
Ius been ensIrIned In Iuw, mukIng wIuL Is IIImsy evIdence, uL besL,
suIIIcIenL Ior successIuI prosecuLIon.
evy (1qq;) properIy concIudes LIuL we ure deuIIng Iere wILI
moruI, poIILIcuI, und IeguI quesLIons LIuL Lrunscend uny sIngIe IndusLry. I
one reuds onIy medIcuI journuIs, IL wouId be ImpossIbIe Lo dIscern LIuL
unLI-Lobucco IILIguLIon Is u IIgIIy conLroversIuI Issue LIuL Ius Lo LIIs poInL
InvoIved LIe perverLIng oI due process (see uIso OukIey, 1qqq, CI.1z).
TIereIore, IL cun onIy be concIuded LIuL medIcuI perspecLIve represenLs u
sImpIe-mInded und seII-servIng vIew.
TIe uLLempL by epIdemIoIogyJprevenLIve medIcIne Lo porLruy LIe
Lobucco IndusLry us bIused und ubsorbed by seII-InLeresL wIIIe presenLIng
ILseII us beyond reproucI und reIIecLIng uII LIuL Is benevoIenL und
objecLIve, Is jusL unoLIer uspecL oI LIe greuL Iruud und Lrugedy In progress.
CorrupLIon oI objecLIvILy sucI us Iume Ior InvesLIguLors und InsLILuLIons,
IuLure reseurcI grunLs, und corporuLe proIILs... (SLeInbrook, zooo,
p.16;o) Is ever-presenL In LIe medIcuI esLubIIsImenL (see uIso WIILe,
zooo). TIe seII-seekIng conducL oI pIurmuceuLIcuI compunIes und oLIer
228
228
q.
Preoentioe Medicine & Heolth
Promotion
ndIvIduuI und pubIIc IeuILI Iuve bIoIogIcuI, psycIoIogIcuI,
socIuI, moruI und spIrILuuI uspecLs. TIe evuIuuLIon und dIssemInuLIon oI
InIormuLIon In LIe InLeresLs oI IeuILI Is u deIIcuLe buIuncIng exercIse. TIe
sILuuLIon Is IurLIer compIIcuLed by LIe emoLIon oI IeurJLerror ussocIuLed
wILI dIseuseJmorLuIILy und economIc Iorces LIuL wouId seek Lo expIoIL LIIs
Ieur. PuneIs convened Ior LIe evuIuuLIon oI uny evIdence requIre multi-
dimensioncl experLIse und InLegrILy oI conducL. A crucIuI LooI oI sucI
compreIensIve evuIuuLIon Is scIence und LIe scIenLIIIcJcuusuI sLuLus oI
purLIcuIur evIdence, und LIe pIucemenL oI scIence In greuLer muILI-
dImensIonuI conLexL. TIe prIme cIrcumsLunce LIuL sucI evuIuuLIon wIII
guurd uguInsL Is severe over-InLerpreLuLIon oI evIdence, I.e., reInIorcers oI
psycIoIogIcuI und psycIosocIuI III-IeuILI. Over-InLerpreLuLIon cun be Ied
by numerous IucLors, e.g., peLuIunce, wIIm, superIIcIuIILy, IncompeLence,
vesLed InLeresL, supersLILIon, IuugILIness, IuII-buked IdeoIogy. MucI oI
LIe work oI sucI evuIuuLIon puneIs wouId be LIe dismissin, us
scIenLIIIcuIIy vuIId, oI degrees oI over-InLerpreLuLIon oI duLu.
RIsk IucLors LIuL Iuve poor ubsoIuLe predIcLIve sLrengLI do not
meeL LIe requIremenLs oI cuusuI urgumenL Ior enLIre groups; prescrIpLIveJ
proscrIpLIve recommenduLIons, IeL uIone coercion In LIIs dIrecLIon, Iuve
no coIerenL busIs. TIe roIe oI IeuILI uuLIorILIes Is Lo presenL Iow-IeveI
rIsk InIormuLIon us sLuLIsLIcuIIy bused und LIuL Iow-IeveI rIsk disconjirms
u IucLor us u prImury cuuse oI uny specIIIc dIseuse. TIe uppruIsuI oI Iow-
IeveI rIsk InIormuLIon by IndIvIduuIs Is un enLIreIy subjectite muLLer. L Is u
IIgIIy reusonubIe posILIon LIuL muny IndIvIduuIs sImpIy dIsregurd sucI
IIImsy rIsk InIormuLIon In LIuL LIey do noL vIew IIIe us u Iong serIes oI
sLuLIsLIcuI gumbIes. WILIIn LIIs rIsk Irumework no one cun ever wIn In
LIuL us rIsk Ius supposedIy been reduced Ior one dIseuse, u person IInds
LIemseIves uL IIgIer rIsk oI unoLIer dIseuse, I.e., reurrungemenL oI LIe
deck cIuIrs on LIe TILunIc scenurIo: SucI u Irumework Is uIso devoId oI
uny LrunscendenL meunIngIuIness. n suner LImes, LIe demonsLruLIon oI
rIsk uversIon us u generuI Lendency, purLIcuIurIy on sLuLIsLIcuI InIormuLIon
Rampant Antismoking Signifies Grave Danger
medIcuI supporL corporuLIons und ILs eIIecL on medIcuI ruLIonuIes uIso
cunnoL be mInImIzed (e.g., see uIso MoynIIun eL uI., zooz; ILzgeruId,
zoo1). TIere Is no depIcLIon wIuLsoever In LIe medIcuI IILeruLure LIuL u
decIsIon Ior u smokeIree venue or dIspIuyIng posLers oI cIgureLLe
cessuLIon producLs cun uLLrucL pIurmuceuLIcuI compuny IundIng (e.g.,
see www.Iorces.org); unLIsmokIng provIdes u IIgIIy IucruLIve murkeL Ior
pIurmuceuLIcuI compunIes.
TIere Is uIso no IndIcuLIon In LIe medIcuI IILeruLure oI LIe LruIy
usLronomIcuI Iees upproprIuLed Lo LrIuI Iuwyers In successIuI unLI-
Lobucco IILIguLIon: or IorIdu, Texus und MIssIssIppI uIone, LIe puyoII un
urbILruLIon puneI uwurded Lo LIose sLuLes` Iuwyers wus $8.1 bIIIIon! - wILI
more bIIIIons Lo come Irom LIe seLLIemenL wILI MInnesoLu und LIe resL oI
LIe o sLuLes. (OukIey, 1qqq, CI.1z, p.z)
TIe ImporLunL Issue oI bIusJvesLed InLeresL In LIe medIcuI
esLubIIsImenL Is oI Iur, Iur greuLer concern LIun LIuL oI LIe Lobucco
IndusLry, Ior exumpIe, In LIe sIeer runge oI deLrImenLuI repercussIons Ior
psycIoIogIcuI, psycIosocIuI, und moruI IeuILI. TIe Lobucco IndusLry
represenLs LIe suIe oI u sIngIe producL; concerns ubouL LIIs producL ure
bused on quesLIonubIe epIdemIoIogIc surmIsIng. AILernuLIveIy, medIco-
muLerIuIIsm represenLs un IdeoIogIcuI worIdvIew LIuL cun demonsLruLe
muny oI LIe dungerous uspecLs oI LIe Iumun condILIon, e.g., IuscIsL
LendencIes. L Is onIy LIe IuLLer LIuL Is In desperuLe, urgenL need oI
scruLIny.
Preventive Medicine & Health Promotion
229
229
q.
Preoentioe Medicine & Heolth
Promotion
ndIvIduuI und pubIIc IeuILI Iuve bIoIogIcuI, psycIoIogIcuI,
socIuI, moruI und spIrILuuI uspecLs. TIe evuIuuLIon und dIssemInuLIon oI
InIormuLIon In LIe InLeresLs oI IeuILI Is u deIIcuLe buIuncIng exercIse. TIe
sILuuLIon Is IurLIer compIIcuLed by LIe emoLIon oI IeurJLerror ussocIuLed
wILI dIseuseJmorLuIILy und economIc Iorces LIuL wouId seek Lo expIoIL LIIs
Ieur. PuneIs convened Ior LIe evuIuuLIon oI uny evIdence requIre multi-
dimensioncl experLIse und InLegrILy oI conducL. A crucIuI LooI oI sucI
compreIensIve evuIuuLIon Is scIence und LIe scIenLIIIcJcuusuI sLuLus oI
purLIcuIur evIdence, und LIe pIucemenL oI scIence In greuLer muILI-
dImensIonuI conLexL. TIe prIme cIrcumsLunce LIuL sucI evuIuuLIon wIII
guurd uguInsL Is severe over-InLerpreLuLIon oI evIdence, I.e., reInIorcers oI
psycIoIogIcuI und psycIosocIuI III-IeuILI. Over-InLerpreLuLIon cun be Ied
by numerous IucLors, e.g., peLuIunce, wIIm, superIIcIuIILy, IncompeLence,
vesLed InLeresL, supersLILIon, IuugILIness, IuII-buked IdeoIogy. MucI oI
LIe work oI sucI evuIuuLIon puneIs wouId be LIe dismissin, us
scIenLIIIcuIIy vuIId, oI degrees oI over-InLerpreLuLIon oI duLu.
RIsk IucLors LIuL Iuve poor ubsoIuLe predIcLIve sLrengLI do not
meeL LIe requIremenLs oI cuusuI urgumenL Ior enLIre groups; prescrIpLIveJ
proscrIpLIve recommenduLIons, IeL uIone coercion In LIIs dIrecLIon, Iuve
no coIerenL busIs. TIe roIe oI IeuILI uuLIorILIes Is Lo presenL Iow-IeveI
rIsk InIormuLIon us sLuLIsLIcuIIy bused und LIuL Iow-IeveI rIsk disconjirms
u IucLor us u prImury cuuse oI uny specIIIc dIseuse. TIe uppruIsuI oI Iow-
IeveI rIsk InIormuLIon by IndIvIduuIs Is un enLIreIy subjectite muLLer. L Is u
IIgIIy reusonubIe posILIon LIuL muny IndIvIduuIs sImpIy dIsregurd sucI
IIImsy rIsk InIormuLIon In LIuL LIey do noL vIew IIIe us u Iong serIes oI
sLuLIsLIcuI gumbIes. WILIIn LIIs rIsk Irumework no one cun ever wIn In
LIuL us rIsk Ius supposedIy been reduced Ior one dIseuse, u person IInds
LIemseIves uL IIgIer rIsk oI unoLIer dIseuse, I.e., reurrungemenL oI LIe
deck cIuIrs on LIe TILunIc scenurIo: SucI u Irumework Is uIso devoId oI
uny LrunscendenL meunIngIuIness. n suner LImes, LIe demonsLruLIon oI
rIsk uversIon us u generuI Lendency, purLIcuIurIy on sLuLIsLIcuI InIormuLIon
Rampant Antismoking Signifies Grave Danger
medIcuI supporL corporuLIons und ILs eIIecL on medIcuI ruLIonuIes uIso
cunnoL be mInImIzed (e.g., see uIso MoynIIun eL uI., zooz; ILzgeruId,
zoo1). TIere Is no depIcLIon wIuLsoever In LIe medIcuI IILeruLure LIuL u
decIsIon Ior u smokeIree venue or dIspIuyIng posLers oI cIgureLLe
cessuLIon producLs cun uLLrucL pIurmuceuLIcuI compuny IundIng (e.g.,
see www.Iorces.org); unLIsmokIng provIdes u IIgIIy IucruLIve murkeL Ior
pIurmuceuLIcuI compunIes.
TIere Is uIso no IndIcuLIon In LIe medIcuI IILeruLure oI LIe LruIy
usLronomIcuI Iees upproprIuLed Lo LrIuI Iuwyers In successIuI unLI-
Lobucco IILIguLIon: or IorIdu, Texus und MIssIssIppI uIone, LIe puyoII un
urbILruLIon puneI uwurded Lo LIose sLuLes` Iuwyers wus $8.1 bIIIIon! - wILI
more bIIIIons Lo come Irom LIe seLLIemenL wILI MInnesoLu und LIe resL oI
LIe o sLuLes. (OukIey, 1qqq, CI.1z, p.z)
TIe ImporLunL Issue oI bIusJvesLed InLeresL In LIe medIcuI
esLubIIsImenL Is oI Iur, Iur greuLer concern LIun LIuL oI LIe Lobucco
IndusLry, Ior exumpIe, In LIe sIeer runge oI deLrImenLuI repercussIons Ior
psycIoIogIcuI, psycIosocIuI, und moruI IeuILI. TIe Lobucco IndusLry
represenLs LIe suIe oI u sIngIe producL; concerns ubouL LIIs producL ure
bused on quesLIonubIe epIdemIoIogIc surmIsIng. AILernuLIveIy, medIco-
muLerIuIIsm represenLs un IdeoIogIcuI worIdvIew LIuL cun demonsLruLe
muny oI LIe dungerous uspecLs oI LIe Iumun condILIon, e.g., IuscIsL
LendencIes. L Is onIy LIe IuLLer LIuL Is In desperuLe, urgenL need oI
scruLIny.
Preventive Medicine & Health Promotion
230
230
Rampant Antismoking Signifies Grave Danger
IuckIng uny sound cuusuI LIeme, wouId be consIdered neuroLIc.
TIereIore, u crILIcuI concern oI coIerenL IeuILI udvIsemenL Is LIe
proLecLIon oI u normuLIve runge oI IuncLIonIng, I.e., proLecLIon oI LIe weII
popuIuLIon Irom mIsrepresenLed InIormuLIon LIuL cun Iuve deLrImenLuI
psycIoIogIcuI, socIuI und moruI consequences. TIe socIuI munduLe oI LIe
medIcuI esLubIIsImenL concerns LIe prImury cure oI III persons. TIe weII
popuIuLIon Is noL LIe reuIm oI LIe medIcuI esLubIIsImenL. I LIe medIcuI
esLubIIsImenL wIsIes Lo uddress LIe weII popuIuLIon Ior prevenLIon
purposes, LIen IL requIres exLremeIy good evIdence, I.e., IIgI-IeveI
predIcLors, Ior so doIng.
(.: The Mctericlist Mcnijesto
L Ius been consIdered LIuL LIe MedIco-MuLerIuIIsL-ExLernuIIsL-
SLuLIsLIcuI worIdvIew ImproperIy eIevuLes, und by muny orders oI
mugnILude, LIe Ideu oI sLuLIsLIcuI rIsk und prescrIbes sLuLIsLIcuI-rIsk
uversIon us objecLIve und normuLIve. BeIng un upsIde-down, buck-Lo-IronL
LIInkIng, IL ImproperIy vIews ILs reusonIng us ruLIonuI. L LIen obvIousIy
regurds uny devIuLIon or dIssenL Irom LIIs dogmu us IrruLIonuI. L Is
purLIcuIurIy LIIs combInuLIon oI IrruLIonuIILy und IuugILIness LIuL Ius
been cIurucLerIzed us LIe superiorit sndrome.
TIe Ideu oI rIsk uversIon, In wIuLever Lerms, Is u pecuIIurILy oI
LIe muLerIuIIsL menLuIILy. HIII (1;61) suggesLed:
eL IL noL uppeur sLrunge, LIuL snuII, wIIcI cun eIIecL uII
LIIs mIscIIeI, Is noL Iound In every InsLunce Lo do IL. n
muny persons IL Is LIe cuuse oI dIsorders, wIIcI LIey
perIups do noL uLLrIbuLe Lo IL, und oI wIIcI LIeIr
pIysIcIun IImseII muy seek some oLIer cuuse: buL II LIe
number wus smuII oI LIose wIo suIIer, In compurIson oI
LIose wIo Luke snuII, wIuL wIse person wouId yeL
enguge In IL? I onIy IIve In un Iundred ruIned LIeIr
consLILuLIons by IL, wIo sIuII be ubIe Lo suy, wIen Ie
enLers on LIe cusLom, wIeLIer Ie sIuII be one oI LIe
nIneLy-IIve wIo escupe, or oI LIe IIve LIuL perIsI?
(quoLed In Redmond, 1q;o, p.zz)
nLeresLIng Is LIe IuIImurk, erroneous sIIIL beLween probubIIIsLIc
und deLermInIsLIc Irumeworks LIuL Imbues exLernuIILIes wILI mugIc
powers (buck-Lo-IronL LIInkIng). Even more LeIIIng Is LIe LreuLmenL oI u
normuLIve runge oI q% us Iucky In escupIng u deLrImenLuI ouLcome. L
wouId, ruLIer, be Iucky II LIe normuLIve runge oI q% concerned u
deLrImenLuI ouLcome und wIere u person wus one oI LIe % noL Lo
Preventive Medicine & Health Promotion
succumb. TIe menLuIILy becomes IIxuLed on u possIbIe deLrImenLuI
ouLcome (upsIde-down LIInkIng), dIsregurds LIuL LIe predIcLor InvoIved Is
very poor (%), In wIIcI cuse even LIe LrIgger sLuLus oI sucI u IucLor Is In
quesLIon, und IL Is enLIreIy obIIvIous Lo LIe deLrImenLuI psycIoIogIcuI
rumIIIcuLIons oI preucIIng mugIc powers urgumenLs.
HIII (1;61) couId be gIven LIe beneIIL oI LIe doubL In LIuL LIe
scIenLIIIc meLIod wus noL InLroduced InLo medIcuI enquIry wILI uny rIgor
unLII LIIs IusL cenLury. However, LIe menLuIILy sLIII persIsLs. or exumpIe,
IoIIowIng LIe SG ReporL (1q6q), BernsLeIn (1q6q) posILs: TIe quesLIon oI
wIy LIe mujorILy oI smokers does noL quIL In IIgIL oI LIe uvuIIubIe
evIdence Is noL un eusy one. (p.q1q)
AIso, unLIsmokIng und dIeLury senLImenL umongsL medIcuI
prucLILIoners wus noL dormunL prIor Lo SG (1q6q), onIy Lo LIen be sLIrred
up by LIIs reporL. TIe moLIon pIcLure The Seten-Yecr Itch (CInemuscope,
1q), sLurrIng MurIIyn Monroe, Ius LIe Ieud cIurucLer (Tom EweII)
seeIng IIs wIIe und son oII uL LIe LruIn sLuLIon Ior u summer vucuLIon. TIe
wIIe remInds Ier Iusbund ubouL LIe docLor`s wurnIng Lo sLuy uwuy Irom
LIe cIgureLLes und uIcoIoI. TIere Is no IndIcuLIon LIuL Ie Is suIIerIng Irom
uny muIudy. n LIe IIrsL Len mInuLes oI LIe IIIm, LIe Ieud cIurucLer Is seen
wresLIIng wILI LIe cIgureLLe puck In IIs sIIrL pockeL. He uIso IuncIes uL u
IeuILI Iood (vegeLurIun) dIner. TIIs wus q yeurs beIore LIe SG ReporL
(1q6q), or LIe even more recenL burruge on dIeLury IeuILI.
L seems LIuL durIng LIe eurIy-Lo-mId-1q;o`s, u crILIcuI sIIIL In
perspecLIve occurred umongsL IeuILI uuLIorILIes. TIIs wus possIbIy
propeIIed by SG (1q6q), buL cerLuInIy domInuLed by medIco-muLerIuIIsm.
TIe newIy-InLroduced epIdemIoIogIc meLIod und use oI meLu-unuIysIs
uIIowed LIe quunLIIIcuLIon oI rIsk, Iowever reIevunL LIIs sLuLIsLIcuI concepL
or LIe superIIcIuIILy oI muLerIuIIsL InLerpreLuLIon oI LIIs concepL Is Lo un
undersLundIng oI LIe Iumun condILIon.
PopuIuLIon-bused sLuLIsLIcs becume LIe busIs Ior IeuILI
promoLIon, I.e., IIIesLyIe prescrIpLIons. UnLII LIIs LIme governmenLs In
democruLIc socIeLIes dId noL see LIeIr roIe us InLervenIng In muLLers oI
wIuL were consIdered IndIvIduuI responsIbIIILy. TIe use by governmenLs
oI popuIuLIon-bused sLuLIsLIcs Ior unyLIIng oLIer LIun LIe pIunnIng oI
scIooIs, rouds, LrunsporL, eLc., Is dungerous Lo LIe Ideu oI democruLIc
sysLems: PopuIuLIon-bused InIormuLIon oI quesLIonubIe cuusuI und
IndIvIduuI deIInILIon Is u IundumenLuI uspecL oI nuLIonuIIsL, socIuIIsL or
communIsL sysLems.
BerrIdge (1qqq) IndIcuLes LIuL durIng LIIs LIme LIe muLerIuIIsL
Ideu oI LIe rIsk uvoIdIng IndIvIduuI wus esLubIIsIed us LIe busIs Ior
IeuILI promoLIon. L Is Irom LIIs LIme LIuL IeuILI uuLIorILIes udopLed un
unLIsmokIng sLunce. TIe IubIL wus depIcLed In progressIveIy more
231
231
Rampant Antismoking Signifies Grave Danger
IuckIng uny sound cuusuI LIeme, wouId be consIdered neuroLIc.
TIereIore, u crILIcuI concern oI coIerenL IeuILI udvIsemenL Is LIe
proLecLIon oI u normuLIve runge oI IuncLIonIng, I.e., proLecLIon oI LIe weII
popuIuLIon Irom mIsrepresenLed InIormuLIon LIuL cun Iuve deLrImenLuI
psycIoIogIcuI, socIuI und moruI consequences. TIe socIuI munduLe oI LIe
medIcuI esLubIIsImenL concerns LIe prImury cure oI III persons. TIe weII
popuIuLIon Is noL LIe reuIm oI LIe medIcuI esLubIIsImenL. I LIe medIcuI
esLubIIsImenL wIsIes Lo uddress LIe weII popuIuLIon Ior prevenLIon
purposes, LIen IL requIres exLremeIy good evIdence, I.e., IIgI-IeveI
predIcLors, Ior so doIng.
(.: The Mctericlist Mcnijesto
L Ius been consIdered LIuL LIe MedIco-MuLerIuIIsL-ExLernuIIsL-
SLuLIsLIcuI worIdvIew ImproperIy eIevuLes, und by muny orders oI
mugnILude, LIe Ideu oI sLuLIsLIcuI rIsk und prescrIbes sLuLIsLIcuI-rIsk
uversIon us objecLIve und normuLIve. BeIng un upsIde-down, buck-Lo-IronL
LIInkIng, IL ImproperIy vIews ILs reusonIng us ruLIonuI. L LIen obvIousIy
regurds uny devIuLIon or dIssenL Irom LIIs dogmu us IrruLIonuI. L Is
purLIcuIurIy LIIs combInuLIon oI IrruLIonuIILy und IuugILIness LIuL Ius
been cIurucLerIzed us LIe superiorit sndrome.
TIe Ideu oI rIsk uversIon, In wIuLever Lerms, Is u pecuIIurILy oI
LIe muLerIuIIsL menLuIILy. HIII (1;61) suggesLed:
eL IL noL uppeur sLrunge, LIuL snuII, wIIcI cun eIIecL uII
LIIs mIscIIeI, Is noL Iound In every InsLunce Lo do IL. n
muny persons IL Is LIe cuuse oI dIsorders, wIIcI LIey
perIups do noL uLLrIbuLe Lo IL, und oI wIIcI LIeIr
pIysIcIun IImseII muy seek some oLIer cuuse: buL II LIe
number wus smuII oI LIose wIo suIIer, In compurIson oI
LIose wIo Luke snuII, wIuL wIse person wouId yeL
enguge In IL? I onIy IIve In un Iundred ruIned LIeIr
consLILuLIons by IL, wIo sIuII be ubIe Lo suy, wIen Ie
enLers on LIe cusLom, wIeLIer Ie sIuII be one oI LIe
nIneLy-IIve wIo escupe, or oI LIe IIve LIuL perIsI?
(quoLed In Redmond, 1q;o, p.zz)
nLeresLIng Is LIe IuIImurk, erroneous sIIIL beLween probubIIIsLIc
und deLermInIsLIc Irumeworks LIuL Imbues exLernuIILIes wILI mugIc
powers (buck-Lo-IronL LIInkIng). Even more LeIIIng Is LIe LreuLmenL oI u
normuLIve runge oI q% us Iucky In escupIng u deLrImenLuI ouLcome. L
wouId, ruLIer, be Iucky II LIe normuLIve runge oI q% concerned u
deLrImenLuI ouLcome und wIere u person wus one oI LIe % noL Lo
Preventive Medicine & Health Promotion
succumb. TIe menLuIILy becomes IIxuLed on u possIbIe deLrImenLuI
ouLcome (upsIde-down LIInkIng), dIsregurds LIuL LIe predIcLor InvoIved Is
very poor (%), In wIIcI cuse even LIe LrIgger sLuLus oI sucI u IucLor Is In
quesLIon, und IL Is enLIreIy obIIvIous Lo LIe deLrImenLuI psycIoIogIcuI
rumIIIcuLIons oI preucIIng mugIc powers urgumenLs.
HIII (1;61) couId be gIven LIe beneIIL oI LIe doubL In LIuL LIe
scIenLIIIc meLIod wus noL InLroduced InLo medIcuI enquIry wILI uny rIgor
unLII LIIs IusL cenLury. However, LIe menLuIILy sLIII persIsLs. or exumpIe,
IoIIowIng LIe SG ReporL (1q6q), BernsLeIn (1q6q) posILs: TIe quesLIon oI
wIy LIe mujorILy oI smokers does noL quIL In IIgIL oI LIe uvuIIubIe
evIdence Is noL un eusy one. (p.q1q)
AIso, unLIsmokIng und dIeLury senLImenL umongsL medIcuI
prucLILIoners wus noL dormunL prIor Lo SG (1q6q), onIy Lo LIen be sLIrred
up by LIIs reporL. TIe moLIon pIcLure The Seten-Yecr Itch (CInemuscope,
1q), sLurrIng MurIIyn Monroe, Ius LIe Ieud cIurucLer (Tom EweII)
seeIng IIs wIIe und son oII uL LIe LruIn sLuLIon Ior u summer vucuLIon. TIe
wIIe remInds Ier Iusbund ubouL LIe docLor`s wurnIng Lo sLuy uwuy Irom
LIe cIgureLLes und uIcoIoI. TIere Is no IndIcuLIon LIuL Ie Is suIIerIng Irom
uny muIudy. n LIe IIrsL Len mInuLes oI LIe IIIm, LIe Ieud cIurucLer Is seen
wresLIIng wILI LIe cIgureLLe puck In IIs sIIrL pockeL. He uIso IuncIes uL u
IeuILI Iood (vegeLurIun) dIner. TIIs wus q yeurs beIore LIe SG ReporL
(1q6q), or LIe even more recenL burruge on dIeLury IeuILI.
L seems LIuL durIng LIe eurIy-Lo-mId-1q;o`s, u crILIcuI sIIIL In
perspecLIve occurred umongsL IeuILI uuLIorILIes. TIIs wus possIbIy
propeIIed by SG (1q6q), buL cerLuInIy domInuLed by medIco-muLerIuIIsm.
TIe newIy-InLroduced epIdemIoIogIc meLIod und use oI meLu-unuIysIs
uIIowed LIe quunLIIIcuLIon oI rIsk, Iowever reIevunL LIIs sLuLIsLIcuI concepL
or LIe superIIcIuIILy oI muLerIuIIsL InLerpreLuLIon oI LIIs concepL Is Lo un
undersLundIng oI LIe Iumun condILIon.
PopuIuLIon-bused sLuLIsLIcs becume LIe busIs Ior IeuILI
promoLIon, I.e., IIIesLyIe prescrIpLIons. UnLII LIIs LIme governmenLs In
democruLIc socIeLIes dId noL see LIeIr roIe us InLervenIng In muLLers oI
wIuL were consIdered IndIvIduuI responsIbIIILy. TIe use by governmenLs
oI popuIuLIon-bused sLuLIsLIcs Ior unyLIIng oLIer LIun LIe pIunnIng oI
scIooIs, rouds, LrunsporL, eLc., Is dungerous Lo LIe Ideu oI democruLIc
sysLems: PopuIuLIon-bused InIormuLIon oI quesLIonubIe cuusuI und
IndIvIduuI deIInILIon Is u IundumenLuI uspecL oI nuLIonuIIsL, socIuIIsL or
communIsL sysLems.
BerrIdge (1qqq) IndIcuLes LIuL durIng LIIs LIme LIe muLerIuIIsL
Ideu oI LIe rIsk uvoIdIng IndIvIduuI wus esLubIIsIed us LIe busIs Ior
IeuILI promoLIon. L Is Irom LIIs LIme LIuL IeuILI uuLIorILIes udopLed un
unLIsmokIng sLunce. TIe IubIL wus depIcLed In progressIveIy more
232
232
Rampant Antismoking Signifies Grave Danger
neguLIve Lerms. L Is LIe busIs Ior SG (1q88) wIere smokIng wus re-
deIIned us un uddIcLIon und dIseuse, und wus consIdered onl In neguLIve
Lerms. SInce LIen, unLIsmokIng und muLerIuIIsL IeuILI promoLIon
generuIIy Iuve become progressIveIy more uggressIve und conLroIIIng (I.e.,
domIneerIng, dIcLuLorIuI). As wIII be consIdered IuLer, LIIs Is onIy one
uspecL oI un overuII muLerIuIIsL munIIesLo In keepIng wILI LIe SkInnerIun
Ideu oI socIuIIy engIneerIng LIe muLerIuIIsL uLopIu (see uIso secLIon
Rcdiccl ehctiorism). TIe mId-1q;o`s wus LIe begInnIng oI u desLrucLIve
perIod In Lerms oI spIrILuuI, moruI, reIuLIonuI, und psycIoIogIcuI IeuILI.
(.z Pretentite Medicine
PrevenLIve medIcIne reIers Lo LIe uLLempL Lo cIrcumvenL
ueLIoIogIcuI IucLors In dIseuseJmorLuIILy, I.e., uIIowIng LIe uvoIdunce oI
IIgIIy probubIe und deLrImenLuI ouLcomes. PrevenLIve medIcIne, by
deIInILIon, sIouId noL be LIe IInuI IeuILI reIeree In LIuL IeuILI Is Iur
more LIun u medIcuI Issue. PrevenLIve medIcIne, und underIuIn by MMES
reusonIng, ImproperIy sIIILs u crILIcuI Iocus oI LIe medIcuI esLubIIsImenL
on LIe weII popuIuLIon. WIen un MMES Irumework wIoIIy occupIes LIe
reusonIng oI IeuILI uuLIorILIes, LIen LIe muILI-dImensIonuI uspecL oI
IeuILI Ius been vIoIuLed. PrevenLIve medIcIne Is LypIcuIIy prucLIced on Lwo
IeveIs: eurIy deLecLIon (LIrougI screenIng) und rIsk-reducLIonJ
eIImInuLIon, e.g., see KupIun, zooo. As wIII be consIdered, boLI IeveIs ure
IIgIIy probIemuLIc.
TIIs cIupLer wIII concern Iow prevenLIve medIcIne, by wuy oI
pubIIc IeuILI uuLIorILIes, Ius Luken up LIIs MMES IIIesLyIe Ideu und Ius
uLLempLed Lo InIIIcL IL upon LIe pubIIc In muny WesLern nuLIons. TIe
IeuILI promoLIon Is usuuIIy uggressIve und, more recenLIy, even IosLIIe.
Ouks (zoo1) noLes LIuL gIven LIe pervusIveness oI Loduy`s 'cIoose u
IeuILIy IIIesLyIe` messuge - Irom LeIevIsIon pubIIc servIce unnouncemenLs
Lo breukIusL cereuI boxes - IL Is surprIsIng LIuL LIe noLIon LIuL we ougIL Lo
unuIyze our rIsk IucLors und modIIy our IeuILI beIuvIors Lo prevenL
dIseuse Is quILe recenL. L wus noL unLII LIe mId-1q;o`s LIuL IeuILI
proIessIonuIs Lurned LIeIr uLLenLIon Lo IndIvIduuI und group IIIesLyIe
IucLors LIuL pIuce peopIe uL rIsk oI IIIness und deuLI, sucI us smokIng,
drInkIng, IIgI-IuL dIeL, sexuuI ucLIvILy und sLress. (p. 8q)
Over LIe IusL Lwo or LIree decudes LIe vIew oI IeuILI Ius
coIIupsed InLo un ubsence oI dIseuse or IIIness modeI (I.e., muLerIuIIsL -
bioloiccl cnd behctiorcl - domInuLIon); u sound Ideu oI psycIoIogIcuI
und socIuI IeuILI Ius been jeLLIsoned Irom consIderuLIon. TIere ure
cerLuInIy sLrong economIc Iorces LIuL Iuvor IeuILI promoLIon In LIIs
conLorLed Iorm. TIese economIc Iorces ure sImpIy unoLIer uspecL oI u
Preventive Medicine & Health Promotion
muLerIuIIsL ussuuIL on Iumun IuncLIonIng. TIIs rIsk-bused Ideu oI
prevenLIve medIcIne gIves LIe medIcuI esLubIIsImenL uccess Lo LIe
popuIuLIon uL Iurge. No Ionger Is IL concerned wILI onIy LIe sIck, buL cun
now Lup InLo LIe Iur Iurger pooI oI IeuILIy persons. TIrougI LIe use oI
purLIcuIur (Iow-IeveI) rIsk IucLors, erroneousIy eIevuLed Lo uppeur IIgIIy
ImporLunL, LIere Is uccess Lo u very Iurge voIume oI persons negoLIuLIng
LIe medIcuI producLIon-IIne oI LesLIngs, screenIngs, und IeuILI
educuLIon. TIere Is u wIoIe super-IndusLry LIuL Ius been buIIL on LIIs
muLerIuIIsL versIon oI IeuILI, e.g., dIugnosLIc servIces, puLIoIogy servIces,
pIurmuceuLIcuI compunIes, specIuIIsLs, super-specIuIIsLs, medIcuI
equIpmenL munuIucLurers, eLc.. TIIs medIcuI producLIon-IIne Is occupIed
Ior LIe mosL purL In LIe InvesLIguLIon oI non-dIseuse, I.e., InIormIng
persons LIuL LIey ure bIoIogIcuIIy weII.
By ImproperIy usIng Iow-IeveI sLuLIsLIcuI rIsk Lo urgue Ior cuusuI
reIuLIonsIIps IoIdIng beLween evenLs, medIco-muLerIuIIsm Ius been ubIe
Lo generuLe esLImuLes oI economIc cosL ussocIuLed wILI purLIcuIur
beIuvIor, e.g., smokIng, dIeL. L Ius LIen munuged Lo IruuduIenLIy
convInce governmenLs LIuL by udIerence Lo rIsk-bused IeuILI promoLIon
LIuL, IIrsLIy, Income (economIc opporLunIsm) cun be generuLed by un ever-
expundIng medIcuI-producLIon IIne und, secondIy, LIuL IL wIII suve
(economIc ruLIonuIIsm) on LreuLmenL expendILure In LIe Iong Lerm. TIe
urgumenL Is LIuL IeuILI educuLIon Is cIeuper LIun medIcuI LreuLmenL In
LIe Iong Lerm. TIIs reIIecLs no more LIun LIe muLerIuIIsL quunLIIIcuLIon
und commercIuIIzuLIon oI IeuILI. WIuL LIIs cctucll meuns Is LIuL
ussuuILs on psycIoIogIcuI und socIuI IeuILI ure cIeup, requIre IILLIe
LIougIL, und ure IucruLIve; noL onIy does muLerIuIIsm noL Iuve Lo IucLor In
LIe cosLs Lo psycIoIogIcuI, socIuI und moruI IeuILI oI ILs conducL, IL Is
obIIvIous Lo LIese dImensIons.
PrevenLIve medIcIne, In scIenLIIIc Lerms, onIy Ius poLenLIuI
jusLIIIcuLIon, und LIen onIy In muILI-dImensIonuI conLexL, wIere cuusuI
processes In dIseuseJmorLuIILy Iuve been cIeurIy demonsLruLed und
reIIecLed In IIgI-IeveI predIcLors Ior sucI dIseuseJmorLuIILy. ConcernIng
sucI dIseuses us cuncer und CHD LIere Is no sucI demonsLruLIon. n LIIs
regurd LIe muLerIuIIsL Ideu oI prevenLIve medIcIne Is enLIreIy predIcuLed
on IuIse premIses. UnIorLunuLeIy, LIe IIurry oI LesLIng ucLIvILy und LIe
propuguLIon oI numerous rIsk IucLors IosLers LIe mIspercepLIon In LIe
pubIIc uL Iurge LIuL LIe medIcuI esLubIIsImenL undersLunds Iur, Iur more
LIun IL ucLuuIIy does. WIuL becomes more und more uppurenL und
dIsLurbIng Is jusL Iow IILLIe undersLundIng Is demonsLruLed by IeuILI
proIessIonuIs ubouL sLuLIsLIcuI InIerence, scIenLIIIc enquIry, psycIoIogIcuI,
socIuI und moruI IeuILI.
n LIe IusL number oI decudes, und propeIIed muInIy by
233
233
Rampant Antismoking Signifies Grave Danger
neguLIve Lerms. L Is LIe busIs Ior SG (1q88) wIere smokIng wus re-
deIIned us un uddIcLIon und dIseuse, und wus consIdered onl In neguLIve
Lerms. SInce LIen, unLIsmokIng und muLerIuIIsL IeuILI promoLIon
generuIIy Iuve become progressIveIy more uggressIve und conLroIIIng (I.e.,
domIneerIng, dIcLuLorIuI). As wIII be consIdered IuLer, LIIs Is onIy one
uspecL oI un overuII muLerIuIIsL munIIesLo In keepIng wILI LIe SkInnerIun
Ideu oI socIuIIy engIneerIng LIe muLerIuIIsL uLopIu (see uIso secLIon
Rcdiccl ehctiorism). TIe mId-1q;o`s wus LIe begInnIng oI u desLrucLIve
perIod In Lerms oI spIrILuuI, moruI, reIuLIonuI, und psycIoIogIcuI IeuILI.
(.z Pretentite Medicine
PrevenLIve medIcIne reIers Lo LIe uLLempL Lo cIrcumvenL
ueLIoIogIcuI IucLors In dIseuseJmorLuIILy, I.e., uIIowIng LIe uvoIdunce oI
IIgIIy probubIe und deLrImenLuI ouLcomes. PrevenLIve medIcIne, by
deIInILIon, sIouId noL be LIe IInuI IeuILI reIeree In LIuL IeuILI Is Iur
more LIun u medIcuI Issue. PrevenLIve medIcIne, und underIuIn by MMES
reusonIng, ImproperIy sIIILs u crILIcuI Iocus oI LIe medIcuI esLubIIsImenL
on LIe weII popuIuLIon. WIen un MMES Irumework wIoIIy occupIes LIe
reusonIng oI IeuILI uuLIorILIes, LIen LIe muILI-dImensIonuI uspecL oI
IeuILI Ius been vIoIuLed. PrevenLIve medIcIne Is LypIcuIIy prucLIced on Lwo
IeveIs: eurIy deLecLIon (LIrougI screenIng) und rIsk-reducLIonJ
eIImInuLIon, e.g., see KupIun, zooo. As wIII be consIdered, boLI IeveIs ure
IIgIIy probIemuLIc.
TIIs cIupLer wIII concern Iow prevenLIve medIcIne, by wuy oI
pubIIc IeuILI uuLIorILIes, Ius Luken up LIIs MMES IIIesLyIe Ideu und Ius
uLLempLed Lo InIIIcL IL upon LIe pubIIc In muny WesLern nuLIons. TIe
IeuILI promoLIon Is usuuIIy uggressIve und, more recenLIy, even IosLIIe.
Ouks (zoo1) noLes LIuL gIven LIe pervusIveness oI Loduy`s 'cIoose u
IeuILIy IIIesLyIe` messuge - Irom LeIevIsIon pubIIc servIce unnouncemenLs
Lo breukIusL cereuI boxes - IL Is surprIsIng LIuL LIe noLIon LIuL we ougIL Lo
unuIyze our rIsk IucLors und modIIy our IeuILI beIuvIors Lo prevenL
dIseuse Is quILe recenL. L wus noL unLII LIe mId-1q;o`s LIuL IeuILI
proIessIonuIs Lurned LIeIr uLLenLIon Lo IndIvIduuI und group IIIesLyIe
IucLors LIuL pIuce peopIe uL rIsk oI IIIness und deuLI, sucI us smokIng,
drInkIng, IIgI-IuL dIeL, sexuuI ucLIvILy und sLress. (p. 8q)
Over LIe IusL Lwo or LIree decudes LIe vIew oI IeuILI Ius
coIIupsed InLo un ubsence oI dIseuse or IIIness modeI (I.e., muLerIuIIsL -
bioloiccl cnd behctiorcl - domInuLIon); u sound Ideu oI psycIoIogIcuI
und socIuI IeuILI Ius been jeLLIsoned Irom consIderuLIon. TIere ure
cerLuInIy sLrong economIc Iorces LIuL Iuvor IeuILI promoLIon In LIIs
conLorLed Iorm. TIese economIc Iorces ure sImpIy unoLIer uspecL oI u
Preventive Medicine & Health Promotion
muLerIuIIsL ussuuIL on Iumun IuncLIonIng. TIIs rIsk-bused Ideu oI
prevenLIve medIcIne gIves LIe medIcuI esLubIIsImenL uccess Lo LIe
popuIuLIon uL Iurge. No Ionger Is IL concerned wILI onIy LIe sIck, buL cun
now Lup InLo LIe Iur Iurger pooI oI IeuILIy persons. TIrougI LIe use oI
purLIcuIur (Iow-IeveI) rIsk IucLors, erroneousIy eIevuLed Lo uppeur IIgIIy
ImporLunL, LIere Is uccess Lo u very Iurge voIume oI persons negoLIuLIng
LIe medIcuI producLIon-IIne oI LesLIngs, screenIngs, und IeuILI
educuLIon. TIere Is u wIoIe super-IndusLry LIuL Ius been buIIL on LIIs
muLerIuIIsL versIon oI IeuILI, e.g., dIugnosLIc servIces, puLIoIogy servIces,
pIurmuceuLIcuI compunIes, specIuIIsLs, super-specIuIIsLs, medIcuI
equIpmenL munuIucLurers, eLc.. TIIs medIcuI producLIon-IIne Is occupIed
Ior LIe mosL purL In LIe InvesLIguLIon oI non-dIseuse, I.e., InIormIng
persons LIuL LIey ure bIoIogIcuIIy weII.
By ImproperIy usIng Iow-IeveI sLuLIsLIcuI rIsk Lo urgue Ior cuusuI
reIuLIonsIIps IoIdIng beLween evenLs, medIco-muLerIuIIsm Ius been ubIe
Lo generuLe esLImuLes oI economIc cosL ussocIuLed wILI purLIcuIur
beIuvIor, e.g., smokIng, dIeL. L Ius LIen munuged Lo IruuduIenLIy
convInce governmenLs LIuL by udIerence Lo rIsk-bused IeuILI promoLIon
LIuL, IIrsLIy, Income (economIc opporLunIsm) cun be generuLed by un ever-
expundIng medIcuI-producLIon IIne und, secondIy, LIuL IL wIII suve
(economIc ruLIonuIIsm) on LreuLmenL expendILure In LIe Iong Lerm. TIe
urgumenL Is LIuL IeuILI educuLIon Is cIeuper LIun medIcuI LreuLmenL In
LIe Iong Lerm. TIIs reIIecLs no more LIun LIe muLerIuIIsL quunLIIIcuLIon
und commercIuIIzuLIon oI IeuILI. WIuL LIIs cctucll meuns Is LIuL
ussuuILs on psycIoIogIcuI und socIuI IeuILI ure cIeup, requIre IILLIe
LIougIL, und ure IucruLIve; noL onIy does muLerIuIIsm noL Iuve Lo IucLor In
LIe cosLs Lo psycIoIogIcuI, socIuI und moruI IeuILI oI ILs conducL, IL Is
obIIvIous Lo LIese dImensIons.
PrevenLIve medIcIne, In scIenLIIIc Lerms, onIy Ius poLenLIuI
jusLIIIcuLIon, und LIen onIy In muILI-dImensIonuI conLexL, wIere cuusuI
processes In dIseuseJmorLuIILy Iuve been cIeurIy demonsLruLed und
reIIecLed In IIgI-IeveI predIcLors Ior sucI dIseuseJmorLuIILy. ConcernIng
sucI dIseuses us cuncer und CHD LIere Is no sucI demonsLruLIon. n LIIs
regurd LIe muLerIuIIsL Ideu oI prevenLIve medIcIne Is enLIreIy predIcuLed
on IuIse premIses. UnIorLunuLeIy, LIe IIurry oI LesLIng ucLIvILy und LIe
propuguLIon oI numerous rIsk IucLors IosLers LIe mIspercepLIon In LIe
pubIIc uL Iurge LIuL LIe medIcuI esLubIIsImenL undersLunds Iur, Iur more
LIun IL ucLuuIIy does. WIuL becomes more und more uppurenL und
dIsLurbIng Is jusL Iow IILLIe undersLundIng Is demonsLruLed by IeuILI
proIessIonuIs ubouL sLuLIsLIcuI InIerence, scIenLIIIc enquIry, psycIoIogIcuI,
socIuI und moruI IeuILI.
n LIe IusL number oI decudes, und propeIIed muInIy by
234
234
Rampant Antismoking Signifies Grave Danger
LecInoIogIcuI udvuncemenLs LIuL muke muss screenIngs possIbIe, LIe
medIcuI esLubIIsImenL Ius mude use oI reIuLIve rIsk IucLors In uLLempLIng
Lo IdenLIIy dIseuse eurIy In ILs process, I.e., drIIL-neL IIsIIng meLupIor.
or exumpIe, women over o ure encouruged Lo undergo reguIur (e.g.,
yeurIy) screenIng Ior breusL cuncer. DIseuse Is deLecLed onIy In u very
smuII percenLuge oI purLIcIpunLs gIven LIuL LIe reIuLIve rIsk IucLors beIng
used ure very poor predIcLors, I.e., LIe ueLIoIogy oI purLIcuIur dIseuses Is
not undersLood. As uIreudy noLed LIIs reIIecLs u depurLure Irom LIe
medIcuI esLubIIsImenL`s LrudILIonuI roIe oI prImury cure oI LIe sIck.
urLIermore, IL resLs on u very unsLubIe IounduLIon In LIuL IL opens up u
Pundoru`s Box oI poLenLIuI IuLrogenIc psycIopuLIoIogy, e.g., unxIeLy
reucLIons, IypocIondrIu, depressIon. or exumpIe, wIuL Is LIe sLuLe oI
mInd, oter c lijetime, oI u womun LIuL Is LoId uL u reIuLIveIy eurIy uge LIuL
sIe Is uL IIgI rIsk oI deveIopIng breusL cuncer wIen In IucL mosL women
on LIIs rIsk IucLor never deveIop LIe dIseuse? TIere Is u dIsLurbIng deurLI
oI InvesLIguLIon InLo LIIs Issue.
ConsIder LIe exumpIe oI u medIu reporL (AusLruIIun o Minutes,
MurcI , zooz) exumInIng LIe cuse oI u zq-yeur-oId womun IIgIIy
unguIsIed uL beIng uL IIgI rIsk Ior breusL cuncer. AppurenLIy, LIere wus
u IumIIy IIsLory oI LIe dIseuse; Ier moLIer Iud opLed Ior u precuuLIonury
doubIe musLecLomy. MoLIvuLed by LIe need Lo uppeuse u consLunL Lerror oI
LIe dIseuse, LIe womun, wIo uL one LIme Iud modeIed, decIded Lo uIso
Iuve u doubIe musLecLomy und pIusLIc surgery (ImpIunLs) Lo rebuIId LIe
breusLs. SIe wus uIso encouruged by Ier surgeon LIuL Ier decIsIon wus
ruLIonuI und LIuL IL wouId eIImInuLe LIe rIsk, und LIuL LIe younger LIuL LIe
decIsIon wus urrIved uL, LIe beLLer. TIe womun wus noL Iuppy wILI LIe
surgery LIuL resuILed In rIppIIng oI LIe ImpIunLs und Iuck oI sensuLIon In
LIe breusLs. On consuILIng unoLIer surgeon some LIme IuLer, Ie concurred
LIuL LIe pIusLIc surgery resuIL wus noL opLImuI. He uIso Ied Ier so-cuIIed
rIsk IucLors InLo u specIuIIsL cuIcuIuLor und deLermIned LIuL Ier IIIeLIme
(ubsoIuLe), muILIIucLor rIsk Ior breusL cuncer wus 8.%. He rIgILIy
suggesLed Lo Ier LIuL Ie wouId noL Iuve udvIsed or encouruged u doubIe
musLecLomy on LIe busIs oI sucI u Iow ubsoIuLe rIsk oI LIe dIseuse. He
reussured Ier LIuL Ier Lerror wus so IIgI uL LIe LIme LIuL rudIcuI surgery
seemed Lo be LIe onIy wuy Lo reduce IL. UndersLundubIy, sIe wus very
IIgIIy dIsLressed LIuL sIe wus under LIe IIrm beIIeI, und Irom un eurIy
uge, LIuL sIe wus uL IIgI rIsk oI LIe dIseuse. L Is IIgIIIgILed In LIIs
exumpIe LIuL LIe relctite Iunguuge oI epIdemIoIogIc rIsk IucLors Is
dungerous Lo psycIoIogIcuI und psycIosocIuI IeuILI.
CerLuInIy, some IucLors Iuve u IIgIer rIsk LIun oLIers In reIuLIve
Lerms. However, LIese sume IucLors ure LypIcuIIy very Iow rIsk IucLors In
ubsoIuLe Lerms; In muny InsLunces LIey ure bureIy ubove zero In ubsoIuLe
Preventive Medicine & Health Promotion
Lerms. L Is LIe responsIbIIILy oI LIe medIcuI esLubIIsImenL Lo ensure LIuL
no sucI conIusIon Is IosLered In LIe pubIIc. n LIe cuse oI LIe young
womun, Ier Lerror wus IrruLIonuIIyJImproperIy Iounded. SIe sIouId Iuve
oriincll been oIIered counseIIng us Lo wIuL sLuLIsLIcuI rIsk ucLuuIIy
reIers Lo In uLLempLIng Lo reduce Ier Lerror. UnIorLunuLeIy, us wIII be
IurLIer consIdered In LIe IoIIowIng, wIereus LIe medIcuI esLubIIsImenL
sIouId be ensurIng LIuL rIsk IucLors ure noL over-InLerpreLed, IL Is LIe very
medIcuI esLubIIsImenL LIuL Ius suvuged LIe pubIIc IeuILI wILI ILs own
IncompeLenL, endemIc, InsLILuLIonuIIzed, seII-servIng, over-InLerpreLuLIon
oI sLuLIsLIcuI rIsk.
L wouId be u reusonubIe ussessmenL LIuL LIe Iumun bIoIogIcuI
sysLem Is Iurdy und resIIIenL und wouId be In need oI InLervenLIon onIy
InIrequenLIy. TIe Ideu oI prevenLIve medIcIne Iere Is predIcuLed on u
conLrury uppruIsuI. TIe Iumun sysLem Is depIcLed us essenLIuIIy IruII, In
dunger oI IuIIIng upurL uL uny LIme, und In consLunL need oI screenIngs,
LesLIngs und InLervenLIon. L compromIses u person`s very ubIIILy
(psycIoIogIcuIIy) Lo dIscern LIeIr own sLuLe oI weII-beIng. HeuILI
(bIoIogIcuI) Is porLruyed us some IIeeLIng und myLIIcuI quunLILy LIuL Is
onIy conIIrmed by consLunL medIcuI IIndIngs oI non-dIseuse. TIe
prevenLIve medIcIne Ideu Is ILseII morose In ouLIook, I.e., neuroLIc. L vIews
LIe pubIIc us eILIer sIck or poLenLIuIIy sIck und LIus reIIecLs u
puLIenLIzuLIon oI LIe pubIIc uL Iurge.
L wus menLIoned In CIupLer One LIuL scIence sub-serves u
greuLer psycIoIogIcuI, socIuI und moruI conLexL. PrevenLIve medIcIne, us
consIdered Iere, enLIreIy uILers LIIs dynumIc. L Is LIe pubIIc now LIuL
serves prevenLIve medIcIne; LIe pubIIc Is vIewed us un experImenLuI
quunLILy uL LIe dIsposuI oI IeuILIIsm.
TIomus (1q;) commenLs LIuL:
LIe LroubIe Is, we ure beIng Luken In by LIe propugundu,
und IL Is noL onIy bud Ior LIe spIrIL oI socIeLy, IL wIII
muke uny IeuILI cure sysLem, no muLLer Iow Iurge und
eIIIcIenL, unworkubIe. I peopIe ure educuLed LIuL LIey
ure IundumenLuIIy IrugIIe, uIwuys on LIe verge oI morLuI
dIseuse, perpeLuuIIy In need oI supporL by IeuILI
proIessIonuIs uL every sIde, uIwuys dependenL on un
ImugIned dIscIpIIne oI u 'prevenLIve medIcIne`, LIere cun
be no IImIL Lo LIe number oI docLors` oIIIces, cIInIcs und
IospILuIs requIred Lo meeL LIe demund. n LIe end we
wouId uII become docLors, spendIng our duys screenIng
eucI oLIer Ior dIseuse. We ure In reuI IIIe u reusonubIy
IeuILIy peopIe. ur Irom beIng InepLIy puL LogeLIer, we
ure umuzIngIy LougI, durubIe orgunIsms, IuII oI IeuILI,
235
235
Rampant Antismoking Signifies Grave Danger
LecInoIogIcuI udvuncemenLs LIuL muke muss screenIngs possIbIe, LIe
medIcuI esLubIIsImenL Ius mude use oI reIuLIve rIsk IucLors In uLLempLIng
Lo IdenLIIy dIseuse eurIy In ILs process, I.e., drIIL-neL IIsIIng meLupIor.
or exumpIe, women over o ure encouruged Lo undergo reguIur (e.g.,
yeurIy) screenIng Ior breusL cuncer. DIseuse Is deLecLed onIy In u very
smuII percenLuge oI purLIcIpunLs gIven LIuL LIe reIuLIve rIsk IucLors beIng
used ure very poor predIcLors, I.e., LIe ueLIoIogy oI purLIcuIur dIseuses Is
not undersLood. As uIreudy noLed LIIs reIIecLs u depurLure Irom LIe
medIcuI esLubIIsImenL`s LrudILIonuI roIe oI prImury cure oI LIe sIck.
urLIermore, IL resLs on u very unsLubIe IounduLIon In LIuL IL opens up u
Pundoru`s Box oI poLenLIuI IuLrogenIc psycIopuLIoIogy, e.g., unxIeLy
reucLIons, IypocIondrIu, depressIon. or exumpIe, wIuL Is LIe sLuLe oI
mInd, oter c lijetime, oI u womun LIuL Is LoId uL u reIuLIveIy eurIy uge LIuL
sIe Is uL IIgI rIsk oI deveIopIng breusL cuncer wIen In IucL mosL women
on LIIs rIsk IucLor never deveIop LIe dIseuse? TIere Is u dIsLurbIng deurLI
oI InvesLIguLIon InLo LIIs Issue.
ConsIder LIe exumpIe oI u medIu reporL (AusLruIIun o Minutes,
MurcI , zooz) exumInIng LIe cuse oI u zq-yeur-oId womun IIgIIy
unguIsIed uL beIng uL IIgI rIsk Ior breusL cuncer. AppurenLIy, LIere wus
u IumIIy IIsLory oI LIe dIseuse; Ier moLIer Iud opLed Ior u precuuLIonury
doubIe musLecLomy. MoLIvuLed by LIe need Lo uppeuse u consLunL Lerror oI
LIe dIseuse, LIe womun, wIo uL one LIme Iud modeIed, decIded Lo uIso
Iuve u doubIe musLecLomy und pIusLIc surgery (ImpIunLs) Lo rebuIId LIe
breusLs. SIe wus uIso encouruged by Ier surgeon LIuL Ier decIsIon wus
ruLIonuI und LIuL IL wouId eIImInuLe LIe rIsk, und LIuL LIe younger LIuL LIe
decIsIon wus urrIved uL, LIe beLLer. TIe womun wus noL Iuppy wILI LIe
surgery LIuL resuILed In rIppIIng oI LIe ImpIunLs und Iuck oI sensuLIon In
LIe breusLs. On consuILIng unoLIer surgeon some LIme IuLer, Ie concurred
LIuL LIe pIusLIc surgery resuIL wus noL opLImuI. He uIso Ied Ier so-cuIIed
rIsk IucLors InLo u specIuIIsL cuIcuIuLor und deLermIned LIuL Ier IIIeLIme
(ubsoIuLe), muILIIucLor rIsk Ior breusL cuncer wus 8.%. He rIgILIy
suggesLed Lo Ier LIuL Ie wouId noL Iuve udvIsed or encouruged u doubIe
musLecLomy on LIe busIs oI sucI u Iow ubsoIuLe rIsk oI LIe dIseuse. He
reussured Ier LIuL Ier Lerror wus so IIgI uL LIe LIme LIuL rudIcuI surgery
seemed Lo be LIe onIy wuy Lo reduce IL. UndersLundubIy, sIe wus very
IIgIIy dIsLressed LIuL sIe wus under LIe IIrm beIIeI, und Irom un eurIy
uge, LIuL sIe wus uL IIgI rIsk oI LIe dIseuse. L Is IIgIIIgILed In LIIs
exumpIe LIuL LIe relctite Iunguuge oI epIdemIoIogIc rIsk IucLors Is
dungerous Lo psycIoIogIcuI und psycIosocIuI IeuILI.
CerLuInIy, some IucLors Iuve u IIgIer rIsk LIun oLIers In reIuLIve
Lerms. However, LIese sume IucLors ure LypIcuIIy very Iow rIsk IucLors In
ubsoIuLe Lerms; In muny InsLunces LIey ure bureIy ubove zero In ubsoIuLe
Preventive Medicine & Health Promotion
Lerms. L Is LIe responsIbIIILy oI LIe medIcuI esLubIIsImenL Lo ensure LIuL
no sucI conIusIon Is IosLered In LIe pubIIc. n LIe cuse oI LIe young
womun, Ier Lerror wus IrruLIonuIIyJImproperIy Iounded. SIe sIouId Iuve
oriincll been oIIered counseIIng us Lo wIuL sLuLIsLIcuI rIsk ucLuuIIy
reIers Lo In uLLempLIng Lo reduce Ier Lerror. UnIorLunuLeIy, us wIII be
IurLIer consIdered In LIe IoIIowIng, wIereus LIe medIcuI esLubIIsImenL
sIouId be ensurIng LIuL rIsk IucLors ure noL over-InLerpreLed, IL Is LIe very
medIcuI esLubIIsImenL LIuL Ius suvuged LIe pubIIc IeuILI wILI ILs own
IncompeLenL, endemIc, InsLILuLIonuIIzed, seII-servIng, over-InLerpreLuLIon
oI sLuLIsLIcuI rIsk.
L wouId be u reusonubIe ussessmenL LIuL LIe Iumun bIoIogIcuI
sysLem Is Iurdy und resIIIenL und wouId be In need oI InLervenLIon onIy
InIrequenLIy. TIe Ideu oI prevenLIve medIcIne Iere Is predIcuLed on u
conLrury uppruIsuI. TIe Iumun sysLem Is depIcLed us essenLIuIIy IruII, In
dunger oI IuIIIng upurL uL uny LIme, und In consLunL need oI screenIngs,
LesLIngs und InLervenLIon. L compromIses u person`s very ubIIILy
(psycIoIogIcuIIy) Lo dIscern LIeIr own sLuLe oI weII-beIng. HeuILI
(bIoIogIcuI) Is porLruyed us some IIeeLIng und myLIIcuI quunLILy LIuL Is
onIy conIIrmed by consLunL medIcuI IIndIngs oI non-dIseuse. TIe
prevenLIve medIcIne Ideu Is ILseII morose In ouLIook, I.e., neuroLIc. L vIews
LIe pubIIc us eILIer sIck or poLenLIuIIy sIck und LIus reIIecLs u
puLIenLIzuLIon oI LIe pubIIc uL Iurge.
L wus menLIoned In CIupLer One LIuL scIence sub-serves u
greuLer psycIoIogIcuI, socIuI und moruI conLexL. PrevenLIve medIcIne, us
consIdered Iere, enLIreIy uILers LIIs dynumIc. L Is LIe pubIIc now LIuL
serves prevenLIve medIcIne; LIe pubIIc Is vIewed us un experImenLuI
quunLILy uL LIe dIsposuI oI IeuILIIsm.
TIomus (1q;) commenLs LIuL:
LIe LroubIe Is, we ure beIng Luken In by LIe propugundu,
und IL Is noL onIy bud Ior LIe spIrIL oI socIeLy, IL wIII
muke uny IeuILI cure sysLem, no muLLer Iow Iurge und
eIIIcIenL, unworkubIe. I peopIe ure educuLed LIuL LIey
ure IundumenLuIIy IrugIIe, uIwuys on LIe verge oI morLuI
dIseuse, perpeLuuIIy In need oI supporL by IeuILI
proIessIonuIs uL every sIde, uIwuys dependenL on un
ImugIned dIscIpIIne oI u 'prevenLIve medIcIne`, LIere cun
be no IImIL Lo LIe number oI docLors` oIIIces, cIInIcs und
IospILuIs requIred Lo meeL LIe demund. n LIe end we
wouId uII become docLors, spendIng our duys screenIng
eucI oLIer Ior dIseuse. We ure In reuI IIIe u reusonubIy
IeuILIy peopIe. ur Irom beIng InepLIy puL LogeLIer, we
ure umuzIngIy LougI, durubIe orgunIsms, IuII oI IeuILI,
236
236
Rampant Antismoking Signifies Grave Danger
reudy Ior mosL conLIngencIes. TIe new dunger Lo our
weII-beIng, II we conLInue Lo IIsLen Lo LIIs LuIk, Is In
becomIng u nuLIon oI IeuILIy IypocIondrIucs, IIvIng
gIngerIy, worryIng ourseIves IuII Lo deuLI.
TuyIor (1q;q) uIso poInLs ouL LIuL:
LIe vusL mujorILy oI LIose wIo submIL LIemseIves Lo LIIs
burruge oI LesLs ure normuI und IeuILIy. UnIorLunuLeIy,
muny oI LIIs group do noL regurd LIemseIves us sucI or,
uILIougI LIey IeeI weII, ure worrIed IesL LIey ure noL.
TIIs group oI IeuILIy, normuI peopIe wIo ure
concerned LIuL LIey ure noL wIuL LIey muy seem, Iuve
In recenL LImes grown Lo sucI proporLIons LIuL LIey
Iuve been dIgnIIIed by u nume - LIe uorried uell. TIey
ure u group LIuL Ius been convInced LIuL IeuILI Is noL u
subjecLIve IeeIIng oI weII-beIng, buL ruLIer Is un
objecLIve sLuLe wIIcI cun onIy be ucIIeved wIen every
possIbIe LesL und exumInuLIon Ior every possIbIe dIseuse
Is neguLIve. Moreover, LIey Iuve been convInced LIuL uII
mInor ucIes und puIns, vIruI IIIness, IeuducIe, or
dIgesLIve upseL muy be IurbIngers oI serIous dIseuse
und so requIre InsLunL medIcuI ussessmenL. TIe
exIsLence oI LIIs group oI peopIe - LIe uorried uell - Is
IuLrogenIc. BurnIum dIsIIkes LIe Lerm uorried uell. He
preIers LIe Lerm uorried sicl becuuse In IIs experIence
peopIe worry LIemseIves sIck und 'worry, Ieur und
dreud uII speII unIILness or sIckness, noL weIIness`..
He Iound LIuL 11% oI IIs puLIenLs were uorried sicl In
LIuL LIey experIenced Lo vuryIng degrees, 'u sIckenIng
IncupucILuLIng dreud wILI Ioss oI zesL und purpose oILen
ussocIuLed wILI upuLIy, depressIon, und InsomnIu und
wILI vurIous pIysIcuI sympLoms sucI us Ioss oI uppeLILe
und weIgIL, und IeuvIness In LIe cIesL und ubdomen`. L
becomes cIeur LIuL LIe reucLIon Lo ucLuuI pIysIcuI
IIIness, or LIe LIreuL oI sucI un IIIness, cun cuuse more
dIsubIIILy LIun LIe IIIness ILseII. (p.18)
TuyIor und TIomus ure obvIousIy IucLorIng In LIe crILerIon oI
menLuI IeuILI us un uspecL oI overuII IeuILI. As Ius uIreudy been
consIdered, conLemporury IeuILI promoLIon, bused on LIe muLerIuIIsm oI
bIoIogIcuI reducLIonIsm und rudIcuI beIuvIorIsm, Ius eIIecLIveIy
obIILeruLed LIe Ideu oI psycIoIogIcuI und socIuI IeuILI Irom ILs reusonIng.
Preventive Medicine & Health Promotion
Even jusL LIe use oI Iow-IeveI rIsk IucLors In uLLempLs uL eurIy deLecLIon
uILers LIe enLIre socIuI mInd seL. Muny begIn Lo vIew LIe Ideu oI rIsk In u
wuy LIuL IL sImpIy does noL merIL, I.e., InLroducLIon Lo LIe
psycIopuLIoIogy oI rIsk uversIon. L uIso IosLers body IIxuLIons. I
poLenLIuI psycIopuLIoIogy concernIng LIe uLLempL uL eurIy deLecLIon oI
dIseuse Is noL uIreudy oI suIIIcIenL concern, LIen IL Is LIe LreuLmenL oI rIsk
reducLIonJuversIon, I.e., IIIesLyIe uILeruLIons, LIuL Is LIe overwIeImIng
Lrugedy In LIIs sud, sorry sugu.
WILI epIdemIoIogIc InvesLIguLIon IuvIng produced u pIeLIoru oI
reIuLIve rIsk IucLors Ior specIIIc dIseuse, IL Ius been consIdered ubove Iow
prevenLIve medIcIne Ius used some oI LIese Lo encouruge screenIng Ior
eurIy deLecLIon oI dIseuse. However, wIen reIuLIve rIsk concerns uspecLs oI
IIIesLyIe, e.g., dIeL, smokIng, exercIse, u vILuI Issue concerns LIe use Lo
wIIcI LIese rIsk IucLors ure puL by prevenLIve medIcIne. I LIe roIe oI
prevenLIve medIcIne Is Lo sImpIy InIorm LIe pubIIc us Lo reIuLIve rIsk
IucLors, LIen even LIe compreIensIve vIoIuLIon by epIdemIoIogIcuI
InvesLIguLIon oI eter prIncIpIe oI scIenLIIIc enquIry und cuusuI urgumenL
consIdered In LIe prevIous cIupLers wouId noL be IIgIIy probIemuLIc In
greuLer consequence. Persons wouId be uwure LIuL LIe Ideu oI rIsk uL Iow
IeveIs (uLypIcuI) Is compIeLeIy subjecLIve und noL udequuLe grounds Ior
prImury cuusuI urgumenL. Persons cun LIen decIde wIeLIer beneIILs Irom
purLIcuIur ucLIvILy ouLweIgI possIbIe deLrImenLs. As menLIoned eurIIer, II u
person does noL Iuve some very good reuson beyond u purLIcuIur rIsk
IucLor, e.g., sLrong IumIIy IIsLory oI u dIseuse, LIen Lo Iyper-reucL (I.e., rIsk
uversIon) wouId be consIdered us neuroLIc dIsposILIon. n oLIer words, LIe
rctioncl LreuLmenL oI Iow-IeveI rIsk Is essenLIuIIy Lo Ignore IL.
UnIorLunuLeIy, prevenLIve medIcIne Ius moved In LIe exucL
opposILe dIrecLIon. RuLIer LIun uIIowIng persons Lo uppruIse LIe
subjecLIve Ideu oI Iow-IeveI rIsk wILIIn LIeIr own subjecLIve cognILIve
Irumework und IIIesLyIe, IeuILI uuLIorILIes Iuve deIuded LIemseIves InLo
preucIIng LIe Ideu LIuL IIIesLyIe IucLors LIuL ure sLuLIsLIcuIIy IInked wILI
dIseuse sIouId noL onIy be reduced, buL compIeLeIy removed, I.e.,
uLLempLIng Lo preucI LIuL (sLuLIsLIcuI) rIsk-uversIon Is un objecLIve und
normuLIve posILIon - uhich it is not. n LIIs sLep LIe cuILIsL MMES
IIIesLyIe Is Iorwurded us LIe prescrIpLIve IIIesLyIe LIuL uII sIouId uspIre Lo.
TIe cenLruI IeuLure oI LIIs cuIL movemenL Is LIe superiorit sndrome.
AversIon Lo sLuLIsLIcuI rIsk Is porLruyed us ruLIonuI und IeuILIy, und uny
devIuLIons Irom LIIs prescrIpLIon ure depIcLed us IrruLIonuI, IrresponsIbIe
und unIeuILIy.
n uLLempLIng Lo undersLund LIe LreuLmenL oI cIgureLLe-smokIng
by prevenLIve medIcIne, wIIcI Is one oI LIe muIn LIemes oI LIIs
dIscussIon, LIIs IucLor needs Lo be consIdered uguInsL LIe greuLer buckdrop
237
237
Rampant Antismoking Signifies Grave Danger
reudy Ior mosL conLIngencIes. TIe new dunger Lo our
weII-beIng, II we conLInue Lo IIsLen Lo LIIs LuIk, Is In
becomIng u nuLIon oI IeuILIy IypocIondrIucs, IIvIng
gIngerIy, worryIng ourseIves IuII Lo deuLI.
TuyIor (1q;q) uIso poInLs ouL LIuL:
LIe vusL mujorILy oI LIose wIo submIL LIemseIves Lo LIIs
burruge oI LesLs ure normuI und IeuILIy. UnIorLunuLeIy,
muny oI LIIs group do noL regurd LIemseIves us sucI or,
uILIougI LIey IeeI weII, ure worrIed IesL LIey ure noL.
TIIs group oI IeuILIy, normuI peopIe wIo ure
concerned LIuL LIey ure noL wIuL LIey muy seem, Iuve
In recenL LImes grown Lo sucI proporLIons LIuL LIey
Iuve been dIgnIIIed by u nume - LIe uorried uell. TIey
ure u group LIuL Ius been convInced LIuL IeuILI Is noL u
subjecLIve IeeIIng oI weII-beIng, buL ruLIer Is un
objecLIve sLuLe wIIcI cun onIy be ucIIeved wIen every
possIbIe LesL und exumInuLIon Ior every possIbIe dIseuse
Is neguLIve. Moreover, LIey Iuve been convInced LIuL uII
mInor ucIes und puIns, vIruI IIIness, IeuducIe, or
dIgesLIve upseL muy be IurbIngers oI serIous dIseuse
und so requIre InsLunL medIcuI ussessmenL. TIe
exIsLence oI LIIs group oI peopIe - LIe uorried uell - Is
IuLrogenIc. BurnIum dIsIIkes LIe Lerm uorried uell. He
preIers LIe Lerm uorried sicl becuuse In IIs experIence
peopIe worry LIemseIves sIck und 'worry, Ieur und
dreud uII speII unIILness or sIckness, noL weIIness`..
He Iound LIuL 11% oI IIs puLIenLs were uorried sicl In
LIuL LIey experIenced Lo vuryIng degrees, 'u sIckenIng
IncupucILuLIng dreud wILI Ioss oI zesL und purpose oILen
ussocIuLed wILI upuLIy, depressIon, und InsomnIu und
wILI vurIous pIysIcuI sympLoms sucI us Ioss oI uppeLILe
und weIgIL, und IeuvIness In LIe cIesL und ubdomen`. L
becomes cIeur LIuL LIe reucLIon Lo ucLuuI pIysIcuI
IIIness, or LIe LIreuL oI sucI un IIIness, cun cuuse more
dIsubIIILy LIun LIe IIIness ILseII. (p.18)
TuyIor und TIomus ure obvIousIy IucLorIng In LIe crILerIon oI
menLuI IeuILI us un uspecL oI overuII IeuILI. As Ius uIreudy been
consIdered, conLemporury IeuILI promoLIon, bused on LIe muLerIuIIsm oI
bIoIogIcuI reducLIonIsm und rudIcuI beIuvIorIsm, Ius eIIecLIveIy
obIILeruLed LIe Ideu oI psycIoIogIcuI und socIuI IeuILI Irom ILs reusonIng.
Preventive Medicine & Health Promotion
Even jusL LIe use oI Iow-IeveI rIsk IucLors In uLLempLs uL eurIy deLecLIon
uILers LIe enLIre socIuI mInd seL. Muny begIn Lo vIew LIe Ideu oI rIsk In u
wuy LIuL IL sImpIy does noL merIL, I.e., InLroducLIon Lo LIe
psycIopuLIoIogy oI rIsk uversIon. L uIso IosLers body IIxuLIons. I
poLenLIuI psycIopuLIoIogy concernIng LIe uLLempL uL eurIy deLecLIon oI
dIseuse Is noL uIreudy oI suIIIcIenL concern, LIen IL Is LIe LreuLmenL oI rIsk
reducLIonJuversIon, I.e., IIIesLyIe uILeruLIons, LIuL Is LIe overwIeImIng
Lrugedy In LIIs sud, sorry sugu.
WILI epIdemIoIogIc InvesLIguLIon IuvIng produced u pIeLIoru oI
reIuLIve rIsk IucLors Ior specIIIc dIseuse, IL Ius been consIdered ubove Iow
prevenLIve medIcIne Ius used some oI LIese Lo encouruge screenIng Ior
eurIy deLecLIon oI dIseuse. However, wIen reIuLIve rIsk concerns uspecLs oI
IIIesLyIe, e.g., dIeL, smokIng, exercIse, u vILuI Issue concerns LIe use Lo
wIIcI LIese rIsk IucLors ure puL by prevenLIve medIcIne. I LIe roIe oI
prevenLIve medIcIne Is Lo sImpIy InIorm LIe pubIIc us Lo reIuLIve rIsk
IucLors, LIen even LIe compreIensIve vIoIuLIon by epIdemIoIogIcuI
InvesLIguLIon oI eter prIncIpIe oI scIenLIIIc enquIry und cuusuI urgumenL
consIdered In LIe prevIous cIupLers wouId noL be IIgIIy probIemuLIc In
greuLer consequence. Persons wouId be uwure LIuL LIe Ideu oI rIsk uL Iow
IeveIs (uLypIcuI) Is compIeLeIy subjecLIve und noL udequuLe grounds Ior
prImury cuusuI urgumenL. Persons cun LIen decIde wIeLIer beneIILs Irom
purLIcuIur ucLIvILy ouLweIgI possIbIe deLrImenLs. As menLIoned eurIIer, II u
person does noL Iuve some very good reuson beyond u purLIcuIur rIsk
IucLor, e.g., sLrong IumIIy IIsLory oI u dIseuse, LIen Lo Iyper-reucL (I.e., rIsk
uversIon) wouId be consIdered us neuroLIc dIsposILIon. n oLIer words, LIe
rctioncl LreuLmenL oI Iow-IeveI rIsk Is essenLIuIIy Lo Ignore IL.
UnIorLunuLeIy, prevenLIve medIcIne Ius moved In LIe exucL
opposILe dIrecLIon. RuLIer LIun uIIowIng persons Lo uppruIse LIe
subjecLIve Ideu oI Iow-IeveI rIsk wILIIn LIeIr own subjecLIve cognILIve
Irumework und IIIesLyIe, IeuILI uuLIorILIes Iuve deIuded LIemseIves InLo
preucIIng LIe Ideu LIuL IIIesLyIe IucLors LIuL ure sLuLIsLIcuIIy IInked wILI
dIseuse sIouId noL onIy be reduced, buL compIeLeIy removed, I.e.,
uLLempLIng Lo preucI LIuL (sLuLIsLIcuI) rIsk-uversIon Is un objecLIve und
normuLIve posILIon - uhich it is not. n LIIs sLep LIe cuILIsL MMES
IIIesLyIe Is Iorwurded us LIe prescrIpLIve IIIesLyIe LIuL uII sIouId uspIre Lo.
TIe cenLruI IeuLure oI LIIs cuIL movemenL Is LIe superiorit sndrome.
AversIon Lo sLuLIsLIcuI rIsk Is porLruyed us ruLIonuI und IeuILIy, und uny
devIuLIons Irom LIIs prescrIpLIon ure depIcLed us IrruLIonuI, IrresponsIbIe
und unIeuILIy.
n uLLempLIng Lo undersLund LIe LreuLmenL oI cIgureLLe-smokIng
by prevenLIve medIcIne, wIIcI Is one oI LIe muIn LIemes oI LIIs
dIscussIon, LIIs IucLor needs Lo be consIdered uguInsL LIe greuLer buckdrop
238
238
Rampant Antismoking Signifies Grave Danger
oI rIsk-uversIon propugundu LIuL Ius been InIIIcLed on LIe pubIIc over LIe
IusL Iew decudes. ALrens (zooo) provIdes un exceIIenL revIew oI
conLrudIcLory evIdence concernIng rIsk IucLors Ior CHD sucI us
cIoIesLeroI und IyperLensIon. RIvuIed onIy by cIgureLLe smokIng on LIe
demonIzed scuIe Is cIoIesLeroI. Persons Iuve been coerced InLo LIe
beIIeI LIuL reducIng bIood cIoIesLeroI, by dIeL or medIcuLIon, und
ucIIevIng some mugIcuI bIood-cIoIesLeroI counL, LIe person Ius uIso
ucIIeved suIeLy. TIe evIdence Iowever suggesLs LIuL bIood cIoIesLeroI Is
u Iow-IeveI predIcLor oI CHD, I.e., IL Is noL u sIngIe IucLor, prImury cuuse oI
CHD, und possIbIy noL even u LrIgger IucLor. urLIermore, LIe evIdence
Irom rundomIzed conLroIIed sLudIes oI rIsk-IucLor InLervenLIon, eurIIer
menLIoned, IndIcuLe smuII guIns (InvoIvIng smuII subgroups), uL besL, Irom
rIsk reducLIon. BIood cIoIesLeroI cun uIso IuII Loo Iow In wIIcI cuse IL
becomes u rIsk IucLor Ior oLIer probIems, I.e., rIsk reducLIonJuversIon Is
noL u IurmIess pursuIL even In pureIy bIoIogIcuI Lerms.
L Is weII worLI revIewIng wIuL sLuLIsLIcuI rIsk cctucll meuns
wILIIn LIe conLexL oI IIIesLyIe epIdemIoIogy. ConsIder u dIseuse (Y) Ior
wIIcI IucLor X Ius u IIIeIong predIcLIve sLrengLI oI 8%. NIneLy-Lwo
percenL oI LIe overuII group curryIng LIe rIsk IucLor wIII noL deveIop LIe
dIseuse over u IIIeLIme (see Igure ). I every (bIoIogIcuI, psycIoIogIcuI,
socIuI) uspecL oI members oI subgroup A und B wus compIeLeIy known, IL
wouId be possIbIe Lo dIscern wILI IIgI uccurucy (I.e., 1oo% or neur-1oo%)
wIuL LIe cuusuI cIuIn oI evenLs IeudIng Lo LIe dIseuse Is. n u deLermInIsLIc
sense, 8% oI LIe overuII group (subgroup B), und wIere cuusuI
cIrcumsLunces ure IeIL Lo run LIeIr course, wus uIwuys uL 1oo% rIsk oI
dIseuse und qz% oI LIe overuII group (subgroup A) wus uIwuys uL o% rIsk.
rom LIIs cuusuI cIuIn IL wouId be possIbIe Lo dIscern commonuIILIes oI
unLecedenLs Ior subgroup B LIuL cIeurIy dIsLInguIsI IL Irom subgroup A,
I.e., LIe IdenLIIIcuLIon oI u suIIIcIenL, or suIIIcIenL und necessury, condILIon
oI dIseuse Y. L wouId uIso be possIbIe Lo deIIneuLe u LIme course Ior LIe
unLecedenL condILIons oI dIseuse Y sucI LIuL members oI subgroup B cun
specIIIcuIIy be IdenLIIIed prIor Lo dIseuse onseL. RemedIuI ucLIon, II
possIbIe, cun be Luken. L wIII be noLed LIuL becuuse subgroup B cun be
specIIIcuIIy (uccuruLeIy) IdenLIIIed, LIen LIe normuLIve runge (subgroup A)
oI non-ussocIuLIon wILI dIseuse Y Is noL uIIecLed by uLLempLs uL remedy
(I.e., uIIowIng zero or neur-zero IuIse cIussIIIcuLIons). n murked conLrusL
Lo LIe cIrcumsLunce oI IuvIng compIeLe knowIedge oI uII IucLors perLuInIng
Lo subgroup A und B, IucLor X Is u poor predIcLor oI dIseuse Y. As sucI, IL
Is deIInILeIy noL u suIIIcIenL condILIon Ior LIe dIseuse. GIven ILs poor
predIcLIve sLrengLI, und In LIe ubsence oI oLIer IIgIer predIcLors, LIe
sLuLus oI IucLor X us u necessury condILIonJconLrIbuLIng IucLor Is
IndeLermInuLe und ImprobubIe. TIe ImpIIcuLIon oI LIe duLu Is LIuL IucLor X
Preventive Medicine & Health Promotion
cun onIy be reIerred Lo In
sLuLIsLIcuI, und noL cuusuI,
Lerms.
oIIowIng Irom LIe
ubove, epIdemIoIogIcuI
reseurcI Ius dIscerned LIuL
compured Lo u conLroI group
(I.e., no IucLor X) LIe relctite
risl oI IucLor X Ior LIe dIseuse
Y Is q.o. n uccordunce wILI ILs
conLorLed InLerpreLuLIon oI
reIuLIve rIsk und ILs IuIIure Lo
uddress ubsoIuLe rIsk,
prevenLIve medIcIne concIudes
LIuL uII uLLempLs sIouId be
mude Lo remove LIe rIsk IucLor.
L emburks on u propugundu
cumpuIgn Lo educuLe
members oI LIe overuII rIsk-
IucLor X group Lo eIImInuLe LIe
IucLor (I.e., compIIunce wILI LIe
MMES IIIesLyIe). L wIII uLLempL
Lo convInce every sIngIe
member LIuL LIey ure uL rIsk,
wIen In IucL mosL ure noL. JusL
LIIs ucL Is uIreudy erroneousIy
depIcLIng u sLuLIsLIcuI IucLor us
u cuusuI one und engugIng In
LIe coercIon Lo IuIse beIIeI.
However, Ior urgumenL`s suke,
uII members compIy wILI rIsk uversIon. AL LIIs poInL LIere ure u number
oI possIbIe scenurIos. TIese wIII runge Irom no cIunge In IncIdence oI
dIseuse Y Lo u compIeLe eIImInuLIon oI dIseuse Y. L Is cerLuInIy possIbIe Lo
ucIIeve u reducLIon In dIseuse Y (e.g., 1-qo%) wILI no cuusuI ImpIIcuLIon,
I.e., u reducLIon Is possIbIe soIeIy on LIe grounds LIuL IucLor X Is u
sLuLIsLIcuIIy correIuLed IucLor wILI dIseuse Y und LIere muy be numerous
possIbIe cross-correIuLIons beLween LIe Lwo IucLors. eL`s suy LIuL LIere Is
u 1z% reducLIon In IncIdence oI dIseuse Y Ior subgroup B equIvuIenL Lo 1%
oI LIe overuII group. To produce LIIs reducLIon, prevenLIve medIcIne Ius
Iud Lo enguge In u number oI compIeLeIy quesLIonubIe ucLIvILIes.
IrsLIy, IL Ius Iud Lo erroneousIy convInce cll members oI
subgroup A LIuL LIey ure uL rIsk wIen In IucL LIey ure noL, I.e., IuIse sense
A.
Persons
who will
never
manifest
disease Y.
B.
Persons
who will
manifest
disease Y.
Factor X
Figure 3: Graphic depiction of disease
contingencies associated with factor
239
239
Rampant Antismoking Signifies Grave Danger
oI rIsk-uversIon propugundu LIuL Ius been InIIIcLed on LIe pubIIc over LIe
IusL Iew decudes. ALrens (zooo) provIdes un exceIIenL revIew oI
conLrudIcLory evIdence concernIng rIsk IucLors Ior CHD sucI us
cIoIesLeroI und IyperLensIon. RIvuIed onIy by cIgureLLe smokIng on LIe
demonIzed scuIe Is cIoIesLeroI. Persons Iuve been coerced InLo LIe
beIIeI LIuL reducIng bIood cIoIesLeroI, by dIeL or medIcuLIon, und
ucIIevIng some mugIcuI bIood-cIoIesLeroI counL, LIe person Ius uIso
ucIIeved suIeLy. TIe evIdence Iowever suggesLs LIuL bIood cIoIesLeroI Is
u Iow-IeveI predIcLor oI CHD, I.e., IL Is noL u sIngIe IucLor, prImury cuuse oI
CHD, und possIbIy noL even u LrIgger IucLor. urLIermore, LIe evIdence
Irom rundomIzed conLroIIed sLudIes oI rIsk-IucLor InLervenLIon, eurIIer
menLIoned, IndIcuLe smuII guIns (InvoIvIng smuII subgroups), uL besL, Irom
rIsk reducLIon. BIood cIoIesLeroI cun uIso IuII Loo Iow In wIIcI cuse IL
becomes u rIsk IucLor Ior oLIer probIems, I.e., rIsk reducLIonJuversIon Is
noL u IurmIess pursuIL even In pureIy bIoIogIcuI Lerms.
L Is weII worLI revIewIng wIuL sLuLIsLIcuI rIsk cctucll meuns
wILIIn LIe conLexL oI IIIesLyIe epIdemIoIogy. ConsIder u dIseuse (Y) Ior
wIIcI IucLor X Ius u IIIeIong predIcLIve sLrengLI oI 8%. NIneLy-Lwo
percenL oI LIe overuII group curryIng LIe rIsk IucLor wIII noL deveIop LIe
dIseuse over u IIIeLIme (see Igure ). I every (bIoIogIcuI, psycIoIogIcuI,
socIuI) uspecL oI members oI subgroup A und B wus compIeLeIy known, IL
wouId be possIbIe Lo dIscern wILI IIgI uccurucy (I.e., 1oo% or neur-1oo%)
wIuL LIe cuusuI cIuIn oI evenLs IeudIng Lo LIe dIseuse Is. n u deLermInIsLIc
sense, 8% oI LIe overuII group (subgroup B), und wIere cuusuI
cIrcumsLunces ure IeIL Lo run LIeIr course, wus uIwuys uL 1oo% rIsk oI
dIseuse und qz% oI LIe overuII group (subgroup A) wus uIwuys uL o% rIsk.
rom LIIs cuusuI cIuIn IL wouId be possIbIe Lo dIscern commonuIILIes oI
unLecedenLs Ior subgroup B LIuL cIeurIy dIsLInguIsI IL Irom subgroup A,
I.e., LIe IdenLIIIcuLIon oI u suIIIcIenL, or suIIIcIenL und necessury, condILIon
oI dIseuse Y. L wouId uIso be possIbIe Lo deIIneuLe u LIme course Ior LIe
unLecedenL condILIons oI dIseuse Y sucI LIuL members oI subgroup B cun
specIIIcuIIy be IdenLIIIed prIor Lo dIseuse onseL. RemedIuI ucLIon, II
possIbIe, cun be Luken. L wIII be noLed LIuL becuuse subgroup B cun be
specIIIcuIIy (uccuruLeIy) IdenLIIIed, LIen LIe normuLIve runge (subgroup A)
oI non-ussocIuLIon wILI dIseuse Y Is noL uIIecLed by uLLempLs uL remedy
(I.e., uIIowIng zero or neur-zero IuIse cIussIIIcuLIons). n murked conLrusL
Lo LIe cIrcumsLunce oI IuvIng compIeLe knowIedge oI uII IucLors perLuInIng
Lo subgroup A und B, IucLor X Is u poor predIcLor oI dIseuse Y. As sucI, IL
Is deIInILeIy noL u suIIIcIenL condILIon Ior LIe dIseuse. GIven ILs poor
predIcLIve sLrengLI, und In LIe ubsence oI oLIer IIgIer predIcLors, LIe
sLuLus oI IucLor X us u necessury condILIonJconLrIbuLIng IucLor Is
IndeLermInuLe und ImprobubIe. TIe ImpIIcuLIon oI LIe duLu Is LIuL IucLor X
Preventive Medicine & Health Promotion
cun onIy be reIerred Lo In
sLuLIsLIcuI, und noL cuusuI,
Lerms.
oIIowIng Irom LIe
ubove, epIdemIoIogIcuI
reseurcI Ius dIscerned LIuL
compured Lo u conLroI group
(I.e., no IucLor X) LIe relctite
risl oI IucLor X Ior LIe dIseuse
Y Is q.o. n uccordunce wILI ILs
conLorLed InLerpreLuLIon oI
reIuLIve rIsk und ILs IuIIure Lo
uddress ubsoIuLe rIsk,
prevenLIve medIcIne concIudes
LIuL uII uLLempLs sIouId be
mude Lo remove LIe rIsk IucLor.
L emburks on u propugundu
cumpuIgn Lo educuLe
members oI LIe overuII rIsk-
IucLor X group Lo eIImInuLe LIe
IucLor (I.e., compIIunce wILI LIe
MMES IIIesLyIe). L wIII uLLempL
Lo convInce every sIngIe
member LIuL LIey ure uL rIsk,
wIen In IucL mosL ure noL. JusL
LIIs ucL Is uIreudy erroneousIy
depIcLIng u sLuLIsLIcuI IucLor us
u cuusuI one und engugIng In
LIe coercIon Lo IuIse beIIeI.
However, Ior urgumenL`s suke,
uII members compIy wILI rIsk uversIon. AL LIIs poInL LIere ure u number
oI possIbIe scenurIos. TIese wIII runge Irom no cIunge In IncIdence oI
dIseuse Y Lo u compIeLe eIImInuLIon oI dIseuse Y. L Is cerLuInIy possIbIe Lo
ucIIeve u reducLIon In dIseuse Y (e.g., 1-qo%) wILI no cuusuI ImpIIcuLIon,
I.e., u reducLIon Is possIbIe soIeIy on LIe grounds LIuL IucLor X Is u
sLuLIsLIcuIIy correIuLed IucLor wILI dIseuse Y und LIere muy be numerous
possIbIe cross-correIuLIons beLween LIe Lwo IucLors. eL`s suy LIuL LIere Is
u 1z% reducLIon In IncIdence oI dIseuse Y Ior subgroup B equIvuIenL Lo 1%
oI LIe overuII group. To produce LIIs reducLIon, prevenLIve medIcIne Ius
Iud Lo enguge In u number oI compIeLeIy quesLIonubIe ucLIvILIes.
IrsLIy, IL Ius Iud Lo erroneousIy convInce cll members oI
subgroup A LIuL LIey ure uL rIsk wIen In IucL LIey ure noL, I.e., IuIse sense
A.
Persons
who will
never
manifest
disease Y.
B.
Persons
who will
manifest
disease Y.
Factor X
Figure 3: Graphic depiction of disease
contingencies associated with factor
240
240
Rampant Antismoking Signifies Grave Danger
oI InsecurILy. By LIen beIng encouruged InLo rIsk uversIon, LIIs subgroup
Is LIen In u IuIse sense oI securILy - securILy Ior LIe wrong reusons.
Persons ure LIereIore InILIuIIy LerrorIzed InLo IrruLIonuI beIIeI und LIen
convInced LIuL rIsk uversIon wIII uppeuse LIeIr IrruLIonuI Ieur.
SecondIy, IL Ius properIy, uILIougI nonspecIIIcuIIy, convInced uII
members oI subgroup B LIuL LIey ure uL rIsk. By engugIng In rIsk uversIon,
1z% ucLuuIIy guIn, buL LIe remuInIng 88% oI subgroup B ure In u IuIse
sense oI securILy, I.e., LIey wIII sLIII deveIop dIseuse Y. TIereIore, Lo
produce u 1% guIn (Ior LIe overuII group), prevenLIve medIcIne Ius Iud Lo
coerce qq% oI LIe overuII group InLo sLuLes oI IuIse beIIeI. TIIs Is un
ussuuIL on u normuLIve runge oI IuncLIonIng und menLuI IeuILI, I.e., LIe
conducL Is IruuduIenL, decepLIve, ImmoruI. BeIng convInced LIuL LIey ure
uL rIsk, wIen In IucL LIey ure noL, Ius one Lype oI psycIopuLIoIogy
rumIIIcuLIon Ior u porLIon oI subgroup A, e.g., unxIeLy reucLIons,
IypocIondrIu, depressIon. n LIe remuInder oI subgroup A IL reInIorces
LIe erroneous Ideu LIuL rIsk uversIon Ius uIIowed LIeIr escupe Irom
dIseuse Y; IL becomes u seII-reInIorcIng IuIIucy LIuL rIsk uversIon Is
producLIve, objecLIve und normuLIve (I.e., uspecL oI superiorit
sndrome). TIere Is uIso LIe possIbIIILy oI u porLIon oI subgroup A, by
LukIng prevenLIve sLeps LIuL LIey need noL Iuve Luken, ure now uL IIgIer
rIsk Ior other dIseuses. L Is uIso IndeLermInuLe wIuL LIe IuLe oI LIe
successIuI 1% Is. TIese muy sImpIy now be uL very IIgI rIsk Ior cnother
muIudy.
L musL be kepL In mInd LIuL II subgroup A Is noL InLerIered wILI
by prevenLIve meusures, IL Is currenLIy IeuILIy wILI regurd Lo dIseuse Y
und wIII never deveIop dIseuse Y, I.e., LIIs subgroup Is weII und wIII
remuIn weII wILI regurd Lo dIseuse Y ouLcome. YeL prevenLIve medIcIne
puLIenLIzes LIIs enLIre group. L gIves LIIs subgroup someLIIng Lo worry
ubouL LIuL IL need noL worry ubouL. L Is u menLuIIy unIeuILIy
cIrcumsLunce wIen u LypIcuI group (qz%) Is coerced InLo LIInkIng und
ucLIng us II LIey ure LIe uLypIcuI (8%) group. n LIIs cruzed uLLempL uL
prevenLIon IL cun be noLed LIuL u normuLIve runge oI IuncLIonIng Is now
uncIored Lo ubnormuI sLuLes (dIseuse Y) or preoccupuLIon wILI ubnormuI
sLuLes. Even II LIere wus u IIgI-IeveI guIn Ior subgroup B, uILIougI
unIIkeIy, IL sLIII does noL jusLIIy LIe menLuI ussuuIL on subgroup A. n suner
LImes, uny pubIIc IeuILI perspecLIve, I.e., one LIuL properIy uccounLs Ior
menLuI IeuILI, wouId IIrsL proLecL LIIs normuLIve runge oI IuncLIonIng.
TIe proper roIe oI scIence wouId LIen be Lo IInd IIgI-IeveI predIcLors LIuL
cun IdenLIIy subgroup B und mInImIze IuIse cIussIIIcuLIons. And, unLII IL
cun do LIIs, LIe beLLer purL oI judIcIousness wouId counseI Lo Ieuve weII
enougI uIone, und Lo Ieuve LIe weII popuIuLIon uIone.
SLuLemenLs by IeuILI uuLIorILIes Lo LIe eIIecL LIuL II you Iower
Preventive Medicine & Health Promotion
your suIL InLuke, sLop smokIng, und euL u buIunced dIeL, you wIII reduce
your rIsk oI IeurL dIseuse ure ucLuuIIy IruuduIenL. SucI sLuLemenLs do noL
uppIy Lo most oI LIe supposed uL rIsk group LIuL LIey ure dIrecLed uL. A
consIderuLIon oI LIe duLu In Igure q provIdes un ucLuuI exumpIe oI Iow
InIormuLIon Is conLorLed by IIIesLyIe epIdemIoIogy und LIuL, by LIe LIme IL
moves LIrougI prevenLIve medIcIne und reucIes LIe pubIIc vIu LIe medIu,
IL Is even more conLorLed. n Igure q Is presenLed duLu represenLIng
mujor munIIesLuLIon oI CHD In men uged o-q Ior LIe rIsk IucLors oI
smokIng, IyperLensIon und cIoIesLeroI uguInsL u buseIIne (no rIsk IucLors).
L cun be noLed LIuL uII LIree IucLors, IndIvIduuIIy or coIIecLIveIy, ure very
241
241
Rampant Antismoking Signifies Grave Danger
oI InsecurILy. By LIen beIng encouruged InLo rIsk uversIon, LIIs subgroup
Is LIen In u IuIse sense oI securILy - securILy Ior LIe wrong reusons.
Persons ure LIereIore InILIuIIy LerrorIzed InLo IrruLIonuI beIIeI und LIen
convInced LIuL rIsk uversIon wIII uppeuse LIeIr IrruLIonuI Ieur.
SecondIy, IL Ius properIy, uILIougI nonspecIIIcuIIy, convInced uII
members oI subgroup B LIuL LIey ure uL rIsk. By engugIng In rIsk uversIon,
1z% ucLuuIIy guIn, buL LIe remuInIng 88% oI subgroup B ure In u IuIse
sense oI securILy, I.e., LIey wIII sLIII deveIop dIseuse Y. TIereIore, Lo
produce u 1% guIn (Ior LIe overuII group), prevenLIve medIcIne Ius Iud Lo
coerce qq% oI LIe overuII group InLo sLuLes oI IuIse beIIeI. TIIs Is un
ussuuIL on u normuLIve runge oI IuncLIonIng und menLuI IeuILI, I.e., LIe
conducL Is IruuduIenL, decepLIve, ImmoruI. BeIng convInced LIuL LIey ure
uL rIsk, wIen In IucL LIey ure noL, Ius one Lype oI psycIopuLIoIogy
rumIIIcuLIon Ior u porLIon oI subgroup A, e.g., unxIeLy reucLIons,
IypocIondrIu, depressIon. n LIe remuInder oI subgroup A IL reInIorces
LIe erroneous Ideu LIuL rIsk uversIon Ius uIIowed LIeIr escupe Irom
dIseuse Y; IL becomes u seII-reInIorcIng IuIIucy LIuL rIsk uversIon Is
producLIve, objecLIve und normuLIve (I.e., uspecL oI superiorit
sndrome). TIere Is uIso LIe possIbIIILy oI u porLIon oI subgroup A, by
LukIng prevenLIve sLeps LIuL LIey need noL Iuve Luken, ure now uL IIgIer
rIsk Ior other dIseuses. L Is uIso IndeLermInuLe wIuL LIe IuLe oI LIe
successIuI 1% Is. TIese muy sImpIy now be uL very IIgI rIsk Ior cnother
muIudy.
L musL be kepL In mInd LIuL II subgroup A Is noL InLerIered wILI
by prevenLIve meusures, IL Is currenLIy IeuILIy wILI regurd Lo dIseuse Y
und wIII never deveIop dIseuse Y, I.e., LIIs subgroup Is weII und wIII
remuIn weII wILI regurd Lo dIseuse Y ouLcome. YeL prevenLIve medIcIne
puLIenLIzes LIIs enLIre group. L gIves LIIs subgroup someLIIng Lo worry
ubouL LIuL IL need noL worry ubouL. L Is u menLuIIy unIeuILIy
cIrcumsLunce wIen u LypIcuI group (qz%) Is coerced InLo LIInkIng und
ucLIng us II LIey ure LIe uLypIcuI (8%) group. n LIIs cruzed uLLempL uL
prevenLIon IL cun be noLed LIuL u normuLIve runge oI IuncLIonIng Is now
uncIored Lo ubnormuI sLuLes (dIseuse Y) or preoccupuLIon wILI ubnormuI
sLuLes. Even II LIere wus u IIgI-IeveI guIn Ior subgroup B, uILIougI
unIIkeIy, IL sLIII does noL jusLIIy LIe menLuI ussuuIL on subgroup A. n suner
LImes, uny pubIIc IeuILI perspecLIve, I.e., one LIuL properIy uccounLs Ior
menLuI IeuILI, wouId IIrsL proLecL LIIs normuLIve runge oI IuncLIonIng.
TIe proper roIe oI scIence wouId LIen be Lo IInd IIgI-IeveI predIcLors LIuL
cun IdenLIIy subgroup B und mInImIze IuIse cIussIIIcuLIons. And, unLII IL
cun do LIIs, LIe beLLer purL oI judIcIousness wouId counseI Lo Ieuve weII
enougI uIone, und Lo Ieuve LIe weII popuIuLIon uIone.
SLuLemenLs by IeuILI uuLIorILIes Lo LIe eIIecL LIuL II you Iower
Preventive Medicine & Health Promotion
your suIL InLuke, sLop smokIng, und euL u buIunced dIeL, you wIII reduce
your rIsk oI IeurL dIseuse ure ucLuuIIy IruuduIenL. SucI sLuLemenLs do noL
uppIy Lo most oI LIe supposed uL rIsk group LIuL LIey ure dIrecLed uL. A
consIderuLIon oI LIe duLu In Igure q provIdes un ucLuuI exumpIe oI Iow
InIormuLIon Is conLorLed by IIIesLyIe epIdemIoIogy und LIuL, by LIe LIme IL
moves LIrougI prevenLIve medIcIne und reucIes LIe pubIIc vIu LIe medIu,
IL Is even more conLorLed. n Igure q Is presenLed duLu represenLIng
mujor munIIesLuLIon oI CHD In men uged o-q Ior LIe rIsk IucLors oI
smokIng, IyperLensIon und cIoIesLeroI uguInsL u buseIIne (no rIsk IucLors).
L cun be noLed LIuL uII LIree IucLors, IndIvIduuIIy or coIIecLIveIy, ure very
242
242
Rampant Antismoking Signifies Grave Danger
poor predIcLors oI CHD. TIe predIcLIve sLrengLI oI smokIng Ior CHD
uguInsL u buseIIne Is .oz6 (z.6%), I.e., neur-zero predIcLIve sLrengLI.
TIereIore, q;.q% oI smokers (normuLIve runge) wIII not demonsLruLe
mujor munIIesLuLIon oI CHD In LIe uge bruckeL o-q. CIoIesLeroI und
IyperLensIon ure sImIIur-IeveI predIcLors. AII LIree rIsk IucLors combIned
Iuve u predIcLIve sLrengLI oI .1; (1;%). n oLIer words, 8% oI men
(normuLIve runge) uged o-q IuvIng cll three rIsk IucLors wIII not
demonsLruLe mujor munIIesLuLIon oI CHD over LIe reIevunL uge bruckeL.
WILI sucI poor predIcLIve sLrengLI, IndIvIduuIIy or coIIecLIveIy, none oI
LIese IucLors cun be consIdered us prImury cuuses oI mujor munIIesLuLIons
oI CHD (e.g., SLeIbens, 1qqz; McCormIck & Skrubunek, 1q88; Grundy,
1q;).
TIe medIcuI esLubIIsImenL does not know LIe cuuse(s) oI CHD; IL
Ius noL yeL IdenLIIIed uny IIgI-IeveI predIcLors. ow-IeveI predIcLors
demonsLruLe u lccl oI undersLundIng concernIng underIyIng cuuse. By LIe
LIme LIIs InIormuLIon Is presenLed In medIcuI journuIs, IL Is reduced Lo
reIuLIve rIsk ruLIos; LIe crILIcuI InIormuLIon uIIowIng un uppruIsuI oI LIe
rIsk IucLors Ior LIe dIseuse In quesLIon (ubsoIuLe rIsk) Ius been sLrIpped
uwuy. or exumpIe, RR(smokIng) = z.z; RR(IyperLensIon) = z.6; RR
(cIoIesLeroI) = .1; RR(smokIng & IyperLensIon) = q.6; RR(smokIng &
cIoIesLeroI) = q.6; RR(IyperLensIon & cIoIesLeroI) = q.z; RR(smokIng &
cIoIesLeroI & IyperLensIon) = 8.. TIIs InIormuLIon cun onl be
mIsIeudIng.
n un urLIcIe uppeurIng In u mujor AusLruIIun sLuLe newspuper
(Hercld,Sun, ;J6Jzoo1, p.1z) LIe reuder Is InIormed wILI LIe cupLIon
HeurL RIsks Bud or Men. L LIen expIuIns LIuL or young men wIo
smoke und Iuve IIgI cIoIesLeroI und bIood pressure, LIe news Is grIm.
TIe NorLIwesLern UnIversILy MedIcuI ScIooI In IIInoIs Iound IIgI
cIoIesLeroI Increused LIe rIsk oI IeurL dIseuse by qz%, IIgI bIood pressure
by up Lo z%, und smokIng by 6%.
n reIuLIve-rIsk Lerms, LIe percenLuges depIcLed In LIe urLIcIe ure
1.qz, 1.z, und 1.6. TIese ure consIderubIy Iower LIun LIose Ior LIe
Igure q duLu. AILIougI IL Is dIIIIcuIL Lo LeII gIven LIuL LIe urLIcIe does noL
properIy cILe ILs reIerence, LIe dIscrepuncy wouId mosL IIkeIy be LIuL LIe
urLIcIe sLudy InvoIved onIy LIe younger uspecL (e.g., o-q) oI LIe o-q
uge bruckeL In LIe Igure q duLu. n oLIer words, LIe predIcLIve sLrengLI oI
uII LIese IucLors Ior CHD In LIe urLIcIe sLudy Is even poorer LIun LIuL Ior
LIe Igure q duLu. YeL LIe urLIcIe Ieuds LIe reuder on Iow Lo InLerpreL LIe
presenLed InIormuLIon wILI LIe emoLIve Lerm grIm news (IrIgILIuI or
gIusLIy news), und LIIs Is dIrecLed uL cll young men wILI LIe rIsk IucLors In
quesLIon. L LIen mukes u sLundurd error oI presenLuLIon In depIcLIng uII
rIsk IucLors us increcsin LIe rIsk oI CHD. TIe sLuLemenL Lo Increuse LIe
Preventive Medicine & Health Promotion
rIsk oI .. ImpIIes prImury cuuse. TIe proper depIcLIon Is LIuL LIese
IucLors ure cssocicted (sLuLIsLIcuI) wILI u IIgIer rIsk oI CHD. TIe urLIcIe Is
LIorougIIy IruuduIenL In LIe InIormuLIon IL presenLs. TIe ImpressIon IL
depIcLs Is LIe exucL opposILe Lo LIe ucLuuI sLuLe oI uIIuIrs; Increused rIsk oI
CHD Is noL ussocIuLed wILI LIe mujorILy oI LIose demonsLruLIng purLIcuIur
rIsk IucLors, I.e., LIe news Is noL grIm. I LIIs wus jusL one IsoIuLed urLIcIe,
IL wouId be one muLLer. However, LIese sorLs oI urLIcIes wILI LIe sume
IruuduIenL depIcLIons, muny LImes IuII-puge spreuds wILI LIe use oI Iur
more emoLIve Iunguuge, occur wILI monoLonous reguIurILy. mporLunLIy,
LIIs medIu InIormuLIon Is dIrecLIy LruceubIe Lo IIIesLyIe epIdemIoIogy und
prevenLIve medIcIne wIere LIe gross mIsconducL begIns. TIIs sorL oI
propugundu burruge Is u buLcIery oI due scIenLIIIc process LIuL cun onl
IosLer menLuI dysIuncLIon.
Persons ure uIso beIng LreuLed wILI prescrIpLIon drugs Lo Iower
IIgI cIoIesLeroI und IyperLensIon. Even II LIe medIcuI LreuLmenL oI IIgI
cIoIesLeroI und IyperLensIon produced u guIn Ior u smuII subgroup In LIe
Iong-Lerm, und LIere Is poor evIdence Ior LIIs - purLIcuIurIy cIoIesLeroI, IL
sLIII does noL jusLIIy un ussuuIL on menLuI IeuILI. Persons Iere ure beIng
medIcuIIy LreuLed Ior non-dIseuse, I.e., weII persons ure quILe IILeruIIy
LreuLed us sIck. HIgI cIoIesLeroI und IyperLensIon ure noL dIseuses In
LIemseIves. YeL persons ure expecLed Lo be LreuLed us purL oI LIeIr duLy
Lo socIeLuI IeuILI or II LIey ure oLIerwIse LerrIIIed by possIbIe dIseuse. n
oLIer words, even u rIsk IucLor now cIusses u IeuILIy person us unIeuILIy
und In need oI medIcuI LreuLmenL. urLIermore, IL keeps reInIorcIng In LIe
mInds oI LIe pubIIc LIe supersLILIous beIIeI LIuL rIsk IucLor Is
LunLumounL Lo cuuse. TIIs IosLers u morbId preoccupuLIon, noL onIy wILI
dIseuse und morLuIILy, buL wILI rIsk IucLors, I.e., reInIorcemenL oI
sLuLIsLIcuI-rIsk uversIon.
L Ius LIus Iur been consIdered LIuL IIIesLyIe epIdemIoIogy
generuLes severe over-InLerpreLuLIon oI epIdemIoIogIc duLu. PrevenLIve
medIcIne LIen udds LIe dImensIon oI prescrIpLIve ubsoIuLIsm.
UnIorLunuLeIy, LIIs represenLs u muLerIuIIsL cIosed-Ioop LIuL uLLerIy
domInuLes pubIIc IeuILI poIIcy. TIIs IeuILIIsm Ius convInced ILseII und
mucI oI LIe pubIIc LIuL u weII person conducLIng LIemseIves us II LIey ure
sIck wIII sLuve oII sIckness by LIIs very conducL; u person Is onIy weII II
LIey ucL us II LIey ure sIck. L Is this LIInkIng LIuL Is sIck. TIe muLerIuIIsm
(I.e., obIIvIousness Lo psycIoIogIcuI, socIuI und moruI dImensIons) und
ubsoIuLIsm LIuL LypIcuIIy InvoIves LIe dysIuncLIonsJImmuLurILIes oI
IuugILIness, ImperIousness, ure very mucI In keepIng wILI LIe medIco-
muLerIuIIsm oI NuzIsm. TIe quesLIon couId weII be usked Iow LIIs
deIuded LIInkIng Ius musqueruded ILseII In more conLemporury und
democruLIc socIeLIes. TIIs musquerude goes by uL IeusL u number oI
243
243
Rampant Antismoking Signifies Grave Danger
poor predIcLors oI CHD. TIe predIcLIve sLrengLI oI smokIng Ior CHD
uguInsL u buseIIne Is .oz6 (z.6%), I.e., neur-zero predIcLIve sLrengLI.
TIereIore, q;.q% oI smokers (normuLIve runge) wIII not demonsLruLe
mujor munIIesLuLIon oI CHD In LIe uge bruckeL o-q. CIoIesLeroI und
IyperLensIon ure sImIIur-IeveI predIcLors. AII LIree rIsk IucLors combIned
Iuve u predIcLIve sLrengLI oI .1; (1;%). n oLIer words, 8% oI men
(normuLIve runge) uged o-q IuvIng cll three rIsk IucLors wIII not
demonsLruLe mujor munIIesLuLIon oI CHD over LIe reIevunL uge bruckeL.
WILI sucI poor predIcLIve sLrengLI, IndIvIduuIIy or coIIecLIveIy, none oI
LIese IucLors cun be consIdered us prImury cuuses oI mujor munIIesLuLIons
oI CHD (e.g., SLeIbens, 1qqz; McCormIck & Skrubunek, 1q88; Grundy,
1q;).
TIe medIcuI esLubIIsImenL does not know LIe cuuse(s) oI CHD; IL
Ius noL yeL IdenLIIIed uny IIgI-IeveI predIcLors. ow-IeveI predIcLors
demonsLruLe u lccl oI undersLundIng concernIng underIyIng cuuse. By LIe
LIme LIIs InIormuLIon Is presenLed In medIcuI journuIs, IL Is reduced Lo
reIuLIve rIsk ruLIos; LIe crILIcuI InIormuLIon uIIowIng un uppruIsuI oI LIe
rIsk IucLors Ior LIe dIseuse In quesLIon (ubsoIuLe rIsk) Ius been sLrIpped
uwuy. or exumpIe, RR(smokIng) = z.z; RR(IyperLensIon) = z.6; RR
(cIoIesLeroI) = .1; RR(smokIng & IyperLensIon) = q.6; RR(smokIng &
cIoIesLeroI) = q.6; RR(IyperLensIon & cIoIesLeroI) = q.z; RR(smokIng &
cIoIesLeroI & IyperLensIon) = 8.. TIIs InIormuLIon cun onl be
mIsIeudIng.
n un urLIcIe uppeurIng In u mujor AusLruIIun sLuLe newspuper
(Hercld,Sun, ;J6Jzoo1, p.1z) LIe reuder Is InIormed wILI LIe cupLIon
HeurL RIsks Bud or Men. L LIen expIuIns LIuL or young men wIo
smoke und Iuve IIgI cIoIesLeroI und bIood pressure, LIe news Is grIm.
TIe NorLIwesLern UnIversILy MedIcuI ScIooI In IIInoIs Iound IIgI
cIoIesLeroI Increused LIe rIsk oI IeurL dIseuse by qz%, IIgI bIood pressure
by up Lo z%, und smokIng by 6%.
n reIuLIve-rIsk Lerms, LIe percenLuges depIcLed In LIe urLIcIe ure
1.qz, 1.z, und 1.6. TIese ure consIderubIy Iower LIun LIose Ior LIe
Igure q duLu. AILIougI IL Is dIIIIcuIL Lo LeII gIven LIuL LIe urLIcIe does noL
properIy cILe ILs reIerence, LIe dIscrepuncy wouId mosL IIkeIy be LIuL LIe
urLIcIe sLudy InvoIved onIy LIe younger uspecL (e.g., o-q) oI LIe o-q
uge bruckeL In LIe Igure q duLu. n oLIer words, LIe predIcLIve sLrengLI oI
uII LIese IucLors Ior CHD In LIe urLIcIe sLudy Is even poorer LIun LIuL Ior
LIe Igure q duLu. YeL LIe urLIcIe Ieuds LIe reuder on Iow Lo InLerpreL LIe
presenLed InIormuLIon wILI LIe emoLIve Lerm grIm news (IrIgILIuI or
gIusLIy news), und LIIs Is dIrecLed uL cll young men wILI LIe rIsk IucLors In
quesLIon. L LIen mukes u sLundurd error oI presenLuLIon In depIcLIng uII
rIsk IucLors us increcsin LIe rIsk oI CHD. TIe sLuLemenL Lo Increuse LIe
Preventive Medicine & Health Promotion
rIsk oI .. ImpIIes prImury cuuse. TIe proper depIcLIon Is LIuL LIese
IucLors ure cssocicted (sLuLIsLIcuI) wILI u IIgIer rIsk oI CHD. TIe urLIcIe Is
LIorougIIy IruuduIenL In LIe InIormuLIon IL presenLs. TIe ImpressIon IL
depIcLs Is LIe exucL opposILe Lo LIe ucLuuI sLuLe oI uIIuIrs; Increused rIsk oI
CHD Is noL ussocIuLed wILI LIe mujorILy oI LIose demonsLruLIng purLIcuIur
rIsk IucLors, I.e., LIe news Is noL grIm. I LIIs wus jusL one IsoIuLed urLIcIe,
IL wouId be one muLLer. However, LIese sorLs oI urLIcIes wILI LIe sume
IruuduIenL depIcLIons, muny LImes IuII-puge spreuds wILI LIe use oI Iur
more emoLIve Iunguuge, occur wILI monoLonous reguIurILy. mporLunLIy,
LIIs medIu InIormuLIon Is dIrecLIy LruceubIe Lo IIIesLyIe epIdemIoIogy und
prevenLIve medIcIne wIere LIe gross mIsconducL begIns. TIIs sorL oI
propugundu burruge Is u buLcIery oI due scIenLIIIc process LIuL cun onl
IosLer menLuI dysIuncLIon.
Persons ure uIso beIng LreuLed wILI prescrIpLIon drugs Lo Iower
IIgI cIoIesLeroI und IyperLensIon. Even II LIe medIcuI LreuLmenL oI IIgI
cIoIesLeroI und IyperLensIon produced u guIn Ior u smuII subgroup In LIe
Iong-Lerm, und LIere Is poor evIdence Ior LIIs - purLIcuIurIy cIoIesLeroI, IL
sLIII does noL jusLIIy un ussuuIL on menLuI IeuILI. Persons Iere ure beIng
medIcuIIy LreuLed Ior non-dIseuse, I.e., weII persons ure quILe IILeruIIy
LreuLed us sIck. HIgI cIoIesLeroI und IyperLensIon ure noL dIseuses In
LIemseIves. YeL persons ure expecLed Lo be LreuLed us purL oI LIeIr duLy
Lo socIeLuI IeuILI or II LIey ure oLIerwIse LerrIIIed by possIbIe dIseuse. n
oLIer words, even u rIsk IucLor now cIusses u IeuILIy person us unIeuILIy
und In need oI medIcuI LreuLmenL. urLIermore, IL keeps reInIorcIng In LIe
mInds oI LIe pubIIc LIe supersLILIous beIIeI LIuL rIsk IucLor Is
LunLumounL Lo cuuse. TIIs IosLers u morbId preoccupuLIon, noL onIy wILI
dIseuse und morLuIILy, buL wILI rIsk IucLors, I.e., reInIorcemenL oI
sLuLIsLIcuI-rIsk uversIon.
L Ius LIus Iur been consIdered LIuL IIIesLyIe epIdemIoIogy
generuLes severe over-InLerpreLuLIon oI epIdemIoIogIc duLu. PrevenLIve
medIcIne LIen udds LIe dImensIon oI prescrIpLIve ubsoIuLIsm.
UnIorLunuLeIy, LIIs represenLs u muLerIuIIsL cIosed-Ioop LIuL uLLerIy
domInuLes pubIIc IeuILI poIIcy. TIIs IeuILIIsm Ius convInced ILseII und
mucI oI LIe pubIIc LIuL u weII person conducLIng LIemseIves us II LIey ure
sIck wIII sLuve oII sIckness by LIIs very conducL; u person Is onIy weII II
LIey ucL us II LIey ure sIck. L Is this LIInkIng LIuL Is sIck. TIe muLerIuIIsm
(I.e., obIIvIousness Lo psycIoIogIcuI, socIuI und moruI dImensIons) und
ubsoIuLIsm LIuL LypIcuIIy InvoIves LIe dysIuncLIonsJImmuLurILIes oI
IuugILIness, ImperIousness, ure very mucI In keepIng wILI LIe medIco-
muLerIuIIsm oI NuzIsm. TIe quesLIon couId weII be usked Iow LIIs
deIuded LIInkIng Ius musqueruded ILseII In more conLemporury und
democruLIc socIeLIes. TIIs musquerude goes by uL IeusL u number oI
244
244
Rampant Antismoking Signifies Grave Danger
numes.
IncI (1qqo) IIgIIIgILs wIuL Is reIerred Lo us LIe Lclonde
doctrine. L Is LIe sorL oI senLImenLs voIced by Murc uIonde, LIe LIen
CunudIun MInIsLer oI NuLIonuI HeuILI und WeIIure, In A New PerspecLIve
on LIe HeuILI oI CunudIuns (1q;q) LIuL mIgIL weII murk LIe begInnIngs
oI LIe currenL muLerIuIIsL ussuuIL on IeuILI, I.e., muLerIuIIsL munIIesLo.
uIonde urgued LIuL scIence Is IuII oI 'IIs`, 'buLs` und 'muybes` wIIIe
messuges desIgned Lo InIIuence LIe pubIIc musL be Ioud, cIeur und
unequIvocuI; ucLIon Ius Lo be Luken...even II uII LIe evIdence Is noL In;
TIe scIenLIIIc 'yes, buL` Is essenLIuI Lo reseurcI buL Ior modIIyIng Iumun
beIuvIor oI LIe popuIuLIon IL someLImes produces LIe 'uncerLuIn sound`
LIuL Is uII LIe excuse needed by muny Lo cuILIvuLe und LoIeruLe un
envIronmenL und IIIesLyIe LIuL Is Iuzurdous Lo IeuILI. (quoLed In IncI,
1qqo, p. q) mmedIuLeIy noLeworLIy Is LIe sLrong beIuvIorIsL Lendency In
LIe uIonde proposuIs; ucLuuI evIdence ruLes very IowIy, conLroI over LIe
pubIIc Is pre-emInenL, und non-muLerIuIIsL IeuILI concerns
(psycIoIogIcuI, socIuI, moruI) ure non-exIsLenL. uIondIsm Is u pubIIc Iuce
oI LIe muLerIuIIsL munIIesLo. PrescrIpLIonsJproscrIpLIons LIuL go Iur
beyond LIe ImpIIcuLIons oI IucL ure jusLIIIed In LIe engIneerIng oI LIe
rIsk uvoIdIng IndIvIduuI.
WIuL Ius been consIdered LIus Iur Is LIuL LIere ure reuIIy no
cIose cuIIs In IIIesLyIe epIdemIoIogy. TIe IdenLIIIcuLIon oI poor predIcLors
(reIuLIve rIsk) demonsLruLes LIuL ussocIuLed dIseuse does not cppl Ior
mosL oI LIose wILI LIe rIsk IucLor In quesLIon. No uddILIonuI duLu Is
necessury on LIIs poInL. ow-IeveI predIcLors demonsLruLe, unequitoccll,
LIuL LIe rIsk IucLor In quesLIon is not u suIIIcIenL condILIon Ior LIe dIseuse
In quesLIon. TIe onIy Issue LIuL remuIns vugueIy open Is wIeLIer LIIs
IucLor Is un uggruvuLIng IucLor In LIe dIseuse once LIe ucLuuI uL rIsk
subgroup Ius been Iur more uccuruLeIy IdenLIIIed by other jcctors, e.g.,
endogenous ubnormuIILy. L, LIereIore, mukes no sense uL uII LIuL eter
member In LIIs rIsk IucLor group needs Lo be coerced InLo beIuvIor
modIIIcuLIon. WIuL Is IosL In uIondIsL reusonIng Is LIuL compeLenL
reseurcIers ure very cureIuI wILI descrIpLIve Iunguuge so us noL Lo
mIsrepresenL duLu, I.e., IIs, buLs und muybes serve u very crILIcuI, honest
purpose. RemovuI oI upproprIuLe quuIIIyIng Iunguuge, by deIInILIon, uill
mIsrepresenL duLu und, LIereIore, IncILe IuIse beIIeI. n very sImpIe und
busIc Lerms, sucI conducL Is dIsIonesL, ImmoruI.
urLIermore, uIondIsL reusonIng Is uLLerIy obIIvIous Lo LIe IucL
LIuL LIe edIcLs oI scIenLIIIc enquIry serve u menLuI und socIuI IeuILI
uspecL. TIe InLenL oI LIese edIcLs, wIen properIy prucLIced, Is Lo guurd
uguInsL severe over-InLerpreLuLIon (I.e., supersLILIous beIIeI) wIIcI cun
wreuk socIuI pundemonIum. WIereus scIence wouId seek Lo proLecL
Preventive Medicine & Health Promotion
uguInsL LIe mosL busIc oI InIerenLIuI IIuws, e.g., generuIIzIng Irom Iow-
IeveI predIcLors und wIere mosL oI LIe observed InsLunces dIsconIIrm LIe
generuI proposILIon, uIondIsm wouId commIL LIIs mosL IundumenLuI
InIerenLIuI error us u muLLer oI course. Worse sLIII, IL wouId do so In LIe
nume oI IeuILI.
L Ius uIreudy been consIdered LIuL In sound scIenLIIIc Lerms
epIdemIoIogy perLuInIng Lo IIIesLyIe dIseuses Is u dIsmuI IuIIure. WIen
LIIs scIenLIIIc IncompeLence Is coupIed wILI LIe IncompeLence oI
muLerIuIIsL ubsoIuLIsm (cuLusLropIIzuLIon) InvoIvIng u LrIgger-Iuppy
obsessIon wILI conLroI, LIe resuIL cun onIy be devusLuLIng In non-
muLerIuIIsL Lerms. TIe uIonde docLrIne demonsLruLes u compIeLe
IncognIzunce oI psycIoIogIcuI, socIuI und moruI IeuILI. BeIng LIus bIInd,
IL cunnoL recognIze ILs own menLuI dysIuncLIon (e.g., scIenLIIIc
IncompeLence, obsessIon wILI conLroI, IuugILIness); LIIs Is LIe sLundurd
und crILIcuI probIem oI beIuvIorIsm. TIere Is mucI desIre Lo do und Lo
conLroI und Lo seII-serve, buL very IILLIe uccompunyIng coIerenL, ecIecLIc
und judIcIous reusonIng.
TIe uIonde docLrIne Is u munIIesLuLIon oI LIe superIorILy
syndrome. As wIII be consIdered In LIe IoIIowIng, LIIs sorL oI menLuIILy
generuLes supersLILIous beIIeI mude Lo uppeur us scIenLIIIcuIIy credIbIe.
TIe ter ocl oI scIenLIIIc enquIry Is Lo proLecL uguInsL over-
InLerpreLuLIon oI IIndIngs. uIondIsm reIIecLs u compreIensIve subverLIng
oI due scIenLIIIc process; LIe prucLIce oI Iow-IeveI predIcLors beIng
ImproperIy ruIsed Lo LIe sLuLus oI ubsoIuLe cuuse und LIen coucIed In
InIIummuLory und emoLIve Iunguuge Is unLI-scIenLIIIc und unIeuILIy.
WIere LIIs conducL Is presenLed us scIenLIIIc (objecLIve) und promoLIng
IeuILI, IL Is IruuduIenL, deIInquenL und IIgIIy dungerous. IncI (1qqo)
IndIcuLes LIuL LIe uIonde ReporL (1q;q) wus ucknowIedged by LIe
AusLruIIun nsLILuLe oI HeuILI In ILs 1q88 bIennIuI reporL AusLruIIu`s
HeuILI us IuvIng u mujor ImpucL on LIInkIng ubouL IeuILI, IeuILI
servIces, IeuILI promoLIon und IIIness prevenLIon. L wouId seem LIuL
LIIs conLorLed reusonIng Ius InIecLed LIe IeuILI LIInkIng oI noL onIy
AusLruIIu buL muny wesLernIzed nuLIons.
AnoLIer nume LIuL MMES musquerudes by Is Rose's pcrcdox or
LIe pretention pcrcdox wIIcI rougIIy sLuLes LIuL prevenLIve
InLervenLIons onIy beneIIL u mInorILy oI LIe 'beneIIcIurIes` und LIose wIo
beneIIL ure noL necessurIIy IndIvIduuIIy IdenLIIIubIe. (e.g., MorubIu, 1qq8,
p.61z) Here Is LIe ubsurdILy LIuL mosL members oI u group ure consIdered
us beneIIcIurIes buL wIo Iuve no demonsLrubIe beneIILs, und ucLuuI
(smuII group) beneIIcIurIes LIuL cunnoL be IdenLIIIed, und wIere IL cunnoL
be demonsLruLed LIuL LIe InLervenLIon Is cuusuIIy reIuLed Lo LIe beneIIL.
TIIs, uguIn, represenLs LIe drIIL-neL IIsIIng upproucI oI prevenLIve
245
245
Rampant Antismoking Signifies Grave Danger
numes.
IncI (1qqo) IIgIIIgILs wIuL Is reIerred Lo us LIe Lclonde
doctrine. L Is LIe sorL oI senLImenLs voIced by Murc uIonde, LIe LIen
CunudIun MInIsLer oI NuLIonuI HeuILI und WeIIure, In A New PerspecLIve
on LIe HeuILI oI CunudIuns (1q;q) LIuL mIgIL weII murk LIe begInnIngs
oI LIe currenL muLerIuIIsL ussuuIL on IeuILI, I.e., muLerIuIIsL munIIesLo.
uIonde urgued LIuL scIence Is IuII oI 'IIs`, 'buLs` und 'muybes` wIIIe
messuges desIgned Lo InIIuence LIe pubIIc musL be Ioud, cIeur und
unequIvocuI; ucLIon Ius Lo be Luken...even II uII LIe evIdence Is noL In;
TIe scIenLIIIc 'yes, buL` Is essenLIuI Lo reseurcI buL Ior modIIyIng Iumun
beIuvIor oI LIe popuIuLIon IL someLImes produces LIe 'uncerLuIn sound`
LIuL Is uII LIe excuse needed by muny Lo cuILIvuLe und LoIeruLe un
envIronmenL und IIIesLyIe LIuL Is Iuzurdous Lo IeuILI. (quoLed In IncI,
1qqo, p. q) mmedIuLeIy noLeworLIy Is LIe sLrong beIuvIorIsL Lendency In
LIe uIonde proposuIs; ucLuuI evIdence ruLes very IowIy, conLroI over LIe
pubIIc Is pre-emInenL, und non-muLerIuIIsL IeuILI concerns
(psycIoIogIcuI, socIuI, moruI) ure non-exIsLenL. uIondIsm Is u pubIIc Iuce
oI LIe muLerIuIIsL munIIesLo. PrescrIpLIonsJproscrIpLIons LIuL go Iur
beyond LIe ImpIIcuLIons oI IucL ure jusLIIIed In LIe engIneerIng oI LIe
rIsk uvoIdIng IndIvIduuI.
WIuL Ius been consIdered LIus Iur Is LIuL LIere ure reuIIy no
cIose cuIIs In IIIesLyIe epIdemIoIogy. TIe IdenLIIIcuLIon oI poor predIcLors
(reIuLIve rIsk) demonsLruLes LIuL ussocIuLed dIseuse does not cppl Ior
mosL oI LIose wILI LIe rIsk IucLor In quesLIon. No uddILIonuI duLu Is
necessury on LIIs poInL. ow-IeveI predIcLors demonsLruLe, unequitoccll,
LIuL LIe rIsk IucLor In quesLIon is not u suIIIcIenL condILIon Ior LIe dIseuse
In quesLIon. TIe onIy Issue LIuL remuIns vugueIy open Is wIeLIer LIIs
IucLor Is un uggruvuLIng IucLor In LIe dIseuse once LIe ucLuuI uL rIsk
subgroup Ius been Iur more uccuruLeIy IdenLIIIed by other jcctors, e.g.,
endogenous ubnormuIILy. L, LIereIore, mukes no sense uL uII LIuL eter
member In LIIs rIsk IucLor group needs Lo be coerced InLo beIuvIor
modIIIcuLIon. WIuL Is IosL In uIondIsL reusonIng Is LIuL compeLenL
reseurcIers ure very cureIuI wILI descrIpLIve Iunguuge so us noL Lo
mIsrepresenL duLu, I.e., IIs, buLs und muybes serve u very crILIcuI, honest
purpose. RemovuI oI upproprIuLe quuIIIyIng Iunguuge, by deIInILIon, uill
mIsrepresenL duLu und, LIereIore, IncILe IuIse beIIeI. n very sImpIe und
busIc Lerms, sucI conducL Is dIsIonesL, ImmoruI.
urLIermore, uIondIsL reusonIng Is uLLerIy obIIvIous Lo LIe IucL
LIuL LIe edIcLs oI scIenLIIIc enquIry serve u menLuI und socIuI IeuILI
uspecL. TIe InLenL oI LIese edIcLs, wIen properIy prucLIced, Is Lo guurd
uguInsL severe over-InLerpreLuLIon (I.e., supersLILIous beIIeI) wIIcI cun
wreuk socIuI pundemonIum. WIereus scIence wouId seek Lo proLecL
Preventive Medicine & Health Promotion
uguInsL LIe mosL busIc oI InIerenLIuI IIuws, e.g., generuIIzIng Irom Iow-
IeveI predIcLors und wIere mosL oI LIe observed InsLunces dIsconIIrm LIe
generuI proposILIon, uIondIsm wouId commIL LIIs mosL IundumenLuI
InIerenLIuI error us u muLLer oI course. Worse sLIII, IL wouId do so In LIe
nume oI IeuILI.
L Ius uIreudy been consIdered LIuL In sound scIenLIIIc Lerms
epIdemIoIogy perLuInIng Lo IIIesLyIe dIseuses Is u dIsmuI IuIIure. WIen
LIIs scIenLIIIc IncompeLence Is coupIed wILI LIe IncompeLence oI
muLerIuIIsL ubsoIuLIsm (cuLusLropIIzuLIon) InvoIvIng u LrIgger-Iuppy
obsessIon wILI conLroI, LIe resuIL cun onIy be devusLuLIng In non-
muLerIuIIsL Lerms. TIe uIonde docLrIne demonsLruLes u compIeLe
IncognIzunce oI psycIoIogIcuI, socIuI und moruI IeuILI. BeIng LIus bIInd,
IL cunnoL recognIze ILs own menLuI dysIuncLIon (e.g., scIenLIIIc
IncompeLence, obsessIon wILI conLroI, IuugILIness); LIIs Is LIe sLundurd
und crILIcuI probIem oI beIuvIorIsm. TIere Is mucI desIre Lo do und Lo
conLroI und Lo seII-serve, buL very IILLIe uccompunyIng coIerenL, ecIecLIc
und judIcIous reusonIng.
TIe uIonde docLrIne Is u munIIesLuLIon oI LIe superIorILy
syndrome. As wIII be consIdered In LIe IoIIowIng, LIIs sorL oI menLuIILy
generuLes supersLILIous beIIeI mude Lo uppeur us scIenLIIIcuIIy credIbIe.
TIe ter ocl oI scIenLIIIc enquIry Is Lo proLecL uguInsL over-
InLerpreLuLIon oI IIndIngs. uIondIsm reIIecLs u compreIensIve subverLIng
oI due scIenLIIIc process; LIe prucLIce oI Iow-IeveI predIcLors beIng
ImproperIy ruIsed Lo LIe sLuLus oI ubsoIuLe cuuse und LIen coucIed In
InIIummuLory und emoLIve Iunguuge Is unLI-scIenLIIIc und unIeuILIy.
WIere LIIs conducL Is presenLed us scIenLIIIc (objecLIve) und promoLIng
IeuILI, IL Is IruuduIenL, deIInquenL und IIgIIy dungerous. IncI (1qqo)
IndIcuLes LIuL LIe uIonde ReporL (1q;q) wus ucknowIedged by LIe
AusLruIIun nsLILuLe oI HeuILI In ILs 1q88 bIennIuI reporL AusLruIIu`s
HeuILI us IuvIng u mujor ImpucL on LIInkIng ubouL IeuILI, IeuILI
servIces, IeuILI promoLIon und IIIness prevenLIon. L wouId seem LIuL
LIIs conLorLed reusonIng Ius InIecLed LIe IeuILI LIInkIng oI noL onIy
AusLruIIu buL muny wesLernIzed nuLIons.
AnoLIer nume LIuL MMES musquerudes by Is Rose's pcrcdox or
LIe pretention pcrcdox wIIcI rougIIy sLuLes LIuL prevenLIve
InLervenLIons onIy beneIIL u mInorILy oI LIe 'beneIIcIurIes` und LIose wIo
beneIIL ure noL necessurIIy IndIvIduuIIy IdenLIIIubIe. (e.g., MorubIu, 1qq8,
p.61z) Here Is LIe ubsurdILy LIuL mosL members oI u group ure consIdered
us beneIIcIurIes buL wIo Iuve no demonsLrubIe beneIILs, und ucLuuI
(smuII group) beneIIcIurIes LIuL cunnoL be IdenLIIIed, und wIere IL cunnoL
be demonsLruLed LIuL LIe InLervenLIon Is cuusuIIy reIuLed Lo LIe beneIIL.
TIIs, uguIn, represenLs LIe drIIL-neL IIsIIng upproucI oI prevenLIve
246
246
Rampant Antismoking Signifies Grave Danger Preventive Medicine & Health Promotion
muLerIuIIsL prevenLIve meusures cun wreuk.
(. The Contemporcr Antismolin Dnslcuht
MedIco-muLerIuIIsm und LIe preucIIng oI rIsk uversIon und
pessImIsm us normuLIve wus uIreudy evIdenL ImmedIuLeIy IoIIowIng LIe
US Surgeon-GeneruI ReporL (1q6q) on smokIng und dIseuse: TIe
quesLIon oI wIy LIe mujorILy oI smokers does noL quIL In IIgIL oI LIe
uvuIIubIe evIdence Is noL un eusy one. (BernsLeIn, 1q6q, p.q1q) MedIco-
muLerIuIIsm cunnoL IuLIom LIuL LIere ure uny posILIves Lo smokIng or
uny neguLIves Lo medIco-muLerIuIIsm or LIe rIsk uversIon IL currenLIy
preucIes. L LIereIore consIders LIuL cn smoker IuvIng uII LIe uvuIIubIe
IucLs wIII ImmedIuLeIy desIsL Irom LIe IubIL und LIuL LIIs Is LIe onIy
ruLIonuI course.
TIe nIneLeen-sIxLIes LIrougI Lo LIe eurIy nIneLeen-eIgILIes suw
vurIous uLLempLs Lo enIIgILen smokers InLo desIsLIng und wus conIIned
essenLIuIIy wILIIn LIe reuIm oI InIormuLIon dIssemInuLIon, e.g., IeuILI
wurnIngs on cIgureLLe pucks. n LIuL LIe smokIng ruLe In LIe US dId noL
decreuse Lo LIe exLenL LIuL medIco-muLerIuIIsm wouId IInd uccepLubIe, LIe
medIco-muLerIuIIsL menLuIILy becume Iur more mIIILunL LIrougIouL LIIs
perIod. TIIs perIod suw LIe begInnIng oI LIe muLerIuIIsL munIIesLo. A
cuImInuLIng poInL oI LIIs deIuded quesL wus LIe US Surgeon-GeneruI
ReporL (1q88) LIuL decIured smokIng us onl un uddIcLIon und LIereIore u
dIseuse, sLrIpped oI psycIoIogIcuI und psycIosocIuI dImensIons or uny
counLerbuIuncIng beneIILs.
AguIn, us Ius been urgued eurIIer, LIIs suys Iur more ubouL LIe
medIco-muLerIuIIsL menLuIILy LIun IL does ubouL smokIng. As wus LIe cuse
wILI medIco-muLerIuIIsm In NuzI Germuny, medIco-muLerIuIIsm beIIeves
ILs posILIon Lo be ruLIonuI und InIuIIIbIe. Smokers Iud been gIven u Iew
decudes oI IeuILI InIormuLIon und sLIII persIsLed In LIe IubIL. TIereIore,
LIere musL be un obsLucIe Lo LIeIr ruLIonuI decIsIon-mukIng. ObvIousIy
Ior medIco-muLerIuIIsm, deIInIng LIe IubIL us uddIcLIon und dIseuse
soIves LIe Issue; onIy conIormILy demonsLruLes ruLIonuIILy und IeuILI,
conLInuuLIon oI LIe IubIL demonsLruLes IrruLIonuIILy und unIeuILIIness.
RuLIer, us wus LIe cuse wILI NuzI Germuny, muLerIuIIsm Is presenLed us
LIe deIInILIve worId vIew und, IncognIzunL oI coIerenL psycIoIogIcuI,
socIuI und moruI dImensIons, becomes u conduIL Ior uII munner oI
dysIuncLIon, dIsordered LIougIL, ImmuLurILy, IncompeLence, deIuded
IdeoIogy, wILIIn LIe muLerIuIIsL menLuIILy.
A crILIcuI Issue perLInenL Lo LIe buIIdIng unLIsmokIng burruge Is
ILs eIIecL on conLInuIng smokers. Smokers Iuve been psycIoIogIcuIIy
InLervenLIons LIuL ure bused on very poor predIcLors oI dIseuse. L sIouId
be noLed uguIn LIuL LIe conducL Is unLILIeLIcuI Lo LIe pInpoInLIng gouI oI
scIenLIIIc enquIry.
GunnIng-ScIepers eL uI. (1q8q) proIIer LIuL IL Is oILen Ieurd LIuL
muny Iuve Lo cIunge LIeIr IIIesLyIes buL onIy u Iew wIII beneIIL Irom LIe
cIungIng HD rIsks. TIe IucL LIuL onIy u smuII proporLIon oI LIose
exposed wIII ucLuuIIy geL poIIomyeIILIs Ius never been un urgumenL Lo
deny u generuLIon LIe beneIILs oI vuccInuLIon. SImIIurIy, we sIouId noL
deny our cIIIdren LIe beneIILs oI u IeuILIy IIIesLyIe, II no Iurm Is
done. (p.q81) NoLeworLIy Is LIuL Lype oI dIeL or smokIng, wIIcI ure noL
bucLerIuI or vIruI In nuLure, ure noLIIng IIke poIIomyeIILIs. urLIermore,
IIIesLyIe (conLInuIng) uILeruLIons ure noL LIe sume us u sIngIe or IIgIIy
InIrequenL vuccInuLIon. TIIs Is uguIn IndIcuLIve oI LIe sIuIIowness oI
MMES reusonIng. TIe gouI oI scIence und greuLer muILI-dImensIonuI
reusonIng Is Lo properIy dIscern dIIIerences beLween pIenomenu LIuL cre
dIIIerenL, und noL Lo ImproperIy muke very dIIIerenL pIenomenu uppeur
uIIke (I.e., IuIIucy oI IncoIerenL unuIogy). SmokIng cunnoL be equuLed
wILI, Ior exumpIe, LIe ucLIvILy und poLenLIuI eIIecLs oI LIuIIdomIde.
SmokIng Is ussocIuLed wILI dIseuse LIuL Is ILseII cross-correIuLed wILI
oLIer IucLors LIuL ure uIso ussocIuLed wILI LIe dIseuse. SmokIng Is uIso noL
LIe equIvuIenL oI sImpIe pIII-LukIng, I.e., IL Ius psycIoIogIcuI und
psycIosocIuI dImensIons. Due Lo superIIcIuIILy oI ussocIuLIons Iorced by
rudIcuI beIuvIorIsm, us one uspecL oI LIe muLerIuIIsL menLuIILy,
pIenomenu LIuL ure very dIIIerenL ure IruuduIenLIy mude Lo uppeur uIIke.
L cun uIso be upprecIuLed LIuL LIe propuguLIon oI LIe ubsoIuLIsL
Iukery (uIondIsm) LIuL LIe muLerIuIIsL munIIesLo pursues In LIe uLLempL
Lo coerce muss beIuvIor modIIIcuLIon In LIe Iope oI yIeIdIng quesLIonubIe
Iow-IeveI bIoIogIcuI guIns Is no more LIun muLerIuIIsL nuLIonuIIsm. L uIso
reIIecLs LIe sume LIemes oI medIco-muLerIuIIsL propugundu oI LIe
NuLIonuI SocIuIIsm In NuzI Germuny.
TIe overrIdIng IoIIy oI MMES reusonIng cun be summurIzed In
LIe beIIeI LIuL LIere Is us yeL InsuIIIcIenL evIdence Lo sLop LIe IurmIess
udvIce Lo LIe popuIuLIon Lo sLop smokIng, IImIL LIeIr IuL InLuke, und know
LIeIr bIood pressure. (GunnIng-ScIepers eL uI., 1q8q, p.q81) SucI u vIew
represenLs u pecuIIur Iorm oI InIuIIIbIIILy - uII prevenLIve meusures wIII
eILIer Iuve LIe desIred eIIecL (beneIIL) or no eIIecL. TIe possIbIIILy oI
deLrImenLuI eIIecLs never enLers LIe consIderuLIon. However, wIen
psycIoIogIcuI, socIuI, und moruI dImensIons ure IucLored buck InLo
consIderuLIon, LIen prevenLIve medIcIne Is un ussuuIL (muLerIuIIsL) oI un
exLruordInury kInd on uII oI LIese dImensIons. QuILe conLrury Lo LIIs Ideu
oI IurmIessness, LIe IoIIowIng wIII consIder LIe LreuLmenL oI smokIng und
smokers by prevenLIve medIcIne over LIe IusL decude und LIe Iuvoc LIuL
247
247
Rampant Antismoking Signifies Grave Danger Preventive Medicine & Health Promotion
muLerIuIIsL prevenLIve meusures cun wreuk.
(. The Contemporcr Antismolin Dnslcuht
MedIco-muLerIuIIsm und LIe preucIIng oI rIsk uversIon und
pessImIsm us normuLIve wus uIreudy evIdenL ImmedIuLeIy IoIIowIng LIe
US Surgeon-GeneruI ReporL (1q6q) on smokIng und dIseuse: TIe
quesLIon oI wIy LIe mujorILy oI smokers does noL quIL In IIgIL oI LIe
uvuIIubIe evIdence Is noL un eusy one. (BernsLeIn, 1q6q, p.q1q) MedIco-
muLerIuIIsm cunnoL IuLIom LIuL LIere ure uny posILIves Lo smokIng or
uny neguLIves Lo medIco-muLerIuIIsm or LIe rIsk uversIon IL currenLIy
preucIes. L LIereIore consIders LIuL cn smoker IuvIng uII LIe uvuIIubIe
IucLs wIII ImmedIuLeIy desIsL Irom LIe IubIL und LIuL LIIs Is LIe onIy
ruLIonuI course.
TIe nIneLeen-sIxLIes LIrougI Lo LIe eurIy nIneLeen-eIgILIes suw
vurIous uLLempLs Lo enIIgILen smokers InLo desIsLIng und wus conIIned
essenLIuIIy wILIIn LIe reuIm oI InIormuLIon dIssemInuLIon, e.g., IeuILI
wurnIngs on cIgureLLe pucks. n LIuL LIe smokIng ruLe In LIe US dId noL
decreuse Lo LIe exLenL LIuL medIco-muLerIuIIsm wouId IInd uccepLubIe, LIe
medIco-muLerIuIIsL menLuIILy becume Iur more mIIILunL LIrougIouL LIIs
perIod. TIIs perIod suw LIe begInnIng oI LIe muLerIuIIsL munIIesLo. A
cuImInuLIng poInL oI LIIs deIuded quesL wus LIe US Surgeon-GeneruI
ReporL (1q88) LIuL decIured smokIng us onl un uddIcLIon und LIereIore u
dIseuse, sLrIpped oI psycIoIogIcuI und psycIosocIuI dImensIons or uny
counLerbuIuncIng beneIILs.
AguIn, us Ius been urgued eurIIer, LIIs suys Iur more ubouL LIe
medIco-muLerIuIIsL menLuIILy LIun IL does ubouL smokIng. As wus LIe cuse
wILI medIco-muLerIuIIsm In NuzI Germuny, medIco-muLerIuIIsm beIIeves
ILs posILIon Lo be ruLIonuI und InIuIIIbIe. Smokers Iud been gIven u Iew
decudes oI IeuILI InIormuLIon und sLIII persIsLed In LIe IubIL. TIereIore,
LIere musL be un obsLucIe Lo LIeIr ruLIonuI decIsIon-mukIng. ObvIousIy
Ior medIco-muLerIuIIsm, deIInIng LIe IubIL us uddIcLIon und dIseuse
soIves LIe Issue; onIy conIormILy demonsLruLes ruLIonuIILy und IeuILI,
conLInuuLIon oI LIe IubIL demonsLruLes IrruLIonuIILy und unIeuILIIness.
RuLIer, us wus LIe cuse wILI NuzI Germuny, muLerIuIIsm Is presenLed us
LIe deIInILIve worId vIew und, IncognIzunL oI coIerenL psycIoIogIcuI,
socIuI und moruI dImensIons, becomes u conduIL Ior uII munner oI
dysIuncLIon, dIsordered LIougIL, ImmuLurILy, IncompeLence, deIuded
IdeoIogy, wILIIn LIe muLerIuIIsL menLuIILy.
A crILIcuI Issue perLInenL Lo LIe buIIdIng unLIsmokIng burruge Is
ILs eIIecL on conLInuIng smokers. Smokers Iuve been psycIoIogIcuIIy
InLervenLIons LIuL ure bused on very poor predIcLors oI dIseuse. L sIouId
be noLed uguIn LIuL LIe conducL Is unLILIeLIcuI Lo LIe pInpoInLIng gouI oI
scIenLIIIc enquIry.
GunnIng-ScIepers eL uI. (1q8q) proIIer LIuL IL Is oILen Ieurd LIuL
muny Iuve Lo cIunge LIeIr IIIesLyIes buL onIy u Iew wIII beneIIL Irom LIe
cIungIng HD rIsks. TIe IucL LIuL onIy u smuII proporLIon oI LIose
exposed wIII ucLuuIIy geL poIIomyeIILIs Ius never been un urgumenL Lo
deny u generuLIon LIe beneIILs oI vuccInuLIon. SImIIurIy, we sIouId noL
deny our cIIIdren LIe beneIILs oI u IeuILIy IIIesLyIe, II no Iurm Is
done. (p.q81) NoLeworLIy Is LIuL Lype oI dIeL or smokIng, wIIcI ure noL
bucLerIuI or vIruI In nuLure, ure noLIIng IIke poIIomyeIILIs. urLIermore,
IIIesLyIe (conLInuIng) uILeruLIons ure noL LIe sume us u sIngIe or IIgIIy
InIrequenL vuccInuLIon. TIIs Is uguIn IndIcuLIve oI LIe sIuIIowness oI
MMES reusonIng. TIe gouI oI scIence und greuLer muILI-dImensIonuI
reusonIng Is Lo properIy dIscern dIIIerences beLween pIenomenu LIuL cre
dIIIerenL, und noL Lo ImproperIy muke very dIIIerenL pIenomenu uppeur
uIIke (I.e., IuIIucy oI IncoIerenL unuIogy). SmokIng cunnoL be equuLed
wILI, Ior exumpIe, LIe ucLIvILy und poLenLIuI eIIecLs oI LIuIIdomIde.
SmokIng Is ussocIuLed wILI dIseuse LIuL Is ILseII cross-correIuLed wILI
oLIer IucLors LIuL ure uIso ussocIuLed wILI LIe dIseuse. SmokIng Is uIso noL
LIe equIvuIenL oI sImpIe pIII-LukIng, I.e., IL Ius psycIoIogIcuI und
psycIosocIuI dImensIons. Due Lo superIIcIuIILy oI ussocIuLIons Iorced by
rudIcuI beIuvIorIsm, us one uspecL oI LIe muLerIuIIsL menLuIILy,
pIenomenu LIuL ure very dIIIerenL ure IruuduIenLIy mude Lo uppeur uIIke.
L cun uIso be upprecIuLed LIuL LIe propuguLIon oI LIe ubsoIuLIsL
Iukery (uIondIsm) LIuL LIe muLerIuIIsL munIIesLo pursues In LIe uLLempL
Lo coerce muss beIuvIor modIIIcuLIon In LIe Iope oI yIeIdIng quesLIonubIe
Iow-IeveI bIoIogIcuI guIns Is no more LIun muLerIuIIsL nuLIonuIIsm. L uIso
reIIecLs LIe sume LIemes oI medIco-muLerIuIIsL propugundu oI LIe
NuLIonuI SocIuIIsm In NuzI Germuny.
TIe overrIdIng IoIIy oI MMES reusonIng cun be summurIzed In
LIe beIIeI LIuL LIere Is us yeL InsuIIIcIenL evIdence Lo sLop LIe IurmIess
udvIce Lo LIe popuIuLIon Lo sLop smokIng, IImIL LIeIr IuL InLuke, und know
LIeIr bIood pressure. (GunnIng-ScIepers eL uI., 1q8q, p.q81) SucI u vIew
represenLs u pecuIIur Iorm oI InIuIIIbIIILy - uII prevenLIve meusures wIII
eILIer Iuve LIe desIred eIIecL (beneIIL) or no eIIecL. TIe possIbIIILy oI
deLrImenLuI eIIecLs never enLers LIe consIderuLIon. However, wIen
psycIoIogIcuI, socIuI, und moruI dImensIons ure IucLored buck InLo
consIderuLIon, LIen prevenLIve medIcIne Is un ussuuIL (muLerIuIIsL) oI un
exLruordInury kInd on uII oI LIese dImensIons. QuILe conLrury Lo LIIs Ideu
oI IurmIessness, LIe IoIIowIng wIII consIder LIe LreuLmenL oI smokIng und
smokers by prevenLIve medIcIne over LIe IusL decude und LIe Iuvoc LIuL
248
248
Rampant Antismoking Signifies Grave Danger
pounded Irom uII ungIes oI IeuILI promoLIon LIrougI LIe medIu LIuL
smokIng wIII cuuse uII munner oI muIudIes. BeIng wuywurd In cuusuI
cIuIms und wILI LIe use oI emoLIve, LerrorIzIng Iunguuge, u crILIcuI Issue Is
LIe ImpucL oI LIIs conducL on LIe psycIoIogIcuI sLuLes oI smokers, I.e.,
neguLIve suggesLIon or nocebo eIIecL. TIIs sorL oI Issue Is u core one Ior
non-reducLIonIsL psycIoIogy.
L Is u IIgIIy dIsLurbIng IucL LIuL oI LIe muny Lens oI LIousunds oI
sLudIes on smokIng LIere seems Lo be onIy one LIuL Ius uddressed LIIs
Issue. GrossurLI-MuLIcek & Eysenck (1q8q) Iound LIuL LIose smokers wIo
beIIeved IeuILI wurnIngs derIved onIy Irom LIe medIu Iud u sLuLIsLIcuIIy
sIgnIIIcunL IIgIer morLuIILy ruLe LIun smokers LIuL dId noL beIIeve IeuILI
wurnIngs or smokers wIo dId beIIeve LIe IeuILI wurnIngs buL derIved LIe
beIIeI Irom boLI LIe medIu und LIeIr own experIence. TIe uuLIors
concIude LIuL LIese duLu Iend some supporL Lo LIe
IypoLIesIs...suggesLIng LIuL LIe consLunL repeLILIon oI LIe evII
consequences oI cIgureLLe smokIng on IeuILI mIgIL udd Lo LIe sLress oI
conLInuIng smokers und so mIgIL consLILuLe u seII-IuIIIIIIng propIecy, In
LIe sense LIuL LIe udded sLress mIgIL be u IucLor In cuusIng deuLIs Irom
cuncer, coronury IeurL dIseuse or oLIer cuuses. (p.1;8) UnIorLunuLeIy,
LIere Ius been no uLLempL Lo repIIcuLe LIe sLudy or expIore LIe Issue.
Beyond even LIe Issue oI eurIy morLuIILy, LIe quesLIon sLIII
remuIns us Lo wIuL LIe neguLIve eIIecLs oI propugundu ure on conLInuIng
smokers. MedIco-muLerIuIIsm cun obvIousIy jusLIIy LerrorIsm und
cIurucLer-ussussInuLIon In LIe pursuIL oI smokIng cessuLIon. However, IL
cunnoL IuLIom LIe consequences oI LIIs on conLInuIng smokers. A smoker,
uILIougI noL IuvIng u reIuLIveIy eurIy morLuIILy, muy be In consLunL
unxIeLy sLuLes Ior LIe remuInder oI LIeIr IIves, beIIevIng LIuL LIey
conLInuuIIy LeeLer on LIe edge oI dIseuse und deuLI due Lo LIeIr smokIng.
or exumpIe, wILI LIe recenL reIeuse oI bupropIon (Zybun) In AusLruIIu, u
smoker InLervIewed Ior LIe IocuI news (VIcLorIu, AusLruIIu) wus udvIsed by
LIe reporLer LIuL LIe drug Iud poLenLIuIIy consIderubIe sIde eIIecLs. TIe
smoker responded LIuL LIIs wus noL un Issue becuuse Ie wus uIreudy
under u deuLI senLence. TIe smoker wus In IIs mId-IorLIes, uppeured
IeuILIy und guve no IndIcuLIon LIuL Ie suIIered Irom uny crILIcuI dIseuse.
An InLervIewer In unoLIer progrum usked persons wIeLIer LIey
smoked Lobucco or drunk uIcoIoI. or LIose wIo unswered yes Lo eILIer,
LIey were usked II LIeIr IubIL(s) posed u probIem Ior LIem. AII LIose wIo
smoked were upoIogeLIc Ior LIe IucL. One smoker, uLLerIy sLurLIed by LIe
quesLIon, reLorLed wIuL seemed In IIs mInd u seII-evIdenL LruLI, LIuL
smokIng wIII kIII you.
n one newspuper urLIcIe u smoker mukes sucI reIerences: MusL
we dIe oI pneumonIu |Irom smokIng ouLdoors In LIe coId due Lo smokIng
Preventive Medicine & Health Promotion
buns| sImpIy becuuse we pIun Lo kIII ourseIves wILI cIgureLLes?..s IL
wrong Lo IeeI sorry Ior myseII jusL becuuse unLI pussIve smokIng IobbyIsLs
mIgIL Iuve u poInL?..ExposIng InnocenL bysLunders Lo curcInogens LIey
Iuve noL LIemseIves deemed u necessury evII Is probubIy wrong..WIuL`s
so durned puLIeLIc ubouL some peopIe wunLIng u meusure oI conLroI over
Iow LIey wIII meeL LIeIr deuLI?..Yes, cIgureLLes kIII peopIe, und Iurm
oLIers.. (Hercld,Sun, AugusL 1, zoo1)
SucI IrruLIonuI beIIeIs, Ieur, und guIIL, due onIy Lo IeuILIIsL
propugundu, Is coercIon Lo psycIopuLIoIogy, und Is IuLrogenIc. WIen IL Is
undersLood LIuL mosL unLIsmokIng cIuIms Iuve no scIenLIIIc busIs, LIen
LIe IosLerIng oI sucI dysIuncLIonuI sLuLes under LIe preLense oI scIenLIIIc
credIbIIILy, Is u criticcl muLLer. L Is noL LIe smoker LIuL needs Lo expIuIn
LIeIr smokIng, buL u LIorougI scruLIny Is urgenLIy requIred oI LIIs
compIeLeIy quesLIonubIe medIco-muLerIuIIsL conducL (see uIso ILzgeruId,
1qq6).
(.( The Pcssite Smolin Discster
I LIe ussuuIL on LIe smoker wus noL uIreudy suIIIcIenLIy
dIsusLrous, LIen LIe nIneLeen-nIneLIes udded new dImensIons oI
perversILy Lo LIe IeuILIIsL onsIuugIL. TIe US EnvIronmenLuI ProLecLIon
Agency (1qq) decIured LIuL exposure Lo umbIenL Lobucco smoke cuuses
dIseuse In nonsmokers. TrunsIormIng wIuL wus Iong consIdered u prIvuLe
vIce InLo u pubIIc vIce, LIe crILIcuI reporL oI EPA (1qq) exponenLIuIIy
IueIIed LIe mIIILuncy, IerocILy und puLIoIogy oI LIe currenL unLIsmokIng
crusude. TIe combInuLIon oI LIe US Surgeon-GeneruI ReporL (1q88) und
LIe EPA ReporL (1qq) depIcL smokers us onIy uddIcLed, und LIereIore
IncupubIe oI ruLIonuI LIougIL, und ure now vIewed us u LIreuL Lo ruLIonuI
nonsmokers. TIe EPA (1qq) reporL wIII be scruLInIzed sIorLIy. AL LIIs
poInL IL Is useIuI Lo documenL some oI LIe unLIsmokIng ucLIons LIuL Iuve
been Luken on LIe busIs oI LIIs reporL. AILIougI AusLruIIu, und purLIcuIurIy
LIe sLuLe oI VIcLorIu, Is used us LIe cuse exumpIe, LIe unLIsmokIng
meusures udopLed In LIIs purLIcuIur counLry ure very mucI ukIn Lo LIose
udopLed In muny wesLern und wesLernIzed nuLIons.
(.(.: A Ccse Stud - Victoric, Austrclic
n AusLruIIu, smokIng wus bunned In LIe eurIy-1qqo`s (I.e., on LIe
busIs oI EPA, 1qq) In uII governmenL buIIdIngs, IncIudIng unIversILIes. L
Ius sInce been bunned In mosL workpIuces, In cuIes, resLuurunLs, muIIs,
sIoppIng cenLers, cusInos und LIere ure purLIuI buns In IoLeIs. TIere ure
Iew pIuces wIere u person cun smoke Indoors. SmokIng Ius uIso been
249
249
Rampant Antismoking Signifies Grave Danger
pounded Irom uII ungIes oI IeuILI promoLIon LIrougI LIe medIu LIuL
smokIng wIII cuuse uII munner oI muIudIes. BeIng wuywurd In cuusuI
cIuIms und wILI LIe use oI emoLIve, LerrorIzIng Iunguuge, u crILIcuI Issue Is
LIe ImpucL oI LIIs conducL on LIe psycIoIogIcuI sLuLes oI smokers, I.e.,
neguLIve suggesLIon or nocebo eIIecL. TIIs sorL oI Issue Is u core one Ior
non-reducLIonIsL psycIoIogy.
L Is u IIgIIy dIsLurbIng IucL LIuL oI LIe muny Lens oI LIousunds oI
sLudIes on smokIng LIere seems Lo be onIy one LIuL Ius uddressed LIIs
Issue. GrossurLI-MuLIcek & Eysenck (1q8q) Iound LIuL LIose smokers wIo
beIIeved IeuILI wurnIngs derIved onIy Irom LIe medIu Iud u sLuLIsLIcuIIy
sIgnIIIcunL IIgIer morLuIILy ruLe LIun smokers LIuL dId noL beIIeve IeuILI
wurnIngs or smokers wIo dId beIIeve LIe IeuILI wurnIngs buL derIved LIe
beIIeI Irom boLI LIe medIu und LIeIr own experIence. TIe uuLIors
concIude LIuL LIese duLu Iend some supporL Lo LIe
IypoLIesIs...suggesLIng LIuL LIe consLunL repeLILIon oI LIe evII
consequences oI cIgureLLe smokIng on IeuILI mIgIL udd Lo LIe sLress oI
conLInuIng smokers und so mIgIL consLILuLe u seII-IuIIIIIIng propIecy, In
LIe sense LIuL LIe udded sLress mIgIL be u IucLor In cuusIng deuLIs Irom
cuncer, coronury IeurL dIseuse or oLIer cuuses. (p.1;8) UnIorLunuLeIy,
LIere Ius been no uLLempL Lo repIIcuLe LIe sLudy or expIore LIe Issue.
Beyond even LIe Issue oI eurIy morLuIILy, LIe quesLIon sLIII
remuIns us Lo wIuL LIe neguLIve eIIecLs oI propugundu ure on conLInuIng
smokers. MedIco-muLerIuIIsm cun obvIousIy jusLIIy LerrorIsm und
cIurucLer-ussussInuLIon In LIe pursuIL oI smokIng cessuLIon. However, IL
cunnoL IuLIom LIe consequences oI LIIs on conLInuIng smokers. A smoker,
uILIougI noL IuvIng u reIuLIveIy eurIy morLuIILy, muy be In consLunL
unxIeLy sLuLes Ior LIe remuInder oI LIeIr IIves, beIIevIng LIuL LIey
conLInuuIIy LeeLer on LIe edge oI dIseuse und deuLI due Lo LIeIr smokIng.
or exumpIe, wILI LIe recenL reIeuse oI bupropIon (Zybun) In AusLruIIu, u
smoker InLervIewed Ior LIe IocuI news (VIcLorIu, AusLruIIu) wus udvIsed by
LIe reporLer LIuL LIe drug Iud poLenLIuIIy consIderubIe sIde eIIecLs. TIe
smoker responded LIuL LIIs wus noL un Issue becuuse Ie wus uIreudy
under u deuLI senLence. TIe smoker wus In IIs mId-IorLIes, uppeured
IeuILIy und guve no IndIcuLIon LIuL Ie suIIered Irom uny crILIcuI dIseuse.
An InLervIewer In unoLIer progrum usked persons wIeLIer LIey
smoked Lobucco or drunk uIcoIoI. or LIose wIo unswered yes Lo eILIer,
LIey were usked II LIeIr IubIL(s) posed u probIem Ior LIem. AII LIose wIo
smoked were upoIogeLIc Ior LIe IucL. One smoker, uLLerIy sLurLIed by LIe
quesLIon, reLorLed wIuL seemed In IIs mInd u seII-evIdenL LruLI, LIuL
smokIng wIII kIII you.
n one newspuper urLIcIe u smoker mukes sucI reIerences: MusL
we dIe oI pneumonIu |Irom smokIng ouLdoors In LIe coId due Lo smokIng
Preventive Medicine & Health Promotion
buns| sImpIy becuuse we pIun Lo kIII ourseIves wILI cIgureLLes?..s IL
wrong Lo IeeI sorry Ior myseII jusL becuuse unLI pussIve smokIng IobbyIsLs
mIgIL Iuve u poInL?..ExposIng InnocenL bysLunders Lo curcInogens LIey
Iuve noL LIemseIves deemed u necessury evII Is probubIy wrong..WIuL`s
so durned puLIeLIc ubouL some peopIe wunLIng u meusure oI conLroI over
Iow LIey wIII meeL LIeIr deuLI?..Yes, cIgureLLes kIII peopIe, und Iurm
oLIers.. (Hercld,Sun, AugusL 1, zoo1)
SucI IrruLIonuI beIIeIs, Ieur, und guIIL, due onIy Lo IeuILIIsL
propugundu, Is coercIon Lo psycIopuLIoIogy, und Is IuLrogenIc. WIen IL Is
undersLood LIuL mosL unLIsmokIng cIuIms Iuve no scIenLIIIc busIs, LIen
LIe IosLerIng oI sucI dysIuncLIonuI sLuLes under LIe preLense oI scIenLIIIc
credIbIIILy, Is u criticcl muLLer. L Is noL LIe smoker LIuL needs Lo expIuIn
LIeIr smokIng, buL u LIorougI scruLIny Is urgenLIy requIred oI LIIs
compIeLeIy quesLIonubIe medIco-muLerIuIIsL conducL (see uIso ILzgeruId,
1qq6).
(.( The Pcssite Smolin Discster
I LIe ussuuIL on LIe smoker wus noL uIreudy suIIIcIenLIy
dIsusLrous, LIen LIe nIneLeen-nIneLIes udded new dImensIons oI
perversILy Lo LIe IeuILIIsL onsIuugIL. TIe US EnvIronmenLuI ProLecLIon
Agency (1qq) decIured LIuL exposure Lo umbIenL Lobucco smoke cuuses
dIseuse In nonsmokers. TrunsIormIng wIuL wus Iong consIdered u prIvuLe
vIce InLo u pubIIc vIce, LIe crILIcuI reporL oI EPA (1qq) exponenLIuIIy
IueIIed LIe mIIILuncy, IerocILy und puLIoIogy oI LIe currenL unLIsmokIng
crusude. TIe combInuLIon oI LIe US Surgeon-GeneruI ReporL (1q88) und
LIe EPA ReporL (1qq) depIcL smokers us onIy uddIcLed, und LIereIore
IncupubIe oI ruLIonuI LIougIL, und ure now vIewed us u LIreuL Lo ruLIonuI
nonsmokers. TIe EPA (1qq) reporL wIII be scruLInIzed sIorLIy. AL LIIs
poInL IL Is useIuI Lo documenL some oI LIe unLIsmokIng ucLIons LIuL Iuve
been Luken on LIe busIs oI LIIs reporL. AILIougI AusLruIIu, und purLIcuIurIy
LIe sLuLe oI VIcLorIu, Is used us LIe cuse exumpIe, LIe unLIsmokIng
meusures udopLed In LIIs purLIcuIur counLry ure very mucI ukIn Lo LIose
udopLed In muny wesLern und wesLernIzed nuLIons.
(.(.: A Ccse Stud - Victoric, Austrclic
n AusLruIIu, smokIng wus bunned In LIe eurIy-1qqo`s (I.e., on LIe
busIs oI EPA, 1qq) In uII governmenL buIIdIngs, IncIudIng unIversILIes. L
Ius sInce been bunned In mosL workpIuces, In cuIes, resLuurunLs, muIIs,
sIoppIng cenLers, cusInos und LIere ure purLIuI buns In IoLeIs. TIere ure
Iew pIuces wIere u person cun smoke Indoors. SmokIng Ius uIso been
250
250
Rampant Antismoking Signifies Grave Danger
bunned In uII ouLdoor sporLIng urenus.
TIe preucIIng oI smokIng cessuLIon Ius become IIgIIy Iunded,
uggressIve und unreIenLIng. n VIcLorIu, AusLruIIu, LIere Is u QuIL
progrum conducLed under LIe uuspIces oI LIe AnLI-cuncer CouncII.
TeIevIsIon udverLIsemenLs Ior smokIng cessuLIon LypIcuIIy porLruy
smokers us dIsIeveIed, young, neur deuLI, und conLucLIng LIe QuIL
progrum us LIeIr meuns Lo suIvuLIon. TIe QuIL orgunIzuLIon dIIIers onIy
In nume Irom LIe NuzI Associction jor the Strule Acinst the Tobccco
Dcner LIuL orgunIzed counseIIng cenLers wIere LIe Lobucco III couId
seek IeIp (see ProcLor, 1qq;, p.q;; see uIso secLIon - The Nczi Anti-
Tobccco Motement). TIe currenL SLuLe governmenL LIuL cume InLo power
In LIe IuLe 1qqo`s Iud mude geLLIng LougI on smokIng purL oI ILs poIIcy
pIuLIorm. SInce LIuL LIme, unLIsmokIng propugundu Ius been uIIowed Lo
work ILs wuy Lo u monomunIucuI Irenzy; wILI eucI sLep LIe unLIsmokIng
demunds Iuve become more deIusIonuI.
n zooo, LIe sume AusLruIIun SLuLe opened LIe unLIsmokIng
CenLre Ior Tobucco ConLroI umId medIu IunIure noL unIIke, one wouId
LIInk, KurI AsLeI`s Institute jor Tobccco Hczcrds Resecrch und ILs
openIng In NuzI Germuny In 1qq1 (see ProcLor, 1qq;, p.q6). VIcLorIu Ius
uIso InsLILuLed Leen Lobucco squuds uLLempLIng Lo cuLcI reLuII sIops
seIIIng cIgureLLes Lo mInors (e.g., Hercld,Sun, qJ1zJzoo1, p.1;). TIIs Is
uIso remInIscenL oI some oI LIe ucLIvILIes oI HILIer YouLI.
AIso consIsLenL wILI LIe muLerIuIIsm oI NuzIsm und IueIIng oI LIe
unLIsmokIng senLImenL Is LIuL In LIe mId-1qqo`s AusLruIIu wus uwurded
LIe zooo OIympIc gumes. SInce LIen, uLIIeLIcIsm und body IIxuLIon
generuIIy Iuve been ruIsed Lo u mosL-IIgI socIuI proIIIe. GymnusIums
Iuve proIIIeruLed und ure one Iorm oI muLerIuIIsL cIurcIes. ProIessIonuI
sporLsmen ure now very IIgIIy puId und ure expecLed Lo be roIe modeIs Ior
youLI - Lobucco smokIng Is proIIbILed. SmokIng Is consIdered unLILIeLIcuI
Lo LIe gIorIIIcuLIon oI body or body IIxuLIon menLuIILy LIuL permeuLes u
consIderubIe exLenL oI conLemporury AusLruIIun socIeLy.
AnoLIer very crILIcuI IucLor LIuL wIII be consIdered In IurLIer
deLuII In u IuLer secLIon Is LIuL In LIe IuLe-1q8o`s u mujor LrunsIormuLIon oI
ucudemIu occurred In AusLruIIu LIuL Ius resuILed In u generuIIy muLerIuIIsL
und specIIIcuIIy medIco-muLerIuIIsL domInuLIon oI unIversILIes. As sucI,
non-reducLIonIsL dIscIpIInes, purLIcuIurIy psycIoIogy, Iuve eILIer been
dIspensed wILI or overpowered InLo u Iow-proIIIe sLuLus. TIIs Is uIso
consIsLenL wILI LIe NuzI regIme. L wouId Iuve been purLIcuIurIy non-
reducLIonIsL psycIoIogy LIuL wouId Iuve provIded counLer-urgumenL Lo
LIe muLerIuIIsm LIuL LIe currenL unLIsmokIng crusude resLs on. SucI
scruLIny Ius noL been IorLIcomIng und LIe unLIsmokIng juggernuuL Ius
been uIIowed Lo propuguLe ILs perverse urgumenLuLIon und ussuuILs on
Preventive Medicine & Health Promotion
psycIoIogIcuI und psycIosocIuI IeuILI wILI LIe greuLesL oI euse. TIe IIurry
und exLenL oI unLIsmokIng reguIuLIons nuLIonwIde und specIIIcuIIy In LIe
sLuLe oI VIcLorIu, purLIcuIurIy In LIe IuLe-qo`s und eurIy-zooo`s, wouId now
ruLe AusLruIIu us LIe Ieuder In Lobucco conLroI. As wIII be consIdered
LIrougIouL, LIIs Is noL un IonorubIe posILIon buL Is sympLomuLIc oI very
severe socIuI probIems.
n Junuury, 1qq, new IeuILI wurnIngs on cIgureLLe pucks cume
InLo eIIecL (see Igure ). AII oI LIese depIcL sLuLemenLs oI smokIng beIng
LIe prImury cuuse (suIIIcIenL condILIon) oI specIIIc dIseuseJIurm. As Ius
uIreudy been consIdered In eurIIer cIupLers, sucI cIuIms purporLIng u very
IIgI degree oI ussocIuLIon beLween smokIng und specIIIc dIseuse Iuve no
scIenLIIIc busIs und vIoIuLe uII oI LIe uvuIIubIe und consIderubIe evIdence;
Ior exumpIe, smokIng cuuses Iung cuncer mecns LIuL wIere LIe
unLecedenL (smokIng) Is, LIe consequenL (Iung cuncer) wIII IoIIow - uL
IeusL wILI very IIgI reguIurILy. SucI u proposILIon Is sImpIy unLrue. TIere
Is now LIe ubsurd cIrcumsLunce oI cIgureLLe puckuges beIng used us
bIIIbourds Ior u conLrury (unLIsmokIng) group. TIe ubsurdILy muy noL be
IosL so eusIIy, purLIcuIurIy on poIILIcIuns, II LIe eIecLIon cumpuIgns oI
poIILIcuI purLIes were run by unurcIIsLs.
TIe new IeuILI wurnIngs reIenLIessIy pound InLo LIe mInds oI
smokers LIuL noL onIy wIII LIey be sIck buL LIuL LIey sIouId be sIck, I.e.,
coercIng conLInuuI deLrImenLuI expecLuncy - IIgI poLenLIuI Ior nocebo
eIIecLs. Smokers ure noL permILLed Lo beIIeve LIuL LIey couId possIbIy be
weII wIIIe LIey remuIn smokers. TIere now seems Lo be u need Ior
psycIoIogIcuI IeuILI wurnIngs Ior LIe bIoIogIcuI IeuILI wurnIngs. AguIn, oI
LIe LIousunds oI sLudIes on smokIng durIng LIe nIneLIes, not one Ius
uddressed LIIs Issue oI IruuduIenLIy Induced neurosIs In smokers, IeL uIone
seII-IuIIIIIIng propIesy; LIIs Is un exLruordInury sLuLe oI uIIuIrs.
AL every Lurn, LIe smoker specIIIcuIIy Is Iurussed wILI IeuILIIsL
messuges wIere LIe InLenL Is Lo Invoke Ieur, guIIL, und sIume. One
governmenL unLIsmokIng TV udverL depIcLs u dIsmembered uorLu cIogged
wILI IuLLy deposILs. VIewers ure InIormed LIuL IL beIonged Lo u z-yeur oId
smoker. ApurL Irom provIdIng no IurLIer InIormuLIon und, LIereIore,
IosLerIng LIe IuIse ImpressIon LIuL LIe uorLIc condILIon Is LypIcuI oI young
smokers, us Is morLuIILy, LIe use oI dIsmembered body purLs In udverLs Is
IIgIIy quesLIonubIe In LIuL LIese uIone cun evoke dIsLusLe und uversIon
regurdIess oI LIe mujor subjecL muLLer und ILs credIbIIILy.
AnoLIer governmenL TV commercIuI sIows u dIsLressed mun In u
IospILuI bed breuLIIng wILI LIe ussIsLunce oI un oxygen musk. He Is
probubIy In IIs mId-LIIrLIes, gIven LIe seemIng uge oI IIs duugILer (ubouL
8-1o yeurs oId). L cun onIy be ussumed LIuL Ie Is suIIerIng Irom u severe
puImonury dIseuse. As IIs grIeI-sLrIcken wIIe Iooks on, IIs duugILer,
251
251
Rampant Antismoking Signifies Grave Danger
bunned In uII ouLdoor sporLIng urenus.
TIe preucIIng oI smokIng cessuLIon Ius become IIgIIy Iunded,
uggressIve und unreIenLIng. n VIcLorIu, AusLruIIu, LIere Is u QuIL
progrum conducLed under LIe uuspIces oI LIe AnLI-cuncer CouncII.
TeIevIsIon udverLIsemenLs Ior smokIng cessuLIon LypIcuIIy porLruy
smokers us dIsIeveIed, young, neur deuLI, und conLucLIng LIe QuIL
progrum us LIeIr meuns Lo suIvuLIon. TIe QuIL orgunIzuLIon dIIIers onIy
In nume Irom LIe NuzI Associction jor the Strule Acinst the Tobccco
Dcner LIuL orgunIzed counseIIng cenLers wIere LIe Lobucco III couId
seek IeIp (see ProcLor, 1qq;, p.q;; see uIso secLIon - The Nczi Anti-
Tobccco Motement). TIe currenL SLuLe governmenL LIuL cume InLo power
In LIe IuLe 1qqo`s Iud mude geLLIng LougI on smokIng purL oI ILs poIIcy
pIuLIorm. SInce LIuL LIme, unLIsmokIng propugundu Ius been uIIowed Lo
work ILs wuy Lo u monomunIucuI Irenzy; wILI eucI sLep LIe unLIsmokIng
demunds Iuve become more deIusIonuI.
n zooo, LIe sume AusLruIIun SLuLe opened LIe unLIsmokIng
CenLre Ior Tobucco ConLroI umId medIu IunIure noL unIIke, one wouId
LIInk, KurI AsLeI`s Institute jor Tobccco Hczcrds Resecrch und ILs
openIng In NuzI Germuny In 1qq1 (see ProcLor, 1qq;, p.q6). VIcLorIu Ius
uIso InsLILuLed Leen Lobucco squuds uLLempLIng Lo cuLcI reLuII sIops
seIIIng cIgureLLes Lo mInors (e.g., Hercld,Sun, qJ1zJzoo1, p.1;). TIIs Is
uIso remInIscenL oI some oI LIe ucLIvILIes oI HILIer YouLI.
AIso consIsLenL wILI LIe muLerIuIIsm oI NuzIsm und IueIIng oI LIe
unLIsmokIng senLImenL Is LIuL In LIe mId-1qqo`s AusLruIIu wus uwurded
LIe zooo OIympIc gumes. SInce LIen, uLIIeLIcIsm und body IIxuLIon
generuIIy Iuve been ruIsed Lo u mosL-IIgI socIuI proIIIe. GymnusIums
Iuve proIIIeruLed und ure one Iorm oI muLerIuIIsL cIurcIes. ProIessIonuI
sporLsmen ure now very IIgIIy puId und ure expecLed Lo be roIe modeIs Ior
youLI - Lobucco smokIng Is proIIbILed. SmokIng Is consIdered unLILIeLIcuI
Lo LIe gIorIIIcuLIon oI body or body IIxuLIon menLuIILy LIuL permeuLes u
consIderubIe exLenL oI conLemporury AusLruIIun socIeLy.
AnoLIer very crILIcuI IucLor LIuL wIII be consIdered In IurLIer
deLuII In u IuLer secLIon Is LIuL In LIe IuLe-1q8o`s u mujor LrunsIormuLIon oI
ucudemIu occurred In AusLruIIu LIuL Ius resuILed In u generuIIy muLerIuIIsL
und specIIIcuIIy medIco-muLerIuIIsL domInuLIon oI unIversILIes. As sucI,
non-reducLIonIsL dIscIpIInes, purLIcuIurIy psycIoIogy, Iuve eILIer been
dIspensed wILI or overpowered InLo u Iow-proIIIe sLuLus. TIIs Is uIso
consIsLenL wILI LIe NuzI regIme. L wouId Iuve been purLIcuIurIy non-
reducLIonIsL psycIoIogy LIuL wouId Iuve provIded counLer-urgumenL Lo
LIe muLerIuIIsm LIuL LIe currenL unLIsmokIng crusude resLs on. SucI
scruLIny Ius noL been IorLIcomIng und LIe unLIsmokIng juggernuuL Ius
been uIIowed Lo propuguLe ILs perverse urgumenLuLIon und ussuuILs on
Preventive Medicine & Health Promotion
psycIoIogIcuI und psycIosocIuI IeuILI wILI LIe greuLesL oI euse. TIe IIurry
und exLenL oI unLIsmokIng reguIuLIons nuLIonwIde und specIIIcuIIy In LIe
sLuLe oI VIcLorIu, purLIcuIurIy In LIe IuLe-qo`s und eurIy-zooo`s, wouId now
ruLe AusLruIIu us LIe Ieuder In Lobucco conLroI. As wIII be consIdered
LIrougIouL, LIIs Is noL un IonorubIe posILIon buL Is sympLomuLIc oI very
severe socIuI probIems.
n Junuury, 1qq, new IeuILI wurnIngs on cIgureLLe pucks cume
InLo eIIecL (see Igure ). AII oI LIese depIcL sLuLemenLs oI smokIng beIng
LIe prImury cuuse (suIIIcIenL condILIon) oI specIIIc dIseuseJIurm. As Ius
uIreudy been consIdered In eurIIer cIupLers, sucI cIuIms purporLIng u very
IIgI degree oI ussocIuLIon beLween smokIng und specIIIc dIseuse Iuve no
scIenLIIIc busIs und vIoIuLe uII oI LIe uvuIIubIe und consIderubIe evIdence;
Ior exumpIe, smokIng cuuses Iung cuncer mecns LIuL wIere LIe
unLecedenL (smokIng) Is, LIe consequenL (Iung cuncer) wIII IoIIow - uL
IeusL wILI very IIgI reguIurILy. SucI u proposILIon Is sImpIy unLrue. TIere
Is now LIe ubsurd cIrcumsLunce oI cIgureLLe puckuges beIng used us
bIIIbourds Ior u conLrury (unLIsmokIng) group. TIe ubsurdILy muy noL be
IosL so eusIIy, purLIcuIurIy on poIILIcIuns, II LIe eIecLIon cumpuIgns oI
poIILIcuI purLIes were run by unurcIIsLs.
TIe new IeuILI wurnIngs reIenLIessIy pound InLo LIe mInds oI
smokers LIuL noL onIy wIII LIey be sIck buL LIuL LIey sIouId be sIck, I.e.,
coercIng conLInuuI deLrImenLuI expecLuncy - IIgI poLenLIuI Ior nocebo
eIIecLs. Smokers ure noL permILLed Lo beIIeve LIuL LIey couId possIbIy be
weII wIIIe LIey remuIn smokers. TIere now seems Lo be u need Ior
psycIoIogIcuI IeuILI wurnIngs Ior LIe bIoIogIcuI IeuILI wurnIngs. AguIn, oI
LIe LIousunds oI sLudIes on smokIng durIng LIe nIneLIes, not one Ius
uddressed LIIs Issue oI IruuduIenLIy Induced neurosIs In smokers, IeL uIone
seII-IuIIIIIIng propIesy; LIIs Is un exLruordInury sLuLe oI uIIuIrs.
AL every Lurn, LIe smoker specIIIcuIIy Is Iurussed wILI IeuILIIsL
messuges wIere LIe InLenL Is Lo Invoke Ieur, guIIL, und sIume. One
governmenL unLIsmokIng TV udverL depIcLs u dIsmembered uorLu cIogged
wILI IuLLy deposILs. VIewers ure InIormed LIuL IL beIonged Lo u z-yeur oId
smoker. ApurL Irom provIdIng no IurLIer InIormuLIon und, LIereIore,
IosLerIng LIe IuIse ImpressIon LIuL LIe uorLIc condILIon Is LypIcuI oI young
smokers, us Is morLuIILy, LIe use oI dIsmembered body purLs In udverLs Is
IIgIIy quesLIonubIe In LIuL LIese uIone cun evoke dIsLusLe und uversIon
regurdIess oI LIe mujor subjecL muLLer und ILs credIbIIILy.
AnoLIer governmenL TV commercIuI sIows u dIsLressed mun In u
IospILuI bed breuLIIng wILI LIe ussIsLunce oI un oxygen musk. He Is
probubIy In IIs mId-LIIrLIes, gIven LIe seemIng uge oI IIs duugILer (ubouL
8-1o yeurs oId). L cun onIy be ussumed LIuL Ie Is suIIerIng Irom u severe
puImonury dIseuse. As IIs grIeI-sLrIcken wIIe Iooks on, IIs duugILer,
252
252
Rampant Antismoking Signifies Grave Danger Preventive Medicine & Health Promotion
sILLIng on LIe bed, deIIvers u senLImenLuI sLory, wILI u cerLuIn joIe de vIe,
IIgIIIgILIng LIe III IuLIer`s mIssed IumIIy excursIons. TIe udverL
concIudes wILI How wIII your smokIng uIIecL you? On uLIer`s Duy, u
sLIII pIoLo Irom LIIs udverL uppeured In LIe mujor VIcLorIun newspuper
curryIng LIe cupLIon WurnIng: smokIng reduces your uLIer`s
Duys. (Hercld,Sun, SepLember z, zoo1) A nIcoLIne-gum commercIuI
presenLs u young coupIe (IuLe zo-yeur oIds) cIuImIng LIuL LIeIr desIre Lo
quIL smokIng, und uIded by LIe gum, Is Ior LIe suke oI LIeIr cIIIdren (-q-
yeur-oIds).
AII LIese udverLsJcommercIuIs depIcL LIe IruuduIenL Ideu LIuL
smokers ure serIousIy III or dyIng uL u young uge (In LIeIr o`s) wILI IIgI
reguIurILy, due onIy Lo LIeIr smokIng, und eILIer IeuvIng LIeIr young
cIIIdren orpIuned or eIIecLIveIy so due Lo severe IIIness. TIe IucL oI LIe
muLLer Is LIuL severe IIIness Ior LIe uduIL uge-runge In quesLIon Is IIgIIy
uLypIcuI Ior smokers und nonsmokers uIIke. TIere ure Increuses In reIuLIve
rIsk oI specIIIc dIseuse (e.g., CHD) ussocIuLed wILI smokIng. However, LIe
predIcLIve sLrengLI oI smokIng Ior LIese dIseusesJuge-specIIIc morLuIILy Is
eIIecLIveIy zero, I.e., IIgIIy uLypIcuI. TIese sorLs oI depIcLIons ure noL onIy
mIsIeudIng, buL muxImuIIy so. TIe cupucILy Ior LIese InLenLIonuI
mIsrepresenLuLIons Lo IosLer IrruLIonuI Ieur In cIIIdren, guIIL In smokers,
und IrruLIonuI superIorILy In nonsmokers Is uIurmIng. L musL be
remembered LIuL LIIs conducL Is presenLed Lo LIe pubIIc us IeuILI
promoLIon.
OLIer unLIsmokIng propugundu empIusIzes u rebeIIIousness or
oLIer psycIopuLIoIogy oI LIe smoker In uddILIon Lo LIeIr generuI IeuILI
burden on socIeLy. One oI AusLruIIu`s cIIeI unLIsmokIng IobbyIsLs wrILes
|I|uve your smoke, romunLIcIze wILI oLIers ubouL Iow rebeIIIous und
InLeresLIng you ure, buL Ieuve LIe Iungs oI LIe resL oI us uIone. (CIupmun,
zoo1u) TIIs rebeIIIousness (unLIsocIuI) urgumenL Is currenLIy very-oILen
used, buL Is u weII-worn und IIImsy urgumenL. L Is sLIII used regurdIng
udoIescenLs, und Ius sImpIy been exLended Lo uduILs. TIe SG (1q6q)
concIuded LIuL |n|o scIenLIIIc evIdence supporLs LIe popuIur IypoLIesIs
LIuL smokIng umong udoIescenLs Is un expressIon oI rebeIIIon uguInsL
uuLIorILy. (p.;6) TIere Is no new evIdence LIuL wouId requIre un
umendmenL Lo LIIs concIusIon. urLIermore, LIere Is no evIdence LIuL
IndIcuLes LIuL rebeIIIousness Is u mujor LIeme Ior uduIL smokers.
rruLIonuI und erruLIc beIIeI weII cIurucLerIze LIe unLIsmokIng menLuIILy.
BeIIeI Is usuuIIy opporLunIsLIc In IorwurdIng LIe unLIsmokIng cuuse uL
uny poInL In LIme. ConLrury Lo CIupmun (zoo1u), CuroI & HoburL (1qq8),
co-dIrecLors oI LIe CuIIIornIun orgunIzuLIon Americcn's jor Nonsmolers'
Rihts, IndIcuLe LIuL |m|osL smokers ure poIILe, Iuw-ubIdIng cILIzens, us
one wouId expecL ure mosL nonsmokers.
253
253
Rampant Antismoking Signifies Grave Danger Preventive Medicine & Health Promotion
sILLIng on LIe bed, deIIvers u senLImenLuI sLory, wILI u cerLuIn joIe de vIe,
IIgIIIgILIng LIe III IuLIer`s mIssed IumIIy excursIons. TIe udverL
concIudes wILI How wIII your smokIng uIIecL you? On uLIer`s Duy, u
sLIII pIoLo Irom LIIs udverL uppeured In LIe mujor VIcLorIun newspuper
curryIng LIe cupLIon WurnIng: smokIng reduces your uLIer`s
Duys. (Hercld,Sun, SepLember z, zoo1) A nIcoLIne-gum commercIuI
presenLs u young coupIe (IuLe zo-yeur oIds) cIuImIng LIuL LIeIr desIre Lo
quIL smokIng, und uIded by LIe gum, Is Ior LIe suke oI LIeIr cIIIdren (-q-
yeur-oIds).
AII LIese udverLsJcommercIuIs depIcL LIe IruuduIenL Ideu LIuL
smokers ure serIousIy III or dyIng uL u young uge (In LIeIr o`s) wILI IIgI
reguIurILy, due onIy Lo LIeIr smokIng, und eILIer IeuvIng LIeIr young
cIIIdren orpIuned or eIIecLIveIy so due Lo severe IIIness. TIe IucL oI LIe
muLLer Is LIuL severe IIIness Ior LIe uduIL uge-runge In quesLIon Is IIgIIy
uLypIcuI Ior smokers und nonsmokers uIIke. TIere ure Increuses In reIuLIve
rIsk oI specIIIc dIseuse (e.g., CHD) ussocIuLed wILI smokIng. However, LIe
predIcLIve sLrengLI oI smokIng Ior LIese dIseusesJuge-specIIIc morLuIILy Is
eIIecLIveIy zero, I.e., IIgIIy uLypIcuI. TIese sorLs oI depIcLIons ure noL onIy
mIsIeudIng, buL muxImuIIy so. TIe cupucILy Ior LIese InLenLIonuI
mIsrepresenLuLIons Lo IosLer IrruLIonuI Ieur In cIIIdren, guIIL In smokers,
und IrruLIonuI superIorILy In nonsmokers Is uIurmIng. L musL be
remembered LIuL LIIs conducL Is presenLed Lo LIe pubIIc us IeuILI
promoLIon.
OLIer unLIsmokIng propugundu empIusIzes u rebeIIIousness or
oLIer psycIopuLIoIogy oI LIe smoker In uddILIon Lo LIeIr generuI IeuILI
burden on socIeLy. One oI AusLruIIu`s cIIeI unLIsmokIng IobbyIsLs wrILes
|I|uve your smoke, romunLIcIze wILI oLIers ubouL Iow rebeIIIous und
InLeresLIng you ure, buL Ieuve LIe Iungs oI LIe resL oI us uIone. (CIupmun,
zoo1u) TIIs rebeIIIousness (unLIsocIuI) urgumenL Is currenLIy very-oILen
used, buL Is u weII-worn und IIImsy urgumenL. L Is sLIII used regurdIng
udoIescenLs, und Ius sImpIy been exLended Lo uduILs. TIe SG (1q6q)
concIuded LIuL |n|o scIenLIIIc evIdence supporLs LIe popuIur IypoLIesIs
LIuL smokIng umong udoIescenLs Is un expressIon oI rebeIIIon uguInsL
uuLIorILy. (p.;6) TIere Is no new evIdence LIuL wouId requIre un
umendmenL Lo LIIs concIusIon. urLIermore, LIere Is no evIdence LIuL
IndIcuLes LIuL rebeIIIousness Is u mujor LIeme Ior uduIL smokers.
rruLIonuI und erruLIc beIIeI weII cIurucLerIze LIe unLIsmokIng menLuIILy.
BeIIeI Is usuuIIy opporLunIsLIc In IorwurdIng LIe unLIsmokIng cuuse uL
uny poInL In LIme. ConLrury Lo CIupmun (zoo1u), CuroI & HoburL (1qq8),
co-dIrecLors oI LIe CuIIIornIun orgunIzuLIon Americcn's jor Nonsmolers'
Rihts, IndIcuLe LIuL |m|osL smokers ure poIILe, Iuw-ubIdIng cILIzens, us
one wouId expecL ure mosL nonsmokers.
254
254
Rampant Antismoking Signifies Grave Danger
TIe sume AusLruIIun unLIsmokIng IobbyIsL conLrIbuLed Lo u
newspuper urLIcIe IeudIIned Smokers Lo cosL $zb. (Hercld,Sun,
qJ11Jzooo, p.z) AmongsL oLIer LIIngs, LIe urLIcIe IndIcuLes LIuL
smokIng-reIuLed IIInesses ure expecLed Lo cosL AusLruIIuns $z bIIIIon u
yeur by zozo - uImosL doubIe currenL ouLIuys. TIe Improper use oI
uLLrIbuLubIe rIsk und uLLrIbuLubIe numbers In generuLIng uLLrIbuLubIe
cosL Ius been dIscussed In un eurIIer cIupLer. However, even more
InIIummuLory Is LIuL un overuII cosL Is presenLed now (I.e., LIe yeur zooo)
LIuL InvoIves zo yeurs worLI oI predIcLed InIIuLIon und cosLs deLermIned
by oLIer secLIons oI socIeLy (e.g., medIcuI esLubIIsImenL). TIIs IosLers LIe
present mIspercepLIon oI IIgIIy exuggeruLed (doubIe) cosL. TIe urLIcIe
uIso decIures LIuL |L|uxpuyers wIII IooL mosL oI LIe IeILy bIII, bIumed on
worsenIng smokIng IubILs und rIsIng IeuILI cosLs wIIIe uL LIe sume LIme
predIcLIng LIuL AusLruIIun smokIng ruLes wIII drop sIIgILIy Lo ubouL 16 per
cenL oI LIe popuIuLIon. TIese worsenIng smokIng IubILs reIer Lo
experLs predIcLIng LIuL smokers wIII Iuve IeuvIer und Ionger-IusLIng
uddIcLIons. No deIInILIon oI LIese Lerms Is provIded nor wIy LIey ure
predIcLed Lo occur. Do IeuvIer und Ionger-IusLIng meun LIuL LIe
smoker Is even more ouL-oI-conLroI, IrruLIonuI In LIeIr IubIL?
AddIcLIon (ouL oI conLroI) und ETS dunger Iuve been LIe busIs
Ior LIe currenL unLIsmokIng Irenzy. A Lerm sucI us IeuvIer uddIcLIon
onIy IosLers LIe IurLIer mIspercepLIon LIuL IuLure smokers wIII be more
ouL-oI-conLroI und more dungerous. Ike mosL unLIsmokIng dogmu, LIese
Lerms ure vucuous, devoId oI uny meunIngIuIness, buL dungerous In LIeIr
cupucILy Lo IueI IrruLIonuI superIorILy und Ieur umongsL nonsmokers. TIe
urLIcIe uIso predIcLs LIuL smokIng wIII be concenLruLed umongsL LIe poor,
bIue-coIIur workers, LIe Iess educuLed, und peopIe wILI menLuI IIInesses
und InLeIIecLuuI dIsubIIILIes. TIIs Is no more LIun LIe uLLempL Lo
munuIucLure und reInIorce u sLereoLype wIere LIose LIuL smoke ure
consIdered us IrruLIonuI und deIIcIenL - rungIng Irom IIIILeruLe Lo sLupId Lo
psycIoLIc. TIereIore, sune, educuLed, cuILured persons do noL smoke. TIIs
uIso reInIorces IrruLIonuI superIorILy und Ieur umongsL LIe now mosLIy
nonsmokIng upper-cIuss und bourgeoIsIe In reIuLIon Lo LIe InIerIor und
dungerous Iower-cIuss. n muny deveIoped nuLIons, LIere Is u Iower
smokIng ruLe umongsL LIe mIddIe und upper cIusses. However, LIIs muy
IndIcuLe LIuL LIese cIusses Iuve embruced muLerIuIIsL propugundu; IL Is LIe
upper-cIuss und bourgeoIsIe LIuL Iuve u IIgI purLIcIpuLIon ruLe In LIe
MMES cuIL. AguIn, LIIs Is noL uII Loo dIIIerenL Irom LIe NuzI porLruyuI oI
smokers (see eurIIer secLIon).
TIIs IuLLer urLIcIe reIIecLed predIcLIons Ior LIe nuLIon`s smokIng
IubILs In zo yeurs bused on currenL Lrends. TIe uuLIorILIes conLrIbuLIng
Lo LIe sLudy, zozo Vision, were Quit, VicHeclth, LIe Austrclicn Mediccl
Preventive Medicine & Health Promotion
Associction (AMA) und LIe Nctioncl Hecrt Ioundction. AII oI LIese
groups ure mIIILunLIy unLIsmokIng In sLunce. AddIng u IInuI bIused LoucI Is
LIuL LIe reporL wus commIssIoned by Nicorette (nIcoLIne repIucemenL
producLs) murkeLer, Phcrmccic.
TIe ubove udverLsJcommercIuIsJurLIcIes represenL onIy u tin
sumpIe oI LIe currenL unLIsmokIng burruge. L reIIecLs u consIsLenL pIuy on
Ieur, guIIL, und sIume LIrougI InIIummuLory, emoLIve meuns LIuL ure oI
compIeLeIy quesLIonubIe merIL. TIe cupucILy Ior nocebo eIIecLs, In
smokersJnonsmokers und uduILsJcIIIdren uIIke, und consequenLIuI socIuI
dIvIsIon, Is sLuggerIng. OnIy more sLuggerIng Is LIuL LIIs unLIsmokIng
nonsense Ius been uIIowed Lo be propuguLed, essenLIuIIy uncIuIIenged,
under LIe preLense oI scIenLIIIc credIbIIILy und IeuILI promoLIon. AguIn, IL
Is u mosL IIgIIy dIsLurbIng sIgn LIuL oI LIe muny Lens oI LIousunds oI
more recenL smokIng sLudIes, LIere Iuve been very Iew uLLempLs, II uny,
uL u scIoIurIy scruLIny oI LIe unLIsmokIng menLuIILy und ILs IIgI poLenLIuI
Ior deLrImenLuI psycIoIogIcuI, psycIosocIuI, und moruI IeuILI
consequences. TIIs IndIcuLes LIe exLruordInury cIrcumsLunce LIuL un
enLIre reseurcI dIscIpIIne (I.e., non-reducLIonIsL psycIoIogy) Ius no
represenLuLIon.
RudIcuI beIuvIorIsm IIgures very IIgIIy In LIe unLIsmokIng
crusude. ncupubIe oI dIscernIng LIe scIenLIIIc, psycIoIogIcuI,
psycIosocIuI, or moruI merIL oI cIuIms, IL becomes LIe propugundu urm oI
medIco-muLerIuIIsm, munuIucLurIng uII sorLs oI IncoIerenL ussocIuLIons In
un uLLempL Lo neguLIveIy reInIorce LIe smokIng IubIL or Lo remove posILIve
reInIorcemenL. or exumpIe, In LIe sLuLe oI VIcLorIu, AusLruIIu, LIere Ius
been u Iong-Lerm cumpuIgn uguInsL speedIng In uuLomobIIes. A Ieud
cupLIon Ior LIe cumpuIgn Is speed kIIIs. n un uLLempL Lo
opporLunIsLIcuIIy cupILuIIze on LIIs cumpuIgn, LIere Iuve been duuI-
bIIIbourds uppeurIng on LIe VIcLorIun Iundscupe wIere one bIIIbourd
reuds speed kIIIs und LIe oLIer reuds smokIng kIIIs. No compeLenL
reseurcIer or LIInker wouId uLLempL Lo IInk LIe Lwo In LIuL LIey InvoIve
compIeLeIy dIIIerenL dIsLrIbuLIons oI ussocIuLIon, Lype oI rIsk, ImpIIcuLed
IucLors, und underIyIng demonsLrubIe cuusuI Irumework.
SImIIurIy, one IeuILI wurnIng uppeurIng on LIe bccl oI
cIgureLLe pucks Is Tobucco smokIng cuuses more LIun Iour LImes LIe
number oI deuLIs cuused by cur uccIdenLs, I.e., LIe meLIod oI
ussussInuLIon by ussocIuLIon. AguIn, LIe conducL Is unLI-scIenLIIIc,
dIsordered und seII-servIng - uIondIsL.
BorIund (1qq;) concIudes oI LIe new IeuILI wurnIngs
uppeurIng on cIgureLLe pucks LIuL TIe new sysLem oI wurnIngs wus bused
on empIrIcuI reseurcI desIgned Lo ensure muxImum ImpucL. L Is LIIs
ensurIng muxImum ImpucL LIuL permeuLes LIe conLemporury
255
255
Rampant Antismoking Signifies Grave Danger
TIe sume AusLruIIun unLIsmokIng IobbyIsL conLrIbuLed Lo u
newspuper urLIcIe IeudIIned Smokers Lo cosL $zb. (Hercld,Sun,
qJ11Jzooo, p.z) AmongsL oLIer LIIngs, LIe urLIcIe IndIcuLes LIuL
smokIng-reIuLed IIInesses ure expecLed Lo cosL AusLruIIuns $z bIIIIon u
yeur by zozo - uImosL doubIe currenL ouLIuys. TIe Improper use oI
uLLrIbuLubIe rIsk und uLLrIbuLubIe numbers In generuLIng uLLrIbuLubIe
cosL Ius been dIscussed In un eurIIer cIupLer. However, even more
InIIummuLory Is LIuL un overuII cosL Is presenLed now (I.e., LIe yeur zooo)
LIuL InvoIves zo yeurs worLI oI predIcLed InIIuLIon und cosLs deLermIned
by oLIer secLIons oI socIeLy (e.g., medIcuI esLubIIsImenL). TIIs IosLers LIe
present mIspercepLIon oI IIgIIy exuggeruLed (doubIe) cosL. TIe urLIcIe
uIso decIures LIuL |L|uxpuyers wIII IooL mosL oI LIe IeILy bIII, bIumed on
worsenIng smokIng IubILs und rIsIng IeuILI cosLs wIIIe uL LIe sume LIme
predIcLIng LIuL AusLruIIun smokIng ruLes wIII drop sIIgILIy Lo ubouL 16 per
cenL oI LIe popuIuLIon. TIese worsenIng smokIng IubILs reIer Lo
experLs predIcLIng LIuL smokers wIII Iuve IeuvIer und Ionger-IusLIng
uddIcLIons. No deIInILIon oI LIese Lerms Is provIded nor wIy LIey ure
predIcLed Lo occur. Do IeuvIer und Ionger-IusLIng meun LIuL LIe
smoker Is even more ouL-oI-conLroI, IrruLIonuI In LIeIr IubIL?
AddIcLIon (ouL oI conLroI) und ETS dunger Iuve been LIe busIs
Ior LIe currenL unLIsmokIng Irenzy. A Lerm sucI us IeuvIer uddIcLIon
onIy IosLers LIe IurLIer mIspercepLIon LIuL IuLure smokers wIII be more
ouL-oI-conLroI und more dungerous. Ike mosL unLIsmokIng dogmu, LIese
Lerms ure vucuous, devoId oI uny meunIngIuIness, buL dungerous In LIeIr
cupucILy Lo IueI IrruLIonuI superIorILy und Ieur umongsL nonsmokers. TIe
urLIcIe uIso predIcLs LIuL smokIng wIII be concenLruLed umongsL LIe poor,
bIue-coIIur workers, LIe Iess educuLed, und peopIe wILI menLuI IIInesses
und InLeIIecLuuI dIsubIIILIes. TIIs Is no more LIun LIe uLLempL Lo
munuIucLure und reInIorce u sLereoLype wIere LIose LIuL smoke ure
consIdered us IrruLIonuI und deIIcIenL - rungIng Irom IIIILeruLe Lo sLupId Lo
psycIoLIc. TIereIore, sune, educuLed, cuILured persons do noL smoke. TIIs
uIso reInIorces IrruLIonuI superIorILy und Ieur umongsL LIe now mosLIy
nonsmokIng upper-cIuss und bourgeoIsIe In reIuLIon Lo LIe InIerIor und
dungerous Iower-cIuss. n muny deveIoped nuLIons, LIere Is u Iower
smokIng ruLe umongsL LIe mIddIe und upper cIusses. However, LIIs muy
IndIcuLe LIuL LIese cIusses Iuve embruced muLerIuIIsL propugundu; IL Is LIe
upper-cIuss und bourgeoIsIe LIuL Iuve u IIgI purLIcIpuLIon ruLe In LIe
MMES cuIL. AguIn, LIIs Is noL uII Loo dIIIerenL Irom LIe NuzI porLruyuI oI
smokers (see eurIIer secLIon).
TIIs IuLLer urLIcIe reIIecLed predIcLIons Ior LIe nuLIon`s smokIng
IubILs In zo yeurs bused on currenL Lrends. TIe uuLIorILIes conLrIbuLIng
Lo LIe sLudy, zozo Vision, were Quit, VicHeclth, LIe Austrclicn Mediccl
Preventive Medicine & Health Promotion
Associction (AMA) und LIe Nctioncl Hecrt Ioundction. AII oI LIese
groups ure mIIILunLIy unLIsmokIng In sLunce. AddIng u IInuI bIused LoucI Is
LIuL LIe reporL wus commIssIoned by Nicorette (nIcoLIne repIucemenL
producLs) murkeLer, Phcrmccic.
TIe ubove udverLsJcommercIuIsJurLIcIes represenL onIy u tin
sumpIe oI LIe currenL unLIsmokIng burruge. L reIIecLs u consIsLenL pIuy on
Ieur, guIIL, und sIume LIrougI InIIummuLory, emoLIve meuns LIuL ure oI
compIeLeIy quesLIonubIe merIL. TIe cupucILy Ior nocebo eIIecLs, In
smokersJnonsmokers und uduILsJcIIIdren uIIke, und consequenLIuI socIuI
dIvIsIon, Is sLuggerIng. OnIy more sLuggerIng Is LIuL LIIs unLIsmokIng
nonsense Ius been uIIowed Lo be propuguLed, essenLIuIIy uncIuIIenged,
under LIe preLense oI scIenLIIIc credIbIIILy und IeuILI promoLIon. AguIn, IL
Is u mosL IIgIIy dIsLurbIng sIgn LIuL oI LIe muny Lens oI LIousunds oI
more recenL smokIng sLudIes, LIere Iuve been very Iew uLLempLs, II uny,
uL u scIoIurIy scruLIny oI LIe unLIsmokIng menLuIILy und ILs IIgI poLenLIuI
Ior deLrImenLuI psycIoIogIcuI, psycIosocIuI, und moruI IeuILI
consequences. TIIs IndIcuLes LIe exLruordInury cIrcumsLunce LIuL un
enLIre reseurcI dIscIpIIne (I.e., non-reducLIonIsL psycIoIogy) Ius no
represenLuLIon.
RudIcuI beIuvIorIsm IIgures very IIgIIy In LIe unLIsmokIng
crusude. ncupubIe oI dIscernIng LIe scIenLIIIc, psycIoIogIcuI,
psycIosocIuI, or moruI merIL oI cIuIms, IL becomes LIe propugundu urm oI
medIco-muLerIuIIsm, munuIucLurIng uII sorLs oI IncoIerenL ussocIuLIons In
un uLLempL Lo neguLIveIy reInIorce LIe smokIng IubIL or Lo remove posILIve
reInIorcemenL. or exumpIe, In LIe sLuLe oI VIcLorIu, AusLruIIu, LIere Ius
been u Iong-Lerm cumpuIgn uguInsL speedIng In uuLomobIIes. A Ieud
cupLIon Ior LIe cumpuIgn Is speed kIIIs. n un uLLempL Lo
opporLunIsLIcuIIy cupILuIIze on LIIs cumpuIgn, LIere Iuve been duuI-
bIIIbourds uppeurIng on LIe VIcLorIun Iundscupe wIere one bIIIbourd
reuds speed kIIIs und LIe oLIer reuds smokIng kIIIs. No compeLenL
reseurcIer or LIInker wouId uLLempL Lo IInk LIe Lwo In LIuL LIey InvoIve
compIeLeIy dIIIerenL dIsLrIbuLIons oI ussocIuLIon, Lype oI rIsk, ImpIIcuLed
IucLors, und underIyIng demonsLrubIe cuusuI Irumework.
SImIIurIy, one IeuILI wurnIng uppeurIng on LIe bccl oI
cIgureLLe pucks Is Tobucco smokIng cuuses more LIun Iour LImes LIe
number oI deuLIs cuused by cur uccIdenLs, I.e., LIe meLIod oI
ussussInuLIon by ussocIuLIon. AguIn, LIe conducL Is unLI-scIenLIIIc,
dIsordered und seII-servIng - uIondIsL.
BorIund (1qq;) concIudes oI LIe new IeuILI wurnIngs
uppeurIng on cIgureLLe pucks LIuL TIe new sysLem oI wurnIngs wus bused
on empIrIcuI reseurcI desIgned Lo ensure muxImum ImpucL. L Is LIIs
ensurIng muxImum ImpucL LIuL permeuLes LIe conLemporury
256
256
Rampant Antismoking Signifies Grave Danger
unLIsmokIng crusude, I.e., muxImum ImpucL by wIuLever meuns. GIven
LIuL LIe urLIcIe Is unLIsmokIng In dIsposILIon, BorIund (1qq;) never
consIders LIe prospecL LIuL LIe IeuILI wurnIngs ure ucLuuIIy unLrue, IuIse,
IruuduIenL, und LerrorIsL In dIsposILIon. urLIermore, LIe empIrIcuI
reseurcI BorIund uIIudes Lo concerned onIy Iow cIeurIy LIe Iurge, boId
IeuILI wurnIngs couId be seen wIen cIgureLLe pucks were In dIspIuy
sLunds uL reLuII ouLIeLs und Ior wIIcI LIe AnLI-cuncer CouncII (I.e., unoLIer
IIgI-proIIIe unLIsmokIng group) pIuyed u mujor roIe. TIIs enLIre conducL
demonsLruLes LIe conLorLed mIre LIuL muLerIuIIsm (rudIcuI beIuvIorIsm)
coIIupses InLo wIere u deIuded end (unLIsmokIng) jusLIIIes deIuded
meuns. One Ius Lo conLInuuIIy be remInded LIuL LIIs ucLIvILy Is supposedIy
IeuILI promoLIon.
I LIe Issue oI verucILy oI cIuIms und psycIoIogIcuI ImpucL on
conLInuIng smokers wus uIreudy crILIcuI prIor Lo LIe 1qqo`s, LIen LIe
sILuuLIon Ius deLerIoruLed even IurLIer durIng LIe 1qqo`s wILI u pussIve
smokIng-Ied ussuuIL. L musL be remembered LIuL sInce LIe mId-1q;o`s
LIe ugendu oI unLIsmokIng groups Ius been LIe exLermInuLIon oI LIe
smokIng IubIL; Ior LIese groups no compromIse Is possIbIe. n LIe Iunds
oI LIese groups, InIormuLIon wIII be corrupLed, perverLed Lo IIL ILs deIuded
IdeoIogIcuI quesL. OnIy In LIe IusL Iew yeurs, VIcLorIun unLIsmokIng groups
LIuL ure IuIIy endorsed by LIe SLuLe governmenL Iuve mude progressIveIy
more derunged demunds.
TIere Ius been u pusI Ior bun on smokIng In curs. A zooo
newspuper urLIcIe begIns wILI LIe sLuLemenL: A bun on smokIng In curs
curryIng cIIIdren couId be LIe unLIsmokIng Iobby`s IIrsL venLure InLo
poIIcIng prIvuLe spuce. (Hercld,Sun, Muy zz, zooo, p.) TIe urLIcIe
provIdes sLuLemenLs Irom u vurIeLy oI unLIsmokIng IobbyIsLsJgroups und
wILI no cIuIIenge Lo LIe scIenLIIIc merIL oI uny oI LIe cIuIms. RuLIer, IuII
oI LIe urLIcIe presenLs IrreIevunL sLuLIsLIcuI InIormuLIon concernIng
smokIng-reIuLed dIseuses umong uduILs subdIvIded by ureus oI LIe sLuLe.
TIIs sorL oI dIsjoInLed presenLuLIon Is u IeuLure oI sucI urLIcIes.
PrIor Lo LIe currenL SLuLe governmenL comIng Lo power (very
IuLe-1qqo`s), LIe unLIsmokIng Iobby wus uLLempLIng Lo convInce u smuII
proporLIon oI resLuuruLeurs Lo oIIer one smoke-Iree weekend per yeur. As
soon us LIe currenL governmenL cume InLo power, LIe propugundu
mucIIne reucIed IuII-power. SmokIng wus bunned ouLrIgIL In euLerIes In
mId-zoo1. oIIowIng cIose on ILs IeeIs, smokIng wus bunned In cusInos
und poker-mucIIne venues In SepLember, zooz.
AnLIsmokIng groups In VIcLorIu, IuIIy endorsed by LIe SLuLe
governmenL, Iuve reucIed u dIzzyIng IeIgIL oI urrogunce und
IuugILIness, InsLuIIIng LIemseIves us moruI overseers oI socIeLy-uL-Iurge
wIen LIe enLIre perspecLIve Is devoId oI uny coIerenL uspecL, especIuIIy u
Preventive Medicine & Health Promotion
moruI one; LIey Iorwurd LIemseIves us suvIors oI LIe IuIIen. TIe
AusLruIIun LennIs cIumpIon, IeyLon HewILL, u nonsmoker, mude LIe IronL
puge oI LIe SLuLe`s mujor newspuper uILer Ie mouLIed u cIgur In IronL oI
cumerus IoIIowIng IIs WImbIedon CIumpIonsIIp wIn. Some duys IuLer, un
urLIcIe In LIe sume newspuper reporLed LIuL:
CIgur-smokIng IeyLon HewILL couId become u posLer
boy oI LIe unLILobucco movemenL. TIe newIy crowned
WImbIedon cIumpIon spurked ouLruge uILer beIng
pIoLogrupIed smokIng u ceIebruLory cIgur LIIs monLI.
BuL now LIe worId`s besL LennIs pIuyer Is beIng courLed
by QuIL VIcLorIu us un unLIsmokIng roIe modeI. AILer
crILIcIsIng HewILL`s conducL, QuIL VIcLorIu`s execuLIve
dIrecLor, Mr. Todd Hurper, upproucIed IIs munugers.
SInce LIuL IncIdenL, we`ve been IuvIng reguIur
dIscussIons wILI IeyLon HewILL`s munugemenL, und
LIuL`s been very producLIve, Mr. Hurper suId. LIInk
LIere`s un opporLunILy LIuL we couId work LogeLIer In
LIe IuLure. (Hercld,Sun, JuIy zz, zooz, p.q)
n unoLIer epIsode u IooLbuII broudcusLer Iud un on-uIr ouLbursL
wILI u IooLbuII Iun wIose cIgureLLe smoke wus bIowIng InLo LIe broudcusL
booLI. TIe smoker wus In u desIgnuLed smokIng secLIon (Hercld,Sun,
June 18, zooz, p.;1). TIe newspuper urLIcIe uIso noLed LIuL QuIL Ius gone
on LIe IronL IooL Lo encouruge |LIe IooLbuII venue| Lo become u smoke-Iree
venue. L wIII meeL |venue| oIIIcIuIs Loduy Lo press LIe poInL. 'L's IIgI LIme
|LIIs venue| joIned LIe resL oI us In LIe z1sL cenLury und wenL smoke Iree
IIke oLIer muIn IooLbuII sLudIums`, LIe QuIL execuLIve dIrecLor suId
yesLerduy. TIe QuIL unLIsmokIng group cun uppurenLIy dIspuLcI un
emergency suIvuLIon Leum Lo guIde errunL, non-unLIsmokIng
esLubIIsImenLs. L Is exLruordInury LIuL sucI monomunIucuI groups Iuve
been gIven sucI Iree scope Lo peddIe ucuLe IIxuLIon.
nLeresLIngIy, LIe 1q-yeur presIdenL oI LIe IooLbuII cIub ubove, u
smoker wIo muInLuIned smokIng secLIons uL LIe venue, wus repIuced In
IuLe-zooz. TIIs puved LIe wuy Lo uIIgn LIIs IooLbuII cIub InLo unLIsmokIng
poIILIcuI correcLness: VIcHeuILI yesLerduy unnounced IL Iud sIgned u
deuI wILI CurILon ooLbuII CIub Lo bun smokIng uL OpLus OvuI Irom AprII.
Under LIe deuI, bIg QUT und SmokeIree sIgns wIII be pIusLered on
IencIng und sLunds. VIcHeuILI cIIeI execuLIve Dr Rob MoodIe suId Ie Iud
been deIIgILed wIen |LIe Iormer presIdenL| wus dumped Irom LIe
presIdency..'We`d prevIousIy Luken our money uwuy Irom CurILon sImpIy
becuuse |LIe presIdenL| kepL udverLIsIng our compeLILors by smokIng,` Dr
MoodIe suId. (Hercld,Sun, ebruury zz, zoo, p.1q) L seems us LIougI
257
257
Rampant Antismoking Signifies Grave Danger
unLIsmokIng crusude, I.e., muxImum ImpucL by wIuLever meuns. GIven
LIuL LIe urLIcIe Is unLIsmokIng In dIsposILIon, BorIund (1qq;) never
consIders LIe prospecL LIuL LIe IeuILI wurnIngs ure ucLuuIIy unLrue, IuIse,
IruuduIenL, und LerrorIsL In dIsposILIon. urLIermore, LIe empIrIcuI
reseurcI BorIund uIIudes Lo concerned onIy Iow cIeurIy LIe Iurge, boId
IeuILI wurnIngs couId be seen wIen cIgureLLe pucks were In dIspIuy
sLunds uL reLuII ouLIeLs und Ior wIIcI LIe AnLI-cuncer CouncII (I.e., unoLIer
IIgI-proIIIe unLIsmokIng group) pIuyed u mujor roIe. TIIs enLIre conducL
demonsLruLes LIe conLorLed mIre LIuL muLerIuIIsm (rudIcuI beIuvIorIsm)
coIIupses InLo wIere u deIuded end (unLIsmokIng) jusLIIIes deIuded
meuns. One Ius Lo conLInuuIIy be remInded LIuL LIIs ucLIvILy Is supposedIy
IeuILI promoLIon.
I LIe Issue oI verucILy oI cIuIms und psycIoIogIcuI ImpucL on
conLInuIng smokers wus uIreudy crILIcuI prIor Lo LIe 1qqo`s, LIen LIe
sILuuLIon Ius deLerIoruLed even IurLIer durIng LIe 1qqo`s wILI u pussIve
smokIng-Ied ussuuIL. L musL be remembered LIuL sInce LIe mId-1q;o`s
LIe ugendu oI unLIsmokIng groups Ius been LIe exLermInuLIon oI LIe
smokIng IubIL; Ior LIese groups no compromIse Is possIbIe. n LIe Iunds
oI LIese groups, InIormuLIon wIII be corrupLed, perverLed Lo IIL ILs deIuded
IdeoIogIcuI quesL. OnIy In LIe IusL Iew yeurs, VIcLorIun unLIsmokIng groups
LIuL ure IuIIy endorsed by LIe SLuLe governmenL Iuve mude progressIveIy
more derunged demunds.
TIere Ius been u pusI Ior bun on smokIng In curs. A zooo
newspuper urLIcIe begIns wILI LIe sLuLemenL: A bun on smokIng In curs
curryIng cIIIdren couId be LIe unLIsmokIng Iobby`s IIrsL venLure InLo
poIIcIng prIvuLe spuce. (Hercld,Sun, Muy zz, zooo, p.) TIe urLIcIe
provIdes sLuLemenLs Irom u vurIeLy oI unLIsmokIng IobbyIsLsJgroups und
wILI no cIuIIenge Lo LIe scIenLIIIc merIL oI uny oI LIe cIuIms. RuLIer, IuII
oI LIe urLIcIe presenLs IrreIevunL sLuLIsLIcuI InIormuLIon concernIng
smokIng-reIuLed dIseuses umong uduILs subdIvIded by ureus oI LIe sLuLe.
TIIs sorL oI dIsjoInLed presenLuLIon Is u IeuLure oI sucI urLIcIes.
PrIor Lo LIe currenL SLuLe governmenL comIng Lo power (very
IuLe-1qqo`s), LIe unLIsmokIng Iobby wus uLLempLIng Lo convInce u smuII
proporLIon oI resLuuruLeurs Lo oIIer one smoke-Iree weekend per yeur. As
soon us LIe currenL governmenL cume InLo power, LIe propugundu
mucIIne reucIed IuII-power. SmokIng wus bunned ouLrIgIL In euLerIes In
mId-zoo1. oIIowIng cIose on ILs IeeIs, smokIng wus bunned In cusInos
und poker-mucIIne venues In SepLember, zooz.
AnLIsmokIng groups In VIcLorIu, IuIIy endorsed by LIe SLuLe
governmenL, Iuve reucIed u dIzzyIng IeIgIL oI urrogunce und
IuugILIness, InsLuIIIng LIemseIves us moruI overseers oI socIeLy-uL-Iurge
wIen LIe enLIre perspecLIve Is devoId oI uny coIerenL uspecL, especIuIIy u
Preventive Medicine & Health Promotion
moruI one; LIey Iorwurd LIemseIves us suvIors oI LIe IuIIen. TIe
AusLruIIun LennIs cIumpIon, IeyLon HewILL, u nonsmoker, mude LIe IronL
puge oI LIe SLuLe`s mujor newspuper uILer Ie mouLIed u cIgur In IronL oI
cumerus IoIIowIng IIs WImbIedon CIumpIonsIIp wIn. Some duys IuLer, un
urLIcIe In LIe sume newspuper reporLed LIuL:
CIgur-smokIng IeyLon HewILL couId become u posLer
boy oI LIe unLILobucco movemenL. TIe newIy crowned
WImbIedon cIumpIon spurked ouLruge uILer beIng
pIoLogrupIed smokIng u ceIebruLory cIgur LIIs monLI.
BuL now LIe worId`s besL LennIs pIuyer Is beIng courLed
by QuIL VIcLorIu us un unLIsmokIng roIe modeI. AILer
crILIcIsIng HewILL`s conducL, QuIL VIcLorIu`s execuLIve
dIrecLor, Mr. Todd Hurper, upproucIed IIs munugers.
SInce LIuL IncIdenL, we`ve been IuvIng reguIur
dIscussIons wILI IeyLon HewILL`s munugemenL, und
LIuL`s been very producLIve, Mr. Hurper suId. LIInk
LIere`s un opporLunILy LIuL we couId work LogeLIer In
LIe IuLure. (Hercld,Sun, JuIy zz, zooz, p.q)
n unoLIer epIsode u IooLbuII broudcusLer Iud un on-uIr ouLbursL
wILI u IooLbuII Iun wIose cIgureLLe smoke wus bIowIng InLo LIe broudcusL
booLI. TIe smoker wus In u desIgnuLed smokIng secLIon (Hercld,Sun,
June 18, zooz, p.;1). TIe newspuper urLIcIe uIso noLed LIuL QuIL Ius gone
on LIe IronL IooL Lo encouruge |LIe IooLbuII venue| Lo become u smoke-Iree
venue. L wIII meeL |venue| oIIIcIuIs Loduy Lo press LIe poInL. 'L's IIgI LIme
|LIIs venue| joIned LIe resL oI us In LIe z1sL cenLury und wenL smoke Iree
IIke oLIer muIn IooLbuII sLudIums`, LIe QuIL execuLIve dIrecLor suId
yesLerduy. TIe QuIL unLIsmokIng group cun uppurenLIy dIspuLcI un
emergency suIvuLIon Leum Lo guIde errunL, non-unLIsmokIng
esLubIIsImenLs. L Is exLruordInury LIuL sucI monomunIucuI groups Iuve
been gIven sucI Iree scope Lo peddIe ucuLe IIxuLIon.
nLeresLIngIy, LIe 1q-yeur presIdenL oI LIe IooLbuII cIub ubove, u
smoker wIo muInLuIned smokIng secLIons uL LIe venue, wus repIuced In
IuLe-zooz. TIIs puved LIe wuy Lo uIIgn LIIs IooLbuII cIub InLo unLIsmokIng
poIILIcuI correcLness: VIcHeuILI yesLerduy unnounced IL Iud sIgned u
deuI wILI CurILon ooLbuII CIub Lo bun smokIng uL OpLus OvuI Irom AprII.
Under LIe deuI, bIg QUT und SmokeIree sIgns wIII be pIusLered on
IencIng und sLunds. VIcHeuILI cIIeI execuLIve Dr Rob MoodIe suId Ie Iud
been deIIgILed wIen |LIe Iormer presIdenL| wus dumped Irom LIe
presIdency..'We`d prevIousIy Luken our money uwuy Irom CurILon sImpIy
becuuse |LIe presIdenL| kepL udverLIsIng our compeLILors by smokIng,` Dr
MoodIe suId. (Hercld,Sun, ebruury zz, zoo, p.1q) L seems us LIougI
258
258
Rampant Antismoking Signifies Grave Danger
smokIng Is LIe crILIcuI crILerIon In evuIuuLIng persons wILIIn u sIuIIow,
conLrIved udversurIuI Irumework. L Is LIe sume sImpIe-mIndedness
demonsLruLed by LIe unLIsmokIng Iobby In NuzI Germuny. L musL be
noLed LIuL LIIs superIIcIuIILy oI reusonIng In LIIs cIrcumsLunce Is beIng
demonsLruLed by LIe dIrecLor oI LIe mujor SLuLe-governmenL IeuILI
orgunIzuLIon.
n u IurLIer IeudIIne-mukIng sLory, u mujor AusLruIIun LeIevIsIon
sLuLIon wus sued by LIe AusLruIIun BroudcusLIng AuLIorILy (ABA) Ior
breucIIng ILs broudcusLIng IIcense In LIuL durIng u o Minutes InLervIew
wILI screen ucLor, RusseII Crowe, IL uIred (1 seconds) LIe ucLor IIgILIng u
cIgureLLe wIo uIso covered LIe cIgureLLe wILI u brunded cIgureLLe puck
(Hercld,Sun, JuIy 18, zooz, p.q; JuIy zq, zooz, p.zo). L wus noL LIe
orIgInuI uIrIng LIuL wus LroubIesome. RuLIer, IL wus wIen LIe progrum
uIred LIe brunded puck segmenL uguIn In response Lo vIewer muIIbug
crILIcIsm oI LIe ucLor`s IubIL LIuL uLLrucLed LIe ABA`s uLLenLIon.
TIere Is now even governmenLuI consIderuLIon oI LIe
unLIsmokIng demund LIuL smokIng be bunned Irom uppeurIng In IocuIIy
produced TV serIuIs: SLurs mIgIL be LoId Lo buLL ouL: TIe ederuI
GovernmenL wIII Iook InLo LIe possIbIIILy oI bunnIng IIIm und LeIevIsIon
ucLors smokIng on screen. ederuI purIIumenLury secreLury Ior IeuILI,
TrIsI WorLI, yesLerduy used WorId No Tobucco Duy Lo unnounce LIe IIrsL
revIew oI nuLIonuI Lobucco udverLIsIng Iuws In Len yeurs. 'n un IdeuI worId
you wouId Iope supersLurs, modeIs und LIe peopIe wIo know LIey
InIIuence young peopIe wouId beIuve In u responsIbIe wuy und Lry Lo gIve
good exumpIes`, Ms WorLI suId. 'BuL II LIuL`s noL LIe cuse, LIen we
obvIousIy Iuve Lo Luke u bIgger sLIck Lo LIuL.` (Hercld,Sun, June 1, zooz)
TIe reckonIng Is noL cIuIIenged In LIe urLIcIe; LIuL IL mIgIL seL u deIuded
precedenL Ior censorsIIp Is noL ruIsed.
AnoLIer newspuper urLIcIe wus cupLIoned nquIry Lo Iook uL new
smoke buns (Hercld,Sun, AugusL zq, zooz, p.8). TIe urLIcIe IndIcuLes
LIuL |n|ew cIumps on smokIng In pubIIc couId IIow Irom u Lop-IeveI sLuLe
governmenL InquIry. L Is LIe governmenL LIuL Is requesLIng LIe InquIry
LIuL wIII consIder smokIng buns uL ruIIwuy sLuLIons und Lrum sLops. TIe
AusLruIIun CouncII on SmokIng und HeuILI uIso wunLs smokIng bunned
compIeLeIy In nIgILcIubs und pubs. AguIn, LIe urLIcIe, us usuuI, Is enLIreIy
one-sIded.
Even more recenLIy, LIere Ius been u cuII by VIcHeuILI`s Centre
jor Tobccco Control Lo provIde suIe rooms Ior smokers:
Smokers wouId be Iorced oI LIe sLreeLs und InLo uddIcL-
sLyIe 'suIe IngesLIng rooms` under u rudIcuI pIun by
VIcLorIu`s Lop IeuILI uuLIorILy. SeuIed smokIng rooms
wouId be seL up ucross LIe cILy under LIe VIcHeuILI
Preventive Medicine & Health Promotion
pIun, wILI sIgnposLs dIrecLIng oIIIce workers In need oI
u nIcoLIne IIx. Busy sIoppIng sLrIps couId uIso geL LIe
desIgnuLed rooms und smokers couId be mude Lo puy Lo
use LIem, mucI IIke some pubIIc LoIIeLs.
Dr. Ron BorIund, co-dIrecLor oI VIcHeuILI`s CenLre Ior
Tobucco ConLroI, suId smokIng ouLsIde cILy buIIdIngs
wus u probIem LIuL demunded ucLIon. Dr. BorIund suId
wILI growIng buns on smokIng Indoors, LIere muy be u
need Lo consIder II we sIouId seL up suIe IngesLIng
rooms. JusL us we don`L wunL IeroIn uddIcLs sIooLIng
up In buck uIIeys, so Loo we don`L wunL Lo pusI smokers
InLo LIose sILuuLIons, Ie suId. beIIeve LIere wIII be
moves Lo bun puvemenL smokIng us u pubIIc unnoyunce
Issue. L Is dIIIIcuIL Lo jusLIIy LIIs bun on pubIIc IeuILI
grounds. BuL In Lerms oI LIe unnoyunce IucLor, peopIe
Iuve Lo wuIk LIrougI cIouds oI smoke Lo geL InLo
buIIdIngs und sLund beIInd smokers und LIIs wIII
become un IncreusIng probIem... Dr. BorIund, wIo
Ius un InLernuLIonuI repuLuLIon Ior Lobucco conLroIs,
suId wILI ubouL z per cenL oI uduILs sLIII smokIng,
LIose uddIcLed Iud Lo go somewIere. (Hercld,Sun,
OcLober q, zooz, p.1&q)
TIIs purLIcuIur urLIcIe Is InLeresLIng Ior u number oI reusons.
IrsLIy, LIIs sIorL excerpL Is repIeLe wILI conLemporury unLIsmokIng
rIeLorIc. TIe smoker Is conLInuuIIy reIerred Lo us onIy un uddIcL und LIe
uIIusIon Lo suIe IngesLIng rooms Is LIe uLLempL, LIrougI IncoIerenL
unuIogy, Lo porLruy LIe smokIng uddIcL us LIe equIvuIenL oI LIe IeroIn
uddIcL (I.e., suIe InjecLIng rooms); Ior LIeIr own beneIIL boLI sIouId be
bundIed oII Lo suIe rooms. TIe nonsmoker Is uIso porLruyed us LIe
InnocenL vIcLIm oI LIe uddIcLs` conducL, IuvIng Lo negoLIuLe cIouds oI
smoke Lo guIn enLry Lo cILy buIIdIngs. SecondIy, smokers ouLsIde buIIdIngs
Iuve uppurenLIy become u probIem becuuse LIeIr dIscurded cIgureLLe
buLLs Iuve become u mujor IILLer probIem. TIIs seems Lo Iuve urIsen
becuuse muny IundIords do noL wunL Lo uppeur us condonIng LIe IubIL by
provIdIng ouLdoor cIgureLLe bIns, und LIereIore rIskIng IILIguLIon. As wIII
be consIdered In LIIs cIupLer, smokers sIouId never Iuve been LIrown
onLo LIe sLreeL Lo begIn wILI; IL Ius no scIenLIIIc busIs. TIuL LIIs
segreguLIon, bused on u coercIon oI psycIoIogIcuI und psycIosocIuI
dysIuncLIon, Ius occurred Is IuLrogenIc. TIuL LIere ure cIgureLLe-buLLs
IILLerIng puvemenLs, und II LIIs Is probIemuLIc, Is uIso IuLrogenIc. TIe very
groups LIuL Iuve cuused LIe sILuuLIon, und In uLLempLIng Lo mIsdIrecL
259
259
Rampant Antismoking Signifies Grave Danger
smokIng Is LIe crILIcuI crILerIon In evuIuuLIng persons wILIIn u sIuIIow,
conLrIved udversurIuI Irumework. L Is LIe sume sImpIe-mIndedness
demonsLruLed by LIe unLIsmokIng Iobby In NuzI Germuny. L musL be
noLed LIuL LIIs superIIcIuIILy oI reusonIng In LIIs cIrcumsLunce Is beIng
demonsLruLed by LIe dIrecLor oI LIe mujor SLuLe-governmenL IeuILI
orgunIzuLIon.
n u IurLIer IeudIIne-mukIng sLory, u mujor AusLruIIun LeIevIsIon
sLuLIon wus sued by LIe AusLruIIun BroudcusLIng AuLIorILy (ABA) Ior
breucIIng ILs broudcusLIng IIcense In LIuL durIng u o Minutes InLervIew
wILI screen ucLor, RusseII Crowe, IL uIred (1 seconds) LIe ucLor IIgILIng u
cIgureLLe wIo uIso covered LIe cIgureLLe wILI u brunded cIgureLLe puck
(Hercld,Sun, JuIy 18, zooz, p.q; JuIy zq, zooz, p.zo). L wus noL LIe
orIgInuI uIrIng LIuL wus LroubIesome. RuLIer, IL wus wIen LIe progrum
uIred LIe brunded puck segmenL uguIn In response Lo vIewer muIIbug
crILIcIsm oI LIe ucLor`s IubIL LIuL uLLrucLed LIe ABA`s uLLenLIon.
TIere Is now even governmenLuI consIderuLIon oI LIe
unLIsmokIng demund LIuL smokIng be bunned Irom uppeurIng In IocuIIy
produced TV serIuIs: SLurs mIgIL be LoId Lo buLL ouL: TIe ederuI
GovernmenL wIII Iook InLo LIe possIbIIILy oI bunnIng IIIm und LeIevIsIon
ucLors smokIng on screen. ederuI purIIumenLury secreLury Ior IeuILI,
TrIsI WorLI, yesLerduy used WorId No Tobucco Duy Lo unnounce LIe IIrsL
revIew oI nuLIonuI Lobucco udverLIsIng Iuws In Len yeurs. 'n un IdeuI worId
you wouId Iope supersLurs, modeIs und LIe peopIe wIo know LIey
InIIuence young peopIe wouId beIuve In u responsIbIe wuy und Lry Lo gIve
good exumpIes`, Ms WorLI suId. 'BuL II LIuL`s noL LIe cuse, LIen we
obvIousIy Iuve Lo Luke u bIgger sLIck Lo LIuL.` (Hercld,Sun, June 1, zooz)
TIe reckonIng Is noL cIuIIenged In LIe urLIcIe; LIuL IL mIgIL seL u deIuded
precedenL Ior censorsIIp Is noL ruIsed.
AnoLIer newspuper urLIcIe wus cupLIoned nquIry Lo Iook uL new
smoke buns (Hercld,Sun, AugusL zq, zooz, p.8). TIe urLIcIe IndIcuLes
LIuL |n|ew cIumps on smokIng In pubIIc couId IIow Irom u Lop-IeveI sLuLe
governmenL InquIry. L Is LIe governmenL LIuL Is requesLIng LIe InquIry
LIuL wIII consIder smokIng buns uL ruIIwuy sLuLIons und Lrum sLops. TIe
AusLruIIun CouncII on SmokIng und HeuILI uIso wunLs smokIng bunned
compIeLeIy In nIgILcIubs und pubs. AguIn, LIe urLIcIe, us usuuI, Is enLIreIy
one-sIded.
Even more recenLIy, LIere Ius been u cuII by VIcHeuILI`s Centre
jor Tobccco Control Lo provIde suIe rooms Ior smokers:
Smokers wouId be Iorced oI LIe sLreeLs und InLo uddIcL-
sLyIe 'suIe IngesLIng rooms` under u rudIcuI pIun by
VIcLorIu`s Lop IeuILI uuLIorILy. SeuIed smokIng rooms
wouId be seL up ucross LIe cILy under LIe VIcHeuILI
Preventive Medicine & Health Promotion
pIun, wILI sIgnposLs dIrecLIng oIIIce workers In need oI
u nIcoLIne IIx. Busy sIoppIng sLrIps couId uIso geL LIe
desIgnuLed rooms und smokers couId be mude Lo puy Lo
use LIem, mucI IIke some pubIIc LoIIeLs.
Dr. Ron BorIund, co-dIrecLor oI VIcHeuILI`s CenLre Ior
Tobucco ConLroI, suId smokIng ouLsIde cILy buIIdIngs
wus u probIem LIuL demunded ucLIon. Dr. BorIund suId
wILI growIng buns on smokIng Indoors, LIere muy be u
need Lo consIder II we sIouId seL up suIe IngesLIng
rooms. JusL us we don`L wunL IeroIn uddIcLs sIooLIng
up In buck uIIeys, so Loo we don`L wunL Lo pusI smokers
InLo LIose sILuuLIons, Ie suId. beIIeve LIere wIII be
moves Lo bun puvemenL smokIng us u pubIIc unnoyunce
Issue. L Is dIIIIcuIL Lo jusLIIy LIIs bun on pubIIc IeuILI
grounds. BuL In Lerms oI LIe unnoyunce IucLor, peopIe
Iuve Lo wuIk LIrougI cIouds oI smoke Lo geL InLo
buIIdIngs und sLund beIInd smokers und LIIs wIII
become un IncreusIng probIem... Dr. BorIund, wIo
Ius un InLernuLIonuI repuLuLIon Ior Lobucco conLroIs,
suId wILI ubouL z per cenL oI uduILs sLIII smokIng,
LIose uddIcLed Iud Lo go somewIere. (Hercld,Sun,
OcLober q, zooz, p.1&q)
TIIs purLIcuIur urLIcIe Is InLeresLIng Ior u number oI reusons.
IrsLIy, LIIs sIorL excerpL Is repIeLe wILI conLemporury unLIsmokIng
rIeLorIc. TIe smoker Is conLInuuIIy reIerred Lo us onIy un uddIcL und LIe
uIIusIon Lo suIe IngesLIng rooms Is LIe uLLempL, LIrougI IncoIerenL
unuIogy, Lo porLruy LIe smokIng uddIcL us LIe equIvuIenL oI LIe IeroIn
uddIcL (I.e., suIe InjecLIng rooms); Ior LIeIr own beneIIL boLI sIouId be
bundIed oII Lo suIe rooms. TIe nonsmoker Is uIso porLruyed us LIe
InnocenL vIcLIm oI LIe uddIcLs` conducL, IuvIng Lo negoLIuLe cIouds oI
smoke Lo guIn enLry Lo cILy buIIdIngs. SecondIy, smokers ouLsIde buIIdIngs
Iuve uppurenLIy become u probIem becuuse LIeIr dIscurded cIgureLLe
buLLs Iuve become u mujor IILLer probIem. TIIs seems Lo Iuve urIsen
becuuse muny IundIords do noL wunL Lo uppeur us condonIng LIe IubIL by
provIdIng ouLdoor cIgureLLe bIns, und LIereIore rIskIng IILIguLIon. As wIII
be consIdered In LIIs cIupLer, smokers sIouId never Iuve been LIrown
onLo LIe sLreeL Lo begIn wILI; IL Ius no scIenLIIIc busIs. TIuL LIIs
segreguLIon, bused on u coercIon oI psycIoIogIcuI und psycIosocIuI
dysIuncLIon, Ius occurred Is IuLrogenIc. TIuL LIere ure cIgureLLe-buLLs
IILLerIng puvemenLs, und II LIIs Is probIemuLIc, Is uIso IuLrogenIc. TIe very
groups LIuL Iuve cuused LIe sILuuLIon, und In uLLempLIng Lo mIsdIrecL
260
260
Rampant Antismoking Signifies Grave Danger
uLLenLIon uwuy Irom LIeIr own IIgIIy quesLIonubIe conducL, LIen see LIe
soIuLIon LIrougI u IurLIer ussuuIL on smokers, I.e., uddIcLs LIuL deserve
reIeguLIon Lo seuIed rooms; LIIs Is un uddILIonuI IuLrogenIc eIIecL.
I LIIs unLIsmokIng conducL Is vIewed us un IsoIuLed epIsode, IL Is
ucLuuIIy IurcIcuI In ILs IeebIe-mInded use oI concepLs und unuIogIes.
UnIorLunuLeIy, LIe crILIcuI probIem Is LIuL IL Is noL un IsoIuLed epIsode buL
u buIIdIng, dungerous Irenzy In u IIsLory oI deIuded reusonIng LIuL Is
IeudIng LIe wuy In pubIIc IeuILI poIIcy. TIIrdIy, LIe urLIcIe Is LypIcuIIy one-
sIded wILI no cIuIIenge Lo LIe sensIbIIILy oI cIuIms; LIe urLIcIe presenLs
onIy LIe supporLIng opInIons oI oLIer unLIsmokIng groups. n IucL, LIe
edILorIuI In LIe sume newspuper LIe IoIIowIng duy suggesLs LIuL LIe pIun
Ius merIL. Worse sLIII Is LIuL LIe urLIcIe IndIcuLes LIuL |L|Ie SLuLe
governmenL Ius uIreudy usked PurIIumenL`s uII-purLy umIIy und
CommunILy DeveIopmenL CommILLee Lo InvesLIguLe possIbIe reIorms. TIe
peuk IocuI governmenL body Ius weIcomed Dr. BorIund`s Ideus. AguIn,
LIe unsLubIe unLIsmokIng menLuIILy Ius been uIIowed Lo run rumpunL due
Lo governmenLuI coIIusIon.
TIe very IoIIowIng duy LIe sume newspuper conLuIned unoLIer
urLIcIe presenLIng BorIund`s IurLIer pubIIc IeuILI demunds: SmokIng In
curs couId be LIe nexL buLLIeground on LIe cIgureLLe reIorm IronL.
OuLspoken pubIIc IeuILI experL Dr. Ron BorIund suId LIere wus u IInk
beLween smokIng und cur crusIes. '(Some reseurcI suggesLs) LIere Is u
weII-known ussocIuLIon beLween smokIng und roud uccIdenLs,` suId Dr.
BorIund, co-dIrecLor oI LIe VicHeclth CenLre Ior Tobucco
ConLroI. (Hercld,Sun, OcLober 1o, zooz, p.q) BorIund LIen moves
Irom LIIs IIImsy premIse Lo LIe concIusIon |s|o LIere Is u IuIrIy sLrong
pubIIc IeuILI cuse Ior noL uIIowIng drIvers Lo smoke. He LIen sIIILs Lo LIe
premIse LIuL LIere wus poLenLIuI Ior IIgI IeveIs oI cIgureLLe smoke
exposure Ior pussengers, purLIcuIurIy cIIIdren. TIe IuLLer urgumenL Is noL
new, IuvIng uppeured In LIe sume newspuper u Iew yeurs eurIIer.
However, wIuL one Issue Ius Lo do wILI LIe oLIer In LIe conLexL oI LIe
currenL urLIcIe Is uncIeur. TIe urLIcIe LIen sIIILs uguIn, LIIs LIme buck Lo
LIe sLory oI LIe prevIous duy, I.e., suIe IngesLIng rooms. nLeresLIngIy, In
LIIs urLIcIe IL Is IndIcuLed LIuL LIe cIIeI oI VicHeclth, Rob MoodIe,
dIsLunced IImseII Irom LIe debuLe, suyIng LIere wus no ucLuuI pIun Lo
move uguInsL ouLdoor smokIng. UnIorLunuLeIy, LIere Is no crILIque oI LIe
vIews presenLed. TIe enLIre urLIcIe reIIecLs LIe erruLIc nuLure oI LIe
menLuIILy InvoIved. AL LIIs poInL IL Ius uIreudy reucIed u cruzed IeveI.
OnIy LIree duys IuLer, LIe sume newspuper conLuIns cnother
unLIsmokIng urLIcIe. TIIs LIme IL presenLed, uncIuIIenged, LIe vIews oI LIe
mIIILunL unLIsmokIng group AcLIon on SmokIng und HeuILI wIIcI Is
demundIng u cIgureLLe bun uL LruIn, Lrum und bus sLops: Any ouLdoor
Preventive Medicine & Health Promotion
crowded ureu sIouId be smoke-Iree becuuse LIere`s Loo mucI Iurm LIuL
cun be done Lo oLIers In cIose proxImILy. TIIs sIouId be un ureu oI serIous
concern by LrunsporL uuLIorILIes (LIe Hercld,Sun, OcLober 1, zooz,
p.1); Lerms sucI us Loo mucI Iurm und serIous concern ure noL
expIuIned. TIe urLIcIe uIso recruILs LIe supporL oI oLIer IrInge Iobby
groups sucI us u pubIIc-LrunsporL users ussocIuLIon, u smokIng IILIguLIon
Iuwyer, LIe cIIeI execuLIve oI AsLImu VIcLorIu, und LIe execuLIve dIrecLor
oI QuIL. AII oI LIese groups ure experL uL purroLIng LIe sume rIeLorIc. An
objecLIonubIe pIoy In sucI urLIcIes Is LIe mIsIeudIng use oI sLuLIsLIcuI
InIormuLIon. TIe AsLImu VIcLorIu spokesmun sLuLes LIuL |s|ome peopIe
specIIIcuIIy Iuve LIeIr usLImu LrIggered by cIgureLLe smoke. Up Lo one
quurLer oI uII cIIIdren und one In seven udoIescenLs Iuve usLImu und
muny LruveI by pubIIc LrunsporL. UnLII recenLIy, ETS dId noL IIgure IIgIIy
us u poLenLIuI LrIgger Ior usLImu; LIere ure even usLImuLIcs wIo smoke. I
LIere ure usLImuLIcs deLrImenLuIIy uIIecLed by ETS, IL Is u very smuII
subgroup oI LIe overuII usLImuLIcs group. urLIermore, sucI reucLIons
muy InvoIve u psycIogenIc componenL - purLIcuIurIy In LIe currenL
unLIsmokIng Irenzy. TIe use oI sLuLIsLIcuI InIormuLIon In LIe ubove
sLuLemenL Is Improper In LIuL IL ImpIIes LIuL ETS exposure Is deLrImenLuI
Ior uL IeusL mosL young usLImuLIcs.
OnIy u monLI IuLer, LIere wus presenLed u dIsjoInLed urgumenL
concernIng u rIse In smokIng uppeurIng In movIes und ILs cupucILy Lo
Iure udoIescenLs InLo smokIng. AuLIors oI LIe Tobucco uL LIe MovIes
reporL IndIcuLed LIuL |I|ewer IIIms conLuIned neguLIve messuges ubouL
smokIng, und some..sIowed LIe prucLIce In u posILIve IIgIL. ...TIe
AusLruIIun Cuncer CouncII bucked cuIIs Ior u specIuI 'smokIng ruLIng` Lo be
InLroduced, und suId unLI-smokIng uds sIouId be pIuced uL LIe sLurL oI
oIIendIng IIIms. (Hercld,Sun, November 11, zooz) No quesLIonIng oI
LIese Ideus uppeured In LIe urLIcIe.
TIe cIuIm Lo Iume oI LIe currenL SLuLe GovernmenL Is LIe
InLroducLIon oI wIdespreud smokIng buns durIng ILs LIree yeurs oI oIIIce.
L Is LIIs governmenL LIuL ceIebruLed LIe IIrsL yeur oI resLuurunL smokIng
buns, umId greuL medIu IunIure, by sIIcIng u ceIebruLory cuke wILI one
cundIe uLop. TIIs sume governmenL wus re-eIecLed In un IIsLorIc,
IundsIIde vIcLory In IuLe-November, zooz.
WILIIn under u week oI LIe GovernmenL`s reInsLuLemenL,
cnother unLIsmokIng urLIcIe uppeured demundIng even more wIdespreud
smokIng buns:
TIere Is u IoL wrong wILI os AngeIes. SpruwIIng
Ireewuys, poIIuLIon und LIe IucL OJ SImpson Is u Iree
mun. BuL wIuL u joy IL Is Lo vIsIL A`s burs, cIubs, IoLeIs
und workpIuces wIere smokIng Is bunned. CompIeLeIy
261
261
Rampant Antismoking Signifies Grave Danger
uLLenLIon uwuy Irom LIeIr own IIgIIy quesLIonubIe conducL, LIen see LIe
soIuLIon LIrougI u IurLIer ussuuIL on smokers, I.e., uddIcLs LIuL deserve
reIeguLIon Lo seuIed rooms; LIIs Is un uddILIonuI IuLrogenIc eIIecL.
I LIIs unLIsmokIng conducL Is vIewed us un IsoIuLed epIsode, IL Is
ucLuuIIy IurcIcuI In ILs IeebIe-mInded use oI concepLs und unuIogIes.
UnIorLunuLeIy, LIe crILIcuI probIem Is LIuL IL Is noL un IsoIuLed epIsode buL
u buIIdIng, dungerous Irenzy In u IIsLory oI deIuded reusonIng LIuL Is
IeudIng LIe wuy In pubIIc IeuILI poIIcy. TIIrdIy, LIe urLIcIe Is LypIcuIIy one-
sIded wILI no cIuIIenge Lo LIe sensIbIIILy oI cIuIms; LIe urLIcIe presenLs
onIy LIe supporLIng opInIons oI oLIer unLIsmokIng groups. n IucL, LIe
edILorIuI In LIe sume newspuper LIe IoIIowIng duy suggesLs LIuL LIe pIun
Ius merIL. Worse sLIII Is LIuL LIe urLIcIe IndIcuLes LIuL |L|Ie SLuLe
governmenL Ius uIreudy usked PurIIumenL`s uII-purLy umIIy und
CommunILy DeveIopmenL CommILLee Lo InvesLIguLe possIbIe reIorms. TIe
peuk IocuI governmenL body Ius weIcomed Dr. BorIund`s Ideus. AguIn,
LIe unsLubIe unLIsmokIng menLuIILy Ius been uIIowed Lo run rumpunL due
Lo governmenLuI coIIusIon.
TIe very IoIIowIng duy LIe sume newspuper conLuIned unoLIer
urLIcIe presenLIng BorIund`s IurLIer pubIIc IeuILI demunds: SmokIng In
curs couId be LIe nexL buLLIeground on LIe cIgureLLe reIorm IronL.
OuLspoken pubIIc IeuILI experL Dr. Ron BorIund suId LIere wus u IInk
beLween smokIng und cur crusIes. '(Some reseurcI suggesLs) LIere Is u
weII-known ussocIuLIon beLween smokIng und roud uccIdenLs,` suId Dr.
BorIund, co-dIrecLor oI LIe VicHeclth CenLre Ior Tobucco
ConLroI. (Hercld,Sun, OcLober 1o, zooz, p.q) BorIund LIen moves
Irom LIIs IIImsy premIse Lo LIe concIusIon |s|o LIere Is u IuIrIy sLrong
pubIIc IeuILI cuse Ior noL uIIowIng drIvers Lo smoke. He LIen sIIILs Lo LIe
premIse LIuL LIere wus poLenLIuI Ior IIgI IeveIs oI cIgureLLe smoke
exposure Ior pussengers, purLIcuIurIy cIIIdren. TIe IuLLer urgumenL Is noL
new, IuvIng uppeured In LIe sume newspuper u Iew yeurs eurIIer.
However, wIuL one Issue Ius Lo do wILI LIe oLIer In LIe conLexL oI LIe
currenL urLIcIe Is uncIeur. TIe urLIcIe LIen sIIILs uguIn, LIIs LIme buck Lo
LIe sLory oI LIe prevIous duy, I.e., suIe IngesLIng rooms. nLeresLIngIy, In
LIIs urLIcIe IL Is IndIcuLed LIuL LIe cIIeI oI VicHeclth, Rob MoodIe,
dIsLunced IImseII Irom LIe debuLe, suyIng LIere wus no ucLuuI pIun Lo
move uguInsL ouLdoor smokIng. UnIorLunuLeIy, LIere Is no crILIque oI LIe
vIews presenLed. TIe enLIre urLIcIe reIIecLs LIe erruLIc nuLure oI LIe
menLuIILy InvoIved. AL LIIs poInL IL Ius uIreudy reucIed u cruzed IeveI.
OnIy LIree duys IuLer, LIe sume newspuper conLuIns cnother
unLIsmokIng urLIcIe. TIIs LIme IL presenLed, uncIuIIenged, LIe vIews oI LIe
mIIILunL unLIsmokIng group AcLIon on SmokIng und HeuILI wIIcI Is
demundIng u cIgureLLe bun uL LruIn, Lrum und bus sLops: Any ouLdoor
Preventive Medicine & Health Promotion
crowded ureu sIouId be smoke-Iree becuuse LIere`s Loo mucI Iurm LIuL
cun be done Lo oLIers In cIose proxImILy. TIIs sIouId be un ureu oI serIous
concern by LrunsporL uuLIorILIes (LIe Hercld,Sun, OcLober 1, zooz,
p.1); Lerms sucI us Loo mucI Iurm und serIous concern ure noL
expIuIned. TIe urLIcIe uIso recruILs LIe supporL oI oLIer IrInge Iobby
groups sucI us u pubIIc-LrunsporL users ussocIuLIon, u smokIng IILIguLIon
Iuwyer, LIe cIIeI execuLIve oI AsLImu VIcLorIu, und LIe execuLIve dIrecLor
oI QuIL. AII oI LIese groups ure experL uL purroLIng LIe sume rIeLorIc. An
objecLIonubIe pIoy In sucI urLIcIes Is LIe mIsIeudIng use oI sLuLIsLIcuI
InIormuLIon. TIe AsLImu VIcLorIu spokesmun sLuLes LIuL |s|ome peopIe
specIIIcuIIy Iuve LIeIr usLImu LrIggered by cIgureLLe smoke. Up Lo one
quurLer oI uII cIIIdren und one In seven udoIescenLs Iuve usLImu und
muny LruveI by pubIIc LrunsporL. UnLII recenLIy, ETS dId noL IIgure IIgIIy
us u poLenLIuI LrIgger Ior usLImu; LIere ure even usLImuLIcs wIo smoke. I
LIere ure usLImuLIcs deLrImenLuIIy uIIecLed by ETS, IL Is u very smuII
subgroup oI LIe overuII usLImuLIcs group. urLIermore, sucI reucLIons
muy InvoIve u psycIogenIc componenL - purLIcuIurIy In LIe currenL
unLIsmokIng Irenzy. TIe use oI sLuLIsLIcuI InIormuLIon In LIe ubove
sLuLemenL Is Improper In LIuL IL ImpIIes LIuL ETS exposure Is deLrImenLuI
Ior uL IeusL mosL young usLImuLIcs.
OnIy u monLI IuLer, LIere wus presenLed u dIsjoInLed urgumenL
concernIng u rIse In smokIng uppeurIng In movIes und ILs cupucILy Lo
Iure udoIescenLs InLo smokIng. AuLIors oI LIe Tobucco uL LIe MovIes
reporL IndIcuLed LIuL |I|ewer IIIms conLuIned neguLIve messuges ubouL
smokIng, und some..sIowed LIe prucLIce In u posILIve IIgIL. ...TIe
AusLruIIun Cuncer CouncII bucked cuIIs Ior u specIuI 'smokIng ruLIng` Lo be
InLroduced, und suId unLI-smokIng uds sIouId be pIuced uL LIe sLurL oI
oIIendIng IIIms. (Hercld,Sun, November 11, zooz) No quesLIonIng oI
LIese Ideus uppeured In LIe urLIcIe.
TIe cIuIm Lo Iume oI LIe currenL SLuLe GovernmenL Is LIe
InLroducLIon oI wIdespreud smokIng buns durIng ILs LIree yeurs oI oIIIce.
L Is LIIs governmenL LIuL ceIebruLed LIe IIrsL yeur oI resLuurunL smokIng
buns, umId greuL medIu IunIure, by sIIcIng u ceIebruLory cuke wILI one
cundIe uLop. TIIs sume governmenL wus re-eIecLed In un IIsLorIc,
IundsIIde vIcLory In IuLe-November, zooz.
WILIIn under u week oI LIe GovernmenL`s reInsLuLemenL,
cnother unLIsmokIng urLIcIe uppeured demundIng even more wIdespreud
smokIng buns:
TIere Is u IoL wrong wILI os AngeIes. SpruwIIng
Ireewuys, poIIuLIon und LIe IucL OJ SImpson Is u Iree
mun. BuL wIuL u joy IL Is Lo vIsIL A`s burs, cIubs, IoLeIs
und workpIuces wIere smokIng Is bunned. CompIeLeIy
262
262
Rampant Antismoking Signifies Grave Danger
bunned.
TIe sume sIouId Iuppen In VIcLorIu. WIeLIer you`re un
empIoyer, empIoyee or u puLron, IIIe-LIreuLenIng
pussIve smoke does noL dIscrImInuLe. SmokIng kIIIs.
And pussIve smokIng kIIIs. No muLLer wIo you ure or
wIere you ure. n LIe pusL yeur, IL`s esLImuLed LIuL
pussIve smokIng cuused 16oo AusLruIIun deuLIs.
n VIcLorIu, smokIng Is now bunned In resLuurunLs,
cuIes, IoLeI dInIng rooms, gumIng venues und sIoppIng
cenLres. And LIere ure IInes Ior IIgILIng up In pokIe und
bIngo IuIIs. TIe onIy excepLIons ure LIe IIgI-roIIer
rooms und severuI burs uL Crown cusIno, wIere smokIng
Is uIIowed - u concessIon wIIcI sIouId never Iuve been
grunLed. Icensed premIses wILI more LIun one
operuLIonuI room musL uIso provIde u smoke-Iree
uILernuLIve.
ConLrusL LIIs Lo jusL u Iew yeurs ugo, wIen you couId
smoke prucLIcuIIy unywIere you IIked. And LIuL wus
despILe IrreIuLubIe scIenLIIIc evIdence LIuL pussIve
smokIng cuused Iung cuncer, usLImu und oLIer
dIseuses..TIIs yeur, LIe governmenL`s ucIIevemenLs
were recognIzed wIen IL wus grunLed LIe NuLIonuI
Tobucco Scorebourd uwurd by LIe AusLruIIun MedIcuI
ussocIuLIon.
I onIy LIe governmenL couId ucIIeve us mucI In ILs
second Lerm.. (Hercld,Sun, December q, zooz).
L Is Indeed LrugIc wIere u reporLer cun urrogunLIy purroL
sLundurd, mugIc powers, unLIsmokIng rIeLorIc, sucI us pussIve smoke
cun kIII unyone uL uny LIme, wILI sureLy us Lo ILs scIenLIIIc IrreIuLubIIILy.
TIe urLIcIe uIso IndIcuLes Iow quIckIy IunuLIcIsm cun wreuk Iuvoc.
MenLIon sIouId uIso be mude oI un urLIcIe uppeurIng In LIe
Hercld,Sun In JuIy, zooz, wIIcI descrIbed preIImInury resuILs Irom un
AusLruIIu-wIde poIIuLIon sLudy: Cur drIvers ure exposed Lo IIgIer IeveIs
oI cIemIcuIs LIun pussIve smokers..TIe sLudy, wIIcI exumIned LIe
IIIesLyIes oI o voIunLeers In eucI sLuLe, Iound sILLIng In u cur In LruIIIc
exposed drIvers Lo more poIIuLIon LIun pedesLrIuns und bIke rIders In
LruIIIc. I drIvers kepL LIeIr wIndows down und uIr venLs oII, LIey were
exposed Lo Iess poIIuLIon, preIImInury resuILs oI LIe sLudy Iound. Wood
IeuLers und open Iog IIres Increused LIe rIsk oI poIIuLIon us weII us cerLuIn
IobbIes, purLIcuIurIy LIose LIuL used gIue..TIe IuII sLudy wIII be reIeused
In OcLober. (JuIy q, zooz)
Preventive Medicine & Health Promotion
TIIs sorL oI sLudy Is InLeresLIng In LIuL IL IndIcuLes greuLer
sources und cIrcumsLunces oI cIemIcuI exposure LIun ETS. urLIermore,
uny oI LIe exposure Is noL necessurIIy dungerous Lo u normuLIve runge oI
IuncLIonIng. SucI IIndIngs wouId cerLuInIy quesLIon LIe sensIbIIILy oI
conLempIuLIng smokIng buns uL bus und Lrum sLops on IeuILI grounds.
UnIorLunuLeIy, LIe nume oI LIe sLudy wus noL IndIcuLed In LIe newspuper
urLIcIe, uILIougI LIe EnvIronmenL ProLecLIon AuLIorILy`s (VIcLorIu)
munuger oI uLmospIerIc unIL commenLed on LIe sLudy. L uppeurs LIuL
LIIs sLudy wus noL reIeused In OcLober us InLended, or uL uII. I LIe sLudy
Ius been reIeused, IL wus noL covered In LIe IocuI newspupers, und no
umounL oI InLerneL seurcIIng Ius been ubIe Lo IocuLe IL. A requesL Lo LIe
EPA Ior LIe nume oI LIe sLudy wenL ununswered. L wouId noL be
surprIsIng In LIe currenL unLIsmokIng Irenzy II reIeuse oI LIe sLudy`s
IIndIngs Iuve been sIow-Lrucked or burIed uILogeLIer.
TIere ure oLIer sympLoms LIuL ure uppeurIng In LIe VIcLorIun
popuIuLIon. or exumpIe, EPA VIcLorIu IndIcuLes LIuL IInes resuILIng
mosLIy (q;%) Irom cuIIs Lo ILs IILLer reporL IIne Iuve sLeudIIy Increused
Irom 618 IInes Issued In LIe 1qq-q6 IInuncIuI yeur Lo ;o; IInes Ior LIe
1qqq-zooo IInuncIuI yeur. CIgureLLe buLLs LIrown Irom curs mude up q6%
oI LIose IIned (Hercld,Sun, JuIy zq, zoo1, p.q). TIe number Increused
uguIn Lo 8z In zooo-zoo1 (Hercld,Sun, AugusL , zooz, p.1). Under
un unLIsmokIng burruge, more und more seem Lo beIIeve LIuL LIe
scourge oI cIgureLLe IILLer Is suIIIcIenL Lo wurrunL u surveIIIunce und
LuLLIIng menLuIILy. n one oI LIe numerous pIone poIIs conducLed by LIe
Hercld,Sun concernIng smokIng, oI 88 cuIIers, qz.% voLed yes Lo LIe
quesLIon: SIouId moLorIsLs dob In |LuLLIe on| LIose wIo LIrow cIgureLLe
buLLs ouL oI cur wIndows?
n eurIy-zoo, LIe ABC TV sLuLIon In VIcLorIu unnounced LIuL ILs
smokIng empIoyees rIsked dIsmIssuI II LIey smoked wILIIn o IeeL oI ILs
buIIdIng`s enLrunce. TIIs sLory wus covered In LIe nIgILIy news oI uII LIe
mujor TV cIunneIs. TIe bIus Lo LIe news coveruge wus LIuL LIe ABC wus
ucLIng properIy und LIuL IL mIgIL encouruge oLIer orgunIzuLIons Lo do
sImIIurIy. On LIe Sunrise progrum (CIunneI ;) LIe IoIIowIng mornIng, u
pIone poII wus conducLed us Lo wIeLIer smokIng sIouId be bunned In uII
pubIIc pIuces, I.e., onIy permILLed In LIe Iome. AILIougI LIe number oI
cuIIers wus noL IndIcuLed, ;q% ugreed LIuL smokIng sIouId be bunned In
uII pubIIc pIuces. TIe newsreuder IIgIIIgILed LIuL LIe poII resuILs wouId
be Iorwurded Lo LIe SLuLe HeuILI MInIsLer.
TIIs IusL cIrcumsLunce Is purLIcuIurIy dIsLurbIng. TIe
bruInwusIIng oI muny InLo compIIunce wILI LIe muLerIuIIsLJmedIco-
muLerIuIIsL worIdvIew Is sucI LIuL LIe LrumpIIng oI democruLIc prIncIpIes
cun now eusIIy be jusLIIIed. Democrucy does noL sImpIy meun mujorILy-
263
263
Rampant Antismoking Signifies Grave Danger
bunned.
TIe sume sIouId Iuppen In VIcLorIu. WIeLIer you`re un
empIoyer, empIoyee or u puLron, IIIe-LIreuLenIng
pussIve smoke does noL dIscrImInuLe. SmokIng kIIIs.
And pussIve smokIng kIIIs. No muLLer wIo you ure or
wIere you ure. n LIe pusL yeur, IL`s esLImuLed LIuL
pussIve smokIng cuused 16oo AusLruIIun deuLIs.
n VIcLorIu, smokIng Is now bunned In resLuurunLs,
cuIes, IoLeI dInIng rooms, gumIng venues und sIoppIng
cenLres. And LIere ure IInes Ior IIgILIng up In pokIe und
bIngo IuIIs. TIe onIy excepLIons ure LIe IIgI-roIIer
rooms und severuI burs uL Crown cusIno, wIere smokIng
Is uIIowed - u concessIon wIIcI sIouId never Iuve been
grunLed. Icensed premIses wILI more LIun one
operuLIonuI room musL uIso provIde u smoke-Iree
uILernuLIve.
ConLrusL LIIs Lo jusL u Iew yeurs ugo, wIen you couId
smoke prucLIcuIIy unywIere you IIked. And LIuL wus
despILe IrreIuLubIe scIenLIIIc evIdence LIuL pussIve
smokIng cuused Iung cuncer, usLImu und oLIer
dIseuses..TIIs yeur, LIe governmenL`s ucIIevemenLs
were recognIzed wIen IL wus grunLed LIe NuLIonuI
Tobucco Scorebourd uwurd by LIe AusLruIIun MedIcuI
ussocIuLIon.
I onIy LIe governmenL couId ucIIeve us mucI In ILs
second Lerm.. (Hercld,Sun, December q, zooz).
L Is Indeed LrugIc wIere u reporLer cun urrogunLIy purroL
sLundurd, mugIc powers, unLIsmokIng rIeLorIc, sucI us pussIve smoke
cun kIII unyone uL uny LIme, wILI sureLy us Lo ILs scIenLIIIc IrreIuLubIIILy.
TIe urLIcIe uIso IndIcuLes Iow quIckIy IunuLIcIsm cun wreuk Iuvoc.
MenLIon sIouId uIso be mude oI un urLIcIe uppeurIng In LIe
Hercld,Sun In JuIy, zooz, wIIcI descrIbed preIImInury resuILs Irom un
AusLruIIu-wIde poIIuLIon sLudy: Cur drIvers ure exposed Lo IIgIer IeveIs
oI cIemIcuIs LIun pussIve smokers..TIe sLudy, wIIcI exumIned LIe
IIIesLyIes oI o voIunLeers In eucI sLuLe, Iound sILLIng In u cur In LruIIIc
exposed drIvers Lo more poIIuLIon LIun pedesLrIuns und bIke rIders In
LruIIIc. I drIvers kepL LIeIr wIndows down und uIr venLs oII, LIey were
exposed Lo Iess poIIuLIon, preIImInury resuILs oI LIe sLudy Iound. Wood
IeuLers und open Iog IIres Increused LIe rIsk oI poIIuLIon us weII us cerLuIn
IobbIes, purLIcuIurIy LIose LIuL used gIue..TIe IuII sLudy wIII be reIeused
In OcLober. (JuIy q, zooz)
Preventive Medicine & Health Promotion
TIIs sorL oI sLudy Is InLeresLIng In LIuL IL IndIcuLes greuLer
sources und cIrcumsLunces oI cIemIcuI exposure LIun ETS. urLIermore,
uny oI LIe exposure Is noL necessurIIy dungerous Lo u normuLIve runge oI
IuncLIonIng. SucI IIndIngs wouId cerLuInIy quesLIon LIe sensIbIIILy oI
conLempIuLIng smokIng buns uL bus und Lrum sLops on IeuILI grounds.
UnIorLunuLeIy, LIe nume oI LIe sLudy wus noL IndIcuLed In LIe newspuper
urLIcIe, uILIougI LIe EnvIronmenL ProLecLIon AuLIorILy`s (VIcLorIu)
munuger oI uLmospIerIc unIL commenLed on LIe sLudy. L uppeurs LIuL
LIIs sLudy wus noL reIeused In OcLober us InLended, or uL uII. I LIe sLudy
Ius been reIeused, IL wus noL covered In LIe IocuI newspupers, und no
umounL oI InLerneL seurcIIng Ius been ubIe Lo IocuLe IL. A requesL Lo LIe
EPA Ior LIe nume oI LIe sLudy wenL ununswered. L wouId noL be
surprIsIng In LIe currenL unLIsmokIng Irenzy II reIeuse oI LIe sLudy`s
IIndIngs Iuve been sIow-Lrucked or burIed uILogeLIer.
TIere ure oLIer sympLoms LIuL ure uppeurIng In LIe VIcLorIun
popuIuLIon. or exumpIe, EPA VIcLorIu IndIcuLes LIuL IInes resuILIng
mosLIy (q;%) Irom cuIIs Lo ILs IILLer reporL IIne Iuve sLeudIIy Increused
Irom 618 IInes Issued In LIe 1qq-q6 IInuncIuI yeur Lo ;o; IInes Ior LIe
1qqq-zooo IInuncIuI yeur. CIgureLLe buLLs LIrown Irom curs mude up q6%
oI LIose IIned (Hercld,Sun, JuIy zq, zoo1, p.q). TIe number Increused
uguIn Lo 8z In zooo-zoo1 (Hercld,Sun, AugusL , zooz, p.1). Under
un unLIsmokIng burruge, more und more seem Lo beIIeve LIuL LIe
scourge oI cIgureLLe IILLer Is suIIIcIenL Lo wurrunL u surveIIIunce und
LuLLIIng menLuIILy. n one oI LIe numerous pIone poIIs conducLed by LIe
Hercld,Sun concernIng smokIng, oI 88 cuIIers, qz.% voLed yes Lo LIe
quesLIon: SIouId moLorIsLs dob In |LuLLIe on| LIose wIo LIrow cIgureLLe
buLLs ouL oI cur wIndows?
n eurIy-zoo, LIe ABC TV sLuLIon In VIcLorIu unnounced LIuL ILs
smokIng empIoyees rIsked dIsmIssuI II LIey smoked wILIIn o IeeL oI ILs
buIIdIng`s enLrunce. TIIs sLory wus covered In LIe nIgILIy news oI uII LIe
mujor TV cIunneIs. TIe bIus Lo LIe news coveruge wus LIuL LIe ABC wus
ucLIng properIy und LIuL IL mIgIL encouruge oLIer orgunIzuLIons Lo do
sImIIurIy. On LIe Sunrise progrum (CIunneI ;) LIe IoIIowIng mornIng, u
pIone poII wus conducLed us Lo wIeLIer smokIng sIouId be bunned In uII
pubIIc pIuces, I.e., onIy permILLed In LIe Iome. AILIougI LIe number oI
cuIIers wus noL IndIcuLed, ;q% ugreed LIuL smokIng sIouId be bunned In
uII pubIIc pIuces. TIe newsreuder IIgIIIgILed LIuL LIe poII resuILs wouId
be Iorwurded Lo LIe SLuLe HeuILI MInIsLer.
TIIs IusL cIrcumsLunce Is purLIcuIurIy dIsLurbIng. TIe
bruInwusIIng oI muny InLo compIIunce wILI LIe muLerIuIIsLJmedIco-
muLerIuIIsL worIdvIew Is sucI LIuL LIe LrumpIIng oI democruLIc prIncIpIes
cun now eusIIy be jusLIIIed. Democrucy does noL sImpIy meun mujorILy-
264
264
Rampant Antismoking Signifies Grave Danger
ruIe buL uIso IuIr IeurIng und deuIIng, I.e., due process: WIere due process
Ius been ubundoned, mujorILy ruIe degeneruLes InLo mob ruIe. TIere Is
noL even LIe sembIunce oI u conLrIved IeuILI Issue Ior nonsmokers
InvoIved Iere. WIuL smokers und Lobucco smoke Iuve come Lo represenL
In LIe mInds oI muny nonsmokers, LIrougI IndocLrInuLIon, Is so
ubIorrenL und ugILuLIng LIuL onIy LIe exLermInuLIon oI LIeIr uppeurunce In
socIuI seLLIngs wIII suIIIce. As wIII be urgued LIrougIouL, IL Is LIIs
superIorIsL unLIsmokIng Lrunce, borne oI deIuded muLerIuIIsL IdeoIogy,
LIuL Is socIuIIy und gIobuIIy dungerous.
n eurIy-MurcI, zoo, IL wus unnounced LIuL u Iormer Lwo-LIme
moLorcycIe worId cIumpIon Iud dIed oI cuncer oI LIe oesopIugus und
upper-sLomucI. He wus uged z. n u newspuper reporL IL wus cIuImed
|I|e wus dIugnosed wILI cuncer IuLe IusL yeur, wIIcI wus u sIock becuuse
Ie wus onIy z, buL no surprIse Lo unyone wIo suw Iow mucI Ie
smoked. (Hercld,Sun, MurcI 11, zoo, p.1z). So IndocLrInuLed Is LIe
pubIIc und LIe medIu LIuL reusonIng concernIng smokIng Ius degeneruLed
enLIreIy InLo LIe IuIIucy oI post hoc ero propter hoc. TIuL unyone couId
IoId LIe vIew LIuL smokIng expIuIns LIe dIseuse In quesLIon undJor eurIy
morLuIILy Is In u sLuLe oI sLrong deIusIon. TIe IumIIy concerned Iud
uIreudy suIIered suIIIcIenL Lrugedy wILIouL LIe person`s IIIe, wIIcI muy
Iuve Iud Iur more reIuLIonuI, emoLIonuI und moruI depLI LIun LIe LypIcuI
medIco-muLerIuIIsL, beIng InuneIy reduced by medIco-muLerIuIIsm Lo LIe
sLuLus oI u vIcLIm oI smokIng.
JusL LIe IoIIowIng duy, und seemIngIy opporLunIsLIcuIIy so, u
sLory uIred on u nuLIonuI currenL-uIIuIrs progrum wIere u medIcuI
prucLILIoner Irom PerLI (WesLern AusLruIIu) suggesLed LIe InLroducLIon oI
un uddIcL-curd Ior smokers; smokers wouId need Lo be regIsLered, by
LukIng u bIood LesL, us nIcoLIne uddIcLs In order Lo be suppIIed Lobucco.
n supporL oI LIIs sLunce wus oIIered u ;-yeur-oId smoker wIo Iud
suIIered u IeurL uLLuck. TIe smoker IeId LIe bruInwusIed beIIeI LIuL IIs
smokIng cuused LIe IeurL uLLuck. SmokIng Is u zero-IeveI predIcLor Ior
LIIs sorL oI evenL (uge-specIIIc curdIuc urresL). TIe smoker wus expecLIng
smokIng-cuused dIseuse In IIs o`s buL wus IorrIIIed uL Iow quIckIy
smokIng Iud wreuked ILs dumuge, cIuImIng one cIgureLLe Is uII IL
Lukes. (A Current Ajjcir, CIunneI q, MurcI 11, zoo) AguIn, LIe
reusonIng InvoIved Is pILIIuI - IuIIucy oI post hoc ero propter hoc und
mugIc powers - und Ius been uIIowed Lo proceed enLIreIy uncIuIIenged.
n LIIs cuse LIere Is LIe uddILIonuI IogIcuI, uIbeIL deIusIonuI, demund Ior
LIe regIsLerIng und surveIIIunce oI uddIcLs wIIcI Is predIcuLed on LIe
orIgInuI conLorLed reusonIng. TIIs demund Is noL uII Loo dIIIerenL Irom LIe
upproucI Lo smokers by LIe NuzI regIme; medIco-muLerIuIIsm Is u
superIIcIuI menLuIILy LIuL Is very IImILed buL dungerous In ILs sImpIe-
Preventive Medicine & Health Promotion
mInded percepLIon und soIuLIon oI probIems.
OnIy LIe ruq wur couId LemporurIIy dIspIuce LIe unLIsmokIng
bundwugon In LIe medIu. YeL, wILIIn LIree weeks, LIe unLIsmokIng
onsIuugIL resumed.
TIe sILuuLIon In AusLruIIu, und purLIcuIurIy VIcLorIu, IndIcuLes LIe
greuL dumuge LIuL cun be done wIen LIere Is coIIusIon beLween LIe
medIcuI esLubIIsImenL, governmenL, ucudemIu, LIe medIu, und
monomunIucuI Iobby groups In u muLerIuIIsL, IdeoIogIcuI quesL (muLerIuIIsL
munIIesLo), I.e., muLerIuIIsL domInuLIon. L sIouId uIso be noLed LIuL LIe
VIcLorIun GovernmenL und LIe MeIbourne (cupILoI) CILy CouncII ure boLI
sIgnuLorIes Lo LIe UN EurLI CIurLer - u gIobuI Iorm oI LIe muLerIuIIsL
munIIesLo (see CIupLer ). TIIs cerLuInIy IeIps In undersLundIng LIe
unLIsmokIng Irenzy In VIcLorIu, AusLruIIu, wIIcI cun weII be consIdered us
un MMES-cuIL cenLer.
Muny purLIcIpunLs muy noL even be uwure LIuL LIIs Is wIuL LIey
ure purLy Lo. TIeIr IuILI Is mIsguIded und Iuve sImpIy IeurnL Lo repeuL, cd
ncusecm, dogmuLIc bubbIe wILI no IInL us Lo LIe IIsLory und nuLure oI LIe
crusude. TIIs enLIre VIcLorIun epIsode, wIIcI Is beIng pIuyed ouL In
muny nuLIons Lo vuryIng degrees, reuds us u sLudy In LIe muLerIuIIsL
munuIucLure oI deIusIon on u genuIneIy muss-scuIe.
As wIII be urgued In LIIs cIupLer, IL Is so-cuIIed IeuILI uuLIorILIes
und LIeIr Iobby group Iungers-on LIuL pose u gruve LIreuL Lo pubIIc
IeuILI. TIrougI LIe pIenomenon oI envIronmenLuI Lobucco smoke, LIey
Iuve munuIucLured u mosL severe muss deIusIon, I.e., superIorILy
syndrome und LIe envIronmenLuI somuLIzuLIon syndrome. urLIermore, IL
wIII be urgued In IoIIowIng cIupLers LIuL rumpunL unLIsmokIng Is crILIcuIIy
sympLomuLIc oI u Iur more dungerous muLerIuIIsL menLuIILy. TIese groups
ure Loo IIxuLed und correspondIngIy menLuIIy bIocked Lo Iuve uny
cognIzunce LIuL In LIe pursuIL oI LIeIr IIxuLIon LIey ure buIIdozIng LIeIr
wuy LIrougI uII munner oI due process on LIe busIs oI seII-servIng Ieur,
guIIL, dIseuse, und IuLe-mongerIng.
(.(.z The Entironmentcl Protection Aenc (EPA) cnd
Pcssite Smolin
TIe IIrsL, uIbeIL LIorougIIy IIuwed, IormuI uppruIsuI oI dIseuse-
rIsk ussocIuLed wILI exposure Lo envIronmenLuI or umbIenL Lobucco smoke
(ETS) wus presenLed In eurIy-1qq by LIe US EnvIronmenLuI ProLecLIon
Agency (EPA). MuInsLreum smoke (MS) reIers Lo LIe smoke InIuIed by u
smoker. ETS Is composed oI secondIund smoke (smoke exIuIed by LIe
smoker) und sIde-sLreum smoke (smoke emILLed Irom u IIL cIgureLLe). TIe
Lwo componenLs oI ETS dIIIer Irom eucI oLIer und Irom MS. ETS Is IIgIIy
265
265
Rampant Antismoking Signifies Grave Danger
ruIe buL uIso IuIr IeurIng und deuIIng, I.e., due process: WIere due process
Ius been ubundoned, mujorILy ruIe degeneruLes InLo mob ruIe. TIere Is
noL even LIe sembIunce oI u conLrIved IeuILI Issue Ior nonsmokers
InvoIved Iere. WIuL smokers und Lobucco smoke Iuve come Lo represenL
In LIe mInds oI muny nonsmokers, LIrougI IndocLrInuLIon, Is so
ubIorrenL und ugILuLIng LIuL onIy LIe exLermInuLIon oI LIeIr uppeurunce In
socIuI seLLIngs wIII suIIIce. As wIII be urgued LIrougIouL, IL Is LIIs
superIorIsL unLIsmokIng Lrunce, borne oI deIuded muLerIuIIsL IdeoIogy,
LIuL Is socIuIIy und gIobuIIy dungerous.
n eurIy-MurcI, zoo, IL wus unnounced LIuL u Iormer Lwo-LIme
moLorcycIe worId cIumpIon Iud dIed oI cuncer oI LIe oesopIugus und
upper-sLomucI. He wus uged z. n u newspuper reporL IL wus cIuImed
|I|e wus dIugnosed wILI cuncer IuLe IusL yeur, wIIcI wus u sIock becuuse
Ie wus onIy z, buL no surprIse Lo unyone wIo suw Iow mucI Ie
smoked. (Hercld,Sun, MurcI 11, zoo, p.1z). So IndocLrInuLed Is LIe
pubIIc und LIe medIu LIuL reusonIng concernIng smokIng Ius degeneruLed
enLIreIy InLo LIe IuIIucy oI post hoc ero propter hoc. TIuL unyone couId
IoId LIe vIew LIuL smokIng expIuIns LIe dIseuse In quesLIon undJor eurIy
morLuIILy Is In u sLuLe oI sLrong deIusIon. TIe IumIIy concerned Iud
uIreudy suIIered suIIIcIenL Lrugedy wILIouL LIe person`s IIIe, wIIcI muy
Iuve Iud Iur more reIuLIonuI, emoLIonuI und moruI depLI LIun LIe LypIcuI
medIco-muLerIuIIsL, beIng InuneIy reduced by medIco-muLerIuIIsm Lo LIe
sLuLus oI u vIcLIm oI smokIng.
JusL LIe IoIIowIng duy, und seemIngIy opporLunIsLIcuIIy so, u
sLory uIred on u nuLIonuI currenL-uIIuIrs progrum wIere u medIcuI
prucLILIoner Irom PerLI (WesLern AusLruIIu) suggesLed LIe InLroducLIon oI
un uddIcL-curd Ior smokers; smokers wouId need Lo be regIsLered, by
LukIng u bIood LesL, us nIcoLIne uddIcLs In order Lo be suppIIed Lobucco.
n supporL oI LIIs sLunce wus oIIered u ;-yeur-oId smoker wIo Iud
suIIered u IeurL uLLuck. TIe smoker IeId LIe bruInwusIed beIIeI LIuL IIs
smokIng cuused LIe IeurL uLLuck. SmokIng Is u zero-IeveI predIcLor Ior
LIIs sorL oI evenL (uge-specIIIc curdIuc urresL). TIe smoker wus expecLIng
smokIng-cuused dIseuse In IIs o`s buL wus IorrIIIed uL Iow quIckIy
smokIng Iud wreuked ILs dumuge, cIuImIng one cIgureLLe Is uII IL
Lukes. (A Current Ajjcir, CIunneI q, MurcI 11, zoo) AguIn, LIe
reusonIng InvoIved Is pILIIuI - IuIIucy oI post hoc ero propter hoc und
mugIc powers - und Ius been uIIowed Lo proceed enLIreIy uncIuIIenged.
n LIIs cuse LIere Is LIe uddILIonuI IogIcuI, uIbeIL deIusIonuI, demund Ior
LIe regIsLerIng und surveIIIunce oI uddIcLs wIIcI Is predIcuLed on LIe
orIgInuI conLorLed reusonIng. TIIs demund Is noL uII Loo dIIIerenL Irom LIe
upproucI Lo smokers by LIe NuzI regIme; medIco-muLerIuIIsm Is u
superIIcIuI menLuIILy LIuL Is very IImILed buL dungerous In ILs sImpIe-
Preventive Medicine & Health Promotion
mInded percepLIon und soIuLIon oI probIems.
OnIy LIe ruq wur couId LemporurIIy dIspIuce LIe unLIsmokIng
bundwugon In LIe medIu. YeL, wILIIn LIree weeks, LIe unLIsmokIng
onsIuugIL resumed.
TIe sILuuLIon In AusLruIIu, und purLIcuIurIy VIcLorIu, IndIcuLes LIe
greuL dumuge LIuL cun be done wIen LIere Is coIIusIon beLween LIe
medIcuI esLubIIsImenL, governmenL, ucudemIu, LIe medIu, und
monomunIucuI Iobby groups In u muLerIuIIsL, IdeoIogIcuI quesL (muLerIuIIsL
munIIesLo), I.e., muLerIuIIsL domInuLIon. L sIouId uIso be noLed LIuL LIe
VIcLorIun GovernmenL und LIe MeIbourne (cupILoI) CILy CouncII ure boLI
sIgnuLorIes Lo LIe UN EurLI CIurLer - u gIobuI Iorm oI LIe muLerIuIIsL
munIIesLo (see CIupLer ). TIIs cerLuInIy IeIps In undersLundIng LIe
unLIsmokIng Irenzy In VIcLorIu, AusLruIIu, wIIcI cun weII be consIdered us
un MMES-cuIL cenLer.
Muny purLIcIpunLs muy noL even be uwure LIuL LIIs Is wIuL LIey
ure purLy Lo. TIeIr IuILI Is mIsguIded und Iuve sImpIy IeurnL Lo repeuL, cd
ncusecm, dogmuLIc bubbIe wILI no IInL us Lo LIe IIsLory und nuLure oI LIe
crusude. TIIs enLIre VIcLorIun epIsode, wIIcI Is beIng pIuyed ouL In
muny nuLIons Lo vuryIng degrees, reuds us u sLudy In LIe muLerIuIIsL
munuIucLure oI deIusIon on u genuIneIy muss-scuIe.
As wIII be urgued In LIIs cIupLer, IL Is so-cuIIed IeuILI uuLIorILIes
und LIeIr Iobby group Iungers-on LIuL pose u gruve LIreuL Lo pubIIc
IeuILI. TIrougI LIe pIenomenon oI envIronmenLuI Lobucco smoke, LIey
Iuve munuIucLured u mosL severe muss deIusIon, I.e., superIorILy
syndrome und LIe envIronmenLuI somuLIzuLIon syndrome. urLIermore, IL
wIII be urgued In IoIIowIng cIupLers LIuL rumpunL unLIsmokIng Is crILIcuIIy
sympLomuLIc oI u Iur more dungerous muLerIuIIsL menLuIILy. TIese groups
ure Loo IIxuLed und correspondIngIy menLuIIy bIocked Lo Iuve uny
cognIzunce LIuL In LIe pursuIL oI LIeIr IIxuLIon LIey ure buIIdozIng LIeIr
wuy LIrougI uII munner oI due process on LIe busIs oI seII-servIng Ieur,
guIIL, dIseuse, und IuLe-mongerIng.
(.(.z The Entironmentcl Protection Aenc (EPA) cnd
Pcssite Smolin
TIe IIrsL, uIbeIL LIorougIIy IIuwed, IormuI uppruIsuI oI dIseuse-
rIsk ussocIuLed wILI exposure Lo envIronmenLuI or umbIenL Lobucco smoke
(ETS) wus presenLed In eurIy-1qq by LIe US EnvIronmenLuI ProLecLIon
Agency (EPA). MuInsLreum smoke (MS) reIers Lo LIe smoke InIuIed by u
smoker. ETS Is composed oI secondIund smoke (smoke exIuIed by LIe
smoker) und sIde-sLreum smoke (smoke emILLed Irom u IIL cIgureLLe). TIe
Lwo componenLs oI ETS dIIIer Irom eucI oLIer und Irom MS. ETS Is IIgIIy
266
266
Rampant Antismoking Signifies Grave Danger
dIIuLed concernIng LIe purLIcuIuLes LIuL muke smoke vIsIbIe. On LIIs
poInL, Huber, BrockIe & MuIujun (1qq) noLe LIuL In sLrIcL LecInIcuI Lerms
IL Is u mIsLuke Lo even cuII ETS smoke uL uII.
ETS Is u compIex mIxLure oI over q,ooo compounds. Some oI
LIese ure deemed curcInogenIc und some unLI-curcInogenIc, beurIng In
mInd LIuL LIese desIgnuLIons were produced by LIe wIoIIy quesLIonubIe
weIgIL oI evIdence process evuIuuLed In un eurIIer cIupLer. AII oI LIese
compounds, excepL nIcoLIne, uIso Iuve oLIer Indoor sources (e.g., wood-
burnIng IIrepIuces, gus sLoves, kerosene IeuLers) und ouLdoor sources
(e.g., exIuusL emIssIons Irom moLor veIIcIes, uIrcruIL, eLc.). NIcoLIne uIso
Ius non-Lobucco sources (e.g., eggpIunL, LomuLo, green pepper, poLuLoes,
cuuIIIIower, Leu). MeusuremenL oI exposure Lo ETS (e.g., use oI
bIomurkers) Is u dIIIIcuIL proposuI gIven LIe IIgIIy dIIuLed nuLure oI ETS,
und uny meLIod oI meusuremenL wIII Iuve IImILuLIons (e.g., see uIso
CuIIIornIu EPA, 1qq;, cI.z).
GorI (1qqq) provIdes reIerenced deLuII oI ETS uLLrIbuLes:
EnvIronmenLuI Lobucco smoke (ETS) comes Irom LIe
dIIuLIon oI sIde-sLreum smoke produces by smoIderIng
cIgureLLes, und Irom LIe smuII resIdues oI muInsLreum
smoke exIuIed by ucLIve smokers. GeneruLed und
exIsLIng under mucI dIIIerenL condILIons, LIese
dIIIerenL smokes Iuve some sImIIurILIes buL murked
dIIIerences In cIemIcuI und pIysIcuI composILIon und
beIuvIour. AII comprIse guses (LIe gus pIuse), und
smuII purLIcIes (LIe respIrubIe suspended purLIcIes or
RSP). TIese purLIcIes In Lurn muy conLuIn uL vurIous
LImes, dIIIerenL umounLs oI wuLer und oLIer voIuLIIe
componenLs LIuL muy excIunge wILI LIe gus pIuse.
MuIn-sLreum smoke-InIuIed dIrecLIy by smokers-In
concenLruLed und conIIned Lo LIe moIsL envIronmenL oI
mouLI, LIrouL und Iung. Ls IIgIer gus pIuse
concenLruLIons Iuvor Iurger respIrubIe purLIcIes LIuL
condense und reLuIn more wuLer und voIuLIIes. By
conLrusL, ordInury ETS Is over 1oo,ooo LImes more
dIIuLed, wILI mucI Iower IumIdILy und exLremeIy Iow
concenLruLIons oI voIuLIIes. EvuporuLIon Is IusLer Irom
ETS purLIcIes, wIIcI, wILIIn IrucLIons oI u second Irom
LIeIr generuLIon, uLLuIn sIzes o-1oo LImes smuIIer In
muss und voIume LIun In LIeIr muInsLreum
counLerpurLs. As ETS uges, IL undergoes oxIduLIve und
pIoLocIemIcuI LrunsIormuLIons, poIymerIzuLIons Irom
Ioss oI wuLer und voIuLIIes, reucLIons wILI oLIer
Preventive Medicine & Health Promotion
envIronmenLuI componenLs, und oLIer cIunges.
rom severuI LIousund componenLs oI muIn-sLreum
smoke, HoIImun und HecIL Iuve seIecLed some qo
ugenLs suspecLed oI beIng curcInogenIc on experImenLuI
unImuIs. n generuI, Iowever, LIese ugenLs Iuve sIown
curcInogenIcILy In unImuI orguns oLIer LIun In LIe
Iungs, und onIy uL doses mucI Iurger LIun smokers cun
experIence. AL LIe sume LIme, muIn-sLreum und sIde-
sLreum smoke conLuIn even Iurger numbers und
concenLruLIons oI known suppressors oI curcInogenesIs,
presenL uL dose ruLIos sImIIur Lo LIose Iound eIIecLIve In
suppressIng experImenLuI cuncer .
OI LIe severuI LIousund componenLs IdenLIIIed In muIn-
sLreum smoke, onIy perIups 1oo Iuve been deLecLed In
sIde-sLreum smoke, due Lo exLreme dIIuLIons. Becuuse
oI even greuLer dIIuLIons, Iewer LIun zo ETS
componenLs Iuve been IdenLIIIed dIrecLIy. MosL ETS
componenLs ure Iur beIow LIe sensILIvILy oI currenL
unuIyLIcuI cupubIIILIes. ndeed, LIe compIIers oI reporLs
Irom LIe NuLIonuI Acudemy oI ScIences, LIe US Surgeon
GeneruI, und LIe EnvIronmenLuI ProLecLIon Agency,
Iuve been Iorced Lo InIer LIe presence oI ETS
componenLs by proxy, bused on LIe composILIon oI
sIde-sLreum smoke Irom wIIcI ETS derIves.
NomInuIIy, LIen ETS und muIn-sLreum smoke muy
sIure some componenLs, buL LIeIr cIemIcuI und
pIysIcuI dIIIerences ure subsLunLIuI. Moreover, LIe
presence oI mosL ETS componenLs cun onIy be
posLuIuLed becuuse LIey ure beyond muLerIuI deLecLIon.
TIe uvuIIubIe evIdence oIIers some IImILed
opporLunILIes Lo guuge ETS exposures und doses In
reIuLIon Lo ucLIve muIn-sLreum smokIng counLerpurLs.
Due Lo LIe dIIIIcuILy or ImpossIbIIILy oI meusurIng LIe
consLILuenLs oI sucI u IIgIIy dIIuLed subsLunce, IndIrecL meusures oI
exposure Iuve been reIIed on. Two oILen-used meusures oI ETS exposure
ure quesLIonnuIres und LIe bIomurker oI cotinine IeveIs presenL In
pIysIoIogIcuI IIuIds; coLInIne Is u meLuboIILe oI nIcoLIne. QuesLIonnuIres
uIIow un esLImuLe oI Iong-Lerm exposure buL Iuve consIderubIe IImILuLIons
sucI us InuccurucIes oI recuII und Iuck oI evIdence concernIng ucLuuI
exposure. CoLInIne, wIIcI Is noL consIdered IurmIuI, cerLuInIy
demonsLruLes LIuL exposure Lo ETS Ius occurred. However, exLrupoIuLIons
267
267
Rampant Antismoking Signifies Grave Danger
dIIuLed concernIng LIe purLIcuIuLes LIuL muke smoke vIsIbIe. On LIIs
poInL, Huber, BrockIe & MuIujun (1qq) noLe LIuL In sLrIcL LecInIcuI Lerms
IL Is u mIsLuke Lo even cuII ETS smoke uL uII.
ETS Is u compIex mIxLure oI over q,ooo compounds. Some oI
LIese ure deemed curcInogenIc und some unLI-curcInogenIc, beurIng In
mInd LIuL LIese desIgnuLIons were produced by LIe wIoIIy quesLIonubIe
weIgIL oI evIdence process evuIuuLed In un eurIIer cIupLer. AII oI LIese
compounds, excepL nIcoLIne, uIso Iuve oLIer Indoor sources (e.g., wood-
burnIng IIrepIuces, gus sLoves, kerosene IeuLers) und ouLdoor sources
(e.g., exIuusL emIssIons Irom moLor veIIcIes, uIrcruIL, eLc.). NIcoLIne uIso
Ius non-Lobucco sources (e.g., eggpIunL, LomuLo, green pepper, poLuLoes,
cuuIIIIower, Leu). MeusuremenL oI exposure Lo ETS (e.g., use oI
bIomurkers) Is u dIIIIcuIL proposuI gIven LIe IIgIIy dIIuLed nuLure oI ETS,
und uny meLIod oI meusuremenL wIII Iuve IImILuLIons (e.g., see uIso
CuIIIornIu EPA, 1qq;, cI.z).
GorI (1qqq) provIdes reIerenced deLuII oI ETS uLLrIbuLes:
EnvIronmenLuI Lobucco smoke (ETS) comes Irom LIe
dIIuLIon oI sIde-sLreum smoke produces by smoIderIng
cIgureLLes, und Irom LIe smuII resIdues oI muInsLreum
smoke exIuIed by ucLIve smokers. GeneruLed und
exIsLIng under mucI dIIIerenL condILIons, LIese
dIIIerenL smokes Iuve some sImIIurILIes buL murked
dIIIerences In cIemIcuI und pIysIcuI composILIon und
beIuvIour. AII comprIse guses (LIe gus pIuse), und
smuII purLIcIes (LIe respIrubIe suspended purLIcIes or
RSP). TIese purLIcIes In Lurn muy conLuIn uL vurIous
LImes, dIIIerenL umounLs oI wuLer und oLIer voIuLIIe
componenLs LIuL muy excIunge wILI LIe gus pIuse.
MuIn-sLreum smoke-InIuIed dIrecLIy by smokers-In
concenLruLed und conIIned Lo LIe moIsL envIronmenL oI
mouLI, LIrouL und Iung. Ls IIgIer gus pIuse
concenLruLIons Iuvor Iurger respIrubIe purLIcIes LIuL
condense und reLuIn more wuLer und voIuLIIes. By
conLrusL, ordInury ETS Is over 1oo,ooo LImes more
dIIuLed, wILI mucI Iower IumIdILy und exLremeIy Iow
concenLruLIons oI voIuLIIes. EvuporuLIon Is IusLer Irom
ETS purLIcIes, wIIcI, wILIIn IrucLIons oI u second Irom
LIeIr generuLIon, uLLuIn sIzes o-1oo LImes smuIIer In
muss und voIume LIun In LIeIr muInsLreum
counLerpurLs. As ETS uges, IL undergoes oxIduLIve und
pIoLocIemIcuI LrunsIormuLIons, poIymerIzuLIons Irom
Ioss oI wuLer und voIuLIIes, reucLIons wILI oLIer
Preventive Medicine & Health Promotion
envIronmenLuI componenLs, und oLIer cIunges.
rom severuI LIousund componenLs oI muIn-sLreum
smoke, HoIImun und HecIL Iuve seIecLed some qo
ugenLs suspecLed oI beIng curcInogenIc on experImenLuI
unImuIs. n generuI, Iowever, LIese ugenLs Iuve sIown
curcInogenIcILy In unImuI orguns oLIer LIun In LIe
Iungs, und onIy uL doses mucI Iurger LIun smokers cun
experIence. AL LIe sume LIme, muIn-sLreum und sIde-
sLreum smoke conLuIn even Iurger numbers und
concenLruLIons oI known suppressors oI curcInogenesIs,
presenL uL dose ruLIos sImIIur Lo LIose Iound eIIecLIve In
suppressIng experImenLuI cuncer .
OI LIe severuI LIousund componenLs IdenLIIIed In muIn-
sLreum smoke, onIy perIups 1oo Iuve been deLecLed In
sIde-sLreum smoke, due Lo exLreme dIIuLIons. Becuuse
oI even greuLer dIIuLIons, Iewer LIun zo ETS
componenLs Iuve been IdenLIIIed dIrecLIy. MosL ETS
componenLs ure Iur beIow LIe sensILIvILy oI currenL
unuIyLIcuI cupubIIILIes. ndeed, LIe compIIers oI reporLs
Irom LIe NuLIonuI Acudemy oI ScIences, LIe US Surgeon
GeneruI, und LIe EnvIronmenLuI ProLecLIon Agency,
Iuve been Iorced Lo InIer LIe presence oI ETS
componenLs by proxy, bused on LIe composILIon oI
sIde-sLreum smoke Irom wIIcI ETS derIves.
NomInuIIy, LIen ETS und muIn-sLreum smoke muy
sIure some componenLs, buL LIeIr cIemIcuI und
pIysIcuI dIIIerences ure subsLunLIuI. Moreover, LIe
presence oI mosL ETS componenLs cun onIy be
posLuIuLed becuuse LIey ure beyond muLerIuI deLecLIon.
TIe uvuIIubIe evIdence oIIers some IImILed
opporLunILIes Lo guuge ETS exposures und doses In
reIuLIon Lo ucLIve muIn-sLreum smokIng counLerpurLs.
Due Lo LIe dIIIIcuILy or ImpossIbIIILy oI meusurIng LIe
consLILuenLs oI sucI u IIgIIy dIIuLed subsLunce, IndIrecL meusures oI
exposure Iuve been reIIed on. Two oILen-used meusures oI ETS exposure
ure quesLIonnuIres und LIe bIomurker oI cotinine IeveIs presenL In
pIysIoIogIcuI IIuIds; coLInIne Is u meLuboIILe oI nIcoLIne. QuesLIonnuIres
uIIow un esLImuLe oI Iong-Lerm exposure buL Iuve consIderubIe IImILuLIons
sucI us InuccurucIes oI recuII und Iuck oI evIdence concernIng ucLuuI
exposure. CoLInIne, wIIcI Is noL consIdered IurmIuI, cerLuInIy
demonsLruLes LIuL exposure Lo ETS Ius occurred. However, exLrupoIuLIons
268
268
Rampant Antismoking Signifies Grave Danger
on LIe busIs oI coLInIne IeveIs ure IImILed In LIuL coLInIne, oI ILseII,
provIdes onIy u reIuLIve IndIcuLIon oI IeveI oI exposure und Is u poor
IndIcuLor oI ETS consLILuenLs; LIere Is LIe very Lenuous ussumpLIon oI
consIsLenL ruLIos oI nIcoLIneJcoLInIne und oLIer smoke consLILuenLs Ior
boLI MS und ETS.
GorI (1qqq) reusonubIy proIIers LIuL overuII, LIese
consIderuLIons Ieud Lo LIe concIusIon LIuL LIe prevuIenL ETS-RSP dose Is
mInuscuIe. AILIougI dIIIIcuIL Lo deIIne, IL Is beLween 1o,ooo und 1oo,ooo
LImes smuIIer LIun LIe muInsLreum smoke dose In ucLIve smokers, us
oIIIcIuI EPA reporLs ucknowIedge. or LIe uveruge ETS-exposed
IndIvIduuI, LIIs esLImuLe LrunsIuLes InLo un unnuuI dose equIvuIenL Lo
consIderubIy Iess LIun LIe muInsLreum RSP oI one cIgureLLe.
n LIuL ETS Is IIgIIy dIIuLed, wIeLIer IL dIIIers subsLunLIuIIy In
composILIon Irom MS or noL, ETS Ius noL IIsLorIcuIIy IIgured us u generuI
IeuILI Iuzurd - oLIer LIun In NuzI Germuny. L cun weII be usked wIy
LIere wus IncreusIng InLeresL In ILs sLudy Irom LIe eurIy-eIgILIes? or
exumpIe, Kennedy & Bero (1qqq) Iound LIuL LIe number oI newspuper
und muguzIne urLIcIes reporLIng on pussIve smokIng reseurcI Increused
Irom Iour In 1q81 Lo ; In 1qqz und z In 1qqq. urLIermore, IL couId even
more ImporLunLIy be usked wIy secLIons oI IndusLry Iud uIreudy been
mukIng uIIowunces Ior nonsmokIng ureus In LIe workpIuce Iong beIore LIe
EPA reporL on ETS In 1qq?
TIe sLruIgILIorwurd unswer Lo LIese quesLIons Is LIuL weII prIor
Lo LIe EPA ReporL (1qq), wesLern socIeLIes were uIreudy beIng Ied IIgIIy
InIIummuLory unLIsmokIng propugundu IndIcuLIng LIuL ETS wus u cuuse oI
dIseuse und morLuIILy, und wIere IndusLry couId rIsk IILIguLIon II IL dId noL
Luke prevenLIve meusures. AguIn, IL musL be noLed LIuL LIere wus no
scIenLIIIc busIs Lo LIese cIuIms, buL wus LIe producL oI conLorLed
muLerIuIIsL IdeoIogy. As wus demonsLruLed In NuzI Germuny, unLIsmokIng
does noL requIre scIenLIIIc evIdence Lo IIourIsI. n IuscIsL Germuny, uII
LIuL wus requIred wus LIe unLIsmokIng dIcLuLe oI LIe supreme ruIer,
regurdIess oI wIuL scIenLIIIc evIdence wus or wus noL uvuIIubIe. n wesLern
socIeLIes, wIIcI ure LypIcuIIy democruLIc, uLLempLs uL unsubsLunLIuLed
coercIon run LIe very IIgI rIsk oI beIng recognIzed Ior wIuL LIey ure -
dIcLuLorIuI. TIereIore, In democruLIc socIeLIes, unLIsmokIng wouId requIre
LIe sembIunce oI scIenLIIIc credIbIIILy Ior IL Lo IIourIsI.
TIe unLIsmokIng group AcLIon on SmokIng und HeuILI (ASH)
wus commILLed Lo LIe exLermInuLIon oI LIe smokIng IubIL sInce LIe IuLe
1q6o`s. TIIs purLIcuIur group Ius been, by Iur, LIe Ieuder In persIsLenL
conLorLIons oI IucL und ussuuILIng LIe menLuI und socIuI IeuILI oI boLI
smokers und nonsmokers. ASH wus one oI LIe key enLrunLs In LIe rIsk
uvoIdIng IndIvIduuI ugendu oI LIe 1q;o`s (I.e., muLerIuIIsL munIIesLo).
Preventive Medicine & Health Promotion
rom LIIs very begInnIng ASH Ius IoIIowed LIe course LIuL onIy sLoppIng
smokIng und prevenLIng persons Irom sLurLIng smokIng Is uccepLubIe (see
BerrIdge, 1qqq). ASH Ius uIwuys opposed uny uLLempL uL rIsk
mInImIzuLIon, e.g., pIpe or cIgur smokIng, suIer cIgureLLes, deveIopIng
beLLer LreuLmenLs Ior Iung dIseuse. rom LIe 1q;o`s |L|Ie smokIng
couIILIon wus puyIng Increused uLLenLIon Lo LIe use oI medIu sLruLegIes,
wILI ubsLenLIon us ILs mujor uIm. (BerrIdge, 1qqq, p.1186) BerrIdge
(1qqq) IIgIIIgILs LIuL brIeIIng noLes Ior u 1q; ASH meeLIng IndIcuLe:
need Lo Increuse pubIIc uwureness oI IImILuLIons oI so-cuIIed 'suIer`
smokIng. Need Ior ucLIon Lo prevenL 'suIer` smokIng Irom perpeLuuLIng u
IubIL wIIcI mIgIL oLIerwIse be eIImInuLed evenLuuIIy. (quoLed on
p.118;) L wouId uIso be expecLed LIuL ASH Ius uLLempLed Lo IoII uLLempLs
Lo seurcI Ior beLLer LreuLmenLs Ior Iung cuncer und LIe IundIng LIIs wouId
requIre; Ior ASH, sucI u curuLIve venLure wouId be u condonIng oI LIe
smokIng IubIL. TIe crILIcuI busIs Ior ASH conducL Is LIe Ideu oI
nonsmokers` rIgILs, IncIudIng cIIIdren, In LIeIr exposure Lo ETS ruLIer
LIun on scIenLIIIc IucLs (see BerrIdge, 1qqq).
UnLII LIe mId-Lo-IuLe 1q8o`s, ETS wus noL consIdered dungerous
Lo nonsmokers. TIe Ideu oI nonsmokers` rIgILs dId noL Iuve mucI
uppeuI umongsL poIIcy mukers. TIose demundIng resLrIcLIons on smokIng
Iud been LypIcuIIy vIewed us crunky or eccenLrIc. However, LIe poor
requIremenLs oI evIdence by LIe epIdemIoIogIcuI meLIod und weIgIL-oI-
evIdence upproucI, und LIe promoLIon oI LIe rIsk uvoIdIng IndIvIduuI us
normuLIve (I.e., u buIIdIng muLerIuIIsL momenLum) were Lo drusLIcuIIy
cIunge LIe cIrcumsLunce. L wus weII undersLood by unLIsmokIng groups,
und purLIcuIurIy ASH, LIuL II ETS couId be consLrued us dungerous Ior
nonsmokers, LIIs couId quIckIy uccompIIsI wIuL u Iew decudes oI pusIIng
Ior nonsmokers` rIgILs Iud undersLundubIy IuIIed Lo uccompIIsI -
drumuLIc resLrIcLIons on smokIng. L Is, LIereIore, noL surprIsIng LIuL key
personneI In LIe EPA LIuL produced LIe 1qq ETS ReporL Iud LIeIr rooLs
In unLIsmokIng Iobby groups.
n u governmenLuI InvesLIguLIon (SLuLemenL Lo LIe House
CommILLee on Energy und Commerce) oI EPA conducL IeudIng Lo ILs 1qq
ETS reporL, BIIIey (1qq) Iorwurds:
n order Lo undersLund EPA`s roIe In LIe ETS
conLroversy, one musL undersLund Iow LIe 'pussIve
smokIng` Issue emerged In LIe IIrsL pIuce. AccordIng Lo
RIcIurd Duynurd, u weII-known unLIsmokIng ucLIvIsL,
LIe orgunIzed movemenL Lo erudIcuLe smokIng Ius
proceeded In LIree dIsLIncL pIuses. DurIng LIe IIrsL
pIuse, ucLIvIsLs uLLempLed Lo persuude smokers Lo sLop
smokIng on LIe ground LIuL smokIng wus bud Ior LIe
269
269
Rampant Antismoking Signifies Grave Danger
on LIe busIs oI coLInIne IeveIs ure IImILed In LIuL coLInIne, oI ILseII,
provIdes onIy u reIuLIve IndIcuLIon oI IeveI oI exposure und Is u poor
IndIcuLor oI ETS consLILuenLs; LIere Is LIe very Lenuous ussumpLIon oI
consIsLenL ruLIos oI nIcoLIneJcoLInIne und oLIer smoke consLILuenLs Ior
boLI MS und ETS.
GorI (1qqq) reusonubIy proIIers LIuL overuII, LIese
consIderuLIons Ieud Lo LIe concIusIon LIuL LIe prevuIenL ETS-RSP dose Is
mInuscuIe. AILIougI dIIIIcuIL Lo deIIne, IL Is beLween 1o,ooo und 1oo,ooo
LImes smuIIer LIun LIe muInsLreum smoke dose In ucLIve smokers, us
oIIIcIuI EPA reporLs ucknowIedge. or LIe uveruge ETS-exposed
IndIvIduuI, LIIs esLImuLe LrunsIuLes InLo un unnuuI dose equIvuIenL Lo
consIderubIy Iess LIun LIe muInsLreum RSP oI one cIgureLLe.
n LIuL ETS Is IIgIIy dIIuLed, wIeLIer IL dIIIers subsLunLIuIIy In
composILIon Irom MS or noL, ETS Ius noL IIsLorIcuIIy IIgured us u generuI
IeuILI Iuzurd - oLIer LIun In NuzI Germuny. L cun weII be usked wIy
LIere wus IncreusIng InLeresL In ILs sLudy Irom LIe eurIy-eIgILIes? or
exumpIe, Kennedy & Bero (1qqq) Iound LIuL LIe number oI newspuper
und muguzIne urLIcIes reporLIng on pussIve smokIng reseurcI Increused
Irom Iour In 1q81 Lo ; In 1qqz und z In 1qqq. urLIermore, IL couId even
more ImporLunLIy be usked wIy secLIons oI IndusLry Iud uIreudy been
mukIng uIIowunces Ior nonsmokIng ureus In LIe workpIuce Iong beIore LIe
EPA reporL on ETS In 1qq?
TIe sLruIgILIorwurd unswer Lo LIese quesLIons Is LIuL weII prIor
Lo LIe EPA ReporL (1qq), wesLern socIeLIes were uIreudy beIng Ied IIgIIy
InIIummuLory unLIsmokIng propugundu IndIcuLIng LIuL ETS wus u cuuse oI
dIseuse und morLuIILy, und wIere IndusLry couId rIsk IILIguLIon II IL dId noL
Luke prevenLIve meusures. AguIn, IL musL be noLed LIuL LIere wus no
scIenLIIIc busIs Lo LIese cIuIms, buL wus LIe producL oI conLorLed
muLerIuIIsL IdeoIogy. As wus demonsLruLed In NuzI Germuny, unLIsmokIng
does noL requIre scIenLIIIc evIdence Lo IIourIsI. n IuscIsL Germuny, uII
LIuL wus requIred wus LIe unLIsmokIng dIcLuLe oI LIe supreme ruIer,
regurdIess oI wIuL scIenLIIIc evIdence wus or wus noL uvuIIubIe. n wesLern
socIeLIes, wIIcI ure LypIcuIIy democruLIc, uLLempLs uL unsubsLunLIuLed
coercIon run LIe very IIgI rIsk oI beIng recognIzed Ior wIuL LIey ure -
dIcLuLorIuI. TIereIore, In democruLIc socIeLIes, unLIsmokIng wouId requIre
LIe sembIunce oI scIenLIIIc credIbIIILy Ior IL Lo IIourIsI.
TIe unLIsmokIng group AcLIon on SmokIng und HeuILI (ASH)
wus commILLed Lo LIe exLermInuLIon oI LIe smokIng IubIL sInce LIe IuLe
1q6o`s. TIIs purLIcuIur group Ius been, by Iur, LIe Ieuder In persIsLenL
conLorLIons oI IucL und ussuuILIng LIe menLuI und socIuI IeuILI oI boLI
smokers und nonsmokers. ASH wus one oI LIe key enLrunLs In LIe rIsk
uvoIdIng IndIvIduuI ugendu oI LIe 1q;o`s (I.e., muLerIuIIsL munIIesLo).
Preventive Medicine & Health Promotion
rom LIIs very begInnIng ASH Ius IoIIowed LIe course LIuL onIy sLoppIng
smokIng und prevenLIng persons Irom sLurLIng smokIng Is uccepLubIe (see
BerrIdge, 1qqq). ASH Ius uIwuys opposed uny uLLempL uL rIsk
mInImIzuLIon, e.g., pIpe or cIgur smokIng, suIer cIgureLLes, deveIopIng
beLLer LreuLmenLs Ior Iung dIseuse. rom LIe 1q;o`s |L|Ie smokIng
couIILIon wus puyIng Increused uLLenLIon Lo LIe use oI medIu sLruLegIes,
wILI ubsLenLIon us ILs mujor uIm. (BerrIdge, 1qqq, p.1186) BerrIdge
(1qqq) IIgIIIgILs LIuL brIeIIng noLes Ior u 1q; ASH meeLIng IndIcuLe:
need Lo Increuse pubIIc uwureness oI IImILuLIons oI so-cuIIed 'suIer`
smokIng. Need Ior ucLIon Lo prevenL 'suIer` smokIng Irom perpeLuuLIng u
IubIL wIIcI mIgIL oLIerwIse be eIImInuLed evenLuuIIy. (quoLed on
p.118;) L wouId uIso be expecLed LIuL ASH Ius uLLempLed Lo IoII uLLempLs
Lo seurcI Ior beLLer LreuLmenLs Ior Iung cuncer und LIe IundIng LIIs wouId
requIre; Ior ASH, sucI u curuLIve venLure wouId be u condonIng oI LIe
smokIng IubIL. TIe crILIcuI busIs Ior ASH conducL Is LIe Ideu oI
nonsmokers` rIgILs, IncIudIng cIIIdren, In LIeIr exposure Lo ETS ruLIer
LIun on scIenLIIIc IucLs (see BerrIdge, 1qqq).
UnLII LIe mId-Lo-IuLe 1q8o`s, ETS wus noL consIdered dungerous
Lo nonsmokers. TIe Ideu oI nonsmokers` rIgILs dId noL Iuve mucI
uppeuI umongsL poIIcy mukers. TIose demundIng resLrIcLIons on smokIng
Iud been LypIcuIIy vIewed us crunky or eccenLrIc. However, LIe poor
requIremenLs oI evIdence by LIe epIdemIoIogIcuI meLIod und weIgIL-oI-
evIdence upproucI, und LIe promoLIon oI LIe rIsk uvoIdIng IndIvIduuI us
normuLIve (I.e., u buIIdIng muLerIuIIsL momenLum) were Lo drusLIcuIIy
cIunge LIe cIrcumsLunce. L wus weII undersLood by unLIsmokIng groups,
und purLIcuIurIy ASH, LIuL II ETS couId be consLrued us dungerous Ior
nonsmokers, LIIs couId quIckIy uccompIIsI wIuL u Iew decudes oI pusIIng
Ior nonsmokers` rIgILs Iud undersLundubIy IuIIed Lo uccompIIsI -
drumuLIc resLrIcLIons on smokIng. L Is, LIereIore, noL surprIsIng LIuL key
personneI In LIe EPA LIuL produced LIe 1qq ETS ReporL Iud LIeIr rooLs
In unLIsmokIng Iobby groups.
n u governmenLuI InvesLIguLIon (SLuLemenL Lo LIe House
CommILLee on Energy und Commerce) oI EPA conducL IeudIng Lo ILs 1qq
ETS reporL, BIIIey (1qq) Iorwurds:
n order Lo undersLund EPA`s roIe In LIe ETS
conLroversy, one musL undersLund Iow LIe 'pussIve
smokIng` Issue emerged In LIe IIrsL pIuce. AccordIng Lo
RIcIurd Duynurd, u weII-known unLIsmokIng ucLIvIsL,
LIe orgunIzed movemenL Lo erudIcuLe smokIng Ius
proceeded In LIree dIsLIncL pIuses. DurIng LIe IIrsL
pIuse, ucLIvIsLs uLLempLed Lo persuude smokers Lo sLop
smokIng on LIe ground LIuL smokIng wus bud Ior LIe
270
270
Rampant Antismoking Signifies Grave Danger
smoker. AILIougI muny smokers dId sLop smokIng Ior
LIuL reuson, oLIers conLInued. DurIng LIe second pIuse,
ucLIvIsLs uLLempLed Lo muke smokers IeeI guIILy ubouL
LIeIr enjoymenL oI smokIng. AguIn, Iowever, muny
IndIvIduuIs conLInued Lo smoke. TIe LIIrd und currenL
pIuse, uccordIng Lo Duynurd, murked u more
IundumenLuI sLruLegIc sIIIL. n LIIs pIuse, LIe
movemenL begun Lo Iocus on LIe 'deveIopmenL` oI
'evIdence` ubouL ETS. I peopIe cun be persuuded Lo
beIIeve LIuL Lobucco smoke Is IurmIuI Lo non-smokers,
IL becomes eusIer Lo persuude boLI prIvuLe enLILIes und
governmenL uuLIorILIes Lo resLrIcL or bun smokIng.
AccordIng Lo SLunLon GIunLz, Iounder oI CuIIIornIuns
Ior Nonsmokers` RIgILs (IuLer cIrIsLened AmerIcuns Ior
Nonsmokers` RIgILs), LIe LurgeL oI sucI Iuws Is LIe
smoker ruLIer LIun LIe nonsmoker - Althouh the
nonsmolers rihts motement concentrctes on
protectin the nonsmoler rcther thcn on urin the
smoler to quit jor his or her benejit, [cntismolin
leislction] reduces smolin beccuse it undercuts the
socicl support netuorl jor smolin b implicitl
dejinin smolin cs cn cnti-socicl cct. (p.)
n LIe quesL Ior scIenLIIIc IegILImucy oI Lobucco Iurm Lo
nonsmokers KIuger (1qq6) uIso noLes LIuL wIuL LIe unLIsmokIng
movemenL mosL needed wus u IIndIng by LIe EnvIronmenLuI ProLecLIon
Agency LIuL ETS quuIIIIed us wIuL LIe EPA Lermed u Group A
curcInogen...By sucI u IIndIng, ETS wouId be eIevuLed Lo un oIIIcIuI
pubIIc menuce, gIven LIe uII buL unIversuI exposure Lo IL by LIe AmerIcun
pubIIc, und IL wouId IurdIy muLLer Iow reIuLIveIy sIIgIL LIe rIsk Irom IL
mIgIL be Ior uny IeuILIy IndIvIduuI; In LIe process LIe |Lobucco|
IndusLry`s cIIeI deIense - LIuL ETS Iud noL been sIown Lo be u IegILImuLe
IeuILI rIsk buL wus Ior some, u source oI unnoyunce, reudIIy mILIguLed by
courLesy on boLI sIdes - wouId be desLroyed. (quoLed In OukIey, 1qqq,
CI.6, p.zo)
BIIIey`s (1qq, p.) InvesLIguLIon reveuIed LIuL u number oI IIgI-
proIIIe, mIIILunL unLIsmokIng ucLIvIsLs were uppeurIng In LIe medIu In LIe
eurIy eIgILIes wILI uII munner oI ouLIundIsI und InIIummuLory cIuIms
regurdIng ETS. More dIsLurbIng sLIII Is LIuL u number oI LIese
unLIsmokIng IobbyIsLs were eILIer EPA sLuII or Iud conLrIbuLed Lo LIe
IusIIonIng oI EPA poIIcy on smokIng und ETS prIor Lo EPA (1qq). or
exumpIe, Jumes Repuce, un envIronmenL proLecLIon specIuIIsL In EPA`s
Preventive Medicine & Health Promotion
ndoor AIr DIvIsIon, Iud done exLensIve work wILI poIILIcuI udvocucy
orgunIzuLIons sucI us LIe Group AguInsL Smoke PoIIuLIon (GASP) und
AcLIon on SmokIng und HeuILI (ASH). Repuce Iud uIso uppeured us u puId
wILness In numerous IuwsuILs und LesLIIyIng beIore vurIous IegIsIuLIve
bodIes Lo supporL governmenLuI resLrIcLIons on smokIng. Repuce sLuLed Lo
LIe press regurdIng LIe IuIIure oI unLIsmokIng IegIsIuLIon In MuryIund,
1q8o, LIuL PeopIe uren`L goIng Lo sLund Ior LIIs. Now LIuL LIe IucLs ure
cIeur, you`re goIng Lo sLurL seeIng nonsmokers become u IoL more vIoIenL.
You`re goIng Lo see IIgILs breukIng ouL uII over.
AccordIng Lo BIIIey (1qq):
durIng LIe IuLe-1q8o`s, Mr. Repuce becume LIe drIvIng
Iorce beIInd EPA`s pusI Lo cIussIIy ETS us u 'Group A`
curcInogen. He begun by ouLIInIng pIuns Ior Lwo reporLs
desIgned Lo promoLe LIe eIImInuLIon oI ETS. AILIougI
IIs pIuns personuIIy Lo druIL u 'Iundbook` on LIe subjecL
were noL reuIIzed, Repuce ussumed prImury
responsIbIIILy Ior Lwo Iong-Lerm projecLs - un 'ETS
IILeruLure compendIum` und un 'ETS workpIuce
smokIng guIde`, us weII us u smuIIer projecL, un 'ETS IucL
sIeeL`. TIese projecLs were meunL Lo IurLIer LIe ugendu
IIrsL unnounced In Repuce`s 1q8o urLIcIe. Even us Mr.
Repuce expunded IIs ucLIvILIes wILI LIe ndoor AIr
DIvIsIon, Ie wus LruveIIng uround LIe worId, uL LIe
InvILuLIon und expense oI smokIng orgunIzuLIons, Lo
uppeur uL vurIous conIerences und medIu evenLs Lo
promoLe unLIsmokIng resLrIcLIons. or exumpIe, Mr.
Repuce LruveIed Lo New ZeuIund In 1qqo Lo supporL
unLIsmokIng IegIsIuLIon In LIuL counLry. Press coveruge
LIere wus LypIcuI oI Mr. Repuce`s medIu uppeurunces,
IncIudIng LIe IdenLIIIcuLIon oI Mr. Repuce us un EPA
empIoyee unuccompunIed by LIe requIred dIscIuImer
LIuL IIs vIews dId noL reIIecL un oIIIcIuI EPA posILIon. n
numerous medIu InLervIews, Mr. Repuce Ius mude LIe
buseIess usserLIon LIuL o,ooo peopIe In LIe U.S. dIe
eucI yeur Irom exposure Lo ETS und Ius IeIL LIe cIeur
ImpressIon LIuL LIese vIews reIIecL EPA`s oIIIcIuI
posILIon ruLIer LIun IIs personuI vIews. SucI
demonsLruLed bIus wouId creuLe u serIous conIIIcL oI
Issue uL uny reguIuLory ugency, uppurenLIy wILI LIe
excepLIon oI EPA, mosL IIkeIy IeudIng Lo LIe oIIIcIuI`s
reIusuI Irom IurLIer InvoIvemenL In LIe Issue In
quesLIon. n IucL, Mr. Repuce conLInued Lo pIuy u key
271
271
Rampant Antismoking Signifies Grave Danger
smoker. AILIougI muny smokers dId sLop smokIng Ior
LIuL reuson, oLIers conLInued. DurIng LIe second pIuse,
ucLIvIsLs uLLempLed Lo muke smokers IeeI guIILy ubouL
LIeIr enjoymenL oI smokIng. AguIn, Iowever, muny
IndIvIduuIs conLInued Lo smoke. TIe LIIrd und currenL
pIuse, uccordIng Lo Duynurd, murked u more
IundumenLuI sLruLegIc sIIIL. n LIIs pIuse, LIe
movemenL begun Lo Iocus on LIe 'deveIopmenL` oI
'evIdence` ubouL ETS. I peopIe cun be persuuded Lo
beIIeve LIuL Lobucco smoke Is IurmIuI Lo non-smokers,
IL becomes eusIer Lo persuude boLI prIvuLe enLILIes und
governmenL uuLIorILIes Lo resLrIcL or bun smokIng.
AccordIng Lo SLunLon GIunLz, Iounder oI CuIIIornIuns
Ior Nonsmokers` RIgILs (IuLer cIrIsLened AmerIcuns Ior
Nonsmokers` RIgILs), LIe LurgeL oI sucI Iuws Is LIe
smoker ruLIer LIun LIe nonsmoker - Althouh the
nonsmolers rihts motement concentrctes on
protectin the nonsmoler rcther thcn on urin the
smoler to quit jor his or her benejit, [cntismolin
leislction] reduces smolin beccuse it undercuts the
socicl support netuorl jor smolin b implicitl
dejinin smolin cs cn cnti-socicl cct. (p.)
n LIe quesL Ior scIenLIIIc IegILImucy oI Lobucco Iurm Lo
nonsmokers KIuger (1qq6) uIso noLes LIuL wIuL LIe unLIsmokIng
movemenL mosL needed wus u IIndIng by LIe EnvIronmenLuI ProLecLIon
Agency LIuL ETS quuIIIIed us wIuL LIe EPA Lermed u Group A
curcInogen...By sucI u IIndIng, ETS wouId be eIevuLed Lo un oIIIcIuI
pubIIc menuce, gIven LIe uII buL unIversuI exposure Lo IL by LIe AmerIcun
pubIIc, und IL wouId IurdIy muLLer Iow reIuLIveIy sIIgIL LIe rIsk Irom IL
mIgIL be Ior uny IeuILIy IndIvIduuI; In LIe process LIe |Lobucco|
IndusLry`s cIIeI deIense - LIuL ETS Iud noL been sIown Lo be u IegILImuLe
IeuILI rIsk buL wus Ior some, u source oI unnoyunce, reudIIy mILIguLed by
courLesy on boLI sIdes - wouId be desLroyed. (quoLed In OukIey, 1qqq,
CI.6, p.zo)
BIIIey`s (1qq, p.) InvesLIguLIon reveuIed LIuL u number oI IIgI-
proIIIe, mIIILunL unLIsmokIng ucLIvIsLs were uppeurIng In LIe medIu In LIe
eurIy eIgILIes wILI uII munner oI ouLIundIsI und InIIummuLory cIuIms
regurdIng ETS. More dIsLurbIng sLIII Is LIuL u number oI LIese
unLIsmokIng IobbyIsLs were eILIer EPA sLuII or Iud conLrIbuLed Lo LIe
IusIIonIng oI EPA poIIcy on smokIng und ETS prIor Lo EPA (1qq). or
exumpIe, Jumes Repuce, un envIronmenL proLecLIon specIuIIsL In EPA`s
Preventive Medicine & Health Promotion
ndoor AIr DIvIsIon, Iud done exLensIve work wILI poIILIcuI udvocucy
orgunIzuLIons sucI us LIe Group AguInsL Smoke PoIIuLIon (GASP) und
AcLIon on SmokIng und HeuILI (ASH). Repuce Iud uIso uppeured us u puId
wILness In numerous IuwsuILs und LesLIIyIng beIore vurIous IegIsIuLIve
bodIes Lo supporL governmenLuI resLrIcLIons on smokIng. Repuce sLuLed Lo
LIe press regurdIng LIe IuIIure oI unLIsmokIng IegIsIuLIon In MuryIund,
1q8o, LIuL PeopIe uren`L goIng Lo sLund Ior LIIs. Now LIuL LIe IucLs ure
cIeur, you`re goIng Lo sLurL seeIng nonsmokers become u IoL more vIoIenL.
You`re goIng Lo see IIgILs breukIng ouL uII over.
AccordIng Lo BIIIey (1qq):
durIng LIe IuLe-1q8o`s, Mr. Repuce becume LIe drIvIng
Iorce beIInd EPA`s pusI Lo cIussIIy ETS us u 'Group A`
curcInogen. He begun by ouLIInIng pIuns Ior Lwo reporLs
desIgned Lo promoLe LIe eIImInuLIon oI ETS. AILIougI
IIs pIuns personuIIy Lo druIL u 'Iundbook` on LIe subjecL
were noL reuIIzed, Repuce ussumed prImury
responsIbIIILy Ior Lwo Iong-Lerm projecLs - un 'ETS
IILeruLure compendIum` und un 'ETS workpIuce
smokIng guIde`, us weII us u smuIIer projecL, un 'ETS IucL
sIeeL`. TIese projecLs were meunL Lo IurLIer LIe ugendu
IIrsL unnounced In Repuce`s 1q8o urLIcIe. Even us Mr.
Repuce expunded IIs ucLIvILIes wILI LIe ndoor AIr
DIvIsIon, Ie wus LruveIIng uround LIe worId, uL LIe
InvILuLIon und expense oI smokIng orgunIzuLIons, Lo
uppeur uL vurIous conIerences und medIu evenLs Lo
promoLe unLIsmokIng resLrIcLIons. or exumpIe, Mr.
Repuce LruveIed Lo New ZeuIund In 1qqo Lo supporL
unLIsmokIng IegIsIuLIon In LIuL counLry. Press coveruge
LIere wus LypIcuI oI Mr. Repuce`s medIu uppeurunces,
IncIudIng LIe IdenLIIIcuLIon oI Mr. Repuce us un EPA
empIoyee unuccompunIed by LIe requIred dIscIuImer
LIuL IIs vIews dId noL reIIecL un oIIIcIuI EPA posILIon. n
numerous medIu InLervIews, Mr. Repuce Ius mude LIe
buseIess usserLIon LIuL o,ooo peopIe In LIe U.S. dIe
eucI yeur Irom exposure Lo ETS und Ius IeIL LIe cIeur
ImpressIon LIuL LIese vIews reIIecL EPA`s oIIIcIuI
posILIon ruLIer LIun IIs personuI vIews. SucI
demonsLruLed bIus wouId creuLe u serIous conIIIcL oI
Issue uL uny reguIuLory ugency, uppurenLIy wILI LIe
excepLIon oI EPA, mosL IIkeIy IeudIng Lo LIe oIIIcIuI`s
reIusuI Irom IurLIer InvoIvemenL In LIe Issue In
quesLIon. n IucL, Mr. Repuce conLInued Lo pIuy u key
272
272
Rampant Antismoking Signifies Grave Danger
roIe In LIe prepuruLIon oI documenLs Ior LIe pubIIc LIuL
were represenLed us neuLruI und dIspussIonuLe unuIyses
oI LIe IucLs perLuInIng Lo ETS despILe LIe udvocucy roIe
Ie wus pIuyIng In IIs 'prIvuLe cupucILy.` (p.6)
n 1q8q, u druIL oI LIe ubove-menLIoned compendIum wus
reIeused by LIe EPA:
TIe onIy unIIyIng LIeme oI LIe compendIum Is LIuL, In
LIe Agency`s vIew, smokIng und ETS ure 'bud`. Ike
mosL oI LIe Agency`s ouLsIde conLrucLors on ETS, muny
cIupLer uuLIors oI LIe compendIum, IncIudIng SLunLon
GIunLz, JonuLIon SumeL, und oI course, Jumes Repuce,
Iud Iong been ucLIve In LIe unLIsmokIng
movemenL...AILIougI sLIII In druIL Iorm und noL
revIewed by LIe S|cIence| A|dvIsory| B|ourd|, LIe
compendIum receIved wIdespreud medIu uLLenLIon.
RoberL AxeIrud, DIrecLor oI LIe ndoor AIr DIvIsIon, Iud
usserLed unequIvocuIIy In u Muy 8, 1qqo, IeLLer Lo TIe
Tobucco nsLILuLe`s counseI LIuL EPA wus 'noL InLeresLed
In promoLIng uny medIu uLLenLIon Lo LIe documenLs
wIIIe LIey ure In druIL Iorm und wIII do everyLIIng
possIbIe Lo ussure LIuL LIey ure noL consLrued us EPA
poIIcy`. NoLwILIsLundIng Mr. AxeIrud`s ussurunces, LIe
compendIum wus Ieuked Lo LIe press und ILs more
sensuLIonuI cIuIms openIy pubIIcIzed prIor Lo uny
scIenLIIIc revIew oI LIe documenL`s conLenLs. AccordIng
Lo u ebruury, 1qq by LIe GeneruI AccounLIng OIIIce
(GAO), EPA sLuII In AprII 1qq1, beIore EPA Iud
compIeLed ILs own InLernuI revIew oI LIe documenL,
ImproperIy senL u druIL oI LIe compendIum Lo severuI
exLernuI revIewers, IncIudIng SLunLon GIunLz. GIunLz, un
ouLspoken unLIsmokIng ucLIvIsL sInce LIe 1q6o`s,
ImmedIuLeIy proceeded Lo provIde u copy Lo un
AssocIuLed Press reporLer. AccordIng Lo LIe GAO,
GIunLz cIuIms LIuL IIs reIeuse oI LIe reporL wus sImpIy u
'mIsLuke`. MosL dIsLurbIng wus LIe pubIIc dIssemInuLIon
oI LIe cIupLer on curdIovuscuIur dIseuse. GIunLz, one oI
LIe uuLIors oI LIuL cIupLer, uppeured In BosLon - uguIn
wILI Jumes Repuce - uL LIe WorId ConIerence on ung
HeuILI In IuLe Muy 1qqo und guve boLI u presenLuLIon
und news InLervIews on LIuL cIupLer. Dr. GIunLz used
LIe opporLunILy Lo repeuL und underscore LIe
Preventive Medicine & Health Promotion
unsupporLed cIuIm LIuL more LIun o,ooo nonsmokIng
AmerIcuns dIe oI IeurL dIseuse eucI yeur us u resuIL oI
exposure Lo ETS. TIIs ucLIvILy mude u mockery oI EPA`s
procedures Ior ensurIng LIuL ILs poIIcy documenLs
receIve u IuII und IuIr revIew beIore LIey ure IInuIIzed.
GIunLz Ius u Iong record oI pubIIc sLuLemenLs
demonsLruLIng IIs commILmenL Lo LIuL poIILIcuI ugendu,
noLwILIsLundIng LIe Iuck oI scIenLIIIc supporL Ior IIs
cIuIms concernIng ETS. WIIIe IIs LruInIng Is In
mecIunIcuI engIneerIng ruLIer LIun medIcIne or some
oLIer reIevunL dIscIpIIne, Ie Ius ponLIIIcuLed on every
conceIvubIe smokIng-reIuLed LopIc, sucI us udverLIsIng
und economIc Issues, ubouL wIIcI Ie pIuInIy cun muke
no cIuIm Lo proIessIonuI compeLence. To cILe one
exumpIe, Dr. GIunLz`s orgunIzuLIon sLuLed In ILs 1q8
unnuuI reporL LIuL 'IrreIuLubIe medIcuI und scIenLIIIc
evIdence Ius conIIrmed wIuL mIIIIons oI nonsmokers
Iuve InLuILIveIy known Ior u Iong LIme: Tobucco
smoke..poses u serIous IeuILI rIsk Ior nonsmokers
wIo breuLIe secondIund smoke.` (p. ;-q)
BIIIey (1qq) conLInues LIuL:
n June 1qqo, EPA reIeused IormuIIy LIe IIrsL druIL oI ILs
poIIcy guIde, enLILIed 'EnvIronmenLuI Tobucco Smoke: A
GuIde Lo WorkpIuce SmokIng PoIIcIes`. TIe guIde`s
sLuLed purpose wus Lo provIde governmenL und prIvuLe
secLor decIsIon mukers wILI InIormuLIon on LIe
LecInIcuI busIs oI conLroIIIng exposure Lo envIronmenLuI
Lobucco smoke und Lo descrIbe u vurIeLy oI LecInIcuI und
poIIcy opLIons Ior InsLILuLIng eIIecLIve smokIng
resLrIcLIons. L Ius never been cIeur wIy EPA prepured
und reIeused u rIsk munugemenL documenL IIke LIe
poIIcy guIde und beIore LIuL, LIe 'IucL sIeeL` und
compendIum, In udvunce oI uny IInuI scIenLIIIc
ussessmenL oI LIe supposed 'rIsk` Lo be
munuged...ObvIousIy, II LIe rIsk Irom ETS uL IeveIs
LypIcuIIy In LIe workpIuce wus Iound Lo be mInImuI,
LIere wouId be no jusLIIIcuLIon Ior recommendIng, us
dId LIe 'IucL sIeeL` und poIIcy guIde, LIuL smokIng be
proIIbILed excepL In sepuruLeIy venLIIuLed
ureus....EquuIIy LroubIIng Is LIe IucL LIuL LIe guIde
even wenL so Iur us Lo encouruge ETS-bused IuwsuILs by
273
273
Rampant Antismoking Signifies Grave Danger
roIe In LIe prepuruLIon oI documenLs Ior LIe pubIIc LIuL
were represenLed us neuLruI und dIspussIonuLe unuIyses
oI LIe IucLs perLuInIng Lo ETS despILe LIe udvocucy roIe
Ie wus pIuyIng In IIs 'prIvuLe cupucILy.` (p.6)
n 1q8q, u druIL oI LIe ubove-menLIoned compendIum wus
reIeused by LIe EPA:
TIe onIy unIIyIng LIeme oI LIe compendIum Is LIuL, In
LIe Agency`s vIew, smokIng und ETS ure 'bud`. Ike
mosL oI LIe Agency`s ouLsIde conLrucLors on ETS, muny
cIupLer uuLIors oI LIe compendIum, IncIudIng SLunLon
GIunLz, JonuLIon SumeL, und oI course, Jumes Repuce,
Iud Iong been ucLIve In LIe unLIsmokIng
movemenL...AILIougI sLIII In druIL Iorm und noL
revIewed by LIe S|cIence| A|dvIsory| B|ourd|, LIe
compendIum receIved wIdespreud medIu uLLenLIon.
RoberL AxeIrud, DIrecLor oI LIe ndoor AIr DIvIsIon, Iud
usserLed unequIvocuIIy In u Muy 8, 1qqo, IeLLer Lo TIe
Tobucco nsLILuLe`s counseI LIuL EPA wus 'noL InLeresLed
In promoLIng uny medIu uLLenLIon Lo LIe documenLs
wIIIe LIey ure In druIL Iorm und wIII do everyLIIng
possIbIe Lo ussure LIuL LIey ure noL consLrued us EPA
poIIcy`. NoLwILIsLundIng Mr. AxeIrud`s ussurunces, LIe
compendIum wus Ieuked Lo LIe press und ILs more
sensuLIonuI cIuIms openIy pubIIcIzed prIor Lo uny
scIenLIIIc revIew oI LIe documenL`s conLenLs. AccordIng
Lo u ebruury, 1qq by LIe GeneruI AccounLIng OIIIce
(GAO), EPA sLuII In AprII 1qq1, beIore EPA Iud
compIeLed ILs own InLernuI revIew oI LIe documenL,
ImproperIy senL u druIL oI LIe compendIum Lo severuI
exLernuI revIewers, IncIudIng SLunLon GIunLz. GIunLz, un
ouLspoken unLIsmokIng ucLIvIsL sInce LIe 1q6o`s,
ImmedIuLeIy proceeded Lo provIde u copy Lo un
AssocIuLed Press reporLer. AccordIng Lo LIe GAO,
GIunLz cIuIms LIuL IIs reIeuse oI LIe reporL wus sImpIy u
'mIsLuke`. MosL dIsLurbIng wus LIe pubIIc dIssemInuLIon
oI LIe cIupLer on curdIovuscuIur dIseuse. GIunLz, one oI
LIe uuLIors oI LIuL cIupLer, uppeured In BosLon - uguIn
wILI Jumes Repuce - uL LIe WorId ConIerence on ung
HeuILI In IuLe Muy 1qqo und guve boLI u presenLuLIon
und news InLervIews on LIuL cIupLer. Dr. GIunLz used
LIe opporLunILy Lo repeuL und underscore LIe
Preventive Medicine & Health Promotion
unsupporLed cIuIm LIuL more LIun o,ooo nonsmokIng
AmerIcuns dIe oI IeurL dIseuse eucI yeur us u resuIL oI
exposure Lo ETS. TIIs ucLIvILy mude u mockery oI EPA`s
procedures Ior ensurIng LIuL ILs poIIcy documenLs
receIve u IuII und IuIr revIew beIore LIey ure IInuIIzed.
GIunLz Ius u Iong record oI pubIIc sLuLemenLs
demonsLruLIng IIs commILmenL Lo LIuL poIILIcuI ugendu,
noLwILIsLundIng LIe Iuck oI scIenLIIIc supporL Ior IIs
cIuIms concernIng ETS. WIIIe IIs LruInIng Is In
mecIunIcuI engIneerIng ruLIer LIun medIcIne or some
oLIer reIevunL dIscIpIIne, Ie Ius ponLIIIcuLed on every
conceIvubIe smokIng-reIuLed LopIc, sucI us udverLIsIng
und economIc Issues, ubouL wIIcI Ie pIuInIy cun muke
no cIuIm Lo proIessIonuI compeLence. To cILe one
exumpIe, Dr. GIunLz`s orgunIzuLIon sLuLed In ILs 1q8
unnuuI reporL LIuL 'IrreIuLubIe medIcuI und scIenLIIIc
evIdence Ius conIIrmed wIuL mIIIIons oI nonsmokers
Iuve InLuILIveIy known Ior u Iong LIme: Tobucco
smoke..poses u serIous IeuILI rIsk Ior nonsmokers
wIo breuLIe secondIund smoke.` (p. ;-q)
BIIIey (1qq) conLInues LIuL:
n June 1qqo, EPA reIeused IormuIIy LIe IIrsL druIL oI ILs
poIIcy guIde, enLILIed 'EnvIronmenLuI Tobucco Smoke: A
GuIde Lo WorkpIuce SmokIng PoIIcIes`. TIe guIde`s
sLuLed purpose wus Lo provIde governmenL und prIvuLe
secLor decIsIon mukers wILI InIormuLIon on LIe
LecInIcuI busIs oI conLroIIIng exposure Lo envIronmenLuI
Lobucco smoke und Lo descrIbe u vurIeLy oI LecInIcuI und
poIIcy opLIons Ior InsLILuLIng eIIecLIve smokIng
resLrIcLIons. L Ius never been cIeur wIy EPA prepured
und reIeused u rIsk munugemenL documenL IIke LIe
poIIcy guIde und beIore LIuL, LIe 'IucL sIeeL` und
compendIum, In udvunce oI uny IInuI scIenLIIIc
ussessmenL oI LIe supposed 'rIsk` Lo be
munuged...ObvIousIy, II LIe rIsk Irom ETS uL IeveIs
LypIcuIIy In LIe workpIuce wus Iound Lo be mInImuI,
LIere wouId be no jusLIIIcuLIon Ior recommendIng, us
dId LIe 'IucL sIeeL` und poIIcy guIde, LIuL smokIng be
proIIbILed excepL In sepuruLeIy venLIIuLed
ureus....EquuIIy LroubIIng Is LIe IucL LIuL LIe guIde
even wenL so Iur us Lo encouruge ETS-bused IuwsuILs by
274
274
Rampant Antismoking Signifies Grave Danger
empIoyees uguInsL LIeIr empIoyers. n doIng so, LIe
poIIcy guIde grossIy oversLuLed LIe IeguI sIgnIIIcunce
und precedenLuI vuIue oI LIe IundIuI oI cuses IuvorubIe
Lo LIe poIIcy guIde`s vIewpoInL wIIIe undersLuLIng LIe
sIgnIIIcunce oI LIe vusL mujorILy oI oLIers, wIIcI were
noL.....TIe SAB`s evenLuuI revIew oI LIe scIenLIIIc
concIusIons In LIe poIIcy guIde wus IncompIeLe uL besL.
PrIor Lo LIe guIde`s reIeuse, EPA Iud decIded Lo IImIL
LIe SAB`s revIew Lo LIose purLs LIuL reIerred Lo LIe rIsk
ussessmenL, Lo ensure LIuL LIe IuLLer wus 'properIy
cIurucLerIzed`. SInce LIe SAB Iud noL yeL seen u rIsk
ussessmenL druIL IL couId upprove, one musL quesLIon
Iow IL couId muke sure LIuL LIe poIIcy guIde properIy
cIurucLerIzed IL. Moreover, LIe poIIcy guIde covered u
mucI brouder runge oI Issues LIun LIe rIsk ussessmenL.
TIe poIIcy guIde Iud been druILed bused on LIe
LecInIcuI compendIum, wIIcI, us Iuve expIuIned, EPA
Ius never gIven Lo LIe SAB Lo revIew, und wIIcI mukes
muny more IeuILI cIuIms LIun does LIe ETS rIsk
ussessmenL. TIese IncIude unsupporLed usserLIons LIuL
ETS Ius been sIown Lo cuuse curdIovuscuIur dIseuse
und suggesLIons LIuL ETS Ius been ussocIuLed wILI
bruIn cuncer. SucI exLruvugunL cIuIms ure uL odds wILI
EPA`s prIvuLe udmIssIons Lo oLIer governmenL oIIIcIuIs
LIuL 'we know very IILLIe ubouL ETS exposure In LIe
workpIuce, und cunnoL esLImuLe LIe reIuLIve sIgnIIIcunce
oI workpIuce vs. Iome vs. uII oLIer sources oI exposure;
nor cun we cIurIIy LIe sIgnIIIcunceJroIeJImpucL oI
exposure Lo oLIer poIIuLunLs (e.g., rudon und oLIer uIr
curcInogens) In uddILIonJconjuncLIon wILI ETS
exposure`. I EPA knows 'very IILLIe` ubouL ETS exposure
In LIe workpIuce, IL Is dIIIIcuIL Lo undersLund wIy IL
wouId decIde Lo Issue u workpIuce poIIcy guIde. EPA
cunnoL usserL, us IL dId repeuLedIy In LIe poIIcy guIde,
LIuL onIy smokIng buns or sepuruLeIy venLIIuLed
smokIng Iounges ure upproprIuLe wILIouL occupuLIonuI
exposure duLu. n LIe ubsence oI sucI duLu, LIe poIIcy
guIde`s recommenduLIons necessurIIy reIIecL onIy LIe
personuI preIerences oI LIe guIde`s uuLIors. expressed
LIese concerns muny LImes In wrILIng Lo EPA
AdmInIsLruLor ReIIIy und receIved noncommILLuI
repIIes....TIe seIecLIon oI LIe poIIcy guIde`s uuLIor,
Preventive Medicine & Health Promotion
RoberL Rosner, oI LIe SmokIng PoIIcy nsLILuLe (SP),
ruIses IurLIer quesLIons ubouL LIe documenL`s
objecLIvILy und reIIubIIILy. SP Is In LIe busIness oI
counseIIng empIoyers on LIe ImpIemenLuLIon oI
smokIng poIIcIes und operuLIng smokIng cessuLIon
cIInIcs. TIIs orgunIzuLIon LIereIore Iud u vesLed
IInuncIuI InLeresL In conveyIng LIe ImpressIon In LIe
poIIcy guIde LIuL empIoyers wILIouL smokIng poIIcIes or
cessuLIon progrums were uL rIsk oI IuwsuILs or worse.
(p.1o-11)
TIe EPA cIrcumsLunce prIor Lo 1qq Is exLruordInury. WILI
unLIsmokIng poIIcy IormuIuLed Iong beIore LIe IIrsL IormuI rIsk
ussessmenL oI ETS In 1qq, LIe EPA wus no more LIun un unLIsmokIng
orgunIzuLIon, domInuLed by IIgI-proIIIe, unLIsmokIng ucLIvIsLs. As wus
IndIcuLed In un eurIIer cIupLer, In scIenLIIIc Lerms, wIere objecLIvILy Is
IosL, uII Is IosL. TIe IrreguIurILIes, ImproprIeLy und bIus IndIcuLed ubove
represenL onIy some oI LIe uIurmIng mIsconducL oI LIe EPA. L Is noL
surprIsIng LIuL wILI Ieuks und reIeuses oI unsubsLunLIuLed,
InIIummuLory, Ieur-mongerIng unLIsmokIng rIeLorIc und dogmu, LIuL
uLLempLs Lo resLrIcL smokIng und, LIereIore, proLecL nonsmokers, were
uIreudy weII under wuy beIore 1qq. AIso probIemuLIc Is LIuL uL IeusL mucI
oI LIIs conducL wus noL scIenLIIIcuIIy cIuIIenged or quesLIoned - eILIer In
LIe IormuI IILeruLure or In LIe medIu.
L Is uguIn useIuI Lo scruLInIze LIIs unLIsmokIng menLuIILy. TIe
unLIsmokIng ucLIvIsLs InvoIved Iuve IeId Lo LIIs rIgId posILIon over muny
yeurs. ConcernIng ETS, IL cun be noLed LIuL IucL or reuson do noL IIgure In
LIe menLuIILy; wIuLever Ius been mude oI smokIng und exposure Lo
smoke by LIe unLIsmokIng menLuIILy Is u seII-produced concocLIon LIuL
Ius no busIs In IucL. As wus IndIcuLed In LIe NuzI InsLunce, LIIs Is u IIgIIy
LroubIed menLuIILy. L suIIers Irom sIuIIowness und rIgIdILy oI LIougIL,
und unresoIved, conIIIcLed reusonIng. TIe InLernuI LurbuIenL sLuLe, ruLIer
LIun beIng uddressed wIere IL IIes, Is projecLed ouLwurd onLo, In LIIs cuse,
smokIng und umbIenL smoke. L LIen convInces ILseII LIuL IL requIres
proLecLIon Irom LIIs exLernuI dunger. n LIuL IL beIIeves ILs percepLIon Lo
be deIInILIve (InIuIIIbIe), LIen IL IogIcuIIy IoIIows LIuL it sIouId noL move
uwuy Irom LIe exLernuI dunger buL LIuL IL Is IuIIy jusLIIIed In
exLermInuLIng LIe dunger (I.e., superIorILy syndrome).
WILIIn ILs conLorLed Irumework ILs exLermInuLIon crusude
uppeurs very nobIe Indeed. TIe menLuIILy cun cerLuInIy evuIuuLe wIeLIer
ILs LIInkIng promoLes ILs deIuded exLernuIIzed gouI, yeL demonsLruLes no
cupucILy Lo evuIuuLe LIe sLundurd or coIerence oI LIe gouI. n suner LImes,
275
275
Rampant Antismoking Signifies Grave Danger
empIoyees uguInsL LIeIr empIoyers. n doIng so, LIe
poIIcy guIde grossIy oversLuLed LIe IeguI sIgnIIIcunce
und precedenLuI vuIue oI LIe IundIuI oI cuses IuvorubIe
Lo LIe poIIcy guIde`s vIewpoInL wIIIe undersLuLIng LIe
sIgnIIIcunce oI LIe vusL mujorILy oI oLIers, wIIcI were
noL.....TIe SAB`s evenLuuI revIew oI LIe scIenLIIIc
concIusIons In LIe poIIcy guIde wus IncompIeLe uL besL.
PrIor Lo LIe guIde`s reIeuse, EPA Iud decIded Lo IImIL
LIe SAB`s revIew Lo LIose purLs LIuL reIerred Lo LIe rIsk
ussessmenL, Lo ensure LIuL LIe IuLLer wus 'properIy
cIurucLerIzed`. SInce LIe SAB Iud noL yeL seen u rIsk
ussessmenL druIL IL couId upprove, one musL quesLIon
Iow IL couId muke sure LIuL LIe poIIcy guIde properIy
cIurucLerIzed IL. Moreover, LIe poIIcy guIde covered u
mucI brouder runge oI Issues LIun LIe rIsk ussessmenL.
TIe poIIcy guIde Iud been druILed bused on LIe
LecInIcuI compendIum, wIIcI, us Iuve expIuIned, EPA
Ius never gIven Lo LIe SAB Lo revIew, und wIIcI mukes
muny more IeuILI cIuIms LIun does LIe ETS rIsk
ussessmenL. TIese IncIude unsupporLed usserLIons LIuL
ETS Ius been sIown Lo cuuse curdIovuscuIur dIseuse
und suggesLIons LIuL ETS Ius been ussocIuLed wILI
bruIn cuncer. SucI exLruvugunL cIuIms ure uL odds wILI
EPA`s prIvuLe udmIssIons Lo oLIer governmenL oIIIcIuIs
LIuL 'we know very IILLIe ubouL ETS exposure In LIe
workpIuce, und cunnoL esLImuLe LIe reIuLIve sIgnIIIcunce
oI workpIuce vs. Iome vs. uII oLIer sources oI exposure;
nor cun we cIurIIy LIe sIgnIIIcunceJroIeJImpucL oI
exposure Lo oLIer poIIuLunLs (e.g., rudon und oLIer uIr
curcInogens) In uddILIonJconjuncLIon wILI ETS
exposure`. I EPA knows 'very IILLIe` ubouL ETS exposure
In LIe workpIuce, IL Is dIIIIcuIL Lo undersLund wIy IL
wouId decIde Lo Issue u workpIuce poIIcy guIde. EPA
cunnoL usserL, us IL dId repeuLedIy In LIe poIIcy guIde,
LIuL onIy smokIng buns or sepuruLeIy venLIIuLed
smokIng Iounges ure upproprIuLe wILIouL occupuLIonuI
exposure duLu. n LIe ubsence oI sucI duLu, LIe poIIcy
guIde`s recommenduLIons necessurIIy reIIecL onIy LIe
personuI preIerences oI LIe guIde`s uuLIors. expressed
LIese concerns muny LImes In wrILIng Lo EPA
AdmInIsLruLor ReIIIy und receIved noncommILLuI
repIIes....TIe seIecLIon oI LIe poIIcy guIde`s uuLIor,
Preventive Medicine & Health Promotion
RoberL Rosner, oI LIe SmokIng PoIIcy nsLILuLe (SP),
ruIses IurLIer quesLIons ubouL LIe documenL`s
objecLIvILy und reIIubIIILy. SP Is In LIe busIness oI
counseIIng empIoyers on LIe ImpIemenLuLIon oI
smokIng poIIcIes und operuLIng smokIng cessuLIon
cIInIcs. TIIs orgunIzuLIon LIereIore Iud u vesLed
IInuncIuI InLeresL In conveyIng LIe ImpressIon In LIe
poIIcy guIde LIuL empIoyers wILIouL smokIng poIIcIes or
cessuLIon progrums were uL rIsk oI IuwsuILs or worse.
(p.1o-11)
TIe EPA cIrcumsLunce prIor Lo 1qq Is exLruordInury. WILI
unLIsmokIng poIIcy IormuIuLed Iong beIore LIe IIrsL IormuI rIsk
ussessmenL oI ETS In 1qq, LIe EPA wus no more LIun un unLIsmokIng
orgunIzuLIon, domInuLed by IIgI-proIIIe, unLIsmokIng ucLIvIsLs. As wus
IndIcuLed In un eurIIer cIupLer, In scIenLIIIc Lerms, wIere objecLIvILy Is
IosL, uII Is IosL. TIe IrreguIurILIes, ImproprIeLy und bIus IndIcuLed ubove
represenL onIy some oI LIe uIurmIng mIsconducL oI LIe EPA. L Is noL
surprIsIng LIuL wILI Ieuks und reIeuses oI unsubsLunLIuLed,
InIIummuLory, Ieur-mongerIng unLIsmokIng rIeLorIc und dogmu, LIuL
uLLempLs Lo resLrIcL smokIng und, LIereIore, proLecL nonsmokers, were
uIreudy weII under wuy beIore 1qq. AIso probIemuLIc Is LIuL uL IeusL mucI
oI LIIs conducL wus noL scIenLIIIcuIIy cIuIIenged or quesLIoned - eILIer In
LIe IormuI IILeruLure or In LIe medIu.
L Is uguIn useIuI Lo scruLInIze LIIs unLIsmokIng menLuIILy. TIe
unLIsmokIng ucLIvIsLs InvoIved Iuve IeId Lo LIIs rIgId posILIon over muny
yeurs. ConcernIng ETS, IL cun be noLed LIuL IucL or reuson do noL IIgure In
LIe menLuIILy; wIuLever Ius been mude oI smokIng und exposure Lo
smoke by LIe unLIsmokIng menLuIILy Is u seII-produced concocLIon LIuL
Ius no busIs In IucL. As wus IndIcuLed In LIe NuzI InsLunce, LIIs Is u IIgIIy
LroubIed menLuIILy. L suIIers Irom sIuIIowness und rIgIdILy oI LIougIL,
und unresoIved, conIIIcLed reusonIng. TIe InLernuI LurbuIenL sLuLe, ruLIer
LIun beIng uddressed wIere IL IIes, Is projecLed ouLwurd onLo, In LIIs cuse,
smokIng und umbIenL smoke. L LIen convInces ILseII LIuL IL requIres
proLecLIon Irom LIIs exLernuI dunger. n LIuL IL beIIeves ILs percepLIon Lo
be deIInILIve (InIuIIIbIe), LIen IL IogIcuIIy IoIIows LIuL it sIouId noL move
uwuy Irom LIe exLernuI dunger buL LIuL IL Is IuIIy jusLIIIed In
exLermInuLIng LIe dunger (I.e., superIorILy syndrome).
WILIIn ILs conLorLed Irumework ILs exLermInuLIon crusude
uppeurs very nobIe Indeed. TIe menLuIILy cun cerLuInIy evuIuuLe wIeLIer
ILs LIInkIng promoLes ILs deIuded exLernuIIzed gouI, yeL demonsLruLes no
cupucILy Lo evuIuuLe LIe sLundurd or coIerence oI LIe gouI. n suner LImes,
276
276
Rampant Antismoking Signifies Grave Danger
u person pursuIng sIngIe-Issue IobbyIng (e.g., unLIsmokIng) wILI quusI-
reIIgIous Iervor, wouId be descrIbed us monomunIucuI. TIe very Ideu oI
sIngIe-Issue IIxuLIon IndIcuLes unbuIunced reusonIng, I.e., Iuck oI
perspecLIve In greuLer conLexL. TIe menLuIILy Ius no grusp oI LIe
epIsLemoIogIcuI gouI oI scIenLIIIc enquIry, or uny InsIgIL InLo coIerenL
psycIoIogIcuI, psycIosocIuI und moruI Irumeworks. HonesL depIcLIon oI
InIormuLIon does noL IIgure In LIe reusonIng, nor does muILIdImensIonuI,
deLrImenLuI repercussIons oI ILs conducL, e.g., nocebo eIIecLs. Ls onIy
scruLIny oI conducL Is wIeLIer sLeps Iuve LIe poLenLIuI Lo promoLe or
IInder ILs monomunIucuI pursuIL. TIIs sorL oI monomunIu Is sympLomuLIc
oI u more generuI muLerIuIIsL IdeoIogy; muLerIuIIsm Is uIso LIe resuIL oI
mInds IuIIIng Lo deveIop greuLer ubsLrucL reusonIng LIuL IncorporuLes
crILIcuI muILIdImensIonuI uspecLs oI LIe Iumun condILIon - unLIsmokIng
Is sImpIy one projecLIon poInL (sympLomuLIc) oI LIe deIusIon oI muLerIuIIsL
IdeoIogy. L Is uIso noL surprIsIng LIuL LIere wouId be u meeLIng oI IIke-
mInded, superIIcIuI LIInkers wILIIn LIe EPA. BeIng envIronmenLuI, LIe
EPA Is, by deIInILIon, muLerIuIIsL und exLernuIIsL In dIsposILIon; LIe EPA
wIII uLLempL Lo IdenLIIy und soIve probIems enLIreIy on LIe busIs oI
exLernuI (muLerIuI) pIenomenu. TIuL preoccupuLIons wILI purLIcuIur
exLernuI pIenomenu mIgIL be LIe resuIL oI psycIoIogIcuI dysIuncLIon,
IncIudIng ILs own, Is unIuLIomubIe Lo LIe muLerIuIIsL menLuIILy.
TIe sIumeIessness und IuugILIness (superIorILy syndrome) oI
unLIsmokIng conducL Is obvIous durIng LIe 1q8o`s und eurIy-1qqo`s
concernIng ETS. TIe IncILemenL Lo Ieur und IuLred LIrougI LIe
unquesLIoned propuguLIon oI IuIseIoods und dogmu, musqueruded us
scIenLIIIcuIIy-bused, wus so eIIecLIve, und over sucI u sIorL LIme, LIuL
noL onIy dId LIe number oI ETS sLudIes Increuse over LIIs perIod und
IndusLry uIreudy LukIng prevenLIve meusures, buL LIuL, uccordIng Lo even
LIe EPA AdmInIsLruLor ReIIIy concernIng LIe IormuLIon oI u puneI Lo
crILIcuIIy revIew LIe EPA`s rIsk ussessmenL oI ETS, IL Is noL eusy Lo seIecL
u puneI oI experLs on uny 'IIgIIy cIurged emoLIonuI und poIILIcuI Issue`
sucI us ETS. (In BIIIey, 1qq, p.16) How un InILIuIIy Iow-proIIIe
pIenomenon sucI us ETS Iud been eIevuLed Lo sucI u cIurged sLuLus
bejore LIe IIrsL IormuI rIsk ussessmenL oI ETS Is LesLImony Lo LIe gross
mIsconducL oI LIe unLIsmokIng Iobby und LIe EPA ILseII; LIe Iormer`s
mIsconducL Is Lo be expecLed, LIe IuLLer`s Is u compreIensIve dIsgruce -
scunduIous.
Beyond uII LIe rIeLorIc, dogmu, nonsense, dysIuncLIon, eLc., LIe
dIscussIon now IInuIIy Lurns Lo LIe ucLuuI EPA`s jormcl rIsk ussessmenL oI
ETS. n keepIng wILI LIe IoregoIng, LIIs Loo wus rIddIed wILI ImproprIeLy,
bIus und conLorLed IdeoIogy LIuL compIeLeIy compromIsed uny coIerenL,
objecLIve ouLcome. A deLuIIed consIderuLIon oI LIIs mIsconducL uppeurs In
Preventive Medicine & Health Promotion
BIIIey (1qq). Some oI LIIs ImproprIeLy concerns sLuckIng oI LIe ScIence
AdvIsory Bourd (SAB), wIIcI wus LIe revIewIng puneI oI LIe 'rIsk
ussessmenL` druIL, wILI pubIIcIy decIured unLIsmokers - some Iud pIuyed
u mujor roIe In druILIng or revIewIng porLIons oI LIe quesLIonubIe
LecInIcuI compendIum und poIIcy guIde (see BIIIey, 1qq, p.16). Even
beIore EPA AdmInIsLruLor ReIIIy`s udmIssIon oI dIIIIcuILy In ensurIng
objecLIvILy oI LIe SAB, LIe observuLIon Iud uIreudy been mude by oLIers
und u reconsLILuLIon oI LIe SAB wus suggesLed: Even LIe New York TImes
cuIIed Ior sucI u move, In un edILorIuI enLILIed 'ObjecLIvILy Up In Smoke.`
ConLrury Lo ReIIIy`s udmIssIon oI compromIsed objecLIvILy, LIe EPA
sImpIy proceeded us II no probIem exIsLed. (BIIIey, 1qq, p.16)
BIIIey (1qq) uIso IndIcuLes LIuL:
despILe Mr. ReIIIy`s promIses, LIe SAB puneI meeLIng on
December q-, 1qqo, wus conducLed In u munner LIuL
eIIecLIveIy prevenLed scIenLIIIc vIewpoInLs crILIcuI oI LIe
Lwo druIL ETS documenLs Irom beIng gIven unyLIIng
resembIIng u IuII und IuIr IeurIng. ess LIun Lwo Iours
were uIIowed Ior presenLuLIons by scIenLIsLs crILIcuI oI
LIe reporL. CerLuIn uLLendees wIo Iud personuIIy
requesLed LIme Irom LIe CIuIrmen were IorecIosed
Irom speukIng under LIe ugendu LIuL Iud been
IormuIuLed. TIe InpuL oI severuI crILIcuI poInLs oI vIew
wus IosL, us weII us LIe opporLunILy Ior LIe puneI Lo usk
quesLIons und Lo conducL u dIuIogue wILI oLIer
scIenLIsLs. n conLrusL, LwIce us mucI LIme wus gIven Lo
unLIsmokIng orgunIzuLIons. AILIougI LIere cerLuInIy
wus enougI LIme Lo uccommoduLe uII wIo Iud usked Lo
speuk, severuI scIenLIsLs wIo Iud expressed doubLs
ubouL LIe rIsk ussessmenL und poIIcy guIde were denIed
LIe cIunce. No expIunuLIon wus gIven Ior LIe IuIIure Lo
uccommoduLe LIese speukers or wIy LIe SAB IeurIng
wus conducLed wILI sucI rIgIdILy. MosL SAB revIew
puneIs ure conducLed In un open und coIIegIuI munner
LIuL encouruges vIgorous dIscussIon oI uII compeLIng
scIenLIIIc vIewpoInLs. Two oI LIe ETS puneI members
wIo ugreed Lo revIew LIe reporL dId noL even uLLend LIe
IIrsL duy oI LIe meeLIng, wIIcI wus LIe onIy LIme
reserved Ior pubIIc commenL. OLIer puneI members
openIy udmILLed LIuL LIey dId noL reud uny oI LIe
wrILLen submIssIons. TIe puneI members dId noL
uddress or ucknowIedge LIe muny pubIIc commenLs In
LIeIr wrILLen revIews..
277
277
Rampant Antismoking Signifies Grave Danger
u person pursuIng sIngIe-Issue IobbyIng (e.g., unLIsmokIng) wILI quusI-
reIIgIous Iervor, wouId be descrIbed us monomunIucuI. TIe very Ideu oI
sIngIe-Issue IIxuLIon IndIcuLes unbuIunced reusonIng, I.e., Iuck oI
perspecLIve In greuLer conLexL. TIe menLuIILy Ius no grusp oI LIe
epIsLemoIogIcuI gouI oI scIenLIIIc enquIry, or uny InsIgIL InLo coIerenL
psycIoIogIcuI, psycIosocIuI und moruI Irumeworks. HonesL depIcLIon oI
InIormuLIon does noL IIgure In LIe reusonIng, nor does muILIdImensIonuI,
deLrImenLuI repercussIons oI ILs conducL, e.g., nocebo eIIecLs. Ls onIy
scruLIny oI conducL Is wIeLIer sLeps Iuve LIe poLenLIuI Lo promoLe or
IInder ILs monomunIucuI pursuIL. TIIs sorL oI monomunIu Is sympLomuLIc
oI u more generuI muLerIuIIsL IdeoIogy; muLerIuIIsm Is uIso LIe resuIL oI
mInds IuIIIng Lo deveIop greuLer ubsLrucL reusonIng LIuL IncorporuLes
crILIcuI muILIdImensIonuI uspecLs oI LIe Iumun condILIon - unLIsmokIng
Is sImpIy one projecLIon poInL (sympLomuLIc) oI LIe deIusIon oI muLerIuIIsL
IdeoIogy. L Is uIso noL surprIsIng LIuL LIere wouId be u meeLIng oI IIke-
mInded, superIIcIuI LIInkers wILIIn LIe EPA. BeIng envIronmenLuI, LIe
EPA Is, by deIInILIon, muLerIuIIsL und exLernuIIsL In dIsposILIon; LIe EPA
wIII uLLempL Lo IdenLIIy und soIve probIems enLIreIy on LIe busIs oI
exLernuI (muLerIuI) pIenomenu. TIuL preoccupuLIons wILI purLIcuIur
exLernuI pIenomenu mIgIL be LIe resuIL oI psycIoIogIcuI dysIuncLIon,
IncIudIng ILs own, Is unIuLIomubIe Lo LIe muLerIuIIsL menLuIILy.
TIe sIumeIessness und IuugILIness (superIorILy syndrome) oI
unLIsmokIng conducL Is obvIous durIng LIe 1q8o`s und eurIy-1qqo`s
concernIng ETS. TIe IncILemenL Lo Ieur und IuLred LIrougI LIe
unquesLIoned propuguLIon oI IuIseIoods und dogmu, musqueruded us
scIenLIIIcuIIy-bused, wus so eIIecLIve, und over sucI u sIorL LIme, LIuL
noL onIy dId LIe number oI ETS sLudIes Increuse over LIIs perIod und
IndusLry uIreudy LukIng prevenLIve meusures, buL LIuL, uccordIng Lo even
LIe EPA AdmInIsLruLor ReIIIy concernIng LIe IormuLIon oI u puneI Lo
crILIcuIIy revIew LIe EPA`s rIsk ussessmenL oI ETS, IL Is noL eusy Lo seIecL
u puneI oI experLs on uny 'IIgIIy cIurged emoLIonuI und poIILIcuI Issue`
sucI us ETS. (In BIIIey, 1qq, p.16) How un InILIuIIy Iow-proIIIe
pIenomenon sucI us ETS Iud been eIevuLed Lo sucI u cIurged sLuLus
bejore LIe IIrsL IormuI rIsk ussessmenL oI ETS Is LesLImony Lo LIe gross
mIsconducL oI LIe unLIsmokIng Iobby und LIe EPA ILseII; LIe Iormer`s
mIsconducL Is Lo be expecLed, LIe IuLLer`s Is u compreIensIve dIsgruce -
scunduIous.
Beyond uII LIe rIeLorIc, dogmu, nonsense, dysIuncLIon, eLc., LIe
dIscussIon now IInuIIy Lurns Lo LIe ucLuuI EPA`s jormcl rIsk ussessmenL oI
ETS. n keepIng wILI LIe IoregoIng, LIIs Loo wus rIddIed wILI ImproprIeLy,
bIus und conLorLed IdeoIogy LIuL compIeLeIy compromIsed uny coIerenL,
objecLIve ouLcome. A deLuIIed consIderuLIon oI LIIs mIsconducL uppeurs In
Preventive Medicine & Health Promotion
BIIIey (1qq). Some oI LIIs ImproprIeLy concerns sLuckIng oI LIe ScIence
AdvIsory Bourd (SAB), wIIcI wus LIe revIewIng puneI oI LIe 'rIsk
ussessmenL` druIL, wILI pubIIcIy decIured unLIsmokers - some Iud pIuyed
u mujor roIe In druILIng or revIewIng porLIons oI LIe quesLIonubIe
LecInIcuI compendIum und poIIcy guIde (see BIIIey, 1qq, p.16). Even
beIore EPA AdmInIsLruLor ReIIIy`s udmIssIon oI dIIIIcuILy In ensurIng
objecLIvILy oI LIe SAB, LIe observuLIon Iud uIreudy been mude by oLIers
und u reconsLILuLIon oI LIe SAB wus suggesLed: Even LIe New York TImes
cuIIed Ior sucI u move, In un edILorIuI enLILIed 'ObjecLIvILy Up In Smoke.`
ConLrury Lo ReIIIy`s udmIssIon oI compromIsed objecLIvILy, LIe EPA
sImpIy proceeded us II no probIem exIsLed. (BIIIey, 1qq, p.16)
BIIIey (1qq) uIso IndIcuLes LIuL:
despILe Mr. ReIIIy`s promIses, LIe SAB puneI meeLIng on
December q-, 1qqo, wus conducLed In u munner LIuL
eIIecLIveIy prevenLed scIenLIIIc vIewpoInLs crILIcuI oI LIe
Lwo druIL ETS documenLs Irom beIng gIven unyLIIng
resembIIng u IuII und IuIr IeurIng. ess LIun Lwo Iours
were uIIowed Ior presenLuLIons by scIenLIsLs crILIcuI oI
LIe reporL. CerLuIn uLLendees wIo Iud personuIIy
requesLed LIme Irom LIe CIuIrmen were IorecIosed
Irom speukIng under LIe ugendu LIuL Iud been
IormuIuLed. TIe InpuL oI severuI crILIcuI poInLs oI vIew
wus IosL, us weII us LIe opporLunILy Ior LIe puneI Lo usk
quesLIons und Lo conducL u dIuIogue wILI oLIer
scIenLIsLs. n conLrusL, LwIce us mucI LIme wus gIven Lo
unLIsmokIng orgunIzuLIons. AILIougI LIere cerLuInIy
wus enougI LIme Lo uccommoduLe uII wIo Iud usked Lo
speuk, severuI scIenLIsLs wIo Iud expressed doubLs
ubouL LIe rIsk ussessmenL und poIIcy guIde were denIed
LIe cIunce. No expIunuLIon wus gIven Ior LIe IuIIure Lo
uccommoduLe LIese speukers or wIy LIe SAB IeurIng
wus conducLed wILI sucI rIgIdILy. MosL SAB revIew
puneIs ure conducLed In un open und coIIegIuI munner
LIuL encouruges vIgorous dIscussIon oI uII compeLIng
scIenLIIIc vIewpoInLs. Two oI LIe ETS puneI members
wIo ugreed Lo revIew LIe reporL dId noL even uLLend LIe
IIrsL duy oI LIe meeLIng, wIIcI wus LIe onIy LIme
reserved Ior pubIIc commenL. OLIer puneI members
openIy udmILLed LIuL LIey dId noL reud uny oI LIe
wrILLen submIssIons. TIe puneI members dId noL
uddress or ucknowIedge LIe muny pubIIc commenLs In
LIeIr wrILLen revIews..
278
278
Rampant Antismoking Signifies Grave Danger
TIe neguLIve percepLIon creuLed by LIe SAB wus
IeIgILened by LIe CIuIrmun`s summury remurks und
sLuLemenLs by IIm und oLIers Lo LIe press uILer LIe
puneI udjourned, mIsIeudIngIy suggesLIng LIuL LIe puneI
Iud reucIed u 'consensus` on LIe cIussIIIcuLIon oI ETS us
u Iumun curcInogen. As LIe LrunscrIpL oI LIe meeLIng
sIows, LIere wus no sucI 'consensus`.... Dr. Ippmunn,
SAB puneI cIuIrmun, IeId u press conIerence Lo
unnounce LIe concIusIon LIuL 'ETS sIouId be cIussIIIed
us u cIuss A curcInogen`. TIe ImproprIeLy oI u
supposedIy ImpurLIuI scIenLIIIc experL uLLempLIng Lo
IrIgILen LIe pubIIc on LIe busIs oI un IncompIeLe und
unsupporLed documenL speuks Ior ILseII. (BIIIey, 1qq,
p.1;-18)
TIe revIew process IurLIer degeneruLed wIen Dr. Ippmunn
presenLed LIe SAB puneI`s reporL Lo LIe SAB`s ExecuLIve CommILLee
meeLIng In 1qq1:
TIIs reporL wus curIous Ior severuI reusons. IrsL, LIe
SAB concIuded LIuL LIe worIdwIde epIdemIoIogIc duLu
on ETS were Loo weuk und InconcIusIve Lo supporL LIe
druIL rIsk ussessmenL`s concIusIon LIuL ETS Is u cuuse oI
Iung cuncer In nonsmokers. n uddILIon, LIe puneI dId
noL endorse LIe Agency`s quunLILuLIve Iung cuncer
unuIysIs noLIng LIuL LIe 'reuI` number 'muy be greuLer or
Iess LIun LIe number EPA cILes`. AILer concIudIng LIuL
LIe ruLIonuIe underIyIng LIe EPA sLuII`s concIusIons
ubouL Iung cuncer couId noL be susLuIned, Iowever, LIe
SAB couId noL brIng ILseII Lo Luke LIe IogIcuI, II
poIILIcuIIy unpuIuLubIe, nexL sLep und rejecL EPA`s
concIusIons regurdIng ETS und Iung cuncer umong
nonsmokers. nsLeud, LIe SAB endorsed LIe concIusIon
LIuL ETS Is u 'Group A` curcInogen wIIIe LukIng LIe
exLruordInury sLep oI urgIng LIe EPA sLuII Lo uLLempL Lo
'muke LIe cuse` uguInsL ETS bused on exLrupoIuLIon
Irom duLu concernIng ucLIve smokIng. n essence, LIe
Agency wus beIng encouruged Lo do LIe scIence
buckwurds - muInLuIn ILs concIusIon wIIIe goIng ubouL
LIe Lusk oI IIndIng supporL Ior IL.......TIe SAB`s reporL
IeebIy suggesLed LIuL LIe puneI 'Iud some dIIIIcuILy In
uppIyIng LIe Guidelines jor Ccrcinoen Risl
Assessment, us LIey ure currenLIy IormuIuLed`, Lo LIe
Preventive Medicine & Health Promotion
ETS duLu. PurLIcuIur uLLenLIon wus gIven Lo LIe reporL`s
sLuLemenL LIuL 'II LIe guIdeIInes Ior CurcInogen RIsk
AssessmenL cun be used Lo cusL doubL on u IIndIng LIuL
InIuIuLIon oI Lobucco smoke by Iumuns cuuses un
Increused rIsk oI Iung cuncer, LIe sILuuLIon suggesLs u
need Lo revIse LIe guIdeIInes` (SAB Rep. z8). TIIs
prompLed one member oI LIe SAB ExecuLIve CommILLee
Lo noLe LIuL IL sounded u IILLIe IIke suyIng 'II LIe duLu
doesn`L IIL LIe guIdeIInes, LIe guIdeIInes sIouId be
cIunged`. NeverLIeIess, LIe CommILLee uccepLed LIe
puneI`s Group A desIgnuLIon despILe LIe cIeur IuIIure oI
LIe duLu Lo suLIsIy LIe Agency`s own guIdeIInes.
oIIowIng LIe ExecuLIve CommILLee meeLIng, Dr.
Ippmunn once uguIn spoke Lo LIe press ubouL LIe
SAB`s concIusIons. TIIs LIme Dr. Ippmunn`s
sLuLemenLs were consIderubIy more resLruIned LIun IIs
remurks uL LIe December 1qqo press conIerence. TIIs
LIme Ie sLuLed LIuL 'occusIonuI, IIgIL exposure |Lo ETS|
Is noL IIkeIy Lo cuuse uny Iurm`. Dr. Ippmunn uIso
observed LIuL In IIs vIew LIe rIsk due Lo ETS exposure
Is 'probubIy mucI Iess LIun you Look Lo geL Iere LIrougI
WusIIngLon LruIIIc`. On LIree sepuruLe occusIons my
sLuII usked Dr. Ippmunn LIuL II one were Lo uppIy LIe
guIdeIInes us wrILLen, couId you cIussIIy ETS us u CIuss
A known Iumun curcInogen? On uII LIree occusIons, Dr.
Ippmunn IuIIed Lo respond Lo LIe quesLIon. TIe nexL
duy, Iowever, Dr. Ippmunn sLuLed uL u meeLIng ouLsIde
LIe gIure oI medIu uLLenLIon LIuL II LIe guIdeIInes were
uppIIed sLrIcLIy LIere wus no cIeur mecIunIsLIc busIs oI
cuIIIng ETS curcInogenIc. (BIIIey, 1qq, p. 18-1q)
L wus unoLIer one und u IuII yeurs beIore LIe second druIL oI
ETS rIsk ussessmenL wus Issued In mId-1qqz. AguIn, LIere were Issues oI
LIme consLruInLs or denIuIs oI quesLIonIng or pubIIc commenL - LIe
second druIL wus neurIy doubIe LIe IengLI oI LIe IIrsL und yeL Iewer duys
were uIIocuLed Ior scruLIny. TIe EPA uIso cIeurIy IIddIed (I.e., vIoIuLIon oI
procedure) wILI wIIcI sLudIes were evenLuuIIy IncorporuLed InLo LIe
meLu-unuIysIs, I.e., IncIusIon oI LIose sLudIes LIuL wouId Iuvor u
sLuLIsLIcuIIy sIgnIIIcunL resuIL. NoLwILIsLundIng LIIs uIreudy serIous
mIsconducL, LIe EPA Iud Lo IurLIer udopL u Iower conIIdence InLervuI
(qo% compured Lo LIe proceduruI q% InLervuI) In order Lo ucIIeve u
bureIy sLuLIsLIcuIIy sIgnIIIcunL resuIL.
279
279
Rampant Antismoking Signifies Grave Danger
TIe neguLIve percepLIon creuLed by LIe SAB wus
IeIgILened by LIe CIuIrmun`s summury remurks und
sLuLemenLs by IIm und oLIers Lo LIe press uILer LIe
puneI udjourned, mIsIeudIngIy suggesLIng LIuL LIe puneI
Iud reucIed u 'consensus` on LIe cIussIIIcuLIon oI ETS us
u Iumun curcInogen. As LIe LrunscrIpL oI LIe meeLIng
sIows, LIere wus no sucI 'consensus`.... Dr. Ippmunn,
SAB puneI cIuIrmun, IeId u press conIerence Lo
unnounce LIe concIusIon LIuL 'ETS sIouId be cIussIIIed
us u cIuss A curcInogen`. TIe ImproprIeLy oI u
supposedIy ImpurLIuI scIenLIIIc experL uLLempLIng Lo
IrIgILen LIe pubIIc on LIe busIs oI un IncompIeLe und
unsupporLed documenL speuks Ior ILseII. (BIIIey, 1qq,
p.1;-18)
TIe revIew process IurLIer degeneruLed wIen Dr. Ippmunn
presenLed LIe SAB puneI`s reporL Lo LIe SAB`s ExecuLIve CommILLee
meeLIng In 1qq1:
TIIs reporL wus curIous Ior severuI reusons. IrsL, LIe
SAB concIuded LIuL LIe worIdwIde epIdemIoIogIc duLu
on ETS were Loo weuk und InconcIusIve Lo supporL LIe
druIL rIsk ussessmenL`s concIusIon LIuL ETS Is u cuuse oI
Iung cuncer In nonsmokers. n uddILIon, LIe puneI dId
noL endorse LIe Agency`s quunLILuLIve Iung cuncer
unuIysIs noLIng LIuL LIe 'reuI` number 'muy be greuLer or
Iess LIun LIe number EPA cILes`. AILer concIudIng LIuL
LIe ruLIonuIe underIyIng LIe EPA sLuII`s concIusIons
ubouL Iung cuncer couId noL be susLuIned, Iowever, LIe
SAB couId noL brIng ILseII Lo Luke LIe IogIcuI, II
poIILIcuIIy unpuIuLubIe, nexL sLep und rejecL EPA`s
concIusIons regurdIng ETS und Iung cuncer umong
nonsmokers. nsLeud, LIe SAB endorsed LIe concIusIon
LIuL ETS Is u 'Group A` curcInogen wIIIe LukIng LIe
exLruordInury sLep oI urgIng LIe EPA sLuII Lo uLLempL Lo
'muke LIe cuse` uguInsL ETS bused on exLrupoIuLIon
Irom duLu concernIng ucLIve smokIng. n essence, LIe
Agency wus beIng encouruged Lo do LIe scIence
buckwurds - muInLuIn ILs concIusIon wIIIe goIng ubouL
LIe Lusk oI IIndIng supporL Ior IL.......TIe SAB`s reporL
IeebIy suggesLed LIuL LIe puneI 'Iud some dIIIIcuILy In
uppIyIng LIe Guidelines jor Ccrcinoen Risl
Assessment, us LIey ure currenLIy IormuIuLed`, Lo LIe
Preventive Medicine & Health Promotion
ETS duLu. PurLIcuIur uLLenLIon wus gIven Lo LIe reporL`s
sLuLemenL LIuL 'II LIe guIdeIInes Ior CurcInogen RIsk
AssessmenL cun be used Lo cusL doubL on u IIndIng LIuL
InIuIuLIon oI Lobucco smoke by Iumuns cuuses un
Increused rIsk oI Iung cuncer, LIe sILuuLIon suggesLs u
need Lo revIse LIe guIdeIInes` (SAB Rep. z8). TIIs
prompLed one member oI LIe SAB ExecuLIve CommILLee
Lo noLe LIuL IL sounded u IILLIe IIke suyIng 'II LIe duLu
doesn`L IIL LIe guIdeIInes, LIe guIdeIInes sIouId be
cIunged`. NeverLIeIess, LIe CommILLee uccepLed LIe
puneI`s Group A desIgnuLIon despILe LIe cIeur IuIIure oI
LIe duLu Lo suLIsIy LIe Agency`s own guIdeIInes.
oIIowIng LIe ExecuLIve CommILLee meeLIng, Dr.
Ippmunn once uguIn spoke Lo LIe press ubouL LIe
SAB`s concIusIons. TIIs LIme Dr. Ippmunn`s
sLuLemenLs were consIderubIy more resLruIned LIun IIs
remurks uL LIe December 1qqo press conIerence. TIIs
LIme Ie sLuLed LIuL 'occusIonuI, IIgIL exposure |Lo ETS|
Is noL IIkeIy Lo cuuse uny Iurm`. Dr. Ippmunn uIso
observed LIuL In IIs vIew LIe rIsk due Lo ETS exposure
Is 'probubIy mucI Iess LIun you Look Lo geL Iere LIrougI
WusIIngLon LruIIIc`. On LIree sepuruLe occusIons my
sLuII usked Dr. Ippmunn LIuL II one were Lo uppIy LIe
guIdeIInes us wrILLen, couId you cIussIIy ETS us u CIuss
A known Iumun curcInogen? On uII LIree occusIons, Dr.
Ippmunn IuIIed Lo respond Lo LIe quesLIon. TIe nexL
duy, Iowever, Dr. Ippmunn sLuLed uL u meeLIng ouLsIde
LIe gIure oI medIu uLLenLIon LIuL II LIe guIdeIInes were
uppIIed sLrIcLIy LIere wus no cIeur mecIunIsLIc busIs oI
cuIIIng ETS curcInogenIc. (BIIIey, 1qq, p. 18-1q)
L wus unoLIer one und u IuII yeurs beIore LIe second druIL oI
ETS rIsk ussessmenL wus Issued In mId-1qqz. AguIn, LIere were Issues oI
LIme consLruInLs or denIuIs oI quesLIonIng or pubIIc commenL - LIe
second druIL wus neurIy doubIe LIe IengLI oI LIe IIrsL und yeL Iewer duys
were uIIocuLed Ior scruLIny. TIe EPA uIso cIeurIy IIddIed (I.e., vIoIuLIon oI
procedure) wILI wIIcI sLudIes were evenLuuIIy IncorporuLed InLo LIe
meLu-unuIysIs, I.e., IncIusIon oI LIose sLudIes LIuL wouId Iuvor u
sLuLIsLIcuIIy sIgnIIIcunL resuIL. NoLwILIsLundIng LIIs uIreudy serIous
mIsconducL, LIe EPA Iud Lo IurLIer udopL u Iower conIIdence InLervuI
(qo% compured Lo LIe proceduruI q% InLervuI) In order Lo ucIIeve u
bureIy sLuLIsLIcuIIy sIgnIIIcunL resuIL.
280
280
Rampant Antismoking Signifies Grave Danger
AddILIonuIIy, LIe EPA presenLuLIon sLIII reIIed on LIe urgumenL
by unuIogy Irom ucLIve smokIng Lo exposure Lo ETS even LIougI LIe
reporL ucknowIedged LIuL muInsLreum smoke (MS) und ETS ure
essenLIuIIy dIIIerenL subsLunces und exposure occurs uL Iur Iower IeveIs
(see BIIIey, 1qq, p. 1q).
BIIIey (1qq) provIdes u summury oI IIrsL und second revIew
IIndIngs:
TIe SAB concIuded In ILs second revIew LIuL
exLrupoIuLIon Irom ucLIve smokIng duLu couId noL, uILer
uII, serve us LIe soIe or predomInunL busIs Ior LIe
concIusIon LIuL ETS Is u Group A curcInogen; TIe SAB
Iud concIuded In ILs IIrsL revIew LIuL LIe epIdemIoIogIc
duLu were Loo weuk Lo supporL LIe InIerence LIuL
exposure Lo ETS cuuses Iung cuncer In nonsmokers. TIe
SAB reversed ILs posILIon In ILs revIew oI LIe second
druIL rIsk ussessmenL once IL becume cIeur LIuL ucLIve
smokIng duLu couId noL provIde un uILernuLIve busIs Ior
LIuL concIusIon; LIe SAB concIuded In ILs revIew oI LIe
IIrsL rIsk ussessmenL LIuL uII sLudIes oI ETS conducLed
worIdwIde sIouId be IncIuded. n LIe second revIew, LIe
SAB decIded LIuL EPA need onIy IncIude LIe U.S.
sLudIes. Hud LIe Agency und LIe SAB udIered Lo LIeIr
orIgInuI decIsIon Lo use uII ETS sLudIes, LIe meLu-
unuIysIs wouId noL Iuve sIown u sLuLIsLIcuIIy sIgnIIIcunL
rIsk; LIe SAB noneLIeIess concIuded LIuL ETS Is u
Group A curcInogen responsIbIe Ior upproxImuLeIy
ooo Iung cuncer cuses every yeur In LIe UnILed SLuLes.
n LIe IIrsL revIew, LIe SAB Iud concIuded LIuL LIe duLu
were Loo uncerLuIn Ior EPA Lo uLLucI u specIIIc number
Ior LIe deuLIs supposedIy uLLrIbuLubIe Lo exposure Lo
ETS. PuL sImpIy, LIe SAB concIuded LIuL ETS Is u
Group A curcInogen even LIougI neILIer oI LIe Lwo
ruLIonuIes udvunced by LIe EPA sLuII Lo jusLIIy sucI
cIussIIIcuLIon Is scIenLIIIcuIIy deIensIbIe. TIe IIrsL revIew
deLermIned LIuL LIe spousuI smokIng were Loo weuk Lo
supporL un InIerence oI cuusuLIon. TIe second revIew
concIuded LIuL LIe ucLIve smokIng duLu couId noL be
used us un uILernuLIve ground. NoneLIeIess, LIe SAB
decIded LIuL LIe LoLuI 'weIgIL oI evIdence` supporLed u
group A cIussIIIcuLIon. oIIowIng LIe SAB`s OcLober
reporL, EPA rusIed Lo revIse und reIeuse LIe IInuI rIsk
ussessmenL. TIe Agency`s IusLe uppurenLIy wus
Preventive Medicine & Health Promotion
moLIvuLed In purL by LIe ImpendIng cIunge In LIe
AdmInIsLruLIon. PerIups oI even greuLer concern Lo
EPA, Iowever, wus LIe reIeuse oI LIe Brownson sLudy
dIscussed ubove. TIe IucL LIuL LIe IurgesL U.S. cuse-
conLroI sLudy ever conducLed reporLed no sLuLIsLIcuIIy
sIgnIIIcunL ussocIuLIon beLween ETS exposure und Iung
cuncer IncIdence cusLs IurLIer doubL on EPA`s cIuIms.
Hud LIe Brownson sLudy been IncIuded In EPA`s
unuIysIs, LIe Agency`s cuIcuIuLIons wouId noL Iuve
sIown u sIgnIIIcunL rIsk Irom ETS even usIng LIe
Agency`s IIgIIy suspecL sLuLIsLIcuI meLIodoIogy. RuLIer
LIun Iuce LIIs emburrussmenL, EPA rusIed Lo reIeuse
LIe reporL wILIouL consIderIng LIe Brownson sLudy on
LIe preLexL LIuL 'IL Iud Lo sLop somewIere`. TogeLIer
EPA und SAB Iuve undermIned LIe process by wIIcI
rIsk ussessmenLs ougIL Lo be conducLed: IIrsL, by
IgnorIng LIe subsLunLIuI scIenLIIIc conLroversy ubouL
wIuL LIe ETS sLudIes ucLuuIIy sIow; und, second, by
conducLIng LIe Iorum wIere LIuL conLroversy sIouId
Iuve been LIorougIIy uIred us u mere rubber sLump
proceedIng. As u resuIL, EPA`s prepuruLIon und revIew
oI LIe rIsk ussessmenL Iuve gIven LIe uppeurunce oI u
scIenLIIIc sIow LrIuI Lo IegILImIze u predeLermIned
poIIcy. (p. zo)
AddIng IurLIer dIsLurbIng dImensIons Lo LIe uppruIsuI Is LIuL
EPA mIsconducL InvoIvIng ETS Is sympLomuLIc oI u more pervusIve
purposIve probIem uL LIe Agency. BIIIey (1qq) noLes LIuL InvesLIguLIons
conducLed by oLIers InLo EPA conducL Iud uncovered serIuI vIoIuLIons oI
due process und procedure, und LIuL IL wouId be uII Loo eusy Lo concIude
LIuL scIence sub-serves poIIcy ruLIer LIun vIce-versu. TIe EPA Ius u
IIsLory oI bIus und seII-jusLIIyIng scure-mongerIng. TIe EdILorIuI oI LIe
Detroit Neus (AugusL ;, 1qq8) reporLed LIuL:
LIe second-Iund smoke sLory IoIIows u puLLern oI EPA
decepLIon on oLIer Issues. ConsIder u Iew:
Dioxin: TIe ugency bunned dIoxIn even LIougI IL Iud
no evIdence oI u LungIbIe IeuILI rIsk. TIe EPA now
udmILs LIuL ILs orIgInuI bun wus bused on sIoddy
scIence und promIses Lo reussess LIe muLLer. L Iusn'L
yeL ucLed.
PCs: TIe EPA Ius decIured LIuL PCBs ure u cuncer
LIreuL, uIso In LIe ubsence oI overwIeImIng evIdence.
281
281
Rampant Antismoking Signifies Grave Danger
AddILIonuIIy, LIe EPA presenLuLIon sLIII reIIed on LIe urgumenL
by unuIogy Irom ucLIve smokIng Lo exposure Lo ETS even LIougI LIe
reporL ucknowIedged LIuL muInsLreum smoke (MS) und ETS ure
essenLIuIIy dIIIerenL subsLunces und exposure occurs uL Iur Iower IeveIs
(see BIIIey, 1qq, p. 1q).
BIIIey (1qq) provIdes u summury oI IIrsL und second revIew
IIndIngs:
TIe SAB concIuded In ILs second revIew LIuL
exLrupoIuLIon Irom ucLIve smokIng duLu couId noL, uILer
uII, serve us LIe soIe or predomInunL busIs Ior LIe
concIusIon LIuL ETS Is u Group A curcInogen; TIe SAB
Iud concIuded In ILs IIrsL revIew LIuL LIe epIdemIoIogIc
duLu were Loo weuk Lo supporL LIe InIerence LIuL
exposure Lo ETS cuuses Iung cuncer In nonsmokers. TIe
SAB reversed ILs posILIon In ILs revIew oI LIe second
druIL rIsk ussessmenL once IL becume cIeur LIuL ucLIve
smokIng duLu couId noL provIde un uILernuLIve busIs Ior
LIuL concIusIon; LIe SAB concIuded In ILs revIew oI LIe
IIrsL rIsk ussessmenL LIuL uII sLudIes oI ETS conducLed
worIdwIde sIouId be IncIuded. n LIe second revIew, LIe
SAB decIded LIuL EPA need onIy IncIude LIe U.S.
sLudIes. Hud LIe Agency und LIe SAB udIered Lo LIeIr
orIgInuI decIsIon Lo use uII ETS sLudIes, LIe meLu-
unuIysIs wouId noL Iuve sIown u sLuLIsLIcuIIy sIgnIIIcunL
rIsk; LIe SAB noneLIeIess concIuded LIuL ETS Is u
Group A curcInogen responsIbIe Ior upproxImuLeIy
ooo Iung cuncer cuses every yeur In LIe UnILed SLuLes.
n LIe IIrsL revIew, LIe SAB Iud concIuded LIuL LIe duLu
were Loo uncerLuIn Ior EPA Lo uLLucI u specIIIc number
Ior LIe deuLIs supposedIy uLLrIbuLubIe Lo exposure Lo
ETS. PuL sImpIy, LIe SAB concIuded LIuL ETS Is u
Group A curcInogen even LIougI neILIer oI LIe Lwo
ruLIonuIes udvunced by LIe EPA sLuII Lo jusLIIy sucI
cIussIIIcuLIon Is scIenLIIIcuIIy deIensIbIe. TIe IIrsL revIew
deLermIned LIuL LIe spousuI smokIng were Loo weuk Lo
supporL un InIerence oI cuusuLIon. TIe second revIew
concIuded LIuL LIe ucLIve smokIng duLu couId noL be
used us un uILernuLIve ground. NoneLIeIess, LIe SAB
decIded LIuL LIe LoLuI 'weIgIL oI evIdence` supporLed u
group A cIussIIIcuLIon. oIIowIng LIe SAB`s OcLober
reporL, EPA rusIed Lo revIse und reIeuse LIe IInuI rIsk
ussessmenL. TIe Agency`s IusLe uppurenLIy wus
Preventive Medicine & Health Promotion
moLIvuLed In purL by LIe ImpendIng cIunge In LIe
AdmInIsLruLIon. PerIups oI even greuLer concern Lo
EPA, Iowever, wus LIe reIeuse oI LIe Brownson sLudy
dIscussed ubove. TIe IucL LIuL LIe IurgesL U.S. cuse-
conLroI sLudy ever conducLed reporLed no sLuLIsLIcuIIy
sIgnIIIcunL ussocIuLIon beLween ETS exposure und Iung
cuncer IncIdence cusLs IurLIer doubL on EPA`s cIuIms.
Hud LIe Brownson sLudy been IncIuded In EPA`s
unuIysIs, LIe Agency`s cuIcuIuLIons wouId noL Iuve
sIown u sIgnIIIcunL rIsk Irom ETS even usIng LIe
Agency`s IIgIIy suspecL sLuLIsLIcuI meLIodoIogy. RuLIer
LIun Iuce LIIs emburrussmenL, EPA rusIed Lo reIeuse
LIe reporL wILIouL consIderIng LIe Brownson sLudy on
LIe preLexL LIuL 'IL Iud Lo sLop somewIere`. TogeLIer
EPA und SAB Iuve undermIned LIe process by wIIcI
rIsk ussessmenLs ougIL Lo be conducLed: IIrsL, by
IgnorIng LIe subsLunLIuI scIenLIIIc conLroversy ubouL
wIuL LIe ETS sLudIes ucLuuIIy sIow; und, second, by
conducLIng LIe Iorum wIere LIuL conLroversy sIouId
Iuve been LIorougIIy uIred us u mere rubber sLump
proceedIng. As u resuIL, EPA`s prepuruLIon und revIew
oI LIe rIsk ussessmenL Iuve gIven LIe uppeurunce oI u
scIenLIIIc sIow LrIuI Lo IegILImIze u predeLermIned
poIIcy. (p. zo)
AddIng IurLIer dIsLurbIng dImensIons Lo LIe uppruIsuI Is LIuL
EPA mIsconducL InvoIvIng ETS Is sympLomuLIc oI u more pervusIve
purposIve probIem uL LIe Agency. BIIIey (1qq) noLes LIuL InvesLIguLIons
conducLed by oLIers InLo EPA conducL Iud uncovered serIuI vIoIuLIons oI
due process und procedure, und LIuL IL wouId be uII Loo eusy Lo concIude
LIuL scIence sub-serves poIIcy ruLIer LIun vIce-versu. TIe EPA Ius u
IIsLory oI bIus und seII-jusLIIyIng scure-mongerIng. TIe EdILorIuI oI LIe
Detroit Neus (AugusL ;, 1qq8) reporLed LIuL:
LIe second-Iund smoke sLory IoIIows u puLLern oI EPA
decepLIon on oLIer Issues. ConsIder u Iew:
Dioxin: TIe ugency bunned dIoxIn even LIougI IL Iud
no evIdence oI u LungIbIe IeuILI rIsk. TIe EPA now
udmILs LIuL ILs orIgInuI bun wus bused on sIoddy
scIence und promIses Lo reussess LIe muLLer. L Iusn'L
yeL ucLed.
PCs: TIe EPA Ius decIured LIuL PCBs ure u cuncer
LIreuL, uIso In LIe ubsence oI overwIeImIng evIdence.
282
282
Rampant Antismoking Signifies Grave Danger
TIe ugency wunLs Lo dredge LIe Hudson RIver, uL u cosL
oI Iundreds oI mIIIIons oI doIIurs, Lo remove LIe PCBs
LIere. ronIcuIIy, LIe dredgIng operuLIons ure IIkeIy Lo
Increuse drumuLIcuIIy LIe pubIIc's exposure Lo LIe
supposed cuncer-cuusIng compounds.
Dzone: usL yeur, LIe EPA bIumed ground-IeveI ozone
Ior LIe Increuse In usLImu ruLes - even LIougI ozone
IeveIs Iuve IuIIen In recenL yeurs!
Entironmentcl rccism: TIe ugency recenLIy
dIsLrIbuLed 'guIdeIInes` requIrIng sLuLes Lo ensure LIuL
mInorILIes do noL suIIer 'dIsproporLIonuLe ImpucL` Irom
poIIuLIon. As our DuvId MusLIo Ius reporLed, Iowever,
LIe EPA deIIberuLeIy conceuIed up Lo 1,ooo puges oI
reporLs on LIe Issue, possIbIy becuuse LIe reseurcI
IndIcuLes LIuL LIe reguIuLIon wouId do more Iurm LIun
good Lo mInorILy cILIzens. TIe prucLIcuI eIIecL oI LIe ruIe
wouId be Lo ouLIuw deveIopmenL In economIcuIIy
deprIved Inner cILIes.
Climcte chcne: TIe EPA consLunLIy wurns LIuL
gIobuI wurmIng LIreuLens our very survIvuI. L wunLs
Congress Lo udopL un InLernuLIonuI ugreemenL reucIed
IusL yeur In KyoLo, Jupun, LIuL wouId bInd LIe UnILed
SLuLes Lo reducIng curbon dIoxIde emIssIons In LIe yeur
zo1z Lo LIe IeveIs LIuL prevuIIed In 1qqo. YeL even
scIenLIsLs wIo worry ubouL gIobuI wurmIng concede LIuL
IL's Loo eurIy Lo suy Ior sure wIeLIer wurmIng Is LukIng
pIuce - or wIuL LIe eIIecLs wouId be.
As sucI, LIe EPA conducLs ILseII us un IdeoIogIcuIIy-drIven
orgunIzuLIon. TIe compIeLeIy quesLIonubIe muLerIuIIsL purILunIsm LIuL
weII cIurucLerIzes ILs dIsposILIon, uguIn, couId be eusIIy LrunspIunLed InLo
LIe NuzI Irumework, I.e., envIronmenLuI IygIene. or LIIs cIrcumsLunce
Lo urIse In u democruLIc socIeLy, wIere deIuded IdeoIogy cun IIjuck u Iurge
governmenL bureuucrucy, wIere uLLempLs Lo brIng IL InLo cIeck ure
essenLIuIIy unsuccessIuI, und wIere IL cun LIereIore run ILs IuII conLorLed
course InLo LIe munIpuIuLIon oI pubIIc poIIcy und LIInkIng oI very
consIderubIe consequence, Is LruIy usLoundIng.
BIIIey (1qq) properIy concIudes LIuL some muy urgue LIuL
uppIyIng u doubIe sLundurd Lo ETS Is jusLIIIubIe, or uL IeusL
undersLundubIe, on LIe ground LIuL LIe LurgeL oI EPA`s ucLIon Is Lobucco
smokIng. RegurdIess oI one`s personuI beIIeIs ubouL smokIng, Iowever,
LIe specLucIe oI u Iuge, weII-Iunded governmenL bureuucrucy wILI
Preventive Medicine & Health Promotion
enormous power enguged In LIe deIIberuLe munIpuIuLIon oI LIe pubIIc Is
proIoundIy dIsLurbIng. (p. zz) AILIougI BIIIey`s dIsconLenL Is reusonubIy
und jusLIIIubIy evIdenL, IL Is possIbIy Loo resLruIned. TIIs dIscussIon wIII go
Iur IurLIer by suggesLIng LIuL In scIenLIIIc Lerms LIe EPA conducL Is un
uLrocILy In ILs vIoIuLIon oI every InLenL oI sound, IonesL, judIcIous enquIry.
urLIermore, IL Is noLIIng sIorL oI sInIsLer In Lerms oI LIe sIeer cupucILy
oI LIIs conducL Lo dIcLuLe pubIIc poIIcy und Lo generuLe psycIoIogIcuI und
psycIosocIuI puLIoIogy. As wIII be consIdered, LIIs deIIberuLe
munIpuIuLIon oI LIe pubIIc Ius very setere deLrImenLuI consequences und
Is sympLomuLIc oI deLerIoruLIng socIeLuI IuncLIonIng.
AmId mucI medIu IunIure, LIe IInuI EPA ReporL on ETS wus
oIIIcIuIIy presenLed In LIe documenL RespIruLory HeuILI EIIecLs oI
PussIve SmokIng: ung Cuncer und OLIer DIsorders (1qq). L concIuded
LIuL ETS Is cIussIIIed us u Group A curcInogen und LIuL IL Is LIe cuuse oI
ooo Iung-cuncer deuLIs umongsL nonsmokIng AmerIcuns per yeur.
urLIermore, In cIIIdren, IIrsLIy, ETS exposure Is cuusuIIy ussocIuLed wILI
un Increused rIsk oI Iower respIruLory LrucL InIecLIons, e.g., broncIILIs,
pneumonIu. TIe reporL esLImuLed LIuL 1o,ooo Lo oo,ooo cuses unnuuIIy
In InIunLs und young cIIIdren up Lo 18 monLIs oI uge ure uLLrIbuLubIe Lo
ETS. SecondIy, ETS exposure Is cuusuIIy ussocIuLed wILI Increused
prevuIence oI IIuId In LIe mIddIe eur, sympLoms oI upper respIruLory LrucL
IrrILuLIon, und u smuII buL sIgnIIIcunL reducLIon In Iung IuncLIon. TIIrdIy,
ETS exposure Is cuusuIIy ussocIuLed wILI uddILIonuI epIsodes und
Increused severILy oI sympLoms In cIIIdren wILI usLImu. TIe reporL
esLImuLed LIuL zoo,ooo Lo 1,ooo,ooo usLImuLIc cIIIdren Iuve LIeIr
condILIon worsened by exposure Lo ETS. ourLIIy, ETS exposure Is u rIsk
IucLor Ior new cuses oI usLImu In cIIIdren wIo Iuve noL prevIousIy
dIspIuyed sympLoms. AL LIe reporL press conIerence LIe EPA
AdmInIsLruLor conveyed LIe cIeur ImpressIon LIuL LIere Is no uncerLuInLy
wIuLsoever so Iur us ETS Is concerned - LIuL LIe rIsk ussessmenL Ius
sIown concIusIveIy LIuL ETS exposure Is responsIbIe Ior upproxImuLeIy
ooo cuses oI Iung cuncer umong U.S. nonsmokers eucI yeur und specIIIc
numbers oI respIruLory probIems umong cIIIdren (In BIIIey, 1qq, p.zz).
ung cuncer umong uduILs und cIIIdIood respIruLory uIImenLs
ure very dIIIerenL pIenomenu und need Lo be consIdered sepuruLeIy.
(.(. Entironmentcl Tobccco Smole cnd Lun Ccncer
TIe EPA (1qq) reporL urgued LIuL LIe concIusIve evIdence oI
LIe dose-reIuLed Iung curconogenIcILy oI M|uInsLreum|S|moke| In ucLIve
smokers, coupIed wILI InIormuLIon on LIe cIemIcuI sImIIurILIes oI MS und
ETS upLuke In nonsmokers, Is suIIIcIenL by ILseII Lo esLubIIsI ETS us u
283
283
Rampant Antismoking Signifies Grave Danger
TIe ugency wunLs Lo dredge LIe Hudson RIver, uL u cosL
oI Iundreds oI mIIIIons oI doIIurs, Lo remove LIe PCBs
LIere. ronIcuIIy, LIe dredgIng operuLIons ure IIkeIy Lo
Increuse drumuLIcuIIy LIe pubIIc's exposure Lo LIe
supposed cuncer-cuusIng compounds.
Dzone: usL yeur, LIe EPA bIumed ground-IeveI ozone
Ior LIe Increuse In usLImu ruLes - even LIougI ozone
IeveIs Iuve IuIIen In recenL yeurs!
Entironmentcl rccism: TIe ugency recenLIy
dIsLrIbuLed 'guIdeIInes` requIrIng sLuLes Lo ensure LIuL
mInorILIes do noL suIIer 'dIsproporLIonuLe ImpucL` Irom
poIIuLIon. As our DuvId MusLIo Ius reporLed, Iowever,
LIe EPA deIIberuLeIy conceuIed up Lo 1,ooo puges oI
reporLs on LIe Issue, possIbIy becuuse LIe reseurcI
IndIcuLes LIuL LIe reguIuLIon wouId do more Iurm LIun
good Lo mInorILy cILIzens. TIe prucLIcuI eIIecL oI LIe ruIe
wouId be Lo ouLIuw deveIopmenL In economIcuIIy
deprIved Inner cILIes.
Climcte chcne: TIe EPA consLunLIy wurns LIuL
gIobuI wurmIng LIreuLens our very survIvuI. L wunLs
Congress Lo udopL un InLernuLIonuI ugreemenL reucIed
IusL yeur In KyoLo, Jupun, LIuL wouId bInd LIe UnILed
SLuLes Lo reducIng curbon dIoxIde emIssIons In LIe yeur
zo1z Lo LIe IeveIs LIuL prevuIIed In 1qqo. YeL even
scIenLIsLs wIo worry ubouL gIobuI wurmIng concede LIuL
IL's Loo eurIy Lo suy Ior sure wIeLIer wurmIng Is LukIng
pIuce - or wIuL LIe eIIecLs wouId be.
As sucI, LIe EPA conducLs ILseII us un IdeoIogIcuIIy-drIven
orgunIzuLIon. TIe compIeLeIy quesLIonubIe muLerIuIIsL purILunIsm LIuL
weII cIurucLerIzes ILs dIsposILIon, uguIn, couId be eusIIy LrunspIunLed InLo
LIe NuzI Irumework, I.e., envIronmenLuI IygIene. or LIIs cIrcumsLunce
Lo urIse In u democruLIc socIeLy, wIere deIuded IdeoIogy cun IIjuck u Iurge
governmenL bureuucrucy, wIere uLLempLs Lo brIng IL InLo cIeck ure
essenLIuIIy unsuccessIuI, und wIere IL cun LIereIore run ILs IuII conLorLed
course InLo LIe munIpuIuLIon oI pubIIc poIIcy und LIInkIng oI very
consIderubIe consequence, Is LruIy usLoundIng.
BIIIey (1qq) properIy concIudes LIuL some muy urgue LIuL
uppIyIng u doubIe sLundurd Lo ETS Is jusLIIIubIe, or uL IeusL
undersLundubIe, on LIe ground LIuL LIe LurgeL oI EPA`s ucLIon Is Lobucco
smokIng. RegurdIess oI one`s personuI beIIeIs ubouL smokIng, Iowever,
LIe specLucIe oI u Iuge, weII-Iunded governmenL bureuucrucy wILI
Preventive Medicine & Health Promotion
enormous power enguged In LIe deIIberuLe munIpuIuLIon oI LIe pubIIc Is
proIoundIy dIsLurbIng. (p. zz) AILIougI BIIIey`s dIsconLenL Is reusonubIy
und jusLIIIubIy evIdenL, IL Is possIbIy Loo resLruIned. TIIs dIscussIon wIII go
Iur IurLIer by suggesLIng LIuL In scIenLIIIc Lerms LIe EPA conducL Is un
uLrocILy In ILs vIoIuLIon oI every InLenL oI sound, IonesL, judIcIous enquIry.
urLIermore, IL Is noLIIng sIorL oI sInIsLer In Lerms oI LIe sIeer cupucILy
oI LIIs conducL Lo dIcLuLe pubIIc poIIcy und Lo generuLe psycIoIogIcuI und
psycIosocIuI puLIoIogy. As wIII be consIdered, LIIs deIIberuLe
munIpuIuLIon oI LIe pubIIc Ius very setere deLrImenLuI consequences und
Is sympLomuLIc oI deLerIoruLIng socIeLuI IuncLIonIng.
AmId mucI medIu IunIure, LIe IInuI EPA ReporL on ETS wus
oIIIcIuIIy presenLed In LIe documenL RespIruLory HeuILI EIIecLs oI
PussIve SmokIng: ung Cuncer und OLIer DIsorders (1qq). L concIuded
LIuL ETS Is cIussIIIed us u Group A curcInogen und LIuL IL Is LIe cuuse oI
ooo Iung-cuncer deuLIs umongsL nonsmokIng AmerIcuns per yeur.
urLIermore, In cIIIdren, IIrsLIy, ETS exposure Is cuusuIIy ussocIuLed wILI
un Increused rIsk oI Iower respIruLory LrucL InIecLIons, e.g., broncIILIs,
pneumonIu. TIe reporL esLImuLed LIuL 1o,ooo Lo oo,ooo cuses unnuuIIy
In InIunLs und young cIIIdren up Lo 18 monLIs oI uge ure uLLrIbuLubIe Lo
ETS. SecondIy, ETS exposure Is cuusuIIy ussocIuLed wILI Increused
prevuIence oI IIuId In LIe mIddIe eur, sympLoms oI upper respIruLory LrucL
IrrILuLIon, und u smuII buL sIgnIIIcunL reducLIon In Iung IuncLIon. TIIrdIy,
ETS exposure Is cuusuIIy ussocIuLed wILI uddILIonuI epIsodes und
Increused severILy oI sympLoms In cIIIdren wILI usLImu. TIe reporL
esLImuLed LIuL zoo,ooo Lo 1,ooo,ooo usLImuLIc cIIIdren Iuve LIeIr
condILIon worsened by exposure Lo ETS. ourLIIy, ETS exposure Is u rIsk
IucLor Ior new cuses oI usLImu In cIIIdren wIo Iuve noL prevIousIy
dIspIuyed sympLoms. AL LIe reporL press conIerence LIe EPA
AdmInIsLruLor conveyed LIe cIeur ImpressIon LIuL LIere Is no uncerLuInLy
wIuLsoever so Iur us ETS Is concerned - LIuL LIe rIsk ussessmenL Ius
sIown concIusIveIy LIuL ETS exposure Is responsIbIe Ior upproxImuLeIy
ooo cuses oI Iung cuncer umong U.S. nonsmokers eucI yeur und specIIIc
numbers oI respIruLory probIems umong cIIIdren (In BIIIey, 1qq, p.zz).
ung cuncer umong uduILs und cIIIdIood respIruLory uIImenLs
ure very dIIIerenL pIenomenu und need Lo be consIdered sepuruLeIy.
(.(. Entironmentcl Tobccco Smole cnd Lun Ccncer
TIe EPA (1qq) reporL urgued LIuL LIe concIusIve evIdence oI
LIe dose-reIuLed Iung curconogenIcILy oI M|uInsLreum|S|moke| In ucLIve
smokers, coupIed wILI InIormuLIon on LIe cIemIcuI sImIIurILIes oI MS und
ETS upLuke In nonsmokers, Is suIIIcIenL by ILseII Lo esLubIIsI ETS us u
284
284
Rampant Antismoking Signifies Grave Danger
known Iumun Iung curcInogen, or 'Group A` curcInogen under U.S. EPA`s
curcInogen cIussIIIcuLIon sysLem. (s.1.z) TIIs proposILIon Is sImpIy
unLrue und conLrury Lo LIe EPA`s own operuLIng deIInILIon (s.;.z.1) LIuL
cIeurIy dIsLInguIsIes MS und ETS us dIIIerenL In composILIon weIgILIng
und concenLruLIon. L uIso conLrudIcLs LIe EPA und SAB`s own reckonIng
In LIe second druIL oI LIe ETS InvesLIguLIon: TIe |second| druIL reporL
sLuLed, Ior exumpIe, LIuL 'LIIs ussumpLIon |compurIng MS und ETS Lo
cuIcuIuLe Iung cuncer rIsks| muy noL be LenubIe, ..us MS und SS dIIIer In
LIe reIuLIve composILIon oI curcInogens und oLIer componenLs IdenLIIIed
In Lobucco smoke und In LIeIr pIysIcocIemIcuI properLIes In generuI. (In
BIIIey, 1qq, p.z6) urLIermore, noLwILIsLundIng LIuL there cre
demonsLrubIy crILIcuI dIIIerences beLween MS und ETS und LIeIr upLuke
(e.g., GorI, 1qqq; Huber eL uI., 1qq; ScIerer eL uI., 1q8q), IL wus urgued In
u prevIous cIupLer LIuL even depIcLIons oI MS us u Group A curcInogen
ure Improper - deIyIng uny coIerenL Irumework oI cuusuI urgumenLuLIon.
To use MS und ILs Improper cIussIIIcuLIon us u Group A curcInogen us
LIe busIs, by unuIogy, Lo so cIussIIy ETS Ius no scIenLIIIc meunIngIuI-
ness.
Very ImporLunLIy Is LIuL ETS Is u IIgIIy dIIuLed subsLunce noL
IendIng ILseII weII Lo meusuremenL oI consLILuenLs. EPA (1qq) properIy
ucknowIedged LIuL LIe IeveI oI exposure Lo consLILuenLs und compounds Is
smuII. AILIougI sucI compurIsons wurrunL un umounL oI cuuLIon, LIe
IeveI oI u nonsmokers` exposure Lo ETS consLILuenLs und compounds Is u
IrucLIon LIuL oI u smoker`s exposure Lo MS consLILuenLs und compounds.
CoLInIne meusuremenL Is used us u proxy murker Ior ETS
exposure, uILIougI IL provIdes IILLIe or no InIormuLIon regurdIng exLenL oI
exposure Lo ETS consLILuenLs or compounds. TIe unuccepLubIe bIus oI LIe
EPA reporL Is obvIous In ILs use oI purLIcuIur Lerms. or exumpIe, EPA
(1qq) sLuLes LIuL |u]Ir sumpIIng conducLed In u vurIeLy oI Indoor
envIronmenLs Ius sIown LIuL nonsmoker exposure Lo ETS-relcted toxic
cnd ccrcinoenic substcnces wIII occur... |itclics cdded| (s..q); ||n
summury, ETS represenLs un ImporLunL source oI LoxIc und curcInogenIc
Indoor uIr conLumInunLs. (s..q) TIIs SecLIon deuIs onIy wILI uLLempLs Lo
meusure ETS exposure. As sucI, none oI LIe InIormuLIon, oI ILseII,
demonsLruLes LoxIcILy or curcInogenIcILy. n udIerence Lo LIe LoxIcoIogIc
muxIm LIuL LIe dose mukes LIe poIson, LIe IeveI oI exposure musL be
connecLed Lo purLIcuIur deLrImenLuI ouLcomes, In cuusuI Lerms, beIore
usIng sucI LermInoIogy. TIeIr use In SecLIon `s conLexL presupposes wIuL
Ius noL been demonsLruLed.
urLIermore, Lerms sucI us pussIve smokIng or InvoIunLury
smokIng ure InIIummuLory und poIILIco-IdeoIogIcuI Lerms LIuL IosLer LIe
ImpressIon LIuL exposure Lo ETS Is LIe equIvuIenL oI nonsmokers ucLIveIy
Preventive Medicine & Health Promotion
smokIng uguInsL LIeIr wIII und LIuL LIe exposure Is LoxIc. I LIe exposure
Is noL LoxIc, LIen wIy wouId InvoIunLurIness oI exposure be oI uny
concern? AguIn, LIe reporL presupposes wIuL Ius noL been demonsLruLed,
buL IndIcuLes wIuL IL obvIousIy seems Lo beIIeve und Lo pubIIcIy concIude.
TIe uLLempL Lo ImpIy LIuL exposure Lo ETS Is someIow unuIogous Lo u
pussIve ucLIve-smoker Ius no coIerenL busIs wIuLsoever. UnIorLunuLeIy,
LIe reporL Is rIddIed wILI sucI Lerms. OnIy neuLruI Lerms sucI us ETS
exposure sIouId be used.
EPA (1qq) concIuded LIuL wIIIe MS und ETS muy be
quuIILuLIveIy compurubIe, ucLIve smokIng duLu do noL consLILuLe u good
busIs Ior quunLILuLIve esLImuLIon oI LIe IeuILI eIIecLs oI pussIve smokIng
oI LIe ugenL(s) responsIbIe Ior LIese eIIecLs ure noL known. ProvIded LIe
epIdemIoIogIc sLudIes ure oI suIIIcIenL power und udequuLe sLudy desIgn,
LIIs duLubuse cun oIIer unIque InIormuLIon on LIe ucLuuI Iung cuncer rIsk
Lo nonsmokers Irom exposure Lo Lrue umbIenL IeveIs oI ETS. (s.q.)
TIereIore, LIe epIdemIoIogIc duLu IIgure very IIgIIy In LIe
overuII EPA concIusIons on ETS. n uddILIon Lo LIe usuuI probIems
ussocIuLed wILI reIIubIIILy oI meusures, conIoundIng IucLors, und meLu-
unuIysIs, IL Ius uIreudy been noLed LIuL LIere wus consIderubIe, IIgIIy
uneLIIcuI seIecLIvILy oI sLudIes LIuL were uILImuLeIy IncIuded In LIe meLu-
unuIysIs: LIe sLuLIsLIcuI sIgnIIIcunce oI LIe resuILs couId vury dependIng on
wIuL sLudIes were IncIudedJexcIuded. TIe IInuI meLu-unuIysIs Iound un
Increused rIsk oI Iung cuncer In LIe U.S. Ior nonsmokIng spouses (wIves)
oI smokers vs. nonsmokers ussocIuLed (sLuLIsLIcuIIy) wILI ETS exposure
(RR=1.1q), wIIcI wus sLuLIsLIcuIIy sIgnIIIcunL uL LIe qo% conIIdence
InLervuI. L wus uIso eurIIer consIdered LIuL LIIs Iower conIIdence InLervuI
wus uLypIcuI oI sucI InvesLIguLIonsJevuIuuLIons und wus used, wIere uII
oLIer munIpuIuLIon sLIII IuIIed, Lo generuLe u sLuLIsLIcuIIy sIgnIIIcunL resuIL.
TIere ure u number oI poInLs In LIIs conducL und IIndIng LIuL
merIL IurLIer scruLIny. IrsLIy, LIe use oI un RR oI 1.1q Lo generuLe
cuusuI urgumenL does noL even conIorm Lo LIe exLremeIy poor rIsk
ussessmenL sLundurd oI RR=z-q us u Iower IImIL oI weuk ussocIuLIon Ior
possIbIe cuusuI consIderuLIons. SecondIy, IL demonsLruLes, uguIn, LIe
deIuded obsessIon wILI RR und sLuLIsLIcuI sIgnIIIcunce dIscussed In un
eurIIer cIupLer. SLuLIsLIcuI sIgnIIIcunce onIy IndIcuLes LIuL LIere Is u very
Iow probubIIILy (e.g., Iess LIun .o) LIuL u IIndIng wus uLLrIbuLubIe Lo
cIunce.However, sLuLIsLIcuI sIgnIIIcunce IndIcuLes noLIIng concernIng LIe
ncture (e.g., cuusuI, LrIgger, cross-correIuLIonuI) oI un ussocIuLIon or
correIuLIon. RR Is not LIe busIs Ior coIerenL cuusuI urgumenL uL uII (see
CIupLer z). AddILIonuIIy, LIe unIounded beIIeI LIuL LIe sLuLIsLIcuI
sIgnIIIcunce oI u IIndIng someIow eIevuLes u IucLor InLo LIe cuusuI reuIm Is
dIsLurbIngIy obvIous In LIIs EPA reporL. GIven LIuL un urgumenL by
285
285
Rampant Antismoking Signifies Grave Danger
known Iumun Iung curcInogen, or 'Group A` curcInogen under U.S. EPA`s
curcInogen cIussIIIcuLIon sysLem. (s.1.z) TIIs proposILIon Is sImpIy
unLrue und conLrury Lo LIe EPA`s own operuLIng deIInILIon (s.;.z.1) LIuL
cIeurIy dIsLInguIsIes MS und ETS us dIIIerenL In composILIon weIgILIng
und concenLruLIon. L uIso conLrudIcLs LIe EPA und SAB`s own reckonIng
In LIe second druIL oI LIe ETS InvesLIguLIon: TIe |second| druIL reporL
sLuLed, Ior exumpIe, LIuL 'LIIs ussumpLIon |compurIng MS und ETS Lo
cuIcuIuLe Iung cuncer rIsks| muy noL be LenubIe, ..us MS und SS dIIIer In
LIe reIuLIve composILIon oI curcInogens und oLIer componenLs IdenLIIIed
In Lobucco smoke und In LIeIr pIysIcocIemIcuI properLIes In generuI. (In
BIIIey, 1qq, p.z6) urLIermore, noLwILIsLundIng LIuL there cre
demonsLrubIy crILIcuI dIIIerences beLween MS und ETS und LIeIr upLuke
(e.g., GorI, 1qqq; Huber eL uI., 1qq; ScIerer eL uI., 1q8q), IL wus urgued In
u prevIous cIupLer LIuL even depIcLIons oI MS us u Group A curcInogen
ure Improper - deIyIng uny coIerenL Irumework oI cuusuI urgumenLuLIon.
To use MS und ILs Improper cIussIIIcuLIon us u Group A curcInogen us
LIe busIs, by unuIogy, Lo so cIussIIy ETS Ius no scIenLIIIc meunIngIuI-
ness.
Very ImporLunLIy Is LIuL ETS Is u IIgIIy dIIuLed subsLunce noL
IendIng ILseII weII Lo meusuremenL oI consLILuenLs. EPA (1qq) properIy
ucknowIedged LIuL LIe IeveI oI exposure Lo consLILuenLs und compounds Is
smuII. AILIougI sucI compurIsons wurrunL un umounL oI cuuLIon, LIe
IeveI oI u nonsmokers` exposure Lo ETS consLILuenLs und compounds Is u
IrucLIon LIuL oI u smoker`s exposure Lo MS consLILuenLs und compounds.
CoLInIne meusuremenL Is used us u proxy murker Ior ETS
exposure, uILIougI IL provIdes IILLIe or no InIormuLIon regurdIng exLenL oI
exposure Lo ETS consLILuenLs or compounds. TIe unuccepLubIe bIus oI LIe
EPA reporL Is obvIous In ILs use oI purLIcuIur Lerms. or exumpIe, EPA
(1qq) sLuLes LIuL |u]Ir sumpIIng conducLed In u vurIeLy oI Indoor
envIronmenLs Ius sIown LIuL nonsmoker exposure Lo ETS-relcted toxic
cnd ccrcinoenic substcnces wIII occur... |itclics cdded| (s..q); ||n
summury, ETS represenLs un ImporLunL source oI LoxIc und curcInogenIc
Indoor uIr conLumInunLs. (s..q) TIIs SecLIon deuIs onIy wILI uLLempLs Lo
meusure ETS exposure. As sucI, none oI LIe InIormuLIon, oI ILseII,
demonsLruLes LoxIcILy or curcInogenIcILy. n udIerence Lo LIe LoxIcoIogIc
muxIm LIuL LIe dose mukes LIe poIson, LIe IeveI oI exposure musL be
connecLed Lo purLIcuIur deLrImenLuI ouLcomes, In cuusuI Lerms, beIore
usIng sucI LermInoIogy. TIeIr use In SecLIon `s conLexL presupposes wIuL
Ius noL been demonsLruLed.
urLIermore, Lerms sucI us pussIve smokIng or InvoIunLury
smokIng ure InIIummuLory und poIILIco-IdeoIogIcuI Lerms LIuL IosLer LIe
ImpressIon LIuL exposure Lo ETS Is LIe equIvuIenL oI nonsmokers ucLIveIy
Preventive Medicine & Health Promotion
smokIng uguInsL LIeIr wIII und LIuL LIe exposure Is LoxIc. I LIe exposure
Is noL LoxIc, LIen wIy wouId InvoIunLurIness oI exposure be oI uny
concern? AguIn, LIe reporL presupposes wIuL Ius noL been demonsLruLed,
buL IndIcuLes wIuL IL obvIousIy seems Lo beIIeve und Lo pubIIcIy concIude.
TIe uLLempL Lo ImpIy LIuL exposure Lo ETS Is someIow unuIogous Lo u
pussIve ucLIve-smoker Ius no coIerenL busIs wIuLsoever. UnIorLunuLeIy,
LIe reporL Is rIddIed wILI sucI Lerms. OnIy neuLruI Lerms sucI us ETS
exposure sIouId be used.
EPA (1qq) concIuded LIuL wIIIe MS und ETS muy be
quuIILuLIveIy compurubIe, ucLIve smokIng duLu do noL consLILuLe u good
busIs Ior quunLILuLIve esLImuLIon oI LIe IeuILI eIIecLs oI pussIve smokIng
oI LIe ugenL(s) responsIbIe Ior LIese eIIecLs ure noL known. ProvIded LIe
epIdemIoIogIc sLudIes ure oI suIIIcIenL power und udequuLe sLudy desIgn,
LIIs duLubuse cun oIIer unIque InIormuLIon on LIe ucLuuI Iung cuncer rIsk
Lo nonsmokers Irom exposure Lo Lrue umbIenL IeveIs oI ETS. (s.q.)
TIereIore, LIe epIdemIoIogIc duLu IIgure very IIgIIy In LIe
overuII EPA concIusIons on ETS. n uddILIon Lo LIe usuuI probIems
ussocIuLed wILI reIIubIIILy oI meusures, conIoundIng IucLors, und meLu-
unuIysIs, IL Ius uIreudy been noLed LIuL LIere wus consIderubIe, IIgIIy
uneLIIcuI seIecLIvILy oI sLudIes LIuL were uILImuLeIy IncIuded In LIe meLu-
unuIysIs: LIe sLuLIsLIcuI sIgnIIIcunce oI LIe resuILs couId vury dependIng on
wIuL sLudIes were IncIudedJexcIuded. TIe IInuI meLu-unuIysIs Iound un
Increused rIsk oI Iung cuncer In LIe U.S. Ior nonsmokIng spouses (wIves)
oI smokers vs. nonsmokers ussocIuLed (sLuLIsLIcuIIy) wILI ETS exposure
(RR=1.1q), wIIcI wus sLuLIsLIcuIIy sIgnIIIcunL uL LIe qo% conIIdence
InLervuI. L wus uIso eurIIer consIdered LIuL LIIs Iower conIIdence InLervuI
wus uLypIcuI oI sucI InvesLIguLIonsJevuIuuLIons und wus used, wIere uII
oLIer munIpuIuLIon sLIII IuIIed, Lo generuLe u sLuLIsLIcuIIy sIgnIIIcunL resuIL.
TIere ure u number oI poInLs In LIIs conducL und IIndIng LIuL
merIL IurLIer scruLIny. IrsLIy, LIe use oI un RR oI 1.1q Lo generuLe
cuusuI urgumenL does noL even conIorm Lo LIe exLremeIy poor rIsk
ussessmenL sLundurd oI RR=z-q us u Iower IImIL oI weuk ussocIuLIon Ior
possIbIe cuusuI consIderuLIons. SecondIy, IL demonsLruLes, uguIn, LIe
deIuded obsessIon wILI RR und sLuLIsLIcuI sIgnIIIcunce dIscussed In un
eurIIer cIupLer. SLuLIsLIcuI sIgnIIIcunce onIy IndIcuLes LIuL LIere Is u very
Iow probubIIILy (e.g., Iess LIun .o) LIuL u IIndIng wus uLLrIbuLubIe Lo
cIunce.However, sLuLIsLIcuI sIgnIIIcunce IndIcuLes noLIIng concernIng LIe
ncture (e.g., cuusuI, LrIgger, cross-correIuLIonuI) oI un ussocIuLIon or
correIuLIon. RR Is not LIe busIs Ior coIerenL cuusuI urgumenL uL uII (see
CIupLer z). AddILIonuIIy, LIe unIounded beIIeI LIuL LIe sLuLIsLIcuI
sIgnIIIcunce oI u IIndIng someIow eIevuLes u IucLor InLo LIe cuusuI reuIm Is
dIsLurbIngIy obvIous In LIIs EPA reporL. GIven LIuL un urgumenL by
286
286
Rampant Antismoking Signifies Grave Danger
unuIogy Lo MS Is noL vIubIe concernIng ETS, LIen LIe cIussIIIcuLIon oI
ETS us u Group A curcInogen resLs enLIreIy on LIIs IIImsy use oI u LIny
RR dIIIerence und ILs sLuLIsLIcuI sIgnIIIcunce.
TIe crILIcuI busIs Ior cuusuI urgumenL Is predIcLIve sLrengLI oI
IucLors Ior IucLors. n LIe InsLunce oI ucLIve smokIng, Ieuvy smokIng Iud u
predIcLIve sLrengLI Ior Iung cuncer oI uround 1o% ubove u buseIIne; II
smokIng Is used us LIe soIe predIcLor oI Iung cuncer, LIe predIcLIon wouId
be wrong qo% oI LIe LIme. TIIs poor IeveI oI uccurucy Is nowIere neur
LIuL requIred (-6o%) Lo cIussIIy u IucLor(s) us u prImury cuuse (suIIIcIenL
condILIon) oI unoLIer IucLor, und cunnoL be consLrued, In uny Lerms, us
IndIcuLIng u depLI oI undersLundIng regurdIng LIe ueLIoIogy oI Iung
cuncer. ConcernIng ETS, LIe sILuuLIon becomes jcr worse und serves Lo
even beLLer IIgIIIgIL LIe compIeLe InupproprIuLeness oI RR In cuusuI
urgumenL; IL brIngs Lo LIe Iore LIe mugnILude und IuIIness oI LIe IoIIy LIuL
weII cIurucLerIzes IIIesLyIe epIdemIoIogy und prevenLIve medIcIne.
UsIng LIe EPA`s own IIgures, IL suggesLs LIuL u conservuLIve
esLImuLe oI U.S. nonsmokers uged 18 or over LIuL ure exposed Lo ETS
(usIng LIe bIomurker oI coLInIne) Is 6,ooo,ooo (s.1..1.z). EPA uIso
concIuded, LIrougI LIe Improper use oI LIe 'uLLrIbuLubIe rIsk` sLuLIsLIc,
LIuL upproxImuLeIy ooo Iung cuncer deuLIs per yeur In U.S. nonsmokers
uge und over ure uLLrIbuLubIe Lo ETS. I LIere ure 6,ooo,ooo
nonsmokers uged 18 und over wIo ure exposed Lo ETS, LIen LIere ure
upproxImuLeIy q,ooo,ooo nonsmokers uged und over wIo ure
exposed Lo ETS. TIe predIcLIve sLrengLI oI exposure Lo ETS Ior Iung
cuncer Is LIereIore oooJq,ooo,ooo=oo.oo6;%. TIIs predIcLIve
sLrengLI Is injinitesimcll ubove zero und LIe predIcLIon wouId be wrong
qq.qq% oI LIe LIme. Even II some unreusonubIe IuLILude wus uIIowed by
consIderIng LIe denomInuLor Lo equuI LIe deuLI ruLe Ior one udvunced uge
group (I.e., -1,ooo,ooo), LIen LIe predIcLIve sLrengLI oI exposure Lo ETS
Ior Iung cuncer wouId be oooJ1,ooo,ooo = oo.%, I.e., LIe predIcLIon
wouId be wrong qq.;% oI LIe LIme - one wouId expecL u Iur, Iur IIgIer
success ruLe Ior IorLune-LeIIIng. L musL be noLed LIuL even LIougI IL Ius
provIded esLImuLes oI numbers exposed, LIe EPA Ius noL LIe remoLesL
InkIIng LIuL LIIs InIormuLIon Is criticcl Lo coIerenL cuusuI urgumenL und
dejinititel demonsLruLes LIuL LIere ure no grounds Ior prImury cuusuI
urgumenL. n IucL, LIese esLImuLes ure provIded by LIe EPA us II LIese
boIsLer cuusuI urgumenL. RuLIer, LIey IIgIIIgIL LIe sIeer IoIIy oI LIe EPA
exercIse, und IIIesLyIe epIdemIoIogy more generuIIy.
AppIyIng LIe crILerIu ouLIIned In LIe openIng cIupLers, evIdence
wIII suggesL LIuL eILIer ETS Is u prImury cuuse oI Iung cuncer, or LIuL IL Is
u poLenLIuI LrIgger Ior endogenous ubnormuIILy, or LIuL RR dIIIerences ure
LuppIng InLo some oLIer subgroup eIIecLs. TIe extremel poor predIcLIve
Preventive Medicine & Health Promotion
sLrengLI oI ETS Ior Iung cuncer (I.e., eIIecLIveIy zero) compreIensIveIy
dIsconIIrms ETS us u prImury cuuse oI Iung cuncer. TIe possIbIIILy oI ETS
us u LrIgger Is uIso hihl doubLIuI gIven LIe neur-zero predIcLIve sLrengLI.
AIso ImporLunL Is LIuL LIe reIuLIveIy Iow IncIdence oI Iung cuncer
umong nonsmokers Is prImurIIy oI u dIIIerenL Iorm (udenocurcInomu) Lo
LIuL predomInunLIy Iound In smokers (squumous und ouL ceII curcInomu).
e unu (1qqq) IndIcuLes:
LIere ure essenLIuIIy Lwo Lypes oI Iung cuncer. TIe
commonesL ure squumous und ouL ceII cuncers, wIIcI
urIse Irom LIe ceIIs IInIng LIe muIn broncII. TIe second
ure cuIIed udenocurcInomus, wIIcI urIse Irom gIunduIur
LIssue In LIe uIr sucs In LIe perIpIery oI LIe Iung. rom
LIe eurIy 1qo's, wIen SIr RIcIurd DoII und LIe IuLe SIr
AusLen BrudIord-HIII IIrsL proved LIuL smokIng cuuses
Iung cuncer, LIe ImporLunL dIsLIncLIon wus mude LIuL
LIe cuncers cuused were oI LIe squumous und ouL ceII
Lype. n 1q6q, uL LIe concIusIon oI LIeIr Iumous 1o-yeur
sLudy oI docLors' smokIng IubILs, LIey Iound 'no murked
ussocIuLIon wILI smokIng und udenocurcInomu`. On LIe
very rure occusIons LIuL non-smokers do geL Iung
cuncer, IL Is uImosL uIwuys oI LIe udenocurcInomu Lype.
TIere Is uIso u dIIIerence In Iung-cuncer Lype beLween
men und women, LIe IuLLer demonsLruLIng u greuLer
IncIdence oI udenocurcInomu. TIIs poInL wus noL IosL on
MurpIy (1qqz) wIo, us u member oI LIe EPA`s OIIIce oI
ReseurcI und DeveIopmenL-EnvIronmenLuI CrILerIu und
AssessmenL OIIIce In CIncInnuLI, provIded u revIew oI
LIe second druIL oI EPA`s ETS ussessmenL. AmongsL
oLIer probIems wILI LIe documenL, sIe noLes LIuL ...
recuII ; or 8 yeurs ugo wIen IL wus IIrsL noLed LIuL
udenocurcInomu seemed Lo occur wILI greuLer
Irequency In women compured Lo men. AL LIuL LIme, LIe
LIeory wus LIuL LIese udenocurcInomus were IIkeIy due
Lo domesLIc rudon exposure; now LIey ure beIng
uLLrIbuLed Lo ETS.
L wus InILIuIIy urgued LIuL ETS cuused LIe sume Iung cuncer In
non-smokers us MS cuused In smokers. WIen LIe ubove dIIIerences
were IIgIIIgILed, LIe urgumenL sIIILed Lo ETS beIng LIe cuuse oI u
dIIIerenL Lype oI Iung cuncer. SucI urgumenLuLIon reIIecLs LIe upIoIdIng
oI unIuIsIIIubIe proposILIons. ETS cun cuuse wIuLever one wunLs IL Lo
cuuse. TIe urgumenLuLIon begIns Irom LIe premIse LIuL ETS cuuses
287
287
Rampant Antismoking Signifies Grave Danger
unuIogy Lo MS Is noL vIubIe concernIng ETS, LIen LIe cIussIIIcuLIon oI
ETS us u Group A curcInogen resLs enLIreIy on LIIs IIImsy use oI u LIny
RR dIIIerence und ILs sLuLIsLIcuI sIgnIIIcunce.
TIe crILIcuI busIs Ior cuusuI urgumenL Is predIcLIve sLrengLI oI
IucLors Ior IucLors. n LIe InsLunce oI ucLIve smokIng, Ieuvy smokIng Iud u
predIcLIve sLrengLI Ior Iung cuncer oI uround 1o% ubove u buseIIne; II
smokIng Is used us LIe soIe predIcLor oI Iung cuncer, LIe predIcLIon wouId
be wrong qo% oI LIe LIme. TIIs poor IeveI oI uccurucy Is nowIere neur
LIuL requIred (-6o%) Lo cIussIIy u IucLor(s) us u prImury cuuse (suIIIcIenL
condILIon) oI unoLIer IucLor, und cunnoL be consLrued, In uny Lerms, us
IndIcuLIng u depLI oI undersLundIng regurdIng LIe ueLIoIogy oI Iung
cuncer. ConcernIng ETS, LIe sILuuLIon becomes jcr worse und serves Lo
even beLLer IIgIIIgIL LIe compIeLe InupproprIuLeness oI RR In cuusuI
urgumenL; IL brIngs Lo LIe Iore LIe mugnILude und IuIIness oI LIe IoIIy LIuL
weII cIurucLerIzes IIIesLyIe epIdemIoIogy und prevenLIve medIcIne.
UsIng LIe EPA`s own IIgures, IL suggesLs LIuL u conservuLIve
esLImuLe oI U.S. nonsmokers uged 18 or over LIuL ure exposed Lo ETS
(usIng LIe bIomurker oI coLInIne) Is 6,ooo,ooo (s.1..1.z). EPA uIso
concIuded, LIrougI LIe Improper use oI LIe 'uLLrIbuLubIe rIsk` sLuLIsLIc,
LIuL upproxImuLeIy ooo Iung cuncer deuLIs per yeur In U.S. nonsmokers
uge und over ure uLLrIbuLubIe Lo ETS. I LIere ure 6,ooo,ooo
nonsmokers uged 18 und over wIo ure exposed Lo ETS, LIen LIere ure
upproxImuLeIy q,ooo,ooo nonsmokers uged und over wIo ure
exposed Lo ETS. TIe predIcLIve sLrengLI oI exposure Lo ETS Ior Iung
cuncer Is LIereIore oooJq,ooo,ooo=oo.oo6;%. TIIs predIcLIve
sLrengLI Is injinitesimcll ubove zero und LIe predIcLIon wouId be wrong
qq.qq% oI LIe LIme. Even II some unreusonubIe IuLILude wus uIIowed by
consIderIng LIe denomInuLor Lo equuI LIe deuLI ruLe Ior one udvunced uge
group (I.e., -1,ooo,ooo), LIen LIe predIcLIve sLrengLI oI exposure Lo ETS
Ior Iung cuncer wouId be oooJ1,ooo,ooo = oo.%, I.e., LIe predIcLIon
wouId be wrong qq.;% oI LIe LIme - one wouId expecL u Iur, Iur IIgIer
success ruLe Ior IorLune-LeIIIng. L musL be noLed LIuL even LIougI IL Ius
provIded esLImuLes oI numbers exposed, LIe EPA Ius noL LIe remoLesL
InkIIng LIuL LIIs InIormuLIon Is criticcl Lo coIerenL cuusuI urgumenL und
dejinititel demonsLruLes LIuL LIere ure no grounds Ior prImury cuusuI
urgumenL. n IucL, LIese esLImuLes ure provIded by LIe EPA us II LIese
boIsLer cuusuI urgumenL. RuLIer, LIey IIgIIIgIL LIe sIeer IoIIy oI LIe EPA
exercIse, und IIIesLyIe epIdemIoIogy more generuIIy.
AppIyIng LIe crILerIu ouLIIned In LIe openIng cIupLers, evIdence
wIII suggesL LIuL eILIer ETS Is u prImury cuuse oI Iung cuncer, or LIuL IL Is
u poLenLIuI LrIgger Ior endogenous ubnormuIILy, or LIuL RR dIIIerences ure
LuppIng InLo some oLIer subgroup eIIecLs. TIe extremel poor predIcLIve
Preventive Medicine & Health Promotion
sLrengLI oI ETS Ior Iung cuncer (I.e., eIIecLIveIy zero) compreIensIveIy
dIsconIIrms ETS us u prImury cuuse oI Iung cuncer. TIe possIbIIILy oI ETS
us u LrIgger Is uIso hihl doubLIuI gIven LIe neur-zero predIcLIve sLrengLI.
AIso ImporLunL Is LIuL LIe reIuLIveIy Iow IncIdence oI Iung cuncer
umong nonsmokers Is prImurIIy oI u dIIIerenL Iorm (udenocurcInomu) Lo
LIuL predomInunLIy Iound In smokers (squumous und ouL ceII curcInomu).
e unu (1qqq) IndIcuLes:
LIere ure essenLIuIIy Lwo Lypes oI Iung cuncer. TIe
commonesL ure squumous und ouL ceII cuncers, wIIcI
urIse Irom LIe ceIIs IInIng LIe muIn broncII. TIe second
ure cuIIed udenocurcInomus, wIIcI urIse Irom gIunduIur
LIssue In LIe uIr sucs In LIe perIpIery oI LIe Iung. rom
LIe eurIy 1qo's, wIen SIr RIcIurd DoII und LIe IuLe SIr
AusLen BrudIord-HIII IIrsL proved LIuL smokIng cuuses
Iung cuncer, LIe ImporLunL dIsLIncLIon wus mude LIuL
LIe cuncers cuused were oI LIe squumous und ouL ceII
Lype. n 1q6q, uL LIe concIusIon oI LIeIr Iumous 1o-yeur
sLudy oI docLors' smokIng IubILs, LIey Iound 'no murked
ussocIuLIon wILI smokIng und udenocurcInomu`. On LIe
very rure occusIons LIuL non-smokers do geL Iung
cuncer, IL Is uImosL uIwuys oI LIe udenocurcInomu Lype.
TIere Is uIso u dIIIerence In Iung-cuncer Lype beLween
men und women, LIe IuLLer demonsLruLIng u greuLer
IncIdence oI udenocurcInomu. TIIs poInL wus noL IosL on
MurpIy (1qqz) wIo, us u member oI LIe EPA`s OIIIce oI
ReseurcI und DeveIopmenL-EnvIronmenLuI CrILerIu und
AssessmenL OIIIce In CIncInnuLI, provIded u revIew oI
LIe second druIL oI EPA`s ETS ussessmenL. AmongsL
oLIer probIems wILI LIe documenL, sIe noLes LIuL ...
recuII ; or 8 yeurs ugo wIen IL wus IIrsL noLed LIuL
udenocurcInomu seemed Lo occur wILI greuLer
Irequency In women compured Lo men. AL LIuL LIme, LIe
LIeory wus LIuL LIese udenocurcInomus were IIkeIy due
Lo domesLIc rudon exposure; now LIey ure beIng
uLLrIbuLed Lo ETS.
L wus InILIuIIy urgued LIuL ETS cuused LIe sume Iung cuncer In
non-smokers us MS cuused In smokers. WIen LIe ubove dIIIerences
were IIgIIIgILed, LIe urgumenL sIIILed Lo ETS beIng LIe cuuse oI u
dIIIerenL Lype oI Iung cuncer. SucI urgumenLuLIon reIIecLs LIe upIoIdIng
oI unIuIsIIIubIe proposILIons. ETS cun cuuse wIuLever one wunLs IL Lo
cuuse. TIe urgumenLuLIon begIns Irom LIe premIse LIuL ETS cuuses
288
288
Rampant Antismoking Signifies Grave Danger
someLIIng. L LIen concIudes LIuL ETS musL cuuse wIuLever Iung-
dIseuse dIIIerences exIsL beLween smokers und nonsmokers. L musL be
reILeruLed LIuL LIIs Is noL scIenLIIIc dIscourse buL LIe rumbIIngs-on oI
IncompeLence und oLIer menLuI dysIuncLIon workIng Lo IIxed und deIuded
concIusIons. TIIs IeebIe urgumenLuLIon Is uIso compIeLeIy sIIenL us Lo wIy
smokers, wIo ure uIso exposed Lo ETS - possIbIy even more so LIun
nonsmokers, demonsLruLe u predomInunce oI curcInomu supposedIy
unreIuLed Lo ETS.
e unu (1qq8) noLes u number oI oLIer ImporLunL poInLs:
IrsLIy, ..18 oI LIe ; sLudIes |IncIuded In meLu-
unuIysIs - HucksIuw eL uI., 1qq;| cILed come Irom
CIInu, Jupun, or Hong Kong - counLrIes wIere LIe
epIdemIoIogy oI Iung cuncer Is dIIIerenL Irom LIuL In LIe
WesL (LIese counLrIes Iuve u reIuLIveIy IIgI IncIdence oI
udenocurcInomu umong women) und LIe sLrengLI oI LIe
cuusuLIve reIuLIon beLween smokIng und Iung cuncer Is
subsLunLIuIIy weuker. TIus LIe IncIusIon oI LIese
sLudIes cunnoL be jusLIIIed.
SecondIy, und more ImporLunLIy, ..LIe ;LI, und IusL,
sLudy Is u mussIve coIorL sLudy coordInuLed by LIe
AmerIcun Cuncer SocIeLy oI neurIy zo,ooo men und
women - uImosL equuI In numbers Lo LIe oLIer 6 LrIuIs
puL LogeLIer. TIIs IuIIed Lo sIow u sIgnIIIcunL reIuLIon
beLween pussIve smokIng und Iung cuncer..
TIus LIe quesLIon wIeLIer pussIve smokIng cuuses Iung
cuncer depends on wIuL sorL oI evIdence Is LIe more
convIncIng: LIe 'neguLIve` resuILs oI Lwo mussIve sLudIes
oI dIIIerenL desIgn (LIe ARC`s cuse-conLroI und LIe
AmerIcun Cuncer SocIeLy`s coIorL sLudIes) or LIe
'posILIve` resuILs oI u meLu-unuIysIs wIose bIoIogIcuIIy
unwurrunLed IncIusIon oI muny smuII sLudIes Irom LIe
ur eusL conceuIs LIe ouLcome oI LIe AmerIcun Cuncer
SocIeLy`s coIorL sLudy. Any LIInkIng docLor wouId no
doubL pIump Ior LIe Iormer..TIere couId be no more
dumnIng verdIcL on LIe InLeIIecLuuI IuIseIoods
generuLed by conLemporury epIdemIoIogy und LIe
erroneous pubIIc IeuILI udvIce Lo wIIcI IL gIves rIse.
TIrougIouL LIIs dIscussIon, urgumenL Ius Iud Lo proceed on Lwo
IeveIs. TIe IIrsL concerns LIe ucLuuI requIremenLs oI cuusuI urgumenL us
consIdered In eurIIer cIupLers, und wIIcI sLundurd rIsk ussessmenL
procedures do noL meeL by orders oI mugnILude. TIe second concerns un
Preventive Medicine & Health Promotion
evuIuuLIon oI epIdemIoIogy`s reseurcI conducL In LIe uppIIcuLIon oI wIuL it
beIIeves Lo be proper proLocoI (I.e., sLundurd rIsk ussessmenL procedures).
Even LIougI IL wouId muke no dIIIerence uL uII Lo coIerenL cuusuI
urgumenL, wILIIn LIe epIdemIoIogIc Irumework LIere Is u poLenLIuI
conIoundIng IucLor concernIng Iung cuncer In nonsmokers LIuL sIouId
Iuve been uccommoduLed beIore uII eIse. n un eurIIer secLIon regurdIng
Iung cuncer und ucLIve smokers LIe probIem oI deLecLIon bIus wus u
crILIcuI concern. DeLecLIon bIus Is un even more crucIuI Issue regurdIng
ETS In LIuL Iung cuncer umong nonsmokers Is quILe smuII. Some members
oI LIe medIcuI esLubIIsImenL Iuve been pusIIng LIe ETS us u cuuse oI
dIseuse sLory Ior LIe beLLer purL oI u number oI decudes. L Is very
possIbIe LIuL meLusLusIzed Lumors (noL orIgInuLIng In LIe Iungs) In some
nonsmokers, known Lo Iuve been murrIed Lo u smoker, Iuve been IuIseIy
cIussIIIed us Iung cuncer. ConverseIy, Iung cuncer In nonsmokers known Lo
Iuve been murrIed Lo nonsmokers muy be IuIseIy cIussIIIed oLIerwIse.
ndependenL oI oLIer poLenLIuI IdenLIIIed or unIdenLIIIed conIounders, IL
wouId requIre onIy u smuII degree oI mIscIussIIIcuLIon In eILIer or boLI
dIrecLIons Lo eruse LIe LIny RR dIIIerence In quesLIon. L Is mosL
usLoundIng LIuL LIIs titcl Issue never enLered LIe reckonIng oI LIe EPA,
und Ius noL seemIngIy been ruIsed by unyone eIse, LIen or sInce; deLecLIon
bIus sIouId Iuve been LIe IIrsL poLenLIuI conIounder Lo be dIscounLed.
urLIermore, dIIIerences In specIIIc dIseuse morLuIILy beLween
exposedJnonexposed nonsmokers Ior uII-cuuse morLuIILy Ius noL been
provIded. L Is, LIereIore, noL possIbIe Lo scruLInIze proporLIonuI
dIIIerences In specIIIc dIseuse Ior LIe Lwo groups. ConcernIng Iung cuncer,
IL Is ImpossIbIe Lo dIscern wIeLIer eIevuLed RR Ior LIe exposed group
reIIecLs un Increused IncIdence oI LIe dIseuse, or Is produced by vurIuLIons
(uge specIIIc) In dIseuse onseL. AL mInImum, LIe ubsence oI LIIs
InIormuLIon IndIcuLes u Iuck oI LIorougIness In enquIry. WIen
consIderIng uII oI LIe numerous IuIIures oI EPA (1qq), IL reIIecLs u
LIorougIIy und dIsLurbIngIy IIuwed InvesLIguLIon.
A crILIcIsm oI EPA (1qq) LIuL LypIcuIIy Ius noL been mude Is
LIuL, Iowever reIevunL EPA seems Lo LIe ussIgnmenL oI ussessIng ETS
rIsk, reIIunce on IncIdence oI Iung cuncer In nonsmokIng spouses oI
smokersJnonsmokers, renders EPA, even II LIe orgunIzuLIon wus
IuncLIonIng properIy, sInguIurIy unquuIIIIed Ior LIe Lusk. n conducL
LypIcuI oI epIdemIoIogIc InvesLIguLIon, LIere Is LIe ussumpLIon oI
IomogeneILy oI nonsmokers Ior LIe smokIngJnonsmokIng spousuI
groups. n LIe currenL conLexL LIIs LrunsIuLes us murrIuge Lo smokersJ
nonsmokers by nonsmokers Is u rundom evenL. TIIs ussumpLIon Is
completel unLenubIe. Persons do noL murry on u rundom busIs. TIere
muy be numerous IucLors LIuL uILImuLeIy underIIe u person`s decIsIon us Lo
289
289
Rampant Antismoking Signifies Grave Danger
someLIIng. L LIen concIudes LIuL ETS musL cuuse wIuLever Iung-
dIseuse dIIIerences exIsL beLween smokers und nonsmokers. L musL be
reILeruLed LIuL LIIs Is noL scIenLIIIc dIscourse buL LIe rumbIIngs-on oI
IncompeLence und oLIer menLuI dysIuncLIon workIng Lo IIxed und deIuded
concIusIons. TIIs IeebIe urgumenLuLIon Is uIso compIeLeIy sIIenL us Lo wIy
smokers, wIo ure uIso exposed Lo ETS - possIbIy even more so LIun
nonsmokers, demonsLruLe u predomInunce oI curcInomu supposedIy
unreIuLed Lo ETS.
e unu (1qq8) noLes u number oI oLIer ImporLunL poInLs:
IrsLIy, ..18 oI LIe ; sLudIes |IncIuded In meLu-
unuIysIs - HucksIuw eL uI., 1qq;| cILed come Irom
CIInu, Jupun, or Hong Kong - counLrIes wIere LIe
epIdemIoIogy oI Iung cuncer Is dIIIerenL Irom LIuL In LIe
WesL (LIese counLrIes Iuve u reIuLIveIy IIgI IncIdence oI
udenocurcInomu umong women) und LIe sLrengLI oI LIe
cuusuLIve reIuLIon beLween smokIng und Iung cuncer Is
subsLunLIuIIy weuker. TIus LIe IncIusIon oI LIese
sLudIes cunnoL be jusLIIIed.
SecondIy, und more ImporLunLIy, ..LIe ;LI, und IusL,
sLudy Is u mussIve coIorL sLudy coordInuLed by LIe
AmerIcun Cuncer SocIeLy oI neurIy zo,ooo men und
women - uImosL equuI In numbers Lo LIe oLIer 6 LrIuIs
puL LogeLIer. TIIs IuIIed Lo sIow u sIgnIIIcunL reIuLIon
beLween pussIve smokIng und Iung cuncer..
TIus LIe quesLIon wIeLIer pussIve smokIng cuuses Iung
cuncer depends on wIuL sorL oI evIdence Is LIe more
convIncIng: LIe 'neguLIve` resuILs oI Lwo mussIve sLudIes
oI dIIIerenL desIgn (LIe ARC`s cuse-conLroI und LIe
AmerIcun Cuncer SocIeLy`s coIorL sLudIes) or LIe
'posILIve` resuILs oI u meLu-unuIysIs wIose bIoIogIcuIIy
unwurrunLed IncIusIon oI muny smuII sLudIes Irom LIe
ur eusL conceuIs LIe ouLcome oI LIe AmerIcun Cuncer
SocIeLy`s coIorL sLudy. Any LIInkIng docLor wouId no
doubL pIump Ior LIe Iormer..TIere couId be no more
dumnIng verdIcL on LIe InLeIIecLuuI IuIseIoods
generuLed by conLemporury epIdemIoIogy und LIe
erroneous pubIIc IeuILI udvIce Lo wIIcI IL gIves rIse.
TIrougIouL LIIs dIscussIon, urgumenL Ius Iud Lo proceed on Lwo
IeveIs. TIe IIrsL concerns LIe ucLuuI requIremenLs oI cuusuI urgumenL us
consIdered In eurIIer cIupLers, und wIIcI sLundurd rIsk ussessmenL
procedures do noL meeL by orders oI mugnILude. TIe second concerns un
Preventive Medicine & Health Promotion
evuIuuLIon oI epIdemIoIogy`s reseurcI conducL In LIe uppIIcuLIon oI wIuL it
beIIeves Lo be proper proLocoI (I.e., sLundurd rIsk ussessmenL procedures).
Even LIougI IL wouId muke no dIIIerence uL uII Lo coIerenL cuusuI
urgumenL, wILIIn LIe epIdemIoIogIc Irumework LIere Is u poLenLIuI
conIoundIng IucLor concernIng Iung cuncer In nonsmokers LIuL sIouId
Iuve been uccommoduLed beIore uII eIse. n un eurIIer secLIon regurdIng
Iung cuncer und ucLIve smokers LIe probIem oI deLecLIon bIus wus u
crILIcuI concern. DeLecLIon bIus Is un even more crucIuI Issue regurdIng
ETS In LIuL Iung cuncer umong nonsmokers Is quILe smuII. Some members
oI LIe medIcuI esLubIIsImenL Iuve been pusIIng LIe ETS us u cuuse oI
dIseuse sLory Ior LIe beLLer purL oI u number oI decudes. L Is very
possIbIe LIuL meLusLusIzed Lumors (noL orIgInuLIng In LIe Iungs) In some
nonsmokers, known Lo Iuve been murrIed Lo u smoker, Iuve been IuIseIy
cIussIIIed us Iung cuncer. ConverseIy, Iung cuncer In nonsmokers known Lo
Iuve been murrIed Lo nonsmokers muy be IuIseIy cIussIIIed oLIerwIse.
ndependenL oI oLIer poLenLIuI IdenLIIIed or unIdenLIIIed conIounders, IL
wouId requIre onIy u smuII degree oI mIscIussIIIcuLIon In eILIer or boLI
dIrecLIons Lo eruse LIe LIny RR dIIIerence In quesLIon. L Is mosL
usLoundIng LIuL LIIs titcl Issue never enLered LIe reckonIng oI LIe EPA,
und Ius noL seemIngIy been ruIsed by unyone eIse, LIen or sInce; deLecLIon
bIus sIouId Iuve been LIe IIrsL poLenLIuI conIounder Lo be dIscounLed.
urLIermore, dIIIerences In specIIIc dIseuse morLuIILy beLween
exposedJnonexposed nonsmokers Ior uII-cuuse morLuIILy Ius noL been
provIded. L Is, LIereIore, noL possIbIe Lo scruLInIze proporLIonuI
dIIIerences In specIIIc dIseuse Ior LIe Lwo groups. ConcernIng Iung cuncer,
IL Is ImpossIbIe Lo dIscern wIeLIer eIevuLed RR Ior LIe exposed group
reIIecLs un Increused IncIdence oI LIe dIseuse, or Is produced by vurIuLIons
(uge specIIIc) In dIseuse onseL. AL mInImum, LIe ubsence oI LIIs
InIormuLIon IndIcuLes u Iuck oI LIorougIness In enquIry. WIen
consIderIng uII oI LIe numerous IuIIures oI EPA (1qq), IL reIIecLs u
LIorougIIy und dIsLurbIngIy IIuwed InvesLIguLIon.
A crILIcIsm oI EPA (1qq) LIuL LypIcuIIy Ius noL been mude Is
LIuL, Iowever reIevunL EPA seems Lo LIe ussIgnmenL oI ussessIng ETS
rIsk, reIIunce on IncIdence oI Iung cuncer In nonsmokIng spouses oI
smokersJnonsmokers, renders EPA, even II LIe orgunIzuLIon wus
IuncLIonIng properIy, sInguIurIy unquuIIIIed Ior LIe Lusk. n conducL
LypIcuI oI epIdemIoIogIc InvesLIguLIon, LIere Is LIe ussumpLIon oI
IomogeneILy oI nonsmokers Ior LIe smokIngJnonsmokIng spousuI
groups. n LIe currenL conLexL LIIs LrunsIuLes us murrIuge Lo smokersJ
nonsmokers by nonsmokers Is u rundom evenL. TIIs ussumpLIon Is
completel unLenubIe. Persons do noL murry on u rundom busIs. TIere
muy be numerous IucLors LIuL uILImuLeIy underIIe u person`s decIsIon us Lo
290
290
Rampant Antismoking Signifies Grave Danger
wIom LIey wIII murry. WIeLIer u poLenLIuI purLner smokes muy Iuve
reIuLIve weIgIL und LIe smokIng ILseII muy be cross-correIuLed wILI
numerous oLIer psycIoIogIcuI, psycIosocIuI und dIeLury IucLors LIuL
purLners sIureJdo noL sIure, wIIcI ure In Lurn cross-correIuLed wILI LIe
Lype und exLenL oI ucLIvILIesJexposures LIuL eILIer or boLI purLners enguge
In. RegurdIess oI wIeLIer LIese IucLors cun be IdenLIIIed or noL, IL cun be
undersLood, c priori, LIuL LIe groups In quesLIon ure noL Iomogenous
eILIer beLween or wILIIn groups. TIereIore dIIIerenL sLudIes usIng LIIs
sume or sImIIur IucLors (nonsmoker spousuI exposure Lo ETS), LIuL
produce vurIubIe RR dIIIerences und exLremeIy Iow predIcLIve sLrengLI oI
ETS Ior wIuLever dIseuse Is under InvesLIguLIon, cun be LuppIng wILI IIgI
probubIIILy InLo sImIIur or dIIIerenL subroup dIIIerences LIuL Iuve
noLIIng Lo do wILI LIe possIbIe eIIecLs oI exposure Lo ETS uL uII. or
exumpIe, rIsk-uverse nonsmoker IemuIes muy be Iur more IIkeIy Lo be
murrIed Lo nonsmokers. L musL be kepL In mInd LIuL IL requIres onIy very
smuII subgroup dIIIerences beLween overuII groups Lo generuLe u
sLuLIsLIcuIIy sIgnIIIcunL RR dIIIerence. TIIs Is uIso crILIcuI In consIderIng
exposure Lo ETS us u poLenLIuI LrIgger or wIeLIer RR dIIIerences ure
LuppIng InLo oLIer subgroup dIIIerences uILogeLIer. TIe use oI LIe IucLor
oI nonsmoker spousuI exposure Lo ETS opens up u Pundoru`s Box oI
muILIdImensIonuI IucLors LIuL uny Iorm oI muLerIuIIsm Is compIeLeIy III-
equIpped Lo uddress: TIe cIrcumsLunce Is ucLuuIIy ubsurd. TIe sume cun
be suId concernIng wIere u person evenLuuIIy works - wIere u person
uILImuLeIy cIooses Lo work Is noL u rundom ussIgnmenL.
TIe Entironmentcl ProLecLIon Agency Is, by deIInILIon,
muLerIuIIsL und exLernuIIsL In dIsposILIon; IL wIII onIy seek Ior exLernuI und
reducLIonIsL expIunuLIons Ior evenLs. As sucI, noL onIy does IL Iuve no
quuIIIIcuLIon Lo ussess LIe nuLure und sLrucLure oI purLIcuIur group
membersIIp (especIuIIy psycIoIogIcuI und psycIosocIuI IucLors) und Iow
or LIuL LIese muy be munIIesLed In RR dIIIerences, LIe EPA cunnoL even
IuLIom LIIs possIbIIILy. or exumpIe, LIe SAB LIuL revIewed LIe EPA
druILs on ETS wus composed enLIreIy oI medIcuIIy or envIronmenLuIIy
LruIned personneI - one member (J.E. Woods, Jr.) wus u proIessor oI
buIIdIng consLrucLIon; LIe revIew puneI dId noL IncIude even one non-
reducLIonIsL psycIoIogIsL, or psycIIuLrIsL or socIuI psycIoIogIsL. TIIs
muLerIuIIsL (exLernuIIsL) bIus Is evIdenL LIrougIouL LIe EPA reporL In LIuL
no reIerence Is mude uL uny poInL Lo uny reIevunL psycIoIogIcuI und
psycIosocIuI consIderuLIons.
TIe onIy reusonubIe concIusIon LIuL cun be druwn Irom LIe
uvuIIubIe evIdence Is LIuL ETS Is deIInILIveIy disconjirmed us u prImury
cuuse oI Iung cuncer In exposed nonsmokers; LIe dIseuse Is not
ussocIuLed wILI over qq.q% oI LIe overuII LurgeL-group In quesLIon ubove u
Preventive Medicine & Health Promotion
buseIIne. urLIermore, consIderIng LIuL LIe Iorm oI Iung cuncer In
nonsmokers Is oI u dIIIerenL Lype Lo LIuL Ior smokers, LIuL LIere ure very
consIderubIe probIemsJInuccurucIes ussocIuLed wILI meLu-unuIysIs, LIuL
LIere ure poLenLIuI probIemsJInuccurucIes InvoIved In LIe quesLIonnuIre
meLIod oI meusurIng ETS exposure, und LIuL LIere ure poLenLIuIIy
numerous subgroup dIvIsIons (wILIIn und beLween groups) LIuL cun
produce sLuLIsLIcuIIy sIgnIIIcunL RR dIIIerences IndependenL oI ETS
exposure, IL cun onIy be concIuded LIuL ETS cunnoL even be consIdered us
u poLenLIuI LrIgger Ior endogenous ubnormuIILy. TIe IIndIngs oI RR
dIIIerences ure ucudemIcuIIy InLeresLIng buL unswer no subsLunLIve
ueLIoIogIcuI or cuusuI quesLIons - und by u very Iong wuy.
Beyond LIe uIreudy scunduIous bIus LIuL drove LIe EPA
InvesLIguLIon, LIe sILuuLIon Is LruIy un uppuIIIng one wIere u IucLor LIuL
Ius un essenLIuIIy-zero predIcLIve sLrengLI Ior Iung cuncer, I.e., bureIy
regIsLerIng on LIe condILIonuI probubIIILy scuIe, Is desIgnuLed us u Group
A curcInogen (u prImury cuuse oI Iung cuncer) us Is LIe cuse In EPA
(1qq). Worse sLIII, IL Is cIuImed LIuL LIere Is no suIe IeveI oI exposure
Ior cnone. TIIs reIIecLs u sLundurd mugIc powers urgumenL
(supersLILIon) consIdered In un eurIIer cIupLer, I.e., Improper sLruddIIng
oI, or IIIp-IIoppIng beLween, deLermInIsLIc und probubIIIsLIc Irumeworks.
n LIIs cuse ETS Is even more mugIcuIIy endowed LIun MS, I.e., over-
InLerpreLuLIon In LIe exLreme. TIe enLIre EPA uppruIsuI udds nothin Lo
un undersLundIng oI ueLIoIogIcuI IucLors In Iung cuncer, buL onIy beurs
LesLImony Lo LIe IncompeLence, ImmuLurILy, superIIcIuIILy oI LIe menLuIILy
LIuL generuLed IL.
MenLIon musL uIso be mude LIuL LIIs operuLIng uL LIe boLLom or
wrong-end oI LIe condILIonuI-probubIIILy scuIe Is InLenLIonuI. n uddILIon
Lo RR, EPA Ius oLIer rIsk-ussessmenL upproucIes (e.g., UnIL RIsk
EsLImuLe) sucI LIuL |u| rIsk IeveI oI one In u mIIIIon ImpIIes u IIkeIIIood
LIuL up Lo one person ouL oI one mIIIIon equuIIy exposed peopIe wouId
conLrucL cuncer II exposed conLInuousIy (zq Iours per duy) Lo LIe specIIIc
concenLruLIon over ;o yeurs (un ussumed IIIeLIme) - |8 Iours per duy over
qo yeurs Ior workers| (uL www.epu.gov.JLLnJuLwJnuLuJgIoss1.ILmI).
One In u mIIIIon ubove u buseIIne Is uII LIuL Is requIred Ior
correcLIve ucLIon Lo be wurrunLed. TIe muLerIuIIsL superIIcIuIILy oI EPA
reusonIng, urmed wILI uII munner oI osLenLuLIous sLuLIsLIcuI modeIIng,
ucLuuIIy beIIeves LIuL IL cun IdenLIIy LIe cuuse oI dIseuse Ior one In u
mIIIIon wIen LIe sume exLernuI IucLor Is noL ussocIuLed wILI LIe dIseuse
Ior qqq,qqq. TIIs Is exLruordInurIIy perverse: L Is conLrury Lo LIe enLIre
scIenLIIIc enLerprIse LIuL goes Lo LIe very IeurL oI wIuL Is Lo be undersLood
by LIe Ideu oI cuuse - purLIcuIurIy In u deLermInIsLIc Irumework.
TIe very cIrcumsLunce (one In u mIIIIon ussocIuLIon wILI dIseuse
291
291
Rampant Antismoking Signifies Grave Danger
wIom LIey wIII murry. WIeLIer u poLenLIuI purLner smokes muy Iuve
reIuLIve weIgIL und LIe smokIng ILseII muy be cross-correIuLed wILI
numerous oLIer psycIoIogIcuI, psycIosocIuI und dIeLury IucLors LIuL
purLners sIureJdo noL sIure, wIIcI ure In Lurn cross-correIuLed wILI LIe
Lype und exLenL oI ucLIvILIesJexposures LIuL eILIer or boLI purLners enguge
In. RegurdIess oI wIeLIer LIese IucLors cun be IdenLIIIed or noL, IL cun be
undersLood, c priori, LIuL LIe groups In quesLIon ure noL Iomogenous
eILIer beLween or wILIIn groups. TIereIore dIIIerenL sLudIes usIng LIIs
sume or sImIIur IucLors (nonsmoker spousuI exposure Lo ETS), LIuL
produce vurIubIe RR dIIIerences und exLremeIy Iow predIcLIve sLrengLI oI
ETS Ior wIuLever dIseuse Is under InvesLIguLIon, cun be LuppIng wILI IIgI
probubIIILy InLo sImIIur or dIIIerenL subroup dIIIerences LIuL Iuve
noLIIng Lo do wILI LIe possIbIe eIIecLs oI exposure Lo ETS uL uII. or
exumpIe, rIsk-uverse nonsmoker IemuIes muy be Iur more IIkeIy Lo be
murrIed Lo nonsmokers. L musL be kepL In mInd LIuL IL requIres onIy very
smuII subgroup dIIIerences beLween overuII groups Lo generuLe u
sLuLIsLIcuIIy sIgnIIIcunL RR dIIIerence. TIIs Is uIso crILIcuI In consIderIng
exposure Lo ETS us u poLenLIuI LrIgger or wIeLIer RR dIIIerences ure
LuppIng InLo oLIer subgroup dIIIerences uILogeLIer. TIe use oI LIe IucLor
oI nonsmoker spousuI exposure Lo ETS opens up u Pundoru`s Box oI
muILIdImensIonuI IucLors LIuL uny Iorm oI muLerIuIIsm Is compIeLeIy III-
equIpped Lo uddress: TIe cIrcumsLunce Is ucLuuIIy ubsurd. TIe sume cun
be suId concernIng wIere u person evenLuuIIy works - wIere u person
uILImuLeIy cIooses Lo work Is noL u rundom ussIgnmenL.
TIe Entironmentcl ProLecLIon Agency Is, by deIInILIon,
muLerIuIIsL und exLernuIIsL In dIsposILIon; IL wIII onIy seek Ior exLernuI und
reducLIonIsL expIunuLIons Ior evenLs. As sucI, noL onIy does IL Iuve no
quuIIIIcuLIon Lo ussess LIe nuLure und sLrucLure oI purLIcuIur group
membersIIp (especIuIIy psycIoIogIcuI und psycIosocIuI IucLors) und Iow
or LIuL LIese muy be munIIesLed In RR dIIIerences, LIe EPA cunnoL even
IuLIom LIIs possIbIIILy. or exumpIe, LIe SAB LIuL revIewed LIe EPA
druILs on ETS wus composed enLIreIy oI medIcuIIy or envIronmenLuIIy
LruIned personneI - one member (J.E. Woods, Jr.) wus u proIessor oI
buIIdIng consLrucLIon; LIe revIew puneI dId noL IncIude even one non-
reducLIonIsL psycIoIogIsL, or psycIIuLrIsL or socIuI psycIoIogIsL. TIIs
muLerIuIIsL (exLernuIIsL) bIus Is evIdenL LIrougIouL LIe EPA reporL In LIuL
no reIerence Is mude uL uny poInL Lo uny reIevunL psycIoIogIcuI und
psycIosocIuI consIderuLIons.
TIe onIy reusonubIe concIusIon LIuL cun be druwn Irom LIe
uvuIIubIe evIdence Is LIuL ETS Is deIInILIveIy disconjirmed us u prImury
cuuse oI Iung cuncer In exposed nonsmokers; LIe dIseuse Is not
ussocIuLed wILI over qq.q% oI LIe overuII LurgeL-group In quesLIon ubove u
Preventive Medicine & Health Promotion
buseIIne. urLIermore, consIderIng LIuL LIe Iorm oI Iung cuncer In
nonsmokers Is oI u dIIIerenL Lype Lo LIuL Ior smokers, LIuL LIere ure very
consIderubIe probIemsJInuccurucIes ussocIuLed wILI meLu-unuIysIs, LIuL
LIere ure poLenLIuI probIemsJInuccurucIes InvoIved In LIe quesLIonnuIre
meLIod oI meusurIng ETS exposure, und LIuL LIere ure poLenLIuIIy
numerous subgroup dIvIsIons (wILIIn und beLween groups) LIuL cun
produce sLuLIsLIcuIIy sIgnIIIcunL RR dIIIerences IndependenL oI ETS
exposure, IL cun onIy be concIuded LIuL ETS cunnoL even be consIdered us
u poLenLIuI LrIgger Ior endogenous ubnormuIILy. TIe IIndIngs oI RR
dIIIerences ure ucudemIcuIIy InLeresLIng buL unswer no subsLunLIve
ueLIoIogIcuI or cuusuI quesLIons - und by u very Iong wuy.
Beyond LIe uIreudy scunduIous bIus LIuL drove LIe EPA
InvesLIguLIon, LIe sILuuLIon Is LruIy un uppuIIIng one wIere u IucLor LIuL
Ius un essenLIuIIy-zero predIcLIve sLrengLI Ior Iung cuncer, I.e., bureIy
regIsLerIng on LIe condILIonuI probubIIILy scuIe, Is desIgnuLed us u Group
A curcInogen (u prImury cuuse oI Iung cuncer) us Is LIe cuse In EPA
(1qq). Worse sLIII, IL Is cIuImed LIuL LIere Is no suIe IeveI oI exposure
Ior cnone. TIIs reIIecLs u sLundurd mugIc powers urgumenL
(supersLILIon) consIdered In un eurIIer cIupLer, I.e., Improper sLruddIIng
oI, or IIIp-IIoppIng beLween, deLermInIsLIc und probubIIIsLIc Irumeworks.
n LIIs cuse ETS Is even more mugIcuIIy endowed LIun MS, I.e., over-
InLerpreLuLIon In LIe exLreme. TIe enLIre EPA uppruIsuI udds nothin Lo
un undersLundIng oI ueLIoIogIcuI IucLors In Iung cuncer, buL onIy beurs
LesLImony Lo LIe IncompeLence, ImmuLurILy, superIIcIuIILy oI LIe menLuIILy
LIuL generuLed IL.
MenLIon musL uIso be mude LIuL LIIs operuLIng uL LIe boLLom or
wrong-end oI LIe condILIonuI-probubIIILy scuIe Is InLenLIonuI. n uddILIon
Lo RR, EPA Ius oLIer rIsk-ussessmenL upproucIes (e.g., UnIL RIsk
EsLImuLe) sucI LIuL |u| rIsk IeveI oI one In u mIIIIon ImpIIes u IIkeIIIood
LIuL up Lo one person ouL oI one mIIIIon equuIIy exposed peopIe wouId
conLrucL cuncer II exposed conLInuousIy (zq Iours per duy) Lo LIe specIIIc
concenLruLIon over ;o yeurs (un ussumed IIIeLIme) - |8 Iours per duy over
qo yeurs Ior workers| (uL www.epu.gov.JLLnJuLwJnuLuJgIoss1.ILmI).
One In u mIIIIon ubove u buseIIne Is uII LIuL Is requIred Ior
correcLIve ucLIon Lo be wurrunLed. TIe muLerIuIIsL superIIcIuIILy oI EPA
reusonIng, urmed wILI uII munner oI osLenLuLIous sLuLIsLIcuI modeIIng,
ucLuuIIy beIIeves LIuL IL cun IdenLIIy LIe cuuse oI dIseuse Ior one In u
mIIIIon wIen LIe sume exLernuI IucLor Is noL ussocIuLed wILI LIe dIseuse
Ior qqq,qqq. TIIs Is exLruordInurIIy perverse: L Is conLrury Lo LIe enLIre
scIenLIIIc enLerprIse LIuL goes Lo LIe very IeurL oI wIuL Is Lo be undersLood
by LIe Ideu oI cuuse - purLIcuIurIy In u deLermInIsLIc Irumework.
TIe very cIrcumsLunce (one In u mIIIIon ussocIuLIon wILI dIseuse
292
292
Rampant Antismoking Signifies Grave Danger
ubove u buseIIne) mecns LIuL LIe exLernuI IucLor In quesLIon Ius no
generuI propensILy Lo cuuse LIe dIseuse In quesLIon. TIe enLIre Ideu oI u
cuuse Is LIuL IL Ius u generuI propensILy Lo generuLe un eIIecL. AnyLIIng
eIse wIII ImpIIcuLe mugIc powers urgumenLs. L wus consIdered In
CIupLer One LIuL In LIe IdeuI cuse LIere Is u 1oo% ussocIuLIon beLween u
purLIcuIur exogenous IucLor(s) und u purLIcuIur consequenL. L wus uIso
consIdered LIuL LIere muy be bIockuges Lo u generuI eIIecL, sucI LIuL Iur
Iower LIun u 1oo% ussocIuLIon (e.g., 6o%) wIII suIIIce Ior cuusuI urgumenL.
I LIere ure qqq,qqq demonsLruLIng no dIseuse ussocIuLed wILI consLunL
und specIIIc exposure, LIen LIIs Is sureIy LIe normuLIve runge oI
IuncLIonIng. TIe IIgIesL sLuLus LIuL cun be uccorded Lo un exLernuIILy
ussocIuLed wILI dIseuse Ior u non-normuLIve runge Is us u LrIgger. n
sucI u cuse, LIe munIIesLed dIseuse reIIecLs endogenous ubnormuIILy und
noL LIe cuusuI propensILIes oI LIe exLernuIILy. n LIe InsLunce oI one-In-u-
mIIIIon dIseuse ussocIuLIon, LIIs wouId represenL un InIInILesImuIIy-rure
ubnormuI sLuLe. L Is quesLIonubIe wIeLIer sucI ubnormuI sLuLes ucLuuIIy
exIsL. AL sucI Iow IeveIs oI probubIIILy, IL Is wIsesL Lo dIsregurd LIe
sLuLIsLIcuI ussocIuLIon us even IndIcuLIng u LrIgger sLuLus Ior un exLernuIILy.
Remember LIuL LIe gouI oI scIence Is Lo pInpoInL LIe cuusuI unLecedenL(s)
oI u consequenL und reIIecLed In u IIgI IeveI oI predIcLIve sLrengLI. n LIe
one-In-u-mIIIIon exumpIe, usIng u purLIcuIur exogenous IucLor us u
predIcLor oI dIseuse, Ior every cuncer correcLIy predIcLed, IL wIII be wrong
qqq,qqq LImes. TIe use oI sucI un upproucI Ior cuusuI urgumenL Is noL
scIence buL sLuLIsLIcs mudness (bIuck-box, doubIe bIuck-box reusonIng).
One-In-u-mIIIIon Is onIy u sLuLIsLIcuI proposILIon. As soon us LIe Ideu oI
cuuse Is Invoked, LIe Irumework Is sIIILed Irom u probubIIIsLIc Lo u
deLermInIsLIc one, und LIe very sLuLIsLIcs beIng reIerred Lo deIInILIveIy
dIsconIIrm prImury cuusuI urgumenL. TIIs Is LIe IIIp-IIop mode oI
urgumenL descrIbed In CIupLer z. AL sucI IncredIbIy Iow predIcLIve IeveIs,
IL Is ImpossIbIe Lo even jusLIIy u LrIgger urgumenL. TIe resuIL oI LIIs
upproucI Is supersLILIous or mugIc powers beIIeIs ubouL exLernuIILIes:
TIIs deIInquenL conducL, wIen promoLed under LIe guIse oI scIenLIIIc
uuLIorILy, Is ImmoruI und un ussuuIL on menLuI und socIuI IeuILI. L Is u
preLenLIous, eIuboruLe Iorm oI post hoc ero propter hoc urgumenL; LIe
cIoser LIe ussocIuLIon beLween un exLernuIILy und dIseuse Is Lo zero, LIe
more perverse Is LIe urgumenL.
TIIs Is u crILIcuI probIem In LIuL LIe EPA upproucI (uIso
epIdemIoIogy) uncIors pubIIc poIIcy Lo IIgIIy uLypIcuI ussocIuLIons,
wIereus pubIIc poIIcy sIouId be uncIored Lo LIe normuLIve (LypIcuI) runge
oI IuncLIonIng. TIIs Ius very ImporLunL menLuI und socIuI IeuILI
consequences, und Is ImmoruI. or exumpIe, EPA enquIry mIgIL IndIcuLe
LIe conLroI oI eIgIL purLIcuIur exposures IndIcuLIng greuLer LIun or equuI
Preventive Medicine & Health Promotion
Lo one In u mIIIIon ussocIuLIon wILI u dIseuse ouLcome. AII oI LIese ure
IIgIIy uLypIcuI. TIIs resuILs In LIe mujorILy oI LIe popuIuLIon (normuLIve
runge), LIuL Iuve demonsLruLed no ussocIuLIon wILI LIe dIseuse ouLcomes,
uLLempLIng Lo IuncLIon noL onIy us II LIey ure sIck (curryIng ubnormuI
condILIon) buL us II LIey ure muILIpIy sIck. I IeIL Lo medIco-muLerIuIIsm, IL
wIII munuIucLure greuLer socIeLy InLo un exLensIon oI LIe IospILuI, I.e., u
IuboruLory or u pudded ceII, enLIreIy obIIvIous Lo LIe deLrImenLuI menLuI,
socIuI und moruI rumIIIcuLIons oI undue resLruInL.
L musL be remembered LIuL, uL Iow IeveIs oI correIuLIon, II one
Iud LIe LIme, resources und IncIInuLIon, LIere muy be numerous
correIuLed und cross-correIuLed IucLors, uII oI LIem essenLIuIIy useIess In
predIcLIng un ouLcome. MedIco-muLerIuIIsm Iocuses on onIy u IundIuI oI
IucLors (e.g., smokIng, ETS), uLLerIy obIIvIous Lo LIeIr generuI sLuLIsLIcuI
conLexL. GIven LIuL IL does noL compreIend LIe requIremenL oI expIuInIng
IuIIure oI un ouLcome In LIe presence oI un unLecedenL, medIco-
muLerIuIIsm sImpIy buIIds u pIuusIbIe sLory-IIne LIuL supposedIy
expIuIns Iow LIese ouL-oI-conLexL und poor predIcLors cuuse un
uLypIcuI ouLcome.
A number oI revIews (e.g., GorI, 1qqq; BIIIey, 1qq; Huber eL uI.,
1qq; eInsLeIn, 1qqz) dId IIgIIIgIL muny oI LIe meLIodoIogIcuI und
LIeoreLIcuI IIuws oI LIe EPA reporL onIy InsoIur LIuL purLIcuIur conducL IeII
sIorL oI rIsk ussessmenL sLundurds, I.e., LIe EPA conducL represenLs
cIeuLIng wILIIn LIe sLundurd Irumework. However, us Ius been urgued
LIrougIouL, epIdemIoIogIc rIsk ussessmenL sLundurds uIreudy reIIecL u
greuL scIenLIIIc und urgumenLuLIve cIeuLIng. Here, LIe EPA conducL
represenLs u jurther cIeuLIng wILIIn LIe cIeuLIng. None oI LIe
munIpuIuLIon, IncIudIng uILerIng oI LIe conIIdence InLervuI, muke one IoLu
oI dIIIerence Lo sound cuusuI urgumenL. TIe enLIre cIrcumsLunce
represenLs u IorwurdIng oI conLorLed IdeoIogy supporLed by severeIy
over-InLerpreLed sLuLIsLIcuI nonsense. TIe EPA, In ILs evuIuuLIon oI ETS,
und us one uspecL oI u Ionger und Iurger IIsLory oI bIus, wus workIng Lo u
concIusIon (jeLLIsonIng oI objecLIvILy) - u Ieresy In scIenLIIIc enquIry. As
wIII be consIdered sIorLIy, LIe more mugIcuIIy-dIsposed ure LIe cIuIms,
I.e., LIe more exLreme Is LIe over-InLerpreLuLIon, LIe more psycIoIogIcuIIy
und socIuIIy devusLuLIng ure LIe correcLIve pubIIc prescrIpLIonsJ
proscrIpLIons LIuL LIe sume conLorLed menLuIILy LIen produces.
(.(.( ETS cnd Non-Ccncer Respirctor Ailments in
Children
AL LIe SAB IeurIng oI LIe IIrsL ETS rIsk-ussessmenL druIL In IuLe-
1qqo, no presenLuLIons were permILLed on LIe rIsk ussessmenL cIupLer
293
293
Rampant Antismoking Signifies Grave Danger
ubove u buseIIne) mecns LIuL LIe exLernuI IucLor In quesLIon Ius no
generuI propensILy Lo cuuse LIe dIseuse In quesLIon. TIe enLIre Ideu oI u
cuuse Is LIuL IL Ius u generuI propensILy Lo generuLe un eIIecL. AnyLIIng
eIse wIII ImpIIcuLe mugIc powers urgumenLs. L wus consIdered In
CIupLer One LIuL In LIe IdeuI cuse LIere Is u 1oo% ussocIuLIon beLween u
purLIcuIur exogenous IucLor(s) und u purLIcuIur consequenL. L wus uIso
consIdered LIuL LIere muy be bIockuges Lo u generuI eIIecL, sucI LIuL Iur
Iower LIun u 1oo% ussocIuLIon (e.g., 6o%) wIII suIIIce Ior cuusuI urgumenL.
I LIere ure qqq,qqq demonsLruLIng no dIseuse ussocIuLed wILI consLunL
und specIIIc exposure, LIen LIIs Is sureIy LIe normuLIve runge oI
IuncLIonIng. TIe IIgIesL sLuLus LIuL cun be uccorded Lo un exLernuIILy
ussocIuLed wILI dIseuse Ior u non-normuLIve runge Is us u LrIgger. n
sucI u cuse, LIe munIIesLed dIseuse reIIecLs endogenous ubnormuIILy und
noL LIe cuusuI propensILIes oI LIe exLernuIILy. n LIe InsLunce oI one-In-u-
mIIIIon dIseuse ussocIuLIon, LIIs wouId represenL un InIInILesImuIIy-rure
ubnormuI sLuLe. L Is quesLIonubIe wIeLIer sucI ubnormuI sLuLes ucLuuIIy
exIsL. AL sucI Iow IeveIs oI probubIIILy, IL Is wIsesL Lo dIsregurd LIe
sLuLIsLIcuI ussocIuLIon us even IndIcuLIng u LrIgger sLuLus Ior un exLernuIILy.
Remember LIuL LIe gouI oI scIence Is Lo pInpoInL LIe cuusuI unLecedenL(s)
oI u consequenL und reIIecLed In u IIgI IeveI oI predIcLIve sLrengLI. n LIe
one-In-u-mIIIIon exumpIe, usIng u purLIcuIur exogenous IucLor us u
predIcLor oI dIseuse, Ior every cuncer correcLIy predIcLed, IL wIII be wrong
qqq,qqq LImes. TIe use oI sucI un upproucI Ior cuusuI urgumenL Is noL
scIence buL sLuLIsLIcs mudness (bIuck-box, doubIe bIuck-box reusonIng).
One-In-u-mIIIIon Is onIy u sLuLIsLIcuI proposILIon. As soon us LIe Ideu oI
cuuse Is Invoked, LIe Irumework Is sIIILed Irom u probubIIIsLIc Lo u
deLermInIsLIc one, und LIe very sLuLIsLIcs beIng reIerred Lo deIInILIveIy
dIsconIIrm prImury cuusuI urgumenL. TIIs Is LIe IIIp-IIop mode oI
urgumenL descrIbed In CIupLer z. AL sucI IncredIbIy Iow predIcLIve IeveIs,
IL Is ImpossIbIe Lo even jusLIIy u LrIgger urgumenL. TIe resuIL oI LIIs
upproucI Is supersLILIous or mugIc powers beIIeIs ubouL exLernuIILIes:
TIIs deIInquenL conducL, wIen promoLed under LIe guIse oI scIenLIIIc
uuLIorILy, Is ImmoruI und un ussuuIL on menLuI und socIuI IeuILI. L Is u
preLenLIous, eIuboruLe Iorm oI post hoc ero propter hoc urgumenL; LIe
cIoser LIe ussocIuLIon beLween un exLernuIILy und dIseuse Is Lo zero, LIe
more perverse Is LIe urgumenL.
TIIs Is u crILIcuI probIem In LIuL LIe EPA upproucI (uIso
epIdemIoIogy) uncIors pubIIc poIIcy Lo IIgIIy uLypIcuI ussocIuLIons,
wIereus pubIIc poIIcy sIouId be uncIored Lo LIe normuLIve (LypIcuI) runge
oI IuncLIonIng. TIIs Ius very ImporLunL menLuI und socIuI IeuILI
consequences, und Is ImmoruI. or exumpIe, EPA enquIry mIgIL IndIcuLe
LIe conLroI oI eIgIL purLIcuIur exposures IndIcuLIng greuLer LIun or equuI
Preventive Medicine & Health Promotion
Lo one In u mIIIIon ussocIuLIon wILI u dIseuse ouLcome. AII oI LIese ure
IIgIIy uLypIcuI. TIIs resuILs In LIe mujorILy oI LIe popuIuLIon (normuLIve
runge), LIuL Iuve demonsLruLed no ussocIuLIon wILI LIe dIseuse ouLcomes,
uLLempLIng Lo IuncLIon noL onIy us II LIey ure sIck (curryIng ubnormuI
condILIon) buL us II LIey ure muILIpIy sIck. I IeIL Lo medIco-muLerIuIIsm, IL
wIII munuIucLure greuLer socIeLy InLo un exLensIon oI LIe IospILuI, I.e., u
IuboruLory or u pudded ceII, enLIreIy obIIvIous Lo LIe deLrImenLuI menLuI,
socIuI und moruI rumIIIcuLIons oI undue resLruInL.
L musL be remembered LIuL, uL Iow IeveIs oI correIuLIon, II one
Iud LIe LIme, resources und IncIInuLIon, LIere muy be numerous
correIuLed und cross-correIuLed IucLors, uII oI LIem essenLIuIIy useIess In
predIcLIng un ouLcome. MedIco-muLerIuIIsm Iocuses on onIy u IundIuI oI
IucLors (e.g., smokIng, ETS), uLLerIy obIIvIous Lo LIeIr generuI sLuLIsLIcuI
conLexL. GIven LIuL IL does noL compreIend LIe requIremenL oI expIuInIng
IuIIure oI un ouLcome In LIe presence oI un unLecedenL, medIco-
muLerIuIIsm sImpIy buIIds u pIuusIbIe sLory-IIne LIuL supposedIy
expIuIns Iow LIese ouL-oI-conLexL und poor predIcLors cuuse un
uLypIcuI ouLcome.
A number oI revIews (e.g., GorI, 1qqq; BIIIey, 1qq; Huber eL uI.,
1qq; eInsLeIn, 1qqz) dId IIgIIIgIL muny oI LIe meLIodoIogIcuI und
LIeoreLIcuI IIuws oI LIe EPA reporL onIy InsoIur LIuL purLIcuIur conducL IeII
sIorL oI rIsk ussessmenL sLundurds, I.e., LIe EPA conducL represenLs
cIeuLIng wILIIn LIe sLundurd Irumework. However, us Ius been urgued
LIrougIouL, epIdemIoIogIc rIsk ussessmenL sLundurds uIreudy reIIecL u
greuL scIenLIIIc und urgumenLuLIve cIeuLIng. Here, LIe EPA conducL
represenLs u jurther cIeuLIng wILIIn LIe cIeuLIng. None oI LIe
munIpuIuLIon, IncIudIng uILerIng oI LIe conIIdence InLervuI, muke one IoLu
oI dIIIerence Lo sound cuusuI urgumenL. TIe enLIre cIrcumsLunce
represenLs u IorwurdIng oI conLorLed IdeoIogy supporLed by severeIy
over-InLerpreLed sLuLIsLIcuI nonsense. TIe EPA, In ILs evuIuuLIon oI ETS,
und us one uspecL oI u Ionger und Iurger IIsLory oI bIus, wus workIng Lo u
concIusIon (jeLLIsonIng oI objecLIvILy) - u Ieresy In scIenLIIIc enquIry. As
wIII be consIdered sIorLIy, LIe more mugIcuIIy-dIsposed ure LIe cIuIms,
I.e., LIe more exLreme Is LIe over-InLerpreLuLIon, LIe more psycIoIogIcuIIy
und socIuIIy devusLuLIng ure LIe correcLIve pubIIc prescrIpLIonsJ
proscrIpLIons LIuL LIe sume conLorLed menLuIILy LIen produces.
(.(.( ETS cnd Non-Ccncer Respirctor Ailments in
Children
AL LIe SAB IeurIng oI LIe IIrsL ETS rIsk-ussessmenL druIL In IuLe-
1qqo, no presenLuLIons were permILLed on LIe rIsk ussessmenL cIupLer
294
294
Rampant Antismoking Signifies Grave Danger
deuIIng wILI LIe respIruLory IeuILI oI cIIIdren. WILIouL provIdIng uny
opporLunILy Ior pubIIc commenL, EPA Iud LrunsmILLed Lo LIe SAB u new
'druIL reporL wILI u deLuIIed descrIpLIon und unuIysIs oI z6 sLudIes` on
cIIIdIood exposure Lo ETS. NoL surprIsIngIy, LIe documenL IuIIed Lo
dIscuss uny sLudIes LIuL dId noL supporL EPA`s preIerred concIusIons. By
InserLIng IL uL LIe IusL momenL und prevenLIng pubIIc dIscussIon oI LIe
LopIc uL LIe IeurIng, meunIngIuI pubIIc scruLIny oI LIe Agency`s
concIusIon wus excIuded (BIIIey, 1qq, p. 1;); TIe second druIL rIsk
ussessmenL unnounced LIuL ETS exposure Iud been esLubIIsIed us u cuuse
oI respIruLory dIseuse In cIIIdren. TIe IIrsL druIL rIsk ussessmenL Iud
sLuLed LIuL LIe duLu were Loo InconcIusIve Lo druw un InIerence oI
cuusuLIon. No new InIormuLIon becume uvuIIubIe beLween LIe reIeuse oI
LIe IIrsL und second druIL rIsk ussessmenL Lo supporL LIIs sIIIL In LIe
Agency`s posILIon. AppurenLIy, EPA sLuII Look LIe SAB`s eurIIer suggesLIon
LIuL IL consIder 'sLrengLIenIng` LIe reporL`s concIusIons concernIng
cIIIdren us u IIcense Lo sensuLIonuIIze IurLIer LIe Agency`s cIuIms ubouL
ETS. (BIIIey, 1qq, p. 1q)
TIe use oI cIIIdren`s IeuILI Lo promoLe IdeoIogIcuI ugendu Ius
become very IusIIonubIe In LIe 1qqo`s. umenLo (1qqq) suggesLs LIuL LIe
word Ius been ouL Ior LIe IusL Iew yeurs In WusIIngLon: I you wunL your
propugundu Lo peneLruLe, your bIII Lo puss, your speecI Lo be noLed on LIe
evenIng news, IInd some wuy by Iook or by crook Lo LIe IL Lo cIIIdren. TIe
EPA wus cerLuInIy weII uwure, und possIbIy LIe currenL LrendseLLer, oI LIe
promoLIonuI opporLunILIes uIIorded by LyIng unLIsmokIng Lo cIIIdren`s
IeuILI. AguIn, LIIs Is noL new Ior LIe unLIsmokIng menLuIILy. n 1qLI-
cenLury BrILuIn, LIere wus u consensus umongsL medIcuI prucLILIoners, In
LIe ubsence oI uny scIenLIIIc evIdence, LIuL juvenIIe smokIng wus IurmIuI
und sIouId be bunned (see WuIker, 1q8o). n LIe currenL cIrcumsLunce,
LIe Ideu Ius sImpIy been exLended Lo cover even exposure Lo umbIenL
Lobucco smoke.
RespIruLory IIInesses ure IIgIIy probIemuLIc Ior u number oI
reusons. PerLInenL Lo LIIs dIscussIon Is LIuL LIere muy be numerous
IucLors (e.g., ruce, purenLuI respIruLory sympLoms, presence oI oLIer
sIbIIngs, socIoeconomIc sLuLus or purenLuI educuLIon, crowdIng, muLernuI
uge, eLc. - see EPA, 1qq, s.;..z) InvoIved In eurIy cIIIdIood (up Lo 18
monLIs) respIruLory IeuILI und subgroup dIspurILIes LIereIn, IncIudIng
vurIuLIons In muLuruLIon und uLypIcuI endogenous ubnormuIILy. Muny
InILIuI dIspurILIes In respIruLory IeuILI dIsuppeur over LIe IIrsL Lwo Lo IIve
yeurs oI uge, I.e., muny cIIIdren IuvIng uLypIcuI respIruLory probIems eurIy
In IIIe grow ouL oI LIem. L Is noLeworLIy LIuL LIe EPA`s Iocus on
respIruLory uIImenLs up Lo 18 monLIs oI uge Is reuIIy presenLIng onIy purL
oI u duLu runge LIuL does no jusLIce Lo LIe numerous IucLors und processes
Preventive Medicine & Health Promotion
InvoIved und wIIcI, uguIn, Is IndIcuLIve oI workIng Lo u concIusIon.
TIe EPA`s cIuIms regurdIng LIe ussocIuLIon oI ETS und Iower
respIruLory LrucL IIIness (Rs) Is bused on RRs oI beLween 1. und z.o Ior
u vurIeLy oI sLudIes (s.;.). AguIn, LIese ure very Iow reIuLIve-rIsk ruLIos
even wILIIn LIe IIImsy Irumework oI sLundurd epIdemIoIogIcuI rIsk
ussessmenL. n LypIcuI IusIIon, LIe Increused RR ussocIuLed (sLuLIsLIcuIIy)
wILI ETS Is LrunsIuLed InLo uLLrIbuLubIe rIsk und LIen mugIcuIIy
LrunsIormed InLo cuusuI Lerms: ETS exposure Is cuusuIIy ussocIuLed wILI
un Increused rIsk oI Rs sucI us broncIILIs und pneumonIu. TIIs reporL
esLImuLes LIuL 1o,ooo Lo oo,ooo cuses unnuuIIy In InIunLs und young
cIIIdren up Lo 18 monLIs oI uge ure uLLrIbuLubIe Lo ETS. (s.1.1) TIe reporL
noLes LIuL LIere ure upproxImuLeIy ,oo,ooo cIIIdren up Lo 18 monLIs oI
uge. TIe reporL uIso IndIcuLes LIuL one-IuII Lo Lwo-LIIrds oI uII cIIIdren
under -yeurs-oI-uge muy be exposed Lo cIgureLLe smoke In LIe Iome
(s.1..z). I LIe crILIcuI crILerIon oI ubsoIuLe rIsk, us properIy underIyIng
cuusuI urgumenL, Is uppIIed Lo LIIs InIormuLIon, LIen usIng LIe equuLIon
((1o,ooo+oo,ooo)Jz)J((o.+o.66)Jz)x,oo,ooo) resuILs In un
ubsoIuLe rIsk oI ETS Ior Rs oI ;%, I.e., q% oI cIIIdren under 18 monLIs
LIuL ure exposed Lo ETS do not demonsLruLe uny Increused rIsk oI Rs.
urLIermore, LIe reporL`s esLImuLed unnuuI cuses oI Rs ussocIuLed wILI
ETS vury In severILy. TIe EPA esLImuLes LIuL ;,oo Lo 1,ooo oI LIe
overuII cuses wIII requIre IospILuIIzuLIon. TIe predIcLIve sLrengLI oI ETS
Ior severe cuses oI R Is ((;,oo+1,ooo)Jz)J((o.+o.66)Jz)x,oo,ooo)
= oo.q%, I.e., qq.6% oI cIIIdren under 18 monLIs LIuL ure exposed Lo ETS
do not demonsLruLe uny Increused rIsk oI severe Rs. TIIs IeveI oI
predIcLIve sLrengLI Ior Rs compreIensIveIy dIsconIIrms ETS us u
prImury cuuse oI Rs, I.e., LIe ussocIuLIon Is hihl uLypIcuI - non-
normuLIve.
TIe porLruyuI oI LIe sLuLIsLIcuI reIuLIonsIIp beLween ETS und
Rs us cuusuI In nuLure und LIe reIerence Lo uLLrIbuLubIe rIsk esLImuLes
InvoIvIng wIoIe numbers wILIouL ever reIerrIng Lo Increused Rs us u
proporLIon oI overuII ETS-exposed cIIIdren Is LIe LypIcuI IncompeLence oI
sLundurd rIsk ussessmenL procedures LIuL generuLes mugIc-powers
urgumenLs, I.e., exLreme over-InLerpreLuLIon oI rIsk or cuLusLropIIzuLIon.
L LIen becomes un ussuuIL on LIe menLuI IeuILI oI LIe pubIIc LIuL LIIs
IruuduIenL InIormuLIon Is InIIIcLed upon. SucI rIsk ussessmenLs go Lo
greuL sLuLIsLIcuI IengLIs Lo uccuruLeIy esLImuLe uLLrIbuLubIe rIsk (I.e., un
urILImeLIc exercIse) LIuL, In Lerms oI LIe requIremenLs oI genuIne cuusuI
urgumenL, Is uLLerIy useIess (I.e., sLuLIsLIcuIIsm).
TIe muLLer oI respIruLory InIecLIons Is IurLIer compIIcuLed by LIe
IucL LIuL sucI InIecLIons uIIow LIe Immune sysLem Lo muLure. None oI LIe
InvesLIguLIons revIewed In EPA (1qq) consIdered wIeLIer Iower ruLes oI
295
295
Rampant Antismoking Signifies Grave Danger
deuIIng wILI LIe respIruLory IeuILI oI cIIIdren. WILIouL provIdIng uny
opporLunILy Ior pubIIc commenL, EPA Iud LrunsmILLed Lo LIe SAB u new
'druIL reporL wILI u deLuIIed descrIpLIon und unuIysIs oI z6 sLudIes` on
cIIIdIood exposure Lo ETS. NoL surprIsIngIy, LIe documenL IuIIed Lo
dIscuss uny sLudIes LIuL dId noL supporL EPA`s preIerred concIusIons. By
InserLIng IL uL LIe IusL momenL und prevenLIng pubIIc dIscussIon oI LIe
LopIc uL LIe IeurIng, meunIngIuI pubIIc scruLIny oI LIe Agency`s
concIusIon wus excIuded (BIIIey, 1qq, p. 1;); TIe second druIL rIsk
ussessmenL unnounced LIuL ETS exposure Iud been esLubIIsIed us u cuuse
oI respIruLory dIseuse In cIIIdren. TIe IIrsL druIL rIsk ussessmenL Iud
sLuLed LIuL LIe duLu were Loo InconcIusIve Lo druw un InIerence oI
cuusuLIon. No new InIormuLIon becume uvuIIubIe beLween LIe reIeuse oI
LIe IIrsL und second druIL rIsk ussessmenL Lo supporL LIIs sIIIL In LIe
Agency`s posILIon. AppurenLIy, EPA sLuII Look LIe SAB`s eurIIer suggesLIon
LIuL IL consIder 'sLrengLIenIng` LIe reporL`s concIusIons concernIng
cIIIdren us u IIcense Lo sensuLIonuIIze IurLIer LIe Agency`s cIuIms ubouL
ETS. (BIIIey, 1qq, p. 1q)
TIe use oI cIIIdren`s IeuILI Lo promoLe IdeoIogIcuI ugendu Ius
become very IusIIonubIe In LIe 1qqo`s. umenLo (1qqq) suggesLs LIuL LIe
word Ius been ouL Ior LIe IusL Iew yeurs In WusIIngLon: I you wunL your
propugundu Lo peneLruLe, your bIII Lo puss, your speecI Lo be noLed on LIe
evenIng news, IInd some wuy by Iook or by crook Lo LIe IL Lo cIIIdren. TIe
EPA wus cerLuInIy weII uwure, und possIbIy LIe currenL LrendseLLer, oI LIe
promoLIonuI opporLunILIes uIIorded by LyIng unLIsmokIng Lo cIIIdren`s
IeuILI. AguIn, LIIs Is noL new Ior LIe unLIsmokIng menLuIILy. n 1qLI-
cenLury BrILuIn, LIere wus u consensus umongsL medIcuI prucLILIoners, In
LIe ubsence oI uny scIenLIIIc evIdence, LIuL juvenIIe smokIng wus IurmIuI
und sIouId be bunned (see WuIker, 1q8o). n LIe currenL cIrcumsLunce,
LIe Ideu Ius sImpIy been exLended Lo cover even exposure Lo umbIenL
Lobucco smoke.
RespIruLory IIInesses ure IIgIIy probIemuLIc Ior u number oI
reusons. PerLInenL Lo LIIs dIscussIon Is LIuL LIere muy be numerous
IucLors (e.g., ruce, purenLuI respIruLory sympLoms, presence oI oLIer
sIbIIngs, socIoeconomIc sLuLus or purenLuI educuLIon, crowdIng, muLernuI
uge, eLc. - see EPA, 1qq, s.;..z) InvoIved In eurIy cIIIdIood (up Lo 18
monLIs) respIruLory IeuILI und subgroup dIspurILIes LIereIn, IncIudIng
vurIuLIons In muLuruLIon und uLypIcuI endogenous ubnormuIILy. Muny
InILIuI dIspurILIes In respIruLory IeuILI dIsuppeur over LIe IIrsL Lwo Lo IIve
yeurs oI uge, I.e., muny cIIIdren IuvIng uLypIcuI respIruLory probIems eurIy
In IIIe grow ouL oI LIem. L Is noLeworLIy LIuL LIe EPA`s Iocus on
respIruLory uIImenLs up Lo 18 monLIs oI uge Is reuIIy presenLIng onIy purL
oI u duLu runge LIuL does no jusLIce Lo LIe numerous IucLors und processes
Preventive Medicine & Health Promotion
InvoIved und wIIcI, uguIn, Is IndIcuLIve oI workIng Lo u concIusIon.
TIe EPA`s cIuIms regurdIng LIe ussocIuLIon oI ETS und Iower
respIruLory LrucL IIIness (Rs) Is bused on RRs oI beLween 1. und z.o Ior
u vurIeLy oI sLudIes (s.;.). AguIn, LIese ure very Iow reIuLIve-rIsk ruLIos
even wILIIn LIe IIImsy Irumework oI sLundurd epIdemIoIogIcuI rIsk
ussessmenL. n LypIcuI IusIIon, LIe Increused RR ussocIuLed (sLuLIsLIcuIIy)
wILI ETS Is LrunsIuLed InLo uLLrIbuLubIe rIsk und LIen mugIcuIIy
LrunsIormed InLo cuusuI Lerms: ETS exposure Is cuusuIIy ussocIuLed wILI
un Increused rIsk oI Rs sucI us broncIILIs und pneumonIu. TIIs reporL
esLImuLes LIuL 1o,ooo Lo oo,ooo cuses unnuuIIy In InIunLs und young
cIIIdren up Lo 18 monLIs oI uge ure uLLrIbuLubIe Lo ETS. (s.1.1) TIe reporL
noLes LIuL LIere ure upproxImuLeIy ,oo,ooo cIIIdren up Lo 18 monLIs oI
uge. TIe reporL uIso IndIcuLes LIuL one-IuII Lo Lwo-LIIrds oI uII cIIIdren
under -yeurs-oI-uge muy be exposed Lo cIgureLLe smoke In LIe Iome
(s.1..z). I LIe crILIcuI crILerIon oI ubsoIuLe rIsk, us properIy underIyIng
cuusuI urgumenL, Is uppIIed Lo LIIs InIormuLIon, LIen usIng LIe equuLIon
((1o,ooo+oo,ooo)Jz)J((o.+o.66)Jz)x,oo,ooo) resuILs In un
ubsoIuLe rIsk oI ETS Ior Rs oI ;%, I.e., q% oI cIIIdren under 18 monLIs
LIuL ure exposed Lo ETS do not demonsLruLe uny Increused rIsk oI Rs.
urLIermore, LIe reporL`s esLImuLed unnuuI cuses oI Rs ussocIuLed wILI
ETS vury In severILy. TIe EPA esLImuLes LIuL ;,oo Lo 1,ooo oI LIe
overuII cuses wIII requIre IospILuIIzuLIon. TIe predIcLIve sLrengLI oI ETS
Ior severe cuses oI R Is ((;,oo+1,ooo)Jz)J((o.+o.66)Jz)x,oo,ooo)
= oo.q%, I.e., qq.6% oI cIIIdren under 18 monLIs LIuL ure exposed Lo ETS
do not demonsLruLe uny Increused rIsk oI severe Rs. TIIs IeveI oI
predIcLIve sLrengLI Ior Rs compreIensIveIy dIsconIIrms ETS us u
prImury cuuse oI Rs, I.e., LIe ussocIuLIon Is hihl uLypIcuI - non-
normuLIve.
TIe porLruyuI oI LIe sLuLIsLIcuI reIuLIonsIIp beLween ETS und
Rs us cuusuI In nuLure und LIe reIerence Lo uLLrIbuLubIe rIsk esLImuLes
InvoIvIng wIoIe numbers wILIouL ever reIerrIng Lo Increused Rs us u
proporLIon oI overuII ETS-exposed cIIIdren Is LIe LypIcuI IncompeLence oI
sLundurd rIsk ussessmenL procedures LIuL generuLes mugIc-powers
urgumenLs, I.e., exLreme over-InLerpreLuLIon oI rIsk or cuLusLropIIzuLIon.
L LIen becomes un ussuuIL on LIe menLuI IeuILI oI LIe pubIIc LIuL LIIs
IruuduIenL InIormuLIon Is InIIIcLed upon. SucI rIsk ussessmenLs go Lo
greuL sLuLIsLIcuI IengLIs Lo uccuruLeIy esLImuLe uLLrIbuLubIe rIsk (I.e., un
urILImeLIc exercIse) LIuL, In Lerms oI LIe requIremenLs oI genuIne cuusuI
urgumenL, Is uLLerIy useIess (I.e., sLuLIsLIcuIIsm).
TIe muLLer oI respIruLory InIecLIons Is IurLIer compIIcuLed by LIe
IucL LIuL sucI InIecLIons uIIow LIe Immune sysLem Lo muLure. None oI LIe
InvesLIguLIons revIewed In EPA (1qq) consIdered wIeLIer Iower ruLes oI
296
296
Rampant Antismoking Signifies Grave Danger
respIruLory InIecLIons In nonexposed cIIIdren, us one uspecL oI LIe
uLLempL Lo sLerIIIze u cIIId`s envIronmenL (I.e., overproLecLIon), wus In
Lurn ussocIuLed wILI IIgIer ruLes oI uIIergIes.
On LIe muLLer oI ucuLe mIddIe eur InIecLIons und ucuLe upper
respIruLory LrucL IIInesses, LIe EPA reporL proIIers conLrudIcLory sLunces.
On LIe one Iund IL suggesLs LIuL LIere Is some evIdence suggesLIng LIuL
LIe IncIdence oI ucuLe upper respIruLory LrucL IIInesses und ucuLe mIddIe
eur InIecLIons muy be more common In cIIIdren exposed Lo ETS.
However, severuI sLudIes Iuve IuIIed Lo IInd uny eIIecL. n uddILIon, LIe
possIbIe roIe oI conIoundIng IucLors, LIe Iuck oI sLudIes sIowIng cIeur
dose-response reIuLIonsIIps, und LIe ubsence oI u pIuusIbIe bIoIogIcuI
mecIunIsm precIude more deIInILIve concIusIons; IL LIen suggesLs LIuL
uvuIIubIe duLu provIde good evIdence demonsLruLIng u sIgnIIIcunL
Increuse In LIe prevuIence oI mIddIe eur eIIusIon In cIIIdren exposed Lo
ETS. SeveruI sLudIes In wIIcI no sIgnIIIcunL ussocIuLIon wus Iound
beLween ETS exposure und mIddIe eur eIIusIon were noL specIIIcuIIy
desIgned Lo LesL LIIs reIuLIonsIIp, und, LIereIore, eILIer power wus
InsuIIIcIenL or ussessmenL oI LIe degree oI exposure wus InudequuLe. AIso,
versen und coworkers (1q8), wIo ussessed mIddIe eur eIIusIon
objecLIveIy, suggesLed LIuL LIe rIsk ussocIuLed wILI pussIve smokIng
Increused wILI uge. TIIs muy expIuIn LIe neguLIve resuILs oI severuI
sLudIes bused on prescIooI cIIIdren; LIe sumpIe sIzes oI LIese sLudIes muy
Iuve been InudequuLe Lo LesL Ior Increused rIsks oI o% or Iess, us wouId
be expecLed In cIIIdren under 6 yeurs oI uge. TIe IIndIng oI u Iog-IIneur
dose-response reIuLIonsIIp beLween suIIvury coLInIne IeveIs und LIe
prevuIence oI ubnormuI LympunomeLry In one sLudy (SLrucIun eL uI.,
1q8q) udds Lo LIe evIdence IuvorIng u cuusuI IInk. AILIougI noL uII sLudIes
udjusLed Ior possIbIe conIounders und seIecLIon bIus cunnoL be excIuded
In LIe cuse-conLroI sLudIes revIewed, LIe evIdence us u wIoIe suggesLs LIuL
LIe ussocIuLIon Is noL IIkeIy Lo be due Lo cIunce, bIus, or IucLors reIuLed Lo
boLI ETS exposure und mIddIe eur eIIusIon. (s.;.q.z) AILIougI LIere ure
IIgIIy vurIubIe IIndIngs LIuL InvoIve smuII RR`s und LIuL wIII uILImuLeIy
yIeId exLremeIy poor predIcLIve sLrengLI oI ETS Ior purLIcuIur InIecLIonsJ
IIInesses, und u compIeLe Iuck oI expIunuLIon us Lo LIe reIuLIonsIIp
beLween u non-InIecLIous quunLILy (ETS) und wIuL Is essenLIuIIy un
InIecLIon-medIuLed condILIon (mIddIe-eur eIIusIon), LIe reporL neverLIe-
Iess concIuded LIuL ETS exposure Is cuusuIIy ussocIuLed wILI Increused
prevuIence oI IIuId In LIe mIddIe eur, sympLoms oI upper respIruLory LrucL
IrrILuLIon, und u smuII buL sIgnIIIcunL reducLIon In Iung IuncLIon. (s.1.1)
TIIs conLorLed evuIuuLIon reIIecLs even more LIun LIe LypIcuI
IncompeLence oI sLundurd rIsk ussessmenL procedure. L musL be borne In
mInd LIuL ETS dId noL IIgure In prIor consIderuLIons oI mIddIe eur
Preventive Medicine & Health Promotion
eIIusIon. TIe enLIre urgumenL Is bused on reIuLIve rIsk.
TIe evuIuuLIon oI usLImu Is Indeed one oI LIe greuLer IoIIIes oI
LIe EPA (1qq) reporL. RegurdIng exposure Lo ETS und new cuses oI
usLImu, LIe EPA reporL Is, uguIn, IncoIerenL In urgumenLuLIon. TIe reporL
posILs LIe conLrudIcLory sLunces:
n uddILIon, LIe epIdemIoIogIc evIdence Is suggesLIve
buL noL concIusIve LIuL ETS exposure Increuses LIe
number oI new cuses oI usLImu In cIIIdren wIo Iuve
noL prevIousIy exIIbILed sympLoms. Bused on LIIs
evIdence und LIe known ETS eIIecLs on boLI LIe
Immune sysLem und Iungs (e.g., uLopy und uIrwuy
IyperresponsIveness), LIIs reporL concIudes LIuL ETS Is
u rIsk IucLor Ior LIe InducLIon oI usLImu In prevIousIy
usympLomuLIc cIIIdren. DuLu suggesL LIuL reIuLIveIy
IIgI IeveIs oI exposure ure requIred Lo Induce new cuses
oI usLImu In cIIIdren. TIIs reporL cuIcuIuLes LIuL
prevIousIy usympLomuLIc cIIIdren exposed Lo ETS Irom
moLIers wIo smoke uL IeusL 1o cIgureLLes per duy wIII
exIIbIL un esLImuLed 8,ooo Lo z6,ooo new cuses oI
usLImu unnuuIIy. TIe conIIdence In LIIs runge Is
medIum und Is dependenL on LIe concIusIon LIuL ETS Is
u rIsk IucLor Ior usLImu InducLIon. (s.1.)
I ETS Is onIy u rIsk IucLor Ior new cuses oI usLImu, LIen LIe
sLuLIsLIc oI uLLrIbuLubIe cuses sIouId noL be Iorwurded In LIuL LIIs
sLuLIsLIc Is LypIcuIIy und erroneousIy used synonymousIy wILI cuuse.
Terms sucI us induce new cuses ure ccuscl cIuIms LIuL sIouId noL be
used. AguIn, LIe euse oI sIIIL beLween rIsk IucLoroIogy und cuusuI cIuIms
wILI compIeLe obIIvIousness Lo LIe correspondIng sIIIL In concepLuuI
domuIns (probubIIIsLIcJdeLermInIsLIc) und urgumenLuLIve requIremenLs Is
IIgIIy dIsLurbIng, uILIougI IL represenLs sLundurd epIdemIoIogIcuI
reusonIng. ConsIsLenL wILI oLIer cuIcuIuLIons, II IuII LIe cIIIdren
beLween und 18 ure exposed Lo ETS, LIen LIe predIcLIve sLrengLI oI ETS
Ior new cuses oI usLImu Is ((8,ooo+z6,ooo)Jz)J-q,ooo,ooo) = oo.oq%,
I.e., qq.q% oI LIose exposed Lo ETS do not deveIop usLImu. AguIn, uny
reIerence, In cuusuI Lerms, Lo u IucLor LIuL Ius vIrLuuIIy zero-IeveI
predIcLIve sLrengLI Ior unoLIer IucLor Ius no sensIbIIILy.
AsLImu Ius Iong been sLudIed. AILIougI muny IucLors possIbIy
conLrIbuLIng Lo, und exucerbuLIng or muInLuInIng, LIe condILIon Iuve been
IdenLIIIed, LIere Ius been IILLIe success In deIInIng u cIeur cuL ueLIoIogy
(Ies); LIe ueLIoIogy(Ies) oI new cuses oI usLImu Is not undersLood. YeL,
uIong swuggers EPA (1qq) wILI LIe dIscovery oI u cIeur-cuL ueLIoIogy
297
297
Rampant Antismoking Signifies Grave Danger
respIruLory InIecLIons In nonexposed cIIIdren, us one uspecL oI LIe
uLLempL Lo sLerIIIze u cIIId`s envIronmenL (I.e., overproLecLIon), wus In
Lurn ussocIuLed wILI IIgIer ruLes oI uIIergIes.
On LIe muLLer oI ucuLe mIddIe eur InIecLIons und ucuLe upper
respIruLory LrucL IIInesses, LIe EPA reporL proIIers conLrudIcLory sLunces.
On LIe one Iund IL suggesLs LIuL LIere Is some evIdence suggesLIng LIuL
LIe IncIdence oI ucuLe upper respIruLory LrucL IIInesses und ucuLe mIddIe
eur InIecLIons muy be more common In cIIIdren exposed Lo ETS.
However, severuI sLudIes Iuve IuIIed Lo IInd uny eIIecL. n uddILIon, LIe
possIbIe roIe oI conIoundIng IucLors, LIe Iuck oI sLudIes sIowIng cIeur
dose-response reIuLIonsIIps, und LIe ubsence oI u pIuusIbIe bIoIogIcuI
mecIunIsm precIude more deIInILIve concIusIons; IL LIen suggesLs LIuL
uvuIIubIe duLu provIde good evIdence demonsLruLIng u sIgnIIIcunL
Increuse In LIe prevuIence oI mIddIe eur eIIusIon In cIIIdren exposed Lo
ETS. SeveruI sLudIes In wIIcI no sIgnIIIcunL ussocIuLIon wus Iound
beLween ETS exposure und mIddIe eur eIIusIon were noL specIIIcuIIy
desIgned Lo LesL LIIs reIuLIonsIIp, und, LIereIore, eILIer power wus
InsuIIIcIenL or ussessmenL oI LIe degree oI exposure wus InudequuLe. AIso,
versen und coworkers (1q8), wIo ussessed mIddIe eur eIIusIon
objecLIveIy, suggesLed LIuL LIe rIsk ussocIuLed wILI pussIve smokIng
Increused wILI uge. TIIs muy expIuIn LIe neguLIve resuILs oI severuI
sLudIes bused on prescIooI cIIIdren; LIe sumpIe sIzes oI LIese sLudIes muy
Iuve been InudequuLe Lo LesL Ior Increused rIsks oI o% or Iess, us wouId
be expecLed In cIIIdren under 6 yeurs oI uge. TIe IIndIng oI u Iog-IIneur
dose-response reIuLIonsIIp beLween suIIvury coLInIne IeveIs und LIe
prevuIence oI ubnormuI LympunomeLry In one sLudy (SLrucIun eL uI.,
1q8q) udds Lo LIe evIdence IuvorIng u cuusuI IInk. AILIougI noL uII sLudIes
udjusLed Ior possIbIe conIounders und seIecLIon bIus cunnoL be excIuded
In LIe cuse-conLroI sLudIes revIewed, LIe evIdence us u wIoIe suggesLs LIuL
LIe ussocIuLIon Is noL IIkeIy Lo be due Lo cIunce, bIus, or IucLors reIuLed Lo
boLI ETS exposure und mIddIe eur eIIusIon. (s.;.q.z) AILIougI LIere ure
IIgIIy vurIubIe IIndIngs LIuL InvoIve smuII RR`s und LIuL wIII uILImuLeIy
yIeId exLremeIy poor predIcLIve sLrengLI oI ETS Ior purLIcuIur InIecLIonsJ
IIInesses, und u compIeLe Iuck oI expIunuLIon us Lo LIe reIuLIonsIIp
beLween u non-InIecLIous quunLILy (ETS) und wIuL Is essenLIuIIy un
InIecLIon-medIuLed condILIon (mIddIe-eur eIIusIon), LIe reporL neverLIe-
Iess concIuded LIuL ETS exposure Is cuusuIIy ussocIuLed wILI Increused
prevuIence oI IIuId In LIe mIddIe eur, sympLoms oI upper respIruLory LrucL
IrrILuLIon, und u smuII buL sIgnIIIcunL reducLIon In Iung IuncLIon. (s.1.1)
TIIs conLorLed evuIuuLIon reIIecLs even more LIun LIe LypIcuI
IncompeLence oI sLundurd rIsk ussessmenL procedure. L musL be borne In
mInd LIuL ETS dId noL IIgure In prIor consIderuLIons oI mIddIe eur
Preventive Medicine & Health Promotion
eIIusIon. TIe enLIre urgumenL Is bused on reIuLIve rIsk.
TIe evuIuuLIon oI usLImu Is Indeed one oI LIe greuLer IoIIIes oI
LIe EPA (1qq) reporL. RegurdIng exposure Lo ETS und new cuses oI
usLImu, LIe EPA reporL Is, uguIn, IncoIerenL In urgumenLuLIon. TIe reporL
posILs LIe conLrudIcLory sLunces:
n uddILIon, LIe epIdemIoIogIc evIdence Is suggesLIve
buL noL concIusIve LIuL ETS exposure Increuses LIe
number oI new cuses oI usLImu In cIIIdren wIo Iuve
noL prevIousIy exIIbILed sympLoms. Bused on LIIs
evIdence und LIe known ETS eIIecLs on boLI LIe
Immune sysLem und Iungs (e.g., uLopy und uIrwuy
IyperresponsIveness), LIIs reporL concIudes LIuL ETS Is
u rIsk IucLor Ior LIe InducLIon oI usLImu In prevIousIy
usympLomuLIc cIIIdren. DuLu suggesL LIuL reIuLIveIy
IIgI IeveIs oI exposure ure requIred Lo Induce new cuses
oI usLImu In cIIIdren. TIIs reporL cuIcuIuLes LIuL
prevIousIy usympLomuLIc cIIIdren exposed Lo ETS Irom
moLIers wIo smoke uL IeusL 1o cIgureLLes per duy wIII
exIIbIL un esLImuLed 8,ooo Lo z6,ooo new cuses oI
usLImu unnuuIIy. TIe conIIdence In LIIs runge Is
medIum und Is dependenL on LIe concIusIon LIuL ETS Is
u rIsk IucLor Ior usLImu InducLIon. (s.1.)
I ETS Is onIy u rIsk IucLor Ior new cuses oI usLImu, LIen LIe
sLuLIsLIc oI uLLrIbuLubIe cuses sIouId noL be Iorwurded In LIuL LIIs
sLuLIsLIc Is LypIcuIIy und erroneousIy used synonymousIy wILI cuuse.
Terms sucI us induce new cuses ure ccuscl cIuIms LIuL sIouId noL be
used. AguIn, LIe euse oI sIIIL beLween rIsk IucLoroIogy und cuusuI cIuIms
wILI compIeLe obIIvIousness Lo LIe correspondIng sIIIL In concepLuuI
domuIns (probubIIIsLIcJdeLermInIsLIc) und urgumenLuLIve requIremenLs Is
IIgIIy dIsLurbIng, uILIougI IL represenLs sLundurd epIdemIoIogIcuI
reusonIng. ConsIsLenL wILI oLIer cuIcuIuLIons, II IuII LIe cIIIdren
beLween und 18 ure exposed Lo ETS, LIen LIe predIcLIve sLrengLI oI ETS
Ior new cuses oI usLImu Is ((8,ooo+z6,ooo)Jz)J-q,ooo,ooo) = oo.oq%,
I.e., qq.q% oI LIose exposed Lo ETS do not deveIop usLImu. AguIn, uny
reIerence, In cuusuI Lerms, Lo u IucLor LIuL Ius vIrLuuIIy zero-IeveI
predIcLIve sLrengLI Ior unoLIer IucLor Ius no sensIbIIILy.
AsLImu Ius Iong been sLudIed. AILIougI muny IucLors possIbIy
conLrIbuLIng Lo, und exucerbuLIng or muInLuInIng, LIe condILIon Iuve been
IdenLIIIed, LIere Ius been IILLIe success In deIInIng u cIeur cuL ueLIoIogy
(Ies); LIe ueLIoIogy(Ies) oI new cuses oI usLImu Is not undersLood. YeL,
uIong swuggers EPA (1qq) wILI LIe dIscovery oI u cIeur-cuL ueLIoIogy
298
298
Rampant Antismoking Signifies Grave Danger
Ior uL IeusL some cuses oI usLImu - wIIcI ones Is noL cIeur. TIe crithmetic
procedure oI uLLrIbuLubIe cuses, derIved Irom Increused RR ussocIuLed
wILI exposure Lo ETS, beIng used us LIe busIs Ior cuusuI urgumenL,
purLIcuIurIy Ior usLImu, In LIe ubsence oI mecIunIsms oI cuuse und eIIecL
und un eIIecLIveIy-zero IeveI oI predIcLIve sLrengLI oI ETS Ior usLImu Is
LesLImony onIy Lo LIe unscIoIurIy sLundurd oI InIerence LIuL permeuLes,
noL onIy EPA (1qq), buL LIe muLerIuIIsm oI conLemporury medIcuI
LIInkIng.
Two IurLIer poInLs ure ImporLunL Iere. IrsLIy, Lobucco smokIng
wus uL one LIme prescrIbed us un unLIspusmodIc Ior usLImu In uduILs (e.g.,
see WuIker, 1q8o). TIe beIIeI LIuL becuuse usLImu InvoIves u respIruLory
dIIIIcuILy necessurIIy meuns LIuL usLImuLIcs wIII Iuve dIIIIcuILy wILI
smoke Is sImpIy IncorrecL. urLIermore, unLII recenLIy umbIenL smoke
Irom cookIng und IeuLIng were sLundurd IeuLures oI IouseIoIds.
SecondIy, LIere Is no uLLempL by EPA (1qq) Lo consIder uny oLIer, more
pIuusIbIe, possIbIIILIes LIuL properIy pinpoint wIere LIe subgroup
probIems ure occurrIng.
TIe evIdence reIIed-on IndIcuLes LIuL LIe RR dIIIerences Ior
respIruLory IIIness und usLImu ure generuLed by u very smcll subgroup oI
LIe overuII exposed group wIIcI Is Iurger LIun u very smuII subgroup oI
LIe overuII nonexposed group. TIe quesLIon LIuL cun properIy be usked
concerns pecuIIurILIes oI LIese Lwo subgroups, oLIer LIun ETS exposure,
LIuL cun uccounL Ior RR dIIIerences. or exumpIe, Ior LIe exposed group,
wIIcI LypIcuIIy Iuve smoker purenLs, IL muy be LIuL Ior u smuII subgroup
oI LIese, und possIbIy In Ieur oI odor crILIcIsms, muy use Iur greuLer
umounLs und combInuLIons oI uIr-IresIener or produce druILy
uccommoduLIons by openIng doors und wIndows. Or, more wILIIn LIe
smoker`s group mIgIL IIve In ureus oI IIgIer poIIuLIon (e.g., dIeseI
emIssIons). Or, u recenL sLudy Iound LIuL cIIIdren wIo sIeep wILI
synLIeLIc pIIIows ure IIve LImes (RR=.o) more IIkeIy Lo suIIer Irom
IrequenL wIeezIng LIun LIose wIo do noL (Hercld,Sun, ebruury z1,
zoo). And, IL Is LIese sorLs oI exposures LIuL muy be LrIggers Ior
purLIcuIur IIIness; LIere muy be more wILIIn LIe ETS-exposed group LIuL
use synLIeLIc pIIIows (e.g., u correIuLe oI socIo-economIc sLuLus).
AILernuLIveIy, u smuII subgroup wILIIn LIe overuII nonexposed group muy
be uLypIcuI oI LIuL group. TIIs sorL oI pIuusIbIe cIrcumsLunce cun produce
Iow-IeveI RR dIIIerences beLween LIe Lwo overuII groups. TIIs muy reIIecL
u rIsk-uverse purenL subgroup. TIere muy be more medIcuI prucLILIoners
In LIIs subgroup gIven LIuL smokIng Is under-represenLed umongsL US
docLors compured Lo LIe smokIng ruLe In greuLer socIeLy. CIIIdren muy
Iuve docLor-purenLsJIrIends wIere sympLoms cun be uIIevIuLed wILIouL
resorLIng Lo u docLor vIsIL or IospILuI udmIssIon. n oLIer words, un RR
Preventive Medicine & Health Promotion
dIIIerence couId be generuLed beLween LIe Lwo overuII groups soIeIy on LIe
busIs oI LIIs pIuusIbIe pIenomenon. HIgIIIgILed Is LIe consIsLenL
epIdemIoIogIc IoIIy oI ussumIng IomogeneILy oI group membersIIp, boLI
wILIIn und beLween groups.
DespILe conLrudIcLory urgumenLuLIon und zero-IeveI predIcLIve
sLrengLI, Perske (zooo) noLes LIuL IoIIowIng EPA (1qq) LIe AmerIcun
HeurL AssocIuLIon cIuImed LIuL MoLIers wIo smoke 1o or more cIgureLLes
u duy cun cuuse us muny us z6,ooo new cuses oI usLImu umong LIeIr
cIIIdren eucI yeur. Perske (zooo) uIso IndIcuLes LIuL In 1qqq EPA
AdmInIsLruLor CuroI Browner wurned noL Lo smoke In IronL oI cIIIdren
becuuse umong oLIer LIIngs secondIund smoke cuuses cIIIdren Lo
deveIop usLImu und LIuL secondIund smoke cuuses cIIIdren Lo deveIop
usLImu In LIe IIrsL pIuce. To IurLIer conIuse muLLers, In 1qq; LIe EPA
bIumed ground-IeveI ozone Ior LIe Increuse In usLImu ruLes - even LIougI
ozone IeveIs Iuve IuIIen In recenL yeurs. HoILzmun (1qqq) udds u IurLIer
LwIsL Lo possIbIe ueLIoIogy, proposIng LIuL usLImu Is cuused by u
geneLIcuIIy-bused IuuILy Immune reucLIon In LIe ceIIs IInIng LIe uIrwuys.
However, LIIs uIso does noL purLIcuIurIy expIuIn wIy muny grow ouL oI
eurIy usLImu, unIess IL InvoIves compensuLIng IucLors.
RegurdIng exIsLIng usLImu, LIere ure uIso very consIderubIe
psycIoIogIcuI, psycIo-emoLIonuI und psycIosocIuI Issues LIuL Iuve been
compIeLeIy obIILeruLed In LIe EPA LreuLmenL; u muLerIuIIsL und exLernuIIsL
menLuIILy Is sImpIy unquuIIIIed Lo ussess LIese Issues. TIe EPA reporL
concIuded LIuL ETS exposure Is cuusuIIy ussocIuLed wILI uddILIonuI
epIsodes und Increused severILy oI sympLoms In cIIIdren wILI
usLImu. (s.1.1)
PurceII & WeIss (1q;o) descrIbed usLImu us u sympLom compIex
cIurucLerIzed by un Increused responsIveness oI LIe LrucIeu, mujor
broncII, und perIpIeruI broncIIoIes Lo vurIous sLImuII, und Is munIIesLed
by exLensIve nurrowIng oI LIe uIrwuys wIIcI cuuses ImpuIrmenL oI uIr
excIunge, prImurIIy In expIruLIon, InducIng wIeezIng. (p.q;) AsLImu
uLLucks cun be sudden, InvoIvIng u sense oI LIgILness In LIe cIesL,
wIeezIng, cougI, spuLum. PunIcJIeur und IrrILubIIILy, Ior exumpIe, ure
subjecLIve reucLIons In usLImu; LIese psycIo-emoLIonuI IucLors cun
underIIe uLLucks or exucerbuLe wIuL muy InILIuIIy be mIId sympLoms. n
muny InsLunces LIere muy noL even be uny dIscernubIe reusons (LrIgger)
Ior LIe uLLuck.
Rees (1q6q) consIdered LIuL usLImu Iud one oI LIree possIbIe
ueLIoIogIes. Alleric reucLIons InvoIvIng respIruLory LrucL sensILIvILy Lo
subsLunces (e.g., dusL, poIIen). Respirctor injections (e.g., ucuLe
broncIILIs) cun uIso muke LIe respIruLory sysLem vuInerubIe Lo usLImu.
Pscholoiccl IucLors (e.g., unxIeLy, LensIon produced by IrusLruLIon,
299
299
Rampant Antismoking Signifies Grave Danger
Ior uL IeusL some cuses oI usLImu - wIIcI ones Is noL cIeur. TIe crithmetic
procedure oI uLLrIbuLubIe cuses, derIved Irom Increused RR ussocIuLed
wILI exposure Lo ETS, beIng used us LIe busIs Ior cuusuI urgumenL,
purLIcuIurIy Ior usLImu, In LIe ubsence oI mecIunIsms oI cuuse und eIIecL
und un eIIecLIveIy-zero IeveI oI predIcLIve sLrengLI oI ETS Ior usLImu Is
LesLImony onIy Lo LIe unscIoIurIy sLundurd oI InIerence LIuL permeuLes,
noL onIy EPA (1qq), buL LIe muLerIuIIsm oI conLemporury medIcuI
LIInkIng.
Two IurLIer poInLs ure ImporLunL Iere. IrsLIy, Lobucco smokIng
wus uL one LIme prescrIbed us un unLIspusmodIc Ior usLImu In uduILs (e.g.,
see WuIker, 1q8o). TIe beIIeI LIuL becuuse usLImu InvoIves u respIruLory
dIIIIcuILy necessurIIy meuns LIuL usLImuLIcs wIII Iuve dIIIIcuILy wILI
smoke Is sImpIy IncorrecL. urLIermore, unLII recenLIy umbIenL smoke
Irom cookIng und IeuLIng were sLundurd IeuLures oI IouseIoIds.
SecondIy, LIere Is no uLLempL by EPA (1qq) Lo consIder uny oLIer, more
pIuusIbIe, possIbIIILIes LIuL properIy pinpoint wIere LIe subgroup
probIems ure occurrIng.
TIe evIdence reIIed-on IndIcuLes LIuL LIe RR dIIIerences Ior
respIruLory IIIness und usLImu ure generuLed by u very smcll subgroup oI
LIe overuII exposed group wIIcI Is Iurger LIun u very smuII subgroup oI
LIe overuII nonexposed group. TIe quesLIon LIuL cun properIy be usked
concerns pecuIIurILIes oI LIese Lwo subgroups, oLIer LIun ETS exposure,
LIuL cun uccounL Ior RR dIIIerences. or exumpIe, Ior LIe exposed group,
wIIcI LypIcuIIy Iuve smoker purenLs, IL muy be LIuL Ior u smuII subgroup
oI LIese, und possIbIy In Ieur oI odor crILIcIsms, muy use Iur greuLer
umounLs und combInuLIons oI uIr-IresIener or produce druILy
uccommoduLIons by openIng doors und wIndows. Or, more wILIIn LIe
smoker`s group mIgIL IIve In ureus oI IIgIer poIIuLIon (e.g., dIeseI
emIssIons). Or, u recenL sLudy Iound LIuL cIIIdren wIo sIeep wILI
synLIeLIc pIIIows ure IIve LImes (RR=.o) more IIkeIy Lo suIIer Irom
IrequenL wIeezIng LIun LIose wIo do noL (Hercld,Sun, ebruury z1,
zoo). And, IL Is LIese sorLs oI exposures LIuL muy be LrIggers Ior
purLIcuIur IIIness; LIere muy be more wILIIn LIe ETS-exposed group LIuL
use synLIeLIc pIIIows (e.g., u correIuLe oI socIo-economIc sLuLus).
AILernuLIveIy, u smuII subgroup wILIIn LIe overuII nonexposed group muy
be uLypIcuI oI LIuL group. TIIs sorL oI pIuusIbIe cIrcumsLunce cun produce
Iow-IeveI RR dIIIerences beLween LIe Lwo overuII groups. TIIs muy reIIecL
u rIsk-uverse purenL subgroup. TIere muy be more medIcuI prucLILIoners
In LIIs subgroup gIven LIuL smokIng Is under-represenLed umongsL US
docLors compured Lo LIe smokIng ruLe In greuLer socIeLy. CIIIdren muy
Iuve docLor-purenLsJIrIends wIere sympLoms cun be uIIevIuLed wILIouL
resorLIng Lo u docLor vIsIL or IospILuI udmIssIon. n oLIer words, un RR
Preventive Medicine & Health Promotion
dIIIerence couId be generuLed beLween LIe Lwo overuII groups soIeIy on LIe
busIs oI LIIs pIuusIbIe pIenomenon. HIgIIIgILed Is LIe consIsLenL
epIdemIoIogIc IoIIy oI ussumIng IomogeneILy oI group membersIIp, boLI
wILIIn und beLween groups.
DespILe conLrudIcLory urgumenLuLIon und zero-IeveI predIcLIve
sLrengLI, Perske (zooo) noLes LIuL IoIIowIng EPA (1qq) LIe AmerIcun
HeurL AssocIuLIon cIuImed LIuL MoLIers wIo smoke 1o or more cIgureLLes
u duy cun cuuse us muny us z6,ooo new cuses oI usLImu umong LIeIr
cIIIdren eucI yeur. Perske (zooo) uIso IndIcuLes LIuL In 1qqq EPA
AdmInIsLruLor CuroI Browner wurned noL Lo smoke In IronL oI cIIIdren
becuuse umong oLIer LIIngs secondIund smoke cuuses cIIIdren Lo
deveIop usLImu und LIuL secondIund smoke cuuses cIIIdren Lo deveIop
usLImu In LIe IIrsL pIuce. To IurLIer conIuse muLLers, In 1qq; LIe EPA
bIumed ground-IeveI ozone Ior LIe Increuse In usLImu ruLes - even LIougI
ozone IeveIs Iuve IuIIen In recenL yeurs. HoILzmun (1qqq) udds u IurLIer
LwIsL Lo possIbIe ueLIoIogy, proposIng LIuL usLImu Is cuused by u
geneLIcuIIy-bused IuuILy Immune reucLIon In LIe ceIIs IInIng LIe uIrwuys.
However, LIIs uIso does noL purLIcuIurIy expIuIn wIy muny grow ouL oI
eurIy usLImu, unIess IL InvoIves compensuLIng IucLors.
RegurdIng exIsLIng usLImu, LIere ure uIso very consIderubIe
psycIoIogIcuI, psycIo-emoLIonuI und psycIosocIuI Issues LIuL Iuve been
compIeLeIy obIILeruLed In LIe EPA LreuLmenL; u muLerIuIIsL und exLernuIIsL
menLuIILy Is sImpIy unquuIIIIed Lo ussess LIese Issues. TIe EPA reporL
concIuded LIuL ETS exposure Is cuusuIIy ussocIuLed wILI uddILIonuI
epIsodes und Increused severILy oI sympLoms In cIIIdren wILI
usLImu. (s.1.1)
PurceII & WeIss (1q;o) descrIbed usLImu us u sympLom compIex
cIurucLerIzed by un Increused responsIveness oI LIe LrucIeu, mujor
broncII, und perIpIeruI broncIIoIes Lo vurIous sLImuII, und Is munIIesLed
by exLensIve nurrowIng oI LIe uIrwuys wIIcI cuuses ImpuIrmenL oI uIr
excIunge, prImurIIy In expIruLIon, InducIng wIeezIng. (p.q;) AsLImu
uLLucks cun be sudden, InvoIvIng u sense oI LIgILness In LIe cIesL,
wIeezIng, cougI, spuLum. PunIcJIeur und IrrILubIIILy, Ior exumpIe, ure
subjecLIve reucLIons In usLImu; LIese psycIo-emoLIonuI IucLors cun
underIIe uLLucks or exucerbuLe wIuL muy InILIuIIy be mIId sympLoms. n
muny InsLunces LIere muy noL even be uny dIscernubIe reusons (LrIgger)
Ior LIe uLLuck.
Rees (1q6q) consIdered LIuL usLImu Iud one oI LIree possIbIe
ueLIoIogIes. Alleric reucLIons InvoIvIng respIruLory LrucL sensILIvILy Lo
subsLunces (e.g., dusL, poIIen). Respirctor injections (e.g., ucuLe
broncIILIs) cun uIso muke LIe respIruLory sysLem vuInerubIe Lo usLImu.
Pscholoiccl IucLors (e.g., unxIeLy, LensIon produced by IrusLruLIon,
300
300
Rampant Antismoking Signifies Grave Danger
unger, depressIon), LIrougI Induced emoLIonuIILy, cun resuIL In usLImuLIc
epIsodes. Rees (1q6q) uIso concIuded LIuL In onIy ;% oI cuses were
psycIoIogIcuI IucLors consIdered Lo be domInunL und LIuL In unoLIer o%
oI cuses psycIoIogIcuI IucLors were consIdered Lo be compIeLeIy
unImporLunL. AddILIonuIIy, ueLIoIogIcuI IucLors vurIed In ImporLunce us u
IuncLIon oI LIe IndIvIduuI`s uge. or exumpIe, under IIve yeurs oI uge,
InIecLIve IucLors domInuLed; uILIougI InIecLIve IucLors sLIII predomInuLed,
psycIoIogIcuI IucLors Increused In ImporLunce Irom uges 6 Lo 16;
psycIoIogIcuI IucLors decreused In ImporLunce Irom 1; yeurs oI uge unLII
ubouL uge , und LIen becomIng consequenLIuI uguIn.
TIe ouLIIne ubove IndIcuLes LIuL psycIoIogIcuI IucLors cun IIgure
consIderubIy In usLImu. However, LIe roIe oI psycIoIogIcuI IucLors muy be
even more consIderubIe sLIII. KIeemun (1q6;) Iound LIuL 6q% oI usLImu
uLLucks begun wILI un emoLIonuI dIsLurbunce Ior z6 puLIenLs InLervIewed
over un 18 monLI perIod. Dekker & Groen (1q6) Iound LIuL u subgroup oI
purLIcIpunLs deveIoped vuryIng degrees oI usLImu (IncIudIng IuII-bIown)
Lo sILuuLIons IndIcuLed by puLIenLs us precIpILuLIng uLLucks LIuL were
reproduced In LIe IuboruLory In ucLuuI or pIcLorIuI Iorm; LIe sLImuII Lo
wIIcI LIe subjecLs uscrIbed LIeIr usLImu IncIuded LIe nuLIonuI unLIem,
perIume, LIe siht oI dusL, Iorses, und wuLerIuIIs.
Even persons Ior wIom uIIergIc reucLIons ure consIdered Lo be
LIe prImury busIs oI LIeIr usLImu ure open Lo LIe psycIoIogIcuI IucLor oI
suggesLIbIIILy. upureIIo eL uI. (1q;1) InsLrucLed u group (qo) oI usLImuLIcs
und u sImIIurIy sIzed conLroI group LIuL LIey were purLIcIpuLIng In u sLudy
oI uIr poIIuLIon. L wus expIuIned LIuL LIe sLudy wus Lo deLermIne wIuL
concenLruLIons oI vurIous subsLunces wouId Induce wIeezIng. TIe
usLImuLIcs were udvIsed LIuL LIey wouId be InIuIIng IIve dIIIerenL
concenLruLIons oI un IrrILunL or un uIIergen LIuL Iud prevIousIy been
deLermIned us u conLrIbuLIng cuuse oI LIeIr usLImu uLLucks. AILIougI boLI
usLImuLIcs und conLroIs were gIven onIy IIve non-uIIergenIc suIIne
soIuLIons Lo InIuIe, usLImuLIcs were Ied Lo beIIeve LIuL eucI successIve
sumpIe wouId Iuve u IIgIer concenLruLIon oI LIe uIIergen; conLroIs were
udvIsed LIuL LIey wouId be InIuIIng poIIuLunLs wIIcI couId IrrILuLe LIe
broncIIuI Lubes und muke IL dIIIIcuIL Ior LIem Lo breuLIe. SIgnIIIcunL
uIrwuy obsLrucLIon occurred Ior IourLeen oI LIe IorLy usLImuLIc subjecLs;
LweIve oI LIese deveIoped IuII-bIown uLLucks. RespIruLory sympLoms were
noL observed In uny oI LIe conLroIs. Even more InLeresLIngIy, LIe LweIve
subjecLs LIuL Iud deveIoped IuII-bIown uLLucks were LoId LIuL LIey were
beIng gIven u broncIodIuIuLor Lo InIuIe wIen In IucL IL wus LIe sume suIIne
soIuLIon. TIe condILIon oI uII LweIve Improved, conIIrmIng LIe roIe oI
suggesLIon In some usLImuLIcs.
TIe suggesLIbIIILy In LIe upureIIo eL uI. (1q;1) sLudy InvoIves u
Preventive Medicine & Health Promotion
Iorm oI nocebo eIIecL und u plccebo eIIecL. TIe Ideu oI u pIucebo Ius u
Iong und vurIed IIsLory (see Jospe, 1q;8, p.xII). n conLemporury Lerms,
plccebo (Irom LIe uLIn: sIuII pIeuse) reIers Lo uny LIerupeuLIc
procedure (or LIuL componenL oI LIerupeuLIc procedure) wIIcI Is
deIIberuLeIy gIven Lo Iuve un eIIecL on u sympLom, syndrome or dIseuse,
buL wIIcI Is wILIouL specIIIc ucLIvILy Ior u condILIon Lo be LreuLed; LIe
pIucebo eIIecL Is ...cIunges produced by pIucebos or procedures ucLIng us
pIucebos. (SIupIro, 1q6) An exumpIe oI LIe pIucebo eIIecL Is LIe
uIIevIuLIon oI sympLoms, eLc., Irom LIe udmInIsLruLIon oI u sugur pIII
beIIeved by LIe puLIenL Lo be ucLuuI medIcuLIon, I.e., posILIve eIIecL wIere
none Is expecLed In reducLIonIsL (bIomedIcuI) Lerms (see uIso AcILerberg
& uwIIs, 1q8o, p.6-8).
TIe Lerm nocebo wus IIrsL coIned by Kennedy (1q61) und
expounded by KIsseI & Burrucund (1q6q) - see HuIn (1qq;). L derIves
Irom LIe uLIn Ior sIuII IurL, Iurm und, In ILs eurIIesL sense,
subsLILuLed Ior u neguLIve pIucebo, I.e., neguLIve eIIecL wIere none Is
expecLed In reducLIonIsL Lerms. However, HuIn (1qq;) properIy noLes LIuL
Kennedy (1q61) und KIsseI & Burrucund (1q6q) onIy consIdered neguLIve
eIIecL, buL dId noL dIsLInguIsI beLween ussocIuLed posILIve or neguLIve
expecLuncy. n u very ImporLunL sense u neguLIve pIucebo Is compIeLeIy
dIIIerenL Lo u nocebo. A neguLIve pIucebo properIy reIers Lo u neguLIve
eIIecL ussocIuLed wILI u posILIve expecLuncy, e.g., u person Is gIven u sugur
pIII beIIeved Lo be posILIve medIcuLIon buL LIe person deveIops sympLoms.
A nocebo properIy reIers Lo neguLIve eIIecL ussocIuLed wILI neguLIve
expecLuncy, e.g., u person deveIops sympLoms uILer beIng gIven u sugur
pIII beIIeved Lo be u dungerous subsLunce: WIuL dIsLInguIsIes nocebos Is
LIuL LIe subjecL Ius neguLIve expecLuLIons und ucLuuIIy experIences u
neguLIve ouL-come. (HuIn, 1qq;, p.;)
n LIe currenL sILuuLIon, LIe nocebo (IurmIuI) eIIecL Is reIIecLed
In producLIon oI u severe usLImuLIc uLLuck enLIreIy on LIe beliej LIuL u
neguLIve sLImuIus (deLermIned IrrILunLJuIIergen) Is presenL wIen LIe
neguLIve sLImuIus Is ucLuuIIy ubsenL. TIe pIucebo (posILIve) eIIecL Is
reIIecLed In LIe ImprovemenL oI un usLImuLIc condILIon enLIreIy on LIe
beIIeI LIuL u posILIve sLImuIus (broncIodIuIuLor) Is presenL wIen IL Is
ucLuuIIy ubsenL. TIe cIrcumsLunce oI usLImuLIc uLLuck (bIoIogIcuI cIunges
or dIsLurbunces In orgun IuncLIonIng) beIng produced by psycIogenIc
IucLors Is reIerred Lo us psycIopIysIoIogIcuI or psycIosomuLIc. TIIs Is noL
Lo suy LIuL uII usLImu uLLucks or even uII usLImu uLLucks Ior uny one
person ure psycIosomuLIc. However, LIere Is evIdence LIuL LIIs cun be LIe
cuse In some IndIvIduuIs uL LImes. TIuL u condILIon Is psycIosomuLIc
mukes IL no Iess ImporLunL or debIIILuLIng. WIen u medIco-muLerIuIIsL
mukes LIe sLuLemenL LIuL IL`s uII In LIe mInd, LIIs sounds beIILLIIng
301
301
Rampant Antismoking Signifies Grave Danger
unger, depressIon), LIrougI Induced emoLIonuIILy, cun resuIL In usLImuLIc
epIsodes. Rees (1q6q) uIso concIuded LIuL In onIy ;% oI cuses were
psycIoIogIcuI IucLors consIdered Lo be domInunL und LIuL In unoLIer o%
oI cuses psycIoIogIcuI IucLors were consIdered Lo be compIeLeIy
unImporLunL. AddILIonuIIy, ueLIoIogIcuI IucLors vurIed In ImporLunce us u
IuncLIon oI LIe IndIvIduuI`s uge. or exumpIe, under IIve yeurs oI uge,
InIecLIve IucLors domInuLed; uILIougI InIecLIve IucLors sLIII predomInuLed,
psycIoIogIcuI IucLors Increused In ImporLunce Irom uges 6 Lo 16;
psycIoIogIcuI IucLors decreused In ImporLunce Irom 1; yeurs oI uge unLII
ubouL uge , und LIen becomIng consequenLIuI uguIn.
TIe ouLIIne ubove IndIcuLes LIuL psycIoIogIcuI IucLors cun IIgure
consIderubIy In usLImu. However, LIe roIe oI psycIoIogIcuI IucLors muy be
even more consIderubIe sLIII. KIeemun (1q6;) Iound LIuL 6q% oI usLImu
uLLucks begun wILI un emoLIonuI dIsLurbunce Ior z6 puLIenLs InLervIewed
over un 18 monLI perIod. Dekker & Groen (1q6) Iound LIuL u subgroup oI
purLIcIpunLs deveIoped vuryIng degrees oI usLImu (IncIudIng IuII-bIown)
Lo sILuuLIons IndIcuLed by puLIenLs us precIpILuLIng uLLucks LIuL were
reproduced In LIe IuboruLory In ucLuuI or pIcLorIuI Iorm; LIe sLImuII Lo
wIIcI LIe subjecLs uscrIbed LIeIr usLImu IncIuded LIe nuLIonuI unLIem,
perIume, LIe siht oI dusL, Iorses, und wuLerIuIIs.
Even persons Ior wIom uIIergIc reucLIons ure consIdered Lo be
LIe prImury busIs oI LIeIr usLImu ure open Lo LIe psycIoIogIcuI IucLor oI
suggesLIbIIILy. upureIIo eL uI. (1q;1) InsLrucLed u group (qo) oI usLImuLIcs
und u sImIIurIy sIzed conLroI group LIuL LIey were purLIcIpuLIng In u sLudy
oI uIr poIIuLIon. L wus expIuIned LIuL LIe sLudy wus Lo deLermIne wIuL
concenLruLIons oI vurIous subsLunces wouId Induce wIeezIng. TIe
usLImuLIcs were udvIsed LIuL LIey wouId be InIuIIng IIve dIIIerenL
concenLruLIons oI un IrrILunL or un uIIergen LIuL Iud prevIousIy been
deLermIned us u conLrIbuLIng cuuse oI LIeIr usLImu uLLucks. AILIougI boLI
usLImuLIcs und conLroIs were gIven onIy IIve non-uIIergenIc suIIne
soIuLIons Lo InIuIe, usLImuLIcs were Ied Lo beIIeve LIuL eucI successIve
sumpIe wouId Iuve u IIgIer concenLruLIon oI LIe uIIergen; conLroIs were
udvIsed LIuL LIey wouId be InIuIIng poIIuLunLs wIIcI couId IrrILuLe LIe
broncIIuI Lubes und muke IL dIIIIcuIL Ior LIem Lo breuLIe. SIgnIIIcunL
uIrwuy obsLrucLIon occurred Ior IourLeen oI LIe IorLy usLImuLIc subjecLs;
LweIve oI LIese deveIoped IuII-bIown uLLucks. RespIruLory sympLoms were
noL observed In uny oI LIe conLroIs. Even more InLeresLIngIy, LIe LweIve
subjecLs LIuL Iud deveIoped IuII-bIown uLLucks were LoId LIuL LIey were
beIng gIven u broncIodIuIuLor Lo InIuIe wIen In IucL IL wus LIe sume suIIne
soIuLIon. TIe condILIon oI uII LweIve Improved, conIIrmIng LIe roIe oI
suggesLIon In some usLImuLIcs.
TIe suggesLIbIIILy In LIe upureIIo eL uI. (1q;1) sLudy InvoIves u
Preventive Medicine & Health Promotion
Iorm oI nocebo eIIecL und u plccebo eIIecL. TIe Ideu oI u pIucebo Ius u
Iong und vurIed IIsLory (see Jospe, 1q;8, p.xII). n conLemporury Lerms,
plccebo (Irom LIe uLIn: sIuII pIeuse) reIers Lo uny LIerupeuLIc
procedure (or LIuL componenL oI LIerupeuLIc procedure) wIIcI Is
deIIberuLeIy gIven Lo Iuve un eIIecL on u sympLom, syndrome or dIseuse,
buL wIIcI Is wILIouL specIIIc ucLIvILy Ior u condILIon Lo be LreuLed; LIe
pIucebo eIIecL Is ...cIunges produced by pIucebos or procedures ucLIng us
pIucebos. (SIupIro, 1q6) An exumpIe oI LIe pIucebo eIIecL Is LIe
uIIevIuLIon oI sympLoms, eLc., Irom LIe udmInIsLruLIon oI u sugur pIII
beIIeved by LIe puLIenL Lo be ucLuuI medIcuLIon, I.e., posILIve eIIecL wIere
none Is expecLed In reducLIonIsL (bIomedIcuI) Lerms (see uIso AcILerberg
& uwIIs, 1q8o, p.6-8).
TIe Lerm nocebo wus IIrsL coIned by Kennedy (1q61) und
expounded by KIsseI & Burrucund (1q6q) - see HuIn (1qq;). L derIves
Irom LIe uLIn Ior sIuII IurL, Iurm und, In ILs eurIIesL sense,
subsLILuLed Ior u neguLIve pIucebo, I.e., neguLIve eIIecL wIere none Is
expecLed In reducLIonIsL Lerms. However, HuIn (1qq;) properIy noLes LIuL
Kennedy (1q61) und KIsseI & Burrucund (1q6q) onIy consIdered neguLIve
eIIecL, buL dId noL dIsLInguIsI beLween ussocIuLed posILIve or neguLIve
expecLuncy. n u very ImporLunL sense u neguLIve pIucebo Is compIeLeIy
dIIIerenL Lo u nocebo. A neguLIve pIucebo properIy reIers Lo u neguLIve
eIIecL ussocIuLed wILI u posILIve expecLuncy, e.g., u person Is gIven u sugur
pIII beIIeved Lo be posILIve medIcuLIon buL LIe person deveIops sympLoms.
A nocebo properIy reIers Lo neguLIve eIIecL ussocIuLed wILI neguLIve
expecLuncy, e.g., u person deveIops sympLoms uILer beIng gIven u sugur
pIII beIIeved Lo be u dungerous subsLunce: WIuL dIsLInguIsIes nocebos Is
LIuL LIe subjecL Ius neguLIve expecLuLIons und ucLuuIIy experIences u
neguLIve ouL-come. (HuIn, 1qq;, p.;)
n LIe currenL sILuuLIon, LIe nocebo (IurmIuI) eIIecL Is reIIecLed
In producLIon oI u severe usLImuLIc uLLuck enLIreIy on LIe beliej LIuL u
neguLIve sLImuIus (deLermIned IrrILunLJuIIergen) Is presenL wIen LIe
neguLIve sLImuIus Is ucLuuIIy ubsenL. TIe pIucebo (posILIve) eIIecL Is
reIIecLed In LIe ImprovemenL oI un usLImuLIc condILIon enLIreIy on LIe
beIIeI LIuL u posILIve sLImuIus (broncIodIuIuLor) Is presenL wIen IL Is
ucLuuIIy ubsenL. TIe cIrcumsLunce oI usLImuLIc uLLuck (bIoIogIcuI cIunges
or dIsLurbunces In orgun IuncLIonIng) beIng produced by psycIogenIc
IucLors Is reIerred Lo us psycIopIysIoIogIcuI or psycIosomuLIc. TIIs Is noL
Lo suy LIuL uII usLImu uLLucks or even uII usLImu uLLucks Ior uny one
person ure psycIosomuLIc. However, LIere Is evIdence LIuL LIIs cun be LIe
cuse In some IndIvIduuIs uL LImes. TIuL u condILIon Is psycIosomuLIc
mukes IL no Iess ImporLunL or debIIILuLIng. WIen u medIco-muLerIuIIsL
mukes LIe sLuLemenL LIuL IL`s uII In LIe mInd, LIIs sounds beIILLIIng
302
302
Rampant Antismoking Signifies Grave Danger
becuuse IL Is beIILLIIng; muLerIuIIsLs Iuve u conLempL Ior LIe Ideu oI u
consequenLIuI psycIoIogIcuI dImensIon oI IuncLIonIng. However, u non-
reducLIonIsL psycIoIogIsL, Ior exumpIe, ucknowIedges LIuL mInd Is u very
powerIuI InsLrumenL LIuL, wIen ImproperIy used, cun generuLe
consIderubIe, deLrImenLuI consequences.
TIere ure u number oI poInLs Lo noLe concernIng psycIogenIc
uspecLs oI usLImu. IrsLIy, persons cun Iurbor uII munner oI psycIogenIc
conIIIcL LIuL cun be projecLed onLo exLernuI IucLors und munIIesLed In
usLImu uLLucks. ucLors do noL even need Lo be breuLIubIe subsLunces or
subsLunces uL uII, e.g., u pIcLure oI u purLIcuIur person. SecondIy, LIe
exLenL oI LIe roIe oI uIIergens In usLImu Is uIso urguubIe. or exumpIe,
monosodIum gIuLumuLe (MSG), u Iood uddILIve wIIcI Ior some LIme Ius
been consIdered un uIIergen LIuL cun LrIgger usLImuLIc reucLIons,
demonsLruLes no udverse eIIecLs wIen MSG-sensILIve usLImuLIcs do noL
know wIen IL Ius been udded Lo LIeIr Iood - even In Iurge umounLs
(SLevenson, zooo). n LIIs InsLunce u new Lerm wIII be coIned - un cbscebo
- un ubsence oI neguLIve reucLIon wIen u person Is noL uwure oI LIe
presence oI u supposed neguLIve sLImuIus, I.e., ubsence or dIsuppeurunce
oI expecLed eIIecL In reducLIonIsL Lerms. TIIrdIy, subsLunces LIuL ure
ussocIuLed wILI udverse reucLIon In usLImuLIcs, e.g., dusL, poIIen, ure
LypIcuIIy IurmIess wILIIn u normuLIve runge oI exposure und IuncLIonIng.
n u very crILIcuI sense sucI exogenous IucLors sIouId noL und usuuIIy
Iuve noL been reIerred Lo us cuuses oI usLImu uLLucks In LIuL LIey ure
noL ussocIuLed wILI usLImuLIc reucLIons In non-usLImuLIcs, I.e., usLImuLIc
reucLIon Lo sucI subsLunces Is IndIcuLIve oI LIe condILIon oI usLImu ruLIer
LIun generuI properLIes or propensILIes oI LIese subsLunces. As sucI, LIese
subsLunces ure usuuIIy reIerred Lo us triers. ourLIIy, un InILIuIIy mIId
reucLIon Lo exogenous IucLors cun be severeIy exucerbuLed by LIe
uddILIonuI psycIoIogIcuI Iyper-reucLIon oI punIcJIeur.
AIso crILIcuI Lo uny consIderuLIon oI usLImu Is IumIIIuI IucLors.
DuvIson & NeuIe (1q;8), Irom u sIorL revIew, concIude LIuL:
..LIe reseurcI LIuL we Iuve dIscussed reveuIs LIe
ImporLunce oI LIe Iome IIIe oI usLImuLIcs. L sIouId be
noLed, Iowever, LIuL we cunnoL uIwuys LeII wIeLIer
vurIous IumIIIuI vurIubIes ure cuusuI ugenLs or
muInLuInIng ugenLs. AILIougI cerLuIn emoLIonuI IucLors
In LIe Iome muy be ImporLunL In eIIcILIng eurIy
usLImuLIc uLLucks In some cIIIdren, In oLIers LIe IIIness
muy orIgInuIIy deveIop Ior nonIumIIIuI reusons, und
LIen LIe cIIIdren`s purenLs muy unwILLIngIy rewurd
vurIous sympLoms oI LIe syndrome. or exumpIe, LIe
purenLs muy cuLer Lo LIe cIIId und LreuL IIm specIuIIy
Preventive Medicine & Health Promotion
becuuse oI IIs usLImu. CurrenL recommenduLIons Ior
LIe LreuLmenL oI usLImuLIc cIIIdren suppIy IndIrecL
supporL Ior LIIs LIesIs. DocLors prescrIbe no specIuI
LreuLmenL und no overproLecLIon. nsLeud, usLImuLIc
cIIIdren ure urged Lo Ieud us normuI u IIIe us possIbIe,
even Lo LIe exLenL oI purLIcIpuLIng In uLIIeLIc evenLs. An
uLLempL Is mude, LIen, Lo keep LIe cIIIdren Irom
consIderIng LIeIr sIckness us LIe domInuLIng IucLor In
LIeIr IIves. TIIs uLLILude Is weII IIIusLruLed In LIe
IoIIowIng InLerucLIon presenLed by KIuger (1q6q):
Pctient: cun`L go Lo scIooI Loduy becuuse my usLImu Is
worse.
Doctor: know, buL sInce IL`s noL conLugIous wIy cun`L
you be In scIooI?
Pctient (IrrILuLed): Becuuse `m IuvIng LroubIe
breuLIIng!
Doctor: cun see LIuL, buL you`II Iuve LroubIe breuLIIng
wIeLIer you go Lo scIooI or noL. RemuInIng In bed
won`L IeIp your breuLIIng.
Pctient (dIsgusLedIy): Boy, LIey don`L even IeL you be
sIck In LIIs IospILuI. (p.186)
TIe usuuI medIcuI und psycIoIogIcuI sLunce Ius Luken InLo
consIderuLIon LIuL III cIIIdren generuIIy cun enguge In neuroLIc
overproLecLIon und cun uLLempL Lo use LIeIr condILIon Lo guIn un
udvunLuge by IIIness In IumIIy und socIuI conLexLs. And LIIs Is
purLIcuIurIy so Ior usLImu. PurenLs Iuve wuIked u IIne IIne oI noL
overproLecLIng cIIIdren, noL reInIorcIng LIe projecLIon onLo exLernuIILIes
oI wIuL muy In IucL be psycIoIogIcuIIy-bused usLImu uLLucks, und LIe
reusonubIe guurdIng uguInsL LIe cIIId IIjuckIng IumIIIuI dynumIcs LIrougI
LIe IIIness or LIe IIIness beIng used Lo bIuckmuII cerLuIn purenLuI
conducL, I.e., seekIng udvunLuge by IIIness. Even In InsLunces wIere un
uLLuck Is noL psycIoIogIcuIIy bused, udvunLuge by IIIness cun be ucIIeved
by InsIsLIng LIuL IL wus cuused by u purLIcuIur exLernuI IucLor - In muny
InsLunces LIe cuuse oI un uLLuck muy be IndeLermInuLe us Lo possIbIe
exogenous IucLors.
L cun uIso be noLed LIuL muny cIIIdren grow ouL oI LIeIr
usLImu LIrougI IuLer cIIIdIood und udoIescence. TIIs Is noL sImpIy u
muLLer oI Iungs muLurIng buL uIso psycIoIogIcuI und psycIosocIuI
muLuruLIon beyond peLuIunce, cuprIcIousness und IrruLIonuI Ieur oI
exogenous IucLors LIuL muy Iuve been mujor muInLuIners oI LIe condILIon.
TIe ucLuuI usLImu uLLuck Is obvIousIy noL u pIeusunL experIence, und, In
303
303
Rampant Antismoking Signifies Grave Danger
becuuse IL Is beIILLIIng; muLerIuIIsLs Iuve u conLempL Ior LIe Ideu oI u
consequenLIuI psycIoIogIcuI dImensIon oI IuncLIonIng. However, u non-
reducLIonIsL psycIoIogIsL, Ior exumpIe, ucknowIedges LIuL mInd Is u very
powerIuI InsLrumenL LIuL, wIen ImproperIy used, cun generuLe
consIderubIe, deLrImenLuI consequences.
TIere ure u number oI poInLs Lo noLe concernIng psycIogenIc
uspecLs oI usLImu. IrsLIy, persons cun Iurbor uII munner oI psycIogenIc
conIIIcL LIuL cun be projecLed onLo exLernuI IucLors und munIIesLed In
usLImu uLLucks. ucLors do noL even need Lo be breuLIubIe subsLunces or
subsLunces uL uII, e.g., u pIcLure oI u purLIcuIur person. SecondIy, LIe
exLenL oI LIe roIe oI uIIergens In usLImu Is uIso urguubIe. or exumpIe,
monosodIum gIuLumuLe (MSG), u Iood uddILIve wIIcI Ior some LIme Ius
been consIdered un uIIergen LIuL cun LrIgger usLImuLIc reucLIons,
demonsLruLes no udverse eIIecLs wIen MSG-sensILIve usLImuLIcs do noL
know wIen IL Ius been udded Lo LIeIr Iood - even In Iurge umounLs
(SLevenson, zooo). n LIIs InsLunce u new Lerm wIII be coIned - un cbscebo
- un ubsence oI neguLIve reucLIon wIen u person Is noL uwure oI LIe
presence oI u supposed neguLIve sLImuIus, I.e., ubsence or dIsuppeurunce
oI expecLed eIIecL In reducLIonIsL Lerms. TIIrdIy, subsLunces LIuL ure
ussocIuLed wILI udverse reucLIon In usLImuLIcs, e.g., dusL, poIIen, ure
LypIcuIIy IurmIess wILIIn u normuLIve runge oI exposure und IuncLIonIng.
n u very crILIcuI sense sucI exogenous IucLors sIouId noL und usuuIIy
Iuve noL been reIerred Lo us cuuses oI usLImu uLLucks In LIuL LIey ure
noL ussocIuLed wILI usLImuLIc reucLIons In non-usLImuLIcs, I.e., usLImuLIc
reucLIon Lo sucI subsLunces Is IndIcuLIve oI LIe condILIon oI usLImu ruLIer
LIun generuI properLIes or propensILIes oI LIese subsLunces. As sucI, LIese
subsLunces ure usuuIIy reIerred Lo us triers. ourLIIy, un InILIuIIy mIId
reucLIon Lo exogenous IucLors cun be severeIy exucerbuLed by LIe
uddILIonuI psycIoIogIcuI Iyper-reucLIon oI punIcJIeur.
AIso crILIcuI Lo uny consIderuLIon oI usLImu Is IumIIIuI IucLors.
DuvIson & NeuIe (1q;8), Irom u sIorL revIew, concIude LIuL:
..LIe reseurcI LIuL we Iuve dIscussed reveuIs LIe
ImporLunce oI LIe Iome IIIe oI usLImuLIcs. L sIouId be
noLed, Iowever, LIuL we cunnoL uIwuys LeII wIeLIer
vurIous IumIIIuI vurIubIes ure cuusuI ugenLs or
muInLuInIng ugenLs. AILIougI cerLuIn emoLIonuI IucLors
In LIe Iome muy be ImporLunL In eIIcILIng eurIy
usLImuLIc uLLucks In some cIIIdren, In oLIers LIe IIIness
muy orIgInuIIy deveIop Ior nonIumIIIuI reusons, und
LIen LIe cIIIdren`s purenLs muy unwILLIngIy rewurd
vurIous sympLoms oI LIe syndrome. or exumpIe, LIe
purenLs muy cuLer Lo LIe cIIId und LreuL IIm specIuIIy
Preventive Medicine & Health Promotion
becuuse oI IIs usLImu. CurrenL recommenduLIons Ior
LIe LreuLmenL oI usLImuLIc cIIIdren suppIy IndIrecL
supporL Ior LIIs LIesIs. DocLors prescrIbe no specIuI
LreuLmenL und no overproLecLIon. nsLeud, usLImuLIc
cIIIdren ure urged Lo Ieud us normuI u IIIe us possIbIe,
even Lo LIe exLenL oI purLIcIpuLIng In uLIIeLIc evenLs. An
uLLempL Is mude, LIen, Lo keep LIe cIIIdren Irom
consIderIng LIeIr sIckness us LIe domInuLIng IucLor In
LIeIr IIves. TIIs uLLILude Is weII IIIusLruLed In LIe
IoIIowIng InLerucLIon presenLed by KIuger (1q6q):
Pctient: cun`L go Lo scIooI Loduy becuuse my usLImu Is
worse.
Doctor: know, buL sInce IL`s noL conLugIous wIy cun`L
you be In scIooI?
Pctient (IrrILuLed): Becuuse `m IuvIng LroubIe
breuLIIng!
Doctor: cun see LIuL, buL you`II Iuve LroubIe breuLIIng
wIeLIer you go Lo scIooI or noL. RemuInIng In bed
won`L IeIp your breuLIIng.
Pctient (dIsgusLedIy): Boy, LIey don`L even IeL you be
sIck In LIIs IospILuI. (p.186)
TIe usuuI medIcuI und psycIoIogIcuI sLunce Ius Luken InLo
consIderuLIon LIuL III cIIIdren generuIIy cun enguge In neuroLIc
overproLecLIon und cun uLLempL Lo use LIeIr condILIon Lo guIn un
udvunLuge by IIIness In IumIIy und socIuI conLexLs. And LIIs Is
purLIcuIurIy so Ior usLImu. PurenLs Iuve wuIked u IIne IIne oI noL
overproLecLIng cIIIdren, noL reInIorcIng LIe projecLIon onLo exLernuIILIes
oI wIuL muy In IucL be psycIoIogIcuIIy-bused usLImu uLLucks, und LIe
reusonubIe guurdIng uguInsL LIe cIIId IIjuckIng IumIIIuI dynumIcs LIrougI
LIe IIIness or LIe IIIness beIng used Lo bIuckmuII cerLuIn purenLuI
conducL, I.e., seekIng udvunLuge by IIIness. Even In InsLunces wIere un
uLLuck Is noL psycIoIogIcuIIy bused, udvunLuge by IIIness cun be ucIIeved
by InsIsLIng LIuL IL wus cuused by u purLIcuIur exLernuI IucLor - In muny
InsLunces LIe cuuse oI un uLLuck muy be IndeLermInuLe us Lo possIbIe
exogenous IucLors.
L cun uIso be noLed LIuL muny cIIIdren grow ouL oI LIeIr
usLImu LIrougI IuLer cIIIdIood und udoIescence. TIIs Is noL sImpIy u
muLLer oI Iungs muLurIng buL uIso psycIoIogIcuI und psycIosocIuI
muLuruLIon beyond peLuIunce, cuprIcIousness und IrruLIonuI Ieur oI
exogenous IucLors LIuL muy Iuve been mujor muInLuIners oI LIe condILIon.
TIe ucLuuI usLImu uLLuck Is obvIousIy noL u pIeusunL experIence, und, In
304
304
Rampant Antismoking Signifies Grave Danger
Iew InsLunces, cun even be IIIe-LIreuLenIng. However, In uLLempLIng Lo
gIve u cIIId every opporLunILy oI overcomIng LIe condILIon, purLIcuIurIy
Irom psycIoIogIcuI LuInLIng, requIres medIcuI prucLILIoners und purenLs
LIuL ure psycIoIogIcuIIy und psycIosocIuIIy usLuLe. urLIermore, crILIcuI
IucLors Ior uny IndIvIduuI cun onIy be properIy uddressed on u cuse by cuse
busIs und cerLuInIy noL In epIdemIoIogIcuI, popuIuLIon-sLuLIsLIcuI Lerms.
n LIe conLexL oI LIe currenL dIscussIon, exposure Lo ETS Ius noL
usuuIIy IIgured IIgIIy, II uL uII, In consIderuLIons oI usLImu. n Lerms oI
poLenLIuI uIIergens or LrIggers, subsLunces sucI us dusL, poIIen, dusL mILes,
peL dunder, mouId, cockroucI droppIngs, Iuve been Iur more promInenL
umongsL LIe numerous poLenLIuI LrIggers LIus Iur IdenLIIIed. or exumpIe,
In LIe rcre evenL oI u cIIId IndIcuLIng LIuL LIey dId noL cure Loo mucI Ior
smoke (ETS) und occusIonuIIy exIIbILed usLImuLIc sympLoms, purenLs
wouId Iuve, uL one LIme, been properIy InsLrucLed noL Lo purLIcuIurIy curb
uny oI LIeIr smokIng beIuvIor uround LIe cIIId. TIe Ideu LIuL usLImu Is u
normuI reucLIon Lo smoke wouId noL be reInIorced, I.e., sucI reucLIon Is
hihl uLypIcuI, Is poLenLIuIIy psycIoIogIcuIIy-drIven undJor cun reInIorce
projecLIon onLo purLIcuIur exogenous IucLors oI erroneous cuuse-eIIecL
beIIeIs. A proper evuIuuLIon oI wIeLIer ETS cun ucL us u LrIgger Ior usLImu
wIII InvoIve LesLIng Ior noceboJubscebo eIIecLs. TIere Ius been no sucI
sysLemuLIc InvesLIguLIon. TIe enLIre concIusIon oI ETS beIng u LrIgger Ior
usLImu, und ImproperIy reIerred Lo us u cuuse, resLs enLIreIy on LIe
epIdemIoIogIc Irumework wIIcI, In uddILIon Lo very consIderubIe
sIorLcomIngs uIreudy dIscussed, Is wIoIIy InupproprIuLe Ior LIe puLIenL by
puLIenL Issues uL Iund.
TIe reuson Ior usIng oIder reIerences In LIIs consIderuLIon Is LIuL
IL Ius lon been undersLood LIuL conLInuIng usLImu cun InvoIve, uILIougI
noL uIwuys, psycIoIogIcuI und psycIo-emoLIonuI IucLors. YeL, uL one IeII
swoop, LIe muLerIuIIsm oI LIe EPA InvesLIguLIon, und wIIcI Is
sympLomuLIc oI LIe currenL, greuLer, medIco-muLerIuIIsm, compIeLeIy
obIILeruLes crILIcuI psycIoIogIcuI und psycIosocIuI IucLors Irom
consIderuLIon. TIe beIIeI LIuL one cun sImpIy reud oII RR dIIIerences,
converL LIese InLo uLLrIbuLubIe rIsk und ussocIuLed number oI usLImu-
sympLom cuses und uscrIbe LIese uLLucks Lo LIe cuusuI eIIecLs oI ETS Is
ouIIsI und does noL begIn Lo do jusLIce Lo LIe muILI-dImensIonuI IucLors
poLenLIuIIy InvoIved. TIIs IoIIy InvoIves LIe beIIeI LIuL usLImu Is enLIreIy u
medIcuI und bIoIogIcuI condILIon und Is vIewed us u bIuck box, sLuLIc
condILIon LIuL Is onIy cuused by exogenous IucLors. TIe IucLs oI LIe
muLLer ure LIuL usLImu reIIecLs endogenous ubnormuIILy (In uny Lerms),
LIuL exLernuI IucLors muy be LrIggers, uL mosL, und noL cuuses, und LIuL
purL oI LIe endogenous ubnormuIILy Ior uL IeusL some cun InvoIve
correcLubIe psycIoIogIcuI IucLors. TIe use oI LIe Lerm cuuse Lo descrIbe
Preventive Medicine & Health Promotion
even poLenLIuI LrIggers (e.g., ETS) Is enLIreIy reckIess und reIIecLs LIe
muLerIuIIsL domInuLIon oI LIe LIme. or LIese reusons LIe currenL
dIscussIon cunnoL Luke serIousIy, In uny sense, LIe stctisticcl cuIcuIuLIons
oI usLImu Induced by ETS provIded by LIe EPA.
(.(. Sudden Injcnt Decth Sndrome
EPA (1qq) uIso concIuded LIuL: n LIe UnILed SLuLes, more LIun
,ooo InIunLs dIe oI SDS unnuuIIy. L Is LIe mujor cuuse oI deuLI In
InIunLs beLween LIe uges oI 1 monLI und 1 yeur, und LIe IInkuge wILI
muLernuI smokIng Is weII esLubIIsIed. TIe Surgeon GeneruI und LIe WorId
HeuILI OrgunIzuLIon esLImuLe LIuL more LIun ;oo U.S. InIunL deuLIs per
yeur Irom SDS |Sudden nIunL DeuLI Syndrome| ure uLLrIbuLubIe Lo
muLernuI smokIng (CenLer Ior DIseuse ConLroI, 1qq1u, 1qqzb). However,
LIIs reporL concIudes LIuL uL presenL LIere Is noL enougI dIrecL evIdence
supporLIng LIe conLrIbuLIon oI ETS exposure Lo decIure IL u rIsk IucLor or
Lo esLImuLe ILs popuIuLIon ImpucL on SDS.
AILIougI EPA (1qq) dId noL consIder ETS exposure us cuusIng
SDS, LIIs vIew Ius sInce cIunged. L Is purLIcuIurIy on LIe Issue oI SDS,
un uIreudy LrugIc cIrcumsLunce LIuL cun LIen produce uddILIonuI
emoLIonuI LorLure und sLIgmuLIzuLIon In post hoc guessIng oI cuusuI
underpInnIngs, LIuL LIe IoIIy und deLrImenLuI consequences oI LIe weIgIL
oI evIdence procedure cun IurLIer be IIgIIIgILed.
TIe supposed reIuLIonsIIp beLween ETS exposure und SDS
cunnoL properIy be evuIuuLed wILIouL consIderIng LIe greuLer conLexL oI
Iow smokIng und pregnuncy Iuve been vIewed und LreuLed by MMES-
reusonIng over LIe IusL number oI decudes, und wIy ETS exposure und
SDS wus even u consIderuLIon In EPA (1qq).
Ouks (zoo1), In provIdIng u deLuIIed IIsLory oI smokIng und
pregnuncy, noLes LIuL:
TIe pregnunL smoker us LIe objecL oI pregnuncy
poIIcIng Is u reIuLIveIy recenL InvenLIon In LIe UnILed
SLuLes, und LIe socIuI sLIgmu currenLIy uLLucIed Lo
smokIng by pregnunL women Is LIe producL oI compIex
und convergIng Lrends. TIese IncIude medIcuI reseurcI
on LIe rIsks oI smokIng; unLILobucco IobbyIng Ior
reguIuLIon oI smoke-Iree envIronmenLs; eIIorLs by
unLIuborLIon udvocuLes Lo deIIne LIe IeLus us u person
wILI IeguI rIgILs; LIe medIcuI concepLuuIIzuLIon oI LIe
IeLus us u puLIenL; und rIsIng socIuI, medIcuI, und IeguI
expecLuLIons ubouL pregnunL women`s responsIbIIILIes
Lo ucL on beIuII oI LIeIr bubIes-Lo-be. (p.)
305
305
Rampant Antismoking Signifies Grave Danger
Iew InsLunces, cun even be IIIe-LIreuLenIng. However, In uLLempLIng Lo
gIve u cIIId every opporLunILy oI overcomIng LIe condILIon, purLIcuIurIy
Irom psycIoIogIcuI LuInLIng, requIres medIcuI prucLILIoners und purenLs
LIuL ure psycIoIogIcuIIy und psycIosocIuIIy usLuLe. urLIermore, crILIcuI
IucLors Ior uny IndIvIduuI cun onIy be properIy uddressed on u cuse by cuse
busIs und cerLuInIy noL In epIdemIoIogIcuI, popuIuLIon-sLuLIsLIcuI Lerms.
n LIe conLexL oI LIe currenL dIscussIon, exposure Lo ETS Ius noL
usuuIIy IIgured IIgIIy, II uL uII, In consIderuLIons oI usLImu. n Lerms oI
poLenLIuI uIIergens or LrIggers, subsLunces sucI us dusL, poIIen, dusL mILes,
peL dunder, mouId, cockroucI droppIngs, Iuve been Iur more promInenL
umongsL LIe numerous poLenLIuI LrIggers LIus Iur IdenLIIIed. or exumpIe,
In LIe rcre evenL oI u cIIId IndIcuLIng LIuL LIey dId noL cure Loo mucI Ior
smoke (ETS) und occusIonuIIy exIIbILed usLImuLIc sympLoms, purenLs
wouId Iuve, uL one LIme, been properIy InsLrucLed noL Lo purLIcuIurIy curb
uny oI LIeIr smokIng beIuvIor uround LIe cIIId. TIe Ideu LIuL usLImu Is u
normuI reucLIon Lo smoke wouId noL be reInIorced, I.e., sucI reucLIon Is
hihl uLypIcuI, Is poLenLIuIIy psycIoIogIcuIIy-drIven undJor cun reInIorce
projecLIon onLo purLIcuIur exogenous IucLors oI erroneous cuuse-eIIecL
beIIeIs. A proper evuIuuLIon oI wIeLIer ETS cun ucL us u LrIgger Ior usLImu
wIII InvoIve LesLIng Ior noceboJubscebo eIIecLs. TIere Ius been no sucI
sysLemuLIc InvesLIguLIon. TIe enLIre concIusIon oI ETS beIng u LrIgger Ior
usLImu, und ImproperIy reIerred Lo us u cuuse, resLs enLIreIy on LIe
epIdemIoIogIc Irumework wIIcI, In uddILIon Lo very consIderubIe
sIorLcomIngs uIreudy dIscussed, Is wIoIIy InupproprIuLe Ior LIe puLIenL by
puLIenL Issues uL Iund.
TIe reuson Ior usIng oIder reIerences In LIIs consIderuLIon Is LIuL
IL Ius lon been undersLood LIuL conLInuIng usLImu cun InvoIve, uILIougI
noL uIwuys, psycIoIogIcuI und psycIo-emoLIonuI IucLors. YeL, uL one IeII
swoop, LIe muLerIuIIsm oI LIe EPA InvesLIguLIon, und wIIcI Is
sympLomuLIc oI LIe currenL, greuLer, medIco-muLerIuIIsm, compIeLeIy
obIILeruLes crILIcuI psycIoIogIcuI und psycIosocIuI IucLors Irom
consIderuLIon. TIe beIIeI LIuL one cun sImpIy reud oII RR dIIIerences,
converL LIese InLo uLLrIbuLubIe rIsk und ussocIuLed number oI usLImu-
sympLom cuses und uscrIbe LIese uLLucks Lo LIe cuusuI eIIecLs oI ETS Is
ouIIsI und does noL begIn Lo do jusLIce Lo LIe muILI-dImensIonuI IucLors
poLenLIuIIy InvoIved. TIIs IoIIy InvoIves LIe beIIeI LIuL usLImu Is enLIreIy u
medIcuI und bIoIogIcuI condILIon und Is vIewed us u bIuck box, sLuLIc
condILIon LIuL Is onIy cuused by exogenous IucLors. TIe IucLs oI LIe
muLLer ure LIuL usLImu reIIecLs endogenous ubnormuIILy (In uny Lerms),
LIuL exLernuI IucLors muy be LrIggers, uL mosL, und noL cuuses, und LIuL
purL oI LIe endogenous ubnormuIILy Ior uL IeusL some cun InvoIve
correcLubIe psycIoIogIcuI IucLors. TIe use oI LIe Lerm cuuse Lo descrIbe
Preventive Medicine & Health Promotion
even poLenLIuI LrIggers (e.g., ETS) Is enLIreIy reckIess und reIIecLs LIe
muLerIuIIsL domInuLIon oI LIe LIme. or LIese reusons LIe currenL
dIscussIon cunnoL Luke serIousIy, In uny sense, LIe stctisticcl cuIcuIuLIons
oI usLImu Induced by ETS provIded by LIe EPA.
(.(. Sudden Injcnt Decth Sndrome
EPA (1qq) uIso concIuded LIuL: n LIe UnILed SLuLes, more LIun
,ooo InIunLs dIe oI SDS unnuuIIy. L Is LIe mujor cuuse oI deuLI In
InIunLs beLween LIe uges oI 1 monLI und 1 yeur, und LIe IInkuge wILI
muLernuI smokIng Is weII esLubIIsIed. TIe Surgeon GeneruI und LIe WorId
HeuILI OrgunIzuLIon esLImuLe LIuL more LIun ;oo U.S. InIunL deuLIs per
yeur Irom SDS |Sudden nIunL DeuLI Syndrome| ure uLLrIbuLubIe Lo
muLernuI smokIng (CenLer Ior DIseuse ConLroI, 1qq1u, 1qqzb). However,
LIIs reporL concIudes LIuL uL presenL LIere Is noL enougI dIrecL evIdence
supporLIng LIe conLrIbuLIon oI ETS exposure Lo decIure IL u rIsk IucLor or
Lo esLImuLe ILs popuIuLIon ImpucL on SDS.
AILIougI EPA (1qq) dId noL consIder ETS exposure us cuusIng
SDS, LIIs vIew Ius sInce cIunged. L Is purLIcuIurIy on LIe Issue oI SDS,
un uIreudy LrugIc cIrcumsLunce LIuL cun LIen produce uddILIonuI
emoLIonuI LorLure und sLIgmuLIzuLIon In post hoc guessIng oI cuusuI
underpInnIngs, LIuL LIe IoIIy und deLrImenLuI consequences oI LIe weIgIL
oI evIdence procedure cun IurLIer be IIgIIIgILed.
TIe supposed reIuLIonsIIp beLween ETS exposure und SDS
cunnoL properIy be evuIuuLed wILIouL consIderIng LIe greuLer conLexL oI
Iow smokIng und pregnuncy Iuve been vIewed und LreuLed by MMES-
reusonIng over LIe IusL number oI decudes, und wIy ETS exposure und
SDS wus even u consIderuLIon In EPA (1qq).
Ouks (zoo1), In provIdIng u deLuIIed IIsLory oI smokIng und
pregnuncy, noLes LIuL:
TIe pregnunL smoker us LIe objecL oI pregnuncy
poIIcIng Is u reIuLIveIy recenL InvenLIon In LIe UnILed
SLuLes, und LIe socIuI sLIgmu currenLIy uLLucIed Lo
smokIng by pregnunL women Is LIe producL oI compIex
und convergIng Lrends. TIese IncIude medIcuI reseurcI
on LIe rIsks oI smokIng; unLILobucco IobbyIng Ior
reguIuLIon oI smoke-Iree envIronmenLs; eIIorLs by
unLIuborLIon udvocuLes Lo deIIne LIe IeLus us u person
wILI IeguI rIgILs; LIe medIcuI concepLuuIIzuLIon oI LIe
IeLus us u puLIenL; und rIsIng socIuI, medIcuI, und IeguI
expecLuLIons ubouL pregnunL women`s responsIbIIILIes
Lo ucL on beIuII oI LIeIr bubIes-Lo-be. (p.)
306
306
Rampant Antismoking Signifies Grave Danger
AnLIsmokIng concernIng pregnuncy preduLes LIe currenL wuve.
EurIy In LIe 1qoo`s IL wus some cIurcI groups (e.g., MeLIodIsL EpIscopuI
CIurcI`s Bourd oI Temperunce, ProIIbILIon, und PubIIc MoruIs) LIuL
consIdered nIcoLIne us u kIIIer oI bubIes. TIe conLroversy wus pIcked
up by LIe Neu Yorl Times In Lwo sLorIes. n one sLory IL wus cIuImed LIuL
qo bubIes Irom u New York muLernILy IospILuI suIIered Irom Lobucco
IeurL cuused by LIe cIgureL smokIng oI LIeIr moLIers. n LIe oLIer IL wus
cIuImed LIuL sIxLy percenL oI uII bubIes born oI cIgureL-smokIng moLIers
dIe beIore LIey reucI LIe uge oI Lwo, due prImurIIy Lo nIcoLIne
poIsonIng. (quoLed In Ouks, zoo1, p.; JournuI oI LIe AmerIcun MedIcuI
AssocIuLIon, 1qzq, p.1z) TIe AmerIcun Tobucco TrusL wus vIewed by LIe
cIurcI bourd us conscIenceIess buby-kIIIers LIuL by promoLIng cIgureLLes
Lo women were dIrecLIng u IyIng murderous cumpuIgn. L sIouId uIso be
noLed LIuL LIIs moruIIsLIc crusude wus bused on u IedonIsLIc noLIon oI
smokIng, I.e., u seIIIsI pIeusure.
AL LIIs eurIIer LIme LIe medIcuI esLubIIsImenL dIsLunced ILseII
Irom sucI cIuIms, dIspuLIng LIe dunger oI smokIng durIng pregnuncy. AL
uny ruLe, IL wus consIdered LIuL IurLIer reseurcI wus requIred on LIe
muLLer. L wus noL unLII LIe 1qo`s LIuL u Iew reseurcIers InvesLIguLed LIe
muLLer In uny consIderubIe deLuII (e.g., SImpson, 1q;). However, LIe
subjecL remuIned essenLIuIIy unconLroversIuI und cerLuInIy noL u pressIng
pubIIc IeuILI Issue. TIIs cIunged quILe drumuLIcuIIy In LIe 1q;o`s us
medIco-muLerIuIIsm Look IoId In muLLers oI IeuILI LIrougI LIe
quunLIIIcuLIon oI rIsk uIIorded by epIdemIoIogy und LIe muLerIuIIsL Ideu oI
LIe rIsk uvoIdIng IndIvIduuI. (see BerrIdge, 1qqq) L Is In LIIs currenL
unLIsmokIng wuve LIuL LIe medIcuI esLubIIsImenL Is uL LIe Iore. NowIere
Is LIe cuIL muLerIuIIsL Ideu oI rIsk uversIon us normuLIve preucIed more
mIIILunLIy und LIrougI unreIenLIng Ieur und guIIL-mongerIng LIun In LIe
ureu oI pregnuncy. TIe poLenLIuI Ior supersLILIous beIIeIs, nocebo eIIecLs,
unIounded sLIgmuLIzIng eIIecLs, uIIenuLIon, eLc., ure LruIy sLuggerIng.
One oI LIe mujor unLIsmokIng urgumenLs concerns bIrLI weIgIL;
LIere Is u IIgIer IncIdence oI Iower bIrLIweIgIL bubIes born Lo smokIng
women. TIIs Ius been known Ior muny decudes (e.g., SImpson, 1q;).
OukIey (1qqz) Lruces LIe use In LIe UnILed SLuLes oI LIe meusuremenL oI
bIrLI weIgIL Lo 1qqq wIen weIgIL uL bIrLI wus udded Lo LIe SLundurd
CerLIIIcuLe oI Ive BIrLI (cILed In Ouks, zoo1, p.q). TIe currenL
InLernuLIonuI sLundurd Is LIuL Iow bIrLIweIgIL Is deIIned us under z,oo
grums. OukIey (1qqz) IndIcuLes LIuL weIgIL uL bIrLI, u seemIngIy sImpIe
und LIereIore objecLIve meusure, Is subjecL Lo conIoundIng: L muLLers
Iow, wIen und In wIuL munner bubIes ure weIgIed, und IL muLLers wIo
does LIe weIgIIng, wIuL LIe nuLure oI LIe weIgIIng equIpmenL Is, und Iow
Preventive Medicine & Health Promotion
LIe weIgIL Is boLI reud und recorded. (quoLed In ouks, zoo1, p.zz)
TIere Is un uspecL oI urbILrurIness LIuL Is LypIcuIIy noL consIdered. or
exumpIe, IemuIe InIunLs, on uveruge, weIgI Iess uL bIrLI LIun muIe InIunLs.
TIey cunnoL boLI Iuve LIe sume demurcuLIon IIne Ior Iow und normuI
bIrLIweIgIL. I z,oo grums Is LIe demurcuLIon IIne Ior muIe InIunLs, LIen
wIuL Is LIe compurubIe IIne Ior IemuIe InIunLs? Or ure IemuIe InIunLs
beIow z,oo grums, und oI wIIcI LIere wIII probubIy be more LIun muIe
InIunLs, cIussIIIed us Iow bIrLIweIgIL?
L musL be noLed LIuL Iow bIrLIweIgIL oI ILseII Is noL u dIseuse,
IIIness, or medIcuI condILIon. MosL Iow bIrLIweIgIL bubIes ure IeuILIy und
LIe weIgIL dIIIerenLIuI Ior InIunLs born Lo smokers, Ior exumpIe,
dIsuppeurs wILIIn ubouL 6 monLIs (e.g., ConLer eL uI., 1qq). ow
bIrLIweIgIL sIouId noL be conIused wILI premuLure bIrLIs (pre IuII-Lerm
deIIvery) wIIcI ure usuuIIy uIso oI Iow bIrLIweIgIL; LIe mujorILy oI Iow
bIrLIweIgIL bubIes born Lo smokers ure IuII-Lerm (muLure). TIere ure uIso
numerous oLIer Iow-IeveI rIsk IucLors Ior Iow bIrLIweIgIL, e.g., educuLIon,
empIoymenL, murILuI sLuLus, ruce, number oI prevIous bIrLIs, muLernuI
uge, nuLrILIon, drug use, cuIIeIne, uIcoIoI, sLress. ow bIrLIweIgIL Is In
Lurn u lou-letel rIsk IucLor Ior purLIcuIur medIcuI condILIons und morLuIILy
sucI us InIecLIous-dIseuse morLuIILy (e.g., Reud eL uI., 1qqq).
SImpson (1q;) Iound LIuL LIe reIuLIve rIsk (RR) oI Iow
bIrLIweIgIL Ior smokers wus uround z.o. TIIs Ius sInce been IurLIer
reIIned so LIuL IIgIL smokers (Iess LIun 1 puck) Iuve un RR=1. und
Ieuvy smokers un RR=z. oI Iow bIrLIweIgIL deIIverIes. TIe percenLuge oI
nonsmokers IuvIng Iow bIrLIweIgIL bubIes Is 8.%. TIIs percenLuge uIso
represenLs ubsoIuLe rIsk (I.e., predIcLIve sLrengLI). TIe percenLuge oI IIgIL
smokers IuvIng Iow bIrLIweIgIL bubIes Is 1% (I.e., 8.% x 1.); LIe
percenLuge oI Ieuvy smokers IuvIng Iow bIrLIweIgIL bubIes Is 1q.6% (I.e.,
8.% x z.). TIereIore, LIe percenLuge oI IIgIL smokers IuvIng Iow
bIrLIweIgIL bubIes Is q.% ubove LIe buseIIne oI 8.%; unoLIer wuy oI
sLuLIng LIIs Is LIuL q%, ubove LIe buseIIne, oI bIrLIs Ior IIgIL smokers ure
normuI weIgIL. TIe percenLuge oI Ieuvy smokers IuvIng Iow bIrLIweIgIL
bubIes Is -11% ubove LIe buseIIne; 8q%, ubove LIe buseIIne, oI bIrLIs Ior
Ieuvy smokers ure normuI weIgIL. n oLIer words, LIe jcr greuLer mujorILy
oI bIrLIs Ior smokers ure normuI weIgIL. ow bIrLIweIgIL Is uLypIcuI Ior
boLI smokers und nonsmokers, buL reIuLIveIy Iess uLypIcuI Ior smokers.
TIere ure u number oI poInLs LIuL cun be mude Iere. IrsLIy, Iow
bIrLIweIgIL deIIverIes uIso occur Ior nonsmokers. SecondIy, LIere ure
oLIer rIsk IucLors LIuL wIen IucLored InLo LIe consIderuLIon (uccounLIng
Ior cross-correIuLIons) wIII IurLIer dImInIsI LIe Iow-IeveI ussocIuLIon oI
uny one IucLor wILI Iow bIrLIweIgIL. TIIrdIy, smokIng us u prImury cuuse
oI Iow bIrLIweIgIL Is dejinititel dIsconIIrmed, I.e., II LIIs IucLor Is used Lo
307
307
Rampant Antismoking Signifies Grave Danger
AnLIsmokIng concernIng pregnuncy preduLes LIe currenL wuve.
EurIy In LIe 1qoo`s IL wus some cIurcI groups (e.g., MeLIodIsL EpIscopuI
CIurcI`s Bourd oI Temperunce, ProIIbILIon, und PubIIc MoruIs) LIuL
consIdered nIcoLIne us u kIIIer oI bubIes. TIe conLroversy wus pIcked
up by LIe Neu Yorl Times In Lwo sLorIes. n one sLory IL wus cIuImed LIuL
qo bubIes Irom u New York muLernILy IospILuI suIIered Irom Lobucco
IeurL cuused by LIe cIgureL smokIng oI LIeIr moLIers. n LIe oLIer IL wus
cIuImed LIuL sIxLy percenL oI uII bubIes born oI cIgureL-smokIng moLIers
dIe beIore LIey reucI LIe uge oI Lwo, due prImurIIy Lo nIcoLIne
poIsonIng. (quoLed In Ouks, zoo1, p.; JournuI oI LIe AmerIcun MedIcuI
AssocIuLIon, 1qzq, p.1z) TIe AmerIcun Tobucco TrusL wus vIewed by LIe
cIurcI bourd us conscIenceIess buby-kIIIers LIuL by promoLIng cIgureLLes
Lo women were dIrecLIng u IyIng murderous cumpuIgn. L sIouId uIso be
noLed LIuL LIIs moruIIsLIc crusude wus bused on u IedonIsLIc noLIon oI
smokIng, I.e., u seIIIsI pIeusure.
AL LIIs eurIIer LIme LIe medIcuI esLubIIsImenL dIsLunced ILseII
Irom sucI cIuIms, dIspuLIng LIe dunger oI smokIng durIng pregnuncy. AL
uny ruLe, IL wus consIdered LIuL IurLIer reseurcI wus requIred on LIe
muLLer. L wus noL unLII LIe 1qo`s LIuL u Iew reseurcIers InvesLIguLed LIe
muLLer In uny consIderubIe deLuII (e.g., SImpson, 1q;). However, LIe
subjecL remuIned essenLIuIIy unconLroversIuI und cerLuInIy noL u pressIng
pubIIc IeuILI Issue. TIIs cIunged quILe drumuLIcuIIy In LIe 1q;o`s us
medIco-muLerIuIIsm Look IoId In muLLers oI IeuILI LIrougI LIe
quunLIIIcuLIon oI rIsk uIIorded by epIdemIoIogy und LIe muLerIuIIsL Ideu oI
LIe rIsk uvoIdIng IndIvIduuI. (see BerrIdge, 1qqq) L Is In LIIs currenL
unLIsmokIng wuve LIuL LIe medIcuI esLubIIsImenL Is uL LIe Iore. NowIere
Is LIe cuIL muLerIuIIsL Ideu oI rIsk uversIon us normuLIve preucIed more
mIIILunLIy und LIrougI unreIenLIng Ieur und guIIL-mongerIng LIun In LIe
ureu oI pregnuncy. TIe poLenLIuI Ior supersLILIous beIIeIs, nocebo eIIecLs,
unIounded sLIgmuLIzIng eIIecLs, uIIenuLIon, eLc., ure LruIy sLuggerIng.
One oI LIe mujor unLIsmokIng urgumenLs concerns bIrLI weIgIL;
LIere Is u IIgIer IncIdence oI Iower bIrLIweIgIL bubIes born Lo smokIng
women. TIIs Ius been known Ior muny decudes (e.g., SImpson, 1q;).
OukIey (1qqz) Lruces LIe use In LIe UnILed SLuLes oI LIe meusuremenL oI
bIrLI weIgIL Lo 1qqq wIen weIgIL uL bIrLI wus udded Lo LIe SLundurd
CerLIIIcuLe oI Ive BIrLI (cILed In Ouks, zoo1, p.q). TIe currenL
InLernuLIonuI sLundurd Is LIuL Iow bIrLIweIgIL Is deIIned us under z,oo
grums. OukIey (1qqz) IndIcuLes LIuL weIgIL uL bIrLI, u seemIngIy sImpIe
und LIereIore objecLIve meusure, Is subjecL Lo conIoundIng: L muLLers
Iow, wIen und In wIuL munner bubIes ure weIgIed, und IL muLLers wIo
does LIe weIgIIng, wIuL LIe nuLure oI LIe weIgIIng equIpmenL Is, und Iow
Preventive Medicine & Health Promotion
LIe weIgIL Is boLI reud und recorded. (quoLed In ouks, zoo1, p.zz)
TIere Is un uspecL oI urbILrurIness LIuL Is LypIcuIIy noL consIdered. or
exumpIe, IemuIe InIunLs, on uveruge, weIgI Iess uL bIrLI LIun muIe InIunLs.
TIey cunnoL boLI Iuve LIe sume demurcuLIon IIne Ior Iow und normuI
bIrLIweIgIL. I z,oo grums Is LIe demurcuLIon IIne Ior muIe InIunLs, LIen
wIuL Is LIe compurubIe IIne Ior IemuIe InIunLs? Or ure IemuIe InIunLs
beIow z,oo grums, und oI wIIcI LIere wIII probubIy be more LIun muIe
InIunLs, cIussIIIed us Iow bIrLIweIgIL?
L musL be noLed LIuL Iow bIrLIweIgIL oI ILseII Is noL u dIseuse,
IIIness, or medIcuI condILIon. MosL Iow bIrLIweIgIL bubIes ure IeuILIy und
LIe weIgIL dIIIerenLIuI Ior InIunLs born Lo smokers, Ior exumpIe,
dIsuppeurs wILIIn ubouL 6 monLIs (e.g., ConLer eL uI., 1qq). ow
bIrLIweIgIL sIouId noL be conIused wILI premuLure bIrLIs (pre IuII-Lerm
deIIvery) wIIcI ure usuuIIy uIso oI Iow bIrLIweIgIL; LIe mujorILy oI Iow
bIrLIweIgIL bubIes born Lo smokers ure IuII-Lerm (muLure). TIere ure uIso
numerous oLIer Iow-IeveI rIsk IucLors Ior Iow bIrLIweIgIL, e.g., educuLIon,
empIoymenL, murILuI sLuLus, ruce, number oI prevIous bIrLIs, muLernuI
uge, nuLrILIon, drug use, cuIIeIne, uIcoIoI, sLress. ow bIrLIweIgIL Is In
Lurn u lou-letel rIsk IucLor Ior purLIcuIur medIcuI condILIons und morLuIILy
sucI us InIecLIous-dIseuse morLuIILy (e.g., Reud eL uI., 1qqq).
SImpson (1q;) Iound LIuL LIe reIuLIve rIsk (RR) oI Iow
bIrLIweIgIL Ior smokers wus uround z.o. TIIs Ius sInce been IurLIer
reIIned so LIuL IIgIL smokers (Iess LIun 1 puck) Iuve un RR=1. und
Ieuvy smokers un RR=z. oI Iow bIrLIweIgIL deIIverIes. TIe percenLuge oI
nonsmokers IuvIng Iow bIrLIweIgIL bubIes Is 8.%. TIIs percenLuge uIso
represenLs ubsoIuLe rIsk (I.e., predIcLIve sLrengLI). TIe percenLuge oI IIgIL
smokers IuvIng Iow bIrLIweIgIL bubIes Is 1% (I.e., 8.% x 1.); LIe
percenLuge oI Ieuvy smokers IuvIng Iow bIrLIweIgIL bubIes Is 1q.6% (I.e.,
8.% x z.). TIereIore, LIe percenLuge oI IIgIL smokers IuvIng Iow
bIrLIweIgIL bubIes Is q.% ubove LIe buseIIne oI 8.%; unoLIer wuy oI
sLuLIng LIIs Is LIuL q%, ubove LIe buseIIne, oI bIrLIs Ior IIgIL smokers ure
normuI weIgIL. TIe percenLuge oI Ieuvy smokers IuvIng Iow bIrLIweIgIL
bubIes Is -11% ubove LIe buseIIne; 8q%, ubove LIe buseIIne, oI bIrLIs Ior
Ieuvy smokers ure normuI weIgIL. n oLIer words, LIe jcr greuLer mujorILy
oI bIrLIs Ior smokers ure normuI weIgIL. ow bIrLIweIgIL Is uLypIcuI Ior
boLI smokers und nonsmokers, buL reIuLIveIy Iess uLypIcuI Ior smokers.
TIere ure u number oI poInLs LIuL cun be mude Iere. IrsLIy, Iow
bIrLIweIgIL deIIverIes uIso occur Ior nonsmokers. SecondIy, LIere ure
oLIer rIsk IucLors LIuL wIen IucLored InLo LIe consIderuLIon (uccounLIng
Ior cross-correIuLIons) wIII IurLIer dImInIsI LIe Iow-IeveI ussocIuLIon oI
uny one IucLor wILI Iow bIrLIweIgIL. TIIrdIy, smokIng us u prImury cuuse
oI Iow bIrLIweIgIL Is dejinititel dIsconIIrmed, I.e., II LIIs IucLor Is used Lo
308
308
Rampant Antismoking Signifies Grave Danger
predIcL Iow bIrLIweIgIL IL wouId be wrong mosL oI LIe LIme. SucI u
sILuuLIon demonsLruLes u lccl oI undersLundIng oI cuusuLIon. ourLIIy, IL
wus consIdered In un eurIIer secLIon LIuL smokIng ILseII Is u summurIzIng
pIenomenon Ior oLIer IucLors LIuL cun uIso be correIuLed wILI Iow
bIrLIweIgIL und LIuL uIso uccounLs Ior u pIunLom dose-response
ussocIuLIon; LIere Is uIso u poLenLIuI conLrusLIng eIIecL (I.e., IIgIIy rIsk-
uverse nonsmokers LIuL cun economIcuIIy uIIord LIe dIsposILIon) us
consIdered eurIIer, I.e., IL Is noL surprIsIng LIuL reIuLIve rIsk dIIIerenLIuIs
ure Iound beLween smokers und nonsmokers. IILIIy, LIe enLIre Ideu LIuL,
Ior smokers, IL Is LIe properLIes oI Lobucco smoke LIuL cuuse Iow
bIrLIweIgIL Is compIeLeIy quesLIonubIe. L cun uIso be suId LIuL LIe crILIcuI
IucLor(s) (I.e., demonsLruLIng IIgI predIcLIve sLrengLI) Ior Iow bIrLIweIgIL
Ius noL yeL been IdenLIIIed - und by u Iong wuy. InuIIy, IL musL be re-
ILeruLed LIuL Iow bIrLIweIgIL oI ILseII Is noL u dIseuse.
Very recenL Jupunese reseurcI Ius Iound LIuL |s|mokIng by
purenLs uround LIe LIme oI concepLIon cun reduce LIe cIunce oI IuvIng u
boy by up Lo u LIIrd..PsycIoIogIcuI und pIysIcuI sLress, Loo, ure known Lo
pIuy u purL. (The Ae, AprII zo, zooz) AILIougI LIe sLuLemenL Is mude In
cuusuI Lerms (I.e., uses LIe Lerm reduce ruLIer LIun ussocIuLed wILI u
Iower IncIdence oI), wIIcI Ius no busIs, LIIs IIndIng Is IIgIIy ImporLunL
Ior uL IeusL Lwo reusons. IrsLIy, IemuIe InIunLs, on uveruge, weIgI Iess
LIun muIe InIunLs. I LIe InIunL`s gender Is noL uccounLed Ior In sLudIes,
LIen LIe Iow bIrLIweIgIL dIIIerenLIuI Ior smokers und nonsmokers muy uL
IeusL In purL reIIecL LIIs ender dIIIerenLIuI. or exumpIe, SImpson (1q;),
und oLIers sInce, muke no menLIon oI uccommoduLIng gender
dIIIerenLIuIs. I LIIs Is LIe cuse, In scIoIurIy Lerms LIIs Is In LIe order oI
scunduI. WIIIe unLIsmokIng ugendu Ius been progressIveIy IueIed und
wIIIe smokers Iuve been pounded by unLIsmokIng prescrIpLIons Ior uL
IeusL LIe IusL Iew decudes, sucI u IundumenLuI muLLer oI LeusIng ouL LIe
mosL obvIous reusons Ior wIy dIIIerenLIuIs mIgIL exIsL (I.e., scIenLIIIc
InLegrILy) Iuve been compIeLeIy overIooked, I.e., gruve IncompeLence.
SecondIy, LIrougI LIIs IIndIng LIe medIcuI esLubIIsImenL Ius worked
ILseII InLo u LIeoreLIcuI corner. L demonsLruLes LIuL even wIen LIere Is
no c priori reuson Ior dIIIerences beLween smokers und nonsmokers,
dIIIerences sLIII occur. TIe IucLor oI smokIng Ius LypIcuIIy been
InvesLIguLed wILI respecL Lo Increused ussocIuLIons wILI dIseuse - even
wIen LIere Is no c priori reuson Ior LIese Lo occur. WIere reIuLIve
Increuses Iuve been observed, LIese Iuve LypIcuIIy been IncompeLenLIy
reusoned us cuused by LIe curcInogenIc properLIes oI Lobucco smoke. n
LIe currenL exumpIe, even LIougI LIere Is probubIy some IormonuI IucLor
InvoIved, IL wouId be dIIIIcuIL, II noL ImpossIbIe, Lo urgue LIuL un Increused
probubIIILy oI u IemuIe InIunL Is LIe equIvuIenL oI u dIseuse sLuLe. L couId
Preventive Medicine & Health Promotion
be urgued LIuL smokIng uIIecLs LIe buIunce oI muIeJIemuIe InIunLs.
However, LIIs ussumes LIe IncoIerenL one orgunIsm vIew oI smokers.
urLIermore, LIere Is u sImIIur counLer-ImbuIunce Ior nonsmokers.
DIIIerences beLween smokers und nonsmokers occur on u wIoIe IosL oI
meusures Ior no cppcrent reuson und LIey ure usuuIIy IndIcuLIve oI smuII
subgroup dIIIerences. GeneruI proposILIons concernIng uII smokers or uII
nonsmokers In LIIs cIrcumsLunce Iuve no meunIngIuIness; In scIenLIIIc
Lerms LIey ure bIuLunLIy wrong. urLIer compIIcuLIng LIIs Iow-probubIIILy
mIre Is LIuL pIIoLs, usLronuuLs und dIvers IuLIer more gIrIs (The Ae, AprII
zo, zooz), und domInunL women ure more IIkeIy Lo Iuve sons (Hercld,
Sun, SepLember 1z, zooz).
TIus Iur IL Ius been consIdered LIuL mosL bIrLIs resuIL In IeuILIy
bubIes und LIuL mosL bubIes ure born normuI weIgIL ((q1.%+8;%
+8o.q%)J=86.%). TIIs Is so Ior boLI smokers und nonsmokers. TIere Is
cerLuInIy u reIuLIveIy IIgIer, uILIougI ubsoIuLeIy Iow, IncIdence oI Iow
bIrLIweIgIL bubIes born Lo smokers. However, Iow bIrLIweIgIL bubIes
consLILuLe u smuII proporLIon oI overuII bIrLIs und Iow bIrLIweIgIL oI ILseII
Is noL probIemuLIc.
ReIuLIve dIIIerences beLween smokers und nonsmokers Iuve uIso
been expIored Ior more cuLusLropIIc evenLs, e.g., InIunL morLuIILy. CenLers
Ior DIseuse ConLroI (1qq) IndIcuLes LIuL, Ior smokers, LIere Is un
Increused rIsk oI InIunL morLuIILy (InIunLs under 1 yeur oId) Irom sIorL
gesLuLIonJIow bIrLIweIgIL (RR=1.8), respIruLory dIsLress syndrome
(RR=1.8), oLIer respIruLory condILIons oI newborn (RR=1.8), und sudden
InIunL deuLI syndrome (RR=1.). TIrougI LIe compIeLeIy quesLIonubIe
SAMMEC procedure eurIIer dIscussed, LIese RR`s ure converLed Lo
uLLrIbuLubIe rIsk und LIen uLLrIbuLubIe numbers. or sIorL gesLuLIon,
uLLrIbuLubIe number Is o;; Ior respIruLory dIsLress syndrome,
uLLrIbuLubIe number Is 6o; Ior oLIer respIruLory condILIons, uLLrIbuLubIe
number Is ;q; Ior sudden InIunL deuLI syndrome, uLLrIbuLubIe number Is
q;o.
AccordIng Lo u CDC IucL sIeeL, ubouL 1 percenL oI women
smoke wIIIe pregnunL - ubouL qoo,ooo women In 1qq6. I uII oI LIe
ubove morLuIILy numbers ure summed (o;+6o+;q+q;o=1;11), LIen
LIe predIcLIve sLrengLI oI smokIng Ior LIIs morLuIILy, ubove u buseIIne, Is
eIIecLIveIy zero (1;11Jqoo,ooo=.ooq); LIe predIcLIve sLrengLI oI smokIng
Ior uny specIIIc morLuIILy Is even cIoser Lo zero. SucI morLuIILy does noL
occur Ior qq%+ oI smokers. TIere Is no prImury cuusuI urgumenL
concernIng smokIng und InIunL morLuIILy; LIe duLu deIInILIveIy
dIsconIIrms sucI u proposILIon. TIe ucLuuI cuusuI sequence producIng
dIseuse und resuILIng In morLuIILy Is unknown, I.e., LIere Ius noL been LIe
IdenLIIIcuLIon oI IIgI-IeveI predIcLors.
309
309
Rampant Antismoking Signifies Grave Danger
predIcL Iow bIrLIweIgIL IL wouId be wrong mosL oI LIe LIme. SucI u
sILuuLIon demonsLruLes u lccl oI undersLundIng oI cuusuLIon. ourLIIy, IL
wus consIdered In un eurIIer secLIon LIuL smokIng ILseII Is u summurIzIng
pIenomenon Ior oLIer IucLors LIuL cun uIso be correIuLed wILI Iow
bIrLIweIgIL und LIuL uIso uccounLs Ior u pIunLom dose-response
ussocIuLIon; LIere Is uIso u poLenLIuI conLrusLIng eIIecL (I.e., IIgIIy rIsk-
uverse nonsmokers LIuL cun economIcuIIy uIIord LIe dIsposILIon) us
consIdered eurIIer, I.e., IL Is noL surprIsIng LIuL reIuLIve rIsk dIIIerenLIuIs
ure Iound beLween smokers und nonsmokers. IILIIy, LIe enLIre Ideu LIuL,
Ior smokers, IL Is LIe properLIes oI Lobucco smoke LIuL cuuse Iow
bIrLIweIgIL Is compIeLeIy quesLIonubIe. L cun uIso be suId LIuL LIe crILIcuI
IucLor(s) (I.e., demonsLruLIng IIgI predIcLIve sLrengLI) Ior Iow bIrLIweIgIL
Ius noL yeL been IdenLIIIed - und by u Iong wuy. InuIIy, IL musL be re-
ILeruLed LIuL Iow bIrLIweIgIL oI ILseII Is noL u dIseuse.
Very recenL Jupunese reseurcI Ius Iound LIuL |s|mokIng by
purenLs uround LIe LIme oI concepLIon cun reduce LIe cIunce oI IuvIng u
boy by up Lo u LIIrd..PsycIoIogIcuI und pIysIcuI sLress, Loo, ure known Lo
pIuy u purL. (The Ae, AprII zo, zooz) AILIougI LIe sLuLemenL Is mude In
cuusuI Lerms (I.e., uses LIe Lerm reduce ruLIer LIun ussocIuLed wILI u
Iower IncIdence oI), wIIcI Ius no busIs, LIIs IIndIng Is IIgIIy ImporLunL
Ior uL IeusL Lwo reusons. IrsLIy, IemuIe InIunLs, on uveruge, weIgI Iess
LIun muIe InIunLs. I LIe InIunL`s gender Is noL uccounLed Ior In sLudIes,
LIen LIe Iow bIrLIweIgIL dIIIerenLIuI Ior smokers und nonsmokers muy uL
IeusL In purL reIIecL LIIs ender dIIIerenLIuI. or exumpIe, SImpson (1q;),
und oLIers sInce, muke no menLIon oI uccommoduLIng gender
dIIIerenLIuIs. I LIIs Is LIe cuse, In scIoIurIy Lerms LIIs Is In LIe order oI
scunduI. WIIIe unLIsmokIng ugendu Ius been progressIveIy IueIed und
wIIIe smokers Iuve been pounded by unLIsmokIng prescrIpLIons Ior uL
IeusL LIe IusL Iew decudes, sucI u IundumenLuI muLLer oI LeusIng ouL LIe
mosL obvIous reusons Ior wIy dIIIerenLIuIs mIgIL exIsL (I.e., scIenLIIIc
InLegrILy) Iuve been compIeLeIy overIooked, I.e., gruve IncompeLence.
SecondIy, LIrougI LIIs IIndIng LIe medIcuI esLubIIsImenL Ius worked
ILseII InLo u LIeoreLIcuI corner. L demonsLruLes LIuL even wIen LIere Is
no c priori reuson Ior dIIIerences beLween smokers und nonsmokers,
dIIIerences sLIII occur. TIe IucLor oI smokIng Ius LypIcuIIy been
InvesLIguLed wILI respecL Lo Increused ussocIuLIons wILI dIseuse - even
wIen LIere Is no c priori reuson Ior LIese Lo occur. WIere reIuLIve
Increuses Iuve been observed, LIese Iuve LypIcuIIy been IncompeLenLIy
reusoned us cuused by LIe curcInogenIc properLIes oI Lobucco smoke. n
LIe currenL exumpIe, even LIougI LIere Is probubIy some IormonuI IucLor
InvoIved, IL wouId be dIIIIcuIL, II noL ImpossIbIe, Lo urgue LIuL un Increused
probubIIILy oI u IemuIe InIunL Is LIe equIvuIenL oI u dIseuse sLuLe. L couId
Preventive Medicine & Health Promotion
be urgued LIuL smokIng uIIecLs LIe buIunce oI muIeJIemuIe InIunLs.
However, LIIs ussumes LIe IncoIerenL one orgunIsm vIew oI smokers.
urLIermore, LIere Is u sImIIur counLer-ImbuIunce Ior nonsmokers.
DIIIerences beLween smokers und nonsmokers occur on u wIoIe IosL oI
meusures Ior no cppcrent reuson und LIey ure usuuIIy IndIcuLIve oI smuII
subgroup dIIIerences. GeneruI proposILIons concernIng uII smokers or uII
nonsmokers In LIIs cIrcumsLunce Iuve no meunIngIuIness; In scIenLIIIc
Lerms LIey ure bIuLunLIy wrong. urLIer compIIcuLIng LIIs Iow-probubIIILy
mIre Is LIuL pIIoLs, usLronuuLs und dIvers IuLIer more gIrIs (The Ae, AprII
zo, zooz), und domInunL women ure more IIkeIy Lo Iuve sons (Hercld,
Sun, SepLember 1z, zooz).
TIus Iur IL Ius been consIdered LIuL mosL bIrLIs resuIL In IeuILIy
bubIes und LIuL mosL bubIes ure born normuI weIgIL ((q1.%+8;%
+8o.q%)J=86.%). TIIs Is so Ior boLI smokers und nonsmokers. TIere Is
cerLuInIy u reIuLIveIy IIgIer, uILIougI ubsoIuLeIy Iow, IncIdence oI Iow
bIrLIweIgIL bubIes born Lo smokers. However, Iow bIrLIweIgIL bubIes
consLILuLe u smuII proporLIon oI overuII bIrLIs und Iow bIrLIweIgIL oI ILseII
Is noL probIemuLIc.
ReIuLIve dIIIerences beLween smokers und nonsmokers Iuve uIso
been expIored Ior more cuLusLropIIc evenLs, e.g., InIunL morLuIILy. CenLers
Ior DIseuse ConLroI (1qq) IndIcuLes LIuL, Ior smokers, LIere Is un
Increused rIsk oI InIunL morLuIILy (InIunLs under 1 yeur oId) Irom sIorL
gesLuLIonJIow bIrLIweIgIL (RR=1.8), respIruLory dIsLress syndrome
(RR=1.8), oLIer respIruLory condILIons oI newborn (RR=1.8), und sudden
InIunL deuLI syndrome (RR=1.). TIrougI LIe compIeLeIy quesLIonubIe
SAMMEC procedure eurIIer dIscussed, LIese RR`s ure converLed Lo
uLLrIbuLubIe rIsk und LIen uLLrIbuLubIe numbers. or sIorL gesLuLIon,
uLLrIbuLubIe number Is o;; Ior respIruLory dIsLress syndrome,
uLLrIbuLubIe number Is 6o; Ior oLIer respIruLory condILIons, uLLrIbuLubIe
number Is ;q; Ior sudden InIunL deuLI syndrome, uLLrIbuLubIe number Is
q;o.
AccordIng Lo u CDC IucL sIeeL, ubouL 1 percenL oI women
smoke wIIIe pregnunL - ubouL qoo,ooo women In 1qq6. I uII oI LIe
ubove morLuIILy numbers ure summed (o;+6o+;q+q;o=1;11), LIen
LIe predIcLIve sLrengLI oI smokIng Ior LIIs morLuIILy, ubove u buseIIne, Is
eIIecLIveIy zero (1;11Jqoo,ooo=.ooq); LIe predIcLIve sLrengLI oI smokIng
Ior uny specIIIc morLuIILy Is even cIoser Lo zero. SucI morLuIILy does noL
occur Ior qq%+ oI smokers. TIere Is no prImury cuusuI urgumenL
concernIng smokIng und InIunL morLuIILy; LIe duLu deIInILIveIy
dIsconIIrms sucI u proposILIon. TIe ucLuuI cuusuI sequence producIng
dIseuse und resuILIng In morLuIILy Is unknown, I.e., LIere Ius noL been LIe
IdenLIIIcuLIon oI IIgI-IeveI predIcLors.
310
310
Rampant Antismoking Signifies Grave Danger
TIe InsLunce oI Sudden nIunL DeuLI Syndrome (SDS) or coL
deuLI produces IurLIer conIusIon. UnIIke oLIer morLuIILy, IL Ius no
IdenLIIIed dIseuse precondILIon. L Is u syndrome deIIned by excIusIon
ruLIer LIun demonsLrubIe, specIIIc puLIoIogy. AccordIng Lo unoLIer CDC
IucL sIeeL, SDS Is deIIned us LIe sudden deuLI oI un InIunL under 1 yeur
oI uge LIuL cunnoL be expIuIned uILer u LIorougI cuse InvesLIguLIon,
IncIudIng u compIeLe uuLopsy, exumInuLIon oI LIe deuLI scene, und revIew
oI LIe cIInIcuI IIsLory...SDS deuLIs occur umong uII socIoeconomIc und
rucIuIJeLInIc groups, buL ure IIgIer umong AIrIcun AmerIcuns und some
AmerIcun ndIun LrIbes. ncreused rIsk oI SDS Is ussocIuLed wILI Iow
bIrLI weIgIL, young muLernuI uge, poor pre-nuLuI cure, und poverLy. An
InIunL wIo sIeeps on ILs sLomucI Is uIso more uL rIsk Ior SDS. BubIes wIo
ure noL breusLIed, wIo ure exposed Lo Lobucco smoke, und wIo geL
overIeuLed becuuse oI Loo muny cIoLIes uIso seem Lo be uL Increused rIsk,
us ure InIunLs wIose sIeepIng surIuce Is Loo soIL und excessIveIy pudded.
TIe rIsk Increuses wIen u buby sIures u bed wILI un uduIL; LIe rIsk Is
greuLer sLIII II more LIun one uduIL Is In LIe bed or II LIe uduIL Is under LIe
InIIuence oI uIcoIoI or drugs. MosL deuLIs occur durIng LIe IuII, wInLer,
und eurIy sprIng monLIs.
mporLunLIy, SDS Is u IuIrIy recenL pIenomenon. An Increuse In
unexpecLed und unexpIuIned InIunL deuLIs wus IIrsL descrIbed In LIe
1qo`s. TIe Lerm SDS wus coIned by J. BeckwILI In LIe IuLe-1q6o`s (see
I'HoIr eL uI., 1qq8). urLIermore, IL Is essenLIuIIy u EuropeunJAmerIcun
pIenomenon. n Jupun, Ior exumpIe, SDS Is exLremeIy rure. SDS begun
Lo decIIne In LIe IuLe 1q8o`s (e.g., DuILveIL eL uI., 1qq;).
More recenLIy, IurLIer rIsk IucLors Iuve been udded Lo u rupIdIy
growIng IIsL: CoL deuLI couId be LIe resuIL oI u guL InIecLIon, scIenLIsLs
Iuve cIuImed. nIecLIous dIseuse specIuIIsLs Iound 88% oI sudden InIunL
deuLI cuses sIowed LIe presence oI HeIIcobucLer pyIorI..TIe germ InIecLs
LIe sLomucI IInIng und cun be pussed Irom uduILs Lo cIIIdren LIrougI
suIIvu (Hercld,Sun, o OcLober, zooo) - see uIso Kerr eL uI., zooo; A
gene LIuL IeIps reguIuLe IeurL rIyLIm Ius been IInked wILI sudden InIunL
deuLI syndrome. TIe gene, cuIIed SCNA, IeIps conLroI Iow IeurL ceIIs
use sodIum Lo reguIuLe LIeIr eIecLrIcuI rIyLIm..'TIIs Is sLep one oI muny
LIuL couId evenLuuIIy prevenL SDS`, Dr. Ackermun suId In u sLuLemenL.
'TIIs sLudy uLLempLs Lo muke SDS Iess oI u mysLerIous bIuck box. We`re
jusL sLurLIng Lo be ubIe Lo IdenLIIy LIose InIunLs LIuL muy be uL rIsk und
Luke sLeps Lo prevenL LIe IncIdence oI deuLI` (Hercld,Sun, November 16,
zoo1); AusLruIIun reseurcIers Iuve dIscovered LIe presence oI u bucLerIuI
proLeIn In uII 68 cuses oI sudden InIunL deuLI syndrome LIey sLudIes. TIey
descrIbed IL us LIe mosL sIgnIIIcunL SDS breukLIrougI yeL ..DocLors uL
LIe AdeIuIde Women`s und CIIIdren`s HospILuI Iound curIIn proLeIns In uII
Preventive Medicine & Health Promotion
68 InIunLs InvoIved In LIeIr reseurcI wIo dIed oI SDS. n IeuILIy bodIes,
no curIIn proLeIns exIsLed. SepuruLe reseurcI Ius sIown LIuL curIIn
proLeIns couId cuuse InIIummuLIon, Iow bIood pressure und sIock, Dr.
PuuI GoIdwuLer suId. He suId LIe proLeIns couId Iuve cuused LIe bubIes Lo
dIe oI sepLIc sIock - u IIndIng uL odds wILI LIe common Ideu LIuL SDS
bubIes dIed oI uspIyxIuLIon..Dr. GoIdwuLer suId posL morLem
exumInuLIons oI bubIes sIowed LIeIr Iungs Iud become Ieuvy und weL und
LIeIr bIood IuIIed Lo cIoL - common reucLIons Lo curIIn proLeIns (Hercld,
Sun, 18 June, zooz) - see uIso GoIdwuLer & BeLLeIIeIm, zooz; L wus
reveuIed In LIe Sundc Hercld Sun IusL week LIuL worId-IIrsL reseurcI
suggesLs LIuL promeLIuzIne - conLuIned In LIe popuIur cIIIdren`s
unLIIIsLumIne PIenergun - cun Increuse LIe rIsk oI SDS (Hercld,Sun,
June 1;, zoo1); u possIbIe connecLIon beLween SDS und cuIIeIne
LreuLmenL gIven Lo preLerm bubIes (e.g., Bock eL uI., 1qqq).
urLIermore, IdenLIIIed rIsk IucLors ure noL uII oI LIe sume order.
or exumpIe, IL cun be undersLood In pIysIco-mecIunIcuI Lerms LIuL un
InIunL sIeepIng on ILs sIde or sLomucI cun Iuve ILs Iuce Lrupped uguInsL u
muLLress und, unubIe Lo IIIL ILs Ieud, suIIocuLIon Is quILe probubIe. n u
crILIcuI sense, uny InIunL IIndIng ILseII In LIIs posILIon Is uL gruve rIsk. L
sIouId be u poInL oI LIunkIuIness LIuL mosL InIunLs do noL IInd LIemseIves
In LIIs posILIon. ETS exposure, Iowever, Is u dIIIerenL pIenomenon
uILogeLIer. L uIso does noL Iend ILseII Lo mecIunIcuI expIunuLIons.
urLIermore, numerous cIIIdren ure exposed, yeL SDS Is u tin
proporLIon oI LIe exposed group.
TIere Is no sensIbIIILy In usIng eILIer ucLIve smokIng or ETS
exposure Lo expIuIn SDS. Even In popuIuLIon-IeveI Lerms, SDS begun Lo
Increuse us LIe IncIdence oI smokIng begun Lo decreuse. AIso, Jupun, Ior
exumpIe, wIIcI Ius u rure IncIdence oI SDS, Ius u reIuLIveIy IIgI
prevuIence oI smokIng. TIe mosL sLrongIy ImpIIcuLed IucLor Is prone
sIeepIng posILIon. RecenL IeuILI InILIuLIves promoLIng on LIe buck
sIeepIng posILIon seem Lo be reIuLed Lo u decIIne In SDS. CoLe (zooo)
udds LIuL SDS muy mosLIy occur Ior InIunLs unuccusLomed Lo prone
sIeepIng.
Hogberg & BergsLrom (zooo) muke u mosL sIgnIIIcunL
conLrIbuLIon Lo un undersLundIng oI LIe SDS pIenomenon. TIey
exumIned LIe IIsLorIcuI conLexL In wIIcI LIe IncIdence oI SDS boLI rose
und IeII. TIey suggesL LIuL eurIy, unsubsLunLIuLed, vIews LrIggered LIe
Iong-IeId prescrIpLIon oI prone sIeepIng, e.g., LIe CuLIoIIc CIurcI
consIderIng SDS us cuses oI InIunLIcIde. TIey uIso IIgIIIgIL LIe
compIeLeIy quesLIonubIe prucLIce oI recommendIng wIoIesuIe
prescrIpLIons Ior LIe enLIre popuIuLIon LIuL onIy concern u LIny, probubIy
unIdenLIIIubIe, subgroup. OnIy In one oLIer InsLunce Is LIe concepL oI
311
311
Rampant Antismoking Signifies Grave Danger
TIe InsLunce oI Sudden nIunL DeuLI Syndrome (SDS) or coL
deuLI produces IurLIer conIusIon. UnIIke oLIer morLuIILy, IL Ius no
IdenLIIIed dIseuse precondILIon. L Is u syndrome deIIned by excIusIon
ruLIer LIun demonsLrubIe, specIIIc puLIoIogy. AccordIng Lo unoLIer CDC
IucL sIeeL, SDS Is deIIned us LIe sudden deuLI oI un InIunL under 1 yeur
oI uge LIuL cunnoL be expIuIned uILer u LIorougI cuse InvesLIguLIon,
IncIudIng u compIeLe uuLopsy, exumInuLIon oI LIe deuLI scene, und revIew
oI LIe cIInIcuI IIsLory...SDS deuLIs occur umong uII socIoeconomIc und
rucIuIJeLInIc groups, buL ure IIgIer umong AIrIcun AmerIcuns und some
AmerIcun ndIun LrIbes. ncreused rIsk oI SDS Is ussocIuLed wILI Iow
bIrLI weIgIL, young muLernuI uge, poor pre-nuLuI cure, und poverLy. An
InIunL wIo sIeeps on ILs sLomucI Is uIso more uL rIsk Ior SDS. BubIes wIo
ure noL breusLIed, wIo ure exposed Lo Lobucco smoke, und wIo geL
overIeuLed becuuse oI Loo muny cIoLIes uIso seem Lo be uL Increused rIsk,
us ure InIunLs wIose sIeepIng surIuce Is Loo soIL und excessIveIy pudded.
TIe rIsk Increuses wIen u buby sIures u bed wILI un uduIL; LIe rIsk Is
greuLer sLIII II more LIun one uduIL Is In LIe bed or II LIe uduIL Is under LIe
InIIuence oI uIcoIoI or drugs. MosL deuLIs occur durIng LIe IuII, wInLer,
und eurIy sprIng monLIs.
mporLunLIy, SDS Is u IuIrIy recenL pIenomenon. An Increuse In
unexpecLed und unexpIuIned InIunL deuLIs wus IIrsL descrIbed In LIe
1qo`s. TIe Lerm SDS wus coIned by J. BeckwILI In LIe IuLe-1q6o`s (see
I'HoIr eL uI., 1qq8). urLIermore, IL Is essenLIuIIy u EuropeunJAmerIcun
pIenomenon. n Jupun, Ior exumpIe, SDS Is exLremeIy rure. SDS begun
Lo decIIne In LIe IuLe 1q8o`s (e.g., DuILveIL eL uI., 1qq;).
More recenLIy, IurLIer rIsk IucLors Iuve been udded Lo u rupIdIy
growIng IIsL: CoL deuLI couId be LIe resuIL oI u guL InIecLIon, scIenLIsLs
Iuve cIuImed. nIecLIous dIseuse specIuIIsLs Iound 88% oI sudden InIunL
deuLI cuses sIowed LIe presence oI HeIIcobucLer pyIorI..TIe germ InIecLs
LIe sLomucI IInIng und cun be pussed Irom uduILs Lo cIIIdren LIrougI
suIIvu (Hercld,Sun, o OcLober, zooo) - see uIso Kerr eL uI., zooo; A
gene LIuL IeIps reguIuLe IeurL rIyLIm Ius been IInked wILI sudden InIunL
deuLI syndrome. TIe gene, cuIIed SCNA, IeIps conLroI Iow IeurL ceIIs
use sodIum Lo reguIuLe LIeIr eIecLrIcuI rIyLIm..'TIIs Is sLep one oI muny
LIuL couId evenLuuIIy prevenL SDS`, Dr. Ackermun suId In u sLuLemenL.
'TIIs sLudy uLLempLs Lo muke SDS Iess oI u mysLerIous bIuck box. We`re
jusL sLurLIng Lo be ubIe Lo IdenLIIy LIose InIunLs LIuL muy be uL rIsk und
Luke sLeps Lo prevenL LIe IncIdence oI deuLI` (Hercld,Sun, November 16,
zoo1); AusLruIIun reseurcIers Iuve dIscovered LIe presence oI u bucLerIuI
proLeIn In uII 68 cuses oI sudden InIunL deuLI syndrome LIey sLudIes. TIey
descrIbed IL us LIe mosL sIgnIIIcunL SDS breukLIrougI yeL ..DocLors uL
LIe AdeIuIde Women`s und CIIIdren`s HospILuI Iound curIIn proLeIns In uII
Preventive Medicine & Health Promotion
68 InIunLs InvoIved In LIeIr reseurcI wIo dIed oI SDS. n IeuILIy bodIes,
no curIIn proLeIns exIsLed. SepuruLe reseurcI Ius sIown LIuL curIIn
proLeIns couId cuuse InIIummuLIon, Iow bIood pressure und sIock, Dr.
PuuI GoIdwuLer suId. He suId LIe proLeIns couId Iuve cuused LIe bubIes Lo
dIe oI sepLIc sIock - u IIndIng uL odds wILI LIe common Ideu LIuL SDS
bubIes dIed oI uspIyxIuLIon..Dr. GoIdwuLer suId posL morLem
exumInuLIons oI bubIes sIowed LIeIr Iungs Iud become Ieuvy und weL und
LIeIr bIood IuIIed Lo cIoL - common reucLIons Lo curIIn proLeIns (Hercld,
Sun, 18 June, zooz) - see uIso GoIdwuLer & BeLLeIIeIm, zooz; L wus
reveuIed In LIe Sundc Hercld Sun IusL week LIuL worId-IIrsL reseurcI
suggesLs LIuL promeLIuzIne - conLuIned In LIe popuIur cIIIdren`s
unLIIIsLumIne PIenergun - cun Increuse LIe rIsk oI SDS (Hercld,Sun,
June 1;, zoo1); u possIbIe connecLIon beLween SDS und cuIIeIne
LreuLmenL gIven Lo preLerm bubIes (e.g., Bock eL uI., 1qqq).
urLIermore, IdenLIIIed rIsk IucLors ure noL uII oI LIe sume order.
or exumpIe, IL cun be undersLood In pIysIco-mecIunIcuI Lerms LIuL un
InIunL sIeepIng on ILs sIde or sLomucI cun Iuve ILs Iuce Lrupped uguInsL u
muLLress und, unubIe Lo IIIL ILs Ieud, suIIocuLIon Is quILe probubIe. n u
crILIcuI sense, uny InIunL IIndIng ILseII In LIIs posILIon Is uL gruve rIsk. L
sIouId be u poInL oI LIunkIuIness LIuL mosL InIunLs do noL IInd LIemseIves
In LIIs posILIon. ETS exposure, Iowever, Is u dIIIerenL pIenomenon
uILogeLIer. L uIso does noL Iend ILseII Lo mecIunIcuI expIunuLIons.
urLIermore, numerous cIIIdren ure exposed, yeL SDS Is u tin
proporLIon oI LIe exposed group.
TIere Is no sensIbIIILy In usIng eILIer ucLIve smokIng or ETS
exposure Lo expIuIn SDS. Even In popuIuLIon-IeveI Lerms, SDS begun Lo
Increuse us LIe IncIdence oI smokIng begun Lo decreuse. AIso, Jupun, Ior
exumpIe, wIIcI Ius u rure IncIdence oI SDS, Ius u reIuLIveIy IIgI
prevuIence oI smokIng. TIe mosL sLrongIy ImpIIcuLed IucLor Is prone
sIeepIng posILIon. RecenL IeuILI InILIuLIves promoLIng on LIe buck
sIeepIng posILIon seem Lo be reIuLed Lo u decIIne In SDS. CoLe (zooo)
udds LIuL SDS muy mosLIy occur Ior InIunLs unuccusLomed Lo prone
sIeepIng.
Hogberg & BergsLrom (zooo) muke u mosL sIgnIIIcunL
conLrIbuLIon Lo un undersLundIng oI LIe SDS pIenomenon. TIey
exumIned LIe IIsLorIcuI conLexL In wIIcI LIe IncIdence oI SDS boLI rose
und IeII. TIey suggesL LIuL eurIy, unsubsLunLIuLed, vIews LrIggered LIe
Iong-IeId prescrIpLIon oI prone sIeepIng, e.g., LIe CuLIoIIc CIurcI
consIderIng SDS us cuses oI InIunLIcIde. TIey uIso IIgIIIgIL LIe
compIeLeIy quesLIonubIe prucLIce oI recommendIng wIoIesuIe
prescrIpLIons Ior LIe enLIre popuIuLIon LIuL onIy concern u LIny, probubIy
unIdenLIIIubIe, subgroup. OnIy In one oLIer InsLunce Is LIe concepL oI
312
312
Rampant Antismoking Signifies Grave Danger
ubsoIuLe predIcLIve sLrengLI oI IucLors Ior SDS dIrecLIy consIdered. or
exumpIe, ogun eL uI. (zooo), In consIderIng u possIbIe ussocIuLIon
beLween poor posLnuLuI growLI und un Increused rIsk oI SDS posILed by
BIuIr eL uI. (zooo), IndIcuLe LIuL LIe ubsoIuLe predIcLIve sLrengLI InvoIved
Is poor. AILIougI LIere ure some members oI LIe epIdemIoIogIc
communILy LIuL ure IumIIIur wILI LIe crILIcuI concepL oI ubsoIuLe
predIcLIve sLrengLI, u LIeme oI LIIs enLIre dIscussIon Is LIuL LIIs concepL
rureIy IIgures In medIco-muLerIuIIsL reusonIng und prescrIpLIons, und
purLIcuIurIy concernIng smokIng und ETS.
TIe uLLempL Iere Is noL Lo posIL u besL expIunuLIon Ior SDS,
buL sImpIy Lo noLe LIuL, Lo duLe, LIere ure u muILILude oI rIsk IucLors Ior
SDS, uII IuvIng exLremeIy poor ubsoIuLe predIcLIve sLrengLI. YeL, cuusuI
cIuIms Iuve been mude ubouL muLernuI smokIng und SDS sInce LIe eurIy-
1qqo`s, e.g., LIe Surgeon GeneruI und LIe WorId HeuILI OrgunIzuLIon - In
EPA, 1qq, S.1. TIe cIuIm Ius been reILeruLed muny LImes sInce: or
exumpIe, LIe WorId HeuILI OrgunIzuLIon (1qqq) decIures |L|Ie
ConsuILuLIon uIso concIuded LIuL muLernuI smokIng durIng pregnuncy Is u
mujor cuuse oI sudden InIunL deuLI syndrome. (secLIon 1) AguIn, LIIs Is
LIe consequence oI u consensus eIIecL wILIIn un IdeoIogIcuI crusude LIuL
Ius no scIenLIIIc merIL wIuLsoever.
n LIe cuse oI SDS, conLorLed medIco-muLerIuIIsL reusonIng
produces u IurLIer ubsurdILy. n oLIer smokIng-reIuLed (sLuLIsLIcuI)
pIenomenu, cuusuI ueLIoIogy Ius noL been deIIned und cerLuInIy cunnoL be
deIIned Lo supporL LIe generuI proposILIon smokIng cuuses X. n LIese
cuses Lobucco smoke Is some mugIcuI quunLILy LIuL cun produce numerous
specIIIc eIIecLs oI Iow probubIIILy; wIuL does LIe producIng und Iow LIIs
Is uccompIIsIed ure unknown. n LIe cuse oI SDS boLI sIdes oI LIe cuusuI
equuLIon ure unknown; un unknown uLLrIbuLe(s) oI Lobucco smoke
produces un unknown condILIon LIrougI un undeIIned process LIuL
resuILs In morLuIILy. SucI u proposILIon Is onIy deIusIonuI. L Is noLIIng
sIorL oI sLuggerIng LIuL sucI cIuIms ure even gIven cursory consIderuLIon
IeL uIone IncoIerenLIy eIevuLed Lo LIe sLuLus oI deIInILIveness.
L cun be concIuded oI smokIng, und numerous oLIer IucLors,
LIuL IL Is u IucLor ussocIuLed, sLuLIsLIcuIIy, wILI un Increused relctite rIsk oI
purLIcuIur occurrences. TIe cbsolute predIcLIve sLrengLI oI smokIng Ior
LIese occurrences Is exLremeIy poor - usuuIIy uround LIe zero murk. MosL
women wIo smoke durIng pregnuncy do noL Iuve compromIsed bIrLIs or
deLrImenLuI posLnuLuI ouLcomes Ior LIeIr cIIIdren. However, us wIII be
consIdered beIow, urmed wILI rIsk IucLoroIogy, IeuILI proIessIonuIs ure
poundIng pregnunL women, generuIIy, und pregnunL smokers, specIIIcuIIy,
InLo uII munner oI deIusIonuI beIIeIs.
PregnunL women In purLIcuIur ure u IIgIIy scruLInIzed group.
Preventive Medicine & Health Promotion
Ouks (zoo1) noLes |L|IuL scruLIny oI pregnunL women`s IeuILI decIsIons
Is pervusIve; In uddILIon Lo receIvIng medIcuI udvIce LIrougI pubIIc
wurnIngs, muny pregnunL women IInd LIemseIves surrounded In LIeIr
duIIy IIves by perIups weII-meunIng buL oILen InLrusIve Iuy experLs. GIven
LIe experIences oI women LuIked wILI wIo Iud smoked durIng
pregnuncy, IL Is IIkeIy LIuL someone dId upproucI u pregnunL womun In un
uIrporL or eIsewIere Lo remInd Ier LIuL sIe sIouId noL smoke. (p.q) One
pregnuncy udvIce book wurns LIuL LIe worId Is IIIIed wILI peopIe wIo IeeI
IL Is LIeIr responsIbIIILy Lo monILor your perIormunce ... TIe pregnuncy
PoIIce. (ovIne, 1qq, quoLed In Ouks, zoo1, p.q)
TIere Is no sIorLuge oI pregnuncy experLs or numerous Iobby
groups vyIng Ior domInuLIon oI perspecLIve. AdvIce by IeuILI
proIessIonuIs obvIousIy reIIecLs muLerIuIIsL rIsk-uversIon us u superIor
ucLIvILy. TIey seem Lo beIIeve LIuL LIey IoId deIInILIve pregnuncy
knowIedge und IuIIy expecL compIIunce by pregnunL women: EucI
pregnunL womun Is expecLed, wILIouL quesLIon, Lo compIy wILI medIcuI
udvIce ubouL rIsk reducLIon, despILe uncerLuInLy over wIeLIer Ier own
rIsk-LukIng beIuvIors wIII Iurm Ier IeLus`s IeuILI. (Ouks, zoo1, p.1)
Non-conIormers ure vIewed us IrruLIonuI, IrresponsIbIe, undermInIng LIe
IeuILI sysLem und cosLIy Lo LIe nuLIonuI IeuILI. WIere compIIunce Is noL
IorLIcomIng, LIe IeuILIIsL LIrude cun become IIgIIy uggressIve In ILs
InLenL Lo IosLer noL onIy IrruLIonuI Ieur buL IrruLIonuI guIIL. Ouks (zoo1)
IndIcuLes LIuL |w|IIIe LIese IeuILI proIessIonuIs see cIgureLLe use us
serIous u rIsk us drug use, LIey encounLer women wIo beIIeve LIuL
smokIng does noL udverseIy uIIecL IeLuI or InIunL IeuILI. TIus LIe IeuILI
educuLors` job Is Lo convInce women Lo see LIe rIsks oI smokIng Irom LIe
experLs` poInL oI vIew und Lo ucL on LIe cIunce LIuL u buby born Lo u
moLIer wIo smokes wIII be udverseIy uIIecLed. (p.1;) TIe enLIre gouI oI
IeuILI promoLIon Is smoke-Iree bubIes.
A perusuI oI Ouks (zoo1), wIere vIews und bunLer by IeuILI
proIessIonuIs In LIeIr excIunges wILI pregnunL smokers ure presenLed, Is
noLIIng sIorL oI usLoundIng. TIe very sLrong, monoLonous LIeme Is LIe
uLLempL Lo reduce pregnuncy Lo u gumbIIng meLupIor und Lo convInce
pregnunL smokers LIuL u IeuILIy buby Ior LIem under LIe cIrcumsLunce oI
smokIng Is u muLLer oI Iuck. TIIs deIusIonuI messuge Is beIng LuugIL Lo
IeuILI proIessIonuIs counLrywIde und In muny nuLIons. or exumpIe, LIe
MuryIund DepurLmenL oI HeuILI und MenLuI HygIene dIsLrIbuLes
unLIsmokIng T-sIIrLs wILI LIe wordIng Smoke-Iree BABY us purL oI LIe
QuIL und Be ree! smokIng cessuLIon progrum (Ouks, zoo1, p.;6); u
smoke-Iree buby Is supposedIy u superIor creuLure. TIe sume IeuILI
depurLmenL decIures LIuL II you keep smokIng you wIII...be more IIkeIy
Lo mIscurry |und| doubIe your cIunces oI IuvIng u smuII sIck buby LIuL
313
313
Rampant Antismoking Signifies Grave Danger
ubsoIuLe predIcLIve sLrengLI oI IucLors Ior SDS dIrecLIy consIdered. or
exumpIe, ogun eL uI. (zooo), In consIderIng u possIbIe ussocIuLIon
beLween poor posLnuLuI growLI und un Increused rIsk oI SDS posILed by
BIuIr eL uI. (zooo), IndIcuLe LIuL LIe ubsoIuLe predIcLIve sLrengLI InvoIved
Is poor. AILIougI LIere ure some members oI LIe epIdemIoIogIc
communILy LIuL ure IumIIIur wILI LIe crILIcuI concepL oI ubsoIuLe
predIcLIve sLrengLI, u LIeme oI LIIs enLIre dIscussIon Is LIuL LIIs concepL
rureIy IIgures In medIco-muLerIuIIsL reusonIng und prescrIpLIons, und
purLIcuIurIy concernIng smokIng und ETS.
TIe uLLempL Iere Is noL Lo posIL u besL expIunuLIon Ior SDS,
buL sImpIy Lo noLe LIuL, Lo duLe, LIere ure u muILILude oI rIsk IucLors Ior
SDS, uII IuvIng exLremeIy poor ubsoIuLe predIcLIve sLrengLI. YeL, cuusuI
cIuIms Iuve been mude ubouL muLernuI smokIng und SDS sInce LIe eurIy-
1qqo`s, e.g., LIe Surgeon GeneruI und LIe WorId HeuILI OrgunIzuLIon - In
EPA, 1qq, S.1. TIe cIuIm Ius been reILeruLed muny LImes sInce: or
exumpIe, LIe WorId HeuILI OrgunIzuLIon (1qqq) decIures |L|Ie
ConsuILuLIon uIso concIuded LIuL muLernuI smokIng durIng pregnuncy Is u
mujor cuuse oI sudden InIunL deuLI syndrome. (secLIon 1) AguIn, LIIs Is
LIe consequence oI u consensus eIIecL wILIIn un IdeoIogIcuI crusude LIuL
Ius no scIenLIIIc merIL wIuLsoever.
n LIe cuse oI SDS, conLorLed medIco-muLerIuIIsL reusonIng
produces u IurLIer ubsurdILy. n oLIer smokIng-reIuLed (sLuLIsLIcuI)
pIenomenu, cuusuI ueLIoIogy Ius noL been deIIned und cerLuInIy cunnoL be
deIIned Lo supporL LIe generuI proposILIon smokIng cuuses X. n LIese
cuses Lobucco smoke Is some mugIcuI quunLILy LIuL cun produce numerous
specIIIc eIIecLs oI Iow probubIIILy; wIuL does LIe producIng und Iow LIIs
Is uccompIIsIed ure unknown. n LIe cuse oI SDS boLI sIdes oI LIe cuusuI
equuLIon ure unknown; un unknown uLLrIbuLe(s) oI Lobucco smoke
produces un unknown condILIon LIrougI un undeIIned process LIuL
resuILs In morLuIILy. SucI u proposILIon Is onIy deIusIonuI. L Is noLIIng
sIorL oI sLuggerIng LIuL sucI cIuIms ure even gIven cursory consIderuLIon
IeL uIone IncoIerenLIy eIevuLed Lo LIe sLuLus oI deIInILIveness.
L cun be concIuded oI smokIng, und numerous oLIer IucLors,
LIuL IL Is u IucLor ussocIuLed, sLuLIsLIcuIIy, wILI un Increused relctite rIsk oI
purLIcuIur occurrences. TIe cbsolute predIcLIve sLrengLI oI smokIng Ior
LIese occurrences Is exLremeIy poor - usuuIIy uround LIe zero murk. MosL
women wIo smoke durIng pregnuncy do noL Iuve compromIsed bIrLIs or
deLrImenLuI posLnuLuI ouLcomes Ior LIeIr cIIIdren. However, us wIII be
consIdered beIow, urmed wILI rIsk IucLoroIogy, IeuILI proIessIonuIs ure
poundIng pregnunL women, generuIIy, und pregnunL smokers, specIIIcuIIy,
InLo uII munner oI deIusIonuI beIIeIs.
PregnunL women In purLIcuIur ure u IIgIIy scruLInIzed group.
Preventive Medicine & Health Promotion
Ouks (zoo1) noLes |L|IuL scruLIny oI pregnunL women`s IeuILI decIsIons
Is pervusIve; In uddILIon Lo receIvIng medIcuI udvIce LIrougI pubIIc
wurnIngs, muny pregnunL women IInd LIemseIves surrounded In LIeIr
duIIy IIves by perIups weII-meunIng buL oILen InLrusIve Iuy experLs. GIven
LIe experIences oI women LuIked wILI wIo Iud smoked durIng
pregnuncy, IL Is IIkeIy LIuL someone dId upproucI u pregnunL womun In un
uIrporL or eIsewIere Lo remInd Ier LIuL sIe sIouId noL smoke. (p.q) One
pregnuncy udvIce book wurns LIuL LIe worId Is IIIIed wILI peopIe wIo IeeI
IL Is LIeIr responsIbIIILy Lo monILor your perIormunce ... TIe pregnuncy
PoIIce. (ovIne, 1qq, quoLed In Ouks, zoo1, p.q)
TIere Is no sIorLuge oI pregnuncy experLs or numerous Iobby
groups vyIng Ior domInuLIon oI perspecLIve. AdvIce by IeuILI
proIessIonuIs obvIousIy reIIecLs muLerIuIIsL rIsk-uversIon us u superIor
ucLIvILy. TIey seem Lo beIIeve LIuL LIey IoId deIInILIve pregnuncy
knowIedge und IuIIy expecL compIIunce by pregnunL women: EucI
pregnunL womun Is expecLed, wILIouL quesLIon, Lo compIy wILI medIcuI
udvIce ubouL rIsk reducLIon, despILe uncerLuInLy over wIeLIer Ier own
rIsk-LukIng beIuvIors wIII Iurm Ier IeLus`s IeuILI. (Ouks, zoo1, p.1)
Non-conIormers ure vIewed us IrruLIonuI, IrresponsIbIe, undermInIng LIe
IeuILI sysLem und cosLIy Lo LIe nuLIonuI IeuILI. WIere compIIunce Is noL
IorLIcomIng, LIe IeuILIIsL LIrude cun become IIgIIy uggressIve In ILs
InLenL Lo IosLer noL onIy IrruLIonuI Ieur buL IrruLIonuI guIIL. Ouks (zoo1)
IndIcuLes LIuL |w|IIIe LIese IeuILI proIessIonuIs see cIgureLLe use us
serIous u rIsk us drug use, LIey encounLer women wIo beIIeve LIuL
smokIng does noL udverseIy uIIecL IeLuI or InIunL IeuILI. TIus LIe IeuILI
educuLors` job Is Lo convInce women Lo see LIe rIsks oI smokIng Irom LIe
experLs` poInL oI vIew und Lo ucL on LIe cIunce LIuL u buby born Lo u
moLIer wIo smokes wIII be udverseIy uIIecLed. (p.1;) TIe enLIre gouI oI
IeuILI promoLIon Is smoke-Iree bubIes.
A perusuI oI Ouks (zoo1), wIere vIews und bunLer by IeuILI
proIessIonuIs In LIeIr excIunges wILI pregnunL smokers ure presenLed, Is
noLIIng sIorL oI usLoundIng. TIe very sLrong, monoLonous LIeme Is LIe
uLLempL Lo reduce pregnuncy Lo u gumbIIng meLupIor und Lo convInce
pregnunL smokers LIuL u IeuILIy buby Ior LIem under LIe cIrcumsLunce oI
smokIng Is u muLLer oI Iuck. TIIs deIusIonuI messuge Is beIng LuugIL Lo
IeuILI proIessIonuIs counLrywIde und In muny nuLIons. or exumpIe, LIe
MuryIund DepurLmenL oI HeuILI und MenLuI HygIene dIsLrIbuLes
unLIsmokIng T-sIIrLs wILI LIe wordIng Smoke-Iree BABY us purL oI LIe
QuIL und Be ree! smokIng cessuLIon progrum (Ouks, zoo1, p.;6); u
smoke-Iree buby Is supposedIy u superIor creuLure. TIe sume IeuILI
depurLmenL decIures LIuL II you keep smokIng you wIII...be more IIkeIy
Lo mIscurry |und| doubIe your cIunces oI IuvIng u smuII sIck buby LIuL
314
314
Rampant Antismoking Signifies Grave Danger
weIgIs 1Jz pounds or Iess. (Ouks, zoo1, p.q) TIe sume IeuILI
depurLmenL proIIers LIe IoIIowIng us u sLruLegy Ior IeuILI proIessIonuIs
Lo convInce pregnunL smokers Lo quIL LIe IubIL: SomeLImes |smokIng|
cuuses bIg probIems und someLImes onIy smuII ones (e.g., reduced weIgIL
guIn oI zoo grums). TIIs Is un Issue oI odds, IIke gumbIIng. SmokIng
doubIes LIe odds uguInsL you |Ior Iow bIrLI weIgIL|. You (your IrIend)
were Iucky IusL LIme. TIe probIem Is we don`L know II you wIII be so Iucky
LIIs LIme. Your besL beL Is Lo quIL. (Ouks, zoo1, p.q;)
One smokIng-cessuLIon counseIor responds Lo pregnunL smokers
wIo Iuve uIreudy Iud IeuILIy bubIes wILI L`s IIke RussIun rouIeLLe. You
jusL don`L know. usk LIem 'Do you wunL Lo Luke LIuL cIunce?` A nurse uL
u ruruI muLernILy cIInIc IurLIer 'reIInes` LIe gumbIIng meLupIor wILI un
uddILIonuI IuIIucy oI IncoIerenL unuIogy by LeIIIng women wIo smoke LIuL
IL Is IIke puLLIng u gun Lo your Ieud wIen you don`L know LIuL IL`s Iouded.
Do you wunL Lo Luke u cIunce wILI your buby IIke LIuL? (boLI quoLed In
Ouks, zoo1, p.q;) L musL be remembered LIuL LIIs conducL, und wIIcI In
LIIs cuse Is especIuIIy ubIorrenL, Is Iorwurded under LIe guIse oI IeuILI
promoLIon! Ouks` (zoo1) summuLIon Is quILe upL: L Is noL dIIIIcuIL Lo
exLend LIIs Imuge |Iouded gun Lo LIe Ieud| Lo one oI u pregnunL womun
puLLIng u gun Lo Ier buby`s Ieud, cerLuInIy u dIsLurbIng Imuge. TIe
RussIun rouIeLLe meLupIor Is purLIcuIurIy severe becuuse IL ImpIIes LIuL u
womun mukes IIIe or deuLI cIoIces wIen sIe smokes....TIe RussIun
rouIeLLe wurnIng Iucks IeuILI InIormuLIon und IuIIs buck on LIe moruI
urgumenL LIuL uvoIdIng IeuILI rIsks Is purL oI beIng u good moLIer-Lo-
be. (p.q;)
n pregnuncy books guIore LIe MMES-cuIL beIIeIs ure propuguLed
wILI greuL sureLy. One book concIudes LIuL |I|n eIIecL, wIen you smoke,
your buby Is conIIned In u smoke-IIIIed womb. HIs IeurLbeuL speeds, Ie
cougIs und spuLLers, und worsL oI uII, due Lo InsuIIIcIenL oxygen, Ie cun`L
grow und LIrIve us Ie sIouId. (EIsenberg eL uI., zoo1, p.o) n
respondIng Lo cuses wIere pregnunL smokers Iuve gIven bIrLI Lo IeuILIy
bubIes, und wIIcI Is LIe very-greuL mujorILy oI LIem, LIe sume uuLIors
proIIer:
TIere ure no sure LIIngs wIen mukIng u buby, buL LIere
ure muny wuys oI beLLerIng LIe odds. And gIvIng up
smokIng Is one oI LIe mosL LungIbIe wuys you cun
Improve LIe odds oI your IuvIng un uncompIIcuLed
pregnuncy und deIIvery und u IeuILIy buby. TIougI
LIere`s LIe cIunce LIuL you, Loo, cun Iuve u vIgorous
IuII-Lerm buby even II you smoke your wuy LIrougI your
pregnuncy, LIere`s uIso u sIgnIIIcunL rIsk LIuL your buby
wouId suIIer some or uII oI LIe eIIecLs deLuIIed on puge
Preventive Medicine & Health Promotion
o. Your sIsLer-In-Iuw wus Iucky (und Lo u cerLuIn
exLenL, LIIs Iuck couId Iuve goLLen u boosL Irom IeredILy
or oLIer IucLors LIuL mIgIL noL IoId Ior you); buL do you
reuIIy wunL Lo Luke LIe gumbIe LIuL you wIII be Iucky
Loo? And LIen LIuL Iuck muy noL be uII LIuL IL seems Lo
be. Some oI LIe deIIcILs - pIysIcuI und InLeIIecLuuI -
LIuL uIIIIcL bubIes oI smokers uren`L uppurenL
ImmedIuLeIy. TIe seemIngIy IeuILIy InIunL cun grow
InLo u cIIId wIo Is oILen sIck, wIo Is IyperucLIve, or wIo
Ius LroubIe IeurnIng.
n uddILIon Lo LIe eIIecL smokIng couId Iuve on your
buby wIIIe you`re sLIII pregnunL, LIere Is LIe eIIecL IL
wouId Iuve once Ie or sIe Ius moved Irom your smoke-
IIIIed womb Lo your smoke-IIIIed rooms. BubIes oI
purenLs (moLIers undJor duds) wIo smoke ure sIck
more oILen LIun LIe bubIes oI nonsmokers und ure more
IIkeIy Lo be IospILuIIzed LIrougI InIuncy und cIIIdIood.
(p.z-)
TIe IeuILIIsL propugundu sLrongIy IosLers LIe beIIeI LIuL quILLIng
smokIng wIII ensure u IeuILIy buby. or exumpIe, u pumpIIeL provIded by
LIe CoIorudo DepurLmenL oI HeuILI udvIses: I you quIL smokIng...your
buby wIII grow beLLer; your buby wIII geL more Iood und oxygen; your
buby`s Iungs wIII work beLLer; your pregnuncy wIII be IeuILIIer; und you
und your buby cun Ieuve LIe IospILuI LogeLIer. (quoLed In Ouks, zoo1,
p.q)
TypIcuI IeuILIIsL propugundu demonsLruLes u number oI
IeuLures. IrsLIy, IL Is usuuIIy devoId oI uny ucLuuI, IeL uIone reIevunL,
sLuLIsLIcuI InIormuLIon. TIere Is u reIIunce on reIuLIve rIsk sLuLemenLs sucI
us LwIce us IIkeIy Lo or more IIkeIy Lo. However, LIere Is no IndIcuLIon
us Lo - LwIce us IIkeIy us uhct? - In numerIc Lerms, und, more ImporLunLIy,
wIuL LIIs IIgure represenLs us u proporLIon oI LIe enLIre group oI smokers
(I.e., predIcLIve sLrengLI). SecondIy, IL IosLers LIe erroneous beIIeI LIuL
nonsmokers deIIver onIy IeuILIy bubIes. TIIrdIy, LIe IuIIure Lo provIde
perLInenL sLuLIsLIcuI InIormuLIon LogeLIer wILI LIe depIcLIon oI pregnunL
smokers IuvIng IeuILIy bubIes us Iucky promoLes LIe erroneous beIIeI
LIuL LIIs IuLLer cIrcumsLunce Is IIgIIy uLypIcuI; In IucL, mosL pregnunL
smokers Iuve IeuILIy bubIes. ourLIIy, u pregnunL smoker Is depIcLed us u
gumbIer LIuL Is wIIIIng Lo gumbIe wILI LIe IeuILI oI LIeIr buby. TIeIr
cupucILy us IIL moLIers Is uIso smeured, I.e., cd hominem urgumenL.
RuLIer, IL Is LIe menLuI sLubIIILy oI LIIs cuILIsL LIInkIng LIuL wouId reduce
pregnuncy Lo u gumbIIng-equIvuIenL und jeopurdIze LIe menLuI IeuILI oI
315
315
Rampant Antismoking Signifies Grave Danger
weIgIs 1Jz pounds or Iess. (Ouks, zoo1, p.q) TIe sume IeuILI
depurLmenL proIIers LIe IoIIowIng us u sLruLegy Ior IeuILI proIessIonuIs
Lo convInce pregnunL smokers Lo quIL LIe IubIL: SomeLImes |smokIng|
cuuses bIg probIems und someLImes onIy smuII ones (e.g., reduced weIgIL
guIn oI zoo grums). TIIs Is un Issue oI odds, IIke gumbIIng. SmokIng
doubIes LIe odds uguInsL you |Ior Iow bIrLI weIgIL|. You (your IrIend)
were Iucky IusL LIme. TIe probIem Is we don`L know II you wIII be so Iucky
LIIs LIme. Your besL beL Is Lo quIL. (Ouks, zoo1, p.q;)
One smokIng-cessuLIon counseIor responds Lo pregnunL smokers
wIo Iuve uIreudy Iud IeuILIy bubIes wILI L`s IIke RussIun rouIeLLe. You
jusL don`L know. usk LIem 'Do you wunL Lo Luke LIuL cIunce?` A nurse uL
u ruruI muLernILy cIInIc IurLIer 'reIInes` LIe gumbIIng meLupIor wILI un
uddILIonuI IuIIucy oI IncoIerenL unuIogy by LeIIIng women wIo smoke LIuL
IL Is IIke puLLIng u gun Lo your Ieud wIen you don`L know LIuL IL`s Iouded.
Do you wunL Lo Luke u cIunce wILI your buby IIke LIuL? (boLI quoLed In
Ouks, zoo1, p.q;) L musL be remembered LIuL LIIs conducL, und wIIcI In
LIIs cuse Is especIuIIy ubIorrenL, Is Iorwurded under LIe guIse oI IeuILI
promoLIon! Ouks` (zoo1) summuLIon Is quILe upL: L Is noL dIIIIcuIL Lo
exLend LIIs Imuge |Iouded gun Lo LIe Ieud| Lo one oI u pregnunL womun
puLLIng u gun Lo Ier buby`s Ieud, cerLuInIy u dIsLurbIng Imuge. TIe
RussIun rouIeLLe meLupIor Is purLIcuIurIy severe becuuse IL ImpIIes LIuL u
womun mukes IIIe or deuLI cIoIces wIen sIe smokes....TIe RussIun
rouIeLLe wurnIng Iucks IeuILI InIormuLIon und IuIIs buck on LIe moruI
urgumenL LIuL uvoIdIng IeuILI rIsks Is purL oI beIng u good moLIer-Lo-
be. (p.q;)
n pregnuncy books guIore LIe MMES-cuIL beIIeIs ure propuguLed
wILI greuL sureLy. One book concIudes LIuL |I|n eIIecL, wIen you smoke,
your buby Is conIIned In u smoke-IIIIed womb. HIs IeurLbeuL speeds, Ie
cougIs und spuLLers, und worsL oI uII, due Lo InsuIIIcIenL oxygen, Ie cun`L
grow und LIrIve us Ie sIouId. (EIsenberg eL uI., zoo1, p.o) n
respondIng Lo cuses wIere pregnunL smokers Iuve gIven bIrLI Lo IeuILIy
bubIes, und wIIcI Is LIe very-greuL mujorILy oI LIem, LIe sume uuLIors
proIIer:
TIere ure no sure LIIngs wIen mukIng u buby, buL LIere
ure muny wuys oI beLLerIng LIe odds. And gIvIng up
smokIng Is one oI LIe mosL LungIbIe wuys you cun
Improve LIe odds oI your IuvIng un uncompIIcuLed
pregnuncy und deIIvery und u IeuILIy buby. TIougI
LIere`s LIe cIunce LIuL you, Loo, cun Iuve u vIgorous
IuII-Lerm buby even II you smoke your wuy LIrougI your
pregnuncy, LIere`s uIso u sIgnIIIcunL rIsk LIuL your buby
wouId suIIer some or uII oI LIe eIIecLs deLuIIed on puge
Preventive Medicine & Health Promotion
o. Your sIsLer-In-Iuw wus Iucky (und Lo u cerLuIn
exLenL, LIIs Iuck couId Iuve goLLen u boosL Irom IeredILy
or oLIer IucLors LIuL mIgIL noL IoId Ior you); buL do you
reuIIy wunL Lo Luke LIe gumbIe LIuL you wIII be Iucky
Loo? And LIen LIuL Iuck muy noL be uII LIuL IL seems Lo
be. Some oI LIe deIIcILs - pIysIcuI und InLeIIecLuuI -
LIuL uIIIIcL bubIes oI smokers uren`L uppurenL
ImmedIuLeIy. TIe seemIngIy IeuILIy InIunL cun grow
InLo u cIIId wIo Is oILen sIck, wIo Is IyperucLIve, or wIo
Ius LroubIe IeurnIng.
n uddILIon Lo LIe eIIecL smokIng couId Iuve on your
buby wIIIe you`re sLIII pregnunL, LIere Is LIe eIIecL IL
wouId Iuve once Ie or sIe Ius moved Irom your smoke-
IIIIed womb Lo your smoke-IIIIed rooms. BubIes oI
purenLs (moLIers undJor duds) wIo smoke ure sIck
more oILen LIun LIe bubIes oI nonsmokers und ure more
IIkeIy Lo be IospILuIIzed LIrougI InIuncy und cIIIdIood.
(p.z-)
TIe IeuILIIsL propugundu sLrongIy IosLers LIe beIIeI LIuL quILLIng
smokIng wIII ensure u IeuILIy buby. or exumpIe, u pumpIIeL provIded by
LIe CoIorudo DepurLmenL oI HeuILI udvIses: I you quIL smokIng...your
buby wIII grow beLLer; your buby wIII geL more Iood und oxygen; your
buby`s Iungs wIII work beLLer; your pregnuncy wIII be IeuILIIer; und you
und your buby cun Ieuve LIe IospILuI LogeLIer. (quoLed In Ouks, zoo1,
p.q)
TypIcuI IeuILIIsL propugundu demonsLruLes u number oI
IeuLures. IrsLIy, IL Is usuuIIy devoId oI uny ucLuuI, IeL uIone reIevunL,
sLuLIsLIcuI InIormuLIon. TIere Is u reIIunce on reIuLIve rIsk sLuLemenLs sucI
us LwIce us IIkeIy Lo or more IIkeIy Lo. However, LIere Is no IndIcuLIon
us Lo - LwIce us IIkeIy us uhct? - In numerIc Lerms, und, more ImporLunLIy,
wIuL LIIs IIgure represenLs us u proporLIon oI LIe enLIre group oI smokers
(I.e., predIcLIve sLrengLI). SecondIy, IL IosLers LIe erroneous beIIeI LIuL
nonsmokers deIIver onIy IeuILIy bubIes. TIIrdIy, LIe IuIIure Lo provIde
perLInenL sLuLIsLIcuI InIormuLIon LogeLIer wILI LIe depIcLIon oI pregnunL
smokers IuvIng IeuILIy bubIes us Iucky promoLes LIe erroneous beIIeI
LIuL LIIs IuLLer cIrcumsLunce Is IIgIIy uLypIcuI; In IucL, mosL pregnunL
smokers Iuve IeuILIy bubIes. ourLIIy, u pregnunL smoker Is depIcLed us u
gumbIer LIuL Is wIIIIng Lo gumbIe wILI LIe IeuILI oI LIeIr buby. TIeIr
cupucILy us IIL moLIers Is uIso smeured, I.e., cd hominem urgumenL.
RuLIer, IL Is LIe menLuI sLubIIILy oI LIIs cuILIsL LIInkIng LIuL wouId reduce
pregnuncy Lo u gumbIIng-equIvuIenL und jeopurdIze LIe menLuI IeuILI oI
316
316
Rampant Antismoking Signifies Grave Danger
pregnunL women LIuL Is cuIIed InLo quesLIon. L uIso beggurs beIIeI Iow
LIIs sorL oI IeuILIIsL conducL Is promoLed under LIe uuspIces oI menLuI
IygIene. TIe conducL demonsLruLes un obIIvIousness Lo u coIerenL
psycIoIogIcuI Irumework und LIe IonesL presenLuLIon oI InIormuLIon.
urLIermore, LIe IeuILIIsL onsIuugIL does noL end wILI
cIIIdbIrLI. EIsenberg eL uI.`s (zoo1) oIIerIng suggesLs LIuL uII cIIIdren oI
smokers ure sIcker LIun uII LIose oI nonsmokers; II smokIng Ius noL Luken
ILs IurmIuI LoII durIng pregnuncy, LIen IL sureIy wIII uILerwurds. PregnunL
smokers ure porLruyed us unIeuILIy und LIe progeny oI uII oI LIem wIII
demonsLruLe III-IeuILI uL some poInL, I.e., LIe smoker`s buby Is un InIerIor
creuLure. Tobucco smoke wIII uIwuys Iurm every InIunL eILIer durIng or
uILer pregnuncy. However, LIe gIurIng IucL oI LIe muLLer Is LIuL InIunL
morbIdILy und morLuIILy ure hihl ctpiccl occurrences Ior boLI smokIng
und nonsmokIng moLIers. InuIIy, LIe IeuILIIsL IILeruLure und conducL
ubounds wILI IuIIucIes oI IncoIerenL unuIogy. or exumpIe, rIdIcuIous,
emoLIve meLupIors sucI us u smoke-IIIIed womb or uLLempLIng Lo depIcL
LIe rIsks ussocIuLed wILI smokIng durIng pregnuncy us unuIogous wILI LIe
rIsk oI unwunLed pregnuncy Irom IuIIure Lo use conLrucepLIon or LIe rIsk
oI InIecLIous dIseuse (e.g., HV) Irom unproLecLed sexuuI reIuLIons (see
Ouks, zoo1, p.q6). TIe IuLLer Lwo Iuve cIeurIy deIInubIe cuusuI puLIwuys
(e.g., ImpregnuLIon, vIruI); LIe urgumenL uguInsL smokIng durIng
pregnuncy Is bused on IncoIerenL sLuLIsLIcuI InIerence wILI no
demonsLrubIe cuusuI puLIwuys - und noL Ior LIe wunL oI LryIng.
TIe IeuILIIsL sLunce wIII noL permIL u pregnunL smoker uny
posILIve beIIeI ubouL LIeIr pregnuncy so Iong us LIey smoke und Iocuses
enLIreIy on LIe worsL, uILIougI exLremeIy uLypIcuI und cuusuIIy
quesLIonubIe, oI sLuLIsLIcuIIy possIbIe ouLcomes. TIIs Is un ussuuIL on
menLuI IeuILI uL LIe very IeusL; LIe poLenLIuI Ior nocebo eIIecLs Is
exLruordInury. L musL be remembered LIuL mosL pregnunL smokers Lo
wIom LIIs cuILIsL nonsense Is dIrecLed wIII Iuve IeuILIy bubIes.
UnIorLunuLeIy, LIe pregnunL smoker now Iuces u IosLIIe medIcuI
esLubIIsImenL InLenL on InLroducIng needIess worry und conIronLuLIon uL
every Lurn. Any pregnunL smoker Is noL permILLed Lo Iuve u worry-Iree or
enjoyubIe pregnuncy.
TIe deIIvery oI u IeuILIy buby Ior muny pregnunL smokers musL
come IoremosL us u proIound reIIeI, gIven LIuL uny deLrImenLuI ouLcome
wIII mosL probubIy be bIumed on LIeIr smokIng (I.e., IuIIucy oI post hoc
ero propter hoc). ConverseIy, u IeuILIy ouLcome Ior u pregnunL smoker
cun be vIewed by IeuILI proIessIonuIs us dImInIsIIng LIeIr unLIsmokIng
messuge und reInIorcIng smokIng beIuvIor. One IeuILI educuLor Is quoLed
us sudIy suggesLIng |L|IIs sounds LerrIbIe, buL we sIouId sorL oI 'wunL` LIe
buby Lo be Iow bIrLIweIgIL, so LIuL LIey`II beIIeve LIuL smokIng Is
Preventive Medicine & Health Promotion
IurmIuI. (quoLed In Ouks, zoo1, p.q) TIIs Is noL Lo suy LIuL IeuILI
educuLors reuIIy wunL deLrImenLuI ouLcomes Lo prove LIeIr poInL.
However, LIe wIoIe IeuILI promoLIon sysLem Ius been geured Iess Lo
IeuILI promoLIon predIcuLed on coIerenL Lerms und more wILI provIng
u quesLIonubIe meLupIysIcuI (muLerIuIIsL) poInL oI vIew. A supposed
IeuILI promoLIon sysLem LIuL Ius uIIowed LIIs deIusIonuI udversurIuI
Irumework Lo deveIop Is very sIck.
AIso ImporLunL Lo noLe Is LIuL IeuILI educuLors mosL probubIy
Iuve no Ideu wIuL LIe sLuLIsLIcs underIyIng purLIcuIur IeuILI promoLIon
ure. TIIs musL sureIy be LIe cuse II LIey ure LryIng Lo convInce uII pregnunL
smokers LIuL u IeuILIy buby Ior LIem Is u muLLer oI Iuck. TIIs Is noL u
smuII probIem. Ouks (zoo1) Ius u sympuLIeLIc vIew oI LIe pIIgIL oI LIe
pregnunL womun In LIe Iuce oI LIe IeuILIIsL LIrude. However, LIrougI u
mIscuIcuIuLIon sIe consIderubIy overesLImuLes LIe ubsoIuLe rIsk oI u
pregnunL smoker IuvIng u Iow bIrLIweIgIL buby. SIe ImproperIy
concIuded LIuL u womun wIo smokes more LIun u puck u duy Ius u 6q%
cIunce oI IuvIng u Iow bIrLIweIgIL buby (p.q), I.e., 6q ouL oI 1oo Iuve u
Iow bIrLIweIgIL buby. RuLIer, LIe ubsoIuLe rIsk Is uround 11% ubove u
buseIIne, or uround 1q% generuIIy.
TIe InLenL Iere Is noL Lo Impugn Ouks (zoo1) wIo provIdes u
mosL InsIgILIuI und weII-reseurcIed work. RuLIer, IL Is Lo IIgIIIgIL jusL
Iow eusy IL Is Lo mIsInLerpreL LIe dIsjoInLed bILs oI sLuLIsLIcuI InIormuLIon
mude uvuIIubIe by IeuILI uuLIorILIes. CrILIcuI sLuLIsLIcuI InIormuLIon (I.e.,
predIcLIve sLrengLI) Is never presenLed by IeuILI uuLIorILIes In
promoLIonuI IILeruLure. AILIougI LIe InLenL Is probubIy noL specIIIcuIIy Lo
mIsIeud LIe pubIIc, LIe uncIorIng oI pIecemeuI sLuLIsLIcuI InIormuLIon Lo
wIuL ure cuIL muLerIuIIsL beIIeIs (e.g., rIsk uversIon) Ius LIe sume
mIsIeudIng resuIL; promoLIonuI muLerIuI sIIILs erruLIcuIIy Irom RR`s Lo
reIuLIve percenL Increuse Lo uLLrIbuLubIe numbers InsoIur us IL
promoLes errunL medIcuI-esLubIIsImenL poIIcy. UnIess someone Ius been
IormuIIy LruIned In sLuLIsLIcs, LIe probubIIILy Is very IIgI LIuL LIIs
dIsjoInLed sLuLIsLIcuI InIormuLIon uill be mIsInLerpreLed.
GenuIne IeuILI promoLIon sIouId provIde rIsk InIormuLIon und
IndIcuLIng LIuL In mosL InsLunces rIsk IucLors ure very poor predIcLors oI
purLIcuIur ouLcomes und, LIereIore, oI quesLIonubIe ueLIoIogIcuI
sIgnIIIcunce. L sIouId uIIow IndIvIduuIs Lo InLerpreL wIuL Is essenLIuIIy
subjecLIve sLuLIsLIcuI InIormuLIon wIIIe LryIng Lo ensure LIuL IL Is noL over-
InLerpreLed by puLIenLs. RuLIer, conLemporury IeuILI promoLIon does LIe
exucL opposILe. L uggressIveIy preucIes LIe cuIL beIIeI LIuL sLuLIsLIcuI rIsk
uversIon Is normuI, I.e., uIondIsm, LIe muLerIuIIsL munIIesLo; IL Is LIe very
IeuILI educuLors LIuL ure severeIy over-InLerpreLIng Iow-IeveI sLuLIsLIcuI
ussocIuLIons. TIe resuIL Is un exuggeruLed ImporLunce uccorded Lo IeuILI
317
317
Rampant Antismoking Signifies Grave Danger
pregnunL women LIuL Is cuIIed InLo quesLIon. L uIso beggurs beIIeI Iow
LIIs sorL oI IeuILIIsL conducL Is promoLed under LIe uuspIces oI menLuI
IygIene. TIe conducL demonsLruLes un obIIvIousness Lo u coIerenL
psycIoIogIcuI Irumework und LIe IonesL presenLuLIon oI InIormuLIon.
urLIermore, LIe IeuILIIsL onsIuugIL does noL end wILI
cIIIdbIrLI. EIsenberg eL uI.`s (zoo1) oIIerIng suggesLs LIuL uII cIIIdren oI
smokers ure sIcker LIun uII LIose oI nonsmokers; II smokIng Ius noL Luken
ILs IurmIuI LoII durIng pregnuncy, LIen IL sureIy wIII uILerwurds. PregnunL
smokers ure porLruyed us unIeuILIy und LIe progeny oI uII oI LIem wIII
demonsLruLe III-IeuILI uL some poInL, I.e., LIe smoker`s buby Is un InIerIor
creuLure. Tobucco smoke wIII uIwuys Iurm every InIunL eILIer durIng or
uILer pregnuncy. However, LIe gIurIng IucL oI LIe muLLer Is LIuL InIunL
morbIdILy und morLuIILy ure hihl ctpiccl occurrences Ior boLI smokIng
und nonsmokIng moLIers. InuIIy, LIe IeuILIIsL IILeruLure und conducL
ubounds wILI IuIIucIes oI IncoIerenL unuIogy. or exumpIe, rIdIcuIous,
emoLIve meLupIors sucI us u smoke-IIIIed womb or uLLempLIng Lo depIcL
LIe rIsks ussocIuLed wILI smokIng durIng pregnuncy us unuIogous wILI LIe
rIsk oI unwunLed pregnuncy Irom IuIIure Lo use conLrucepLIon or LIe rIsk
oI InIecLIous dIseuse (e.g., HV) Irom unproLecLed sexuuI reIuLIons (see
Ouks, zoo1, p.q6). TIe IuLLer Lwo Iuve cIeurIy deIInubIe cuusuI puLIwuys
(e.g., ImpregnuLIon, vIruI); LIe urgumenL uguInsL smokIng durIng
pregnuncy Is bused on IncoIerenL sLuLIsLIcuI InIerence wILI no
demonsLrubIe cuusuI puLIwuys - und noL Ior LIe wunL oI LryIng.
TIe IeuILIIsL sLunce wIII noL permIL u pregnunL smoker uny
posILIve beIIeI ubouL LIeIr pregnuncy so Iong us LIey smoke und Iocuses
enLIreIy on LIe worsL, uILIougI exLremeIy uLypIcuI und cuusuIIy
quesLIonubIe, oI sLuLIsLIcuIIy possIbIe ouLcomes. TIIs Is un ussuuIL on
menLuI IeuILI uL LIe very IeusL; LIe poLenLIuI Ior nocebo eIIecLs Is
exLruordInury. L musL be remembered LIuL mosL pregnunL smokers Lo
wIom LIIs cuILIsL nonsense Is dIrecLed wIII Iuve IeuILIy bubIes.
UnIorLunuLeIy, LIe pregnunL smoker now Iuces u IosLIIe medIcuI
esLubIIsImenL InLenL on InLroducIng needIess worry und conIronLuLIon uL
every Lurn. Any pregnunL smoker Is noL permILLed Lo Iuve u worry-Iree or
enjoyubIe pregnuncy.
TIe deIIvery oI u IeuILIy buby Ior muny pregnunL smokers musL
come IoremosL us u proIound reIIeI, gIven LIuL uny deLrImenLuI ouLcome
wIII mosL probubIy be bIumed on LIeIr smokIng (I.e., IuIIucy oI post hoc
ero propter hoc). ConverseIy, u IeuILIy ouLcome Ior u pregnunL smoker
cun be vIewed by IeuILI proIessIonuIs us dImInIsIIng LIeIr unLIsmokIng
messuge und reInIorcIng smokIng beIuvIor. One IeuILI educuLor Is quoLed
us sudIy suggesLIng |L|IIs sounds LerrIbIe, buL we sIouId sorL oI 'wunL` LIe
buby Lo be Iow bIrLIweIgIL, so LIuL LIey`II beIIeve LIuL smokIng Is
Preventive Medicine & Health Promotion
IurmIuI. (quoLed In Ouks, zoo1, p.q) TIIs Is noL Lo suy LIuL IeuILI
educuLors reuIIy wunL deLrImenLuI ouLcomes Lo prove LIeIr poInL.
However, LIe wIoIe IeuILI promoLIon sysLem Ius been geured Iess Lo
IeuILI promoLIon predIcuLed on coIerenL Lerms und more wILI provIng
u quesLIonubIe meLupIysIcuI (muLerIuIIsL) poInL oI vIew. A supposed
IeuILI promoLIon sysLem LIuL Ius uIIowed LIIs deIusIonuI udversurIuI
Irumework Lo deveIop Is very sIck.
AIso ImporLunL Lo noLe Is LIuL IeuILI educuLors mosL probubIy
Iuve no Ideu wIuL LIe sLuLIsLIcs underIyIng purLIcuIur IeuILI promoLIon
ure. TIIs musL sureIy be LIe cuse II LIey ure LryIng Lo convInce uII pregnunL
smokers LIuL u IeuILIy buby Ior LIem Is u muLLer oI Iuck. TIIs Is noL u
smuII probIem. Ouks (zoo1) Ius u sympuLIeLIc vIew oI LIe pIIgIL oI LIe
pregnunL womun In LIe Iuce oI LIe IeuILIIsL LIrude. However, LIrougI u
mIscuIcuIuLIon sIe consIderubIy overesLImuLes LIe ubsoIuLe rIsk oI u
pregnunL smoker IuvIng u Iow bIrLIweIgIL buby. SIe ImproperIy
concIuded LIuL u womun wIo smokes more LIun u puck u duy Ius u 6q%
cIunce oI IuvIng u Iow bIrLIweIgIL buby (p.q), I.e., 6q ouL oI 1oo Iuve u
Iow bIrLIweIgIL buby. RuLIer, LIe ubsoIuLe rIsk Is uround 11% ubove u
buseIIne, or uround 1q% generuIIy.
TIe InLenL Iere Is noL Lo Impugn Ouks (zoo1) wIo provIdes u
mosL InsIgILIuI und weII-reseurcIed work. RuLIer, IL Is Lo IIgIIIgIL jusL
Iow eusy IL Is Lo mIsInLerpreL LIe dIsjoInLed bILs oI sLuLIsLIcuI InIormuLIon
mude uvuIIubIe by IeuILI uuLIorILIes. CrILIcuI sLuLIsLIcuI InIormuLIon (I.e.,
predIcLIve sLrengLI) Is never presenLed by IeuILI uuLIorILIes In
promoLIonuI IILeruLure. AILIougI LIe InLenL Is probubIy noL specIIIcuIIy Lo
mIsIeud LIe pubIIc, LIe uncIorIng oI pIecemeuI sLuLIsLIcuI InIormuLIon Lo
wIuL ure cuIL muLerIuIIsL beIIeIs (e.g., rIsk uversIon) Ius LIe sume
mIsIeudIng resuIL; promoLIonuI muLerIuI sIIILs erruLIcuIIy Irom RR`s Lo
reIuLIve percenL Increuse Lo uLLrIbuLubIe numbers InsoIur us IL
promoLes errunL medIcuI-esLubIIsImenL poIIcy. UnIess someone Ius been
IormuIIy LruIned In sLuLIsLIcs, LIe probubIIILy Is very IIgI LIuL LIIs
dIsjoInLed sLuLIsLIcuI InIormuLIon uill be mIsInLerpreLed.
GenuIne IeuILI promoLIon sIouId provIde rIsk InIormuLIon und
IndIcuLIng LIuL In mosL InsLunces rIsk IucLors ure very poor predIcLors oI
purLIcuIur ouLcomes und, LIereIore, oI quesLIonubIe ueLIoIogIcuI
sIgnIIIcunce. L sIouId uIIow IndIvIduuIs Lo InLerpreL wIuL Is essenLIuIIy
subjecLIve sLuLIsLIcuI InIormuLIon wIIIe LryIng Lo ensure LIuL IL Is noL over-
InLerpreLed by puLIenLs. RuLIer, conLemporury IeuILI promoLIon does LIe
exucL opposILe. L uggressIveIy preucIes LIe cuIL beIIeI LIuL sLuLIsLIcuI rIsk
uversIon Is normuI, I.e., uIondIsm, LIe muLerIuIIsL munIIesLo; IL Is LIe very
IeuILI educuLors LIuL ure severeIy over-InLerpreLIng Iow-IeveI sLuLIsLIcuI
ussocIuLIons. TIe resuIL Is un exuggeruLed ImporLunce uccorded Lo IeuILI
318
318
Rampant Antismoking Signifies Grave Danger
experLs und, In LIIs InsLunce, pregnunL women coerced, under LIe
musquerude oI scIenLIIIc credIbIIILy, InLo supersLILIous, deIuded beIIeI.
n LIe cuse oI pregnuncy, LIe quuIILy oI IeuILI InIormuLIon Is oI
even Iur greuLer ImporLunce. Muny pregnunL women, purLIcuIurIy IIrsL-
LIme pregnuncIes, ure prone Lo neuroLIc LendencIes sucI us over-
proLecLIon und supersLILIous beIIeI - u cIrcumsLunce noL mude uny beLLer
by LIe pubIIc pregnuncy poIIce. Ouks (zoo1) noLes LIuL |s|ome women
IoIIow IeuILI udvIce Lo wIuL even LIey see us exLremes. TIese women ucL
on LIe ussumpLIon LIuL II LIeIr IndIvIduuI IeuILI prucLIces conIorm Lo
experL udvIce, LIey cun reduce pregnuncy rIsks und conLroI LIe IeuILI oI
LIe buby-Lo-be. SucI beIuvIor Is LIe resuIL oI wIuL one womun`s Iusbund
(u pIysIcIun) Lermed 'pregnuncy purunoIu`.. Pressure Lo be exLru-
vIgIIunL moLIvuLes some women Lo uILer LIeIr usuuI rouLInes Lo un exLenL
LIuL LIey know exceeds oLIers` expecLuLIons. Pregnuncy purunoIu, LIe
resuIL oI LIe combInuLIon oI pregnuncy udvIce und women`s own desIres Lo
Iuve u IeuILIy buby, Is perpeLuuLed by brouder socIuI IdeoIogIes LIuL pIuce
responsIbIIILy Ior IeuILI upon eucI IndIvIduuI`s ucLIons. L uIso sIows Iow
udepL some women ure uL poIIcIng LIemseIves. (p.q6-;)
RuLIer LIun reussurIng pregnunL women und dIrecLIng LIem
uwuy Irom IncoIerenL beIIeI und ucLIvILy, IL Is so-cuIIed experLs LIuL
demonsLruLe deIusIonuI beIIeIs und wouId coerce LIe sume In LIe pubIIc uL
Iurge. AmbIvuIenL, conLrudIcLory messuges IIrsL ussuuIL menLuI IeuILI by
exuggeruLIng wIuL ure uLypIcuI (deLrImenLuI) ouLcomes und LIen Lry Lo
soILen LIe bIow wIen LIIngs do ucLuuIIy go wrong. TIe ucLuuI busIs oI
conLemporury IeuILI promoLIon Is LIuL no womun, smokIng or
nonsmokIng, Is permILLed Lo beIIeve LIuL LIeIr buby wIII be IeuILIy In
gesLuLIon und bIrLI. TIe preucIIng oI rIsk und (s)rIsk-uversIon
erroneousIy uncIors conducL Lo uLypIcuI ouLcomes. n uLLempLIng Lo uvoId
uII munner oI beIuvIors und exposures, women ure beIng LuugIL LIuL LIey
sIouId expecL LIe worsL In every cuse; LIey sIouId noL enLerLuIn LIe Ideu
LIuL LIeIr buby Is normuI und LIuL purLIcuIur exposures ure weII wILIIn u
normuLIve runge oI IuncLIonIng; IL Is promoLed LIuL IL Is IeuILIy Ior u
womun Lo beIIeve LIuL Ier cIIId or buby-Lo-be Is ubnormuI und, LIereIore,
IncupubIe oI LoIeruLIng u normuLIve runge oI exposures. AguIn, IL Is LIIs
sorL oI IeuILI promoLIon sysLem LIuL Is dungerousIy sIck.
TIe resuIL Is pregnunL women und moLIers conLInuuIIy second-
guessIng LIemseIves us Lo underIyIng cuuses oI evenLs. or exumpIe,
ProIeL (1qq) suggesLs:
|GeneLIc| muIIormuLIons ure bound Lo occur by cIunce
In LIe deveIopmenL oI some embryos becuuse LIere ure
LIousunds oI LIIngs LIuL cun go wrong durIng LIe
IormuLIon oI u IeLus Irom u IerLIIIzed egg; one LIny
Preventive Medicine & Health Promotion
perLurbuLIon In LIe deveIopmenLuI puLLern muy resuIL In
u serIous deIecL. I u womun wIo Ieurns LIuL Ier IeLus or
InIunL Is muIIormed revIews Ier enLIre IIrsL LrImesLer,
sIe probubIy wIII be ubIe Lo IerreL ouL uII kInds oI
possIbIe cuIprILs; LIe poLuLoes sIe uLe uL CIrIsLmus
dInner; LIe unLIIIsLumIne sIe Look Ior IIves uILer u
IIke; LIe Iong IoL buLI sIe Look one evenIng; LIe X-ruy
sIe goL wIen sIe spruIned Ier unkIe; LIe Iour gIusses oI
wIne sIe drunk uL LIe New Yeur`s purLy beIore sIe
reuIIzed sIe wus pregnunL; LIe Iumes sIe uccIdenLuIIy
InIuIed wIIIe pumpIng gus one duy; LIe muke-up sIe
wore Lo conceuI LIe IucL sIe dIdn`L IeeI weII. BuL LIe reuI
cuIprIL muy sImpIy be IuLe.
I u pregnunL womun reuIIzes durIng LIe IIrsL LrImesLer
sIe uLe some oI LIe Ioods on LIe 'sIn` IIsL, InudverLenLIy
Look some medIcIne, cume down wILI u coId, or wus
exposed Lo someLIIng 'bud`, sIe sIouIdn`L punIc. MosL
bubIes ure born IeuILIy, even LIougI uImosL uII IIrsL-
LrImesLer women ure exposed Lo subsLunces LIuL, uL
some doses, ure LeruLogens |ugenLs LIuL cuuse bIrLI
deIecLs|. (quoLed In Ouks, zoo1, p.6-;)
Ouks (zoo1) reIers Lo |o|ne womun wIo Iud experIenced eurIy
Ioss oI u pregnuncy udmILLed LIuL sIe worrIed ubouL LIe oIIIce buIIdIng
sIe worked In: ' know ILs LesLed Ior uII LIose LIIngs, IIke usbesLos,
buL..wIen IosL LIe buby, LIougIL some envIronmenLuI IucLor Iud
someLIIng Lo do wILI IL, or wIuLever, buL you don`L reuIIy know..TIey
|LIe docLors| jusL suId, you know, LIuL`s nuLure, LIuL`s LIe wuy IL goes`. BuL
sIe wus noL LoLuIIy suLIsIIed wILI LIIs expIunuLIon und wonders wIeLIer
sIe couId Iuve prevenLed LIe pregnuncy Ioss II sIe Iud quIL Ier job. n
IIne wILI one domInunL pregnuncy dIscourse, sIe usserLs LIuL sIe couId
Iuve Luken IndIvIduuI ucLIon Lo cIunge Ier IIIesLyIe Lo mInImIze Ier
exposure Lo envIronmenLuI rIsk. (p.6)
UnIorLunuLeIy, even LIe IncompeLence oI umbIvuIenL messuges Is
noL uccorded LIe pregnunL smoker. HeuILI promoLIon uLLempLs Lo IosLer
LIe beIIeI LIuL u deLrImenLuI ouLcome Ior u pregnunL smoker Is uImosL u
sureLy - u IeuILIy buby Is u muLLer oI Iuck. TIere Is uIso no sIorLuge oI
Iobby groups oI quesLIonubIe IdeoIogIcuI busIs wunLIng Lo Iend LIeIr
monomunIucuI, unbuIunced weIgIL Lo LIe unLIsmokIng cuuse. WILI
regurd Lo smokIng und pregnuncy, LIe AmerIcun ung AssocIuLIon (AA),
LIe AmerIcun Cuncer SocIeLy (ACS), und AcLIon on SmokIng und HeuILI
(ASH) IIgure IIgIIy. And wILI eucI IeuILI messuge Is IrruLIonuI Ieur und
319
319
Rampant Antismoking Signifies Grave Danger
experLs und, In LIIs InsLunce, pregnunL women coerced, under LIe
musquerude oI scIenLIIIc credIbIIILy, InLo supersLILIous, deIuded beIIeI.
n LIe cuse oI pregnuncy, LIe quuIILy oI IeuILI InIormuLIon Is oI
even Iur greuLer ImporLunce. Muny pregnunL women, purLIcuIurIy IIrsL-
LIme pregnuncIes, ure prone Lo neuroLIc LendencIes sucI us over-
proLecLIon und supersLILIous beIIeI - u cIrcumsLunce noL mude uny beLLer
by LIe pubIIc pregnuncy poIIce. Ouks (zoo1) noLes LIuL |s|ome women
IoIIow IeuILI udvIce Lo wIuL even LIey see us exLremes. TIese women ucL
on LIe ussumpLIon LIuL II LIeIr IndIvIduuI IeuILI prucLIces conIorm Lo
experL udvIce, LIey cun reduce pregnuncy rIsks und conLroI LIe IeuILI oI
LIe buby-Lo-be. SucI beIuvIor Is LIe resuIL oI wIuL one womun`s Iusbund
(u pIysIcIun) Lermed 'pregnuncy purunoIu`.. Pressure Lo be exLru-
vIgIIunL moLIvuLes some women Lo uILer LIeIr usuuI rouLInes Lo un exLenL
LIuL LIey know exceeds oLIers` expecLuLIons. Pregnuncy purunoIu, LIe
resuIL oI LIe combInuLIon oI pregnuncy udvIce und women`s own desIres Lo
Iuve u IeuILIy buby, Is perpeLuuLed by brouder socIuI IdeoIogIes LIuL pIuce
responsIbIIILy Ior IeuILI upon eucI IndIvIduuI`s ucLIons. L uIso sIows Iow
udepL some women ure uL poIIcIng LIemseIves. (p.q6-;)
RuLIer LIun reussurIng pregnunL women und dIrecLIng LIem
uwuy Irom IncoIerenL beIIeI und ucLIvILy, IL Is so-cuIIed experLs LIuL
demonsLruLe deIusIonuI beIIeIs und wouId coerce LIe sume In LIe pubIIc uL
Iurge. AmbIvuIenL, conLrudIcLory messuges IIrsL ussuuIL menLuI IeuILI by
exuggeruLIng wIuL ure uLypIcuI (deLrImenLuI) ouLcomes und LIen Lry Lo
soILen LIe bIow wIen LIIngs do ucLuuIIy go wrong. TIe ucLuuI busIs oI
conLemporury IeuILI promoLIon Is LIuL no womun, smokIng or
nonsmokIng, Is permILLed Lo beIIeve LIuL LIeIr buby wIII be IeuILIy In
gesLuLIon und bIrLI. TIe preucIIng oI rIsk und (s)rIsk-uversIon
erroneousIy uncIors conducL Lo uLypIcuI ouLcomes. n uLLempLIng Lo uvoId
uII munner oI beIuvIors und exposures, women ure beIng LuugIL LIuL LIey
sIouId expecL LIe worsL In every cuse; LIey sIouId noL enLerLuIn LIe Ideu
LIuL LIeIr buby Is normuI und LIuL purLIcuIur exposures ure weII wILIIn u
normuLIve runge oI IuncLIonIng; IL Is promoLed LIuL IL Is IeuILIy Ior u
womun Lo beIIeve LIuL Ier cIIId or buby-Lo-be Is ubnormuI und, LIereIore,
IncupubIe oI LoIeruLIng u normuLIve runge oI exposures. AguIn, IL Is LIIs
sorL oI IeuILI promoLIon sysLem LIuL Is dungerousIy sIck.
TIe resuIL Is pregnunL women und moLIers conLInuuIIy second-
guessIng LIemseIves us Lo underIyIng cuuses oI evenLs. or exumpIe,
ProIeL (1qq) suggesLs:
|GeneLIc| muIIormuLIons ure bound Lo occur by cIunce
In LIe deveIopmenL oI some embryos becuuse LIere ure
LIousunds oI LIIngs LIuL cun go wrong durIng LIe
IormuLIon oI u IeLus Irom u IerLIIIzed egg; one LIny
Preventive Medicine & Health Promotion
perLurbuLIon In LIe deveIopmenLuI puLLern muy resuIL In
u serIous deIecL. I u womun wIo Ieurns LIuL Ier IeLus or
InIunL Is muIIormed revIews Ier enLIre IIrsL LrImesLer,
sIe probubIy wIII be ubIe Lo IerreL ouL uII kInds oI
possIbIe cuIprILs; LIe poLuLoes sIe uLe uL CIrIsLmus
dInner; LIe unLIIIsLumIne sIe Look Ior IIves uILer u
IIke; LIe Iong IoL buLI sIe Look one evenIng; LIe X-ruy
sIe goL wIen sIe spruIned Ier unkIe; LIe Iour gIusses oI
wIne sIe drunk uL LIe New Yeur`s purLy beIore sIe
reuIIzed sIe wus pregnunL; LIe Iumes sIe uccIdenLuIIy
InIuIed wIIIe pumpIng gus one duy; LIe muke-up sIe
wore Lo conceuI LIe IucL sIe dIdn`L IeeI weII. BuL LIe reuI
cuIprIL muy sImpIy be IuLe.
I u pregnunL womun reuIIzes durIng LIe IIrsL LrImesLer
sIe uLe some oI LIe Ioods on LIe 'sIn` IIsL, InudverLenLIy
Look some medIcIne, cume down wILI u coId, or wus
exposed Lo someLIIng 'bud`, sIe sIouIdn`L punIc. MosL
bubIes ure born IeuILIy, even LIougI uImosL uII IIrsL-
LrImesLer women ure exposed Lo subsLunces LIuL, uL
some doses, ure LeruLogens |ugenLs LIuL cuuse bIrLI
deIecLs|. (quoLed In Ouks, zoo1, p.6-;)
Ouks (zoo1) reIers Lo |o|ne womun wIo Iud experIenced eurIy
Ioss oI u pregnuncy udmILLed LIuL sIe worrIed ubouL LIe oIIIce buIIdIng
sIe worked In: ' know ILs LesLed Ior uII LIose LIIngs, IIke usbesLos,
buL..wIen IosL LIe buby, LIougIL some envIronmenLuI IucLor Iud
someLIIng Lo do wILI IL, or wIuLever, buL you don`L reuIIy know..TIey
|LIe docLors| jusL suId, you know, LIuL`s nuLure, LIuL`s LIe wuy IL goes`. BuL
sIe wus noL LoLuIIy suLIsIIed wILI LIIs expIunuLIon und wonders wIeLIer
sIe couId Iuve prevenLed LIe pregnuncy Ioss II sIe Iud quIL Ier job. n
IIne wILI one domInunL pregnuncy dIscourse, sIe usserLs LIuL sIe couId
Iuve Luken IndIvIduuI ucLIon Lo cIunge Ier IIIesLyIe Lo mInImIze Ier
exposure Lo envIronmenLuI rIsk. (p.6)
UnIorLunuLeIy, even LIe IncompeLence oI umbIvuIenL messuges Is
noL uccorded LIe pregnunL smoker. HeuILI promoLIon uLLempLs Lo IosLer
LIe beIIeI LIuL u deLrImenLuI ouLcome Ior u pregnunL smoker Is uImosL u
sureLy - u IeuILIy buby Is u muLLer oI Iuck. TIere Is uIso no sIorLuge oI
Iobby groups oI quesLIonubIe IdeoIogIcuI busIs wunLIng Lo Iend LIeIr
monomunIucuI, unbuIunced weIgIL Lo LIe unLIsmokIng cuuse. WILI
regurd Lo smokIng und pregnuncy, LIe AmerIcun ung AssocIuLIon (AA),
LIe AmerIcun Cuncer SocIeLy (ACS), und AcLIon on SmokIng und HeuILI
(ASH) IIgure IIgIIy. And wILI eucI IeuILI messuge Is IrruLIonuI Ieur und
320
320
Rampant Antismoking Signifies Grave Danger
guIIL exucerbuLed.
TIe sLundurd upproucI oI LIese unLIsmokIng groups Is Lo depIcL u
pregnunL nonsmoker us u superIor, nurLurIng, IovIng, curIng moLIer-Lo-
be. AILernuLIveIy, LIe pregnunL smoker Is depIcLed us LIe converse -
InIerIor, seIIIsI, uncurIng, unIovIng. HeuILI Is porLruyed us onIy
uLLuInubIe, Ior uduILs or LIe unborn, In u smoke-Iree envIronmenL.
PumpIIeLs, IIIms, sLIckers, und sLund-up curds Iuve been empIoyed In LIe
unLIsmokIng cuuse. A pregnunL womun cun surround IerseII wILI uII
munner oI prInLed sIoguns In un uLLempL Lo dIscIpIIne IerseII or wurd oI
sources oI envIronmenLuI dunger. BeIow ure IIsLed jusL u Iew oI LIe
pIeLIoru oI unLIsmokIng sIoguns uppeurIng sInce LIe IuLe-1q;o`s. TIey ure
LypIcuIIy very IIgIL on scIenLIIIc subsLunce und Iouded wILI emoLIve
Imugery und numerous IuIIucIes oI IncoIerenL unuIogy (see Ouks, zoo1,
Ior u more deLuIIed scruLIny oI LIIs unLIsmokIng sugu):
WIen |LIe pregnunL smoker| sLops smokIng, sIe
sIows LIuL sIe wunLs Lo ruIse Ier buby In u smoke-Iree
worId (AA, 1qqq, quoLed In Ouks, zoo1, p.;8);
Your buby-Lo-be, snuggIed InsIde your womb, Is
sIIenLIy enguged In u wonder-IIIIed udvenLure: LIe
sLruggIe Lowurd IIIe. Your unborn buby needs uII LIe
IeIp IL cun geL In LIuL sLruggIe. EspecIuIIy Irom
you....wIen you quIL smokIng LIIs mInuLe you`II be
gIvIng your unborn buby LIe smoke-Iree envIronmenL
boLI oI you need Lo be IeuILIy. L`s more LIun u gIIL. L`s
u muLLer oI IIIe und breuLI (AA, 1q8o, quoLed In Ouks,
zoo1, p.1z);
Becuuse you ove your Buby... TIere`s Never been u
BeLLer TIme Lo QuIL; In LIe mId-1q8o`s LIIs wus
modIIIed Lo QuIL SmokIng: Becuuse ove My
Buby (AA, 1q8o`s, quoLed In Ouks, zoo1, p.1q8);
No SmokIng PEASE, `m BreuLIIng Ior Two; A
IeuILIy BegInnIng: TIe Smoke-ree umIIy GuIde Ior
New PurenLs (AA, IuLe-1q8o`s, quoLed In Ouks, zoo1,
p.1qq);
WIy SLurL IIe Under A CIoud? (ACS, IuLe-1q;o`s,
quoLed In Ouks, zoo1, p.1qq);
Deur ____, My buby wunLs me Lo quIL smokIng - so
um! PIeuse don`L smoke neur me or gIve me
cIgureLLes. (ACS, 1q88, quoLed In Ouks, zoo1, p.1o)
TIe sIeer suLuruLIon oI unsubsLunLIuLed, IIgIIy emoLIve cIuIms
by Iobby groups, und wIIcI Iuve been IeIL uncIecked, Ius mude IL onIy
Preventive Medicine & Health Promotion
Loo eusy Ior IunuLIcIsm Lo IurLIer IIourIsI. I LIe pregnunL smoker wIII noL
desIsL Irom LIe IubIL voIunLurIIy, LIen LIe deIusIonuI nuLure oI muLerIuIIsL
IdeoIogy wIII uLLempL Lo coerce IL In uILernuLIve wuys. AccordIng Lo un ACS
(1q86) posLer: Some peopIe commIL cIIId ubuse beIore LIe cIIId Is even
born. AccordIng Lo LIe Surgeon-GeneruI, smokIng by u pregnunL womun
muy resuIL In u cIIId`s premuLure bIrLI, Iow bIrLIweIgIL, und IeLuI Injury.
I LIuL`s noL cIIId ubuse, LIen wIuL Is? Ouks` (zoo1) ussessmenL oI LIIs
pIoy Is upproprIuLe: By IrumIng LIe Surgeon-GeneruI`s IeuILI wurnIng
(munduLed In 1q8q Lo be prInLed on cIgureLLe pucks und uds) wILI LIe
usserLIon LIuL smokIng durIng pregnuncy Is cIIId ubuse, LIe ACS
LrunsIorms LIe IeuILI wurnIng InLo u IeguIIsLIc commenL ubouL smokIng
durIng pregnuncy. TIe posLer ImpIIes LIuL smokIng durIng pregnuncy
sIouId curry crImInuI consequences, und IL muy mIsIeud women InLo
beIIevIng LIuL IL does. (p.181)
TIere Ius even been un uLLempL Lo deIIne u IeLuI Lobucco
syndrome ukIn Lo IeLuI uIcoIoI syndrome und cruck bubIes. (see Ouks,
zoo1, p.;q) TIe InLenL Is Lo LerrorIze pregnunL smokers InLo desIsLIng
Irom LIe IubIL under LIreuL oI beIng cIurged wILI IeLuI ubuse. NoL Ior
LIe wunL oI LryIng, LIe probIem Is LIuL LIere Is no sucI IdenLIIIubIe
syndrome. AccordIng Lo one obsLeLrIcIun: L Isn`L enougI oI un enLILy Lo
be u syndrome. I you see u Iundred bubIes, you cun`L pIck ouL LIe
smokIng moms (quoLed In Ouks, zoo1, p.81), I.e., IurLIer IuIIucIes oI
IncoIerenL unuIogy. AguIn, LIe crILIcuI LIeme Is LIuL, regurdIess oI IucL or
reuson, Iobby groups reIIecLIng conLorLed IdeoIogIcuI vIewpoInLs Iuve
buIIdozed LIeIr wuy LIrougI uII munner oI due process In workIng Lo
IIxed, deIuded concIusIons. SmokIng Ius been munuIucLured InLo u
projecLIon poInL Ior unsLubIe mInds; LIe onIy LIIng occurrIng In LIese
cIrcumsLunces Is LIe enucLIng oI obsessIon wILI conLroI, ImperIousness,
psycIoIogIcuI LerrorIsm, IuugILIness, bIgoLry, eLc..
OLIers Iuve uLLempLed Lo IIken smokIng durIng pregnuncy Lo LIe
producLIon oI un ImmoruI Lype oI uborLIon, I.e., IurLIer IuIIucy oI deIuded
unuIogy. or exumpIe, DIrunzu & ew (1qq) reIer Lo uny Increused
reIuLIve rIsk oI mIscurrIuge Ior pregnunL smokers us Lobucco-Induced
uborLIon. (see Ouks, zoo1, p.16) AccordIng Lo Ouks (zoo1), one Lobucco
conLroI udvocuLe suggesLed In |MuryIund`s| Lobucco growIng counLIes,
pusLors und preucIers speuk ouL uguInsL uborLIon, buL noL ubouL smokIng
durIng pregnuncy. (p.166) TIese concIusIons ure bused on LIe IurLIer
IncompeLenL use oI uIreudy quesLIonubIe InIormuLIon (I.e., uLLrIbuLubIe
numbers produced by LIe SAMMEC procedure).
TIe LypIcuI meunIng oI uborLIon Is LIe InLenL, usuuIIy LIrougI u
conLrucL beLween u womun und u medIcuI prucLILIoner, Lo LermInuLe, kIII-
oII, u vIubIe pregnuncy LIrougI very specIIIc, dIrecL, cuusuIIy deIInubIe
321
321
Rampant Antismoking Signifies Grave Danger
guIIL exucerbuLed.
TIe sLundurd upproucI oI LIese unLIsmokIng groups Is Lo depIcL u
pregnunL nonsmoker us u superIor, nurLurIng, IovIng, curIng moLIer-Lo-
be. AILernuLIveIy, LIe pregnunL smoker Is depIcLed us LIe converse -
InIerIor, seIIIsI, uncurIng, unIovIng. HeuILI Is porLruyed us onIy
uLLuInubIe, Ior uduILs or LIe unborn, In u smoke-Iree envIronmenL.
PumpIIeLs, IIIms, sLIckers, und sLund-up curds Iuve been empIoyed In LIe
unLIsmokIng cuuse. A pregnunL womun cun surround IerseII wILI uII
munner oI prInLed sIoguns In un uLLempL Lo dIscIpIIne IerseII or wurd oI
sources oI envIronmenLuI dunger. BeIow ure IIsLed jusL u Iew oI LIe
pIeLIoru oI unLIsmokIng sIoguns uppeurIng sInce LIe IuLe-1q;o`s. TIey ure
LypIcuIIy very IIgIL on scIenLIIIc subsLunce und Iouded wILI emoLIve
Imugery und numerous IuIIucIes oI IncoIerenL unuIogy (see Ouks, zoo1,
Ior u more deLuIIed scruLIny oI LIIs unLIsmokIng sugu):
WIen |LIe pregnunL smoker| sLops smokIng, sIe
sIows LIuL sIe wunLs Lo ruIse Ier buby In u smoke-Iree
worId (AA, 1qqq, quoLed In Ouks, zoo1, p.;8);
Your buby-Lo-be, snuggIed InsIde your womb, Is
sIIenLIy enguged In u wonder-IIIIed udvenLure: LIe
sLruggIe Lowurd IIIe. Your unborn buby needs uII LIe
IeIp IL cun geL In LIuL sLruggIe. EspecIuIIy Irom
you....wIen you quIL smokIng LIIs mInuLe you`II be
gIvIng your unborn buby LIe smoke-Iree envIronmenL
boLI oI you need Lo be IeuILIy. L`s more LIun u gIIL. L`s
u muLLer oI IIIe und breuLI (AA, 1q8o, quoLed In Ouks,
zoo1, p.1z);
Becuuse you ove your Buby... TIere`s Never been u
BeLLer TIme Lo QuIL; In LIe mId-1q8o`s LIIs wus
modIIIed Lo QuIL SmokIng: Becuuse ove My
Buby (AA, 1q8o`s, quoLed In Ouks, zoo1, p.1q8);
No SmokIng PEASE, `m BreuLIIng Ior Two; A
IeuILIy BegInnIng: TIe Smoke-ree umIIy GuIde Ior
New PurenLs (AA, IuLe-1q8o`s, quoLed In Ouks, zoo1,
p.1qq);
WIy SLurL IIe Under A CIoud? (ACS, IuLe-1q;o`s,
quoLed In Ouks, zoo1, p.1qq);
Deur ____, My buby wunLs me Lo quIL smokIng - so
um! PIeuse don`L smoke neur me or gIve me
cIgureLLes. (ACS, 1q88, quoLed In Ouks, zoo1, p.1o)
TIe sIeer suLuruLIon oI unsubsLunLIuLed, IIgIIy emoLIve cIuIms
by Iobby groups, und wIIcI Iuve been IeIL uncIecked, Ius mude IL onIy
Preventive Medicine & Health Promotion
Loo eusy Ior IunuLIcIsm Lo IurLIer IIourIsI. I LIe pregnunL smoker wIII noL
desIsL Irom LIe IubIL voIunLurIIy, LIen LIe deIusIonuI nuLure oI muLerIuIIsL
IdeoIogy wIII uLLempL Lo coerce IL In uILernuLIve wuys. AccordIng Lo un ACS
(1q86) posLer: Some peopIe commIL cIIId ubuse beIore LIe cIIId Is even
born. AccordIng Lo LIe Surgeon-GeneruI, smokIng by u pregnunL womun
muy resuIL In u cIIId`s premuLure bIrLI, Iow bIrLIweIgIL, und IeLuI Injury.
I LIuL`s noL cIIId ubuse, LIen wIuL Is? Ouks` (zoo1) ussessmenL oI LIIs
pIoy Is upproprIuLe: By IrumIng LIe Surgeon-GeneruI`s IeuILI wurnIng
(munduLed In 1q8q Lo be prInLed on cIgureLLe pucks und uds) wILI LIe
usserLIon LIuL smokIng durIng pregnuncy Is cIIId ubuse, LIe ACS
LrunsIorms LIe IeuILI wurnIng InLo u IeguIIsLIc commenL ubouL smokIng
durIng pregnuncy. TIe posLer ImpIIes LIuL smokIng durIng pregnuncy
sIouId curry crImInuI consequences, und IL muy mIsIeud women InLo
beIIevIng LIuL IL does. (p.181)
TIere Ius even been un uLLempL Lo deIIne u IeLuI Lobucco
syndrome ukIn Lo IeLuI uIcoIoI syndrome und cruck bubIes. (see Ouks,
zoo1, p.;q) TIe InLenL Is Lo LerrorIze pregnunL smokers InLo desIsLIng
Irom LIe IubIL under LIreuL oI beIng cIurged wILI IeLuI ubuse. NoL Ior
LIe wunL oI LryIng, LIe probIem Is LIuL LIere Is no sucI IdenLIIIubIe
syndrome. AccordIng Lo one obsLeLrIcIun: L Isn`L enougI oI un enLILy Lo
be u syndrome. I you see u Iundred bubIes, you cun`L pIck ouL LIe
smokIng moms (quoLed In Ouks, zoo1, p.81), I.e., IurLIer IuIIucIes oI
IncoIerenL unuIogy. AguIn, LIe crILIcuI LIeme Is LIuL, regurdIess oI IucL or
reuson, Iobby groups reIIecLIng conLorLed IdeoIogIcuI vIewpoInLs Iuve
buIIdozed LIeIr wuy LIrougI uII munner oI due process In workIng Lo
IIxed, deIuded concIusIons. SmokIng Ius been munuIucLured InLo u
projecLIon poInL Ior unsLubIe mInds; LIe onIy LIIng occurrIng In LIese
cIrcumsLunces Is LIe enucLIng oI obsessIon wILI conLroI, ImperIousness,
psycIoIogIcuI LerrorIsm, IuugILIness, bIgoLry, eLc..
OLIers Iuve uLLempLed Lo IIken smokIng durIng pregnuncy Lo LIe
producLIon oI un ImmoruI Lype oI uborLIon, I.e., IurLIer IuIIucy oI deIuded
unuIogy. or exumpIe, DIrunzu & ew (1qq) reIer Lo uny Increused
reIuLIve rIsk oI mIscurrIuge Ior pregnunL smokers us Lobucco-Induced
uborLIon. (see Ouks, zoo1, p.16) AccordIng Lo Ouks (zoo1), one Lobucco
conLroI udvocuLe suggesLed In |MuryIund`s| Lobucco growIng counLIes,
pusLors und preucIers speuk ouL uguInsL uborLIon, buL noL ubouL smokIng
durIng pregnuncy. (p.166) TIese concIusIons ure bused on LIe IurLIer
IncompeLenL use oI uIreudy quesLIonubIe InIormuLIon (I.e., uLLrIbuLubIe
numbers produced by LIe SAMMEC procedure).
TIe LypIcuI meunIng oI uborLIon Is LIe InLenL, usuuIIy LIrougI u
conLrucL beLween u womun und u medIcuI prucLILIoner, Lo LermInuLe, kIII-
oII, u vIubIe pregnuncy LIrougI very specIIIc, dIrecL, cuusuIIy deIInubIe
322
322
Rampant Antismoking Signifies Grave Danger
InLervenLIon (usuuIIy surgIcuI). MIscurrIuge Is uIso reIerred Lo us
sponLuneous uborLIon. However, Iere LIe cuusuLIon Is LypIcuIIy
IndeLermInuLe und noL reIIecLIng InLenL by LIe pregnunL womun. TIrougI
empIusIzIng onIy LIe uborLIon uspecL oI LIe nomencIuLure, LIe
unLIsmokIng Iobby Ius LrIed Lo Iorce un Increused reIuLIve rIsk oI
sponLuneous uborLIon (mIscurrIuge) Ior smokers InLo LIe reuIm oI
InLenLIonuI or moruIIy quesLIonubIe uborLIon.
TIe reIuLIve rIsk oI mIscurrIuge Ior smokers Is LIny - uround 1.z
Lo 1.o Ior IIgIL Lo moderuLe smokIng und sIIgILIy IIgIer Ior IeuvIer
smokIng (see WIndIum eL uI., 1qqq). WIndIum eL uI. (1qqq) Iound u
reIuLIve rIsk oI 1.o even Ior IeuvIer smokers. TIe proporLIon oI
mIscurrIuges oI overuII pregnuncIes Is smuII - uround 1o% Ior nonsmokers
und 1o-1% Ior smokers (see WIndIum eL uI., 1qqq). TIereIore, IIrsLIy,
mosL pregnunL women, smokers und nonsmokers, do noL Iuve
mIscurrIuges; ubove u buseIIne, q;% oI pregnunL smokers do noL Iuve
mIscurrIuges. SecondIy, LIe predIcLIve sLrengLI oI smokIng durIng
pregnuncy Ior mIscurrIuge ubove u buseIIne Is, uguIn, bureIy ubove zero
(I.e., -%). TIere Is no prImury cuusuI urgumenL Iere. And, gIven LIuL
LIere ure uIso numerous oLIer rIsk IucLors ussocIuLed wILI mIscurrIuge, IL
wouId be exLremeIy dIIIIcuIL Lo conjure even u LrIgger urgumenL Ior
suscepLIbIe women. YeL, Iobby groups Iuve uLLempLed Lo use LIIs Iess LIun
wuIer-LIIn sLuLIsLIcuI urgumenL Lo IIken smokIng durIng pregnuncy Lo, uL
LIe very IeusL, uLLempLed uborLIon. TIere muy Indeed be u moruI
urgumenL uguInsL Induced uborLIon. However, uLLempLIng Lo propeI
mIscurrIuge In smokers InLo LIIs reuIm LIrougI IncoIerenL unuIogy Ius no
scIenLIIIc or IeuILI merIL. TIe gume beIng pIuyed by LIese Iobby groups
wILI purLIcuIurIy LIe menLuI IeuILI oI pregnunL smokers Is ubIorrenL.
AguIn, LIe cIrcumsLunce suys Iur more ubouL LIe deIusIonuI nuLure oI LIe
uccusuLory menLuIILy LIun ubouL smokIng.
I LIe muLerIuIIsL menLuIILy cunnoL exucL ILs conLroI over LIe
pregnunL smoker LIrougI u cIurge oI IeLuI ubuse, LIen IL wIII persIsL
wILI LIe posL-deIIvery cIurge oI cIIId ubuse. n LIIs regurd AcLIon on
SmokIng und HeuILI (ASH) Is noLorIous Ior ILs ussuuILs on LIe menLuI und
socIuI IeuILI oI purenLs wIo smoke In ILs deIuded pursuIL oI u smoke-
Iree socIeLy. Ouks (zoo1) noLes LIuL ASH |1qq| deIInes exposure Lo
secondIund smoke us cIIId endungermenL, bused on LIe IeguI
undersLundIng LIuL cIIId ubuse Is enercll dejined cs cn jorm oj
cruelt to c child's phsiccl, morcl, or mentcl uell-bein. (p.18q)
AguIn, Ouks (zoo1, p.18q-) provIdes InsIgIL und u number oI
exumpIes oI Iow LIIs cIIId ubuse Ideu Ius guIned momenLum oI IuLe. n
u 1qq ruIIng In JucksonvIIIe, IorIdu, u sLuLe cIrcuIL courL judge uwurded
Lemporury cusLody oI un usLImuLIc seven-yeur-oId boy Lo IIs IuLIer Lo
Preventive Medicine & Health Promotion
proLecL LIe boy Irom IIs sLepIuLIer`s smoke; Judge BIII Pursons decIured
LIuL `m noL suyIng uduILs cun`L smoke. `m jusL suyIng don`L do IL In IronL
oI u IeIpIess cIIId. SecondIund smoke Is kIIIIng cIIIdren und LIInk IL`s
LIme Ior LIe courLs oI LIIs counLry Lo IeIp LIese cIIIdren. n u 1qqq ruIIng
In Oregon cusLody oI u cIIId wus uwurded Lo LIe SLuLe Lo proLecL Ier Irom
u smoke-IIIIed Iome. n 1qqq u IumIIy courL judge In uILon CounLy, New
York, uwurded cusLody oI u LweIve-yeur-oId boy suIIerIng usLImu,
uIIergIes, und puImonury dIsorders Lo IIs nonsmokIng IuLIer und
sLepmoLIer; LIe boy`s smoker moLIer wus consIdered us IuIIIng Lo see
smokIng us u serIous LIreuL Lo Ier son. Judge DuvId E. ung usserLed
LIuL we ure uL u poInL In LIme wIen, In LIe opInIon oI LIIs judge, u purenL
or guurdIun couId be prosecuLed successIuIIy Ior negIecLIng IIs or Ier
cIIId us u resuIL oI subjecLIng LIe InIunL Lo un uLmospIere conLumInuLed
wILI IeuILI-desLrucLIve Lobucco smoke.
n u IuIIed cusLody bId In 1qqz, WIIIIum CuIun, u mIIILunL
unLIsmoker, In LesLIIyIng on beIuII oI IIs cIIenL proIIered LIuL u Iome
sIouId be u reIuge, u Iuven, noL u Iuzurd..Lo reur u cIIId In u smoke-
Iuden envIronmenL Is noL unIIke IIvIng In un usbesLos-IIned Iouse or one
buIIL on rudIoucLIve soII. A cIIId does noL Iuve Lo be beuLen und bruIsed Lo
be ubused. CIuIms sucI us serIous LIreuL, IeuILI desLrucLIve Iuve no
busIs In IucL, buL ure LIe resuIL oI severe conLorLIons oI sLuLIsLIcuI
InIormuLIon und Ieur und guIIL-mongerIng. n LIe IusL cuse, LIe reIIunce on
sucI IIgIIy IncoIerenL unuIogy Is LesLImony onIy Lo LIe deIuded nuLure oI
LIe underIyIng menLuIILy. urLIer Is LIuL u key socIuI InsLILuLIon sucI us
courLs oI Iuw ure IuIIIng Lo dIsLInguIsI IucL Irom IIcLIon und Lo keep
monomunIu In cIeck. TIe LrugIc resuIL Is LIe seLLIng oI quesLIonubIe
precedenLs LIuL cun uILImuLeIy be IeveIed uL uII purenLs Ior reusons
conLrIved LIrougI IurLIer IncoIerenL unuIogy (e.g., dIeL, TV vIewIng,
cIoIce oI IrIends).
As couId be expecLed, more recenLIy, u cIIId`s pIysIcuI condILIon
does noL even IIgure In deIIberuLIons wIere smokIng by u purenL Is
concerned: NIcIoIus De MuLLeo, 1, wenL Lo courL Lo geL IIs moLIer Lo
buLL ouL becuuse Ie dIdn`L IIke LIe smeII oI cIgureLLes und Ieured
secondIund smoke wus bud Ior IIs IeuILI. JusLIce RoberL JuIIun, oI ULIcu,
New York, Issued LIe bun uILIougI LIe youLI Is noL uIIergIc Lo Lobucco
smoke und doesn`L suIIer Irom uny IeuILI condILIon, sucI us usLImu, LIuL
wouId be worsened by IL. CILIng sLudIes sIowIng LIe IeuILI dungers oI
secondIund smoke, LIe judge`s decIsIon suId LIe moLIer`s puIIIng wus noL
In LIe boy`s 'besL InLeresLs.` WIere LIe cIIId`s IeuILI Is InvoIved, LIe judge
suId, LIe courL wouId InLervene. (Hercld,Sun, MurcI z8, zooz)
AccordIng Lo ACNEWS.com: TIe judge suId severuI courLs In New York
und oLIer sLuLes Iuve burred purenLs Irom smokIng In cuses wIere LIey
323
323
Rampant Antismoking Signifies Grave Danger
InLervenLIon (usuuIIy surgIcuI). MIscurrIuge Is uIso reIerred Lo us
sponLuneous uborLIon. However, Iere LIe cuusuLIon Is LypIcuIIy
IndeLermInuLe und noL reIIecLIng InLenL by LIe pregnunL womun. TIrougI
empIusIzIng onIy LIe uborLIon uspecL oI LIe nomencIuLure, LIe
unLIsmokIng Iobby Ius LrIed Lo Iorce un Increused reIuLIve rIsk oI
sponLuneous uborLIon (mIscurrIuge) Ior smokers InLo LIe reuIm oI
InLenLIonuI or moruIIy quesLIonubIe uborLIon.
TIe reIuLIve rIsk oI mIscurrIuge Ior smokers Is LIny - uround 1.z
Lo 1.o Ior IIgIL Lo moderuLe smokIng und sIIgILIy IIgIer Ior IeuvIer
smokIng (see WIndIum eL uI., 1qqq). WIndIum eL uI. (1qqq) Iound u
reIuLIve rIsk oI 1.o even Ior IeuvIer smokers. TIe proporLIon oI
mIscurrIuges oI overuII pregnuncIes Is smuII - uround 1o% Ior nonsmokers
und 1o-1% Ior smokers (see WIndIum eL uI., 1qqq). TIereIore, IIrsLIy,
mosL pregnunL women, smokers und nonsmokers, do noL Iuve
mIscurrIuges; ubove u buseIIne, q;% oI pregnunL smokers do noL Iuve
mIscurrIuges. SecondIy, LIe predIcLIve sLrengLI oI smokIng durIng
pregnuncy Ior mIscurrIuge ubove u buseIIne Is, uguIn, bureIy ubove zero
(I.e., -%). TIere Is no prImury cuusuI urgumenL Iere. And, gIven LIuL
LIere ure uIso numerous oLIer rIsk IucLors ussocIuLed wILI mIscurrIuge, IL
wouId be exLremeIy dIIIIcuIL Lo conjure even u LrIgger urgumenL Ior
suscepLIbIe women. YeL, Iobby groups Iuve uLLempLed Lo use LIIs Iess LIun
wuIer-LIIn sLuLIsLIcuI urgumenL Lo IIken smokIng durIng pregnuncy Lo, uL
LIe very IeusL, uLLempLed uborLIon. TIere muy Indeed be u moruI
urgumenL uguInsL Induced uborLIon. However, uLLempLIng Lo propeI
mIscurrIuge In smokers InLo LIIs reuIm LIrougI IncoIerenL unuIogy Ius no
scIenLIIIc or IeuILI merIL. TIe gume beIng pIuyed by LIese Iobby groups
wILI purLIcuIurIy LIe menLuI IeuILI oI pregnunL smokers Is ubIorrenL.
AguIn, LIe cIrcumsLunce suys Iur more ubouL LIe deIusIonuI nuLure oI LIe
uccusuLory menLuIILy LIun ubouL smokIng.
I LIe muLerIuIIsL menLuIILy cunnoL exucL ILs conLroI over LIe
pregnunL smoker LIrougI u cIurge oI IeLuI ubuse, LIen IL wIII persIsL
wILI LIe posL-deIIvery cIurge oI cIIId ubuse. n LIIs regurd AcLIon on
SmokIng und HeuILI (ASH) Is noLorIous Ior ILs ussuuILs on LIe menLuI und
socIuI IeuILI oI purenLs wIo smoke In ILs deIuded pursuIL oI u smoke-
Iree socIeLy. Ouks (zoo1) noLes LIuL ASH |1qq| deIInes exposure Lo
secondIund smoke us cIIId endungermenL, bused on LIe IeguI
undersLundIng LIuL cIIId ubuse Is enercll dejined cs cn jorm oj
cruelt to c child's phsiccl, morcl, or mentcl uell-bein. (p.18q)
AguIn, Ouks (zoo1, p.18q-) provIdes InsIgIL und u number oI
exumpIes oI Iow LIIs cIIId ubuse Ideu Ius guIned momenLum oI IuLe. n
u 1qq ruIIng In JucksonvIIIe, IorIdu, u sLuLe cIrcuIL courL judge uwurded
Lemporury cusLody oI un usLImuLIc seven-yeur-oId boy Lo IIs IuLIer Lo
Preventive Medicine & Health Promotion
proLecL LIe boy Irom IIs sLepIuLIer`s smoke; Judge BIII Pursons decIured
LIuL `m noL suyIng uduILs cun`L smoke. `m jusL suyIng don`L do IL In IronL
oI u IeIpIess cIIId. SecondIund smoke Is kIIIIng cIIIdren und LIInk IL`s
LIme Ior LIe courLs oI LIIs counLry Lo IeIp LIese cIIIdren. n u 1qqq ruIIng
In Oregon cusLody oI u cIIId wus uwurded Lo LIe SLuLe Lo proLecL Ier Irom
u smoke-IIIIed Iome. n 1qqq u IumIIy courL judge In uILon CounLy, New
York, uwurded cusLody oI u LweIve-yeur-oId boy suIIerIng usLImu,
uIIergIes, und puImonury dIsorders Lo IIs nonsmokIng IuLIer und
sLepmoLIer; LIe boy`s smoker moLIer wus consIdered us IuIIIng Lo see
smokIng us u serIous LIreuL Lo Ier son. Judge DuvId E. ung usserLed
LIuL we ure uL u poInL In LIme wIen, In LIe opInIon oI LIIs judge, u purenL
or guurdIun couId be prosecuLed successIuIIy Ior negIecLIng IIs or Ier
cIIId us u resuIL oI subjecLIng LIe InIunL Lo un uLmospIere conLumInuLed
wILI IeuILI-desLrucLIve Lobucco smoke.
n u IuIIed cusLody bId In 1qqz, WIIIIum CuIun, u mIIILunL
unLIsmoker, In LesLIIyIng on beIuII oI IIs cIIenL proIIered LIuL u Iome
sIouId be u reIuge, u Iuven, noL u Iuzurd..Lo reur u cIIId In u smoke-
Iuden envIronmenL Is noL unIIke IIvIng In un usbesLos-IIned Iouse or one
buIIL on rudIoucLIve soII. A cIIId does noL Iuve Lo be beuLen und bruIsed Lo
be ubused. CIuIms sucI us serIous LIreuL, IeuILI desLrucLIve Iuve no
busIs In IucL, buL ure LIe resuIL oI severe conLorLIons oI sLuLIsLIcuI
InIormuLIon und Ieur und guIIL-mongerIng. n LIe IusL cuse, LIe reIIunce on
sucI IIgIIy IncoIerenL unuIogy Is LesLImony onIy Lo LIe deIuded nuLure oI
LIe underIyIng menLuIILy. urLIer Is LIuL u key socIuI InsLILuLIon sucI us
courLs oI Iuw ure IuIIIng Lo dIsLInguIsI IucL Irom IIcLIon und Lo keep
monomunIu In cIeck. TIe LrugIc resuIL Is LIe seLLIng oI quesLIonubIe
precedenLs LIuL cun uILImuLeIy be IeveIed uL uII purenLs Ior reusons
conLrIved LIrougI IurLIer IncoIerenL unuIogy (e.g., dIeL, TV vIewIng,
cIoIce oI IrIends).
As couId be expecLed, more recenLIy, u cIIId`s pIysIcuI condILIon
does noL even IIgure In deIIberuLIons wIere smokIng by u purenL Is
concerned: NIcIoIus De MuLLeo, 1, wenL Lo courL Lo geL IIs moLIer Lo
buLL ouL becuuse Ie dIdn`L IIke LIe smeII oI cIgureLLes und Ieured
secondIund smoke wus bud Ior IIs IeuILI. JusLIce RoberL JuIIun, oI ULIcu,
New York, Issued LIe bun uILIougI LIe youLI Is noL uIIergIc Lo Lobucco
smoke und doesn`L suIIer Irom uny IeuILI condILIon, sucI us usLImu, LIuL
wouId be worsened by IL. CILIng sLudIes sIowIng LIe IeuILI dungers oI
secondIund smoke, LIe judge`s decIsIon suId LIe moLIer`s puIIIng wus noL
In LIe boy`s 'besL InLeresLs.` WIere LIe cIIId`s IeuILI Is InvoIved, LIe judge
suId, LIe courL wouId InLervene. (Hercld,Sun, MurcI z8, zooz)
AccordIng Lo ACNEWS.com: TIe judge suId severuI courLs In New York
und oLIer sLuLes Iuve burred purenLs Irom smokIng In cuses wIere LIey
324
324
Rampant Antismoking Signifies Grave Danger
rIsked uggruvuLIng LIeIr cIIIdren`s preexIsLIng IIIness or uIIergy. He suId
Ie Iound no precedenL Ior IIs ruIIng, buL IeIL LIe courLs Iud u rIgIL Lo
InLervene wIen u cIIId`s IeuILI - even II IL Is exceIIenL - Is uL rIsk. (MurcI
z;, zooz)
TIe boy Is Irom u dIvorced IumIIy, und usuuIIy IIves wILI IIs non-
smokIng IuLIer und puLernuI grundpurenLs. TIe Issue oI smokIng Ius been
munuIucLured InLo u conduIL Ior unresoIved Issues beLween LIe boy und
IIs moLIer, und probubIy beLween IIs moLIer und IuLIer; LIe courL ucLIon
uppeurs Lo be u mIsguIded poIILIco-emoLIonuI sLuLemenL.
ACNEWS.com wus one oI LIe Iew medIu commenLurIes
IndIcuLIng boLI sIdes oI LIe cIrcumsLunce:
TIe 1-yeur-oId uIIegedIy compIuIned Lo IIs Iuwyer und
IuLIer IusL AugusL LIuL Ie dId noL wunL Lo vIsIL IIs
moLIer becuuse cIgureLLe smoke permeuLed Ier Iome.
|JonILu| DeMuLLeo suId sIe wouId compIy In order Lo
see Ier son, buL InsIsLed LIe order wus noL IuIr. ' wIII do
wIuLever Iuve Lo, buL LIInk LIere ure u IoL more
Issues LIun Lo sLop smokIng, DeMuLLeo LoId Good
Mornin Americc Loduy. TIuL doesn`L soIve LIe
probIem oI LIe InLrusIon InLo peopIe`s personuI IIves...
A Puwn In u PurenL Wur?
JoInILu DeMuLLeo`s uLLorney, Joun SIkune, Ius cuIIed
Judge JuIIun`s order InLrusIve und suys IL vIoIuLed Ier
cIIenL`s rIgIL Lo smoke. JoInILu, SIkune suId, Ius u rIgIL
Lo smoke In LIe prIvucy oI Ier Iome und Ier cur.
SIkune sLressed LIuL JoInILu never smokes In Ier son`s
presence, wIeLIer IL be In LIe cur or wIen Ie sLuys wILI
Ier In Ier upsLuLe New York Iome. I sIe needs Lo
smoke wIen sIe Ius NIcIoIus, sIe goes ouL on Ier
porcI.
NIcIoIus, SIkune udded, never prevIousIy compIuIned
Lo IIs moLIer IImseII ubouL Ier smokIng IubIL. SIe
suspecLs LIuL LIe NIcIoIus` IuLIer und puLernuI
grundpurenLs ure reuIIy beIInd LIe smokIng compIuInLs
und Iuve pIuced LIeIr boy In LIe mIddIe oI LIeIr Iong-
runnIng ugIy dIvorce, u cIurge LIey Iuve pubIIcIy
denIed.
'Under LIe Judge`s order, LIe IuLIer cun requesL urIne
sumpIes, uIr sumpIes Irom Ier Iome und LIuL`s jusL
unoLIer wuy Ie |LIe IuLIer| Is InLrudIng on Ier IIIe,
SIkune suId. 'And wIuL LIey`ve done Is Lurn NIcIoIus
InLo u IILLIe InIormunL.`..
Preventive Medicine & Health Promotion
BuL Ior SIkune, LIe Issue Is ubouL more LIun smokIng or
even LIe vIsILuLIon Issue surroundIng NIcIoIus. Under
Judge JuIIun`s order, SIkune urgued, boLI purenLs
couId be uccused oI puLLIng NIcIoIus In Iurm`s wuy by
brIngIng IIm Lo u resLuurunL, u muII, or uny pIuce wIere
LIere Is smokIng or LIe boy Is exposed Lo gus Iumes.
'TIIs Is ubouL Iow Iur we ure goIng Lo IeL oLIers InLrude
on our IIves,` SIkune suId. 'TIe IIne Ius been druwn Loo
Iur In LIIs cuse. WIere do we druw LIe IIne?`
GovernmenLs, LIe IeguI sysLem und socIeLy generuIIy seem Lo
Iuve IILLIe probIem wILI dIvorce, never concerned wILI ILs IeuILI
rumIIIcuLIons on cIIIdren (see CIupLer ). And yeL, IL wIII dredge up
sLuLIsLIcuIIsL nonsense In urrIvIng uL judgemenLs LIuL IueI wIuL seems Lo
be III-IeeIIng beLween u cIIId und purenL or purenLJpurenL, und LIuL
reInIorces MMES-cuIL beIIeIs (superIorIsL). TIe Issues oI IeuILI und
suIeLy, purLIcuIurIy In u muLerIuIIsL Irumework, very eusIIy musquerude
LIe muInLenunce oI conLorLed psycIoIogy und reIuLIonsIIp. Here, IL
reIIecLs LIe muLerIuIIsL domInuLIon oI IeguI opInIon, Loo, under wIIcI ure
beIng seL wuywurd und dungerous precedenLs.
UndersLundubIy, ASH LypIcuIIy uppIuuds courL decIsIons LIuL
Iuvor ILs monomunIucuI sLunce und LIuL IL Ius been InsLrumenLuI In
IusIIonIng (see uIso CIupLer ). AccordIng Lo ASH (1qq): Any purenL or
guurdIun wIo voIunLurIIy exposes u cIIId Lo sucI u IeuILI rIsk .. Is
InIIIcLIng us mucI, II noL more, pIysIcuI Iurm on u cIIId us conducL more
usuuIIy recognIzed us ubusIve or negIecLIuI. Ouks (zoo1) IndIcuLes LIuL
ASH Is IobbyIng LIrougI LIe courL sysLem Ior LIe rouLIne recognILIon oI
smokIng neur cIIIdren us cIIId ubuse und negIecL. (p.18) CIuIms oI ETS
IurmIuIness In specIIIc cIrcumsLunces Is uIreudy quesLIonubIe. ALLempLs
Lo propuguLe u generuI ETS IurmIuIness Ior uII cIIIdren Ius no scIenLIIIc
busIs und Is reckIess In LIe exLreme. L Ius onIy LIe propensILy Lo
munuIucLure mugIcuI, supersLILIous beIIeI LIuL Is menLuIIy enIeebIIng und
socIuIIy dIvIsIve; IL enLIreIy conLrudIcLs LIe very Ideu oI Iurm (concernIng
pIysIcuI, moruI und menLuI weII-beIng) LIuL ASH subscrIbes Lo.
L Is useIuI Lo consIder LIe roIe LIuL ASH, In purLIcuIur, Ius
pIuyed sInce LIe IuLe-1q6o`s In munuIucLurIng conLorLed beIIeI on u muss
scuIe. Ouks (zoo1, p.18) noLes jusL u jeu oI LIe news sLorIes uppeurIng
on LIe ASH web sILe (ILLp:JJusI.org):
Mom's Smolin More Decdl Thcn Crccl Use (1qq8);
Pcrents Are Smolin Their Kids To Decth, Litercll
(1qq8);
Smolin Pcrents Are Killin Their Injcnts (1qq6);
325
325
Rampant Antismoking Signifies Grave Danger
rIsked uggruvuLIng LIeIr cIIIdren`s preexIsLIng IIIness or uIIergy. He suId
Ie Iound no precedenL Ior IIs ruIIng, buL IeIL LIe courLs Iud u rIgIL Lo
InLervene wIen u cIIId`s IeuILI - even II IL Is exceIIenL - Is uL rIsk. (MurcI
z;, zooz)
TIe boy Is Irom u dIvorced IumIIy, und usuuIIy IIves wILI IIs non-
smokIng IuLIer und puLernuI grundpurenLs. TIe Issue oI smokIng Ius been
munuIucLured InLo u conduIL Ior unresoIved Issues beLween LIe boy und
IIs moLIer, und probubIy beLween IIs moLIer und IuLIer; LIe courL ucLIon
uppeurs Lo be u mIsguIded poIILIco-emoLIonuI sLuLemenL.
ACNEWS.com wus one oI LIe Iew medIu commenLurIes
IndIcuLIng boLI sIdes oI LIe cIrcumsLunce:
TIe 1-yeur-oId uIIegedIy compIuIned Lo IIs Iuwyer und
IuLIer IusL AugusL LIuL Ie dId noL wunL Lo vIsIL IIs
moLIer becuuse cIgureLLe smoke permeuLed Ier Iome.
|JonILu| DeMuLLeo suId sIe wouId compIy In order Lo
see Ier son, buL InsIsLed LIe order wus noL IuIr. ' wIII do
wIuLever Iuve Lo, buL LIInk LIere ure u IoL more
Issues LIun Lo sLop smokIng, DeMuLLeo LoId Good
Mornin Americc Loduy. TIuL doesn`L soIve LIe
probIem oI LIe InLrusIon InLo peopIe`s personuI IIves...
A Puwn In u PurenL Wur?
JoInILu DeMuLLeo`s uLLorney, Joun SIkune, Ius cuIIed
Judge JuIIun`s order InLrusIve und suys IL vIoIuLed Ier
cIIenL`s rIgIL Lo smoke. JoInILu, SIkune suId, Ius u rIgIL
Lo smoke In LIe prIvucy oI Ier Iome und Ier cur.
SIkune sLressed LIuL JoInILu never smokes In Ier son`s
presence, wIeLIer IL be In LIe cur or wIen Ie sLuys wILI
Ier In Ier upsLuLe New York Iome. I sIe needs Lo
smoke wIen sIe Ius NIcIoIus, sIe goes ouL on Ier
porcI.
NIcIoIus, SIkune udded, never prevIousIy compIuIned
Lo IIs moLIer IImseII ubouL Ier smokIng IubIL. SIe
suspecLs LIuL LIe NIcIoIus` IuLIer und puLernuI
grundpurenLs ure reuIIy beIInd LIe smokIng compIuInLs
und Iuve pIuced LIeIr boy In LIe mIddIe oI LIeIr Iong-
runnIng ugIy dIvorce, u cIurge LIey Iuve pubIIcIy
denIed.
'Under LIe Judge`s order, LIe IuLIer cun requesL urIne
sumpIes, uIr sumpIes Irom Ier Iome und LIuL`s jusL
unoLIer wuy Ie |LIe IuLIer| Is InLrudIng on Ier IIIe,
SIkune suId. 'And wIuL LIey`ve done Is Lurn NIcIoIus
InLo u IILLIe InIormunL.`..
Preventive Medicine & Health Promotion
BuL Ior SIkune, LIe Issue Is ubouL more LIun smokIng or
even LIe vIsILuLIon Issue surroundIng NIcIoIus. Under
Judge JuIIun`s order, SIkune urgued, boLI purenLs
couId be uccused oI puLLIng NIcIoIus In Iurm`s wuy by
brIngIng IIm Lo u resLuurunL, u muII, or uny pIuce wIere
LIere Is smokIng or LIe boy Is exposed Lo gus Iumes.
'TIIs Is ubouL Iow Iur we ure goIng Lo IeL oLIers InLrude
on our IIves,` SIkune suId. 'TIe IIne Ius been druwn Loo
Iur In LIIs cuse. WIere do we druw LIe IIne?`
GovernmenLs, LIe IeguI sysLem und socIeLy generuIIy seem Lo
Iuve IILLIe probIem wILI dIvorce, never concerned wILI ILs IeuILI
rumIIIcuLIons on cIIIdren (see CIupLer ). And yeL, IL wIII dredge up
sLuLIsLIcuIIsL nonsense In urrIvIng uL judgemenLs LIuL IueI wIuL seems Lo
be III-IeeIIng beLween u cIIId und purenL or purenLJpurenL, und LIuL
reInIorces MMES-cuIL beIIeIs (superIorIsL). TIe Issues oI IeuILI und
suIeLy, purLIcuIurIy In u muLerIuIIsL Irumework, very eusIIy musquerude
LIe muInLenunce oI conLorLed psycIoIogy und reIuLIonsIIp. Here, IL
reIIecLs LIe muLerIuIIsL domInuLIon oI IeguI opInIon, Loo, under wIIcI ure
beIng seL wuywurd und dungerous precedenLs.
UndersLundubIy, ASH LypIcuIIy uppIuuds courL decIsIons LIuL
Iuvor ILs monomunIucuI sLunce und LIuL IL Ius been InsLrumenLuI In
IusIIonIng (see uIso CIupLer ). AccordIng Lo ASH (1qq): Any purenL or
guurdIun wIo voIunLurIIy exposes u cIIId Lo sucI u IeuILI rIsk .. Is
InIIIcLIng us mucI, II noL more, pIysIcuI Iurm on u cIIId us conducL more
usuuIIy recognIzed us ubusIve or negIecLIuI. Ouks (zoo1) IndIcuLes LIuL
ASH Is IobbyIng LIrougI LIe courL sysLem Ior LIe rouLIne recognILIon oI
smokIng neur cIIIdren us cIIId ubuse und negIecL. (p.18) CIuIms oI ETS
IurmIuIness In specIIIc cIrcumsLunces Is uIreudy quesLIonubIe. ALLempLs
Lo propuguLe u generuI ETS IurmIuIness Ior uII cIIIdren Ius no scIenLIIIc
busIs und Is reckIess In LIe exLreme. L Ius onIy LIe propensILy Lo
munuIucLure mugIcuI, supersLILIous beIIeI LIuL Is menLuIIy enIeebIIng und
socIuIIy dIvIsIve; IL enLIreIy conLrudIcLs LIe very Ideu oI Iurm (concernIng
pIysIcuI, moruI und menLuI weII-beIng) LIuL ASH subscrIbes Lo.
L Is useIuI Lo consIder LIe roIe LIuL ASH, In purLIcuIur, Ius
pIuyed sInce LIe IuLe-1q6o`s In munuIucLurIng conLorLed beIIeI on u muss
scuIe. Ouks (zoo1, p.18) noLes jusL u jeu oI LIe news sLorIes uppeurIng
on LIe ASH web sILe (ILLp:JJusI.org):
Mom's Smolin More Decdl Thcn Crccl Use (1qq8);
Pcrents Are Smolin Their Kids To Decth, Litercll
(1qq8);
Smolin Pcrents Are Killin Their Injcnts (1qq6);
326
326
Rampant Antismoking Signifies Grave Danger
Mother Mc Lose Custod Dter Smolin, Eten In
Kentucl (1qq6);
Pcrents Are Deliberctel Mclin Their Kids Sicl, ct
Whct Point Does It ecome Child Abuse or
Endcnerment? (1qq6).
AII oI LIe ubove sLuLemenLs Iuve no scIenLIIIc or IeuILI merIL.
RuLIer, LIey ure LIe producLIons oI deIuded LIougIL LIuL uLLempLs Lo
Impose ILs IIgIIy mIsguIded wIII on greuLer socIeLy LIrougI Ieur und
guIIL-mongerIng; LIe onIy experLIse sucI monomunIucuI groups
demonsLruLe Is LIe munIpuIuLIon oI InIormuLIon - usuuIIy sLuLIsLIcuI, LIe
medIu, und LIe pubIIc. PurLIcuIurIy sIckIy Is LIe IeudIIne SmokIng
purenLs ure kIIIIng LIeIr InIunLs. L reIers Lo LIe Increused reIuLIve rIsk oI
SDS sLuLIsLIcuIIy ussocIuLed wILI smokIng purenLs. As Ius uIreudy been
IIgIIIgILed, LIe predIcLIve sLrengLI oI u smokIng purenL Ior SDS Is
eIIecLIveIy zero, I.e., LIere ure no grounds Ior prImury cuusuI urgumenL.
urLIermore, SDS represenLs un undeIIned condILIon. How LIIs
cIrcumsLunce Is LIen conLorLed InLo u proposILIon oI LIe kIIIIng oI
InIunLs IndIcuLes LIe derunged, IunuLIcuI nuLure oI LIe unLIsmokIng
menLuIILy LIuL wIII seemIngIy sLop uL noLIIng In promoLIng ILs cuuse. n
ugreemenL wILI OukIey (1qqq), LIe uLLempL Lo convInce smokIng purenLs
LIuL IL wus Lobucco smoke LIuL cuused LIe SDS deuLI oI LIeIr cIIId Is
unconscIonubIe. PurenLs LIuL ure uIreudy grIeI-sLrIcken now needIessIy
Iuve Lo deuI wILI LIIs IeveI oI IunuLIcIsm.
ASH`s SDS sLuLemenL uLLrucLed commenL Irom LIe SDS
AIIIunce (BuILImore, MuryIund):
Deur Mr. BunzIuI,
We uL LIe SDS AIIIunce uppIuud your eIIorLs Lo brIng Lo
LIe uLLenLIon oI LIe AmerIcun pubIIc LIe Iuzurds
ussocIuLed wILI smokIng und smoke exposure; we musL,
Iowever, objecL Lo your orgunIzuLIon`s use oI mIsIeudIng
duLu und LermInoIogy wIen IInkIng Sudden nIunL
DeuLI Syndrome Lo your cuuse.
SLuLIsLIcuIIy, pussIve smoke exposure Is u recognIzed,
sIgnIIIcunL IucLor Ior SDS. To duLe, no dIrecL cuusuI
reIuLIonsIIp Ius been esLubIIsIed. n IucL, LIe vusL
mujorILy oI InIunLs born Lo smokIng purenLs do noL dIe
oI SDS. And, sInce muny SDS deuLIs occur In u
smoke-Iree envIronmenL, we musL reIruIn Irom mukIng
smoke exposure uppeur Lo be IInked Lo uII SDS deuLIs.
TIe sensuLIonuI IeudIng Ior one oI your recenL nLerneL
reporLs, SmokIng PurenLs Are KIIIIng TIeIr nIunLs,
Preventive Medicine & Health Promotion
Ius gone Loo Iur. AvoIdIng known rIsk IucLors Ior SDS
muy reduce ILs IncIdence Ior some bubIes, buL oIIers no
guurunLee Ior every buby. RIsk IucLors uIone do noL
cuuse SDS.
L Is IIkeIy LIuL SDS muy be cuused by u subLIe
deveIopmenLuI deIuy, un unuLomIcuI deIecL, or u
IuncLIonuI IuIIure. TIe IIrsL yeur oI IIIe Is IruugIL wILI
perIods oI rupId growLI und deveIopmenL, durIng wIIcI
u buby`s sysLem muy become unsLubIe; durIng sucI
perIods uny buby muy be vuInerubIe.
L Is uIso ImporLunL Lo reuIIze LIuL SDS cun cIuIm uny
buby, In spILe oI purenLs doIng everyLIIng rIgIL.
nsensILIve generuIIzuLIons ubouL SDS broudcusL
LIrougI prInL or LIe eIecLronIc medIu serve onIy Lo
perpeLuuLe LIe pubIIc`s mIsconcepLIons. TIe IusL LIIng
we need Lo do Lo purenLs wIo suIIer LIIs Lrugedy Is
sLIgmuLIze or murgInuIIze LIem. TIe sImpIe LruLI Is LIuL
muny SDS vIcLIms Iuve no known rIsk IucLors; und,
mosL bubIes wILI one or more rIsk IucLors wIII survIve.
Your IILeruLure sLuLes LIuL smokIng kIIIs more LIun
z,ooo InIunLs eucI yeur Irom SDS. Any pubIIsIed
IIgures ure sIeer specuIuLIon, or guesses, noL grounded
In ucLuuI experImenLuLIon. TIe besL we cun do uL LIIs
juncLure Is LuIk In Lerms oI uLLrIbuLubIe rIsk - und LIere
Is no consensus on wIuL LIuL mIgIL be..
|W|e respecLIuIIy requesL LIuL you udjusL your messuge
us Iur us SDS Is concerned. WIIIe we supporL your
cuuse, we cunnoL do so uL LIe expense oI LIe Lens oI
LIousunds oI IumIIIes we represenL.
SIncereIy, PIIpps Y. CoIe, NuLIonuI PubIIc AIIuIrs
DIrecLor. (quoLed In OukIey, 1qqq, CI.8, p.;)
A number oI ImporLunL observuLIons cun be mude Irom LIe
ubove. IrsLIy, ASH dId noL reLrucL ILs IeudIIne or conLInuIng propugundu.
SecondIy, IL Is InLeresLIng In LIIs cuse LIuL IL Is u Iobby group LIuL Is
uLLempLIng Lo correcL errunL und dungerous cIuIms; IL Is usuuIIy Iobby
groups LIuL ure LIe producers oI seII-servIng rIeLorIc. TIe sILuuLIon does
IIgIIIgIL, Iowever, LIe no wIn sILuuLIon LIuL muny groups Iuve pIuced
LIemseIves In LIrougI LIe Improper use oI LIe Ideu oI sLuLIsLIcuI rIsk.
nLeresLJsupporL groups cun cerLuInIy IIgIIIgIL LIe sLuLIsLIcuI rIsk oI
purLIcuIur ouLcomes stctisticcll cssocicted wILI purLIcuIur unLecedenL
IucLors. However, LIese rIsk IucLors sIouId noL be coucIed In prescrIpLIveJ
327
327
Rampant Antismoking Signifies Grave Danger
Mother Mc Lose Custod Dter Smolin, Eten In
Kentucl (1qq6);
Pcrents Are Deliberctel Mclin Their Kids Sicl, ct
Whct Point Does It ecome Child Abuse or
Endcnerment? (1qq6).
AII oI LIe ubove sLuLemenLs Iuve no scIenLIIIc or IeuILI merIL.
RuLIer, LIey ure LIe producLIons oI deIuded LIougIL LIuL uLLempLs Lo
Impose ILs IIgIIy mIsguIded wIII on greuLer socIeLy LIrougI Ieur und
guIIL-mongerIng; LIe onIy experLIse sucI monomunIucuI groups
demonsLruLe Is LIe munIpuIuLIon oI InIormuLIon - usuuIIy sLuLIsLIcuI, LIe
medIu, und LIe pubIIc. PurLIcuIurIy sIckIy Is LIe IeudIIne SmokIng
purenLs ure kIIIIng LIeIr InIunLs. L reIers Lo LIe Increused reIuLIve rIsk oI
SDS sLuLIsLIcuIIy ussocIuLed wILI smokIng purenLs. As Ius uIreudy been
IIgIIIgILed, LIe predIcLIve sLrengLI oI u smokIng purenL Ior SDS Is
eIIecLIveIy zero, I.e., LIere ure no grounds Ior prImury cuusuI urgumenL.
urLIermore, SDS represenLs un undeIIned condILIon. How LIIs
cIrcumsLunce Is LIen conLorLed InLo u proposILIon oI LIe kIIIIng oI
InIunLs IndIcuLes LIe derunged, IunuLIcuI nuLure oI LIe unLIsmokIng
menLuIILy LIuL wIII seemIngIy sLop uL noLIIng In promoLIng ILs cuuse. n
ugreemenL wILI OukIey (1qqq), LIe uLLempL Lo convInce smokIng purenLs
LIuL IL wus Lobucco smoke LIuL cuused LIe SDS deuLI oI LIeIr cIIId Is
unconscIonubIe. PurenLs LIuL ure uIreudy grIeI-sLrIcken now needIessIy
Iuve Lo deuI wILI LIIs IeveI oI IunuLIcIsm.
ASH`s SDS sLuLemenL uLLrucLed commenL Irom LIe SDS
AIIIunce (BuILImore, MuryIund):
Deur Mr. BunzIuI,
We uL LIe SDS AIIIunce uppIuud your eIIorLs Lo brIng Lo
LIe uLLenLIon oI LIe AmerIcun pubIIc LIe Iuzurds
ussocIuLed wILI smokIng und smoke exposure; we musL,
Iowever, objecL Lo your orgunIzuLIon`s use oI mIsIeudIng
duLu und LermInoIogy wIen IInkIng Sudden nIunL
DeuLI Syndrome Lo your cuuse.
SLuLIsLIcuIIy, pussIve smoke exposure Is u recognIzed,
sIgnIIIcunL IucLor Ior SDS. To duLe, no dIrecL cuusuI
reIuLIonsIIp Ius been esLubIIsIed. n IucL, LIe vusL
mujorILy oI InIunLs born Lo smokIng purenLs do noL dIe
oI SDS. And, sInce muny SDS deuLIs occur In u
smoke-Iree envIronmenL, we musL reIruIn Irom mukIng
smoke exposure uppeur Lo be IInked Lo uII SDS deuLIs.
TIe sensuLIonuI IeudIng Ior one oI your recenL nLerneL
reporLs, SmokIng PurenLs Are KIIIIng TIeIr nIunLs,
Preventive Medicine & Health Promotion
Ius gone Loo Iur. AvoIdIng known rIsk IucLors Ior SDS
muy reduce ILs IncIdence Ior some bubIes, buL oIIers no
guurunLee Ior every buby. RIsk IucLors uIone do noL
cuuse SDS.
L Is IIkeIy LIuL SDS muy be cuused by u subLIe
deveIopmenLuI deIuy, un unuLomIcuI deIecL, or u
IuncLIonuI IuIIure. TIe IIrsL yeur oI IIIe Is IruugIL wILI
perIods oI rupId growLI und deveIopmenL, durIng wIIcI
u buby`s sysLem muy become unsLubIe; durIng sucI
perIods uny buby muy be vuInerubIe.
L Is uIso ImporLunL Lo reuIIze LIuL SDS cun cIuIm uny
buby, In spILe oI purenLs doIng everyLIIng rIgIL.
nsensILIve generuIIzuLIons ubouL SDS broudcusL
LIrougI prInL or LIe eIecLronIc medIu serve onIy Lo
perpeLuuLe LIe pubIIc`s mIsconcepLIons. TIe IusL LIIng
we need Lo do Lo purenLs wIo suIIer LIIs Lrugedy Is
sLIgmuLIze or murgInuIIze LIem. TIe sImpIe LruLI Is LIuL
muny SDS vIcLIms Iuve no known rIsk IucLors; und,
mosL bubIes wILI one or more rIsk IucLors wIII survIve.
Your IILeruLure sLuLes LIuL smokIng kIIIs more LIun
z,ooo InIunLs eucI yeur Irom SDS. Any pubIIsIed
IIgures ure sIeer specuIuLIon, or guesses, noL grounded
In ucLuuI experImenLuLIon. TIe besL we cun do uL LIIs
juncLure Is LuIk In Lerms oI uLLrIbuLubIe rIsk - und LIere
Is no consensus on wIuL LIuL mIgIL be..
|W|e respecLIuIIy requesL LIuL you udjusL your messuge
us Iur us SDS Is concerned. WIIIe we supporL your
cuuse, we cunnoL do so uL LIe expense oI LIe Lens oI
LIousunds oI IumIIIes we represenL.
SIncereIy, PIIpps Y. CoIe, NuLIonuI PubIIc AIIuIrs
DIrecLor. (quoLed In OukIey, 1qqq, CI.8, p.;)
A number oI ImporLunL observuLIons cun be mude Irom LIe
ubove. IrsLIy, ASH dId noL reLrucL ILs IeudIIne or conLInuIng propugundu.
SecondIy, IL Is InLeresLIng In LIIs cuse LIuL IL Is u Iobby group LIuL Is
uLLempLIng Lo correcL errunL und dungerous cIuIms; IL Is usuuIIy Iobby
groups LIuL ure LIe producers oI seII-servIng rIeLorIc. TIe sILuuLIon does
IIgIIIgIL, Iowever, LIe no wIn sILuuLIon LIuL muny groups Iuve pIuced
LIemseIves In LIrougI LIe Improper use oI LIe Ideu oI sLuLIsLIcuI rIsk.
nLeresLJsupporL groups cun cerLuInIy IIgIIIgIL LIe sLuLIsLIcuI rIsk oI
purLIcuIur ouLcomes stctisticcll cssocicted wILI purLIcuIur unLecedenL
IucLors. However, LIese rIsk IucLors sIouId noL be coucIed In prescrIpLIveJ
328
328
Rampant Antismoking Signifies Grave Danger
proscrIpLIve udvIce; IL sIouId be IeIL Lo IndIvIduuIs Lo ussess sucI rIsk
IucLors. n IucL, supporL groups und LIe medIcuI esLubIIsImenL sIouId
ensure LIuL LIe Ideu oI sLuLIsLIcuI rIsk Is noL over-InLerpreLed. Once
sLuLIsLIcuI rIsk IucLors ure Iorwurded In prescrIpLIveJproscrIpLIve Lerms LIe
psycIoIogIcuI dumuge Is uIreudy done, I.e., LIese IucLors hcte been over-
InLerpreLed. rom LIIs poInL IL Is very dIIIIcuIL Lo urgue, post hoc, LIuL
purLIcuIur rIsk IucLors were noL reIevunL In SDS gIven LIuL LIeIr
reIevunce wus IIgIIIgILed LIrougI prescrIpLIveJproscrIpLIve udvIce.
TIIrdIy, LIe medIcuI esLubIIsImenL, wIIcI Is In LIe besL posILIon Lo correcL
errunL, monomunIucuI beIIeI, noL onIy does noL do so buL Is u cIIeI
promoLer oI deIuded beIIeI.
L cun be concIuded Irom LIe IoregoIng LIuL pregnuncy und cIIId-
reurIng Iuve Iong Iud u IIsLory oI beIng u Iocus Ior numerous
IdeoIogIcuIIy-quesLIonubIe monomunIucuI groups. ncoIerenL unuIogy und
cd hominem urgumenLs IIgure very IIgIIy In LIese groups` uLLempLs Lo
conLroI LIe beIuvIor oI moLIers-Lo-be und purenLs. TIe pregnunL smoker
und smokIng purenL Iuve purLIcuIurIy been In LIe cross-IuIrs oI muny oI
LIese groups Ior quILe some LIme. n Lerms oI LIe poor sLundurd oI
urgumenL und LIe poIIcIes pursued, wIIcI Iuve u LIeme oI severe Ieur und
guIIL-mongerIng und quesLIonubIe uLLempLs Lo crImInuIIze purLIcuIur
beIuvIor, LIe underIyIng menLuIILy Is psycIoIogIcuIIy und psycIosocIuIIy
vIoIenL In dIsposILIon.
L Is uguInsL LIIs buckdrop oI Iow smokIng Ius been vIewed Ior u
number oI decudes LIuL IL becomes obvIous LIuL pussIve smokIng us u
cuuse oI SDS Is u IogIcuI progressIon In LIe pursuIL oI u smoke-Iree
worId. TIe uLLempL uL u cuusuI urgumenL Ior ETS exposure (oI eILIer un
InIunL or u pregnunL nonsmoker) und SDS Is even more ubsurd LIun LIuL
Ior muLernuI smokIng und SDS. ApurL Irom LIe unknown cuusuI uLLrIbuLe
(s), underIyIng puLIoIogy, und LIe reIuLIonsIIp beLween LIese, LIe
exposed group Is consIderubIy Iurger In LIe Iormer sILuuLIon und LIe
IncIdence oI SDS Is Iower, sucI LIuL LIe predIcLIve sLrengLI oI ETS
exposure Ior SDS Is even cIoser Lo zero, I.e., InIInILesImuIIy ubove zero.
or exumpIe, 8;% oI pregnunL women ure nonsmokers (I.e., z,6o,ooo).
L Is consIdered LIuL uL IeusL IuII oI LIIs number ure exposed Lo ETS durIng
pregnuncy, or LIeIr newborn InIunLs ure exposed Lo ETS. TIe uLLrIbuLubIe
excess (u sLuLIsLIcuIIy derIved IIgure) oI SDS ussocIuLed wILI exposure Lo
ETS Is weII under 1oo. TIe predIcLIve sLrengLI oI exposure Lo ETS, Ior
eILIer u pregnunL nonsmoker or InIunLs under 1 yeur, Ior SDS Is
-oJ1,z,ooo=.oooo;. TIe greuLer mujorILy (qq.qq%+) oI InIunLs or
pregnunL nonsmokers exposed Lo ETS do noL dIe oI SDS. L Is essenLIuIIy
LIe sume ruLe us InIunLs noL exposed Lo ETS. urLIermore, LIIs Is noL
uccounLIng Ior LIe pIeLIoru oI oLIer IucLors sLuLIsLIcuIIy ussocIuLed wILI
Preventive Medicine & Health Promotion
SDS. TIe uLLempL Lo convInce nonsmokers LIuL LIeIr InIunLs or unborn
InIunLs ure In gruve dunger Irom exposure Lo ETS, bused on uIIround
IndeLermInucIes und wIere LIe use oI exposure Lo ETS us u predIcLor oI
SDS wouId produce IuIse cIussIIIcuLIons In qq.qq% oI cuses, Is purLIcuIurIy
perverse.
EPA (1qq) concIuded LIuL uL presenL LIere Is noL enougI dIrecL
evIdence supporLIng LIe conLrIbuLIon oI ETS exposure Lo decIure IL us u
rIsk IucLor or Lo esLImuLe ILs popuIuLIon ImpucL on SDS. (S.1) However,
wILIIn LIe unLIsmokIng Irenzy oI LIe 1qqo`s, LIuL LIere Is no scIenLIIIc
busIs Lo cIuIms Is essenLIuIIy IrreIevunL. UnreIenLIng propugundu wILIIn
LIe medIcuI esLubIIsImenL und by monomunIucuI Iobby groups wIII
produce u IumIIIur process LIuL wIII uILImuLeIy resuIL In u consensus
eIIecL.
WILIIn u smuII number oI yeurs posL-EPA (1qq), WHO (1qqq)
sLuLed LIuL |I|nIunL exposure Lo ETS muy conLrIbuLe Lo LIe rIsk oI
SDS. (S.1) TIIs purLIcuIur cIuIm, wIIcI Is essenLIuIIy sLuLIsLIcuI bIuLIer,
does noL yeL IndIcuLe u cuusuI connecLIon buL Is u work In progress
Lowurd u consensus eIIecL. By zooz, u newspuper urLIcIe In VIcLorIu,
AusLruIIu, decIured LIuL PussIve smokIng Ius been IInked Lo LIe deuLIs oI
z AusLruIIun cIIIdren. A sLudy Iound pussIve smokIng wus u conLrIbuLIng
cuuse Ior LIe deuLI oI LIe cIIIdren, wIo were uII uged under one... TIe
reporL, by LIe AusLruIIun nsLILuLe oI HeuILI und WeIIure, suId LIe z
cIIIdren dIed Irom Sudden nIunL DeuLI Syndrome, buL LIuL pussIve
smokIng wus uIso IInked Lo LIeIr deuLIs. (Hercld,Sun, Muy , zooz,
p.1q) PurLIcuIurIy oI InLeresL Is LIe InsLILuLIonuIIzed euse wILI wIIcI
proposILIons sIIIL beLween sLuLIsLIcuI (uLLrIbuLubIe rIskJnumbers) und
cuusuI Irumeworks; ETS Is uILernuLIveIy reIerred Lo us u IInk und u
conLrIbuLIng cuuse. A IurLIer dIsLurbIng uspecL oI LIIs urLIcIe Is LIuL LIe
mujorILy oI LIe urLIcIe reIers Lo LIe AusLruIIun NH&MRC (1qq;) revIew us
supporLIng cIuIms oI ETS us u cuuse oI uII munner oI cIIIdIood
muIudIes. TIIs Is LIe sume revIew LIuL wIII be reIerred Lo sIorLIy wIere LIe
uuLIors were Iound guIILy oI mIsconducL In LIe revIew`s compIIuLIon by un
AusLruIIun courL oI Iuw, I.e., LIe revIew Is beIng used us supporL cjter IL
wus Iound Lo be In breucI oI due process.
L musL be reILeruLed LIuL sucI cIuIms us In LIe ubove Iuve no
scIenLIIIc busIs, buL IoIIow LIe sLundurd, IncompeLenL process oI sLuLIsLIcuI
cIuIms eIevuLed Lo u cuusuI sLuLus LIrougI u consensus eIIecL. ALLrIbuLubIe
numbers ure LIen IuugILIIy IIung ubouL LIe pubIIc domuIn us
scIenLIIIcuIIy produced. L Is especIuIIy concernIng SDS, wIIcI LIunkIuIIy
Ius u very Iow IncIdence (und LIereIore poor predIcLIve sLrengLI by IIgI
Irequency IucLors sucI us ETS exposure) und wIIcI Ius uII-round
unknowns, LIuL cIuIms sIngIIng-ouL smokIng or ETS exposure us cuuses
329
329
Rampant Antismoking Signifies Grave Danger
proscrIpLIve udvIce; IL sIouId be IeIL Lo IndIvIduuIs Lo ussess sucI rIsk
IucLors. n IucL, supporL groups und LIe medIcuI esLubIIsImenL sIouId
ensure LIuL LIe Ideu oI sLuLIsLIcuI rIsk Is noL over-InLerpreLed. Once
sLuLIsLIcuI rIsk IucLors ure Iorwurded In prescrIpLIveJproscrIpLIve Lerms LIe
psycIoIogIcuI dumuge Is uIreudy done, I.e., LIese IucLors hcte been over-
InLerpreLed. rom LIIs poInL IL Is very dIIIIcuIL Lo urgue, post hoc, LIuL
purLIcuIur rIsk IucLors were noL reIevunL In SDS gIven LIuL LIeIr
reIevunce wus IIgIIIgILed LIrougI prescrIpLIveJproscrIpLIve udvIce.
TIIrdIy, LIe medIcuI esLubIIsImenL, wIIcI Is In LIe besL posILIon Lo correcL
errunL, monomunIucuI beIIeI, noL onIy does noL do so buL Is u cIIeI
promoLer oI deIuded beIIeI.
L cun be concIuded Irom LIe IoregoIng LIuL pregnuncy und cIIId-
reurIng Iuve Iong Iud u IIsLory oI beIng u Iocus Ior numerous
IdeoIogIcuIIy-quesLIonubIe monomunIucuI groups. ncoIerenL unuIogy und
cd hominem urgumenLs IIgure very IIgIIy In LIese groups` uLLempLs Lo
conLroI LIe beIuvIor oI moLIers-Lo-be und purenLs. TIe pregnunL smoker
und smokIng purenL Iuve purLIcuIurIy been In LIe cross-IuIrs oI muny oI
LIese groups Ior quILe some LIme. n Lerms oI LIe poor sLundurd oI
urgumenL und LIe poIIcIes pursued, wIIcI Iuve u LIeme oI severe Ieur und
guIIL-mongerIng und quesLIonubIe uLLempLs Lo crImInuIIze purLIcuIur
beIuvIor, LIe underIyIng menLuIILy Is psycIoIogIcuIIy und psycIosocIuIIy
vIoIenL In dIsposILIon.
L Is uguInsL LIIs buckdrop oI Iow smokIng Ius been vIewed Ior u
number oI decudes LIuL IL becomes obvIous LIuL pussIve smokIng us u
cuuse oI SDS Is u IogIcuI progressIon In LIe pursuIL oI u smoke-Iree
worId. TIe uLLempL uL u cuusuI urgumenL Ior ETS exposure (oI eILIer un
InIunL or u pregnunL nonsmoker) und SDS Is even more ubsurd LIun LIuL
Ior muLernuI smokIng und SDS. ApurL Irom LIe unknown cuusuI uLLrIbuLe
(s), underIyIng puLIoIogy, und LIe reIuLIonsIIp beLween LIese, LIe
exposed group Is consIderubIy Iurger In LIe Iormer sILuuLIon und LIe
IncIdence oI SDS Is Iower, sucI LIuL LIe predIcLIve sLrengLI oI ETS
exposure Ior SDS Is even cIoser Lo zero, I.e., InIInILesImuIIy ubove zero.
or exumpIe, 8;% oI pregnunL women ure nonsmokers (I.e., z,6o,ooo).
L Is consIdered LIuL uL IeusL IuII oI LIIs number ure exposed Lo ETS durIng
pregnuncy, or LIeIr newborn InIunLs ure exposed Lo ETS. TIe uLLrIbuLubIe
excess (u sLuLIsLIcuIIy derIved IIgure) oI SDS ussocIuLed wILI exposure Lo
ETS Is weII under 1oo. TIe predIcLIve sLrengLI oI exposure Lo ETS, Ior
eILIer u pregnunL nonsmoker or InIunLs under 1 yeur, Ior SDS Is
-oJ1,z,ooo=.oooo;. TIe greuLer mujorILy (qq.qq%+) oI InIunLs or
pregnunL nonsmokers exposed Lo ETS do noL dIe oI SDS. L Is essenLIuIIy
LIe sume ruLe us InIunLs noL exposed Lo ETS. urLIermore, LIIs Is noL
uccounLIng Ior LIe pIeLIoru oI oLIer IucLors sLuLIsLIcuIIy ussocIuLed wILI
Preventive Medicine & Health Promotion
SDS. TIe uLLempL Lo convInce nonsmokers LIuL LIeIr InIunLs or unborn
InIunLs ure In gruve dunger Irom exposure Lo ETS, bused on uIIround
IndeLermInucIes und wIere LIe use oI exposure Lo ETS us u predIcLor oI
SDS wouId produce IuIse cIussIIIcuLIons In qq.qq% oI cuses, Is purLIcuIurIy
perverse.
EPA (1qq) concIuded LIuL uL presenL LIere Is noL enougI dIrecL
evIdence supporLIng LIe conLrIbuLIon oI ETS exposure Lo decIure IL us u
rIsk IucLor or Lo esLImuLe ILs popuIuLIon ImpucL on SDS. (S.1) However,
wILIIn LIe unLIsmokIng Irenzy oI LIe 1qqo`s, LIuL LIere Is no scIenLIIIc
busIs Lo cIuIms Is essenLIuIIy IrreIevunL. UnreIenLIng propugundu wILIIn
LIe medIcuI esLubIIsImenL und by monomunIucuI Iobby groups wIII
produce u IumIIIur process LIuL wIII uILImuLeIy resuIL In u consensus
eIIecL.
WILIIn u smuII number oI yeurs posL-EPA (1qq), WHO (1qqq)
sLuLed LIuL |I|nIunL exposure Lo ETS muy conLrIbuLe Lo LIe rIsk oI
SDS. (S.1) TIIs purLIcuIur cIuIm, wIIcI Is essenLIuIIy sLuLIsLIcuI bIuLIer,
does noL yeL IndIcuLe u cuusuI connecLIon buL Is u work In progress
Lowurd u consensus eIIecL. By zooz, u newspuper urLIcIe In VIcLorIu,
AusLruIIu, decIured LIuL PussIve smokIng Ius been IInked Lo LIe deuLIs oI
z AusLruIIun cIIIdren. A sLudy Iound pussIve smokIng wus u conLrIbuLIng
cuuse Ior LIe deuLI oI LIe cIIIdren, wIo were uII uged under one... TIe
reporL, by LIe AusLruIIun nsLILuLe oI HeuILI und WeIIure, suId LIe z
cIIIdren dIed Irom Sudden nIunL DeuLI Syndrome, buL LIuL pussIve
smokIng wus uIso IInked Lo LIeIr deuLIs. (Hercld,Sun, Muy , zooz,
p.1q) PurLIcuIurIy oI InLeresL Is LIe InsLILuLIonuIIzed euse wILI wIIcI
proposILIons sIIIL beLween sLuLIsLIcuI (uLLrIbuLubIe rIskJnumbers) und
cuusuI Irumeworks; ETS Is uILernuLIveIy reIerred Lo us u IInk und u
conLrIbuLIng cuuse. A IurLIer dIsLurbIng uspecL oI LIIs urLIcIe Is LIuL LIe
mujorILy oI LIe urLIcIe reIers Lo LIe AusLruIIun NH&MRC (1qq;) revIew us
supporLIng cIuIms oI ETS us u cuuse oI uII munner oI cIIIdIood
muIudIes. TIIs Is LIe sume revIew LIuL wIII be reIerred Lo sIorLIy wIere LIe
uuLIors were Iound guIILy oI mIsconducL In LIe revIew`s compIIuLIon by un
AusLruIIun courL oI Iuw, I.e., LIe revIew Is beIng used us supporL cjter IL
wus Iound Lo be In breucI oI due process.
L musL be reILeruLed LIuL sucI cIuIms us In LIe ubove Iuve no
scIenLIIIc busIs, buL IoIIow LIe sLundurd, IncompeLenL process oI sLuLIsLIcuI
cIuIms eIevuLed Lo u cuusuI sLuLus LIrougI u consensus eIIecL. ALLrIbuLubIe
numbers ure LIen IuugILIIy IIung ubouL LIe pubIIc domuIn us
scIenLIIIcuIIy produced. L Is especIuIIy concernIng SDS, wIIcI LIunkIuIIy
Ius u very Iow IncIdence (und LIereIore poor predIcLIve sLrengLI by IIgI
Irequency IucLors sucI us ETS exposure) und wIIcI Ius uII-round
unknowns, LIuL cIuIms sIngIIng-ouL smokIng or ETS exposure us cuuses
330
330
Rampant Antismoking Signifies Grave Danger
oI SDS cun cIeurIy be evuIuuLed us LIe concocLIons oI u IeebIe LIInkIng.
UnIorLunuLeIy, LIese ETS cIuIms LerrorIze nonsmokers InLo compIIunce
wILI MMES-cuIL edIcLs; nonsmokers LIuL uIIow LIeIr cIIIdren Lo be
exposed Lo uny ETS ure porLruyed us IrresponsIbIe und reckIess.
AguIn, Iobby groups sucI us ASH IIgure IIgIIy In LIe
munuIucLure oI muss deIusIon. or exumpIe, one oI LIe more recenL
uddILIons Lo LIe numerous, sensuLIonuIIzed, unLIsmokIng IeudIInes
uppeurIng on ILs web sILe (www.usI.org) Is LIe IeudIIne DocLors Ind
WIy Smoke KIIIs BubIes (zooz). TIe IeudIIne perLuIns Lo excerpLs Irom u
Reuters Heclth urLIcIe (qJJoz) enLILIed SLudy SuggesLs WIy CIgureLLe
Smoke u SDS RIsk. TIe ReuLers urLIcIe In Lurn reIers Lo u sLudy
presenLed uL LIe Europeun SocIeLy oI CurdIoIogy. TIe reseurcIers In
quesLIon exposed pregnunL ruLs Lo curbon monoxIde, u componenL oI
cIgureLLe smoke, uL u concenLruLIon sImuIuLIng LIe IeveIs experIenced by u
cIgureLLe smoker. TIey Iound LIuL LIIs exposure cun deIuy LIe muLuruLIon
oI some properLIes In IeurL ceIIs In LIe deveIopIng IeLus. TIere Is no
IndIcuLIon oI LIe proporLIonuI number oI ruL IeLuses LIuL LIIs deIuyed
muLuruLIon occurred In. TIIs deIuyed muLuruLIon, In Lurn, uIIecLs LIe QT
InLervuI wIIcI Is one porLIon oI un eIecLrocurdIogrum (ECG).
AILIougI LIe exLrupoIuLIon poLenLIuI Irom ruLs Lo Iumuns Is very
poor, IL Is uncIeur wIy LIese reseurcIers dId noL expose LIe pregnunL ruLs
Lo muInsLreum smoke. AL IeusL LIIs wouId provIde u consLunL pIenomenon
under consIderuLIon. NoLwILIsLundIng, LIe urgumenL by unuIogy InvoIves
IurLIer quesLIonubIe ussumpLIons. TIe reseurcIers conLend LIuL Iong QT
InLervuIs In ruLs ure unuIogous wILI bubIes demonsLruLIng LIe sume
pIenomenon. TIey do noL provIde uny evIdence Ior LIe sLuLIsLIcuI rIsk oI
Iong QT InLervuI In bubIes wIose moLIers smoked durIng pregnuncy.
TIen, bubIes wILI u Iong QT InLervuI, In Lurn, Iuve u IIgIer rIsk oI
IrreguIur IeurL beuLs wIIcI, In Lurn, Is u IIgIer rIsk IucLor Ior SDS:
TIereIore, uccordIng Lo LIIs urgumenL, muLernuI smokIng Is u rIsk IucLor
Ior u IIgIer rIsk IucLor (Iong QT InLervuI), wIIcI Is u rIsk IucLor Ior u
IIgIer rIsk IucLor (IrreguIur IeurL beuL) Ior SDS. RegurdIess oI uII LIIs
cIrcuIurILy LIrougI rIsk IucLors, LIe predIcLIve sLrengLI oI muLernuI
smokIng Ior SDS remuIns LIe sume - essenLIuIIy zero. urLIermore, LIe
predIcLIve sLrengLI oI uny oI LIese IucLors Ior SDS Is neur-zero. As Iong us
reseurcIers conLInue Lo Iocus on properLIes oI smoke us u prImury cuuse,
LIe sILuuLIon wIII noL cIunge. ucLors need Lo be IdenLIIIed LIuL cun
specIIIcuIIy pInpoInL LIose InIunLs uL exLremeIy IIgI rIsk. L cun be
undersLood, c priori, LIuL muLernuI smokIng, u reIuLIveIy IIgI-Irequency
evenL, cunnoL IuIIIII LIe requIremenL oI uccuruLeIy pInpoInLIng u very Iow-
Irequency evenL (e.g., SDS). TIe mosL IIkeIy cundIduLe Is endogenous
ubnormuIILy. n oLIer words, regurdIng SDS, LIIs enLIre upproucI Is un
Preventive Medicine & Health Promotion
uLLer wusLe oI LIme, eIIorL, und reseurcI Iunds.
UnIorLunuLeIy, LIe deLrImenLuI repercussIons oI LIese cIuIms do
noL end Iere. TIe cIIeI reseurcIer concIuded Irom uII LIe quesLIonubIe
surmIsIng: |D|on`L smoke II you ure pregnunL, und don`L smoke In u room
wIere LIere Is u buby, I.e., sLundurd rIsk-uversIon prescrIpLIon. L Is uIso
uncIeur wIy LIe second prescrIpLIon Is gIven In LIuL LIe reseurcI onIy
uddresses IeLuI deveIopmenL. Does IL meun noL smokIng uround bubIes oI
women wIo smoked durIng pregnuncy or uny bubIes? TIe prescrIpLIve
udvIce represenLs severe over-InLerpreLuLIon LIuL goes Iur beyond LIe
ImpIIcuLIon oI IucLs; none oI LIe requIremenLs oI coIerenL cuusuI
urgumenL ure meL. L seems LIuL muny InIerenLIuI sIorL cuLs Iuve been
Luken In workIng Lo un unLIsmokIng concIusIon.
NoLubIe Is LIuL LIe reseurcIers uL IeusL ucknowIedge LIuL LIeIr
IIndIng muy expIuIn LIe IInk (sLuLIsLIcuI) beLween smokIng und SDS.
TIe ReuLers urLIcIe ucLuuIIy begIns wILI u sLuLemenL LIuL IncIudes Lerms
sucI us possIbIe und muy: LuIIun reseurcIers Iuve Iound u possIbIe
expIunuLIon Ior wIy exposure Lo cIgureLLe smoke durIng pregnuncy muy
Increuse u buby`s rIsk oI sudden InIunL deuLI syndrome or SDS. TIe
ReuLers IeudIIne udds u IeveI oI cuLusLropIIzuLIon by removIng uII LIe
condILIonuI LermInoIogy: SLudy SuggesLs WIy CIgureLLe Smoke u SDS
RIsk. By LIe LIme LIIs reseurcI IIndIng undergoes LIe ASH IIILerIng, LIe
IeudIIne becomes LIorougIIy cuLusLropIIzed: DocLors Ind WIy
CIgureLLe Smoke KIIIs BubIes. TIe cIuIm ImpIIes LIuL cIgureLLe smoke,
generuIIy (I.e., wIeLIer un ucLIve smoker, u pregnunL nonsmoker exposed
Lo ETS, or u newborn buby exposed Lo ETS), does kIII bubIes.
urLIermore, LIIs kIIIIng Is produced by u generuI cuusuI propensILy oI
smoke uLLrIbuLes IndependenL oI endogenous sysLem vurIuLIon (I.e.,
compIeLe exLernuIIzIng oI cuuse), und LIuL LIe deIInILIve mecIunIsm by
wIIcI cuusuLIon occurs Ius been IdenLIIIed. SucI u cIuIm Is dIsIonesL In
LIe exLreme, deIInquenL, deIuded, und LypIcuI oI LIe numerous
unLIsmokIng cIuIms LIuL uppeur on LIe ASH websILe. More recenLIy, LIere
ure cIuIms LIuL un ubnormuIILy In gene (SCNA) IuncLIon Is ussocIuLed
wILI Iong-QT syndrome In Iumun InIunLs (Hercld,Sun, November 16,
zoo1). No menLIon Is mude oI smokIng ussocIuLed wILI LIe geneLIc deIecL.
MosL ImporLunLIy, 1ourncl Wctch (GeneruI) (1qq8) noLes LIuL proIonged
QT Is u poor predIcLor oI SDS, I.e., mosL InIunLs wILI proIonged QT do
noL dIe oI SDS.
AguIn, LIIs conducL Is noL new Ior LIe unLIsmokIng menLuIILy.
ScruLInIzIng u vurIeLy oI unLIsmokIng movemenLs In 1qLI und zoLI-
cenLury BrILuIn, WuIker (1q8o) IndIcuLes: |T|Ie zeuIoLs IndIscrImInuLeIy
dIIIused LIe mosL exLruvugunL usserLIons oI obscure medIco-
LobuccopIobes. (p.q6) MonomunIucuI groups, by deIInILIon, Iuve no
331
331
Rampant Antismoking Signifies Grave Danger
oI SDS cun cIeurIy be evuIuuLed us LIe concocLIons oI u IeebIe LIInkIng.
UnIorLunuLeIy, LIese ETS cIuIms LerrorIze nonsmokers InLo compIIunce
wILI MMES-cuIL edIcLs; nonsmokers LIuL uIIow LIeIr cIIIdren Lo be
exposed Lo uny ETS ure porLruyed us IrresponsIbIe und reckIess.
AguIn, Iobby groups sucI us ASH IIgure IIgIIy In LIe
munuIucLure oI muss deIusIon. or exumpIe, one oI LIe more recenL
uddILIons Lo LIe numerous, sensuLIonuIIzed, unLIsmokIng IeudIInes
uppeurIng on ILs web sILe (www.usI.org) Is LIe IeudIIne DocLors Ind
WIy Smoke KIIIs BubIes (zooz). TIe IeudIIne perLuIns Lo excerpLs Irom u
Reuters Heclth urLIcIe (qJJoz) enLILIed SLudy SuggesLs WIy CIgureLLe
Smoke u SDS RIsk. TIe ReuLers urLIcIe In Lurn reIers Lo u sLudy
presenLed uL LIe Europeun SocIeLy oI CurdIoIogy. TIe reseurcIers In
quesLIon exposed pregnunL ruLs Lo curbon monoxIde, u componenL oI
cIgureLLe smoke, uL u concenLruLIon sImuIuLIng LIe IeveIs experIenced by u
cIgureLLe smoker. TIey Iound LIuL LIIs exposure cun deIuy LIe muLuruLIon
oI some properLIes In IeurL ceIIs In LIe deveIopIng IeLus. TIere Is no
IndIcuLIon oI LIe proporLIonuI number oI ruL IeLuses LIuL LIIs deIuyed
muLuruLIon occurred In. TIIs deIuyed muLuruLIon, In Lurn, uIIecLs LIe QT
InLervuI wIIcI Is one porLIon oI un eIecLrocurdIogrum (ECG).
AILIougI LIe exLrupoIuLIon poLenLIuI Irom ruLs Lo Iumuns Is very
poor, IL Is uncIeur wIy LIese reseurcIers dId noL expose LIe pregnunL ruLs
Lo muInsLreum smoke. AL IeusL LIIs wouId provIde u consLunL pIenomenon
under consIderuLIon. NoLwILIsLundIng, LIe urgumenL by unuIogy InvoIves
IurLIer quesLIonubIe ussumpLIons. TIe reseurcIers conLend LIuL Iong QT
InLervuIs In ruLs ure unuIogous wILI bubIes demonsLruLIng LIe sume
pIenomenon. TIey do noL provIde uny evIdence Ior LIe sLuLIsLIcuI rIsk oI
Iong QT InLervuI In bubIes wIose moLIers smoked durIng pregnuncy.
TIen, bubIes wILI u Iong QT InLervuI, In Lurn, Iuve u IIgIer rIsk oI
IrreguIur IeurL beuLs wIIcI, In Lurn, Is u IIgIer rIsk IucLor Ior SDS:
TIereIore, uccordIng Lo LIIs urgumenL, muLernuI smokIng Is u rIsk IucLor
Ior u IIgIer rIsk IucLor (Iong QT InLervuI), wIIcI Is u rIsk IucLor Ior u
IIgIer rIsk IucLor (IrreguIur IeurL beuL) Ior SDS. RegurdIess oI uII LIIs
cIrcuIurILy LIrougI rIsk IucLors, LIe predIcLIve sLrengLI oI muLernuI
smokIng Ior SDS remuIns LIe sume - essenLIuIIy zero. urLIermore, LIe
predIcLIve sLrengLI oI uny oI LIese IucLors Ior SDS Is neur-zero. As Iong us
reseurcIers conLInue Lo Iocus on properLIes oI smoke us u prImury cuuse,
LIe sILuuLIon wIII noL cIunge. ucLors need Lo be IdenLIIIed LIuL cun
specIIIcuIIy pInpoInL LIose InIunLs uL exLremeIy IIgI rIsk. L cun be
undersLood, c priori, LIuL muLernuI smokIng, u reIuLIveIy IIgI-Irequency
evenL, cunnoL IuIIIII LIe requIremenL oI uccuruLeIy pInpoInLIng u very Iow-
Irequency evenL (e.g., SDS). TIe mosL IIkeIy cundIduLe Is endogenous
ubnormuIILy. n oLIer words, regurdIng SDS, LIIs enLIre upproucI Is un
Preventive Medicine & Health Promotion
uLLer wusLe oI LIme, eIIorL, und reseurcI Iunds.
UnIorLunuLeIy, LIe deLrImenLuI repercussIons oI LIese cIuIms do
noL end Iere. TIe cIIeI reseurcIer concIuded Irom uII LIe quesLIonubIe
surmIsIng: |D|on`L smoke II you ure pregnunL, und don`L smoke In u room
wIere LIere Is u buby, I.e., sLundurd rIsk-uversIon prescrIpLIon. L Is uIso
uncIeur wIy LIe second prescrIpLIon Is gIven In LIuL LIe reseurcI onIy
uddresses IeLuI deveIopmenL. Does IL meun noL smokIng uround bubIes oI
women wIo smoked durIng pregnuncy or uny bubIes? TIe prescrIpLIve
udvIce represenLs severe over-InLerpreLuLIon LIuL goes Iur beyond LIe
ImpIIcuLIon oI IucLs; none oI LIe requIremenLs oI coIerenL cuusuI
urgumenL ure meL. L seems LIuL muny InIerenLIuI sIorL cuLs Iuve been
Luken In workIng Lo un unLIsmokIng concIusIon.
NoLubIe Is LIuL LIe reseurcIers uL IeusL ucknowIedge LIuL LIeIr
IIndIng muy expIuIn LIe IInk (sLuLIsLIcuI) beLween smokIng und SDS.
TIe ReuLers urLIcIe ucLuuIIy begIns wILI u sLuLemenL LIuL IncIudes Lerms
sucI us possIbIe und muy: LuIIun reseurcIers Iuve Iound u possIbIe
expIunuLIon Ior wIy exposure Lo cIgureLLe smoke durIng pregnuncy muy
Increuse u buby`s rIsk oI sudden InIunL deuLI syndrome or SDS. TIe
ReuLers IeudIIne udds u IeveI oI cuLusLropIIzuLIon by removIng uII LIe
condILIonuI LermInoIogy: SLudy SuggesLs WIy CIgureLLe Smoke u SDS
RIsk. By LIe LIme LIIs reseurcI IIndIng undergoes LIe ASH IIILerIng, LIe
IeudIIne becomes LIorougIIy cuLusLropIIzed: DocLors Ind WIy
CIgureLLe Smoke KIIIs BubIes. TIe cIuIm ImpIIes LIuL cIgureLLe smoke,
generuIIy (I.e., wIeLIer un ucLIve smoker, u pregnunL nonsmoker exposed
Lo ETS, or u newborn buby exposed Lo ETS), does kIII bubIes.
urLIermore, LIIs kIIIIng Is produced by u generuI cuusuI propensILy oI
smoke uLLrIbuLes IndependenL oI endogenous sysLem vurIuLIon (I.e.,
compIeLe exLernuIIzIng oI cuuse), und LIuL LIe deIInILIve mecIunIsm by
wIIcI cuusuLIon occurs Ius been IdenLIIIed. SucI u cIuIm Is dIsIonesL In
LIe exLreme, deIInquenL, deIuded, und LypIcuI oI LIe numerous
unLIsmokIng cIuIms LIuL uppeur on LIe ASH websILe. More recenLIy, LIere
ure cIuIms LIuL un ubnormuIILy In gene (SCNA) IuncLIon Is ussocIuLed
wILI Iong-QT syndrome In Iumun InIunLs (Hercld,Sun, November 16,
zoo1). No menLIon Is mude oI smokIng ussocIuLed wILI LIe geneLIc deIecL.
MosL ImporLunLIy, 1ourncl Wctch (GeneruI) (1qq8) noLes LIuL proIonged
QT Is u poor predIcLor oI SDS, I.e., mosL InIunLs wILI proIonged QT do
noL dIe oI SDS.
AguIn, LIIs conducL Is noL new Ior LIe unLIsmokIng menLuIILy.
ScruLInIzIng u vurIeLy oI unLIsmokIng movemenLs In 1qLI und zoLI-
cenLury BrILuIn, WuIker (1q8o) IndIcuLes: |T|Ie zeuIoLs IndIscrImInuLeIy
dIIIused LIe mosL exLruvugunL usserLIons oI obscure medIco-
LobuccopIobes. (p.q6) MonomunIucuI groups, by deIInILIon, Iuve no
332
332
Rampant Antismoking Signifies Grave Danger
greuLer-conLexL perspecLIve or coIerenL moruI Irumework. TIe
monomunIu reIIecLs un ucuLe IIxuLIon und, LIereIore, ucuLe menLuI bIocks
Lo uny conLrury InIormuLIon. TIe very IucL LIuL groups sucI us ASH
promoLe LIemseIves us moruI guurdIuns oI socIeLy, generuIIy, und
cIIIdren, specIIIcuIIy, reIIecLs LIe IeIgILs oI urrogunce und IuugILIness,
und deIusIons oI superIorILy. TIe menLuIILy demonsLruLes no compeLence
In uny Lerms - scIenLIIIcuIIy, psycIoIogIcuIIy, socIuIIy, or moruIIy. TIeIr
cIuIms Iuck LIe mosL busIc eIemenL oI IonesLy und cun IosLer onIy IuIse
beIIeI (supersLILIon) LIrougI Ieur und guIIL-mongerIng. n workIng Lo
deIuded gouIs, LIrougI equuIIy deIuded meuns, IL Is sucI groups LIuL
ussuuIL LIe psycIoIogIcuI, socIuI, und moruI IeuILI oI cIIIdren, udoIescenLs
und uduILs, und smokers und nonsmokers uIIke, us u muLLer oI course. L Is
LIe conducL oI sucI groups LIuL Is In urgenL need oI crILIcuI scruLIny.
L Ius uIso been consIdered LIuL IL Is LIe scIenLIIIcJsLuLIsLIcuI
IncompeLence und muLerIuIIsm oI IIIesLyIe epIdemIoIogy LIuL Ius
scIenLIIIcuIIy IegILImIzed LIe conducL oI purLIcuIurIy unLIsmokIng Iobby
groups. SInce LIe IuLe-1q8o`s und cuImInuLIng In EPA (1qq), LIe Iocus oI
medIco-muLerIuIIsm`s unLIsmokIng sLunce Ius Iocused predomInunLIy on
nonsmokers. TIere Is now u pIeLIoru oI epIdemIoIogIc sLudIes uLLempLIng
Lo evuIuuLe LIe eIIecLs oI ETS exposure In pregnunL nonsmokers und LIe
cIIIdren oI nonsmokers. n LIIs regurd, und In workIng Lo IIxed
concIusIons, LIe sLundurd oI epIdemIoIogIc reseurcI, wIIcI wus poor Lo
begIn wILI, Ius progressIveIy degeneruLed. or exumpIe, um eL uI. (zoo1)
uLLempLed Lo exumIne LIe eIIecLs oI ETS on IeuILI servIces use In
CIInese InIunLs wILI nonsmokIng moLIers. AILer udjusLIng Ior u smuII
group oI poLenLIuI conIounders LIey Iound LIuL:
ETS exposure LIrougI LIe moLIer In uLero wus
posILIveIy ussocIuLed wILI IIgIer consuILuLIon (udjusLed
odds ruLIo |OR| = 1.z6) und IospILuIIzuLIon (OR = 1.18)
use In InIunLs wILI nonsmokIng moLIers uLLrIbuLubIe Lo
uny IIIness. n uddILIon, posLnuLuI exposure Lo ETS
exposure uL Iome wus IInked Lo IIgIer ruLes oI
IospILuIIzuLIons Ior uny IIIness compured wILI non-
exposed InIunLs (OR = 1.1z), uILIougI LIe reIuLIonsIIp
dId noL IoId Ior ouLpuLIenL consuILuLIon vIsILs. TIe OR
Ior IIgIer IospILuI use In InIunLs exposed Lo z or more
smokers uL Iome wus 1.o. (p.eq1)
TIe reIuLIve-rIsk ussocIuLIons ure very smuII (bureIy ubove 1.o) -
weII beIow LIe poor epIdemIoIogIc sLundurd oI z.o-q.o Ior weuk
ussocIuLIons. TIe proporLIon oI LIe overuII groups presenLIng on LIe
experImenLuI meusures Is noL IndIcuLed; predIcLIve sLrengLI oI ETS Ior uny
Preventive Medicine & Health Promotion
IucLor does noL IIgure In LIe reckonIng. TIese resuILs IndIcuLe smuII
subgroup dIIIerences wILIIn LIe Lwo overuII groups und, LIereIore, no
generuI proposILIon ubouL ETS cun be jusLIIIed. TIere muy be numerous
oLIer IucLors LIuL cun Iur more uccuruLeIy dIscern LIe subgroups In
quesLIon. OI LIe muILILude oI IucLors LIuL mIgIL be reIevunL (see prevIous
secLIon), conLemporury reseurcI musL uIso uccounL Ior poLenLIuI nocebo
eIIecLs LIuL cun be generuLed by purenLs oI exposed cIIIdren (I.e.,
IuLrogenIc eIIecL) und rIsk-uverse quuIILIes In u subgroup oI LIe
nonsmokersJnonexposed group. urLIermore, LIe OR`s reIer Lo
consuILuLIons und IospILuIIzuLIons Ior cn IIIness. L Is uncIeur wIuL LIe c
priori jusLIIIcuLIon Ior sucI un expecLuLIon Is. UILImuLeIy, one wouId noL
muke uII Loo mucI oI LIese IIndIngs.
YeL, um eL uI. (zoo1) concIude:
TIe use oI Lobucco producLs by IouseIoId members,
even umong nonsmokIng moLIers, Ius un enormous
udverse ImpucL on LIe IeuILI oI cIIIdren, us weII us
Increuses IeuILI servIces use und cosL. TIe presenL duLu
supporL LIe revIsIon oI pubIIc poIIcy Lo reIIecL un
evIdence-bused upproucI Lo LIe promoLIon oI smokIng
cessuLIon In uII IouseIoId members durIng und uILer
pregnuncy.
SmuII rIsk ruLIos LIuL ure InILIuIIy reIerred Lo us IInks und
correIuLIons ure suddenIy, und mugIcuIIy, LrunsIormed InLo IndIcuLors
oI cuuse und eIIecL. Moreover, LIese LIny reIuLIve rIsk ruLIos, IeL uIone
predIcLIve sLrengLI, become un enormous udverse ImpucL on LIe IeuILI oI
cIIIdren. UndersLundubIy, LIere Is LIen u cuII Ior wIdespreud unLIsmokIng
poIIcy. TIIs sorL oI reseurcI Is workIng Lo InsLILuLIonuIIzed concIusIons
und Is deIInquenL. TIe sLundurd Ius become so poor LIuL uny sLuLIsLIcuIIy-
sIgnIIIcunL reIuLIve-rIsk Increuse ussocIuLed wILI smokIng or ETS, Iowever
smuII und wIeLIer LIere Is uny rIyme or reuson Lo purLIcuIur sLuLIsLIcuI
ussocIuLIons, Is cuLusLropIIzed InLo u cuuseJeIIecL reIuLIonsIIp und InLo
LIe need Ior socIuI upIeuvuI. TIIs conducL Is noL scIence buL LesLImony Lo
LIe sIeer Iuck oI genuIne scIoIursIIp, purLIcuIurIy In muILIdImensIonuI
Lerms, In epIdemIoIogIc reseurcI. As Ius uIreudy been consIdered, LIe
over-InLerpreLuLIon begun by epIdemIoIogy Is LIen brougIL Lo un exLreme
by monomunIucuI Iobby groups. L Is uIso very LypIcuI oI LIe poInL Lo wIIcI
unLIsmokIng rIeLorIc degeneruLes. TIe unLecedenL oI smokIng, und now
LIe unLecedenL oI exposure Lo envIronmenLuI Lobucco smoke, becomes un
expIuIn uII uILer LIe IucL, I.e., post hoc expIunuLIons.
(. Post-EPA (:pp)
333
333
Rampant Antismoking Signifies Grave Danger
greuLer-conLexL perspecLIve or coIerenL moruI Irumework. TIe
monomunIu reIIecLs un ucuLe IIxuLIon und, LIereIore, ucuLe menLuI bIocks
Lo uny conLrury InIormuLIon. TIe very IucL LIuL groups sucI us ASH
promoLe LIemseIves us moruI guurdIuns oI socIeLy, generuIIy, und
cIIIdren, specIIIcuIIy, reIIecLs LIe IeIgILs oI urrogunce und IuugILIness,
und deIusIons oI superIorILy. TIe menLuIILy demonsLruLes no compeLence
In uny Lerms - scIenLIIIcuIIy, psycIoIogIcuIIy, socIuIIy, or moruIIy. TIeIr
cIuIms Iuck LIe mosL busIc eIemenL oI IonesLy und cun IosLer onIy IuIse
beIIeI (supersLILIon) LIrougI Ieur und guIIL-mongerIng. n workIng Lo
deIuded gouIs, LIrougI equuIIy deIuded meuns, IL Is sucI groups LIuL
ussuuIL LIe psycIoIogIcuI, socIuI, und moruI IeuILI oI cIIIdren, udoIescenLs
und uduILs, und smokers und nonsmokers uIIke, us u muLLer oI course. L Is
LIe conducL oI sucI groups LIuL Is In urgenL need oI crILIcuI scruLIny.
L Ius uIso been consIdered LIuL IL Is LIe scIenLIIIcJsLuLIsLIcuI
IncompeLence und muLerIuIIsm oI IIIesLyIe epIdemIoIogy LIuL Ius
scIenLIIIcuIIy IegILImIzed LIe conducL oI purLIcuIurIy unLIsmokIng Iobby
groups. SInce LIe IuLe-1q8o`s und cuImInuLIng In EPA (1qq), LIe Iocus oI
medIco-muLerIuIIsm`s unLIsmokIng sLunce Ius Iocused predomInunLIy on
nonsmokers. TIere Is now u pIeLIoru oI epIdemIoIogIc sLudIes uLLempLIng
Lo evuIuuLe LIe eIIecLs oI ETS exposure In pregnunL nonsmokers und LIe
cIIIdren oI nonsmokers. n LIIs regurd, und In workIng Lo IIxed
concIusIons, LIe sLundurd oI epIdemIoIogIc reseurcI, wIIcI wus poor Lo
begIn wILI, Ius progressIveIy degeneruLed. or exumpIe, um eL uI. (zoo1)
uLLempLed Lo exumIne LIe eIIecLs oI ETS on IeuILI servIces use In
CIInese InIunLs wILI nonsmokIng moLIers. AILer udjusLIng Ior u smuII
group oI poLenLIuI conIounders LIey Iound LIuL:
ETS exposure LIrougI LIe moLIer In uLero wus
posILIveIy ussocIuLed wILI IIgIer consuILuLIon (udjusLed
odds ruLIo |OR| = 1.z6) und IospILuIIzuLIon (OR = 1.18)
use In InIunLs wILI nonsmokIng moLIers uLLrIbuLubIe Lo
uny IIIness. n uddILIon, posLnuLuI exposure Lo ETS
exposure uL Iome wus IInked Lo IIgIer ruLes oI
IospILuIIzuLIons Ior uny IIIness compured wILI non-
exposed InIunLs (OR = 1.1z), uILIougI LIe reIuLIonsIIp
dId noL IoId Ior ouLpuLIenL consuILuLIon vIsILs. TIe OR
Ior IIgIer IospILuI use In InIunLs exposed Lo z or more
smokers uL Iome wus 1.o. (p.eq1)
TIe reIuLIve-rIsk ussocIuLIons ure very smuII (bureIy ubove 1.o) -
weII beIow LIe poor epIdemIoIogIc sLundurd oI z.o-q.o Ior weuk
ussocIuLIons. TIe proporLIon oI LIe overuII groups presenLIng on LIe
experImenLuI meusures Is noL IndIcuLed; predIcLIve sLrengLI oI ETS Ior uny
Preventive Medicine & Health Promotion
IucLor does noL IIgure In LIe reckonIng. TIese resuILs IndIcuLe smuII
subgroup dIIIerences wILIIn LIe Lwo overuII groups und, LIereIore, no
generuI proposILIon ubouL ETS cun be jusLIIIed. TIere muy be numerous
oLIer IucLors LIuL cun Iur more uccuruLeIy dIscern LIe subgroups In
quesLIon. OI LIe muILILude oI IucLors LIuL mIgIL be reIevunL (see prevIous
secLIon), conLemporury reseurcI musL uIso uccounL Ior poLenLIuI nocebo
eIIecLs LIuL cun be generuLed by purenLs oI exposed cIIIdren (I.e.,
IuLrogenIc eIIecL) und rIsk-uverse quuIILIes In u subgroup oI LIe
nonsmokersJnonexposed group. urLIermore, LIe OR`s reIer Lo
consuILuLIons und IospILuIIzuLIons Ior cn IIIness. L Is uncIeur wIuL LIe c
priori jusLIIIcuLIon Ior sucI un expecLuLIon Is. UILImuLeIy, one wouId noL
muke uII Loo mucI oI LIese IIndIngs.
YeL, um eL uI. (zoo1) concIude:
TIe use oI Lobucco producLs by IouseIoId members,
even umong nonsmokIng moLIers, Ius un enormous
udverse ImpucL on LIe IeuILI oI cIIIdren, us weII us
Increuses IeuILI servIces use und cosL. TIe presenL duLu
supporL LIe revIsIon oI pubIIc poIIcy Lo reIIecL un
evIdence-bused upproucI Lo LIe promoLIon oI smokIng
cessuLIon In uII IouseIoId members durIng und uILer
pregnuncy.
SmuII rIsk ruLIos LIuL ure InILIuIIy reIerred Lo us IInks und
correIuLIons ure suddenIy, und mugIcuIIy, LrunsIormed InLo IndIcuLors
oI cuuse und eIIecL. Moreover, LIese LIny reIuLIve rIsk ruLIos, IeL uIone
predIcLIve sLrengLI, become un enormous udverse ImpucL on LIe IeuILI oI
cIIIdren. UndersLundubIy, LIere Is LIen u cuII Ior wIdespreud unLIsmokIng
poIIcy. TIIs sorL oI reseurcI Is workIng Lo InsLILuLIonuIIzed concIusIons
und Is deIInquenL. TIe sLundurd Ius become so poor LIuL uny sLuLIsLIcuIIy-
sIgnIIIcunL reIuLIve-rIsk Increuse ussocIuLed wILI smokIng or ETS, Iowever
smuII und wIeLIer LIere Is uny rIyme or reuson Lo purLIcuIur sLuLIsLIcuI
ussocIuLIons, Is cuLusLropIIzed InLo u cuuseJeIIecL reIuLIonsIIp und InLo
LIe need Ior socIuI upIeuvuI. TIIs conducL Is noL scIence buL LesLImony Lo
LIe sIeer Iuck oI genuIne scIoIursIIp, purLIcuIurIy In muILIdImensIonuI
Lerms, In epIdemIoIogIc reseurcI. As Ius uIreudy been consIdered, LIe
over-InLerpreLuLIon begun by epIdemIoIogy Is LIen brougIL Lo un exLreme
by monomunIucuI Iobby groups. L Is uIso very LypIcuI oI LIe poInL Lo wIIcI
unLIsmokIng rIeLorIc degeneruLes. TIe unLecedenL oI smokIng, und now
LIe unLecedenL oI exposure Lo envIronmenLuI Lobucco smoke, becomes un
expIuIn uII uILer LIe IucL, I.e., post hoc expIunuLIons.
(. Post-EPA (:pp)
334
334
Rampant Antismoking Signifies Grave Danger
rom LIe IoregoIng, IL cun be concIuded LIuL EPA (1qq) wus un
IdeoIogIcuIIy-moLIvuLed (muLerIuIIsL purILunIsm) InvesLIguLIon. Even jusL
LIe use oI poIILIco-IdeoIogIcuI Lerms sucI us InvoIunLury smokIng und
pussIve smokIng LIuL IILLer LIe reporL Irom begInnIng Lo end IndIcuLes
LIe unLIsmokIng sLunce oI LIe InvesLIguLIon. TIe reporL uIso IIgIIIgILs In
LIe exLreme LIe greuL IoIIIes LIuL ure IIIesLyIe epIdemIoIogy und rIsk-
ussessmenL procedures. TIe Lerm cuuse Is IIung ubouL wILI sIeer
reckIessness; In uII InsLunces LIe predIcLIve sLrengLI oI ETS Ior LIe specIIIc
IIInesses consIdered Is eIIecLIveIy zero. BeIng psycIoIogIcuIIy,
psycIosocIuIIy und moruIIy InepL, LIe muLerIuIIsL menLuIILy excIudes uII oI
LIese dImensIons Irom consIderuLIon. HuvIng done so, LIe menLuIILy Is
uIso compIeLeIy obIIvIous Lo LIe very severe rumIIIcuLIons oI ILs mIsguIded
concIusIons Ior psycIoIogIcuI, socIuI und moruI IeuILI, us wIII be
consIdered sIorLIy.
L sIouId uIso be noLed LIuL LIe workIng Lo u concIusIon Is u
conspIrucy oI Ignorunce. None oI LIe InvesLIguLIon wus concerned wILI un
uLLempL uL u genuIne undersLundIng oI ueLIoIogy oI dIseuse. TIe mosL
sImpIe-mInded unLIsmokIng concIusIons were ImmedIuLeIy druwn Ior uny
IIgIer reIuLIve-rIsk ussocIuLed wILI ETS exposure. However, LIe menLuIILy
Is so scIenLIIIcuIIy IncompeLenL und bound by LIe superIIcIuIILy oI
sLuLIsLIcuIIsm und muLerIuIIsm LIuL LIe InvesLIguLors wouId probubIy noL
Iuve LIe remoLesL Ideu oI LIe IoIIy InvoIved; IL Is IuIIy expecLed LIuL LIe
InvesLIguLors IIrmIy beIIeved LIuL LIey enguged In u coIerenL enquIry.
UnIorLunuLeIy, IL Is LIIs superIIcIuIILy LIuL mukes LIe menLuIILy IIgIIy
dungerous. TIe menLuIILy couId be generuLIng psycIo und psycIosocIuI
dysIuncLIon us u muLLer oI course, und yeL smIIe LIrougIouL beIIevIng LIuL
u greuL good Ius been conLrIbuLed Lo socIeLy.
AILIougI LIe BIIIey (1qq) enquIry IIgIIIgILed severe unomuIIes
und vIoIuLIons oI due process IeudIng Lo EPA (1qq), LIe concIusIons
LIereIn were noL IurLIer InvesLIguLed or even Ieurd oI uguIn. TIe reporL
wus sIeIved. EPA (1qq) wus workIng Lo un unLIsmokIng concIusIon LIuL
wus seL In LIe mId-Lo-IuLe-1q;o`s (see BerrIdge, 1qqq). RuLIer LIun u
dIrecL ussuuIL on smokers, LIe unLIsmokIng crusude Ius more recenLIy
Lurned ILs uLLenLIon onLo LIe nonsmoker. ALLempLIng Lo demonsLruLe
LIuL umbIenL Lobucco smoke Is dungerous Ior uII nonsmokers Iur beLLer
promoLes LIe IdeuI oI Lobucco erudIcuLIon LIun does onIy LIe beIILLIIng
und IumIIIuLIon oI LIe smoker.
TIe EPA concIusIons were IuIIy endorsed by LIe medIcuI
esLubIIsImenL und compIeLeIy consIsLenL wILI ILs smoke-Iree worId
poIIcy. L Is uIso u IogIcuI progressIon oI LIe muLerIuIIsL munIIesLo. OI
emInenL ImporLunce Lo LIIs dIscussIon Is LIe use Lo wIIcI LIe EPA
Preventive Medicine & Health Promotion
concIusIons Iuve been puL by so-cuIIed IeuILI uuLIorILIes. L musL be kepL
In mInd LIuL LIe predIcLIve sLrengLI oI ETS Ior uny oI LIe condILIons
consIdered In LIe reporL Is essenLIuIIy zero; mosL persons (qq+%) exposed
Lo ETS, cIIIdren or uduILs, did not demonsLruLe uny Increused sLuLIsLIcuI
ussocIuLIon wILI purLIcuIur muIudIes. TIe EPA concIusIons represenL over-
InLerpreLuLIon In LIe exLreme und ILs proIIered soIuLIons wIII
correspondIngIy be over-reucLIve In LIe exLreme.
oIIowIng ILs reporL, In mId-1qq LIe EPA reIeused
recommenduLIons Ior deuIIng wILI ETS:
EPA IIrmIy beIIeves LIuL LIe scIenLIIIc evIdence Is
suIIIcIenL Lo wurrunL ucLIons Lo proLecL nonsmokers
Irom InvoIunLury exposure Lo secondIund smoke.
AccordIngIy, we ure conducLIng u pubIIc ouLreucI
progrum Lo communIcuLe LIe IIndIngs oI LIe reporL Lo
LIe pubIIc.
n JuIy |1qq|, LIe Agency pubIIsIed u brocIure, WIuL
You Cun Do AbouL SecondIund Smoke, wIIcI specIIIes
ucLIons LIuL purenLs, decIsIon mukers, und buIIdIng
occupunLs cun Luke Lo proLecL nonsmokers, IncIudIng
cIIIdren, Irom Indoor exposure Lo secondIund smoke.
TIe brocIure uIso conLuIns u specIuI messuge Ior
smokers ubouL Iow LIey cun IeIp proLecL peopIe uround
LIem.
WIuL kInds oI ucLIons ure beIng udvIsed? TIe IoIIowIng
sLeps cun IeIp curb ETS exposure In LIe Iome, uL cIIId-
cure cenLers und scIooIs, In LIe workpIuce, und In
resLuurunLs und burs:
Don`L smoke In your Iome or permIL oLIers Lo do so.
I u IumIIy member smokes Indoors, we recommend
IncreusIng venLIIuLIon In LIe ureu by openIng wIndows
or usIng exIuusL Iuns. We uIso recommend LIuL
smokIng sIouId noL occur II cIIIdren ure presenL,
purLIcuIurIy II InIunLs und LoddIers. Buby-sILLers und
oLIers wIo work In LIe Iome sIouId noL be uIIowed Lo
smoke Indoors or neur cIIIdren.
Every orgunIzuLIon deuIIng wILI cIIIdren - scIooIs,
duycure IucIIILIes, und oLIer pIuces wIere cIIIdren
spend LIme - sIouId Iuve u smokIng poIIcy LIuL
proLecLs cIIIdren Irom exposure Lo ETS.
Every compuny sIouId Iuve u smokIng poIIcy LIuL
proLecLs nonsmokers Irom InvoIunLury exposure Lo
Lobucco smoke. Muny busInesses und orgunIzuLIons
335
335
Rampant Antismoking Signifies Grave Danger
rom LIe IoregoIng, IL cun be concIuded LIuL EPA (1qq) wus un
IdeoIogIcuIIy-moLIvuLed (muLerIuIIsL purILunIsm) InvesLIguLIon. Even jusL
LIe use oI poIILIco-IdeoIogIcuI Lerms sucI us InvoIunLury smokIng und
pussIve smokIng LIuL IILLer LIe reporL Irom begInnIng Lo end IndIcuLes
LIe unLIsmokIng sLunce oI LIe InvesLIguLIon. TIe reporL uIso IIgIIIgILs In
LIe exLreme LIe greuL IoIIIes LIuL ure IIIesLyIe epIdemIoIogy und rIsk-
ussessmenL procedures. TIe Lerm cuuse Is IIung ubouL wILI sIeer
reckIessness; In uII InsLunces LIe predIcLIve sLrengLI oI ETS Ior LIe specIIIc
IIInesses consIdered Is eIIecLIveIy zero. BeIng psycIoIogIcuIIy,
psycIosocIuIIy und moruIIy InepL, LIe muLerIuIIsL menLuIILy excIudes uII oI
LIese dImensIons Irom consIderuLIon. HuvIng done so, LIe menLuIILy Is
uIso compIeLeIy obIIvIous Lo LIe very severe rumIIIcuLIons oI ILs mIsguIded
concIusIons Ior psycIoIogIcuI, socIuI und moruI IeuILI, us wIII be
consIdered sIorLIy.
L sIouId uIso be noLed LIuL LIe workIng Lo u concIusIon Is u
conspIrucy oI Ignorunce. None oI LIe InvesLIguLIon wus concerned wILI un
uLLempL uL u genuIne undersLundIng oI ueLIoIogy oI dIseuse. TIe mosL
sImpIe-mInded unLIsmokIng concIusIons were ImmedIuLeIy druwn Ior uny
IIgIer reIuLIve-rIsk ussocIuLed wILI ETS exposure. However, LIe menLuIILy
Is so scIenLIIIcuIIy IncompeLenL und bound by LIe superIIcIuIILy oI
sLuLIsLIcuIIsm und muLerIuIIsm LIuL LIe InvesLIguLors wouId probubIy noL
Iuve LIe remoLesL Ideu oI LIe IoIIy InvoIved; IL Is IuIIy expecLed LIuL LIe
InvesLIguLors IIrmIy beIIeved LIuL LIey enguged In u coIerenL enquIry.
UnIorLunuLeIy, IL Is LIIs superIIcIuIILy LIuL mukes LIe menLuIILy IIgIIy
dungerous. TIe menLuIILy couId be generuLIng psycIo und psycIosocIuI
dysIuncLIon us u muLLer oI course, und yeL smIIe LIrougIouL beIIevIng LIuL
u greuL good Ius been conLrIbuLed Lo socIeLy.
AILIougI LIe BIIIey (1qq) enquIry IIgIIIgILed severe unomuIIes
und vIoIuLIons oI due process IeudIng Lo EPA (1qq), LIe concIusIons
LIereIn were noL IurLIer InvesLIguLed or even Ieurd oI uguIn. TIe reporL
wus sIeIved. EPA (1qq) wus workIng Lo un unLIsmokIng concIusIon LIuL
wus seL In LIe mId-Lo-IuLe-1q;o`s (see BerrIdge, 1qqq). RuLIer LIun u
dIrecL ussuuIL on smokers, LIe unLIsmokIng crusude Ius more recenLIy
Lurned ILs uLLenLIon onLo LIe nonsmoker. ALLempLIng Lo demonsLruLe
LIuL umbIenL Lobucco smoke Is dungerous Ior uII nonsmokers Iur beLLer
promoLes LIe IdeuI oI Lobucco erudIcuLIon LIun does onIy LIe beIILLIIng
und IumIIIuLIon oI LIe smoker.
TIe EPA concIusIons were IuIIy endorsed by LIe medIcuI
esLubIIsImenL und compIeLeIy consIsLenL wILI ILs smoke-Iree worId
poIIcy. L Is uIso u IogIcuI progressIon oI LIe muLerIuIIsL munIIesLo. OI
emInenL ImporLunce Lo LIIs dIscussIon Is LIe use Lo wIIcI LIe EPA
Preventive Medicine & Health Promotion
concIusIons Iuve been puL by so-cuIIed IeuILI uuLIorILIes. L musL be kepL
In mInd LIuL LIe predIcLIve sLrengLI oI ETS Ior uny oI LIe condILIons
consIdered In LIe reporL Is essenLIuIIy zero; mosL persons (qq+%) exposed
Lo ETS, cIIIdren or uduILs, did not demonsLruLe uny Increused sLuLIsLIcuI
ussocIuLIon wILI purLIcuIur muIudIes. TIe EPA concIusIons represenL over-
InLerpreLuLIon In LIe exLreme und ILs proIIered soIuLIons wIII
correspondIngIy be over-reucLIve In LIe exLreme.
oIIowIng ILs reporL, In mId-1qq LIe EPA reIeused
recommenduLIons Ior deuIIng wILI ETS:
EPA IIrmIy beIIeves LIuL LIe scIenLIIIc evIdence Is
suIIIcIenL Lo wurrunL ucLIons Lo proLecL nonsmokers
Irom InvoIunLury exposure Lo secondIund smoke.
AccordIngIy, we ure conducLIng u pubIIc ouLreucI
progrum Lo communIcuLe LIe IIndIngs oI LIe reporL Lo
LIe pubIIc.
n JuIy |1qq|, LIe Agency pubIIsIed u brocIure, WIuL
You Cun Do AbouL SecondIund Smoke, wIIcI specIIIes
ucLIons LIuL purenLs, decIsIon mukers, und buIIdIng
occupunLs cun Luke Lo proLecL nonsmokers, IncIudIng
cIIIdren, Irom Indoor exposure Lo secondIund smoke.
TIe brocIure uIso conLuIns u specIuI messuge Ior
smokers ubouL Iow LIey cun IeIp proLecL peopIe uround
LIem.
WIuL kInds oI ucLIons ure beIng udvIsed? TIe IoIIowIng
sLeps cun IeIp curb ETS exposure In LIe Iome, uL cIIId-
cure cenLers und scIooIs, In LIe workpIuce, und In
resLuurunLs und burs:
Don`L smoke In your Iome or permIL oLIers Lo do so.
I u IumIIy member smokes Indoors, we recommend
IncreusIng venLIIuLIon In LIe ureu by openIng wIndows
or usIng exIuusL Iuns. We uIso recommend LIuL
smokIng sIouId noL occur II cIIIdren ure presenL,
purLIcuIurIy II InIunLs und LoddIers. Buby-sILLers und
oLIers wIo work In LIe Iome sIouId noL be uIIowed Lo
smoke Indoors or neur cIIIdren.
Every orgunIzuLIon deuIIng wILI cIIIdren - scIooIs,
duycure IucIIILIes, und oLIer pIuces wIere cIIIdren
spend LIme - sIouId Iuve u smokIng poIIcy LIuL
proLecLs cIIIdren Irom exposure Lo ETS.
Every compuny sIouId Iuve u smokIng poIIcy LIuL
proLecLs nonsmokers Irom InvoIunLury exposure Lo
Lobucco smoke. Muny busInesses und orgunIzuLIons
336
336
Rampant Antismoking Signifies Grave Danger
uIreudy Iuve poIIcIes In pIuce und more und more ure
InsLILuLIng LIem, buL LIese poIIcIes vury In eIIecLIveness.
SImpIy sepuruLIng smokers und nonsmokers wILIIn LIe
sume ureu, sucI us u cuIeLerIu, wIII sLIII expose
nonsmokers Lo recIrcuIuLed smoke und Lo smoke
drIILIng In Irom smokIng ureus. nsLeud, compunIes
sIouId eILIer proIIbIL smokIng Indoors or IImIL
smokIng Lo rooms LIuL Iuve been specIuIIy desIgned Lo
prevenL smoke Irom escupIng Lo oLIer ureus oI LIe
buIIdIng.
I smokIng Is permILLed In u resLuurunL or u bur ,
smokIng ureus sIouId be IocuLed In weII-venLIIuLed
ureus so nonsmokers wIII Iuce Iess exposure. More und
more resLuurunLs und resLuurunL cIuIns ure proIIbILIng
smokIng In LIeIr IucIIILIes, und cILIes und counLrIes
ucross LIe UnILed SLuLes ure resLrIcLIng smokIng In
resLuurunLs wILIIn LIeIr jurIsdIcLIons.
EPA wIII be pubIIsIIng guIdunce Lo IeIp orgunIzuLIons
esLubIIsI smokIng poIIcIes In Indoor envIronmenLs.
ProvIdIng our cIIIdren und LIe pubIIc wILI u smoke-Iree
envIronmenL musL be u nuLIonuI prIorILy.
A 1z-mInuLe vIdeo enLILIed 'PoIsonIng Your CIIIdren:
TIe PerIIs oI SecondIund Smoke` Is uvuIIubIe Irom
LIe....(uL www.epu.govJdocsJepujrnuIJIuIIqJ
brown1.LxL.ILmI)
TIese recommenduLIons were uIso Lo be Iound In LIe
ImproperIy generuLed IucL sIeeL LIuL LIe EPA Iud been cIrcuIuLIng Iong
beIore 1qq. Now, Iowever, IL Iud LIe seemIng sLump oI IuII scIenLIIIc
upprovuI. n LypIcuI cuLusLropIIzIng or uIondIsL, ubsoIuLIzIng IusIIon,
LIese recommenduLIons IndIcuLe LIuL cll nonsmokers, cIIIdren or uduILs,
sIouId be proLecLed Irom cll ETS, cll oI LIe LIme. TIIs Is LIe sorL oI
recommenduLIon LIuL one wouId expecL In LIe InsLunce oI nucIeur IuIIouL
or u nerve-gus Ieuk or LIe spreud oI u IIgIIy conLugIous dIseuse, und
cerLuInIy noL one concernIng u neur-zero-IeveI predIcLor oI muIudIes. TIe
recommenduLIons do noL reIIecL IucL, und In LIe exLreme. TIey uIso Iuve
IIgI poLenLIuI Ior nocebo eIIecLs LIuL IosLer socIuI dIvIsIon. n LIuL LIe
menLuIILy LIuL produced LIese recommenduLIons Is cIeurIy obIIvIous Lo uII
oI LIese IIgIIy probubIe rumIIIcuLIons, IL Is psycIoIogIcuIIy,
psycIosocIuIIy, und moruIIy dysIuncLIonuI. UndersLundubIy, uILIougI
unIorLunuLeIy, und us menLIoned eurIIer, LIe EPA reporL und ILs
recommenduLIons were LIe busIs Ior uII munner oI smokIng buns und
Preventive Medicine & Health Promotion
Increused propugundu ussuuILs on smokers und nonsmokers uIIke.
n u mosL crILIcuI sense, cuLusLropIIzuLIon reIIecLs und IosLers LIe
erroneous beIIeI LIuL InvoIunLury smokIng Is u cuuse oI dIseuse In heclth
nonsmokers. (Surgeon-GeneruI, 1q86) Browner (1qqq) IndIcuLes LIuL |T|
Iey |cIgureLLes| uIso LIreuLen LIe IeuILI oI cnone wIo Is even neur u
IIgILed cIgureLLe, especIuIIy cIIIdren. TIe unLIsmokIng IILeruLure Is
rIddIed wILI LIIs sorL oI conLorLed cIuIm. or exumpIe, on one
unLIsmokIng web sILe ('SAE` uL www.pucIIIcneL.neLJ-suIeJIIL.ILmI) cun
be Iound sucI sLuLemenLs: No one Is suIe II LIey ure breuLIIng
secondIund smoke (p.1); Lo ruIse LIe conscIousness oI LIe communILy
unLII IL becomes common knowIedge LIuL exposure Lo secondIund smoke
Is dungerous Ior eterone (p.18); we know Irom personuI experIence
LIuL wIen secondIund smoke Is presenL In u workpIuce, no one Is suIe.
Anone cun be Injured, dIsubIed, or deveIop u poLenLIuIIy IuLuI
IIIness. (p.18) n LIe quoLuLIons ubove, ILuIIcs Iuve been udded. Perske
(1qq) noLes LIuL u CenLer Ior DIseuse ConLroI udverL noL onIy reInIorces
LIe uII uL rIsk noLIon buL uIso uses IIgIIy exuggeruLed Iunguuge Lo depIcL
u quesLIonubIe RR vuIue bureIy ubove 1.oo:
DId you know LIuL II you`re exposed Lo secondIund
smoke wIere you work you`ve goL u q% cIunce
|RR=1.q| oI deveIopIng Iung cuncer? Thct's cn cujul
bi risl II you`re noL even LIe one doIng LIe smokIng.
TeII your empIoyer you wunL Lo work In u smoke-Iree
envIronmenL...Becuuse ue're cll ct risl. TIIs messuge
brougIL Lo you by LIe CDC und LIIs sLuLIon. |itclics
cdded|.
RegurdIng LIe deveIopmenL oI new IIIness, LIere Is no evIdence
LIuL supporLs LIuL ETS Is u cuuse oI uny specIIIc IIIness; uII duLu
deIInILIveIy dIsconIIrm sucI proposILIons. AII IndIcuLIons ure LIuL LIe
udequuLe processIng oI ETS by nonsmokers Is wILIIn u normuLIve runge oI
IuncLIonIng. TIere muy be u cuse LIuL ETS cun poLenLIuIIy ucL us u LrIgger
Ior u smuII subgroup oI nonsmokers wIo uIreudy Iuve purLIcuIur dIseuses
(e.g., usLImu). n sucI cIrcumsLunces, IL Is LIe nuLure oI LIe IIIness LIuL Is
beIng IIgIIIgILed und noL LIe generuI cuusuI propensILIes oI LIe
exogenous IucLor. TIIs subgroup reucLIvILy Is uLypIcuI und does noL reIIecL
u normuLIve runge oI IuncLIonIng. TIereIore, these nonsmolers cre not
otheruise heclth. n oLIer words, noL jusL unyone cun be uIIecLed by ETS
- II uL uII, und cerLuInIy noL oLIerwIse IeuILIy persons. TIere Is uIso LIe
uddILIonuI probIem LIuL persons LIuL ure uIreudy III cun enguge In IIIness
LIInkIng or beIuvIors LIuL ure IrruLIonuIIy overproLecLIve. SucI
pschoenic reucLIons muy be Iur more probIemuLIc In LIeIr IIIness
337
337
Rampant Antismoking Signifies Grave Danger
uIreudy Iuve poIIcIes In pIuce und more und more ure
InsLILuLIng LIem, buL LIese poIIcIes vury In eIIecLIveness.
SImpIy sepuruLIng smokers und nonsmokers wILIIn LIe
sume ureu, sucI us u cuIeLerIu, wIII sLIII expose
nonsmokers Lo recIrcuIuLed smoke und Lo smoke
drIILIng In Irom smokIng ureus. nsLeud, compunIes
sIouId eILIer proIIbIL smokIng Indoors or IImIL
smokIng Lo rooms LIuL Iuve been specIuIIy desIgned Lo
prevenL smoke Irom escupIng Lo oLIer ureus oI LIe
buIIdIng.
I smokIng Is permILLed In u resLuurunL or u bur ,
smokIng ureus sIouId be IocuLed In weII-venLIIuLed
ureus so nonsmokers wIII Iuce Iess exposure. More und
more resLuurunLs und resLuurunL cIuIns ure proIIbILIng
smokIng In LIeIr IucIIILIes, und cILIes und counLrIes
ucross LIe UnILed SLuLes ure resLrIcLIng smokIng In
resLuurunLs wILIIn LIeIr jurIsdIcLIons.
EPA wIII be pubIIsIIng guIdunce Lo IeIp orgunIzuLIons
esLubIIsI smokIng poIIcIes In Indoor envIronmenLs.
ProvIdIng our cIIIdren und LIe pubIIc wILI u smoke-Iree
envIronmenL musL be u nuLIonuI prIorILy.
A 1z-mInuLe vIdeo enLILIed 'PoIsonIng Your CIIIdren:
TIe PerIIs oI SecondIund Smoke` Is uvuIIubIe Irom
LIe....(uL www.epu.govJdocsJepujrnuIJIuIIqJ
brown1.LxL.ILmI)
TIese recommenduLIons were uIso Lo be Iound In LIe
ImproperIy generuLed IucL sIeeL LIuL LIe EPA Iud been cIrcuIuLIng Iong
beIore 1qq. Now, Iowever, IL Iud LIe seemIng sLump oI IuII scIenLIIIc
upprovuI. n LypIcuI cuLusLropIIzIng or uIondIsL, ubsoIuLIzIng IusIIon,
LIese recommenduLIons IndIcuLe LIuL cll nonsmokers, cIIIdren or uduILs,
sIouId be proLecLed Irom cll ETS, cll oI LIe LIme. TIIs Is LIe sorL oI
recommenduLIon LIuL one wouId expecL In LIe InsLunce oI nucIeur IuIIouL
or u nerve-gus Ieuk or LIe spreud oI u IIgIIy conLugIous dIseuse, und
cerLuInIy noL one concernIng u neur-zero-IeveI predIcLor oI muIudIes. TIe
recommenduLIons do noL reIIecL IucL, und In LIe exLreme. TIey uIso Iuve
IIgI poLenLIuI Ior nocebo eIIecLs LIuL IosLer socIuI dIvIsIon. n LIuL LIe
menLuIILy LIuL produced LIese recommenduLIons Is cIeurIy obIIvIous Lo uII
oI LIese IIgIIy probubIe rumIIIcuLIons, IL Is psycIoIogIcuIIy,
psycIosocIuIIy, und moruIIy dysIuncLIonuI. UndersLundubIy, uILIougI
unIorLunuLeIy, und us menLIoned eurIIer, LIe EPA reporL und ILs
recommenduLIons were LIe busIs Ior uII munner oI smokIng buns und
Preventive Medicine & Health Promotion
Increused propugundu ussuuILs on smokers und nonsmokers uIIke.
n u mosL crILIcuI sense, cuLusLropIIzuLIon reIIecLs und IosLers LIe
erroneous beIIeI LIuL InvoIunLury smokIng Is u cuuse oI dIseuse In heclth
nonsmokers. (Surgeon-GeneruI, 1q86) Browner (1qqq) IndIcuLes LIuL |T|
Iey |cIgureLLes| uIso LIreuLen LIe IeuILI oI cnone wIo Is even neur u
IIgILed cIgureLLe, especIuIIy cIIIdren. TIe unLIsmokIng IILeruLure Is
rIddIed wILI LIIs sorL oI conLorLed cIuIm. or exumpIe, on one
unLIsmokIng web sILe ('SAE` uL www.pucIIIcneL.neLJ-suIeJIIL.ILmI) cun
be Iound sucI sLuLemenLs: No one Is suIe II LIey ure breuLIIng
secondIund smoke (p.1); Lo ruIse LIe conscIousness oI LIe communILy
unLII IL becomes common knowIedge LIuL exposure Lo secondIund smoke
Is dungerous Ior eterone (p.18); we know Irom personuI experIence
LIuL wIen secondIund smoke Is presenL In u workpIuce, no one Is suIe.
Anone cun be Injured, dIsubIed, or deveIop u poLenLIuIIy IuLuI
IIIness. (p.18) n LIe quoLuLIons ubove, ILuIIcs Iuve been udded. Perske
(1qq) noLes LIuL u CenLer Ior DIseuse ConLroI udverL noL onIy reInIorces
LIe uII uL rIsk noLIon buL uIso uses IIgIIy exuggeruLed Iunguuge Lo depIcL
u quesLIonubIe RR vuIue bureIy ubove 1.oo:
DId you know LIuL II you`re exposed Lo secondIund
smoke wIere you work you`ve goL u q% cIunce
|RR=1.q| oI deveIopIng Iung cuncer? Thct's cn cujul
bi risl II you`re noL even LIe one doIng LIe smokIng.
TeII your empIoyer you wunL Lo work In u smoke-Iree
envIronmenL...Becuuse ue're cll ct risl. TIIs messuge
brougIL Lo you by LIe CDC und LIIs sLuLIon. |itclics
cdded|.
RegurdIng LIe deveIopmenL oI new IIIness, LIere Is no evIdence
LIuL supporLs LIuL ETS Is u cuuse oI uny specIIIc IIIness; uII duLu
deIInILIveIy dIsconIIrm sucI proposILIons. AII IndIcuLIons ure LIuL LIe
udequuLe processIng oI ETS by nonsmokers Is wILIIn u normuLIve runge oI
IuncLIonIng. TIere muy be u cuse LIuL ETS cun poLenLIuIIy ucL us u LrIgger
Ior u smuII subgroup oI nonsmokers wIo uIreudy Iuve purLIcuIur dIseuses
(e.g., usLImu). n sucI cIrcumsLunces, IL Is LIe nuLure oI LIe IIIness LIuL Is
beIng IIgIIIgILed und noL LIe generuI cuusuI propensILIes oI LIe
exogenous IucLor. TIIs subgroup reucLIvILy Is uLypIcuI und does noL reIIecL
u normuLIve runge oI IuncLIonIng. TIereIore, these nonsmolers cre not
otheruise heclth. n oLIer words, noL jusL unyone cun be uIIecLed by ETS
- II uL uII, und cerLuInIy noL oLIerwIse IeuILIy persons. TIere Is uIso LIe
uddILIonuI probIem LIuL persons LIuL ure uIreudy III cun enguge In IIIness
LIInkIng or beIuvIors LIuL ure IrruLIonuIIy overproLecLIve. SucI
pschoenic reucLIons muy be Iur more probIemuLIc In LIeIr IIIness
338
338
Rampant Antismoking Signifies Grave Danger
experIences LIun exogenous IucLors. TIese sorLs oI reucLIons wIII be
consIdered IuLer.
UnIorLunuLeIy, gIven LIe unLIsmokIng senLImenL LIuL InspIred
LIe EPA concIusIons, gIven LIuL nonsmoker vIcLIms provIdes
consIderubIe IegIsIuLIve und IeguI Ieveruge, und gIven LIe uIreudy IumIIIur
cuLusLropIIzuLIon LIuL weII cIurucLerIzes conLemporury IeuILI
promoLIon, IeuILI uuLIorILIes Iuve emburked on LIe deIuded underLukIng
oI convIncIng cll nonsmokers LIuL LIey ure cll In gruve dunger Irom cn
exposure Lo ETS. TIIs Is LIe munuIucLurIng oI supersLILIous beIIeI LIrougI
u mugIc powers urgumenL concernIng ETS; ETS Is mugIcuIIy Imbued
wILI powers LIuL cun cuuse uII munner oI IIIness In unyone uL unyLIme,
und wIen IL does (?) IL Is uIwuys In oLIerwIse IeuILIy nonsmokers. L wus
consIdered In un eurIIer cIupLer LIuL sucI LIInkIng Is LIe resuIL oI
epIdemIoIogy`s sLruddIIng oI boLI probubIIIsLIc und deLermInIsLIc
Irumeworks, vIoIuLIng cll LIe crILIcuI ussumpLIons oI boLI, I.e.,
dysIuncLIonuI, IncompeLenL InIerence.
n 1qq8, IIve yeurs uILer u Iuw suIL wus IIIed by LIe Lobucco
IndusLry, US DIsLrIcL CourL Judge W.. OsLeen InvuIIduLed EPA`s (1qq)
concIusIon LIuL secondIund smoke Is u Iumun curcInogen und, LIus,
vucuLed CIupLers 1 LIrougI 6 (und reIuLed AppendIces) oI LIe EPA ReporL
(1qq). AmongsL oLIer ImproprIeLy Judge OsLeen Iound LIuL EPA
pubIIcIy commILLed Lo u concIusIon beIore reseurcI Iud begun, excIuded
IndusLry by vIoIuLIng |sLuLuLory| proceduruI requIremenLs; udjusLed
esLubIIsIed procedure und scIenLIIIc norms Lo vuIIduLe LIe Agency's pubIIc
concIusIon, und uggressIveIy uLIIIzed |sLuLuLory| uuLIorILy Lo dIssemInuLe
IIndIngs Lo esLubIIsI u de IucLo reguIuLory scIeme InLended Lo resLrIcL
PIuInLIII's producLs und Lo InIIuence pubIIc opInIon; He uIso concIuded
LIuL In conducLIng LIe ETS RIsk AssessmenL, EPA dIsregurded
InIormuLIon und mude IIndIngs on seIecLIve InIormuLIon, dId noL
dIssemInuLe sIgnIIIcunL epIdemIoIogIc InIormuLIon; devIuLed Irom ILs RIsk
AssessmenL GuIdeIInes; IuIIed Lo dIscIose ImporLunL IIndIngs und
reusonIng; und IeIL sIgnIIIcunL quesLIons wILIouL unswers. EPA's conducL
IeIL subsLunLIuI IoIes In LIe udmInIsLruLIve record. WIIIe so doIng, EPA
produced IImILed evIdence, LIen cIuImed LIe weIgIL oI LIe Agency's
reseurcI evIdence demonsLruLed ETS cuuses cuncer. TIe OsLeen RuIIng
wus compIeLeIy consIsLenL wILI LIe IIndIngs oI BIIIey (1qq).
n LIe InLerIm, und even IoIIowIng LIe OsLeen RuIIng, LIe
unLIsmokIng bundwugon, unperLurbed by IucL or reuson, Ius conLInued In
ILs ussuuIL on psycIoIogIcuI und psycIosocIuI IeuILI. urLIermore, muny
oLIer udvIsoryJreguIuLory uuLIorILIes Iuve uIso conducLed
InvesLIguLIons InLo ETS (e.g., CuIIIornIu EPA, 1qq;; U.S. NuLIonuI
ToxIcoIogy Progrum, 1qqq; AusLruIIun NH&MRC, 1qq;; UK HeuILI
Preventive Medicine & Health Promotion
DepurLmenL, 1qq8). CuIJEPA und NTP reILeruLe EPA (1qq), cIussIIyIng
ETS us u Group A curcInogen. CuIJEPA uIso udds ETS us u cuuse oI
coronury IeurL dIseuse. TIese concIusIons ure deduced Irom more recenL
sLudIesJmeLu-unuIyses concernIng LIe sLuLIsLIcuI ussocIuLIon beLween ETS
und Iung cuncer, CHD, eLc.. ncreused reIuLIve rIsk oI Iung cuncer
ussocIuLed wILI ETS exposure Is LypIcuIIy beIow z.o; Ior exumpIe, RR=1.zq
(HucksIuw eL uI., 1qq;), und u more recenL CunudIun sLudy IndIcuLes
RR=1.z1 - 1.6 (JoInson eL uI., zoo1).
TIe Lwo mujor sLudIes InLo ETS und Iung cuncer, LIe
nLernuLIonuI Agency Ior ReseurcI on Cuncer sLudy (BoIIeLLu eL uI., 1qq8)
und LIe AmerIcun Cuncer SocIeLy sLudy ( Curdenus eL uI., 1qq;), LIe IuLLer
sLudy InvoIvIng u sumpIe sIze compurubIe Lo LIe combIned 6 sLudIes used
In EPA (1qq), Iound no sLuLIsLIcuIIy sIgnIIIcunL dIIIerences uILer
conLroIIIng Ior u IundIuI oI poLenLIuI conIounders. HucksIuw eL uI. (1qq;)
IncIuded LIe AmerIcun Cuncer SocIeLy sLudy In uddILIon Lo LIe orIgInuI 6
sLudIes. However, e unu`s (1qq8) crILIcIsm oI LIIs meLu-unuIysIs Is
IIgIIy reIevunL.
RegurdIng CHD, RR-Increuses ussocIuLed wILI ETS exposure ure
uIso LypIcuIIy beIow z.o; Ior exumpIe, RR=1.o (uw eL uI., 1qq;), RR=1.zo
(SLeenIund eL uI., 1qq6), und, more recenLIy, RR=1.z (He eL uI., 1qqq). n
un edILorIuI In The Neu Enlcnd 1ourncl oj Medicine, BuIIur (1qqq)
properIy noLes LIe very severe sIorLcomIngs oI meLu-unuIyses oI ETS und
CHD, und wILI specIIIc reIerence Lo He eL uI. (1qqq) wIIcI wus LIe mosL
recenL uLLempL uL meLu-unuIysIs: regreLIuIIy concIude LIuL we sLIII do
noL know, wILI uccurucy, Iow mucI or even wIeLIer exposure Lo
envIronmenLuI Lobucco smoke Increuses LIe rIsk oI coronury IeurL
dIseuse. (p.qq)
Evuns & BenneLL (1qq8) provIde u summury oI more recenL
IIndIngs (e.g., SLrucIun & Cook, 1qq;; Cook & SLrucIun, 1qq;; DIrunzu &
ew, 1qq6) concernIng cIIIdIood dIseuses. PurenLuI smokIng (exposure Lo
ETS) Is stctisticcll ussocIuLed wILI un Increused reIuLIve rIsk oI Iower
respIruLory LrucL IIIness: TIe pooIed odds ruLIo Ior eILIer purenL smokIng
Is 1.q8 und Ior muLernuI smokIng Is 1.6q. PurenLuI smokIng Is stctisticcll
ussocIuLed wILI un Increused reIuLIve rIsk oI usLImu und respIruLory
sympLoms (e.g., cougI, spuLum, wIeeze): TIe pooIed odds ruLIos Ior
eILIer purenL smokIng ure 1.z1 Ior usLImu; 1.zq Ior wIeeze; 1.qo Ior
cougI. PurenLuI smokIng Is stctisticcll ussocIuLed wILI mIddIe eur
dIseuse: TIe pooIed odds ruLIo Ior recurrenL oLILIs medIu II eILIer purenL
smokes Is 1.q1, und Ior mIddIe eur eIIusIon Is 1.8.
AguIn, RR dIIIerences ure LypIcuIIy weII beIow z.o. TIe cuusuI
evuIuuLIons oI LIese RR dIIIerences ure enLIreIy muLerIuIIsL In dIsposILIon
und do noL meeL even LIe exLremeIy poor requIremenLs oI usuuI
339
339
Rampant Antismoking Signifies Grave Danger
experIences LIun exogenous IucLors. TIese sorLs oI reucLIons wIII be
consIdered IuLer.
UnIorLunuLeIy, gIven LIe unLIsmokIng senLImenL LIuL InspIred
LIe EPA concIusIons, gIven LIuL nonsmoker vIcLIms provIdes
consIderubIe IegIsIuLIve und IeguI Ieveruge, und gIven LIe uIreudy IumIIIur
cuLusLropIIzuLIon LIuL weII cIurucLerIzes conLemporury IeuILI
promoLIon, IeuILI uuLIorILIes Iuve emburked on LIe deIuded underLukIng
oI convIncIng cll nonsmokers LIuL LIey ure cll In gruve dunger Irom cn
exposure Lo ETS. TIIs Is LIe munuIucLurIng oI supersLILIous beIIeI LIrougI
u mugIc powers urgumenL concernIng ETS; ETS Is mugIcuIIy Imbued
wILI powers LIuL cun cuuse uII munner oI IIIness In unyone uL unyLIme,
und wIen IL does (?) IL Is uIwuys In oLIerwIse IeuILIy nonsmokers. L wus
consIdered In un eurIIer cIupLer LIuL sucI LIInkIng Is LIe resuIL oI
epIdemIoIogy`s sLruddIIng oI boLI probubIIIsLIc und deLermInIsLIc
Irumeworks, vIoIuLIng cll LIe crILIcuI ussumpLIons oI boLI, I.e.,
dysIuncLIonuI, IncompeLenL InIerence.
n 1qq8, IIve yeurs uILer u Iuw suIL wus IIIed by LIe Lobucco
IndusLry, US DIsLrIcL CourL Judge W.. OsLeen InvuIIduLed EPA`s (1qq)
concIusIon LIuL secondIund smoke Is u Iumun curcInogen und, LIus,
vucuLed CIupLers 1 LIrougI 6 (und reIuLed AppendIces) oI LIe EPA ReporL
(1qq). AmongsL oLIer ImproprIeLy Judge OsLeen Iound LIuL EPA
pubIIcIy commILLed Lo u concIusIon beIore reseurcI Iud begun, excIuded
IndusLry by vIoIuLIng |sLuLuLory| proceduruI requIremenLs; udjusLed
esLubIIsIed procedure und scIenLIIIc norms Lo vuIIduLe LIe Agency's pubIIc
concIusIon, und uggressIveIy uLIIIzed |sLuLuLory| uuLIorILy Lo dIssemInuLe
IIndIngs Lo esLubIIsI u de IucLo reguIuLory scIeme InLended Lo resLrIcL
PIuInLIII's producLs und Lo InIIuence pubIIc opInIon; He uIso concIuded
LIuL In conducLIng LIe ETS RIsk AssessmenL, EPA dIsregurded
InIormuLIon und mude IIndIngs on seIecLIve InIormuLIon, dId noL
dIssemInuLe sIgnIIIcunL epIdemIoIogIc InIormuLIon; devIuLed Irom ILs RIsk
AssessmenL GuIdeIInes; IuIIed Lo dIscIose ImporLunL IIndIngs und
reusonIng; und IeIL sIgnIIIcunL quesLIons wILIouL unswers. EPA's conducL
IeIL subsLunLIuI IoIes In LIe udmInIsLruLIve record. WIIIe so doIng, EPA
produced IImILed evIdence, LIen cIuImed LIe weIgIL oI LIe Agency's
reseurcI evIdence demonsLruLed ETS cuuses cuncer. TIe OsLeen RuIIng
wus compIeLeIy consIsLenL wILI LIe IIndIngs oI BIIIey (1qq).
n LIe InLerIm, und even IoIIowIng LIe OsLeen RuIIng, LIe
unLIsmokIng bundwugon, unperLurbed by IucL or reuson, Ius conLInued In
ILs ussuuIL on psycIoIogIcuI und psycIosocIuI IeuILI. urLIermore, muny
oLIer udvIsoryJreguIuLory uuLIorILIes Iuve uIso conducLed
InvesLIguLIons InLo ETS (e.g., CuIIIornIu EPA, 1qq;; U.S. NuLIonuI
ToxIcoIogy Progrum, 1qqq; AusLruIIun NH&MRC, 1qq;; UK HeuILI
Preventive Medicine & Health Promotion
DepurLmenL, 1qq8). CuIJEPA und NTP reILeruLe EPA (1qq), cIussIIyIng
ETS us u Group A curcInogen. CuIJEPA uIso udds ETS us u cuuse oI
coronury IeurL dIseuse. TIese concIusIons ure deduced Irom more recenL
sLudIesJmeLu-unuIyses concernIng LIe sLuLIsLIcuI ussocIuLIon beLween ETS
und Iung cuncer, CHD, eLc.. ncreused reIuLIve rIsk oI Iung cuncer
ussocIuLed wILI ETS exposure Is LypIcuIIy beIow z.o; Ior exumpIe, RR=1.zq
(HucksIuw eL uI., 1qq;), und u more recenL CunudIun sLudy IndIcuLes
RR=1.z1 - 1.6 (JoInson eL uI., zoo1).
TIe Lwo mujor sLudIes InLo ETS und Iung cuncer, LIe
nLernuLIonuI Agency Ior ReseurcI on Cuncer sLudy (BoIIeLLu eL uI., 1qq8)
und LIe AmerIcun Cuncer SocIeLy sLudy ( Curdenus eL uI., 1qq;), LIe IuLLer
sLudy InvoIvIng u sumpIe sIze compurubIe Lo LIe combIned 6 sLudIes used
In EPA (1qq), Iound no sLuLIsLIcuIIy sIgnIIIcunL dIIIerences uILer
conLroIIIng Ior u IundIuI oI poLenLIuI conIounders. HucksIuw eL uI. (1qq;)
IncIuded LIe AmerIcun Cuncer SocIeLy sLudy In uddILIon Lo LIe orIgInuI 6
sLudIes. However, e unu`s (1qq8) crILIcIsm oI LIIs meLu-unuIysIs Is
IIgIIy reIevunL.
RegurdIng CHD, RR-Increuses ussocIuLed wILI ETS exposure ure
uIso LypIcuIIy beIow z.o; Ior exumpIe, RR=1.o (uw eL uI., 1qq;), RR=1.zo
(SLeenIund eL uI., 1qq6), und, more recenLIy, RR=1.z (He eL uI., 1qqq). n
un edILorIuI In The Neu Enlcnd 1ourncl oj Medicine, BuIIur (1qqq)
properIy noLes LIe very severe sIorLcomIngs oI meLu-unuIyses oI ETS und
CHD, und wILI specIIIc reIerence Lo He eL uI. (1qqq) wIIcI wus LIe mosL
recenL uLLempL uL meLu-unuIysIs: regreLIuIIy concIude LIuL we sLIII do
noL know, wILI uccurucy, Iow mucI or even wIeLIer exposure Lo
envIronmenLuI Lobucco smoke Increuses LIe rIsk oI coronury IeurL
dIseuse. (p.qq)
Evuns & BenneLL (1qq8) provIde u summury oI more recenL
IIndIngs (e.g., SLrucIun & Cook, 1qq;; Cook & SLrucIun, 1qq;; DIrunzu &
ew, 1qq6) concernIng cIIIdIood dIseuses. PurenLuI smokIng (exposure Lo
ETS) Is stctisticcll ussocIuLed wILI un Increused reIuLIve rIsk oI Iower
respIruLory LrucL IIIness: TIe pooIed odds ruLIo Ior eILIer purenL smokIng
Is 1.q8 und Ior muLernuI smokIng Is 1.6q. PurenLuI smokIng Is stctisticcll
ussocIuLed wILI un Increused reIuLIve rIsk oI usLImu und respIruLory
sympLoms (e.g., cougI, spuLum, wIeeze): TIe pooIed odds ruLIos Ior
eILIer purenL smokIng ure 1.z1 Ior usLImu; 1.zq Ior wIeeze; 1.qo Ior
cougI. PurenLuI smokIng Is stctisticcll ussocIuLed wILI mIddIe eur
dIseuse: TIe pooIed odds ruLIo Ior recurrenL oLILIs medIu II eILIer purenL
smokes Is 1.q1, und Ior mIddIe eur eIIusIon Is 1.8.
AguIn, RR dIIIerences ure LypIcuIIy weII beIow z.o. TIe cuusuI
evuIuuLIons oI LIese RR dIIIerences ure enLIreIy muLerIuIIsL In dIsposILIon
und do noL meeL even LIe exLremeIy poor requIremenLs oI usuuI
340
340
Rampant Antismoking Signifies Grave Danger
epIdemIoIogIc rIsk ussessmenL sLundurds, IeL uIone LIose oI sound cuusuI
urgumenL. Even wILIIn LIe very poor epIdemIoIogIc Irumework, LIere Is
severe over-InLerpreLuLIon oI IIndIngs wIere IL concerns ETS. OukIey
(1qqq) noLes un experImenL by CurIo eL uI... LIuL dIvIded some 1,q6o
epIdemIoIogIsLs, LoxIcoIogIsLs, pIysIcIuns und generuI scIenLIsLs InLo Lwo
groups. TIe IIrsL group wus reud u vIgneLLe LIuL reIIecLed 'muInsLreum`
scIenLIIIc LIInkIng on secondIund smoke. WIen querIed, ;o percenL oI LIe
scIenLIsLs und pIysIcIuns suId LIuL ETS wus u serIous envIronmenLuI
Iuzurd, und 8 percenL IeIL LIuL pubIIc IeuILI InLervenLIon wus necessury.
TIe second group wus reud LIe sume vIgneLLe, buL wus LoId LIuL IL Iud Lo
do wILI 'subsLunce X.` OnIy percenL oI LIese scIenLIsLs und pIysIcIuns
LIougIL LIuL 'subsLunce X` wus u serIous IeuILI Iuzurd, even LIougI IL wus
ucLuuIIy secondIund smoke, und onIy q1 percenL IeIL LIuL IL wurrunLed
pubIIc IeuILI reguIuLIon. (CI.;, p.zq) TIIs resuIL Is noL uL uII surprIsIng
gIven LIuL u smokeIree socIeLy or worId Ius been promoLed by medIcuI
oIIIcIuIdom Iong beIore LIe ETS sugu (e.g., C. EvereLL Koop, 1q8q). Muny
wILIIn LIe medIcuI esLubIIsImenL IoId exLreme, IIxed, neguLIve beIIeIs
regurdIng ETS. WIuLever LIese beIIeIs ure, LIey ure seII-munuIucLured
concocLIons LIuL Iuve no busIs In IucL, und cIeurIy IndIcuLe u menLuIIy
dysIuncLIonuI uspecL LIuL drIves u quesLIonubIe worId vIew und
InLerpreLuLIon.
HucksIuw eL uI. (1qq8) wIII serve Lo IIgIIIgIL LIe sIeer sImpIe-
mIndedness, IncompeLence, und dIsLurbIng sureLy LIuL cIurucLerIzes
conLemporury IeuILI (IIIesLyIe) reseurcI, purLIcuIurIy LIuL concernIng
Lobucco smoke. TIey concIude |n|on-smokers InIuIe curcInogens Irom
Lobucco smoke. CurcInogens In generuI Iuve no LIresIoId. Non-smokers
exposed Lo envIronmenLuI Lobucco smoke sIow un excess rIsk unexpIuIned
by bIus, commensuruLe wILI LIe exLenL oI exposure, wILI u dose-response
reIuLIon. TIe onIy reusonubIe concIusIon Is LIuL breuLIIng oLIer peopIe`s
smoke cuuses Iung cuncer. TIIs concIusIon Is bused on un RR=1.z6, LIe
predIcLIve sLrengLI oI ETS exposure Ior Iung cuncer Is eIIecLIveIy zero, und
onIy u IundIuI oI conIounders Iuve been consIdered In uII Iung cuncer
reseurcI.
L cun be suId wILI compIeLe conIIdence LIuL LIe ueLIoIogy oI Iung
cuncer In eILIer smokers or nonsmokers Is unknown; wIuLever LIe crILIcuI
IucLors ure Lo ueLIoIogy, uL LIIs poInL LIey Iuve noL been IdenLIIIed. n
uddILIon Lo LIe numerous InIerenLIuI IuIIucIes uIreudy InvoIved, HucksIuw
eL uI. (1qq8), umongsL muny oLIers, resorL Lo deIuuILIsm or u wIuL eIse
couId IL be urgumenL wIen uII eIse IuIIs. TIIs ussumes LIuL LIe IundIuI oI
conIounders consIdered In LIe reseurcI ure uccuruLe und exIuusLIve: BoLI
oI LIese ussumpLIons ure enLIreIy quesLIonubIe. SInce LIere Is sLIII un
excess reIuLIve-rIsk uILer LIese Iew conIounders Iuve been uccounLed Ior,
Preventive Medicine & Health Promotion
IL Is concIuded LIuL ETS, LIe onIy IucLor IeIL In LIIs puny upproucI, must
cuuse Iung cuncer, I.e., urgumenL by deIuuIL. RuLIer, LIe onIy reusonubIe
und IonesL concIusIon Is LIuL ETS Is un essenLIuIIy zero-IeveI predIcLor
(I.e., useIess) und LIuL LIe cuuse oI Iung cuncer Is unknown. TIe medIcuI
IILeruLure on IIIesLyIe dIseuses Is rIddIed wILI LIIs sorL oI erruLIc
reusonIng LIuL, unIorLunuLeIy, works Lo IIxed concIusIons.
TIe IoIIy oI Lobucco smoke musL cuuse uny Iung cuncer
urgumenL Is demonsLruLed by u number oI very recenL IIndIngs. or
exumpIe, purLIcuIur Ioods ure ussocIuLed wILI LIe deveIopmenL oI Iung
cuncer In nonsmokers noL exposed Lo Lobucco smoke. n u sLudy
InvesLIguLIng dIeLury IuL und Iung cuncer rIsk In Uruguuy Iound RR=z.8
Ior Ieuvy consumpLIon oI duIry producLs, RR=1.q Ior Ieuvy InLuke oI
IrIed Ioods, und RR=z.z Ior desserLs (sLudy cILed In The Dttcuc Citizen,
AugusL ;, 1qq;). ucLors sucI us body Lype, IumIIy IIsLory, LoLuI cuIorIc
InLuke, und smokIng were uccounLed Ior. AII LIese RR`s ure consIderubIy
IIgIer LIun ETS. AIevunju eL uI. (1qq) uIso Iound eIevuLed RR (up Lo
>6.o) oI Iung cuncer Ior suLuruLed IuL consumpLIon In nonsmokIng
women. AnoLIer exumpIe, Is LIe IIndIng LIuL very young cIIIdren, I.e.,
younger LIun Iour, ure deveIopIng skIn und Iung cuncers LIuL ure usuuIIy
conIIned Lo oIder uduILs. A newspuper urLIcIe InIorms: ExperLs ure buIIIed
by LIe cuuse oI Iung cuncers In cIIIdren, buL suy LIuL LIey ure unreIuLed Lo
uduIL smokIng-reIuLed Iung cuncer. ProIessor DuvId AsIIey, Ieud oI
IuemuLoIogy und oncoIogy uL MeIbourne`s RoyuI CIIIdren`s HospILuI, suId
Loo Iew cuses Iud been seen Lo IdenLIIy LIe cuuse. 'We don`L beIIeve IL`s
InIerILed, und we Iuven`L been ubIe Lo IdenLIIy un envIronmenLuI rIsk
IucLor`, Ie suId. (Hercld,Sun, November z6, zooz) TIere Is uIso LIe Issue
oI dIeseI emIssIons beIng ussocIuLed wILI Iung cuncer, RR=1.qo (EPA,
1qq8), uIso IIgIer LIun ETS.
L cun uIso be noLed LIuL LIe AusLruIIun NH&MRC revIew, Loo,
wus Luken Lo Lusk by LIe Lobucco IndusLry on muLLers oI ImproprIeLy.
JusLIce Inn (1qq6), oI LIe AusLruIIun ederuI CourL, concIuded
concernIng LIe NH&MRC druIL reporL on pussIve smokIng LIuL: L Is cIeur
LIuL LIe NH&MRC Ius IuIIen weII sIorL oI meeLIng . LIe obIIguLIon Lo
Iuve regurd Lo submIssIons receIved . Lo Luke LIem InLo uccounL und Lo
gIve posILIve consIderuLIon Lo LIeIr conLenLs us u IundumenLuI eIemenL In
ILs decIsIon mukIng.; LIe communILy Is noL Lo be excIuded Irom LIuL
purLIcIpuLIon sImpIy becuuse, Ior wIuLever reuson, LIe NH&MRC does noL
wIsI Lo gIve consIderuLIon Lo some purL oI LIe conLenLs oI submIssIons. L
Iud unIIuLeruIIy excIuded Irom consIderuLIon muLerIuI, wIIcI IL prevIousIy
Iud deLermIned Lo be reIevunL by vIrLue oI LIe Terms oI ReIerence IL Iud
upproved.; WIuL wus objecLIonubIe In wIuL LIe WorkIng PurLy dId wus
Lo udopL LIIs excIusIonury dIscrImInuLor wILIouL brIngIng Lo LIe noLIce oI
341
341
Rampant Antismoking Signifies Grave Danger
epIdemIoIogIc rIsk ussessmenL sLundurds, IeL uIone LIose oI sound cuusuI
urgumenL. Even wILIIn LIe very poor epIdemIoIogIc Irumework, LIere Is
severe over-InLerpreLuLIon oI IIndIngs wIere IL concerns ETS. OukIey
(1qqq) noLes un experImenL by CurIo eL uI... LIuL dIvIded some 1,q6o
epIdemIoIogIsLs, LoxIcoIogIsLs, pIysIcIuns und generuI scIenLIsLs InLo Lwo
groups. TIe IIrsL group wus reud u vIgneLLe LIuL reIIecLed 'muInsLreum`
scIenLIIIc LIInkIng on secondIund smoke. WIen querIed, ;o percenL oI LIe
scIenLIsLs und pIysIcIuns suId LIuL ETS wus u serIous envIronmenLuI
Iuzurd, und 8 percenL IeIL LIuL pubIIc IeuILI InLervenLIon wus necessury.
TIe second group wus reud LIe sume vIgneLLe, buL wus LoId LIuL IL Iud Lo
do wILI 'subsLunce X.` OnIy percenL oI LIese scIenLIsLs und pIysIcIuns
LIougIL LIuL 'subsLunce X` wus u serIous IeuILI Iuzurd, even LIougI IL wus
ucLuuIIy secondIund smoke, und onIy q1 percenL IeIL LIuL IL wurrunLed
pubIIc IeuILI reguIuLIon. (CI.;, p.zq) TIIs resuIL Is noL uL uII surprIsIng
gIven LIuL u smokeIree socIeLy or worId Ius been promoLed by medIcuI
oIIIcIuIdom Iong beIore LIe ETS sugu (e.g., C. EvereLL Koop, 1q8q). Muny
wILIIn LIe medIcuI esLubIIsImenL IoId exLreme, IIxed, neguLIve beIIeIs
regurdIng ETS. WIuLever LIese beIIeIs ure, LIey ure seII-munuIucLured
concocLIons LIuL Iuve no busIs In IucL, und cIeurIy IndIcuLe u menLuIIy
dysIuncLIonuI uspecL LIuL drIves u quesLIonubIe worId vIew und
InLerpreLuLIon.
HucksIuw eL uI. (1qq8) wIII serve Lo IIgIIIgIL LIe sIeer sImpIe-
mIndedness, IncompeLence, und dIsLurbIng sureLy LIuL cIurucLerIzes
conLemporury IeuILI (IIIesLyIe) reseurcI, purLIcuIurIy LIuL concernIng
Lobucco smoke. TIey concIude |n|on-smokers InIuIe curcInogens Irom
Lobucco smoke. CurcInogens In generuI Iuve no LIresIoId. Non-smokers
exposed Lo envIronmenLuI Lobucco smoke sIow un excess rIsk unexpIuIned
by bIus, commensuruLe wILI LIe exLenL oI exposure, wILI u dose-response
reIuLIon. TIe onIy reusonubIe concIusIon Is LIuL breuLIIng oLIer peopIe`s
smoke cuuses Iung cuncer. TIIs concIusIon Is bused on un RR=1.z6, LIe
predIcLIve sLrengLI oI ETS exposure Ior Iung cuncer Is eIIecLIveIy zero, und
onIy u IundIuI oI conIounders Iuve been consIdered In uII Iung cuncer
reseurcI.
L cun be suId wILI compIeLe conIIdence LIuL LIe ueLIoIogy oI Iung
cuncer In eILIer smokers or nonsmokers Is unknown; wIuLever LIe crILIcuI
IucLors ure Lo ueLIoIogy, uL LIIs poInL LIey Iuve noL been IdenLIIIed. n
uddILIon Lo LIe numerous InIerenLIuI IuIIucIes uIreudy InvoIved, HucksIuw
eL uI. (1qq8), umongsL muny oLIers, resorL Lo deIuuILIsm or u wIuL eIse
couId IL be urgumenL wIen uII eIse IuIIs. TIIs ussumes LIuL LIe IundIuI oI
conIounders consIdered In LIe reseurcI ure uccuruLe und exIuusLIve: BoLI
oI LIese ussumpLIons ure enLIreIy quesLIonubIe. SInce LIere Is sLIII un
excess reIuLIve-rIsk uILer LIese Iew conIounders Iuve been uccounLed Ior,
Preventive Medicine & Health Promotion
IL Is concIuded LIuL ETS, LIe onIy IucLor IeIL In LIIs puny upproucI, must
cuuse Iung cuncer, I.e., urgumenL by deIuuIL. RuLIer, LIe onIy reusonubIe
und IonesL concIusIon Is LIuL ETS Is un essenLIuIIy zero-IeveI predIcLor
(I.e., useIess) und LIuL LIe cuuse oI Iung cuncer Is unknown. TIe medIcuI
IILeruLure on IIIesLyIe dIseuses Is rIddIed wILI LIIs sorL oI erruLIc
reusonIng LIuL, unIorLunuLeIy, works Lo IIxed concIusIons.
TIe IoIIy oI Lobucco smoke musL cuuse uny Iung cuncer
urgumenL Is demonsLruLed by u number oI very recenL IIndIngs. or
exumpIe, purLIcuIur Ioods ure ussocIuLed wILI LIe deveIopmenL oI Iung
cuncer In nonsmokers noL exposed Lo Lobucco smoke. n u sLudy
InvesLIguLIng dIeLury IuL und Iung cuncer rIsk In Uruguuy Iound RR=z.8
Ior Ieuvy consumpLIon oI duIry producLs, RR=1.q Ior Ieuvy InLuke oI
IrIed Ioods, und RR=z.z Ior desserLs (sLudy cILed In The Dttcuc Citizen,
AugusL ;, 1qq;). ucLors sucI us body Lype, IumIIy IIsLory, LoLuI cuIorIc
InLuke, und smokIng were uccounLed Ior. AII LIese RR`s ure consIderubIy
IIgIer LIun ETS. AIevunju eL uI. (1qq) uIso Iound eIevuLed RR (up Lo
>6.o) oI Iung cuncer Ior suLuruLed IuL consumpLIon In nonsmokIng
women. AnoLIer exumpIe, Is LIe IIndIng LIuL very young cIIIdren, I.e.,
younger LIun Iour, ure deveIopIng skIn und Iung cuncers LIuL ure usuuIIy
conIIned Lo oIder uduILs. A newspuper urLIcIe InIorms: ExperLs ure buIIIed
by LIe cuuse oI Iung cuncers In cIIIdren, buL suy LIuL LIey ure unreIuLed Lo
uduIL smokIng-reIuLed Iung cuncer. ProIessor DuvId AsIIey, Ieud oI
IuemuLoIogy und oncoIogy uL MeIbourne`s RoyuI CIIIdren`s HospILuI, suId
Loo Iew cuses Iud been seen Lo IdenLIIy LIe cuuse. 'We don`L beIIeve IL`s
InIerILed, und we Iuven`L been ubIe Lo IdenLIIy un envIronmenLuI rIsk
IucLor`, Ie suId. (Hercld,Sun, November z6, zooz) TIere Is uIso LIe Issue
oI dIeseI emIssIons beIng ussocIuLed wILI Iung cuncer, RR=1.qo (EPA,
1qq8), uIso IIgIer LIun ETS.
L cun uIso be noLed LIuL LIe AusLruIIun NH&MRC revIew, Loo,
wus Luken Lo Lusk by LIe Lobucco IndusLry on muLLers oI ImproprIeLy.
JusLIce Inn (1qq6), oI LIe AusLruIIun ederuI CourL, concIuded
concernIng LIe NH&MRC druIL reporL on pussIve smokIng LIuL: L Is cIeur
LIuL LIe NH&MRC Ius IuIIen weII sIorL oI meeLIng . LIe obIIguLIon Lo
Iuve regurd Lo submIssIons receIved . Lo Luke LIem InLo uccounL und Lo
gIve posILIve consIderuLIon Lo LIeIr conLenLs us u IundumenLuI eIemenL In
ILs decIsIon mukIng.; LIe communILy Is noL Lo be excIuded Irom LIuL
purLIcIpuLIon sImpIy becuuse, Ior wIuLever reuson, LIe NH&MRC does noL
wIsI Lo gIve consIderuLIon Lo some purL oI LIe conLenLs oI submIssIons. L
Iud unIIuLeruIIy excIuded Irom consIderuLIon muLerIuI, wIIcI IL prevIousIy
Iud deLermIned Lo be reIevunL by vIrLue oI LIe Terms oI ReIerence IL Iud
upproved.; WIuL wus objecLIonubIe In wIuL LIe WorkIng PurLy dId wus
Lo udopL LIIs excIusIonury dIscrImInuLor wILIouL brIngIng Lo LIe noLIce oI
342
342
Rampant Antismoking Signifies Grave Danger
LIe pubIIc LIuL LIIs wus wIuL LIey were goIng Lo do. TIey mIsIed LIe
pubIIc; um prepured Lo concIude LIuL LIe WorkIng PurLy, Ience LIe
NH&MRC, IuIIed Lo Iuve regurd Lo LIe submIssIons receIved In prepurIng
LIe druIL recommenduLIons... um LIe more conIIdenL In urrIvIng uL LIIs
concIusIon gIven LIuL no member oI LIe WorkIng PurLy or oI LIe CouncII
cIose Lo gIve evIdence on LIe muLLer; Iuve concIuded LIuL LIe
NH&MRC Ius IuIIed In dIscIurgIng ILs sLuLuLory duLy oI pubIIc
consuILuLIon; LIuL IL dId noL gIve genuIne consIderuLIon Lo reIevunL
muLerIuI In LIe submIssIons mude Lo IL; und LIuL IL denIed LIe uppIIcunLs
Preventive Medicine & Health Promotion
proceduruI IuIrness.
n uddILIon Lo scunduIous IuIIures oI InLegrILy oI conducL und LIe
proIIIeruLIon oI reseurcI LIuL udds noLIIng Lo cuusuI urgumenL
wIuLsoever, wIuL Is mosL dIsLurbIng Is LIuL, wIIIe LIere Iuve been
uLLempLs (e.g., ILLIewood & enneII, 1qqq; GorI, 1qq), uIbeIL very Iew
Indeed, Lo cIuIIenge LIe IIgIIy quesLIonubIe unLIsmokIng conducL wILIIn
LIe sLundurd epIdemIoIogIcuI Irumework, LIere Is usuuIIy no menLIon
mude In LIe IILeruLure concernIng LIe ucLuuI requIremenLs oI cuusuI
urgumenL, I.e., predIcLIve sLrengLI. TIe reuI Lrugedy In LIIs InsLunce Is LIuL
u IucLor (ETS exposure) LIuL Ius vIrLuuIIy zero-IeveI predIcLIve sLrengLI Ior
specIIIc dIseuse (see Igure 6) Is depIcLed (cuLusLropIIzed) us u IIgI-IeveI
predIcLor; IL reIIecLs sLundurd upsIde-down reusonIng.
L Is purLIcuIurIy on LIe muLLer oI ETS, wIIcI Ius vIrLuuIIy zero-
IeveI predIcLIve sLrengLI Ior uny muIudy, In uddILIon Lo LIe exLreme
cupucILy oI poor sLundurd oI InIerence Lo IosLer psycIoIogIcuI und
psycIosocIuI dysIuncLIon on u muss scuIe, LIuL LIe Issue oI predIcLIve
sLrengLI wouId become gIurIngIy obvIous. L Is on LIIs poInL LIuL LIe
dungerous Iurce LIuL weII cIurucLerIzes IIIesLyIe epIdemIoIogy und
prevenLIve medIcIne couId IInuIIy be exposed. UnIorLunuLeIy sucI
evuIuuLIons IocussIng on LIe predIcLIve sLrengLI oI IucLors Ior IucLors ure
non-exIsLenL. TIe resuIL Ius been u wusLeIuI Lo-Ing und Iro-Ing wILIIn LIe
poor epIdemIoIogIc InIerenLIuI Irumework noL unIIke LIuL Ior ucLIve
smokIng over LIe 1q;o`s und 1q8o`s. And uIso very mucI IIke LIe
LreuLmenL oI ucLIve smokIng, cuusuI cIuIms ure now beIng mude Ior cn
sLuLIsLIcuIIy sIgnIIIcunL RR dIIIerence LIuL ETS Is ussocIuLed wILI, e.g.,
Iung cuncer, CHD, respIruLory IIInesses, sLrokes, SDS - regurdIess oI
rIyme or reuson., I.e., sLundurd MMES consensus eIIecL.
WILIIn Iess LIun u decude, und reIIecLIng u subversIon oI due
scIenLIIIc process und IIugrunL dIsregurd Ior muLLers oI menLuI und socIuI
IeuILI, LIe unLIsmokIng crusude Ius munuIucLured exposure Lo ETS us LIe
LIIrd IeudIng cuuse oI prevenLubIe deuLI beIInd ucLIve smokIng und
uIcoIoI consumpLIon. TIere Is urrIved uL, uguIn, u mugIc powers
urgumenL (I.e., supersLILIous beIIeI) wIere LIe mugIc mIsL oI ETS cun
cuuse uII munner oI IIIness In unyone uL uny LIme. AnoLIer wuy oI sLuLIng
LIIs conLorLed proposILIon Is LIuL Ior wIuLever muIudy LIuL ETS Ius
IIgIer RR`s, LIen II LIe muIudy occurs und II ETS exposure wus un
unLecedenL Lo LIe muIudy, LIen IL Is concIuded LIuL ETS wus LIe cuuse,
I.e., IuIIucy oI post hoc ero propter hoc. SucI supersLILIous, upsIde-down,
buck-Lo-IronL beIIeI meeLs none oI LIe requIremenLs oI coIerenL cuusuI
urgumenL, I.e., uLLerIy reckIess In LIe use oI cuusuI LermInoIogy. AIso oI
InLeresL Is LIuL LIe cctucl IeudIng cuuse oI prevenLubIe deuLI (IuLrogenIc)
- LIe medIcuI esLubIIsImenL - Is never reIerred Lo.
343
343
Rampant Antismoking Signifies Grave Danger
LIe pubIIc LIuL LIIs wus wIuL LIey were goIng Lo do. TIey mIsIed LIe
pubIIc; um prepured Lo concIude LIuL LIe WorkIng PurLy, Ience LIe
NH&MRC, IuIIed Lo Iuve regurd Lo LIe submIssIons receIved In prepurIng
LIe druIL recommenduLIons... um LIe more conIIdenL In urrIvIng uL LIIs
concIusIon gIven LIuL no member oI LIe WorkIng PurLy or oI LIe CouncII
cIose Lo gIve evIdence on LIe muLLer; Iuve concIuded LIuL LIe
NH&MRC Ius IuIIed In dIscIurgIng ILs sLuLuLory duLy oI pubIIc
consuILuLIon; LIuL IL dId noL gIve genuIne consIderuLIon Lo reIevunL
muLerIuI In LIe submIssIons mude Lo IL; und LIuL IL denIed LIe uppIIcunLs
Preventive Medicine & Health Promotion
proceduruI IuIrness.
n uddILIon Lo scunduIous IuIIures oI InLegrILy oI conducL und LIe
proIIIeruLIon oI reseurcI LIuL udds noLIIng Lo cuusuI urgumenL
wIuLsoever, wIuL Is mosL dIsLurbIng Is LIuL, wIIIe LIere Iuve been
uLLempLs (e.g., ILLIewood & enneII, 1qqq; GorI, 1qq), uIbeIL very Iew
Indeed, Lo cIuIIenge LIe IIgIIy quesLIonubIe unLIsmokIng conducL wILIIn
LIe sLundurd epIdemIoIogIcuI Irumework, LIere Is usuuIIy no menLIon
mude In LIe IILeruLure concernIng LIe ucLuuI requIremenLs oI cuusuI
urgumenL, I.e., predIcLIve sLrengLI. TIe reuI Lrugedy In LIIs InsLunce Is LIuL
u IucLor (ETS exposure) LIuL Ius vIrLuuIIy zero-IeveI predIcLIve sLrengLI Ior
specIIIc dIseuse (see Igure 6) Is depIcLed (cuLusLropIIzed) us u IIgI-IeveI
predIcLor; IL reIIecLs sLundurd upsIde-down reusonIng.
L Is purLIcuIurIy on LIe muLLer oI ETS, wIIcI Ius vIrLuuIIy zero-
IeveI predIcLIve sLrengLI Ior uny muIudy, In uddILIon Lo LIe exLreme
cupucILy oI poor sLundurd oI InIerence Lo IosLer psycIoIogIcuI und
psycIosocIuI dysIuncLIon on u muss scuIe, LIuL LIe Issue oI predIcLIve
sLrengLI wouId become gIurIngIy obvIous. L Is on LIIs poInL LIuL LIe
dungerous Iurce LIuL weII cIurucLerIzes IIIesLyIe epIdemIoIogy und
prevenLIve medIcIne couId IInuIIy be exposed. UnIorLunuLeIy sucI
evuIuuLIons IocussIng on LIe predIcLIve sLrengLI oI IucLors Ior IucLors ure
non-exIsLenL. TIe resuIL Ius been u wusLeIuI Lo-Ing und Iro-Ing wILIIn LIe
poor epIdemIoIogIc InIerenLIuI Irumework noL unIIke LIuL Ior ucLIve
smokIng over LIe 1q;o`s und 1q8o`s. And uIso very mucI IIke LIe
LreuLmenL oI ucLIve smokIng, cuusuI cIuIms ure now beIng mude Ior cn
sLuLIsLIcuIIy sIgnIIIcunL RR dIIIerence LIuL ETS Is ussocIuLed wILI, e.g.,
Iung cuncer, CHD, respIruLory IIInesses, sLrokes, SDS - regurdIess oI
rIyme or reuson., I.e., sLundurd MMES consensus eIIecL.
WILIIn Iess LIun u decude, und reIIecLIng u subversIon oI due
scIenLIIIc process und IIugrunL dIsregurd Ior muLLers oI menLuI und socIuI
IeuILI, LIe unLIsmokIng crusude Ius munuIucLured exposure Lo ETS us LIe
LIIrd IeudIng cuuse oI prevenLubIe deuLI beIInd ucLIve smokIng und
uIcoIoI consumpLIon. TIere Is urrIved uL, uguIn, u mugIc powers
urgumenL (I.e., supersLILIous beIIeI) wIere LIe mugIc mIsL oI ETS cun
cuuse uII munner oI IIIness In unyone uL uny LIme. AnoLIer wuy oI sLuLIng
LIIs conLorLed proposILIon Is LIuL Ior wIuLever muIudy LIuL ETS Ius
IIgIer RR`s, LIen II LIe muIudy occurs und II ETS exposure wus un
unLecedenL Lo LIe muIudy, LIen IL Is concIuded LIuL ETS wus LIe cuuse,
I.e., IuIIucy oI post hoc ero propter hoc. SucI supersLILIous, upsIde-down,
buck-Lo-IronL beIIeI meeLs none oI LIe requIremenLs oI coIerenL cuusuI
urgumenL, I.e., uLLerIy reckIess In LIe use oI cuusuI LermInoIogy. AIso oI
InLeresL Is LIuL LIe cctucl IeudIng cuuse oI prevenLubIe deuLI (IuLrogenIc)
- LIe medIcuI esLubIIsImenL - Is never reIerred Lo.
344
344
Rampant Antismoking Signifies Grave Danger
AILIougI none oI LIe requIremenLs oI coIerenL cuusuI urgumenL
Iuve been meL, unLIsmokIng IobbyIsLs Iuve LIe uuducILy Lo muke sucI
cIuIms us |L|Ie sLencI LIuL geLs uII LIrougI your IuIr und cIoLIes Ior LIe
coupIe oI Iours you mIgIL occusIonuIIy spend In u pub goes InLo IoLeI
sLuII`s pInk Iungs eucI nIgIL Ior seven Iours. Smoke purLIcIes Iodge In LIe
vIsceru. AILer yeurs oI LIIs, we know LIe resL. (CIupmun, zoo1u) TIe
compreIensIve Iuck oI sound cuusuI urgumenL Is reduced by un
IncompeLenL menLuIILy InLo we know LIe resL. TIe conjurIng oI mugIcuI
reIuLIonsIIps wIII noL suIIIce. TIe scIenLIIIc gouI Is Lo urLIcuIuLe cuusuI
reIuLIonsIIps, sLep by sLep, II LIIs reIIecLs genuIne knowIedge. UnubIe Lo
do so, LIe IunLusy worId LIuL muny unLIsmokers obvIousIy occupy uIIows
LIe knowIng LIuL cunnoL be scIenLIIIcuIIy urLIcuIuLed Lo be subsLILuLed
wILI IuIIucIes oI IncoIerenL, cuLusLropIIzIng unuIogy. or exumpIe,
CIupmun (zoo1u) posILs LIuL burworkers` exposure Lo ETS Is ukIn Lo
busLIng one`s Iungs, or Lo LIe DIckensIun cIrcumsLunce oI 1o-yeur-oIds
beIng down couI mInes. TIe onIy muLLer more dIsLurbIng Is LIuL LIIs
unLIsmokIng rIeLorIc Ius noL onIy been uIIowed Lo IesLer uncIuIIenged,
buL Ius been gIven dIrecL uccess Lo pubIIc poIIcy IormuIuLIon.
AII poInLs mude concernIng IuIsIIIubIIILy oI proposILIons In LIe
secLIon on ucLIve smokIng uIso uppIy Lo LIe Issue oI ETS. TIe ussumpLIon
oI IomogeneILy oI groups (exposedJnon-exposed nonsmokers) Is wIoIIy
unLenubIe. TIe occurrence oI reguIur, smuII subgroup dIIIerences
IndependenL oI ETS exposure beLween exposedJnonexposed nonsmokers
und wIIcI wIII ImmedIuLeIy und erroneousIy be InLerpreLed us cuusuIIy
produced by ETS generuLes essenLIuIIy unIuIsIIIubIe proposILIons. n
scIenLIIIc Lerms, LIIs cIrcumsLunce Is compIeLeIy unuccepLubIe.
TIe sIeer voIume oI unLIsmokIng propugundu Is sLuggerIng, I.e.,
crumentum cd terecundicm, crumentum cd numerum, crumentum
cd ncusecm, crumentum cd populum. An InLerneL seurcI In MurcI,
zooz, usIng googIe (www.googIe.com) seurcI engIne yIeIded z,8zo,ooo
IIsLIngs under smokIng, ;68,ooo IIsLIngs under cIgureLLe, z8,zoo
under envIronmenLuI Lobucco smoke, und 1,6oo under unLIsmokIng.
TIese mInd-boggIIng numbers were subsLunLIuIIy IIgIer by Junuury,
zoo - smokIng (,qo,ooo), cIgureLLe (1,6o,ooo), ETS (qq,ooo),
unLIsmokIng (z,qoo). AILIougI unLesLed, IL Is esLImuLed Irom u
sumpIIng LIuL LIe vusL mujorILy (qq%+) ure unLIsmokIng In sLunce. QuILe u
number oI LIe IIsLIngs ure governmenL, medIcuI InsLILuLIon und unIversILy
medIcuI depurLmenL websILes. nIormuLIon Is LypIcuIIy presenLed In
percenL Increuse In rIsk Lerms. or exumpIe, un RR oI 1.o Is presenLed
us u o% Increuse In reIuLIve rIsk; un RR oI 1.; Is presenLed us u ;%
Increuse In reIuLIve rIsk, eLc. TIese percenLuges ure LIen LrunsIuLed InLo
uLLrIbuLubIe numbers - un enLIreIy urILImeLIc exercIse devoId oI cuusuLIve
Preventive Medicine & Health Promotion
subsLunce. CHD represenLs LIe IIgIesL specIIIc-cuuse morLuIILy. TIe
InLeresL In cIuImIng LIuL ETS Is u cuuse oI, purLIcuIurIy, CHD Is obvIousIy
IIgI In LIuL uILIougI LIe reIuLIve rIsk oI CHD ussocIuLed wILI ETS
exposure Is bureIy ubove 1.oo, LIe uLLrIbuLubIe numbers ure consIderubIe.
BeIng ubIe Lo cIuIm qo,ooo or o,ooo CHD deuLIs uLLrIbuLubIe Lo ETS
In uddILIon Lo LIe ,ooo uIreudy cIuImed Ior Iung cuncer cerLuInIy
promoLes LIe unLIsmokIng crusude. NoLwILIsLundIng LIuL LIe enLIre
enLerprIse Is IruuduIenL, LIere Is IurLIer conLempL In LIuL no uLLempL Is
mude Lo purLILIon Ior cross-correIuLed rIsk IucLors (I.e., IdenLIIIed
conIoundIng IucLors); uL IusL counL, Ior CHD LIere ure neurIy oo
IdenLIIIed rIsk IucLors. AccounLIng Ior mujor rIsk IucLors wouId eruse LIe
excess rIsk ussocIuLed wILI ETS. TIereIore, LIe InIormuLIon Is noL onIy
mIsIeudIng buL, uguIn, mcximcll mIsIeudIng.
DepIcLIons oI LecInIcuI InIormuLIon by supposed scIoIurs or
scIoIurIy InvesLIguLIons Is uppuIIIng. SIIILs beLween sLuLIsLIcuI und cuusuI
InIerences occur us u muLLer oI LIe convenIence oI IncompeLence und
conLorLed IdeoIogy. or exumpIe, sLuLIsLIcuI InIerences sucI us PurenLuI
smokIng Is ussocIuLed wILI u IIgIer rIsk oI .. ure reworded us PurenLuI
smokIng Increuses LIe rIsk oI ... TIe IuLLer proposILIon Is no Ionger u
sLuLIsLIcuI one buL Is cuusuI. Terms sucI us prooI or proven IInk ure
used reckIessIy In LIe IILeruLure. ProoIs ure Lo be Iound In muLIemuLIcuI
LIeorems und noL In scIenLIIIc enquIry; LIIs concepL Ius no
meunIngIuIness In LIe IypoLIeLIco-deducLIve sysLem oI scIenLIIIc enquIry.
WIere LIe Lerm prooI Is used In LIese conLexLs, one cun be sure LIuL LIe
uuLIor(s) Is, uL LIe very IeusL, scIenLIIIcuIIy IncompeLenL.
OLIers ImproperIy use lecl LermInoIogy Lo subsLILuLe Ior
coIerenL cuusuI urgumenL; Ior exumpIe, |u|ny compeLenL scIenLIsL Is
uwure oI LIe evIdence LIuL LIere Is prooI beyond reusonubIe doubL LIuL
smokIng cuuses Iung cuncer. (PeLo, 1qqq) AnoLIer probIem Is LIuL
proposILIons ure presenLed und muInLuIned In generuI Iorm wIen
Increuses In reIuLIve rIsk very cIeurIy reIIecL smuII or LIny subgroup
sLuLIsLIcuI ussocIuLIons. or exumpIe, proposILIons sucI us WIen
compured Lo cIIIdren oI nonsmokers, cIIIdren oI smokers perIorm more
poorIy In scIooI IosLer LIe erroneous ImpressIon LIuL cll cIIIdren oI
smokers perIorm more poorIy In scIooI compured Lo cll cIIIdren oI
nonsmokers. TIIs In Lurn reInIorces LIe erroneous beIIeI LIuL exposure Lo
ETS Is u prImury cuuse oI some consequence LIuL Is reIIecLed In uII LIose
exposed. TIe IucL oI LIe muLLer Is LIuL exposure Lo ETS Is un essenLIuIIy
zero-IeveI predIcLor oI purLIcuIur dIseuse.
A IurLIer consIderubIe probIem Is LIe IncompeLenL sIIIL beLween
reIuLIve rIsk und uLLrIbuLubIe numbers. or exumpIe, LIe WorId HeuILI
OrgunIzuLIon (1qqq) IndIcuLes LIuL uILIougI LIese Increused rIsks ure
345
345
Rampant Antismoking Signifies Grave Danger
AILIougI none oI LIe requIremenLs oI coIerenL cuusuI urgumenL
Iuve been meL, unLIsmokIng IobbyIsLs Iuve LIe uuducILy Lo muke sucI
cIuIms us |L|Ie sLencI LIuL geLs uII LIrougI your IuIr und cIoLIes Ior LIe
coupIe oI Iours you mIgIL occusIonuIIy spend In u pub goes InLo IoLeI
sLuII`s pInk Iungs eucI nIgIL Ior seven Iours. Smoke purLIcIes Iodge In LIe
vIsceru. AILer yeurs oI LIIs, we know LIe resL. (CIupmun, zoo1u) TIe
compreIensIve Iuck oI sound cuusuI urgumenL Is reduced by un
IncompeLenL menLuIILy InLo we know LIe resL. TIe conjurIng oI mugIcuI
reIuLIonsIIps wIII noL suIIIce. TIe scIenLIIIc gouI Is Lo urLIcuIuLe cuusuI
reIuLIonsIIps, sLep by sLep, II LIIs reIIecLs genuIne knowIedge. UnubIe Lo
do so, LIe IunLusy worId LIuL muny unLIsmokers obvIousIy occupy uIIows
LIe knowIng LIuL cunnoL be scIenLIIIcuIIy urLIcuIuLed Lo be subsLILuLed
wILI IuIIucIes oI IncoIerenL, cuLusLropIIzIng unuIogy. or exumpIe,
CIupmun (zoo1u) posILs LIuL burworkers` exposure Lo ETS Is ukIn Lo
busLIng one`s Iungs, or Lo LIe DIckensIun cIrcumsLunce oI 1o-yeur-oIds
beIng down couI mInes. TIe onIy muLLer more dIsLurbIng Is LIuL LIIs
unLIsmokIng rIeLorIc Ius noL onIy been uIIowed Lo IesLer uncIuIIenged,
buL Ius been gIven dIrecL uccess Lo pubIIc poIIcy IormuIuLIon.
AII poInLs mude concernIng IuIsIIIubIIILy oI proposILIons In LIe
secLIon on ucLIve smokIng uIso uppIy Lo LIe Issue oI ETS. TIe ussumpLIon
oI IomogeneILy oI groups (exposedJnon-exposed nonsmokers) Is wIoIIy
unLenubIe. TIe occurrence oI reguIur, smuII subgroup dIIIerences
IndependenL oI ETS exposure beLween exposedJnonexposed nonsmokers
und wIIcI wIII ImmedIuLeIy und erroneousIy be InLerpreLed us cuusuIIy
produced by ETS generuLes essenLIuIIy unIuIsIIIubIe proposILIons. n
scIenLIIIc Lerms, LIIs cIrcumsLunce Is compIeLeIy unuccepLubIe.
TIe sIeer voIume oI unLIsmokIng propugundu Is sLuggerIng, I.e.,
crumentum cd terecundicm, crumentum cd numerum, crumentum
cd ncusecm, crumentum cd populum. An InLerneL seurcI In MurcI,
zooz, usIng googIe (www.googIe.com) seurcI engIne yIeIded z,8zo,ooo
IIsLIngs under smokIng, ;68,ooo IIsLIngs under cIgureLLe, z8,zoo
under envIronmenLuI Lobucco smoke, und 1,6oo under unLIsmokIng.
TIese mInd-boggIIng numbers were subsLunLIuIIy IIgIer by Junuury,
zoo - smokIng (,qo,ooo), cIgureLLe (1,6o,ooo), ETS (qq,ooo),
unLIsmokIng (z,qoo). AILIougI unLesLed, IL Is esLImuLed Irom u
sumpIIng LIuL LIe vusL mujorILy (qq%+) ure unLIsmokIng In sLunce. QuILe u
number oI LIe IIsLIngs ure governmenL, medIcuI InsLILuLIon und unIversILy
medIcuI depurLmenL websILes. nIormuLIon Is LypIcuIIy presenLed In
percenL Increuse In rIsk Lerms. or exumpIe, un RR oI 1.o Is presenLed
us u o% Increuse In reIuLIve rIsk; un RR oI 1.; Is presenLed us u ;%
Increuse In reIuLIve rIsk, eLc. TIese percenLuges ure LIen LrunsIuLed InLo
uLLrIbuLubIe numbers - un enLIreIy urILImeLIc exercIse devoId oI cuusuLIve
Preventive Medicine & Health Promotion
subsLunce. CHD represenLs LIe IIgIesL specIIIc-cuuse morLuIILy. TIe
InLeresL In cIuImIng LIuL ETS Is u cuuse oI, purLIcuIurIy, CHD Is obvIousIy
IIgI In LIuL uILIougI LIe reIuLIve rIsk oI CHD ussocIuLed wILI ETS
exposure Is bureIy ubove 1.oo, LIe uLLrIbuLubIe numbers ure consIderubIe.
BeIng ubIe Lo cIuIm qo,ooo or o,ooo CHD deuLIs uLLrIbuLubIe Lo ETS
In uddILIon Lo LIe ,ooo uIreudy cIuImed Ior Iung cuncer cerLuInIy
promoLes LIe unLIsmokIng crusude. NoLwILIsLundIng LIuL LIe enLIre
enLerprIse Is IruuduIenL, LIere Is IurLIer conLempL In LIuL no uLLempL Is
mude Lo purLILIon Ior cross-correIuLed rIsk IucLors (I.e., IdenLIIIed
conIoundIng IucLors); uL IusL counL, Ior CHD LIere ure neurIy oo
IdenLIIIed rIsk IucLors. AccounLIng Ior mujor rIsk IucLors wouId eruse LIe
excess rIsk ussocIuLed wILI ETS. TIereIore, LIe InIormuLIon Is noL onIy
mIsIeudIng buL, uguIn, mcximcll mIsIeudIng.
DepIcLIons oI LecInIcuI InIormuLIon by supposed scIoIurs or
scIoIurIy InvesLIguLIons Is uppuIIIng. SIIILs beLween sLuLIsLIcuI und cuusuI
InIerences occur us u muLLer oI LIe convenIence oI IncompeLence und
conLorLed IdeoIogy. or exumpIe, sLuLIsLIcuI InIerences sucI us PurenLuI
smokIng Is ussocIuLed wILI u IIgIer rIsk oI .. ure reworded us PurenLuI
smokIng Increuses LIe rIsk oI ... TIe IuLLer proposILIon Is no Ionger u
sLuLIsLIcuI one buL Is cuusuI. Terms sucI us prooI or proven IInk ure
used reckIessIy In LIe IILeruLure. ProoIs ure Lo be Iound In muLIemuLIcuI
LIeorems und noL In scIenLIIIc enquIry; LIIs concepL Ius no
meunIngIuIness In LIe IypoLIeLIco-deducLIve sysLem oI scIenLIIIc enquIry.
WIere LIe Lerm prooI Is used In LIese conLexLs, one cun be sure LIuL LIe
uuLIor(s) Is, uL LIe very IeusL, scIenLIIIcuIIy IncompeLenL.
OLIers ImproperIy use lecl LermInoIogy Lo subsLILuLe Ior
coIerenL cuusuI urgumenL; Ior exumpIe, |u|ny compeLenL scIenLIsL Is
uwure oI LIe evIdence LIuL LIere Is prooI beyond reusonubIe doubL LIuL
smokIng cuuses Iung cuncer. (PeLo, 1qqq) AnoLIer probIem Is LIuL
proposILIons ure presenLed und muInLuIned In generuI Iorm wIen
Increuses In reIuLIve rIsk very cIeurIy reIIecL smuII or LIny subgroup
sLuLIsLIcuI ussocIuLIons. or exumpIe, proposILIons sucI us WIen
compured Lo cIIIdren oI nonsmokers, cIIIdren oI smokers perIorm more
poorIy In scIooI IosLer LIe erroneous ImpressIon LIuL cll cIIIdren oI
smokers perIorm more poorIy In scIooI compured Lo cll cIIIdren oI
nonsmokers. TIIs In Lurn reInIorces LIe erroneous beIIeI LIuL exposure Lo
ETS Is u prImury cuuse oI some consequence LIuL Is reIIecLed In uII LIose
exposed. TIe IucL oI LIe muLLer Is LIuL exposure Lo ETS Is un essenLIuIIy
zero-IeveI predIcLor oI purLIcuIur dIseuse.
A IurLIer consIderubIe probIem Is LIe IncompeLenL sIIIL beLween
reIuLIve rIsk und uLLrIbuLubIe numbers. or exumpIe, LIe WorId HeuILI
OrgunIzuLIon (1qqq) IndIcuLes LIuL uILIougI LIese Increused rIsks ure
346
346
Rampant Antismoking Signifies Grave Danger
modesL, LIese ure common IeuILI probIems uround LIe worId. TIus smuII
Increuses In rIsk LrunsIuLe InLo u subsLunLIuI burden oI dIseuse Ior cIIIdren
urIsIng Irom exposure Lo ETS. (p.6) n LIIs very common occurrence
wIere RR dIIIerences ure very smuII, LIe urgumenLuLIon IIIps Lo
uLLrIbuLubIe numbers LIuL LypIcuIIy sound more uIurmIng LIun Iow-IeveI
RR dIIIerences. AguIn, LIe IucL oI LIe muLLer Is LIuL uLLrIbuLubIe numbers
or cuses, per se, Iuve noLIIng Lo do wILI cuusuI urgumenL uL uII. OnIy LIe
proportion oI IncIdence oI u pIenomenon ussocIuLed wILI exposure Lo un
unLecedenL (I.e., predIcLIve sLrengLI) Is reIevunL Lo cuusuI urgumenL. n
workIng Lo IdeoIogIcuI concIusIons, LIe scIenLIIIc IncompeLence oI medIco-
muLerIuIIsm InIerenLIuIIy sIIILs, us u muLLer oI convenIence, Irom
probubIIIsLIc Lo deLermInIsLIc Irumeworks or Irom reIuLIve rIsk Lo
uLLrIbuLubIe numbers. L cunnoL Iuve IL uII LIese wuys LIuL InvoIve
dIIIerenL concepLuuI Irumeworks: LIe conducL Is deIuded.
TIese sorLs oI errors oI InIerence und presenLuLIon demonsLruLe
u mosL proIound IncompeLence wIen recognIzIng LIuL u crILIcuI InLenL oI
scIenLIIIc presenLuLIon Is Lo not mIsIeud LIe reuder. A IIgIer sLundurd
wouId Iuve once been expecLed Irom IIrsL-yeur (undergruduuLe) reseurcI
sLudenLs. TIe resuIL Is u procedure LIuL produces dIsordered concIusIons
LIuL ure unLILIeLIcuI Lo LIe scIenLIIIc enLerprIse. TIIs Is seen In LIe exLreme
regurdIng ETS wIere sweepIng und IusLy generuIIzuLIons ure
munuIucLured Irom u neur-zero IeveI predIcLor us u muLLer oI course.
TIese InIerenLIuI errors Iuve u IIgI cupucILy Lo IosLer psycIoIogIcuI und
psycIosocIuI dysIuncLIon und ure LypIcuIIy used In workIng Lo deIuded
IdeoIogIcuI gouIs. IIesLyIe epIdemIoIogy Is operuLIng on LIe zero, or
wrong, end oI LIe condILIonuI probubIIILy scuIe, yeL uLLempLIng Lo IosLer
LIe ImpressIon LIuL IL Ius mude uII munner oI remurkubIe dIscoverIes oI
cuuse und eIIecL. RuLIer, IL Is LIe sLuII oI duILness.
TIe buIk oI LIe numerous remuInIng InLerneL IIsLIngs Is
represenLed by uII munner oI IeuILIIsLJunLIsmokIng Iobby groups. TIe
sLrong poInL oI LIese groups Is cerLuInIy noL scIenLIIIc compeLence or LIe
IonesL porLruyuI oI InIormuLIon. TIese groups Luke wIuL Is uIreudy
IruuduIenL InIormuLIon Irom IIIesLyIe epIdemIoIogy und IeuILI
uuLIorILIes und embeIIIsI IL wILI even more InIIummuLory Iunguuge,
IncoIerenL unuIogIes, quesLIonubIe unecdoLuI InIormuLIon, IILIguLIon
udvIsemenL, und ussorLed IIsLrIonIcs. TIe mIsguIded use oI Lerms sucI us
cuuse und prooI ure IurLIer IueIed In uddILIon Lo Lerms sucI us
kIIIIng, poIson, deuLI, InnocenL vIcLIms, nIcoLIne-uddIcLed
smokers. TIere Is even un unLIsmokIng websILe LIuL udvIses LIe
IIkemInded on LIe use und munIpuIuLIon oI IunguugeJLermInoIogy,
LypIcuIIy jcr beyond LIe ImpIIcuLIons oI duLu, Lo muxImIze poLenLIuI Ior
LIe unLIsmokIng crusude (see Mcudden, zoo1). or exumpIe, LIe Lerm
Preventive Medicine & Health Promotion
envIronmenLuI Lobucco smoke Is Iur Loo LImId Ior LIe crusude
uspIruLIons. TIe websILe recommends LIe use oI LIe Lerm envIronmenLuI
smoke pollution. Even more dIsconcerLIng Is LIuL In u number oI
AusLruIIun unIversILy IIbrury duLubuses, u seurcI Ior ETS IIsLIngs yIeIds u
nII resuIL; u seurcI Ior envIronmenLuI smoke poIIuLIon yIeIds uII LIe
reIevunL IIsLIngs. OLIer unLIsmokIng IobbyIsLs (e.g., PIeLLen, zooo) use
even more InIIummuLory Lerms sucI us toxic Lobucco smoke. TIe
InLerneL Ius uIIowed Ior LIe speedy dIssemInuLIon oI InIormuLIon.
UnIorLunuLeIy, IL does noL dIsLInguIsI beLween useIuI und conLorLed
InIormuLIon.
Muny wesLern socIeLIes ure currenLIy In LIe grIp oI u IIgI degree
oI psycIoIogIcuI, reIuLIonuI und moruI dysIuncLIon (see CIupLer ). L Is
noL dIIIIcuIL Lo undersLund LIe very consIderubIe dIIIIcuILy In IorwurdIng
uny vIew LIuL Is conLrury Lo LIe unLIsmokIng bundwugon und LIIs IILeruI
propugundu burruge. AguIn, one Ius Lo conLInuuIIy be remInded LIuL LIIs
mudness Ius been generuLed on LIe busIs oI un eIIecLIveIy zero-IeveI
predIcLor (exposure Lo ETS) und under LIe guIse oI IeuILI promoLIon.
As menLIoned eurIIer, IInkIng u IucLor Lo cIIIdren`s IeuILI Ius u
Iur IIgIer poLenLIuI Ior poIILIcuI und socIuI ucLIon, wIeLIer reusonubIe or
unreusonubIe, LIun uduIL IeuILI Issues. TIIs Ius uIso been reInIorced by
LIe IucL LIuL, uILIougI LIe cIupLers deuIIng wILI cIIIdren`s IeuILI ure
compIeLeIy quesLIonubIe, LIe Lobucco IndusLry dId noL cIuIIenge LIese
cIupLers oI EPA (1qq), I.e., cIuIIenged onIy cIupLers 1-6 LIuL were
ussessed In LIe OsLeen RuIIng. L Is noL cIeur wIy LIe Lobucco IndusLry
Look LIIs puLIwuy und Is consIsLenL wILI ILs erruLIc LreuLmenL oI Issues
over muny decudes. UnIorLunuLeIy, LIe unLIsmokIng menLuIILy Ius
consLrued LIIs Lobucco-IndusLry conducL Lo IndIcuLe LIuL Issues perLuInIng
Lo cIIIdren`s IeuILI und exposure Lo ETS ure beyond quesLIon. L Is
LIereIore Issues oI cIIIdren`s IeuILI LIuL LIe unLIsmokIng pursuIL Ius
empIusIzed. or exumpIe, In 1qq; LIe G8 mude u DecIuruLIon on
CIIIdren`s EnvIronmenLuI HeuILI IndIcuLIng LIuL:
EnvIronmenLuI Tobucco Smoke: CIIIdren exposed Lo
envIronmenLuI Lobucco smoke ure more IIkeIy Lo suIIer
Irom reduced Iung IuncLIon, Iower respIruLory LrucL
InIecLIons und respIruLory IrrILuLIons. AsLImuLIc
cIIIdren ure purLIcuIurIy uL rIsk. Muny oI LIese
sympLoms Ieud Lo Increused IospILuIIzuLIons oI
cIIIdren.
We uIIIrm LIuL envIronmenLuI Lobucco smoke Is u
sIgnIIIcunL pubIIc IeuILI rIsk Lo young cIIIdren und LIuL
purenLs need Lo know ubouL LIe rIsks oI smokIng In LIe
Iome uround LIeIr young cIIIdren. We ugree Lo
347
347
Rampant Antismoking Signifies Grave Danger
modesL, LIese ure common IeuILI probIems uround LIe worId. TIus smuII
Increuses In rIsk LrunsIuLe InLo u subsLunLIuI burden oI dIseuse Ior cIIIdren
urIsIng Irom exposure Lo ETS. (p.6) n LIIs very common occurrence
wIere RR dIIIerences ure very smuII, LIe urgumenLuLIon IIIps Lo
uLLrIbuLubIe numbers LIuL LypIcuIIy sound more uIurmIng LIun Iow-IeveI
RR dIIIerences. AguIn, LIe IucL oI LIe muLLer Is LIuL uLLrIbuLubIe numbers
or cuses, per se, Iuve noLIIng Lo do wILI cuusuI urgumenL uL uII. OnIy LIe
proportion oI IncIdence oI u pIenomenon ussocIuLed wILI exposure Lo un
unLecedenL (I.e., predIcLIve sLrengLI) Is reIevunL Lo cuusuI urgumenL. n
workIng Lo IdeoIogIcuI concIusIons, LIe scIenLIIIc IncompeLence oI medIco-
muLerIuIIsm InIerenLIuIIy sIIILs, us u muLLer oI convenIence, Irom
probubIIIsLIc Lo deLermInIsLIc Irumeworks or Irom reIuLIve rIsk Lo
uLLrIbuLubIe numbers. L cunnoL Iuve IL uII LIese wuys LIuL InvoIve
dIIIerenL concepLuuI Irumeworks: LIe conducL Is deIuded.
TIese sorLs oI errors oI InIerence und presenLuLIon demonsLruLe
u mosL proIound IncompeLence wIen recognIzIng LIuL u crILIcuI InLenL oI
scIenLIIIc presenLuLIon Is Lo not mIsIeud LIe reuder. A IIgIer sLundurd
wouId Iuve once been expecLed Irom IIrsL-yeur (undergruduuLe) reseurcI
sLudenLs. TIe resuIL Is u procedure LIuL produces dIsordered concIusIons
LIuL ure unLILIeLIcuI Lo LIe scIenLIIIc enLerprIse. TIIs Is seen In LIe exLreme
regurdIng ETS wIere sweepIng und IusLy generuIIzuLIons ure
munuIucLured Irom u neur-zero IeveI predIcLor us u muLLer oI course.
TIese InIerenLIuI errors Iuve u IIgI cupucILy Lo IosLer psycIoIogIcuI und
psycIosocIuI dysIuncLIon und ure LypIcuIIy used In workIng Lo deIuded
IdeoIogIcuI gouIs. IIesLyIe epIdemIoIogy Is operuLIng on LIe zero, or
wrong, end oI LIe condILIonuI probubIIILy scuIe, yeL uLLempLIng Lo IosLer
LIe ImpressIon LIuL IL Ius mude uII munner oI remurkubIe dIscoverIes oI
cuuse und eIIecL. RuLIer, IL Is LIe sLuII oI duILness.
TIe buIk oI LIe numerous remuInIng InLerneL IIsLIngs Is
represenLed by uII munner oI IeuILIIsLJunLIsmokIng Iobby groups. TIe
sLrong poInL oI LIese groups Is cerLuInIy noL scIenLIIIc compeLence or LIe
IonesL porLruyuI oI InIormuLIon. TIese groups Luke wIuL Is uIreudy
IruuduIenL InIormuLIon Irom IIIesLyIe epIdemIoIogy und IeuILI
uuLIorILIes und embeIIIsI IL wILI even more InIIummuLory Iunguuge,
IncoIerenL unuIogIes, quesLIonubIe unecdoLuI InIormuLIon, IILIguLIon
udvIsemenL, und ussorLed IIsLrIonIcs. TIe mIsguIded use oI Lerms sucI us
cuuse und prooI ure IurLIer IueIed In uddILIon Lo Lerms sucI us
kIIIIng, poIson, deuLI, InnocenL vIcLIms, nIcoLIne-uddIcLed
smokers. TIere Is even un unLIsmokIng websILe LIuL udvIses LIe
IIkemInded on LIe use und munIpuIuLIon oI IunguugeJLermInoIogy,
LypIcuIIy jcr beyond LIe ImpIIcuLIons oI duLu, Lo muxImIze poLenLIuI Ior
LIe unLIsmokIng crusude (see Mcudden, zoo1). or exumpIe, LIe Lerm
Preventive Medicine & Health Promotion
envIronmenLuI Lobucco smoke Is Iur Loo LImId Ior LIe crusude
uspIruLIons. TIe websILe recommends LIe use oI LIe Lerm envIronmenLuI
smoke pollution. Even more dIsconcerLIng Is LIuL In u number oI
AusLruIIun unIversILy IIbrury duLubuses, u seurcI Ior ETS IIsLIngs yIeIds u
nII resuIL; u seurcI Ior envIronmenLuI smoke poIIuLIon yIeIds uII LIe
reIevunL IIsLIngs. OLIer unLIsmokIng IobbyIsLs (e.g., PIeLLen, zooo) use
even more InIIummuLory Lerms sucI us toxic Lobucco smoke. TIe
InLerneL Ius uIIowed Ior LIe speedy dIssemInuLIon oI InIormuLIon.
UnIorLunuLeIy, IL does noL dIsLInguIsI beLween useIuI und conLorLed
InIormuLIon.
Muny wesLern socIeLIes ure currenLIy In LIe grIp oI u IIgI degree
oI psycIoIogIcuI, reIuLIonuI und moruI dysIuncLIon (see CIupLer ). L Is
noL dIIIIcuIL Lo undersLund LIe very consIderubIe dIIIIcuILy In IorwurdIng
uny vIew LIuL Is conLrury Lo LIe unLIsmokIng bundwugon und LIIs IILeruI
propugundu burruge. AguIn, one Ius Lo conLInuuIIy be remInded LIuL LIIs
mudness Ius been generuLed on LIe busIs oI un eIIecLIveIy zero-IeveI
predIcLor (exposure Lo ETS) und under LIe guIse oI IeuILI promoLIon.
As menLIoned eurIIer, IInkIng u IucLor Lo cIIIdren`s IeuILI Ius u
Iur IIgIer poLenLIuI Ior poIILIcuI und socIuI ucLIon, wIeLIer reusonubIe or
unreusonubIe, LIun uduIL IeuILI Issues. TIIs Ius uIso been reInIorced by
LIe IucL LIuL, uILIougI LIe cIupLers deuIIng wILI cIIIdren`s IeuILI ure
compIeLeIy quesLIonubIe, LIe Lobucco IndusLry dId noL cIuIIenge LIese
cIupLers oI EPA (1qq), I.e., cIuIIenged onIy cIupLers 1-6 LIuL were
ussessed In LIe OsLeen RuIIng. L Is noL cIeur wIy LIe Lobucco IndusLry
Look LIIs puLIwuy und Is consIsLenL wILI ILs erruLIc LreuLmenL oI Issues
over muny decudes. UnIorLunuLeIy, LIe unLIsmokIng menLuIILy Ius
consLrued LIIs Lobucco-IndusLry conducL Lo IndIcuLe LIuL Issues perLuInIng
Lo cIIIdren`s IeuILI und exposure Lo ETS ure beyond quesLIon. L Is
LIereIore Issues oI cIIIdren`s IeuILI LIuL LIe unLIsmokIng pursuIL Ius
empIusIzed. or exumpIe, In 1qq; LIe G8 mude u DecIuruLIon on
CIIIdren`s EnvIronmenLuI HeuILI IndIcuLIng LIuL:
EnvIronmenLuI Tobucco Smoke: CIIIdren exposed Lo
envIronmenLuI Lobucco smoke ure more IIkeIy Lo suIIer
Irom reduced Iung IuncLIon, Iower respIruLory LrucL
InIecLIons und respIruLory IrrILuLIons. AsLImuLIc
cIIIdren ure purLIcuIurIy uL rIsk. Muny oI LIese
sympLoms Ieud Lo Increused IospILuIIzuLIons oI
cIIIdren.
We uIIIrm LIuL envIronmenLuI Lobucco smoke Is u
sIgnIIIcunL pubIIc IeuILI rIsk Lo young cIIIdren und LIuL
purenLs need Lo know ubouL LIe rIsks oI smokIng In LIe
Iome uround LIeIr young cIIIdren. We ugree Lo
348
348
Rampant Antismoking Signifies Grave Danger
cooperuLe on educuLIon und pubIIc uwureness eIIorLs
uImed uL reducIng cIIIdren`s exposure Lo envIronmenLuI
Lobucco smoke.
AguIn, IL musL be borne In mInd LIuL ETS Is eIIecLIveIy u zero-
IeveI predIcLor Ior muIudIes reIevunL Lo LIIs dIscussIon. n oLIer words, LIe
greuL mujorILy (I.e., mosL) oI cIIIdren exposed Lo ETS do noL demonsLruLe
uny Increused IncIdence oI LIese muIudIes. YeL, LIe erudIcuLIon oI ETS
Irom uII cIIIdren`s envIronmenL Ius been munuIucLured InLo u pressIng
gIobuI Issue. TIe WHO (1qqq) Ius even conLrIved cn cIIId`s exposure Lo
ETS us u Iumun rIgILs vIoIuLIon:
TIIs reporL concIudes LIuL LIe evIdence oI LIIs Iurm Lo
cIIIdren Is consIsLenL und robusL. Even II cerLuIn
quesLIons sLIII requIre IurLIer reseurcI, LIere Is more
LIun suIIIcIenL evIdence oI Iurm Lo demund ucLIon Lo
reduce cIIIdren`s InvoIunLury exposure Lo Lobucco
smoke. urLIermore, LIIs InvoIunLury und IurmIuI
exposure cun uIso be seen us u Iumun rIgILs vIoIuLIon,
gIven LIe provIsIons oI ArLIcIes 6 und zq oI LIe 1q8q
UnILed NuLIons ConvenLIon on LIe RIgILs oI LIe CIIId.
(p.)
L Is purLIcuIurIy concernIng LIe IIIness oI usLImu LIuL LIe currenL
unLIsmokIng crusude Ius perpeLruLed u greuL dIsservIce. Ls IIgIIy
uggressIve rIeLorIc und mIsguIded cuusuI urgumenLuLIon Ius LIe IIgI
poLenLIuI Ior IncILIng vurIous dysIuncLIon In cIIIdren. or exumpIe, some
usLImuLIc cIIIdren Iuve become convInced LIuL LIeIr smokIng purenLs cun
kIII LIem wILI ETS uL uny momenL. OLIers beIIeve LIuL LIeIr smokIng
purenLs mIgIL dIe uL uny momenL due Lo LIeIr smokIng und Ieuve LIem
orpIuned. TIIs beIIeI Is bused on IeuILI depurLmenL und pIurmuceuLIcuI
compuny udverLIsIng LIuL IosLers LIe erroneous ImpressIon LIuL young
smokers dIe wILI IIgI reguIurILy und due onIy Lo LIeIr smokIng. OLIer
cIIIdren, sLIII, muy see In LIe cIrcumsLunce oI u smokIng purenL(s) LIe
opporLunILy Ior udvunLuge by IIIness, e.g., pIuyIng oII u nonsmokIng
purenL uguInsL u smokIng purenL. urLIermore, deIuded beIIeIs ubouL
smokIng und ETS cun InsLIguLe or exLend dIscord beLween purenLs. TIe
summury eIIecL Is LIuL smokIng und exposure Lo ETS Iuve been
munuIucLured InLo dysIuncLIonuI poIILIcuI LooIs In IumIIIuI seLLIngs LIuL
cun noL onIy generuLe severe IumIIIuI LensIon buL uIso works uL
muInLuInIng (proLecLIng) or uIIowIng u domInuLIon oI LIe IIIness oI
usLImu. TIe possIbIIILy oI pedIuLrIc somuLIzuLIon sIouId be u crILIcuI
concern (e.g., Cumpo & rILz, zoo1; see uIso secLIon Entironmentcl
Preventive Medicine & Health Promotion
Somctizction Sndrome).
TIe sILuuLIon Ius become so perverse und devoId oI
psycIoIogIcuI, psycIosocIuI und moruI coIerence LIuL wIeLIer u purenL
smokes Ius become u crucIuI IucLor In numerous cIIId cusLody IeurIngs.
PurenLs Iuve been denIed cusLody or cusLody Ius been cIuIIenged enLIreIy
on LIe busIs oI wIeLIer LIey smoke (e.g., see OukIey, 1qqq, CI.;, p.o;
Ouks, zoo1, p18q-18). n LIe InsLunce oI cIIIdren uIreudy IuvIng usLImu,
LIere Is no uLLempL Lo ussess noceboJubscebo eIIecLs concernIng exposure
Lo ETS. L Ius been cssumed In LIe courLs, on LIe busIs oI EPA (1qq) und
medIco-muLerIuIIsm generuIIy, LIuL IL Is deIInILIve LIuL ETS exposure Is
deLrImenLuI Ior uII usLImu suIIerers. TIIs Is Indeed u LrugIc cIrcumsLunce.
umIIIuI dynumIcs Iuve been suvuged by LIe unLIsmokIng crusude.
NegIIgenL und deIInquenL ure upL cIurucLerIzuLIons oI LIIs medIcuI
conducL. ConLemporury medIcuI reusonIng Ius obIILeruLed prevIous, Iong-
sLundIng InsIgILs InLo usLImu LIuL IncIuded crILIcuI psycIoIogIcuI und
psycIosocIuI IucLors. urLIermore, In ILs IncompeLenL obIIvIousness und
workIng Lo conLorLed IdeoIogIcuI gouIs, IL Ius IosLered new dImensIons oI
dysIuncLIon In LIe IIIness oI usLImu. AII deLrImenLuI consequences oI LIIs
dIsordered medIco-muLerIuIIsL conducL ure IuLrogenIc.
AguIn, unLIsmokIng ucLIvIsLs und Iobby groups IIgure IIgIIy In
LIe IueIIng oI deIuded, dIvIsIve beIIeIs. JoIn BunzIuI, Irom AcLIon on
SmokIng und HeuILI (ASH), urges unyone (e.g., purenLs, grundpurenLs,
pIysIcIuns, scIooI nurses) Lo IIIe or LesLIIy In cusLody dIspuLes InvoIvIng
smokIng. ASH Is ever-reudy Lo ussIsL LIem. BunzIuI conLends LIuL |p|
urenLs exposIng LIeIr cIIIdren Lo secondIund smoke Is LIe mosL common
Iorm oI cIIId ubuse In AmerIcu.. um cerLuInIy noL suggesLIng LIuL every
LIme u purenL IIgILs up In LIe sume room, we`re goIng Lo cry cIIId ubuse.
BuL LIe sume proLecLIon wIII evenLuuIIy be exLended Lo cIIIdren In
ongoIng murrIuges LIrougI cIIId-negIecL proceedIngs. (In OukIey, 1qqq,
CI.;, p.z)
ormer US Surgeon-GeneruI, C. EvereLL Koop, u key IIgure In LIe
currenL unLIsmokIng pundemIc, wouId wunL Lo conLorL percepLIon
somewIuL IurLIer. WILI un uIr oI weIcome, Ie predIcLed In LIe eurIy qo`s
LIuL LIe duy wIen crImInuI cIurges wIII be IIIed uguInsL smokIng purenLs
cun`L be Iur oII. (In OukIey, 1qqq, p.) WILI uII due respecL Lo LIe
Surgeon-GeneruI`s medIcuI LruInIng und experLIse, In Lerms oI reseurcI,
LIe muILI-dImensIonuI nuLure oI LIe Iumun condILIon, und depLI oI
reusonIng, IIs venLure InLo ureus LIuL ure cIeurIy beyond IIs experLIse Is
sub-umuLeurIsI uL besL und, unIorLunuLeIy, dungerous.
Ouks (zoo1) provIdes some uddILIonuI InsIgIL InLo LIe
conLorLIons oI beIIeI LIuL cIIIdren ure beIng coerced InLo by unLIsmokIng
rIeLorIc und sLruLegIes:
349
349
Rampant Antismoking Signifies Grave Danger
cooperuLe on educuLIon und pubIIc uwureness eIIorLs
uImed uL reducIng cIIIdren`s exposure Lo envIronmenLuI
Lobucco smoke.
AguIn, IL musL be borne In mInd LIuL ETS Is eIIecLIveIy u zero-
IeveI predIcLor Ior muIudIes reIevunL Lo LIIs dIscussIon. n oLIer words, LIe
greuL mujorILy (I.e., mosL) oI cIIIdren exposed Lo ETS do noL demonsLruLe
uny Increused IncIdence oI LIese muIudIes. YeL, LIe erudIcuLIon oI ETS
Irom uII cIIIdren`s envIronmenL Ius been munuIucLured InLo u pressIng
gIobuI Issue. TIe WHO (1qqq) Ius even conLrIved cn cIIId`s exposure Lo
ETS us u Iumun rIgILs vIoIuLIon:
TIIs reporL concIudes LIuL LIe evIdence oI LIIs Iurm Lo
cIIIdren Is consIsLenL und robusL. Even II cerLuIn
quesLIons sLIII requIre IurLIer reseurcI, LIere Is more
LIun suIIIcIenL evIdence oI Iurm Lo demund ucLIon Lo
reduce cIIIdren`s InvoIunLury exposure Lo Lobucco
smoke. urLIermore, LIIs InvoIunLury und IurmIuI
exposure cun uIso be seen us u Iumun rIgILs vIoIuLIon,
gIven LIe provIsIons oI ArLIcIes 6 und zq oI LIe 1q8q
UnILed NuLIons ConvenLIon on LIe RIgILs oI LIe CIIId.
(p.)
L Is purLIcuIurIy concernIng LIe IIIness oI usLImu LIuL LIe currenL
unLIsmokIng crusude Ius perpeLruLed u greuL dIsservIce. Ls IIgIIy
uggressIve rIeLorIc und mIsguIded cuusuI urgumenLuLIon Ius LIe IIgI
poLenLIuI Ior IncILIng vurIous dysIuncLIon In cIIIdren. or exumpIe, some
usLImuLIc cIIIdren Iuve become convInced LIuL LIeIr smokIng purenLs cun
kIII LIem wILI ETS uL uny momenL. OLIers beIIeve LIuL LIeIr smokIng
purenLs mIgIL dIe uL uny momenL due Lo LIeIr smokIng und Ieuve LIem
orpIuned. TIIs beIIeI Is bused on IeuILI depurLmenL und pIurmuceuLIcuI
compuny udverLIsIng LIuL IosLers LIe erroneous ImpressIon LIuL young
smokers dIe wILI IIgI reguIurILy und due onIy Lo LIeIr smokIng. OLIer
cIIIdren, sLIII, muy see In LIe cIrcumsLunce oI u smokIng purenL(s) LIe
opporLunILy Ior udvunLuge by IIIness, e.g., pIuyIng oII u nonsmokIng
purenL uguInsL u smokIng purenL. urLIermore, deIuded beIIeIs ubouL
smokIng und ETS cun InsLIguLe or exLend dIscord beLween purenLs. TIe
summury eIIecL Is LIuL smokIng und exposure Lo ETS Iuve been
munuIucLured InLo dysIuncLIonuI poIILIcuI LooIs In IumIIIuI seLLIngs LIuL
cun noL onIy generuLe severe IumIIIuI LensIon buL uIso works uL
muInLuInIng (proLecLIng) or uIIowIng u domInuLIon oI LIe IIIness oI
usLImu. TIe possIbIIILy oI pedIuLrIc somuLIzuLIon sIouId be u crILIcuI
concern (e.g., Cumpo & rILz, zoo1; see uIso secLIon Entironmentcl
Preventive Medicine & Health Promotion
Somctizction Sndrome).
TIe sILuuLIon Ius become so perverse und devoId oI
psycIoIogIcuI, psycIosocIuI und moruI coIerence LIuL wIeLIer u purenL
smokes Ius become u crucIuI IucLor In numerous cIIId cusLody IeurIngs.
PurenLs Iuve been denIed cusLody or cusLody Ius been cIuIIenged enLIreIy
on LIe busIs oI wIeLIer LIey smoke (e.g., see OukIey, 1qqq, CI.;, p.o;
Ouks, zoo1, p18q-18). n LIe InsLunce oI cIIIdren uIreudy IuvIng usLImu,
LIere Is no uLLempL Lo ussess noceboJubscebo eIIecLs concernIng exposure
Lo ETS. L Ius been cssumed In LIe courLs, on LIe busIs oI EPA (1qq) und
medIco-muLerIuIIsm generuIIy, LIuL IL Is deIInILIve LIuL ETS exposure Is
deLrImenLuI Ior uII usLImu suIIerers. TIIs Is Indeed u LrugIc cIrcumsLunce.
umIIIuI dynumIcs Iuve been suvuged by LIe unLIsmokIng crusude.
NegIIgenL und deIInquenL ure upL cIurucLerIzuLIons oI LIIs medIcuI
conducL. ConLemporury medIcuI reusonIng Ius obIILeruLed prevIous, Iong-
sLundIng InsIgILs InLo usLImu LIuL IncIuded crILIcuI psycIoIogIcuI und
psycIosocIuI IucLors. urLIermore, In ILs IncompeLenL obIIvIousness und
workIng Lo conLorLed IdeoIogIcuI gouIs, IL Ius IosLered new dImensIons oI
dysIuncLIon In LIe IIIness oI usLImu. AII deLrImenLuI consequences oI LIIs
dIsordered medIco-muLerIuIIsL conducL ure IuLrogenIc.
AguIn, unLIsmokIng ucLIvIsLs und Iobby groups IIgure IIgIIy In
LIe IueIIng oI deIuded, dIvIsIve beIIeIs. JoIn BunzIuI, Irom AcLIon on
SmokIng und HeuILI (ASH), urges unyone (e.g., purenLs, grundpurenLs,
pIysIcIuns, scIooI nurses) Lo IIIe or LesLIIy In cusLody dIspuLes InvoIvIng
smokIng. ASH Is ever-reudy Lo ussIsL LIem. BunzIuI conLends LIuL |p|
urenLs exposIng LIeIr cIIIdren Lo secondIund smoke Is LIe mosL common
Iorm oI cIIId ubuse In AmerIcu.. um cerLuInIy noL suggesLIng LIuL every
LIme u purenL IIgILs up In LIe sume room, we`re goIng Lo cry cIIId ubuse.
BuL LIe sume proLecLIon wIII evenLuuIIy be exLended Lo cIIIdren In
ongoIng murrIuges LIrougI cIIId-negIecL proceedIngs. (In OukIey, 1qqq,
CI.;, p.z)
ormer US Surgeon-GeneruI, C. EvereLL Koop, u key IIgure In LIe
currenL unLIsmokIng pundemIc, wouId wunL Lo conLorL percepLIon
somewIuL IurLIer. WILI un uIr oI weIcome, Ie predIcLed In LIe eurIy qo`s
LIuL LIe duy wIen crImInuI cIurges wIII be IIIed uguInsL smokIng purenLs
cun`L be Iur oII. (In OukIey, 1qqq, p.) WILI uII due respecL Lo LIe
Surgeon-GeneruI`s medIcuI LruInIng und experLIse, In Lerms oI reseurcI,
LIe muILI-dImensIonuI nuLure oI LIe Iumun condILIon, und depLI oI
reusonIng, IIs venLure InLo ureus LIuL ure cIeurIy beyond IIs experLIse Is
sub-umuLeurIsI uL besL und, unIorLunuLeIy, dungerous.
Ouks (zoo1) provIdes some uddILIonuI InsIgIL InLo LIe
conLorLIons oI beIIeI LIuL cIIIdren ure beIng coerced InLo by unLIsmokIng
rIeLorIc und sLruLegIes:
350
350
Rampant Antismoking Signifies Grave Danger
AnLIsmokIng educuLIon uL LIe eIemenLury scIooI IeveI
muy uIso empIusIze LIuL nIcoLIne Is u drug. HeuILI
educuLor Iz KIuzInskI sLrongIy crILIcIzed LIe InsensILIve
use oI LIIs messuge us un educuLIonuI LucLIc, reIuLIng
LIIs sLory: My IrIend`s duugILer Ior LIree duys In u row
suId sIe Iud u sLomucI ucIe und couIdn`L go Lo scIooI.
BuL Ier moLIer suw LIrougI LIIs und usked Ier wIuL
wus goIng on uL scIooI - wIy dIdn`L sIe wunL Lo go. TIIs
poor IILLIe second gruder suId LIuL LIe LeucIer suId LIuL
uII smokers ure drug uddIcLs und wIII dIe! Her IuLIer
und Ier uunL smoked, so LIe kId wus scured Lo deuLI!
WIIIe educuLIon ubouL u smoker`s rIsk oI deuLI due Lo
Iung cuncer or IeurL dIseuse mIgIL ILseII IrIgILen u
cIIId, LIe unLIsmokIng messuge LIuL cIgureLLe smokers
ure drug uddIcLs cun compound LIe cIIId`s Ieur;
crImInuIs, or bud peopIe, use drugs und ure punIsIed
II cuugIL. (p.8z)
Ouks (zoo1) uIso provIdes u grupIIc oI un unLIsmokIng posLcurd.
TIe posLcurd depIcLs u moLIer wILI un upoIogeLIc IucIuI expressIon und
young duugILer wILI u seemIngIy peLuIunL expressIon. TIe InLerucLIon IL
depIcLs Is; DuugILer: You`re u weuk, puLIeLIc drug uddIcL!! MoLIer: BuL
LIey`re onIy cIgureLLes. DuugILer: WIuLever. Ouks (zoo1) properIy
noLes LIuL |C|IIIdren urmed wILI unLIsmokIng educuLIon mIgIL resorL Lo
moruIIy puLroIIIng smokers In LIeIr Iomes. (p.8z)
AnLIsmokIng deIusIon Ius uIreudy wreuked Iuvoc wILI IumIIIuI
dynumIcs, IosLerIng dysIuncLIon rungIng Irom compounded Ieur Lo
IuugILIness. L Is unknown Iow LIIs nonsense Ius InIIuenced cIIIdren`s
InLerucLIons beLween LIose wILI smokIng purenLs und nonsmokIng
purenLs, or wIeLIer nonsmokIng purenLs do noL uIIow LIeIr cIIIdren Lo
vIsIL IrIends wIose purenLs smoke, I.e., socIuIIy dIvIsIve. AII oI LIIs
dysIuncLIon cun reucI u crescendo In LIe IIIness oI usLImu wIere cIIIdren
cun munIIesL Ieur or IuugILIness (udvunLuge by IIIness) LIrougI LIe
IIIness, I.e., somuLoIorm dIsorders.
TIIs unLIsmokIng menLuIILy cunnoL uccounL Ior uny sense oI
menLuI und socIuI IeuILI generuIIy, or LIe crILIcuI reIevunce oI LIese
dImensIons In ongoIng usLImu, or LIe precurIousness oI ILs own
psycIoIogIcuI und psycIosocIuI sLubIIILy. TIe cIurge oI cIIId ubuse, or
ubuse generuIIy, cun properIy be dIrecLed uL LIIs IncompeLenL,
superIorIsL reusonIng. GIven un upcomIng consIderuLIon oI LIe
munuIucLure und IueIIng oI LIe superIorILy syndrome und LIe
envIronmenLuI somuLIzuLIon syndrome, wIIcI ure uILImuLeIy IuLrogenIc
Preventive Medicine & Health Promotion
und IuvIng wIdespreud rumIIIcuLIons, cIurges oI ubuse und crImInuIILy
cun properIy be IuId uL LIe doorsLep oI muLerIuIIsm generuIIy, medIco-
muLerIuIIsm (IncIudIng IIIesLyIe epIdemIoIogy und prevenLIve medIcIne)
more specIIIcuIIy, und uII oI LIeIr Iungers-on sucI us monomunIucuI Iobby
groups (e.g., unLIsmokIng).
HIgIIIgILIng LIe rusIness und reckIessness oI conLemporury
medIcuI LIInkIng on ETS exposure und usLImu Is u revIew oI recenL
sLudIes by HumIILon (zooo) IndIcuLIng LIuL LIere Ius been u murked
increcse In usLImu und uIIergIes over LIe 1q8o`s und 1qqo`s In deveIoped
socIeLIes. TIIs Is durIng u LIme-Irume wIen smokIng ruLes und ETS
exposure Iuve been decrecsin. or exumpIe, In u zo-yeur, ScoLLIsI
InLergeneruLIonuI sLudy, UpLon eL uI. (zooo) Iound LIuL, wIIIe LIe
smokIng ruLe Iud IuIved Ior LIe perIod 1q;6-1qq6, LIe ruLe oI usLImu Iud
doubIed.
TIIs pIenomenon seems Lo be pecuIIur Lo deveIoped counLrIes
ruLIer LIun poorer counLrIes, und wILIIn LIe mIddIe und upper cIusses.
MurLInez (zooo), dIrecLor oI respIruLory scIences uL LIe UnIversILy oI
ArIzonu und co-uuLIor oI CIupLer 8 oI EPA (1qq) LIuL erroneousIy
depIcLed ETS us u cuuse oI new cuses oI usLImu, Is one oI muny LIuL ure
reLIInkIng LIe IIIness oI usLImu: Ike mosL peopIe, ussumed Lobucco
smoke und poIIuLIon were LIe probIem - LIIs wus LIe poIILIcuIIy correcL
wuy Lo LIInk. BuL LIese IucLors Lurned ouL noL Lo pIuy u mujor roIe. n IIgI
poIIuLIon ureus, In Iow-poIIuLIon ureus, umong uII eLInIc groups, LIere wus
usLImu. CIeurIy, someLIIng eIse wus InvoIved. MurLInez (zooo) beIIeves
LIuL LIe probIem IIes In InudequuLe cIuIIenge Lo LIe deveIopIng Immune
sysLems oI LIe young In modern, uIIIuenL socIeLIes: jusL us you need Lo
use your eyes Lo deveIop sIgIL und your Iegs Lo deveIop LIe muscIes Lo
wuIk, your Immune sysLem deveIops LIrougI ILs experIence. By
IegILImuLeIy proLecLIng our kIds Irom dungerous InIecLIons we muy Iuve
kepL purL oI LIeIr Immune sysLems Irom muLurIng.
WuIn (zooo), speukIng oI LIe Europeun popuIuLIon, proIIers
LIuL |I|L Is very conIusIng. TIese ure mIddIe cIuss purenLs, wIo Iuve
Luken on bourd LIe need Ior u IeuILIy IIIesLyIe: Iow ruLes oI smokIng In
pregnuncy, Iow ruLes oI smokIng In LIe Iome und Iow IeveIs oI peL
ownersIIp, LogeLIer wILI IIgI ruLes oI breusL IeedIng... TIere Is cIeurIy
un unIdenLIIIed IucLor LIuL Is so sLrong IL cun overcome uII LIe IIIesLyIe
cIunges we encouruge purenLs Lo udopL. UnIorLunuLeIy, LIIs suggesLIon
goes Iur beyond LIe ImpIIcuLIons oI duLu. TIe surmIsIng ussumes, In seII-
servIng und exoneruLIng IusIIon, LIuL LIe recommended IIIesLyIe cIunges
ure cuusuI und beneIIcIuI, buL Iuve been overrIdden by some oLIer, Iur
sLronger, cuusuI IucLor(s). TIIs proposILIon Is unLesLubIe. A Iur more
pIuusIbIe possIbIIILy Is LIuL muny oI LIe recommended IIIesLyIe cIunges
351
351
Rampant Antismoking Signifies Grave Danger
AnLIsmokIng educuLIon uL LIe eIemenLury scIooI IeveI
muy uIso empIusIze LIuL nIcoLIne Is u drug. HeuILI
educuLor Iz KIuzInskI sLrongIy crILIcIzed LIe InsensILIve
use oI LIIs messuge us un educuLIonuI LucLIc, reIuLIng
LIIs sLory: My IrIend`s duugILer Ior LIree duys In u row
suId sIe Iud u sLomucI ucIe und couIdn`L go Lo scIooI.
BuL Ier moLIer suw LIrougI LIIs und usked Ier wIuL
wus goIng on uL scIooI - wIy dIdn`L sIe wunL Lo go. TIIs
poor IILLIe second gruder suId LIuL LIe LeucIer suId LIuL
uII smokers ure drug uddIcLs und wIII dIe! Her IuLIer
und Ier uunL smoked, so LIe kId wus scured Lo deuLI!
WIIIe educuLIon ubouL u smoker`s rIsk oI deuLI due Lo
Iung cuncer or IeurL dIseuse mIgIL ILseII IrIgILen u
cIIId, LIe unLIsmokIng messuge LIuL cIgureLLe smokers
ure drug uddIcLs cun compound LIe cIIId`s Ieur;
crImInuIs, or bud peopIe, use drugs und ure punIsIed
II cuugIL. (p.8z)
Ouks (zoo1) uIso provIdes u grupIIc oI un unLIsmokIng posLcurd.
TIe posLcurd depIcLs u moLIer wILI un upoIogeLIc IucIuI expressIon und
young duugILer wILI u seemIngIy peLuIunL expressIon. TIe InLerucLIon IL
depIcLs Is; DuugILer: You`re u weuk, puLIeLIc drug uddIcL!! MoLIer: BuL
LIey`re onIy cIgureLLes. DuugILer: WIuLever. Ouks (zoo1) properIy
noLes LIuL |C|IIIdren urmed wILI unLIsmokIng educuLIon mIgIL resorL Lo
moruIIy puLroIIIng smokers In LIeIr Iomes. (p.8z)
AnLIsmokIng deIusIon Ius uIreudy wreuked Iuvoc wILI IumIIIuI
dynumIcs, IosLerIng dysIuncLIon rungIng Irom compounded Ieur Lo
IuugILIness. L Is unknown Iow LIIs nonsense Ius InIIuenced cIIIdren`s
InLerucLIons beLween LIose wILI smokIng purenLs und nonsmokIng
purenLs, or wIeLIer nonsmokIng purenLs do noL uIIow LIeIr cIIIdren Lo
vIsIL IrIends wIose purenLs smoke, I.e., socIuIIy dIvIsIve. AII oI LIIs
dysIuncLIon cun reucI u crescendo In LIe IIIness oI usLImu wIere cIIIdren
cun munIIesL Ieur or IuugILIness (udvunLuge by IIIness) LIrougI LIe
IIIness, I.e., somuLoIorm dIsorders.
TIIs unLIsmokIng menLuIILy cunnoL uccounL Ior uny sense oI
menLuI und socIuI IeuILI generuIIy, or LIe crILIcuI reIevunce oI LIese
dImensIons In ongoIng usLImu, or LIe precurIousness oI ILs own
psycIoIogIcuI und psycIosocIuI sLubIIILy. TIe cIurge oI cIIId ubuse, or
ubuse generuIIy, cun properIy be dIrecLed uL LIIs IncompeLenL,
superIorIsL reusonIng. GIven un upcomIng consIderuLIon oI LIe
munuIucLure und IueIIng oI LIe superIorILy syndrome und LIe
envIronmenLuI somuLIzuLIon syndrome, wIIcI ure uILImuLeIy IuLrogenIc
Preventive Medicine & Health Promotion
und IuvIng wIdespreud rumIIIcuLIons, cIurges oI ubuse und crImInuIILy
cun properIy be IuId uL LIe doorsLep oI muLerIuIIsm generuIIy, medIco-
muLerIuIIsm (IncIudIng IIIesLyIe epIdemIoIogy und prevenLIve medIcIne)
more specIIIcuIIy, und uII oI LIeIr Iungers-on sucI us monomunIucuI Iobby
groups (e.g., unLIsmokIng).
HIgIIIgILIng LIe rusIness und reckIessness oI conLemporury
medIcuI LIInkIng on ETS exposure und usLImu Is u revIew oI recenL
sLudIes by HumIILon (zooo) IndIcuLIng LIuL LIere Ius been u murked
increcse In usLImu und uIIergIes over LIe 1q8o`s und 1qqo`s In deveIoped
socIeLIes. TIIs Is durIng u LIme-Irume wIen smokIng ruLes und ETS
exposure Iuve been decrecsin. or exumpIe, In u zo-yeur, ScoLLIsI
InLergeneruLIonuI sLudy, UpLon eL uI. (zooo) Iound LIuL, wIIIe LIe
smokIng ruLe Iud IuIved Ior LIe perIod 1q;6-1qq6, LIe ruLe oI usLImu Iud
doubIed.
TIIs pIenomenon seems Lo be pecuIIur Lo deveIoped counLrIes
ruLIer LIun poorer counLrIes, und wILIIn LIe mIddIe und upper cIusses.
MurLInez (zooo), dIrecLor oI respIruLory scIences uL LIe UnIversILy oI
ArIzonu und co-uuLIor oI CIupLer 8 oI EPA (1qq) LIuL erroneousIy
depIcLed ETS us u cuuse oI new cuses oI usLImu, Is one oI muny LIuL ure
reLIInkIng LIe IIIness oI usLImu: Ike mosL peopIe, ussumed Lobucco
smoke und poIIuLIon were LIe probIem - LIIs wus LIe poIILIcuIIy correcL
wuy Lo LIInk. BuL LIese IucLors Lurned ouL noL Lo pIuy u mujor roIe. n IIgI
poIIuLIon ureus, In Iow-poIIuLIon ureus, umong uII eLInIc groups, LIere wus
usLImu. CIeurIy, someLIIng eIse wus InvoIved. MurLInez (zooo) beIIeves
LIuL LIe probIem IIes In InudequuLe cIuIIenge Lo LIe deveIopIng Immune
sysLems oI LIe young In modern, uIIIuenL socIeLIes: jusL us you need Lo
use your eyes Lo deveIop sIgIL und your Iegs Lo deveIop LIe muscIes Lo
wuIk, your Immune sysLem deveIops LIrougI ILs experIence. By
IegILImuLeIy proLecLIng our kIds Irom dungerous InIecLIons we muy Iuve
kepL purL oI LIeIr Immune sysLems Irom muLurIng.
WuIn (zooo), speukIng oI LIe Europeun popuIuLIon, proIIers
LIuL |I|L Is very conIusIng. TIese ure mIddIe cIuss purenLs, wIo Iuve
Luken on bourd LIe need Ior u IeuILIy IIIesLyIe: Iow ruLes oI smokIng In
pregnuncy, Iow ruLes oI smokIng In LIe Iome und Iow IeveIs oI peL
ownersIIp, LogeLIer wILI IIgI ruLes oI breusL IeedIng... TIere Is cIeurIy
un unIdenLIIIed IucLor LIuL Is so sLrong IL cun overcome uII LIe IIIesLyIe
cIunges we encouruge purenLs Lo udopL. UnIorLunuLeIy, LIIs suggesLIon
goes Iur beyond LIe ImpIIcuLIons oI duLu. TIe surmIsIng ussumes, In seII-
servIng und exoneruLIng IusIIon, LIuL LIe recommended IIIesLyIe cIunges
ure cuusuI und beneIIcIuI, buL Iuve been overrIdden by some oLIer, Iur
sLronger, cuusuI IucLor(s). TIIs proposILIon Is unLesLubIe. A Iur more
pIuusIbIe possIbIIILy Is LIuL muny oI LIe recommended IIIesLyIe cIunges
352
352
Rampant Antismoking Signifies Grave Danger
ure onIy sLuLIsLIcuI rIsk IucLors LIuL Iuve been over-InLerpreLed us cuusuI
IucLors, I.e., LIey poLenLIuIIy Iuve no eIIecL. However, some IucLors LIuL
Iuve been removed muy Iuve prevIousIy conLrIbuLed u beneIIcIuI eIIecL.
TIe mosL crILIcuI oI LIese ure psycIoIogIcuI IucLors und LIe generuI
uLLILude Lowurd LIe IIIness. PrIor Lo u muLerIuIIsL ussuuIL, IL wus
undersLood LIuL dysIuncLIonuI LIInkIng cun Iuve deLrImenLuI
ImmunoIogIcuI und somuLIc eIIecLs. TIe probIem muy now be one oI
cosseLIng or overproLecLIon, cttitudincll, oI LIe IIIness LIuL does noL
IosLer psycIoIogIcuI und psycIosocIuI muLuruLIon und promoLes LIe
psycIosomuLIc or projecLIon consequences LIereoI.
TIere ure now numerous new expIunuLIons Ior LIe rIsIng
usLImu ruLes, e.g., Iuck oI pIysIcuI ucLIvILy, cIungIng puLLerns oI dIeL,
geneLIc predIsposILIon, LIe IncreusIng presence oI mun-mude cIemIcuIs,
mIce, doubIe gIuzIng und cenLruI IeuLIng, overuse oI unLIbIoLIcs, ozone.
However, wIuL Is sLIII bIocked In LIe muLerIuIIsm oI conLemporury
medIcuI reusonIng ure psycIoIogIcuI und psycIosocIuI dImensIons und
IurLIer deLrImenLuI rumIIIcuLIons oI LIe IIIness. TIere ure even newer
expIunuLIons, LypIcuIIy muLerIuIIsL In dIsposILIon, Ior usLImu generuIIy.
or exumpIe: DocLors beIIeve LIey Iuve Iound u sIngIe gene responsIbIe
Ior Lwo In IIve cuses oI usLImu (Hercld,Sun, ebruury z, zoo1); |m|
uscIe ceIIs IoId key Lo usLImu. (Hercld,Sun, December 1q, zoo1)
Even more ImporLunLIy Is LIuL no reIerence Is mude Lo LIe very
consIderubIe und ongoIng IuLrogenIc dumuge uIreudy done, e.g., IumIIIuI
conLorLIons und mIsguIded IeguI precedenLs, on LIe busIs oI IuII-buked,
IncompeLenL, muLerIuIIsL uppruIsuIs oI usLImu us IIrsL depIcLed In EPA
(1qq). DespILe even LIese reIuLIveIy new InsIgILs InLo usLImu und LIe
Lurnuround by muny experLs concernIng LIe roIe oI ETS exposure, Perske
(zooo) IIgIIIgILs LIuL In JuIy, zooo, u IuII-puge unLI-smokIng udverL run
In LIe Neu Yorl Times cIuImIng, umong oLIer LIIngs, LIuL secondIund
smoke cuuses z6,ooo new usLImu cuses eucI yeur In LIe U.S., I.e., seII-
servIng reIusI by Iobby groups oI oId, LIred, conLorLed und dungerous
cIuIms.
More recenLIy sLIII, u CenLers Ior DIseuse ConLroI (zooz) reporL
ucknowIedges u psycIoIogIcuI (Ieur, Lruumu) componenL In usLImu Ior uL
IeusL some persons IoIIowIng LIe SepLember 11, WorId Trude CenLer
uLLucks In New York CILy. A new sLudy Ius begun In AusLruIIu
InvesLIguLIng wIeLIer breuLIIng LecInIques couId reduce LIe severILy oI
usLImu: WIen someone Ius un usLImu uLLuck LIey Iuve u sense oI cIesL
LIgILness und sIorLness oI breuLI wIIcI muy Increuse u sense oI punIc und
unxIeLy; Ience, LIey Lend Lo breuLIe IusLer und LIuL mIgIL worsen LIe
sympLoms oI usLImu..I we cun reduce LIe ruLe oI LIeIr breuLIIng, LIey
mIgIL geL beLLer conLroI oI LIe usLImu wILIouL LIe use oI
Preventive Medicine & Health Promotion
medIcuLIon. (Hercld,Sun, Junuury 11, zoo, p.1) Over LIe IusL decude or
so, muLerIuIIsm Ius obIILeruLed wIuL wus once undersLood, und LIe
concepL oI u psycIogenIc componenL In usLImu Is onIy begInnIng Lo be
redIscovered. UnIorLunuLeIy, In LIe InLerIm muLerIuIIsm Ius wreuked
Iuvoc wILI ILs mIsguIded, psycIoIogIcuIIy sLerIIe, InLerpreLuLIon oI LIe
pIenomenon oI usLImu.
TIereIore, u key Iocus oI LIe unLIsmokIng dogmu Ius concerned
usLImu, specIIIcuIIy, und LIe supposed proLecLIon oI uII cIIIdren,
generuIIy. TIIs Iocus Is bused on reIuLIve-rIsk dIIIerences (sLuLIsLIcuI) In
IIIness ussocIuLed wILI exposure Lo ETS usIng LIe epIdemIoIogIc meLIod
und noL LIe experImenLuI ussessmenL oI IndIvIduuI puLIenLs. urLIermore,
Ior IIInesses LIuL ETS Is reIuLIveIy more IIgIIy ussocIuLed wILI (I.e., IIgIer
RR`s), LIe predIcLIve sLrengLI oI exposure Lo ETS Ior LIese IIInesses Is
eIIecLIveIy zero.
L sIouId uIso be noLed LIuL LIe crILIcuI reuson us Lo wIy cll
purenLs ure uggressIveIy udvIsed Lo noL smoke uround cll cIIIdren, even
LIougI LIere Is no Increused ussocIuLIon wILI IIIness Ior mosL cIIIdren
exposed Lo ETS, Is essenLIuIIy u beIuvIorIsL (muLerIuIIsL) pIoy uLLempLIng
muss beIuvIor modIIIcuLIon. TIe InLenL Is Lo remove or mInImIze LIe
poLenLIuI posILIve reInIorcemenL oI cIIIdren seein LIeIr purenLs or oLIer
uduILs smokIng In LIe Iope oI reducIng LIe upLuke oI smokIng In LIe
younger generuLIon. n uLLempLIng Lo munuIucLure LIIs cIrcumsLunce,
IeuILIIsm Ius no dIIIIcuILy In convIncIng uII smokIng purenLs LIuL LIeIr
beIuvIor Is neur-crImInuI und sIouId sIumeIuIIy be prucLIced In IIdIng, or
convIncIng uII purenLs LIuL uII cIIIdren ure In gruve und ever-presenL
dunger Irom uny exposure Lo ETS, I.e., cIIIdren ure weII onIy II LIey ure
LreuLed us II sIck. or exumpIe, u newspuper urLIcIe cupLIoned Smoker
gruns u rIsk decIures LIuL grundpurenLs wIo smoke pose u serIous rIsk Lo
cIIIdren..I LIey`re goIng Lo smoke, do IL ouLsIde - und IdeuIIy ouL oI
sIgIL. (Hercld,Sun, VIcLorIu, AusLruIIu, Muy z, zooo, p.q)
As Ius been consIdered, LIIs Ius Iud consIderubIe deLrImenLuI
consequences Ior purenLs und cIIIdren uIIke. Even nonsmokIng purenLs
LIuL InILIuIIy dId noL Iuve u probIem wILI ETS Iuve been browbeuLen InLo
LIe beIIeI LIuL uIIowIng LIeIr cIIIdren, or uny cIIId, Lo be exposed Is
IrresponsIbIe. AguIn, IL Is LIIs enLIre medIcuI conducL LIuL Is IrresponsIbIe
In LIe exLreme.
TIe very consIderubIe dysIuncLIonuI consequences regurdIng
usLImu ure unIorLunuLeIy noL LIe worsL rumIIIcuLIon oI MMES-reusonIng.
ConsIdered In LIe IoIIowIng secLIon Is u greuLer conLexL oI dysIuncLIon, oI
pundemIc und dungerous proporLIons, LIuL Is wIoIIy uLLrIbuLubIe Lo LIe
wuywurd, mIsguIded conducL oI LIe conLemporury medIcuI esLubIIsImenL,
I.e., IuLrogenIc, us purL oI u greuLer muLerIuIIsL onsIuugIL.
353
353
Rampant Antismoking Signifies Grave Danger
ure onIy sLuLIsLIcuI rIsk IucLors LIuL Iuve been over-InLerpreLed us cuusuI
IucLors, I.e., LIey poLenLIuIIy Iuve no eIIecL. However, some IucLors LIuL
Iuve been removed muy Iuve prevIousIy conLrIbuLed u beneIIcIuI eIIecL.
TIe mosL crILIcuI oI LIese ure psycIoIogIcuI IucLors und LIe generuI
uLLILude Lowurd LIe IIIness. PrIor Lo u muLerIuIIsL ussuuIL, IL wus
undersLood LIuL dysIuncLIonuI LIInkIng cun Iuve deLrImenLuI
ImmunoIogIcuI und somuLIc eIIecLs. TIe probIem muy now be one oI
cosseLIng or overproLecLIon, cttitudincll, oI LIe IIIness LIuL does noL
IosLer psycIoIogIcuI und psycIosocIuI muLuruLIon und promoLes LIe
psycIosomuLIc or projecLIon consequences LIereoI.
TIere ure now numerous new expIunuLIons Ior LIe rIsIng
usLImu ruLes, e.g., Iuck oI pIysIcuI ucLIvILy, cIungIng puLLerns oI dIeL,
geneLIc predIsposILIon, LIe IncreusIng presence oI mun-mude cIemIcuIs,
mIce, doubIe gIuzIng und cenLruI IeuLIng, overuse oI unLIbIoLIcs, ozone.
However, wIuL Is sLIII bIocked In LIe muLerIuIIsm oI conLemporury
medIcuI reusonIng ure psycIoIogIcuI und psycIosocIuI dImensIons und
IurLIer deLrImenLuI rumIIIcuLIons oI LIe IIIness. TIere ure even newer
expIunuLIons, LypIcuIIy muLerIuIIsL In dIsposILIon, Ior usLImu generuIIy.
or exumpIe: DocLors beIIeve LIey Iuve Iound u sIngIe gene responsIbIe
Ior Lwo In IIve cuses oI usLImu (Hercld,Sun, ebruury z, zoo1); |m|
uscIe ceIIs IoId key Lo usLImu. (Hercld,Sun, December 1q, zoo1)
Even more ImporLunLIy Is LIuL no reIerence Is mude Lo LIe very
consIderubIe und ongoIng IuLrogenIc dumuge uIreudy done, e.g., IumIIIuI
conLorLIons und mIsguIded IeguI precedenLs, on LIe busIs oI IuII-buked,
IncompeLenL, muLerIuIIsL uppruIsuIs oI usLImu us IIrsL depIcLed In EPA
(1qq). DespILe even LIese reIuLIveIy new InsIgILs InLo usLImu und LIe
Lurnuround by muny experLs concernIng LIe roIe oI ETS exposure, Perske
(zooo) IIgIIIgILs LIuL In JuIy, zooo, u IuII-puge unLI-smokIng udverL run
In LIe Neu Yorl Times cIuImIng, umong oLIer LIIngs, LIuL secondIund
smoke cuuses z6,ooo new usLImu cuses eucI yeur In LIe U.S., I.e., seII-
servIng reIusI by Iobby groups oI oId, LIred, conLorLed und dungerous
cIuIms.
More recenLIy sLIII, u CenLers Ior DIseuse ConLroI (zooz) reporL
ucknowIedges u psycIoIogIcuI (Ieur, Lruumu) componenL In usLImu Ior uL
IeusL some persons IoIIowIng LIe SepLember 11, WorId Trude CenLer
uLLucks In New York CILy. A new sLudy Ius begun In AusLruIIu
InvesLIguLIng wIeLIer breuLIIng LecInIques couId reduce LIe severILy oI
usLImu: WIen someone Ius un usLImu uLLuck LIey Iuve u sense oI cIesL
LIgILness und sIorLness oI breuLI wIIcI muy Increuse u sense oI punIc und
unxIeLy; Ience, LIey Lend Lo breuLIe IusLer und LIuL mIgIL worsen LIe
sympLoms oI usLImu..I we cun reduce LIe ruLe oI LIeIr breuLIIng, LIey
mIgIL geL beLLer conLroI oI LIe usLImu wILIouL LIe use oI
Preventive Medicine & Health Promotion
medIcuLIon. (Hercld,Sun, Junuury 11, zoo, p.1) Over LIe IusL decude or
so, muLerIuIIsm Ius obIILeruLed wIuL wus once undersLood, und LIe
concepL oI u psycIogenIc componenL In usLImu Is onIy begInnIng Lo be
redIscovered. UnIorLunuLeIy, In LIe InLerIm muLerIuIIsm Ius wreuked
Iuvoc wILI ILs mIsguIded, psycIoIogIcuIIy sLerIIe, InLerpreLuLIon oI LIe
pIenomenon oI usLImu.
TIereIore, u key Iocus oI LIe unLIsmokIng dogmu Ius concerned
usLImu, specIIIcuIIy, und LIe supposed proLecLIon oI uII cIIIdren,
generuIIy. TIIs Iocus Is bused on reIuLIve-rIsk dIIIerences (sLuLIsLIcuI) In
IIIness ussocIuLed wILI exposure Lo ETS usIng LIe epIdemIoIogIc meLIod
und noL LIe experImenLuI ussessmenL oI IndIvIduuI puLIenLs. urLIermore,
Ior IIInesses LIuL ETS Is reIuLIveIy more IIgIIy ussocIuLed wILI (I.e., IIgIer
RR`s), LIe predIcLIve sLrengLI oI exposure Lo ETS Ior LIese IIInesses Is
eIIecLIveIy zero.
L sIouId uIso be noLed LIuL LIe crILIcuI reuson us Lo wIy cll
purenLs ure uggressIveIy udvIsed Lo noL smoke uround cll cIIIdren, even
LIougI LIere Is no Increused ussocIuLIon wILI IIIness Ior mosL cIIIdren
exposed Lo ETS, Is essenLIuIIy u beIuvIorIsL (muLerIuIIsL) pIoy uLLempLIng
muss beIuvIor modIIIcuLIon. TIe InLenL Is Lo remove or mInImIze LIe
poLenLIuI posILIve reInIorcemenL oI cIIIdren seein LIeIr purenLs or oLIer
uduILs smokIng In LIe Iope oI reducIng LIe upLuke oI smokIng In LIe
younger generuLIon. n uLLempLIng Lo munuIucLure LIIs cIrcumsLunce,
IeuILIIsm Ius no dIIIIcuILy In convIncIng uII smokIng purenLs LIuL LIeIr
beIuvIor Is neur-crImInuI und sIouId sIumeIuIIy be prucLIced In IIdIng, or
convIncIng uII purenLs LIuL uII cIIIdren ure In gruve und ever-presenL
dunger Irom uny exposure Lo ETS, I.e., cIIIdren ure weII onIy II LIey ure
LreuLed us II sIck. or exumpIe, u newspuper urLIcIe cupLIoned Smoker
gruns u rIsk decIures LIuL grundpurenLs wIo smoke pose u serIous rIsk Lo
cIIIdren..I LIey`re goIng Lo smoke, do IL ouLsIde - und IdeuIIy ouL oI
sIgIL. (Hercld,Sun, VIcLorIu, AusLruIIu, Muy z, zooo, p.q)
As Ius been consIdered, LIIs Ius Iud consIderubIe deLrImenLuI
consequences Ior purenLs und cIIIdren uIIke. Even nonsmokIng purenLs
LIuL InILIuIIy dId noL Iuve u probIem wILI ETS Iuve been browbeuLen InLo
LIe beIIeI LIuL uIIowIng LIeIr cIIIdren, or uny cIIId, Lo be exposed Is
IrresponsIbIe. AguIn, IL Is LIIs enLIre medIcuI conducL LIuL Is IrresponsIbIe
In LIe exLreme.
TIe very consIderubIe dysIuncLIonuI consequences regurdIng
usLImu ure unIorLunuLeIy noL LIe worsL rumIIIcuLIon oI MMES-reusonIng.
ConsIdered In LIe IoIIowIng secLIon Is u greuLer conLexL oI dysIuncLIon, oI
pundemIc und dungerous proporLIons, LIuL Is wIoIIy uLLrIbuLubIe Lo LIe
wuywurd, mIsguIded conducL oI LIe conLemporury medIcuI esLubIIsImenL,
I.e., IuLrogenIc, us purL oI u greuLer muLerIuIIsL onsIuugIL.
354
354
Rampant Antismoking Signifies Grave Danger
(. The Superiorit Sndrome (SS) cnd the
Entironmentcl Somctizction Sndrome (ESS)
(..: The Superiorit Sndrome
L Ius been consIdered LIrougIouL LIuL MMES reusonIng IosLers
IrruLIonuI IeurJLerror. osLerIng Lerror LIrougI supersLILIous beIIeI wouId
onIy resuIL In persons uvoIdIng wIuL LIey ure now erroneousIy IeurIuI oI,
e.g., pIobIu. UnIorLunuLeIy, under LIe guIdunce oI so-cuIIed IeuILI
uuLIorILIes, LIe sILuuLIon becomes Iur worse. TIose LIuL ure coerced InLo
supersLILIous Ieur ure uIso educuLed LIuL LIeIr Ieur Is noL IrruLIonuI buL
scIenLIIIcuIIy-bused, und LIereIore ruLIonuI, I.e. psycIoIogIcuI In-
versIon oI IrruLIonuI Ieur InLo LIe superIorILy syndrome. As sucI, IL Is noL
LIey LIuL sIouId uvoId LIe dungerous exLernuIILy, buL LIe dungerous
exLernuIILy sIouId be removedJexLermInuLed. TIose (nonsmokers) LIuL
ure pIuced In dunger ure vIewed us InnocenL vIcLIms or poLenLIuI vIcLIms
oI LIe cruzed menLuIILy (smokers) LIuL wouId pIuce LIem In unnecessury
dunger. L Is onIy LIey wIo ure oI superIor, uncruzed LIInkIng LIuL cun
suve LIemseIves, und LIe worId, Irom LIe gruve und ever-presenL ETS
dunger.
TIe LempLuLIon Lo u superIorILy menLuIILy Is u very sLrong one,
purLIcuIurIy wIen persons Iuve noL muLured beyond superIIcIuI LIInkIng
(I.e., IurborIng uII munner oI dysIuncLIonuI, dIsjoInLed LIougIL). TIese
persons ure uccorded LIe superIor sLuLus wILI no eIIorL requIred In ILs
uLLuInmenL, e.g., by sImpIy beIng u nonsmoker. uke superIorILy reIIes on
munuIucLurIng u pIenomenon InLo wIuL IL Is noL. BurLIoIomew (1qq;)
proIIers u reusonubIe deIInILIon oI popuIur muss deIusIon us InvoIvIng u
rupId spreud oI IuIse, buL pIuusIbIe, exuggeruLed beIIeIs LIuL guIn
credIbIIILy wILIIn u purLIcuIur socIuI und cuILuruI conLexL..|E|veryduy
objecLs, evenLs, und cIrcumsLunces LIuL wouId ordInurIIy receIve scunL
uLLenLIon become LIe subjecL oI exLruordInury scruLIny. AmbIguous ugenLs
ure soon redeIIned uccordIng Lo LIe emergIng deIInILIon oI LIe sILuuLIon,
creuLIng u seII-IuIIIIIIng propIesy. SucI u deIInILIon cun cerLuInIy be
uppIIed Lo LIe socIuI consLrucLIon oI ETS us u pervusIve dunger. ETS, once
u psycIoIogIcuIIy or percepLuuIIy buckground pIenomenon, Ius been
munuIucLured InLo u crILIcuI Ioreground pIenomenon.
GIven LIe uppeuI Lo superIorILy und LIe IuIIure Lo provIde
udequuLe counLer-urgumenL In LIe Iuce oI u propugundu burruge, muny
nonsmokers ure In dysIuncLIonuI sLuLes oI LIougIL (e.g., superIorILy
syndrome) mude Lo uppeur normuI onIy by LIe prevuIIIng IeuILIIsL
menLuIILy LIuL IosLered LIe dysIuncLIon Lo begIn wILI. WIuL begun us u
Preventive Medicine & Health Promotion
smuII monomunIucuI group (unLIsmokIng) Ius been uIIowed Lo recruIL,
uIbeIL IruuduIenLIy, muny nonsmokers LIuL were noL IormerIy unLIsmokIng
In dIsposILIon. TIe cIrcumsLunce Ius been uIIowed Lo occur by u
domIneerIng muLerIuIIsm LIuL Is ILseII menLuIIy dysIuncLIonuI, cunnoL
compreIend non-reducLIonIsL dImensIons oI LIe Iumun condILIon, und
cunnoL IuLIom LIe deLrImenLuI consequences uIong LIese dImensIons oI
ILs own conducL.
By reIenLIess InIIummuLory uppeuIs Lo ETS ussocIuLed wILI
cuncer, deuLI, kIIIIng, eLc., ETS Ius become LIe projecLIon poInL Ior
numerous psycIopuLIoIogIes; medIco-muLerIuIIsm Ius bIIndIy opened
unoLIer, very consIderubIe, Pundoru`s Box oI menLuI dysIuncLIon. TIe
psycIoIogIcuI InversIon oI LIe IrruLIonuI Ieur oI ETS InLo u superIorILy
syndrome Ius LIe eIIecL oI normuIIzIng uII munner oI exIsLIng
psycIopuLIoIogIes. or exumpIe, obsessIveJcompuIsIve dIsorders LIuL cun
be munIIesLed us exuggeruLed preoccupuLIons wILI exLernuI cIeunIIness
und IygIene ure now uccorded u sense oI noL onIy normuIILy buL
superIorILy Irom LIeIr one-LIme IrruLIonuI demunds Ior unpoIIuLed
envIrons. PIobIus sucI us necropIobIu (morbId Ieur oI deuLI),
cunceropIobIu (morbId Ieur oI cuncer), oIIucLopIobIu (morbId Ieur oI
smeIIs), ure uIso gIven u superIor sLuLus In reucLIvILy Lo ETS.
Beyond reInIorcIng psycIopuLIoIogIes us LIose ubovemenLIoned,
LIe reuI Lrugedy oI LIe superIorILy syndrome Is ILs cupucILy us u LooI Ior
socIuI dIvIsIveness. n LIIs sense, LIe superIorILy syndrome Is no more
LIun bIgoLry und, by LIe munner LIuL IL wus munuIucLured (medIcuI
esLubIIsImenL), LIe syndrome und uII deLrImenLuI consequences ure
IuLrogenIc. n u sIorL LIme muny nonsmokers cun now jusLIIy In LIeIr
newIy conLorLed reusonIng uII munner oI psycIoIogIcuI und psycIosocIuI
dysIuncLIon us superIor und moruI. or exumpIe, beIow ure onIy u jeu oI
LIe numerous unLIsmokIng IeLLersJcommenLs uppeurIng In u mujor
AusLruIIun SLuLe (VIcLorIu) newspuper:
As u pussIonuLe non-smoker, ugree In prIncIpIe LIuL
smokers sIouId noL be uIIowed Lo smoke wILI cIIIdren
In LIe cur. BuL pussIng u Iuw uguInsL IL? Come on. L`s
noL us II smokers uren`L uwure oI LIe dungers. TIey`ve
been LoId. IeeI Ior LIe cIIIdren buL, IeL`s Iuce IL,
smokers uren`L renowned Ior IuvIng u IIgI Q. I LIese
peopIe ure so sLupId LIuL LIey wIII knowIngIy puL Ioved
ones uL rIsk, pussIng u Iuw won`L sLop LIem. Among LIe
deudIy cIemIcuI cockLuII, cIgureLLes obvIousIy conLuIn u
mInd-uILerIng drug wIIcI cuuses LIe smoker Lo Iose uII
common sense und reuson. AILer uII LIe educuLIon,
LIose sLIII smokIng ure no more InLeIIIgenL LIun drug
355
355
Rampant Antismoking Signifies Grave Danger
(. The Superiorit Sndrome (SS) cnd the
Entironmentcl Somctizction Sndrome (ESS)
(..: The Superiorit Sndrome
L Ius been consIdered LIrougIouL LIuL MMES reusonIng IosLers
IrruLIonuI IeurJLerror. osLerIng Lerror LIrougI supersLILIous beIIeI wouId
onIy resuIL In persons uvoIdIng wIuL LIey ure now erroneousIy IeurIuI oI,
e.g., pIobIu. UnIorLunuLeIy, under LIe guIdunce oI so-cuIIed IeuILI
uuLIorILIes, LIe sILuuLIon becomes Iur worse. TIose LIuL ure coerced InLo
supersLILIous Ieur ure uIso educuLed LIuL LIeIr Ieur Is noL IrruLIonuI buL
scIenLIIIcuIIy-bused, und LIereIore ruLIonuI, I.e. psycIoIogIcuI In-
versIon oI IrruLIonuI Ieur InLo LIe superIorILy syndrome. As sucI, IL Is noL
LIey LIuL sIouId uvoId LIe dungerous exLernuIILy, buL LIe dungerous
exLernuIILy sIouId be removedJexLermInuLed. TIose (nonsmokers) LIuL
ure pIuced In dunger ure vIewed us InnocenL vIcLIms or poLenLIuI vIcLIms
oI LIe cruzed menLuIILy (smokers) LIuL wouId pIuce LIem In unnecessury
dunger. L Is onIy LIey wIo ure oI superIor, uncruzed LIInkIng LIuL cun
suve LIemseIves, und LIe worId, Irom LIe gruve und ever-presenL ETS
dunger.
TIe LempLuLIon Lo u superIorILy menLuIILy Is u very sLrong one,
purLIcuIurIy wIen persons Iuve noL muLured beyond superIIcIuI LIInkIng
(I.e., IurborIng uII munner oI dysIuncLIonuI, dIsjoInLed LIougIL). TIese
persons ure uccorded LIe superIor sLuLus wILI no eIIorL requIred In ILs
uLLuInmenL, e.g., by sImpIy beIng u nonsmoker. uke superIorILy reIIes on
munuIucLurIng u pIenomenon InLo wIuL IL Is noL. BurLIoIomew (1qq;)
proIIers u reusonubIe deIInILIon oI popuIur muss deIusIon us InvoIvIng u
rupId spreud oI IuIse, buL pIuusIbIe, exuggeruLed beIIeIs LIuL guIn
credIbIIILy wILIIn u purLIcuIur socIuI und cuILuruI conLexL..|E|veryduy
objecLs, evenLs, und cIrcumsLunces LIuL wouId ordInurIIy receIve scunL
uLLenLIon become LIe subjecL oI exLruordInury scruLIny. AmbIguous ugenLs
ure soon redeIIned uccordIng Lo LIe emergIng deIInILIon oI LIe sILuuLIon,
creuLIng u seII-IuIIIIIIng propIesy. SucI u deIInILIon cun cerLuInIy be
uppIIed Lo LIe socIuI consLrucLIon oI ETS us u pervusIve dunger. ETS, once
u psycIoIogIcuIIy or percepLuuIIy buckground pIenomenon, Ius been
munuIucLured InLo u crILIcuI Ioreground pIenomenon.
GIven LIe uppeuI Lo superIorILy und LIe IuIIure Lo provIde
udequuLe counLer-urgumenL In LIe Iuce oI u propugundu burruge, muny
nonsmokers ure In dysIuncLIonuI sLuLes oI LIougIL (e.g., superIorILy
syndrome) mude Lo uppeur normuI onIy by LIe prevuIIIng IeuILIIsL
menLuIILy LIuL IosLered LIe dysIuncLIon Lo begIn wILI. WIuL begun us u
Preventive Medicine & Health Promotion
smuII monomunIucuI group (unLIsmokIng) Ius been uIIowed Lo recruIL,
uIbeIL IruuduIenLIy, muny nonsmokers LIuL were noL IormerIy unLIsmokIng
In dIsposILIon. TIe cIrcumsLunce Ius been uIIowed Lo occur by u
domIneerIng muLerIuIIsm LIuL Is ILseII menLuIIy dysIuncLIonuI, cunnoL
compreIend non-reducLIonIsL dImensIons oI LIe Iumun condILIon, und
cunnoL IuLIom LIe deLrImenLuI consequences uIong LIese dImensIons oI
ILs own conducL.
By reIenLIess InIIummuLory uppeuIs Lo ETS ussocIuLed wILI
cuncer, deuLI, kIIIIng, eLc., ETS Ius become LIe projecLIon poInL Ior
numerous psycIopuLIoIogIes; medIco-muLerIuIIsm Ius bIIndIy opened
unoLIer, very consIderubIe, Pundoru`s Box oI menLuI dysIuncLIon. TIe
psycIoIogIcuI InversIon oI LIe IrruLIonuI Ieur oI ETS InLo u superIorILy
syndrome Ius LIe eIIecL oI normuIIzIng uII munner oI exIsLIng
psycIopuLIoIogIes. or exumpIe, obsessIveJcompuIsIve dIsorders LIuL cun
be munIIesLed us exuggeruLed preoccupuLIons wILI exLernuI cIeunIIness
und IygIene ure now uccorded u sense oI noL onIy normuIILy buL
superIorILy Irom LIeIr one-LIme IrruLIonuI demunds Ior unpoIIuLed
envIrons. PIobIus sucI us necropIobIu (morbId Ieur oI deuLI),
cunceropIobIu (morbId Ieur oI cuncer), oIIucLopIobIu (morbId Ieur oI
smeIIs), ure uIso gIven u superIor sLuLus In reucLIvILy Lo ETS.
Beyond reInIorcIng psycIopuLIoIogIes us LIose ubovemenLIoned,
LIe reuI Lrugedy oI LIe superIorILy syndrome Is ILs cupucILy us u LooI Ior
socIuI dIvIsIveness. n LIIs sense, LIe superIorILy syndrome Is no more
LIun bIgoLry und, by LIe munner LIuL IL wus munuIucLured (medIcuI
esLubIIsImenL), LIe syndrome und uII deLrImenLuI consequences ure
IuLrogenIc. n u sIorL LIme muny nonsmokers cun now jusLIIy In LIeIr
newIy conLorLed reusonIng uII munner oI psycIoIogIcuI und psycIosocIuI
dysIuncLIon us superIor und moruI. or exumpIe, beIow ure onIy u jeu oI
LIe numerous unLIsmokIng IeLLersJcommenLs uppeurIng In u mujor
AusLruIIun SLuLe (VIcLorIu) newspuper:
As u pussIonuLe non-smoker, ugree In prIncIpIe LIuL
smokers sIouId noL be uIIowed Lo smoke wILI cIIIdren
In LIe cur. BuL pussIng u Iuw uguInsL IL? Come on. L`s
noL us II smokers uren`L uwure oI LIe dungers. TIey`ve
been LoId. IeeI Ior LIe cIIIdren buL, IeL`s Iuce IL,
smokers uren`L renowned Ior IuvIng u IIgI Q. I LIese
peopIe ure so sLupId LIuL LIey wIII knowIngIy puL Ioved
ones uL rIsk, pussIng u Iuw won`L sLop LIem. Among LIe
deudIy cIemIcuI cockLuII, cIgureLLes obvIousIy conLuIn u
mInd-uILerIng drug wIIcI cuuses LIe smoker Lo Iose uII
common sense und reuson. AILer uII LIe educuLIon,
LIose sLIII smokIng ure no more InLeIIIgenL LIun drug
356
356
Rampant Antismoking Signifies Grave Danger
uddIcLs wIo sLeuI LIousunds oI doIIurs In properLy und
seII IL Ior u pILLunce Lo supporL LIeIr drug IubIL. Do
Iuck compussIon? Muybe. Do LIey cure ubouL my weII-
beIng wIen um Iorced Lo InIuIe LIeIr IIILI? DoubL IL!
BuL sLIII LIInk LryIng Lo puss u Iuw won`L work on wIuL
on wIuL beIIeve Lo be LIe LIIckesL Ieuds oI uII Iumuns
- LIe smokers! (Nume suppIIed, Hercld,Sun, Muy z,
zooo)
To ....us you ure u nonsmoker um surprIsed LIuL you
wouId cIoose Lo breuLIe uIr poIIuLed by your Iusbund`s
cIgureLLe smoke. WouIdn`L your Iove und supporL Ior
your Iusbund be beLLer expressed by IeIpIng IIm quIL
LIe IubIL und Luke cure oI IIs IeuILI? As you poInLed
ouL, IL`s LIeIr cIoIce und IIIe, buL wIuL cIoIce do
nonsmokers Iuve wIen In u room IuII oI smokers? My
cIoIce wouId be Lo breuLIe cIeun uIr, buL oILen LIIs
cIoIce Is Luken ouL oI my Iunds by smokers wIo do noL
beIIeve LIuL IL Is my IIIe und my cIoIce. (Nume suppIIed,
Hercld,Sun, June zo, zooo)
Your edILorIuI ubouL LIe proposed bun on smokIng In
resLuurunLs goes ouL oI ILs wuy Lo LrumpeL LIe noLIon
LIuL In u Iree socIeLy LIe resLuuruLeurs sIouId be
uIIowed Lo cIoose wIeLIer Lo Iuve smokIng secLIons.
WIuL ubouL LIeIr empIoyees? Do LIey Iuve u cIoIce
ubouL wIeLIer LIey geL Lobucco bIown In LIeIr Iuce?
LIInk noL. WIen worked In LIe IospILuIILy IndusLry
dIdn`L Iuve u cIoIce. HuvIng known someone wIo
dIed oI Iung cuncer uL z8 uILer workIng LIeIr wIoIe
uduIL IIIe In enLerLuInmenL venues surrounded by
smoke, Iuve no sympuLIy Ior puL-ouL smokers. A LoLuI
bun cun`L come soon enougI. (Nume suppIIed, Hercld,
Sun, Muy 1;, zooo)
MosL cIgureLLe smokers ure In denIuI ubouL LIe deudIy
eIIecLs oI LIeIr IubIL. Unconcerned ubouL LIeIr own
IeuILI, LIey ure cerLuInIy noL goIng Lo geL excILed ubouL
proLecLIng LIe IeuILI oI non-smokers. L Is up Lo non-
smokers Lo geL proLecLIve Iuws pussed. We wouIdn`L
uIIow IeroIn uddIcLs und LIe drug deuIers Lo dIcLuLe
drug Iuws - wIy sIouId we uIIow cIgureLLe smokers und
LIe Lobucco compunIes Lo dIcLuLe Iuws ubouL smokIng?
SmokIng Ius been bunned Irom resLuurunLs und mosL
pubIIc pIuces In CuIIIornIu wILI none oI LIe neguLIve
Preventive Medicine & Health Promotion
repercussIons LouLed by LIe Lobucco Iobby, besIdes u
reducLIon oI LIeIr proIILs. (Nume suppIIed, Hercld,Sun,
Muy 16, zooo)
don`L smoke, buL cun`L sLop. wunL Lo sLop. IuLe IL.
eeI LIe sume wuy? TIen LIere`s u good cIunce you`re
suIIerIng Irom pussIve smoker syndrome. L kIIIs me
LIuL no one cun reuIIsLIcuIIy cIoose noL Lo smoke.
PeopIe wIo smoke smeII revoILIng. TIIs vIIe smeII
IuLcIes on Lo InnocenL bysLunders. SILLIng uL LIe bus
sLop In LIe mornIng, euL smoke Ior breukIusL. WIy
sIouId be subjecLed Lo LIIs? SmokIng sIouId be
bunned In pubIIc pIuces. Iope uII you smokers Iuve u
guIILy conscIence. (Nume suppIIed, Hercld,Sun, Muy
1z, zooo)
SmokIng In pubs und cIubs sLInks! IuLe LIe IucL LIuL
Iuve Lo puL up wILI cuncer-cuusIng, IouI smoke
wIenever wunL Lo go ouL In AusLruIIu. n oLIer purLs oI
LIe worId, smokIng In cIubs und pubs Ius been LoLuIIy
bunned, und IL`s IunLusLIc. My cIoLIIng doesn`L sLInk,
eyes und LIrouL don`L geL sore, und cun spend more
LIme uL LIe venue. Iope LIose pIuces LIuL reIuse Lo bun
smokIng geL sued by LIeIr dyIng cusLomers und
empIoyees. L`s common sense - smokIng kIIIs. (Nume
suppIIed, Hercld,Sun, Junuury 16, zooz)
TIose wIo dIed In LIe |U.S.| LerrorIsL uLLucks Iud no
cIoIce. Smokers do. QuIL und IIve. (Nume suppIIed,
Hercld,Sun, November 1, zoo1)
WIy do IIImmukers LIInk IL Is necessury Lo sIow LIeIr
Ieroes smokIng? An enjoyubIe nIgIL uL LIe pIcLures Lo
see The Winslou o wus ruIned uL LIe sIckenIng sIgIL
oI one und, uL LImes, uII oI LIe ucLors smokIng. DurIng u
IIIm we cun be subjecLed Lo scenes oI murder, rupe or
worse. TIIs muy be dIsLurbIng buL we know LIe ucLors
ure onIy ucLIng und u moruI messuge Is uLLucIed. BuL
wILI smokIng on LIe screen LIe ucLors ure noL ucLIng. L
Is Ior reuI und LIe messuge IL gIves, especIuIIy Lo young
vIewers, Is LIuL smokIng Is socIuIIy uccepLubIe. TIIs
InsIdIous udverLIsIng oI u deudIy producL sIouId be
removed Irom our screens. (Nume suppIIed, Hercld,
Sun, AugusL 1;, 1qqq)
WIen smokers Luke LIuL Iong, IusL drug oI LIeIr cIgureLLe
beIore bourdIng u LruIn, LIen exIuIe InsIde LIe currIuge,
357
357
Rampant Antismoking Signifies Grave Danger
uddIcLs wIo sLeuI LIousunds oI doIIurs In properLy und
seII IL Ior u pILLunce Lo supporL LIeIr drug IubIL. Do
Iuck compussIon? Muybe. Do LIey cure ubouL my weII-
beIng wIen um Iorced Lo InIuIe LIeIr IIILI? DoubL IL!
BuL sLIII LIInk LryIng Lo puss u Iuw won`L work on wIuL
on wIuL beIIeve Lo be LIe LIIckesL Ieuds oI uII Iumuns
- LIe smokers! (Nume suppIIed, Hercld,Sun, Muy z,
zooo)
To ....us you ure u nonsmoker um surprIsed LIuL you
wouId cIoose Lo breuLIe uIr poIIuLed by your Iusbund`s
cIgureLLe smoke. WouIdn`L your Iove und supporL Ior
your Iusbund be beLLer expressed by IeIpIng IIm quIL
LIe IubIL und Luke cure oI IIs IeuILI? As you poInLed
ouL, IL`s LIeIr cIoIce und IIIe, buL wIuL cIoIce do
nonsmokers Iuve wIen In u room IuII oI smokers? My
cIoIce wouId be Lo breuLIe cIeun uIr, buL oILen LIIs
cIoIce Is Luken ouL oI my Iunds by smokers wIo do noL
beIIeve LIuL IL Is my IIIe und my cIoIce. (Nume suppIIed,
Hercld,Sun, June zo, zooo)
Your edILorIuI ubouL LIe proposed bun on smokIng In
resLuurunLs goes ouL oI ILs wuy Lo LrumpeL LIe noLIon
LIuL In u Iree socIeLy LIe resLuuruLeurs sIouId be
uIIowed Lo cIoose wIeLIer Lo Iuve smokIng secLIons.
WIuL ubouL LIeIr empIoyees? Do LIey Iuve u cIoIce
ubouL wIeLIer LIey geL Lobucco bIown In LIeIr Iuce?
LIInk noL. WIen worked In LIe IospILuIILy IndusLry
dIdn`L Iuve u cIoIce. HuvIng known someone wIo
dIed oI Iung cuncer uL z8 uILer workIng LIeIr wIoIe
uduIL IIIe In enLerLuInmenL venues surrounded by
smoke, Iuve no sympuLIy Ior puL-ouL smokers. A LoLuI
bun cun`L come soon enougI. (Nume suppIIed, Hercld,
Sun, Muy 1;, zooo)
MosL cIgureLLe smokers ure In denIuI ubouL LIe deudIy
eIIecLs oI LIeIr IubIL. Unconcerned ubouL LIeIr own
IeuILI, LIey ure cerLuInIy noL goIng Lo geL excILed ubouL
proLecLIng LIe IeuILI oI non-smokers. L Is up Lo non-
smokers Lo geL proLecLIve Iuws pussed. We wouIdn`L
uIIow IeroIn uddIcLs und LIe drug deuIers Lo dIcLuLe
drug Iuws - wIy sIouId we uIIow cIgureLLe smokers und
LIe Lobucco compunIes Lo dIcLuLe Iuws ubouL smokIng?
SmokIng Ius been bunned Irom resLuurunLs und mosL
pubIIc pIuces In CuIIIornIu wILI none oI LIe neguLIve
Preventive Medicine & Health Promotion
repercussIons LouLed by LIe Lobucco Iobby, besIdes u
reducLIon oI LIeIr proIILs. (Nume suppIIed, Hercld,Sun,
Muy 16, zooo)
don`L smoke, buL cun`L sLop. wunL Lo sLop. IuLe IL.
eeI LIe sume wuy? TIen LIere`s u good cIunce you`re
suIIerIng Irom pussIve smoker syndrome. L kIIIs me
LIuL no one cun reuIIsLIcuIIy cIoose noL Lo smoke.
PeopIe wIo smoke smeII revoILIng. TIIs vIIe smeII
IuLcIes on Lo InnocenL bysLunders. SILLIng uL LIe bus
sLop In LIe mornIng, euL smoke Ior breukIusL. WIy
sIouId be subjecLed Lo LIIs? SmokIng sIouId be
bunned In pubIIc pIuces. Iope uII you smokers Iuve u
guIILy conscIence. (Nume suppIIed, Hercld,Sun, Muy
1z, zooo)
SmokIng In pubs und cIubs sLInks! IuLe LIe IucL LIuL
Iuve Lo puL up wILI cuncer-cuusIng, IouI smoke
wIenever wunL Lo go ouL In AusLruIIu. n oLIer purLs oI
LIe worId, smokIng In cIubs und pubs Ius been LoLuIIy
bunned, und IL`s IunLusLIc. My cIoLIIng doesn`L sLInk,
eyes und LIrouL don`L geL sore, und cun spend more
LIme uL LIe venue. Iope LIose pIuces LIuL reIuse Lo bun
smokIng geL sued by LIeIr dyIng cusLomers und
empIoyees. L`s common sense - smokIng kIIIs. (Nume
suppIIed, Hercld,Sun, Junuury 16, zooz)
TIose wIo dIed In LIe |U.S.| LerrorIsL uLLucks Iud no
cIoIce. Smokers do. QuIL und IIve. (Nume suppIIed,
Hercld,Sun, November 1, zoo1)
WIy do IIImmukers LIInk IL Is necessury Lo sIow LIeIr
Ieroes smokIng? An enjoyubIe nIgIL uL LIe pIcLures Lo
see The Winslou o wus ruIned uL LIe sIckenIng sIgIL
oI one und, uL LImes, uII oI LIe ucLors smokIng. DurIng u
IIIm we cun be subjecLed Lo scenes oI murder, rupe or
worse. TIIs muy be dIsLurbIng buL we know LIe ucLors
ure onIy ucLIng und u moruI messuge Is uLLucIed. BuL
wILI smokIng on LIe screen LIe ucLors ure noL ucLIng. L
Is Ior reuI und LIe messuge IL gIves, especIuIIy Lo young
vIewers, Is LIuL smokIng Is socIuIIy uccepLubIe. TIIs
InsIdIous udverLIsIng oI u deudIy producL sIouId be
removed Irom our screens. (Nume suppIIed, Hercld,
Sun, AugusL 1;, 1qqq)
WIen smokers Luke LIuL Iong, IusL drug oI LIeIr cIgureLLe
beIore bourdIng u LruIn, LIen exIuIe InsIde LIe currIuge,
358
358
Rampant Antismoking Signifies Grave Danger
non-smokers ure Iorced Lo breuLI LIeIr smoke Ior LIe
nexL Iew sLuLIons. (Nume SuppIIed, Hercld,Sun,
SepLember z;, zooz)
WIuL u pIeusure IL Is Lo go Lo cuIes, resLuurunLs und
sIoppIng cenLres und noL puL up wILI smokers..
(Nume SuppIIed, Hercld,Sun, SepLember o, zooz)
noLIced some gIrIs uged ubouL 1; smokIng ouLsIde un
oIIIce bIock und LoId LIem LIey probubIy smoked
becuuse LIeIr IrIends smoked. You`ve goL Lo dIe oI
someLIIng, LIey suId. Yes, suId, buL you don`L Iuve Lo
dIe o yeurs beIore you need Lo. TIey were u bIL sIuken
und LIey mIgIL sLop beIore LIeIr smokIng becomes
IubIL IormIng. (Nume SuppIIed, Hercld,Sun, Muy 18,
zooz)
TIose seIIIsI, sLInkIng, IdIe smokers....No, wIuL`s
scurIer Is Iow Lobucco Lurns muny oLIerwIse decenL
peopIe InLo me-IIrsL IooIIguns. OnIy u smoker wouId
LIInk IL IIne Lo sLInk up my uIr. I broke wInd In LIeIr
snIII zone, LIey`d ugree `d ucLed oIIensIveIy. BuL IeLLIng
oII u cIgureLLe...n sIorL, IL`s noL LIe smokIng ILseII
LIuL`s LIe worry. L`s LIe seIIIsI sod IL cun muke you
become. (ArLIcIe, Andrew BoIL, Hercld,Sun, AugusL ,
zooz)
couId noL beIIeve my eyes wIen suw u drIver wILI uII
LIe wIndows up und u seven or eIgIL-yeur-oId cIIId
sILLIng In LIe IronL seuL breuLIIng LIe cIgureLLe smoke..
(Nume SuppIIed, Hercld,Sun, AugusL q, zooz)
WIen wus u cIIId In LIe 1qo`s, Iuve vugue
memorIes oI reudIng LIuL IomosexuuIILy (wIuLever LIuL
wus) Iud been IeguIIsed II IL wus beLween consenLIng
uduILs In prIvuLe. suggesL LIe sume Iuws ure mude Ior
smokers. (Nume SuppIIed, Hercld,Sun, November z6,
zooz)
SIoppIng cenLres sIouId bun peopIe Irom smokIng
wILIIn 1om oI LIe enLrunce. SIoppers sIouId noL Iuve
Lo negoLIuLe u guunLIeL oI smokers. (Nume SuppIIed,
Hercld,Sun, AprII 1o, zoo)
cunnoL beIIeve LIuL smokers conLInue Lo Ignore LIe
wurnIng IubeIs on cIgureLLe puckeLs, especIuIIy LIe one
In Iurge, boId prInL LIuL suys, SmokIng cuuses Iung
cuncer. (Nume SuppIIed, Hercld,Sun, AprII 1, zoo)
PurenLs wIo subjecL LIeIr cIIIdren Lo pussIve smokIng
Preventive Medicine & Health Promotion
sIouId be cIurged wILI cIIId ubuse. (Nume SuppIIed,
Hercld,Sun, AprII 1, zoo)
CIIIdren Iuve uIso been weII-versed In LIe unLIsmokIng
dIsposILIon, ukIn Lo LIe IndocLrInuLIon oI HILIer YouLI In LIIs regurd.
BeIow Is u smuII seIecLIon Irom LIe Youth Iorum secLIon oI LIe Hercld,
Sun (VIcLorIu, AusLruIIu) newspuper:
LIInk cIgureLLes sIouIdn`L be mude. I LIey ure so
dungerous LIuL LIey kIII peopIe, LIen wIy LempL peopIe
wILI LIem? TIe onIy reuson LIey ure beIng soId Is
becuuse compunIes ure mukIng so mucI money Irom
LIem. Even LIougI peopIe know LIey ure dungerous,
LIey sLIII smoke LIem. HuII LIe LIme LIey ure uddIcLed
und cun`L quIL. TIuL`s wIy LIInk LIuL nIcoLIne puLcIes
ure greuL. (Nume suppIIed, uge 1, Hercld,Sun, JuIy 16,
zoo1)
LIInk LIuL smokIng sIouId be bunned LoLuIIy. L Is
puLIeLIc Iow LIey wrILe uII sLupId quoLes on LIe puckeLs,
IIke smokIng gIves you Iung cuncer, buL LIen keep on
mukIng LIem. I you know wIuL IL does, LIen wIy keep
seIIIng LIem? Or II LIey ure goIng Lo keep on mukIng
LIem, LIen muke sure LIuL LIey ure bunned uL uII pubIIc
Indoor pIuces - pubs, sIops und especIuIIy Iood-
IundIIng pIuces. SmokIng sIouId be bunned uILogeLIer.
L Is u dIsgusLIng smeII und cun reuIIy IurL peopIe LIuL
Iuve usLImu. (Nume suppIIed, uge 1q, Hercld,Sun, JuIy
16, zoo1)
WIy do pregnunL women smoke? cunnoL unswer LIIs,
buL cun LeII you LIuL wIen see pregnunL women
smoke, IL LoLuIIy puLs me oII. TIey ure sImpIy IurmIng
LIemseIves, LIeIr unborn bubIes und pussIve smokers.
CIgureLLes ure u wusLe oI money Ior someLIIng LIuL
uIIecLs your body und LIe unborn. (Nume suppIIed, uge
1q, Hercld,Sun, AugusL 1, zoo1)
Smokers, boozers und peopIe wIo don`L exercIse sIouId
noL Iuve uccess Lo MedIcure beneIILs. TIey sIouId Iuve
Lo puy Ior LIeIr own Iung cuncer und IeurL dIseuse
LreuLmenL. (Nume suppIIed, uge 1z, Hercld,Sun, AugusL
1, zoo1)
Under-uge kIds smokIng Is uLrocIous becuuse wIuL kIds
359
359
Rampant Antismoking Signifies Grave Danger
non-smokers ure Iorced Lo breuLI LIeIr smoke Ior LIe
nexL Iew sLuLIons. (Nume SuppIIed, Hercld,Sun,
SepLember z;, zooz)
WIuL u pIeusure IL Is Lo go Lo cuIes, resLuurunLs und
sIoppIng cenLres und noL puL up wILI smokers..
(Nume SuppIIed, Hercld,Sun, SepLember o, zooz)
noLIced some gIrIs uged ubouL 1; smokIng ouLsIde un
oIIIce bIock und LoId LIem LIey probubIy smoked
becuuse LIeIr IrIends smoked. You`ve goL Lo dIe oI
someLIIng, LIey suId. Yes, suId, buL you don`L Iuve Lo
dIe o yeurs beIore you need Lo. TIey were u bIL sIuken
und LIey mIgIL sLop beIore LIeIr smokIng becomes
IubIL IormIng. (Nume SuppIIed, Hercld,Sun, Muy 18,
zooz)
TIose seIIIsI, sLInkIng, IdIe smokers....No, wIuL`s
scurIer Is Iow Lobucco Lurns muny oLIerwIse decenL
peopIe InLo me-IIrsL IooIIguns. OnIy u smoker wouId
LIInk IL IIne Lo sLInk up my uIr. I broke wInd In LIeIr
snIII zone, LIey`d ugree `d ucLed oIIensIveIy. BuL IeLLIng
oII u cIgureLLe...n sIorL, IL`s noL LIe smokIng ILseII
LIuL`s LIe worry. L`s LIe seIIIsI sod IL cun muke you
become. (ArLIcIe, Andrew BoIL, Hercld,Sun, AugusL ,
zooz)
couId noL beIIeve my eyes wIen suw u drIver wILI uII
LIe wIndows up und u seven or eIgIL-yeur-oId cIIId
sILLIng In LIe IronL seuL breuLIIng LIe cIgureLLe smoke..
(Nume SuppIIed, Hercld,Sun, AugusL q, zooz)
WIen wus u cIIId In LIe 1qo`s, Iuve vugue
memorIes oI reudIng LIuL IomosexuuIILy (wIuLever LIuL
wus) Iud been IeguIIsed II IL wus beLween consenLIng
uduILs In prIvuLe. suggesL LIe sume Iuws ure mude Ior
smokers. (Nume SuppIIed, Hercld,Sun, November z6,
zooz)
SIoppIng cenLres sIouId bun peopIe Irom smokIng
wILIIn 1om oI LIe enLrunce. SIoppers sIouId noL Iuve
Lo negoLIuLe u guunLIeL oI smokers. (Nume SuppIIed,
Hercld,Sun, AprII 1o, zoo)
cunnoL beIIeve LIuL smokers conLInue Lo Ignore LIe
wurnIng IubeIs on cIgureLLe puckeLs, especIuIIy LIe one
In Iurge, boId prInL LIuL suys, SmokIng cuuses Iung
cuncer. (Nume SuppIIed, Hercld,Sun, AprII 1, zoo)
PurenLs wIo subjecL LIeIr cIIIdren Lo pussIve smokIng
Preventive Medicine & Health Promotion
sIouId be cIurged wILI cIIId ubuse. (Nume SuppIIed,
Hercld,Sun, AprII 1, zoo)
CIIIdren Iuve uIso been weII-versed In LIe unLIsmokIng
dIsposILIon, ukIn Lo LIe IndocLrInuLIon oI HILIer YouLI In LIIs regurd.
BeIow Is u smuII seIecLIon Irom LIe Youth Iorum secLIon oI LIe Hercld,
Sun (VIcLorIu, AusLruIIu) newspuper:
LIInk cIgureLLes sIouIdn`L be mude. I LIey ure so
dungerous LIuL LIey kIII peopIe, LIen wIy LempL peopIe
wILI LIem? TIe onIy reuson LIey ure beIng soId Is
becuuse compunIes ure mukIng so mucI money Irom
LIem. Even LIougI peopIe know LIey ure dungerous,
LIey sLIII smoke LIem. HuII LIe LIme LIey ure uddIcLed
und cun`L quIL. TIuL`s wIy LIInk LIuL nIcoLIne puLcIes
ure greuL. (Nume suppIIed, uge 1, Hercld,Sun, JuIy 16,
zoo1)
LIInk LIuL smokIng sIouId be bunned LoLuIIy. L Is
puLIeLIc Iow LIey wrILe uII sLupId quoLes on LIe puckeLs,
IIke smokIng gIves you Iung cuncer, buL LIen keep on
mukIng LIem. I you know wIuL IL does, LIen wIy keep
seIIIng LIem? Or II LIey ure goIng Lo keep on mukIng
LIem, LIen muke sure LIuL LIey ure bunned uL uII pubIIc
Indoor pIuces - pubs, sIops und especIuIIy Iood-
IundIIng pIuces. SmokIng sIouId be bunned uILogeLIer.
L Is u dIsgusLIng smeII und cun reuIIy IurL peopIe LIuL
Iuve usLImu. (Nume suppIIed, uge 1q, Hercld,Sun, JuIy
16, zoo1)
WIy do pregnunL women smoke? cunnoL unswer LIIs,
buL cun LeII you LIuL wIen see pregnunL women
smoke, IL LoLuIIy puLs me oII. TIey ure sImpIy IurmIng
LIemseIves, LIeIr unborn bubIes und pussIve smokers.
CIgureLLes ure u wusLe oI money Ior someLIIng LIuL
uIIecLs your body und LIe unborn. (Nume suppIIed, uge
1q, Hercld,Sun, AugusL 1, zoo1)
Smokers, boozers und peopIe wIo don`L exercIse sIouId
noL Iuve uccess Lo MedIcure beneIILs. TIey sIouId Iuve
Lo puy Ior LIeIr own Iung cuncer und IeurL dIseuse
LreuLmenL. (Nume suppIIed, uge 1z, Hercld,Sun, AugusL
1, zoo1)
Under-uge kIds smokIng Is uLrocIous becuuse wIuL kIds
360
360
Rampant Antismoking Signifies Grave Danger
don`L reuIIze Is LIey ure puyIng Lo kIII LIemseIves.
TougIer Iuws ure needed und uny uduIL wIo uIIows u
cIIId Lo smoke sIouId be punIsIed. (Nume suppIIed,
uge 1, Hercld,Sun, AugusL 1z, zooz)
SmokIng In pubIIc ureus Is revoILIng und sIouId noL be
uIIowed. I you`re neur smoke Irom cIgureLLes und pIpes
you geL LIe sume eIIecL us II you were LIe smoker. So, II
uImosL everybody smoked, LIen cIIIdren und non-
smokers wouId geL sIck, so wIuL Is LIe poInL oI noL
smokIng? L`s jusL u dIsgruce. L`s dIsgusLIng sILLIng
down Lo u nIce meuI ouLsIde und LIen u smoker comes
pusL und ruIns IL Ior you. TIere ure sepuruLe pIuces Ior
smokers now buL you cun sLIII smeII LIe smoke und
LIere ure buLLs everywIere. TIey sIouIdn`L muke uny
more cIgureLLes und LIen peopIe wouId be Iorced Lo
quIL. (Nume suppIIed, uge 11, Hercld,Sun, JuIy zz,
zooz)
um wrILIng Lo suy LIuL ugree wILI unyone wIo LIInks
smokIng sIouId be ouLIuwed.
L Is very bud Ior peopIe you smoke uround becuuse IL
roLs your Iungs.
OLIer peopIe mIgIL uIso uccIdenLuIIy InIuIe LIe smoke II
LIey ure uround you. L cun gIve you Iung cuncer or even
kIII you younger LIun you expecLed..
SmokIng cun uIIecL your uppeurunce. You cun geL
wrInkIes, Iose your IuIr, IL Lurns your IIngers yeIIow
und, worsL oI uII, you sLInk.
SmokIng uIso cosLs u IoL oI money In LIe Iong run. So II
you Iuve kIds you cun buy LIem more Loys, or more
LIIngs Ior yourseII, InsLeud oI wusLIng money on
someLIIng LIuL desLroys your IeuILI. (Nume suppIIed,
uge 11, Hercld,Sun, AprII ;, zoo)
And exumpIes oI unLIsmokIng rIeLorIc Irom oLIer sources:
WIy sIouId Iuve Lo Iuve someone kIII me |wILI
cIgureLLe smoke|? WIuL II someone cume up wILI u gun
und suId, WIy don`L you Lry LIIs buIIeL? (urry
Hugmun, In OukIey, 1qqq, CI.;, p.1)
smeII LIe cIgureLLe`s smoke us IL wuILs LIrougI LIe uIr,
und Ireeze, consumed wILI us mucI Ieur us II LIe
smoke were u mun wILI u gun on u durk sLreeL...TIe
smoker wuIks Lowurd me. um Lrupped by courLesy.
Preventive Medicine & Health Promotion
(Susun GIIberL McGuIre, In OukIey, 1qqq, CI.;, p.1)
Non-smokers suve money, ure IeuILIIer und uIso Iuve
beLLer sex IIves. (PurL oI udverLIsemenL Ior
'Smokenders`, Melbourne Ycrrc Lecder, OcLober z,
zooo - LIe cupLIon wus removed Irom subsequenL
udverLIsIng)
...To provIde supporL und InIormuLIon Lo IndIvIduuIs
wIo ure beIng ussuuILed by secondIund smoke undJor
Iurussed by peopIe uddIcLed Lo nIcoLIne...ProvIdIng u
IIvIng memorIuI Ior LIose wIo Iuve dIed us u resuIL oI
exposure Lo secondIund smoke. (SAE, AnLIsmokIng
obby Group, uL www.pucIIIcneL.neLJ-suIeJIIL.ILmI,
p.18)
|oIIowIng u wIoIe serIes oI unquesLIoned reIuLIve rIsk
IucLors|...So II you ure u WOMAN smoker you cun Iook
Iorwurd Lo beIng IuL und LooLIIess wILI u IuIry Iuce und
u crumbIIng spIne. I your purLner Is uIso u smoker don`L
worry LIuL your ruLIer unpIeusunL uppeurunce Lurns
IIm oII. He Is IIkeIy Lo become ImpoLenL unywuy (II Ie
IIves LIuL Iong oI course!) (uL www.puges.IoLboL.comJ
IeuILIJrungI.ILmI, p.z)
|CupLIon uLLucIed Lo u deroguLory Imuge senL Lo
smoker`s InIormuLIon group| ..We wIII cIeun ouL LIe
smokers` InIesLuLIon. You uddIcLed subIumun
mLIerIckers poIIuLes us buL we wIII dIsInIecL LIe
envIronmenL. (uL www.Iorces.orgJIuLeJ)
beIIeve LIe onIy wuy Lo geL someone Lo quIL smokIng Is
Lo IeL LIem know LIuL smokers ure generuIIy regurded us
noL very InLeIIIgenL und LIuL LIey smeII bud. Smokers
suck..BuL uImosL unyone under LIe uge oI qo Is eILIer
un IdIoL, u sIeep, or boLI II LIey cIose Lo beIng smokIng.
(uL www.duLuopLIons.comJsmokers)
PedesLrIuns Iuve Lo conLend wILI u Iuck oI spuce...L
Ius become worse sInce smokers were Iorced Lo sIL
ouLsIde. As pussers-by sLruggIe Lo wuIk pusL, LIey Iuve
Lo endure LIe sLencI oI cIgureLLe smoke. (eLLer Lo LIe
EdILor, The Melbourne Times, ebruury 1, zooz)
TIe conLorLed vIews expressed ubove ure IuIIy Lo be expecLed In
LIeIr beIng IueIed by LIe demugoguery und monomunIu oI unLIsmokIng
under LIe preLense oI scIenLIIIc credIbIIILy. WIuL wus once u buckground
pIenomenon LIuL nonsmokers were unperLurbed by - even wIIIsL dInIng
361
361
Rampant Antismoking Signifies Grave Danger
don`L reuIIze Is LIey ure puyIng Lo kIII LIemseIves.
TougIer Iuws ure needed und uny uduIL wIo uIIows u
cIIId Lo smoke sIouId be punIsIed. (Nume suppIIed,
uge 1, Hercld,Sun, AugusL 1z, zooz)
SmokIng In pubIIc ureus Is revoILIng und sIouId noL be
uIIowed. I you`re neur smoke Irom cIgureLLes und pIpes
you geL LIe sume eIIecL us II you were LIe smoker. So, II
uImosL everybody smoked, LIen cIIIdren und non-
smokers wouId geL sIck, so wIuL Is LIe poInL oI noL
smokIng? L`s jusL u dIsgruce. L`s dIsgusLIng sILLIng
down Lo u nIce meuI ouLsIde und LIen u smoker comes
pusL und ruIns IL Ior you. TIere ure sepuruLe pIuces Ior
smokers now buL you cun sLIII smeII LIe smoke und
LIere ure buLLs everywIere. TIey sIouIdn`L muke uny
more cIgureLLes und LIen peopIe wouId be Iorced Lo
quIL. (Nume suppIIed, uge 11, Hercld,Sun, JuIy zz,
zooz)
um wrILIng Lo suy LIuL ugree wILI unyone wIo LIInks
smokIng sIouId be ouLIuwed.
L Is very bud Ior peopIe you smoke uround becuuse IL
roLs your Iungs.
OLIer peopIe mIgIL uIso uccIdenLuIIy InIuIe LIe smoke II
LIey ure uround you. L cun gIve you Iung cuncer or even
kIII you younger LIun you expecLed..
SmokIng cun uIIecL your uppeurunce. You cun geL
wrInkIes, Iose your IuIr, IL Lurns your IIngers yeIIow
und, worsL oI uII, you sLInk.
SmokIng uIso cosLs u IoL oI money In LIe Iong run. So II
you Iuve kIds you cun buy LIem more Loys, or more
LIIngs Ior yourseII, InsLeud oI wusLIng money on
someLIIng LIuL desLroys your IeuILI. (Nume suppIIed,
uge 11, Hercld,Sun, AprII ;, zoo)
And exumpIes oI unLIsmokIng rIeLorIc Irom oLIer sources:
WIy sIouId Iuve Lo Iuve someone kIII me |wILI
cIgureLLe smoke|? WIuL II someone cume up wILI u gun
und suId, WIy don`L you Lry LIIs buIIeL? (urry
Hugmun, In OukIey, 1qqq, CI.;, p.1)
smeII LIe cIgureLLe`s smoke us IL wuILs LIrougI LIe uIr,
und Ireeze, consumed wILI us mucI Ieur us II LIe
smoke were u mun wILI u gun on u durk sLreeL...TIe
smoker wuIks Lowurd me. um Lrupped by courLesy.
Preventive Medicine & Health Promotion
(Susun GIIberL McGuIre, In OukIey, 1qqq, CI.;, p.1)
Non-smokers suve money, ure IeuILIIer und uIso Iuve
beLLer sex IIves. (PurL oI udverLIsemenL Ior
'Smokenders`, Melbourne Ycrrc Lecder, OcLober z,
zooo - LIe cupLIon wus removed Irom subsequenL
udverLIsIng)
...To provIde supporL und InIormuLIon Lo IndIvIduuIs
wIo ure beIng ussuuILed by secondIund smoke undJor
Iurussed by peopIe uddIcLed Lo nIcoLIne...ProvIdIng u
IIvIng memorIuI Ior LIose wIo Iuve dIed us u resuIL oI
exposure Lo secondIund smoke. (SAE, AnLIsmokIng
obby Group, uL www.pucIIIcneL.neLJ-suIeJIIL.ILmI,
p.18)
|oIIowIng u wIoIe serIes oI unquesLIoned reIuLIve rIsk
IucLors|...So II you ure u WOMAN smoker you cun Iook
Iorwurd Lo beIng IuL und LooLIIess wILI u IuIry Iuce und
u crumbIIng spIne. I your purLner Is uIso u smoker don`L
worry LIuL your ruLIer unpIeusunL uppeurunce Lurns
IIm oII. He Is IIkeIy Lo become ImpoLenL unywuy (II Ie
IIves LIuL Iong oI course!) (uL www.puges.IoLboL.comJ
IeuILIJrungI.ILmI, p.z)
|CupLIon uLLucIed Lo u deroguLory Imuge senL Lo
smoker`s InIormuLIon group| ..We wIII cIeun ouL LIe
smokers` InIesLuLIon. You uddIcLed subIumun
mLIerIckers poIIuLes us buL we wIII dIsInIecL LIe
envIronmenL. (uL www.Iorces.orgJIuLeJ)
beIIeve LIe onIy wuy Lo geL someone Lo quIL smokIng Is
Lo IeL LIem know LIuL smokers ure generuIIy regurded us
noL very InLeIIIgenL und LIuL LIey smeII bud. Smokers
suck..BuL uImosL unyone under LIe uge oI qo Is eILIer
un IdIoL, u sIeep, or boLI II LIey cIose Lo beIng smokIng.
(uL www.duLuopLIons.comJsmokers)
PedesLrIuns Iuve Lo conLend wILI u Iuck oI spuce...L
Ius become worse sInce smokers were Iorced Lo sIL
ouLsIde. As pussers-by sLruggIe Lo wuIk pusL, LIey Iuve
Lo endure LIe sLencI oI cIgureLLe smoke. (eLLer Lo LIe
EdILor, The Melbourne Times, ebruury 1, zooz)
TIe conLorLed vIews expressed ubove ure IuIIy Lo be expecLed In
LIeIr beIng IueIed by LIe demugoguery und monomunIu oI unLIsmokIng
under LIe preLense oI scIenLIIIc credIbIIILy. WIuL wus once u buckground
pIenomenon LIuL nonsmokers were unperLurbed by - even wIIIsL dInIng
362
362
Rampant Antismoking Signifies Grave Danger
- ETS becume someLIIng uILogeLIer dIIIerenL us soon us IL wus decIured us
dungerous Ior uII In 1qq, und reIenLIessIy propuguLed ever sInce. TIe
US DepurLmenL oI TrunsporL (1q8q) noLed LIuL Ioss oI sensILIvILy |Lo
Lobucco smoke odor| occurs...wILIIn Iour mInuLes uILer |InILIuI| exposure.
YeL, uILer ETS wus decIured us dungerous, odor becume menLuIIy
domInunL und severeIy exuggeruLed; Lobucco sensILIvILy Ius now become
un en toue compIuInL und vIewed us u dIsubIIILy. TIe sIIIL Is enLIreIy u
percepLuuI or psycIoIogIcuI one wIere even LIe odor oI smoke Ius now
become u revoILIng sLencI LIuL Is uII Loo mucI Lo endure Ior muny
nonsmokers. TIIs represenLs u progressIve menLuI enIeebIIng on u muss
scuIe, I.e., munuIucLurIng oI u nocebo eIIecL. UnIorLunuLeIy, LIese sorLs oI
nocebo eIIecLs ure uIso socIuIIy dIvIsIve. TIe conducL LIuL Ius produced
LIIs resuIL Is ImmoruI und Is un ussuuIL on psycIoIogIcuI und reIuLIonuI
IeuILI.
TIe superIorILy syndrome cun runge Irom InLeIIecLuuI
browbeuLIng und LIe coercIon oI unIounded Iuw reIorm Lo vuryIng degrees
oI conIronLuLIon und vIoIence, or combInuLIons LIereoI. TIe superIorILy
syndrome Is u munIIesLuLIon oI ubjecL und dIrecL IuLred; exposure Lo ETS
Is IuIseIy vIewed us jusLIIyIng wIuL ure reuIIy pre-exIsLIng psycIogenIc
sLuLes - ETS und smokers become u munuIucLured conduIL (I.e., u
IusIIonubIe bIgoLry) Ior venLIng unresoIved, IIgIIy conIIIcLed
psycIoIogIcuI sLuLes.
n unLIsmokIng sLunce, LIe conducL oI IIIesLyIe epIdemIoIogy und
IeuILIIsm reIIecLs LIe more InLeIIecLuuI Iorm oI LIe syndrome. Here,
persons Iorwurd LIemseIves us experL or scIenLIIIcuIIy scIoIurIy,
LypIcuIIy LIrougI LIe IncompeLenL und reckIess use oI sLuLIsLIcuI
InIormuLIon, wIIcI Is no more LIun un uLLempL Lo jusLIIy LIeIr own
conLorLed reusonIng und recruILIng oLIers Lo LIe cuuse. Some oI LIe key
IIgures In LIe unLIsmokIng crusude Iuve IIgIIy quesLIonubIe quuIIIIcuLIons
Ior uny coIerenL Ideu oI IeuILI Lo be promoLed.
SLunLon GIunLz, one oI LIe key IIgures In LIe currenL unLIsmokIng
pIenomenon, preucIIng ETS dungers In LIe 1q8o`s, Iong beIore LIe IIrsL
oIIIcIuI reporL on ETS und nonsmokers, IIsLs IIs quuIIIIcuLIon us u PID.
AccordIng Lo IIs onIIne bIogrupIy LIIs degree wus uwurded In 1q; Irom
SLunIord UnIversILy In AppIIed MecIunIcs und EngIneerIng EconomIc
SysLems. rom LIIs mecIunIcuI (muLerIuIIsL) buckground, GIunLz
underLook u posLdocLoruI yeur uL SLunIord UnIversILy In CurdIoIogy (1q;),
und unoLIer posLdocLoruI yeur uL LIe UnIversILy oI CuIIIornIu (Sun
runcIsco) In curdIovuscuIur reseurcI (1q;;). L uppeurs LIuL LIe
connecLIon Lo curdIoIogy Is In uppIIed mecIunIcuI Lerms. GIunLz Is
currenLIy u ProIessor oI MedIcIne und DIrecLor oI LIe CenLer Ior Tobucco
ConLroI ReseurcI & EducuLIon uL LIe UnIversILy oI CuIIIornIu (Sun
Preventive Medicine & Health Promotion
runcIsco). L uppeurs LIuL LIe medIcuI sLuLus serves essenLIuIIy Lo
IegILImIze LIe unLILobucco sLuLus und expIoIL GIunLz`s IIgI proIIIe In LIIs
ureu.
Jumes Repuce, unoLIer key unLIsmokIng IIgure, Ius reIerred Lo
IImseII us u IeuILI pIysIcIsL, wIuLever LIIs meuns, und, more recenLIy,
us u secondIund smoke consuILunL. HIs quuIIIIcuLIon Is IIsLed us un MSc
(e.g., Repuce, zooz). n u puper Ie co-uuLIors (HedIey eL uI., zoo1) und
uppeurIng In un obscure newsIeLLer (Hong Kong CouncII on SmokIng und
HeuILI), LIe sLudy oI ETS exposure und IeuILI Is reduced Lo un exercIse In
geomeLry und sLuLIsLIcuI sopIIsLry. n unoLIer urLIcIe, Repuce (zooo)
mukes consIderubIe use oI vucuous LecInIcuI Lerms sucI us pIume rIse
und InLersecLIng cones In descrIbIng ETS exposure In ouLdoor seLLIngs.
TIe urgumenL LIen sIIILs Irom nonsensIcuI pIysIcs Lo LIe pIIgIL oI
uII nonsmokers IuvIng Lo endure LIe dIscomIorL oI ETS exposure In
ouLdoor seLLIngs sucI us cuIes In PurIs, ALIens, us PuImus, or SuIL uke
CILy. TIe urgumenL reIIecLs LIe sLundurd crunkIness (neguLIve Iyper-
reucLIvILy), vIcLImIood LendencIes, und obsessIon wILI conLroI oI LIe
exLreme unLIsmokIng menLuIILy. TIe urgumenL LIen IurLIer deLerIoruLes
InLo ouLrIgIL unsubsLunLIuLed emoLIve cIuIms LIuL properIy beLruy LIe
underIyIng ucuLe menLuI IIxuLIon: or exumpIe, |s|mokIng Ius no socIuI
vuIue oLIer LIun Lo creuLe unnecessury work Ior pIysIcIuns, und wIndIuII
proIILs Ior morLIcIuns. (p.q8) AILIougI LIe urgumenL reIIecLs dIsjoInLed,
IncoIerenL, muLerIuIIsL reusonIng, IL Is enLILIed BunnIng ouLdoor smokIng
Is scIenLIIIcuIIy jusLIIIubIe.
BoLI oI LIese persons Iuve sLrong mecIunIsLIc, muLerIuIIsL
buckgrounds und pIuyed very sIgnIIIcunL roIes In LIe bIused sIumbIes oI
EPA (1qq), LIe documenL LIuL underIIes worIdwIde unLIsmokIng poIIcy
by governmenLs. NowIere In uny oI LIeIr concepLuuIIzIng or vocubuIury
ure uny coIerenL psycIoIogIcuI, psycIosocIuI or moruI Lerms Lo be Iound.
n LIIs menLuIILy, devoId oI u compreIensIon oI LIe dImensIons LIuL
specIIIcuIIy dIsLInguIsI Iumuns` Irom oLIer specIes` ucLIvILy, cuusuI
reIuLIonsIIps ure Iorced beLween evenLs uIong LIe sInguIur muLerIuI
dImensIon LIuL ure noL ImpIIed by duLu und LIuL wouId noL even be u
consIderuLIon wILIIn u muILIdImensIonuI vIew oI IeuILI. BoLI oI LIese
reseurcIers ure noLorIous Ior reIIunce on LIe unLenubIe ussumpLIon oI
IomogeneILy oI groups oLIer LIun LIe experImenLuI IucLor oI smokIng or
LIe exposure Lo Lobucco smoke.
A key AusLruIIun unLIsmokIng IIgure, SImon CIupmun, wIose
unIversILy sLuLus Is ussocIuLe proIessor In LIe depurLmenL oI pubIIc IeuILI
und communILy medIcIne, supposedIy Ius un educuLIonuI buckground In
murkeLIng, medIu und udvocucy. TIIs purLIcuIur unLIsmokIng udvocuLe
pubIIsIes sIorL urLIcIes und IeLLers wILI IIgI reguIurILy In purLIcuIurIy LIe
363
363
Rampant Antismoking Signifies Grave Danger
- ETS becume someLIIng uILogeLIer dIIIerenL us soon us IL wus decIured us
dungerous Ior uII In 1qq, und reIenLIessIy propuguLed ever sInce. TIe
US DepurLmenL oI TrunsporL (1q8q) noLed LIuL Ioss oI sensILIvILy |Lo
Lobucco smoke odor| occurs...wILIIn Iour mInuLes uILer |InILIuI| exposure.
YeL, uILer ETS wus decIured us dungerous, odor becume menLuIIy
domInunL und severeIy exuggeruLed; Lobucco sensILIvILy Ius now become
un en toue compIuInL und vIewed us u dIsubIIILy. TIe sIIIL Is enLIreIy u
percepLuuI or psycIoIogIcuI one wIere even LIe odor oI smoke Ius now
become u revoILIng sLencI LIuL Is uII Loo mucI Lo endure Ior muny
nonsmokers. TIIs represenLs u progressIve menLuI enIeebIIng on u muss
scuIe, I.e., munuIucLurIng oI u nocebo eIIecL. UnIorLunuLeIy, LIese sorLs oI
nocebo eIIecLs ure uIso socIuIIy dIvIsIve. TIe conducL LIuL Ius produced
LIIs resuIL Is ImmoruI und Is un ussuuIL on psycIoIogIcuI und reIuLIonuI
IeuILI.
TIe superIorILy syndrome cun runge Irom InLeIIecLuuI
browbeuLIng und LIe coercIon oI unIounded Iuw reIorm Lo vuryIng degrees
oI conIronLuLIon und vIoIence, or combInuLIons LIereoI. TIe superIorILy
syndrome Is u munIIesLuLIon oI ubjecL und dIrecL IuLred; exposure Lo ETS
Is IuIseIy vIewed us jusLIIyIng wIuL ure reuIIy pre-exIsLIng psycIogenIc
sLuLes - ETS und smokers become u munuIucLured conduIL (I.e., u
IusIIonubIe bIgoLry) Ior venLIng unresoIved, IIgIIy conIIIcLed
psycIoIogIcuI sLuLes.
n unLIsmokIng sLunce, LIe conducL oI IIIesLyIe epIdemIoIogy und
IeuILIIsm reIIecLs LIe more InLeIIecLuuI Iorm oI LIe syndrome. Here,
persons Iorwurd LIemseIves us experL or scIenLIIIcuIIy scIoIurIy,
LypIcuIIy LIrougI LIe IncompeLenL und reckIess use oI sLuLIsLIcuI
InIormuLIon, wIIcI Is no more LIun un uLLempL Lo jusLIIy LIeIr own
conLorLed reusonIng und recruILIng oLIers Lo LIe cuuse. Some oI LIe key
IIgures In LIe unLIsmokIng crusude Iuve IIgIIy quesLIonubIe quuIIIIcuLIons
Ior uny coIerenL Ideu oI IeuILI Lo be promoLed.
SLunLon GIunLz, one oI LIe key IIgures In LIe currenL unLIsmokIng
pIenomenon, preucIIng ETS dungers In LIe 1q8o`s, Iong beIore LIe IIrsL
oIIIcIuI reporL on ETS und nonsmokers, IIsLs IIs quuIIIIcuLIon us u PID.
AccordIng Lo IIs onIIne bIogrupIy LIIs degree wus uwurded In 1q; Irom
SLunIord UnIversILy In AppIIed MecIunIcs und EngIneerIng EconomIc
SysLems. rom LIIs mecIunIcuI (muLerIuIIsL) buckground, GIunLz
underLook u posLdocLoruI yeur uL SLunIord UnIversILy In CurdIoIogy (1q;),
und unoLIer posLdocLoruI yeur uL LIe UnIversILy oI CuIIIornIu (Sun
runcIsco) In curdIovuscuIur reseurcI (1q;;). L uppeurs LIuL LIe
connecLIon Lo curdIoIogy Is In uppIIed mecIunIcuI Lerms. GIunLz Is
currenLIy u ProIessor oI MedIcIne und DIrecLor oI LIe CenLer Ior Tobucco
ConLroI ReseurcI & EducuLIon uL LIe UnIversILy oI CuIIIornIu (Sun
Preventive Medicine & Health Promotion
runcIsco). L uppeurs LIuL LIe medIcuI sLuLus serves essenLIuIIy Lo
IegILImIze LIe unLILobucco sLuLus und expIoIL GIunLz`s IIgI proIIIe In LIIs
ureu.
Jumes Repuce, unoLIer key unLIsmokIng IIgure, Ius reIerred Lo
IImseII us u IeuILI pIysIcIsL, wIuLever LIIs meuns, und, more recenLIy,
us u secondIund smoke consuILunL. HIs quuIIIIcuLIon Is IIsLed us un MSc
(e.g., Repuce, zooz). n u puper Ie co-uuLIors (HedIey eL uI., zoo1) und
uppeurIng In un obscure newsIeLLer (Hong Kong CouncII on SmokIng und
HeuILI), LIe sLudy oI ETS exposure und IeuILI Is reduced Lo un exercIse In
geomeLry und sLuLIsLIcuI sopIIsLry. n unoLIer urLIcIe, Repuce (zooo)
mukes consIderubIe use oI vucuous LecInIcuI Lerms sucI us pIume rIse
und InLersecLIng cones In descrIbIng ETS exposure In ouLdoor seLLIngs.
TIe urgumenL LIen sIIILs Irom nonsensIcuI pIysIcs Lo LIe pIIgIL oI
uII nonsmokers IuvIng Lo endure LIe dIscomIorL oI ETS exposure In
ouLdoor seLLIngs sucI us cuIes In PurIs, ALIens, us PuImus, or SuIL uke
CILy. TIe urgumenL reIIecLs LIe sLundurd crunkIness (neguLIve Iyper-
reucLIvILy), vIcLImIood LendencIes, und obsessIon wILI conLroI oI LIe
exLreme unLIsmokIng menLuIILy. TIe urgumenL LIen IurLIer deLerIoruLes
InLo ouLrIgIL unsubsLunLIuLed emoLIve cIuIms LIuL properIy beLruy LIe
underIyIng ucuLe menLuI IIxuLIon: or exumpIe, |s|mokIng Ius no socIuI
vuIue oLIer LIun Lo creuLe unnecessury work Ior pIysIcIuns, und wIndIuII
proIILs Ior morLIcIuns. (p.q8) AILIougI LIe urgumenL reIIecLs dIsjoInLed,
IncoIerenL, muLerIuIIsL reusonIng, IL Is enLILIed BunnIng ouLdoor smokIng
Is scIenLIIIcuIIy jusLIIIubIe.
BoLI oI LIese persons Iuve sLrong mecIunIsLIc, muLerIuIIsL
buckgrounds und pIuyed very sIgnIIIcunL roIes In LIe bIused sIumbIes oI
EPA (1qq), LIe documenL LIuL underIIes worIdwIde unLIsmokIng poIIcy
by governmenLs. NowIere In uny oI LIeIr concepLuuIIzIng or vocubuIury
ure uny coIerenL psycIoIogIcuI, psycIosocIuI or moruI Lerms Lo be Iound.
n LIIs menLuIILy, devoId oI u compreIensIon oI LIe dImensIons LIuL
specIIIcuIIy dIsLInguIsI Iumuns` Irom oLIer specIes` ucLIvILy, cuusuI
reIuLIonsIIps ure Iorced beLween evenLs uIong LIe sInguIur muLerIuI
dImensIon LIuL ure noL ImpIIed by duLu und LIuL wouId noL even be u
consIderuLIon wILIIn u muILIdImensIonuI vIew oI IeuILI. BoLI oI LIese
reseurcIers ure noLorIous Ior reIIunce on LIe unLenubIe ussumpLIon oI
IomogeneILy oI groups oLIer LIun LIe experImenLuI IucLor oI smokIng or
LIe exposure Lo Lobucco smoke.
A key AusLruIIun unLIsmokIng IIgure, SImon CIupmun, wIose
unIversILy sLuLus Is ussocIuLe proIessor In LIe depurLmenL oI pubIIc IeuILI
und communILy medIcIne, supposedIy Ius un educuLIonuI buckground In
murkeLIng, medIu und udvocucy. TIIs purLIcuIur unLIsmokIng udvocuLe
pubIIsIes sIorL urLIcIes und IeLLers wILI IIgI reguIurILy In purLIcuIurIy LIe
364
364
Rampant Antismoking Signifies Grave Danger
ritish Mediccl 1ourncl und Tobccco Control. TIe onIy consIsLency LIuL
cun be Iound In LIIs work, und In uddILIon Lo uII LIe numerous IuIIucIes
LIuL IIIesLyIe epIdemIoIogy Is uIreudy predIcuLed on, Is LIe exLensIve use oI
conLorLed unuIogy und cd hominem urgumenLs In pressIng Ior
progressIveIy more deIuded unLIsmokIng poIIcy.
JoIn BunzIuI, u proIessor oI Iuw, un unLIsmokIng ucLIvIsL wILI
ASH, und u key IIgure In coercIng unLIsmokIng IeguI precedenL, receIved
IIs undergruduuLe degree In eIecLrIcuI engIneerIng (I.e., muLerIuIIsL,
mecIunIsLIc). n keepIng wILI LIe oLIer key unLIsmokIng IIgures, BunzIuI
demonsLruLes u Iuck oI proIIcIency In uccounLIng Ior u coIerenL
psycIoIogIcuI, reIuLIonuI, und moruI Irumework. mproperIy ussumIng
LIuL LIe sLuLIsLIcuIIsm oI IIIesLyIe epIdemIoIogy Ius uny scIenLIIIc merIL,
BunzIuI Ius been u mujor puwn In LIe IuyIng oI u psycIoIogIcuIIy-
enIeebIIng, muLerIuIIsL InIrusLrucLure und LIe coercIon oI LIe rIsk
uvoIdIng IndIvIduuI. BoLI GoLIe eL uI. (1qq) und TyndeI (1qqq) noLe LIe
roIe oI Iuw In promoLIng somuLIzuLIon dIsorders. TIe sume cun be suId Ior
conLorLIons oI Iuw LIuL promoLe ETS-Induced syndromes.
TIe InLenL Is noL Lo udjudIcuLe cupucILy Ior reusonIng bused on
buckground und ImmedIuLe quuIIIIcuLIons, II compeLency In
muILIdImensIonuI reusonIng Is demonsLruLed. However, LIese IndIvIduuIs
dIspIuy uL every Lurn LIe superIIcIuIILy und vocubuIury oI u muLerIuIIsL
Irumework: TIese IeuILIIsLs, und LIe more generuI medIco-muLerIuIIsL
Irumework In wIIcI LIey operuLe, noL onIy demonsLruLe no cognIzunce
LIuL, Ior exumpIe, nocebo eIIecLs, ESS und conLugIon cre IeuILI Issues, buL
demonsLruLe no cognIzunce oI LIese concepLs ct cll. nsLILuLIons oI uII
sorLs (e.g., IeuILI, unIversILIes) Iuve been overrun by ImposLors. HeuILI
Ius been LrIvIuIIzed LIrougI muLerIuIIsm InLo poIILIcuI quesLs Ior eIIIcIenL,
uIbeIL mIsguIded, propugundu und socIuI engIneerIng.
TIe LIeme LIuL emerges Is LIuL persons gIven oIIIcIuI IeuILI
promoLIon roIes or IorwurdIng LIemseIves us IeuILI gurus demonsLruLe
unequIvocuIIy LIuL, wIuLever LIeIr quuIIIIcuLIons muy be, LIey ure
cerLuInIy noL scIenLIIIcuIIy compeLenL, I.e., InIerenLIuI IuIIucIes ure
produced us u muLLer oI course, purLIcuIurIy In consIderIng pIenomenu
sucI us Iumun IeuILI wIIcI Is muILIdImensIonuI In nuLure. WIen LIIs Is
IurLIer combIned wILI u menLuIILy LIuL demonsLruLes no cognIzunce oI
psycIoIogIcuI, psycIosocIuI und moruI dImensIons oI experIence und
enquIry, LIe resuIL Is cuLusLropIIc. TIe so-cuIIed IeuILI promoLIon
rouLIneIy promoLes supersLILIous beIIeIs und, us In LIe cuse oI ETS, IncILes
uIrs oI superIorILy (IuLred), socIuI dIvIsIon, und somuLoIorm dIsorders.
TIe LypIcuI dogmu Is muLerIuIIsL und sLuLIsLIcuI In dIsposILIon,
reduces IIIe Lo u Iong serIes oI sLuLIsLIcuI gumbIes, demonsLruLes no
cognIzunce oI psycIoIogIcuI und psycIosocIuI IeuILI, und preucIes rIsk-
Preventive Medicine & Health Promotion
uversIon us superIor-mIndedness. Non-conIormers Lo LIe edIcLs oI
MMES-reusonIng ure depIcLed us IrruLIonuI, economIcuIIy cosLIy Lo LIe
IeuILI sysLem, und poLenLIuIIy dungerous Lo conIormers. TIe dogmu Is
LypIcuIIy cIurucLer-ussussInuLIng (crumentum cd hominem) LIrougI LIe
use oI sLuLIsLIcuI bubbIe und Ieur und guIIL-mongerIng. TIe dIsusLer In
moLIon Is LIuL LIIs nonsense Is promoLed us scIenLIIIcuIIy bused und us
IeuILI promoLIon.
TIose wIo become cuIL devoLees cun mosL eusIIy recILe
dIsordered sLuLIsLIcuI InIormuLIon In correcLIng oLIers` (smokers) InIerIor
conducL. or exumpIe, workIng Irom LIe premIse LIuL more smokers
(smuII number) sLop or pIun Lo sLop smokIng II LIey beIIeve LIuL
secondIund smoke Iurmed oLIers, regurdIess oI wIeLIer sucI Iurm
ucLuuIIy occurs, GIunLz & JumIeson (zooo) opporLunIsLIcuIIy recommend:
EducuLIng young peopIe ubouL LIe dungers oI secondIund smoke und
empowerIng nonsmokers Lo speuk ouL sIouId be u sLrong eIemenL oI uny
Lobucco conLroI progrum; LIuL educuLIng ubouL LIe dungers oI ETS muy
In IucL be psycIoIogIcuIIy enIeebIIng nonsmokers, LIuL empowerIng
nonsmokers Lo speuk ouL Is onIy u cuII Lo superIorIsm (I.e., IurLIer menLuI
dysIuncLIon) und LIe pursuIL oI socIuI dIvIsIon, und LIuL uII oI LIIs Is u
psycIoIogIcuI buLLerIng oI smokers InLo unIounded guIIL, Is unIuLIomubIe
Lo LIe puny reusonIng oI LIese IeuILI promoLers. OnIy LIe ucuLe IIxuLIon
oI Lobucco conLroI IIgures In LIe LIInkIng, und wIuLever cun be musLered
Lowurds LIIs end Is uccepLubIe.
A more uggressIve Iorm uguIn InvoIves vuryIng degrees oI
conIronLuLIon und LIe poLenLIuI Ior, uL IeusL, moderuLe IeveIs oI vIoIence.
GIven LIe supersLILIous beIIeIs LIuL ure munuIucLured us u muLLer oI
course by IIIesLyIe epIdemIoIogy und IeuILIIsm LIuL conLInuuIIy pIuy on
IrruLIonuI IeurJIuLred, muny now beIIeve LIuL LIey sIouId noL sLund Ior
beIng exposed Lo ETS. A LypIcuI exumpIe Is nonsmokIng persons wuIkIng
InLo Indoor seLLIngs (prIvuLeJpubIIc, commercIuIJsocIuI) und demundIng
LIuL unyone smokIng musL exLInguIsI LIeIr cIgureLLes; IL Is LIe superIor
nonsmoker LIuL musL be gIven IIrsL cIoIce us Lo LIe nuLure oI LIe
envIronmenL und, LIereIore, wIeLIer unyone smokes or noL. TIIs Is so
wIeLIer LIe nonsmoker Ius un exIsLIng uIImenL or noL - IL Is u rIgIL
uccorded Lo superIor nonsmokers generuIIy.
ConcernIng LIe InLroducLIon oI unLIsmokIng Iuws In VIcLorIu,
AusLruIIu, IL wus suggesLed LIuL once LIe Iuss Ius dIed down, LIey mIgIL,
mucI IIke LruIIIc IIgILs und juywuIkIng Iuws, be Ionored more In LIe
breucI LIun LIe observuLIon. n response, IL wus cuuLIoned: Don`L you
beIIeve IL. Once LIey`re In, LIey`re In. TIere Is no creuLure more IIerce und
persIsLenL LIun u non-smoker wILI LIe Iuw on IIs or Ier sIde. (The Ae,
June o, zoo1, p.1z)
365
365
Rampant Antismoking Signifies Grave Danger
ritish Mediccl 1ourncl und Tobccco Control. TIe onIy consIsLency LIuL
cun be Iound In LIIs work, und In uddILIon Lo uII LIe numerous IuIIucIes
LIuL IIIesLyIe epIdemIoIogy Is uIreudy predIcuLed on, Is LIe exLensIve use oI
conLorLed unuIogy und cd hominem urgumenLs In pressIng Ior
progressIveIy more deIuded unLIsmokIng poIIcy.
JoIn BunzIuI, u proIessor oI Iuw, un unLIsmokIng ucLIvIsL wILI
ASH, und u key IIgure In coercIng unLIsmokIng IeguI precedenL, receIved
IIs undergruduuLe degree In eIecLrIcuI engIneerIng (I.e., muLerIuIIsL,
mecIunIsLIc). n keepIng wILI LIe oLIer key unLIsmokIng IIgures, BunzIuI
demonsLruLes u Iuck oI proIIcIency In uccounLIng Ior u coIerenL
psycIoIogIcuI, reIuLIonuI, und moruI Irumework. mproperIy ussumIng
LIuL LIe sLuLIsLIcuIIsm oI IIIesLyIe epIdemIoIogy Ius uny scIenLIIIc merIL,
BunzIuI Ius been u mujor puwn In LIe IuyIng oI u psycIoIogIcuIIy-
enIeebIIng, muLerIuIIsL InIrusLrucLure und LIe coercIon oI LIe rIsk
uvoIdIng IndIvIduuI. BoLI GoLIe eL uI. (1qq) und TyndeI (1qqq) noLe LIe
roIe oI Iuw In promoLIng somuLIzuLIon dIsorders. TIe sume cun be suId Ior
conLorLIons oI Iuw LIuL promoLe ETS-Induced syndromes.
TIe InLenL Is noL Lo udjudIcuLe cupucILy Ior reusonIng bused on
buckground und ImmedIuLe quuIIIIcuLIons, II compeLency In
muILIdImensIonuI reusonIng Is demonsLruLed. However, LIese IndIvIduuIs
dIspIuy uL every Lurn LIe superIIcIuIILy und vocubuIury oI u muLerIuIIsL
Irumework: TIese IeuILIIsLs, und LIe more generuI medIco-muLerIuIIsL
Irumework In wIIcI LIey operuLe, noL onIy demonsLruLe no cognIzunce
LIuL, Ior exumpIe, nocebo eIIecLs, ESS und conLugIon cre IeuILI Issues, buL
demonsLruLe no cognIzunce oI LIese concepLs ct cll. nsLILuLIons oI uII
sorLs (e.g., IeuILI, unIversILIes) Iuve been overrun by ImposLors. HeuILI
Ius been LrIvIuIIzed LIrougI muLerIuIIsm InLo poIILIcuI quesLs Ior eIIIcIenL,
uIbeIL mIsguIded, propugundu und socIuI engIneerIng.
TIe LIeme LIuL emerges Is LIuL persons gIven oIIIcIuI IeuILI
promoLIon roIes or IorwurdIng LIemseIves us IeuILI gurus demonsLruLe
unequIvocuIIy LIuL, wIuLever LIeIr quuIIIIcuLIons muy be, LIey ure
cerLuInIy noL scIenLIIIcuIIy compeLenL, I.e., InIerenLIuI IuIIucIes ure
produced us u muLLer oI course, purLIcuIurIy In consIderIng pIenomenu
sucI us Iumun IeuILI wIIcI Is muILIdImensIonuI In nuLure. WIen LIIs Is
IurLIer combIned wILI u menLuIILy LIuL demonsLruLes no cognIzunce oI
psycIoIogIcuI, psycIosocIuI und moruI dImensIons oI experIence und
enquIry, LIe resuIL Is cuLusLropIIc. TIe so-cuIIed IeuILI promoLIon
rouLIneIy promoLes supersLILIous beIIeIs und, us In LIe cuse oI ETS, IncILes
uIrs oI superIorILy (IuLred), socIuI dIvIsIon, und somuLoIorm dIsorders.
TIe LypIcuI dogmu Is muLerIuIIsL und sLuLIsLIcuI In dIsposILIon,
reduces IIIe Lo u Iong serIes oI sLuLIsLIcuI gumbIes, demonsLruLes no
cognIzunce oI psycIoIogIcuI und psycIosocIuI IeuILI, und preucIes rIsk-
Preventive Medicine & Health Promotion
uversIon us superIor-mIndedness. Non-conIormers Lo LIe edIcLs oI
MMES-reusonIng ure depIcLed us IrruLIonuI, economIcuIIy cosLIy Lo LIe
IeuILI sysLem, und poLenLIuIIy dungerous Lo conIormers. TIe dogmu Is
LypIcuIIy cIurucLer-ussussInuLIng (crumentum cd hominem) LIrougI LIe
use oI sLuLIsLIcuI bubbIe und Ieur und guIIL-mongerIng. TIe dIsusLer In
moLIon Is LIuL LIIs nonsense Is promoLed us scIenLIIIcuIIy bused und us
IeuILI promoLIon.
TIose wIo become cuIL devoLees cun mosL eusIIy recILe
dIsordered sLuLIsLIcuI InIormuLIon In correcLIng oLIers` (smokers) InIerIor
conducL. or exumpIe, workIng Irom LIe premIse LIuL more smokers
(smuII number) sLop or pIun Lo sLop smokIng II LIey beIIeve LIuL
secondIund smoke Iurmed oLIers, regurdIess oI wIeLIer sucI Iurm
ucLuuIIy occurs, GIunLz & JumIeson (zooo) opporLunIsLIcuIIy recommend:
EducuLIng young peopIe ubouL LIe dungers oI secondIund smoke und
empowerIng nonsmokers Lo speuk ouL sIouId be u sLrong eIemenL oI uny
Lobucco conLroI progrum; LIuL educuLIng ubouL LIe dungers oI ETS muy
In IucL be psycIoIogIcuIIy enIeebIIng nonsmokers, LIuL empowerIng
nonsmokers Lo speuk ouL Is onIy u cuII Lo superIorIsm (I.e., IurLIer menLuI
dysIuncLIon) und LIe pursuIL oI socIuI dIvIsIon, und LIuL uII oI LIIs Is u
psycIoIogIcuI buLLerIng oI smokers InLo unIounded guIIL, Is unIuLIomubIe
Lo LIe puny reusonIng oI LIese IeuILI promoLers. OnIy LIe ucuLe IIxuLIon
oI Lobucco conLroI IIgures In LIe LIInkIng, und wIuLever cun be musLered
Lowurds LIIs end Is uccepLubIe.
A more uggressIve Iorm uguIn InvoIves vuryIng degrees oI
conIronLuLIon und LIe poLenLIuI Ior, uL IeusL, moderuLe IeveIs oI vIoIence.
GIven LIe supersLILIous beIIeIs LIuL ure munuIucLured us u muLLer oI
course by IIIesLyIe epIdemIoIogy und IeuILIIsm LIuL conLInuuIIy pIuy on
IrruLIonuI IeurJIuLred, muny now beIIeve LIuL LIey sIouId noL sLund Ior
beIng exposed Lo ETS. A LypIcuI exumpIe Is nonsmokIng persons wuIkIng
InLo Indoor seLLIngs (prIvuLeJpubIIc, commercIuIJsocIuI) und demundIng
LIuL unyone smokIng musL exLInguIsI LIeIr cIgureLLes; IL Is LIe superIor
nonsmoker LIuL musL be gIven IIrsL cIoIce us Lo LIe nuLure oI LIe
envIronmenL und, LIereIore, wIeLIer unyone smokes or noL. TIIs Is so
wIeLIer LIe nonsmoker Ius un exIsLIng uIImenL or noL - IL Is u rIgIL
uccorded Lo superIor nonsmokers generuIIy.
ConcernIng LIe InLroducLIon oI unLIsmokIng Iuws In VIcLorIu,
AusLruIIu, IL wus suggesLed LIuL once LIe Iuss Ius dIed down, LIey mIgIL,
mucI IIke LruIIIc IIgILs und juywuIkIng Iuws, be Ionored more In LIe
breucI LIun LIe observuLIon. n response, IL wus cuuLIoned: Don`L you
beIIeve IL. Once LIey`re In, LIey`re In. TIere Is no creuLure more IIerce und
persIsLenL LIun u non-smoker wILI LIe Iuw on IIs or Ier sIde. (The Ae,
June o, zoo1, p.1z)
366
366
Rampant Antismoking Signifies Grave Danger
A 1qq Hih Point Enterprise urLIcIe IndIcuLes some oI LIe
IengLIs LIuL some ure wIIIIng Lo go Lo In seII-proLecLIon und rIgILness
wILI LIe Iuw:
An AIgonquIn, IIInoIs, mun |G. TIompson| wus
urresLed Sunduy uILernoon uL SprIng HIII MuII und
cIurged wILI ussuuILIng u pregnunL womun, uppurenLIy
becuuse Ie wus boLIered by Ier cIgureLLe smoke, poIIce
suId..TIompson Iud been sIoppIng uL LIe muII wIen
uL ubouL p.m., Ie uppurenLIy suw u z8-yeur-oId
CurpenLersvIIIe womun, wIo Is 8 1Jz monLIs pregnunL,
sILLIng und smokIng neurby, poIIce suId.
TIompson uppurenLIy becume enruged becuuse Ie wus
boLIered by LIe smoke, poIIce suId. He uIIegedIy wuIked
up Lo LIe womun und grubbed Ier rIgIL Iund, LIen
LwIsLed IL und benL IL beIInd Ier Ieud unLII sIe dropped
LIe cIgureLLe, poIIce suId.
He wuIked uwuy suyIng, 'TIere Is no smokIng In LIe
muII,` uccordIng Lo LIe poIIce reporL. 'He jusL suId Ie
wus overcome by LIe smoke und Ie Look IL upon IImseII
Lo vIgIIunLe LIe sILuuLIon,` suId WesL Dundee OIIIcer
SLeve PIrLIe. TIe poIIce oIIIcer LIe ussuIIunL wusn`L
necessurIIy ucLIng ouL oI concern Ior LIe eIIecLs smokIng
couId Iuve on LIe womun`s IeLus. 'He Is u nonsmoker,`
PIrLIe suId. 'He wus jusL worrIed ubouL IImseII.`
TIe MMES dogmu Ius uIso LurgeLed pregnunL, nonsmokIng
women und oLIer proLecLors oI LIese women. or exumpIe, EIsenberg eL
uI. (zoo1) udvIse pregnunL, nonsmokIng women Lo noL be emburrussed Lo
suy Yes, mInd very mucI II you smoke. (p.1qq) KILzInger (1qq1) cILes
LIe exumpIe oI u pregnunL, nonsmokIng womun decIurIng reuIIy geL
scured wIen someone IIgILs up. LIInk, wIy sIouId my buby Iuve LIuL
poIson In ILs bIoodsLreum? cun geL quILe rude ubouL IL. (p.q) Ouks
(zoo1) provIdes u Iew IurLIer exumpIes:
One womun LuIked wILI suId LIuL Ier sIsLer-
In-Iuw Is u 'IunuLIc` wIo wIII suy Lo sLrungers,
puL ouL your cIgureLLe, pIeuse!..TIe mosL
remurkubIe InsLunce oI u pregnunL
nonsmoker`s uLLempL Lo uvoId exposure Lo
smoke on beIuII oI LIe IeuILI oI Ier buby-Lo-
be wus reIuLed Lo me by u IrIend. June, wIo
wus In LIe IIrsL LrImesLer oI Ier IIrsL
pregnuncy Iud uLLended u busebuII gume In u
Preventive Medicine & Health Promotion
souLIwesLern cILy. WIIIe sLundIng In u
desIgnuLed smokIng ureu neur u concessIon
sLund, June usked u womun Lo puL ouL Ier
cIgureLLe, expIuInIng LIuL sIe wus pregnunL.
TIe smoker reIused, und un urgumenL
ensued. BeIore oLIers InLervened, June
sIupped LIe smoker ucross LIe Iuce. DespILe
LIe IucL LIuL LIey were In u pIuce wIere
smokIng wus IeguI, June IeIL sIe Iud LIe rIgIL
us u pregnunL womun Lo be In u smoke-Iree
spuce Lo proLecL Ier IeLus`s IeuILI, und sIe
sLrongIy resenLed LIe smoker`s Iuck oI
concern ubouL LIe IeuILI oI Ier buby-Lo-be.
(p.18;)
n LIese exumpIes LIe desIre or LempLuLIon Lo be rIgIL und
superIor Is very sLrong Indeed, und In LIe IusL cuse LIe desIre Is so
overwIeImIng LIuL u smoker Is conIronLed In u smokIng secLIon und
sIupped wIen LIe InIerIor smoker does noL conIorm Lo LIe superIor
nonsmoker`s demund. nLeresLIngIy, In LIe IusL cuse, LIe nonsmoker wus
wIIIIng Lo Luke even greuLer rIsks (conIronLuLIon) LIun wIuL LIey ure
supposedIy LryIng Lo guurd LIemseIves Irom. SucI superIorIsL persons ure
uIreudy LroubIed mInds; LIe unLIsmokIng IIxuLIon Ius sImpIy provIded u
projecLIon poInL Ior IuugILIness, bIgoLry, obsLInucy und oLIer Inner
conIIIcL.
n Iur more uggressIve Iorms, LIe superIorILy syndrome cun
degeneruLe InLo IIgIIy conLorLed beIIeIs und conducL oI LIe crImInuI or
psycIoLIc kInd. TIere Is by LIIs LIme very consIderubIe InIormuLIon,
purLIcuIurIy on websILes, IndIcuLIng perverse beIIeIs und IosLIIILy LIuL
wouId rIvuI, II IL Is noL uIreudy purL oI, LIe NuzI or neo-NuzI dIsposILIon.
Mcudden (zoo1) provIdes some ucLuuI quoLes Luken Irom LIe Usenet
uIL.smokers newsgroup by unwunLed guesLs:
Muy see LIe duy wIen LIose kIds geL over LIeIr Iorced
uddIcLIons und wIen grown Iook buck uL LIe purenLs,
wIen LIe purenLs LIemseIves ure on deuLIs door und In
puIn, muy LIey IuugI In your Iuce und LeII you LIuL you
Iuve goLLen wIuL you deserved und LIen LeII you Lo go Lo
IeII und wuIk ouL on you und Ieuve you Lo puLIeLIcuIIy
dIe In your bed.
A wreLcIed drug uddIcLed scumbug kIIIs more
InnocenLs ...TIey deserve munduLory prIson LIme jusL
367
367
Rampant Antismoking Signifies Grave Danger
A 1qq Hih Point Enterprise urLIcIe IndIcuLes some oI LIe
IengLIs LIuL some ure wIIIIng Lo go Lo In seII-proLecLIon und rIgILness
wILI LIe Iuw:
An AIgonquIn, IIInoIs, mun |G. TIompson| wus
urresLed Sunduy uILernoon uL SprIng HIII MuII und
cIurged wILI ussuuILIng u pregnunL womun, uppurenLIy
becuuse Ie wus boLIered by Ier cIgureLLe smoke, poIIce
suId..TIompson Iud been sIoppIng uL LIe muII wIen
uL ubouL p.m., Ie uppurenLIy suw u z8-yeur-oId
CurpenLersvIIIe womun, wIo Is 8 1Jz monLIs pregnunL,
sILLIng und smokIng neurby, poIIce suId.
TIompson uppurenLIy becume enruged becuuse Ie wus
boLIered by LIe smoke, poIIce suId. He uIIegedIy wuIked
up Lo LIe womun und grubbed Ier rIgIL Iund, LIen
LwIsLed IL und benL IL beIInd Ier Ieud unLII sIe dropped
LIe cIgureLLe, poIIce suId.
He wuIked uwuy suyIng, 'TIere Is no smokIng In LIe
muII,` uccordIng Lo LIe poIIce reporL. 'He jusL suId Ie
wus overcome by LIe smoke und Ie Look IL upon IImseII
Lo vIgIIunLe LIe sILuuLIon,` suId WesL Dundee OIIIcer
SLeve PIrLIe. TIe poIIce oIIIcer LIe ussuIIunL wusn`L
necessurIIy ucLIng ouL oI concern Ior LIe eIIecLs smokIng
couId Iuve on LIe womun`s IeLus. 'He Is u nonsmoker,`
PIrLIe suId. 'He wus jusL worrIed ubouL IImseII.`
TIe MMES dogmu Ius uIso LurgeLed pregnunL, nonsmokIng
women und oLIer proLecLors oI LIese women. or exumpIe, EIsenberg eL
uI. (zoo1) udvIse pregnunL, nonsmokIng women Lo noL be emburrussed Lo
suy Yes, mInd very mucI II you smoke. (p.1qq) KILzInger (1qq1) cILes
LIe exumpIe oI u pregnunL, nonsmokIng womun decIurIng reuIIy geL
scured wIen someone IIgILs up. LIInk, wIy sIouId my buby Iuve LIuL
poIson In ILs bIoodsLreum? cun geL quILe rude ubouL IL. (p.q) Ouks
(zoo1) provIdes u Iew IurLIer exumpIes:
One womun LuIked wILI suId LIuL Ier sIsLer-
In-Iuw Is u 'IunuLIc` wIo wIII suy Lo sLrungers,
puL ouL your cIgureLLe, pIeuse!..TIe mosL
remurkubIe InsLunce oI u pregnunL
nonsmoker`s uLLempL Lo uvoId exposure Lo
smoke on beIuII oI LIe IeuILI oI Ier buby-Lo-
be wus reIuLed Lo me by u IrIend. June, wIo
wus In LIe IIrsL LrImesLer oI Ier IIrsL
pregnuncy Iud uLLended u busebuII gume In u
Preventive Medicine & Health Promotion
souLIwesLern cILy. WIIIe sLundIng In u
desIgnuLed smokIng ureu neur u concessIon
sLund, June usked u womun Lo puL ouL Ier
cIgureLLe, expIuInIng LIuL sIe wus pregnunL.
TIe smoker reIused, und un urgumenL
ensued. BeIore oLIers InLervened, June
sIupped LIe smoker ucross LIe Iuce. DespILe
LIe IucL LIuL LIey were In u pIuce wIere
smokIng wus IeguI, June IeIL sIe Iud LIe rIgIL
us u pregnunL womun Lo be In u smoke-Iree
spuce Lo proLecL Ier IeLus`s IeuILI, und sIe
sLrongIy resenLed LIe smoker`s Iuck oI
concern ubouL LIe IeuILI oI Ier buby-Lo-be.
(p.18;)
n LIese exumpIes LIe desIre or LempLuLIon Lo be rIgIL und
superIor Is very sLrong Indeed, und In LIe IusL cuse LIe desIre Is so
overwIeImIng LIuL u smoker Is conIronLed In u smokIng secLIon und
sIupped wIen LIe InIerIor smoker does noL conIorm Lo LIe superIor
nonsmoker`s demund. nLeresLIngIy, In LIe IusL cuse, LIe nonsmoker wus
wIIIIng Lo Luke even greuLer rIsks (conIronLuLIon) LIun wIuL LIey ure
supposedIy LryIng Lo guurd LIemseIves Irom. SucI superIorIsL persons ure
uIreudy LroubIed mInds; LIe unLIsmokIng IIxuLIon Ius sImpIy provIded u
projecLIon poInL Ior IuugILIness, bIgoLry, obsLInucy und oLIer Inner
conIIIcL.
n Iur more uggressIve Iorms, LIe superIorILy syndrome cun
degeneruLe InLo IIgIIy conLorLed beIIeIs und conducL oI LIe crImInuI or
psycIoLIc kInd. TIere Is by LIIs LIme very consIderubIe InIormuLIon,
purLIcuIurIy on websILes, IndIcuLIng perverse beIIeIs und IosLIIILy LIuL
wouId rIvuI, II IL Is noL uIreudy purL oI, LIe NuzI or neo-NuzI dIsposILIon.
Mcudden (zoo1) provIdes some ucLuuI quoLes Luken Irom LIe Usenet
uIL.smokers newsgroup by unwunLed guesLs:
Muy see LIe duy wIen LIose kIds geL over LIeIr Iorced
uddIcLIons und wIen grown Iook buck uL LIe purenLs,
wIen LIe purenLs LIemseIves ure on deuLIs door und In
puIn, muy LIey IuugI In your Iuce und LeII you LIuL you
Iuve goLLen wIuL you deserved und LIen LeII you Lo go Lo
IeII und wuIk ouL on you und Ieuve you Lo puLIeLIcuIIy
dIe In your bed.
A wreLcIed drug uddIcLed scumbug kIIIs more
InnocenLs ...TIey deserve munduLory prIson LIme jusL
368
368
Rampant Antismoking Signifies Grave Danger
IIke uny oLIer uddIcL wIose beIuvIor murders oLIers ...
No, we need Lo Increuse LIe IeveI oI LoxIcILy so LIuL LIe
onseL oI deuLI Is mucI IusLer In LIe users, IopeIuIIy
beIore LIey propuguLe LIeIr deIecLIve genes .... And
muke sure LIe onIy pIuce LIey cun IeguIIy IIx-up LIeIr
wreLcIed uddIcLIon Is In LIe consLruInLs oI LIeIr puLrId
Iomes.
You junkIes Iuve no respecL or cure Ior oLIers uround
you, you ure enLIreIy |de|pendenL und desperuLeIy
uddIcLed Lo your drug, LIereIore socIeLy Is Iorced Lo
ouLIuw und resLrIcL your oIIensIve und obnoxIo|u|s
PUBC beIuvIor.
Smokers ure dIsproporLI|o|nuLeIy Iower cIuss, budIy
educuLed, weIIure recIpIenLs und menLuIIy unbuIunced.
Iuve no Iove Ior LIem. IuLe LIe sIn und LIe sInner.
On LIe oLIer Iund, wIen go Lo u resLuurunL, II you
smoke, do noL wIsI you Lo be neur me Ior uny reuson
due Lo your repuIsIve odour, und due Lo LIe poIsonous
guses you ure emILLIng Irom your Lobucco-sLuIned und
IIdeous mouLI LIuL wIII enLer my body due Lo your
proxImILy.
Hey you uddIcLed pukes ! Even LIe IocuI Ieud sIop,
wIIcI uIIows Dope smokIng InsIde LIeIr cuIe, mukes LIe
Lobucco junkIes go InLo u segreguLed, secIuded,
IIsIbowI-IIke room Lo burn LIeIr puLrId cIgureLLes ... You
pukes cun'L even geL uny sympuLIy Irom LIe dope
smokers ...
WIuL kInd oI u || IunuLIc LIInks LIuL mukIng uddIcLs
uncomIorLubIe ubouL LIeIr uddIcLIon Is some Iow
bIgoLry? meun wIuL kInd oI u LoLuI || nuL cuse
wIucked ouL on L|o|bucco uddIcLIon wouId come up
wILI sucI un Insune, IreukIsIIy bIzurre noLIon?
keep my kIds uwuy Irom smokIng Lo LIe poInL oI
puLLIng ouL LIe cIgureLLes oI oLIers II LIey Ignore my
poIILe requesL LIuL LIey don'L IIgIL up. 'II LeucI my kIds
Preventive Medicine & Health Promotion
Lo IIve IeuILIIIy us besL cun by poInLIng ouL LIuL
smokers ure IIILIy, sLInky, IdIoLs, uddIcLs, und Iuve IILLIe
respecL Ior oLIers uround LIem. And 'II keep puLLIng
smokes ouL Ior peopIe wIo Ignore me.
TIe bIg probIem wILI Lobucco Is LIuL IL doesn'L kIII
peopIe IusL enougI. TIe uw oI NuLure wouId dIcLuLe
LIuL weukness be punIsIed u IoL IusLer LIun LIuL.
TIuL's exucLIy wIy LIe AA wus born, und wIy IL's rupIdIy
growIng. A buncI oI courugeous, beIIIcose unLIsmokers
wIo ure noL wIIIIng Lo LoIeruLe unymore u worId run by
Lobucco corporuLIons. WIo ure even wIIIIng Lo use
VOENCE uguInsL junkIes wIo deIy LIose smokeIree
Iuws. TIe AnLIsmokIng Army: An InLernuLIonuI
OrgunIsuLIon IeIpIng nonsmokers sInce 1qqq, uImIng Lo
geL deIIneLIveIy rId oI smokers und Lobucco IndusLry by
LIe IuII oI LIe yeur zo1q.
ConsIsLenL wILI LIe concIudIng quoLe, u U.S. zo,zo ReporL
(1qqq) IIgIIIgILed LIuL LIere ure gungs oI LIugs In LIe UnILed SLuLes oI
AmerIcu LIuL dIsLInguIsI LIemseIves us non-drInkers und nonsmokers. To
LIese gungs, LIeIr non-drInkIng und non-smokIng eIevuLes LIem InLo u
pure or superIor sLuLus und wIere smokIng In LIeIr vIcInILy Is
perceIved us u sIgn oI dIsrespecL. n LIese mInds IL Is quILe upproprIuLe
Lo eILIer pIysIcuIIy beuL sucI dIsrespecLIuI persons or even kIII LIem. To
LIIs conLorLed, upsIde-down LIInkIng, exposure Lo ETS becomes u mujor
vIoIuLIon wIIIe murder Is LrIvIuIIzed.
n uddILIon Lo LIe seII-proLecLIon vIoIence IndIcuLed eurIIer,
LIere ure IurLIer exumpIes oI vIoIence und IncILemenL Lo vIoIence posLed
uL www.geocILIes.comJsmokersunILedJWARonSMOKERS.ILm:
AcLIon on SmokIng und HeuILI (ASH) promoLes u book,
Gcspl A Notel oj Retene, on ILs web sILe wIIcI
conLuIns u LesLed und proven wuy Lo Lumper wILI
cIgureLLe puckuges Lo InserL cyunIde. Action on Smolin
cnd Heclth, :pp (http:,,uuu.csh.or)
our IncIdenLs oI Lobucco producL LumperIng In
VIrgInIu, IncIudIng LIe use oI expIosIve devIces, wus
reporLed by The Wcshinton Post (Muy zq, 1qq;)
MIumI - A mun uLLucked u womun Ior smokIng InsIde u
buIIdIng. |A womun|, uged o, wus sLundIng uL LIe
norLI sIde exIL door on LIe LIIrd IIoor oI LIe buIIdIng
369
369
Rampant Antismoking Signifies Grave Danger
IIke uny oLIer uddIcL wIose beIuvIor murders oLIers ...
No, we need Lo Increuse LIe IeveI oI LoxIcILy so LIuL LIe
onseL oI deuLI Is mucI IusLer In LIe users, IopeIuIIy
beIore LIey propuguLe LIeIr deIecLIve genes .... And
muke sure LIe onIy pIuce LIey cun IeguIIy IIx-up LIeIr
wreLcIed uddIcLIon Is In LIe consLruInLs oI LIeIr puLrId
Iomes.
You junkIes Iuve no respecL or cure Ior oLIers uround
you, you ure enLIreIy |de|pendenL und desperuLeIy
uddIcLed Lo your drug, LIereIore socIeLy Is Iorced Lo
ouLIuw und resLrIcL your oIIensIve und obnoxIo|u|s
PUBC beIuvIor.
Smokers ure dIsproporLI|o|nuLeIy Iower cIuss, budIy
educuLed, weIIure recIpIenLs und menLuIIy unbuIunced.
Iuve no Iove Ior LIem. IuLe LIe sIn und LIe sInner.
On LIe oLIer Iund, wIen go Lo u resLuurunL, II you
smoke, do noL wIsI you Lo be neur me Ior uny reuson
due Lo your repuIsIve odour, und due Lo LIe poIsonous
guses you ure emILLIng Irom your Lobucco-sLuIned und
IIdeous mouLI LIuL wIII enLer my body due Lo your
proxImILy.
Hey you uddIcLed pukes ! Even LIe IocuI Ieud sIop,
wIIcI uIIows Dope smokIng InsIde LIeIr cuIe, mukes LIe
Lobucco junkIes go InLo u segreguLed, secIuded,
IIsIbowI-IIke room Lo burn LIeIr puLrId cIgureLLes ... You
pukes cun'L even geL uny sympuLIy Irom LIe dope
smokers ...
WIuL kInd oI u || IunuLIc LIInks LIuL mukIng uddIcLs
uncomIorLubIe ubouL LIeIr uddIcLIon Is some Iow
bIgoLry? meun wIuL kInd oI u LoLuI || nuL cuse
wIucked ouL on L|o|bucco uddIcLIon wouId come up
wILI sucI un Insune, IreukIsIIy bIzurre noLIon?
keep my kIds uwuy Irom smokIng Lo LIe poInL oI
puLLIng ouL LIe cIgureLLes oI oLIers II LIey Ignore my
poIILe requesL LIuL LIey don'L IIgIL up. 'II LeucI my kIds
Preventive Medicine & Health Promotion
Lo IIve IeuILIIIy us besL cun by poInLIng ouL LIuL
smokers ure IIILIy, sLInky, IdIoLs, uddIcLs, und Iuve IILLIe
respecL Ior oLIers uround LIem. And 'II keep puLLIng
smokes ouL Ior peopIe wIo Ignore me.
TIe bIg probIem wILI Lobucco Is LIuL IL doesn'L kIII
peopIe IusL enougI. TIe uw oI NuLure wouId dIcLuLe
LIuL weukness be punIsIed u IoL IusLer LIun LIuL.
TIuL's exucLIy wIy LIe AA wus born, und wIy IL's rupIdIy
growIng. A buncI oI courugeous, beIIIcose unLIsmokers
wIo ure noL wIIIIng Lo LoIeruLe unymore u worId run by
Lobucco corporuLIons. WIo ure even wIIIIng Lo use
VOENCE uguInsL junkIes wIo deIy LIose smokeIree
Iuws. TIe AnLIsmokIng Army: An InLernuLIonuI
OrgunIsuLIon IeIpIng nonsmokers sInce 1qqq, uImIng Lo
geL deIIneLIveIy rId oI smokers und Lobucco IndusLry by
LIe IuII oI LIe yeur zo1q.
ConsIsLenL wILI LIe concIudIng quoLe, u U.S. zo,zo ReporL
(1qqq) IIgIIIgILed LIuL LIere ure gungs oI LIugs In LIe UnILed SLuLes oI
AmerIcu LIuL dIsLInguIsI LIemseIves us non-drInkers und nonsmokers. To
LIese gungs, LIeIr non-drInkIng und non-smokIng eIevuLes LIem InLo u
pure or superIor sLuLus und wIere smokIng In LIeIr vIcInILy Is
perceIved us u sIgn oI dIsrespecL. n LIese mInds IL Is quILe upproprIuLe
Lo eILIer pIysIcuIIy beuL sucI dIsrespecLIuI persons or even kIII LIem. To
LIIs conLorLed, upsIde-down LIInkIng, exposure Lo ETS becomes u mujor
vIoIuLIon wIIIe murder Is LrIvIuIIzed.
n uddILIon Lo LIe seII-proLecLIon vIoIence IndIcuLed eurIIer,
LIere ure IurLIer exumpIes oI vIoIence und IncILemenL Lo vIoIence posLed
uL www.geocILIes.comJsmokersunILedJWARonSMOKERS.ILm:
AcLIon on SmokIng und HeuILI (ASH) promoLes u book,
Gcspl A Notel oj Retene, on ILs web sILe wIIcI
conLuIns u LesLed und proven wuy Lo Lumper wILI
cIgureLLe puckuges Lo InserL cyunIde. Action on Smolin
cnd Heclth, :pp (http:,,uuu.csh.or)
our IncIdenLs oI Lobucco producL LumperIng In
VIrgInIu, IncIudIng LIe use oI expIosIve devIces, wus
reporLed by The Wcshinton Post (Muy zq, 1qq;)
MIumI - A mun uLLucked u womun Ior smokIng InsIde u
buIIdIng. |A womun|, uged o, wus sLundIng uL LIe
norLI sIde exIL door on LIe LIIrd IIoor oI LIe buIIdIng
370
370
Rampant Antismoking Signifies Grave Danger
smokIng u cIgureLLe wIen u mun In IIs os cume up Lo
Ier und sLurLed screumIng uL Ier ubouL smokIng. He
LIen pusIed Ier ouL LIe exIL door und uLLempLed Lo
cIose IL wIIIe Ier Iund wus In LIe doorwuy (Micmi
Hercld, Junuury 6, zooo)
A 6o-yeur-oId New York CILy resLuurunL puLron wus seL
upon by IIve wuILers, kIcked, puncIed, und LIrown ouL
on Lo LIe sLreeL Ior LIe crIme oI smokIng. He Ius
remuIned In u comu sInce LIe uLLuck. HIs uLLuckers were
noL cIurged (Neu Yorl Post, ebruury 1q, 1qq)
A Heud SLurL InsLrucLor In ModesLo, CuIIIornIu, LorLured
und pIysIcuIIy ubused Ier own duugILer becuuse sIe
Iud Lobucco producLs In Ier possessIon (The Modesto
ee, MurcI 1q, 1qqq)
A IocuI rudIo LuIk sIow IosL In SeuLLIe udvocuLed LIuL
persons wIo smoke ouLsIde sporLs urenus be ussuuILed
und buLLered (DorI Monson oI KIRD AM ;:o, June
1qq;)
n Cunudu u reIormed smoker uLLucked IIs wIIe oI o
yeurs, wILI u 1z-IncI kILcIen knIIe, reporLedIy sLubbIng
Ier In LIe neck uILer IIndIng ouL LIuL sIe Iud broken Ier
promIse Lo gIve up smokIng (London Telercph, AprII
z1, zooo)
PIuce u bounLy on unyone seen In u Joe CumeI or
MurIboro T-sIIrL, busebuII cup, eLc. TIey muy be sIoL
on sIgIL und u $1,ooo rewurd wIII be gIven wIen
deIIvered Lo LIe sLuLe CupILoI Iuwn In SucrumenLo. (Los
Aneles Times, IIe & SLyIe, Sunduy Junuury 18,
1qq8)
TIe sLuLe sIouId requIre bur owners Lo IurnIsI ceIIuIur
pIones und PoIuroId cumerus Lo nonsmokers so LIuL
scoIIIuws cun be reporLed, IdenLIIIed und
execuLed. (Los Aneles Times, IIe & SLyIe, Sunduy
Junuury 18, 1qq8)
WIen smokers buy u puck oI cIgureLLes, one wIII Iuve
un expIosIve In IL - so LIe smoker wIII be uIruId Lo IIgIL
up, IeurIng u IucIuI IuceruLIon. (Los Aneles Times,
IIe & SLyIe, Sunduy Junuury 18, 1qq8)
I smokers ure so euger Lo dIe, LIen LIe unswer musL be
Lo cupLure und exLermInuLe LIem. TIe onIy soIuLIon Is
Lo remove LIe probIem; smokers. (Los Aneles Times,
IIe & SLyIe, Sunduy Junuury 18, 1qq8)
Preventive Medicine & Health Promotion
(..z The Entironmentcl Somctizction Sndrome
AnoLIer very dIsLIncL LIeme In LIe ETS sugu Is vIcLImIood or
somuLIc sympLoms Lo ETS. TIese LIen demund upproprIuLe pubIIc
poIIcy Ior LIe proLecLIon Irom InvoIunLury exposure. OukIey (1qqq)
provIdes u sIorL IIsL oI exumpIes oI pIysIcuI probIems uIIegedIy LrIggered
by uIrporL smokIng us reporLed by LIe unLIsmokIng Iobby group AcLIon
on SmokIng und HeuILI (ASH) In ILs Junuury-ebruury 1qq; RevIew:
AngInu resuILIng In u Lemporury InubIIILy Lo wuIk, LuIk,
or curry Iugguge
TIrouL consLrIcLIon Lo LIe poInL oI beIng unubIe Lo
speuk
Eye IrrILuLIon severe enougI Lo cuuse neur bIIndness
Severe puIn uILer devIuLed sepLum
CougIIng up bIuck or grey muLLer
IIness LIuL requIred z- duys Ior recovery
CoIIupsed on LIe IIoor
BurnIng oI sInuses
Weeks oI suIIerIng Irom upper respIruLory probIems
und sInus cougIIng speIIs IusLIng muny Iours
HeurL puIn wIIcI cun resuIL In IeurL dumuge
Cuused me Lo LIrow up severuI LImes
ProsLruLIon vIrLuuIIy Lo LIe poInL oI unconscIousness
BIeedIng Irom eur, nose, or LIrouL
EyeIIds swoIIen sIuL
(n OukIey, 1qqq,
CI.;, p.1).
371
371
Rampant Antismoking Signifies Grave Danger
smokIng u cIgureLLe wIen u mun In IIs os cume up Lo
Ier und sLurLed screumIng uL Ier ubouL smokIng. He
LIen pusIed Ier ouL LIe exIL door und uLLempLed Lo
cIose IL wIIIe Ier Iund wus In LIe doorwuy (Micmi
Hercld, Junuury 6, zooo)
A 6o-yeur-oId New York CILy resLuurunL puLron wus seL
upon by IIve wuILers, kIcked, puncIed, und LIrown ouL
on Lo LIe sLreeL Ior LIe crIme oI smokIng. He Ius
remuIned In u comu sInce LIe uLLuck. HIs uLLuckers were
noL cIurged (Neu Yorl Post, ebruury 1q, 1qq)
A Heud SLurL InsLrucLor In ModesLo, CuIIIornIu, LorLured
und pIysIcuIIy ubused Ier own duugILer becuuse sIe
Iud Lobucco producLs In Ier possessIon (The Modesto
ee, MurcI 1q, 1qqq)
A IocuI rudIo LuIk sIow IosL In SeuLLIe udvocuLed LIuL
persons wIo smoke ouLsIde sporLs urenus be ussuuILed
und buLLered (DorI Monson oI KIRD AM ;:o, June
1qq;)
n Cunudu u reIormed smoker uLLucked IIs wIIe oI o
yeurs, wILI u 1z-IncI kILcIen knIIe, reporLedIy sLubbIng
Ier In LIe neck uILer IIndIng ouL LIuL sIe Iud broken Ier
promIse Lo gIve up smokIng (London Telercph, AprII
z1, zooo)
PIuce u bounLy on unyone seen In u Joe CumeI or
MurIboro T-sIIrL, busebuII cup, eLc. TIey muy be sIoL
on sIgIL und u $1,ooo rewurd wIII be gIven wIen
deIIvered Lo LIe sLuLe CupILoI Iuwn In SucrumenLo. (Los
Aneles Times, IIe & SLyIe, Sunduy Junuury 18,
1qq8)
TIe sLuLe sIouId requIre bur owners Lo IurnIsI ceIIuIur
pIones und PoIuroId cumerus Lo nonsmokers so LIuL
scoIIIuws cun be reporLed, IdenLIIIed und
execuLed. (Los Aneles Times, IIe & SLyIe, Sunduy
Junuury 18, 1qq8)
WIen smokers buy u puck oI cIgureLLes, one wIII Iuve
un expIosIve In IL - so LIe smoker wIII be uIruId Lo IIgIL
up, IeurIng u IucIuI IuceruLIon. (Los Aneles Times,
IIe & SLyIe, Sunduy Junuury 18, 1qq8)
I smokers ure so euger Lo dIe, LIen LIe unswer musL be
Lo cupLure und exLermInuLe LIem. TIe onIy soIuLIon Is
Lo remove LIe probIem; smokers. (Los Aneles Times,
IIe & SLyIe, Sunduy Junuury 18, 1qq8)
Preventive Medicine & Health Promotion
(..z The Entironmentcl Somctizction Sndrome
AnoLIer very dIsLIncL LIeme In LIe ETS sugu Is vIcLImIood or
somuLIc sympLoms Lo ETS. TIese LIen demund upproprIuLe pubIIc
poIIcy Ior LIe proLecLIon Irom InvoIunLury exposure. OukIey (1qqq)
provIdes u sIorL IIsL oI exumpIes oI pIysIcuI probIems uIIegedIy LrIggered
by uIrporL smokIng us reporLed by LIe unLIsmokIng Iobby group AcLIon
on SmokIng und HeuILI (ASH) In ILs Junuury-ebruury 1qq; RevIew:
AngInu resuILIng In u Lemporury InubIIILy Lo wuIk, LuIk,
or curry Iugguge
TIrouL consLrIcLIon Lo LIe poInL oI beIng unubIe Lo
speuk
Eye IrrILuLIon severe enougI Lo cuuse neur bIIndness
Severe puIn uILer devIuLed sepLum
CougIIng up bIuck or grey muLLer
IIness LIuL requIred z- duys Ior recovery
CoIIupsed on LIe IIoor
BurnIng oI sInuses
Weeks oI suIIerIng Irom upper respIruLory probIems
und sInus cougIIng speIIs IusLIng muny Iours
HeurL puIn wIIcI cun resuIL In IeurL dumuge
Cuused me Lo LIrow up severuI LImes
ProsLruLIon vIrLuuIIy Lo LIe poInL oI unconscIousness
BIeedIng Irom eur, nose, or LIrouL
EyeIIds swoIIen sIuL
(n OukIey, 1qqq,
CI.;, p.1).
372
372
Rampant Antismoking Signifies Grave Danger
TIe dIsLurbIng IucL Iere Is LIuL LIIs sorL oI InIormuLIon Is
propuguLed In unLIsmokIng IILeruLure us LIougI IL deIInILIveIy
demonsLruLes cuusuI uLLrIbuLes oI ETS. RuLIer, LIe ter hih probubIIILy
Is LIuL IL demonsLruLes u dysIuncLIonuI psycIoIogIcuI sLuLe oI LIose
InvoIved. Beyond u sLruIgILIorwurd nocebo eIIecL, persons ure very
cupubIe oI munIIesLIng somuLIc (bIoIogIcuI) sympLoms due Lo psycIogenIc
sources LIuL ure LIen bIumed on exLernuIILIes LIuL muy or muy noL Iuve
LIe propensILy Lo LrIgger sucI sympLoms. Somctizction sndrome,
generuIIy, Is u Lendency Lo experIence und communIcuLe psycIogenIc
dIsLress In LIe Iorm oI pIysIcuI sympLoms und Lo seek medIcuI IeIp Ior
LIem. (GoLIe eL uI., 1qq, p.1)
CrILIcuI Lo LIe currenL dIscussIon Is wIuL GoLIe eL uI. (1qq)
nume LIe entironmentcl somctizction sndrome (ESS). TIIs represenLs u
purLIcuIur subdIvIsIon wILIIn LIe Iurge und dIverse group oI somuLIzuLIon
IIInesses wIIcI Is cIurucLerIzed by puLIenLs beIng convInced LIuL LIeIr
IeuILI dIsLurbunces ure cuused by exposure Lo cIemIcuI or pIysIcuI
componenLs oI LIe exLernuI envIronmenL, sucI us poIsonous subsLunces
und eIecLromugneLIc IIeIds, or Lo ergonomIc sLress uLLrIbuLubIe Lo
repeLILIve movemenLs or uncomIorLubIe posLures uL work..LIe puLIenLs
usuuIIy reIuse uILernuLIve expIunuLIons oI LIeIr sympLoms und dIscredIL
und rejecL uny suggesLIon oI u psycIogenIc eLIoIogy. (p.1)
GoLIe eL uI. (1qq) IndIcuLe LIuL LIe envIronmenLuI somuLIzuLIon
syndrome Is underIuIn by, IIrsLIy, LIe deepIy uncIored Lendency In Iumun
nuLure Lo IInk dIseuse Lo vugue und gIosL-IIke componenLs oI LIe exLernuI
envIronmenL und, secondIy, psycIogenIc epIdemIcs oI somuLIc
compIuInLs ure common. (p.1) TIey deLuII some wIdespreud ESS
epIdemIcs LIuL Iuve uL LImes escuIuLed InLo pundemIc proporLIons; Ior
exumpIe, Irom LIe cIuIm oI ursenIc poIsonIng durIng LIe nIneLeenLI
cenLury In CenLruI und NorLIern Europe, Lo cIuIms ubouL cIronIc curbon
monoxIde poIsonIng In LIe 1qqo`s In NordIc counLrIes, Lo cIuIms ubouL
umuIgum und oruI guIvunIsm uL vurIous LImes durIng LIe LwenLIeLI
cenLury In Europe und LIe U.S., Lo cIuIms oI wrILer`s und LeIegrupIIsL`s
crump In LIe mId-Lo-IuLe nIneLeenLI cenLury In BrILuIn und wIIcI
resurIuced In LIe 1q;o`s und 8o`s us repeLILIve sLruIn Injury In AusLruIIu,
Lo cIuIms oI eIecLromugneLIc IIeIds und eIecLrIc uIIergy In LIe 1q;o`s und
8o`s In Europe und NorLI AmerIcu - uII were Iound Lo Iuve no coIerenL
busIs. n mosL oI LIese cuses greuL IengLIs were pursued, purLIcuIurIy by
IeuILI uuLIorILIes, Lo IImIL exposure Lo uIIeged exLernuI cuuses by
uILerIng LIe envIronmenL. OnIy wIen LIe supposed reIuLIonsIIp beLween
subjecLIve sympLoms und exLenL oI exposure were cuIIed InLo quesLIon dId
LIe epIdemIcs evenLuuIIy decIIne.
Preventive Medicine & Health Promotion
n one cuse, In LIe IuLe-1q;o`s, u Iew buLcIes oI curbonIess copy
puper (CCP) used by LIe medIcuI servIces In SLockIoIm were
conLumInuLed by un IrrILunL ImpurILy. Concern begun Lo spreud ubouL
IeuILI Iuzurds uLLrIbuLubIe Lo workIng wILI CCP. OIIIce workers,
counLrywIde, begun reporLIng dIIIerenL Lypes oI dIscomIorL wIen In
conLucL wILI sucI puper, e.g., IrrILuLIon oI LIe eyes, LIrouL, und skIn In
uddILIon Lo generuI sympLoms sucI us IuLIgue, IeuducIe, und dIzzIness.
DurIng LIe IeIgIL oI LIe uIurm, mosL oI LIose compIuInIng wILI sympLoms
Iud never been In conLucL wILI LIe specIIIcuIIy IrrILuLIng brund oI CCP,
I.e., nocebo eIIecL.
n uII oI LIese epIdemIcs LIere ure LypIcuI sympLoms:
ESS |envIronmenLuI somuLIzuLIon syndrome| Is
cIurucLerIzed by sympLoms sucI us dIzzIness, IuLIgue,
puIpILuLIons, IeuducIe, und puIns In dIIIerenL purLs oI
LIe body. SubjecLIve probIems wILI sIeep,
concenLruLIon, und memory ure common.
PoIysympLomuLIc condILIons ure oILen observed..
TIe sympLoms oI somuLoIorm dIsorders ure InIIuenced
boLI by prevuIIIng medIcuI concepLs oI LIe socIeLy und
by presumed dIseuse-InducIng ugenLs. n LIe 'repeLILIve
sLruIn Injury` epIdemIc, puIns und IuncLIonuI
dIsLurbunces In Iunds, urms, und neck were common.
PromInenL sympLoms In somuLoIorm dIsorders coupIed
Lo VDU`s |reIuLIng Lo 'eIecLrIc uIIergy`| und CCP ure
IrrILuLIon oI LIe eyes, skIn, und upper respIruLory LrucL.
n oruI guIvunIsm, LIe generuI subjecLIve sympLoms ure
oILen uccompunIed by IuncLIonuI dIsLurbunces
IndIcuLIng sLress-Induced LensIon In LIe musLIcuLory
muscIes.
TIe somuLIzuLIon puLLern Is oILen cIunged over LIme. L
uIso Iuppens LIuL puLIenLs cIunge LIe expIunuLIon Ior
LIeIr compIuInLs und move Irom, Ior exumpIe, oruI
guIvunIsm Lo eIecLrIc uIIergy. (GoLIe eL uI., 1qq, p.-6)
L musL be mude very cIeur LIuL, uL IeusL In mosL InsLunces,
persons ure noL IukIng sympLoms, buL ure In ucLuuI puIn. TIe Issue Is
wIeLIer LIe cuuse oI LIeIr puIn Is wIuL LIe puLIenLs uIIege Is LIe cuuse -
LypIcuIIy exLernuI IucLors. TIere ure persons wILI, Ior exumpIe, u IIsLory oI
unxIeLy und oLIer dysIuncLIonuI LIougIL LIuL cun generuLe u consIsLenL,
IeurIuI, und puInIuI experIence munIIesLed In somuLoIorm dIsorders.
PsycIogenIc dysIuncLIon cun InvoIve uII munner oI IucLors (e.g., cIIIdIood
Lruumu, IumIIIuI probIems, workpIuce probIems, Ieur oI empIoymenL
373
373
Rampant Antismoking Signifies Grave Danger
TIe dIsLurbIng IucL Iere Is LIuL LIIs sorL oI InIormuLIon Is
propuguLed In unLIsmokIng IILeruLure us LIougI IL deIInILIveIy
demonsLruLes cuusuI uLLrIbuLes oI ETS. RuLIer, LIe ter hih probubIIILy
Is LIuL IL demonsLruLes u dysIuncLIonuI psycIoIogIcuI sLuLe oI LIose
InvoIved. Beyond u sLruIgILIorwurd nocebo eIIecL, persons ure very
cupubIe oI munIIesLIng somuLIc (bIoIogIcuI) sympLoms due Lo psycIogenIc
sources LIuL ure LIen bIumed on exLernuIILIes LIuL muy or muy noL Iuve
LIe propensILy Lo LrIgger sucI sympLoms. Somctizction sndrome,
generuIIy, Is u Lendency Lo experIence und communIcuLe psycIogenIc
dIsLress In LIe Iorm oI pIysIcuI sympLoms und Lo seek medIcuI IeIp Ior
LIem. (GoLIe eL uI., 1qq, p.1)
CrILIcuI Lo LIe currenL dIscussIon Is wIuL GoLIe eL uI. (1qq)
nume LIe entironmentcl somctizction sndrome (ESS). TIIs represenLs u
purLIcuIur subdIvIsIon wILIIn LIe Iurge und dIverse group oI somuLIzuLIon
IIInesses wIIcI Is cIurucLerIzed by puLIenLs beIng convInced LIuL LIeIr
IeuILI dIsLurbunces ure cuused by exposure Lo cIemIcuI or pIysIcuI
componenLs oI LIe exLernuI envIronmenL, sucI us poIsonous subsLunces
und eIecLromugneLIc IIeIds, or Lo ergonomIc sLress uLLrIbuLubIe Lo
repeLILIve movemenLs or uncomIorLubIe posLures uL work..LIe puLIenLs
usuuIIy reIuse uILernuLIve expIunuLIons oI LIeIr sympLoms und dIscredIL
und rejecL uny suggesLIon oI u psycIogenIc eLIoIogy. (p.1)
GoLIe eL uI. (1qq) IndIcuLe LIuL LIe envIronmenLuI somuLIzuLIon
syndrome Is underIuIn by, IIrsLIy, LIe deepIy uncIored Lendency In Iumun
nuLure Lo IInk dIseuse Lo vugue und gIosL-IIke componenLs oI LIe exLernuI
envIronmenL und, secondIy, psycIogenIc epIdemIcs oI somuLIc
compIuInLs ure common. (p.1) TIey deLuII some wIdespreud ESS
epIdemIcs LIuL Iuve uL LImes escuIuLed InLo pundemIc proporLIons; Ior
exumpIe, Irom LIe cIuIm oI ursenIc poIsonIng durIng LIe nIneLeenLI
cenLury In CenLruI und NorLIern Europe, Lo cIuIms ubouL cIronIc curbon
monoxIde poIsonIng In LIe 1qqo`s In NordIc counLrIes, Lo cIuIms ubouL
umuIgum und oruI guIvunIsm uL vurIous LImes durIng LIe LwenLIeLI
cenLury In Europe und LIe U.S., Lo cIuIms oI wrILer`s und LeIegrupIIsL`s
crump In LIe mId-Lo-IuLe nIneLeenLI cenLury In BrILuIn und wIIcI
resurIuced In LIe 1q;o`s und 8o`s us repeLILIve sLruIn Injury In AusLruIIu,
Lo cIuIms oI eIecLromugneLIc IIeIds und eIecLrIc uIIergy In LIe 1q;o`s und
8o`s In Europe und NorLI AmerIcu - uII were Iound Lo Iuve no coIerenL
busIs. n mosL oI LIese cuses greuL IengLIs were pursued, purLIcuIurIy by
IeuILI uuLIorILIes, Lo IImIL exposure Lo uIIeged exLernuI cuuses by
uILerIng LIe envIronmenL. OnIy wIen LIe supposed reIuLIonsIIp beLween
subjecLIve sympLoms und exLenL oI exposure were cuIIed InLo quesLIon dId
LIe epIdemIcs evenLuuIIy decIIne.
Preventive Medicine & Health Promotion
n one cuse, In LIe IuLe-1q;o`s, u Iew buLcIes oI curbonIess copy
puper (CCP) used by LIe medIcuI servIces In SLockIoIm were
conLumInuLed by un IrrILunL ImpurILy. Concern begun Lo spreud ubouL
IeuILI Iuzurds uLLrIbuLubIe Lo workIng wILI CCP. OIIIce workers,
counLrywIde, begun reporLIng dIIIerenL Lypes oI dIscomIorL wIen In
conLucL wILI sucI puper, e.g., IrrILuLIon oI LIe eyes, LIrouL, und skIn In
uddILIon Lo generuI sympLoms sucI us IuLIgue, IeuducIe, und dIzzIness.
DurIng LIe IeIgIL oI LIe uIurm, mosL oI LIose compIuInIng wILI sympLoms
Iud never been In conLucL wILI LIe specIIIcuIIy IrrILuLIng brund oI CCP,
I.e., nocebo eIIecL.
n uII oI LIese epIdemIcs LIere ure LypIcuI sympLoms:
ESS |envIronmenLuI somuLIzuLIon syndrome| Is
cIurucLerIzed by sympLoms sucI us dIzzIness, IuLIgue,
puIpILuLIons, IeuducIe, und puIns In dIIIerenL purLs oI
LIe body. SubjecLIve probIems wILI sIeep,
concenLruLIon, und memory ure common.
PoIysympLomuLIc condILIons ure oILen observed..
TIe sympLoms oI somuLoIorm dIsorders ure InIIuenced
boLI by prevuIIIng medIcuI concepLs oI LIe socIeLy und
by presumed dIseuse-InducIng ugenLs. n LIe 'repeLILIve
sLruIn Injury` epIdemIc, puIns und IuncLIonuI
dIsLurbunces In Iunds, urms, und neck were common.
PromInenL sympLoms In somuLoIorm dIsorders coupIed
Lo VDU`s |reIuLIng Lo 'eIecLrIc uIIergy`| und CCP ure
IrrILuLIon oI LIe eyes, skIn, und upper respIruLory LrucL.
n oruI guIvunIsm, LIe generuI subjecLIve sympLoms ure
oILen uccompunIed by IuncLIonuI dIsLurbunces
IndIcuLIng sLress-Induced LensIon In LIe musLIcuLory
muscIes.
TIe somuLIzuLIon puLLern Is oILen cIunged over LIme. L
uIso Iuppens LIuL puLIenLs cIunge LIe expIunuLIon Ior
LIeIr compIuInLs und move Irom, Ior exumpIe, oruI
guIvunIsm Lo eIecLrIc uIIergy. (GoLIe eL uI., 1qq, p.-6)
L musL be mude very cIeur LIuL, uL IeusL In mosL InsLunces,
persons ure noL IukIng sympLoms, buL ure In ucLuuI puIn. TIe Issue Is
wIeLIer LIe cuuse oI LIeIr puIn Is wIuL LIe puLIenLs uIIege Is LIe cuuse -
LypIcuIIy exLernuI IucLors. TIere ure persons wILI, Ior exumpIe, u IIsLory oI
unxIeLy und oLIer dysIuncLIonuI LIougIL LIuL cun generuLe u consIsLenL,
IeurIuI, und puInIuI experIence munIIesLed In somuLoIorm dIsorders.
PsycIogenIc dysIuncLIon cun InvoIve uII munner oI IucLors (e.g., cIIIdIood
Lruumu, IumIIIuI probIems, workpIuce probIems, Ieur oI empIoymenL
374
374
Rampant Antismoking Signifies Grave Danger
redunduncy) LIuL requIre uLLenLIon on un IndIvIduuI-puLIenL busIs. SucI
sympLoms ure LIen projecLed onLo purLIcuIur exLernuI IucLors us LIe
source or cuuse oI LIeIr condILIon. TIese persons Indeed Iuve u vuIId
compIuInL In Lerms oI sympLoms buL ure noL purLIcuIurIy recepLIve Lo
psycIogenIc expIunuLIons oI LIeIr condILIon: As In oLIer somuLoIorm
dIsorders, puLIenLs wILI ESS usuuIIy rejecL uny suggesLIon oI u
psycIogenIc eLIoIogy und uII uILernuLe expIunuLIons oI LIeIr compIuInLs.
TIe mere suggesLIon oI consuILIng u psycIoIogIsL or u psycIIuLrIsL Is oILen
InLerpreLed us u rejecLIon oI LIe vuIId compIuInLs und cun resuIL In
powerIuI counLerucLIons. (GoLIe eL uI., 1qq, p.6)
GoLIe eL uI. (1qq) IIgIIIgIL LIuL crILIcuI uspecLs oI ESS ure ILs
commonuIILy - usuuIIy uL LIe IeveI oI IndIvIduuI cuses, ILs conLugIousness,
und LIe poLenLIuI Ior cuLusLropIIc resuILs wIen, In ucquIescIng Lo ESS
cIuIms, greuL IengLIs ure pursued by IeuILI uuLIorILIes In un uLLempL Lo
reduce exposures or uIIeged exposures. TIIs does no good In uny Lerms,
eILIer Ior LIe puLIenL or envIronmenLuI muke-up:
n LIe InILIuI pIuse, LIe Lrue cIurucLer oI un ESS
epIdemIc Is eusIIy obscured. Observed correIuLIons
beLween Increused prevuIences oI unnoyIng sympLoms
und uIIeged exposures Lo specIIIc envIronmenLuI
exposures muke IL dIIIIcuIL Lo dIscover LIe psycIogenIc
eIemenLs oI LIe process. TIIs dIIIIcuILy Is IurLIer
exuggeruLed by LIe Iocus oI InLeresL on LIe envIronmenL
ruLIer LIun on LIe puLIenLs. TIe resuIL muy be noL onIy
u deIuy oI udequuLe und eIIecLIve LreuLmenL buL uIso
creuLIon oI un IdeuI sILuuLIon Ior conIIIcL beLween
compeLIng groups oI experLs. TIey ure gIven LIme Lo
InLroduce premuLure IypoLIeses on cuuse und eIIecL
Iounded on cusuIsLIc observuLIons und epIdemIoIogIc
sLudIes dIsLurbed or IIuwed by InILIuIIy mIsInLerpreLed,
dIspuruged, or unnoLIced conIounders.
n sucI sILuuLIons, LIe puLIenLs` probIems ure eusIIy
overIooked. TIerupeuLIc eIIorLs muy be dIrecLed soIeIy
Lowurd eIImInuLIon oI presumed dIseuse-InducIng
ugenLs ruLIer LIun Lowurd LIe vurIous psycIosocIuI
sLressors LIuL usuuIIy ure denIed by LIe puLIenLs
LIemseIves. One poLenL sLressor Is uIwuys ucLIve In LIese
sILuuLIons, numeIy LIe IncreusIng unxIeLy ubouL some
eIusIve envIronmenLuI componenL, gIvIng rIse Lo
unnoyIng sympLoms und ImpuIred vILuIILy. L Is
ImporLunL LIuL LIe desLrucLIve InIIuence oI LIIs sLressor
Is noL Increused by weII-InLenLIoned buL mIsdIrecLed
Preventive Medicine & Health Promotion
propIyIucLIc und LIerupeuLIc meusures. (GoLIe eL uI.,
1qq, p.;)
TIere seems Lo be u smuII subgroup oI persons wIo experIence
reguIur sympLoms und ure consIsLenLIy uLLempLIng Lo IInk LIese Lo
wIuLever exLernuIILIes muy muke sense Lo LIem uL uny purLIcuIur LIme,
I.e., LIrougI psycIoIogIcuI projecLIon. SupporLers, someLImes weII-
InLenLIoned, uIso become convInced oI LIe dunger oI specIIIc
exLernuIILIes. TIese Iorm Iobby groups LIuL cun exerL consIderubIe
pressure, usuuIIy LIrougI Ieur-mongerIng, LIe ubuse oI sLuLIsLIcuI
InIormuLIon, und IuII-buked urgumenL, on LIe medIu und poIILIcuI und
udmInIsLruLIve uuLIorILIes (see uIso GoLIe eL uI., 1qq).
As LIe word spreuds oI LIe dunger or rIsk oI purLIcuIur
exposures, LIe number oI persons exposed Lo LIuL purLIcuIur exLernuIILy
LIuL now exIIbIL sympLoms begIns Lo escuIuLe, I.e., conLugIon und LIe
mukIngs oI un ESS epIdemIc. umenLo (1qq6) provIdes un exumpIe oI u
IIbrurIun LIuL wus InIormed on movIng InLo new oIIIces LIuL LIe IIbrury`s
booksIeIves conLuIned IormuIdeIyde. SIorLIy LIereuILer LIe IIbrurIun wus
exIIbILIng IeuducIe, ucIIng joInLs, und Iubored breuLIIng (I.e., nocebo
eIIecL). TIe sympLoms suddenIy dIsuppeured wIen LIe IIbrurIun Ieurd
LIuL LIere wus no IormuIdeIyde In LIe sIeIves. n IucL, LIe sIeIves dId
conLuIn IormuIdeIyde. However, now unuwure oI LIe IucL, LIe IIbrurIun
Iud no IurLIer sympLoms (I.e., ubscebo eIIecL).
Meusures by IeuILI uuLIorILIes Lo uILer LIe envIronmenL In
uccommoduLIng LIe dunger provIdes onIy IurLIer ImpeLus Ior LIe
epIdemIc by reInIorcIng LIe IuIse cuuseJeIIecL beIIeI, I.e., IueIIng nocebo
eIIecLs und conLugIon LIereoI. Here, u IurLIer dIsLIncLIon musL be mude.
AILIougI reduced exposures muy Iuve u sIorL-Lerm IuvorubIe eIIecL, LIe
needIess erudIcuLIon oI envIronmenLuI IucLors LypIcuIIy does noL uIIevIuLe
sympLoms In LIe InILIuI, orIgInuLIng group In LIuL LIe exLernuI IucLors
were noL LIe cuuse oI LIeIr sympLoms Lo begIn wILI. I LIe underIyIng
psycIoIogIcuIJpsycIosocIuI probIems ure noL uddressed, sympLoms oILen
reuppeur. However, In unoLIer group LIuL enLers LIe epIdemIc In LIe eurIy
pIuses oI conLugIon (e.g., due Lo suggesLIbIIILy und LrunsIenL unxIeLy
reucLIons, ruLIer LIun LIe more deep-seuLed psycIoIogIcuI probIems In LIe
orIgInuLIng group), erudIcuLIon oI envIronmenLuI IucLors muy Indeed
uIIevIuLe sympLoms In LIe Ionger-Lerm Ior specIIIc envIronmenLuI IucLors.
or exumpIe, LIe repIucemenL oI sIeIves conLuInIng IormuIdeIyde wIII
Iuve LIe sume sympLom-uIIevIuLIng eIIecL us LIe beIIeI LIuL LIe sIeIves do
noL conLuIn IormuIdeIyde, even LIougI LIe sIeIves do conLuIn LIe
subsLunce. BoLI sILuuLIons - ucLuuI repIucemenL or uILerIng oI beIIeI - wIII
be cuIIed u coddlin eIIecL. TIese persons ure IIrsLIy LerrorIzed InLo
375
375
Rampant Antismoking Signifies Grave Danger
redunduncy) LIuL requIre uLLenLIon on un IndIvIduuI-puLIenL busIs. SucI
sympLoms ure LIen projecLed onLo purLIcuIur exLernuI IucLors us LIe
source or cuuse oI LIeIr condILIon. TIese persons Indeed Iuve u vuIId
compIuInL In Lerms oI sympLoms buL ure noL purLIcuIurIy recepLIve Lo
psycIogenIc expIunuLIons oI LIeIr condILIon: As In oLIer somuLoIorm
dIsorders, puLIenLs wILI ESS usuuIIy rejecL uny suggesLIon oI u
psycIogenIc eLIoIogy und uII uILernuLe expIunuLIons oI LIeIr compIuInLs.
TIe mere suggesLIon oI consuILIng u psycIoIogIsL or u psycIIuLrIsL Is oILen
InLerpreLed us u rejecLIon oI LIe vuIId compIuInLs und cun resuIL In
powerIuI counLerucLIons. (GoLIe eL uI., 1qq, p.6)
GoLIe eL uI. (1qq) IIgIIIgIL LIuL crILIcuI uspecLs oI ESS ure ILs
commonuIILy - usuuIIy uL LIe IeveI oI IndIvIduuI cuses, ILs conLugIousness,
und LIe poLenLIuI Ior cuLusLropIIc resuILs wIen, In ucquIescIng Lo ESS
cIuIms, greuL IengLIs ure pursued by IeuILI uuLIorILIes In un uLLempL Lo
reduce exposures or uIIeged exposures. TIIs does no good In uny Lerms,
eILIer Ior LIe puLIenL or envIronmenLuI muke-up:
n LIe InILIuI pIuse, LIe Lrue cIurucLer oI un ESS
epIdemIc Is eusIIy obscured. Observed correIuLIons
beLween Increused prevuIences oI unnoyIng sympLoms
und uIIeged exposures Lo specIIIc envIronmenLuI
exposures muke IL dIIIIcuIL Lo dIscover LIe psycIogenIc
eIemenLs oI LIe process. TIIs dIIIIcuILy Is IurLIer
exuggeruLed by LIe Iocus oI InLeresL on LIe envIronmenL
ruLIer LIun on LIe puLIenLs. TIe resuIL muy be noL onIy
u deIuy oI udequuLe und eIIecLIve LreuLmenL buL uIso
creuLIon oI un IdeuI sILuuLIon Ior conIIIcL beLween
compeLIng groups oI experLs. TIey ure gIven LIme Lo
InLroduce premuLure IypoLIeses on cuuse und eIIecL
Iounded on cusuIsLIc observuLIons und epIdemIoIogIc
sLudIes dIsLurbed or IIuwed by InILIuIIy mIsInLerpreLed,
dIspuruged, or unnoLIced conIounders.
n sucI sILuuLIons, LIe puLIenLs` probIems ure eusIIy
overIooked. TIerupeuLIc eIIorLs muy be dIrecLed soIeIy
Lowurd eIImInuLIon oI presumed dIseuse-InducIng
ugenLs ruLIer LIun Lowurd LIe vurIous psycIosocIuI
sLressors LIuL usuuIIy ure denIed by LIe puLIenLs
LIemseIves. One poLenL sLressor Is uIwuys ucLIve In LIese
sILuuLIons, numeIy LIe IncreusIng unxIeLy ubouL some
eIusIve envIronmenLuI componenL, gIvIng rIse Lo
unnoyIng sympLoms und ImpuIred vILuIILy. L Is
ImporLunL LIuL LIe desLrucLIve InIIuence oI LIIs sLressor
Is noL Increused by weII-InLenLIoned buL mIsdIrecLed
Preventive Medicine & Health Promotion
propIyIucLIc und LIerupeuLIc meusures. (GoLIe eL uI.,
1qq, p.;)
TIere seems Lo be u smuII subgroup oI persons wIo experIence
reguIur sympLoms und ure consIsLenLIy uLLempLIng Lo IInk LIese Lo
wIuLever exLernuIILIes muy muke sense Lo LIem uL uny purLIcuIur LIme,
I.e., LIrougI psycIoIogIcuI projecLIon. SupporLers, someLImes weII-
InLenLIoned, uIso become convInced oI LIe dunger oI specIIIc
exLernuIILIes. TIese Iorm Iobby groups LIuL cun exerL consIderubIe
pressure, usuuIIy LIrougI Ieur-mongerIng, LIe ubuse oI sLuLIsLIcuI
InIormuLIon, und IuII-buked urgumenL, on LIe medIu und poIILIcuI und
udmInIsLruLIve uuLIorILIes (see uIso GoLIe eL uI., 1qq).
As LIe word spreuds oI LIe dunger or rIsk oI purLIcuIur
exposures, LIe number oI persons exposed Lo LIuL purLIcuIur exLernuIILy
LIuL now exIIbIL sympLoms begIns Lo escuIuLe, I.e., conLugIon und LIe
mukIngs oI un ESS epIdemIc. umenLo (1qq6) provIdes un exumpIe oI u
IIbrurIun LIuL wus InIormed on movIng InLo new oIIIces LIuL LIe IIbrury`s
booksIeIves conLuIned IormuIdeIyde. SIorLIy LIereuILer LIe IIbrurIun wus
exIIbILIng IeuducIe, ucIIng joInLs, und Iubored breuLIIng (I.e., nocebo
eIIecL). TIe sympLoms suddenIy dIsuppeured wIen LIe IIbrurIun Ieurd
LIuL LIere wus no IormuIdeIyde In LIe sIeIves. n IucL, LIe sIeIves dId
conLuIn IormuIdeIyde. However, now unuwure oI LIe IucL, LIe IIbrurIun
Iud no IurLIer sympLoms (I.e., ubscebo eIIecL).
Meusures by IeuILI uuLIorILIes Lo uILer LIe envIronmenL In
uccommoduLIng LIe dunger provIdes onIy IurLIer ImpeLus Ior LIe
epIdemIc by reInIorcIng LIe IuIse cuuseJeIIecL beIIeI, I.e., IueIIng nocebo
eIIecLs und conLugIon LIereoI. Here, u IurLIer dIsLIncLIon musL be mude.
AILIougI reduced exposures muy Iuve u sIorL-Lerm IuvorubIe eIIecL, LIe
needIess erudIcuLIon oI envIronmenLuI IucLors LypIcuIIy does noL uIIevIuLe
sympLoms In LIe InILIuI, orIgInuLIng group In LIuL LIe exLernuI IucLors
were noL LIe cuuse oI LIeIr sympLoms Lo begIn wILI. I LIe underIyIng
psycIoIogIcuIJpsycIosocIuI probIems ure noL uddressed, sympLoms oILen
reuppeur. However, In unoLIer group LIuL enLers LIe epIdemIc In LIe eurIy
pIuses oI conLugIon (e.g., due Lo suggesLIbIIILy und LrunsIenL unxIeLy
reucLIons, ruLIer LIun LIe more deep-seuLed psycIoIogIcuI probIems In LIe
orIgInuLIng group), erudIcuLIon oI envIronmenLuI IucLors muy Indeed
uIIevIuLe sympLoms In LIe Ionger-Lerm Ior specIIIc envIronmenLuI IucLors.
or exumpIe, LIe repIucemenL oI sIeIves conLuInIng IormuIdeIyde wIII
Iuve LIe sume sympLom-uIIevIuLIng eIIecL us LIe beIIeI LIuL LIe sIeIves do
noL conLuIn IormuIdeIyde, even LIougI LIe sIeIves do conLuIn LIe
subsLunce. BoLI sILuuLIons - ucLuuI repIucemenL or uILerIng oI beIIeI - wIII
be cuIIed u coddlin eIIecL. TIese persons ure IIrsLIy LerrorIzed InLo
376
376
Rampant Antismoking Signifies Grave Danger
IrruLIonuI beIIeI concernIng dunger LIuL resuILs In unxIeLy reucLIons und
sympLoms, und LIen LIe beIIeI und correspondIng Ieur Is pIucuLed LIrougI
LIe eIImInuLIon oI exLernuI IucLors und, LIereIore, exposure. AILIougI LIIs
group muy noL dIspIuy sympLoms Lo u specIIIc envIronmenLuI IucLor once
LIey beIIeve LIey ure no Ionger exposed, LIey sLIII IoId IrruLIonuI beIIeIs
regurdIng purLIcuIur exLernuI IucLors, ure IIgIIy suscepLIbIe Lo IeurIuI
InIormuLIon on quesLIonubIe cuuseJeIIecL reIuLIonsIIps, und prone Lo
somuLIzuLIon oI LIuL Ieur. TIe reuI cure Is In dIspeIIIng IrruLIonuI beIIeIs,
noL generuLIng undJor reInIorcIng LIem.
UnIorLunuLeIy, LIe conducL oI IeuILI uuLIorILIes, In muny
InsLunces, ucLuuIIy reInIorces IrruLIonuI beIIeIs In LIe orIgInuLIng group,
promoLes LIem In suggesLIbIe IndIvIduuIs LIuL IueIs epIdemIc proporLIons
oI ESS, und emburks on envIronmenLuI upIeuvuI In eIImInuLIng
exposures: A gruve compIIcuLIon oI exLensIve eIImInuLIon meusures
durIng ongoIng ESS epIdemIcs Is LIuL mIsconcepLIons ubouL cuuse und
eIIecL wIII be gIven credence. TIIs, In Lurn, Increuses LIe Ieur, und wILI
LIuL, LIe psycIogenIc sLress-Ioud wILIIn LIe rIsk groups Lends Lo ImpIunL
und InLensIIy LIe puLIenLs` sympLoms. (GoLIe eL uI., 1qq, p.;)
n IuIrness, Iowever, Lo medIcuI prucLILIoners und LIe wIder
conLexL oI IeuILI uuLIorILIes, LIe conducL oI puLIenLs und Iobby groups cun
be IIgIIy uggressIve. TIere Is uIso LIe udded probIem oI wIuL Is reIerred
Lo us secondcr cin. or LIe puLIenL, guInIng sympuLIy or vIcLIm sLuLus
und uvoIdIng responsIbIIILy Ior LIeIr psycIo-emoLIonuI sLuLe muy be u
rewurd, even II LIey conLInue Lo suIIer. As sucI, IL Is u vurIunL oI
udvunLuge by IIIness.
MuInLuInIng u puLIenL`s IuIse beIIeIs cun be exucerbuLed by
opporLunIsLIc members oI LIe IeguI esLubIIsImenL wILI LIe prospecL oI
IuwsuILs und by muLerIuIIsL medIcuI prucLILIoners. RegurdIng LIe Iormer
group, SpIegeI (1qq6) suggesLs LIuL uII duy Iong we geL vurIous sensuLIons
we cun`L uccounL Ior. I we cun ussocIuLe u sensuLIon wILI u deep pockeL,
IL`s eusy Lo InLerpreL In sucI u wuy LIuL `m geLLIng u LoxIc eIIecL Irom sucI
und sucI; see uIso TyndeI, 1qqq. TIe IuLLer group, LIuL now go by sucI
numes us cIInIcuI ecoIogIsL or envIronmenLuI pIysIcIun (I.e.,
exLernuIIzers), obvIousIy Iuve vesLed InLeresL In muInLuInIng purLIcuIur
cuuse-eIIecL beIIeIs.
However, IL cun uIso be suId LIuL LIe opporLunIsm muy noL
necessurIIy be InLenLIonuI or uvurIcIous, buL sImpIy reIIecLs IncompeLence
- boLI scIenLIIIcuIIy und psycIoIogIcuIIy. AguIn, LIe crILIcuI probIem Is
muLerIuIIsm, wIere LIe prucLILIoners InvoIved cunnoL uccommoduLe non-
reducLIonIsL Irumeworks (e.g., psycIoIogy, socIuI psycIoIogy); LIese
prucLILIoners cunnoL recognIze LIe possIbIe psycIoIogIcuI ueLIoIogy oI LIeIr
puLIenLs` sympLoms nor LIeIr own psycIoIogIcuI conLrIbuLIon In
Preventive Medicine & Health Promotion
muInLuInIng LIe probIem. GoLIe eL uI. (1qq) concIude LIuL |L|Ie
uggressIve deIense oI LIe puLIenLs` expIunuLIon oI LIe dIsorder creuLes
greuL demunds on proIessIonuI skIII, dIpIomuLIc IInesse, und menLuI power
oI LIe consuILed pIysIcIuns. TIe pressure muy be so sLrong LIuL LIe
pIysIcIuns muy yIeId und udupL LIe LIerupy Lo LIe puLIenLs` convIcLIon us
Lo cuuse und eIIecL. TIe communILy Is oILen pIuced In u sImIIur posILIon by
Iobby groups cuIIIng Ior drusLIc meusures Lo eIImInuLe LIe uIIeged dIseuse-
InducIng exposures. (p.6)
SomuLIzuLIon dIsorders und LIe uLLempL Lo IInk sympLoms Lo
envIronmenLuI exposures need Lo be Luken very serIousIy In LIuL LIese
Iuve LIe cupucILy Lo coerce muILILudes InLo dysIuncLIonuI LIougIL und
reIuLIonsIIp (I.e., muss deIusIon), conLorL LIe sLundurd oI evIdence
requIred In IILIguLIon, und IueI un ever-IncreusIng obsessIon wILI conLroI
oI envIronmenLuI IucLors. TIe Issue Is noL wIeLIer LIere exIsL uny LoxIc
ugenLs or LoxIc doses oI LIese ugenLs, us LIere sureIy do. RuLIer, uII
munner oI cuusuI, dIseuse or sympLom-InducIng, cIuIms ure beIng mude
concernIng wIuL ure Lruce or InIInILesImuI IeveIs oI exposure.
TIe mosL obvIous munner Lo ussess LIe verucILy oI exposureJ
sympLom cIuIms Is LIe InvesLIguLIon oI noceboJubscebo eIIecLs under
experImenLuI condILIons. n LIe very Iew uLLempLs uL sucI InvesLIguLIons
(e.g., JeweLL eL uI., 1qqo) IL Is LypIcuIIy Iound LIuL LIere ure no Increused
sympLoms ussocIuLed wILI exposure Lo suspecLed cIemIcuI ugenLs
compured wILI u neuLruI ugenL wIen boLI LIe reseurcIer und LIe puLIenL
ure unuwure (doubIe-bIInd procedure) oI wIen LIe puLIenL Is ucLuuIIy
exposed, I.e., ubscebo eIIecL. TIereIore, sympLoms ussocIuLed wILI
specIIIc exposures Ior LIese puLIenLs In duy-Lo-duy IIvIng reIIecL u nocebo
eIIecL.
L musL be borne In mInd LIuL nocebo beIIeIs Ior LIese puLIenLs
reIIecL u deIIecLIon uwuy Irom u more IundumenLuI psycIogenIc probIem
(s). As Ius been IndIcuLed, some somuLIzIng puLIenLs do noL respond uL uII
weII Lo LIe possIbIIILy LIuL exLernuI IucLors ure noL LIe cuuse oI LIeIr
sympLoms. OLIers, Iowever, cun be IIgIIy recepLIve dependIng on Iow
LIey ure upproucIed, I.e., noL LrIvIuIIzIng LIeIr sympLoms or LIeIr mInd.
SLuudenmuyer (1qq6) noLes LIuL some puLIenLs sLorm ouL, reIusIng Lo
uccepL LesL resuILs IndIcuLIng nocebo eIIecLs. or oLIers, demonsLruLIon oI
u nocebo eIIecL cun be u IIIe-cIungIng breukLIrougI: do sIow LIem LIey
Iuve sympLoms, buL noL necessurIIy cuused by envIronmenLuI ugenLs.
LeucI LIem Lo reguIuLe LIeIr sLress response pIysIoIogy und LIereby
mILIguLe LIeIr sympLoms. TIe mosL ImporLunL purL oI LIe reIuLIonsIIp Is
LrusL und undersLundIng... don`L cIuIIenge LIeIr beIIeI sysLem, |jusL|
suy, 'eL`s see II cun muke you beLLer`. WIen LIey sLurL LeIIIng you LIeIr
IIIe sLory - wIIcI Is oILen u Iorror sLory ubouL LIeIr cIIIdIood - und you
377
377
Rampant Antismoking Signifies Grave Danger
IrruLIonuI beIIeI concernIng dunger LIuL resuILs In unxIeLy reucLIons und
sympLoms, und LIen LIe beIIeI und correspondIng Ieur Is pIucuLed LIrougI
LIe eIImInuLIon oI exLernuI IucLors und, LIereIore, exposure. AILIougI LIIs
group muy noL dIspIuy sympLoms Lo u specIIIc envIronmenLuI IucLor once
LIey beIIeve LIey ure no Ionger exposed, LIey sLIII IoId IrruLIonuI beIIeIs
regurdIng purLIcuIur exLernuI IucLors, ure IIgIIy suscepLIbIe Lo IeurIuI
InIormuLIon on quesLIonubIe cuuseJeIIecL reIuLIonsIIps, und prone Lo
somuLIzuLIon oI LIuL Ieur. TIe reuI cure Is In dIspeIIIng IrruLIonuI beIIeIs,
noL generuLIng undJor reInIorcIng LIem.
UnIorLunuLeIy, LIe conducL oI IeuILI uuLIorILIes, In muny
InsLunces, ucLuuIIy reInIorces IrruLIonuI beIIeIs In LIe orIgInuLIng group,
promoLes LIem In suggesLIbIe IndIvIduuIs LIuL IueIs epIdemIc proporLIons
oI ESS, und emburks on envIronmenLuI upIeuvuI In eIImInuLIng
exposures: A gruve compIIcuLIon oI exLensIve eIImInuLIon meusures
durIng ongoIng ESS epIdemIcs Is LIuL mIsconcepLIons ubouL cuuse und
eIIecL wIII be gIven credence. TIIs, In Lurn, Increuses LIe Ieur, und wILI
LIuL, LIe psycIogenIc sLress-Ioud wILIIn LIe rIsk groups Lends Lo ImpIunL
und InLensIIy LIe puLIenLs` sympLoms. (GoLIe eL uI., 1qq, p.;)
n IuIrness, Iowever, Lo medIcuI prucLILIoners und LIe wIder
conLexL oI IeuILI uuLIorILIes, LIe conducL oI puLIenLs und Iobby groups cun
be IIgIIy uggressIve. TIere Is uIso LIe udded probIem oI wIuL Is reIerred
Lo us secondcr cin. or LIe puLIenL, guInIng sympuLIy or vIcLIm sLuLus
und uvoIdIng responsIbIIILy Ior LIeIr psycIo-emoLIonuI sLuLe muy be u
rewurd, even II LIey conLInue Lo suIIer. As sucI, IL Is u vurIunL oI
udvunLuge by IIIness.
MuInLuInIng u puLIenL`s IuIse beIIeIs cun be exucerbuLed by
opporLunIsLIc members oI LIe IeguI esLubIIsImenL wILI LIe prospecL oI
IuwsuILs und by muLerIuIIsL medIcuI prucLILIoners. RegurdIng LIe Iormer
group, SpIegeI (1qq6) suggesLs LIuL uII duy Iong we geL vurIous sensuLIons
we cun`L uccounL Ior. I we cun ussocIuLe u sensuLIon wILI u deep pockeL,
IL`s eusy Lo InLerpreL In sucI u wuy LIuL `m geLLIng u LoxIc eIIecL Irom sucI
und sucI; see uIso TyndeI, 1qqq. TIe IuLLer group, LIuL now go by sucI
numes us cIInIcuI ecoIogIsL or envIronmenLuI pIysIcIun (I.e.,
exLernuIIzers), obvIousIy Iuve vesLed InLeresL In muInLuInIng purLIcuIur
cuuse-eIIecL beIIeIs.
However, IL cun uIso be suId LIuL LIe opporLunIsm muy noL
necessurIIy be InLenLIonuI or uvurIcIous, buL sImpIy reIIecLs IncompeLence
- boLI scIenLIIIcuIIy und psycIoIogIcuIIy. AguIn, LIe crILIcuI probIem Is
muLerIuIIsm, wIere LIe prucLILIoners InvoIved cunnoL uccommoduLe non-
reducLIonIsL Irumeworks (e.g., psycIoIogy, socIuI psycIoIogy); LIese
prucLILIoners cunnoL recognIze LIe possIbIe psycIoIogIcuI ueLIoIogy oI LIeIr
puLIenLs` sympLoms nor LIeIr own psycIoIogIcuI conLrIbuLIon In
Preventive Medicine & Health Promotion
muInLuInIng LIe probIem. GoLIe eL uI. (1qq) concIude LIuL |L|Ie
uggressIve deIense oI LIe puLIenLs` expIunuLIon oI LIe dIsorder creuLes
greuL demunds on proIessIonuI skIII, dIpIomuLIc IInesse, und menLuI power
oI LIe consuILed pIysIcIuns. TIe pressure muy be so sLrong LIuL LIe
pIysIcIuns muy yIeId und udupL LIe LIerupy Lo LIe puLIenLs` convIcLIon us
Lo cuuse und eIIecL. TIe communILy Is oILen pIuced In u sImIIur posILIon by
Iobby groups cuIIIng Ior drusLIc meusures Lo eIImInuLe LIe uIIeged dIseuse-
InducIng exposures. (p.6)
SomuLIzuLIon dIsorders und LIe uLLempL Lo IInk sympLoms Lo
envIronmenLuI exposures need Lo be Luken very serIousIy In LIuL LIese
Iuve LIe cupucILy Lo coerce muILILudes InLo dysIuncLIonuI LIougIL und
reIuLIonsIIp (I.e., muss deIusIon), conLorL LIe sLundurd oI evIdence
requIred In IILIguLIon, und IueI un ever-IncreusIng obsessIon wILI conLroI
oI envIronmenLuI IucLors. TIe Issue Is noL wIeLIer LIere exIsL uny LoxIc
ugenLs or LoxIc doses oI LIese ugenLs, us LIere sureIy do. RuLIer, uII
munner oI cuusuI, dIseuse or sympLom-InducIng, cIuIms ure beIng mude
concernIng wIuL ure Lruce or InIInILesImuI IeveIs oI exposure.
TIe mosL obvIous munner Lo ussess LIe verucILy oI exposureJ
sympLom cIuIms Is LIe InvesLIguLIon oI noceboJubscebo eIIecLs under
experImenLuI condILIons. n LIe very Iew uLLempLs uL sucI InvesLIguLIons
(e.g., JeweLL eL uI., 1qqo) IL Is LypIcuIIy Iound LIuL LIere ure no Increused
sympLoms ussocIuLed wILI exposure Lo suspecLed cIemIcuI ugenLs
compured wILI u neuLruI ugenL wIen boLI LIe reseurcIer und LIe puLIenL
ure unuwure (doubIe-bIInd procedure) oI wIen LIe puLIenL Is ucLuuIIy
exposed, I.e., ubscebo eIIecL. TIereIore, sympLoms ussocIuLed wILI
specIIIc exposures Ior LIese puLIenLs In duy-Lo-duy IIvIng reIIecL u nocebo
eIIecL.
L musL be borne In mInd LIuL nocebo beIIeIs Ior LIese puLIenLs
reIIecL u deIIecLIon uwuy Irom u more IundumenLuI psycIogenIc probIem
(s). As Ius been IndIcuLed, some somuLIzIng puLIenLs do noL respond uL uII
weII Lo LIe possIbIIILy LIuL exLernuI IucLors ure noL LIe cuuse oI LIeIr
sympLoms. OLIers, Iowever, cun be IIgIIy recepLIve dependIng on Iow
LIey ure upproucIed, I.e., noL LrIvIuIIzIng LIeIr sympLoms or LIeIr mInd.
SLuudenmuyer (1qq6) noLes LIuL some puLIenLs sLorm ouL, reIusIng Lo
uccepL LesL resuILs IndIcuLIng nocebo eIIecLs. or oLIers, demonsLruLIon oI
u nocebo eIIecL cun be u IIIe-cIungIng breukLIrougI: do sIow LIem LIey
Iuve sympLoms, buL noL necessurIIy cuused by envIronmenLuI ugenLs.
LeucI LIem Lo reguIuLe LIeIr sLress response pIysIoIogy und LIereby
mILIguLe LIeIr sympLoms. TIe mosL ImporLunL purL oI LIe reIuLIonsIIp Is
LrusL und undersLundIng... don`L cIuIIenge LIeIr beIIeI sysLem, |jusL|
suy, 'eL`s see II cun muke you beLLer`. WIen LIey sLurL LeIIIng you LIeIr
IIIe sLory - wIIcI Is oILen u Iorror sLory ubouL LIeIr cIIIdIood - und you
378
378
Rampant Antismoking Signifies Grave Danger
IIsLen, some guIn InsIgIL und progress Lo more InsIgIL-orIenLed
psycIoLIerupy.
L wIII be urgued In LIe IoIIowIng LIuL u crILIcuI purL oI LIe currenL
unLIsmokIng crusude predIcuLed on ETS dunger Ior LIe nonsmoker, In
uddILIon Lo LIe more openIy uggressIve Iorms oI LIe superIorILy syndrome,
Ius uII LIe IuIImurks oI LIe envIronmenLuI somuLIzuLIon syndrome. AII
munner oI sympLoms sucI us IeuducIe, eye or LIrouL IrrILuLIon,
puIpILuLIons, breuLIIessness, Iubored breuLIIng, cIesL LIgILness, dry
mouLI, IeeIIng oI cIokIng, Ieur oI sudden deuLI, dIzzIness, IoL IIusIes or
coId cIIIIs, eLc., presenLed on unLIsmokIng websILes, us supposedIy
cuused by ETS exposure, ure purL oI LIe poLenLIuIIy very Iurge suILe oI
unxIeLy-dIsorder sympLoms generuIIy (see uIso House & SLurk, zooz) und
ESS sympLoms specIIIcuIIy.
OukIey (1qqq) properIy noLes LIuL sucI unLIsmokIng depIcLIons
IosLer LIe ImpressIon LIuL LIere ure numerous nonsmokers LIuL ure IuInL,
debIIILuLed or coIIupsIng uround uny exposure Lo ETS und LIuL LIIs Ius
Iong been so. He properIy poInLs ouL, us wouId mosL smokers, LIuL prIor Lo
LIe eurIy-1qqo`s nonsmokers seemed unperLurbed by ETS. Smokers und
nonsmokers sIured rooms, dormILorIes, upurLmenLs, eLc., wIere smokIng
Indoors, even uL LIe dInner LubIe, wus never un Issue. MuILIpIe usILruys
were u sLundurd IIxLure oI smokIng und nonsmokIng IouseIoIds uIIke. n
oIder movIes, nonsmokIng ucLors dId noL buL un eyeIId or mIss u IIne-
deIIvery even wILI cIgureLLe smoke bIIIowIng InLo LIeIr Iuces uL very cIose
quurLers. TIere Ius cerLuInIy been u Iuge escuIuLIon In nonsmokers
experIencIng sympLoms concernIng ETS exposure. However, LIIs Ius
occurred uILer 1qq wIen exposure Lo ETS wus oIIIcIuIIy decIured us
dungerous Ior uII. TIese new, ImmedIuLe sympLoms now ussocIuLed wILI u
Iong-presenL pIenomenon (ETS) Is u nocebo eIIecL IeedIng un ESS
pundemIc.
As soon us LIe IIrsL wuve oI smokIng buns wus InsLILuLed, bused
on u LIny Increuse In reIuLIve rIsk Ior Iung cuncer oI lijelon exposure Lo
ETS In nonsmokIng wIves oI smokIng spouses, Ieur umongsL some
nonsmokers Increused. As Ieur Increuses, more envIronmenLuI resLrIcLIons
ure demunded; buns reInIorce IrruLIonuI Ieur wIIcI, In Lurn, demund more
buns. TIen, more nonsmokers become IeurIuI oI LIe consequences oI
ETS exposure, I.e., menLuI conLugIon. WILIIn u sIorL LIme, cn exposure Is
deemed us dungerous und In need oI erudIcuLIon; more und more persons
now demonsLruLe immedicte sympLoms Lo uny exposure, I.e., nocebo
eIIecL In suggesLIbIe und somuLIzIng persons.
urLIer exumpIes oI unxIeLy dIsorders und ESS come Irom
S.A..E. SmokeIree AIr or Everyone (www.pucIIIcneL.neLJ-suIeJ
IIL.ILmI), u CuIIIornIu-bused orgunIzuLIon LIuL descrIbes ILseII us u
Preventive Medicine & Health Promotion
neLwork oI IndIvIduuIs wIo Iuve been Injured or dIsubIed by secondIund
smoke:
I Iuve Lo LuIk Lo u person wIo Is smokIng, geL IIgIL-
Ieuded. L`s Iurd Lo LIInk. TIen IL becomes Iurd Lo
breuLIe becuuse my usLImu kIcks In. sLurL cougIIng. I
Iuve Lo breuLIe secondIund smoke on u duIIy busIs,
`II Iuve usLImu uLLucks uL nIgIL so severe, IL Is un
IncredIbIe sLruggIe Lo breuLIe. (GS)
AduIL sLudenLs smoke In IronL oI LIe enLrunce Lo LIe
scIooI wIere LeucI musIc. IoId my breuLI und run
pusL LIem Lo geL LIrougI LIe door. BuL LIe smoke drIILs
InLo LIe Iobby ureu und begIn Lo sLruggIe Lo
breuLIe..WIuL mukes IL worse Is LIuL smokers muke
Iun oI me us run pusL LIem. WouId LIese sume peopIe
pusI u person In u wIeeIcIuIr down u IIIgIL oI sLuIrs.
(RR)
I breuLIe very IILLIe Lobucco smoke, Iuve muscIe
spusms In my cIesL und uL LIe sume LIme my broncIIuI
Lubes IIII wILI LIIck mucous. L cuuses me Lo sLurL
cougIIng und my Iuce Lurns red und suddenIy IInd
myseII on LIe IIoor.. (BMC)
Iuve cIronIc broncIILIs und usLImu. I um uround
secondIund smoke, my voIce wIII geL Iourse und my
cIesL wIII geL LIgIL, us II someone Is pIIIng rocks on IL.
Or mIgIL Iuve u muscIe spusm In my cIesL..(E)
I encounLer u pIysIcuI cIoud oI secondIund smoke,
even ouLsIde, IeeI u LIgILenIng In LIe buck oI my
LIrouL. Iud quInLupIe bypuss surgery und LIInk LIe
sympLom `m descrIbIng Is reIuLed Lo my IeurL...(U)
goL reuI sIck becuuse wus breuLIIng secondIund
smoke wIere wus workIng. wus sIck Ior uImosL Lwo
yeurs. WIen sLurLed Lo geL beLLer, II suw someone
smokIng u cIgureLLe, even ouLdoors, wouId IeeI so
uIruId. L wus us II wus seeIng u weupon In LIeIr Iund.
SomeLImes even u person curryIng u pencII gIves me u
sLurL becuuse LIInk uL IIrsL IL`s u cIgureLLe. (ES)
WIen breuLIe secondIund smoke, eILIer Indoors or
ouLdoors, even In LIe smuIIesL umounL, sLurL Lo cougI,
und jusL keep cougIIng. (AP)
Iuve EnvIronmenLuI IIness - muILIpIe cIemIcuI
sensILIvILIes LIuL Iuve kepL me socIuIIy IsoIuLed Ior
yeurs. `m very seII conscIous ubouL uvoIdIng pIuces
379
379
Rampant Antismoking Signifies Grave Danger
IIsLen, some guIn InsIgIL und progress Lo more InsIgIL-orIenLed
psycIoLIerupy.
L wIII be urgued In LIe IoIIowIng LIuL u crILIcuI purL oI LIe currenL
unLIsmokIng crusude predIcuLed on ETS dunger Ior LIe nonsmoker, In
uddILIon Lo LIe more openIy uggressIve Iorms oI LIe superIorILy syndrome,
Ius uII LIe IuIImurks oI LIe envIronmenLuI somuLIzuLIon syndrome. AII
munner oI sympLoms sucI us IeuducIe, eye or LIrouL IrrILuLIon,
puIpILuLIons, breuLIIessness, Iubored breuLIIng, cIesL LIgILness, dry
mouLI, IeeIIng oI cIokIng, Ieur oI sudden deuLI, dIzzIness, IoL IIusIes or
coId cIIIIs, eLc., presenLed on unLIsmokIng websILes, us supposedIy
cuused by ETS exposure, ure purL oI LIe poLenLIuIIy very Iurge suILe oI
unxIeLy-dIsorder sympLoms generuIIy (see uIso House & SLurk, zooz) und
ESS sympLoms specIIIcuIIy.
OukIey (1qqq) properIy noLes LIuL sucI unLIsmokIng depIcLIons
IosLer LIe ImpressIon LIuL LIere ure numerous nonsmokers LIuL ure IuInL,
debIIILuLed or coIIupsIng uround uny exposure Lo ETS und LIuL LIIs Ius
Iong been so. He properIy poInLs ouL, us wouId mosL smokers, LIuL prIor Lo
LIe eurIy-1qqo`s nonsmokers seemed unperLurbed by ETS. Smokers und
nonsmokers sIured rooms, dormILorIes, upurLmenLs, eLc., wIere smokIng
Indoors, even uL LIe dInner LubIe, wus never un Issue. MuILIpIe usILruys
were u sLundurd IIxLure oI smokIng und nonsmokIng IouseIoIds uIIke. n
oIder movIes, nonsmokIng ucLors dId noL buL un eyeIId or mIss u IIne-
deIIvery even wILI cIgureLLe smoke bIIIowIng InLo LIeIr Iuces uL very cIose
quurLers. TIere Ius cerLuInIy been u Iuge escuIuLIon In nonsmokers
experIencIng sympLoms concernIng ETS exposure. However, LIIs Ius
occurred uILer 1qq wIen exposure Lo ETS wus oIIIcIuIIy decIured us
dungerous Ior uII. TIese new, ImmedIuLe sympLoms now ussocIuLed wILI u
Iong-presenL pIenomenon (ETS) Is u nocebo eIIecL IeedIng un ESS
pundemIc.
As soon us LIe IIrsL wuve oI smokIng buns wus InsLILuLed, bused
on u LIny Increuse In reIuLIve rIsk Ior Iung cuncer oI lijelon exposure Lo
ETS In nonsmokIng wIves oI smokIng spouses, Ieur umongsL some
nonsmokers Increused. As Ieur Increuses, more envIronmenLuI resLrIcLIons
ure demunded; buns reInIorce IrruLIonuI Ieur wIIcI, In Lurn, demund more
buns. TIen, more nonsmokers become IeurIuI oI LIe consequences oI
ETS exposure, I.e., menLuI conLugIon. WILIIn u sIorL LIme, cn exposure Is
deemed us dungerous und In need oI erudIcuLIon; more und more persons
now demonsLruLe immedicte sympLoms Lo uny exposure, I.e., nocebo
eIIecL In suggesLIbIe und somuLIzIng persons.
urLIer exumpIes oI unxIeLy dIsorders und ESS come Irom
S.A..E. SmokeIree AIr or Everyone (www.pucIIIcneL.neLJ-suIeJ
IIL.ILmI), u CuIIIornIu-bused orgunIzuLIon LIuL descrIbes ILseII us u
Preventive Medicine & Health Promotion
neLwork oI IndIvIduuIs wIo Iuve been Injured or dIsubIed by secondIund
smoke:
I Iuve Lo LuIk Lo u person wIo Is smokIng, geL IIgIL-
Ieuded. L`s Iurd Lo LIInk. TIen IL becomes Iurd Lo
breuLIe becuuse my usLImu kIcks In. sLurL cougIIng. I
Iuve Lo breuLIe secondIund smoke on u duIIy busIs,
`II Iuve usLImu uLLucks uL nIgIL so severe, IL Is un
IncredIbIe sLruggIe Lo breuLIe. (GS)
AduIL sLudenLs smoke In IronL oI LIe enLrunce Lo LIe
scIooI wIere LeucI musIc. IoId my breuLI und run
pusL LIem Lo geL LIrougI LIe door. BuL LIe smoke drIILs
InLo LIe Iobby ureu und begIn Lo sLruggIe Lo
breuLIe..WIuL mukes IL worse Is LIuL smokers muke
Iun oI me us run pusL LIem. WouId LIese sume peopIe
pusI u person In u wIeeIcIuIr down u IIIgIL oI sLuIrs.
(RR)
I breuLIe very IILLIe Lobucco smoke, Iuve muscIe
spusms In my cIesL und uL LIe sume LIme my broncIIuI
Lubes IIII wILI LIIck mucous. L cuuses me Lo sLurL
cougIIng und my Iuce Lurns red und suddenIy IInd
myseII on LIe IIoor.. (BMC)
Iuve cIronIc broncIILIs und usLImu. I um uround
secondIund smoke, my voIce wIII geL Iourse und my
cIesL wIII geL LIgIL, us II someone Is pIIIng rocks on IL.
Or mIgIL Iuve u muscIe spusm In my cIesL..(E)
I encounLer u pIysIcuI cIoud oI secondIund smoke,
even ouLsIde, IeeI u LIgILenIng In LIe buck oI my
LIrouL. Iud quInLupIe bypuss surgery und LIInk LIe
sympLom `m descrIbIng Is reIuLed Lo my IeurL...(U)
goL reuI sIck becuuse wus breuLIIng secondIund
smoke wIere wus workIng. wus sIck Ior uImosL Lwo
yeurs. WIen sLurLed Lo geL beLLer, II suw someone
smokIng u cIgureLLe, even ouLdoors, wouId IeeI so
uIruId. L wus us II wus seeIng u weupon In LIeIr Iund.
SomeLImes even u person curryIng u pencII gIves me u
sLurL becuuse LIInk uL IIrsL IL`s u cIgureLLe. (ES)
WIen breuLIe secondIund smoke, eILIer Indoors or
ouLdoors, even In LIe smuIIesL umounL, sLurL Lo cougI,
und jusL keep cougIIng. (AP)
Iuve EnvIronmenLuI IIness - muILIpIe cIemIcuI
sensILIvILIes LIuL Iuve kepL me socIuIIy IsoIuLed Ior
yeurs. `m very seII conscIous ubouL uvoIdIng pIuces
380
380
Rampant Antismoking Signifies Grave Danger
wIere `II susLuIn cIemIcuI exposures wIIcI LrIgger my
sympLoms. SecondIund smoke Is u muILIpIIcILy oI
cIemIcuI exposures. My Iegs go weuk und uII oI u
sudden `m duzed und conIused, jusL Irom LIe smoke oI
one cIgureLLe. Lry Lo LuIk buL my words sIur. IeeI sIck,
nuuseous, my eurs rIng, my Ieud IeeIs Ieuvy, my neck
und Ieg muscIes go IImp. (SM)
AII oI LIese depIcLIons ure sLundurd sympLoms oI unxIeLy
dIsorders und In LIese cuses projecLed onLo umbIenL Lobucco smoke, I.e.,
ESS. or exumpIe, House & SLurk (zooz) IndIcuLe somuLIc und
psycIoIogIcuI sympLoms LypIcuI oI unxIeLy dIsorders: PuIpILuLIons,
poundIng IeurL, ucceIeruLed IeurL ruLe; LrembIIng or sIukIng; dIIIIcuILy In
breuLIIng; cIesL puIn or dIscomIorL; IeeIIng dIzzy, unsLeudy, IuInL, IIgIL-
Ieuded; Ieur oI IosIng conLroI, goIng cruzy, pussIng ouL; sweuLIng; dry
mouLI; IeeIIng oI cIokIng; nuuseu or ubdomInuI dIscomIorL; IeeIIng LIuL
objecLs ure unreuI or LIuL seII Is dIsLunL; Ieur oI dyIng; numbness or
LIngIIng sensuLIons; IoL IIusIes or coId cIIIIs. TIey uIso noLe LIuL |p|
uLIoIogIcuI unxIeLy Is commoner umong puLIenLs wILI u cIronIc medIcuI
condILIon LIun In LIose wILIouL.
TIe InLerneL Ius uIso IucIIILuLed ESS conLugIon; suIIerers und
experLs Ieed LIe Ideu oI sympLoms produced by deIInILe exLernuI
sources on specIuIIsL websILes:
'L`s noL upproprIuLe Lo cuII us zeuIoLs,` |suys u S.A..E.
spokesperson|. 'You don`L cuII LIe vIcLIm oI u rupe or u
muggIng u zeuIoL.`..Some members oI LIe group
descrIbe LIemseIves us beIng ImmedIuLeIy sensILIve Lo
secondIund smoke. OLIers become III or dIsubIed uILer
yeurs oI exposure...
'L Is u very IoneIy experIence wIen you ure LIe onIy one
wIo Is sIck und compIuInIng,` |unoLIer spokesperson
conLInues|. 'PeopIe don`L IeeI so IsoIuLed wIen LIey cuII
us. We LeII our sLorIes, IIsLen Lo LIeIrs, expIore LIeIr
opLIons, und send LIem InIormuLIon.`..
'We ure uII cIIppIng sLorIes ubouL Lobucco. n IucL, we
Iound eucI oLIer InILIuIIy becuuse our sLorIes goL InLo
LIe newspupers.`..
TIe group Ius recenLIy begun Lo Iocus on LIe AmerIcuns
WILI DIsubIIILIes AcL und Iow IL mIgIL uppIy Lo
IndIvIduuIs wILI cIronIc Iung or IeurL dIseuse. 'L Is
cIeur Lo us LIuL pubIIc pIuces wIIcI permIL smokIng ure
In vIoIuLIon oI LIe ADA. TIere ure mIIIIons oI peopIe In
Preventive Medicine & Health Promotion
LIIs counLry wILI IeurL or Iung dIseuse wIo cunnoL
LoIeruLe beIng exposed Lo LIe smoke oI even one
cIgureLLe. We LrIed ouL our LIeory uL AX und LIe Bourd
oI AIrporL CommIssIoners udopLed u smokeIree poIIcy.`
TIe S.A..E. orgunIzuLIon IIsLs some oI ILs ucLIvILIes us:
PrepurIng u resource dIrecLory oI pIysIcIuns und
uLLorneys.
DeveIopIng sLruLegIes Ior pubIIc reIuLIons und poIILIcuI
ucLIvILIes.
CuIIIng uLLenLIon Lo unsuIe workpIuces und unsuIe
pubIIc uccommoduLIons.
NeLworkIng wILI IeuILI und Lobucco conLroI
orgunIzuLIons LIrougIouL LIe counLry.
ProvIdIng u IIvIng memorIuI Ior LIose wIo Iuve dIed us
u resuIL oI exposure Lo secondIund smoke.
L sIouId be dIsLurbIng LIuL LroubIed mInds Iuve Iound eucI
oLIer In common, conLorLed purpose. OnIy more dIsLurbIng Is LIuL socIeLy
generuIIy Ius deLerIoruLed Lo LIe exLenL LIuL LerrIIIed mInds und III-
consIdered Iuw cun enLIreIy dIcLuLe LIe IuncLIonIng oI work und pubIIc
pIuces. TIIs purLIcuIur pundemIc probIem oI ETS dunger Is IuLrogenIc.
BeIng supporLed by LIe medIcuI esLubIIsImenL, uII munner oI proIIbILIon
und Iuws Iuve been enucLed In promoLIng suIeLy. n ucLuuIILy IL Is u
sympLom oI socIeLIes beIng ruIed more und more by Ignorunce,
IncompeLence, und Ieur.
TIere ure now smokIng resLrIcLIons LIuL proIIbIL smokIng wILIIn
u cerLuIn dIsLunce oI u buIIdIng enLrunce Lo proLecL nonsmokers Irom
ImmedIuLe sympLoms cuused by ETS; some IospILuIs In AusLruIIu Iuve
wIILe-IIned recLungIes puInLed on LIe puvemenL, oIIseL Irom LIe buIIdIng
enLrunce, In wIIcI u person musL sLund II LIey wIsI Lo smoke. rruLIonuI
Ieur becomes progressIveIy more obsessed wILI conLroI. or uII LIe
envIronmenLuI cIunges pursued In LIe InLeresLs oI suIeLy, LIe more
unsuIe LIe envIronmenL seems, LIuL LIen requIres even more
envIronmenLuI cIunges. TIe menLuIILy quIckIy degeneruLes InLo nIL-
pIckIng Ior exLernuI dunger. SmuIIer und smuIIer reIuLIve rIsk dIIIerences
counL us evIdence oI dunger. ToIerunce LIresIoIds pIummeL; wIuL wus
once mInor dIscomIorL uL mosL Ior some nonsmokers Is munuIucLured
InLo u gIurIng dunger Ior uII. A LypIcuI sympLom oI unxIeLy dIsorders
generuIIy Is unxIeLy sympLoms dIsproporLIonuLe Lo LIe IeveI oI LIreuL (e.g.,
House & SLurk, zooz).
ESS does uIso InvoIve LIe superIorILy syndrome; suIIerers cun
381
381
Rampant Antismoking Signifies Grave Danger
wIere `II susLuIn cIemIcuI exposures wIIcI LrIgger my
sympLoms. SecondIund smoke Is u muILIpIIcILy oI
cIemIcuI exposures. My Iegs go weuk und uII oI u
sudden `m duzed und conIused, jusL Irom LIe smoke oI
one cIgureLLe. Lry Lo LuIk buL my words sIur. IeeI sIck,
nuuseous, my eurs rIng, my Ieud IeeIs Ieuvy, my neck
und Ieg muscIes go IImp. (SM)
AII oI LIese depIcLIons ure sLundurd sympLoms oI unxIeLy
dIsorders und In LIese cuses projecLed onLo umbIenL Lobucco smoke, I.e.,
ESS. or exumpIe, House & SLurk (zooz) IndIcuLe somuLIc und
psycIoIogIcuI sympLoms LypIcuI oI unxIeLy dIsorders: PuIpILuLIons,
poundIng IeurL, ucceIeruLed IeurL ruLe; LrembIIng or sIukIng; dIIIIcuILy In
breuLIIng; cIesL puIn or dIscomIorL; IeeIIng dIzzy, unsLeudy, IuInL, IIgIL-
Ieuded; Ieur oI IosIng conLroI, goIng cruzy, pussIng ouL; sweuLIng; dry
mouLI; IeeIIng oI cIokIng; nuuseu or ubdomInuI dIscomIorL; IeeIIng LIuL
objecLs ure unreuI or LIuL seII Is dIsLunL; Ieur oI dyIng; numbness or
LIngIIng sensuLIons; IoL IIusIes or coId cIIIIs. TIey uIso noLe LIuL |p|
uLIoIogIcuI unxIeLy Is commoner umong puLIenLs wILI u cIronIc medIcuI
condILIon LIun In LIose wILIouL.
TIe InLerneL Ius uIso IucIIILuLed ESS conLugIon; suIIerers und
experLs Ieed LIe Ideu oI sympLoms produced by deIInILe exLernuI
sources on specIuIIsL websILes:
'L`s noL upproprIuLe Lo cuII us zeuIoLs,` |suys u S.A..E.
spokesperson|. 'You don`L cuII LIe vIcLIm oI u rupe or u
muggIng u zeuIoL.`..Some members oI LIe group
descrIbe LIemseIves us beIng ImmedIuLeIy sensILIve Lo
secondIund smoke. OLIers become III or dIsubIed uILer
yeurs oI exposure...
'L Is u very IoneIy experIence wIen you ure LIe onIy one
wIo Is sIck und compIuInIng,` |unoLIer spokesperson
conLInues|. 'PeopIe don`L IeeI so IsoIuLed wIen LIey cuII
us. We LeII our sLorIes, IIsLen Lo LIeIrs, expIore LIeIr
opLIons, und send LIem InIormuLIon.`..
'We ure uII cIIppIng sLorIes ubouL Lobucco. n IucL, we
Iound eucI oLIer InILIuIIy becuuse our sLorIes goL InLo
LIe newspupers.`..
TIe group Ius recenLIy begun Lo Iocus on LIe AmerIcuns
WILI DIsubIIILIes AcL und Iow IL mIgIL uppIy Lo
IndIvIduuIs wILI cIronIc Iung or IeurL dIseuse. 'L Is
cIeur Lo us LIuL pubIIc pIuces wIIcI permIL smokIng ure
In vIoIuLIon oI LIe ADA. TIere ure mIIIIons oI peopIe In
Preventive Medicine & Health Promotion
LIIs counLry wILI IeurL or Iung dIseuse wIo cunnoL
LoIeruLe beIng exposed Lo LIe smoke oI even one
cIgureLLe. We LrIed ouL our LIeory uL AX und LIe Bourd
oI AIrporL CommIssIoners udopLed u smokeIree poIIcy.`
TIe S.A..E. orgunIzuLIon IIsLs some oI ILs ucLIvILIes us:
PrepurIng u resource dIrecLory oI pIysIcIuns und
uLLorneys.
DeveIopIng sLruLegIes Ior pubIIc reIuLIons und poIILIcuI
ucLIvILIes.
CuIIIng uLLenLIon Lo unsuIe workpIuces und unsuIe
pubIIc uccommoduLIons.
NeLworkIng wILI IeuILI und Lobucco conLroI
orgunIzuLIons LIrougIouL LIe counLry.
ProvIdIng u IIvIng memorIuI Ior LIose wIo Iuve dIed us
u resuIL oI exposure Lo secondIund smoke.
L sIouId be dIsLurbIng LIuL LroubIed mInds Iuve Iound eucI
oLIer In common, conLorLed purpose. OnIy more dIsLurbIng Is LIuL socIeLy
generuIIy Ius deLerIoruLed Lo LIe exLenL LIuL LerrIIIed mInds und III-
consIdered Iuw cun enLIreIy dIcLuLe LIe IuncLIonIng oI work und pubIIc
pIuces. TIIs purLIcuIur pundemIc probIem oI ETS dunger Is IuLrogenIc.
BeIng supporLed by LIe medIcuI esLubIIsImenL, uII munner oI proIIbILIon
und Iuws Iuve been enucLed In promoLIng suIeLy. n ucLuuIILy IL Is u
sympLom oI socIeLIes beIng ruIed more und more by Ignorunce,
IncompeLence, und Ieur.
TIere ure now smokIng resLrIcLIons LIuL proIIbIL smokIng wILIIn
u cerLuIn dIsLunce oI u buIIdIng enLrunce Lo proLecL nonsmokers Irom
ImmedIuLe sympLoms cuused by ETS; some IospILuIs In AusLruIIu Iuve
wIILe-IIned recLungIes puInLed on LIe puvemenL, oIIseL Irom LIe buIIdIng
enLrunce, In wIIcI u person musL sLund II LIey wIsI Lo smoke. rruLIonuI
Ieur becomes progressIveIy more obsessed wILI conLroI. or uII LIe
envIronmenLuI cIunges pursued In LIe InLeresLs oI suIeLy, LIe more
unsuIe LIe envIronmenL seems, LIuL LIen requIres even more
envIronmenLuI cIunges. TIe menLuIILy quIckIy degeneruLes InLo nIL-
pIckIng Ior exLernuI dunger. SmuIIer und smuIIer reIuLIve rIsk dIIIerences
counL us evIdence oI dunger. ToIerunce LIresIoIds pIummeL; wIuL wus
once mInor dIscomIorL uL mosL Ior some nonsmokers Is munuIucLured
InLo u gIurIng dunger Ior uII. A LypIcuI sympLom oI unxIeLy dIsorders
generuIIy Is unxIeLy sympLoms dIsproporLIonuLe Lo LIe IeveI oI LIreuL (e.g.,
House & SLurk, zooz).
ESS does uIso InvoIve LIe superIorILy syndrome; suIIerers cun
382
382
Rampant Antismoking Signifies Grave Danger
very uggressIveIy derIde LIose vIewed us cuusIng or proLecLIng
envIronmenLuI dunger. However, LIe superIorILy Is usuuIIy
demonsLruLed LIrougI vIcLImIood. To cIeurIy dIsLInguIsI somuLIzuLIon
(vIcLImIood), LIe syndrome noL demonsLruLIng somuLIzuLIon und bused
essenLIuIIy on u deIuded Ideu oI scIenLIIIc jusLIIIcuLIon wIII be reIerred Lo us
LIe superIorILy syndrome. TIIs Iorm Ius LIe greuLer propensILy Ior more
exLreme uggressIon. WIereus, ESS wIII reIer specIIIcuIIy Lo LIose
demonsLruLIng somuLIzuLIon. BoLI syndromes reIIecL LroubIed mInds LIuL
Iuve Iound In ETS u convenIenL projecLIon poInL Ior consIderubIe
psycIoIogIcuI, reIuLIonuI und moruI dysIuncLIon.
TIe doubIe Lrugedy In LIe unLIsmokIng sILuuLIon Is LIe
convergence oI LIe superIorILy syndrome (SS) und LIe envIronmenLuI
somuLIzuLIon syndrome. EucI reInIorces LIe oLIer. One group (SS)
ImproperIy deems LIuL u cuuseJeIIecL reIuLIonsIIp beLween ETS exposure
und dIseuseJsympLoms Is deIInILIve und rIgIL. TIe oLIer group (ESS)
enucLs IL. SomuLIzers wIII poInL Lo LIe scIenLIIIc uccurucy oI LIe cuuseJ
eIIecL reIuLIonsIIp, und, In uddILIon Lo rIgILness, superIorIsLs wIII poInL Lo
LIe dumuge done Lo InnocenL nonsmokers (e.g., somuLIzers).
UnIorLunuLeIy Ior LIe smoker, LIe sympLoms und dungers ure ussocIuLed
wILI LIe smoker`s beIuvIor. To deIIecL scruLIny uwuy Irom ILs own
conLorLed reusonIng, u IeurIuI, erruLIc menLuIILy (SS, ESS) musL
conLInuuIIy sLrIve Lo muke LIe smoker seem IooIIsI und merILIng second-
cIuss cILIzensIIp.
L Is LIIs combInuLIon oI SS und ESS LIuL mukes LIe exLenL oI
dIsLorLIon unIque und even more dIIIIcuIL Lo IdenLIIy, IeL uIone overcome -
mosL oI LIe popuIuLIon In reIevunL socIeLIes Is In LIe grIp oI LIe pundemIc.
UnIIke more LypIcuI ESS ouLbreuks, LIe ESS und SS componenLs Iuve
been InsLIguLed und promoLed by IeuILI oIIIcIuIdom generuIIy ruLIer
LIun u IundIuI oI, Ior exumpIe, cIInIcuI ecoIogIsLs; IeuILI uuLIorILIes Iuve
noL InudverLenLIy or IgnorunLIy IosLered LIe pundemIc, buL ure responsIbIe
Ior IL. TIIs ESS und SS ouLbreuk oI monsLrous proporLIons Ius been
munuIucLured by propugundu compIeLeIy consIsLenL wILI LIe IongsLundIng
unLIsmokIng poIIcy (smoke-Iree worId) oI LIe medIcuI esLubIIsImenL. n
sLundurd muLerIuIIsL Lerms, IeuILI oIIIcIuIdom Is uLLerIy obIIvIous Lo LIe
monumenLuI III eIIecLs In psycIoIogIcuI, psycIosocIuI, und moruI Lerms, or
ILs own dysIuncLIon uIong LIese dImensIons.
TIe currenL pundemIc Ius u number oI consIsLencIes wILI oLIer
ouLbreuks. IrsLIy, LIe empIusIs LIrougIouL Ius been on LIe exLernuI
IucLors oI ETS und smokers wIIcI deIIecLs uLLenLIon uwuy Irom LIe
menLuIILy mukIng LIe cIuIms oI uII munner oI dumuge und demundIng uII
munner oI envIronmenLuI cIunge, IncIudIng LIe beIuvIor oI smokers.
SecondIy, LIe roIe oI LIe medIu Is InsLrumenLuI In promoLIng
Preventive Medicine & Health Promotion
conLugIon oI deIuded beIIeI. AnLIsmokIng urLIcIes In newspupersJ
LeIevIsIon Iuve been gIven IIgI-proIIIe sLuLus, und LIIs puLLern Ius
occurred or Is occurrIng In muny socIeLIes. OukIey (1qqq) cILes LIe
exumpIe LIuL, over u one yeur perIod beLween 1qq und 1qq6, medIu
reseurcI on U.S. TV News concIuded LIuL Lobucco us u rIsk probIem Is
overempIusIzed: Lobucco und smokIng were LIe subjecL oI q1 news
sLorIes, compured Lo 16 sLorIes Ior obesILyJIuLLy Ioods, qq Ior uuLo suIeLy,
und 8 Ior uIcoIoI. Tobucco drew even more coveruge LIun cocuIne,
IeroIn, SD und murIjuunu combIned, wIIcI were LIe subjecLs oI qo
sLorIes. TIe dIspurILy wus even greuLer Ior LIe prInL medIu. TIe reseurcI
uIso concIuded LIuL LIe medIu Iuve uIIowed LIe CIInLon AdmInIsLruLIon
Lo use Lobucco us u poIILIcuI weupon und unLILobucco sources Iur exceed
proLobucco sources In Lerms oI boLI quuIILy und quunLILy. (CI.1z, p.z)
A mujor AusLruIIun sLuLe newspuper (LIe VIcLorIun Hercld,Sun)
pubIIsIed uL IeusL zoo urLIcIes on smokIngJETS over u Lwo-und-u-IuII-
yeur perIod beLween IuLe-1qqq und eurIy-zooz. UnIIke LIe U.S.
cIrcumsLunce wIere LIere Is some modIcum oI represenLIng dIIIerIng
vIewpoInLs, LIe urLIcIes Iuve LypIcuIIy been enLIreIy unLIsmokIng In sLunce.
TIe sLundurd sLrucLure oI urLIcIes Is IuII-buked, dIsjoInLed urgumenLuLIon
usIng mIsrepresenLed or even IrreIevunL sLuLIsLIcuI InIormuLIon (e.g., RR
und uLLrIbuLubIe numbers) coucIed In IIgIIy InIIummuLoryJemoLIve
Lerms (e.g., InvoIunLury exposure, Ieur, cuuse, kIII, poIson, proLecL LIe
cIIIdren) und usuuIIy mude by LIe AusLruIIun MedIcuI AssocIuLIon or ILs
members undJor unLIsmokIng groups sucI us Quit. TIe uLLrucLIon Is
obvIous Ior un unLIInkIng und uncrILIcuI medIu, wIere LIe uIreudy
InIIummuLory Lone oI prevenLIve medIcIne prescrIpLIonsJproscrIpLIons cun
be IurLIer sensuLIonuIIzed In IeudIInes. EurIIer on, LIese urLIcIes were
Lugged wILI some benIgn commenL Irom u Lobucco compuny or IndusLry
spokesmun. More recenLIy, even LIIs Ius been dIspensed wILI, sucI LIuL
reuders ure exposed onl Lo unLIsmokIng rIeLorIc, dogmu und
propugundu.
TIereIore, LIe sLundurd Lobucco reporLIng specIIIcuIIy In
VIcLorIu`s Hercld,Sun Is LypIcuIIy unquesLIoned In ILs unLIsmokIng sLunce
und Ius occurred wILI very IIgI Irequency. Even more dIsLurbIng Is LIuL,
uL LImes ImmedIuLeIy precedIng und durIng poIILIcuI debuLe on smokIng
reguIuLIons, LIere Iuve been perIods oI weeks-on-end wIere sucI
unLIsmokIng urLIcIes (IncIudIng muILIpIe urLIcIes, IuII-puge urLIcIes) Iuve
uppeured duIIy. L Is noL surprIsIng LIuL LIe mujorILy oI nonsmokers us
weII us muny smokers, us IndIcuLed In poIIs (conducLed by LIe sume
unLIsmokIng groups), Iuve psycIoIogIcuIIy cupILuIuLed Lo LIIs unreIenLIng
onsIuugIL oI IruuduIenL InIormuLIon, now IuvorIng wIdespreud smokIng
buns Lo uIIevIuLe LIe dunger, I.e., muss-scuIe conLugIon. As soon us LIe
383
383
Rampant Antismoking Signifies Grave Danger
very uggressIveIy derIde LIose vIewed us cuusIng or proLecLIng
envIronmenLuI dunger. However, LIe superIorILy Is usuuIIy
demonsLruLed LIrougI vIcLImIood. To cIeurIy dIsLInguIsI somuLIzuLIon
(vIcLImIood), LIe syndrome noL demonsLruLIng somuLIzuLIon und bused
essenLIuIIy on u deIuded Ideu oI scIenLIIIc jusLIIIcuLIon wIII be reIerred Lo us
LIe superIorILy syndrome. TIIs Iorm Ius LIe greuLer propensILy Ior more
exLreme uggressIon. WIereus, ESS wIII reIer specIIIcuIIy Lo LIose
demonsLruLIng somuLIzuLIon. BoLI syndromes reIIecL LroubIed mInds LIuL
Iuve Iound In ETS u convenIenL projecLIon poInL Ior consIderubIe
psycIoIogIcuI, reIuLIonuI und moruI dysIuncLIon.
TIe doubIe Lrugedy In LIe unLIsmokIng sILuuLIon Is LIe
convergence oI LIe superIorILy syndrome (SS) und LIe envIronmenLuI
somuLIzuLIon syndrome. EucI reInIorces LIe oLIer. One group (SS)
ImproperIy deems LIuL u cuuseJeIIecL reIuLIonsIIp beLween ETS exposure
und dIseuseJsympLoms Is deIInILIve und rIgIL. TIe oLIer group (ESS)
enucLs IL. SomuLIzers wIII poInL Lo LIe scIenLIIIc uccurucy oI LIe cuuseJ
eIIecL reIuLIonsIIp, und, In uddILIon Lo rIgILness, superIorIsLs wIII poInL Lo
LIe dumuge done Lo InnocenL nonsmokers (e.g., somuLIzers).
UnIorLunuLeIy Ior LIe smoker, LIe sympLoms und dungers ure ussocIuLed
wILI LIe smoker`s beIuvIor. To deIIecL scruLIny uwuy Irom ILs own
conLorLed reusonIng, u IeurIuI, erruLIc menLuIILy (SS, ESS) musL
conLInuuIIy sLrIve Lo muke LIe smoker seem IooIIsI und merILIng second-
cIuss cILIzensIIp.
L Is LIIs combInuLIon oI SS und ESS LIuL mukes LIe exLenL oI
dIsLorLIon unIque und even more dIIIIcuIL Lo IdenLIIy, IeL uIone overcome -
mosL oI LIe popuIuLIon In reIevunL socIeLIes Is In LIe grIp oI LIe pundemIc.
UnIIke more LypIcuI ESS ouLbreuks, LIe ESS und SS componenLs Iuve
been InsLIguLed und promoLed by IeuILI oIIIcIuIdom generuIIy ruLIer
LIun u IundIuI oI, Ior exumpIe, cIInIcuI ecoIogIsLs; IeuILI uuLIorILIes Iuve
noL InudverLenLIy or IgnorunLIy IosLered LIe pundemIc, buL ure responsIbIe
Ior IL. TIIs ESS und SS ouLbreuk oI monsLrous proporLIons Ius been
munuIucLured by propugundu compIeLeIy consIsLenL wILI LIe IongsLundIng
unLIsmokIng poIIcy (smoke-Iree worId) oI LIe medIcuI esLubIIsImenL. n
sLundurd muLerIuIIsL Lerms, IeuILI oIIIcIuIdom Is uLLerIy obIIvIous Lo LIe
monumenLuI III eIIecLs In psycIoIogIcuI, psycIosocIuI, und moruI Lerms, or
ILs own dysIuncLIon uIong LIese dImensIons.
TIe currenL pundemIc Ius u number oI consIsLencIes wILI oLIer
ouLbreuks. IrsLIy, LIe empIusIs LIrougIouL Ius been on LIe exLernuI
IucLors oI ETS und smokers wIIcI deIIecLs uLLenLIon uwuy Irom LIe
menLuIILy mukIng LIe cIuIms oI uII munner oI dumuge und demundIng uII
munner oI envIronmenLuI cIunge, IncIudIng LIe beIuvIor oI smokers.
SecondIy, LIe roIe oI LIe medIu Is InsLrumenLuI In promoLIng
Preventive Medicine & Health Promotion
conLugIon oI deIuded beIIeI. AnLIsmokIng urLIcIes In newspupersJ
LeIevIsIon Iuve been gIven IIgI-proIIIe sLuLus, und LIIs puLLern Ius
occurred or Is occurrIng In muny socIeLIes. OukIey (1qqq) cILes LIe
exumpIe LIuL, over u one yeur perIod beLween 1qq und 1qq6, medIu
reseurcI on U.S. TV News concIuded LIuL Lobucco us u rIsk probIem Is
overempIusIzed: Lobucco und smokIng were LIe subjecL oI q1 news
sLorIes, compured Lo 16 sLorIes Ior obesILyJIuLLy Ioods, qq Ior uuLo suIeLy,
und 8 Ior uIcoIoI. Tobucco drew even more coveruge LIun cocuIne,
IeroIn, SD und murIjuunu combIned, wIIcI were LIe subjecLs oI qo
sLorIes. TIe dIspurILy wus even greuLer Ior LIe prInL medIu. TIe reseurcI
uIso concIuded LIuL LIe medIu Iuve uIIowed LIe CIInLon AdmInIsLruLIon
Lo use Lobucco us u poIILIcuI weupon und unLILobucco sources Iur exceed
proLobucco sources In Lerms oI boLI quuIILy und quunLILy. (CI.1z, p.z)
A mujor AusLruIIun sLuLe newspuper (LIe VIcLorIun Hercld,Sun)
pubIIsIed uL IeusL zoo urLIcIes on smokIngJETS over u Lwo-und-u-IuII-
yeur perIod beLween IuLe-1qqq und eurIy-zooz. UnIIke LIe U.S.
cIrcumsLunce wIere LIere Is some modIcum oI represenLIng dIIIerIng
vIewpoInLs, LIe urLIcIes Iuve LypIcuIIy been enLIreIy unLIsmokIng In sLunce.
TIe sLundurd sLrucLure oI urLIcIes Is IuII-buked, dIsjoInLed urgumenLuLIon
usIng mIsrepresenLed or even IrreIevunL sLuLIsLIcuI InIormuLIon (e.g., RR
und uLLrIbuLubIe numbers) coucIed In IIgIIy InIIummuLoryJemoLIve
Lerms (e.g., InvoIunLury exposure, Ieur, cuuse, kIII, poIson, proLecL LIe
cIIIdren) und usuuIIy mude by LIe AusLruIIun MedIcuI AssocIuLIon or ILs
members undJor unLIsmokIng groups sucI us Quit. TIe uLLrucLIon Is
obvIous Ior un unLIInkIng und uncrILIcuI medIu, wIere LIe uIreudy
InIIummuLory Lone oI prevenLIve medIcIne prescrIpLIonsJproscrIpLIons cun
be IurLIer sensuLIonuIIzed In IeudIInes. EurIIer on, LIese urLIcIes were
Lugged wILI some benIgn commenL Irom u Lobucco compuny or IndusLry
spokesmun. More recenLIy, even LIIs Ius been dIspensed wILI, sucI LIuL
reuders ure exposed onl Lo unLIsmokIng rIeLorIc, dogmu und
propugundu.
TIereIore, LIe sLundurd Lobucco reporLIng specIIIcuIIy In
VIcLorIu`s Hercld,Sun Is LypIcuIIy unquesLIoned In ILs unLIsmokIng sLunce
und Ius occurred wILI very IIgI Irequency. Even more dIsLurbIng Is LIuL,
uL LImes ImmedIuLeIy precedIng und durIng poIILIcuI debuLe on smokIng
reguIuLIons, LIere Iuve been perIods oI weeks-on-end wIere sucI
unLIsmokIng urLIcIes (IncIudIng muILIpIe urLIcIes, IuII-puge urLIcIes) Iuve
uppeured duIIy. L Is noL surprIsIng LIuL LIe mujorILy oI nonsmokers us
weII us muny smokers, us IndIcuLed In poIIs (conducLed by LIe sume
unLIsmokIng groups), Iuve psycIoIogIcuIIy cupILuIuLed Lo LIIs unreIenLIng
onsIuugIL oI IruuduIenL InIormuLIon, now IuvorIng wIdespreud smokIng
buns Lo uIIevIuLe LIe dunger, I.e., muss-scuIe conLugIon. As soon us LIe
384
384
Rampant Antismoking Signifies Grave Danger
IusL wuve oI wIdespreud buns were IegIsIuLed Ior In VIcLorIu In eurIy-zooz,
LIe Irequency oI unLIsmokIng urLIcIes dropped Lo u Iew u week. TIe sIeer
ever-presence und over-suLuruLIon oI unLIsmokIng websILes on LIe
InLerneL Ius uIreudy been IndIcuLed.
TIIrdIy, GoLIe eL uI. (1qq) IndIcuLe LIuL Lrude unIons cun uIso
pIuy u crILIcuI roIe In IosLerIng nocebo eIIecLs und conLugIon (p.q). Trude-
unIon IeudersIIp Is noL experL In LIe scIenLIIIc und psycIoIogIcuI Issues uL
Iund, nor sIouId IL be expecLed Lo be. However, us un uspecL oI u
guLIerIng ESS momenLum, LIIs IeudersIIp Is uL LIe mercy oI uggressIve
Iobby groups. By IoIIowIng popuIur dogmu, some unIon Ieuders muy
beIIeve LIuL LIey ure pursuIng beLLer condILIons Ior LIeIr workers.
However, LIere Is uIso LIe Issue oI vesLed InLeresL In seemIng Lo be ucLIve
Ior workers und LIe uppeuI oI IncreusIng LIe membersIIp buse. I LIese
unIons become suLuruLed by u consLunL sLreum oI bIused InIormuLIon
wIIcI Is LIen used Ior LIe workers` good, LIey sImpIy become purL oI un
even Iurger Iobby group IueIIng ESS conLugIon. MukIng LIe sILuuLIon even
worse Is LIuL, once u unIon Is uIIgned und commILLed Lo u cuuse, onIy
success Is vIubIe In demonsLruLIng sLrengLI und worker empuLIy: unyLIIng
sIorL oI success wIII IosLer LIe ImpressIon oI u weuk unIon und LIe
muInLenunce oI dungerous workIng condILIons. ResIsLunce Lo unIon
demunds by munugemenL Is InLerpreLed by unIons us uIwuys seII-servIng
und conspIrIng uguInsL LIe IeuILI oI workers, I.e., un eIemenL oI purunoIu.
TIe enLIre cIrcumsLunce Is unIeuILIy wILI escuIuLIng mIsLrusL und
dIvIsIon beLween munugemenL und LIe unIon, und u conLugIon eIIecL
umongsL workers.
n VIcLorIu, AusLruIIu, one oI LIe IusL wuves oI smokIng reguIuLIon
concerned smokIng buns uL Crown cusIno und gumIng venues generuIIy.
TIe reIevunL Lrude unIon wenL Lo greuL IengLIs Lo Iuve LIese buns
IegIsIuLed. Trude unIon ucLIvILy InILIuIIy InvoIved sLuII rooms beIng
suLuruLed wILI dunger oI ETS InIormuLIon und IrequenL newsIeLLers
devoLed Lo LIe Issue oI pussIve smokIng. GIven LIuL LIe unIon wus
suppIIed by LIe sume unLIsmokIng groups (AMA, QuIL) LIuL uIso Ieed LIe
medIu, LIe InIormuLIon Is obvIousIy IILLered wILI mIsrepresenLed RR und
uLLrIbuLubIe numbers LogeLIer wILI IIgIIy emoLIve Iunguuge (e.g.,
InvoIunLury exposure, poIson, kIII).
obbyIng wus evenLuuIIy munIIesLed us posLuge-puId posLcurds
uddressed Lo LIe VIcLorIun PremIer. On LIe IronL-sIde oI LIe curd wus u
pIoLo oI u womun`s Iuce In u mIsL oI Lobucco smoke cupLIoned L`s u
proIessIonuI poker Iuce...nsIde we ure cIokIng. On LIe bucksIde wus:
Deur PremIer Brucks,
um un empIoyee uL............,
A VIcLorIun HospILuIILy Venue wIIcI permILs smokIng
Preventive Medicine & Health Promotion
uL my workpIuce.
My workpIuce IIIIs wILI smoke Irom LIe puLrons wIo
uLLend. By LIe end oI u sIIIL Iuve ILcIy eyes, my nose
runs, suIIer Irom IeuducIes und Iuve dIIIIcuILy
breuLIIng. smeII IIke un usILruy. don`L even wunL Lo
LIInk ubouL wIuL mIgIL suIIer In unoLIer Len yeurs!
usk LIuL you supporL unLI-smokIng IegIsIuLIon In my
workpIuce, und uIIow me Lo work In u smoke Iree
envIronmenL jusL us you do In your oIIIce...
TIe posLcurd requIred onIy LIe worker`s sIgnuLure, nume, und
uddress. PosLuge wus puId und LIe worker dId noL need Lo conLempIuLe
wIuL sympLoms mIgIL be ussocIuLed wILI exposure Lo ETS - LIe posLcurd
LoId uII workers wIuL sympLoms LIey sIouId be IuvIng, und LoId LIe
PremIer wIuL sympLoms uII workers were IuvIng. TIese ure sLundurd
sympLoms oI somuLIzIng dIsorders sucI us ESS.
WIen LIere wus u IuIIure Lo Iuve smokIng buns InsLILuLed, unIon
newsIeLLers conLuIned Iong dIscourses on wIy LIe munugemenL und
governmenL couId noL be LrusLed on LIe Issue oI ETS exposure. As
conLugIon spreuds und IrruLIonuI Ieur Increuses becuuse oI consLunL
exposure Lo LIe supposed dungerous subsLunce, LIe purunoIu uspecL uIso
Increuses. ConspIruLorIuI sLorIes begIn Lo ubound wIIcI IurLIer IueI LIe
conLugIon.
A IurLIer unIon InILIuLIve InvoIved u pussIve smokIng
regIsLer. One newsIeLLer decIures TIe UnIon, In conjuncLIon wILI ..
QUT und LIe AusLruIIun MedIcuI AssocIuLIon Iuve now deveIoped u
regIsLer Ior unIon members. TIIs regIsLer wIII uIIow members Lo keep u
record oI Iow LIeIr exposure Lo pussIve smoke Ius uIIecLed LIeIr IeuILI.
TIIs InIormuLIon cun LIen be used us purL oI u IeguI sLruLegy Lo bun
smokIng Irom uII IospILuIILy work-pIuces. Muny members ucross VIcLorIu
Iuve uIreudy enquIred ubouL beIng IncIuded In LIe regIsLer. TIey und uII
oLIer unIon members, wIII soon be ubIe Lo sIgn up.
TIIs IIne oI upproucI IosLers LIe deIuded beIIeI LIuL exposure Lo
ETS should gIve rIse Lo sympLoms. urLIermore, IL Is IeIL Lo workers In
LIIs cuse Lo dIscern wIuL sympLoms ure uLLrIbuLubIe Lo ETS; sLundurd
sympLoms cun urIse Irom numerous workpIuce ucLIvILIes, curryovers Irom
non-workpIuce ucLIvILIes, und, more ImporLunLIy, Irom u psycIogenIc
source due Lo suggesLIbIIILy und IrruLIonuI beIIeI und Ieur. TIIs InILIuLIve
wus uIso supporLed by LIe weurIng oI T-sIIrLsJwIndcIeuLers dIspIuyIng
LIe Iurge embIem We`re cIokIng. TIe cupucILy oI LIIs sILuuLIon Lo IosLer
und reInIorce nocebo eIIecLs und conLugIon oI ESS Is exLruordInury.
PurLIcuIur sLudIes Iuve uIso been cILed In supporL oI smokIng
385
385
Rampant Antismoking Signifies Grave Danger
IusL wuve oI wIdespreud buns were IegIsIuLed Ior In VIcLorIu In eurIy-zooz,
LIe Irequency oI unLIsmokIng urLIcIes dropped Lo u Iew u week. TIe sIeer
ever-presence und over-suLuruLIon oI unLIsmokIng websILes on LIe
InLerneL Ius uIreudy been IndIcuLed.
TIIrdIy, GoLIe eL uI. (1qq) IndIcuLe LIuL Lrude unIons cun uIso
pIuy u crILIcuI roIe In IosLerIng nocebo eIIecLs und conLugIon (p.q). Trude-
unIon IeudersIIp Is noL experL In LIe scIenLIIIc und psycIoIogIcuI Issues uL
Iund, nor sIouId IL be expecLed Lo be. However, us un uspecL oI u
guLIerIng ESS momenLum, LIIs IeudersIIp Is uL LIe mercy oI uggressIve
Iobby groups. By IoIIowIng popuIur dogmu, some unIon Ieuders muy
beIIeve LIuL LIey ure pursuIng beLLer condILIons Ior LIeIr workers.
However, LIere Is uIso LIe Issue oI vesLed InLeresL In seemIng Lo be ucLIve
Ior workers und LIe uppeuI oI IncreusIng LIe membersIIp buse. I LIese
unIons become suLuruLed by u consLunL sLreum oI bIused InIormuLIon
wIIcI Is LIen used Ior LIe workers` good, LIey sImpIy become purL oI un
even Iurger Iobby group IueIIng ESS conLugIon. MukIng LIe sILuuLIon even
worse Is LIuL, once u unIon Is uIIgned und commILLed Lo u cuuse, onIy
success Is vIubIe In demonsLruLIng sLrengLI und worker empuLIy: unyLIIng
sIorL oI success wIII IosLer LIe ImpressIon oI u weuk unIon und LIe
muInLenunce oI dungerous workIng condILIons. ResIsLunce Lo unIon
demunds by munugemenL Is InLerpreLed by unIons us uIwuys seII-servIng
und conspIrIng uguInsL LIe IeuILI oI workers, I.e., un eIemenL oI purunoIu.
TIe enLIre cIrcumsLunce Is unIeuILIy wILI escuIuLIng mIsLrusL und
dIvIsIon beLween munugemenL und LIe unIon, und u conLugIon eIIecL
umongsL workers.
n VIcLorIu, AusLruIIu, one oI LIe IusL wuves oI smokIng reguIuLIon
concerned smokIng buns uL Crown cusIno und gumIng venues generuIIy.
TIe reIevunL Lrude unIon wenL Lo greuL IengLIs Lo Iuve LIese buns
IegIsIuLed. Trude unIon ucLIvILy InILIuIIy InvoIved sLuII rooms beIng
suLuruLed wILI dunger oI ETS InIormuLIon und IrequenL newsIeLLers
devoLed Lo LIe Issue oI pussIve smokIng. GIven LIuL LIe unIon wus
suppIIed by LIe sume unLIsmokIng groups (AMA, QuIL) LIuL uIso Ieed LIe
medIu, LIe InIormuLIon Is obvIousIy IILLered wILI mIsrepresenLed RR und
uLLrIbuLubIe numbers LogeLIer wILI IIgIIy emoLIve Iunguuge (e.g.,
InvoIunLury exposure, poIson, kIII).
obbyIng wus evenLuuIIy munIIesLed us posLuge-puId posLcurds
uddressed Lo LIe VIcLorIun PremIer. On LIe IronL-sIde oI LIe curd wus u
pIoLo oI u womun`s Iuce In u mIsL oI Lobucco smoke cupLIoned L`s u
proIessIonuI poker Iuce...nsIde we ure cIokIng. On LIe bucksIde wus:
Deur PremIer Brucks,
um un empIoyee uL............,
A VIcLorIun HospILuIILy Venue wIIcI permILs smokIng
Preventive Medicine & Health Promotion
uL my workpIuce.
My workpIuce IIIIs wILI smoke Irom LIe puLrons wIo
uLLend. By LIe end oI u sIIIL Iuve ILcIy eyes, my nose
runs, suIIer Irom IeuducIes und Iuve dIIIIcuILy
breuLIIng. smeII IIke un usILruy. don`L even wunL Lo
LIInk ubouL wIuL mIgIL suIIer In unoLIer Len yeurs!
usk LIuL you supporL unLI-smokIng IegIsIuLIon In my
workpIuce, und uIIow me Lo work In u smoke Iree
envIronmenL jusL us you do In your oIIIce...
TIe posLcurd requIred onIy LIe worker`s sIgnuLure, nume, und
uddress. PosLuge wus puId und LIe worker dId noL need Lo conLempIuLe
wIuL sympLoms mIgIL be ussocIuLed wILI exposure Lo ETS - LIe posLcurd
LoId uII workers wIuL sympLoms LIey sIouId be IuvIng, und LoId LIe
PremIer wIuL sympLoms uII workers were IuvIng. TIese ure sLundurd
sympLoms oI somuLIzIng dIsorders sucI us ESS.
WIen LIere wus u IuIIure Lo Iuve smokIng buns InsLILuLed, unIon
newsIeLLers conLuIned Iong dIscourses on wIy LIe munugemenL und
governmenL couId noL be LrusLed on LIe Issue oI ETS exposure. As
conLugIon spreuds und IrruLIonuI Ieur Increuses becuuse oI consLunL
exposure Lo LIe supposed dungerous subsLunce, LIe purunoIu uspecL uIso
Increuses. ConspIruLorIuI sLorIes begIn Lo ubound wIIcI IurLIer IueI LIe
conLugIon.
A IurLIer unIon InILIuLIve InvoIved u pussIve smokIng
regIsLer. One newsIeLLer decIures TIe UnIon, In conjuncLIon wILI ..
QUT und LIe AusLruIIun MedIcuI AssocIuLIon Iuve now deveIoped u
regIsLer Ior unIon members. TIIs regIsLer wIII uIIow members Lo keep u
record oI Iow LIeIr exposure Lo pussIve smoke Ius uIIecLed LIeIr IeuILI.
TIIs InIormuLIon cun LIen be used us purL oI u IeguI sLruLegy Lo bun
smokIng Irom uII IospILuIILy work-pIuces. Muny members ucross VIcLorIu
Iuve uIreudy enquIred ubouL beIng IncIuded In LIe regIsLer. TIey und uII
oLIer unIon members, wIII soon be ubIe Lo sIgn up.
TIIs IIne oI upproucI IosLers LIe deIuded beIIeI LIuL exposure Lo
ETS should gIve rIse Lo sympLoms. urLIermore, IL Is IeIL Lo workers In
LIIs cuse Lo dIscern wIuL sympLoms ure uLLrIbuLubIe Lo ETS; sLundurd
sympLoms cun urIse Irom numerous workpIuce ucLIvILIes, curryovers Irom
non-workpIuce ucLIvILIes, und, more ImporLunLIy, Irom u psycIogenIc
source due Lo suggesLIbIIILy und IrruLIonuI beIIeI und Ieur. TIIs InILIuLIve
wus uIso supporLed by LIe weurIng oI T-sIIrLsJwIndcIeuLers dIspIuyIng
LIe Iurge embIem We`re cIokIng. TIe cupucILy oI LIIs sILuuLIon Lo IosLer
und reInIorce nocebo eIIecLs und conLugIon oI ESS Is exLruordInury.
PurLIcuIur sLudIes Iuve uIso been cILed In supporL oI smokIng
386
386
Rampant Antismoking Signifies Grave Danger
buns In gumIng venues. or exumpIe, EIsner eL uI. (1qq8) consIdered LIe
ussocIuLIon beLween ETS exposure und respIruLory sympLoms In uduILs,
wIIcI Lo LIuL duLe Iud noL been weII esLubIIsIed, Ior 6; Sun runcIsco
burLenders pre und posL workpIuce smokIng buns. RespIruLory sympLoms,
sensory IrrILuLIon sympLoms, ETS exposure, personuI smokIng, und recenL
upper respIruLory LrucL InIecLIons were ussessed LIrougI InLervIews.
SpIromeLrIc ussessmenLs were uIso conducLed, IncIudIng Iorced expIruLory
voIume In 1 second (EV1) und Iorced vILuI cupucILy (VC) meusuremenLs.
SeII-reporLed ETS exposure uL work decIIned Irom u medIun oI z8 Lo z
Iours per week. TIey Iound LIuL z oI q burLenders wIo InILIuIIy
reporLed respIruLory sympLoms no Ionger Iud sympLoms uL IoIIow-up.
Sensory IrrILuLIon sympLoms dIsuppeured In z oI q1 burLenders wIo
InILIuIIy reporLed sympLoms. VC und EV1 Improved q.z% und 1.z%
respecLIveIy uILer workpIuce smokIng buns. An ImprovemenL In LIese oI
6.8% und q.% wus ussocIuLed wILI compIeLe cessuLIon oI workpIuce ETS
exposure (compured wILI conLInued exposure) und uILer conLroIIIng Ior
personuI smokIng und recenL upper respIruLory LrucL InIecLIons. EIsner eL
uI. (1qq8) concIuded LIuL |e|sLubIIsImenL oI smoke-Iree burs und Luverns
wus ussocIuLed wILI u rupId ImprovemenL oI respIruLory IeuILI.
GovernmenLs LIuL Iuve specIIIcuIIy proIIbILed smokIng In Luverns und
burs LypIcuIIy decIure LIuL IL wIII Improve workers` IeuILI.
TIere ure u number oI very crILIcuI InIerenLIuI und
meLIodoIogIcuI probIems wILI LIIs Lype oI sLudy. IrsLIy, uII oI LIe
sympLoms consIdered ure uIso LypIcuI oI somuLIzuLIon dIsorders, e.g., ESS
und conLugIon. TIe meLIodoIogy empIoyed Is IncupubIe oI ussessIng LIIs
crucIuI muLLer oI u poLenLIuI psycIosomuLIc eIIecL. BeIng muLerIuIIsL In
dIsposILIon, LIe reseurcIers were mosL probubIy obIIvIous Lo LIe
possIbIIILy. Beyond LIe sLundurd sympLoms sucI us IrrILuLIon oI LIe eyes,
IeuducIe, eLc., psycIogenIc dIsLurbunces cun uIso uIIecL Iung IuncLIon
und, LIereIore, even LIe more sensILIve spIromeLrIc meusures oI EV1 und
VC. SecondIy, uILIougI specIuI meusurIng InsLrumenLs (spIromeLrIc) cun
deLecL purLIcuIur cIunges, puImonury IuncLIon musL In mosL cuses
decreuse on LIe order oI zo% Irom normuI vuIues beIore cn Ioss oI
IuncLIon Is deLecLubIe by eILIer LIe puLIenL or u pIysIcIun. (see Prokop &
BrudIey, 1q81, p.81) TIe sume cun be suId Ior meusured ImprovemenLs.
TIere were cerLuInIy ImprovemenLs In spIromeLrIc meusures. However,
LIese were very smuII, Lo LIe exLenL wIere LIey wouId noL be deLecLubIe us
u IeuILI guIn by LIe purLIcIpunLs exIIbILIng LIese ImprovemenLs. n LIe
cuse oI conLInuIng ETS exposure, LIese wouId mosL probubIy noL be
deLecLed us u IeuILI deLrImenL. urLIermore, wIuL u Iuck oI LIese smuII
spIromeLrIc ImprovemenLs meun Ior overuII IeuILI In LIe Iong Lerm Is
compIeLeIy uncIeur. As uIreudy menLIoned, wIeLIer LIese, LogeLIer wILI
Preventive Medicine & Health Promotion
oLIer more overL sympLoms, ure reIuLed Lo LIe eIIecL oI LIe properLIes oI
ETS us opposed Lo LIe beIIeIs ubouL ETS Is uIso compIeLeIy uncIeur,
uILIougI LIe IIkeIIIood Is LIe IuLLer. Proper reseurcI needs Lo uccounL Ior
possIbIe noceboJubscebo eIIecLs.
TIereIore, smokIng buns cun Improve dIscernubIe sympLoms, uL
IeusL In LIe sIorL Lerm, II sympLoms were LIe resuIL oI IrruLIonuI beIIeI und
Ieur (nocebo eIIecL). n sucI cuses, IegIsIuLed smokIng buns ure u coddIIng
eIIecL LIuL onIy reInIorces LIe IrruLIonuI (supersLILIous) beIIeI. RegurdIess
oI wIuL Is beIIeved ubouL LIe source oI decremenLJImprovemenL, IL Is
IIgIIy urguubIe LIuL wIoIesuIe smokIng buns wouId be InsLILuLed on LIe
busIs oI u spIromeLrIc reudIng LIuL Is uL u IeveI ImpercepLIbIe Lo LIe Iumun
reuIm oI IuncLIonIng und LIuL Ius no demonsLruLed Iong-Lerm deLrImenL
Lo IeuILI. L cun be poInLed ouL LIuL uIong sImIIur LIeoreLIcuI IInes us LIe
ubove experImenL, some LesLIng Iud recenLIy begun uL Crown cusIno
uLLempLIng Lo IInk coLInIne IeveIs (proxy meusure oI ETS exposure) wILI
spIromeLrIc meusures. L Is uncIeur wIuL becume oI LIIs InvesLIguLIon.
However, LIe very sume ImporLunL crILIcIsms, IncIudIng IuIIure Lo uccounL
Ior poLenLIuI noceboJubscebo eIIecLs, uppIy. UnIorLunuLeIy, LIe overrIdIng
puLLern oI conducL Is LIe consIsLenL workIng Lo un unLIsmokIng
concIusIon.
AIso dIsLurbIng Is LIuL unLIsmokIng groups (AMA, VIcHeuILI,
QuIL) ure LIe sume Ieeders oI boLI LIe medIu und LIe Lrude unIons. TIe
syncIronIcILy oI propugunduJucLIvILy In LIe medIu und unIons, und LIe
LImIng oI poIILIcuI debuLe und IegIsIuLIon, Iorms u mosL uIurmIng cIosed
Ioop oI bIused InIormuLIon. TIIs cIosed Ioop oI InIormuLIon-guLIerIng
und dIssemInuLIon wIII bIock uny dIssenLIng vIews Irom even reucIIng LIe
pubIIc. L sIouId be oI crILIcuI concern LIuL cerLuIn groups, deIuded In
beIIeI und Irumework, cun Iuve sucI u sLrungIeIoId on LIe IIow oI
InIormuLIon Lo LIe poInL oI beIng eusIIy ubIe Lo orcIesLruLe equuIIy
deIuded uLLempLs uL socIuI engIneerIng on u grund scuIe.
NoL surprIsIngIy, In eurIy zooz, IegIsIuLIon wus pussed Lo bun
smokIng uL Crown cusIno. ederuI und SLuLe governmenLs Iud uIreudy
uIIgned LIemseIves Lo unLIsmokIng generuIIy und workpIuce smokIng buns
specIIIcuIIy sInce EPA (1qq). L Is LIe sume governmenLs LIuL Iuve Iunded
u pIeLIoru oI wIuL Is uILImuLeIy unLIsmokIng reseurcI und orgunIzuLIonsJ
InsLILuLIons LIuL ure, by deIInILIon, unLIsmokIng (e.g., nsLILuLe Ior
Tobucco ConLroI). GIven LIuL IL Ius IosLered Lobucco conLroI on LIe busIs
oI ETS exposure Ior nonsmokers Ior LIe beLLer purL oI u decude, und gIven
LIuL Ior eucI InsLILuLed bun supersLILIous beIIeI Is reInIorced, LIe demund
Ior conLroI becomes even sLronger und more nIL-pIckIng. L wus onIy u
muLLer oI LIme, IeIL In uncIecked mode, LIuL smokIng buns wouId become
wIdespreud Indeed.
387
387
Rampant Antismoking Signifies Grave Danger
buns In gumIng venues. or exumpIe, EIsner eL uI. (1qq8) consIdered LIe
ussocIuLIon beLween ETS exposure und respIruLory sympLoms In uduILs,
wIIcI Lo LIuL duLe Iud noL been weII esLubIIsIed, Ior 6; Sun runcIsco
burLenders pre und posL workpIuce smokIng buns. RespIruLory sympLoms,
sensory IrrILuLIon sympLoms, ETS exposure, personuI smokIng, und recenL
upper respIruLory LrucL InIecLIons were ussessed LIrougI InLervIews.
SpIromeLrIc ussessmenLs were uIso conducLed, IncIudIng Iorced expIruLory
voIume In 1 second (EV1) und Iorced vILuI cupucILy (VC) meusuremenLs.
SeII-reporLed ETS exposure uL work decIIned Irom u medIun oI z8 Lo z
Iours per week. TIey Iound LIuL z oI q burLenders wIo InILIuIIy
reporLed respIruLory sympLoms no Ionger Iud sympLoms uL IoIIow-up.
Sensory IrrILuLIon sympLoms dIsuppeured In z oI q1 burLenders wIo
InILIuIIy reporLed sympLoms. VC und EV1 Improved q.z% und 1.z%
respecLIveIy uILer workpIuce smokIng buns. An ImprovemenL In LIese oI
6.8% und q.% wus ussocIuLed wILI compIeLe cessuLIon oI workpIuce ETS
exposure (compured wILI conLInued exposure) und uILer conLroIIIng Ior
personuI smokIng und recenL upper respIruLory LrucL InIecLIons. EIsner eL
uI. (1qq8) concIuded LIuL |e|sLubIIsImenL oI smoke-Iree burs und Luverns
wus ussocIuLed wILI u rupId ImprovemenL oI respIruLory IeuILI.
GovernmenLs LIuL Iuve specIIIcuIIy proIIbILed smokIng In Luverns und
burs LypIcuIIy decIure LIuL IL wIII Improve workers` IeuILI.
TIere ure u number oI very crILIcuI InIerenLIuI und
meLIodoIogIcuI probIems wILI LIIs Lype oI sLudy. IrsLIy, uII oI LIe
sympLoms consIdered ure uIso LypIcuI oI somuLIzuLIon dIsorders, e.g., ESS
und conLugIon. TIe meLIodoIogy empIoyed Is IncupubIe oI ussessIng LIIs
crucIuI muLLer oI u poLenLIuI psycIosomuLIc eIIecL. BeIng muLerIuIIsL In
dIsposILIon, LIe reseurcIers were mosL probubIy obIIvIous Lo LIe
possIbIIILy. Beyond LIe sLundurd sympLoms sucI us IrrILuLIon oI LIe eyes,
IeuducIe, eLc., psycIogenIc dIsLurbunces cun uIso uIIecL Iung IuncLIon
und, LIereIore, even LIe more sensILIve spIromeLrIc meusures oI EV1 und
VC. SecondIy, uILIougI specIuI meusurIng InsLrumenLs (spIromeLrIc) cun
deLecL purLIcuIur cIunges, puImonury IuncLIon musL In mosL cuses
decreuse on LIe order oI zo% Irom normuI vuIues beIore cn Ioss oI
IuncLIon Is deLecLubIe by eILIer LIe puLIenL or u pIysIcIun. (see Prokop &
BrudIey, 1q81, p.81) TIe sume cun be suId Ior meusured ImprovemenLs.
TIere were cerLuInIy ImprovemenLs In spIromeLrIc meusures. However,
LIese were very smuII, Lo LIe exLenL wIere LIey wouId noL be deLecLubIe us
u IeuILI guIn by LIe purLIcIpunLs exIIbILIng LIese ImprovemenLs. n LIe
cuse oI conLInuIng ETS exposure, LIese wouId mosL probubIy noL be
deLecLed us u IeuILI deLrImenL. urLIermore, wIuL u Iuck oI LIese smuII
spIromeLrIc ImprovemenLs meun Ior overuII IeuILI In LIe Iong Lerm Is
compIeLeIy uncIeur. As uIreudy menLIoned, wIeLIer LIese, LogeLIer wILI
Preventive Medicine & Health Promotion
oLIer more overL sympLoms, ure reIuLed Lo LIe eIIecL oI LIe properLIes oI
ETS us opposed Lo LIe beIIeIs ubouL ETS Is uIso compIeLeIy uncIeur,
uILIougI LIe IIkeIIIood Is LIe IuLLer. Proper reseurcI needs Lo uccounL Ior
possIbIe noceboJubscebo eIIecLs.
TIereIore, smokIng buns cun Improve dIscernubIe sympLoms, uL
IeusL In LIe sIorL Lerm, II sympLoms were LIe resuIL oI IrruLIonuI beIIeI und
Ieur (nocebo eIIecL). n sucI cuses, IegIsIuLed smokIng buns ure u coddIIng
eIIecL LIuL onIy reInIorces LIe IrruLIonuI (supersLILIous) beIIeI. RegurdIess
oI wIuL Is beIIeved ubouL LIe source oI decremenLJImprovemenL, IL Is
IIgIIy urguubIe LIuL wIoIesuIe smokIng buns wouId be InsLILuLed on LIe
busIs oI u spIromeLrIc reudIng LIuL Is uL u IeveI ImpercepLIbIe Lo LIe Iumun
reuIm oI IuncLIonIng und LIuL Ius no demonsLruLed Iong-Lerm deLrImenL
Lo IeuILI. L cun be poInLed ouL LIuL uIong sImIIur LIeoreLIcuI IInes us LIe
ubove experImenL, some LesLIng Iud recenLIy begun uL Crown cusIno
uLLempLIng Lo IInk coLInIne IeveIs (proxy meusure oI ETS exposure) wILI
spIromeLrIc meusures. L Is uncIeur wIuL becume oI LIIs InvesLIguLIon.
However, LIe very sume ImporLunL crILIcIsms, IncIudIng IuIIure Lo uccounL
Ior poLenLIuI noceboJubscebo eIIecLs, uppIy. UnIorLunuLeIy, LIe overrIdIng
puLLern oI conducL Is LIe consIsLenL workIng Lo un unLIsmokIng
concIusIon.
AIso dIsLurbIng Is LIuL unLIsmokIng groups (AMA, VIcHeuILI,
QuIL) ure LIe sume Ieeders oI boLI LIe medIu und LIe Lrude unIons. TIe
syncIronIcILy oI propugunduJucLIvILy In LIe medIu und unIons, und LIe
LImIng oI poIILIcuI debuLe und IegIsIuLIon, Iorms u mosL uIurmIng cIosed
Ioop oI bIused InIormuLIon. TIIs cIosed Ioop oI InIormuLIon-guLIerIng
und dIssemInuLIon wIII bIock uny dIssenLIng vIews Irom even reucIIng LIe
pubIIc. L sIouId be oI crILIcuI concern LIuL cerLuIn groups, deIuded In
beIIeI und Irumework, cun Iuve sucI u sLrungIeIoId on LIe IIow oI
InIormuLIon Lo LIe poInL oI beIng eusIIy ubIe Lo orcIesLruLe equuIIy
deIuded uLLempLs uL socIuI engIneerIng on u grund scuIe.
NoL surprIsIngIy, In eurIy zooz, IegIsIuLIon wus pussed Lo bun
smokIng uL Crown cusIno. ederuI und SLuLe governmenLs Iud uIreudy
uIIgned LIemseIves Lo unLIsmokIng generuIIy und workpIuce smokIng buns
specIIIcuIIy sInce EPA (1qq). L Is LIe sume governmenLs LIuL Iuve Iunded
u pIeLIoru oI wIuL Is uILImuLeIy unLIsmokIng reseurcI und orgunIzuLIonsJ
InsLILuLIons LIuL ure, by deIInILIon, unLIsmokIng (e.g., nsLILuLe Ior
Tobucco ConLroI). GIven LIuL IL Ius IosLered Lobucco conLroI on LIe busIs
oI ETS exposure Ior nonsmokers Ior LIe beLLer purL oI u decude, und gIven
LIuL Ior eucI InsLILuLed bun supersLILIous beIIeI Is reInIorced, LIe demund
Ior conLroI becomes even sLronger und more nIL-pIckIng. L wus onIy u
muLLer oI LIme, IeIL In uncIecked mode, LIuL smokIng buns wouId become
wIdespreud Indeed.
388
388
Rampant Antismoking Signifies Grave Danger
TIe cover oI LIe Union Neus (ebJMurcI zooz) wus IeudIIned
wILI We won: Smoke Iree buns In LIe gumIng IndusLry wIII Improve
workers` IeuILI. TIe IegIsIuLIon reInIorces IrruLIonuI beIIeI und Is u
coddIIng eIIecL. L uIso provIdes IurLIer InsIgIL InLo LIe snowbuIIIng eIIecL
oI LIe IncILemenL oI IrruLIonuI Ieur InLo muss deIusIon. ConsIsLenL wILI LIe
Ideu oI unIon ucLIvILIes, wIeLIer reusonubIe or unreusonubIe, IosLerIng
worker conIIdence, wIeLIer reusonubIe or unreusonubIe, us poLenLIuIIy
moLIvuLed by vesLed InLeresL, LIe InsIde cover oI LIe sume muguzIne-Issue
decIures LIuL Your unIon Is growIng: we Iuve more und new members
joInIng und IncreusIng our coIIecLIve sLrengLI. (p.z)
A Iew IImILed ureus oI Crown cusIno were grunLed exempLIon
Irom LIe smokIng buns. JusL one monLI IoIIowIng LIe InsLILuLIng oI
smokIng buns (SepLember 1, zooz) LIere wus u LIreuL oI sLrIke ucLIon by
cusIno workers sLIII exposed Lo LIese smokIng ureus. A IocuI mujor
newspuper decIured: PussIve smokIng Ieurs muy LrIgger u sLuII wuIkouL uL
Crown cusIno. More LIun 1o dIsgrunLIed workers Iuve LIreuLened Lo
sLrIke uILer reporLs oI nose bIeeds, nuuseu, usLImu, sore LIrouLs, und
IrrILubIe eyes. CusIno sLuII suy smoke IeveIs Iuve become InLoIerubIe In
ureus grunLed exempLIons Irom smokIng buns.. (Hercld,Sun, qLI
OcLober, zooz, p.zq)
A coddIIng oI IrruLIonuI demunds IurLIer reInIorces IrruLIonuI
beIIeI. NoLIIng sIorL oI u compIeLe exLermInuLIon oI LIe perceIved
dunger wIII suIIIce In uppeusIng LIe progressIve deIusIon. urLIermore,
LIIs Is IuIIy Lo be expecLed.
(.; Dther Questioncble Studies
MenLIon musL be mude oI Lwo oLIer sLudIes In purLIcuIur LIuL, In
LIe Iunds oI LIe ucuLe IIxuLIon oI unLIsmokIng, Iuve been used wILI
devusLuLIng consequences (I.e., un ussuuIL on psycIoIogIcuI und socIuI
IeuILI).
OLsuku eL uI. (zoo1) Iound LIuL o mInuLes oI exposure Lo ETS
reduced coronury IIow veIocILy reserve (CVR), u meusure oI coronury
endoLIeIIuI IuncLIon, In IeuILIy nonsmokers. CVR dId noL cIunge In
exposed smokers. IILeen eucI oI smokers und nonsmokers wILI no mujor
coronury dIseuse rIsk IucLors were exumIned. TIe uuLIors concIuded:
PussIve smokIng sIgnIIIcunLIy reduced CVR In IeuILIy nonsmokers. TIIs
IIndIng provIdes dIrecL evIdence LIuL pussIve smokIng muy cuuse
endoLIeIIuI dysIuncLIon oI LIe coronury cIrcuIuLIon In
nonsmokers. (p.qz6)
TIere ure u number oI severe meLIodoIogIcuI weuknesses In LIIs
upproucI. IrsLIy, LIe sLudy Ius no conLroI group. or exumpIe, CVR wus
Preventive Medicine & Health Promotion
meusured pre und posL-ETS exposure usIng nonInvusIve LrunsLIorucIc
DoppIer ecIocurdIogrupIy. DoppIer recordIng InvoIved udmInIsLerIng
udenosIne LrIpIospIuLe by InLruvenous InIusIon Ior Lwo mInuLes. A
conLroI group LIuL undergoes LIe enLIre procedure excepL exposure Lo ETS
sIouId be IncIuded. TIIs wIII dIscounL LIuL LIe procedure undJor muILIpIe
InIusIons oI udenosIne LrIpIospIuLe cun produce CVR cIunges. TIe
muIn Iocus oI LIIs sLudy Is purLIcuIurIy exposed nonsmokers.
ExperImenLuI procedure musL be dIscounLed us u possIbIe conIounder In
producIng CVR cIunges In purLIcuIurIy nonsmokers.
SecondIy, LIe sLudy does noL IncIude uny oLIer experImenLuI
IucLors. L Is cssumed LIuL CVR-sIIILs ure unIque Lo LIe cIemIcuI
properLIes oI ETS. OLIer cIemIcuI subsLunces (e.g., sLreeL-sLrengLI dIeseI
Iumes, room deodorIzer) musL be IncIuded Lo LesL wIeLIer CVR cIunges
ure unIque Lo ETS. urLIer psycIoIogIcuI eIIecLs cun munIIesL In u
muILILude oI wuys In LIe curdIo-respIruLory sysLem. TIe sLudy needs Lo
dIscounL LIuL CVR sIIILs Ior ETS ure noL uLLrIbuLubIe Lo sensory cues
(I.e., vIsuuI, oIIucLory). or exumpIe, benIgn subsLunces wILI pungenL or
uromuLIc quuIILIes cun be LesLed. AnoLIer vurIunL oI u psycIogenIc eIIecL Is
Ieur reucLIons (I.e., nocebo eIIecL). GIven vIsuuI und oIIucLory cues, CVR
cun be InIIuenced by LIe beIIeI LIuL LIese cues sIgnuI dunger. n LIIs cuse
uII sensory cues sIouId be removed (e.g., udmInIsLerIng conLInuous
dosuge by mouLI musk) Lo LesL Ior ubsceboJnocebo eIIecLs. TIereIore, u
sopIIsLIcuLed muILIIucLorIuI desIgn LIuL expIores odorousJnon-odorous,
vIsIbIeJnon-vIsIbIe, poLenLIuIIy noxIousJbenIgn IucLors Is requIred beIore
uny coIerenL proposILIons ubouL ETS und CVR cun be mude.
TIere ure oLIer probIems wILI LIe currenL upproucI. or
exumpIe, resuILs In LIIs sLudy ure gIven us uveruges. s LIe uveruge CVR
Ior smokers, beIore und uILer exposure, LypIcuI oI eucI smoker, I.e., ure
LIere onIy u Iew ouLIIers LIuL drug LIe uveruge down? IkewIse, und more
ImporLunLIy, Ior LIe nonsmoker`s group. I LIe eIIecL Is noL LypIcuI, LIen IL
poInLs Lo LIe sLrong possIbIIILy oI undeLecLed coronury dysIuncLIon In u
smuII subgroup oI nonsmokers. AIso, LIe currenL meLIodoIogy does noL
uddress uny possIbIe deLrImenLuI Iong-Lerm consequences oI ImmedIuLeIy
reduced CVR. L uIso does noL IndIcuLe wIy reduced CVR In LIe sIorL-
Lerm Is consIdered deLrImenLuI: s u nonsmoker wILI reduced CVR oI LIe
mugnILude In quesLIon unubIe Lo speuk, or run, eLc? CVR Is dIsLunLIy
ussocIuLed Lo coronury IeurL dIseuseJmorLuIILy by u Iong serIes oI
ussumpLIons. AL besL, reduced CVR In LIe Iong Lerm mIgIL be u rIsk
IucLor Ior uLIeroscIIerosIs wIIcI, In Lurn, Is u rIsk IucLor Ior CHDJ
morLuIILy. TIe poLenLIuI reIuLIonsIIp beLween ImmedIuLe reducLIons In
CVR und Ionger-Lerm deLrImenLuI rumIIIcuLIons Is noL demonsLruLed und
very mucI obscure. TIe deLrImenLuI nuLure oI ImmedIuLeIy reduced CVR
389
389
Rampant Antismoking Signifies Grave Danger
TIe cover oI LIe Union Neus (ebJMurcI zooz) wus IeudIIned
wILI We won: Smoke Iree buns In LIe gumIng IndusLry wIII Improve
workers` IeuILI. TIe IegIsIuLIon reInIorces IrruLIonuI beIIeI und Is u
coddIIng eIIecL. L uIso provIdes IurLIer InsIgIL InLo LIe snowbuIIIng eIIecL
oI LIe IncILemenL oI IrruLIonuI Ieur InLo muss deIusIon. ConsIsLenL wILI LIe
Ideu oI unIon ucLIvILIes, wIeLIer reusonubIe or unreusonubIe, IosLerIng
worker conIIdence, wIeLIer reusonubIe or unreusonubIe, us poLenLIuIIy
moLIvuLed by vesLed InLeresL, LIe InsIde cover oI LIe sume muguzIne-Issue
decIures LIuL Your unIon Is growIng: we Iuve more und new members
joInIng und IncreusIng our coIIecLIve sLrengLI. (p.z)
A Iew IImILed ureus oI Crown cusIno were grunLed exempLIon
Irom LIe smokIng buns. JusL one monLI IoIIowIng LIe InsLILuLIng oI
smokIng buns (SepLember 1, zooz) LIere wus u LIreuL oI sLrIke ucLIon by
cusIno workers sLIII exposed Lo LIese smokIng ureus. A IocuI mujor
newspuper decIured: PussIve smokIng Ieurs muy LrIgger u sLuII wuIkouL uL
Crown cusIno. More LIun 1o dIsgrunLIed workers Iuve LIreuLened Lo
sLrIke uILer reporLs oI nose bIeeds, nuuseu, usLImu, sore LIrouLs, und
IrrILubIe eyes. CusIno sLuII suy smoke IeveIs Iuve become InLoIerubIe In
ureus grunLed exempLIons Irom smokIng buns.. (Hercld,Sun, qLI
OcLober, zooz, p.zq)
A coddIIng oI IrruLIonuI demunds IurLIer reInIorces IrruLIonuI
beIIeI. NoLIIng sIorL oI u compIeLe exLermInuLIon oI LIe perceIved
dunger wIII suIIIce In uppeusIng LIe progressIve deIusIon. urLIermore,
LIIs Is IuIIy Lo be expecLed.
(.; Dther Questioncble Studies
MenLIon musL be mude oI Lwo oLIer sLudIes In purLIcuIur LIuL, In
LIe Iunds oI LIe ucuLe IIxuLIon oI unLIsmokIng, Iuve been used wILI
devusLuLIng consequences (I.e., un ussuuIL on psycIoIogIcuI und socIuI
IeuILI).
OLsuku eL uI. (zoo1) Iound LIuL o mInuLes oI exposure Lo ETS
reduced coronury IIow veIocILy reserve (CVR), u meusure oI coronury
endoLIeIIuI IuncLIon, In IeuILIy nonsmokers. CVR dId noL cIunge In
exposed smokers. IILeen eucI oI smokers und nonsmokers wILI no mujor
coronury dIseuse rIsk IucLors were exumIned. TIe uuLIors concIuded:
PussIve smokIng sIgnIIIcunLIy reduced CVR In IeuILIy nonsmokers. TIIs
IIndIng provIdes dIrecL evIdence LIuL pussIve smokIng muy cuuse
endoLIeIIuI dysIuncLIon oI LIe coronury cIrcuIuLIon In
nonsmokers. (p.qz6)
TIere ure u number oI severe meLIodoIogIcuI weuknesses In LIIs
upproucI. IrsLIy, LIe sLudy Ius no conLroI group. or exumpIe, CVR wus
Preventive Medicine & Health Promotion
meusured pre und posL-ETS exposure usIng nonInvusIve LrunsLIorucIc
DoppIer ecIocurdIogrupIy. DoppIer recordIng InvoIved udmInIsLerIng
udenosIne LrIpIospIuLe by InLruvenous InIusIon Ior Lwo mInuLes. A
conLroI group LIuL undergoes LIe enLIre procedure excepL exposure Lo ETS
sIouId be IncIuded. TIIs wIII dIscounL LIuL LIe procedure undJor muILIpIe
InIusIons oI udenosIne LrIpIospIuLe cun produce CVR cIunges. TIe
muIn Iocus oI LIIs sLudy Is purLIcuIurIy exposed nonsmokers.
ExperImenLuI procedure musL be dIscounLed us u possIbIe conIounder In
producIng CVR cIunges In purLIcuIurIy nonsmokers.
SecondIy, LIe sLudy does noL IncIude uny oLIer experImenLuI
IucLors. L Is cssumed LIuL CVR-sIIILs ure unIque Lo LIe cIemIcuI
properLIes oI ETS. OLIer cIemIcuI subsLunces (e.g., sLreeL-sLrengLI dIeseI
Iumes, room deodorIzer) musL be IncIuded Lo LesL wIeLIer CVR cIunges
ure unIque Lo ETS. urLIer psycIoIogIcuI eIIecLs cun munIIesL In u
muILILude oI wuys In LIe curdIo-respIruLory sysLem. TIe sLudy needs Lo
dIscounL LIuL CVR sIIILs Ior ETS ure noL uLLrIbuLubIe Lo sensory cues
(I.e., vIsuuI, oIIucLory). or exumpIe, benIgn subsLunces wILI pungenL or
uromuLIc quuIILIes cun be LesLed. AnoLIer vurIunL oI u psycIogenIc eIIecL Is
Ieur reucLIons (I.e., nocebo eIIecL). GIven vIsuuI und oIIucLory cues, CVR
cun be InIIuenced by LIe beIIeI LIuL LIese cues sIgnuI dunger. n LIIs cuse
uII sensory cues sIouId be removed (e.g., udmInIsLerIng conLInuous
dosuge by mouLI musk) Lo LesL Ior ubsceboJnocebo eIIecLs. TIereIore, u
sopIIsLIcuLed muILIIucLorIuI desIgn LIuL expIores odorousJnon-odorous,
vIsIbIeJnon-vIsIbIe, poLenLIuIIy noxIousJbenIgn IucLors Is requIred beIore
uny coIerenL proposILIons ubouL ETS und CVR cun be mude.
TIere ure oLIer probIems wILI LIe currenL upproucI. or
exumpIe, resuILs In LIIs sLudy ure gIven us uveruges. s LIe uveruge CVR
Ior smokers, beIore und uILer exposure, LypIcuI oI eucI smoker, I.e., ure
LIere onIy u Iew ouLIIers LIuL drug LIe uveruge down? IkewIse, und more
ImporLunLIy, Ior LIe nonsmoker`s group. I LIe eIIecL Is noL LypIcuI, LIen IL
poInLs Lo LIe sLrong possIbIIILy oI undeLecLed coronury dysIuncLIon In u
smuII subgroup oI nonsmokers. AIso, LIe currenL meLIodoIogy does noL
uddress uny possIbIe deLrImenLuI Iong-Lerm consequences oI ImmedIuLeIy
reduced CVR. L uIso does noL IndIcuLe wIy reduced CVR In LIe sIorL-
Lerm Is consIdered deLrImenLuI: s u nonsmoker wILI reduced CVR oI LIe
mugnILude In quesLIon unubIe Lo speuk, or run, eLc? CVR Is dIsLunLIy
ussocIuLed Lo coronury IeurL dIseuseJmorLuIILy by u Iong serIes oI
ussumpLIons. AL besL, reduced CVR In LIe Iong Lerm mIgIL be u rIsk
IucLor Ior uLIeroscIIerosIs wIIcI, In Lurn, Is u rIsk IucLor Ior CHDJ
morLuIILy. TIe poLenLIuI reIuLIonsIIp beLween ImmedIuLe reducLIons In
CVR und Ionger-Lerm deLrImenLuI rumIIIcuLIons Is noL demonsLruLed und
very mucI obscure. TIe deLrImenLuI nuLure oI ImmedIuLeIy reduced CVR
390
390
Rampant Antismoking Signifies Grave Danger
Is noL urLIcuIuLed. YeL, LIe reseurcIers ussume u Iong-Lerm dunger und
ImproperIy uppIy IL Lo LIe ImmedIuLe Lerm. TIereIore, LIe concIusIon
reIIecLs ussumpLIons und noL demonsLruLIons.
TIe IuIIure Lo uccounL Ior psycIoIogIcuIIy-medIuLed or nocebo
eIIecLs Is u muLerIuIIsL dIsubIIILyJIundIcup. MedIco-muLerIuIIsLs LypIcuIIy
cunnoL IuLIom LIe Ideu oI u psycIogenIc eIIecL. However, IL Is crILIcuI Lo
LIe Issue uL Iund und musL be uddressed. Beyond LIIs mujor probIem, LIe
reseurcI Is generuIIy dIIeLLunLIsI or umuLeurIsI, uL besL, In InIerence-
mukIng und cerLuInIy does noL wurrunL LIe concIusIon druwn; LIere ure
sLIII Iur Loo muny unexpIored IucLors Lo provIde u coIerenL conLexL Ior
InLerpreLuLIon.
nLeresLIngIy, LIere Ius essenLIuIIy been no crILIcIsm oI LIe
meLIodoIogy In LIe medIcuI IILeruLure. L Is wIen reseurcI sIIILs InLo LIe
use oI meusures oI u IIgIIy LecInIcuI nuLure - uIIen Lo LIe Iuy person -
LIuL LIeIr cupucILy Ior mIsuse Is even greuLer. TIe poLenLIuI Ior ubuse oI
LIIs reseurcI IIndIng Is very IIgI Ior LIe unLIsmokIng Iobby, I.e.,
ImmedIuLe dumuge Lo nonsmokers cuused by ETS. L Is LIereIore noL
surprIsIng LIuL LIe cIIeI unLIsmokIng proLugonIsLs - S. GIunLz und J.
Repuce - pounced on LIIs resuIL, IIndIng no IIuws In LIe meLIodoIogy und
ucknowIedgIng ILs useIuI und LeIIIng conLrIbuLIon In u medIcuI journuI
(GIunLz & PurmIey, zoo1; Repuce, zooz).
TIIs reseurcI Ius been presenLed In LIe medIu us ETS beIng even
more dungerous Ior nonsmokers - wIuLever LIIs meuns. or exumpIe,
In The Gucrdicn IL wus decIured: Jupunese docLors suId LIey Iud
evIdence LIuL LIe coronury cIrcuIuLIon oI IeuILIy non-smokers wus
uIIecLed so budIy by sIorL exposure Lo Iumes LIuL purLs oI LIeIr IeurLs
Iooked no dIIIerenL Lo LIuL oI smokers. (JuIy z, zoo1) UndersLundubIy,
LIere were ImmedIuLe cuIIs by LIe unLIsmokIng Iobby Lo eIImInuLe uII ETS
exposure Ior nonsmokers.
TIe Hercld,Sun (VIcLorIu, AusLruIIu) wenL even IurLIer. L
reporLed u Jupunese sLudy wIIcI sIowed LIuL non-smokers wIo spend
jusL o mInuLes u duy breuLIIng smoke Irom LIe cIgureLLes oI oLIers Iuve
u IIgIer rIsk oI deveIopIng IeurL dIseuse. (SepLember q, zoo1, p.) TIIs
cIuIm Is IruuduIenL. TIe reseurcI In quesLIon Is generuIIy subsLundurd und
does noL even uddress LIe Issue oI Iong-Lerm ussocIuLIons oI ImmedIuLe
CVR-reducLIons wILI dIseuse. TIe newspuper urLIcIe enLIreIy
mIsrepresenLs und cuLusLropIIzes LIe IIndIng.
The Gucrdicn urLIcIe uIso IndIcuLed LIuL:
An edILorIuI uccompunyIng LIe Jupunese sLudy suId LIe
IIndIngs udd Lo LIe evIdence LIuL everyone sIouId be
proLecLed Irom even sIorL Lerm exposure Lo LoxIns In
secondIund smoke.` One oI LIe edILorIuI`s uuLIors,
Preventive Medicine & Health Promotion
SLunLon GIunLz, oI LIe UnIversILy oI CuIIIornIu wIII
Lomorrow be LIe IIrsL wILness uL un enquIry InLo
smokIng In pubIIc pIuces by LIe GreuLer ondon
ussembIy. AcLIon on SmokIng und HeuILI |ASH| suId: 'I
someLIIng us Iuzurdous us cIgureLLe smoke wus IeukIng
Irom u pIpe In u IucLory, InspecLors wouId cIose IL down,
yeL LIere ure m non-smokers In BrILuIn LIuL ure
IrequenLIy or conLInuousIy exposed Lo Lobucco smoke uL
work. TIe depurLmenL oI HeuILI suId u survey LIIs
summer wouId revIew Iow muny resLuurunLs, pubs und
oLIer IIcensed premIses were IoIIowIng voIunLury codes
on provIdIng more non-smokIng ureus.
WIuL Is In IucL u IIgIIy quesLIonubIe IIndIng mukes LIe rounds
Irom unLIsmokIng ucLIvIsLs LIrougI Lo IeuILI depurLmenLs und uccepLed
enLIreIy uL Iuce vuIue. TIIs Is jusL one oI numerous exumpIes wIere IL Is
demonsLruLed LIuL unLIsmokIng ucLIvIsLs, und purLIcuIurIy LIose occupyIng
unIversILy posILIons, ure noL InLeresLed In LIe eIucIduLIon oI IucL; LIese
Iuck IonesLy und scIoIursIIp. TIe onIy InLeresL In IIndIngs Is LIe exLenL Lo
wIIcI munIpuIuLIng LIese cun IurLIer u deIuded cuuse. UnIorLunuLeIy,
LIIs superIIcIuI, seII-servIng InLerpreLuLIon oI severeIy IIuwed reseurcI Ius
been InsLrumenLuI In IurLIer IueIIng LIe unLIsmokIng deIusIon und LIe
InsLILuLIng oI wIdespreud smokIng buns In muny nuLIons.
TIe sLudy by um eL uI. (zooo) Ius uIso been ubused In
promoLIng LIe unLIsmokIng crusude. TIIs sLudy InvesLIguLed respIruLory
sympLoms In poIIce oIIIcers In Hong Kong LIuL were exposed Lo Lobucco
smoke uL work. ExLenL oI exposure wus deLermIned by LIe ImprecIse
quesLIonnuIre meLIod. EIgILy percenL oI boLI men und women reporLed
ETS exposure uL work. SLuLIsLIcuIIy sIgnIIIcunL Lrends (RR`s mosLIy under
z.oo) were Iound Ior respIruLory sympLoms und pIysIcIun consuILuLIons In
LIe IusL 1q duys. TIe predIcLIve sLrengLI oI exposure Lo ETS Ior uny oI
LIese experImenLuI ouLcomes Is essenLIuIIy zero. AddILIonuIIy, LIe sLudy
does noL uccounL Ior ucLuuI exposure Lo ETS nor uny poLenLIuI
conIoundIng IucLors - IncIudIng poLenLIuI nocebo eIIecLs. n oLIer words,
LIe sLudy ussumes wIuL LIe sLudy cunnoL demonsLruLe - LIuL ETS
exposure Is LIe onIy reIevunL pIenomenon In LIe experImenLuI ouLcomes.
TIe meLIodoIogy Is subsLundurd. YeL, LIe uuLIors concIude LIuL |L|IIs
sLudy provIdes IurLIer evIdence oI LIe serIous IeuILI Iuzurds ussocIuLed
wILI ETS exposure uL work. TIe IIndIngs supporL u bun on smokIng In LIe
workpIuce Lo proLecL uII workers In boLI deveIoped und deveIopIng
counLrIes. (p.;6) AguIn, LIe concIusIon reIIecLs LIe ussumpLIons mude
und noL wIuL LIe sLudy Ius demonsLruLed. L Is ImpossIbIe noL Lo concIude
391
391
Rampant Antismoking Signifies Grave Danger
Is noL urLIcuIuLed. YeL, LIe reseurcIers ussume u Iong-Lerm dunger und
ImproperIy uppIy IL Lo LIe ImmedIuLe Lerm. TIereIore, LIe concIusIon
reIIecLs ussumpLIons und noL demonsLruLIons.
TIe IuIIure Lo uccounL Ior psycIoIogIcuIIy-medIuLed or nocebo
eIIecLs Is u muLerIuIIsL dIsubIIILyJIundIcup. MedIco-muLerIuIIsLs LypIcuIIy
cunnoL IuLIom LIe Ideu oI u psycIogenIc eIIecL. However, IL Is crILIcuI Lo
LIe Issue uL Iund und musL be uddressed. Beyond LIIs mujor probIem, LIe
reseurcI Is generuIIy dIIeLLunLIsI or umuLeurIsI, uL besL, In InIerence-
mukIng und cerLuInIy does noL wurrunL LIe concIusIon druwn; LIere ure
sLIII Iur Loo muny unexpIored IucLors Lo provIde u coIerenL conLexL Ior
InLerpreLuLIon.
nLeresLIngIy, LIere Ius essenLIuIIy been no crILIcIsm oI LIe
meLIodoIogy In LIe medIcuI IILeruLure. L Is wIen reseurcI sIIILs InLo LIe
use oI meusures oI u IIgIIy LecInIcuI nuLure - uIIen Lo LIe Iuy person -
LIuL LIeIr cupucILy Ior mIsuse Is even greuLer. TIe poLenLIuI Ior ubuse oI
LIIs reseurcI IIndIng Is very IIgI Ior LIe unLIsmokIng Iobby, I.e.,
ImmedIuLe dumuge Lo nonsmokers cuused by ETS. L Is LIereIore noL
surprIsIng LIuL LIe cIIeI unLIsmokIng proLugonIsLs - S. GIunLz und J.
Repuce - pounced on LIIs resuIL, IIndIng no IIuws In LIe meLIodoIogy und
ucknowIedgIng ILs useIuI und LeIIIng conLrIbuLIon In u medIcuI journuI
(GIunLz & PurmIey, zoo1; Repuce, zooz).
TIIs reseurcI Ius been presenLed In LIe medIu us ETS beIng even
more dungerous Ior nonsmokers - wIuLever LIIs meuns. or exumpIe,
In The Gucrdicn IL wus decIured: Jupunese docLors suId LIey Iud
evIdence LIuL LIe coronury cIrcuIuLIon oI IeuILIy non-smokers wus
uIIecLed so budIy by sIorL exposure Lo Iumes LIuL purLs oI LIeIr IeurLs
Iooked no dIIIerenL Lo LIuL oI smokers. (JuIy z, zoo1) UndersLundubIy,
LIere were ImmedIuLe cuIIs by LIe unLIsmokIng Iobby Lo eIImInuLe uII ETS
exposure Ior nonsmokers.
TIe Hercld,Sun (VIcLorIu, AusLruIIu) wenL even IurLIer. L
reporLed u Jupunese sLudy wIIcI sIowed LIuL non-smokers wIo spend
jusL o mInuLes u duy breuLIIng smoke Irom LIe cIgureLLes oI oLIers Iuve
u IIgIer rIsk oI deveIopIng IeurL dIseuse. (SepLember q, zoo1, p.) TIIs
cIuIm Is IruuduIenL. TIe reseurcI In quesLIon Is generuIIy subsLundurd und
does noL even uddress LIe Issue oI Iong-Lerm ussocIuLIons oI ImmedIuLe
CVR-reducLIons wILI dIseuse. TIe newspuper urLIcIe enLIreIy
mIsrepresenLs und cuLusLropIIzes LIe IIndIng.
The Gucrdicn urLIcIe uIso IndIcuLed LIuL:
An edILorIuI uccompunyIng LIe Jupunese sLudy suId LIe
IIndIngs udd Lo LIe evIdence LIuL everyone sIouId be
proLecLed Irom even sIorL Lerm exposure Lo LoxIns In
secondIund smoke.` One oI LIe edILorIuI`s uuLIors,
Preventive Medicine & Health Promotion
SLunLon GIunLz, oI LIe UnIversILy oI CuIIIornIu wIII
Lomorrow be LIe IIrsL wILness uL un enquIry InLo
smokIng In pubIIc pIuces by LIe GreuLer ondon
ussembIy. AcLIon on SmokIng und HeuILI |ASH| suId: 'I
someLIIng us Iuzurdous us cIgureLLe smoke wus IeukIng
Irom u pIpe In u IucLory, InspecLors wouId cIose IL down,
yeL LIere ure m non-smokers In BrILuIn LIuL ure
IrequenLIy or conLInuousIy exposed Lo Lobucco smoke uL
work. TIe depurLmenL oI HeuILI suId u survey LIIs
summer wouId revIew Iow muny resLuurunLs, pubs und
oLIer IIcensed premIses were IoIIowIng voIunLury codes
on provIdIng more non-smokIng ureus.
WIuL Is In IucL u IIgIIy quesLIonubIe IIndIng mukes LIe rounds
Irom unLIsmokIng ucLIvIsLs LIrougI Lo IeuILI depurLmenLs und uccepLed
enLIreIy uL Iuce vuIue. TIIs Is jusL one oI numerous exumpIes wIere IL Is
demonsLruLed LIuL unLIsmokIng ucLIvIsLs, und purLIcuIurIy LIose occupyIng
unIversILy posILIons, ure noL InLeresLed In LIe eIucIduLIon oI IucL; LIese
Iuck IonesLy und scIoIursIIp. TIe onIy InLeresL In IIndIngs Is LIe exLenL Lo
wIIcI munIpuIuLIng LIese cun IurLIer u deIuded cuuse. UnIorLunuLeIy,
LIIs superIIcIuI, seII-servIng InLerpreLuLIon oI severeIy IIuwed reseurcI Ius
been InsLrumenLuI In IurLIer IueIIng LIe unLIsmokIng deIusIon und LIe
InsLILuLIng oI wIdespreud smokIng buns In muny nuLIons.
TIe sLudy by um eL uI. (zooo) Ius uIso been ubused In
promoLIng LIe unLIsmokIng crusude. TIIs sLudy InvesLIguLed respIruLory
sympLoms In poIIce oIIIcers In Hong Kong LIuL were exposed Lo Lobucco
smoke uL work. ExLenL oI exposure wus deLermIned by LIe ImprecIse
quesLIonnuIre meLIod. EIgILy percenL oI boLI men und women reporLed
ETS exposure uL work. SLuLIsLIcuIIy sIgnIIIcunL Lrends (RR`s mosLIy under
z.oo) were Iound Ior respIruLory sympLoms und pIysIcIun consuILuLIons In
LIe IusL 1q duys. TIe predIcLIve sLrengLI oI exposure Lo ETS Ior uny oI
LIese experImenLuI ouLcomes Is essenLIuIIy zero. AddILIonuIIy, LIe sLudy
does noL uccounL Ior ucLuuI exposure Lo ETS nor uny poLenLIuI
conIoundIng IucLors - IncIudIng poLenLIuI nocebo eIIecLs. n oLIer words,
LIe sLudy ussumes wIuL LIe sLudy cunnoL demonsLruLe - LIuL ETS
exposure Is LIe onIy reIevunL pIenomenon In LIe experImenLuI ouLcomes.
TIe meLIodoIogy Is subsLundurd. YeL, LIe uuLIors concIude LIuL |L|IIs
sLudy provIdes IurLIer evIdence oI LIe serIous IeuILI Iuzurds ussocIuLed
wILI ETS exposure uL work. TIe IIndIngs supporL u bun on smokIng In LIe
workpIuce Lo proLecL uII workers In boLI deveIoped und deveIopIng
counLrIes. (p.;6) AguIn, LIe concIusIon reIIecLs LIe ussumpLIons mude
und noL wIuL LIe sLudy Ius demonsLruLed. L Is ImpossIbIe noL Lo concIude
392
392
Rampant Antismoking Signifies Grave Danger
LIuL LIese reseurcIers, umongsL muny oLIers, ure workIng Lo IIxed,
MMES-cuIL concIusIons.
TIe muny epIdemIoIogIcJmedIcuI sLudIes consIdered Lo duLe
IndIcuLe u puLLern oI deLerIoruLIng sLundurd Irom wIuL wus uIreudy u poor
sLundurd Lo begIn wILI. L does noL concern onIy LIe Issue oI smokIng, e.g.,
dIeLury epIdemIoIogy. CrILIcIsm oI poor sLundurd Ius been gIven Irom
boLI wILIIn und ouLsIde epIdemIoIogy Ior uL IeusL LIe IusL Lwo decudes.
YeL, LIe conducL Ius worsened und cun worsen even IurLIer. AnLIsmokIng
Is LIe mosL ucuLe oI medIco-muLerIuIIsL IIxuLIons. SLudIes now
uuLomuLIcuIIy IncIude smokIngJETS-exposure us experImenLuI IucLors
wILI no coIerenL c priori busIs Ior LIeIr IncIusIon. ReIuLIve rIsk
dIIIerences bureIy ubove 1.oo und u predIcLIve sLrengLI oI essenLIuIIy zero,
produced by subsLundurd meLIodoIogy und InIerence-mukIng, ure now
rouLIneIy cuLusLropIIzed InLo LIe demonsLruLed need Ior sweepIng
smokIng buns. TIe udded Lrugedy, oI monumenLuI proporLIons, Is LIuL LIIs
nonsense domInuLes pubIIc IeuILI on u gIobuI scuIe, I.e., deIusIon oI
pundemIc proporLIons.
L Is LIIs medIco-muLerIuIIsm LIuL demonsLruLes Ignorunce,
IncompeLence und deLerIoruLIng dysIuncLIon (e.g., IIxuLIons, obsessIon
wILI conLroI, deIuded IdeoIogy). As menLIoned eurIIer, IL Is muLerIuIIsm
generuIIy und medIco-muLerIuIIsm specIIIcuIIy LIuL Iuve Iong been
dungerousIy ouL oI conLroI.
(.8 Summcr to Dcte
As Ius been consIdered, ESS represenLs LIe somuLIzuLIon oI
psycIogenIc dIsLurbunces und projecLed onLo exLernuI IucLors. n LIe
projecLIon sense, LIe sume cun be suId Ior IIIesLyIe epIdemIoIogy generuIIy.
Ls muLerIuIIsL und bIuck box busIs cun onl seurcI Ior exLernuI cuuses,
und wIere LIe IIImsIesL oI evIdence, due Lo un IncompeLenL versIon oI
scIenLIIIc enquIry, Is suIIIcIenL Lo InIer cuuse. L Ius uIso been consIdered
LIuL LIIs exLernuIIzIng InvoIves u LrunsIerence IuIIucy uwuy Irom LIe group
oI endogenous sysLems und onLo supposed properLIes und propensILIes oI
exLernuI IucLors. TIIs Is so wIeLIer LIe ucLuuI source oI sympLomsJdIseuse
reIIecLs bIoIogIcuI or psycIogenIc uspecLs oI LIe endogenous sysLem.
n purLIcuIur cIrcumsLunces wIere LIere Is LIe poLenLIuI
InvoIvemenL oI u psycIosomuLIc eIIecL, LIose In IIIesLyIe epIdemIoIogy
cunnoL uccounL Ior LIe possIbIIILy und wIII sLIII pursue unswers In
exLernuIILIes. TIe psycIoIogIcuI equIvuIenL oI LIe sLundurd exLernuIIzIng
LIuL occurs In IIIesLyIe epIdemIoIogy wIen IL uppIIes Lo poLenLIuI
psycIosomuLIc eIIecL Is psycIoIogIcuI projecLIon. TIose In IIIesLyIe
epIdemIoIogy muke LIe sume projecLIon error us LIose suIIerIng ESS. TIe
Preventive Medicine & Health Promotion
medIco-muLerIuIIsL menLuIILy uses ESS suIIerers us u proxy Ior LIeIr own
projecLIon onLo exLernuI IucLors. IIesLyIe epIdemIoIogy Is prucLIced by
persons wIo, IIke unyone eIse, ure prone Lo dIsLorLed percepLIon oI
cIrcumsLunces und Iuck oI compreIensIon oI LIeIr own menLuI sLuLes und
moLIvuLIon. PrucLILIoners cun be In denIuI oI gross IncompeLence und
Ignorunce LIuL ucLs Lo muInLuIn projecLIon oI cuusuI sLuLus onLo
exLernuIILIes. TIIs wIII uppeur us IuugILIness, conceIL (e.g., superIorILy
syndrome). or exumpIe, even wIere noceboJubscebo eIIecLs Iuve been
demonsLruLed, muny prucLILIoners sLIII persIsL wILI LIe exLernuI cuuse
vIewpoInL. Or, even wIere vurIuLIons In bIoIogIcuI IucLors oI endogenous
sysLems Is IndIcuLed us crILIcuI ruLIer LIun generuI cuusuI properLIes oI
exLernuIILIes, prucLILIoners wIII sLIII persIsL wILI exLernuIILIes us cuuse
und remuIn unquesLIonIng oI LIe epIdemIoIogIc Irumework LIuL mukes IL
uppeur so. or exumpIe, reusonubIe quesLIonIngs oI scIenLIIIc procedure
und urgumenLuLIon Iuve gone unIeeded us u muLLer oI course, und over u
very Iong perIod oI LIme.
L musL uIso be poInLed ouL LIuL becuuse oI LIe sIeer burruge oI
unLIsmokIng propugundu LIuL cun IosLer psycIosomuLIc eIIecLs, uII
reseurcI InLo ETS musL now uccounL Ior poLenLIuI nocebo eIIecLs. AguIn,
LIIs Is u dIsgruce In LIuL LIIs new requIremenL Ius been generuLed by LIe
wuywurd conducL oI u supposed scIenLIIIc dIscIpIIne. RuLIer LIun soIvIng
probIems, IL Is creuLIng LIem. urLIermore, und mosL ImporLunLIy, Is LIuL
LIIs IncompeLenL conducL Ius hih poLenLIuI Lo IosLer psycIoIogIcuI und
psycIosocIuI dysIuncLIon.
n keepIng wILI GoLIe eL uI.`s (1qq) observuLIon LIuL Iocus musL
be pIuced buck on LIe ESS suIIerer ruLIer LIun LIe bIumed exLernuIILIes,
Iocus musL be pIuced on LIe scIenLIIIc vIubIIILy oI IIIesLyIe epIdemIoIogy,
LIe menLuIILy oI prucLILIoners LIuL IgnorunLIy proLecL u conLorLed und
dIsLorLed sysLem oI enquIry, und LIe menLuIILy oI uII oI LIose groups
(Iobby) LIuL wouId use ILs dIscoverIes oI exLernuI cuuses In LIe IosLerIng
oI nocebo eIIecLs und ESS conLugIon, ruLIer LIun on exLernuI IucLors.
AILIougI oLIer groups, sucI us LIe medIu und IobbyIsLs,
conLrIbuLe consIderubIy Lo conLugIon, LIe Issue oI ETS provIdes un
exceIIenL exumpIe LIuL IIgIIIgILs uII LIe scIenLIIIc IuIIIngs oI IIIesLyIe
epIdemIoIogy und LIe menLuI dysIuncLIon oI muny oI ILs prucLILIoners; LIe
probIem oI errunL expIunuLIon cIeurIy begIns wILI IIIesLyIe epIdemIoIogy
und prevenLIve medIcIne. TIe probIems oI epIdemIoIogy ure Iur more LIun
sImpIe IncompeLence. uIIIngs Iuve been poInLed ouL over u Iong perIod oI
LIme. TIese crILIcIsms Iuve been compIeLeIy Ignored, I.e., resIsLunL Lo
correcLIon. TIere musL be oLIer psycIoIogIcuI dIsLurbunces LIuL proLecL
LIIs conLorLed upproucI. TIe muInLenunce oI u sIuIIow, muLerIuIIsL
worIdvIew ensures LIuL LIere Is no requIremenL oI LIe eIIorLIuI demunds
393
393
Rampant Antismoking Signifies Grave Danger
LIuL LIese reseurcIers, umongsL muny oLIers, ure workIng Lo IIxed,
MMES-cuIL concIusIons.
TIe muny epIdemIoIogIcJmedIcuI sLudIes consIdered Lo duLe
IndIcuLe u puLLern oI deLerIoruLIng sLundurd Irom wIuL wus uIreudy u poor
sLundurd Lo begIn wILI. L does noL concern onIy LIe Issue oI smokIng, e.g.,
dIeLury epIdemIoIogy. CrILIcIsm oI poor sLundurd Ius been gIven Irom
boLI wILIIn und ouLsIde epIdemIoIogy Ior uL IeusL LIe IusL Lwo decudes.
YeL, LIe conducL Ius worsened und cun worsen even IurLIer. AnLIsmokIng
Is LIe mosL ucuLe oI medIco-muLerIuIIsL IIxuLIons. SLudIes now
uuLomuLIcuIIy IncIude smokIngJETS-exposure us experImenLuI IucLors
wILI no coIerenL c priori busIs Ior LIeIr IncIusIon. ReIuLIve rIsk
dIIIerences bureIy ubove 1.oo und u predIcLIve sLrengLI oI essenLIuIIy zero,
produced by subsLundurd meLIodoIogy und InIerence-mukIng, ure now
rouLIneIy cuLusLropIIzed InLo LIe demonsLruLed need Ior sweepIng
smokIng buns. TIe udded Lrugedy, oI monumenLuI proporLIons, Is LIuL LIIs
nonsense domInuLes pubIIc IeuILI on u gIobuI scuIe, I.e., deIusIon oI
pundemIc proporLIons.
L Is LIIs medIco-muLerIuIIsm LIuL demonsLruLes Ignorunce,
IncompeLence und deLerIoruLIng dysIuncLIon (e.g., IIxuLIons, obsessIon
wILI conLroI, deIuded IdeoIogy). As menLIoned eurIIer, IL Is muLerIuIIsm
generuIIy und medIco-muLerIuIIsm specIIIcuIIy LIuL Iuve Iong been
dungerousIy ouL oI conLroI.
(.8 Summcr to Dcte
As Ius been consIdered, ESS represenLs LIe somuLIzuLIon oI
psycIogenIc dIsLurbunces und projecLed onLo exLernuI IucLors. n LIe
projecLIon sense, LIe sume cun be suId Ior IIIesLyIe epIdemIoIogy generuIIy.
Ls muLerIuIIsL und bIuck box busIs cun onl seurcI Ior exLernuI cuuses,
und wIere LIe IIImsIesL oI evIdence, due Lo un IncompeLenL versIon oI
scIenLIIIc enquIry, Is suIIIcIenL Lo InIer cuuse. L Ius uIso been consIdered
LIuL LIIs exLernuIIzIng InvoIves u LrunsIerence IuIIucy uwuy Irom LIe group
oI endogenous sysLems und onLo supposed properLIes und propensILIes oI
exLernuI IucLors. TIIs Is so wIeLIer LIe ucLuuI source oI sympLomsJdIseuse
reIIecLs bIoIogIcuI or psycIogenIc uspecLs oI LIe endogenous sysLem.
n purLIcuIur cIrcumsLunces wIere LIere Is LIe poLenLIuI
InvoIvemenL oI u psycIosomuLIc eIIecL, LIose In IIIesLyIe epIdemIoIogy
cunnoL uccounL Ior LIe possIbIIILy und wIII sLIII pursue unswers In
exLernuIILIes. TIe psycIoIogIcuI equIvuIenL oI LIe sLundurd exLernuIIzIng
LIuL occurs In IIIesLyIe epIdemIoIogy wIen IL uppIIes Lo poLenLIuI
psycIosomuLIc eIIecL Is psycIoIogIcuI projecLIon. TIose In IIIesLyIe
epIdemIoIogy muke LIe sume projecLIon error us LIose suIIerIng ESS. TIe
Preventive Medicine & Health Promotion
medIco-muLerIuIIsL menLuIILy uses ESS suIIerers us u proxy Ior LIeIr own
projecLIon onLo exLernuI IucLors. IIesLyIe epIdemIoIogy Is prucLIced by
persons wIo, IIke unyone eIse, ure prone Lo dIsLorLed percepLIon oI
cIrcumsLunces und Iuck oI compreIensIon oI LIeIr own menLuI sLuLes und
moLIvuLIon. PrucLILIoners cun be In denIuI oI gross IncompeLence und
Ignorunce LIuL ucLs Lo muInLuIn projecLIon oI cuusuI sLuLus onLo
exLernuIILIes. TIIs wIII uppeur us IuugILIness, conceIL (e.g., superIorILy
syndrome). or exumpIe, even wIere noceboJubscebo eIIecLs Iuve been
demonsLruLed, muny prucLILIoners sLIII persIsL wILI LIe exLernuI cuuse
vIewpoInL. Or, even wIere vurIuLIons In bIoIogIcuI IucLors oI endogenous
sysLems Is IndIcuLed us crILIcuI ruLIer LIun generuI cuusuI properLIes oI
exLernuIILIes, prucLILIoners wIII sLIII persIsL wILI exLernuIILIes us cuuse
und remuIn unquesLIonIng oI LIe epIdemIoIogIc Irumework LIuL mukes IL
uppeur so. or exumpIe, reusonubIe quesLIonIngs oI scIenLIIIc procedure
und urgumenLuLIon Iuve gone unIeeded us u muLLer oI course, und over u
very Iong perIod oI LIme.
L musL uIso be poInLed ouL LIuL becuuse oI LIe sIeer burruge oI
unLIsmokIng propugundu LIuL cun IosLer psycIosomuLIc eIIecLs, uII
reseurcI InLo ETS musL now uccounL Ior poLenLIuI nocebo eIIecLs. AguIn,
LIIs Is u dIsgruce In LIuL LIIs new requIremenL Ius been generuLed by LIe
wuywurd conducL oI u supposed scIenLIIIc dIscIpIIne. RuLIer LIun soIvIng
probIems, IL Is creuLIng LIem. urLIermore, und mosL ImporLunLIy, Is LIuL
LIIs IncompeLenL conducL Ius hih poLenLIuI Lo IosLer psycIoIogIcuI und
psycIosocIuI dysIuncLIon.
n keepIng wILI GoLIe eL uI.`s (1qq) observuLIon LIuL Iocus musL
be pIuced buck on LIe ESS suIIerer ruLIer LIun LIe bIumed exLernuIILIes,
Iocus musL be pIuced on LIe scIenLIIIc vIubIIILy oI IIIesLyIe epIdemIoIogy,
LIe menLuIILy oI prucLILIoners LIuL IgnorunLIy proLecL u conLorLed und
dIsLorLed sysLem oI enquIry, und LIe menLuIILy oI uII oI LIose groups
(Iobby) LIuL wouId use ILs dIscoverIes oI exLernuI cuuses In LIe IosLerIng
oI nocebo eIIecLs und ESS conLugIon, ruLIer LIun on exLernuI IucLors.
AILIougI oLIer groups, sucI us LIe medIu und IobbyIsLs,
conLrIbuLe consIderubIy Lo conLugIon, LIe Issue oI ETS provIdes un
exceIIenL exumpIe LIuL IIgIIIgILs uII LIe scIenLIIIc IuIIIngs oI IIIesLyIe
epIdemIoIogy und LIe menLuI dysIuncLIon oI muny oI ILs prucLILIoners; LIe
probIem oI errunL expIunuLIon cIeurIy begIns wILI IIIesLyIe epIdemIoIogy
und prevenLIve medIcIne. TIe probIems oI epIdemIoIogy ure Iur more LIun
sImpIe IncompeLence. uIIIngs Iuve been poInLed ouL over u Iong perIod oI
LIme. TIese crILIcIsms Iuve been compIeLeIy Ignored, I.e., resIsLunL Lo
correcLIon. TIere musL be oLIer psycIoIogIcuI dIsLurbunces LIuL proLecL
LIIs conLorLed upproucI. TIe muInLenunce oI u sIuIIow, muLerIuIIsL
worIdvIew ensures LIuL LIere Is no requIremenL oI LIe eIIorLIuI demunds
394
394
Rampant Antismoking Signifies Grave Danger
oI InLrospecLIon, crILIcuI seII-evuIuuLIon, und genuIne scIoIursIIp; u non-
experL cun conLInue Lo seem experL. TIe dungers oI ETS Is u muss
deIusIon oI monumenLuI proporLIons, wILI numerous psycIo und socIo-
puLIoIogIcuI consequences, LIuL Ius been enLIreIy munuIucLured und
IueIed by so-cuIIed IeuILI uuLIorILIes und experLs. AII oI LIe numerous
consequences ure IuLrogenIc. L Ius Iong been u muLLer oI greuL urgency
LIuL LIIs conLorLed muLerIuIIsL deIIecLIon uwuy Irom LIe menLuI dImensIon
be brougIL InLo cIeck.
(.p Proressite SS cnd ESS Rcmijicctions
TIe superIorILy syndrome und LIe envIronmenLuI somuLIzuLIon
syndrome ure more eIuboruLe Lerms Ior wIuL Is LypIcuIIy reIerred Lo us
psycIoIogIcuI denIuI und projecLIon. TroubIed, conIIIcLed mInds wIo Iuve
noL IeurnL Lo, or sImpIy reIuse Lo (I.e., denIuI), deuI wILI InLernuI conIIIcL In
u coIerenL munner wIII projecL LIe Inner-conIIIcL ouLwurd. TIIs produces
LIe IIIusIon LIuL LIe source oI LIe Inner conIIIcL Is exLernuI. TIese sLeps
InLeIIecLuuIIy exoneruLe LIe LIInker Irom LIe dIrecL experIence oI guIIL.
However, LIe LroubIIng Is sLIII wILIIn LIe LIInker. Some wIII munIIesL LIIs
In LIe Iorm oI vIcLImIood und sympLoms. OLIers wIII munIIesL LIIs In uIrs
oI superIorILy LIuL wIII be perceIved by LIe LIInker us suInLIy reusonIng
suvIng LIe worId Irom uII sorLs oI dunger - u proLecLor, no Iess.
L wIII be consIdered In LIe IoIIowIng cIupLer LIuL LIe currenL
unLIsmokIng pundemIc Ius ImporLunL dIsLInguIsIIng IeuLures LIuL mukes
IL unIIke oLIer ESS ouLbreuks, wIIcI ure usuuIIy IsoIuLed In nuLure. L Is
dIIIerenL noL onIy In mugnILude, buL LIuL IL Is sympLomuLIc oI gruve IeveIs
oI conLorLIon und dIsLorLIon In medIcIne, ucudemIu, LIe medIu, und socIeLy
generuIIy. RumpunL unLIsmokIng Is u crILIcuI sympLom oI socIeLIes
buckIIng under LIe weIgIL oI moruI, psycIoIogIcuI, und reIuLIonuI IoIIy,
I.e., meLupIysIcuI crIsIs; unLIsmokIng serves u crILIcuIIy specIIIc, uIbeIL
deIuded, purpose uL LIIs LIme.
As Is IuIIy Lo be expecLed, every smokIng bun Is u coddIIng eIIecL
LIuL sImpIy IueIs IrruLIonuI LIougIL, wIIcI In Lurn demunds IurLIer
proLecLIon und buns. L couId be suId LIuL u psycIoIogIcuI dose-response
IuncLIon Is uL work. or exumpIe, eucI LIme IrruLIonuI IeurJsuperIorILy Is
IueIed, IL requIres u Iesser IndIcuLor oI dunger Lo eIIcIL LIe sume or
greuLer sympLoms und IrruLIonuI demunds Ior proLecLIon.
As wus IndIcuLed In BIIIey (1qq), IncoIerenL cIuIms ubouL LIe
dungers oI ETS exposure were beIng mude In LIe 1q8o`s by LIe more
mIIILunL unLIsmokers (e.g., SLunLon GIunLz, Jumes Repuce). TIese wouId
Iuve uLLrucLed IIgIIy suggesLIbIe und somuLIzIng nonsmokers. As sucI, u
smuII quunLILy oI IILIguLIon Ius occurred LIuL uLLempLed Lo resLrIcL or bun
Preventive Medicine & Health Promotion
smokIng. TIIs reIIecLs LIe begInnIngs oI LIe currenL SS und ESS
pundemIc. As soon us ETS wus oIIIcIuIIy decIured us dungerous Ior uII In
1qq, uLLempLs Lo resLrIcL or bun smokIng In u wIde vurIeLy oI
cIrcumsLunces Iuve IILeruIIy expIoded.
TIere Is, by zoo, sLIII un escuIuLIng pundemIc oI SS und ESS. n
LIe Iormer cuse, LIe Iuke superIorILy cun become so domInunL LIuL buns
ure InsLILuLed Ior no uppurenL IeuILI reuson, buL sImpIy us un exercIse In
conLroIIIng LIe InIerIor smoker und sLrengLIenIng LIe munuIucLured
dIvIsIon beLween LIe superIor und LIe InIerIor. n LIe ESS cuse, LIe
IrruLIonuI Ieur cun become so ucuLe LIuL uny exposure, LIe sIIgILesL smeII
oI ETS, now represenLs gruve dunger und cun eIIcIL ImmedIuLe
sympLoms. UndersLundubIy, us LIe pundemIc progresses, requesLs Ior
smokIng buns und InsLILuLed buns reIIecL u progressIveIy more cruzed
menLuIILy. or exumpIe, LIe Iocus Ius sIIILed Irom Indoor Lo cIose
proxImILy Lo generuI ouLdoor buns, und uII LIe wIIIe LIere Ius been
IncreusIng coercIon on smokers Lo quIL smokIng Ior LIe purposes oI
empIoymenL.
OukIey (1qqq) provIdes u number oI exumpIes oI uLLempLs Lo
resLrIcL smokIng In upurLmenL compIexes. n VIrgInIu, 1qqz, nonsmokIng
occupunLs oI one upurLmenL brougIL un ucLIon uguInsL u IundIord Lo
erudIcuLe uny ETS Irom LIeIr nexL door upurLmenL, occupIed by Lwo
smokers. TIe crILIcuI poInLs ure LIuL one oI LIe nonsmokers LesLIIIed LIuL
severuI LImes Ie Iud gugged...wuIkIng InLo my own buLIroom. TIe
oLIer occupunL, un usLImuLIc, LesLIIIed LIuL sIe suIIered burnIng eyes und
breuLIIng probIems. A number oI oLIer currenL und Iormer occupunLs
LesLIIIed LIuL LIey Iud LIe sume probIems. AguIn, LIese ure sLundurd ESS
sympLoms. L cun uIso be noLed LIuL uILIougI LIe unLIsmokIng group
GASP (Group AguInsL SmokIng In PubIIc) oIIered Lo LesLIIy regurdIng LIe
medIcuI dungers oI ETS, LIIs wus noL uIIowed by LIe presIdIng judge (CI.;,
p.z).
n unoLIer cuse In 1qqq, u New Jersey coupIe uLLempLed Lo
resLrIcL LIe smokIng oI u downsLuIrs neIgIbor, u 6o-yeur-oId wIdow. One
oI LIe cIuIms wus LIuL LIe wIdow`s smokIng Iud cuused LIe wIIe Lo Iuve un
ecLopIc pregnuncy (CI.;, p.z).
n u IurLIer cuse, u os AngeIes mun sued boLI IIs downsLuIrs
neIgIbors Lo sLop LIem Irom smokIng und LIe Iomeowner`s ussocIuLIon Lo
Iuve smokIng bunned or resLrIcLed In LIe compIex. HIs cIuIm wus LIuL Ie
becume pIysIcuIIy III und emoLIonuIIy dIsLressed (CI.;, p.q).
n MussucIuseLLs, 1qq6, u cILy councII member uLLempLed Lo
proIIbIL smokIng InsIde resIdenLs` upurLmenLs In LIe cILy`s eIderIy IousIng
compIexes (CI.;, p.q).
A IorIdu IousIng uuLIorILy pussed u no-smokIng poIIcy LIuL
395
395
Rampant Antismoking Signifies Grave Danger
oI InLrospecLIon, crILIcuI seII-evuIuuLIon, und genuIne scIoIursIIp; u non-
experL cun conLInue Lo seem experL. TIe dungers oI ETS Is u muss
deIusIon oI monumenLuI proporLIons, wILI numerous psycIo und socIo-
puLIoIogIcuI consequences, LIuL Ius been enLIreIy munuIucLured und
IueIed by so-cuIIed IeuILI uuLIorILIes und experLs. AII oI LIe numerous
consequences ure IuLrogenIc. L Ius Iong been u muLLer oI greuL urgency
LIuL LIIs conLorLed muLerIuIIsL deIIecLIon uwuy Irom LIe menLuI dImensIon
be brougIL InLo cIeck.
(.p Proressite SS cnd ESS Rcmijicctions
TIe superIorILy syndrome und LIe envIronmenLuI somuLIzuLIon
syndrome ure more eIuboruLe Lerms Ior wIuL Is LypIcuIIy reIerred Lo us
psycIoIogIcuI denIuI und projecLIon. TroubIed, conIIIcLed mInds wIo Iuve
noL IeurnL Lo, or sImpIy reIuse Lo (I.e., denIuI), deuI wILI InLernuI conIIIcL In
u coIerenL munner wIII projecL LIe Inner-conIIIcL ouLwurd. TIIs produces
LIe IIIusIon LIuL LIe source oI LIe Inner conIIIcL Is exLernuI. TIese sLeps
InLeIIecLuuIIy exoneruLe LIe LIInker Irom LIe dIrecL experIence oI guIIL.
However, LIe LroubIIng Is sLIII wILIIn LIe LIInker. Some wIII munIIesL LIIs
In LIe Iorm oI vIcLImIood und sympLoms. OLIers wIII munIIesL LIIs In uIrs
oI superIorILy LIuL wIII be perceIved by LIe LIInker us suInLIy reusonIng
suvIng LIe worId Irom uII sorLs oI dunger - u proLecLor, no Iess.
L wIII be consIdered In LIe IoIIowIng cIupLer LIuL LIe currenL
unLIsmokIng pundemIc Ius ImporLunL dIsLInguIsIIng IeuLures LIuL mukes
IL unIIke oLIer ESS ouLbreuks, wIIcI ure usuuIIy IsoIuLed In nuLure. L Is
dIIIerenL noL onIy In mugnILude, buL LIuL IL Is sympLomuLIc oI gruve IeveIs
oI conLorLIon und dIsLorLIon In medIcIne, ucudemIu, LIe medIu, und socIeLy
generuIIy. RumpunL unLIsmokIng Is u crILIcuI sympLom oI socIeLIes
buckIIng under LIe weIgIL oI moruI, psycIoIogIcuI, und reIuLIonuI IoIIy,
I.e., meLupIysIcuI crIsIs; unLIsmokIng serves u crILIcuIIy specIIIc, uIbeIL
deIuded, purpose uL LIIs LIme.
As Is IuIIy Lo be expecLed, every smokIng bun Is u coddIIng eIIecL
LIuL sImpIy IueIs IrruLIonuI LIougIL, wIIcI In Lurn demunds IurLIer
proLecLIon und buns. L couId be suId LIuL u psycIoIogIcuI dose-response
IuncLIon Is uL work. or exumpIe, eucI LIme IrruLIonuI IeurJsuperIorILy Is
IueIed, IL requIres u Iesser IndIcuLor oI dunger Lo eIIcIL LIe sume or
greuLer sympLoms und IrruLIonuI demunds Ior proLecLIon.
As wus IndIcuLed In BIIIey (1qq), IncoIerenL cIuIms ubouL LIe
dungers oI ETS exposure were beIng mude In LIe 1q8o`s by LIe more
mIIILunL unLIsmokers (e.g., SLunLon GIunLz, Jumes Repuce). TIese wouId
Iuve uLLrucLed IIgIIy suggesLIbIe und somuLIzIng nonsmokers. As sucI, u
smuII quunLILy oI IILIguLIon Ius occurred LIuL uLLempLed Lo resLrIcL or bun
Preventive Medicine & Health Promotion
smokIng. TIIs reIIecLs LIe begInnIngs oI LIe currenL SS und ESS
pundemIc. As soon us ETS wus oIIIcIuIIy decIured us dungerous Ior uII In
1qq, uLLempLs Lo resLrIcL or bun smokIng In u wIde vurIeLy oI
cIrcumsLunces Iuve IILeruIIy expIoded.
TIere Is, by zoo, sLIII un escuIuLIng pundemIc oI SS und ESS. n
LIe Iormer cuse, LIe Iuke superIorILy cun become so domInunL LIuL buns
ure InsLILuLed Ior no uppurenL IeuILI reuson, buL sImpIy us un exercIse In
conLroIIIng LIe InIerIor smoker und sLrengLIenIng LIe munuIucLured
dIvIsIon beLween LIe superIor und LIe InIerIor. n LIe ESS cuse, LIe
IrruLIonuI Ieur cun become so ucuLe LIuL uny exposure, LIe sIIgILesL smeII
oI ETS, now represenLs gruve dunger und cun eIIcIL ImmedIuLe
sympLoms. UndersLundubIy, us LIe pundemIc progresses, requesLs Ior
smokIng buns und InsLILuLed buns reIIecL u progressIveIy more cruzed
menLuIILy. or exumpIe, LIe Iocus Ius sIIILed Irom Indoor Lo cIose
proxImILy Lo generuI ouLdoor buns, und uII LIe wIIIe LIere Ius been
IncreusIng coercIon on smokers Lo quIL smokIng Ior LIe purposes oI
empIoymenL.
OukIey (1qqq) provIdes u number oI exumpIes oI uLLempLs Lo
resLrIcL smokIng In upurLmenL compIexes. n VIrgInIu, 1qqz, nonsmokIng
occupunLs oI one upurLmenL brougIL un ucLIon uguInsL u IundIord Lo
erudIcuLe uny ETS Irom LIeIr nexL door upurLmenL, occupIed by Lwo
smokers. TIe crILIcuI poInLs ure LIuL one oI LIe nonsmokers LesLIIIed LIuL
severuI LImes Ie Iud gugged...wuIkIng InLo my own buLIroom. TIe
oLIer occupunL, un usLImuLIc, LesLIIIed LIuL sIe suIIered burnIng eyes und
breuLIIng probIems. A number oI oLIer currenL und Iormer occupunLs
LesLIIIed LIuL LIey Iud LIe sume probIems. AguIn, LIese ure sLundurd ESS
sympLoms. L cun uIso be noLed LIuL uILIougI LIe unLIsmokIng group
GASP (Group AguInsL SmokIng In PubIIc) oIIered Lo LesLIIy regurdIng LIe
medIcuI dungers oI ETS, LIIs wus noL uIIowed by LIe presIdIng judge (CI.;,
p.z).
n unoLIer cuse In 1qqq, u New Jersey coupIe uLLempLed Lo
resLrIcL LIe smokIng oI u downsLuIrs neIgIbor, u 6o-yeur-oId wIdow. One
oI LIe cIuIms wus LIuL LIe wIdow`s smokIng Iud cuused LIe wIIe Lo Iuve un
ecLopIc pregnuncy (CI.;, p.z).
n u IurLIer cuse, u os AngeIes mun sued boLI IIs downsLuIrs
neIgIbors Lo sLop LIem Irom smokIng und LIe Iomeowner`s ussocIuLIon Lo
Iuve smokIng bunned or resLrIcLed In LIe compIex. HIs cIuIm wus LIuL Ie
becume pIysIcuIIy III und emoLIonuIIy dIsLressed (CI.;, p.q).
n MussucIuseLLs, 1qq6, u cILy councII member uLLempLed Lo
proIIbIL smokIng InsIde resIdenLs` upurLmenLs In LIe cILy`s eIderIy IousIng
compIexes (CI.;, p.q).
A IorIdu IousIng uuLIorILy pussed u no-smokIng poIIcy LIuL
396
396
Rampant Antismoking Signifies Grave Danger
requIred uII new pubIIc IousIng LenunLs Lo ugree noL Lo smoke In LIeIr own
Iomes (CI.;, p.q).
n ULuI, 1qq;, LIe sLuLe SenuLe PresIdenL usked IegIsIuLors Lo
druIL Iuws LIuL wouId ussIsL nonsmokers wIose upurLmenLs und
condomInIums ure Invuded by Lobucco smoke Irom neurby dweIIIngs
(CI.;, p.q).
TIe ubove reIIecLs onIy u very smuII number oI LIIs kInd oI
IILIguLIon Lo duLe. To reILeruLe, reporLed sympLoms ure LypIcuI oI ESS.
Some IILIguLIon Ius been successIuI, some noL. ILIguLIon Ius been more
successIuI us LIe 1qqo`s Iuve progressed. UnIorLunuLeIy, wILI eucI
successIuI IILIguLIon, SS und ESS ure reInIorced, und, consequenLIy, LIe
Iuke superIorILy und IIxuLIon on dunger become more ucuLe. TIe
InIIuence or roIe oI unLIsmokIng groups In IueIIng SS und ESS, wIIcI Is u
consLunL LIeme, musL uIso be IIgIIIgILed. or exumpIe, AcLIon on
SmokIng und HeuILI (ASH), one oI LIe more promInenL, mIIILunL, medIu-
ucLIve, unLIsmokIng groups, Ius deveIoped guIdeIInes on Iow Lo coerce
condomInIum ussocIuLIons und upurLmenL buIIdIngs Lo bun smokIng
compIeLeIy, IncIudIng In IndIvIduuI unILs. ASH recommends LIese sLeps:
u) ExumIne your Ieuse or condomInIum ugreemenL; b) ObLuIn medIcuI
documenLuLIon II possIbIe; c) Seek ouL oLIer nonsmokers Ior supporL; d)
Seek IeIp Irom IocuI unLI-smokIng orgunIzuLIons; e) ConsIder und propose
dIIIerenL remedIes; I) ConsIder udvIsIng munugemenL oI poLenLIuI IIubIIILy;
g) I uII eIse IuIIs, consIder IeguI ucLIon; I) Know, und LeII oLIers, ubouL LIe
IeuILI dungers. (www.seLInc.comJusIJpupersJI11o.ILmI) AguIn, LIIs
spreudIng LIe word Is conLugIon oI deIuded beIIeI.
TIe pundemIc IIrsL moved Irom concern ubouL u tin Increuse In
reIuLIve rIsk oI Iung cuncer ussocIuLed wILI lijelon exposure Lo ETS by u
nonsmokIng spouse oI u smokIng Iusbund, Lo immedicte sympLoms Lo
ETS exposure In very cIose proxImILy (e.g., workpIuce). L LIen moved Lo
ImmedIuLe sympLoms Lo ETS exposure In noL so cIose proxImILy (e.g.,
vurIubIe dIsLunces In upurLmenL buIIdIngs). L Ius now moved ouLdoors,
wIeLIer LIere ure uny ussocIuLed sympLoms, or poLenLIuI Ior sympLoms,
or noL.
WIIIIums (1qqq) reporLs LIuL smokIng Ius been bunned enLIreIy
on LIe CurnIvuI CruIse Ine sIIp PurudIse. ObvIousIy, LIere ure noL even
quesLIonubIe Indoor IeuILI Issues wILI smokIng ouLdoors (e.g., decks).
However, sInce LIe bun wus InsLILuLed, 1q pussengers und one empIoyee
Iuve been puL oII uL LIe neuresL porL. One oI LIe pussengers wus puL oII
LIe sIIp uILer LIe sLewurd sImpIy Iound u puck oI cIgureLLes. AccordIng Lo
CurnIvuI, sIe wus guIILy oI possessIon. L Is cIeur LIuL smokIng IoIds u
IIgIIy promInenL posILIon In LIe mInds oI munugemenL und pussengers.
WIuLever LIIs menLuIILy Ius mude oI smokIng, LogeLIer wILI LIe
Preventive Medicine & Health Promotion
druconIun remedIes Ior deIIunce oI buns, IL Ius no busIs In IucL or
sensIbIIILy - LIe menLuIILy Is deIusIonuI, I.e., SS. TIe menLuIILy Is eIILIsL
und bIgoLed. n LIe currenL cIImuLe oI uLLempLIng Lo munuIucLure smokIng
us LIe domuIn oI LIe uncuILured, uneducuLed Iower-cIuss, LIen LoLuI
smokIng buns wIII ensure LIuL LIe superIorIsLs wIII noL be conLumInuLed
by LIe ETS or LIe compuny oI LIe Iower-cIuss rIII-ruII.
USA Todc (June 1, 1qq8) reporLs LIuL smokIng buns were soon
Lo Luke eIIecL Ior zq pIuygrounds und recreuLIonuI cenLers under LIe
jurIsdIcLIon oI LIe Sun runcIsco purks commIssIon. TIIs Is consIsLenL
wILI u growIng Lrend Lowurd buns on ouLdoor smokIng despILe uny cIeur
pubIIc IeuILI rIsk. TIe urLIcIe uIso IndIcuLes LIuL In DuvIs, CuIIIornIu,
smokIng Is bunned In buIIdIng enLrunces, cIIIdren`s pIuy ureus und pubIIc
gurdens; In SIuron, MussucIuseLLs, und CurmeI, New York, smokIng Is
bunned on beucIes; In Mesu, ArIzonu, smokIng Is bunned In uImosL uny
ouLdoor ureu open Lo LIe pubIIc. TIe Neu Yorl TImes reporLs LIuL
smokIng Ius been bunned In uII pubIIc purks In BeIIuIre, Texus.
ArIzonu Ius uIso InsLILuLed u sLuLe Iuw LIuL proIIbILs LIe use or
possessIon oI Lobucco producLs by uny uduIL on uII scIooI cumpuses.
PurenLs cun be urresLed Ior IIgILIng up ouLdoors und subjecL Lo u $1oo IIne
Ior curryIng Lobucco producLs In LIeIr purse, pockeL or even In LIeIr
cur. (see WIIIIums, 1qqq)
n KeruIu und Gou In ndIu, smokIng Is bunned In pubIIc spuces
(e.g., beucIes), noncompIIunce uLLrucLIng IInes (cILed In CIupmun, zooo).
AL un ndIun cIemIcuI compuny, u bonus oI up Lo $zo u monLI Is puId Lo
workers` wIves Lo sLop LIeIr Iusbunds` smokIng und drInkIng (VIcLorIun
Hercld,Sun, AugusL z6, zoo1).
n RoIIIng HIIIs, CuIIIornIu, un ordInunce buns smokIng In
Iomeowners` buckyurds. n 1qq6, LIe vIIIuge councII oI rIendsIIp
HeIgILs, MuryIund, consIdered IegIsIuLIon LIuL wouId Iuve bunned
smokIng compIeLeIy In pubIIc; unyone smokIng, usIng smokeIess Lobucco
or dIscurdIng Lobucco producLs unywIere In rIendsIIp HeIgILs wouId be
subjecL Lo u $1oo IIne. TIe muyor, Dr. A. MuIIer, un InLernIsL, suggesLed
LIuL LIe bun wouId IeIp Lo creuLe u smoke-Iree generuLIon. He wus
quoLed In The Wcshinton Times us suyIng EvenLuuIIy, LIey |smokers|
ure goIng Lo dIe ouL. LIInk LIey sIouId smoke us mucI us LIey IIke - LIuL
wIII cuL down LIeIr membersIIp quIckIy. (see OukIey, 1qqq, CI.;, p.)
TIe docLor`s desIre Ior u superIor smoke-Iree generuLIon und uLLer
conLempL Ior smokers Is obvIous. TIuL LIIs menLuIILy Is In IeudersIIp, uL
uny IeveI, und uLLempLIng Lo IosLer purLIcuIur bIgoLed IeunIngs, Is
dIsLurbIng. L Is uIso IIgIIy remInIscenL oI NuzI poIIcy und deIuded
IdeoIogy. OnIy more dIsLurbIng Is II LIe muyor`s quesLIonubIe percepLIon
Is IIgIIy represenLuLIve oI LIe communILy Ie supposedIy serves.
397
397
Rampant Antismoking Signifies Grave Danger
requIred uII new pubIIc IousIng LenunLs Lo ugree noL Lo smoke In LIeIr own
Iomes (CI.;, p.q).
n ULuI, 1qq;, LIe sLuLe SenuLe PresIdenL usked IegIsIuLors Lo
druIL Iuws LIuL wouId ussIsL nonsmokers wIose upurLmenLs und
condomInIums ure Invuded by Lobucco smoke Irom neurby dweIIIngs
(CI.;, p.q).
TIe ubove reIIecLs onIy u very smuII number oI LIIs kInd oI
IILIguLIon Lo duLe. To reILeruLe, reporLed sympLoms ure LypIcuI oI ESS.
Some IILIguLIon Ius been successIuI, some noL. ILIguLIon Ius been more
successIuI us LIe 1qqo`s Iuve progressed. UnIorLunuLeIy, wILI eucI
successIuI IILIguLIon, SS und ESS ure reInIorced, und, consequenLIy, LIe
Iuke superIorILy und IIxuLIon on dunger become more ucuLe. TIe
InIIuence or roIe oI unLIsmokIng groups In IueIIng SS und ESS, wIIcI Is u
consLunL LIeme, musL uIso be IIgIIIgILed. or exumpIe, AcLIon on
SmokIng und HeuILI (ASH), one oI LIe more promInenL, mIIILunL, medIu-
ucLIve, unLIsmokIng groups, Ius deveIoped guIdeIInes on Iow Lo coerce
condomInIum ussocIuLIons und upurLmenL buIIdIngs Lo bun smokIng
compIeLeIy, IncIudIng In IndIvIduuI unILs. ASH recommends LIese sLeps:
u) ExumIne your Ieuse or condomInIum ugreemenL; b) ObLuIn medIcuI
documenLuLIon II possIbIe; c) Seek ouL oLIer nonsmokers Ior supporL; d)
Seek IeIp Irom IocuI unLI-smokIng orgunIzuLIons; e) ConsIder und propose
dIIIerenL remedIes; I) ConsIder udvIsIng munugemenL oI poLenLIuI IIubIIILy;
g) I uII eIse IuIIs, consIder IeguI ucLIon; I) Know, und LeII oLIers, ubouL LIe
IeuILI dungers. (www.seLInc.comJusIJpupersJI11o.ILmI) AguIn, LIIs
spreudIng LIe word Is conLugIon oI deIuded beIIeI.
TIe pundemIc IIrsL moved Irom concern ubouL u tin Increuse In
reIuLIve rIsk oI Iung cuncer ussocIuLed wILI lijelon exposure Lo ETS by u
nonsmokIng spouse oI u smokIng Iusbund, Lo immedicte sympLoms Lo
ETS exposure In very cIose proxImILy (e.g., workpIuce). L LIen moved Lo
ImmedIuLe sympLoms Lo ETS exposure In noL so cIose proxImILy (e.g.,
vurIubIe dIsLunces In upurLmenL buIIdIngs). L Ius now moved ouLdoors,
wIeLIer LIere ure uny ussocIuLed sympLoms, or poLenLIuI Ior sympLoms,
or noL.
WIIIIums (1qqq) reporLs LIuL smokIng Ius been bunned enLIreIy
on LIe CurnIvuI CruIse Ine sIIp PurudIse. ObvIousIy, LIere ure noL even
quesLIonubIe Indoor IeuILI Issues wILI smokIng ouLdoors (e.g., decks).
However, sInce LIe bun wus InsLILuLed, 1q pussengers und one empIoyee
Iuve been puL oII uL LIe neuresL porL. One oI LIe pussengers wus puL oII
LIe sIIp uILer LIe sLewurd sImpIy Iound u puck oI cIgureLLes. AccordIng Lo
CurnIvuI, sIe wus guIILy oI possessIon. L Is cIeur LIuL smokIng IoIds u
IIgIIy promInenL posILIon In LIe mInds oI munugemenL und pussengers.
WIuLever LIIs menLuIILy Ius mude oI smokIng, LogeLIer wILI LIe
Preventive Medicine & Health Promotion
druconIun remedIes Ior deIIunce oI buns, IL Ius no busIs In IucL or
sensIbIIILy - LIe menLuIILy Is deIusIonuI, I.e., SS. TIe menLuIILy Is eIILIsL
und bIgoLed. n LIe currenL cIImuLe oI uLLempLIng Lo munuIucLure smokIng
us LIe domuIn oI LIe uncuILured, uneducuLed Iower-cIuss, LIen LoLuI
smokIng buns wIII ensure LIuL LIe superIorIsLs wIII noL be conLumInuLed
by LIe ETS or LIe compuny oI LIe Iower-cIuss rIII-ruII.
USA Todc (June 1, 1qq8) reporLs LIuL smokIng buns were soon
Lo Luke eIIecL Ior zq pIuygrounds und recreuLIonuI cenLers under LIe
jurIsdIcLIon oI LIe Sun runcIsco purks commIssIon. TIIs Is consIsLenL
wILI u growIng Lrend Lowurd buns on ouLdoor smokIng despILe uny cIeur
pubIIc IeuILI rIsk. TIe urLIcIe uIso IndIcuLes LIuL In DuvIs, CuIIIornIu,
smokIng Is bunned In buIIdIng enLrunces, cIIIdren`s pIuy ureus und pubIIc
gurdens; In SIuron, MussucIuseLLs, und CurmeI, New York, smokIng Is
bunned on beucIes; In Mesu, ArIzonu, smokIng Is bunned In uImosL uny
ouLdoor ureu open Lo LIe pubIIc. TIe Neu Yorl TImes reporLs LIuL
smokIng Ius been bunned In uII pubIIc purks In BeIIuIre, Texus.
ArIzonu Ius uIso InsLILuLed u sLuLe Iuw LIuL proIIbILs LIe use or
possessIon oI Lobucco producLs by uny uduIL on uII scIooI cumpuses.
PurenLs cun be urresLed Ior IIgILIng up ouLdoors und subjecL Lo u $1oo IIne
Ior curryIng Lobucco producLs In LIeIr purse, pockeL or even In LIeIr
cur. (see WIIIIums, 1qqq)
n KeruIu und Gou In ndIu, smokIng Is bunned In pubIIc spuces
(e.g., beucIes), noncompIIunce uLLrucLIng IInes (cILed In CIupmun, zooo).
AL un ndIun cIemIcuI compuny, u bonus oI up Lo $zo u monLI Is puId Lo
workers` wIves Lo sLop LIeIr Iusbunds` smokIng und drInkIng (VIcLorIun
Hercld,Sun, AugusL z6, zoo1).
n RoIIIng HIIIs, CuIIIornIu, un ordInunce buns smokIng In
Iomeowners` buckyurds. n 1qq6, LIe vIIIuge councII oI rIendsIIp
HeIgILs, MuryIund, consIdered IegIsIuLIon LIuL wouId Iuve bunned
smokIng compIeLeIy In pubIIc; unyone smokIng, usIng smokeIess Lobucco
or dIscurdIng Lobucco producLs unywIere In rIendsIIp HeIgILs wouId be
subjecL Lo u $1oo IIne. TIe muyor, Dr. A. MuIIer, un InLernIsL, suggesLed
LIuL LIe bun wouId IeIp Lo creuLe u smoke-Iree generuLIon. He wus
quoLed In The Wcshinton Times us suyIng EvenLuuIIy, LIey |smokers|
ure goIng Lo dIe ouL. LIInk LIey sIouId smoke us mucI us LIey IIke - LIuL
wIII cuL down LIeIr membersIIp quIckIy. (see OukIey, 1qqq, CI.;, p.)
TIe docLor`s desIre Ior u superIor smoke-Iree generuLIon und uLLer
conLempL Ior smokers Is obvIous. TIuL LIIs menLuIILy Is In IeudersIIp, uL
uny IeveI, und uLLempLIng Lo IosLer purLIcuIur bIgoLed IeunIngs, Is
dIsLurbIng. L Is uIso IIgIIy remInIscenL oI NuzI poIIcy und deIuded
IdeoIogy. OnIy more dIsLurbIng Is II LIe muyor`s quesLIonubIe percepLIon
Is IIgIIy represenLuLIve oI LIe communILy Ie supposedIy serves.
398
398
Rampant Antismoking Signifies Grave Danger
NoLwILIsLundIng, LIe ordInunce wus rejecLed by LIe overseeIng
MonLgomery CounLy CouncII.
UnIorLunuLeIy, MonLgomery CounLy CouncII mude unoLIer
excursIon InLo Lobucco conLroI In zoo1:
A councII Ius dILcIed pIuns Lo IIne peopIe wIo smoke uL
Iome. PeopIe In MonLgomery CounLy, neur
WusIIngLon, wouId Iuve Iuced u $1oo IIne II LIeIr
cIgureLLe smoke wuILed InLo u neIgIbor`s Iome.
We Iuve become LIe IuugIIng sLock oI LIe worId, u
councII member suId.
TIe Moscou Times Iud run u coIumn on LIe Issue und
one resIdenL Iud compured LIe councII wILI
AIgIunIsLun`s TuIIbun....
One councIIIor suId: TIIs does noL meun LIuL you
cunnoL smoke In your Iouse. WIuL IL does suy Is LIuL
your smoke cunnoL cross properLy IInes. (VIcLorIun
Hercld,Sun, November o, zoo1)
I Lobucco smoke musL noL cross properLy IInes, LIen IL musL be
so Ior BBQ smoke or Iome open-IIre smoke. L Is ussumed LIuL sucI
resLrIcLIons ure due Lo dunger. On LIe sume precedenL un usLImuLIc or
uIIergy-suIIerer sIouId be ubIe Lo demund IIoru-Iree yurds Lo uvoId poIIen
drIIL.
AnLIsmokers ure now seekIng conLroI oI enLIre upurLmenL
compIexes: AccordIng Lo LIe Neu Yorl Times, reuI esLuLe IIsLory Ius jusL
been mude In LIe US uILer u co-op bourd voLed Lo bun smokers Irom
buyIng InLo u qz-unIL MunIuLLun upurLmenL buIIdIng. CurrenL owners
wIII sLIII be uIIowed Lo smoke In LIeIr own Iomes, buL IuLure buyers wIII be
evIcLed und Iorced Lo seII LIeIr Iomes II unyone Is cuugIL smokIng InsIde
LIem. (Hercld,Sun, JJoz)
A posLIng uL www.Iorces.org IndIcuLes LIuL LIe superIorILy
syndrome Ius uIso InLensIIIed: AILer IIgILIng u cIgureLLe (zo IeeL Irom LIe
neuresL specLuLor) uL u ILLIe eugue gume, u os AngeIes IuLIer Ieurned
LIuL LIe ruIes oI LIe gume Iud cIunged. WIIIe uuLIorILIes deLuIned IIm
und LeIepIoned poIIce (wIo reIused Lo send u cur) IIs son wus beuLen up
by LIe resL oI LIe Iome Leum...HIs son wus permunenLIy kIcked ouL oI
ILLIe eugue..HIs son wus reguIurIy senL Iome Irom scIooI In LIe mIddIe
oI LIe duy on LIe grounds LIuL Ie 'smeIIed oI secondIund smoke.` AILer
LIuL, IL goL worse. TIe scIooI decIded LIuL IIs IuLIer`s cIgureLLes were
ImperIIIng LIe boy`s IeuILI und senL u socIuI worker Lo LIe Iouse. L wus
onIy, LIe IuLIer cIuIms, becuuse Ie Iuppened Lo Iuve u sIIck super-
venLIIuLor In IIs den, LIuL LIey IInuIIy IeIL IIm uIone. He wonders II
Preventive Medicine & Health Promotion
oLIerwIse, LIey mIgIL Iuve (IncredIbIy) Luken IIs son uwuy. (TIe IuLIer
now pIuns Lo sue). (L.A. Times, June 11, 1qq6; InLervIew - AC tcll
rcdio, Stete Mclzber Shou)
Puyne (1qq8) reporLed on un uIrIIne-pIIoL IoIdIng IIs pussengers
IosLuge unLII LIe pussenger responsIbIe Ior smokIng In LIe IuvuLory
conIessed:
A BrILIsI pIIoL Ius been urresLed by LuIIun poIIce Ior
IoIdIng IIs pussengers IosLuge uILer Ie reIused Lo IeL
LIem Ieuve IIs uIrcruIL unLII someone udmILLed smokIng
In LIe IuvuLory.
TIe cupLuIn oI LIe Iow-budgeL Go IIIgIL Lo MIIun wus
LoId LIuL u sLewurd Iud dIscovered LIuL u smoke
deLecLor Iud been bIocked, buL dId noL know wIo LIe
cuIprIL wus.
On IundIng uL MuIpensu uIrporL, CupLuIn BrIun BIIss
LoId pussengers on IIgIL 1z; Irom SLunsLed LIuL no one
wus IeuvIng IIs uIrcruIL unLII LIe guIILy person Iud
conIessed. SmokIng Is bunned on LIe uIrIIne, LIe new
Iow-cosL subsIdIury oI BrILIsI AIrwuys buL no one on LIe
IIIgIL - wIIcI IncIuded u rowdy group oI LuIIun
sLudenLs - owned up.
AILer qo mInuLes, beIore CupLuIn BIIss couId Luke LIe
muLLer IurLIer, LIe pIune wus bourded by LuIIun poIIce
und oIIIcIuIs und Ie wus urresLed Ior uIIegedIy LukIng IIs
pussengers IosLuge..
LuIIun poIIce Iuve mounLed un InvesLIguLIon InLo CupL
BIIss`s ucLIon.
n unoLIer IncIdenL, u nonsmoler wus unceremonIousIy drugged
ouL oI un uIrpIune LoIIeL-cubIcIe, wILI IIs punLs sLIII uround IIs unkIes, by
LIree muIe IIIgIL uLLendunLs. TIe pIune uuLIorILIes were convInced LIuL
LIe mun wus smokIng In LIe LoIIeL. (The Lcst Cicrette, 1qqq).
AII LIe exumpIes ubove IndIcuLe un SS und ESS pcndemic. WILI
eucI pIucuLIon oI LIe deIusIon by IegIsIuLors, LIe deIusIon deepens: IL
requIres Iess und Iess exposure, or perceIved exposure, Lo eIIcIL LIe Iyper-
reucLIvILy LypIcuIIy uccorded Lo sIgnuIs oI gruve dunger. n LIe exumpIe
beIow, IL Is demonsLruLed LIuL ETS does noL even need Lo be presenL:
persons cun sIIIL InLo un ucuLe dysIuncLIonuI epIsode und do noL even
noLIce LIuL LIere Is no ETS presenL.
PuL MIcIueIs, u journuIIsL Ior LIe CuIIIornIu Neuport Neus,
reporLed on un InIormuI experImenL Ie conducLed:
AnLI-cIgureLLe smokIng Ius reucIed u IunuLIcIsm
399
399
Rampant Antismoking Signifies Grave Danger
NoLwILIsLundIng, LIe ordInunce wus rejecLed by LIe overseeIng
MonLgomery CounLy CouncII.
UnIorLunuLeIy, MonLgomery CounLy CouncII mude unoLIer
excursIon InLo Lobucco conLroI In zoo1:
A councII Ius dILcIed pIuns Lo IIne peopIe wIo smoke uL
Iome. PeopIe In MonLgomery CounLy, neur
WusIIngLon, wouId Iuve Iuced u $1oo IIne II LIeIr
cIgureLLe smoke wuILed InLo u neIgIbor`s Iome.
We Iuve become LIe IuugIIng sLock oI LIe worId, u
councII member suId.
TIe Moscou Times Iud run u coIumn on LIe Issue und
one resIdenL Iud compured LIe councII wILI
AIgIunIsLun`s TuIIbun....
One councIIIor suId: TIIs does noL meun LIuL you
cunnoL smoke In your Iouse. WIuL IL does suy Is LIuL
your smoke cunnoL cross properLy IInes. (VIcLorIun
Hercld,Sun, November o, zoo1)
I Lobucco smoke musL noL cross properLy IInes, LIen IL musL be
so Ior BBQ smoke or Iome open-IIre smoke. L Is ussumed LIuL sucI
resLrIcLIons ure due Lo dunger. On LIe sume precedenL un usLImuLIc or
uIIergy-suIIerer sIouId be ubIe Lo demund IIoru-Iree yurds Lo uvoId poIIen
drIIL.
AnLIsmokers ure now seekIng conLroI oI enLIre upurLmenL
compIexes: AccordIng Lo LIe Neu Yorl Times, reuI esLuLe IIsLory Ius jusL
been mude In LIe US uILer u co-op bourd voLed Lo bun smokers Irom
buyIng InLo u qz-unIL MunIuLLun upurLmenL buIIdIng. CurrenL owners
wIII sLIII be uIIowed Lo smoke In LIeIr own Iomes, buL IuLure buyers wIII be
evIcLed und Iorced Lo seII LIeIr Iomes II unyone Is cuugIL smokIng InsIde
LIem. (Hercld,Sun, JJoz)
A posLIng uL www.Iorces.org IndIcuLes LIuL LIe superIorILy
syndrome Ius uIso InLensIIIed: AILer IIgILIng u cIgureLLe (zo IeeL Irom LIe
neuresL specLuLor) uL u ILLIe eugue gume, u os AngeIes IuLIer Ieurned
LIuL LIe ruIes oI LIe gume Iud cIunged. WIIIe uuLIorILIes deLuIned IIm
und LeIepIoned poIIce (wIo reIused Lo send u cur) IIs son wus beuLen up
by LIe resL oI LIe Iome Leum...HIs son wus permunenLIy kIcked ouL oI
ILLIe eugue..HIs son wus reguIurIy senL Iome Irom scIooI In LIe mIddIe
oI LIe duy on LIe grounds LIuL Ie 'smeIIed oI secondIund smoke.` AILer
LIuL, IL goL worse. TIe scIooI decIded LIuL IIs IuLIer`s cIgureLLes were
ImperIIIng LIe boy`s IeuILI und senL u socIuI worker Lo LIe Iouse. L wus
onIy, LIe IuLIer cIuIms, becuuse Ie Iuppened Lo Iuve u sIIck super-
venLIIuLor In IIs den, LIuL LIey IInuIIy IeIL IIm uIone. He wonders II
Preventive Medicine & Health Promotion
oLIerwIse, LIey mIgIL Iuve (IncredIbIy) Luken IIs son uwuy. (TIe IuLIer
now pIuns Lo sue). (L.A. Times, June 11, 1qq6; InLervIew - AC tcll
rcdio, Stete Mclzber Shou)
Puyne (1qq8) reporLed on un uIrIIne-pIIoL IoIdIng IIs pussengers
IosLuge unLII LIe pussenger responsIbIe Ior smokIng In LIe IuvuLory
conIessed:
A BrILIsI pIIoL Ius been urresLed by LuIIun poIIce Ior
IoIdIng IIs pussengers IosLuge uILer Ie reIused Lo IeL
LIem Ieuve IIs uIrcruIL unLII someone udmILLed smokIng
In LIe IuvuLory.
TIe cupLuIn oI LIe Iow-budgeL Go IIIgIL Lo MIIun wus
LoId LIuL u sLewurd Iud dIscovered LIuL u smoke
deLecLor Iud been bIocked, buL dId noL know wIo LIe
cuIprIL wus.
On IundIng uL MuIpensu uIrporL, CupLuIn BrIun BIIss
LoId pussengers on IIgIL 1z; Irom SLunsLed LIuL no one
wus IeuvIng IIs uIrcruIL unLII LIe guIILy person Iud
conIessed. SmokIng Is bunned on LIe uIrIIne, LIe new
Iow-cosL subsIdIury oI BrILIsI AIrwuys buL no one on LIe
IIIgIL - wIIcI IncIuded u rowdy group oI LuIIun
sLudenLs - owned up.
AILer qo mInuLes, beIore CupLuIn BIIss couId Luke LIe
muLLer IurLIer, LIe pIune wus bourded by LuIIun poIIce
und oIIIcIuIs und Ie wus urresLed Ior uIIegedIy LukIng IIs
pussengers IosLuge..
LuIIun poIIce Iuve mounLed un InvesLIguLIon InLo CupL
BIIss`s ucLIon.
n unoLIer IncIdenL, u nonsmoler wus unceremonIousIy drugged
ouL oI un uIrpIune LoIIeL-cubIcIe, wILI IIs punLs sLIII uround IIs unkIes, by
LIree muIe IIIgIL uLLendunLs. TIe pIune uuLIorILIes were convInced LIuL
LIe mun wus smokIng In LIe LoIIeL. (The Lcst Cicrette, 1qqq).
AII LIe exumpIes ubove IndIcuLe un SS und ESS pcndemic. WILI
eucI pIucuLIon oI LIe deIusIon by IegIsIuLors, LIe deIusIon deepens: IL
requIres Iess und Iess exposure, or perceIved exposure, Lo eIIcIL LIe Iyper-
reucLIvILy LypIcuIIy uccorded Lo sIgnuIs oI gruve dunger. n LIe exumpIe
beIow, IL Is demonsLruLed LIuL ETS does noL even need Lo be presenL:
persons cun sIIIL InLo un ucuLe dysIuncLIonuI epIsode und do noL even
noLIce LIuL LIere Is no ETS presenL.
PuL MIcIueIs, u journuIIsL Ior LIe CuIIIornIu Neuport Neus,
reporLed on un InIormuI experImenL Ie conducLed:
AnLI-cIgureLLe smokIng Ius reucIed u IunuLIcIsm
400
400
Rampant Antismoking Signifies Grave Danger
borderIng on IysLerIu. L couId be dungerous Lo your
IeuILI. To prove LIuL poInL, LIIs IeurIess reporLer used
one oI LIose smokeIess cIgureLLes mude oI pIusLIc LIuL
Iook IIke u reuI cIgureLLe. TIey cun`L be IIL, LIougI, und
ure normuIIy supposed Lo IoId some kInd oI InIuIunL Lo
dIscouruge smokIng.
My IIrsL sLop wus uL LIe NewporL Hurbour EIks odge
und u seuL uL LIe pIuno bur In LIe smokIng secLIon. A
Iudy uL u neurby LubIe kepL geLLIng up und openIng u
wIndow LIuL bIew bIusLs oI coId uIr on me. AILer `d
cIosed LIe wIndow LIree LImes, und LIe womun Iud
opened IL un equuI number, sIe suId Lo me: `II muke
you u deuI; II you sLop smokIng, won`L open LIe
wIndow unymore. LoId Ier Iudn`L smoked In zo
yeurs und my cIgureLLe couIdn`L smoke. uIso poInLed
ouL sIe wus seuLed In LIe smokIng secLIon oI LIe room
reserved Ior smokers. don`L cure, sIe screumed,
IgnorIng my sLuLemenL, L`s my LubIe, `m sILLIng uL IL,
und you ure mukIng IL ImpossIbIe Lo enjoy my dInner..
wenL Lo Bunderu In Coronu deI Mur. A wuILress greeLed
me uL Bunderu`s door und ImmedIuLeIy noLIced my
'cIgureLLe`. You`re noL comIng In Iere wILI LIuL, sIe
suId IIrmIy. LoId Ier IL wusn'L u cIgureLLe. SIe cIuImed
sIe knew IL wus u cIgureLLe wIen sIe suw one und
wusn'L ubouL Lo exumIne LIuL dIrLy LIIng...
AL 'MurIe CuIIender`s` u womun In LIe nexL booLI
compIuIned Lo LIe munugemenL sIe couIdn'L breuLIe
becuuse oI my 'cIgureLLe` und wunLed me LIrown ouL oI
LIere Loo...(In OukIey, 1qqq, CI.;, p.z8).
TIIs dIscussIon wouId preIer Lo oIIer more IormuI InvesLIguLIons
oI deIusIonuI reucLIvILy LIun LIuL provIded by LIe IusL exumpIe. However,
Lo LIe uuLIor`s knowIedge LIere ure none. n LIe muny Lens oI LIousunds
oI sLudIes InvesLIguLIng LIe smokIng pIenomenon LIere Is noL one LIuL
uLLempLs Lo coIerenLIy evuIuuLe LIe psycIoIogy or socIuI psycIoIogy oI
unLIsmokIng.
TIIs SS und ESS pundemIc Is on u gIobuI scuIe. NuLIons LIuL
InILIuIIy dId noL buy InLo LIe unLIsmokIng propugundu ure now
cupILuIuLIng. Muny Europeun nuLIons ure InsLILuLIng smokIng buns. or
exumpIe, IL wus unnounced In mId-zooz LIuL smokIng wIII be ouLIuwed In
LIe VuLIcun CILy .. Lrunsgressors wIII Iuce u $o IIne.. (Hercld,Sun,
zqJ6Joz) Greece Is uIso InsLILuLIng buns, mosL probubIy ussocIuLed wILI
Preventive Medicine & Health Promotion
LIe body IIxuLIon menLuIILy generuLed by LIe upcomIng zooq OIympIc
Gumes. An InLerneL seurcI IndIcuLed LIuL nuLIons, In uddILIon Lo Cunudu,
USA, und AusLruIIu, LIuL Iuve recenLIy InsLILuLed vuryIng degrees oI pubIIc
unLIsmokIng IegIsIuLIon IncIude: SouLI AIrIcu, reIund, BrILuIn, RussIu,
Jupun, srueI, Cyprus, LuIy, InIund, Sweden, SL KILLs, PoIund,
PIIIIppInes, SIngupore, New ZeuIund, NeLIerIunds, BeIgIum, Jordun,
Norwuy, Hong Kong, Hungury, BruzII, TIuIIund.
TIIs very crILIcuI gIobuI probIem Is noL due Lo proIound InsIgILs
InLo LIe eIIecLs oI ETS, buL Lo LIe very Iong LenLucIes oI gIobuI
orgunIzuLIons, sucI us LIe WorId HeuILI OrgunIzuLIon und UnILed
NuLIons, und LIeIr cupucILy Lo propuguLe seII-servIng nonsense und Lo
poIILIcuIIy coerce conIormILy. TIe WHO, Ior exumpIe, Is noL u IeuILI
orgunIzuLIon, buL u muLerIuIIsL one. MenLuI, socIuI und moruI IeuILI, In
non-reducLIonIsL Lerms, do noL IIgure In ILs deIIberuLIons - ct cll; LIe
purumounL probIem oI LIe LIme Is rumpunL muLerIuIIsm. CoupIIng LIIs
conLorLed orLIodox sLunce on smokIng, u mujor sympLom oI
muLerIuIIsm, wILI LIe pIeLIoru oI unLIsmokIng Iobby groups cun onIy
ensure deIusIon on u muss scuIe.
And LIe muLerIuIIsL ugendu roIIs on: TIe SMOKNG KS
BusebuII eugue wus Iounded In 1qq8 In KenLucky. n 1qqq, IL expunded Lo
IncIude over 1oo kIds und youLI oI uges 11-1q..TIe Leums ure sponsored
by KenLucky ACTON oI ouIsvIIIe und by LIe NuLIonuI CenLer Ior
Tobucco-ree KIds oI WusIIngLon, DC. (posLed uL www.usI.org) TIe web
puge Ius numerous IInks Lo superIIcIuI sLuLIsLIcuIIsL propugundu,
InLroduced wILI LIe sLuLemenL |c|oncern ubouL Lobucco Is deIInILeIy
needed, due Lo ILs roIe In so muny evIIs und LrugedIes oI IIIe. Here ure
some exumpIes, deLuIIed uL vurIous websILes - uborLIon, uIcoIoIIsm, bruIn
dumuge, deIoresLuLIon, empIysemu, IeurL dIseuse, menLuI dIsorder,
suIcIde, uddIcLIon, AIzIeImer's, breusL cuncer, dIvorce, IIres, Iung cuncer,
seuL beIL dIsuse, LubercuIosIs, ADS, bIrLI deIecLs, crIme, drugs, IeurIng
Ioss, mucuIur degeneruLIon, SDS. TIese ure InLerneL IInks provIded by
The Crime Pretention Group websILe (see IoIIowIng cIupLer). TIere Is
obvIousIy no uLLempL by sucI groups Lo evuIuuLe LIe verucILy oI cIuIms.
TIese Iuy groups reIy on LIe uuLIorILy oI epIdemIoIogy und LIe
medIcuI esLubIIsImenL generuIIy (crumentum cd terecundicm). TIeIr
wIIIIngness Lo propuguLe LIIs IncoIerenL mIsI-musI oI InIormuLIon In
promoLIng mIsguIded beIIeIs reIIecLs urgumenL cd numerum, cd
ncusecm, cd populum. As wIII be consIdered IurLIer In LIe nexL cIupLer,
LIese groups, wIIcI ure monomunIucuIJunbuIunced, by deIInILIon, Iuve
no Ideu LIuL LIey ure purLy Lo un InLernuLIonuIIsLJgIobuI crusude
(muLerIuIIsL munIIesLo) wILI IIgIIy deIuded uspIruLIons und LIe dumbIng
down (see TIomson-serbyL, 1qqq) oI LIe popuIuLIon uL Iurge In muny
401
401
Rampant Antismoking Signifies Grave Danger
borderIng on IysLerIu. L couId be dungerous Lo your
IeuILI. To prove LIuL poInL, LIIs IeurIess reporLer used
one oI LIose smokeIess cIgureLLes mude oI pIusLIc LIuL
Iook IIke u reuI cIgureLLe. TIey cun`L be IIL, LIougI, und
ure normuIIy supposed Lo IoId some kInd oI InIuIunL Lo
dIscouruge smokIng.
My IIrsL sLop wus uL LIe NewporL Hurbour EIks odge
und u seuL uL LIe pIuno bur In LIe smokIng secLIon. A
Iudy uL u neurby LubIe kepL geLLIng up und openIng u
wIndow LIuL bIew bIusLs oI coId uIr on me. AILer `d
cIosed LIe wIndow LIree LImes, und LIe womun Iud
opened IL un equuI number, sIe suId Lo me: `II muke
you u deuI; II you sLop smokIng, won`L open LIe
wIndow unymore. LoId Ier Iudn`L smoked In zo
yeurs und my cIgureLLe couIdn`L smoke. uIso poInLed
ouL sIe wus seuLed In LIe smokIng secLIon oI LIe room
reserved Ior smokers. don`L cure, sIe screumed,
IgnorIng my sLuLemenL, L`s my LubIe, `m sILLIng uL IL,
und you ure mukIng IL ImpossIbIe Lo enjoy my dInner..
wenL Lo Bunderu In Coronu deI Mur. A wuILress greeLed
me uL Bunderu`s door und ImmedIuLeIy noLIced my
'cIgureLLe`. You`re noL comIng In Iere wILI LIuL, sIe
suId IIrmIy. LoId Ier IL wusn'L u cIgureLLe. SIe cIuImed
sIe knew IL wus u cIgureLLe wIen sIe suw one und
wusn'L ubouL Lo exumIne LIuL dIrLy LIIng...
AL 'MurIe CuIIender`s` u womun In LIe nexL booLI
compIuIned Lo LIe munugemenL sIe couIdn'L breuLIe
becuuse oI my 'cIgureLLe` und wunLed me LIrown ouL oI
LIere Loo...(In OukIey, 1qqq, CI.;, p.z8).
TIIs dIscussIon wouId preIer Lo oIIer more IormuI InvesLIguLIons
oI deIusIonuI reucLIvILy LIun LIuL provIded by LIe IusL exumpIe. However,
Lo LIe uuLIor`s knowIedge LIere ure none. n LIe muny Lens oI LIousunds
oI sLudIes InvesLIguLIng LIe smokIng pIenomenon LIere Is noL one LIuL
uLLempLs Lo coIerenLIy evuIuuLe LIe psycIoIogy or socIuI psycIoIogy oI
unLIsmokIng.
TIIs SS und ESS pundemIc Is on u gIobuI scuIe. NuLIons LIuL
InILIuIIy dId noL buy InLo LIe unLIsmokIng propugundu ure now
cupILuIuLIng. Muny Europeun nuLIons ure InsLILuLIng smokIng buns. or
exumpIe, IL wus unnounced In mId-zooz LIuL smokIng wIII be ouLIuwed In
LIe VuLIcun CILy .. Lrunsgressors wIII Iuce u $o IIne.. (Hercld,Sun,
zqJ6Joz) Greece Is uIso InsLILuLIng buns, mosL probubIy ussocIuLed wILI
Preventive Medicine & Health Promotion
LIe body IIxuLIon menLuIILy generuLed by LIe upcomIng zooq OIympIc
Gumes. An InLerneL seurcI IndIcuLed LIuL nuLIons, In uddILIon Lo Cunudu,
USA, und AusLruIIu, LIuL Iuve recenLIy InsLILuLed vuryIng degrees oI pubIIc
unLIsmokIng IegIsIuLIon IncIude: SouLI AIrIcu, reIund, BrILuIn, RussIu,
Jupun, srueI, Cyprus, LuIy, InIund, Sweden, SL KILLs, PoIund,
PIIIIppInes, SIngupore, New ZeuIund, NeLIerIunds, BeIgIum, Jordun,
Norwuy, Hong Kong, Hungury, BruzII, TIuIIund.
TIIs very crILIcuI gIobuI probIem Is noL due Lo proIound InsIgILs
InLo LIe eIIecLs oI ETS, buL Lo LIe very Iong LenLucIes oI gIobuI
orgunIzuLIons, sucI us LIe WorId HeuILI OrgunIzuLIon und UnILed
NuLIons, und LIeIr cupucILy Lo propuguLe seII-servIng nonsense und Lo
poIILIcuIIy coerce conIormILy. TIe WHO, Ior exumpIe, Is noL u IeuILI
orgunIzuLIon, buL u muLerIuIIsL one. MenLuI, socIuI und moruI IeuILI, In
non-reducLIonIsL Lerms, do noL IIgure In ILs deIIberuLIons - ct cll; LIe
purumounL probIem oI LIe LIme Is rumpunL muLerIuIIsm. CoupIIng LIIs
conLorLed orLIodox sLunce on smokIng, u mujor sympLom oI
muLerIuIIsm, wILI LIe pIeLIoru oI unLIsmokIng Iobby groups cun onIy
ensure deIusIon on u muss scuIe.
And LIe muLerIuIIsL ugendu roIIs on: TIe SMOKNG KS
BusebuII eugue wus Iounded In 1qq8 In KenLucky. n 1qqq, IL expunded Lo
IncIude over 1oo kIds und youLI oI uges 11-1q..TIe Leums ure sponsored
by KenLucky ACTON oI ouIsvIIIe und by LIe NuLIonuI CenLer Ior
Tobucco-ree KIds oI WusIIngLon, DC. (posLed uL www.usI.org) TIe web
puge Ius numerous IInks Lo superIIcIuI sLuLIsLIcuIIsL propugundu,
InLroduced wILI LIe sLuLemenL |c|oncern ubouL Lobucco Is deIInILeIy
needed, due Lo ILs roIe In so muny evIIs und LrugedIes oI IIIe. Here ure
some exumpIes, deLuIIed uL vurIous websILes - uborLIon, uIcoIoIIsm, bruIn
dumuge, deIoresLuLIon, empIysemu, IeurL dIseuse, menLuI dIsorder,
suIcIde, uddIcLIon, AIzIeImer's, breusL cuncer, dIvorce, IIres, Iung cuncer,
seuL beIL dIsuse, LubercuIosIs, ADS, bIrLI deIecLs, crIme, drugs, IeurIng
Ioss, mucuIur degeneruLIon, SDS. TIese ure InLerneL IInks provIded by
The Crime Pretention Group websILe (see IoIIowIng cIupLer). TIere Is
obvIousIy no uLLempL by sucI groups Lo evuIuuLe LIe verucILy oI cIuIms.
TIese Iuy groups reIy on LIe uuLIorILy oI epIdemIoIogy und LIe
medIcuI esLubIIsImenL generuIIy (crumentum cd terecundicm). TIeIr
wIIIIngness Lo propuguLe LIIs IncoIerenL mIsI-musI oI InIormuLIon In
promoLIng mIsguIded beIIeIs reIIecLs urgumenL cd numerum, cd
ncusecm, cd populum. As wIII be consIdered IurLIer In LIe nexL cIupLer,
LIese groups, wIIcI ure monomunIucuIJunbuIunced, by deIInILIon, Iuve
no Ideu LIuL LIey ure purLy Lo un InLernuLIonuIIsLJgIobuI crusude
(muLerIuIIsL munIIesLo) wILI IIgIIy deIuded uspIruLIons und LIe dumbIng
down (see TIomson-serbyL, 1qqq) oI LIe popuIuLIon uL Iurge In muny
402
402
Rampant Antismoking Signifies Grave Danger
nuLIons. L IndIcuLes onIy LIe IeebIeness und guIIIbIIILy oI muny uL LIIs
mosL precurIous LIme.
SIIne (zooo) InIorms LIuL u nIcoLIne vuccIne moves Lowurd
cIInIcuI LrIuIs: A new vuccIne LIuL prevenLs nIcoLIne Irom reucIIng LIe
bruIns oI ruLs muy oIIer Iope Ior smokers LryIng Lo breuk LIeIr uddIcLIon.
TIe compound, cuIIed NIcVAX, muy even prove useIuI us un InocuIuLIon
uguInsL nIcoLIne uddIcLIon, mucI IIke LIose LIuL proLecL cIIIdren Irom
LeLunus, meusIes, und poIIo. NDA DIrecLor, Dr. AIun esIner, suys
Some Iorm oI vuccInuLIon uguInsL nIcoLIne wouId be IIgIIy useIuI
becuuse vuccInuLed IndIvIduuIs wouId noL be ubIe Lo geL u 'kIck` Irom LIe
nIcoLIne In Lobucco. I peopIe Iound Lobucco Iess rewurdIng, LIey wouId be
Iess IIkeIy Lo conLInue usIng IL. UILImuLeIy, Iowever, our besL LreuLmenL Ior
nIcoLIne uddIcLIon Is prevenLIon. TIere Ius even been un uLLempL Lo IInd
LIe nIcoLIne gene: Smokers ure Lo Iuve LIeIr genes screened Lo
deLermIne LIe cuuse oI LIeIr uddIcLIon. (Hercld,Sun, Junuury z8, zooo,
p.q) TIIs Is jusL one IurLIer sLep In LIe dIseusIIIcuLIon und medIcuIIzuLIon
oI LIe Iumun condILIon - cIIIdren mIgIL soon be vuccInuLed uguInsL LIe
dIseuse oI nIcoLIne uddIcLIon. n LIe IoIIowIng cIupLer IL wIII be
IIgIIIgILed LIuL, over LIe IusL decude In purLIcuIur, medIco-muLerIuIIsm
Ius deIIned more und more uspecLs oI LypIcuI IIIe us dIseuses (e.g.,
depressIon). AL LIIs LIme LIere ure Iurge groups oI LIe popuIuLIon on
sLrong mood-uILerIng medIcuLIon (e.g., unLI-depressunLs), IncIudIng
cIIIdren (e.g., RILuIIn), wILI very poor busIs. TIese ure jusL uspecLs oI un
enIeebIIng oI LIe musses InLo u muLerIuIIsL worIdvIew. MedIco-
muLerIuIIsm Is u key IIgure In deIuded gIobuI-ruIe uspIruLIons.
TIere ure now numerous exumpIes oI resLrIcLIons on smokIng In
LIe workpIuce, LIe requIremenLs oI u nonsmokIng sLuLus Ior IIrIng
purposes, or empIoymenL beIng LermInuLed II u person smokes. WIeLIer
LIe resLrIcLIons or requIremenLs Iuve uny merIL Ius Iong gone by LIe
wuysIde. n LIe currenL muss deIusIon, IL Is u gIven LIuL cn unLIsmokIng
ucLIvILy Is reusonubIe und jusLIIIed.
or exumpIe, |u| supervIsor uL u IIrm wILI u sLrIcL no-smokIng
poIIcy Ius been sucked Ior uIIegedIy IIgILIng u cIgureLLe In IIs cur us Ie IeIL
uL LIe end oI u nIgIL sIIIL. A vIdeo cumeru uL LIe IucLory - wIIcI suppIIes
prInLed wruppIng muLerIuIs Lo LIe Lobucco IndusLry - recorded u IIusI oI
IIgIL In LIe cur. (The Times, AugusL z8, 1qq8) A BrILIsI mun wus sucked
wIen IIs empIoyer wus LoId LIuL Ie smoked uL Iome: SuIes execuLIve
Murk Hodges, q1, suys Ie wus sucked on LIe second duy oI IIs job becuuse
IIs empIoyers Irowned on LIe |smokIng| IubIL. He Iud been LoId oI LIe
IIrm`s no smokIng poIIcy uL IIs InLervIew..BuL Mr Hodges LoId LIe TImes
newspuper Ie Iud ussumed LIuL onIy uppIIed uL LIe oIIIce und IIs
compuny cur. He suId Ie Iud IeL sIIp Lo IIs new empIoyers on IIs IIrsL duy
Preventive Medicine & Health Promotion
LIuL Ie smoked uL Iome. Mr Hodges oI CuIne, WIILsIIre, wus dIsmIssed
LIe nexL duy wILI one monLI`s puy In IIeu. (C Neus, 1 November,
zoo1)
OukIey (1qqq, CI.8) uIso provIdes u number oI exumpIes oI
unLIsmokIng unLIcs In LIe workpIuce. OI LIe muny deIusIonuI uLLempLs uL
jusLIIyIng unLIsmokIng resLrIcLIons, one In purLIcuIur Is ouLsLundIng und
wIII serve Lo muke u number oI poInLs.
KImbuII PIusLIcs, u US munuIucLurer oI IIgI-LecI componenLs,
IorbId uny empIoyee or vIsILor Lo enLer LIe pIunL LIuL Ius smoked wILIIn
Lwo Iours oI enLerIng LIe IucIIILy becuuse LIey Iuve been 'Lobucco
conLumInuLed` und muy Iuve Lobucco resIdue on LIeIr persons. TIIs
requIremenL wus udded Lo LIe Iormer poIIcy oI u bun onIy on Indoor
smokIng uILer some oI LIeIr empIoyees 'cIuImed` LIuL LIey were geLLIng
IeuducIes und usLImu uLLucks Irom LIe resIduuI smeII oI smoke on
smokers. n response Lo LIIs LIe munugemenL und empIoyees opLed Lo go
Lo LIeIr currenL poIIcy oI noL uIIowIng unyone InLo LIe pIunL LIuL Ius been
Lobucco conLumInuLed wILIIn Lwo Iours oI enLerIng LIe pIunL.
A spokesmun Ior LIe compuny cIuImed LIuL LIe poIIcy wus
InsLILuLed Lo proLecL empIoyees` IeuILI und LIuL IL wus bused on new
duLu LIuL IndIcuLe LIuL LIe resIduuIs Irom Lobucco ure more dungerous
LIun unyone beIIeved (more dungerous LIun LIe smoke ILseII). L wus uIso
cIuImed LIuL LIe evIdence wus Irom pupers pubIIsIed by J. Repuce oI LIe
EPA.
On quesLIonIng, Repuce, one oI LIe key InsLIguLors oI LIe currenL
unLIsmokIng crusude, denIed LIuL Ie Iud ever pubIIsIed or wrILLen u
reporL on LIe muLLer. However, Ie dId conIIrm LIuL Ie Iud spoken Lo u
KImbuII PIusLIcs oIIIcIuI. SInce Repuce Is u secondIund smoke
consuILunL, IL Is dIIIIcuIL Lo ImugIne LIuL unyLIIng oLIer LIun ETS
dunger wouId Iuve been spoken oI. L sIouId be poInLed ouL LIuL LIere Is
no scIenLIIIc evIdence Lo supporL KImbuII PIusLIc`s conducL; LIe compuny
Is In LIe grIp oI muss deIusIon. L sIouId be more LIun obvIous LIuL muny
Iuve been uIIowed Lo propuguLe IruuduIenL InIormuLIon under LIe
preLense oI scIenLIIIc credIbIIILy. n suner LImes, wIen psycIoIogIcuI,
psycIosocIuI und moruI coIerence counLed Ior someLIIng, LIe currenL
propugundIsLs wouId Iuve quIckIy been recognIzed us essenLIuIIy crunky,
eusIIy IrrILubIe, superIIcIuI, und ImmuLure In reusonIng. n LIe currenL
derunged LIme LIIs menLuIILy oI quesLIonubIe psycIoIogIcuI sLubIIILy Is
beIng sougIL Ior ILs guIdunce. n LIe currenL cIrcumsLunce, LIose wIo
smoke Iuve no Ideu on goIng Lo work on uny gIven duy wIuL new
obsLucIes, pIuced In LIe nume oI superIorILy, wIII conIronL LIem.
TIe KImbuII PIusLIcs exumpIe uIso serves Lo IIgIIIgIL Iow u
sILuuLIon cun quIckIy degeneruLe InLo ucuLe psycIoIogIcuI sympLoms Lo
403
403
Rampant Antismoking Signifies Grave Danger
nuLIons. L IndIcuLes onIy LIe IeebIeness und guIIIbIIILy oI muny uL LIIs
mosL precurIous LIme.
SIIne (zooo) InIorms LIuL u nIcoLIne vuccIne moves Lowurd
cIInIcuI LrIuIs: A new vuccIne LIuL prevenLs nIcoLIne Irom reucIIng LIe
bruIns oI ruLs muy oIIer Iope Ior smokers LryIng Lo breuk LIeIr uddIcLIon.
TIe compound, cuIIed NIcVAX, muy even prove useIuI us un InocuIuLIon
uguInsL nIcoLIne uddIcLIon, mucI IIke LIose LIuL proLecL cIIIdren Irom
LeLunus, meusIes, und poIIo. NDA DIrecLor, Dr. AIun esIner, suys
Some Iorm oI vuccInuLIon uguInsL nIcoLIne wouId be IIgIIy useIuI
becuuse vuccInuLed IndIvIduuIs wouId noL be ubIe Lo geL u 'kIck` Irom LIe
nIcoLIne In Lobucco. I peopIe Iound Lobucco Iess rewurdIng, LIey wouId be
Iess IIkeIy Lo conLInue usIng IL. UILImuLeIy, Iowever, our besL LreuLmenL Ior
nIcoLIne uddIcLIon Is prevenLIon. TIere Ius even been un uLLempL Lo IInd
LIe nIcoLIne gene: Smokers ure Lo Iuve LIeIr genes screened Lo
deLermIne LIe cuuse oI LIeIr uddIcLIon. (Hercld,Sun, Junuury z8, zooo,
p.q) TIIs Is jusL one IurLIer sLep In LIe dIseusIIIcuLIon und medIcuIIzuLIon
oI LIe Iumun condILIon - cIIIdren mIgIL soon be vuccInuLed uguInsL LIe
dIseuse oI nIcoLIne uddIcLIon. n LIe IoIIowIng cIupLer IL wIII be
IIgIIIgILed LIuL, over LIe IusL decude In purLIcuIur, medIco-muLerIuIIsm
Ius deIIned more und more uspecLs oI LypIcuI IIIe us dIseuses (e.g.,
depressIon). AL LIIs LIme LIere ure Iurge groups oI LIe popuIuLIon on
sLrong mood-uILerIng medIcuLIon (e.g., unLI-depressunLs), IncIudIng
cIIIdren (e.g., RILuIIn), wILI very poor busIs. TIese ure jusL uspecLs oI un
enIeebIIng oI LIe musses InLo u muLerIuIIsL worIdvIew. MedIco-
muLerIuIIsm Is u key IIgure In deIuded gIobuI-ruIe uspIruLIons.
TIere ure now numerous exumpIes oI resLrIcLIons on smokIng In
LIe workpIuce, LIe requIremenLs oI u nonsmokIng sLuLus Ior IIrIng
purposes, or empIoymenL beIng LermInuLed II u person smokes. WIeLIer
LIe resLrIcLIons or requIremenLs Iuve uny merIL Ius Iong gone by LIe
wuysIde. n LIe currenL muss deIusIon, IL Is u gIven LIuL cn unLIsmokIng
ucLIvILy Is reusonubIe und jusLIIIed.
or exumpIe, |u| supervIsor uL u IIrm wILI u sLrIcL no-smokIng
poIIcy Ius been sucked Ior uIIegedIy IIgILIng u cIgureLLe In IIs cur us Ie IeIL
uL LIe end oI u nIgIL sIIIL. A vIdeo cumeru uL LIe IucLory - wIIcI suppIIes
prInLed wruppIng muLerIuIs Lo LIe Lobucco IndusLry - recorded u IIusI oI
IIgIL In LIe cur. (The Times, AugusL z8, 1qq8) A BrILIsI mun wus sucked
wIen IIs empIoyer wus LoId LIuL Ie smoked uL Iome: SuIes execuLIve
Murk Hodges, q1, suys Ie wus sucked on LIe second duy oI IIs job becuuse
IIs empIoyers Irowned on LIe |smokIng| IubIL. He Iud been LoId oI LIe
IIrm`s no smokIng poIIcy uL IIs InLervIew..BuL Mr Hodges LoId LIe TImes
newspuper Ie Iud ussumed LIuL onIy uppIIed uL LIe oIIIce und IIs
compuny cur. He suId Ie Iud IeL sIIp Lo IIs new empIoyers on IIs IIrsL duy
Preventive Medicine & Health Promotion
LIuL Ie smoked uL Iome. Mr Hodges oI CuIne, WIILsIIre, wus dIsmIssed
LIe nexL duy wILI one monLI`s puy In IIeu. (C Neus, 1 November,
zoo1)
OukIey (1qqq, CI.8) uIso provIdes u number oI exumpIes oI
unLIsmokIng unLIcs In LIe workpIuce. OI LIe muny deIusIonuI uLLempLs uL
jusLIIyIng unLIsmokIng resLrIcLIons, one In purLIcuIur Is ouLsLundIng und
wIII serve Lo muke u number oI poInLs.
KImbuII PIusLIcs, u US munuIucLurer oI IIgI-LecI componenLs,
IorbId uny empIoyee or vIsILor Lo enLer LIe pIunL LIuL Ius smoked wILIIn
Lwo Iours oI enLerIng LIe IucIIILy becuuse LIey Iuve been 'Lobucco
conLumInuLed` und muy Iuve Lobucco resIdue on LIeIr persons. TIIs
requIremenL wus udded Lo LIe Iormer poIIcy oI u bun onIy on Indoor
smokIng uILer some oI LIeIr empIoyees 'cIuImed` LIuL LIey were geLLIng
IeuducIes und usLImu uLLucks Irom LIe resIduuI smeII oI smoke on
smokers. n response Lo LIIs LIe munugemenL und empIoyees opLed Lo go
Lo LIeIr currenL poIIcy oI noL uIIowIng unyone InLo LIe pIunL LIuL Ius been
Lobucco conLumInuLed wILIIn Lwo Iours oI enLerIng LIe pIunL.
A spokesmun Ior LIe compuny cIuImed LIuL LIe poIIcy wus
InsLILuLed Lo proLecL empIoyees` IeuILI und LIuL IL wus bused on new
duLu LIuL IndIcuLe LIuL LIe resIduuIs Irom Lobucco ure more dungerous
LIun unyone beIIeved (more dungerous LIun LIe smoke ILseII). L wus uIso
cIuImed LIuL LIe evIdence wus Irom pupers pubIIsIed by J. Repuce oI LIe
EPA.
On quesLIonIng, Repuce, one oI LIe key InsLIguLors oI LIe currenL
unLIsmokIng crusude, denIed LIuL Ie Iud ever pubIIsIed or wrILLen u
reporL on LIe muLLer. However, Ie dId conIIrm LIuL Ie Iud spoken Lo u
KImbuII PIusLIcs oIIIcIuI. SInce Repuce Is u secondIund smoke
consuILunL, IL Is dIIIIcuIL Lo ImugIne LIuL unyLIIng oLIer LIun ETS
dunger wouId Iuve been spoken oI. L sIouId be poInLed ouL LIuL LIere Is
no scIenLIIIc evIdence Lo supporL KImbuII PIusLIc`s conducL; LIe compuny
Is In LIe grIp oI muss deIusIon. L sIouId be more LIun obvIous LIuL muny
Iuve been uIIowed Lo propuguLe IruuduIenL InIormuLIon under LIe
preLense oI scIenLIIIc credIbIIILy. n suner LImes, wIen psycIoIogIcuI,
psycIosocIuI und moruI coIerence counLed Ior someLIIng, LIe currenL
propugundIsLs wouId Iuve quIckIy been recognIzed us essenLIuIIy crunky,
eusIIy IrrILubIe, superIIcIuI, und ImmuLure In reusonIng. n LIe currenL
derunged LIme LIIs menLuIILy oI quesLIonubIe psycIoIogIcuI sLubIIILy Is
beIng sougIL Ior ILs guIdunce. n LIe currenL cIrcumsLunce, LIose wIo
smoke Iuve no Ideu on goIng Lo work on uny gIven duy wIuL new
obsLucIes, pIuced In LIe nume oI superIorILy, wIII conIronL LIem.
TIe KImbuII PIusLIcs exumpIe uIso serves Lo IIgIIIgIL Iow u
sILuuLIon cun quIckIy degeneruLe InLo ucuLe psycIoIogIcuI sympLoms Lo
404
404
Rampant Antismoking Signifies Grave Danger
wIuL Is eIIecLIveIy non-exposure. TIe unLIsmokIng crusude LIuL wus begun
on LIe busIs oI u LIny Increuse In reIuLIve rIsk Ior IIIeIong exposure Lo ETS,
und wIere prImury cuusuI sLuLus Is compreIensIveIy dIsconIIrmed,
deLerIoruLes InLo purLIcuIur persons exIIbILIng sympLoms Lo breuLI-
resIdue LIuL Is now deemed Lo be dungerous. n LIe mIdsL oI muss
deIusIon, persons` compIuInLs LypIcuIIy go unquesLIoned. As compIuInLs
ure pIucuLed wILI buns, eLc., LIIs sImpIy reInIorces LIe IrruLIonuI Ieur und
IueIs LIe pundemIc. L seems In KImbuII PIusLIcs IL wus noL even un opLIon
Lo consIder wIeLIer LIose experIencIng sympLoms Lo Lobucco resIdue
ure demonsLruLIng IncoIerenL psycIoIogIcuI sLuLes. TIIs quesLIon does noL
seem Lo be usked by muny uL uII.
TIe combInuLIon oI LIe quesLIonubIe uddIcLIon deIInILIon oI
smokers, unLI-dIscrImInuLIon Iuws, und rumpunL muLerIuIIsm und
unLIsmokIng Iuve produced greuL enLungIemenLs In workpIuce poIIcy.
AddIcLs ure supposedIy suIIerIng Irom dIsubIIILy. YeL, Lobucco uddIcLs
ure uccorded no reIIeI under unLI-dIscrImInuLIon Iuw. Smokers exILIng LIe
work premIses Lo smoke ure noL consIdered us munIIesLIng LIeIr dIsubIIILy
LIuL sIouId be uIIorded uccommoduLIon, buL us wusLIng un empIoyer`s
LIme.
L sIouId be obvIous even Lo LIIs poInL LIuL bunIsIIng smokers
Irom LIe workpIuce on LIe busIs oI ETS us dungerous Ior uII Ius IILLIe Lo
do wILI proLecLIng nonsmokers und everyLIIng Lo do wILI evenLuuIIy
removIng every opporLunILy Lo smoke In pubIIc. TIe denIuI oI LIIs poInL by
unLIsmokIng ucLIvIsLs Is u gIurIng IuIseIood. DecIuruLIons by gIobuI
orgunIzuLIons (e.g., UN, WHO) oI u smokeIree worId sureIy InLend
exLermInuLIon und noL reusonubIe uccommoduLIon oI LIe IubIL.
WIen smokers were bunIsIed Irom LIe workpIuce, IL seems us
LIougI LIey expecLed some compromIse Lo be reucIed. YeL unLIsmokIng
ucLIvIsLs were uIreudy expIoILIng LIe sILuuLIon, IIgIIIgILIng Lo empIoyers
LIuL smokers were wusLIng empIoyers` LIme. TIese sorLs oI unLIcs ure
remInIscenL oI unLIsmokIng crusudes In eurIy-zoLI cenLury US (see TuLe,
1qqq) und LIe NuzI regIme. ndusLrIuIIsLs und IndusLrIuI IygIenIsLs
essenLIuIIy vIewed workers us cogs In u mucIIne. TIe workpIuce becomes
de-socIuIIzed - sLerIIe. TIe IubIL oI smokIng wus seen us un uLLuck on
poLenLIuI proIILs.
ConLemporury workpIuces ure uIso deLerIoruLIng InLo LIIs
sLerIIILy due Lo muLerIuIIsL domInuLIon. L Is LIereIore noL surprIsIng LIuL
unLIsmokIng - unoLIer muLerIuIIsL sympLom - Ius been gIven emInenL
sLuLus In empIoyers` reusonIng. ConLemporury unLIsmokIng Ius pIuced u
wedge noL onIy beLween empIoyers und smokers buL uIso nonsmokers und
smokers. NonsmokIng empIoyees beIIeve LIuL smokers ure beIng gIven
Iree LIme LIrougI LIeIr smokIng breuks.
Preventive Medicine & Health Promotion
A recenL newspuper urLIcIe IndIcuLes LIuL |e|mpIoyers ure
IrownIng on cIgureLLe breuks becuuse oI concerns LIuL some smokers ure
Iess producLIve und ure wusLIng LIme IeedIng LIeIr IubIL. (Hercld,Sun,
MurcI z8, zoo1, p.1) TIe TusmunIun governmenL (AusLruIIu) unnounced
LIuL commencIng In zooz und concernIng pubIIc secLor workers, smokIng
breuks oLIer LIun desIgnuLed Leu und IuncI breuks musL be mude up wILI
exLru work LIme. TIIs wus decIded by un empIoyee voLe. YeL LIe voLe uIso
sLIpuIuLed LIuL persons wILI oLIer dIsubIIILIes couId come und go us
necessury wILIouL IuvIng Lo muke up IosL LIme, buL noL so smokers.
TIereIore, Ior LIe purposes oI osLrucIzIng smokers In LIe quesL Ior u
smokeIree worId, LIey ure decIured us uddIcLs und LIereIore dIsubIed;
uILernuLIveIy, concernIng LIe prugmuLIcs oI workpIuce poIIcy LIey ure noL
deemed dIsubIed.
TIIs pecuIIur Iocus on smokers Is u muLerIuIIsL dIsubIIILy LIuL
goes even deeper LIun LIe uddIcLIon Issue. nsurunce compunIes Iuve Iong
used sLuLIsLIcs LIuL IndIcuLe LIuL smokers, on uveruge, Luke more sIck
IeuveJubsenLeeIsm LIun nonsmokers. n LIe Iunds oI Insurunce
compunIes LIIs InIormuLIon Is LrunsIormed InLo IIgIer Insurunce
premIums Ior smokers. However, us IndIcuLed In LIe second cIupLer,
Insurunce compunIes ure noL scIenLIIIc orgunIzuLIons. TIeIr use oI LIe
InIormuLIon, LIougI IL muy even be moruIIy quesLIonubIe, mukes no
decIuruLIons ubouL LIe roIe oI smokIng In Increused sIck IeuveJ
ubsenLeeIsm.
n LIe Iunds oI LIe unLIsmokIng Iobby, Iowever, LIIs InIormuLIon
Lukes on unoLIer compIexIon. AnLIsmokIng boIdIy decIures LIuL smokIng
cuuses ubsenLeeIsm. SucI decIuruLIons reIIecL sLundurd muLerIuIIsL
superIIcIuIILy. IrsLIy, LIe greuLer mujorILy oI smokers Is compurubIe Lo
nonsmokers. AguIn, u smuII Increuse In ubsenLeeIsm Is generuLed by u
smuII subgroup oI smokers. TIIs smuII group muy smoke Ior u vurIeLy oI
reusons (e.g., cuImIng eIIecL Ior exIsLIng IIIness, mIId depressIon) LIuL ure
LIemseIves correIuLed wILI sIck Ieuve. Or, LIey muy noL be uLLerIy
domInuLed by LIeIr work-IIIe, cIoosIng Lo Luke LIe occusIonuI duy oII In
LIe InLeresLs oI buIunce. TIIs Is noL un unIeuILIy cIrcumsLunce. Or, LIey
muy Iuve cIIIdren LIuL need uLLendIng Lo - smokIng Is more IIgIIy
correIuLed wILI sIngIe-purenL IumIIIes. urLIermore, LIuL nonsmokers
Luke Iess sIck Ieuve does noL necessurIIy IndIcuLe u IeuILIy cIrcumsLunce.
or exumpIe, LIere muy be u smuII subgroup oI nonsmokers LIuL Iuve
dysIuncLIonuI IumIIy IIves, IIndIng LIeIr reIuge In LIe workpIuce. TIese
muy be eurIIesL In und IusL Lo Ieuve. OLIers muy be gossIps, IIndIng greuL
ouLIeL In LIe workpIuce. TIese muy rureIy mIss u duy gIven LIe workpIuce`s
uppeuI.
WIerever LIere ure Iumuns, LIere ure muLIdImensIonuI
405
405
Rampant Antismoking Signifies Grave Danger
wIuL Is eIIecLIveIy non-exposure. TIe unLIsmokIng crusude LIuL wus begun
on LIe busIs oI u LIny Increuse In reIuLIve rIsk Ior IIIeIong exposure Lo ETS,
und wIere prImury cuusuI sLuLus Is compreIensIveIy dIsconIIrmed,
deLerIoruLes InLo purLIcuIur persons exIIbILIng sympLoms Lo breuLI-
resIdue LIuL Is now deemed Lo be dungerous. n LIe mIdsL oI muss
deIusIon, persons` compIuInLs LypIcuIIy go unquesLIoned. As compIuInLs
ure pIucuLed wILI buns, eLc., LIIs sImpIy reInIorces LIe IrruLIonuI Ieur und
IueIs LIe pundemIc. L seems In KImbuII PIusLIcs IL wus noL even un opLIon
Lo consIder wIeLIer LIose experIencIng sympLoms Lo Lobucco resIdue
ure demonsLruLIng IncoIerenL psycIoIogIcuI sLuLes. TIIs quesLIon does noL
seem Lo be usked by muny uL uII.
TIe combInuLIon oI LIe quesLIonubIe uddIcLIon deIInILIon oI
smokers, unLI-dIscrImInuLIon Iuws, und rumpunL muLerIuIIsm und
unLIsmokIng Iuve produced greuL enLungIemenLs In workpIuce poIIcy.
AddIcLs ure supposedIy suIIerIng Irom dIsubIIILy. YeL, Lobucco uddIcLs
ure uccorded no reIIeI under unLI-dIscrImInuLIon Iuw. Smokers exILIng LIe
work premIses Lo smoke ure noL consIdered us munIIesLIng LIeIr dIsubIIILy
LIuL sIouId be uIIorded uccommoduLIon, buL us wusLIng un empIoyer`s
LIme.
L sIouId be obvIous even Lo LIIs poInL LIuL bunIsIIng smokers
Irom LIe workpIuce on LIe busIs oI ETS us dungerous Ior uII Ius IILLIe Lo
do wILI proLecLIng nonsmokers und everyLIIng Lo do wILI evenLuuIIy
removIng every opporLunILy Lo smoke In pubIIc. TIe denIuI oI LIIs poInL by
unLIsmokIng ucLIvIsLs Is u gIurIng IuIseIood. DecIuruLIons by gIobuI
orgunIzuLIons (e.g., UN, WHO) oI u smokeIree worId sureIy InLend
exLermInuLIon und noL reusonubIe uccommoduLIon oI LIe IubIL.
WIen smokers were bunIsIed Irom LIe workpIuce, IL seems us
LIougI LIey expecLed some compromIse Lo be reucIed. YeL unLIsmokIng
ucLIvIsLs were uIreudy expIoILIng LIe sILuuLIon, IIgIIIgILIng Lo empIoyers
LIuL smokers were wusLIng empIoyers` LIme. TIese sorLs oI unLIcs ure
remInIscenL oI unLIsmokIng crusudes In eurIy-zoLI cenLury US (see TuLe,
1qqq) und LIe NuzI regIme. ndusLrIuIIsLs und IndusLrIuI IygIenIsLs
essenLIuIIy vIewed workers us cogs In u mucIIne. TIe workpIuce becomes
de-socIuIIzed - sLerIIe. TIe IubIL oI smokIng wus seen us un uLLuck on
poLenLIuI proIILs.
ConLemporury workpIuces ure uIso deLerIoruLIng InLo LIIs
sLerIIILy due Lo muLerIuIIsL domInuLIon. L Is LIereIore noL surprIsIng LIuL
unLIsmokIng - unoLIer muLerIuIIsL sympLom - Ius been gIven emInenL
sLuLus In empIoyers` reusonIng. ConLemporury unLIsmokIng Ius pIuced u
wedge noL onIy beLween empIoyers und smokers buL uIso nonsmokers und
smokers. NonsmokIng empIoyees beIIeve LIuL smokers ure beIng gIven
Iree LIme LIrougI LIeIr smokIng breuks.
Preventive Medicine & Health Promotion
A recenL newspuper urLIcIe IndIcuLes LIuL |e|mpIoyers ure
IrownIng on cIgureLLe breuks becuuse oI concerns LIuL some smokers ure
Iess producLIve und ure wusLIng LIme IeedIng LIeIr IubIL. (Hercld,Sun,
MurcI z8, zoo1, p.1) TIe TusmunIun governmenL (AusLruIIu) unnounced
LIuL commencIng In zooz und concernIng pubIIc secLor workers, smokIng
breuks oLIer LIun desIgnuLed Leu und IuncI breuks musL be mude up wILI
exLru work LIme. TIIs wus decIded by un empIoyee voLe. YeL LIe voLe uIso
sLIpuIuLed LIuL persons wILI oLIer dIsubIIILIes couId come und go us
necessury wILIouL IuvIng Lo muke up IosL LIme, buL noL so smokers.
TIereIore, Ior LIe purposes oI osLrucIzIng smokers In LIe quesL Ior u
smokeIree worId, LIey ure decIured us uddIcLs und LIereIore dIsubIed;
uILernuLIveIy, concernIng LIe prugmuLIcs oI workpIuce poIIcy LIey ure noL
deemed dIsubIed.
TIIs pecuIIur Iocus on smokers Is u muLerIuIIsL dIsubIIILy LIuL
goes even deeper LIun LIe uddIcLIon Issue. nsurunce compunIes Iuve Iong
used sLuLIsLIcs LIuL IndIcuLe LIuL smokers, on uveruge, Luke more sIck
IeuveJubsenLeeIsm LIun nonsmokers. n LIe Iunds oI Insurunce
compunIes LIIs InIormuLIon Is LrunsIormed InLo IIgIer Insurunce
premIums Ior smokers. However, us IndIcuLed In LIe second cIupLer,
Insurunce compunIes ure noL scIenLIIIc orgunIzuLIons. TIeIr use oI LIe
InIormuLIon, LIougI IL muy even be moruIIy quesLIonubIe, mukes no
decIuruLIons ubouL LIe roIe oI smokIng In Increused sIck IeuveJ
ubsenLeeIsm.
n LIe Iunds oI LIe unLIsmokIng Iobby, Iowever, LIIs InIormuLIon
Lukes on unoLIer compIexIon. AnLIsmokIng boIdIy decIures LIuL smokIng
cuuses ubsenLeeIsm. SucI decIuruLIons reIIecL sLundurd muLerIuIIsL
superIIcIuIILy. IrsLIy, LIe greuLer mujorILy oI smokers Is compurubIe Lo
nonsmokers. AguIn, u smuII Increuse In ubsenLeeIsm Is generuLed by u
smuII subgroup oI smokers. TIIs smuII group muy smoke Ior u vurIeLy oI
reusons (e.g., cuImIng eIIecL Ior exIsLIng IIIness, mIId depressIon) LIuL ure
LIemseIves correIuLed wILI sIck Ieuve. Or, LIey muy noL be uLLerIy
domInuLed by LIeIr work-IIIe, cIoosIng Lo Luke LIe occusIonuI duy oII In
LIe InLeresLs oI buIunce. TIIs Is noL un unIeuILIy cIrcumsLunce. Or, LIey
muy Iuve cIIIdren LIuL need uLLendIng Lo - smokIng Is more IIgIIy
correIuLed wILI sIngIe-purenL IumIIIes. urLIermore, LIuL nonsmokers
Luke Iess sIck Ieuve does noL necessurIIy IndIcuLe u IeuILIy cIrcumsLunce.
or exumpIe, LIere muy be u smuII subgroup oI nonsmokers LIuL Iuve
dysIuncLIonuI IumIIy IIves, IIndIng LIeIr reIuge In LIe workpIuce. TIese
muy be eurIIesL In und IusL Lo Ieuve. OLIers muy be gossIps, IIndIng greuL
ouLIeL In LIe workpIuce. TIese muy rureIy mIss u duy gIven LIe workpIuce`s
uppeuI.
WIerever LIere ure Iumuns, LIere ure muLIdImensIonuI
406
406
Rampant Antismoking Signifies Grave Danger
dynumIcs uL work. TIe superIIcIuIILy oI muLerIuIIsm cunnoL IuLIom
psycIoIogIcuI und reIuLIonuI dImensIons. L opLs Ior LIe mosL sImpIe-
mInded InLerpreLuLIon: nonsmokers ure good workers, smokers ure poor
workers, und smokers LIuL cun be urged Lo quIL cun be redeemed InLo
good workers. urLIermore, IL Is erroneousIy consIdered LIuL workers In
LIe workpIuce ure consLunLIy producLIve. MuLerIuIIsm sees no socIuI uspecL
In LIe workpIuce wIIcI Is InLended onIy Ior producLIvILy, I.e., cog
meLupIor.
TIe currenL noLIon oI smokers wusLIng LIme on smoke breuks Is
un exLensIon oI LIIs Ionger-sLundIng conLorLed vIew oI smokers by
muLerIuIIsm. And LIe vIew, beIng deIuded, cun be quILe scuLIIng oI
smokers. or exumpIe, un urLIcIe concernIng u US sLudy on smoker-
nonsmoker producLIvILy recenLIy uppeured In LIe Hercld,Sun, u
newspuper oILen quoLed In LIe eurIIer secLIon on LIe unLIsmokIng cruze In
VIcLorIu, AusLruIIu, und noLorIous Ior propuguLIng unLIsmokIng rIeLorIc.
TIe urLIcIe IIgIIIgILs LIuL:
TIe sLudy oI oo empIoyees uL u mujor US uIrIIne Iound
LIe smokers were sIower uL Lusks sucI us bookIng
IIIgILs. TIey recorded Iess suIes Income Ior LIe
compuny, Look Ionger Lo unswer pIone cuIIs und spenL
more LIme uwuy Irom LIeIr desks..TIe smokers were
ubsenL Irom work Ior sIckness un uveruge oI 6.16 duys u
yeur, compured wILI q. duys Ior ex-smokers und ,86
duys Ior LIose wIo Iud never smoked. As weII us sIck
Ieuve, u smoker cun be Iess producLIve becuuse oI rILuuI
smokIng breuks, LIe reporL suId. TIey oILen IeeI unweII,
wIIcI Ius un ImpucL on work perIormunce. 'Smokers
und workers wILI oLIer Lypes oI uddIcLIons muy deny
LIuL LIeIr uddIcLIons Iuve uny neguLIve InIIuence on
producLIvILy,` IL suId. (SepLember 6, zoo1, p.1)
TIe urLIcIe und LIe sLudy muke muILIpIe reIerences Lo LIey
wIen uny oI LIe vurIuLIons reIerred Lo ure LypIcuIIy subgroup In LIeIr
source: MosL smokers ure compurubIe Lo nonsmokers on LIe meusures. L
musL uIso be IIgIIIgILed LIuL LIese ure smokers LIuL musL Ieuve LIe
premIses II LIey wIsI Lo smoke. n oLIer words, LIey ure vIewed us InIerIor
by LIe prevuIIIng menLuIILy. L Is noL surprIsIng LIuL some smokers IInd
LIe superIorIsL uLmospIere In wIIcI LIey ure now In somewIuL
InLImIduLIng - one oI LIe reusons wIy one mIgIL wunL u cIgureLLe breuk -
or uIIecLIng mecIunIcuI work perIormunce. TIe probIem Is noL smokIng
buL LIe superIorILy syndrome wIIcI Is seII-reInIorcIng. ProbIems
ussocIuLed wILI LIe superIorILy syndrome ure InLerpreLed by LIe
Preventive Medicine & Health Promotion
superIorILy syndrome us probIems oI uddIcLIon, I.e., u muLerIuIIsL cIosed-
Ioop.
L Is InLeresLIng LIuL LIe sLudy does noL IncIude uny quuIILuLIve
meusures (e.g., socIubIIILy) oI perIormunce wIIcI mIgIL Iuvor some
smokers. Nor sIouId uny be expecLed In LIuL LIe sLudy wus conducLed by
unLIsmokers (muLerIuIIsL) pubIIsIIng LIeIr sLudy In LIe unLIsmokIng
journuI Tobccco Control und uppeurIng In u newspuper oI sLrong
unLIsmokIng sLunce. TIe Issues consIdered ure muLerIuIIsL, LIe porLruyuI oI
dIIIerences Is ImproperIy ussIgned Lo LIe enLIre group oI smokers, und
smokIng Is vIewed onIy us un uddIcLIon. TIe onIy reuson unyone wouId
Iuve Ior sucI u sLudy-desIgn Is Ior unLIsmokIng purposes. TIe sLudy`s
desIgn und InIerence-mukIng Is devoId oI muILIdImensIonuI sensIbIIILy
und reIIes on eusy quunLIIIcuLIons und IusLy generuIIzuLIons.
TIe newspuper urLIcIe wus IeudIIned Smokers do Iess work:
TIey`re sIcker, sIucker, sIower. TIe ImpIIcuLIon Is LIuL uII smokers ure
sucI und uII nonsmokers ure noL so. TIIs Is cIeurIy u IruuduIenL und
deIInquenL proposILIon. TIe urLIcIe Is vIcIousIy unLIsmokIngJunLIsmoker
In sLunce, reInIorcIng LIe superIorILy oI nonsmokers und LIe InIerIorILy oI
smokers. TIere Is no quesLIonIng oI LIe sLudy`s premIses or moLIvuLIon. L
sImpIy udds IurLIer Lo LIe muLerIuIIsL mIsrepresenLuLIon wILI vIIIIyIng
IeudIInes. ncIuded In LIe urLIcIe Is LIe munduLory commenL by LIe QuIL
execuLIve dIrecLor wIo urge|s| empIoyers Lo Iook uL InLroducIng
workpIuce quILLIng progrums. TIIs urLIcIe Is jusL one umongsL muny LIuL
represenL un orcIesLruLed ussuuIL on smokers.
L Is LIIs Iuke superIorILy, borne oI deIuded dIsLIncLIons und
superIIcIuIILy oI reusonIng, LIuL muny empIoyers und empIoyees ure
demonsLruLIng. As IndIcuLed In eurIIer exumpIes, empIoyers ure
proIIbILIng smokIng In wuys LIuL go Iur beyond even muLerIuIIsL IeuILI
concerns, reIIecLIng onIy LIe InLenL Lo IuIIy Impose one`s wIII on LIose wIo
smoke. TIIs Is u muLLer oI psycIoIogIcuI und socIuI IeuILI. WIuL recourse
do smokers Iuve wIen conIronLed wILI LIIs cuIL menLuIILy? urLIer
compIIcuLIng muLLers Is LIuL u Lrude unIon In BrILIsI CoIumbIu, Cunudu,
recenLIy brougIL un ucLIon uguInsL un empIoyer on beIuII oI smokers
(Cominco Ltd. V United Steeluorlers oj Americc, Loccl p;o, ArbILruLor
urson, ebruury zq, zooo), cIuIIengIng druconIun unLIsmokIng ruIes In
LIIs workpIuce.
ComInco Ld., u Ieud und zInc smeILIng compIex, dId noL permIL
LIe use or possessIon oI Lobucco In uny Iorm cnuhere on ILs qo ucre
properLy; noL Indoors or ouLdoors, noL In purkIng IoLs und prIvuLe veIIcIes.
NoncompIIunce wouId resuIL In dIscIpIInury ucLIon, IncIudIng LIe
possIbIIILy oI beIng dIscIurged. TIe unIon conLended LIuL, uILIougI
smokIng wus Iuzurdous, LIIs poIIcy wus quesLIonubIe on u number oI
407
407
Rampant Antismoking Signifies Grave Danger
dynumIcs uL work. TIe superIIcIuIILy oI muLerIuIIsm cunnoL IuLIom
psycIoIogIcuI und reIuLIonuI dImensIons. L opLs Ior LIe mosL sImpIe-
mInded InLerpreLuLIon: nonsmokers ure good workers, smokers ure poor
workers, und smokers LIuL cun be urged Lo quIL cun be redeemed InLo
good workers. urLIermore, IL Is erroneousIy consIdered LIuL workers In
LIe workpIuce ure consLunLIy producLIve. MuLerIuIIsm sees no socIuI uspecL
In LIe workpIuce wIIcI Is InLended onIy Ior producLIvILy, I.e., cog
meLupIor.
TIe currenL noLIon oI smokers wusLIng LIme on smoke breuks Is
un exLensIon oI LIIs Ionger-sLundIng conLorLed vIew oI smokers by
muLerIuIIsm. And LIe vIew, beIng deIuded, cun be quILe scuLIIng oI
smokers. or exumpIe, un urLIcIe concernIng u US sLudy on smoker-
nonsmoker producLIvILy recenLIy uppeured In LIe Hercld,Sun, u
newspuper oILen quoLed In LIe eurIIer secLIon on LIe unLIsmokIng cruze In
VIcLorIu, AusLruIIu, und noLorIous Ior propuguLIng unLIsmokIng rIeLorIc.
TIe urLIcIe IIgIIIgILs LIuL:
TIe sLudy oI oo empIoyees uL u mujor US uIrIIne Iound
LIe smokers were sIower uL Lusks sucI us bookIng
IIIgILs. TIey recorded Iess suIes Income Ior LIe
compuny, Look Ionger Lo unswer pIone cuIIs und spenL
more LIme uwuy Irom LIeIr desks..TIe smokers were
ubsenL Irom work Ior sIckness un uveruge oI 6.16 duys u
yeur, compured wILI q. duys Ior ex-smokers und ,86
duys Ior LIose wIo Iud never smoked. As weII us sIck
Ieuve, u smoker cun be Iess producLIve becuuse oI rILuuI
smokIng breuks, LIe reporL suId. TIey oILen IeeI unweII,
wIIcI Ius un ImpucL on work perIormunce. 'Smokers
und workers wILI oLIer Lypes oI uddIcLIons muy deny
LIuL LIeIr uddIcLIons Iuve uny neguLIve InIIuence on
producLIvILy,` IL suId. (SepLember 6, zoo1, p.1)
TIe urLIcIe und LIe sLudy muke muILIpIe reIerences Lo LIey
wIen uny oI LIe vurIuLIons reIerred Lo ure LypIcuIIy subgroup In LIeIr
source: MosL smokers ure compurubIe Lo nonsmokers on LIe meusures. L
musL uIso be IIgIIIgILed LIuL LIese ure smokers LIuL musL Ieuve LIe
premIses II LIey wIsI Lo smoke. n oLIer words, LIey ure vIewed us InIerIor
by LIe prevuIIIng menLuIILy. L Is noL surprIsIng LIuL some smokers IInd
LIe superIorIsL uLmospIere In wIIcI LIey ure now In somewIuL
InLImIduLIng - one oI LIe reusons wIy one mIgIL wunL u cIgureLLe breuk -
or uIIecLIng mecIunIcuI work perIormunce. TIe probIem Is noL smokIng
buL LIe superIorILy syndrome wIIcI Is seII-reInIorcIng. ProbIems
ussocIuLed wILI LIe superIorILy syndrome ure InLerpreLed by LIe
Preventive Medicine & Health Promotion
superIorILy syndrome us probIems oI uddIcLIon, I.e., u muLerIuIIsL cIosed-
Ioop.
L Is InLeresLIng LIuL LIe sLudy does noL IncIude uny quuIILuLIve
meusures (e.g., socIubIIILy) oI perIormunce wIIcI mIgIL Iuvor some
smokers. Nor sIouId uny be expecLed In LIuL LIe sLudy wus conducLed by
unLIsmokers (muLerIuIIsL) pubIIsIIng LIeIr sLudy In LIe unLIsmokIng
journuI Tobccco Control und uppeurIng In u newspuper oI sLrong
unLIsmokIng sLunce. TIe Issues consIdered ure muLerIuIIsL, LIe porLruyuI oI
dIIIerences Is ImproperIy ussIgned Lo LIe enLIre group oI smokers, und
smokIng Is vIewed onIy us un uddIcLIon. TIe onIy reuson unyone wouId
Iuve Ior sucI u sLudy-desIgn Is Ior unLIsmokIng purposes. TIe sLudy`s
desIgn und InIerence-mukIng Is devoId oI muILIdImensIonuI sensIbIIILy
und reIIes on eusy quunLIIIcuLIons und IusLy generuIIzuLIons.
TIe newspuper urLIcIe wus IeudIIned Smokers do Iess work:
TIey`re sIcker, sIucker, sIower. TIe ImpIIcuLIon Is LIuL uII smokers ure
sucI und uII nonsmokers ure noL so. TIIs Is cIeurIy u IruuduIenL und
deIInquenL proposILIon. TIe urLIcIe Is vIcIousIy unLIsmokIngJunLIsmoker
In sLunce, reInIorcIng LIe superIorILy oI nonsmokers und LIe InIerIorILy oI
smokers. TIere Is no quesLIonIng oI LIe sLudy`s premIses or moLIvuLIon. L
sImpIy udds IurLIer Lo LIe muLerIuIIsL mIsrepresenLuLIon wILI vIIIIyIng
IeudIInes. ncIuded In LIe urLIcIe Is LIe munduLory commenL by LIe QuIL
execuLIve dIrecLor wIo urge|s| empIoyers Lo Iook uL InLroducIng
workpIuce quILLIng progrums. TIIs urLIcIe Is jusL one umongsL muny LIuL
represenL un orcIesLruLed ussuuIL on smokers.
L Is LIIs Iuke superIorILy, borne oI deIuded dIsLIncLIons und
superIIcIuIILy oI reusonIng, LIuL muny empIoyers und empIoyees ure
demonsLruLIng. As IndIcuLed In eurIIer exumpIes, empIoyers ure
proIIbILIng smokIng In wuys LIuL go Iur beyond even muLerIuIIsL IeuILI
concerns, reIIecLIng onIy LIe InLenL Lo IuIIy Impose one`s wIII on LIose wIo
smoke. TIIs Is u muLLer oI psycIoIogIcuI und socIuI IeuILI. WIuL recourse
do smokers Iuve wIen conIronLed wILI LIIs cuIL menLuIILy? urLIer
compIIcuLIng muLLers Is LIuL u Lrude unIon In BrILIsI CoIumbIu, Cunudu,
recenLIy brougIL un ucLIon uguInsL un empIoyer on beIuII oI smokers
(Cominco Ltd. V United Steeluorlers oj Americc, Loccl p;o, ArbILruLor
urson, ebruury zq, zooo), cIuIIengIng druconIun unLIsmokIng ruIes In
LIIs workpIuce.
ComInco Ld., u Ieud und zInc smeILIng compIex, dId noL permIL
LIe use or possessIon oI Lobucco In uny Iorm cnuhere on ILs qo ucre
properLy; noL Indoors or ouLdoors, noL In purkIng IoLs und prIvuLe veIIcIes.
NoncompIIunce wouId resuIL In dIscIpIInury ucLIon, IncIudIng LIe
possIbIIILy oI beIng dIscIurged. TIe unIon conLended LIuL, uILIougI
smokIng wus Iuzurdous, LIIs poIIcy wus quesLIonubIe on u number oI
408
408
Rampant Antismoking Signifies Grave Danger
grounds. IrsLIy, smokIng Is u personuI rIgIL. TIe exLenL oI LIe
unLIsmokIng meusures wus un InLrusIon InLo LIe personuI IubILs oI
empIoyees. SecondIy, nIcoLIne uddIcLIon und wILIdruwuI ure dIsubIIILIes
LIuL come under LIe jurIsdIcLIon oI unLI-dIscrImInuLIon Iuws. n LIuL LIere
wus u poLenLIuI Ior 1z-Iour sIIILs, LIe poIIcy dIscrImInuLed uguInsL Ieuvy
smokers In purLIcuIur wIo muy IInd IL dIIIIcuIL Lo go Ior LIIs perIod
wILIouL u cIgureLLe. ReIIeI In LIe Iorm oI permILLed ouLdoor smokIng wus
LIereIore sougIL LIrougI reusonubIe uccommoduLIon oI u dIsubIIILy.
BrIeIIy, LIe urbILruLor rejecLed LIe IIrsL objecLIon. urson
concIuded LIuL LIe compuny Iud LIe rIgIL Lo bun smokIng uL work boLI on
LIe busIs oI ILs IegILImuLe busIness InLeresLs und In promoLIng empIoyee
IeuILI und suIeLy. However, Ie upIeId LIe second objecLIon, concIudIng
LIuL wILIdruwuI sympLoms over IengLIy sIIIL-perIods couId produce
ImpuIred IuncLIonIng. TIereIore, LIe unLIsmokIng poIIcy dIscrImInuLed
uguInsL sucI workers. TIe empIoyer wus obIIged Lo uccommoduLe LIe
dIsubIIILy up Lo undue IurdsIIp (Ior LIe empIoyer).
TIe ruIIng muy seem udvunLugeous Ior LIe smoker In u IosLIIe,
unLIsmokIng envIronmenL. However, IL Is u IoIIow vIcLory. L reInIorces
LIe Ideu oI nIcoLIne uddIcLIon, und LIuL unLIsmokIng cIuIms ure uccuruLe.
RuLIer, LIe surmIsIng In LIe ruIIng reIIecLs LIe superIIcIuIILy oI
muLerIuIIsm.
ConsIdered Irom LIe smoker`s vIewpoInL und wILIIn u
muILIdImensIonuI Irumework, LIe empIoyer`s conducL reIIecLs onIy
superIorIsm. L Is dIIIIcuIL Lo beIIeve LIuL In u workpIuce over sucI u Iurge
expunse und LIuL beIIows ouL noxIous Iumes us u muLLer oI course, LIuL
LIere cun be no pIuce Ior u cIgureLLe. L pIuys on LIe mInd oI LIe smoker,
Ior wIom smokIng Is u second-nuLure IubIL, LIuL smokIng zo-IeeL uwuy,
wIere Ie probubIy used Lo smoke Ior muny yeurs, poses no dunger Lo
unyone. L Is LIe unreusonubIeness oI LIe demund LIuL Is uggruvuLIng und
poLenLIuIIy dIsLrucLIng. L produces u severe LensIon beLween empIoyer
und empIoyee. L Is u mInd-gume beIng pIuyed wILI empIoyees. TIe
empIoyer IIdes beIInd LIe cIuIm oI promoLIng empIoyee IeuILI und
suIeLy. YeL, LIIs Ideu oI IeuILI Is obvIousIy u medIco-muLerIuIIsL one. WIuL
oI psycIoIogIcuI und socIuI IeuILI? TIese ure ubsenL In LIIs workpIuce. L
Is In LIe InLeresLs oI LIe empIoyer Lo muInLuIn good reIuLIons, u poInL oI
IeuILI, wILI empIoyees. WIere empIoyees ure Iuppy, LIey ure producLIve.
TIe quesLIon cun weII be usked us Lo wIy un empIoyer wouId
InLenLIonuIIy muInLuIn dIvIsIon wILI empIoyees. L Is LIe poInL oI LIIs
enLIre dIscussIon. AL u LIme oI muLerIuIIsL domInuLIon, psycIoIogIcuI,
socIuI, moruI und spIrILuuI dImensIons ure sLrIpped Irom consIderuLIon. L
Is LIe cIurucLer deIIcIencIes LIuL come Lo LIe Iore, e.g., IuugILIness,
obsessIon wILI conLroI, meguIomunIu. WILIIn LIIs Irumework LIe
Preventive Medicine & Health Promotion
empIoyee Is vIewed us no more LIun u cog In LIe mucIIne, workIng Ior u
superIorIsL empIoyer und wIere poIIcIes InLenLIonuIIy reIIecL LIe
superIorIsm (deIIcIencIes) In moLIon: LIe empIoyer Is In compIeLe cIurge
uLLempLIng Lo uccounL wILIIn LIIs uusLere envIronmenL Ior every momenL
und movemenL oI un empIoyee. L Is LIe sorL oI uLmospIere wIere smIIIng
Is Irowned upon: SmIIIng cun onIy meun LIuL u person Is noL workIng Iurd
enougI. As menLIoned, LIIs superIorIsm In IndusLrIuI IygIene Ius been
seen beIore und IL LypIcuIIy Ius smokIng In ILs sIgILs; smokIng poses un
uIIen wIII. n IucL, II smokers ure unIuppy wILI LIeIr work sILuuLIon, LIe
IIgI IIkeIIIood Is LIuL LIe workpIuce Is under muLerIuIIsL domInuLIon -
psycIoIogIcuI und socIuI IeuILI do noL IIgure.
TIe urbILruLor wouId Iuve Iound In Iuvor oI LIe IIrsL objecLIon II u
muILIdImensIonuI vIew oI IeuILI wus consIdered. HuvIng IuIIed LIe IIrsL
objecLIon und wIere LIe ucLuuI probIem resIdes, muLerIuIIsm musL IInd In
Iuvor oI LIe second objecLIon. UnIorLunuLeIy, LIIs cIosed Ioop muInLuIns
LIe IIrsL probIem und reInIorces LIe uddIcLIon probIem. WILI LIe second
objecLIon beIng upIeId, LIe empIoyer Is obIIged Lo uccommoduLe LIe
dIsubIIILy, und possIbIy under proLesL. I LIe empIoyer cun now
uccommoduLe LIe dIsubIIILy under IeguI obIIguLIon, LIen uccommoduLIon
couId Iuve been provIded wILIouL u resorLIng Lo urbILruLIon.
AccommoduLIon sIorL oI urbILruLIon dId noL occur becuuse goodwIII und
good sense do noL IIgure In muLerIuIIsL reusonIng. L sIouId be obvIous
LIuL II muLerIuIIsm dId noL domInuLe, II empIoyers und socIeLy Iud u
judIcIous dIsposILIon, boLI probIems ubove wouId noL exIsL.
TIe onIy sIorL-Lerm reIIeI In LIese cIrcumsLunces Is u
reconsIderuLIon oI LIe IIrsL objecLIon. RuLIer LIun quesLIon LIe rIgIL oI LIe
empIoyer Lo Impose unreusonubIe smokIng buns, LIe proposILIon cun be
posed us u requesL Ior un uccommoduLIon oI smokIng. or exumpIe, gIven
LIuL LIere Is no ImmedIuLe dunger posed by smokIng In ouLdoor ureus, u
requesL cun be mude Ior smokIng Lo be permILLed In LIese ureus. L cun
uIso be poInLed ouL Lo un empIoyer LIuL sucI urrungemenLs keep everyone
Iuppy und Is conducIve Lo producLIvILy. I un empIoyer reIuses, un
urbILruLor cun LIen decIde wIeLIer LIe empIoyee`s requesL Is reusonubIe.
TIe Issue oI uddIcLIon need noL enLer LIe consIderuLIon uL uII.
TIe poInL oI LIIs exercIse Is Lo provIde un InsIgIL InLo wIuL LIe
smoker ucLuuIIy Iuces In LIe muLerIuIIsL workpIuce. ALLempLs Lo quesLIon
LIe superIorIsm ure InLerpreLed by superIorIsm us LIe eIIecLs oI nIcoLIne
uddIcLIon. Even wIen LIe smoker wIns (reusonubIe uccommoduLIon), Ie
Ioses - LIe smoker Is no more LIun nIcoLIne-uddIcLed und suIIerIng
wILIdruwuI. As Is urgued LIrougIouL, IL Is onIy rumpunL muLerIuIIsm, und
oI wIIcI unLIsmokIng Is u crILIcuI sympLom, LIuL Is IIgIIy dungerous.
rom uII quurLers, unLIsmokIng Is beIng porLruyed us u mujor
409
409
Rampant Antismoking Signifies Grave Danger
grounds. IrsLIy, smokIng Is u personuI rIgIL. TIe exLenL oI LIe
unLIsmokIng meusures wus un InLrusIon InLo LIe personuI IubILs oI
empIoyees. SecondIy, nIcoLIne uddIcLIon und wILIdruwuI ure dIsubIIILIes
LIuL come under LIe jurIsdIcLIon oI unLI-dIscrImInuLIon Iuws. n LIuL LIere
wus u poLenLIuI Ior 1z-Iour sIIILs, LIe poIIcy dIscrImInuLed uguInsL Ieuvy
smokers In purLIcuIur wIo muy IInd IL dIIIIcuIL Lo go Ior LIIs perIod
wILIouL u cIgureLLe. ReIIeI In LIe Iorm oI permILLed ouLdoor smokIng wus
LIereIore sougIL LIrougI reusonubIe uccommoduLIon oI u dIsubIIILy.
BrIeIIy, LIe urbILruLor rejecLed LIe IIrsL objecLIon. urson
concIuded LIuL LIe compuny Iud LIe rIgIL Lo bun smokIng uL work boLI on
LIe busIs oI ILs IegILImuLe busIness InLeresLs und In promoLIng empIoyee
IeuILI und suIeLy. However, Ie upIeId LIe second objecLIon, concIudIng
LIuL wILIdruwuI sympLoms over IengLIy sIIIL-perIods couId produce
ImpuIred IuncLIonIng. TIereIore, LIe unLIsmokIng poIIcy dIscrImInuLed
uguInsL sucI workers. TIe empIoyer wus obIIged Lo uccommoduLe LIe
dIsubIIILy up Lo undue IurdsIIp (Ior LIe empIoyer).
TIe ruIIng muy seem udvunLugeous Ior LIe smoker In u IosLIIe,
unLIsmokIng envIronmenL. However, IL Is u IoIIow vIcLory. L reInIorces
LIe Ideu oI nIcoLIne uddIcLIon, und LIuL unLIsmokIng cIuIms ure uccuruLe.
RuLIer, LIe surmIsIng In LIe ruIIng reIIecLs LIe superIIcIuIILy oI
muLerIuIIsm.
ConsIdered Irom LIe smoker`s vIewpoInL und wILIIn u
muILIdImensIonuI Irumework, LIe empIoyer`s conducL reIIecLs onIy
superIorIsm. L Is dIIIIcuIL Lo beIIeve LIuL In u workpIuce over sucI u Iurge
expunse und LIuL beIIows ouL noxIous Iumes us u muLLer oI course, LIuL
LIere cun be no pIuce Ior u cIgureLLe. L pIuys on LIe mInd oI LIe smoker,
Ior wIom smokIng Is u second-nuLure IubIL, LIuL smokIng zo-IeeL uwuy,
wIere Ie probubIy used Lo smoke Ior muny yeurs, poses no dunger Lo
unyone. L Is LIe unreusonubIeness oI LIe demund LIuL Is uggruvuLIng und
poLenLIuIIy dIsLrucLIng. L produces u severe LensIon beLween empIoyer
und empIoyee. L Is u mInd-gume beIng pIuyed wILI empIoyees. TIe
empIoyer IIdes beIInd LIe cIuIm oI promoLIng empIoyee IeuILI und
suIeLy. YeL, LIIs Ideu oI IeuILI Is obvIousIy u medIco-muLerIuIIsL one. WIuL
oI psycIoIogIcuI und socIuI IeuILI? TIese ure ubsenL In LIIs workpIuce. L
Is In LIe InLeresLs oI LIe empIoyer Lo muInLuIn good reIuLIons, u poInL oI
IeuILI, wILI empIoyees. WIere empIoyees ure Iuppy, LIey ure producLIve.
TIe quesLIon cun weII be usked us Lo wIy un empIoyer wouId
InLenLIonuIIy muInLuIn dIvIsIon wILI empIoyees. L Is LIe poInL oI LIIs
enLIre dIscussIon. AL u LIme oI muLerIuIIsL domInuLIon, psycIoIogIcuI,
socIuI, moruI und spIrILuuI dImensIons ure sLrIpped Irom consIderuLIon. L
Is LIe cIurucLer deIIcIencIes LIuL come Lo LIe Iore, e.g., IuugILIness,
obsessIon wILI conLroI, meguIomunIu. WILIIn LIIs Irumework LIe
Preventive Medicine & Health Promotion
empIoyee Is vIewed us no more LIun u cog In LIe mucIIne, workIng Ior u
superIorIsL empIoyer und wIere poIIcIes InLenLIonuIIy reIIecL LIe
superIorIsm (deIIcIencIes) In moLIon: LIe empIoyer Is In compIeLe cIurge
uLLempLIng Lo uccounL wILIIn LIIs uusLere envIronmenL Ior every momenL
und movemenL oI un empIoyee. L Is LIe sorL oI uLmospIere wIere smIIIng
Is Irowned upon: SmIIIng cun onIy meun LIuL u person Is noL workIng Iurd
enougI. As menLIoned, LIIs superIorIsm In IndusLrIuI IygIene Ius been
seen beIore und IL LypIcuIIy Ius smokIng In ILs sIgILs; smokIng poses un
uIIen wIII. n IucL, II smokers ure unIuppy wILI LIeIr work sILuuLIon, LIe
IIgI IIkeIIIood Is LIuL LIe workpIuce Is under muLerIuIIsL domInuLIon -
psycIoIogIcuI und socIuI IeuILI do noL IIgure.
TIe urbILruLor wouId Iuve Iound In Iuvor oI LIe IIrsL objecLIon II u
muILIdImensIonuI vIew oI IeuILI wus consIdered. HuvIng IuIIed LIe IIrsL
objecLIon und wIere LIe ucLuuI probIem resIdes, muLerIuIIsm musL IInd In
Iuvor oI LIe second objecLIon. UnIorLunuLeIy, LIIs cIosed Ioop muInLuIns
LIe IIrsL probIem und reInIorces LIe uddIcLIon probIem. WILI LIe second
objecLIon beIng upIeId, LIe empIoyer Is obIIged Lo uccommoduLe LIe
dIsubIIILy, und possIbIy under proLesL. I LIe empIoyer cun now
uccommoduLe LIe dIsubIIILy under IeguI obIIguLIon, LIen uccommoduLIon
couId Iuve been provIded wILIouL u resorLIng Lo urbILruLIon.
AccommoduLIon sIorL oI urbILruLIon dId noL occur becuuse goodwIII und
good sense do noL IIgure In muLerIuIIsL reusonIng. L sIouId be obvIous
LIuL II muLerIuIIsm dId noL domInuLe, II empIoyers und socIeLy Iud u
judIcIous dIsposILIon, boLI probIems ubove wouId noL exIsL.
TIe onIy sIorL-Lerm reIIeI In LIese cIrcumsLunces Is u
reconsIderuLIon oI LIe IIrsL objecLIon. RuLIer LIun quesLIon LIe rIgIL oI LIe
empIoyer Lo Impose unreusonubIe smokIng buns, LIe proposILIon cun be
posed us u requesL Ior un uccommoduLIon oI smokIng. or exumpIe, gIven
LIuL LIere Is no ImmedIuLe dunger posed by smokIng In ouLdoor ureus, u
requesL cun be mude Ior smokIng Lo be permILLed In LIese ureus. L cun
uIso be poInLed ouL Lo un empIoyer LIuL sucI urrungemenLs keep everyone
Iuppy und Is conducIve Lo producLIvILy. I un empIoyer reIuses, un
urbILruLor cun LIen decIde wIeLIer LIe empIoyee`s requesL Is reusonubIe.
TIe Issue oI uddIcLIon need noL enLer LIe consIderuLIon uL uII.
TIe poInL oI LIIs exercIse Is Lo provIde un InsIgIL InLo wIuL LIe
smoker ucLuuIIy Iuces In LIe muLerIuIIsL workpIuce. ALLempLs Lo quesLIon
LIe superIorIsm ure InLerpreLed by superIorIsm us LIe eIIecLs oI nIcoLIne
uddIcLIon. Even wIen LIe smoker wIns (reusonubIe uccommoduLIon), Ie
Ioses - LIe smoker Is no more LIun nIcoLIne-uddIcLed und suIIerIng
wILIdruwuI. As Is urgued LIrougIouL, IL Is onIy rumpunL muLerIuIIsm, und
oI wIIcI unLIsmokIng Is u crILIcuI sympLom, LIuL Is IIgIIy dungerous.
rom uII quurLers, unLIsmokIng Is beIng porLruyed us u mujor
410
410
Rampant Antismoking Signifies Grave Danger
poInL oI superIorILy. SporLsmen wIo smoke musL keep LIeIr IubIL uwuy
Irom LIe pubIIc urenu; IL Is Luboo Lo be seen smokIng. As IndIcuLed In un
eurIIer secLIon, u nonsmokIng LennIs cIumpIon IundIIng u ceIebruLory
cIgur mude LIe IronL puge oI LIe mujor newspuper In VIcLorIu, AusLruIIu.
TIe CenLer Ior DIseuse ConLroI (CDC) Ius u secLIon on ILs websILe Ior
ceIebrILIes uguInsL smokIng; uppurenLIy ceIebrILIes occupy u IIgI-poInL
oI moruI recLILude - purLIcuIurIy II LIey ure unLIsmokIng. RuLIer, boLI LIe
CDC und LIe ceIebrILIes InvoIved demonsLruLe LIe sume superIIcIuIILy oI
reusonIng.
A oston Globe urLIcIe (AugusL 1, zoo1) reporLed on SenuLor
Tom BIrmIngIum`s poIILIcuI quesL Lo be governor. PurL oI LIe
eIecLIoneerIng wus Iong-runge bIcycIIng LIrougI LIe consLILuency.
AppurenLIy, LIIs bIcycIIng vILuIILy wus LIe resuIL oI quILLIng Lobucco
smokIng. TIe more concernIng uspecL oI LIe reporL Is ILs observuLIon LIuL
|p|udgy und pusLy, BIrmIngIum currIed sucI u Ieuvy smoker`s cougI
LIuL Ie wus prone Lo proLrucLed IuckIng jugs. CIose poIILIcuI observers
wondered wIeLIer LIe nIcoLIne-uddIcLed IegIsIuLIve Ieuder Iud LIe
sLumInu Ior u sLuLewIde cumpuIgn Ior governor. And wIeLIer voLers wouId
eIecL someone wILI u Lwo-puck-u-duy IubIL. AILer uII, one musL go buck Lo
LIe 1qo`s und CIrIsLIun HerLer Lo IInd LIe IusL governor wIo wus u
cIgureLLe smoker.
TIe senuLor receIved numerous uccoIudes Irom IIs consLILuenLs
Ior IIs decIsIon Lo quIL smokIng und IIs now more uLIIeLIc uppeurunce. A
smoker beIng eIecLed Lo IIgI posILIons In pubIIc servIce Ius become
ImpIuusIbIe. AppurenLIy, nIcoLIne uddIcLIon renders LIe smoker
IncupubIe oI coIerenL decIsIon-mukIng. EquuIIy uppurenL Is LIuL
uLIIeLIcIsm, und beIng ubIe Lo bIcycIe LIrougI u consLILuency, Is conducIve
Lo proIound LIougIL. TIereIore, IL Is noL jusL nonsmokIng, buL
unLIsmokIng LIuL produces superIor pubIIc servunLs. TIIs Is borderIng on
sLuLemenLs by KurI AsLeI oI LIe NuzI regIme LIuL scIenLIsLs were requIred,
us u IIgI poInL oI duLy, Lo be smoke-Iree; uccordIng Lo LIIs deIuded mInd,
smokIng couId InLerIere wILI scIenLIIIc enquIry. AdoII HILIer beIIeved
LIuL II Ie Iud remuIned u smoker, Ie wouId never Iud come Lo power (see
secLIon A riej Histor oj Antismolin). As wIII be consIdered In LIe IInuI
cIupLer, unLIsmokIng Is u crILIcuI sympLom oI rumpunL muLerIuIIsm, wIIcI
In Lurn Is sympLomuLIc oI u meLupIysIcuI crIsIs. L Is LIe unLIsmokIng
IeudersIIp, sympLomuLIc oI muLerIuIIsL domInuLIon, oI LIe IusL Iew
decudes, und LIe pubIIc LIuL puL LIem LIere, LIuL Ius brougIL muny
wesLern socIeLIes Lo LIe brInk oI u very greuL dIsusLer.
L cun reusonubIy be concIuded Irom LIe IorgoIng LIuL IIgIIy
quesLIonubIe InIormuLIon, munuIucLured by un IncompeLenL, unsLubIe
menLuIILy, cun wreuk Iuvoc wIen IL Is propuguLed under LIe preLense oI
Preventive Medicine & Health Promotion
scIenLIIIc credIbIIILy. As un SS und un ESS pundemIc spreuds, LIe
IrruLIonuI Ieur und superIorILy become more ucuLe und LIe demunds Ior
proLecLIon become more bIzurre und socIuIIy dungerous.
TIere ure muny nonsmokers wIo wIII IuppIIy sIL uround un open
Indoor-IIre, or In u resLuurunL LIuL obvIousIy Ius un operuLIng kILcIen
(I.e., cookIng-smoke). AILIougI umbIenL smoke cun be quILe vIsIbIe In
sucI seLLIngs, IL produces no LroubIIng. YeL, IeL u IIL cIgureLLe uppeur und
punIc und un erudIcuLIon procedure ensue, und proLecLed by LIe
superIorILy syndrome. TIIs reIIecLs LIe deIuded, supersLILIous, beIIeI LIuL
Lobucco smoke Is someIow ter dIIIerenL Irom LIese oLIer sources oI
smoke, mugIcuIIy endowed wILI uII munner oI dungerous propensILIes: n
LypIcuI seLLIngs none oI LIIs smoke, Irom wIuLever source, poses u dunger
Lo u normuLIve runge oI IuncLIonIng. TIese deIuded beIIeIs ure LIe resuIL
oI reIenLIess IeuILIIsL propugundu, I.e., IuLrogenIc.
L wus consIdered In LIe secLIon A riej Histor oj Antismolin
LIuL superIorIsm cun be IosLered In LIe ubsence oI coIerenL IucLs. AII LIe
more IrenzIed Is LIe unLIsmokIng wIen IL beIIeves IL Ius scIenLIIIc supporL.
TIIs ETS-Ied unLIsmokIng cumpuIgn Ius proceeded uIong LIe sume
conLorLed InLerpreLuLIon oI sLuLIsLIcuI InIormuLIon und u medIcuI-
proIessIon consensus eIIecL us wus LIe cuse concernIng ucLIve smokIng -
und wILI even Iur, Iur Iess evIdence. As ucLIve smokIng wus munuIucLured
InLo un expIuIn uII Ior uII munner oI muIudIes und eurIy morLuIILy In
smokers, now, Loo, ETS Ius been munuIucLured InLo un expIuIn uII Ior
muIudIes und eurIy morLuIILy In nonsmokers. L Is LIrougI LIe dIsusLer oI
IIIesLyIe epIdemIoIogy LIuL LIe cIrcumsLunce Ius been uIIowed Lo
degeneruLe InLo sucI un InIerenLIuI mIre. TIe nuLure oI LIe unLIsmokIng
Iunguuge und cIuIms Is essenLIuIIy LIe sume us IL Ius been over LIe IusL Iew
cenLurIes. L Is now sImpIy more uggressIve, more superIorIsL, gIven ILs
scIenLIIIc IegILImucy.
TIe muLerIuIIsL menLuIILy reIIecLed In unLIsmokIng Ius uIso
emburked on redeIInIng IIsLory. or exumpIe, concernIng u
commemoruLIve sLump Issue, LIe US PosL OIIIce uuLIorIzed LIe
uIrbrusIIng ouL oI u cIgureLLe dungIIng Irom Jumes Deun`s IIps. TIe sume
wus done wILI BIuck AmerIcun bIues guILurIsL RoberL JoInson und wILI
urLIsL Juckson PoIIock. TIe rencI PosL OIIIce dId sImIIurIy wILI
pIIIosopIer Andre MuIruux.
CoIumbIu Records Ius removed u cIgureLLe PuuI SImon wus
IoIdIng Lo IIs IIps Ior LIe CD cover oI LIe reLrospecLIve oI SImon und
GurIunkeI LILIed OId rIends. A cIgureLLe wus uIrbrusIed ouL Irom LIe
Iund oI u cusL member Ior LIe cover oI LIe zLI AnnIversury CD oI TIe
Rocky Horror PIcLure SIow. A cIgureLLe In PuuI McCurLney`s rIgIL Iund
Ius been removed Irom LIe cover oI LIe uIbum Abbey Roud. An
411
411
Rampant Antismoking Signifies Grave Danger
poInL oI superIorILy. SporLsmen wIo smoke musL keep LIeIr IubIL uwuy
Irom LIe pubIIc urenu; IL Is Luboo Lo be seen smokIng. As IndIcuLed In un
eurIIer secLIon, u nonsmokIng LennIs cIumpIon IundIIng u ceIebruLory
cIgur mude LIe IronL puge oI LIe mujor newspuper In VIcLorIu, AusLruIIu.
TIe CenLer Ior DIseuse ConLroI (CDC) Ius u secLIon on ILs websILe Ior
ceIebrILIes uguInsL smokIng; uppurenLIy ceIebrILIes occupy u IIgI-poInL
oI moruI recLILude - purLIcuIurIy II LIey ure unLIsmokIng. RuLIer, boLI LIe
CDC und LIe ceIebrILIes InvoIved demonsLruLe LIe sume superIIcIuIILy oI
reusonIng.
A oston Globe urLIcIe (AugusL 1, zoo1) reporLed on SenuLor
Tom BIrmIngIum`s poIILIcuI quesL Lo be governor. PurL oI LIe
eIecLIoneerIng wus Iong-runge bIcycIIng LIrougI LIe consLILuency.
AppurenLIy, LIIs bIcycIIng vILuIILy wus LIe resuIL oI quILLIng Lobucco
smokIng. TIe more concernIng uspecL oI LIe reporL Is ILs observuLIon LIuL
|p|udgy und pusLy, BIrmIngIum currIed sucI u Ieuvy smoker`s cougI
LIuL Ie wus prone Lo proLrucLed IuckIng jugs. CIose poIILIcuI observers
wondered wIeLIer LIe nIcoLIne-uddIcLed IegIsIuLIve Ieuder Iud LIe
sLumInu Ior u sLuLewIde cumpuIgn Ior governor. And wIeLIer voLers wouId
eIecL someone wILI u Lwo-puck-u-duy IubIL. AILer uII, one musL go buck Lo
LIe 1qo`s und CIrIsLIun HerLer Lo IInd LIe IusL governor wIo wus u
cIgureLLe smoker.
TIe senuLor receIved numerous uccoIudes Irom IIs consLILuenLs
Ior IIs decIsIon Lo quIL smokIng und IIs now more uLIIeLIc uppeurunce. A
smoker beIng eIecLed Lo IIgI posILIons In pubIIc servIce Ius become
ImpIuusIbIe. AppurenLIy, nIcoLIne uddIcLIon renders LIe smoker
IncupubIe oI coIerenL decIsIon-mukIng. EquuIIy uppurenL Is LIuL
uLIIeLIcIsm, und beIng ubIe Lo bIcycIe LIrougI u consLILuency, Is conducIve
Lo proIound LIougIL. TIereIore, IL Is noL jusL nonsmokIng, buL
unLIsmokIng LIuL produces superIor pubIIc servunLs. TIIs Is borderIng on
sLuLemenLs by KurI AsLeI oI LIe NuzI regIme LIuL scIenLIsLs were requIred,
us u IIgI poInL oI duLy, Lo be smoke-Iree; uccordIng Lo LIIs deIuded mInd,
smokIng couId InLerIere wILI scIenLIIIc enquIry. AdoII HILIer beIIeved
LIuL II Ie Iud remuIned u smoker, Ie wouId never Iud come Lo power (see
secLIon A riej Histor oj Antismolin). As wIII be consIdered In LIe IInuI
cIupLer, unLIsmokIng Is u crILIcuI sympLom oI rumpunL muLerIuIIsm, wIIcI
In Lurn Is sympLomuLIc oI u meLupIysIcuI crIsIs. L Is LIe unLIsmokIng
IeudersIIp, sympLomuLIc oI muLerIuIIsL domInuLIon, oI LIe IusL Iew
decudes, und LIe pubIIc LIuL puL LIem LIere, LIuL Ius brougIL muny
wesLern socIeLIes Lo LIe brInk oI u very greuL dIsusLer.
L cun reusonubIy be concIuded Irom LIe IorgoIng LIuL IIgIIy
quesLIonubIe InIormuLIon, munuIucLured by un IncompeLenL, unsLubIe
menLuIILy, cun wreuk Iuvoc wIen IL Is propuguLed under LIe preLense oI
Preventive Medicine & Health Promotion
scIenLIIIc credIbIIILy. As un SS und un ESS pundemIc spreuds, LIe
IrruLIonuI Ieur und superIorILy become more ucuLe und LIe demunds Ior
proLecLIon become more bIzurre und socIuIIy dungerous.
TIere ure muny nonsmokers wIo wIII IuppIIy sIL uround un open
Indoor-IIre, or In u resLuurunL LIuL obvIousIy Ius un operuLIng kILcIen
(I.e., cookIng-smoke). AILIougI umbIenL smoke cun be quILe vIsIbIe In
sucI seLLIngs, IL produces no LroubIIng. YeL, IeL u IIL cIgureLLe uppeur und
punIc und un erudIcuLIon procedure ensue, und proLecLed by LIe
superIorILy syndrome. TIIs reIIecLs LIe deIuded, supersLILIous, beIIeI LIuL
Lobucco smoke Is someIow ter dIIIerenL Irom LIese oLIer sources oI
smoke, mugIcuIIy endowed wILI uII munner oI dungerous propensILIes: n
LypIcuI seLLIngs none oI LIIs smoke, Irom wIuLever source, poses u dunger
Lo u normuLIve runge oI IuncLIonIng. TIese deIuded beIIeIs ure LIe resuIL
oI reIenLIess IeuILIIsL propugundu, I.e., IuLrogenIc.
L wus consIdered In LIe secLIon A riej Histor oj Antismolin
LIuL superIorIsm cun be IosLered In LIe ubsence oI coIerenL IucLs. AII LIe
more IrenzIed Is LIe unLIsmokIng wIen IL beIIeves IL Ius scIenLIIIc supporL.
TIIs ETS-Ied unLIsmokIng cumpuIgn Ius proceeded uIong LIe sume
conLorLed InLerpreLuLIon oI sLuLIsLIcuI InIormuLIon und u medIcuI-
proIessIon consensus eIIecL us wus LIe cuse concernIng ucLIve smokIng -
und wILI even Iur, Iur Iess evIdence. As ucLIve smokIng wus munuIucLured
InLo un expIuIn uII Ior uII munner oI muIudIes und eurIy morLuIILy In
smokers, now, Loo, ETS Ius been munuIucLured InLo un expIuIn uII Ior
muIudIes und eurIy morLuIILy In nonsmokers. L Is LIrougI LIe dIsusLer oI
IIIesLyIe epIdemIoIogy LIuL LIe cIrcumsLunce Ius been uIIowed Lo
degeneruLe InLo sucI un InIerenLIuI mIre. TIe nuLure oI LIe unLIsmokIng
Iunguuge und cIuIms Is essenLIuIIy LIe sume us IL Ius been over LIe IusL Iew
cenLurIes. L Is now sImpIy more uggressIve, more superIorIsL, gIven ILs
scIenLIIIc IegILImucy.
TIe muLerIuIIsL menLuIILy reIIecLed In unLIsmokIng Ius uIso
emburked on redeIInIng IIsLory. or exumpIe, concernIng u
commemoruLIve sLump Issue, LIe US PosL OIIIce uuLIorIzed LIe
uIrbrusIIng ouL oI u cIgureLLe dungIIng Irom Jumes Deun`s IIps. TIe sume
wus done wILI BIuck AmerIcun bIues guILurIsL RoberL JoInson und wILI
urLIsL Juckson PoIIock. TIe rencI PosL OIIIce dId sImIIurIy wILI
pIIIosopIer Andre MuIruux.
CoIumbIu Records Ius removed u cIgureLLe PuuI SImon wus
IoIdIng Lo IIs IIps Ior LIe CD cover oI LIe reLrospecLIve oI SImon und
GurIunkeI LILIed OId rIends. A cIgureLLe wus uIrbrusIed ouL Irom LIe
Iund oI u cusL member Ior LIe cover oI LIe zLI AnnIversury CD oI TIe
Rocky Horror PIcLure SIow. A cIgureLLe In PuuI McCurLney`s rIgIL Iund
Ius been removed Irom LIe cover oI LIe uIbum Abbey Roud. An
412
412
Rampant Antismoking Signifies Grave Danger
ImprompLu pIoLo oI BrILney Speurs on LIe buIcony oI u Sydney IoLeI Iud
LIe oIIendIng cIgureLLe sIe wus smokIng uIrbrusIed ouL by US WeekIy.
ORREST (1qq8) provIdes u number oI exumpIes Irom LIe
UnILed KIngdom. A cIgureLLe Ius been removed Irom LIe mouLI oI one oI
LIe cIurucLers uppeurIng In LIe Keep Mum SIe`s NoL So Dumb wur-LIme
udverLIsemenL. n u brocIure pIoLogrupI (TIe MurILIme HerILuge CenLre)
u cIgur Ius been removed Irom LIe mouLI oI LIe greuL engIneer sumburd
KIngdom BruneI. urLIer, |I|n 1q Dr Curdew Iud pIoLogrupIed u
reconsLrucLIon oI LIe IuboruLory bencI on wIIcI IemIng dIscovered
penIcIIIIn. |S|ILuuLed on LIe bencI wus u PeLrI dIsI oI cIgureLLe ends
(IemIng IuvIng been u Ieuvy smoker). TIe reconsLrucLIon wus IocuLed In
SL Mury`s HospILuI, PuddIngLon buL us Dr Curdew reIuLes: 'TIe museum
reconsLrucLIon In 1qq omILLed LIe PeLrI dIsI on LIe grounds LIuL LIe
IospILuI Iud u no smokIng poIIcy..`
L sIouId be un obvIous muLLer LIuL wIuLever unLIsmokers ure
reucLIng Lo, IL Is noL smokIng or cIgureLLes. TIe reucLIon Is enLIreIy
InordInuLe. AnLIsmokers experIence u gruve oIIence uL LIe sIgIL oI u
cIgureLLe or Lobucco smoke. YeL, IL Is by LIeIr own conLorLed LIInkIng LIuL
LIey ure oIIended. TIrougI LIe jeLLIsonIng oI u IIrsL-prIncIpIes spIrILuuIJ
moruI Irumework, mInds ure wuIIowIng In uncorrecLed, conIIIcLed LIougIL
- guIIL, Ieur, IuLred. L Is LIeIr Inner sLuLe LIuL unLIsmokers, LIrougI
denIuI und projecLIon, see In LIe cIgureLLe. And, LIe more conIIIcLed Is LIe
menLuI sLuLe, LIe more ucuLe LIe IIxuLIon. SucI Is LIe conIIIcLed sLuLe LIuL
LIe guIIL-rIdden muLerIuIIsL menLuIILy cunnoL overIook u cIgureLLe
uppeurIng In u pIoLogrupI - IL musL be removed. BeIIevIng LIuL LIeIr
experIence oI woe Is beIng produced by LIe exLernuIILy (cIgureLLe), LIe
mInd beIIeves LIuL IL cun be ubsoIved oI ILs sense oI guIIL by erudIcuLIng
LIe source undJor beIILLIIng LIe smoker. L Is LIe unLIsmokers LIuL reIIecL
LIe unsLubIe menLuIILy, uLLempLIng Lo exoneruLe LIemseIves by projecLIng
LIeIr guIIL onLo smokers.
OI wIuL concern wouId IL be Lo LIe muLerIuIIsL menLuIILy, wIIcI
Ius uIreudy IIjucked scIence, LIuL IL now IIjucks IIsLory? HonesLy does
noL IIgure In LIe menLuIILy uL uII - ILs mode Is Iukery or seII-decepLIon.
TIIs revIsIonIsm Is consIsLenL wILI dIcLuLorIuI (superIorIsL) or LoLuIILurIun
LendencIes; IIsLory Is reconsLrucLed In deIuded, seII-servIng pursuILs.
TIe seLLIng oI enLIreIy quesLIonubIe precedenLs wILI smokIng und
exposure Lo ETS Ius opened LIe door Lo oLIer groups demundIng poIIcy
cIunges uccommoduLIng LIeIr compIuInLs. or exumpIe, OukIey (1qqq)
IndIcuLes LIuL:
personuI scenLs muy weII be nexL on LIe unLI-everyLIIng
IIL IIsL. An orgunIzuLIon cuIIed LIe Humun EcoIogy
AcLIon eugue Ius decIured LIuL 'PerIume Is goIng Lo be
Preventive Medicine & Health Promotion
LIe Lobucco smoke oI Lomorrow.` TIe UnIversILy oI
MInnesoLu`s ScIooI oI SocIuI Work Ius udopLed u 'scenL-
Iree poIIcy` bunnIng perIumes, coIognes, sIumpoos und
oLIer producLs Irom cerLuIn ureus LIuL couId cuuse
dIscomIorL Lo LIose wIo suIIer Irom 'muILIpIe cIemIcuI
sensILIvILIes.` CommenLIng upon LIIs, The Neu Yorl
TImes suggesLed LIuL IL muy murk LIe begInnIng oI u
nuLIonuI 'cIemIcuI correcLness` revoIuLIon..'No one
sIouId be weurIng perIume Lo LIe LIeuLer,` suys JuIIu
KenduII oI LIe CIemIcuI njury ILIguLIon ProjecL. 'WIy
sIouId we Iuve bruIn dumuge becuuse peopIe ure
weurIng LoxIc cIemIcuIs?` ExpIuInIng LIe upLIy numed
orgunIzuLIon`s ugendu, sIe suys, 'BusIcuIIy, we wunL Lo
desLroy LIe Irugrunce IndusLry.` (CI.;, p.1q)
WILIIn u sIorL LIme LIIs scenL-Iree poIIcy Ius been udopLed by
quILe u number oI NorLI AmerIcun esLubIIsImenLs und cILIes. umenLo
(zooo) InIorms:
|I|n OLLuwu, pubIIc buses usk rIders Lo be seuLed onIy
wILIouL scenLs, wIIIe LIe Queenswuy-CurIeLon HospILuI
Ius emburked on u 'No ScenLs Is Good ScenLs`
cumpuIgn. AL IeusL one IIgI scIooI ouLsIde ToronLo Ius
gone Irugrunce-Iree. And LIougI Cunudu Is IurdIy
IILIgIous compured Lo ILs souLIern neIgIbor, u ToronLo
resIdenL IIIed suIL uguInsL u neIgIbor Ior InvudIng Ier
uIr spuce wILI cookIng smeIIs. On PrInce Edwurd sIund,
oII LIe counLry`s eusL cousL, u joInL unIon-empIoyer
recommenduLIon wus recenLIy mude Lo bun perIumes
und uILersIuves Irom governmenL oIIIces.
YeL nowIere Is IL worse LIun oceun-IIsI HuIIIux, Novu
ScoLIu. MosL oI LIe cILy`s pubIIc InsLILuLIons, und u
number oI prIvuLe busInesses, now requesL or demund
LIuL workers be 'scenL-Iree.`..
Grueme GIIduy, u IeuILI und suIeLy oIIIcer wILI LIe York
RegIon (ToronLo`s provInce) DIsLrIcL ScIooI Bourd,
LruveIs Irom scIooI Lo scIooI wILI u Lroupe oI Auroru
HIgI drumu sLudenLs, wIo perIorm under u bunner
decIurIng 'No ScenLs Mukes Sense.` He compures
smeIIIng oLIer peopIe`s Irugrunces Lo LIe dIre cIuIms
some Iuve mude ubouL InIuIIng oLIers` cIgureLLe smoke.
nLeresLIngIy, buns ure beIng InsLILuLed even LIougI LIe medIcuI
413
413
Rampant Antismoking Signifies Grave Danger
ImprompLu pIoLo oI BrILney Speurs on LIe buIcony oI u Sydney IoLeI Iud
LIe oIIendIng cIgureLLe sIe wus smokIng uIrbrusIed ouL by US WeekIy.
ORREST (1qq8) provIdes u number oI exumpIes Irom LIe
UnILed KIngdom. A cIgureLLe Ius been removed Irom LIe mouLI oI one oI
LIe cIurucLers uppeurIng In LIe Keep Mum SIe`s NoL So Dumb wur-LIme
udverLIsemenL. n u brocIure pIoLogrupI (TIe MurILIme HerILuge CenLre)
u cIgur Ius been removed Irom LIe mouLI oI LIe greuL engIneer sumburd
KIngdom BruneI. urLIer, |I|n 1q Dr Curdew Iud pIoLogrupIed u
reconsLrucLIon oI LIe IuboruLory bencI on wIIcI IemIng dIscovered
penIcIIIIn. |S|ILuuLed on LIe bencI wus u PeLrI dIsI oI cIgureLLe ends
(IemIng IuvIng been u Ieuvy smoker). TIe reconsLrucLIon wus IocuLed In
SL Mury`s HospILuI, PuddIngLon buL us Dr Curdew reIuLes: 'TIe museum
reconsLrucLIon In 1qq omILLed LIe PeLrI dIsI on LIe grounds LIuL LIe
IospILuI Iud u no smokIng poIIcy..`
L sIouId be un obvIous muLLer LIuL wIuLever unLIsmokers ure
reucLIng Lo, IL Is noL smokIng or cIgureLLes. TIe reucLIon Is enLIreIy
InordInuLe. AnLIsmokers experIence u gruve oIIence uL LIe sIgIL oI u
cIgureLLe or Lobucco smoke. YeL, IL Is by LIeIr own conLorLed LIInkIng LIuL
LIey ure oIIended. TIrougI LIe jeLLIsonIng oI u IIrsL-prIncIpIes spIrILuuIJ
moruI Irumework, mInds ure wuIIowIng In uncorrecLed, conIIIcLed LIougIL
- guIIL, Ieur, IuLred. L Is LIeIr Inner sLuLe LIuL unLIsmokers, LIrougI
denIuI und projecLIon, see In LIe cIgureLLe. And, LIe more conIIIcLed Is LIe
menLuI sLuLe, LIe more ucuLe LIe IIxuLIon. SucI Is LIe conIIIcLed sLuLe LIuL
LIe guIIL-rIdden muLerIuIIsL menLuIILy cunnoL overIook u cIgureLLe
uppeurIng In u pIoLogrupI - IL musL be removed. BeIIevIng LIuL LIeIr
experIence oI woe Is beIng produced by LIe exLernuIILy (cIgureLLe), LIe
mInd beIIeves LIuL IL cun be ubsoIved oI ILs sense oI guIIL by erudIcuLIng
LIe source undJor beIILLIIng LIe smoker. L Is LIe unLIsmokers LIuL reIIecL
LIe unsLubIe menLuIILy, uLLempLIng Lo exoneruLe LIemseIves by projecLIng
LIeIr guIIL onLo smokers.
OI wIuL concern wouId IL be Lo LIe muLerIuIIsL menLuIILy, wIIcI
Ius uIreudy IIjucked scIence, LIuL IL now IIjucks IIsLory? HonesLy does
noL IIgure In LIe menLuIILy uL uII - ILs mode Is Iukery or seII-decepLIon.
TIIs revIsIonIsm Is consIsLenL wILI dIcLuLorIuI (superIorIsL) or LoLuIILurIun
LendencIes; IIsLory Is reconsLrucLed In deIuded, seII-servIng pursuILs.
TIe seLLIng oI enLIreIy quesLIonubIe precedenLs wILI smokIng und
exposure Lo ETS Ius opened LIe door Lo oLIer groups demundIng poIIcy
cIunges uccommoduLIng LIeIr compIuInLs. or exumpIe, OukIey (1qqq)
IndIcuLes LIuL:
personuI scenLs muy weII be nexL on LIe unLI-everyLIIng
IIL IIsL. An orgunIzuLIon cuIIed LIe Humun EcoIogy
AcLIon eugue Ius decIured LIuL 'PerIume Is goIng Lo be
Preventive Medicine & Health Promotion
LIe Lobucco smoke oI Lomorrow.` TIe UnIversILy oI
MInnesoLu`s ScIooI oI SocIuI Work Ius udopLed u 'scenL-
Iree poIIcy` bunnIng perIumes, coIognes, sIumpoos und
oLIer producLs Irom cerLuIn ureus LIuL couId cuuse
dIscomIorL Lo LIose wIo suIIer Irom 'muILIpIe cIemIcuI
sensILIvILIes.` CommenLIng upon LIIs, The Neu Yorl
TImes suggesLed LIuL IL muy murk LIe begInnIng oI u
nuLIonuI 'cIemIcuI correcLness` revoIuLIon..'No one
sIouId be weurIng perIume Lo LIe LIeuLer,` suys JuIIu
KenduII oI LIe CIemIcuI njury ILIguLIon ProjecL. 'WIy
sIouId we Iuve bruIn dumuge becuuse peopIe ure
weurIng LoxIc cIemIcuIs?` ExpIuInIng LIe upLIy numed
orgunIzuLIon`s ugendu, sIe suys, 'BusIcuIIy, we wunL Lo
desLroy LIe Irugrunce IndusLry.` (CI.;, p.1q)
WILIIn u sIorL LIme LIIs scenL-Iree poIIcy Ius been udopLed by
quILe u number oI NorLI AmerIcun esLubIIsImenLs und cILIes. umenLo
(zooo) InIorms:
|I|n OLLuwu, pubIIc buses usk rIders Lo be seuLed onIy
wILIouL scenLs, wIIIe LIe Queenswuy-CurIeLon HospILuI
Ius emburked on u 'No ScenLs Is Good ScenLs`
cumpuIgn. AL IeusL one IIgI scIooI ouLsIde ToronLo Ius
gone Irugrunce-Iree. And LIougI Cunudu Is IurdIy
IILIgIous compured Lo ILs souLIern neIgIbor, u ToronLo
resIdenL IIIed suIL uguInsL u neIgIbor Ior InvudIng Ier
uIr spuce wILI cookIng smeIIs. On PrInce Edwurd sIund,
oII LIe counLry`s eusL cousL, u joInL unIon-empIoyer
recommenduLIon wus recenLIy mude Lo bun perIumes
und uILersIuves Irom governmenL oIIIces.
YeL nowIere Is IL worse LIun oceun-IIsI HuIIIux, Novu
ScoLIu. MosL oI LIe cILy`s pubIIc InsLILuLIons, und u
number oI prIvuLe busInesses, now requesL or demund
LIuL workers be 'scenL-Iree.`..
Grueme GIIduy, u IeuILI und suIeLy oIIIcer wILI LIe York
RegIon (ToronLo`s provInce) DIsLrIcL ScIooI Bourd,
LruveIs Irom scIooI Lo scIooI wILI u Lroupe oI Auroru
HIgI drumu sLudenLs, wIo perIorm under u bunner
decIurIng 'No ScenLs Mukes Sense.` He compures
smeIIIng oLIer peopIe`s Irugrunces Lo LIe dIre cIuIms
some Iuve mude ubouL InIuIIng oLIers` cIgureLLe smoke.
nLeresLIngIy, buns ure beIng InsLILuLed even LIougI LIe medIcuI
414
414
Rampant Antismoking Signifies Grave Danger
esLubIIsImenL does noL consIder muILIpIe cIemIcuI sensILIvILy (MCS) or
envIronmenLuI IIIness u IegILImuLe orgunIc dIseuse. ProIessor H. Jumes
Wedner proIIers LIuL mIddIe-cIuss wIILe women ure mosL IIkeIy Lo
compIuIn oI IL. TypIcuIIy, LIey`re weII oII enougI LIuL LIey cun uIIord Lo
drop ouL II LIey`re uIIergIc Lo LIe enLIre envIronmenL. I you`re poor, you
sImpIy cun`L uIIord Lo Iuve MuILIpIe CIemIcuI SensILIvILy syndrome. We
don`L IuugI uL LIem, buL our IeeIIng Is LIIs In noL u Lrue cIInIcuI
enLILy. (quoLed In umenLo, zooo) As IndIcuLed In un eurIIer secLIon, IL Is
predomInunLIy muLerIuIIsL LIInkers sucI us envIronmenLuI pIysIcIuns or
cIInIcuI ecoIogIsLs und vIcLIm groups LIuL IeIp Lo perpeLuuLe LIe
probIem. AILIougI muny seem Lo beIIeve LIuL LIIs ucquIescIng Lo demunds
Is kInd-IeurLed or poIILe, IL uccompIIsIes LIe opposILe eIIecL - IueIIng oI
un ESS epIdemIc (I.e., coddIIng or reInIorcIng eIIecL). TIe more IL Is
propuguLed LIuL sucI exposures cun do Iurm, LIe IIgIer LIe IncIdence oI
persons experIencIng LIe Iurm. TIese suIIerers do merIL compussIon
und IeIp. However, IL Is psycIoIogIcuI ussIsLunce LIuL LIey requIre.
DruggIng pubIIc poIIcy down Lo LIe demunds oI un unsLubIe menLuIILy
IeIps no-one.
A dIsLurbIng sIgn Is LIuL persons wILIIn u normuLIve runge oI
IuncLIonIng ure mude Lo IeeI guIILy Ior LIeIr scenL-weurIng ucLIvILy. or
exumpIe, un 8q-yeur-oId wus ejecLed Irom CILy HuII In HuIIIux Ior weurIng
perIume Lo u councII meeLIng. WIen conLucLed by The Dcil Neus Ior
commenL LIe womun responded wILI don`L wunL Lo LuIk ubouL IL,
becuuse IL wus reuIIy my own IuuIL. (The Dcil Neus, AprII 16, zooo) A
Nctioncl Post urLIcIe properIy concIudes LIuL |L|Ie cumpuIgn uguInsL
perIumes Is un exumpIe oI u pubIIc IeuILI debuLe corrupLed by vIcLIm
cuILure. As wILI IuLe speecI und sexuuI IurussmenL, LIe dIscussIon Is
conducLed enLIreIy on LIe uccuser`s Lerms. CIuIms oI Injury, be LIey
psycIIc or broncIIuI, ure uccepLed uL Iuce vuIue, on scunL evIdence. (AprII
zo, zooo)
SuIIerersJvIcLIms seem Lo beIIeve, und IuugILIIy so, LIuL IL Is
LIeIr rIgIL Lo Iuve LIeIr IncupucILy wIoIIy uccommoduLed by socIeLy.
However, LIIs ucLuuIIy meuns LIuL LIose IncupucILuLed cun demund
superIor rIgILs. A perusuI oI LIe InLerneL reveuIs LIuL, jusL IIke LIe Issue oI
exposure Lo Lobucco smoke, some beIIeve LIuL exposure Lo Irugrunces Is
LIe equIvuIenL oI ussuuIL und uguInsL wIIcI LIey cun Luke seII-deIensIve
ucLIon. SuIIerersJvIcLIms seem Lo IorgeL LIuL IL Is the wIo ure curryIng un
ubnormuIILy or suscepLIbIIILy, wIeLIer IL be bIoIogIcuI or psycIoIogIcuI.
TIIs IorgeLIuIness Is IosLered by LIe exLernuIIsL bIus oI medIco-
muLerIuIIsm. By LreuLIng LIe endogenous sysLem us u bIuck box, IL Ius
ImproperIy re-deIIned poLenLIuI LrIggers us cuuses oI reucLIons. A LrIgger
meuns LIuL IL Ius no generuI propensILy Ior un eIIecL; LIe LrIgger Ior
Preventive Medicine & Health Promotion
suscepLIbIe persons Is noL probIemuLIc Ior u normuLIve runge oI
IuncLIonIng. L Is In suscepLIbIe persons LIuL LIeIr endogenous sysLem Is
IuIIIng Lo do wIuL u normuIIy-IuncLIonIng endogenous sysLem cun do LIuL
Is LIe cuse, ruLIer LIun LIe ucLIvILy, per se, oI u LrIgger. TIere Is now LIe
ubsurd sILuuLIon LIuL LIose curryIng ubnormuIILIes vIew LIemseIves us
normuI, vIew LIeIr condILIon us enLIreIy uLLrIbuLubIe Lo LIe generuI
cuusuI eIIecLs oI exogenous IucLors, und ure uLLempLIng, successIuIIy, Lo
muke LIose wILIIn u normuLIve runge IeeI guIILy Ior LIeIr ucLuuI normuIILy
(I.e., LIe normuI ure LreuLed us ubnormuI). TIose wILIIn u normuLIve
runge musL now seek LIe permIssIon oI LIe bIoIogIcuIIy III or LIe
psycIoIogIcuIIy wuywurd In LIeIr conducL.
PubIIc poIIcy wus once uncIored Lo u normuLIve runge. ALypIcuI,
ubnormuI reucLIons, wIeLIer bIoIogIcuI or psycIoIogIcuI, dId noL wurrunL
pubIIc poIIcy uILeruLIons. L Is onIy under u muLerIuIIsL ussuuIL, wIIcI
IncoIerenLIy uncIors LIe normuLIve runge Lo LIe uLypIcuI und
dysIuncLIonuI (see uIso IoIIowIng cIupLer), LIuL LIIs rIgILs IIusco Ius
been uIIowed Lo deveIop.
(.:o Dther Antismolin Domc
TIe unLIsmokIng dogmu resLs on u number oI crILIcuI Ideus.
IrsLIy, IL wrongIy ussumes LIuL LIe InIormuLIon IL Is Ied by IIIesLyIe
epIdemIoIogy Is scIenLIIIcuIIy coIerenL. RuLIer, IIIesLyIe epIdemIoIogy
musL ruLe us LIe worsL orgunIzed uLLempL uL scIenLIIIc enquIry ever
underLuken by uny group In LIe sIorL IIsLory oI scIence. rom LIe
Improper IubeIIng oI ETS us dungerous Ior uII seems Lo urIse LIe Ideu oI
nonsmolers' rihts. TIIs Ideu Is evIdenL In sucI nonsmoker rIeLorIc LIuL u
smoker`s rIgIL Lo smoke ends uL LIe nonsmoker`s nose. TIIs concepL Is
predIcuLed on LIe myLIIcuI Ideu LIuL smoke-Iree uIr Is cIeun uIr. TypIcuI uIr
conLuIns uII munner oI muLerIuI: vIruI, bucLerIuI, IunguI, deud skIn
purLIcIes, Iumun und unImuI dunder, oLIer purLIcuIuLe muLLer und guses,
I.e., u verILubIe debrIs-IIeId; persons ure conLInuuIIy breuLIIng In und ouL
uII munner oI muLerIuI. WIeLIer uIr Is suIe does noL reIy on wIeLIer IL Is
cIeun buL wIeLIer IL cun be udequuLeIy processed wILIIn u normuLIve
runge oI IuncLIonIng (I.e., by persons noL IuvIng ubnormuI condILIons).
TIe Ideu LIuL u nonsmoker Ius LIe rIgIL noL Lo be exposed Lo ETS
or LIe rIgIL Lo cIeun uIr Ius Lwo senses, one Is bIoIogIcuI, LIe oLIer
preIerenLIuI. I ETS cun be demonsLruLed us u bIoIogIcuI dunger Ior uII or
mosL persons (I.e., normuLIve runge), LIen LIere Is Indeed un urgumenL Ior
InsLILuLIng u nonsmokers` rIgIL Lo non-exposure. AII LIe uvuIIubIe und
consIderubIe duLu dejinititel demonsLruLe LIuL LIere Is no sucI dunger Lo
u normuLIve runge. AII unLIsmokIng urgumenLs ure bused on IIgIIy
415
415
Rampant Antismoking Signifies Grave Danger
esLubIIsImenL does noL consIder muILIpIe cIemIcuI sensILIvILy (MCS) or
envIronmenLuI IIIness u IegILImuLe orgunIc dIseuse. ProIessor H. Jumes
Wedner proIIers LIuL mIddIe-cIuss wIILe women ure mosL IIkeIy Lo
compIuIn oI IL. TypIcuIIy, LIey`re weII oII enougI LIuL LIey cun uIIord Lo
drop ouL II LIey`re uIIergIc Lo LIe enLIre envIronmenL. I you`re poor, you
sImpIy cun`L uIIord Lo Iuve MuILIpIe CIemIcuI SensILIvILy syndrome. We
don`L IuugI uL LIem, buL our IeeIIng Is LIIs In noL u Lrue cIInIcuI
enLILy. (quoLed In umenLo, zooo) As IndIcuLed In un eurIIer secLIon, IL Is
predomInunLIy muLerIuIIsL LIInkers sucI us envIronmenLuI pIysIcIuns or
cIInIcuI ecoIogIsLs und vIcLIm groups LIuL IeIp Lo perpeLuuLe LIe
probIem. AILIougI muny seem Lo beIIeve LIuL LIIs ucquIescIng Lo demunds
Is kInd-IeurLed or poIILe, IL uccompIIsIes LIe opposILe eIIecL - IueIIng oI
un ESS epIdemIc (I.e., coddIIng or reInIorcIng eIIecL). TIe more IL Is
propuguLed LIuL sucI exposures cun do Iurm, LIe IIgIer LIe IncIdence oI
persons experIencIng LIe Iurm. TIese suIIerers do merIL compussIon
und IeIp. However, IL Is psycIoIogIcuI ussIsLunce LIuL LIey requIre.
DruggIng pubIIc poIIcy down Lo LIe demunds oI un unsLubIe menLuIILy
IeIps no-one.
A dIsLurbIng sIgn Is LIuL persons wILIIn u normuLIve runge oI
IuncLIonIng ure mude Lo IeeI guIILy Ior LIeIr scenL-weurIng ucLIvILy. or
exumpIe, un 8q-yeur-oId wus ejecLed Irom CILy HuII In HuIIIux Ior weurIng
perIume Lo u councII meeLIng. WIen conLucLed by The Dcil Neus Ior
commenL LIe womun responded wILI don`L wunL Lo LuIk ubouL IL,
becuuse IL wus reuIIy my own IuuIL. (The Dcil Neus, AprII 16, zooo) A
Nctioncl Post urLIcIe properIy concIudes LIuL |L|Ie cumpuIgn uguInsL
perIumes Is un exumpIe oI u pubIIc IeuILI debuLe corrupLed by vIcLIm
cuILure. As wILI IuLe speecI und sexuuI IurussmenL, LIe dIscussIon Is
conducLed enLIreIy on LIe uccuser`s Lerms. CIuIms oI Injury, be LIey
psycIIc or broncIIuI, ure uccepLed uL Iuce vuIue, on scunL evIdence. (AprII
zo, zooo)
SuIIerersJvIcLIms seem Lo beIIeve, und IuugILIIy so, LIuL IL Is
LIeIr rIgIL Lo Iuve LIeIr IncupucILy wIoIIy uccommoduLed by socIeLy.
However, LIIs ucLuuIIy meuns LIuL LIose IncupucILuLed cun demund
superIor rIgILs. A perusuI oI LIe InLerneL reveuIs LIuL, jusL IIke LIe Issue oI
exposure Lo Lobucco smoke, some beIIeve LIuL exposure Lo Irugrunces Is
LIe equIvuIenL oI ussuuIL und uguInsL wIIcI LIey cun Luke seII-deIensIve
ucLIon. SuIIerersJvIcLIms seem Lo IorgeL LIuL IL Is the wIo ure curryIng un
ubnormuIILy or suscepLIbIIILy, wIeLIer IL be bIoIogIcuI or psycIoIogIcuI.
TIIs IorgeLIuIness Is IosLered by LIe exLernuIIsL bIus oI medIco-
muLerIuIIsm. By LreuLIng LIe endogenous sysLem us u bIuck box, IL Ius
ImproperIy re-deIIned poLenLIuI LrIggers us cuuses oI reucLIons. A LrIgger
meuns LIuL IL Ius no generuI propensILy Ior un eIIecL; LIe LrIgger Ior
Preventive Medicine & Health Promotion
suscepLIbIe persons Is noL probIemuLIc Ior u normuLIve runge oI
IuncLIonIng. L Is In suscepLIbIe persons LIuL LIeIr endogenous sysLem Is
IuIIIng Lo do wIuL u normuIIy-IuncLIonIng endogenous sysLem cun do LIuL
Is LIe cuse, ruLIer LIun LIe ucLIvILy, per se, oI u LrIgger. TIere Is now LIe
ubsurd sILuuLIon LIuL LIose curryIng ubnormuIILIes vIew LIemseIves us
normuI, vIew LIeIr condILIon us enLIreIy uLLrIbuLubIe Lo LIe generuI
cuusuI eIIecLs oI exogenous IucLors, und ure uLLempLIng, successIuIIy, Lo
muke LIose wILIIn u normuLIve runge IeeI guIILy Ior LIeIr ucLuuI normuIILy
(I.e., LIe normuI ure LreuLed us ubnormuI). TIose wILIIn u normuLIve
runge musL now seek LIe permIssIon oI LIe bIoIogIcuIIy III or LIe
psycIoIogIcuIIy wuywurd In LIeIr conducL.
PubIIc poIIcy wus once uncIored Lo u normuLIve runge. ALypIcuI,
ubnormuI reucLIons, wIeLIer bIoIogIcuI or psycIoIogIcuI, dId noL wurrunL
pubIIc poIIcy uILeruLIons. L Is onIy under u muLerIuIIsL ussuuIL, wIIcI
IncoIerenLIy uncIors LIe normuLIve runge Lo LIe uLypIcuI und
dysIuncLIonuI (see uIso IoIIowIng cIupLer), LIuL LIIs rIgILs IIusco Ius
been uIIowed Lo deveIop.
(.:o Dther Antismolin Domc
TIe unLIsmokIng dogmu resLs on u number oI crILIcuI Ideus.
IrsLIy, IL wrongIy ussumes LIuL LIe InIormuLIon IL Is Ied by IIIesLyIe
epIdemIoIogy Is scIenLIIIcuIIy coIerenL. RuLIer, IIIesLyIe epIdemIoIogy
musL ruLe us LIe worsL orgunIzed uLLempL uL scIenLIIIc enquIry ever
underLuken by uny group In LIe sIorL IIsLory oI scIence. rom LIe
Improper IubeIIng oI ETS us dungerous Ior uII seems Lo urIse LIe Ideu oI
nonsmolers' rihts. TIIs Ideu Is evIdenL In sucI nonsmoker rIeLorIc LIuL u
smoker`s rIgIL Lo smoke ends uL LIe nonsmoker`s nose. TIIs concepL Is
predIcuLed on LIe myLIIcuI Ideu LIuL smoke-Iree uIr Is cIeun uIr. TypIcuI uIr
conLuIns uII munner oI muLerIuI: vIruI, bucLerIuI, IunguI, deud skIn
purLIcIes, Iumun und unImuI dunder, oLIer purLIcuIuLe muLLer und guses,
I.e., u verILubIe debrIs-IIeId; persons ure conLInuuIIy breuLIIng In und ouL
uII munner oI muLerIuI. WIeLIer uIr Is suIe does noL reIy on wIeLIer IL Is
cIeun buL wIeLIer IL cun be udequuLeIy processed wILIIn u normuLIve
runge oI IuncLIonIng (I.e., by persons noL IuvIng ubnormuI condILIons).
TIe Ideu LIuL u nonsmoker Ius LIe rIgIL noL Lo be exposed Lo ETS
or LIe rIgIL Lo cIeun uIr Ius Lwo senses, one Is bIoIogIcuI, LIe oLIer
preIerenLIuI. I ETS cun be demonsLruLed us u bIoIogIcuI dunger Ior uII or
mosL persons (I.e., normuLIve runge), LIen LIere Is Indeed un urgumenL Ior
InsLILuLIng u nonsmokers` rIgIL Lo non-exposure. AII LIe uvuIIubIe und
consIderubIe duLu dejinititel demonsLruLe LIuL LIere Is no sucI dunger Lo
u normuLIve runge. AII unLIsmokIng urgumenLs ure bused on IIgIIy
416
416
Rampant Antismoking Signifies Grave Danger
ctpiccl sLuLIsLIcuI ussocIuLIons. TIereIore, LIose demundIng non-
exposure ure IndIcuLIng u personuI preIerence. n LIe currenL conLexL IL Is
u preIerence generuLed by cuIL (MMES) beIIeI. Persons muy Indeed IoId
purLIcuIur preIerences Ior wIuLever reusons, coIerenL or IncoIerenL.
However, pubIIc poIIcy Is noL bused on personuI preIerences or on uLypIcuI
ussocIuLIons.
OnIy one oI LIe numerous decepLIons InvoIved In LIe currenL
unLIsmokIng crusude Is LIuL LIe Issue oI nonsmokers` rIgILs Ius been
mude Lo uppeur us II IL onIy emerged Irom LIe more recenL scIenLIIIc
InvesLIguLIon oI ETS. RuLIer, nonsmokers` rIgILs were beIng sougIL, Ior
exumpIe, by ASH uL LIe LIme oI LIIs group`s IncepLIon In LIe IuLe-1q6o`s.
TIese rIgILs were beIng sougIL wIen ETS wus noL consIdered IurmIuI uL
uII. SucI demunds were LypIcuIIy, und properIy, vIewed by reguIuLors us
beIng mude by u crunky menLuIILy (see BerrIdge, 1qqq). Groups sucI us
ASH Iuve sImpIy been opporLunIsLIc over LIe IusL Iew decudes In
expIoILIng LIe muLerIuIIsL rIsk uvoIdIng IndIvIduuI LIuL emerged In LIe
mId-1q;o`s. L Ius unIorLunuLeIy been successIuI In dIrecLIng
epIdemIoIogIc reseurcI und LIen munIpuIuLIng ILs quesLIonubIe resuILs
concernIng ETS us scIenLIIIc supporL Ior ILs IncoIerenL und lon-held
nonsmoker rIgILs posILIon.
A purLIcuIurIy uggressIve unLIsmokIng websILe wIII be consIdered
In summurIzIng u number oI Issues ruIsed Lo duLe, e.g., ETS dunger,
cIeun uIr, LIe superIorILy syndrome, nonsmokers` rIgILs. TIe IoIIowIng Is
Irom LIe SmokeIree RevoIuLIon group (uL
www.smokeIreerevoIuLIon.org):
n LIe SmokeIree RevoIuLIon we wunL Lo sLep beyond
LIe currenL smokeIree orgunIzuLIons Lo Luke more
uggressIve proucLIve sLunds. We wunL Lo ensure LIuL
persons wIo wunL Lo cIuIm LIeIr rIgIL Lo breuLIe cIeun
uIr wIII be ubIe Lo do IL In LIIs IIIeLIme. Our InLenL Is Lo
cIunge LIe Lobucco cuILure by cIungIng LIe percepLIons
und ucLIons oI peopIe wIo don`L smoke..TIIs Is u
grussrooLs orgunIzuLIon LIuL requIres ILs members Lo
Luke personuI responsIbIIILy Ior cIungIng LIe worId! We
IeeI IL Is very ImporLunL Lo supporL exIsLIng smokeIree
orgunIzuLIons, Lo keep wrILIng IeLLers Lo poIILIcIuns und
work on uII IronL|s| uguInsL LIe Lobucco pundemIc! We,
Iowever, need Lo be LIe IooL soIdIers In LIe wur uguInsL
secondIund Lobucco smoke! We ure noL InLeresLed In
udvocuLIng Ior smokers excepL Lo deIend LIeIr rIgIL Lo
overcome LIeIr uddIcLIons. Every sIngIe LIme LIe need oI
nIcoLIne uddIcLs ure consIdered|,| LIose needs ure
Preventive Medicine & Health Promotion
uIwuys suLIsIIed uL LIe expense oI LIe rIgILs oI oLIers Lo
breuLIe cIeun uIr! We need Lo uIwuys be cIeur LIuL LIe
onIy uccepLubIe soIuLIons Lo Lobucco smoke poIIuLIon
ure LIose LIuL eIImInuLe LIe poIIuLIon enLIreIy. TIuL
meuns u LoLuI bun on smokIng everywIere excepL In
prIvuLe Iomes! L meuns no more compromIses
brokered by LIe Lobucco IndusLry!..I smokers IInd IL
dIIIIcuIL Lo IIve In u worId LIuL proLecLs LIe rIgIL Lo
breuLIe cIeun uIr LIen LIey sIouId sLop smokIng! We
don`L InLend Lo wuIL Ior poIILIcIuns, busIness owners or
smokers Lo ugree Lo gIve us wIuL Is uIreudy rIgILIuIIy
ours! We InLend Lo move up Irom LIe buck oI LIe bus
und demund our rIgILIuI pIuces In LIe worId!
Every sLruggIe Ior equuIILy begIns wIen oppressed
peopIe wuke up Lo LIeIr oppressIon. TIey musL IIrsL
Ieurn Iow LIeIr oppressors Iuve coerced LIem InLo
submIssIon, LIen persuude LIeIr peers Lo sLund up und
suy no Lo LIeIr oppressors! L`s dIIIIcuIL Ior some peopIe
Lo undersLund LIuL LIe sLruggIe Ior smokeIree uIr Is u
IIgIL Ior cIvII rIgILs. Ike muny oLIer buLLIes Ior equuIILy
IL meuns LukIng ubusIve prIvIIege uwuy Irom u mInorILy
und gIvIng equuIILy Lo everyone. HIsLorIcuIIy LIe
prIvIIeged mInorILy Ius never gIven up wILIouL u buLLIe.
n LIIs buLLIe we ure up uguInsL u powerIuI IndusLry LIuL
wunLs Lo conLInue Lo muke Iuge proIILs Irom u producL
LIuL kIIIs peopIe. We ure uIso up uguInsL u cuILure oI
nIcoLIne uddIcLs wIo wunL Lo proLecL LIe prIvIIege oI
suLIsIyIng LIeIr uddIcLIons uL LIe expense oI everyone
uround LIem. TIere ure no ruLIonuI excuses Ior LIe
conLInuuLIon oI Lobucco cuILure LIe wuy IL Ius exIsLed In
LIe pusL..We need Lo be cIeur LIuL LIe debuLe over
Lobucco Is u debuLe ubouL wIeLIer Iumun IIIe Is more
ImporLunL LIun proIILs und uddIcLIon! We uIso need Lo
be cIeur LIuL mosL oI LIe pubIIc Is reudy Ior smokeIree
uIr. WIuL sLunds In LIe wuy ure Iuge poIILIcuI
conLrIbuLIons Irom Lobucco compunIes, mIsconcepLIons
ubouL LIe roIe oI Lobucco Luxes, Iuge proIILs Ior Lobucco
InvesLors und IrruLIonuI busIness owners wIo beIIeve
Lobucco propugundu InsLeud oI common sense!
TIe smokeIree revoIuLIon requIres u commILmenL Irom
every person wIo doesn`L smoke! We need Lo recIuIm
LIe worId Ior ourseIves. L meuns we musL demund LIuL
417
417
Rampant Antismoking Signifies Grave Danger
ctpiccl sLuLIsLIcuI ussocIuLIons. TIereIore, LIose demundIng non-
exposure ure IndIcuLIng u personuI preIerence. n LIe currenL conLexL IL Is
u preIerence generuLed by cuIL (MMES) beIIeI. Persons muy Indeed IoId
purLIcuIur preIerences Ior wIuLever reusons, coIerenL or IncoIerenL.
However, pubIIc poIIcy Is noL bused on personuI preIerences or on uLypIcuI
ussocIuLIons.
OnIy one oI LIe numerous decepLIons InvoIved In LIe currenL
unLIsmokIng crusude Is LIuL LIe Issue oI nonsmokers` rIgILs Ius been
mude Lo uppeur us II IL onIy emerged Irom LIe more recenL scIenLIIIc
InvesLIguLIon oI ETS. RuLIer, nonsmokers` rIgILs were beIng sougIL, Ior
exumpIe, by ASH uL LIe LIme oI LIIs group`s IncepLIon In LIe IuLe-1q6o`s.
TIese rIgILs were beIng sougIL wIen ETS wus noL consIdered IurmIuI uL
uII. SucI demunds were LypIcuIIy, und properIy, vIewed by reguIuLors us
beIng mude by u crunky menLuIILy (see BerrIdge, 1qqq). Groups sucI us
ASH Iuve sImpIy been opporLunIsLIc over LIe IusL Iew decudes In
expIoILIng LIe muLerIuIIsL rIsk uvoIdIng IndIvIduuI LIuL emerged In LIe
mId-1q;o`s. L Ius unIorLunuLeIy been successIuI In dIrecLIng
epIdemIoIogIc reseurcI und LIen munIpuIuLIng ILs quesLIonubIe resuILs
concernIng ETS us scIenLIIIc supporL Ior ILs IncoIerenL und lon-held
nonsmoker rIgILs posILIon.
A purLIcuIurIy uggressIve unLIsmokIng websILe wIII be consIdered
In summurIzIng u number oI Issues ruIsed Lo duLe, e.g., ETS dunger,
cIeun uIr, LIe superIorILy syndrome, nonsmokers` rIgILs. TIe IoIIowIng Is
Irom LIe SmokeIree RevoIuLIon group (uL
www.smokeIreerevoIuLIon.org):
n LIe SmokeIree RevoIuLIon we wunL Lo sLep beyond
LIe currenL smokeIree orgunIzuLIons Lo Luke more
uggressIve proucLIve sLunds. We wunL Lo ensure LIuL
persons wIo wunL Lo cIuIm LIeIr rIgIL Lo breuLIe cIeun
uIr wIII be ubIe Lo do IL In LIIs IIIeLIme. Our InLenL Is Lo
cIunge LIe Lobucco cuILure by cIungIng LIe percepLIons
und ucLIons oI peopIe wIo don`L smoke..TIIs Is u
grussrooLs orgunIzuLIon LIuL requIres ILs members Lo
Luke personuI responsIbIIILy Ior cIungIng LIe worId! We
IeeI IL Is very ImporLunL Lo supporL exIsLIng smokeIree
orgunIzuLIons, Lo keep wrILIng IeLLers Lo poIILIcIuns und
work on uII IronL|s| uguInsL LIe Lobucco pundemIc! We,
Iowever, need Lo be LIe IooL soIdIers In LIe wur uguInsL
secondIund Lobucco smoke! We ure noL InLeresLed In
udvocuLIng Ior smokers excepL Lo deIend LIeIr rIgIL Lo
overcome LIeIr uddIcLIons. Every sIngIe LIme LIe need oI
nIcoLIne uddIcLs ure consIdered|,| LIose needs ure
Preventive Medicine & Health Promotion
uIwuys suLIsIIed uL LIe expense oI LIe rIgILs oI oLIers Lo
breuLIe cIeun uIr! We need Lo uIwuys be cIeur LIuL LIe
onIy uccepLubIe soIuLIons Lo Lobucco smoke poIIuLIon
ure LIose LIuL eIImInuLe LIe poIIuLIon enLIreIy. TIuL
meuns u LoLuI bun on smokIng everywIere excepL In
prIvuLe Iomes! L meuns no more compromIses
brokered by LIe Lobucco IndusLry!..I smokers IInd IL
dIIIIcuIL Lo IIve In u worId LIuL proLecLs LIe rIgIL Lo
breuLIe cIeun uIr LIen LIey sIouId sLop smokIng! We
don`L InLend Lo wuIL Ior poIILIcIuns, busIness owners or
smokers Lo ugree Lo gIve us wIuL Is uIreudy rIgILIuIIy
ours! We InLend Lo move up Irom LIe buck oI LIe bus
und demund our rIgILIuI pIuces In LIe worId!
Every sLruggIe Ior equuIILy begIns wIen oppressed
peopIe wuke up Lo LIeIr oppressIon. TIey musL IIrsL
Ieurn Iow LIeIr oppressors Iuve coerced LIem InLo
submIssIon, LIen persuude LIeIr peers Lo sLund up und
suy no Lo LIeIr oppressors! L`s dIIIIcuIL Ior some peopIe
Lo undersLund LIuL LIe sLruggIe Ior smokeIree uIr Is u
IIgIL Ior cIvII rIgILs. Ike muny oLIer buLLIes Ior equuIILy
IL meuns LukIng ubusIve prIvIIege uwuy Irom u mInorILy
und gIvIng equuIILy Lo everyone. HIsLorIcuIIy LIe
prIvIIeged mInorILy Ius never gIven up wILIouL u buLLIe.
n LIIs buLLIe we ure up uguInsL u powerIuI IndusLry LIuL
wunLs Lo conLInue Lo muke Iuge proIILs Irom u producL
LIuL kIIIs peopIe. We ure uIso up uguInsL u cuILure oI
nIcoLIne uddIcLs wIo wunL Lo proLecL LIe prIvIIege oI
suLIsIyIng LIeIr uddIcLIons uL LIe expense oI everyone
uround LIem. TIere ure no ruLIonuI excuses Ior LIe
conLInuuLIon oI Lobucco cuILure LIe wuy IL Ius exIsLed In
LIe pusL..We need Lo be cIeur LIuL LIe debuLe over
Lobucco Is u debuLe ubouL wIeLIer Iumun IIIe Is more
ImporLunL LIun proIILs und uddIcLIon! We uIso need Lo
be cIeur LIuL mosL oI LIe pubIIc Is reudy Ior smokeIree
uIr. WIuL sLunds In LIe wuy ure Iuge poIILIcuI
conLrIbuLIons Irom Lobucco compunIes, mIsconcepLIons
ubouL LIe roIe oI Lobucco Luxes, Iuge proIILs Ior Lobucco
InvesLors und IrruLIonuI busIness owners wIo beIIeve
Lobucco propugundu InsLeud oI common sense!
TIe smokeIree revoIuLIon requIres u commILmenL Irom
every person wIo doesn`L smoke! We need Lo recIuIm
LIe worId Ior ourseIves. L meuns we musL demund LIuL
418
418
Rampant Antismoking Signifies Grave Danger
our IIves be LoLuIIy smokeIree uII LIe LIme, no
excepLIons. Zero LoIerunce oI secondIund Lobucco
smoke requIres us Lo wuIk uwuy, speuk up und boycoLL!
We need Lo wuIk uwuy Irom unyone wIo doesn`L respecL
our rIgIL Lo breuLIe cIeun uIr. We need Lo poIILeIy
remInd smokers Lo Luke responsIbIIILy Ior LIeIr smoke
poIIuLIng LIe uIr und IurmIng oLIer peopIe. We need Lo
boycoLL uII busInesses, IrIends` Iomes, purLIes, pubIIc
meeLIngs und uny pIuce LIuL Isn`L LoLuIIy smokeIree! We
ure LIe mujorILy! I we cIunge our IubILs, LIe worId wIII
become smokeIree mucI sooner! TIIs meuns everyone
oI us Ius Lo Luke responsIbIIILy Ior our purL In uIIowIng
Lobucco Lo ruIe our cuILures und our IIves. EucI LIme we
remuIn sIIenL becuuse IL`s eusIer, we conLrIbuLe Lo LIe
conLInuuLIon oI Lobucco ubuse!
Boycott!
BoycoLL uII busInesses LIuL uIIow LIeIr cusLomers und
empIoyees Lo be exposed Lo secondIund Lobucco smoke!
Zero LoIerunce Is LIe onIy roud Lo cIunge! SmokeIree
meuns wILIouL smoke, noL Iess smoke! We need Lo
encouruge LIe busInesses we puLronIze Lo sLop seIIIng
Lobucco producLs. We need Lo sIop In busInesses LIuL
do noL seII Lobucco producLs.
Speuk Out!
NoLIIy uII busInesses LIuL uIIow secondIund smoke
exposure LIuL you wIII noL puLronIze LIem unLII LIey
become smokeIree! TIIs meuns no more nonsmokIng
secLIons In resLuurunLs, no more smokIng In burs or
cIubs.
Speuk Lp!
Speuk up Ior LIe rIgILs oI cIIIdren! TIey ure LIe mosL
suscepLIbIe Lo secondIund smoke exposure. RemInd
purenLs LIuL Lobucco smoke poIIuLIon Ius been IInked Lo
Sudden nIunL DeuLI Syndrome, mIddIe eur InIecLIons,
usLImu, broncIILIs, und croup In cIIIdren. PurenLs
sIouId be remInded LIuL smokIng InsIde u cIosed
uuLomobIIe wILI smuII cIIIdren Is LoLuIIy unuccepLubIe!
Sue!
BrIng IILIguLIon uguInsL empIoyers, busInesses,
munIcIpuIILIes or unyone eIse wIo requIres you Lo
breuLIe LoxIc Lobucco smoke In order Lo be purL oI
pubIIc IIIe! RequIrIng peopIe Lo breuLIe smoke Is u reuI
Preventive Medicine & Health Promotion
Iorm oI dIscrImInuLIon! Smokers cun go everywIere II
LIey Ieuve LIeIr IIgILed cIgureLLes beIInd.
emonstrute!
Ask your IocuI cIupLers oI LIe Cuncer SocIeLy, LIe ung
AssocIuLIon, Iubor unIons und smokeIree orgunIzuLIons
Lo sponsor u nuLIonuI murcI Ior workers rIgILs Lo u
smokeIree work envIronmenL! L couId uIso be u
memorIuI murcI Ior LIose wIo Iuve dIed Irom Lobucco
reIuLed dIseuses!
Be Politicul!
Ask your poIILIcuI purLy und poIILIcIuns Lo sponsor
IegIsIuLIon Lo bun smokIng In LIe workpIuce nuLIonwIde!
Muke Lobucco smoke poIIuLIon u nuLIonuI poIILIcuI Issue!
OrgunIze IocuI Lown IuII meeLIngs Lo dIscuss LIe
probIems oI secondIund smoke poIIuLIon. OrgunIze
IeLLer wrILIng cumpuIgns Lo IocuI newspupers. BrIng LIe
dIscussIon oI secondIund smoke ouL InLo LIe open!
Network!
Ask your IrIends und IumIIy Lo geL InvoIved In LIe IIgIL
Ior smokeIree uIr! Send LIIs noLIce Lo everyone you
know wIo beIIeves In LIe rIgIL Lo breuLIe cIeun uIr!
CIunge!
End LIe sIIence by uIwuys demundIng u smokeIree
envIronmenL Ior yourseII und your IumIIy. Don`L IeL
smokers und LIe Lobucco IndusLry dIcLuLe socIuI poIIcy
uny Ionger. TIe worId beIongs Lo everyone, noL jusL
smokers!
Strengthen!
Ask your IocuI governmenL Lo sLrengLIen IL`s exIsLIng
smokeIree Iuws. You sIouId be ubIe Lo go ubouL LIe
busIness oI your IIIe wILIouL ever beIng exposed Lo
secondIund smoke. TIIs meuns no smokIng In
doorwuys, uL sIdewuIk cuIes, resLuurunLs or unywIere
smoke cun Iurm oLIers!
Post!
Curry LIe round no smokIng sLIckers wILI you
everywIere you go. PosL LIem on LIe buck oI LoIIeL sLuII
doors, In bus sIeILers und everywIere you LIInk peopIe
need Lo be remInded smokIng Is InupproprIuLe! PosL
sIgns Lo educuLe ubouL LIe dungers oI secondIund
smoke exposure und LIe rIgILs oI everyone Lo breuLIe
cIeun uIr.
419
419
Rampant Antismoking Signifies Grave Danger
our IIves be LoLuIIy smokeIree uII LIe LIme, no
excepLIons. Zero LoIerunce oI secondIund Lobucco
smoke requIres us Lo wuIk uwuy, speuk up und boycoLL!
We need Lo wuIk uwuy Irom unyone wIo doesn`L respecL
our rIgIL Lo breuLIe cIeun uIr. We need Lo poIILeIy
remInd smokers Lo Luke responsIbIIILy Ior LIeIr smoke
poIIuLIng LIe uIr und IurmIng oLIer peopIe. We need Lo
boycoLL uII busInesses, IrIends` Iomes, purLIes, pubIIc
meeLIngs und uny pIuce LIuL Isn`L LoLuIIy smokeIree! We
ure LIe mujorILy! I we cIunge our IubILs, LIe worId wIII
become smokeIree mucI sooner! TIIs meuns everyone
oI us Ius Lo Luke responsIbIIILy Ior our purL In uIIowIng
Lobucco Lo ruIe our cuILures und our IIves. EucI LIme we
remuIn sIIenL becuuse IL`s eusIer, we conLrIbuLe Lo LIe
conLInuuLIon oI Lobucco ubuse!
Boycott!
BoycoLL uII busInesses LIuL uIIow LIeIr cusLomers und
empIoyees Lo be exposed Lo secondIund Lobucco smoke!
Zero LoIerunce Is LIe onIy roud Lo cIunge! SmokeIree
meuns wILIouL smoke, noL Iess smoke! We need Lo
encouruge LIe busInesses we puLronIze Lo sLop seIIIng
Lobucco producLs. We need Lo sIop In busInesses LIuL
do noL seII Lobucco producLs.
Speuk Out!
NoLIIy uII busInesses LIuL uIIow secondIund smoke
exposure LIuL you wIII noL puLronIze LIem unLII LIey
become smokeIree! TIIs meuns no more nonsmokIng
secLIons In resLuurunLs, no more smokIng In burs or
cIubs.
Speuk Lp!
Speuk up Ior LIe rIgILs oI cIIIdren! TIey ure LIe mosL
suscepLIbIe Lo secondIund smoke exposure. RemInd
purenLs LIuL Lobucco smoke poIIuLIon Ius been IInked Lo
Sudden nIunL DeuLI Syndrome, mIddIe eur InIecLIons,
usLImu, broncIILIs, und croup In cIIIdren. PurenLs
sIouId be remInded LIuL smokIng InsIde u cIosed
uuLomobIIe wILI smuII cIIIdren Is LoLuIIy unuccepLubIe!
Sue!
BrIng IILIguLIon uguInsL empIoyers, busInesses,
munIcIpuIILIes or unyone eIse wIo requIres you Lo
breuLIe LoxIc Lobucco smoke In order Lo be purL oI
pubIIc IIIe! RequIrIng peopIe Lo breuLIe smoke Is u reuI
Preventive Medicine & Health Promotion
Iorm oI dIscrImInuLIon! Smokers cun go everywIere II
LIey Ieuve LIeIr IIgILed cIgureLLes beIInd.
emonstrute!
Ask your IocuI cIupLers oI LIe Cuncer SocIeLy, LIe ung
AssocIuLIon, Iubor unIons und smokeIree orgunIzuLIons
Lo sponsor u nuLIonuI murcI Ior workers rIgILs Lo u
smokeIree work envIronmenL! L couId uIso be u
memorIuI murcI Ior LIose wIo Iuve dIed Irom Lobucco
reIuLed dIseuses!
Be Politicul!
Ask your poIILIcuI purLy und poIILIcIuns Lo sponsor
IegIsIuLIon Lo bun smokIng In LIe workpIuce nuLIonwIde!
Muke Lobucco smoke poIIuLIon u nuLIonuI poIILIcuI Issue!
OrgunIze IocuI Lown IuII meeLIngs Lo dIscuss LIe
probIems oI secondIund smoke poIIuLIon. OrgunIze
IeLLer wrILIng cumpuIgns Lo IocuI newspupers. BrIng LIe
dIscussIon oI secondIund smoke ouL InLo LIe open!
Network!
Ask your IrIends und IumIIy Lo geL InvoIved In LIe IIgIL
Ior smokeIree uIr! Send LIIs noLIce Lo everyone you
know wIo beIIeves In LIe rIgIL Lo breuLIe cIeun uIr!
CIunge!
End LIe sIIence by uIwuys demundIng u smokeIree
envIronmenL Ior yourseII und your IumIIy. Don`L IeL
smokers und LIe Lobucco IndusLry dIcLuLe socIuI poIIcy
uny Ionger. TIe worId beIongs Lo everyone, noL jusL
smokers!
Strengthen!
Ask your IocuI governmenL Lo sLrengLIen IL`s exIsLIng
smokeIree Iuws. You sIouId be ubIe Lo go ubouL LIe
busIness oI your IIIe wILIouL ever beIng exposed Lo
secondIund smoke. TIIs meuns no smokIng In
doorwuys, uL sIdewuIk cuIes, resLuurunLs or unywIere
smoke cun Iurm oLIers!
Post!
Curry LIe round no smokIng sLIckers wILI you
everywIere you go. PosL LIem on LIe buck oI LoIIeL sLuII
doors, In bus sIeILers und everywIere you LIInk peopIe
need Lo be remInded smokIng Is InupproprIuLe! PosL
sIgns Lo educuLe ubouL LIe dungers oI secondIund
smoke exposure und LIe rIgILs oI everyone Lo breuLIe
cIeun uIr.
420
420
Rampant Antismoking Signifies Grave Danger
Ask IocuI busInesses Lo posL promInenL sIgns LIuL
IndIcuLe LIey ure LoLuIIy smokeIree!
Think Positive!
Do noL cuII yourseII u non-smoker! CuII yourseII
smokeIree or u person wIo doesn`L smoke. Non-smoker
ImpIIes LIuL smokIng Is normuI und you ure u non
person!
OnIy II you beIIeve you cun cIunge LIe worId, wIII you
even Lry! eL`s do IL LogeLIer!
TIe senLImenLs expressed ubove IndIcuLe ucuLe IIxuLIon: A
person`s enLIre personu Is deIIned, und In superIorIsL Lerms, by LIeIr
smokeIree-ness. A person`s enLIre ucLIvILy Is deIIned by LIe IIxuLIon. So
ubsorbIng Is LIIs one Issue LIuL IL wIII even resuIL In LIe boycoLLIng oI
IrIends` Iomes or wuIkIng uwuy Irom unyone producIng smoke. SucI
mInds ure seII-ubsorbed In u mIre oI LIeIr own conLorLed LIougIL. TIe
IIxuLIon Is munIIesLed us IunuLIcIsm uLLempLIng Lo recruIL uIIIes.
However, LIIs Is no reIIgIon buL LIe projecLIon oI severeIy conIIIcLed
menLuI sLuLes onLo LIe pIenomenu oI smokers und Lobucco smoke. TIe
InordInuLeness oI beIIeI und reucLIvILy sIouId be obvIous. YeL, IL Is noL.
Numerous members oI muny nuLIons Iuve coIIupsed InLo LIIs dungerous
seII-decepLIon, unubIe Lo dIscern LIe ubsurdILy. Exposure Lo Lobucco
smoke Ius been munuIucLured by IIgIIy conIIIcLed mInds InLo sucI
oppressIon oI nonsmokers LIuL LIe IuLLer sIouId udopL u zero
LoIerunce uLLILude und properIy devoLe LIeIr IIves Lo recIuImIng LIe
worId LIrougI wur.
ExposIng LIe pubIIc Lo LIese LypIcuIIy uncIecked Ideus Is un
exceIIenL wuy Lo IncILe SS und ESS conLugIon, und us IL Ius done. TIese
Ideus ure uL LIe rooL oI mucI unLIsmokIng poIIcy worIdwIde. TIe uuLIor oI
LIe SmokeIree RevoIuLIon websILe Is un MMES-cuIL devoLee, expressIng
sLundurd cuIL beIIeIs. EpIdemIoIogIc opInIon concernIng smokIng und ETS
Is unquesLIonIngIy uccepLed us InIuIIIbIe. urLIer, LIe urgumenLuLIon
reIIes on LIe myLI oI cIeun uIr und LIe conLrIvunce oI un udversurIuI
Irumework. n LIe IuLLer, LIe Lobucco IndusLry und smokers, depIcLed us
onIy nIcoLIne uddIcLs, ure conspIruLors uguInsL LIe IeuILI oI LIe oppressed
smokeIree (nonsmokers). OnIy nonsmokers, beIng ruLIonuI, cun
properIy ruIe LIe worId. L Is LIe smokeIree-cuuse LIuL Is onIy nobIe und
InIuIIIbIe. TIe menLuIILy demonsLruLes no menLuI InsIgIL. L Is uLLerIy
convInced by LIe InIuIIIbIIILy und vILuI ImporLunce oI ILs worId-ruIe
uspIruLIons; LIuL LIe reusonIng mIgIL be very mucI usLruy Is
InconceIvubIe. n IucL, LIe menLuIILy demonsLruLes no scIenLIIIc,
psycIoIogIcuI, reIuLIonuI, moruI or pIIIosopIIcuI upLILude. TIe Irumework
Preventive Medicine & Health Promotion
oI beIIeI Is LypIcuI oI LIe superIorILy syndrome.
As IndIcuLed, LIe menLuIILy Is noL new. TIere were LIose wIo
beIIeved In nonsmokers` rIgILs Iong beIore ETS wus consIdered
dungerous. L Is medIco-muLerIuIIsm und ILs Iuke Ideu oI scIence LIuL Ius
eIevuLed boLI medIco-muLerIuIIsm und LIe unLIsmokIng menLuIILy, boLI
represenLIng LIe dysIuncLIons oI superIIcIuI reusonIng, InLo superIorILy
sLuLus. And, IL Is onIy LIIs menLuIILy LIuL sIgnIIIes gruve dunger. L sIouId
be dIsLurbIng LIuL LIe unLIsmokIng vIews expressed ubove Iuve mude
greuL Inrouds InLo LIe pubIIc conscIousness oI muny nuLIons. TIIs
IndIcuLes LIuL LIe mujorILy In muny nuLIons Iuve deLerIoruLed InLo
superIIcIuIILy. SuperIIcIuIILy oI menLuIILy meuns LIuL severe cIurucLer
IIuws Iuve been IeIL unuLLended. UILImuLeIy, uII cIurucLer deIIcIencIes
gruvILuLe uround guIIL, Ieur und IuLred. TIe unLIsmokIng IIxuLIon Is
munuIucLured us u moruI subsLILuLe Ior moruIIy-IIounderIng mInds.
As wIII be consIdered In LIe IoIIowIng cIupLer, wIere LIIs Is
prevuIenL In sucI pundemIc, gIobuI proporLIons, noL onIy wIII LIe
menLuIILy noL brIng ubouL u smokeIree worId buL, us LIe uncIecked IuLred
comes IurLIer Lo LIe Iore, IL wIII brIng ubouL LIe LIIck, ucrId smoke oI wur
und devusLuLIon. TIe superIorIsm und errunL sense oI InIuIIIbIIILy ure
prucLIced wILI reIIgIous zeuIousness, uILIougI LIe Irumework oI LIougIL
Ius no coIerenL moruI dImensIon; ILs conducL Is dIcLuLed enLIreIy by
supersLILIous beIIeIs LIuL IosLer superIorIsm und rumpunL survIvuIIsm.
TIose LIuL ure ucuLeIy IIxuLed requIre u proIound sIIIL In
conscIousness LIuL muy noL be uvuIIubIe uL LIIs LIme. n oLIer words,
presenLIng MMES-cuIL devoLees wILI LIe numerous Issues ruIsed In LIIs
dIscussIon wouId probubIy onIy resuIL In suspIcIon. TIIs Is LIe very poInL:
TIe menLuIILy Is superIIcIuI, rIgId, und wILI poor InsIgIL. However, LIose
LIuL Iuve been IndocLrInuLed by superIorIsL Ieuders cun be redeemed II IL
Is cIeurIy IndIcuLed LIuL LIe beIIeIs LIey Iuve been coerced InLo under LIe
preLense oI scIenLIIIc credIbIIILy ure cuILIsL. PoIILIcIuns, busIness owners,
eLc., sIouId be mude uwure LIuL wIen conIronLed by so-cuIIed
unLIsmokIng ucLIvIsLs, LIey ure reuIIy deuIIng wILI u derunged cuIL
(MMES) uLLempLIng Lo cIuIm LIeIr membersIIp. WIuL LIey wIII Ieur Is u
preucIIng LIuL IosLers IrruLIonuI Ieur, Iuke superIorILy, und IuLred. TIe
crILIcuI probIem oI LIe LIme Is LIuL LIIs cuIL oI LIe duIL currenLIy ruIes LIe
worId. TIe course oI muny nuLIons Is uIreudy seL Lowurds dIsusLer. TIe
Iope In LIIs dIscussIon Is LIuL uL IeusL some LIuL Iuve been duped InLo
LIese cuIL beIIeIs mIgIL reconsIder LIeIr posILIon II LIe IucLs uIong muILI-
dImensIons ure presenLed.
(.:: Injectin oj Lecl Arument
421
421
Rampant Antismoking Signifies Grave Danger
Ask IocuI busInesses Lo posL promInenL sIgns LIuL
IndIcuLe LIey ure LoLuIIy smokeIree!
Think Positive!
Do noL cuII yourseII u non-smoker! CuII yourseII
smokeIree or u person wIo doesn`L smoke. Non-smoker
ImpIIes LIuL smokIng Is normuI und you ure u non
person!
OnIy II you beIIeve you cun cIunge LIe worId, wIII you
even Lry! eL`s do IL LogeLIer!
TIe senLImenLs expressed ubove IndIcuLe ucuLe IIxuLIon: A
person`s enLIre personu Is deIIned, und In superIorIsL Lerms, by LIeIr
smokeIree-ness. A person`s enLIre ucLIvILy Is deIIned by LIe IIxuLIon. So
ubsorbIng Is LIIs one Issue LIuL IL wIII even resuIL In LIe boycoLLIng oI
IrIends` Iomes or wuIkIng uwuy Irom unyone producIng smoke. SucI
mInds ure seII-ubsorbed In u mIre oI LIeIr own conLorLed LIougIL. TIe
IIxuLIon Is munIIesLed us IunuLIcIsm uLLempLIng Lo recruIL uIIIes.
However, LIIs Is no reIIgIon buL LIe projecLIon oI severeIy conIIIcLed
menLuI sLuLes onLo LIe pIenomenu oI smokers und Lobucco smoke. TIe
InordInuLeness oI beIIeI und reucLIvILy sIouId be obvIous. YeL, IL Is noL.
Numerous members oI muny nuLIons Iuve coIIupsed InLo LIIs dungerous
seII-decepLIon, unubIe Lo dIscern LIe ubsurdILy. Exposure Lo Lobucco
smoke Ius been munuIucLured by IIgIIy conIIIcLed mInds InLo sucI
oppressIon oI nonsmokers LIuL LIe IuLLer sIouId udopL u zero
LoIerunce uLLILude und properIy devoLe LIeIr IIves Lo recIuImIng LIe
worId LIrougI wur.
ExposIng LIe pubIIc Lo LIese LypIcuIIy uncIecked Ideus Is un
exceIIenL wuy Lo IncILe SS und ESS conLugIon, und us IL Ius done. TIese
Ideus ure uL LIe rooL oI mucI unLIsmokIng poIIcy worIdwIde. TIe uuLIor oI
LIe SmokeIree RevoIuLIon websILe Is un MMES-cuIL devoLee, expressIng
sLundurd cuIL beIIeIs. EpIdemIoIogIc opInIon concernIng smokIng und ETS
Is unquesLIonIngIy uccepLed us InIuIIIbIe. urLIer, LIe urgumenLuLIon
reIIes on LIe myLI oI cIeun uIr und LIe conLrIvunce oI un udversurIuI
Irumework. n LIe IuLLer, LIe Lobucco IndusLry und smokers, depIcLed us
onIy nIcoLIne uddIcLs, ure conspIruLors uguInsL LIe IeuILI oI LIe oppressed
smokeIree (nonsmokers). OnIy nonsmokers, beIng ruLIonuI, cun
properIy ruIe LIe worId. L Is LIe smokeIree-cuuse LIuL Is onIy nobIe und
InIuIIIbIe. TIe menLuIILy demonsLruLes no menLuI InsIgIL. L Is uLLerIy
convInced by LIe InIuIIIbIIILy und vILuI ImporLunce oI ILs worId-ruIe
uspIruLIons; LIuL LIe reusonIng mIgIL be very mucI usLruy Is
InconceIvubIe. n IucL, LIe menLuIILy demonsLruLes no scIenLIIIc,
psycIoIogIcuI, reIuLIonuI, moruI or pIIIosopIIcuI upLILude. TIe Irumework
Preventive Medicine & Health Promotion
oI beIIeI Is LypIcuI oI LIe superIorILy syndrome.
As IndIcuLed, LIe menLuIILy Is noL new. TIere were LIose wIo
beIIeved In nonsmokers` rIgILs Iong beIore ETS wus consIdered
dungerous. L Is medIco-muLerIuIIsm und ILs Iuke Ideu oI scIence LIuL Ius
eIevuLed boLI medIco-muLerIuIIsm und LIe unLIsmokIng menLuIILy, boLI
represenLIng LIe dysIuncLIons oI superIIcIuI reusonIng, InLo superIorILy
sLuLus. And, IL Is onIy LIIs menLuIILy LIuL sIgnIIIes gruve dunger. L sIouId
be dIsLurbIng LIuL LIe unLIsmokIng vIews expressed ubove Iuve mude
greuL Inrouds InLo LIe pubIIc conscIousness oI muny nuLIons. TIIs
IndIcuLes LIuL LIe mujorILy In muny nuLIons Iuve deLerIoruLed InLo
superIIcIuIILy. SuperIIcIuIILy oI menLuIILy meuns LIuL severe cIurucLer
IIuws Iuve been IeIL unuLLended. UILImuLeIy, uII cIurucLer deIIcIencIes
gruvILuLe uround guIIL, Ieur und IuLred. TIe unLIsmokIng IIxuLIon Is
munuIucLured us u moruI subsLILuLe Ior moruIIy-IIounderIng mInds.
As wIII be consIdered In LIe IoIIowIng cIupLer, wIere LIIs Is
prevuIenL In sucI pundemIc, gIobuI proporLIons, noL onIy wIII LIe
menLuIILy noL brIng ubouL u smokeIree worId buL, us LIe uncIecked IuLred
comes IurLIer Lo LIe Iore, IL wIII brIng ubouL LIe LIIck, ucrId smoke oI wur
und devusLuLIon. TIe superIorIsm und errunL sense oI InIuIIIbIIILy ure
prucLIced wILI reIIgIous zeuIousness, uILIougI LIe Irumework oI LIougIL
Ius no coIerenL moruI dImensIon; ILs conducL Is dIcLuLed enLIreIy by
supersLILIous beIIeIs LIuL IosLer superIorIsm und rumpunL survIvuIIsm.
TIose LIuL ure ucuLeIy IIxuLed requIre u proIound sIIIL In
conscIousness LIuL muy noL be uvuIIubIe uL LIIs LIme. n oLIer words,
presenLIng MMES-cuIL devoLees wILI LIe numerous Issues ruIsed In LIIs
dIscussIon wouId probubIy onIy resuIL In suspIcIon. TIIs Is LIe very poInL:
TIe menLuIILy Is superIIcIuI, rIgId, und wILI poor InsIgIL. However, LIose
LIuL Iuve been IndocLrInuLed by superIorIsL Ieuders cun be redeemed II IL
Is cIeurIy IndIcuLed LIuL LIe beIIeIs LIey Iuve been coerced InLo under LIe
preLense oI scIenLIIIc credIbIIILy ure cuILIsL. PoIILIcIuns, busIness owners,
eLc., sIouId be mude uwure LIuL wIen conIronLed by so-cuIIed
unLIsmokIng ucLIvIsLs, LIey ure reuIIy deuIIng wILI u derunged cuIL
(MMES) uLLempLIng Lo cIuIm LIeIr membersIIp. WIuL LIey wIII Ieur Is u
preucIIng LIuL IosLers IrruLIonuI Ieur, Iuke superIorILy, und IuLred. TIe
crILIcuI probIem oI LIe LIme Is LIuL LIIs cuIL oI LIe duIL currenLIy ruIes LIe
worId. TIe course oI muny nuLIons Is uIreudy seL Lowurds dIsusLer. TIe
Iope In LIIs dIscussIon Is LIuL uL IeusL some LIuL Iuve been duped InLo
LIese cuIL beIIeIs mIgIL reconsIder LIeIr posILIon II LIe IucLs uIong muILI-
dImensIons ure presenLed.
(.:: Injectin oj Lecl Arument
422
422
Rampant Antismoking Signifies Grave Danger
L Ius been consIdered LIrougIouL LIuL epIdemIoIogy und
conLemporury IeuILI promoLIon reIIecLs un upsIde-down, buck-Lo-IronL
reusonIng LIuL uncIors LIe normuLIve runge oI IuncLIonIng Lo uLypIcuI,
ubnormuI sLuLes. TIe upproucI IosLers supersLILIous, mugIc powers
beIIeIs (e.g., SS, ESS, oLIer nocebo eIIecLs) us u muLLer oI course. L uIso
provIdes LIe medIcuI esLubIIsImenL wILI unmerILed socIuI domInuLIon.
TIrougI consensus eIIecLs LIuL conceuI u coIIecLIve superIIcIuIILy und
IncompeLence, medIco-muLerIuIIsm Ius produced uII munner oI cuusuI
cIuIms, purLIcuIurIy concernIng smokIng und ETS, LIuL ure now
consIdered uuLIorILuLIve. Under muLerIuIIsL domInuLIon LIe Ideus oI
sLuLIsLIcuI rIsk und rIsk uversIon Iuve been ussIgned u meunIng LIuL LIey
sImpIy do noL wurrunL (I.e., sLuLIsLIcuIIsm). CuusuI urgumenL bused on LIIs
IIImsy Irumework Is ImmoruI und, us Ius been consIdered, cun Iuve
devusLuLIng consequences Ior psycIoIogIcuI und reIuLIonuI IeuILI, und LIe
IurLIer rumIIIcuLIons Ior nuLIonuI und even InLernuLIonuI IeuILI (see uIso
CIupLer ).
TIe unscIoIurIy, IncompeLenL use oI quunLIIIcuLIon oI rIsk und
LIe promoLIon oI LIe rIsk uvoIdIng IndIvIduuI us purL oI u IrugmenLed
muLerIuIIsL IdeoIogy Iuve empowered monomunIucuI (unLIsmokIng)
groups Lo pursue LIeIr ucuLe IIxuLIon unIeLLered by LIe requIremenLs oI
rIyme or reuson. TIe use oI Iuw In expIoILIng errunL medIco-muLerIuIIsL
perspecLIve In LIe pursuIL oI unLIsmokIng, us purL oI muLerIuIIsL IdeoIogy,
uIso IIgures IIgIIy In LIe propuguLIon und reInIorcemenL oI conLorLed
beIIeI: Tobucco IILIguLIon Ius LrunsIormed LIe prospecLs Ior Lobucco
conLroI. (Duynurd, BuLes & runcey, zooo, p.111). MIIILunL unLIsmokIng
groups, LIrougI LIeIr IeudersIIp, IIgure IIgIIy In LIe conLorLIon oI Iuw
und udvocuLIng LIe ubuse oI Iuw In servIng LIeIr own deIuded ends, e.g.,
JoIn BunzIuI (US ASH), CIIve BuLes (UK ASH).
As IndIcuLed In un eurIIer cIupLer, one oI LIe more vuIgur
conLorLIons oI Iuw Ius been LIe redeIInIng oI IeguI crILerIu sucI LIuL
popuIuLIon-IeveI sLuLIsLIcuI-rIsk suIIIces Ior cuusuI urgumenL In IeguI
proceedIngs (e.g., evy, 1qq;). L Is LIIs redeIInILIon LIuL underIIes LIe US
gIobuI seLLIemenL wIere Lobucco IndusLry purLIcIpunLs were sued by u
coIIecLIve oI US ALLorneys-GeneruI Lo recoup LIe cosL oI medIcuI LreuLmenL
oI smokIng-reIuLed dIseuses.
L Ius uIso been IndIcuLed LIuL LIe onIy dIseuse LIuL cun
pecuIIurIy be ussocIuLed wILI smokIng Is Iung cuncer. A prImury cuusuI
sLuLus Ior smokIng In LIe dIseuse Is deIInILIveIy dIsconIIrmed. TIe cIuIm
LIuL IL Is LIe, or u, prIncIpuI IucLor In LIe dIseuse Is equuIIy wILIouL merIL;
LIe predIcLIve sLrengLI oI smokIng Ior LIe dIseuse Is Iur Loo Iow. AILIougI
ILs sLrongesL sLuLus Is us u poLenLIuI LrIgger IucLor wILIIn u cIusLer oI
IucLors, even LIIs Is sLIII IndeLermInuLe; LIe crILIcuI IucLor Is mosL IIkeIy
Preventive Medicine & Health Promotion
endogenous ubnormuIILyJIuIIure. urLIermore, LIe IucLor oI smokIng Is
ussocIuLed wILI u sIIIL wILIIn cuncer Lype ruLIer LIun wILI un Increused
IncIdence oI cuncer.
TIe noLIon oI smokIng cuusIng u pIeLIoru oI dIseuses (oLIer LIun
Iung cuncer) bused on RR dIIIerences reIIecLs muLerIuIIsL superIIcIuIILy
und un ubsence oI scIoIursIIp; LIe conducL reIIecLs one oI LIe greuL Iruuds
oI LIe zoLI cenLury (medIcuI esLubIIsImenL consensus eIIecL wILIIn LIe
muLerIuIIsL munIIesLo). OLIer dIseuses LIuL ure uscrIbed, cuusuIIy, Lo
smokIng ure noL smokIng-reIuLed uL uII - nonsmokers suIIer LIe sume
dIseuses In rougIIy sImIIur proporLIons. TIe onIy urgumenL Is wIeLIer
smokIng, us one umong numerous oLIer IucLors, promoLes LIe eurIIer
onseL (premuLure) oI LIese specIIIc dIseusesJmorLuIILy LIuL persons ure
uIreudy on u course Lowurds, I.e., InIIuence on ugIng process. YeL, even LIIs
Is IndeLermInuLe In LIuL Ior uL IeusL IuII-u-cenLury IL Ius noL duwned on
LIe superIIcIuIILy oI muLerIuIIsm LIuL eIevuLed RR`s Ior LIe smoker`s group
muy Iuve noLIIng Lo do wILI LIe properLIes oI Lobucco smoke uL uII.
RuLIer, IL cun reIIecL u deIuy (posLmuLurILy) oI dIseuseJmorLuIILy Ior u rIsk-
uverse subgroup wILIIn LIe nonsmoker`s group. L Is LIIs possIbIIILy LIuL Is
LIe Iur more IIkeIy In LIuL IL Is LIIs very rIsk-uverse menLuIILy LIuL
muLerIuIIsm ucLIveIy promoLes. TIe enLIre Ideu oI premuLure morLuIILy
ussocIuLed wILI smokIng Is uIso IIgIIy debuLubIe In LIuL mosL oI LIe
IongevILy dIIIerences ure posL-6 yeurs oI uge. TIere ure uIso oLIer IucLors
LIuL cun InIIuence RR dIIIerences. or exumpIe, LIe very conLorLed
medIco-muLerIuIIsL vIew cun deLrImenLuIIy InIIuence LIe quuIILy oI
LreuLmenL oI smokers, wIeLIer LIe deveIopmenL oI LreuLmenLs Is expIored,
und LIe docLorJpuLIenL reIuLIonsIIp. As IndIcuLed In un eurIIer cIupLer,
LIIs produces LIe ubsurdILy oI IuLrogenesIs wILIIn IuLrogenIc eIIecL.
ExpIIcIL In LIe medIcuI vIew oI smokIng, und uIso IncoIerenL, Is
LIuL smokIng reIIecLs u nIcoLIne uddIcLIon wIIcI Is medIcuIIy deIIned us u
dIseuse. AccordIng Lo LIIs superIIcIuI perspecLIve, no one, oLIer LIun Ior
LIe reuson oI uddIcLIon, wouId be smokIng; muLerIuIIsm Is obIIvIous Lo
psycIoIogIcuI und socIuI uspecLsJbeneIILs oI LIe IubIL. n LIe medIco-
muLerIuIIsL Irumework smokIng Is porLruyed us onIy neguLIve und onIy
cosLIy. Smokers ure vurIubIy vIewed us vIcLIms oI LIeIr uddIcLIon und LIe
Lobucco IndusLry LIuL duped LIem InLo LIIs, or us ussuuILIng nonsmokers
wILI ETS und squunderIng IeuILI Iunds.
TIe redeIInIng oI Iuw, LIen, Is noL LIe resuIL oI scIence or
judIcIous consIderuLIon, buL seLs LIe severeIy IIuwed medIco-muLerIuIIsL
Irumework, purLIcuIurIy sLuLIsLIcuIIsm, us LIe sLundurd Ior IeguI evIdence
und urgumenL: TIe Iuw now represenLs LIe unLIsmokIng, medIco-
muLerIuIIsL vIew (MMES cuIL) - by deIInILIon - us InIuIIIbIe. TIrougI LIIs
move LIe governmenL becomes u gIorIIIed Insurunce compuny. L uIso Ius
423
423
Rampant Antismoking Signifies Grave Danger
L Ius been consIdered LIrougIouL LIuL epIdemIoIogy und
conLemporury IeuILI promoLIon reIIecLs un upsIde-down, buck-Lo-IronL
reusonIng LIuL uncIors LIe normuLIve runge oI IuncLIonIng Lo uLypIcuI,
ubnormuI sLuLes. TIe upproucI IosLers supersLILIous, mugIc powers
beIIeIs (e.g., SS, ESS, oLIer nocebo eIIecLs) us u muLLer oI course. L uIso
provIdes LIe medIcuI esLubIIsImenL wILI unmerILed socIuI domInuLIon.
TIrougI consensus eIIecLs LIuL conceuI u coIIecLIve superIIcIuIILy und
IncompeLence, medIco-muLerIuIIsm Ius produced uII munner oI cuusuI
cIuIms, purLIcuIurIy concernIng smokIng und ETS, LIuL ure now
consIdered uuLIorILuLIve. Under muLerIuIIsL domInuLIon LIe Ideus oI
sLuLIsLIcuI rIsk und rIsk uversIon Iuve been ussIgned u meunIng LIuL LIey
sImpIy do noL wurrunL (I.e., sLuLIsLIcuIIsm). CuusuI urgumenL bused on LIIs
IIImsy Irumework Is ImmoruI und, us Ius been consIdered, cun Iuve
devusLuLIng consequences Ior psycIoIogIcuI und reIuLIonuI IeuILI, und LIe
IurLIer rumIIIcuLIons Ior nuLIonuI und even InLernuLIonuI IeuILI (see uIso
CIupLer ).
TIe unscIoIurIy, IncompeLenL use oI quunLIIIcuLIon oI rIsk und
LIe promoLIon oI LIe rIsk uvoIdIng IndIvIduuI us purL oI u IrugmenLed
muLerIuIIsL IdeoIogy Iuve empowered monomunIucuI (unLIsmokIng)
groups Lo pursue LIeIr ucuLe IIxuLIon unIeLLered by LIe requIremenLs oI
rIyme or reuson. TIe use oI Iuw In expIoILIng errunL medIco-muLerIuIIsL
perspecLIve In LIe pursuIL oI unLIsmokIng, us purL oI muLerIuIIsL IdeoIogy,
uIso IIgures IIgIIy In LIe propuguLIon und reInIorcemenL oI conLorLed
beIIeI: Tobucco IILIguLIon Ius LrunsIormed LIe prospecLs Ior Lobucco
conLroI. (Duynurd, BuLes & runcey, zooo, p.111). MIIILunL unLIsmokIng
groups, LIrougI LIeIr IeudersIIp, IIgure IIgIIy In LIe conLorLIon oI Iuw
und udvocuLIng LIe ubuse oI Iuw In servIng LIeIr own deIuded ends, e.g.,
JoIn BunzIuI (US ASH), CIIve BuLes (UK ASH).
As IndIcuLed In un eurIIer cIupLer, one oI LIe more vuIgur
conLorLIons oI Iuw Ius been LIe redeIInIng oI IeguI crILerIu sucI LIuL
popuIuLIon-IeveI sLuLIsLIcuI-rIsk suIIIces Ior cuusuI urgumenL In IeguI
proceedIngs (e.g., evy, 1qq;). L Is LIIs redeIInILIon LIuL underIIes LIe US
gIobuI seLLIemenL wIere Lobucco IndusLry purLIcIpunLs were sued by u
coIIecLIve oI US ALLorneys-GeneruI Lo recoup LIe cosL oI medIcuI LreuLmenL
oI smokIng-reIuLed dIseuses.
L Ius uIso been IndIcuLed LIuL LIe onIy dIseuse LIuL cun
pecuIIurIy be ussocIuLed wILI smokIng Is Iung cuncer. A prImury cuusuI
sLuLus Ior smokIng In LIe dIseuse Is deIInILIveIy dIsconIIrmed. TIe cIuIm
LIuL IL Is LIe, or u, prIncIpuI IucLor In LIe dIseuse Is equuIIy wILIouL merIL;
LIe predIcLIve sLrengLI oI smokIng Ior LIe dIseuse Is Iur Loo Iow. AILIougI
ILs sLrongesL sLuLus Is us u poLenLIuI LrIgger IucLor wILIIn u cIusLer oI
IucLors, even LIIs Is sLIII IndeLermInuLe; LIe crILIcuI IucLor Is mosL IIkeIy
Preventive Medicine & Health Promotion
endogenous ubnormuIILyJIuIIure. urLIermore, LIe IucLor oI smokIng Is
ussocIuLed wILI u sIIIL wILIIn cuncer Lype ruLIer LIun wILI un Increused
IncIdence oI cuncer.
TIe noLIon oI smokIng cuusIng u pIeLIoru oI dIseuses (oLIer LIun
Iung cuncer) bused on RR dIIIerences reIIecLs muLerIuIIsL superIIcIuIILy
und un ubsence oI scIoIursIIp; LIe conducL reIIecLs one oI LIe greuL Iruuds
oI LIe zoLI cenLury (medIcuI esLubIIsImenL consensus eIIecL wILIIn LIe
muLerIuIIsL munIIesLo). OLIer dIseuses LIuL ure uscrIbed, cuusuIIy, Lo
smokIng ure noL smokIng-reIuLed uL uII - nonsmokers suIIer LIe sume
dIseuses In rougIIy sImIIur proporLIons. TIe onIy urgumenL Is wIeLIer
smokIng, us one umong numerous oLIer IucLors, promoLes LIe eurIIer
onseL (premuLure) oI LIese specIIIc dIseusesJmorLuIILy LIuL persons ure
uIreudy on u course Lowurds, I.e., InIIuence on ugIng process. YeL, even LIIs
Is IndeLermInuLe In LIuL Ior uL IeusL IuII-u-cenLury IL Ius noL duwned on
LIe superIIcIuIILy oI muLerIuIIsm LIuL eIevuLed RR`s Ior LIe smoker`s group
muy Iuve noLIIng Lo do wILI LIe properLIes oI Lobucco smoke uL uII.
RuLIer, IL cun reIIecL u deIuy (posLmuLurILy) oI dIseuseJmorLuIILy Ior u rIsk-
uverse subgroup wILIIn LIe nonsmoker`s group. L Is LIIs possIbIIILy LIuL Is
LIe Iur more IIkeIy In LIuL IL Is LIIs very rIsk-uverse menLuIILy LIuL
muLerIuIIsm ucLIveIy promoLes. TIe enLIre Ideu oI premuLure morLuIILy
ussocIuLed wILI smokIng Is uIso IIgIIy debuLubIe In LIuL mosL oI LIe
IongevILy dIIIerences ure posL-6 yeurs oI uge. TIere ure uIso oLIer IucLors
LIuL cun InIIuence RR dIIIerences. or exumpIe, LIe very conLorLed
medIco-muLerIuIIsL vIew cun deLrImenLuIIy InIIuence LIe quuIILy oI
LreuLmenL oI smokers, wIeLIer LIe deveIopmenL oI LreuLmenLs Is expIored,
und LIe docLorJpuLIenL reIuLIonsIIp. As IndIcuLed In un eurIIer cIupLer,
LIIs produces LIe ubsurdILy oI IuLrogenesIs wILIIn IuLrogenIc eIIecL.
ExpIIcIL In LIe medIcuI vIew oI smokIng, und uIso IncoIerenL, Is
LIuL smokIng reIIecLs u nIcoLIne uddIcLIon wIIcI Is medIcuIIy deIIned us u
dIseuse. AccordIng Lo LIIs superIIcIuI perspecLIve, no one, oLIer LIun Ior
LIe reuson oI uddIcLIon, wouId be smokIng; muLerIuIIsm Is obIIvIous Lo
psycIoIogIcuI und socIuI uspecLsJbeneIILs oI LIe IubIL. n LIe medIco-
muLerIuIIsL Irumework smokIng Is porLruyed us onIy neguLIve und onIy
cosLIy. Smokers ure vurIubIy vIewed us vIcLIms oI LIeIr uddIcLIon und LIe
Lobucco IndusLry LIuL duped LIem InLo LIIs, or us ussuuILIng nonsmokers
wILI ETS und squunderIng IeuILI Iunds.
TIe redeIInIng oI Iuw, LIen, Is noL LIe resuIL oI scIence or
judIcIous consIderuLIon, buL seLs LIe severeIy IIuwed medIco-muLerIuIIsL
Irumework, purLIcuIurIy sLuLIsLIcuIIsm, us LIe sLundurd Ior IeguI evIdence
und urgumenL: TIe Iuw now represenLs LIe unLIsmokIng, medIco-
muLerIuIIsL vIew (MMES cuIL) - by deIInILIon - us InIuIIIbIe. TIrougI LIIs
move LIe governmenL becomes u gIorIIIed Insurunce compuny. L uIso Ius
424
424
Rampant Antismoking Signifies Grave Danger
LIe eIIecL oI removIng uII IeguI deIense Irom LIe Lobucco IndusLry.
UndersLundubIy, LIe Lobucco IndusLry, wILI essenLIuIIy no Iope oI vIcLory
on LIese Lerms, Ius uLLempLed Lo conLuIn LIe IuIIouL wILI u gIobuI
seLLIemenL.
UnLII LIIs redeIInILIon, LIe Lobucco IndusLry reIIed on LIe Ideu oI
ussumed rIsk by smokers und LIe Increused LuxuLIonJInsurunce Imposed
on smokers. WIIIe no more wus mude oI LIe Ideu oI rIsk, LIIs mInImuIIsL
upproucI suIIIced. However, by noL properIy quesLIonIng LIe medIco-
muLerIuIIsL vIew over LIe IusL decudes und reIyIng on LIe bure mInImum In
upproucI, LIe Lobucco IndusLry Ius now been cuugIL ouL by LIe Improper
ensIrInIng oI Iow-order sLuLIsLIcuI rIsk us u IeguI muxIm. TIIs sIouId
IIgIIIgIL LIuL LIe Lobucco IndusLry Ius very IILLIe InsIgIL InLo LIe smokIng
IubIL or medIco-muLerIuIIsm; In muny InsLunces IL Is ILs own worsL enemy.
However, wIuLever one wunLs Lo muke oI LIe Lobucco IndusLry, IL
does noL jusLIIy wIuL Is u mosL perverse underLukIng by unbuIunced
(IuckIng muILI-dImensIonuI perspecLIve) muLerIuIIsL governmenLs guIded
by wuywurd medIco-muLerIuIIsm und IurLIer IueIed by monomunIu.
ALLrIbuLubIe cosL Is derIved Irom LIe enLIreIy quesLIonubIe SAMMEC
procedure. YeL, Iow does one esLImuLe LIe cosL oI LIe superIIcIuIILy und
IncompeLence oI muLerIuIIsm? WIuL Is LIe cosL oI un ussuuIL on menLuI
IeuILI by pIucIng persons InLo IrruLIonuI beIIeI - wIuL Is LIe cosL oI
nocebo eIIecLs? WIuL Is LIe cosL oI LIe socIuI rumIIIcuLIons sucI us
dIvIsIveness, segreguLIon, und superIorILyJbIgoLry? WIuL Is LIe cosL oI
democrucIes pIungIng, LIrougI IrruLIonuI beIIeI, InLo muLerIuIIsL-
nuLIonuIIsL LendencIes? WIuL Is LIe cosL oI redeIInIng Iuw Lo uIIgn wILI
deIuded IdeoIogy? MuLerIuIIsm cunnoL IuLIom LIese Issues, beIng LIe
producer oI LIem.
TIere Is now LIe sILuuLIon LIuL oLIer nuLIonuI governmenLs ure
IoIIowIng suIL, e.g., GuuLemuIu, VenezueIu, BoIIvIu, und NIcuruguu (see
Duynurd eL uI., zooo). TIe prospecL oI IucruLIve seLLIemenLs, wIeLIer
moruI or ImmoruI, Is obvIousIy LempLIng, purLIcuIurIy Ior cusI-sLrupped
governmenLs. Even more perverse Is Insurunce compunIes uLLempLIng Lo
proIIL Irom LIe unLIsmokIng Irenzy. AILIougI Insurunce compunIes
uIreudy IucLor smokIng InLo premIum equuLIons, EmpIre BIue Cross BIue
SIIeId sued u Lobucco IndusLry coIIecLIve Ior $b In dumuges Lo cover LIe
cosL oI curIng Ior sIck smokers. AbsurdIy, EmpIre wus uwurded $zq.6m
(see CIuruLun, zoo1).
UnIorLunuLeIy, LIIs redeIInILIon oI Iuw uIso opens u Pundoru`s
box wIere LIIs IIImsy Ideu oI rIsk, und enLIreIy In muLerIuIIsL Lerms, cun
uILImuLeIy be dIrecLed uL uny IndusLry (e.g., junk Iood, uIcoIoI,
uuLomobIIe).
ILIguLIon uguInsL LIe Lobucco IndusLry Ius uIso been pursued by
Preventive Medicine & Health Promotion
smokers - cIuss ucLIons und IndIvIduuIs. SucI IILIguLIon Lends Lo Iocus on
Lobucco IndusLry conducL In LIe pre-1q;o`s beIore LIe rIsks ussocIuLed
wILI smokIng were more wIdeIy pubIIcIzed (e.g., IeuILI wurnIngs on
cIgureLLe puckuges). L Is urgued LIuL LIe Lobucco IndusLry IuIIed Lo noLIIy
smokers oI uLLendunL rIsks. TIese urgumenLs ure severeIy IIuwed.
TIe Ideu oI rIsk ussocIuLed wILI smokIng und wIuL IL mIgIL
ucLuuIIy meun wus noL u Ioregone concIusIon pre-1q;o`s, und us IL sLIII Is.
TIe Ideu oI LIe rIsk uvoIdIng IndIvIduuI, us un IdeuI, wus noL en toue uL
LIuL LIme. L Is u muLerIuIIsL conLrIvunceJprescrIpLIon LIuL guIned u
IooLIoId In LIe 1q;o`s. L Is under u buIIdIng muLerIuIIsL domInuLIon
propuguLIng rIsk uversIon ever sInce LIuL LIIs IdeuI Ius Indeed come Lo
domInuLe LIe pubIIc conscIousness, purLIcuIurIy In LIe IusL decude.
SLuLIsLIcuI rIsk Is onIy vILuIIy ImporLunL Lo LIIs superIIcIuI muLerIuIIsL
Irumework.
Smokers cIuImIng LIuL u Iuck oI rIsk InIormuLIon In LIe 1q6o`s
represenLs u crILIcuI IuIIure on LIe purL oI LIe Lobucco IndusLry InvoIves u
number oI InIerenLIuI errors. IrsLIy, IL ussumes LIuL LIe medIco-
muLerIuIIsL cIuIm LIuL smokIng 'cuuses` dIseuse X Is uccuruLe. SecondIy,
LIuL LIe Ideu oI rIsk uversIon wus common pre-1q;o`s. TIIrdIy, LIere ure
no uLLendunL beneIILs Lo smokIng. ourLIIy, IuLer dIsconLInuuLIon oI LIe
IubIL wus ImpossIbIe due Lo uddIcLIon. IILIIy, Iud this specIIIc smoker
known oI LIe rIsks pre-1q;o`s, LIey specijiccll wouId noL Iuve
conLInued or Luken up LIe IubIL. And, sIxLIIy, Iud LIIs specIIIc smoker
dIsconLInued or noL Luken up LIe IubIL, LIeIr IIIe wIII onIy Iuve been
beLLer. TIe IIrsL Iour poInLs ure pIuInIy wrong und LIe IusL Lwo poInLs,
wIIcI ure dependenL on LIe IIrsL Iour, ure uddILIonuIIy IndeLermInuLe. TIe
crILIcuI probIem Iere Is LIuL u currenL muLerIuIIsL, monomunIucuI
(unLIsmokIng) Irenzy Is uLLempLIng Lo InLerpreLJevuIuuLe un eurIIer perIod,
ImproperIy uppIyIng u vIew LIuL wus noL domInunL, IeL uIone uccuruLe, uL
LIIs eurIIer LIme.
UnIorLunuLeIy, LIere ure smokers LIuL Iuve suIIered IIIness LIuL
cun very quIckIy be IIjucked by LIe unLIsmokIng cruze. TIese smokers ure
uIreudy devusLuLed und conIused. TIe couxIng InLo pursuIng Lobucco
IILIguLIon LIrougI unLIsmokIng cIunLs oI beIng bruve und courugeous Is
LempLIng Indeed. L uIIows Ior LIe bIumIng oI someLIIng or someone eIse
Ior LIeIr predIcumenL, I.e., un uspecL oI exLernuIIsm. TIIs probIem Is noL
pecuIIur Lo LIe Issue oI smokIng, buL oI muLerIuIIsL, IILIgIous socIeLIes
generuIIy (see CIupLer ). s LIere u busIs or u need Lo bIume unyone,
IncIudIng LIe smoker? WIere LIeIr LIme couId be beLLer spenL by
uLLempLIng Lo suIvuge some ucLuuI proIound meunIng Lo LIeIr IIves, LIere
Is now LIe rIsk oI LIeIr LIme beIng spenL In ugILuLIon produced by u
deIuded crusude (unLIsmokIng) deIIned by u mIsguIded udversurIuI
425
425
Rampant Antismoking Signifies Grave Danger
LIe eIIecL oI removIng uII IeguI deIense Irom LIe Lobucco IndusLry.
UndersLundubIy, LIe Lobucco IndusLry, wILI essenLIuIIy no Iope oI vIcLory
on LIese Lerms, Ius uLLempLed Lo conLuIn LIe IuIIouL wILI u gIobuI
seLLIemenL.
UnLII LIIs redeIInILIon, LIe Lobucco IndusLry reIIed on LIe Ideu oI
ussumed rIsk by smokers und LIe Increused LuxuLIonJInsurunce Imposed
on smokers. WIIIe no more wus mude oI LIe Ideu oI rIsk, LIIs mInImuIIsL
upproucI suIIIced. However, by noL properIy quesLIonIng LIe medIco-
muLerIuIIsL vIew over LIe IusL decudes und reIyIng on LIe bure mInImum In
upproucI, LIe Lobucco IndusLry Ius now been cuugIL ouL by LIe Improper
ensIrInIng oI Iow-order sLuLIsLIcuI rIsk us u IeguI muxIm. TIIs sIouId
IIgIIIgIL LIuL LIe Lobucco IndusLry Ius very IILLIe InsIgIL InLo LIe smokIng
IubIL or medIco-muLerIuIIsm; In muny InsLunces IL Is ILs own worsL enemy.
However, wIuLever one wunLs Lo muke oI LIe Lobucco IndusLry, IL
does noL jusLIIy wIuL Is u mosL perverse underLukIng by unbuIunced
(IuckIng muILI-dImensIonuI perspecLIve) muLerIuIIsL governmenLs guIded
by wuywurd medIco-muLerIuIIsm und IurLIer IueIed by monomunIu.
ALLrIbuLubIe cosL Is derIved Irom LIe enLIreIy quesLIonubIe SAMMEC
procedure. YeL, Iow does one esLImuLe LIe cosL oI LIe superIIcIuIILy und
IncompeLence oI muLerIuIIsm? WIuL Is LIe cosL oI un ussuuIL on menLuI
IeuILI by pIucIng persons InLo IrruLIonuI beIIeI - wIuL Is LIe cosL oI
nocebo eIIecLs? WIuL Is LIe cosL oI LIe socIuI rumIIIcuLIons sucI us
dIvIsIveness, segreguLIon, und superIorILyJbIgoLry? WIuL Is LIe cosL oI
democrucIes pIungIng, LIrougI IrruLIonuI beIIeI, InLo muLerIuIIsL-
nuLIonuIIsL LendencIes? WIuL Is LIe cosL oI redeIInIng Iuw Lo uIIgn wILI
deIuded IdeoIogy? MuLerIuIIsm cunnoL IuLIom LIese Issues, beIng LIe
producer oI LIem.
TIere Is now LIe sILuuLIon LIuL oLIer nuLIonuI governmenLs ure
IoIIowIng suIL, e.g., GuuLemuIu, VenezueIu, BoIIvIu, und NIcuruguu (see
Duynurd eL uI., zooo). TIe prospecL oI IucruLIve seLLIemenLs, wIeLIer
moruI or ImmoruI, Is obvIousIy LempLIng, purLIcuIurIy Ior cusI-sLrupped
governmenLs. Even more perverse Is Insurunce compunIes uLLempLIng Lo
proIIL Irom LIe unLIsmokIng Irenzy. AILIougI Insurunce compunIes
uIreudy IucLor smokIng InLo premIum equuLIons, EmpIre BIue Cross BIue
SIIeId sued u Lobucco IndusLry coIIecLIve Ior $b In dumuges Lo cover LIe
cosL oI curIng Ior sIck smokers. AbsurdIy, EmpIre wus uwurded $zq.6m
(see CIuruLun, zoo1).
UnIorLunuLeIy, LIIs redeIInILIon oI Iuw uIso opens u Pundoru`s
box wIere LIIs IIImsy Ideu oI rIsk, und enLIreIy In muLerIuIIsL Lerms, cun
uILImuLeIy be dIrecLed uL uny IndusLry (e.g., junk Iood, uIcoIoI,
uuLomobIIe).
ILIguLIon uguInsL LIe Lobucco IndusLry Ius uIso been pursued by
Preventive Medicine & Health Promotion
smokers - cIuss ucLIons und IndIvIduuIs. SucI IILIguLIon Lends Lo Iocus on
Lobucco IndusLry conducL In LIe pre-1q;o`s beIore LIe rIsks ussocIuLed
wILI smokIng were more wIdeIy pubIIcIzed (e.g., IeuILI wurnIngs on
cIgureLLe puckuges). L Is urgued LIuL LIe Lobucco IndusLry IuIIed Lo noLIIy
smokers oI uLLendunL rIsks. TIese urgumenLs ure severeIy IIuwed.
TIe Ideu oI rIsk ussocIuLed wILI smokIng und wIuL IL mIgIL
ucLuuIIy meun wus noL u Ioregone concIusIon pre-1q;o`s, und us IL sLIII Is.
TIe Ideu oI LIe rIsk uvoIdIng IndIvIduuI, us un IdeuI, wus noL en toue uL
LIuL LIme. L Is u muLerIuIIsL conLrIvunceJprescrIpLIon LIuL guIned u
IooLIoId In LIe 1q;o`s. L Is under u buIIdIng muLerIuIIsL domInuLIon
propuguLIng rIsk uversIon ever sInce LIuL LIIs IdeuI Ius Indeed come Lo
domInuLe LIe pubIIc conscIousness, purLIcuIurIy In LIe IusL decude.
SLuLIsLIcuI rIsk Is onIy vILuIIy ImporLunL Lo LIIs superIIcIuI muLerIuIIsL
Irumework.
Smokers cIuImIng LIuL u Iuck oI rIsk InIormuLIon In LIe 1q6o`s
represenLs u crILIcuI IuIIure on LIe purL oI LIe Lobucco IndusLry InvoIves u
number oI InIerenLIuI errors. IrsLIy, IL ussumes LIuL LIe medIco-
muLerIuIIsL cIuIm LIuL smokIng 'cuuses` dIseuse X Is uccuruLe. SecondIy,
LIuL LIe Ideu oI rIsk uversIon wus common pre-1q;o`s. TIIrdIy, LIere ure
no uLLendunL beneIILs Lo smokIng. ourLIIy, IuLer dIsconLInuuLIon oI LIe
IubIL wus ImpossIbIe due Lo uddIcLIon. IILIIy, Iud this specIIIc smoker
known oI LIe rIsks pre-1q;o`s, LIey specijiccll wouId noL Iuve
conLInued or Luken up LIe IubIL. And, sIxLIIy, Iud LIIs specIIIc smoker
dIsconLInued or noL Luken up LIe IubIL, LIeIr IIIe wIII onIy Iuve been
beLLer. TIe IIrsL Iour poInLs ure pIuInIy wrong und LIe IusL Lwo poInLs,
wIIcI ure dependenL on LIe IIrsL Iour, ure uddILIonuIIy IndeLermInuLe. TIe
crILIcuI probIem Iere Is LIuL u currenL muLerIuIIsL, monomunIucuI
(unLIsmokIng) Irenzy Is uLLempLIng Lo InLerpreLJevuIuuLe un eurIIer perIod,
ImproperIy uppIyIng u vIew LIuL wus noL domInunL, IeL uIone uccuruLe, uL
LIIs eurIIer LIme.
UnIorLunuLeIy, LIere ure smokers LIuL Iuve suIIered IIIness LIuL
cun very quIckIy be IIjucked by LIe unLIsmokIng cruze. TIese smokers ure
uIreudy devusLuLed und conIused. TIe couxIng InLo pursuIng Lobucco
IILIguLIon LIrougI unLIsmokIng cIunLs oI beIng bruve und courugeous Is
LempLIng Indeed. L uIIows Ior LIe bIumIng oI someLIIng or someone eIse
Ior LIeIr predIcumenL, I.e., un uspecL oI exLernuIIsm. TIIs probIem Is noL
pecuIIur Lo LIe Issue oI smokIng, buL oI muLerIuIIsL, IILIgIous socIeLIes
generuIIy (see CIupLer ). s LIere u busIs or u need Lo bIume unyone,
IncIudIng LIe smoker? WIere LIeIr LIme couId be beLLer spenL by
uLLempLIng Lo suIvuge some ucLuuI proIound meunIng Lo LIeIr IIves, LIere
Is now LIe rIsk oI LIeIr LIme beIng spenL In ugILuLIon produced by u
deIuded crusude (unLIsmokIng) deIIned by u mIsguIded udversurIuI
426
426
Rampant Antismoking Signifies Grave Danger
Irumework (MMES cuIL).
CurrenLIy, IL Is medIco-muLerIuIIsm LIuL domInuLes urgumenL.
TIe sIeer sLrengLI oI consensus eIIecLs promoLes LIe medIco-muLerIuIIsL
vIew us InIuIIIbIe. TIere ure sureIy medIcuI LIInkers, probubIy very Iew,
LIuL do noL ugree wILI orLIodox cuusuI urgumenLs, purLIcuIurIy us LIey
perLuIn Lo smokIng und dIseuse. YeL, wIo wouId beur sucI LesLImony In u
courL oI Iuw und rIsk noL onIy un unLIsmokIng buL u medIco-muLerIuIIsL
buckIusI. OnIy LIose LIuL Iuve Iud some ussocIuLIon wILI LIe Lobucco
IndusLry couId jusLIIy sucI venLurIng. However, LIe Lobucco IndusLry Ius
been so LIorougIIy demonIsed by rumpunL muLerIuIIsm und unLIsmokIng
LIuL LIose even remoLeIy IInked wILI LIe Lobucco IndusLry ure ImmedIuLeIy
dIsmIssed us propuguLors oI IuIseIoods, I.e., ussussInuLIon by ussocIuLIon
- u Iorm oI crumentum cd hominem. TIIs sILuuLIon muInLuIns LIe
medIco-muLerIuIIsL sLrungIeIoId on LIe IIow oI InIormuLIon und, LIereIore,
IosLers LIe perpeLuuLIonJreInIorcemenL oI medIco-muLerIuIIsL myLI-
mukIng.
A recenL cuse conLuIns uII LIe ubove uspecLs. n zoo1, u 6-yeur-
oId smoker suIIerIng bruIn und Iung cuncer sued PIIIIp MorrIs Ior Iruud,
conspIrucy, und negIIgence (e.g., see CIuruLun, zoo1). TIe pIuInLIII,
IuvIng commenced smokIng uL uge 1 und IuvIng smoked Lwo pucks oI
MurIboros u duy Ior qo yeurs, cIuImed LIuL Ie never Ieurd or reud ubouL
LIe IeuILI rIsks oI smokIng unLII congressIonuI IeurIngs were IeId In
1qqq. (cILed In SuIIum, zoo1) TIe pIuInLIII muy Iuve Iud u sIIgILIy more
pIuusIbIe cuse II Ie Iud cIuImed LIuL rIsk wus noL mude obvIous wIen Ie
commenced smokIng. However, IIs cIuIm wus LIuL rIsk wus noL mude
cIeur unLII 1qqq. SuIIum (zoo1) properIy noLes LIuL LIe pIuInLIII
overIooked LIe wurnIng IubeIs LIuL Iuve uppeured on every puck oI
cIgureLLes sInce 1q66 und In every cIgureLLe ud sInce 1q;z. He Ignored or
dIsmIssed LIe pubIIc servIce unnouncemenLs, newspuper und muguzIne
und TV und rudIo reporLs, posLers, pumpIIeLs, buLLons, bIIIbourds, und
bumper sLIckers LIuL IIgIIIgILed LIe mosL wIdeIy pubIIcIzed IeuILI Iuzurd
oI LIe zoLI cenLury. DespILe LIe pIuInLIII`s cIuIm sLreLcIIng creduIILy, u
os AngeIes jury Iound In Iuvor oI LIe pIuInLIII In LIe order oI $6m In
compensuLory dumuges und $b In punILIve dumuges.
CrILIcuI Issues sucI us LIe ucLuuI requIremenLs oI scIenLIIIcJ
cuusuI urgumenL, LIe IIImsIness oI rIsk ussessmenL meLIodoIogy und
vurIuLIons In LIe IIsLorIcuI LreuLmenL oI rIsk Iuve gone by LIe wuysIde.
TIe medIco-muLerIuIIsL vIew Is now ussumed us InIuIIIbIe und IeguI
urgumenL proceeds by demonIc depIcLIons oI LIe Lobucco IndusLry. TIIs Is
reIIecLed In LIe mussIve punILIve dumuges. TIuL Lobucco IndusLry conducL
Is IrreIevunL Lo LIe pIuInLIII`s cIuIm oI u Iuck oI uwureness oI rIsk unLII 1qqq
does noL IIgure In LIe superIIcIuIILy oI LIe LIme. PurLIcuIur Iuwyers ure weII
Preventive Medicine & Health Promotion
uwure LIuL LIe IIkeIIIood oI successIuI Lobucco IILIguLIon Is IIgIIy
enIunced In LIe currenL muLerIuIIsL-munuIucLured muss deIusIon. TIey
need onIy IInd u wIIIIng III-smoker; LIe nuLure oI LIe IuwsuIL Is secondury
- uImosL unyLIIng wIII suIIIce. A Iuwyer need onIy expIoIL LIe poor
sLundIng oI LIe Lobucco IndusLry. n sucI u cIImuLe, medIco-muLerIuIIsL
cIuIms ure never quesLIoned. ArgumenL proceeds by Irenzy und noL by
coIerenL InIerence - u dungerous sLuLe oI uIIuIrs.
n unoLIer recenL cuse In LIe US, u dyIng ex-smoker, BeLLy
BuIIock, wus uwurded u mosL sLuggerIng $USz8 bIIIIon In dumuges uguInsL
PIIIIp MorrIs. n un uppeuI, LIe dumuges were consIdered excessIve by u
CuIIIornIu SuperIor courL, sIusIIng LIem Lo $z8 mIIIIon. (Hercld,Sun,
December zo, zooz, p.;)
n LIe cuse oI EngIe v RJ ReynoIds Tobucco Compuny, un ucLIon
wus brougIL on beIuII oI uII IorIdu smokers wIo Iud dIseuses cuused
by smokIng (e.g., see Duynurd eL uI., zooo). n 1qqq LIe jury verdIcL Iound
zo dIseuses Lo be cuused by cIgureLLe smokIng, cIgureLLes Lo be deIecLIve
und unreusonubIy dungerous producLs, und uII mujor US Lobucco
compunIes Lo Iuve been guIILy oI negIIgence, Iruud, IruuduIenL
conceuImenL, conspIrucy Lo commIL Iruud und IruuduIenL conceuImenL,
und InLenLIonuI InIIIcLIon oI emoLIonuI dIsLress. (Duynurd eL uI., zooo)
TIe poInL noLeworLIy oI IIgIIIgIL Is LIuL uII concIusIons reIy on LIe IIrsL -
zo dIseuses Lo be cuused by cIgureLLe smokIng. L Ius been IndIcuLed on
u number oI occusIons LIuL IL Is LIIs cIuIm LIuL ruLes us one oI LIe greuL
Iruuds oI LIe IusL cenLury. TIIs Is u conspIrucy oI Ignorunce und
IncompeLence muInLuIned by u consensus eIIecL und muLerIuIIsL IdeoIogy.
TIe Lruck record oI medIco-muLerIuIIsm In LIe InvesLIguLIon
(epIdemIoIogy) oI muILIdImensIonuI Issues Is uppuIIIng; LIere Is u gruve
ubsence oI genuIne scIoIursIIp. TIIs sorL oI cuse IndIcuLes LIuL medIcuI
experLs guIore cun peddIe LIe LIred, IncoIerenL RR urgumenLs
underIyIng LIe smokIng cuuses u muILIpIIcILy oI dIseuses cIuIm. I LIey
ure cIuIIenged, IL wouId be by LIe Iew wIo wouId uILImuLeIy be brunded us
Lobucco-IndusLry coIIuboruLors. As IndIcuLed, wIo eIse wouId be wIIIIng
Lo be uL odds wILI u muss-scuIe IunuLIcuI sLunce? TIe crILIcuI probIem,
uguIn, Is LIe overwIeImIng weIgIL oI u consensus eIIecL LIuL enLIreIy
wurps very sIgnIIIcunL decIsIon-mukIng. Jury verdIcLs bused on LIIs
medIco-muLerIuIIsL bubbIe serve onIy Lo reInIorce wIuL Is uIreudy u
cuLusLropIIc cIrcumsLunce.
n u UK cIuss ucLIon, u group oI 6 Iormer smokers dIugnosed
wILI Iung cuncer ure suIng GuIIuIer und mperIuI Tobucco, cIuImIng LIuL
beLween 1q; und 1q;1 LIe compunIes dId noL ucL quIckIy enougI Lo
reduce Lur IeveIs In cIgureLLes (see Dyer, 1qq8). n uddILIon Lo uII oLIer
muLLers ruIsed LIus Iur LIere Is LIe Issue LIuL recenL US reseurcI Ius
427
427
Rampant Antismoking Signifies Grave Danger
Irumework (MMES cuIL).
CurrenLIy, IL Is medIco-muLerIuIIsm LIuL domInuLes urgumenL.
TIe sIeer sLrengLI oI consensus eIIecLs promoLes LIe medIco-muLerIuIIsL
vIew us InIuIIIbIe. TIere ure sureIy medIcuI LIInkers, probubIy very Iew,
LIuL do noL ugree wILI orLIodox cuusuI urgumenLs, purLIcuIurIy us LIey
perLuIn Lo smokIng und dIseuse. YeL, wIo wouId beur sucI LesLImony In u
courL oI Iuw und rIsk noL onIy un unLIsmokIng buL u medIco-muLerIuIIsL
buckIusI. OnIy LIose LIuL Iuve Iud some ussocIuLIon wILI LIe Lobucco
IndusLry couId jusLIIy sucI venLurIng. However, LIe Lobucco IndusLry Ius
been so LIorougIIy demonIsed by rumpunL muLerIuIIsm und unLIsmokIng
LIuL LIose even remoLeIy IInked wILI LIe Lobucco IndusLry ure ImmedIuLeIy
dIsmIssed us propuguLors oI IuIseIoods, I.e., ussussInuLIon by ussocIuLIon
- u Iorm oI crumentum cd hominem. TIIs sILuuLIon muInLuIns LIe
medIco-muLerIuIIsL sLrungIeIoId on LIe IIow oI InIormuLIon und, LIereIore,
IosLers LIe perpeLuuLIonJreInIorcemenL oI medIco-muLerIuIIsL myLI-
mukIng.
A recenL cuse conLuIns uII LIe ubove uspecLs. n zoo1, u 6-yeur-
oId smoker suIIerIng bruIn und Iung cuncer sued PIIIIp MorrIs Ior Iruud,
conspIrucy, und negIIgence (e.g., see CIuruLun, zoo1). TIe pIuInLIII,
IuvIng commenced smokIng uL uge 1 und IuvIng smoked Lwo pucks oI
MurIboros u duy Ior qo yeurs, cIuImed LIuL Ie never Ieurd or reud ubouL
LIe IeuILI rIsks oI smokIng unLII congressIonuI IeurIngs were IeId In
1qqq. (cILed In SuIIum, zoo1) TIe pIuInLIII muy Iuve Iud u sIIgILIy more
pIuusIbIe cuse II Ie Iud cIuImed LIuL rIsk wus noL mude obvIous wIen Ie
commenced smokIng. However, IIs cIuIm wus LIuL rIsk wus noL mude
cIeur unLII 1qqq. SuIIum (zoo1) properIy noLes LIuL LIe pIuInLIII
overIooked LIe wurnIng IubeIs LIuL Iuve uppeured on every puck oI
cIgureLLes sInce 1q66 und In every cIgureLLe ud sInce 1q;z. He Ignored or
dIsmIssed LIe pubIIc servIce unnouncemenLs, newspuper und muguzIne
und TV und rudIo reporLs, posLers, pumpIIeLs, buLLons, bIIIbourds, und
bumper sLIckers LIuL IIgIIIgILed LIe mosL wIdeIy pubIIcIzed IeuILI Iuzurd
oI LIe zoLI cenLury. DespILe LIe pIuInLIII`s cIuIm sLreLcIIng creduIILy, u
os AngeIes jury Iound In Iuvor oI LIe pIuInLIII In LIe order oI $6m In
compensuLory dumuges und $b In punILIve dumuges.
CrILIcuI Issues sucI us LIe ucLuuI requIremenLs oI scIenLIIIcJ
cuusuI urgumenL, LIe IIImsIness oI rIsk ussessmenL meLIodoIogy und
vurIuLIons In LIe IIsLorIcuI LreuLmenL oI rIsk Iuve gone by LIe wuysIde.
TIe medIco-muLerIuIIsL vIew Is now ussumed us InIuIIIbIe und IeguI
urgumenL proceeds by demonIc depIcLIons oI LIe Lobucco IndusLry. TIIs Is
reIIecLed In LIe mussIve punILIve dumuges. TIuL Lobucco IndusLry conducL
Is IrreIevunL Lo LIe pIuInLIII`s cIuIm oI u Iuck oI uwureness oI rIsk unLII 1qqq
does noL IIgure In LIe superIIcIuIILy oI LIe LIme. PurLIcuIur Iuwyers ure weII
Preventive Medicine & Health Promotion
uwure LIuL LIe IIkeIIIood oI successIuI Lobucco IILIguLIon Is IIgIIy
enIunced In LIe currenL muLerIuIIsL-munuIucLured muss deIusIon. TIey
need onIy IInd u wIIIIng III-smoker; LIe nuLure oI LIe IuwsuIL Is secondury
- uImosL unyLIIng wIII suIIIce. A Iuwyer need onIy expIoIL LIe poor
sLundIng oI LIe Lobucco IndusLry. n sucI u cIImuLe, medIco-muLerIuIIsL
cIuIms ure never quesLIoned. ArgumenL proceeds by Irenzy und noL by
coIerenL InIerence - u dungerous sLuLe oI uIIuIrs.
n unoLIer recenL cuse In LIe US, u dyIng ex-smoker, BeLLy
BuIIock, wus uwurded u mosL sLuggerIng $USz8 bIIIIon In dumuges uguInsL
PIIIIp MorrIs. n un uppeuI, LIe dumuges were consIdered excessIve by u
CuIIIornIu SuperIor courL, sIusIIng LIem Lo $z8 mIIIIon. (Hercld,Sun,
December zo, zooz, p.;)
n LIe cuse oI EngIe v RJ ReynoIds Tobucco Compuny, un ucLIon
wus brougIL on beIuII oI uII IorIdu smokers wIo Iud dIseuses cuused
by smokIng (e.g., see Duynurd eL uI., zooo). n 1qqq LIe jury verdIcL Iound
zo dIseuses Lo be cuused by cIgureLLe smokIng, cIgureLLes Lo be deIecLIve
und unreusonubIy dungerous producLs, und uII mujor US Lobucco
compunIes Lo Iuve been guIILy oI negIIgence, Iruud, IruuduIenL
conceuImenL, conspIrucy Lo commIL Iruud und IruuduIenL conceuImenL,
und InLenLIonuI InIIIcLIon oI emoLIonuI dIsLress. (Duynurd eL uI., zooo)
TIe poInL noLeworLIy oI IIgIIIgIL Is LIuL uII concIusIons reIy on LIe IIrsL -
zo dIseuses Lo be cuused by cIgureLLe smokIng. L Ius been IndIcuLed on
u number oI occusIons LIuL IL Is LIIs cIuIm LIuL ruLes us one oI LIe greuL
Iruuds oI LIe IusL cenLury. TIIs Is u conspIrucy oI Ignorunce und
IncompeLence muInLuIned by u consensus eIIecL und muLerIuIIsL IdeoIogy.
TIe Lruck record oI medIco-muLerIuIIsm In LIe InvesLIguLIon
(epIdemIoIogy) oI muILIdImensIonuI Issues Is uppuIIIng; LIere Is u gruve
ubsence oI genuIne scIoIursIIp. TIIs sorL oI cuse IndIcuLes LIuL medIcuI
experLs guIore cun peddIe LIe LIred, IncoIerenL RR urgumenLs
underIyIng LIe smokIng cuuses u muILIpIIcILy oI dIseuses cIuIm. I LIey
ure cIuIIenged, IL wouId be by LIe Iew wIo wouId uILImuLeIy be brunded us
Lobucco-IndusLry coIIuboruLors. As IndIcuLed, wIo eIse wouId be wIIIIng
Lo be uL odds wILI u muss-scuIe IunuLIcuI sLunce? TIe crILIcuI probIem,
uguIn, Is LIe overwIeImIng weIgIL oI u consensus eIIecL LIuL enLIreIy
wurps very sIgnIIIcunL decIsIon-mukIng. Jury verdIcLs bused on LIIs
medIco-muLerIuIIsL bubbIe serve onIy Lo reInIorce wIuL Is uIreudy u
cuLusLropIIc cIrcumsLunce.
n u UK cIuss ucLIon, u group oI 6 Iormer smokers dIugnosed
wILI Iung cuncer ure suIng GuIIuIer und mperIuI Tobucco, cIuImIng LIuL
beLween 1q; und 1q;1 LIe compunIes dId noL ucL quIckIy enougI Lo
reduce Lur IeveIs In cIgureLLes (see Dyer, 1qq8). n uddILIon Lo uII oLIer
muLLers ruIsed LIus Iur LIere Is LIe Issue LIuL recenL US reseurcI Ius
428
428
Rampant Antismoking Signifies Grave Danger
concIuded LIuL smokIng Iow Lur or IIgIL cIgureLLes Is noL ussocIuLed wILI u
reducLIon In Iung cuncer (Hercld,Sun, November zq, zoo1, p.zq). AIso,
LIe munuIucLure oI Iow Lur cIgureLLes wus uL LIe urgIng oI LIe medIcuI
esLubIIsImenL und unLIsmokIng IobbyIsLs us u posILIve meusure. TIe
quesLIon cerLuInIy needs Lo be usked us Lo wIy LIIs sorL oI IILIguLIon
proceeded In LIe ubsence oI IucLs. L wouId seem LIuL, uguIn uL LIe
prompLIng oI unLIsmokIng ucLIvIsLs, In LIe currenL unLIsmokIng cruze
successIuI IILIguLIon Is u IIgI IIkeIIIood - regurdIess oI IucL. OI LIe cuse,
CIIve BuLes, dIrecLor oI UK ASH, suId: We LIInk LIe Lobucco compunIes
were negIIgenL und Iuve u serIous cuse Lo unswer.
(.::.: Entironmentcl Tobccco Smole
TIe Iruud oI u muILIpIIcILy oI dIseuses cuused by Lobucco smoke
Is surpussed onIy by LIe ETS us dungerous Ior uII IIusco. L wus
consIdered In un eurIIer cIupLer LIuL ETS us u predIcLor oI specIIIc dIseuse
bureIy regIsLers on LIe condILIonuI probubIIILy scuIe. PurLIcuIurIy LIrougI
LIe Issue oI ETS, LIe unscIoIurIy, unLI-scIenLIIIc nuLure oI rIsk ussessmenL
meLIods Is mude very cIeur. TIe enLIre upproucI Is underIuIn by un
upsIde-down, buck-Lo-IronL (superIIcIuI) reusonIng. TIe preucIIng oI ETS
us dungerous Ior uII Is LIe preucIIng oI supersLILIous beIIeI wIIcI, In LIIs
cuse, uIso Ius wIdespreud socIuIIy dIvIsIve rumIIIcuLIons. AII oI LIese
consequences ure IuLrogenIc.
YeL, gIven LIe rumpunL muLerIuIIsm LIuL produced LIIs resuIL, LIe
sume momenLum Ius esLubIIsIed LIuL ETS cuuses, Ior exumpIe, Iung
cuncer In oLIerwIse IeuILIy nonsmokers us un IrreIuLubIe medIcuI IucL.
n LIe currenL unLIsmokIng Irenzy IL cun be cIuImed LIuL uny curdIo-
respIruLory muIudy Is cuused by exposure Lo ETS. ndeed, LIere Iuve been
nonsmokers LIuL Iuve expIoILed LIe cIrcumsLunce, und mosL probubIy
cujoIed by unLIsmokIng ucLIvIsLs.
n New SouLI WuIes, AusLruIIu, u 6z-yeur-oId Iormer bur-worker
und u nonsmoker sued Ier Iormer empIoyer (u PorL KembIu cIub bur)
cIuImIng LIuL Ier LIrouL cuncer wus cuused by exposure Lo ETS durIng LIe
11 yeurs LIuL sIe worked uL LIe bur (e.g., see CIupmun, zoo1). TIe
pIuInLIII wus uwurded $Aq66,ooo by u Iour-person jury.
TIrouL cuncer Is reIuLIveIy rure In smokers und rurer sLIII In
women und nonsmokers. or exumpIe, In AusLruIIu, Ior Iung cuncer LIere
ure ;6z1 new cuses dIugnosed per yeur und 6;6q deuLIs per unnum; Ior
LIrouL cuncer LIere ure z;z new cuses dIugnosed per yeur und ;1; deuLIs
per unnum (Hercld,Sun, Junuury , zoo1, p.z6); LIe muIeJIemuIe ruLIo
Ior LIrouL cuncer Is ubouL q:1 (WHO DuLubunk). AIso, LIrouL cuncer Is u
poorIy reseurcIed dIseuse, purLIcuIurIy concernIng exposure Lo ETS
Preventive Medicine & Health Promotion
umongsL nonsmokers. I envIronmenLuI poIIuLunLs ure consIdered, LIere
ure sources oI cIemIcuIs LIuL ure reIuLIveIy IIgIer LIun exposure Lo ETS,
e.g., uuLomobIIe. However, sucI exposures, wIIcI ure common, ure
exLremeIy poor predIcLors oI sucI un uLypIcuI dIseuse. TIe very-IIgI
IIkeIIIood Is endogenous ubnormuIILy LIuL probubIy Ius noLIIng Lo do
wILI exposure Lo envIronmenLuI subsLunces - even us LrIggers. L wus
noLed In un eurIIer secLIon LIuL LIere ure uIso non-respIruLory rIsk IucLors
Ior Iung cuncer In nonsmokers, e.g., dIeL, und LIere ure cuses In LIe very
young LIuL deIy even poor dose-response urgumenLs. YeL, LIese ure uII
rIsk IucLors IuvIng poor predIcLIve sLrengLI Ior LIe dIseuse: TIe ueLIoIogy
oI Iung cuncer Is noL known. TIe decIsIon Lo IILIguLe seems Lo bused
enLIreIy on un urgumenL by IncoIerenL unuIogy In LIuL II ETS cuuses
Iung cuncer, LIen IL musL uIso cuuse LIrouL cuncer.
AL LIIs juncLure IL Is useIuI Lo consIder unoLIer uspecL oI LIe
sLuLIsLIcuI urgumenL uguInsL ETS. n compurIng LIe occurrence oI, suy,
LIrouL cuncer umongsL nonsmokers exposed or noL exposed Lo ETS, u
buseIIne ruLe Is esLubIIsIed. TIIs reIIecLs LIe Irequency oI LIe dIseuse Ior
nonsmokers noL exposed Lo ETS. TIereIore, LIere Is LIe possIbIIILy oI LIe
dIseuse noL ussocIuLed wILI ETS und wIere ueLIoIogy Is unknown. I LIere
Is un Increused Irequency oI LIe dIseuse ussocIuLed wILI exposure Lo ETS
(I.e., ubove u buseIIne), LIIs Is deemed by LIe IncoIerenL rIsk-ussessmenL
meLIod us cuused by ETS. L musL be kepL In mInd LIuL LIe predIcLIve
sLrengLI oI ETS Ior LIe dIseuse Is eIIecLIveIy zero, I.e., qq.q% oI LIose
compurubIy exposed do noL deveIop LIe dIseuse.
TIe concIusIon oI cuusuLIon In LIe ubove Is uIreudy unscIoIurIy
und Is cerLuInIy noL scIenLIIIc. However, wIere cIuIms (e.g., IILIguLIon) ure
mude concernIng cuusuLIon In specIIIc cuses, LIe enLIre urgumenL
deLerIoruLes InLo u dungerous nonsense. or exumpIe, IL Is undersLood
Irom LIe sLuLIsLIcuI urgumenL LIuL wILIIn u buseIIne Ior exposed
nonsmokers, LIe occurrence oI LIe dIseuse Ius un unknown cuuse -
supposedIy LIe sume us LIe occurrence oI LIe dIseuse In unexposed
nonsmokers, I.e., LIere ure persons exposed Lo ETS wIose LIrouL cuncer Is
unreIuLed Lo ETS exposure. n u courL LrIuI LIe crILIcuI quesLIon Is wIeLIer
LIe person wILI LIe dIseuse In quesLIon und exposed Lo ETS Is wILIIn or
ubove u buseIIne. TIIs quesLIon Is ununswerubIe becuuse ucLuuI cuusuLIon
Ior eILIer exposed or nonexposed persons suIIerIng LIe dIseuse Ius noL
been demonsLruLed by LIe superIIcIuIILy oI sLuLIsLIcuIIsm, I.e., LIe enLIre
process Is u greuL IoIIy. L reIIecLs sLundurd post hoc ero propter hoc
urgumenL. AILIougI medIco-muLerIuIIsm cIuIms LIuL ETS cuuses LIrouL
cuncer, IL cunnoL demonsLruLe LIe cIuIm specIIIcuIIy. TIIs Is ubsurdILy.
Even LIougI cuusuLIon Is noL demonsLruLed Ior uny cuse (ubove or beIow u
buseIIne), uL u LIme oI muss deIusIon, cnone mukIng u cIuIm Ior Injury
429
429
Rampant Antismoking Signifies Grave Danger
concIuded LIuL smokIng Iow Lur or IIgIL cIgureLLes Is noL ussocIuLed wILI u
reducLIon In Iung cuncer (Hercld,Sun, November zq, zoo1, p.zq). AIso,
LIe munuIucLure oI Iow Lur cIgureLLes wus uL LIe urgIng oI LIe medIcuI
esLubIIsImenL und unLIsmokIng IobbyIsLs us u posILIve meusure. TIe
quesLIon cerLuInIy needs Lo be usked us Lo wIy LIIs sorL oI IILIguLIon
proceeded In LIe ubsence oI IucLs. L wouId seem LIuL, uguIn uL LIe
prompLIng oI unLIsmokIng ucLIvIsLs, In LIe currenL unLIsmokIng cruze
successIuI IILIguLIon Is u IIgI IIkeIIIood - regurdIess oI IucL. OI LIe cuse,
CIIve BuLes, dIrecLor oI UK ASH, suId: We LIInk LIe Lobucco compunIes
were negIIgenL und Iuve u serIous cuse Lo unswer.
(.::.: Entironmentcl Tobccco Smole
TIe Iruud oI u muILIpIIcILy oI dIseuses cuused by Lobucco smoke
Is surpussed onIy by LIe ETS us dungerous Ior uII IIusco. L wus
consIdered In un eurIIer cIupLer LIuL ETS us u predIcLor oI specIIIc dIseuse
bureIy regIsLers on LIe condILIonuI probubIIILy scuIe. PurLIcuIurIy LIrougI
LIe Issue oI ETS, LIe unscIoIurIy, unLI-scIenLIIIc nuLure oI rIsk ussessmenL
meLIods Is mude very cIeur. TIe enLIre upproucI Is underIuIn by un
upsIde-down, buck-Lo-IronL (superIIcIuI) reusonIng. TIe preucIIng oI ETS
us dungerous Ior uII Is LIe preucIIng oI supersLILIous beIIeI wIIcI, In LIIs
cuse, uIso Ius wIdespreud socIuIIy dIvIsIve rumIIIcuLIons. AII oI LIese
consequences ure IuLrogenIc.
YeL, gIven LIe rumpunL muLerIuIIsm LIuL produced LIIs resuIL, LIe
sume momenLum Ius esLubIIsIed LIuL ETS cuuses, Ior exumpIe, Iung
cuncer In oLIerwIse IeuILIy nonsmokers us un IrreIuLubIe medIcuI IucL.
n LIe currenL unLIsmokIng Irenzy IL cun be cIuImed LIuL uny curdIo-
respIruLory muIudy Is cuused by exposure Lo ETS. ndeed, LIere Iuve been
nonsmokers LIuL Iuve expIoILed LIe cIrcumsLunce, und mosL probubIy
cujoIed by unLIsmokIng ucLIvIsLs.
n New SouLI WuIes, AusLruIIu, u 6z-yeur-oId Iormer bur-worker
und u nonsmoker sued Ier Iormer empIoyer (u PorL KembIu cIub bur)
cIuImIng LIuL Ier LIrouL cuncer wus cuused by exposure Lo ETS durIng LIe
11 yeurs LIuL sIe worked uL LIe bur (e.g., see CIupmun, zoo1). TIe
pIuInLIII wus uwurded $Aq66,ooo by u Iour-person jury.
TIrouL cuncer Is reIuLIveIy rure In smokers und rurer sLIII In
women und nonsmokers. or exumpIe, In AusLruIIu, Ior Iung cuncer LIere
ure ;6z1 new cuses dIugnosed per yeur und 6;6q deuLIs per unnum; Ior
LIrouL cuncer LIere ure z;z new cuses dIugnosed per yeur und ;1; deuLIs
per unnum (Hercld,Sun, Junuury , zoo1, p.z6); LIe muIeJIemuIe ruLIo
Ior LIrouL cuncer Is ubouL q:1 (WHO DuLubunk). AIso, LIrouL cuncer Is u
poorIy reseurcIed dIseuse, purLIcuIurIy concernIng exposure Lo ETS
Preventive Medicine & Health Promotion
umongsL nonsmokers. I envIronmenLuI poIIuLunLs ure consIdered, LIere
ure sources oI cIemIcuIs LIuL ure reIuLIveIy IIgIer LIun exposure Lo ETS,
e.g., uuLomobIIe. However, sucI exposures, wIIcI ure common, ure
exLremeIy poor predIcLors oI sucI un uLypIcuI dIseuse. TIe very-IIgI
IIkeIIIood Is endogenous ubnormuIILy LIuL probubIy Ius noLIIng Lo do
wILI exposure Lo envIronmenLuI subsLunces - even us LrIggers. L wus
noLed In un eurIIer secLIon LIuL LIere ure uIso non-respIruLory rIsk IucLors
Ior Iung cuncer In nonsmokers, e.g., dIeL, und LIere ure cuses In LIe very
young LIuL deIy even poor dose-response urgumenLs. YeL, LIese ure uII
rIsk IucLors IuvIng poor predIcLIve sLrengLI Ior LIe dIseuse: TIe ueLIoIogy
oI Iung cuncer Is noL known. TIe decIsIon Lo IILIguLe seems Lo bused
enLIreIy on un urgumenL by IncoIerenL unuIogy In LIuL II ETS cuuses
Iung cuncer, LIen IL musL uIso cuuse LIrouL cuncer.
AL LIIs juncLure IL Is useIuI Lo consIder unoLIer uspecL oI LIe
sLuLIsLIcuI urgumenL uguInsL ETS. n compurIng LIe occurrence oI, suy,
LIrouL cuncer umongsL nonsmokers exposed or noL exposed Lo ETS, u
buseIIne ruLe Is esLubIIsIed. TIIs reIIecLs LIe Irequency oI LIe dIseuse Ior
nonsmokers noL exposed Lo ETS. TIereIore, LIere Is LIe possIbIIILy oI LIe
dIseuse noL ussocIuLed wILI ETS und wIere ueLIoIogy Is unknown. I LIere
Is un Increused Irequency oI LIe dIseuse ussocIuLed wILI exposure Lo ETS
(I.e., ubove u buseIIne), LIIs Is deemed by LIe IncoIerenL rIsk-ussessmenL
meLIod us cuused by ETS. L musL be kepL In mInd LIuL LIe predIcLIve
sLrengLI oI ETS Ior LIe dIseuse Is eIIecLIveIy zero, I.e., qq.q% oI LIose
compurubIy exposed do noL deveIop LIe dIseuse.
TIe concIusIon oI cuusuLIon In LIe ubove Is uIreudy unscIoIurIy
und Is cerLuInIy noL scIenLIIIc. However, wIere cIuIms (e.g., IILIguLIon) ure
mude concernIng cuusuLIon In specIIIc cuses, LIe enLIre urgumenL
deLerIoruLes InLo u dungerous nonsense. or exumpIe, IL Is undersLood
Irom LIe sLuLIsLIcuI urgumenL LIuL wILIIn u buseIIne Ior exposed
nonsmokers, LIe occurrence oI LIe dIseuse Ius un unknown cuuse -
supposedIy LIe sume us LIe occurrence oI LIe dIseuse In unexposed
nonsmokers, I.e., LIere ure persons exposed Lo ETS wIose LIrouL cuncer Is
unreIuLed Lo ETS exposure. n u courL LrIuI LIe crILIcuI quesLIon Is wIeLIer
LIe person wILI LIe dIseuse In quesLIon und exposed Lo ETS Is wILIIn or
ubove u buseIIne. TIIs quesLIon Is ununswerubIe becuuse ucLuuI cuusuLIon
Ior eILIer exposed or nonexposed persons suIIerIng LIe dIseuse Ius noL
been demonsLruLed by LIe superIIcIuIILy oI sLuLIsLIcuIIsm, I.e., LIe enLIre
process Is u greuL IoIIy. L reIIecLs sLundurd post hoc ero propter hoc
urgumenL. AILIougI medIco-muLerIuIIsm cIuIms LIuL ETS cuuses LIrouL
cuncer, IL cunnoL demonsLruLe LIe cIuIm specIIIcuIIy. TIIs Is ubsurdILy.
Even LIougI cuusuLIon Is noL demonsLruLed Ior uny cuse (ubove or beIow u
buseIIne), uL u LIme oI muss deIusIon, cnone mukIng u cIuIm Ior Injury
430
430
does noL cuuse cuncer Is wrong. ConsequenLIy, LIe cIIeI deIense wILness
wIo Is ussocIuLed wILI LIe Lobucco IndusLry, mukIng LIe sume cuncer
cIuIm, und wILI ImpIIcuLIons deroguLory Lo IIs moruI cIurucLer, musL uIso
be wrong. TIe prosecuLIon LIen enguged In u IInuI pIece oI duzzIIng
LrIckery. L sIIILs LIe erroneousness oI LIe Lobucco IndusLry`s cuncer
cIuIms Lo ImproperIy IncIude LIrouL cuncer wIIcI Ius no consIderubIe
epIdemIoIogIcuI InvesLIguLIon. CuusuI urgumenL concernIng Iung cuncer Is
uIreudy corrupL und onIy more so concernIng LIrouL cuncer. TIe
domInuLIon oI courL cuses by u wuII oI conLorLed IdeoIogy (MMES cuIL)
LIuL cun proceed enLIreIy und successIuIIy by u pIuy on deIusIon Is reIerred
Lo In AusLruIIun purIunce us u kunguroo courL.
ObvIousIy unquesLIonIng und conLenLed by LIe musquerude oI
due process, CIupmun (zoo1b) noLes LIuL LIe dIrecLor oI LIe New SouLI
WuIes Cuncer CouncII, Dr Andrew Penmun, beIIeved LIuL LIe uvuIIubIIILy
oI LIe documenLs rudIcuIIy uILered LIe prospecLs oI cuses bucked by LIe
Lobucco IndusLry ever beIng successIuIIy deIended In IronL oI jurIes uguIn.
'ndusLry supporLed wILnesses wIII Irom now on uIwuys need Lo uccounL
Ior wIy LIey ugreed Lo purLIcIpuLe In wIuL Is demonsLrubIy u IInuncIuIIy
moLIvuLed cumpuIgn by LIe Lobucco IndusLry Lo dIscredIL LIe evIdence
ubouL pussIve smokIng beIng IurmIuI,` suId Dr Penmun.
n unoLIer cuse, |u| LeucIer wIo cIuIms smoke-IIIIed scIooI sLuII
rooms cuused IIs cIronIc Iung dIseuse Ius receIved u sIx-IIgure
puyouL. (Hercld,Sun, JuIy z;, zoo1, p.1,q) TIe urLIcIe conLInues: CourL
documenLs reveuI IIve docLors IInked Mr Brown`s IIIness Lo pussIve
smokIng. ' vIew LIe evIdence oI LIe medIcos us sLrongIy supporLIve oI
(IIs) cuse,` Judge Wurren ugun suId. 'TIey ure ununImous LIuL LIere Is u
cuusuLIve IInk beLween pussIve smokIng und (IIs) condILIon, uL IeusL us Iur
us LIere Is un usLImu componenL..TIe medIcuI condILIon Irom wIIcI (Mr
Brown) suIIers Is descrIbed us empIysemu, usLImu, cIronIc broncIILIs,
broncIecLusIs,` LIe judge suId. Judge ugun uIIowed Mr Brown Lo seek
dumuges Ior puIn und suIIerIng und Ioss oI Income under LIe AccIdenL
CompensuLIon AcL.
TIe pIuInLIII wus suIIerIng Irom LIe bIurry dIseuse group oI
cIronIc obsLrucLIve puImonury dIseuse (COPD) wILI usLImu, LIe IuLLer
Irom cIIIdIood. AguIn, LIere Is noL even uny subsLunLIve epIdemIoIogIc
InvesLIguLIon oI COPD und ETS exposure. COPD cun occur wILI no
sIgnIIIcunL ETS exposure. TIe cuusuLIon urgumenL reIIes enLIreIy on u
medIco-muLerIuIIsL consensus eIIecL. L uIso perpeLuuLes LIe myLI LIuL uII
usLImuLIcs necessurIIy Iuve dIIIIcuILy wILI umbIenL Lobucco smoke.
WILIIn un unLIsmokIng cruze, unyone experIencIng u respIruLory dIsorder
LIuL Ius been exposed Lo Lobucco smoke Ius u very IIgI IIkeIIIood oI
wInnIng LIe cuse, I.e., ETS exposure becomes un expIuIn uII Ior
Rampant Antismoking Signifies Grave Danger
cuused by exposure Lo ETS wIII IruuduIenLIy be uwurded LIe cuse.
L Is noL surprIsIng In LIe currenL unLIsmokIng muss-deIusIon
LIuL LIe jury wouId IInd In Iuvor oI LIe pIuInLIII. However, LIe pecuIIurILy
oI LIIs cuse Is LIe nuLure oI LIe prosecuLIon`s urgumenL. TIe urgumenL
proIIered by LIe prosecuLIon wus LIuL LIere were IInks beLween one oI LIe
key medIcuI wILnesses und LIe Lobucco IndusLry. CIupmun (zoo1b), u
mIIILunL unLIsmoker, IndIcuLes LIuL:
TIe deIense cuIIed PIIIIp WILorscI und SoreII ScIwurLz
Irom LIe nLernuLIonuI CenLer Ior ToxIcoIogy und
MedIcIne In MuryIund, In LIe UnILed SLuLes, us LIeIr
prIncIpuI wILnesses. ProIessor WILorscI Ius uppeured
on muny occusIons Ior LIe Lobucco IndusLry
InLernuLIonuIIy, uILIougI IIs onIIne currIcuIum vILue
mukes no menLIon oI uny ussocIuLIon.
nLernuI Lobucco IndusLry documenLs suppIIed Lo |LIe
pIuInLIII`s| counseI by AusLruIIun Lobucco conLroI groups
proved crILIcuI Lo LIe cuse. TIese Iud been reIeused on
LIe InLerneL uILer courL ucLIon In LIe UnILed SLuLes.
Under cross exumInuLIon, PeLer SemmIer, QC, Ior |LIe
pIuInLIII|, usked ProIessor WILorscI wIeLIer Ie couId
nume uny repuLubIe medIcuI body unywIere In LIe
worId noL sponsored by LIe Lobucco IndusLry wIIcI IeId
LIuL envIronmenLuI Lobucco smoke dId noL cuuse
cuncer. ProIessor WILorscI wus unubIe Lo nume one.
Mr SemmIer uIso usked IIm wIeLIer Ie undersLood LIe
expressIon 'Lo be In bed wILI someone` und LIen
wIeLIer ProIessor WILorscI beIIeved LIuL LIIs
expressIon couId be Luken Lo uppIy Lo IIm. AILer
ProIessor WILorscI`s denIuI, Mr SemmIer LIen spenL
muny Iours sIowIng IIm InLernuI IndusLry documenLs
deLuIIIng IIs prevIous exLensIve work Ior LIe IndusLry
und sLuLemenLs ubouL puymenLs LIuL Ie Iud receIved.
L Is usLoundIng LIuL u cuse cun be decIded enLIreIy by LIe
domInuLIon oI u medIco-muLerIuIIsL consensus eIIecL und LIe vIIIIIcuLIon oI
LIe Lobucco IndusLry or unyone LIuL wouId dure quesLIon LIe ussumed
InIuIIIbIIILy oI medIco-muLerIuIIsL cIuIms. ucLs seem Lo pIuy no purL In LIe
proceedIngs. TIe prosecuLIon`s urgumenL Is rIddIed wILI sopIIsLry.
IrsLIy, medIco-muLerIuIIsL cIuIms ure consIdered us repuLubIe und
IrreIuLubIe. Anyone quesLIonIng LIese cIuIms Is eILIer u medIcuI
orgunIzuLIon IuckIng repuLe or u coIIuboruLor wILI LIe uIwuys-wrong
Lobucco IndusLry. TIe cIuIm, LIereIore, by LIe Lobucco IndusLry LIuL ETS
Preventive Medicine & Health Promotion
431
431
does noL cuuse cuncer Is wrong. ConsequenLIy, LIe cIIeI deIense wILness
wIo Is ussocIuLed wILI LIe Lobucco IndusLry, mukIng LIe sume cuncer
cIuIm, und wILI ImpIIcuLIons deroguLory Lo IIs moruI cIurucLer, musL uIso
be wrong. TIe prosecuLIon LIen enguged In u IInuI pIece oI duzzIIng
LrIckery. L sIIILs LIe erroneousness oI LIe Lobucco IndusLry`s cuncer
cIuIms Lo ImproperIy IncIude LIrouL cuncer wIIcI Ius no consIderubIe
epIdemIoIogIcuI InvesLIguLIon. CuusuI urgumenL concernIng Iung cuncer Is
uIreudy corrupL und onIy more so concernIng LIrouL cuncer. TIe
domInuLIon oI courL cuses by u wuII oI conLorLed IdeoIogy (MMES cuIL)
LIuL cun proceed enLIreIy und successIuIIy by u pIuy on deIusIon Is reIerred
Lo In AusLruIIun purIunce us u kunguroo courL.
ObvIousIy unquesLIonIng und conLenLed by LIe musquerude oI
due process, CIupmun (zoo1b) noLes LIuL LIe dIrecLor oI LIe New SouLI
WuIes Cuncer CouncII, Dr Andrew Penmun, beIIeved LIuL LIe uvuIIubIIILy
oI LIe documenLs rudIcuIIy uILered LIe prospecLs oI cuses bucked by LIe
Lobucco IndusLry ever beIng successIuIIy deIended In IronL oI jurIes uguIn.
'ndusLry supporLed wILnesses wIII Irom now on uIwuys need Lo uccounL
Ior wIy LIey ugreed Lo purLIcIpuLe In wIuL Is demonsLrubIy u IInuncIuIIy
moLIvuLed cumpuIgn by LIe Lobucco IndusLry Lo dIscredIL LIe evIdence
ubouL pussIve smokIng beIng IurmIuI,` suId Dr Penmun.
n unoLIer cuse, |u| LeucIer wIo cIuIms smoke-IIIIed scIooI sLuII
rooms cuused IIs cIronIc Iung dIseuse Ius receIved u sIx-IIgure
puyouL. (Hercld,Sun, JuIy z;, zoo1, p.1,q) TIe urLIcIe conLInues: CourL
documenLs reveuI IIve docLors IInked Mr Brown`s IIIness Lo pussIve
smokIng. ' vIew LIe evIdence oI LIe medIcos us sLrongIy supporLIve oI
(IIs) cuse,` Judge Wurren ugun suId. 'TIey ure ununImous LIuL LIere Is u
cuusuLIve IInk beLween pussIve smokIng und (IIs) condILIon, uL IeusL us Iur
us LIere Is un usLImu componenL..TIe medIcuI condILIon Irom wIIcI (Mr
Brown) suIIers Is descrIbed us empIysemu, usLImu, cIronIc broncIILIs,
broncIecLusIs,` LIe judge suId. Judge ugun uIIowed Mr Brown Lo seek
dumuges Ior puIn und suIIerIng und Ioss oI Income under LIe AccIdenL
CompensuLIon AcL.
TIe pIuInLIII wus suIIerIng Irom LIe bIurry dIseuse group oI
cIronIc obsLrucLIve puImonury dIseuse (COPD) wILI usLImu, LIe IuLLer
Irom cIIIdIood. AguIn, LIere Is noL even uny subsLunLIve epIdemIoIogIc
InvesLIguLIon oI COPD und ETS exposure. COPD cun occur wILI no
sIgnIIIcunL ETS exposure. TIe cuusuLIon urgumenL reIIes enLIreIy on u
medIco-muLerIuIIsL consensus eIIecL. L uIso perpeLuuLes LIe myLI LIuL uII
usLImuLIcs necessurIIy Iuve dIIIIcuILy wILI umbIenL Lobucco smoke.
WILIIn un unLIsmokIng cruze, unyone experIencIng u respIruLory dIsorder
LIuL Ius been exposed Lo Lobucco smoke Ius u very IIgI IIkeIIIood oI
wInnIng LIe cuse, I.e., ETS exposure becomes un expIuIn uII Ior
Rampant Antismoking Signifies Grave Danger
cuused by exposure Lo ETS wIII IruuduIenLIy be uwurded LIe cuse.
L Is noL surprIsIng In LIe currenL unLIsmokIng muss-deIusIon
LIuL LIe jury wouId IInd In Iuvor oI LIe pIuInLIII. However, LIe pecuIIurILy
oI LIIs cuse Is LIe nuLure oI LIe prosecuLIon`s urgumenL. TIe urgumenL
proIIered by LIe prosecuLIon wus LIuL LIere were IInks beLween one oI LIe
key medIcuI wILnesses und LIe Lobucco IndusLry. CIupmun (zoo1b), u
mIIILunL unLIsmoker, IndIcuLes LIuL:
TIe deIense cuIIed PIIIIp WILorscI und SoreII ScIwurLz
Irom LIe nLernuLIonuI CenLer Ior ToxIcoIogy und
MedIcIne In MuryIund, In LIe UnILed SLuLes, us LIeIr
prIncIpuI wILnesses. ProIessor WILorscI Ius uppeured
on muny occusIons Ior LIe Lobucco IndusLry
InLernuLIonuIIy, uILIougI IIs onIIne currIcuIum vILue
mukes no menLIon oI uny ussocIuLIon.
nLernuI Lobucco IndusLry documenLs suppIIed Lo |LIe
pIuInLIII`s| counseI by AusLruIIun Lobucco conLroI groups
proved crILIcuI Lo LIe cuse. TIese Iud been reIeused on
LIe InLerneL uILer courL ucLIon In LIe UnILed SLuLes.
Under cross exumInuLIon, PeLer SemmIer, QC, Ior |LIe
pIuInLIII|, usked ProIessor WILorscI wIeLIer Ie couId
nume uny repuLubIe medIcuI body unywIere In LIe
worId noL sponsored by LIe Lobucco IndusLry wIIcI IeId
LIuL envIronmenLuI Lobucco smoke dId noL cuuse
cuncer. ProIessor WILorscI wus unubIe Lo nume one.
Mr SemmIer uIso usked IIm wIeLIer Ie undersLood LIe
expressIon 'Lo be In bed wILI someone` und LIen
wIeLIer ProIessor WILorscI beIIeved LIuL LIIs
expressIon couId be Luken Lo uppIy Lo IIm. AILer
ProIessor WILorscI`s denIuI, Mr SemmIer LIen spenL
muny Iours sIowIng IIm InLernuI IndusLry documenLs
deLuIIIng IIs prevIous exLensIve work Ior LIe IndusLry
und sLuLemenLs ubouL puymenLs LIuL Ie Iud receIved.
L Is usLoundIng LIuL u cuse cun be decIded enLIreIy by LIe
domInuLIon oI u medIco-muLerIuIIsL consensus eIIecL und LIe vIIIIIcuLIon oI
LIe Lobucco IndusLry or unyone LIuL wouId dure quesLIon LIe ussumed
InIuIIIbIIILy oI medIco-muLerIuIIsL cIuIms. ucLs seem Lo pIuy no purL In LIe
proceedIngs. TIe prosecuLIon`s urgumenL Is rIddIed wILI sopIIsLry.
IrsLIy, medIco-muLerIuIIsL cIuIms ure consIdered us repuLubIe und
IrreIuLubIe. Anyone quesLIonIng LIese cIuIms Is eILIer u medIcuI
orgunIzuLIon IuckIng repuLe or u coIIuboruLor wILI LIe uIwuys-wrong
Lobucco IndusLry. TIe cIuIm, LIereIore, by LIe Lobucco IndusLry LIuL ETS
Preventive Medicine & Health Promotion
432
432
Rampant Antismoking Signifies Grave Danger
respIruLory dIseuses In nonsmokers. And wILI eucI successIuI IILIguLIon Is
LIe deIusIon propeIIed.
TIe S.A..E. unLIsmokIng websILe IndIcuLes oLIer successIuI ETS
IILIguLIon:
One oI LIe mosL recenL exumpIes oI workers`
compensuLIon recovery Is LIuL oI AvuLur UIbI, un
oLIerwIse IeuILIy nonsmoker wILI no IIsLory oI IeurL
dIseuse wIo suIIered u IeurL uLLuck Irom pussIve
smokIng exposure wIIIe workIng us u wuILer In u
resLuurunL wIIcI permILLed smokIng. He wus uwurded
$8,ooo by LIe CuIIIornIu CompensuLIon nsurunce
und In 1qqo.
EsLIer ScIIIIer, u LeucIer wILI LIe os AngeIes UnIIIed
ScIooI DIsLrIcL, wus uwurded u workers` compensuLIon
seLLIemenL oI $o,ooo wIen umbIenL smoke Irom un
empIoyee Iounge cuused Ier Lo become III In Ier
cIussroom.
AguIn, IL deIIes sune descrIpLIon Iow ETS, IuvIng neur-zero
predIcLIve sLrengLI ubove u buseIIne Ior IeurL dIseuse, cun be gIven mujor
cuusuI sLuLus In un unexpecLed IeurL uLLuck. urLIermore, II LIe duLe oI
LIe judgemenL Is uccuruLe, LIere wus very poor epIdemIoIogIcuI evIdence
concernIng ETS und CHD uL LIuL LIme, IeL uIone LIe requIremenLs oI
sound cuusuI urgumenL. n LIe second cuse, IL Is dIIIIcuIL Lo ImugIne Iow
umbIenL Lobucco smoke drIILIng Irom u dIsLunL source, IIgIIy dIIuLed,
couId be consIdered us probIemuLIc by even LIe unLIsmokIng Iobby. TIe
sILuuLIon Is LIuL LIere ure IIInesses In nonsmokers LIuL ure essenLIuIIy
unexpIuIned undJor unexpIuInubIe. I exposure Lo ETS Ius IIgured In
LIese persons` IIsLory, IL Ius become un expIuIn uII Ior LIese condILIons.
L Is medIco-muLerIuIIsL deIusIon LIuL Ius munuIucLured LIIs cIrcumsLunce
und Is IuLrogenIc.
A consensus eIIecL wILIIn medIco-muLerIuIIsm und demonIzIng
oI LIe Lobucco IndusLry us LIe busIs Ior evuIuuLIng courL cuses Is noL new.
n 1qq1, JusLIce Trevor MorIIng oI LIe ederuI CourL oI AusLruIIu ruIed
LIuL LIe Tobucco nsLILuLe oI AusLruIIu wus noL permILLed Lo udverLIse
cIuIms LIuL LIere Is IILLIe evIdence und noLIIng wIIcI proves scIenLIIIcuIIy
LIuL cIgureLLe smoke cuuses dIseuse In non-smokers. (see CIupmun &
Woodwurd, 1qq1) TIIs judgemenL wus mude prIor Lo EPA (1qq). JusLIce
MorIIng beIIeved LIuL LIere wus overwIeImIng evIdence Ior LIe eIIecLs oI
Lobucco smoke on nonsmokers (LIe sume us depIcLed In EPA, 1qq) wIIcI
wus bused on medIcuI opInIon. JusLIce MorIIng uIso crILIcIzed LIe Lobucco
IndusLry`s wILnesses:
Preventive Medicine & Health Promotion
He descrIbed ProIessor Gury Huber ( u ProIessor oI
MedIcIne In Texus) us 'evusIve,` some oI IIs unswers
'unsuLIsIucLory,` und suId LIuL Ie 'dId noL IInd ProIessor
Huber u suLIsIucLory wILness In uII respecLs.` He udded
LIuL , 'OI uII LIe wILnesses cuIIed by LIe respondenL,
Iound IIm LIe IeusL ImpressIve.` OI Dr Sven MuImIors, u
consuILunL LoxIcoIogIsL cuIIed by LIe Lobucco InsLILuLe,
JusLIce MorIIng suId, 'L seems Lo me LIuL Dr MuImIors`
requIremenLs Ior LIe esLubIIsImenL oI scIenLIIIc LruLI
ure uImosL unobLuInubIe.` SImIIurIy, oI emerILus
ProIessor JoIn CIuyLon (ArIzonu) Ie noLed, 'ProIessor
CIuyLon Is oI LIe opInIon LIuL LoxIcoIogy Ius noL
provIded uny prooI LIuL muInsLreum smoke cuuses Iung
cuncer In ucLIve smokers,` und LIuL CIuyLon wus noL
prepured Lo concede LIuL LIe nLernuLIonuI Agency Ior
ReseurcI on Cuncer`s concIusIons ubouL LIe evIdence oI
LIe curcInogenIcILy oI vurIous componenLs oI Lobucco
smoke were soundIy bused.
JusLIce MorIIng`s mosL cuusLIc remurks were perIups
reserved Ior u CuIIIornIun consuILIng sLuLIsLIcIun, Dr
MuxweII uyurd oI wIom Ie wroLe: 'PIuInIy Ie Ius u
very cIose ussocIuLIon wILI LIe Lobucco IndusLry und
depends on IL Ior mosL oI IIs Income.. do noL LIInk
LIuL Dr uyurd expressed opInIons wIIcI Ie does noL
IoId, buL do LIInk IIs IypercrILIcuI upproucI Lo LIe
epIdemIoIogIcuI sLudIes muy noL be dIsussocIuLed wILI
IIs cIose connecLIon wILI LIe Lobucco
IndusLry.` (CIupmun & Woodwurd, 1qq1, p.qqq)
TIe JusLIce uIso uIIuded Lo LIe InIuIIIbIIILy oI epIdemIoIogIcuI
opInIon: JusLIce MorIIng noLed LIuL despILe LIe resources oI LIe
InLernuLIonuI Lobucco IndusLry, LIe Lobucco InsLILuLe wus unubIe Lo IInd
even one epIdemIoIogIsL wIo wouId LesLIIy In u munner conLrury Lo LIe
epIdemIoIogIsLs cuIIed by LIe IederuLIon: TIe respondenLs IuIIed Lo cuII
one wILness wIose specIuI experLIse Is In epIdemIoIogy und oI wIom IL
couId be suId LIuL Ie 'properIy` IeId vIews conLrury Lo LIose expressed by
LIe dIsLInguIsIed epIdemIoIogIsLs cuIIed by LIe uppIIcunL. (CIupmun &
Woodwurd, 1qq1, p.qqq)
TIe onIy poInL oI gruve concern Is rumpunL muLerIuIIsm und LIe
MMES cuIL LIuL currenLIy domInuLes key socIuI InsLILuLIons, IncIudIng
IeguI proceedIngs. MedIcuI opInIon Is udopLed us experL und InIuIIIbIe.
RuLIer, IL demonsLruLes IIgIIy ImpoverIsIed scIoIursIIp. TIe ruIes oI
433
433
Rampant Antismoking Signifies Grave Danger
respIruLory dIseuses In nonsmokers. And wILI eucI successIuI IILIguLIon Is
LIe deIusIon propeIIed.
TIe S.A..E. unLIsmokIng websILe IndIcuLes oLIer successIuI ETS
IILIguLIon:
One oI LIe mosL recenL exumpIes oI workers`
compensuLIon recovery Is LIuL oI AvuLur UIbI, un
oLIerwIse IeuILIy nonsmoker wILI no IIsLory oI IeurL
dIseuse wIo suIIered u IeurL uLLuck Irom pussIve
smokIng exposure wIIIe workIng us u wuILer In u
resLuurunL wIIcI permILLed smokIng. He wus uwurded
$8,ooo by LIe CuIIIornIu CompensuLIon nsurunce
und In 1qqo.
EsLIer ScIIIIer, u LeucIer wILI LIe os AngeIes UnIIIed
ScIooI DIsLrIcL, wus uwurded u workers` compensuLIon
seLLIemenL oI $o,ooo wIen umbIenL smoke Irom un
empIoyee Iounge cuused Ier Lo become III In Ier
cIussroom.
AguIn, IL deIIes sune descrIpLIon Iow ETS, IuvIng neur-zero
predIcLIve sLrengLI ubove u buseIIne Ior IeurL dIseuse, cun be gIven mujor
cuusuI sLuLus In un unexpecLed IeurL uLLuck. urLIermore, II LIe duLe oI
LIe judgemenL Is uccuruLe, LIere wus very poor epIdemIoIogIcuI evIdence
concernIng ETS und CHD uL LIuL LIme, IeL uIone LIe requIremenLs oI
sound cuusuI urgumenL. n LIe second cuse, IL Is dIIIIcuIL Lo ImugIne Iow
umbIenL Lobucco smoke drIILIng Irom u dIsLunL source, IIgIIy dIIuLed,
couId be consIdered us probIemuLIc by even LIe unLIsmokIng Iobby. TIe
sILuuLIon Is LIuL LIere ure IIInesses In nonsmokers LIuL ure essenLIuIIy
unexpIuIned undJor unexpIuInubIe. I exposure Lo ETS Ius IIgured In
LIese persons` IIsLory, IL Ius become un expIuIn uII Ior LIese condILIons.
L Is medIco-muLerIuIIsL deIusIon LIuL Ius munuIucLured LIIs cIrcumsLunce
und Is IuLrogenIc.
A consensus eIIecL wILIIn medIco-muLerIuIIsm und demonIzIng
oI LIe Lobucco IndusLry us LIe busIs Ior evuIuuLIng courL cuses Is noL new.
n 1qq1, JusLIce Trevor MorIIng oI LIe ederuI CourL oI AusLruIIu ruIed
LIuL LIe Tobucco nsLILuLe oI AusLruIIu wus noL permILLed Lo udverLIse
cIuIms LIuL LIere Is IILLIe evIdence und noLIIng wIIcI proves scIenLIIIcuIIy
LIuL cIgureLLe smoke cuuses dIseuse In non-smokers. (see CIupmun &
Woodwurd, 1qq1) TIIs judgemenL wus mude prIor Lo EPA (1qq). JusLIce
MorIIng beIIeved LIuL LIere wus overwIeImIng evIdence Ior LIe eIIecLs oI
Lobucco smoke on nonsmokers (LIe sume us depIcLed In EPA, 1qq) wIIcI
wus bused on medIcuI opInIon. JusLIce MorIIng uIso crILIcIzed LIe Lobucco
IndusLry`s wILnesses:
Preventive Medicine & Health Promotion
He descrIbed ProIessor Gury Huber ( u ProIessor oI
MedIcIne In Texus) us 'evusIve,` some oI IIs unswers
'unsuLIsIucLory,` und suId LIuL Ie 'dId noL IInd ProIessor
Huber u suLIsIucLory wILness In uII respecLs.` He udded
LIuL , 'OI uII LIe wILnesses cuIIed by LIe respondenL,
Iound IIm LIe IeusL ImpressIve.` OI Dr Sven MuImIors, u
consuILunL LoxIcoIogIsL cuIIed by LIe Lobucco InsLILuLe,
JusLIce MorIIng suId, 'L seems Lo me LIuL Dr MuImIors`
requIremenLs Ior LIe esLubIIsImenL oI scIenLIIIc LruLI
ure uImosL unobLuInubIe.` SImIIurIy, oI emerILus
ProIessor JoIn CIuyLon (ArIzonu) Ie noLed, 'ProIessor
CIuyLon Is oI LIe opInIon LIuL LoxIcoIogy Ius noL
provIded uny prooI LIuL muInsLreum smoke cuuses Iung
cuncer In ucLIve smokers,` und LIuL CIuyLon wus noL
prepured Lo concede LIuL LIe nLernuLIonuI Agency Ior
ReseurcI on Cuncer`s concIusIons ubouL LIe evIdence oI
LIe curcInogenIcILy oI vurIous componenLs oI Lobucco
smoke were soundIy bused.
JusLIce MorIIng`s mosL cuusLIc remurks were perIups
reserved Ior u CuIIIornIun consuILIng sLuLIsLIcIun, Dr
MuxweII uyurd oI wIom Ie wroLe: 'PIuInIy Ie Ius u
very cIose ussocIuLIon wILI LIe Lobucco IndusLry und
depends on IL Ior mosL oI IIs Income.. do noL LIInk
LIuL Dr uyurd expressed opInIons wIIcI Ie does noL
IoId, buL do LIInk IIs IypercrILIcuI upproucI Lo LIe
epIdemIoIogIcuI sLudIes muy noL be dIsussocIuLed wILI
IIs cIose connecLIon wILI LIe Lobucco
IndusLry.` (CIupmun & Woodwurd, 1qq1, p.qqq)
TIe JusLIce uIso uIIuded Lo LIe InIuIIIbIIILy oI epIdemIoIogIcuI
opInIon: JusLIce MorIIng noLed LIuL despILe LIe resources oI LIe
InLernuLIonuI Lobucco IndusLry, LIe Lobucco InsLILuLe wus unubIe Lo IInd
even one epIdemIoIogIsL wIo wouId LesLIIy In u munner conLrury Lo LIe
epIdemIoIogIsLs cuIIed by LIe IederuLIon: TIe respondenLs IuIIed Lo cuII
one wILness wIose specIuI experLIse Is In epIdemIoIogy und oI wIom IL
couId be suId LIuL Ie 'properIy` IeId vIews conLrury Lo LIose expressed by
LIe dIsLInguIsIed epIdemIoIogIsLs cuIIed by LIe uppIIcunL. (CIupmun &
Woodwurd, 1qq1, p.qqq)
TIe onIy poInL oI gruve concern Is rumpunL muLerIuIIsm und LIe
MMES cuIL LIuL currenLIy domInuLes key socIuI InsLILuLIons, IncIudIng
IeguI proceedIngs. MedIcuI opInIon Is udopLed us experL und InIuIIIbIe.
RuLIer, IL demonsLruLes IIgIIy ImpoverIsIed scIoIursIIp. TIe ruIes oI
434
434
Rampant Antismoking Signifies Grave Danger
scIenLIIIc enquIry ure sLrIcL, und LIuL sIouId resuIL In pInpoInLIng
uccurucy. TIIs ruIses LIe IeveI oI InIerence ubove sLuLIsLIcuIIsm. uIIure Lo
udIere Lo LIe ruIes oI coIerenL InIerence Iuve consIderubIe psycIoIogIcuI
und socIuI IeuILI rumIIIcuLIons. MuLerIuIIsm, beIng IeebIe uIong LIese
dImensIons, Ius no compreIensIon oI LIese deLrImenLuI consequences.
TIere ure purLIcuIur quesLIons LIuL sIouId be usked oI uny
medIco-muLerIuIIsL mukIng ETS cuuses dIseuse cIuIms. IrsLIy, wIy do
LIe greuLer mujorILy (I.e., qq%+) oI nonsmokers exposed Lo ETS not
demonsLruLe u specIIIc dIseuse In quesLIon? SecondIy, ure LIere uny oLIer
rIsk IucLors? TIIrdIy, wIuL Is LIe crILIcuI dIsLIncLIon beLween LIe cIInIcuI
meLIod und LIe scIenLIIIc meLIod? n LIe Iormer, LIe IIImsIness oI post
hoc uppruIsuIs Is LoIeruLed; In LIe IuLLer, IL Is u IIgI-IeveI oI predIcLIve (c
priori) sLrengLI oI IucLors Ior IucLors LIuL Is purumounL. ourLIIy, wIuL
does LIe Lerm cuuse meun In scIenLIIIc Lerms, I.e., uIIusIon Lo
pInpoInLIng (IIgI predIcLor) IuncLIon LIuL Is expressed In Lerms oI u
generuI propensILy cuusIng u specIIIc eIIecL enercll In LIose exposed?
IILIIy, cun LIe medIco-muLerIuIIsL demonsLruLe wIeLIer u pIuInLIII Is u
member oI LIe dIseuse group up Lo u buseIIne or ubove u buseIIne? TIese
sorLs oI quesLIons sIouId IeIp Lo reInLroduce coIerenL InIerence buck InLo
wIuL Is currenLIy un unbuIunced, IncompeLenL mess.
MenLIon musL uIso be mude oI u purLIcuIur cIuss-ucLIon LIuL
generuLed consIderubIe propugundu mIIeuge Ior LIe unLIsmokIng Iobby
buL wIIcI Ius numerous quesLIonubIe uspecLs. Duynurd eL uI. (zooo) noLe
LIuL LIe Lobucco IndusLry seLLIed u cIuss ucLIon by IIIgIL uLLendunLs suIng
Ior InjurIes supposedIy cuused by ETS us purL oI LIe Iurger gIobuI
seLLIemenL wILI u number oI US sLuLes.
SmokIng wus bunned In LIe US In IuLe-1q8; on IIIgILs oI Iess
LIun z Iours duruLIon. TIe bun Look eIIecL In eurIy-1q88 on u Lwo-yeur
LrIuI busIs. TIere wus no purLIcuIur reuson Ior LIe bun oLIer LIun LIe
muLerIuIIsL munIIesLo und u Surgeon GeneruI (Koop) deLermIned Lo press
LIe smokeIree worId cuuse; Congress requesLed un InvesLIguLIon InLo
poIIuLunL IeveIs In uIrIIner cubIns und Lo ussess LIe ussocIuLed IeuILI rIsks;
LIIs wus noL IIIed by LIe U.S. DepurLmenL oI TrunsporLuLIon unLII
December, 1q8q. TIIs purLIcuIur InvesLIguLIon, AIrIIner CubIn
EnvIronmenL: ConLumInunL MeusuremenLs, HeuILI RIsks, und MILIguLIon
OpLIons (DOT-P-1-8q-), wIIcI Ius Iong been ouL oI prInL (copIes
uvuIIubIe uL ILLp:JJwww.Iorces.org.ILm), Ius been LIe busIs Ior smokIng
buns over LIe IusL decude und wIIcI conLuIns uII LIe ubsurdILIes oI rIsk
ussessmenL proLocoI.
TIe DOT ReporL uddressed LIe more generuI muLLer oI uIrIIner
cubIn uIr quuIILy und ussocIuLed IeuILI rIsks ruLIer LIun LIe sIngIe Issue oI
ETS. AIrborne nIcoLIne, respIrubIe suspended purLIcIes (RSP), und curbon
Preventive Medicine & Health Promotion
monoxIde (CO) were used us Lrucers Ior ETS uILIougI onIy nIcoLIne Is
unIque Lo ETS. OLIer IucLors were uIso meusured: ozone, mIcrobIuI
uerosoIs (bucLerIu, IungI), LemperuLure, reIuLIve IumIdILy, und cubIn uIr
pressure. TIe sumpIe sIze wus 6q smokIng IIIgILs on jeL uIrcruIL, IncIudIng
some InLernuLIonuI IIIgILs, compured Lo z nonsmokIng IIIgILs ucLIng us u
conLroI.
BrIeIIy, uveruge RSP IeveI wus IIgIesL In LIe smokIng secLIon
(1;.8), und wus Iow und compurubIe Ior boundury rows (IIrsL LIree
nonsmokIng rows on u smokIng IIIgIL) (.6), mIddIe rows (o.;) und
remoLe rows (.o) on smokIng IIIgILs und reur rows (q.8) und mIddIe
rows (qo.o) on nonsmokIng IIIgILs. Averuge nIcoLIne IeveI wus IIgIesL In
LIe smokIng secLIon (1.q), und wus Iow und compurubIe Ior boundury
rows (o.z6), mIddIe rows (o.oq) und remoLe rows (o.o) on smokIng
IIIgILs und reur rows (o.oo) und mIddIe rows (o.o8) on nonsmokIng
IIIgILs. TIe percenL oI sumpIes In wIIcI nIcoLIne wus undeLecLubIe wus
IowesL Ior LIe smokIng secLIon (q.), und wus consIderubIy IIgIer Ior
boundury rows (q.q), mIddIe rows (8z.6) und remoLe rows (66.;) on
smokIng IIIgILs und reur rows (1oo.o) und mIddIe rows (;8.) on
nonsmokIng IIIgILs. Averuge CO IeveIs were Iow und compurubIe
LIrougIouL: smokIng secLIon (1.q), boundury rows (o.6), mIddIe rows
(o.;) und remoLe rows (o.8) on smokIng IIIgILs und reur rows (o.6) und
mIddIe rows (o.) on nonsmokIng IIIgILs: CO IeveIs were generuIIy
IIgIesL beIore uIrcruIL were uIrborne, boLI Ior smokIng und nonsmokIng
IIIgILs, due Lo InLrusIon oI ground-IeveI emIssIons. Averuge curbon
dIoxIde (COz) wus 16z Ior LIe smokIng secLIon, 168 Ior remuInIng
secLIons on smokIng IIIgILs, und 1;6 Ior nonsmokIng IIIgILs.
TIe DOT ReporL IndIcuLed LIuL |w|IIIe odor udupLuLIon Lo ETS
occurs over u sIorL LIme Irume, respIruLory und ocuIur IrrILuLIon Increuse
proporLIonuLeIy over uL IeusL one Iour uL IeveIs us Iow us z ppm CO.
Averuge CO IeveIs, even Ior LIe smokIng secLIon, were weII beIow z ppm.
However, DOT noLes LIuL on percenL oI uII IIIgILs LesLed, LIe o-mInuLe
CO uveruges exceeded z ppm In LIe boundury und nonsmokIng secLIons.
TIIs ImpIIes LIuL on percenL oI LIe IIIgILs, 1z percenL oI LIe nonsmokers
In LIese secLIons wouId be dIssuLIsIIed. TIe Issue oI mInor IrrILuLIon Is
compIIcuLed by COz IeveIs. PurLIcuIur IeveIs oI COz, exIuIed by uII
persons, ure uIso ussocIuLed wILI respIruLory IrrILuLIon, IeuducIes und
IuLIgue: ReIuLIveIy IIgI COz IeveIs were meusured, uverugIng over 1,oo
purLs per mIIIIon (ppm) ucross uII monILored IIIgILs. Meusured COz
concenLruLIons exceeded 1,ooo ppm, LIe AmerIcun SocIeLy oI HeuLIng,
ReIrIgeruLIng und AIr CondILIonIng EngIneers (ASHRAE) IeveI ussocIuLed
wILI suLIsIucLIon oI comIorL (odor) crILerIu, on 8; percenL oI LIe
monILored IIIgILs. DependIng on ussumed COz exIuIuLIon ruLes,
435
435
Rampant Antismoking Signifies Grave Danger
scIenLIIIc enquIry ure sLrIcL, und LIuL sIouId resuIL In pInpoInLIng
uccurucy. TIIs ruIses LIe IeveI oI InIerence ubove sLuLIsLIcuIIsm. uIIure Lo
udIere Lo LIe ruIes oI coIerenL InIerence Iuve consIderubIe psycIoIogIcuI
und socIuI IeuILI rumIIIcuLIons. MuLerIuIIsm, beIng IeebIe uIong LIese
dImensIons, Ius no compreIensIon oI LIese deLrImenLuI consequences.
TIere ure purLIcuIur quesLIons LIuL sIouId be usked oI uny
medIco-muLerIuIIsL mukIng ETS cuuses dIseuse cIuIms. IrsLIy, wIy do
LIe greuLer mujorILy (I.e., qq%+) oI nonsmokers exposed Lo ETS not
demonsLruLe u specIIIc dIseuse In quesLIon? SecondIy, ure LIere uny oLIer
rIsk IucLors? TIIrdIy, wIuL Is LIe crILIcuI dIsLIncLIon beLween LIe cIInIcuI
meLIod und LIe scIenLIIIc meLIod? n LIe Iormer, LIe IIImsIness oI post
hoc uppruIsuIs Is LoIeruLed; In LIe IuLLer, IL Is u IIgI-IeveI oI predIcLIve (c
priori) sLrengLI oI IucLors Ior IucLors LIuL Is purumounL. ourLIIy, wIuL
does LIe Lerm cuuse meun In scIenLIIIc Lerms, I.e., uIIusIon Lo
pInpoInLIng (IIgI predIcLor) IuncLIon LIuL Is expressed In Lerms oI u
generuI propensILy cuusIng u specIIIc eIIecL enercll In LIose exposed?
IILIIy, cun LIe medIco-muLerIuIIsL demonsLruLe wIeLIer u pIuInLIII Is u
member oI LIe dIseuse group up Lo u buseIIne or ubove u buseIIne? TIese
sorLs oI quesLIons sIouId IeIp Lo reInLroduce coIerenL InIerence buck InLo
wIuL Is currenLIy un unbuIunced, IncompeLenL mess.
MenLIon musL uIso be mude oI u purLIcuIur cIuss-ucLIon LIuL
generuLed consIderubIe propugundu mIIeuge Ior LIe unLIsmokIng Iobby
buL wIIcI Ius numerous quesLIonubIe uspecLs. Duynurd eL uI. (zooo) noLe
LIuL LIe Lobucco IndusLry seLLIed u cIuss ucLIon by IIIgIL uLLendunLs suIng
Ior InjurIes supposedIy cuused by ETS us purL oI LIe Iurger gIobuI
seLLIemenL wILI u number oI US sLuLes.
SmokIng wus bunned In LIe US In IuLe-1q8; on IIIgILs oI Iess
LIun z Iours duruLIon. TIe bun Look eIIecL In eurIy-1q88 on u Lwo-yeur
LrIuI busIs. TIere wus no purLIcuIur reuson Ior LIe bun oLIer LIun LIe
muLerIuIIsL munIIesLo und u Surgeon GeneruI (Koop) deLermIned Lo press
LIe smokeIree worId cuuse; Congress requesLed un InvesLIguLIon InLo
poIIuLunL IeveIs In uIrIIner cubIns und Lo ussess LIe ussocIuLed IeuILI rIsks;
LIIs wus noL IIIed by LIe U.S. DepurLmenL oI TrunsporLuLIon unLII
December, 1q8q. TIIs purLIcuIur InvesLIguLIon, AIrIIner CubIn
EnvIronmenL: ConLumInunL MeusuremenLs, HeuILI RIsks, und MILIguLIon
OpLIons (DOT-P-1-8q-), wIIcI Ius Iong been ouL oI prInL (copIes
uvuIIubIe uL ILLp:JJwww.Iorces.org.ILm), Ius been LIe busIs Ior smokIng
buns over LIe IusL decude und wIIcI conLuIns uII LIe ubsurdILIes oI rIsk
ussessmenL proLocoI.
TIe DOT ReporL uddressed LIe more generuI muLLer oI uIrIIner
cubIn uIr quuIILy und ussocIuLed IeuILI rIsks ruLIer LIun LIe sIngIe Issue oI
ETS. AIrborne nIcoLIne, respIrubIe suspended purLIcIes (RSP), und curbon
Preventive Medicine & Health Promotion
monoxIde (CO) were used us Lrucers Ior ETS uILIougI onIy nIcoLIne Is
unIque Lo ETS. OLIer IucLors were uIso meusured: ozone, mIcrobIuI
uerosoIs (bucLerIu, IungI), LemperuLure, reIuLIve IumIdILy, und cubIn uIr
pressure. TIe sumpIe sIze wus 6q smokIng IIIgILs on jeL uIrcruIL, IncIudIng
some InLernuLIonuI IIIgILs, compured Lo z nonsmokIng IIIgILs ucLIng us u
conLroI.
BrIeIIy, uveruge RSP IeveI wus IIgIesL In LIe smokIng secLIon
(1;.8), und wus Iow und compurubIe Ior boundury rows (IIrsL LIree
nonsmokIng rows on u smokIng IIIgIL) (.6), mIddIe rows (o.;) und
remoLe rows (.o) on smokIng IIIgILs und reur rows (q.8) und mIddIe
rows (qo.o) on nonsmokIng IIIgILs. Averuge nIcoLIne IeveI wus IIgIesL In
LIe smokIng secLIon (1.q), und wus Iow und compurubIe Ior boundury
rows (o.z6), mIddIe rows (o.oq) und remoLe rows (o.o) on smokIng
IIIgILs und reur rows (o.oo) und mIddIe rows (o.o8) on nonsmokIng
IIIgILs. TIe percenL oI sumpIes In wIIcI nIcoLIne wus undeLecLubIe wus
IowesL Ior LIe smokIng secLIon (q.), und wus consIderubIy IIgIer Ior
boundury rows (q.q), mIddIe rows (8z.6) und remoLe rows (66.;) on
smokIng IIIgILs und reur rows (1oo.o) und mIddIe rows (;8.) on
nonsmokIng IIIgILs. Averuge CO IeveIs were Iow und compurubIe
LIrougIouL: smokIng secLIon (1.q), boundury rows (o.6), mIddIe rows
(o.;) und remoLe rows (o.8) on smokIng IIIgILs und reur rows (o.6) und
mIddIe rows (o.) on nonsmokIng IIIgILs: CO IeveIs were generuIIy
IIgIesL beIore uIrcruIL were uIrborne, boLI Ior smokIng und nonsmokIng
IIIgILs, due Lo InLrusIon oI ground-IeveI emIssIons. Averuge curbon
dIoxIde (COz) wus 16z Ior LIe smokIng secLIon, 168 Ior remuInIng
secLIons on smokIng IIIgILs, und 1;6 Ior nonsmokIng IIIgILs.
TIe DOT ReporL IndIcuLed LIuL |w|IIIe odor udupLuLIon Lo ETS
occurs over u sIorL LIme Irume, respIruLory und ocuIur IrrILuLIon Increuse
proporLIonuLeIy over uL IeusL one Iour uL IeveIs us Iow us z ppm CO.
Averuge CO IeveIs, even Ior LIe smokIng secLIon, were weII beIow z ppm.
However, DOT noLes LIuL on percenL oI uII IIIgILs LesLed, LIe o-mInuLe
CO uveruges exceeded z ppm In LIe boundury und nonsmokIng secLIons.
TIIs ImpIIes LIuL on percenL oI LIe IIIgILs, 1z percenL oI LIe nonsmokers
In LIese secLIons wouId be dIssuLIsIIed. TIe Issue oI mInor IrrILuLIon Is
compIIcuLed by COz IeveIs. PurLIcuIur IeveIs oI COz, exIuIed by uII
persons, ure uIso ussocIuLed wILI respIruLory IrrILuLIon, IeuducIes und
IuLIgue: ReIuLIveIy IIgI COz IeveIs were meusured, uverugIng over 1,oo
purLs per mIIIIon (ppm) ucross uII monILored IIIgILs. Meusured COz
concenLruLIons exceeded 1,ooo ppm, LIe AmerIcun SocIeLy oI HeuLIng,
ReIrIgeruLIng und AIr CondILIonIng EngIneers (ASHRAE) IeveI ussocIuLed
wILI suLIsIucLIon oI comIorL (odor) crILerIu, on 8; percenL oI LIe
monILored IIIgILs. DependIng on ussumed COz exIuIuLIon ruLes,
436
436
Rampant Antismoking Signifies Grave Danger Preventive Medicine & Health Promotion
premuLure. AguIn, LIere ure presenLed IrucLIons oI Iung cuncer deuLIs us
u proporLIon oI u Iurge exposed group, I.e., LIe predIcLIve sLrengLI oI ETS
exposure Ior Iung cuncer Is eIIecLIveIy zero.
DOT uIso provIded Iung cuncer rIsk esLImuLes ussocIuLed wILI
cosmIc rudIuLIon. or cubIn crew (IIyIng q6o Iours per yeur Ior zo yeurs),
LIese runged Irom qo Lo 1,oz6 per 1oo,ooo Ior domesLIc IIIgILs, und zzo
Lo 1z per 1oo,ooo Ior InLernuLIonuI IIIgILs. Pussenger rIsks were
consIdered Lo be IuII LIose oI cubIn crew. AguIn, LIese esLImuLes ure u
sLuLIsLIcuI exercIse. However, LIese esLImuLes dwurI LIose concernIng ETS
und Iung cuncer. PurLIcuIur IIIgIL rouLes presenL u rIsk ussIgnmenL zo
LImes LIuL ussocIuLed wILI ETS.
DespILe LIe sLuLIsLIcuI nuLure oI LIe exercIse, LIe Iow IeveIs oI
ETS Lrucers LIuL nonsmokers ure exposed Lo, LIe reIuLIveIy smuII roIe oI
ETS In greuLer conLumInunL conLexL, LIe DOT ReporL recommended LIuL
smokIng be bunned Irom uII IIIgILs. TIIs Is consIsLenL wILI rIsk
eIImInuLIon, regurdIess oI cuusuI urgumenL, promoLed by LIe superIIcIuIILy
oI LIe muLerIuIIsL munIIesLo. AguIn, LIe producLIons oI u sLuLIsLIcuI IunLusy
worId dIcLuLe concIusIons. TIe DOT concIusIon Ius been LIe busIs Ior
numerous In-IIIgIL smokIng buns. TIere ure now more und more currIers
LIuL do noL permIL smokIng on uny IIIgILs.
TIe worsL eIIecL oI LIe DOT ReporL und ILs subsequenL use Is LIe
cupucILy Lo IueI IrruLIonuI beIIeI und emoLIon. A mujor consequence wus
LIe cIuss ucLIon by IIIgIL uLLendunLs. As menLIoned, LIIs cIuss ucLIon wus
seLLIed In IuLe-1qq; us purL oI LIe gIobuI seLLIemenL und InvoIved u
$oom Iund Lo reseurcI LIe dIugnosIs und LreuLmenL oI dIseuses cuused
by envIronmenLuI Lobucco smoke, us weII us un ugreemenL on procedures
Lo sImpIIIy und IucIIILuLe IuLure LrIuIs. (Duynurd eL uI., zooo)
n sLuLemenLs Lo news reporLers, one IIIgIL uLLendunL cIuImed
LIuL um dIugnosed wILI Iung cuncer Irom pussIve smoke In my
workpIuce; unoLIer uLLendunL cIuImed My Leurs used Lo be LIe coIor oI
coIIee on LIe uIrpIune Irom Lobucco smoke. To Iuve u person on LIe sLreeL
suy someLIIng LIuL we sIouId Iuve known beLLer workIng In Lobucco
smoke - LIuL`s IIke suyIng you wore u sIorL skIrL, you goL ruped, IL`s your
IuuIL. BreuLIIng secondIund smoke Is rupe. And LIe deIInILIon oI LIuL Is
ouLrugeous vIoIuLIon. (TIe usL CIgureLLe, 1qqq) L Is dIIIIcuIL Lo ImugIne
LIe IeveI oI ETS-exposure requIred over u sIorL perIod Lo produce coIIee-
coIored Leurs - II IL Is uL uII possIbIe. However, sucI cIuIms wenL
unquesLIoned, enLIreIy uccepLed uL Iuce vuIue.
n u cIrcumsLunce more perverse LIun oLIer cuses LIus Iur
consIdered, LIIs cIuss ucLIon wus noL urgued uL uII, IeL uIone urgued on ILs
merILs. TIe seLLIemenL wus produced by u cruzed unLIsmokIng momenLum
Ied by medIco-muLerIuIIsm, und LIe Lobucco IndusLry`s cupILuIuLIon. L
meusured IeveIs were us mucI us LwIce LIose predIcLed by u cubIn uIr
quuIILy modeI. Even II LIe meusured IeveIs were Lo be Iowered by IuII,
Iowever, COz concenLruLIons wouId sLIII exceed 1,ooo ppm on zq percenL
oI LIe sLudy IIIgILs. COz IeveIs seem Lo be, by Iur, LIe greuLesL source oI
poLenLIuI dIscomIorL. CO concenLruLIon IeveIs greuLer LIun q ppm ure
ImpIIcuLed In exucerbuLIng curdIovuscuIur sympLoms. However, LIe CO
IeveIs meusured ubourd uIrcruIL In LIIs sLudy, IncIudIng LIe peuk
concenLruLIons, were consIderubIy Iess LIun q ppm.
Averuge nIcoLIne IeveIs, RSP, und CO IeveIs In nonsmokIng
secLIons oI smokIng IIIgILs cunnoL be consIdered us probIemuLIc. Even In
Lerms oI jusL dIscomIorL, poLenLIuI COz probIems dwurI LIose oI CO. AIr
IumIdILy, unoLIer IucLor reIuLed Lo comIorL, wus uIso IIgIer on
nonsmokIng IIIgILs.
TIe DOT ReporL uIso mude reIerence Lo purLIcIe-ussocIuLed
mIcrobIoIogIcuI orgunIsms: AL cruIsIng uILILudes, ouLsIde uIr conLuIns
reIuLIveIy Iew purLIcIe-ussocIuLed mIcrobIoIogIcuI orgunIsms..However,
ouLsIde uIr wIIcI enLers LIe uIrcruIL wIIIe on LIe ground currIes u
consIderubIe specLrum oI mIcroorgunIsms IncIudIng vIruses, bucLerIu,
ucLInomyceLes, IunguI spores und IypIue, unImuI und Iumun dunder, und
uLIropod-ussocIuLed purLIcIes. DIseuse LrunsmIssIon LIrougI LIe uIr Is
known Lo occur boLI by dropIeLs und dropIeL nucIeI: MeLIods oI
uerosoIIzuLIon IncIude dIspersuI by cougIIng, sneezIng, LuIkIng, uIr
movemenL, wuLer spIusIIng und LurbuIence. TuIkIng cun produce us muny
us z,ooo purLIcIes per expIosIve sound und u sneeze cun produce
upproxImuLeIy z mIIIIon vIubIe purLIcIes. As IndIcuLed In un eurIIer
secLIon, LIere Is no sucI LIIng us cIeun uIr. GIven wIuL uIr cun conLuIn,
LIe onIy crILIcuI Issue concerns wIuL IuIIs wILIIn u normuLIve runge oI
IuncLIonIng. ETS Ior nonsmokers on smokIng IIIgILs, purLIcuIurIy wILIIn
LIe greuLer urruy oI uIrborne pIenomenu, Is noL u crILIcuI Issue.
DespILe uII oI LIese IucLs, DOT proceeded wILI ILs rIsk
ussessmenL procedure. UsIng u reIuLIve rIsk oI 1. Ior sLudIes Lo LIuL duLe
on Iung cuncer In nonsmokers murrIed Lo smokers und Lwo sLuLIsLIcuI
modeIs, DOT concIuded LIuL: AppIyIng LIe rIsk esLImuLes..Lo LIe enLIre
U.S. cubIn crew popuIuLIon resuILs In un esLImuLed o.18 premuLure Iung
cuncer deuLIs per yeur Ior domesLIc IIIgILs (LIuL Is, upproxImuLeIy q
premuLure deuLIs cun be expecLed every zo yeurs) und o.16 premuLure
deuLIs per yeur Ior InLernuLIonuI IIIgILs. CorrespondIng esLImuLes Ior LIe
U.S. IIyIng popuIuLIon ure o.zq premuLure Iung cuncer deuLIs per yeur Ior
domesLIc IIIgILs und o.18 premuLure deuLIs per yeur Ior InLernuLIonuI
IIIgILs. L musL be undersLood LIuL LIIs enLIre procedure Is cIrcuIur; IL
does noL demonsLruLe cuuse buL ussumes IL. TIe enLIre Ideu oI Iung cuncer
cuused by ETS Is quesLIonubIe, IeL uIone wIuLever DOT meuns by
437
437
Rampant Antismoking Signifies Grave Danger Preventive Medicine & Health Promotion
premuLure. AguIn, LIere ure presenLed IrucLIons oI Iung cuncer deuLIs us
u proporLIon oI u Iurge exposed group, I.e., LIe predIcLIve sLrengLI oI ETS
exposure Ior Iung cuncer Is eIIecLIveIy zero.
DOT uIso provIded Iung cuncer rIsk esLImuLes ussocIuLed wILI
cosmIc rudIuLIon. or cubIn crew (IIyIng q6o Iours per yeur Ior zo yeurs),
LIese runged Irom qo Lo 1,oz6 per 1oo,ooo Ior domesLIc IIIgILs, und zzo
Lo 1z per 1oo,ooo Ior InLernuLIonuI IIIgILs. Pussenger rIsks were
consIdered Lo be IuII LIose oI cubIn crew. AguIn, LIese esLImuLes ure u
sLuLIsLIcuI exercIse. However, LIese esLImuLes dwurI LIose concernIng ETS
und Iung cuncer. PurLIcuIur IIIgIL rouLes presenL u rIsk ussIgnmenL zo
LImes LIuL ussocIuLed wILI ETS.
DespILe LIe sLuLIsLIcuI nuLure oI LIe exercIse, LIe Iow IeveIs oI
ETS Lrucers LIuL nonsmokers ure exposed Lo, LIe reIuLIveIy smuII roIe oI
ETS In greuLer conLumInunL conLexL, LIe DOT ReporL recommended LIuL
smokIng be bunned Irom uII IIIgILs. TIIs Is consIsLenL wILI rIsk
eIImInuLIon, regurdIess oI cuusuI urgumenL, promoLed by LIe superIIcIuIILy
oI LIe muLerIuIIsL munIIesLo. AguIn, LIe producLIons oI u sLuLIsLIcuI IunLusy
worId dIcLuLe concIusIons. TIe DOT concIusIon Ius been LIe busIs Ior
numerous In-IIIgIL smokIng buns. TIere ure now more und more currIers
LIuL do noL permIL smokIng on uny IIIgILs.
TIe worsL eIIecL oI LIe DOT ReporL und ILs subsequenL use Is LIe
cupucILy Lo IueI IrruLIonuI beIIeI und emoLIon. A mujor consequence wus
LIe cIuss ucLIon by IIIgIL uLLendunLs. As menLIoned, LIIs cIuss ucLIon wus
seLLIed In IuLe-1qq; us purL oI LIe gIobuI seLLIemenL und InvoIved u
$oom Iund Lo reseurcI LIe dIugnosIs und LreuLmenL oI dIseuses cuused
by envIronmenLuI Lobucco smoke, us weII us un ugreemenL on procedures
Lo sImpIIIy und IucIIILuLe IuLure LrIuIs. (Duynurd eL uI., zooo)
n sLuLemenLs Lo news reporLers, one IIIgIL uLLendunL cIuImed
LIuL um dIugnosed wILI Iung cuncer Irom pussIve smoke In my
workpIuce; unoLIer uLLendunL cIuImed My Leurs used Lo be LIe coIor oI
coIIee on LIe uIrpIune Irom Lobucco smoke. To Iuve u person on LIe sLreeL
suy someLIIng LIuL we sIouId Iuve known beLLer workIng In Lobucco
smoke - LIuL`s IIke suyIng you wore u sIorL skIrL, you goL ruped, IL`s your
IuuIL. BreuLIIng secondIund smoke Is rupe. And LIe deIInILIon oI LIuL Is
ouLrugeous vIoIuLIon. (TIe usL CIgureLLe, 1qqq) L Is dIIIIcuIL Lo ImugIne
LIe IeveI oI ETS-exposure requIred over u sIorL perIod Lo produce coIIee-
coIored Leurs - II IL Is uL uII possIbIe. However, sucI cIuIms wenL
unquesLIoned, enLIreIy uccepLed uL Iuce vuIue.
n u cIrcumsLunce more perverse LIun oLIer cuses LIus Iur
consIdered, LIIs cIuss ucLIon wus noL urgued uL uII, IeL uIone urgued on ILs
merILs. TIe seLLIemenL wus produced by u cruzed unLIsmokIng momenLum
Ied by medIco-muLerIuIIsm, und LIe Lobucco IndusLry`s cupILuIuLIon. L
meusured IeveIs were us mucI us LwIce LIose predIcLed by u cubIn uIr
quuIILy modeI. Even II LIe meusured IeveIs were Lo be Iowered by IuII,
Iowever, COz concenLruLIons wouId sLIII exceed 1,ooo ppm on zq percenL
oI LIe sLudy IIIgILs. COz IeveIs seem Lo be, by Iur, LIe greuLesL source oI
poLenLIuI dIscomIorL. CO concenLruLIon IeveIs greuLer LIun q ppm ure
ImpIIcuLed In exucerbuLIng curdIovuscuIur sympLoms. However, LIe CO
IeveIs meusured ubourd uIrcruIL In LIIs sLudy, IncIudIng LIe peuk
concenLruLIons, were consIderubIy Iess LIun q ppm.
Averuge nIcoLIne IeveIs, RSP, und CO IeveIs In nonsmokIng
secLIons oI smokIng IIIgILs cunnoL be consIdered us probIemuLIc. Even In
Lerms oI jusL dIscomIorL, poLenLIuI COz probIems dwurI LIose oI CO. AIr
IumIdILy, unoLIer IucLor reIuLed Lo comIorL, wus uIso IIgIer on
nonsmokIng IIIgILs.
TIe DOT ReporL uIso mude reIerence Lo purLIcIe-ussocIuLed
mIcrobIoIogIcuI orgunIsms: AL cruIsIng uILILudes, ouLsIde uIr conLuIns
reIuLIveIy Iew purLIcIe-ussocIuLed mIcrobIoIogIcuI orgunIsms..However,
ouLsIde uIr wIIcI enLers LIe uIrcruIL wIIIe on LIe ground currIes u
consIderubIe specLrum oI mIcroorgunIsms IncIudIng vIruses, bucLerIu,
ucLInomyceLes, IunguI spores und IypIue, unImuI und Iumun dunder, und
uLIropod-ussocIuLed purLIcIes. DIseuse LrunsmIssIon LIrougI LIe uIr Is
known Lo occur boLI by dropIeLs und dropIeL nucIeI: MeLIods oI
uerosoIIzuLIon IncIude dIspersuI by cougIIng, sneezIng, LuIkIng, uIr
movemenL, wuLer spIusIIng und LurbuIence. TuIkIng cun produce us muny
us z,ooo purLIcIes per expIosIve sound und u sneeze cun produce
upproxImuLeIy z mIIIIon vIubIe purLIcIes. As IndIcuLed In un eurIIer
secLIon, LIere Is no sucI LIIng us cIeun uIr. GIven wIuL uIr cun conLuIn,
LIe onIy crILIcuI Issue concerns wIuL IuIIs wILIIn u normuLIve runge oI
IuncLIonIng. ETS Ior nonsmokers on smokIng IIIgILs, purLIcuIurIy wILIIn
LIe greuLer urruy oI uIrborne pIenomenu, Is noL u crILIcuI Issue.
DespILe uII oI LIese IucLs, DOT proceeded wILI ILs rIsk
ussessmenL procedure. UsIng u reIuLIve rIsk oI 1. Ior sLudIes Lo LIuL duLe
on Iung cuncer In nonsmokers murrIed Lo smokers und Lwo sLuLIsLIcuI
modeIs, DOT concIuded LIuL: AppIyIng LIe rIsk esLImuLes..Lo LIe enLIre
U.S. cubIn crew popuIuLIon resuILs In un esLImuLed o.18 premuLure Iung
cuncer deuLIs per yeur Ior domesLIc IIIgILs (LIuL Is, upproxImuLeIy q
premuLure deuLIs cun be expecLed every zo yeurs) und o.16 premuLure
deuLIs per yeur Ior InLernuLIonuI IIIgILs. CorrespondIng esLImuLes Ior LIe
U.S. IIyIng popuIuLIon ure o.zq premuLure Iung cuncer deuLIs per yeur Ior
domesLIc IIIgILs und o.18 premuLure deuLIs per yeur Ior InLernuLIonuI
IIIgILs. L musL be undersLood LIuL LIIs enLIre procedure Is cIrcuIur; IL
does noL demonsLruLe cuuse buL ussumes IL. TIe enLIre Ideu oI Iung cuncer
cuused by ETS Is quesLIonubIe, IeL uIone wIuLever DOT meuns by
438
438
Rampant Antismoking Signifies Grave Danger
onIy promoLes LIuL ETS dIseuse cIuIms und IncoIerenL unuIogIes (e.g.,
rupe, ouLrugeous vIoIuLIon) ure uccuruLe wIIcI, In Lurn, IurLIer IueIs LIe
unLIsmokIng cruze, I.e., seII-servIng cIrcuIurILy.
AnoLIer key ureu oI IILIguLIon concerns nonsmokers wILI exIsLIng
dIseuse. or exumpIe, LIe AusLruIIun Humun RIgILs und EquuI
OpporLunILy CommIssIon concIuded LIuL u womun wILI usLImu wus
subjecLed Lo unIuIr dIscrImInuLIon wIen uLLendIng u nIgILcIub LIuL
permILLed smokIng. CIupmun (1qq;) descrIbes LIuL:
|TIe pIuInLIII|, u doubIe Iung LrunspIunL recIpIenL, Look
Sydney`s HIILon HoLeI Lo LIe equuI opporLunILy
commIssIon uILer sIe Iud LrIed Lo spend un evenIng In
LIe IoLeI`s nIgILcIub, JuIIunu`s. TIe commIssIoner
IIkened Ier sILuuLIon Lo LIuL oI u purupIegIc person: 'or
u person wIo used u wIeeIcIuIr Lo be prevenLed Irom
enLerIng u IucIIILy used by LIe pubIIc becuuse oI u
pIysIcuI burrIer - sucI us u sLep or LIe sLeepness oI u
rump - Is noL onIy LoLuIIy unuccepLubIe buL muy be
unIuwIuI. TIe sILuuLIon In LIIs cuse, wIere LIe burrIer
reIuLes Lo LIe person`s cupucILy Lo breuLIe wILIouL
Injury..Is no dIIIerenL.` TIe pIuInLIII wus uwurded
$Azooo..und Ier non-usLImuLIc compunIon $oo Ior
dIsLress cuused by LIe IncIdenL.
TIe sILuuLIon oI persons wILI exIsLIng uIImenLs presenLs IurLIer
enLungIemenLs wILIIn un uIreudy conLorLed Irumework. L musL be
undersLood wILIIn u conLexL oI sIIILIng poIIcy. UnLII LIe mId-1q8o`s LIe
onus on empIoyers, us purL oI workpIuce poIIcy, wus Lo uLLempL reusonubIe
uccommoduLIon oI u person`s medIcuI condILIon und wILIouL InLerIerIng
on u normuLIve runge oI IuncLIonIng. n uLLempLIng Lo uccommoduLe some
usLImuLIcs compIuInLs wILI umbIenL Lobucco smoke In LIe workpIuce,
empIoyers uLLempLed dIsLuncIng LIe usLImuLIc Irom smokers or provIdIng
un uIr IIILer. I LIese were unsuccessIuI In uIIevIuLIng LIe usLImuLIc`s
probIems, LIe courLs` onIy InLeresL wus wIeLIer u reusonubIe uLLempL uL
uccommoduLIon oI LIe dIsubIIILy Iud been mude. L wus noL un opLIon, Ior
exumpIe, LIuL smokIng be bunned In LIe workpIuce In LIuL exposure Lo
smoke by nonsmokers wus consIdered Lo be wILIIn u normuLIve runge oI
IuncLIonIng; poIIcy wus LypIcuIIy uncIored Lo u normuLIve runge oI
IuncLIonIng.
TIIs cIunged wILI LIe uILeruLIons Lo workpIuce Iuws In LIe mId-
1q8o`s und LIe InLroducLIon oI unLI-dIscrImInuLIon poIIcy In LIe eurIy-
1qqo`s. TIe crILIcuI wordIng In workpIuce poIIcy Is LIuL un empIoyer musL
provIde u suIe workpIuce. TIe mujor InLenL oI modIIIcuLIons wus weII-
Preventive Medicine & Health Promotion
InLenLIoned enougI. TIey were prImurIIy IeveIed uL Issues sucI us suIe
scuIIoIdIng on consLrucLIon sILes or udequuLe proLecLIon uround movIng
mucIIne-purLs. TIese ure uII cIrcumsLunces wIere u cuusuI sequence oI
evenLs In Injury cun reusonubIy be demonsLruLed. However, probIems
urIse wIen consIderIng exIsLIng medIcuI condILIons. WorkpIuce poIIcy Is
III-consIdered In LIuL IL does noL IndIcuLe suIe Ior wIom? As IL sLunds, IL
meuns suIe Ior unyone, even LIe sIckesL person workIng In un oIIIce-
seLLIng. TIe eIIecL oI unLI-dIscrImInuLIon Iuw, wIIcI IncIudes dIsubIIILy, Is
LIuL In order Lo uvoId beIng cIurged wILI unIuIr dIscrImInuLIon, u person
wILI dIsubIIILy (e.g., usLImu) wIII be IncorporuLed InLo u workpIuce, wILI
LIeIr dIsubIIILy IuIIy uccommoduLed. AILIougI LIe InLenL Is equuI
opporLunILy und suIeLy, LIe eIIecL oI LIese Iuws Is Lo uncIor LIe normuLIve
runge oI IuncLIonIng Lo uLypIcuI, ubnormuI sLuLes. L sIouId noL be
surprIsIng LIuL LIIs Is uIso LIe sLundurd error oI medIco-muLerIuIIsm.
AnLIsmokIng ucLIvIsLs ure weII uwure oI LIe poLenLIuI In LIe
Iooseness oI LIese Iuws. TIrougI LIe expIoILuLIon oI LIese Iuws,
unLIsmokIng Ius uLLempLed Lo redeIIne socIuI sILuuLIons In wIIcI smokIng
occurs us onIy workpIuces or us sILuuLIons LIuL dIscrImInuLe uguInsL, suy,
usLImuLIcs. or exumpIe, resLuurunLs und cusInos LIuL provIde some oI LIe
socIuI busIs Ior smokIng ure spoken oI by unLIsmokIng ucLIvIsLs us onIy
workpIuces. n so doIng IL brIngs LIe cIrcumsLunce wILIIn LIe jurIsdIcLIon
oI workpIuce suIeLy Iuws. However, IL uIso kIIIs oII LIe Ideu oI socIuI pIuces.
n IucL, uny socIuI pIuce LIuL Ius workers Is no Ionger u socIuI pIuce buL
prImurIIy u workpIuce. TIIs Is cerLuInIy udvunLugeous Lo unLIsmokIng In
LIuL IL cun dIsrupL smokers` socIuIIzIng. UnIorLunuLeIy, IL uIso mukes Ior
sLerIIe socIuI pIuces, I.e., socIuIIy unIeuILIy.
ConcurrenLIy, usLImuLIcs Iuve predomInunLIy been InsLrumenLuI
In IuvIng smokIng bunned In numerous venues (e.g., euLerIes, sporLIng
venues). Under LIreuL oI IILIguLIon due Lo u compIuInL by un usLImuLIc,
LIese venues Iuve bunned smokIng. or exumpIe, IL wus reporLed In
lobboclonline.com LIuL un 11-yeur-oId suIIerIng un usLImu uLLuck In u
ubbock, Texus, bowIIng venue wus InsLrumenLuI In IuvIng smokIng
bunned LIere (June 1, zoo1). TIIs Is quILe exLruordInury In LIuL one
usLImuLIc cun dIcLuLe LIe enLIre socIuI cIrcumsLunce. TIere ure u number
oI perLInenL Issues Iere. L Ius been un eusy sLep Lo bun smokIng due Lo
reIenLIess unLIsmokIng propugundu severeIy escuIuLIng durIng LIe 1qqo`s.
AsLImu Ius uIso been munuIucLured InLo u royuIIzed condILIon. MedIco-
muLerIuIIsm Ius been InsLrumenLuI In ImproperIy deIInIng boLI usLImu
und smokIng. AsLImu, Ior exumpIe, wus reduced enLIreIy Lo u bIoIogIcuI
condILIon, sLrIpped oI psycIogenIc uspecLs. SImpIy u compIuInL by
usLImuLIcs Ius been suIIIcIenL Lo Iuve poIIcy-mukers snuppIng LIeIr IeeIs
In compIIunce. TIere Is LypIcuIIy no uLLempL Lo uscerLuIn nocebo und
439
439
Rampant Antismoking Signifies Grave Danger
onIy promoLes LIuL ETS dIseuse cIuIms und IncoIerenL unuIogIes (e.g.,
rupe, ouLrugeous vIoIuLIon) ure uccuruLe wIIcI, In Lurn, IurLIer IueIs LIe
unLIsmokIng cruze, I.e., seII-servIng cIrcuIurILy.
AnoLIer key ureu oI IILIguLIon concerns nonsmokers wILI exIsLIng
dIseuse. or exumpIe, LIe AusLruIIun Humun RIgILs und EquuI
OpporLunILy CommIssIon concIuded LIuL u womun wILI usLImu wus
subjecLed Lo unIuIr dIscrImInuLIon wIen uLLendIng u nIgILcIub LIuL
permILLed smokIng. CIupmun (1qq;) descrIbes LIuL:
|TIe pIuInLIII|, u doubIe Iung LrunspIunL recIpIenL, Look
Sydney`s HIILon HoLeI Lo LIe equuI opporLunILy
commIssIon uILer sIe Iud LrIed Lo spend un evenIng In
LIe IoLeI`s nIgILcIub, JuIIunu`s. TIe commIssIoner
IIkened Ier sILuuLIon Lo LIuL oI u purupIegIc person: 'or
u person wIo used u wIeeIcIuIr Lo be prevenLed Irom
enLerIng u IucIIILy used by LIe pubIIc becuuse oI u
pIysIcuI burrIer - sucI us u sLep or LIe sLeepness oI u
rump - Is noL onIy LoLuIIy unuccepLubIe buL muy be
unIuwIuI. TIe sILuuLIon In LIIs cuse, wIere LIe burrIer
reIuLes Lo LIe person`s cupucILy Lo breuLIe wILIouL
Injury..Is no dIIIerenL.` TIe pIuInLIII wus uwurded
$Azooo..und Ier non-usLImuLIc compunIon $oo Ior
dIsLress cuused by LIe IncIdenL.
TIe sILuuLIon oI persons wILI exIsLIng uIImenLs presenLs IurLIer
enLungIemenLs wILIIn un uIreudy conLorLed Irumework. L musL be
undersLood wILIIn u conLexL oI sIIILIng poIIcy. UnLII LIe mId-1q8o`s LIe
onus on empIoyers, us purL oI workpIuce poIIcy, wus Lo uLLempL reusonubIe
uccommoduLIon oI u person`s medIcuI condILIon und wILIouL InLerIerIng
on u normuLIve runge oI IuncLIonIng. n uLLempLIng Lo uccommoduLe some
usLImuLIcs compIuInLs wILI umbIenL Lobucco smoke In LIe workpIuce,
empIoyers uLLempLed dIsLuncIng LIe usLImuLIc Irom smokers or provIdIng
un uIr IIILer. I LIese were unsuccessIuI In uIIevIuLIng LIe usLImuLIc`s
probIems, LIe courLs` onIy InLeresL wus wIeLIer u reusonubIe uLLempL uL
uccommoduLIon oI LIe dIsubIIILy Iud been mude. L wus noL un opLIon, Ior
exumpIe, LIuL smokIng be bunned In LIe workpIuce In LIuL exposure Lo
smoke by nonsmokers wus consIdered Lo be wILIIn u normuLIve runge oI
IuncLIonIng; poIIcy wus LypIcuIIy uncIored Lo u normuLIve runge oI
IuncLIonIng.
TIIs cIunged wILI LIe uILeruLIons Lo workpIuce Iuws In LIe mId-
1q8o`s und LIe InLroducLIon oI unLI-dIscrImInuLIon poIIcy In LIe eurIy-
1qqo`s. TIe crILIcuI wordIng In workpIuce poIIcy Is LIuL un empIoyer musL
provIde u suIe workpIuce. TIe mujor InLenL oI modIIIcuLIons wus weII-
Preventive Medicine & Health Promotion
InLenLIoned enougI. TIey were prImurIIy IeveIed uL Issues sucI us suIe
scuIIoIdIng on consLrucLIon sILes or udequuLe proLecLIon uround movIng
mucIIne-purLs. TIese ure uII cIrcumsLunces wIere u cuusuI sequence oI
evenLs In Injury cun reusonubIy be demonsLruLed. However, probIems
urIse wIen consIderIng exIsLIng medIcuI condILIons. WorkpIuce poIIcy Is
III-consIdered In LIuL IL does noL IndIcuLe suIe Ior wIom? As IL sLunds, IL
meuns suIe Ior unyone, even LIe sIckesL person workIng In un oIIIce-
seLLIng. TIe eIIecL oI unLI-dIscrImInuLIon Iuw, wIIcI IncIudes dIsubIIILy, Is
LIuL In order Lo uvoId beIng cIurged wILI unIuIr dIscrImInuLIon, u person
wILI dIsubIIILy (e.g., usLImu) wIII be IncorporuLed InLo u workpIuce, wILI
LIeIr dIsubIIILy IuIIy uccommoduLed. AILIougI LIe InLenL Is equuI
opporLunILy und suIeLy, LIe eIIecL oI LIese Iuws Is Lo uncIor LIe normuLIve
runge oI IuncLIonIng Lo uLypIcuI, ubnormuI sLuLes. L sIouId noL be
surprIsIng LIuL LIIs Is uIso LIe sLundurd error oI medIco-muLerIuIIsm.
AnLIsmokIng ucLIvIsLs ure weII uwure oI LIe poLenLIuI In LIe
Iooseness oI LIese Iuws. TIrougI LIe expIoILuLIon oI LIese Iuws,
unLIsmokIng Ius uLLempLed Lo redeIIne socIuI sILuuLIons In wIIcI smokIng
occurs us onIy workpIuces or us sILuuLIons LIuL dIscrImInuLe uguInsL, suy,
usLImuLIcs. or exumpIe, resLuurunLs und cusInos LIuL provIde some oI LIe
socIuI busIs Ior smokIng ure spoken oI by unLIsmokIng ucLIvIsLs us onIy
workpIuces. n so doIng IL brIngs LIe cIrcumsLunce wILIIn LIe jurIsdIcLIon
oI workpIuce suIeLy Iuws. However, IL uIso kIIIs oII LIe Ideu oI socIuI pIuces.
n IucL, uny socIuI pIuce LIuL Ius workers Is no Ionger u socIuI pIuce buL
prImurIIy u workpIuce. TIIs Is cerLuInIy udvunLugeous Lo unLIsmokIng In
LIuL IL cun dIsrupL smokers` socIuIIzIng. UnIorLunuLeIy, IL uIso mukes Ior
sLerIIe socIuI pIuces, I.e., socIuIIy unIeuILIy.
ConcurrenLIy, usLImuLIcs Iuve predomInunLIy been InsLrumenLuI
In IuvIng smokIng bunned In numerous venues (e.g., euLerIes, sporLIng
venues). Under LIreuL oI IILIguLIon due Lo u compIuInL by un usLImuLIc,
LIese venues Iuve bunned smokIng. or exumpIe, IL wus reporLed In
lobboclonline.com LIuL un 11-yeur-oId suIIerIng un usLImu uLLuck In u
ubbock, Texus, bowIIng venue wus InsLrumenLuI In IuvIng smokIng
bunned LIere (June 1, zoo1). TIIs Is quILe exLruordInury In LIuL one
usLImuLIc cun dIcLuLe LIe enLIre socIuI cIrcumsLunce. TIere ure u number
oI perLInenL Issues Iere. L Ius been un eusy sLep Lo bun smokIng due Lo
reIenLIess unLIsmokIng propugundu severeIy escuIuLIng durIng LIe 1qqo`s.
AsLImu Ius uIso been munuIucLured InLo u royuIIzed condILIon. MedIco-
muLerIuIIsm Ius been InsLrumenLuI In ImproperIy deIInIng boLI usLImu
und smokIng. AsLImu, Ior exumpIe, wus reduced enLIreIy Lo u bIoIogIcuI
condILIon, sLrIpped oI psycIogenIc uspecLs. SImpIy u compIuInL by
usLImuLIcs Ius been suIIIcIenL Lo Iuve poIIcy-mukers snuppIng LIeIr IeeIs
In compIIunce. TIere Is LypIcuIIy no uLLempL Lo uscerLuIn nocebo und
440
440
Rampant Antismoking Signifies Grave Danger
udvunLuge by IIIness eIIecLs. urLIermore, LIe reuson wIy LIe Iew
usLImuLIcs LIuL LIere muy be ure noL gIven u musk or gIven u seuIed room
uL u sporLIng venue Is due Lo unLIsmokIng deIusIon on u muss scuIe;
smokers Iuve been depIcLed us nIcoLIne-uddIcLed und dIseused, und
usLImuLIcs us normuI. TIereIore, IL Is LIe smokers LIuL musL move. TIIs
represenLs no more LIun uncIorIng u normuLIve runge oI IuncLIonIng Lo
sIckness or dysIuncLIon, I.e., socIeLy us un exLensIon oI LIe IospILuI, und
IuIIy Lo be expecLed under medIco-muLerIuIIsL domInuLIon.
n LIe HIILon HoLeI exumpIe, LIe commIssIoner`s unuIogy,
IIkenIng usLImuLIc reucLIon Lo unuvuIIubIIILy oI wIeeIcIuIr rumps, Is
IncoIerenL. TIe exLenL oI LIe IncoIerence depends on wIuL Is consIdered
us u soIuLIon Lo LIe cIrcumsLunce. SIouId smokIng be bunned so LIuL uny
oI LIe Iew usLImuLIcs dIsLurbed by umbIenL Lobucco smoke cun now wuIk
InLo uny nIgILcIub? Or, sIouId nIgILcIubs Iuve musk IucIIILIes Lo cuLer Ior
sucI persons? Or, sIouId LIese usLImuLIcs curry LIeIr own musks? OnIy
LIe IuLLer Ius uny sensIbIIILy. I so, dumuges sIouId noL Iuve been
uwurded. I smokIng Is enLIreIy bunned In uccommoduLIon, LIen usLImu Is
noL IIke InudequuLe rumps Ior u wIeeIcIuIr uL uII. L InLerIeres wILI u
crILIcuI socIeLuI uspecL oI u socIuI pIuce.
MedIco-muLerIuIIsm Ius no dIIIIcuILy wILI bunnIng smokIng In
un uLLempL Lo uccommoduLe usLImuLIc`s compIuInLs. eIL Lo ILs own
devIces, medIco-muLerIuIIsm wIII IusIIon greuLer socIeLy InLo un exLensIon
oI LIe IospILuI. MedIco-muLerIuIIsm does noL compreIend psycIoIogIcuI
und socIeLuI IuncLIonIng oI LIe weII popuIuLIon. ALLempLIng Lo
uccommoduLe un usLImuLIc`s sILuuLIon, wIeLIer or noL IL reIIecLs u
psycIogenIc uspecL (e.g., SS, ESS), muy seem benevoIenL Lo muny oI LIe
pubIIc uL LIIs LIme. ndeed, compussIon Is wurrunLed In uLLempLIng Lo
uccommoduLe LIose LIuL ure III. However, redeIInIng socIeLuI IuncLIonIng
In Lerms oI sIckness Is noL u judIcIous opLIon: TIere ure very good reusons
wIy pubIIc poIIcy wus uL one LIme uncIored Lo u normuLIve runge oI
IuncLIonIng, wIIcI IncIudes u buIuncIng ucross bIoIogIcuI, psycIoIogIcuI,
socIuI und moruI dImensIons. I socIeLuI IuncLIonIng Is uncIored Lo
sIckness, us wIII be LIe cuse under medIco-muLerIuIIsL domInuLIon, LIe
mujorILy oI LIe popuIuLIon LIuL ure weII uLLempL Lo IuncLIon In u
Irumework us II LIey Iuve u muILIpIIcILy oI dIseuses, I.e., menLuI, socIuI
und moruI IeuILI rumIIIcuLIons.
TIe S.A..E. unLIsmokIng websILe IndIcuLes LIuL:
EmpIoyees exposed InvoIunLurIIy Lo secondIund smoke
uL LIe oIIIce cun now sue empIoyers Ior ussuuIL und
buLLery, uL IeusL In CuIIIornIu.
A SouLIern CuIIIornIu womun wIo sued Ier empIoyer
Ior buLLery becuuse oI secondIund smoke In Ier oIIIce
Preventive Medicine & Health Promotion
uccepLed un ouL-oI-courL seLLIemenL..uILer u os
AngeIes SuperIor CourL CommIssIoner ruIed LIuL
secondIund smoke, IIke sexuuI IurussmenL, Is noL purL
oI LIe job.
EIIus |LIe commIssIoner| ruIed LIuL workers`
compensuLIon Is noL LIe onIy remedy Ior PorLenIer`s
|pIuInLIII| cIuIm. 'SecondIund smoke Is noL IIke IIgILs
wIIcI everybody needs,` EIIus expIuIned.
PorLenIer deveIoped un usLImu-IIke condILIon uILer
workIng Ior Iour yeurs In un oIIIce LIuL uIIowed
smokIng. AILIougI sIe requesLed u smokeIree
envIronmenL Ior uL IeusL u yeur und brougIL noLes Irom
Ier docLors, LIe IIrm Ignored Ier requesLs.
ConcernIng LIIs cuse, IL uII IInges on u bIurry usLImu-IIke
condILIon supporLed by InIuIIIbIe medIco-muLerIuIIsL LesLImony.
urLIermore, psycIogenIc IucLors und ESS never enLer LIe consIderuLIon.
urLIermore, LIe commIssIoner`s commenLs ure uIso quesLIonubIe. TIe
Issue Is noL wIeLIer everyone needs u IucLor In LIe workpIuce Ior IL Lo be
IegILImuLe. TIe Issue Is wIeLIer uny IucLor IuIIs wILIIn u normuLIve runge
oI IuncLIonIng. By reIyIng on urguubIe medIcuI LesLImony und u IuIIure Lo
IncIude LIe Ideu oI u normuLIve runge, LIe ruIIng IurLIers LIe
IospILuIIzuLIon oI LIe workpIuce - LIe workpIuce musL IIrsL cuLer Ior LIe
unweII, wIeLIer pIysIcuI, psycIoIogIcuI or reIuLIonuI.
As wus noLed In LIe prevIous secLIon, IuvIng opened u Pundoru`s
box wILI ETS, LIere ure now oLIers demundIng uccommoduLIon oI oLIer
uLypIcuI compIuInLs. UnIorLunuLeIy, LIese demunds cun be pursued under
currenL workpIuce und unLI-dIscrImInuLIon Iuws und LIe precedenLs LIuL
Iuve been seL concernIng ETS. L wus consIdered In un eurIIer secLIon LIuL
LIere ure now persons sympLomuLIc Lo perIumes. And, IL Is LIose In u
normuLIve runge oI IuncLIonIng LIuL ure mude Lo IeeI guIILy Ior LIeIr
normuIILy. As more persons ure eILIer remuInIng or regressIng InLo LIe
IIckIeness oI LIe Iower nuLure (see CIupLer ), more persons wIII be
projecLIng sympLoms Lo exLernuIILIes. I medIco-muLerIuIIsm Is IeIL Lo
dIcLuLe proceedIngs, IL wIII IegILImIze LIese condILIons. A recenL sLudy
Ius IndIcuLed LIuL peopIe`s uIIergIc reucLIons In LIe workpIuce muy be due
Lo cuL scenL on co-workers` cIoLIIng (Hercld,Sun, OcLober 18, zooo,
p.6). As Iuws currenLIy sLund, LIere Is no reuson wIy evenLuuIIy uII
workers wIII be requIred Lo Iuve LIeIr cIoLIIng dry-cIeuned beIore
enLerIng LIe workpIuce or even LIe socIuI pIuce. And LIIs Is onIy II no one
Is uIIergIc Lo LIe scenL oI dry-cIeunIng. WorkpIuces und socIuI pIuces cun
LecInIcuIIy be Lurned InLo u Iorm oI sLerIIe IuboruLory - LIe very conLorLed
441
441
Rampant Antismoking Signifies Grave Danger
udvunLuge by IIIness eIIecLs. urLIermore, LIe reuson wIy LIe Iew
usLImuLIcs LIuL LIere muy be ure noL gIven u musk or gIven u seuIed room
uL u sporLIng venue Is due Lo unLIsmokIng deIusIon on u muss scuIe;
smokers Iuve been depIcLed us nIcoLIne-uddIcLed und dIseused, und
usLImuLIcs us normuI. TIereIore, IL Is LIe smokers LIuL musL move. TIIs
represenLs no more LIun uncIorIng u normuLIve runge oI IuncLIonIng Lo
sIckness or dysIuncLIon, I.e., socIeLy us un exLensIon oI LIe IospILuI, und
IuIIy Lo be expecLed under medIco-muLerIuIIsL domInuLIon.
n LIe HIILon HoLeI exumpIe, LIe commIssIoner`s unuIogy,
IIkenIng usLImuLIc reucLIon Lo unuvuIIubIIILy oI wIeeIcIuIr rumps, Is
IncoIerenL. TIe exLenL oI LIe IncoIerence depends on wIuL Is consIdered
us u soIuLIon Lo LIe cIrcumsLunce. SIouId smokIng be bunned so LIuL uny
oI LIe Iew usLImuLIcs dIsLurbed by umbIenL Lobucco smoke cun now wuIk
InLo uny nIgILcIub? Or, sIouId nIgILcIubs Iuve musk IucIIILIes Lo cuLer Ior
sucI persons? Or, sIouId LIese usLImuLIcs curry LIeIr own musks? OnIy
LIe IuLLer Ius uny sensIbIIILy. I so, dumuges sIouId noL Iuve been
uwurded. I smokIng Is enLIreIy bunned In uccommoduLIon, LIen usLImu Is
noL IIke InudequuLe rumps Ior u wIeeIcIuIr uL uII. L InLerIeres wILI u
crILIcuI socIeLuI uspecL oI u socIuI pIuce.
MedIco-muLerIuIIsm Ius no dIIIIcuILy wILI bunnIng smokIng In
un uLLempL Lo uccommoduLe usLImuLIc`s compIuInLs. eIL Lo ILs own
devIces, medIco-muLerIuIIsm wIII IusIIon greuLer socIeLy InLo un exLensIon
oI LIe IospILuI. MedIco-muLerIuIIsm does noL compreIend psycIoIogIcuI
und socIeLuI IuncLIonIng oI LIe weII popuIuLIon. ALLempLIng Lo
uccommoduLe un usLImuLIc`s sILuuLIon, wIeLIer or noL IL reIIecLs u
psycIogenIc uspecL (e.g., SS, ESS), muy seem benevoIenL Lo muny oI LIe
pubIIc uL LIIs LIme. ndeed, compussIon Is wurrunLed In uLLempLIng Lo
uccommoduLe LIose LIuL ure III. However, redeIInIng socIeLuI IuncLIonIng
In Lerms oI sIckness Is noL u judIcIous opLIon: TIere ure very good reusons
wIy pubIIc poIIcy wus uL one LIme uncIored Lo u normuLIve runge oI
IuncLIonIng, wIIcI IncIudes u buIuncIng ucross bIoIogIcuI, psycIoIogIcuI,
socIuI und moruI dImensIons. I socIeLuI IuncLIonIng Is uncIored Lo
sIckness, us wIII be LIe cuse under medIco-muLerIuIIsL domInuLIon, LIe
mujorILy oI LIe popuIuLIon LIuL ure weII uLLempL Lo IuncLIon In u
Irumework us II LIey Iuve u muILIpIIcILy oI dIseuses, I.e., menLuI, socIuI
und moruI IeuILI rumIIIcuLIons.
TIe S.A..E. unLIsmokIng websILe IndIcuLes LIuL:
EmpIoyees exposed InvoIunLurIIy Lo secondIund smoke
uL LIe oIIIce cun now sue empIoyers Ior ussuuIL und
buLLery, uL IeusL In CuIIIornIu.
A SouLIern CuIIIornIu womun wIo sued Ier empIoyer
Ior buLLery becuuse oI secondIund smoke In Ier oIIIce
Preventive Medicine & Health Promotion
uccepLed un ouL-oI-courL seLLIemenL..uILer u os
AngeIes SuperIor CourL CommIssIoner ruIed LIuL
secondIund smoke, IIke sexuuI IurussmenL, Is noL purL
oI LIe job.
EIIus |LIe commIssIoner| ruIed LIuL workers`
compensuLIon Is noL LIe onIy remedy Ior PorLenIer`s
|pIuInLIII| cIuIm. 'SecondIund smoke Is noL IIke IIgILs
wIIcI everybody needs,` EIIus expIuIned.
PorLenIer deveIoped un usLImu-IIke condILIon uILer
workIng Ior Iour yeurs In un oIIIce LIuL uIIowed
smokIng. AILIougI sIe requesLed u smokeIree
envIronmenL Ior uL IeusL u yeur und brougIL noLes Irom
Ier docLors, LIe IIrm Ignored Ier requesLs.
ConcernIng LIIs cuse, IL uII IInges on u bIurry usLImu-IIke
condILIon supporLed by InIuIIIbIe medIco-muLerIuIIsL LesLImony.
urLIermore, psycIogenIc IucLors und ESS never enLer LIe consIderuLIon.
urLIermore, LIe commIssIoner`s commenLs ure uIso quesLIonubIe. TIe
Issue Is noL wIeLIer everyone needs u IucLor In LIe workpIuce Ior IL Lo be
IegILImuLe. TIe Issue Is wIeLIer uny IucLor IuIIs wILIIn u normuLIve runge
oI IuncLIonIng. By reIyIng on urguubIe medIcuI LesLImony und u IuIIure Lo
IncIude LIe Ideu oI u normuLIve runge, LIe ruIIng IurLIers LIe
IospILuIIzuLIon oI LIe workpIuce - LIe workpIuce musL IIrsL cuLer Ior LIe
unweII, wIeLIer pIysIcuI, psycIoIogIcuI or reIuLIonuI.
As wus noLed In LIe prevIous secLIon, IuvIng opened u Pundoru`s
box wILI ETS, LIere ure now oLIers demundIng uccommoduLIon oI oLIer
uLypIcuI compIuInLs. UnIorLunuLeIy, LIese demunds cun be pursued under
currenL workpIuce und unLI-dIscrImInuLIon Iuws und LIe precedenLs LIuL
Iuve been seL concernIng ETS. L wus consIdered In un eurIIer secLIon LIuL
LIere ure now persons sympLomuLIc Lo perIumes. And, IL Is LIose In u
normuLIve runge oI IuncLIonIng LIuL ure mude Lo IeeI guIILy Ior LIeIr
normuIILy. As more persons ure eILIer remuInIng or regressIng InLo LIe
IIckIeness oI LIe Iower nuLure (see CIupLer ), more persons wIII be
projecLIng sympLoms Lo exLernuIILIes. I medIco-muLerIuIIsm Is IeIL Lo
dIcLuLe proceedIngs, IL wIII IegILImIze LIese condILIons. A recenL sLudy
Ius IndIcuLed LIuL peopIe`s uIIergIc reucLIons In LIe workpIuce muy be due
Lo cuL scenL on co-workers` cIoLIIng (Hercld,Sun, OcLober 18, zooo,
p.6). As Iuws currenLIy sLund, LIere Is no reuson wIy evenLuuIIy uII
workers wIII be requIred Lo Iuve LIeIr cIoLIIng dry-cIeuned beIore
enLerIng LIe workpIuce or even LIe socIuI pIuce. And LIIs Is onIy II no one
Is uIIergIc Lo LIe scenL oI dry-cIeunIng. WorkpIuces und socIuI pIuces cun
LecInIcuIIy be Lurned InLo u Iorm oI sLerIIe IuboruLory - LIe very conLorLed
442
442
Rampant Antismoking Signifies Grave Danger
percepLIon LIrougI wIIcI medIco-muLerIuIIsm vIews LIe worId. n
uccommoduLIng uLypIcuI compIuInLs, no regurd Is gIven Lo ILs eIIecL on LIe
cctucl normuLIve runge oI IuncLIonIng. TIIs Is u mosL perverse
cIrcumsLunce LIuL requIres urgenL uddressIng.
TIe soIuLIon Lo LIIs cIrcumsLunce Is quILe sLruIgILIorwurd. BoLI
workpIuce und unLI-dIscrImInuLIon Iuws need Lo be uncIored Lo u
normuLIve runge. ALLempLs uL reusonubIe uccommoduLIon oI dIsubIIILy ure
expecLed, so Iong us LIey do noL InIrInge on u normuLIve runge. Exposure
Lo ETS, Ior exumpIe, Is enLIreIy wILIIn nonsmokers` normuLIve runge oI
IuncLIonIng. urLIermore, condILIons sucI us Iyper-sensILIvILyJ
reucLIvILy Lo Lobucco smoke, wIIcI Iuve been uccepLed uL Iuce vuIue,
requIre proper scIenLIIIc InvesLIguLIon uccounLIng Ior unxIeLy dIsorders
und noceboJubscebo poLenLIuIs.
One oI LIe mosL dungerous consequences oI LIe unLIsmokIng
Irenzy, und uguIn dIrecLed by unLIsmokIng ucLIvIsLs, Is LIe proLecLIon oI
cIIIdren Irom ETS exposure. TIe De MuLLeo cuse, descrIbed In CIupLer q,
Is mosL dIsLurbIng. n LIIs cuse LIe cIIId Ius no exIsLIng muIudIes. YeL, LIe
courL suw us ILs responsIbIIILy LIe proLecLIon oI LIe cIIId Irom LIe very-Iow
(mInIscuIe) sLuLIsLIcuI rIsk oI Iurm LIuL cunnoL be descrIbed cuusuIIy. TIIs
opens unoLIer Pundoru`s box oI deIuded IILIguLIon. L Ius uIreudy been
consIdered LIuL cIIId cusLody cun InvoIve dysIuncLIon beLween purenLs
und cIIIdren. TIe precedenL seL In LIe De MuLLeo cuse now IegILImIzes
LIe seekIng oI proLecLIon Ior weII cIIIdren Irom uny possIbIIILy, Iowever
remoLe, oI Iurm. or exumpIe, u courL cun reIuse cusLodyJvIsILuLIon II one
purenL demunds proLecLIon Irom LIe possIbIIILy oI Iurm Irom, suy, junk-
Iood consumpLIon, purLIcuIur IrIends, purLIcuIur TV progrums, ILLIe
eugue or oLIer sporLs InvoIvemenL. L provIdes uvenues Ior over-conLroI
LIuL cun onIy exucerbuLe uIreudy LroubIed cIrcumsLunces. L Is onIy u
muLLer oI LIme beIore dIsgrunLIed purenLs, compIIunL Iuwyers, und oLIer
monomunIucuI Iobby groups see LIe opporLunILIes uIIorded by LIIs
precedenL. L beggurs beIIeI Iow u courL oI Iuw, wIere one wouId expecL uL
IeusL u modIcum oI sensIbIIILy Lo reIgn, couId muke sucI u deLermInuLIon.
However, IL Is enLIreIy In uccord wILI LIe muLerIuIIsL rIsk uvoIdIng
IndIvIduuI und LIe ucuLe IIxuLIon oI unLIsmokIng, I.e., uspecLs oI MMES-
cuIL beIIeIs. As Ius been evIdenced LIrougIouL LIIs secLIon, LIe judIcIury Is
noL Immune Irom beIng u purLIcIpunL In muss deIusIon.
One IurLIer ureu wIere some governmenLs Iuve IeIL LIemseIves
LerrIbIy exposed concerns LIe medIcuLIng oI rIsk IucLors. or exumpIe,
AusLruIIu Ius enjoyed LIe udvunLuges oI u Luxpuyer-Iunded PIurmu-
ceuLIcuI BeneIILs ScIeme (PBS). L Ius mude medIcuLIons Ior IowerIng
IyperLensIon und IIgI cIoIesLeroI uvuIIubIe uL u Iow cosL Lo LIe pubIIc.
UnIorLunuLeIy, LIere ure now so muny prevenLIve medIcInes LIuL LIe
Preventive Medicine & Health Promotion
scIeme Ius become unuIIordubIe. DocLors Iuve been udvIsed by LIe
governmenL IeuILI depurLmenL LIuL some puLIenLs sIouId be Luken oI
sucI medIcuLIon und prescrIbed dIeLury cIunges und pIysIcuI exercIse -
docLors IILeruIIy wrILe LIIs prescrIpLIon on u prescrIpLIon pud. I puLIenLs
LIuL Iuve been Luken oII LIIs medIcuLIon dIe premuLureIy, LIere Is no
reuson In LIIs currenL IILIguLIon Irenzy bused on u deIuded workIng oI rIsk
wIy u docLor or u governmenL cunnoL be sued Ior noL provIdIng uIIordubIe
medIcuLIon LIuL couId Iuve prevenLed LIe cIrcumsLunce. TIe onIy deIense
Is LIuL LIe medIcuLIon does noL guurunLee prevenLIon oI premuLure
morbIdILyJmorLuIILy: RIsk und, LIereIore, rIsk reducLIon do noL meun us
mucI us LIe pubIIc beIIeves und, yeL, medIco-muLerIuIIsm Ius been
responsIbIe Ior orcIesLruLIng wIuL LIe pubIIc beIIeves. TIe crILIcuI
quesLIon Is wIy Iuve so muny currenLIy weII persons been puLIenLIzed und
u rIsk IucLor medIcuIIzed? TIese ure Issues oI menLuI IeuILI.
(.::.z Possible Recourse
ConsIdered ubove Ius been LIe rumIIIcuLIons oI MMES cuILIsL
ucLIvILy. L Ius opened numerous Pundoru`s boxes oI conLorLed InIerence.
TIIs Is LIe nuLure oI ucuLe IIxuLIon; IL Is menLuIIy bIocked Lo uII
rumIIIcuLIons oI ILs conducL. AL LIe rooL oI IL uII Is one smuII group -
medIco-muLerIuIIsm und ILs Iobby-group Iungers-on - LIuL Ius been ubIe
Lo IruuduIenLIy Impose ILs conLorLed vIew under LIe uuspIces oI scIenLIIIc
credIbIIILy wIIIsL deIIecLIng uLLenLIon uwuy Irom ILseII LIrougI vIIIIIcuLIon
oI LIe Lobucco IndusLry. TIuL IL Ius been uIIowed Lo proceed Lo LIIs cruzed
IeveI Is u sud IndIcLmenL on muny socIeLIes. UnIorLunuLeIy, LIIs mIsguIded
IILIguLIon Is onIy one LIeme In muny oI u muLerIuIIsL domInuLIon on u
gIobuI scuIe.
L uIso IoIIows LIe usuuI rouLe oI muss deIusIon. or exumpIe, In
LIe US oI LIe 1qzo`s numerous cIuIms were mude concernIng LIe neguLIve
eIIecLs oI Lobucco. TIese were munuIucLured by LIe medIcuI prucLILIoners,
LypIcuIIy on post hoc ero propter hoc urgumenLs, und IurLIer propuguLed
by IobbyIsLs. SucI cIuIms wenL unquesLIoned wILI LIe onus oI dIsprooI
on LIe deIenders oI Lobucco, I.e., IuIIucy oI sIIILIng LIe burden oI prooI.
However, us ProcLor (1qq;), In eIuboruLIng BurnIum`s surmIsIng,
IndIcuLes: severuI oI LIe 'dIseuses` crusuded uguInsL uL LIe IeIgIL oI
proIIbILIon (musLurbuLIon, Ior exumpIe) Iud Lurned ouL Lo be pseudo-
dIseuses, und IL wus eusy Lo beIIeve LIuL LIe sume mIgIL be Lrue Ior
Lobucco. WIere, uILer uII, wus LIe evIdence LIuL smokIng cuused
ImpoLence or Ied Lo crIme? or u pubIIc wury oI sucI ImugInuLIve scure-
mongerIng, LIe burden oI prooI sIIILed Irom LIe deIenders oI Lobucco Lo
ILs uccusers. (p.q;) TIe sume cun be uppIIed Lo LIe currenL Ideu oI u
443
443
Rampant Antismoking Signifies Grave Danger
percepLIon LIrougI wIIcI medIco-muLerIuIIsm vIews LIe worId. n
uccommoduLIng uLypIcuI compIuInLs, no regurd Is gIven Lo ILs eIIecL on LIe
cctucl normuLIve runge oI IuncLIonIng. TIIs Is u mosL perverse
cIrcumsLunce LIuL requIres urgenL uddressIng.
TIe soIuLIon Lo LIIs cIrcumsLunce Is quILe sLruIgILIorwurd. BoLI
workpIuce und unLI-dIscrImInuLIon Iuws need Lo be uncIored Lo u
normuLIve runge. ALLempLs uL reusonubIe uccommoduLIon oI dIsubIIILy ure
expecLed, so Iong us LIey do noL InIrInge on u normuLIve runge. Exposure
Lo ETS, Ior exumpIe, Is enLIreIy wILIIn nonsmokers` normuLIve runge oI
IuncLIonIng. urLIermore, condILIons sucI us Iyper-sensILIvILyJ
reucLIvILy Lo Lobucco smoke, wIIcI Iuve been uccepLed uL Iuce vuIue,
requIre proper scIenLIIIc InvesLIguLIon uccounLIng Ior unxIeLy dIsorders
und noceboJubscebo poLenLIuIs.
One oI LIe mosL dungerous consequences oI LIe unLIsmokIng
Irenzy, und uguIn dIrecLed by unLIsmokIng ucLIvIsLs, Is LIe proLecLIon oI
cIIIdren Irom ETS exposure. TIe De MuLLeo cuse, descrIbed In CIupLer q,
Is mosL dIsLurbIng. n LIIs cuse LIe cIIId Ius no exIsLIng muIudIes. YeL, LIe
courL suw us ILs responsIbIIILy LIe proLecLIon oI LIe cIIId Irom LIe very-Iow
(mInIscuIe) sLuLIsLIcuI rIsk oI Iurm LIuL cunnoL be descrIbed cuusuIIy. TIIs
opens unoLIer Pundoru`s box oI deIuded IILIguLIon. L Ius uIreudy been
consIdered LIuL cIIId cusLody cun InvoIve dysIuncLIon beLween purenLs
und cIIIdren. TIe precedenL seL In LIe De MuLLeo cuse now IegILImIzes
LIe seekIng oI proLecLIon Ior weII cIIIdren Irom uny possIbIIILy, Iowever
remoLe, oI Iurm. or exumpIe, u courL cun reIuse cusLodyJvIsILuLIon II one
purenL demunds proLecLIon Irom LIe possIbIIILy oI Iurm Irom, suy, junk-
Iood consumpLIon, purLIcuIur IrIends, purLIcuIur TV progrums, ILLIe
eugue or oLIer sporLs InvoIvemenL. L provIdes uvenues Ior over-conLroI
LIuL cun onIy exucerbuLe uIreudy LroubIed cIrcumsLunces. L Is onIy u
muLLer oI LIme beIore dIsgrunLIed purenLs, compIIunL Iuwyers, und oLIer
monomunIucuI Iobby groups see LIe opporLunILIes uIIorded by LIIs
precedenL. L beggurs beIIeI Iow u courL oI Iuw, wIere one wouId expecL uL
IeusL u modIcum oI sensIbIIILy Lo reIgn, couId muke sucI u deLermInuLIon.
However, IL Is enLIreIy In uccord wILI LIe muLerIuIIsL rIsk uvoIdIng
IndIvIduuI und LIe ucuLe IIxuLIon oI unLIsmokIng, I.e., uspecLs oI MMES-
cuIL beIIeIs. As Ius been evIdenced LIrougIouL LIIs secLIon, LIe judIcIury Is
noL Immune Irom beIng u purLIcIpunL In muss deIusIon.
One IurLIer ureu wIere some governmenLs Iuve IeIL LIemseIves
LerrIbIy exposed concerns LIe medIcuLIng oI rIsk IucLors. or exumpIe,
AusLruIIu Ius enjoyed LIe udvunLuges oI u Luxpuyer-Iunded PIurmu-
ceuLIcuI BeneIILs ScIeme (PBS). L Ius mude medIcuLIons Ior IowerIng
IyperLensIon und IIgI cIoIesLeroI uvuIIubIe uL u Iow cosL Lo LIe pubIIc.
UnIorLunuLeIy, LIere ure now so muny prevenLIve medIcInes LIuL LIe
Preventive Medicine & Health Promotion
scIeme Ius become unuIIordubIe. DocLors Iuve been udvIsed by LIe
governmenL IeuILI depurLmenL LIuL some puLIenLs sIouId be Luken oI
sucI medIcuLIon und prescrIbed dIeLury cIunges und pIysIcuI exercIse -
docLors IILeruIIy wrILe LIIs prescrIpLIon on u prescrIpLIon pud. I puLIenLs
LIuL Iuve been Luken oII LIIs medIcuLIon dIe premuLureIy, LIere Is no
reuson In LIIs currenL IILIguLIon Irenzy bused on u deIuded workIng oI rIsk
wIy u docLor or u governmenL cunnoL be sued Ior noL provIdIng uIIordubIe
medIcuLIon LIuL couId Iuve prevenLed LIe cIrcumsLunce. TIe onIy deIense
Is LIuL LIe medIcuLIon does noL guurunLee prevenLIon oI premuLure
morbIdILyJmorLuIILy: RIsk und, LIereIore, rIsk reducLIon do noL meun us
mucI us LIe pubIIc beIIeves und, yeL, medIco-muLerIuIIsm Ius been
responsIbIe Ior orcIesLruLIng wIuL LIe pubIIc beIIeves. TIe crILIcuI
quesLIon Is wIy Iuve so muny currenLIy weII persons been puLIenLIzed und
u rIsk IucLor medIcuIIzed? TIese ure Issues oI menLuI IeuILI.
(.::.z Possible Recourse
ConsIdered ubove Ius been LIe rumIIIcuLIons oI MMES cuILIsL
ucLIvILy. L Ius opened numerous Pundoru`s boxes oI conLorLed InIerence.
TIIs Is LIe nuLure oI ucuLe IIxuLIon; IL Is menLuIIy bIocked Lo uII
rumIIIcuLIons oI ILs conducL. AL LIe rooL oI IL uII Is one smuII group -
medIco-muLerIuIIsm und ILs Iobby-group Iungers-on - LIuL Ius been ubIe
Lo IruuduIenLIy Impose ILs conLorLed vIew under LIe uuspIces oI scIenLIIIc
credIbIIILy wIIIsL deIIecLIng uLLenLIon uwuy Irom ILseII LIrougI vIIIIIcuLIon
oI LIe Lobucco IndusLry. TIuL IL Ius been uIIowed Lo proceed Lo LIIs cruzed
IeveI Is u sud IndIcLmenL on muny socIeLIes. UnIorLunuLeIy, LIIs mIsguIded
IILIguLIon Is onIy one LIeme In muny oI u muLerIuIIsL domInuLIon on u
gIobuI scuIe.
L uIso IoIIows LIe usuuI rouLe oI muss deIusIon. or exumpIe, In
LIe US oI LIe 1qzo`s numerous cIuIms were mude concernIng LIe neguLIve
eIIecLs oI Lobucco. TIese were munuIucLured by LIe medIcuI prucLILIoners,
LypIcuIIy on post hoc ero propter hoc urgumenLs, und IurLIer propuguLed
by IobbyIsLs. SucI cIuIms wenL unquesLIoned wILI LIe onus oI dIsprooI
on LIe deIenders oI Lobucco, I.e., IuIIucy oI sIIILIng LIe burden oI prooI.
However, us ProcLor (1qq;), In eIuboruLIng BurnIum`s surmIsIng,
IndIcuLes: severuI oI LIe 'dIseuses` crusuded uguInsL uL LIe IeIgIL oI
proIIbILIon (musLurbuLIon, Ior exumpIe) Iud Lurned ouL Lo be pseudo-
dIseuses, und IL wus eusy Lo beIIeve LIuL LIe sume mIgIL be Lrue Ior
Lobucco. WIere, uILer uII, wus LIe evIdence LIuL smokIng cuused
ImpoLence or Ied Lo crIme? or u pubIIc wury oI sucI ImugInuLIve scure-
mongerIng, LIe burden oI prooI sIIILed Irom LIe deIenders oI Lobucco Lo
ILs uccusers. (p.q;) TIe sume cun be uppIIed Lo LIe currenL Ideu oI u
444
444
Rampant Antismoking Signifies Grave Danger
muILIpIIcILy oI dIseuses cuused by Lobucco smoke.
Sound quesLIonIng oI LIe currenL uccusers Is cerLuInIy wurrunLed.
TIrougI epIdemIoIogy und un over-InLerpreLuLIon oI LIe Ideu oI sLuLIsLIcuI
rIsk, LIe medIcuI esLubIIsImenL Is engugIng In onIy more eIegunL or
IormuIIzed Iorms oI LIe IuIIucy oI post hoc ero propter hoc. TIe currenL
unLIsmokIng crusude Is sLIII In LIe muss deIusIon, uccuser pIuse,
supporLed by SS, ESS, und oLIer unxIeLy dIsorders. L Ius been uL IeusL
LIree decudes In LIe mukIng. n LIuL muLerIuIIsm domInuLes uII key socIuI
InsLILuLIons, IL wouId requIre u renuIssunce In genuIne muILIdImensIonuI
scIoIursIIp Lo brIng LIe enLIre uccusuLorIuI Irumework InLo cIeck. TIIs
wouId seem Lo be u Iong LIme In LIe comIng wIen LIe educuLIonuI
Irumework, wIIcI Is uIso domInuLed by muLerIuIIsm, dIscouruges LIIs
occurrence.
TIe currenL muLerIuIIsL domInuLIon does noL concern onIy one
nuLIon, buL Is on u LruIy gIobuI scuIe. or reusons ouLIIned In CIupLer ,
LIe symboIIsm oI unLIsmokIng In LIe generuI muLerIuIIsL Irumework Is
consIdered. A mosL IIkeIy scenurIo Is LIuL LIe underIyIng muLerIuIIsm,
wIIcI Is repIeLe wILI uII munner oI cIurucLer deIIcIencIes, wIII produce
wur: CurrenL unLIsmokIng Is crILIcuIIy sympLomuLIc oI u muLerIuIIsL
menLuIILy on sucI u muss scuIe LIuL dwurIs LIe sume LendencIes In LIe
NuzI regIme und IuvIng u mosL devusLuLIng poLenLIuI. n oLIer words,
beIore uny scIoIurIy correcLIon oI MMES-cuIL beIIeIs cun occur, LIe gIobuI
condILIon Is more IIkeIy Lo be devusLuLed by wur.
However, In uddILIon Lo sLeps IndIcuLed In LIIs secLIon, oLIer
sIorL-Lerm ucLIon cun be Luken In brIngIng rumpunL unLIsmokIng, und ILs
underIyIng muLerIuIIsm, InLo some cIeck. or exumpIe, JoIn BunzIuI oI
ASH Is credILed wILI producIng unLIsmokIng udverLs LIuL were uIred Iree
us u pubIIc servIce unnouncemenL - LIe Iuw mukIng LIIs possIbIe. n LIe
currenL unLIsmokIng Irenzy, pubIIc servIce udverLs cun be orgunIzed us u
counLer Lo currenL unLIsmokIng uds LIuL ure IruuduIenL, severeIy
mIsrepresenLIng sLuLIsLIcuI duLu (see CIupLer q). TIey ure Ieur und guIIL-
mongerIng In dIsposILIon und LIereIore Iuve menLuI und socIuI IeuILI
rumIIIcuLIons, e.g., nocebo eIIecLs.
AIso, IeguI ucLIon cun be consIdered Ior u coIIecLIon oI
orgunIzuLIons, IncIudIng medIcuI groups, und websILes (e.g., ASH, TIe
CrIme PrevenLIon Group) LIuL cIeurIy IndIcuLe u LIeme oI IuLe-mongerIng
on u grund scuIe. TIe uccusuLIons, uIIeguLIons, und vocubuIury In quesLIon
go Iur, Iur beyond LIe ImpIIcuLIon oI IucLs. SmokIng und LIe smoker Iuve
been munuIucLured by u wuywurd menLuIILy InLo u conLemporury
scupegouL or objecL oI bIgoLry. TIe TCPG websILe In purLIcuIur Is
dungerousIy deIuded In LIeme (see IoIIowIng cIupLer). YeL, beLween 1qqq
und zoo, LIe onIy webpuge IuvIng u vIsILor counLer IndIcuLed over
Preventive Medicine & Health Promotion
zq,ooo IILs. Erroneous InIormuLIon on LIIs websILe cun be Iound In LIe
IInks oI oLIer unLIsmokIng websILes; mIsguIded InIormuLIon und
urgumenL Ius LIe poLenLIuI Ior wIdespreud cIrcuIuLIon. TCPG mIsconducL
Is unIorLunuLeIy InIecLIng muny. L wouId requIre some oI LIe urgumenLs
In LIIs dIscussIon und u compeLenL sLuLIsLIcIun und psycIoIogIsL Lo
demonsLruLe LIuL LIe urgumenLs presenLed on LIIs sILe ure IncoIerenL,
unscIoIurIy, und deIInquenL und cun onl promoLe IrruLIonuI Ieur und
IuLred.
Pregnuncy Is unoLIer ureu wIere budgerIng und IurussmenL oI
purLIcuIurIy smokers by supposed IeuILI proIessIonuIs Is uL u sLuggerIng
IeveI. DIsjoInLed bILs oI sLuLIsLIcuI InIormuLIon ure used by LIose wIo
obvIousIy Iuve no compeLence In LIIs regurd Lo LormenL smokers InLo LIe
erroneous beIIeI LIuL u successIuI pregnuncy Is no more LIun Iuck, I.e.,
severe mIsrepresenLuLIon. TIere Is more LIun suIIIcIenL grounds Ior
consIderIng sucI conducL us un ussuuIL on, uL IeusL, menLuI IeuILI.
urLIer, uny vIoIence uguInsL smokers, wIIcI ccn be
demonsLruLed cuusuIIy (I.e., noL jusL u sLuLIsLIcuI urgumenL), cun eusIIy be
IInked Lo LIe IuLe-mongerIng oI LIese groups LIInIy musqueruded us
IeuILI promoLIon. Smokers In u consLunL sLuLe oI worry und unxIeLy due
Lo unLIsmokIng propugundu uIso Iuve sucI recourse uguInsL u burruge oI
IruuduIenL Ieur und guIIL-mongerIng cIuIms mude by boLI LIe medIcuI
esLubIIsImenL und IobbyIsLs. TIese ure muLLers oI psycIoIogIcuI,
reIuLIonuI, und moruI IeuILI - concepLs LIuL LIe superIIcIuIILy oI
muLerIuIIsm cunnoL IuLIom.
TIere Is u need, purLIcIuurIy umongsL smokers, Ior puLIence In
LIe cIrcumsLunce und noL beIng druwn InLo LIe conLrIved udversurIuI
Irumework. Smokers und nonsmokers uIIke wouId do weII Lo become
IumIIIur wILI Lerms sucI us MMES cuIL, LIe superIorILy syndrome, und LIe
envIronmenLuI somuLIzuLIon syndrome. TIese Lerms sIouId be used In
generuI dIscussIon, IopeIuIIy uIerLIng uL IeusL some nonsmokers LIuL LIeIr
unLIsmokIng IIxuLIon mIgIL weII be deIusIonuI.
(.:z The Mcnujccture oj c Cult
L cun be concIuded Irom LIe precedIng LIuL unLIsmokIng Ius
gone ILs LypIcuI wuy oI progressIveIy more deIuded cIuIms. AL unoLIer
LIme, LIe underIyIng crunkIness, umongsL oLIer menLuI und socIuI
IeebIeness, wouId Iuve Iong been IdenLIIIed. UnIorLunuLeIy, In LIIs
unLIsmokIng crusude, LIe new producLIons oI IIIesLyIe epIdemIoIogy, wILI
uII oI ILs scIenLIIIc und InIerenLIuI IuIIIngs, Ius served Lo promoLe, IengLIen
und InLensIIy LIe crusude under LIe preLense oI scIenLIIIc supporL.
n onIy u sIorL LIme, exposure Lo ETS, u IereLoIore IucLor oI no
445
445
Rampant Antismoking Signifies Grave Danger
muILIpIIcILy oI dIseuses cuused by Lobucco smoke.
Sound quesLIonIng oI LIe currenL uccusers Is cerLuInIy wurrunLed.
TIrougI epIdemIoIogy und un over-InLerpreLuLIon oI LIe Ideu oI sLuLIsLIcuI
rIsk, LIe medIcuI esLubIIsImenL Is engugIng In onIy more eIegunL or
IormuIIzed Iorms oI LIe IuIIucy oI post hoc ero propter hoc. TIe currenL
unLIsmokIng crusude Is sLIII In LIe muss deIusIon, uccuser pIuse,
supporLed by SS, ESS, und oLIer unxIeLy dIsorders. L Ius been uL IeusL
LIree decudes In LIe mukIng. n LIuL muLerIuIIsm domInuLes uII key socIuI
InsLILuLIons, IL wouId requIre u renuIssunce In genuIne muILIdImensIonuI
scIoIursIIp Lo brIng LIe enLIre uccusuLorIuI Irumework InLo cIeck. TIIs
wouId seem Lo be u Iong LIme In LIe comIng wIen LIe educuLIonuI
Irumework, wIIcI Is uIso domInuLed by muLerIuIIsm, dIscouruges LIIs
occurrence.
TIe currenL muLerIuIIsL domInuLIon does noL concern onIy one
nuLIon, buL Is on u LruIy gIobuI scuIe. or reusons ouLIIned In CIupLer ,
LIe symboIIsm oI unLIsmokIng In LIe generuI muLerIuIIsL Irumework Is
consIdered. A mosL IIkeIy scenurIo Is LIuL LIe underIyIng muLerIuIIsm,
wIIcI Is repIeLe wILI uII munner oI cIurucLer deIIcIencIes, wIII produce
wur: CurrenL unLIsmokIng Is crILIcuIIy sympLomuLIc oI u muLerIuIIsL
menLuIILy on sucI u muss scuIe LIuL dwurIs LIe sume LendencIes In LIe
NuzI regIme und IuvIng u mosL devusLuLIng poLenLIuI. n oLIer words,
beIore uny scIoIurIy correcLIon oI MMES-cuIL beIIeIs cun occur, LIe gIobuI
condILIon Is more IIkeIy Lo be devusLuLed by wur.
However, In uddILIon Lo sLeps IndIcuLed In LIIs secLIon, oLIer
sIorL-Lerm ucLIon cun be Luken In brIngIng rumpunL unLIsmokIng, und ILs
underIyIng muLerIuIIsm, InLo some cIeck. or exumpIe, JoIn BunzIuI oI
ASH Is credILed wILI producIng unLIsmokIng udverLs LIuL were uIred Iree
us u pubIIc servIce unnouncemenL - LIe Iuw mukIng LIIs possIbIe. n LIe
currenL unLIsmokIng Irenzy, pubIIc servIce udverLs cun be orgunIzed us u
counLer Lo currenL unLIsmokIng uds LIuL ure IruuduIenL, severeIy
mIsrepresenLIng sLuLIsLIcuI duLu (see CIupLer q). TIey ure Ieur und guIIL-
mongerIng In dIsposILIon und LIereIore Iuve menLuI und socIuI IeuILI
rumIIIcuLIons, e.g., nocebo eIIecLs.
AIso, IeguI ucLIon cun be consIdered Ior u coIIecLIon oI
orgunIzuLIons, IncIudIng medIcuI groups, und websILes (e.g., ASH, TIe
CrIme PrevenLIon Group) LIuL cIeurIy IndIcuLe u LIeme oI IuLe-mongerIng
on u grund scuIe. TIe uccusuLIons, uIIeguLIons, und vocubuIury In quesLIon
go Iur, Iur beyond LIe ImpIIcuLIon oI IucLs. SmokIng und LIe smoker Iuve
been munuIucLured by u wuywurd menLuIILy InLo u conLemporury
scupegouL or objecL oI bIgoLry. TIe TCPG websILe In purLIcuIur Is
dungerousIy deIuded In LIeme (see IoIIowIng cIupLer). YeL, beLween 1qqq
und zoo, LIe onIy webpuge IuvIng u vIsILor counLer IndIcuLed over
Preventive Medicine & Health Promotion
zq,ooo IILs. Erroneous InIormuLIon on LIIs websILe cun be Iound In LIe
IInks oI oLIer unLIsmokIng websILes; mIsguIded InIormuLIon und
urgumenL Ius LIe poLenLIuI Ior wIdespreud cIrcuIuLIon. TCPG mIsconducL
Is unIorLunuLeIy InIecLIng muny. L wouId requIre some oI LIe urgumenLs
In LIIs dIscussIon und u compeLenL sLuLIsLIcIun und psycIoIogIsL Lo
demonsLruLe LIuL LIe urgumenLs presenLed on LIIs sILe ure IncoIerenL,
unscIoIurIy, und deIInquenL und cun onl promoLe IrruLIonuI Ieur und
IuLred.
Pregnuncy Is unoLIer ureu wIere budgerIng und IurussmenL oI
purLIcuIurIy smokers by supposed IeuILI proIessIonuIs Is uL u sLuggerIng
IeveI. DIsjoInLed bILs oI sLuLIsLIcuI InIormuLIon ure used by LIose wIo
obvIousIy Iuve no compeLence In LIIs regurd Lo LormenL smokers InLo LIe
erroneous beIIeI LIuL u successIuI pregnuncy Is no more LIun Iuck, I.e.,
severe mIsrepresenLuLIon. TIere Is more LIun suIIIcIenL grounds Ior
consIderIng sucI conducL us un ussuuIL on, uL IeusL, menLuI IeuILI.
urLIer, uny vIoIence uguInsL smokers, wIIcI ccn be
demonsLruLed cuusuIIy (I.e., noL jusL u sLuLIsLIcuI urgumenL), cun eusIIy be
IInked Lo LIe IuLe-mongerIng oI LIese groups LIInIy musqueruded us
IeuILI promoLIon. Smokers In u consLunL sLuLe oI worry und unxIeLy due
Lo unLIsmokIng propugundu uIso Iuve sucI recourse uguInsL u burruge oI
IruuduIenL Ieur und guIIL-mongerIng cIuIms mude by boLI LIe medIcuI
esLubIIsImenL und IobbyIsLs. TIese ure muLLers oI psycIoIogIcuI,
reIuLIonuI, und moruI IeuILI - concepLs LIuL LIe superIIcIuIILy oI
muLerIuIIsm cunnoL IuLIom.
TIere Is u need, purLIcIuurIy umongsL smokers, Ior puLIence In
LIe cIrcumsLunce und noL beIng druwn InLo LIe conLrIved udversurIuI
Irumework. Smokers und nonsmokers uIIke wouId do weII Lo become
IumIIIur wILI Lerms sucI us MMES cuIL, LIe superIorILy syndrome, und LIe
envIronmenLuI somuLIzuLIon syndrome. TIese Lerms sIouId be used In
generuI dIscussIon, IopeIuIIy uIerLIng uL IeusL some nonsmokers LIuL LIeIr
unLIsmokIng IIxuLIon mIgIL weII be deIusIonuI.
(.:z The Mcnujccture oj c Cult
L cun be concIuded Irom LIe precedIng LIuL unLIsmokIng Ius
gone ILs LypIcuI wuy oI progressIveIy more deIuded cIuIms. AL unoLIer
LIme, LIe underIyIng crunkIness, umongsL oLIer menLuI und socIuI
IeebIeness, wouId Iuve Iong been IdenLIIIed. UnIorLunuLeIy, In LIIs
unLIsmokIng crusude, LIe new producLIons oI IIIesLyIe epIdemIoIogy, wILI
uII oI ILs scIenLIIIc und InIerenLIuI IuIIIngs, Ius served Lo promoLe, IengLIen
und InLensIIy LIe crusude under LIe preLense oI scIenLIIIc supporL.
n onIy u sIorL LIme, exposure Lo ETS, u IereLoIore IucLor oI no
446
446
Rampant Antismoking Signifies Grave Danger
purLIcuIur IeuILI concern, Ius been munuIucLured InLo u deudIy
pIenomenon. TIe reucLIon oI muny nonsmokers Is IndIcuLIve oI sLundurd
supersLILIous beIIeI: TIe mugIcuI mIsL oI ETS cun cuuse uII munner oI
muIudIes In unyone uL unyLIme. L Ius even reucIed LIe IIgI-deIusIonuI
poInL wIere ETS Is consIdered even more dungerous LIun muInsLreum
smoke. ETS Is vIewed noL unIIke u germ quunLILy Irom wIIcI one cun
momenLurIIy cuLcI cuncer or oLIer muIudIes. TIe munuIucLure oI muss
deIusIon Ius IoIIowed u course LIuL begIns wILI LIe IuIIucy oI non ccusc
pro ccusc. ReusonIng LIen degeneruLes IurLIer InLo LIe IuIIucy oI post
hoc ero propter hoc und progressIveIy more deIuded unuIogy. or
exumpIe, LIere ure nonsmokers LIuL beIIeve LIuL un uccIdenLuI breuLI oI
ETS cun produce InsLunLuneous morLuIILy In uny nonsmoker (see
Superiorit Sndrome). OLIers Iuve LrIed Lo IIken smokIng und exposure
Lo ETS Lo exposure Lo unLIrux (e.g., www.duLuopLIons.comJsmokers).
UndersLundubIy, ETS exposure cun produce sLrong Ieur or
uggressIon In muny nonsmokers. n LIe quesL Ior proLecLIon or suIeLy,
socIeLuI IuncLIonIng Ius been Lurned upsIde-down und InsIde-ouL LIrougI
uII munner oI deIuded unLIsmokIng reIorm.
TIe unLIsmokIng menLuIILy InILIuIIy cIuImed InLerIor spuces Ior
LIe superIor nonsmoker. TIen IL cIuImed cIose-proxImILy-spuce ouLdoors.
Now IL Is emburkIng on LIe cIuImIng oI uII pubIIc spuce. TIe cumpuIgn Is
jusL sIorL oI Lobucco proIIbILIon. TIe crusude IoIIows LIe LypIcuI course oI
SS und ESS pundemIcs. L uIso IoIIows LIe LypIcuI unLIsmokIng crusude
LIuL mIgIL InILIuIIy begIn us u Lemperunce (moderuLIon) crusude LIuL
quIckIy degeneruLes, LIrougI undIscIpIIned, IrenzIed LIougIL, InLo
proIIbILIonIsL LendencIes.
L Ius uIso been noLed LIuL, uILIougI crunkIness, IrruLIonuI beIIeI
und Ieur represenL IeebIe sLuLes, LIese ure dungerous und poLenLIuIIy
devusLuLIng wIere LIey ure uIIowed Lo proIIIeruLe on u muss scuIe,
purLIcuIurIy wIen musqueruded us u superIor LIInkIng.
TIe underIyIng muLerIuIIsm Ius IosLered u mosL ugIy menLuIILy.
As eurIIer IndIcuLed und worLI reILeruLIng, EdgIey & BrIsseLL (1qq) posIL:
TIese duys..peopIe ure noL onIy known by wIuL LIey don`L do, buL uIso
by wIuL LIey don`L LoIeruLe: ' don`L drInk, smoke, use drugs, or euL LIe
wrong Ioods` Is noL enougI. Now seII Is preserved by uddIng empIuLIcuIIy:
'und don`L LoIeruLe LIose wIo do!` I LIe meddIee seems Lo be Iuppy,
InLeresLIng, Iun-IovIng, und perIups even IeuILIy, suLIsIIed, und IuIIIIIed,
LIIs onIy Increuses LIe grIm-Iuced cIuIIenge oIIered LIe meddIer. (quoLed
In OukIey, 1qqq, CI.;, p.).
TIIs wouId be un udequuLe descrIpLIon oI LIe MMES-cuIL
devoLee. TIe menLuIILy demonsLruLes u poor LoIerunce LIresIoId, euse oI
oIIence, euse oI IrrILubIIILy, ImpuLIence, crunkIness, IuugILIness, Ieur. L Is
Preventive Medicine & Health Promotion
domInuLed by body-IIxuLIon und LIe InudequuLe unI-dImensIonuIILy oI
muLerIuIIsm, generuIIy, und medIco-muLerIuIIsm, specIIIcuIIy. Ls
udIerence Is Lo u Iong serIes oI sLuLIsLIcuIIsL prescrIpLIons In LIe quesL Ior
IeuILI. TIe menLuIILy Is, In IucL, very unIeuILIy. NoL yeL IuvIng
emburked on IonesL seII-scruLIny (InLernuI) us Lo sLundurd oI beIIeIs,
reusonIng und reIuLIonsIIp, LIe menLuIILy Is domInuLed by exLernuIILIes. n
psycIoIogIcuI Lerms, LIe conLorLed, conIIIcLed LIInkIng LIuL LIe devoLee
sLIII reIuses Lo ucknowIedge und evuIuuLe (denIuI) Is projecLed ouLwurds.
Dunger Is LIen seen In uII munner oI exLernuI pIenomenu. TIe menLuIILy
becomes obsessed wILI LIe erudIcuLIon oI LIese dungers under LIe guIse
oI envIronmenLuI IygIene. AII LIe wIIIe IL Is ILs own InLernuI (menLuI) sLuLe
LIuL Is squuIId, corrupL, poIIuLed. Under LIe InIIuence oI muLerIuIIsm, LIe
munner In wIIcI persons perceIve eucI oLIer Ius been dungerousIy
perverLed.
RegurdIng unLIsmokIng purLIcuIurIy, LIe cuIL IeudersIIp Ius so
vIIIuInIzed LIe Lobucco IndusLry LIuL very dIsLIncL In und ouL-groups Iuve
been Iormed wILIIn un udversurIuI Irumework. AII non-conIormers Lo cuIL
edIcLs (sLuLIsLIcuI rIsk-uversIon) or dIssenLers ure consIdered us Lobucco-
uddIcLed or Lobucco-IndusLry sympuLIIzers, I.e., InIerIors. OnIy cuIL
edIcLs ure depIcLed us IucLuuI, Iree Irom bIus und us benevoIenL.
ConIormers ure LIereIore uccorded superIor sLuLus. As SIuLensLeIn
(zooo), In revIewIng GIunLz & BuIbucI`s (zooo) Tobccco Wcr: Inside the
Cclijornic cttles, IndIcuLess, |I|n LIe cuse oI Lobucco conLroI udvocucy,
LIe cenLruI messuges ure sImpIe: LIe Lobucco IndusLry IIes, nIcoLIne Is
uddIcLIve, und secondIund smoke kIIIs. n more generuI Lerms, persons
Iree oI uny subsLunce-uddIcLIons und wIo ure body exercIsers ure
consIdered modeIs Ior IeurnIng Ior LIe remuInder oI socIeLy. TIe
menLuIILy Is superIIcIuI, IuckIng psycIoIogIcuI, reIuLIonuI, und moruI
depLI, und demonsLruLes dungerous nuLIonuIIsLJInLernuLIonuIIsL,
dIcLuLorIuI IeunIngs.
TIe IIImsy busIs oI sLuLIsLIcuIIsm LIuL underIIes boLI IIIesLyIe
epIdemIoIogy und IeuILI promoLIon, combIned wILI LIe muLerIuIIsL
IdeuI oI rIsk und sLuLIsLIcuI-rIsk uversIon, Ius exLended InLo LIe
medIcuIIzuLIonJdIseusIIIcuLIon oI rIsk IucLors. MedIco-muLerIuIIsm
promoLes und some governmenLs even subsIdIze LIe medIcuI LreuLmenL oI
rIsk IucLors (IyperLensIon, IIgI cIoIesLeroI). Persons wIo ure bIoIogIcuIIy
weII, I.e., mosL persons Ior uny rIsk IucLor, und wIo wIII mosL probubIy
remuIn LIuL wuy wILIIn u normuLIve runge ure LreuLed us sIck. L does noL
duwn on LIe superIIcIuI muLerIuIIsL menLuIILy LIuL boLI LIIs medIcuI
conducL und LIe beIIeIs IL IosLers In LIe pubIIc ure psycIoIogIcuIIy, socIuIIy,
und moruIIy unIeuILIy.
TIe Iew LIuL LIere muy be wILIIn LIe medIcuI esLubIIsImenL LIuL
447
447
Rampant Antismoking Signifies Grave Danger
purLIcuIur IeuILI concern, Ius been munuIucLured InLo u deudIy
pIenomenon. TIe reucLIon oI muny nonsmokers Is IndIcuLIve oI sLundurd
supersLILIous beIIeI: TIe mugIcuI mIsL oI ETS cun cuuse uII munner oI
muIudIes In unyone uL unyLIme. L Ius even reucIed LIe IIgI-deIusIonuI
poInL wIere ETS Is consIdered even more dungerous LIun muInsLreum
smoke. ETS Is vIewed noL unIIke u germ quunLILy Irom wIIcI one cun
momenLurIIy cuLcI cuncer or oLIer muIudIes. TIe munuIucLure oI muss
deIusIon Ius IoIIowed u course LIuL begIns wILI LIe IuIIucy oI non ccusc
pro ccusc. ReusonIng LIen degeneruLes IurLIer InLo LIe IuIIucy oI post
hoc ero propter hoc und progressIveIy more deIuded unuIogy. or
exumpIe, LIere ure nonsmokers LIuL beIIeve LIuL un uccIdenLuI breuLI oI
ETS cun produce InsLunLuneous morLuIILy In uny nonsmoker (see
Superiorit Sndrome). OLIers Iuve LrIed Lo IIken smokIng und exposure
Lo ETS Lo exposure Lo unLIrux (e.g., www.duLuopLIons.comJsmokers).
UndersLundubIy, ETS exposure cun produce sLrong Ieur or
uggressIon In muny nonsmokers. n LIe quesL Ior proLecLIon or suIeLy,
socIeLuI IuncLIonIng Ius been Lurned upsIde-down und InsIde-ouL LIrougI
uII munner oI deIuded unLIsmokIng reIorm.
TIe unLIsmokIng menLuIILy InILIuIIy cIuImed InLerIor spuces Ior
LIe superIor nonsmoker. TIen IL cIuImed cIose-proxImILy-spuce ouLdoors.
Now IL Is emburkIng on LIe cIuImIng oI uII pubIIc spuce. TIe cumpuIgn Is
jusL sIorL oI Lobucco proIIbILIon. TIe crusude IoIIows LIe LypIcuI course oI
SS und ESS pundemIcs. L uIso IoIIows LIe LypIcuI unLIsmokIng crusude
LIuL mIgIL InILIuIIy begIn us u Lemperunce (moderuLIon) crusude LIuL
quIckIy degeneruLes, LIrougI undIscIpIIned, IrenzIed LIougIL, InLo
proIIbILIonIsL LendencIes.
L Ius uIso been noLed LIuL, uILIougI crunkIness, IrruLIonuI beIIeI
und Ieur represenL IeebIe sLuLes, LIese ure dungerous und poLenLIuIIy
devusLuLIng wIere LIey ure uIIowed Lo proIIIeruLe on u muss scuIe,
purLIcuIurIy wIen musqueruded us u superIor LIInkIng.
TIe underIyIng muLerIuIIsm Ius IosLered u mosL ugIy menLuIILy.
As eurIIer IndIcuLed und worLI reILeruLIng, EdgIey & BrIsseLL (1qq) posIL:
TIese duys..peopIe ure noL onIy known by wIuL LIey don`L do, buL uIso
by wIuL LIey don`L LoIeruLe: ' don`L drInk, smoke, use drugs, or euL LIe
wrong Ioods` Is noL enougI. Now seII Is preserved by uddIng empIuLIcuIIy:
'und don`L LoIeruLe LIose wIo do!` I LIe meddIee seems Lo be Iuppy,
InLeresLIng, Iun-IovIng, und perIups even IeuILIy, suLIsIIed, und IuIIIIIed,
LIIs onIy Increuses LIe grIm-Iuced cIuIIenge oIIered LIe meddIer. (quoLed
In OukIey, 1qqq, CI.;, p.).
TIIs wouId be un udequuLe descrIpLIon oI LIe MMES-cuIL
devoLee. TIe menLuIILy demonsLruLes u poor LoIerunce LIresIoId, euse oI
oIIence, euse oI IrrILubIIILy, ImpuLIence, crunkIness, IuugILIness, Ieur. L Is
Preventive Medicine & Health Promotion
domInuLed by body-IIxuLIon und LIe InudequuLe unI-dImensIonuIILy oI
muLerIuIIsm, generuIIy, und medIco-muLerIuIIsm, specIIIcuIIy. Ls
udIerence Is Lo u Iong serIes oI sLuLIsLIcuIIsL prescrIpLIons In LIe quesL Ior
IeuILI. TIe menLuIILy Is, In IucL, very unIeuILIy. NoL yeL IuvIng
emburked on IonesL seII-scruLIny (InLernuI) us Lo sLundurd oI beIIeIs,
reusonIng und reIuLIonsIIp, LIe menLuIILy Is domInuLed by exLernuIILIes. n
psycIoIogIcuI Lerms, LIe conLorLed, conIIIcLed LIInkIng LIuL LIe devoLee
sLIII reIuses Lo ucknowIedge und evuIuuLe (denIuI) Is projecLed ouLwurds.
Dunger Is LIen seen In uII munner oI exLernuI pIenomenu. TIe menLuIILy
becomes obsessed wILI LIe erudIcuLIon oI LIese dungers under LIe guIse
oI envIronmenLuI IygIene. AII LIe wIIIe IL Is ILs own InLernuI (menLuI) sLuLe
LIuL Is squuIId, corrupL, poIIuLed. Under LIe InIIuence oI muLerIuIIsm, LIe
munner In wIIcI persons perceIve eucI oLIer Ius been dungerousIy
perverLed.
RegurdIng unLIsmokIng purLIcuIurIy, LIe cuIL IeudersIIp Ius so
vIIIuInIzed LIe Lobucco IndusLry LIuL very dIsLIncL In und ouL-groups Iuve
been Iormed wILIIn un udversurIuI Irumework. AII non-conIormers Lo cuIL
edIcLs (sLuLIsLIcuI rIsk-uversIon) or dIssenLers ure consIdered us Lobucco-
uddIcLed or Lobucco-IndusLry sympuLIIzers, I.e., InIerIors. OnIy cuIL
edIcLs ure depIcLed us IucLuuI, Iree Irom bIus und us benevoIenL.
ConIormers ure LIereIore uccorded superIor sLuLus. As SIuLensLeIn
(zooo), In revIewIng GIunLz & BuIbucI`s (zooo) Tobccco Wcr: Inside the
Cclijornic cttles, IndIcuLess, |I|n LIe cuse oI Lobucco conLroI udvocucy,
LIe cenLruI messuges ure sImpIe: LIe Lobucco IndusLry IIes, nIcoLIne Is
uddIcLIve, und secondIund smoke kIIIs. n more generuI Lerms, persons
Iree oI uny subsLunce-uddIcLIons und wIo ure body exercIsers ure
consIdered modeIs Ior IeurnIng Ior LIe remuInder oI socIeLy. TIe
menLuIILy Is superIIcIuI, IuckIng psycIoIogIcuI, reIuLIonuI, und moruI
depLI, und demonsLruLes dungerous nuLIonuIIsLJInLernuLIonuIIsL,
dIcLuLorIuI IeunIngs.
TIe IIImsy busIs oI sLuLIsLIcuIIsm LIuL underIIes boLI IIIesLyIe
epIdemIoIogy und IeuILI promoLIon, combIned wILI LIe muLerIuIIsL
IdeuI oI rIsk und sLuLIsLIcuI-rIsk uversIon, Ius exLended InLo LIe
medIcuIIzuLIonJdIseusIIIcuLIon oI rIsk IucLors. MedIco-muLerIuIIsm
promoLes und some governmenLs even subsIdIze LIe medIcuI LreuLmenL oI
rIsk IucLors (IyperLensIon, IIgI cIoIesLeroI). Persons wIo ure bIoIogIcuIIy
weII, I.e., mosL persons Ior uny rIsk IucLor, und wIo wIII mosL probubIy
remuIn LIuL wuy wILIIn u normuLIve runge ure LreuLed us sIck. L does noL
duwn on LIe superIIcIuI muLerIuIIsL menLuIILy LIuL boLI LIIs medIcuI
conducL und LIe beIIeIs IL IosLers In LIe pubIIc ure psycIoIogIcuIIy, socIuIIy,
und moruIIy unIeuILIy.
TIe Iew LIuL LIere muy be wILIIn LIe medIcuI esLubIIsImenL LIuL
448
448
g.
The Bigger Picture
L Ius been consIdered LIus Iur LIuL conLemporury IeuILI
promoLIon reIIecLs LIe convergence oI muLerIuIIsL superIIcIuIILy und
epIdemIoIogIc IncompeLence (I.e., scIence reduced Lo sLuLIsLIcuIIsm). TIe
cupucILy Ior LIIs conducL Lo IosLer IrruLIonuI beIIeI und nocebo eIIecLs, und
on u muss scuIe, Is exLruordInury. A quesLIon LIuL Ius uIreudy been posed
u number oI LImes In LIe IoregoIng concerns wIuL Ius become oI non-
reducLIonIsL psycIoIogy. L Is LIIs sorL oI dIscIpIIne LIuL Is In LIe besL
posILIon Lo keep IgnorunL muLerIuIIsL ussuuILs on menLuI IeuILI In cIeck.
TIe cuse exumpIe oI unLIsmokIng In, purLIcuIurIy, VIcLorIu, AusLruIIu, Ius
been used Lo IIgIIIgIL Iow muss deIusIon cun be IosLered over u sIorL
perIod oI LIme. n LIe IoIIowIng, LIe condILIon oI unIversILIes In AusLruIIu
wIII be consIdered und ILs sLrong ussocIuLIon wILI rumpunL unLIsmokIng.
AguIn, IL Is consIdered LIuL LIe cIrcumsLunce In AusLruIIu Is represenLuLIve
oI LIe sILuuLIon In muny wesLern nuLIons.
.: The Mctericlist Dominction Dj Unitersities &
Primcr,Secondcr Educction
.:.: riej cclround
n LIeIr eurIy yeurs, unIversILIesJcoIIeges were connecLedJ
sponsored by reIIgIous (LypIcuIIy CIrIsLIun) InsLILuLIons. Bukun (1q;q)
provIdes u very brIeI InsIgIL InLo LIe sIIILIng busIs Lo unIversILy ucLIvILy
over LIe IusL Lwo cenLurIes:
n LIe begInnIng, LIe AmerIcun coIIeges were LIed Lo LIe
ProLesLunL cIurcIes und were InLended IurgeIy Lo serve
reIIgIousIy bused vuIues. PsycIoIogy wus u IurgeIy
pIIIosopIIcuI und moruI enLerprIse, u IundmuIden Lo
reIIgIon. L proposed Lo ruIse moruI vIrLue.
By LIe mIddIe oI LIe 1qLI cenLury, Iowever, LIe
ucudemy begun Lo purL Irom LIe CIurcI. TIuL
Rampant Antismoking Signifies Grave Danger
quesLIon LIIs cuIL conducL ure IubeIed us crueI und uncurIng, IeuvIng LIose
uL rIsk Lo drIIL sureIy Lowurds prevenLubIe, deLrImenLuI ouLcomes. SucI
doubLers Iuve been dubbed LIe ubomInubIe no-men. (Skrubunek &
McCormIck, 1qqo, p.1o6) TIe Lrugedy oI sLuLIsLIcuI rIsk-uversIon In
purLIcuIur Is LIuL reInIorced (coddIed) IrruLIonuI Ieur wIII use progressIveIy
more IIImsy evIdence (exLremeIy poor predIcLIve IucLors oI quesLIonubIe
cuusuI or LrIgger sIgnIIIcunce) In un uLLempL Lo pre-empL (prevenL)
poLenLIuI neguLIve ouLcomes.
SuccessIve governmenLs In muny democruLIc socIeLIes Iuve
uIIowed LIeIr IeuILI depurLmenLs und LIeIr Ideu oI IeuILI Lo be overrun by
LIe superIIcIuIILy oI medIco-muLerIuIIsm und LIe Iuke scIence oI IIIesLyIe
epIdemIoIogy. n oLIer words, LIIs MMES cuIL Is SLuLe-munuIucLured und
suncLIoned. n LIe IoIIowIng cIupLer LIere wIII be consIdered LIe
devusLuLIng rumIIIcuLIons oI oLIer Iorms oI muLerIuIIsm LIuL Iuve worked
In conjuncLIon wILI medIco-muLerIuIIsm over LIIs LIme perIod.
I LIIs menLuIILy becume promInenL In nuLIons LIuL Iud u IIsLory
oI dIcLuLorsIIp or IuscIsm, LIIs wouId be one muLLer. However, IL Is
occurrIng In nuLIons LIuL ure supposedIy democruLIc. Under LIe guIse oI
suvIng IIves, Improved suIeLy, und cosL suvIngs, und urgued In
popuIuLIon-IeveI sLuLIsLIcuI Lerms, medIco-muLerIuIIsm In purLIcuIur Ius
munuged Lo erode democruLIc IdeuIs Lo wIere socIeLy Ius been coercedJ
engIneered InLo IuncLIonIng us un exLensIon oI LIe IospILuI or u pudded
ceII, I.e., medIco-muLerIuIIsL nuLIonuIIsmJIuscIsm. TIrougI LIe
IncompeLenL use oI sLuLIsLIcs und LIe superIIcIuIILy oI muLerIuIIsm, LIe
body Is beIng re-deIIned us LIe properLy oI LIe SLuLe.
449
449
g.
The Bigger Picture
L Ius been consIdered LIus Iur LIuL conLemporury IeuILI
promoLIon reIIecLs LIe convergence oI muLerIuIIsL superIIcIuIILy und
epIdemIoIogIc IncompeLence (I.e., scIence reduced Lo sLuLIsLIcuIIsm). TIe
cupucILy Ior LIIs conducL Lo IosLer IrruLIonuI beIIeI und nocebo eIIecLs, und
on u muss scuIe, Is exLruordInury. A quesLIon LIuL Ius uIreudy been posed
u number oI LImes In LIe IoregoIng concerns wIuL Ius become oI non-
reducLIonIsL psycIoIogy. L Is LIIs sorL oI dIscIpIIne LIuL Is In LIe besL
posILIon Lo keep IgnorunL muLerIuIIsL ussuuILs on menLuI IeuILI In cIeck.
TIe cuse exumpIe oI unLIsmokIng In, purLIcuIurIy, VIcLorIu, AusLruIIu, Ius
been used Lo IIgIIIgIL Iow muss deIusIon cun be IosLered over u sIorL
perIod oI LIme. n LIe IoIIowIng, LIe condILIon oI unIversILIes In AusLruIIu
wIII be consIdered und ILs sLrong ussocIuLIon wILI rumpunL unLIsmokIng.
AguIn, IL Is consIdered LIuL LIe cIrcumsLunce In AusLruIIu Is represenLuLIve
oI LIe sILuuLIon In muny wesLern nuLIons.
.: The Mctericlist Dominction Dj Unitersities &
Primcr,Secondcr Educction
.:.: riej cclround
n LIeIr eurIy yeurs, unIversILIesJcoIIeges were connecLedJ
sponsored by reIIgIous (LypIcuIIy CIrIsLIun) InsLILuLIons. Bukun (1q;q)
provIdes u very brIeI InsIgIL InLo LIe sIIILIng busIs Lo unIversILy ucLIvILy
over LIe IusL Lwo cenLurIes:
n LIe begInnIng, LIe AmerIcun coIIeges were LIed Lo LIe
ProLesLunL cIurcIes und were InLended IurgeIy Lo serve
reIIgIousIy bused vuIues. PsycIoIogy wus u IurgeIy
pIIIosopIIcuI und moruI enLerprIse, u IundmuIden Lo
reIIgIon. L proposed Lo ruIse moruI vIrLue.
By LIe mIddIe oI LIe 1qLI cenLury, Iowever, LIe
ucudemy begun Lo purL Irom LIe CIurcI. TIuL
Rampant Antismoking Signifies Grave Danger
quesLIon LIIs cuIL conducL ure IubeIed us crueI und uncurIng, IeuvIng LIose
uL rIsk Lo drIIL sureIy Lowurds prevenLubIe, deLrImenLuI ouLcomes. SucI
doubLers Iuve been dubbed LIe ubomInubIe no-men. (Skrubunek &
McCormIck, 1qqo, p.1o6) TIe Lrugedy oI sLuLIsLIcuI rIsk-uversIon In
purLIcuIur Is LIuL reInIorced (coddIed) IrruLIonuI Ieur wIII use progressIveIy
more IIImsy evIdence (exLremeIy poor predIcLIve IucLors oI quesLIonubIe
cuusuI or LrIgger sIgnIIIcunce) In un uLLempL Lo pre-empL (prevenL)
poLenLIuI neguLIve ouLcomes.
SuccessIve governmenLs In muny democruLIc socIeLIes Iuve
uIIowed LIeIr IeuILI depurLmenLs und LIeIr Ideu oI IeuILI Lo be overrun by
LIe superIIcIuIILy oI medIco-muLerIuIIsm und LIe Iuke scIence oI IIIesLyIe
epIdemIoIogy. n oLIer words, LIIs MMES cuIL Is SLuLe-munuIucLured und
suncLIoned. n LIe IoIIowIng cIupLer LIere wIII be consIdered LIe
devusLuLIng rumIIIcuLIons oI oLIer Iorms oI muLerIuIIsm LIuL Iuve worked
In conjuncLIon wILI medIco-muLerIuIIsm over LIIs LIme perIod.
I LIIs menLuIILy becume promInenL In nuLIons LIuL Iud u IIsLory
oI dIcLuLorsIIp or IuscIsm, LIIs wouId be one muLLer. However, IL Is
occurrIng In nuLIons LIuL ure supposedIy democruLIc. Under LIe guIse oI
suvIng IIves, Improved suIeLy, und cosL suvIngs, und urgued In
popuIuLIon-IeveI sLuLIsLIcuI Lerms, medIco-muLerIuIIsm In purLIcuIur Ius
munuged Lo erode democruLIc IdeuIs Lo wIere socIeLy Ius been coercedJ
engIneered InLo IuncLIonIng us un exLensIon oI LIe IospILuI or u pudded
ceII, I.e., medIco-muLerIuIIsL nuLIonuIIsmJIuscIsm. TIrougI LIe
IncompeLenL use oI sLuLIsLIcs und LIe superIIcIuIILy oI muLerIuIIsm, LIe
body Is beIng re-deIIned us LIe properLy oI LIe SLuLe.
450
450
Rampant Antismoking Signifies Grave Danger
sepuruLIon wus cIoseIy ussocIuLed wILI LIe growLI oI
nuLuruI scIence und LIe reIevunce oI nuLuruI scIence Lo
LIe ndusLrIuI RevoIuLIon. n 186z Congress pussed LIe
IIrsL MorrIII AcL Lo esLubIIsI Iund-grunL coIIeges, purLIy
us u response Lo LIe need Ior Increused ugrIcuILuruI
producLIvILy. GreuL IndusLrIuI IorLunes begun Lo supporL
new prIvuLe unIversILIes, becuuse busIness beneIILed
Irom scIenLIIIc reseurcI. TIe cIurcI coIIeges uIso mude
room Ior LIe nuLuruI scIences.
By LIe IuLe 18oos scIence Iud become u vocuLIon. UnLII
LIen, onIy genLIemen wILI resources und IeIsure couId
enguge In LIeIr scIenLIIIc InLeresLs..BuL LIen LIe
proIessIonuI scIenLIsL emerged - one wIo wus puId Lo
deveIop LIeorIes und run experImenLs. (p.1)
TIe perceIved roIe oI PsycIoIogy, Loo, sIIILed:
AguInsL LIIs buckdrop, psycIoIogy seurcIed Ior wuys Lo
esLubIIsI ILseII us u nuLuruI scIence In LIe IuLe 1qLI und
eurIy zoLI cenLurIes. TIe Germun IuboruLory modeI
uppeured Lo be LIe perIecL uILernuLIve Lo LIe AmerIcun
moruI-pIIIosopIIc modeI. Young AmerIcun sLudenLs
eugerIy seL ouL Ior Germuny Lo sLudy Germun
psycIoIogy und brIng IL Iome..
TIe nuLuruI-scIence Ideu IIourIsIed In LIe yeurs
beLween LIe greuL wurs. TIe beIuvIorIsLIc IeurnIng
psycIoIogy oI E.. TIorndIke und JoIn WuLson
prevuIIed, supporLed by u beIIeI LIuL LIe scIenLIIIc
meLIod In psycIoIogy wouId reIeuse unLoId
poLenLIuIILIes In mun. (p.1)
Bukun (1q;q) posILed LIuL In LIe eurIy-1q;o`s psycIoIogy sIouId
Luke udvunLuge oI scIence`s LIen unpopuIurILy und Iree ILseII Irom LIe
nuLuruI-scIence modeI LIuL IL Iud sLrongIy uIIgned ILseII Lo. n LIe 1q6o`s
und ;o`s, LIere were LIree domInunL LIemes In psycIoIogy - beIuvIorIsm,
psycIounuIysIs, exIsLenLIuI psycIoIogy. TIe IIrsL Lwo ure deLermInIsLIc In
Irumework; LIe LIIrd Is un uLLempL uL u more IumunIsLIc - us opposed Lo
roboLIcJmecIunIsLIc - Irumework. ExIsLenLIuI psycIoIogy Is permeuLed
wILI uspecLs oI LIe pIIIosopIy oI exIsLenLIuIIsm (nuLure oI exIsLence) und
LIe meLIod oI pIenomenoIogy (InLrospecLIve). TIere ure ucLuuIIy muny
vurIunLs oI exIsLenLIuI psycIoIogy wIIcI does noL represenL un exucL
worIdvIew. A deLuIIed consIderuLIon oI LIese vurIunLs Is beyond LIe scope
oI LIIs dIscussIon. However, u useIuI uccounL cun be Iound In GruIum
The Bigger Picture
(1q86).
One IundumenLuI uspecL oI exIsLenLIuI psycIoIogy Is LIuL LIe
IndIvIduuI Is Iree und seII-deLermInIng; LIere Is u crILIcuI dIIIerence
beLween Iumuns und unImuIs. AnoLIer LIeme Is LIuL, uILIougI LIere ure
LIeIsLIc (usuuIIy uIIgned Lo eusLern reIIgIons) und uLIeIsLIc vurIunLs, und
uILIougI LIere Is no reuson IL cunnoL be uIIgned Lo CIrIsLIunILy, exIsLenLIuI
psycIoIogy Ius LypIcuIIy been unLI-CIrIsLIun In dIsposILIon.
A mujor LIeme In LIIs dIscussIon Is LIuL muLerIuIIsm wIII
evenLuuIIy domInuLe wIere u coIerenL moruI Irumework sucI us
CIrIsLIunILy Is jeLLIsoned. AILIougI exIsLenLIuIIsm und exIsLenLIuI
psycIoIogy Iuve promIsed uII munner oI Ireedoms, IL LypIcuIIy onIy
IeIps In producIng moruI IeebIeness und In-rouds Ior muLerIuIIsm.
nLeresLIngIy, MurLIn HeIdegger, consIdered us LIe IuLIer oI conLemporury
exIsLenLIuIIsm (LIe busIs oI exIsLenLIuI psycIoIogy), joIned LIe NuzI PurLy,
und Ior wIIcI Ie never IormuIIy upoIogIzed.
ConLrury Lo Bukun`s und oLIers` recommenduLIons, LIe 1q;o`s
becume u renewed sprIngbourd Ior muLerIuIIsm, generuIIy, IncIudIng
muLerIuIIsL psycIoIogy (I.e., muLerIuIIsL munIIesLo). As wIII be
consIdered, by LIe Lurn oI LIe new mIIIennIum, muLerIuIIsm, LIrougI
scIenLIsm und IeuILIIsm, uLLerIy domInuLes ucudemIu, governmenL IeuILI
depurLmenLs, LIe medIu, und LIe pubIIc conscIousness.
.:.z Austrclic
Over LIe IusL IuII-cenLury, unIversILIes Iuve Iud LIeIr IuIr sIure
oI LrIuIs und LrIbuIuLIons. However, unIIke AmerIcun und Europeun
unIversILIes, LIose In AusLruIIu were reusonubIy weII-InsuIuLed Irom vesLed
InLeresL. AcudemIcs couId enguge In reseurcI wILI some sembIunce oI
Ireedom Irom purLIcuIurIy murkeL Iorces. AIso crILIcuI Is LIuL socIeLy uL
IeusL Iud un ImpIIcIL undersLundIng LIuL u consIderubIe umounL oI
scIoIurIy ucLIvILy sIouId be kepL dIsLIncL Irom LIe Iree-murkeL Irumework.
TIere ure some muLLers, especIuIIy spIrILuuI und moruI, us consIdered und
reusoned In LIe ucudemIc conLexL und wILI greuLer socIuI rumIIIcuLIons,
LIuL ure sucrosuncL; LIere ure purLIcuIur moruI vuIues LIuL socIeLy
consIders non-negoLIubIe Lo muLerIuIIsL InIecLIon.
PurLIcuIur subjecL-muLLer, us In muLerIuIIsL concerns, Iends ILseII
Lo IIneur, urILImeLIc reusonIng. OLIer subjecL-muLLer, sucI us
psycIoIogy, pIIIosopIy, LIeoIogy, concern LIe nuLure oI LIe person,
exIsLence und meunIngIuIness. SLudenLs were uL one LIme encouruged Lo
use LIeIr unIversILy LIme Lo expIore some oI LIe deeper Issues oI exIsLence.
MuILI-dImensIonuI InLeresLs were encouruged, even sIde-venLures InLo
pIIIosopIy und LIeoIogy, In deveIopIng u weII-rounded, moruI cIurucLer
451
451
Rampant Antismoking Signifies Grave Danger
sepuruLIon wus cIoseIy ussocIuLed wILI LIe growLI oI
nuLuruI scIence und LIe reIevunce oI nuLuruI scIence Lo
LIe ndusLrIuI RevoIuLIon. n 186z Congress pussed LIe
IIrsL MorrIII AcL Lo esLubIIsI Iund-grunL coIIeges, purLIy
us u response Lo LIe need Ior Increused ugrIcuILuruI
producLIvILy. GreuL IndusLrIuI IorLunes begun Lo supporL
new prIvuLe unIversILIes, becuuse busIness beneIILed
Irom scIenLIIIc reseurcI. TIe cIurcI coIIeges uIso mude
room Ior LIe nuLuruI scIences.
By LIe IuLe 18oos scIence Iud become u vocuLIon. UnLII
LIen, onIy genLIemen wILI resources und IeIsure couId
enguge In LIeIr scIenLIIIc InLeresLs..BuL LIen LIe
proIessIonuI scIenLIsL emerged - one wIo wus puId Lo
deveIop LIeorIes und run experImenLs. (p.1)
TIe perceIved roIe oI PsycIoIogy, Loo, sIIILed:
AguInsL LIIs buckdrop, psycIoIogy seurcIed Ior wuys Lo
esLubIIsI ILseII us u nuLuruI scIence In LIe IuLe 1qLI und
eurIy zoLI cenLurIes. TIe Germun IuboruLory modeI
uppeured Lo be LIe perIecL uILernuLIve Lo LIe AmerIcun
moruI-pIIIosopIIc modeI. Young AmerIcun sLudenLs
eugerIy seL ouL Ior Germuny Lo sLudy Germun
psycIoIogy und brIng IL Iome..
TIe nuLuruI-scIence Ideu IIourIsIed In LIe yeurs
beLween LIe greuL wurs. TIe beIuvIorIsLIc IeurnIng
psycIoIogy oI E.. TIorndIke und JoIn WuLson
prevuIIed, supporLed by u beIIeI LIuL LIe scIenLIIIc
meLIod In psycIoIogy wouId reIeuse unLoId
poLenLIuIILIes In mun. (p.1)
Bukun (1q;q) posILed LIuL In LIe eurIy-1q;o`s psycIoIogy sIouId
Luke udvunLuge oI scIence`s LIen unpopuIurILy und Iree ILseII Irom LIe
nuLuruI-scIence modeI LIuL IL Iud sLrongIy uIIgned ILseII Lo. n LIe 1q6o`s
und ;o`s, LIere were LIree domInunL LIemes In psycIoIogy - beIuvIorIsm,
psycIounuIysIs, exIsLenLIuI psycIoIogy. TIe IIrsL Lwo ure deLermInIsLIc In
Irumework; LIe LIIrd Is un uLLempL uL u more IumunIsLIc - us opposed Lo
roboLIcJmecIunIsLIc - Irumework. ExIsLenLIuI psycIoIogy Is permeuLed
wILI uspecLs oI LIe pIIIosopIy oI exIsLenLIuIIsm (nuLure oI exIsLence) und
LIe meLIod oI pIenomenoIogy (InLrospecLIve). TIere ure ucLuuIIy muny
vurIunLs oI exIsLenLIuI psycIoIogy wIIcI does noL represenL un exucL
worIdvIew. A deLuIIed consIderuLIon oI LIese vurIunLs Is beyond LIe scope
oI LIIs dIscussIon. However, u useIuI uccounL cun be Iound In GruIum
The Bigger Picture
(1q86).
One IundumenLuI uspecL oI exIsLenLIuI psycIoIogy Is LIuL LIe
IndIvIduuI Is Iree und seII-deLermInIng; LIere Is u crILIcuI dIIIerence
beLween Iumuns und unImuIs. AnoLIer LIeme Is LIuL, uILIougI LIere ure
LIeIsLIc (usuuIIy uIIgned Lo eusLern reIIgIons) und uLIeIsLIc vurIunLs, und
uILIougI LIere Is no reuson IL cunnoL be uIIgned Lo CIrIsLIunILy, exIsLenLIuI
psycIoIogy Ius LypIcuIIy been unLI-CIrIsLIun In dIsposILIon.
A mujor LIeme In LIIs dIscussIon Is LIuL muLerIuIIsm wIII
evenLuuIIy domInuLe wIere u coIerenL moruI Irumework sucI us
CIrIsLIunILy Is jeLLIsoned. AILIougI exIsLenLIuIIsm und exIsLenLIuI
psycIoIogy Iuve promIsed uII munner oI Ireedoms, IL LypIcuIIy onIy
IeIps In producIng moruI IeebIeness und In-rouds Ior muLerIuIIsm.
nLeresLIngIy, MurLIn HeIdegger, consIdered us LIe IuLIer oI conLemporury
exIsLenLIuIIsm (LIe busIs oI exIsLenLIuI psycIoIogy), joIned LIe NuzI PurLy,
und Ior wIIcI Ie never IormuIIy upoIogIzed.
ConLrury Lo Bukun`s und oLIers` recommenduLIons, LIe 1q;o`s
becume u renewed sprIngbourd Ior muLerIuIIsm, generuIIy, IncIudIng
muLerIuIIsL psycIoIogy (I.e., muLerIuIIsL munIIesLo). As wIII be
consIdered, by LIe Lurn oI LIe new mIIIennIum, muLerIuIIsm, LIrougI
scIenLIsm und IeuILIIsm, uLLerIy domInuLes ucudemIu, governmenL IeuILI
depurLmenLs, LIe medIu, und LIe pubIIc conscIousness.
.:.z Austrclic
Over LIe IusL IuII-cenLury, unIversILIes Iuve Iud LIeIr IuIr sIure
oI LrIuIs und LrIbuIuLIons. However, unIIke AmerIcun und Europeun
unIversILIes, LIose In AusLruIIu were reusonubIy weII-InsuIuLed Irom vesLed
InLeresL. AcudemIcs couId enguge In reseurcI wILI some sembIunce oI
Ireedom Irom purLIcuIurIy murkeL Iorces. AIso crILIcuI Is LIuL socIeLy uL
IeusL Iud un ImpIIcIL undersLundIng LIuL u consIderubIe umounL oI
scIoIurIy ucLIvILy sIouId be kepL dIsLIncL Irom LIe Iree-murkeL Irumework.
TIere ure some muLLers, especIuIIy spIrILuuI und moruI, us consIdered und
reusoned In LIe ucudemIc conLexL und wILI greuLer socIuI rumIIIcuLIons,
LIuL ure sucrosuncL; LIere ure purLIcuIur moruI vuIues LIuL socIeLy
consIders non-negoLIubIe Lo muLerIuIIsL InIecLIon.
PurLIcuIur subjecL-muLLer, us In muLerIuIIsL concerns, Iends ILseII
Lo IIneur, urILImeLIc reusonIng. OLIer subjecL-muLLer, sucI us
psycIoIogy, pIIIosopIy, LIeoIogy, concern LIe nuLure oI LIe person,
exIsLence und meunIngIuIness. SLudenLs were uL one LIme encouruged Lo
use LIeIr unIversILy LIme Lo expIore some oI LIe deeper Issues oI exIsLence.
MuILI-dImensIonuI InLeresLs were encouruged, even sIde-venLures InLo
pIIIosopIy und LIeoIogy, In deveIopIng u weII-rounded, moruI cIurucLer
452
452
Rampant Antismoking Signifies Grave Danger
LIuL wouId be oI servIce In wIuLever cureer u person uILImuLeIy Iound
LIemseIves. n LIuL LIe unIversILy-LruIned wouId probubIy serve In
IeudersIIp roIes, LIe cupucILy Ior ecIecLIc reusonIng wus IosLered. TIe
occusIonuI generuI LIInker, ubIe Lo compeLenLIy negoLIuLe muILIpIe
dImensIons, wus worLI LIe LruInIng und eIIorL. McCuImun (zoozb)
IndIcuLes LIuL, uILIougI LIere Ius been u IIsLory oI LIe eIILe domInuLIng
LIe unIversILy Irumework, LIeIr snobbIsIness wus mILIguLed by reIIgIon -
u cuILure oI servIce, moruI serIousness und non-muLerIuIIsm.
TIe unIversILy uLmospIere und communILy IIIe wus sucI LIuL
even persons sLudyIng commerce mIgIL rub sIouIders wILI u LIeoIogy
sLudenL. ConversuLIons In socIuI seLLIngs couId become In-depLI, goIng
Iur beyond LIe ImmedIuLe vocuLIonuI InLeresLs oI eILIer purLy. I sucI
excIunges dId noL occur, sLudenLs were uL IeusL IumIIIur wILI oLIer
dIscIpIInes. SImpIy beIng uwure oI u greuLer conLexL properIy Lempers
muLerIuIIsL LendencIes.
TIIs unIversILy uLmospIere cIunged very drumuLIcuIIy In LIe IuLe
1q8o`s, und Is jusL unoLIer cuImInuLIon poInL oI LIe muLerIuIIsL munIIesLo.
AL LIIs LIme cIunges In governmenLuI IundIng requIred InsLILuLIons oI
IIgIer IeurnIng Lo secure purL oI LIeIr IundIng Irom exLernuI sources.
Some Iormer InsLILuLes oI LecInoIogy renumed LIemseIves us
unIversILIes In order Lo muInLuIn purLIcuIur IeveIs oI governmenL
IundIng. OLIer orgunIzuLIons, sucI us LeucIIng coIIeges, Iud Lo
umuIgumuLe wILI oLIer InsLILuLIons In order Ior purLIcuIur servIces Lo
survIve. UnIorLunuLeIy, LIese sIIILs bIurred IeveIs oI sLundurd. TIe mosL
devusLuLIng uspecL oI LIIs move wus LIe reducIng oI scIoIurIy ucLIvILy Lo
generuI murkeLpIuce ruIes. UnIversILIes und depurLmenLs Iud Lo begIn
murkeLIng LIeIr servIces Ior suIe In LIe need Lo uLLrucL IuII-Iee-puyIng
sLudenLs.
An IncreusIng sLreum oI new, IuII-Iee-puyIng sLudenLs Ius come
Irom AsIun counLrIes. TIeIr InLeresLs ure essenLIuIIy In muLerIuIIsL
subjecLs, e.g., medIcuI scIences, bIo-LecInoIogy, InIormuLIon LecInoIogy,
commerce. AusLruIIu, Loo, Ius become progressIveIy more muLerIuIIsLIc
sInce LIe mId-1q;o`s. ocuI sLudenLs uIso IIock uround muLerIuIIsL
subjecLs, und wIere LIe prevuIIIng moLIvuLIon Ior sLudy Is LIe poLenLIuI
Income LIuL u unIversILy degree mIgIL promoLe. WILIIn LIIs muLerIuIIsL
conLexL, unIversILIes Iuve been munuIucLured InLo gIorIIIed InsLILuLes oI
LecInoIogy.
McCuImun (zoozb) noLes LIuL |s|Ince LIe 1q8o`s, LIIs |u cuILure
oI servIce, moruI serIousness und non-muLerIuIIsm| Ius been suppIunLed
by LIe cuIL oI personuI success; you go Lo u good scIooI In Iope oI u
rurIIIed ENTER |unIversILy enLrunce score|, und Luke u doubIe
proIessIonuI degree LIuL wIII open doors Lo bIg money. You cun be
The Bigger Picture
wIuLever you wunL Lo be, II you wunL IL Iurd enougI und know Iow Lo
neLwork. eurnIng Is drIven by exLrInsIc rewurds ruLIer LIun InLrInsIc
suLIsIucLIons, umbILIon ruLIer LIun curIosILy.
Ike LIe IrugmenLed (specIuIIzuLIon, sub-specIuIIzuLIon) mess
IIgIIIgILed wILIIn LIe medIcuI esLubIIsImenL, unIversILIes ure uIso
domInuLed by muLerIuIIsL dIscIpIInes und IrugmenLuLIon wILIIn LIese.
Gone Is LIe Ideu oI u generuI, weII-rounded, cIurucLer-buIIdIng educuLIon.
SLudenLs ure encouruged Irom LIe ouLseL Lo specIuIIze In dIscIpIInes LIuL
ure LIemseIves noL represenLuLIve oI LIe scope oI LIe Iumun condILIon.
TIe resuIL Is LIuL LIe buIk oI gruduuLes Iuve IIgI IumIIIurILy wILI u
muLerIuIIsL specIuIIzuLIon, buL Iuve IILLIe concepL oI uny greuLer, muILI-
dImensIonuI conLexL, I.e., unbuIunced perspecLIve.
Muny subjecLsJcourses Iuve come under muLerIuIIsL scruLIny Ior
LIeIr producLIve poLenLIuI. TIe underIyIng economIc ruLIonuIIsm, one
uspecL oI muLerIuIIsm, proposes LIuL, Lo jusLIIy LIeIr exIsLence, unIversILy
courses sIouId eILIer produce Income or conLrIbuLe Lo suvIng on cosLs. n
LIIs sLep Is scIoIursIIp reduced Lo quunLIIIcuLIon und commercIuI-
IzuLIon, devoId oI uny subsLunLIve, proIound dImensIon. OnIy one crILIcuI
probIem oI economIc ruLIonuIIsm Is LIuL, In order Lo uLLrucL IundIng by
demonsLruLIng poLenLIuI Lo produce Income or reduce cosLs, reseurcI
IIndIngs ure over-InLerpreLed.
L Is noL surprIsIng LIuL In LIIs muLerIuIIsL uLmospIere IL Is
muLerIuIIsL-dIsposed courses LIuL LIrIve; courses LIuL do noL uLLrucL
murkeL demund ure In dunger oI excIsIon. As wIII be urgued, IL Is
purLIcuIurIy dIscIpIInes LIuL cun be uIIgned Lo u IIrsL-prIncIpIes, spIrILuuIJ
moruI Irumework, e.g., psycIoIogy, pIIIosopIy, LIeoIogy, und LIuL cun
pose u LIreuL Lo u domIneerIng muLerIuIIsm, LIuL ure under u cIoud oI
possIbIe exLIncLIon. n LIe currenL murkeL-drIven uLmospIere, sucI
sLudIes ure consIdered pusse, muLerIuIIy useIess. L does noL duwn on LIe
superIIcIuIILy oI LIe muLerIuIIsL menLuIILy LIuL sucI subjecLs were never
InLended Lo produce Income, per se, buL ure crucIuI In promoLIng u
depLI und buIunce oI perspecLIve; by deIInILIon, muLerIuIIsm Is un
unbuIunced perspecLIve.
Under LIe Iure oI muLerIuIIsL rIcIes, IL Is psycIoIogIcuI,
reIuLIonuI, moruI, und spIrILuuI IuncLIonIng LIuL suIIers. McCuImun
(zoozb) IIgIIIgILs LIuL |unIversILy| youLI Is consumed by workIng uL
cusuuI jobs In burs, gumIng rooms, resLuurunLs, IucLorIes, sIops -
unyLIIng Lo eurn money. n cIuss muny ure LIred, resenLIuI oI Ieuvy
workIouds, uIwuys juggIIng LIme. TIeIr mInds ure onIy IuII on-LIe-
job..und LIuL un uIurmIng number oI LIem ure dIsconnecLed Irom LIe
unIversILy us u communILy oI IeurnIng. RIckurds (zooz) InIorms LIuL, In u
speecI Lo LIe AssocIuLIon oI nLernuLIonuI UnIversILy PresIdenLs In mId-
453
453
Rampant Antismoking Signifies Grave Danger
LIuL wouId be oI servIce In wIuLever cureer u person uILImuLeIy Iound
LIemseIves. n LIuL LIe unIversILy-LruIned wouId probubIy serve In
IeudersIIp roIes, LIe cupucILy Ior ecIecLIc reusonIng wus IosLered. TIe
occusIonuI generuI LIInker, ubIe Lo compeLenLIy negoLIuLe muILIpIe
dImensIons, wus worLI LIe LruInIng und eIIorL. McCuImun (zoozb)
IndIcuLes LIuL, uILIougI LIere Ius been u IIsLory oI LIe eIILe domInuLIng
LIe unIversILy Irumework, LIeIr snobbIsIness wus mILIguLed by reIIgIon -
u cuILure oI servIce, moruI serIousness und non-muLerIuIIsm.
TIe unIversILy uLmospIere und communILy IIIe wus sucI LIuL
even persons sLudyIng commerce mIgIL rub sIouIders wILI u LIeoIogy
sLudenL. ConversuLIons In socIuI seLLIngs couId become In-depLI, goIng
Iur beyond LIe ImmedIuLe vocuLIonuI InLeresLs oI eILIer purLy. I sucI
excIunges dId noL occur, sLudenLs were uL IeusL IumIIIur wILI oLIer
dIscIpIInes. SImpIy beIng uwure oI u greuLer conLexL properIy Lempers
muLerIuIIsL LendencIes.
TIIs unIversILy uLmospIere cIunged very drumuLIcuIIy In LIe IuLe
1q8o`s, und Is jusL unoLIer cuImInuLIon poInL oI LIe muLerIuIIsL munIIesLo.
AL LIIs LIme cIunges In governmenLuI IundIng requIred InsLILuLIons oI
IIgIer IeurnIng Lo secure purL oI LIeIr IundIng Irom exLernuI sources.
Some Iormer InsLILuLes oI LecInoIogy renumed LIemseIves us
unIversILIes In order Lo muInLuIn purLIcuIur IeveIs oI governmenL
IundIng. OLIer orgunIzuLIons, sucI us LeucIIng coIIeges, Iud Lo
umuIgumuLe wILI oLIer InsLILuLIons In order Ior purLIcuIur servIces Lo
survIve. UnIorLunuLeIy, LIese sIIILs bIurred IeveIs oI sLundurd. TIe mosL
devusLuLIng uspecL oI LIIs move wus LIe reducIng oI scIoIurIy ucLIvILy Lo
generuI murkeLpIuce ruIes. UnIversILIes und depurLmenLs Iud Lo begIn
murkeLIng LIeIr servIces Ior suIe In LIe need Lo uLLrucL IuII-Iee-puyIng
sLudenLs.
An IncreusIng sLreum oI new, IuII-Iee-puyIng sLudenLs Ius come
Irom AsIun counLrIes. TIeIr InLeresLs ure essenLIuIIy In muLerIuIIsL
subjecLs, e.g., medIcuI scIences, bIo-LecInoIogy, InIormuLIon LecInoIogy,
commerce. AusLruIIu, Loo, Ius become progressIveIy more muLerIuIIsLIc
sInce LIe mId-1q;o`s. ocuI sLudenLs uIso IIock uround muLerIuIIsL
subjecLs, und wIere LIe prevuIIIng moLIvuLIon Ior sLudy Is LIe poLenLIuI
Income LIuL u unIversILy degree mIgIL promoLe. WILIIn LIIs muLerIuIIsL
conLexL, unIversILIes Iuve been munuIucLured InLo gIorIIIed InsLILuLes oI
LecInoIogy.
McCuImun (zoozb) noLes LIuL |s|Ince LIe 1q8o`s, LIIs |u cuILure
oI servIce, moruI serIousness und non-muLerIuIIsm| Ius been suppIunLed
by LIe cuIL oI personuI success; you go Lo u good scIooI In Iope oI u
rurIIIed ENTER |unIversILy enLrunce score|, und Luke u doubIe
proIessIonuI degree LIuL wIII open doors Lo bIg money. You cun be
The Bigger Picture
wIuLever you wunL Lo be, II you wunL IL Iurd enougI und know Iow Lo
neLwork. eurnIng Is drIven by exLrInsIc rewurds ruLIer LIun InLrInsIc
suLIsIucLIons, umbILIon ruLIer LIun curIosILy.
Ike LIe IrugmenLed (specIuIIzuLIon, sub-specIuIIzuLIon) mess
IIgIIIgILed wILIIn LIe medIcuI esLubIIsImenL, unIversILIes ure uIso
domInuLed by muLerIuIIsL dIscIpIInes und IrugmenLuLIon wILIIn LIese.
Gone Is LIe Ideu oI u generuI, weII-rounded, cIurucLer-buIIdIng educuLIon.
SLudenLs ure encouruged Irom LIe ouLseL Lo specIuIIze In dIscIpIInes LIuL
ure LIemseIves noL represenLuLIve oI LIe scope oI LIe Iumun condILIon.
TIe resuIL Is LIuL LIe buIk oI gruduuLes Iuve IIgI IumIIIurILy wILI u
muLerIuIIsL specIuIIzuLIon, buL Iuve IILLIe concepL oI uny greuLer, muILI-
dImensIonuI conLexL, I.e., unbuIunced perspecLIve.
Muny subjecLsJcourses Iuve come under muLerIuIIsL scruLIny Ior
LIeIr producLIve poLenLIuI. TIe underIyIng economIc ruLIonuIIsm, one
uspecL oI muLerIuIIsm, proposes LIuL, Lo jusLIIy LIeIr exIsLence, unIversILy
courses sIouId eILIer produce Income or conLrIbuLe Lo suvIng on cosLs. n
LIIs sLep Is scIoIursIIp reduced Lo quunLIIIcuLIon und commercIuI-
IzuLIon, devoId oI uny subsLunLIve, proIound dImensIon. OnIy one crILIcuI
probIem oI economIc ruLIonuIIsm Is LIuL, In order Lo uLLrucL IundIng by
demonsLruLIng poLenLIuI Lo produce Income or reduce cosLs, reseurcI
IIndIngs ure over-InLerpreLed.
L Is noL surprIsIng LIuL In LIIs muLerIuIIsL uLmospIere IL Is
muLerIuIIsL-dIsposed courses LIuL LIrIve; courses LIuL do noL uLLrucL
murkeL demund ure In dunger oI excIsIon. As wIII be urgued, IL Is
purLIcuIurIy dIscIpIInes LIuL cun be uIIgned Lo u IIrsL-prIncIpIes, spIrILuuIJ
moruI Irumework, e.g., psycIoIogy, pIIIosopIy, LIeoIogy, und LIuL cun
pose u LIreuL Lo u domIneerIng muLerIuIIsm, LIuL ure under u cIoud oI
possIbIe exLIncLIon. n LIe currenL murkeL-drIven uLmospIere, sucI
sLudIes ure consIdered pusse, muLerIuIIy useIess. L does noL duwn on LIe
superIIcIuIILy oI LIe muLerIuIIsL menLuIILy LIuL sucI subjecLs were never
InLended Lo produce Income, per se, buL ure crucIuI In promoLIng u
depLI und buIunce oI perspecLIve; by deIInILIon, muLerIuIIsm Is un
unbuIunced perspecLIve.
Under LIe Iure oI muLerIuIIsL rIcIes, IL Is psycIoIogIcuI,
reIuLIonuI, moruI, und spIrILuuI IuncLIonIng LIuL suIIers. McCuImun
(zoozb) IIgIIIgILs LIuL |unIversILy| youLI Is consumed by workIng uL
cusuuI jobs In burs, gumIng rooms, resLuurunLs, IucLorIes, sIops -
unyLIIng Lo eurn money. n cIuss muny ure LIred, resenLIuI oI Ieuvy
workIouds, uIwuys juggIIng LIme. TIeIr mInds ure onIy IuII on-LIe-
job..und LIuL un uIurmIng number oI LIem ure dIsconnecLed Irom LIe
unIversILy us u communILy oI IeurnIng. RIckurds (zooz) InIorms LIuL, In u
speecI Lo LIe AssocIuLIon oI nLernuLIonuI UnIversILy PresIdenLs In mId-
454
454
Rampant Antismoking Signifies Grave Danger
zooz, IL wus suggesLed LIuL sLudenLs were Iess InLeresLed In unIversILy
IIIe, uLLucIIng more ImporLunce Lo IInuncIuI comIorL LIun ucquIrIng u
meunIngIuI pIIIosopIy oI IIIe. TIe resuILs were Iess LIme Ior cIusses und
'perennIuIIy IuLe` essuys. |Our unIversILIes| Iuve Lo IIgIL uguInsL u
conspIrucy wILI Loduy`s sLudenLs, under economIc pressure Lo muke LIe
unIversILy experIence undemundIng. RIckurds (zooz) noLes LIuL |u|
nIversILy wus once seen us LIe pIuce Lo Iorge LIe IrIendsIIps oI u IIIeLIme.
Toduy`s sLudenLs, juggIIng sLudIes und work, ure Iucky Lo know LIeIr
cIussmuLes` numes.
TIere Is u sLrong suggesLIon LIuL IncreusIng sLudenLJLeucIer
ruLIos, LIe IncreusIng ruLIo oI overseus sLudenLs (some wILI poor EngIIsI
skIIIs), und corporuLe IundIng Is deLrImenLuIIy uIIecLIng ucudemIc
sLundurds: ProIessor PummenL suys LIuL crowded cIussrooms gIve rIse Lo
yeL unoLIer probIem: ucudemIcs IeeIIng LIe pressure Lo ruIse puss ruLes Ior
sLudenLs ucross LIe bourd. ' LIInk subIImInuIIy LIougI LIere`s been u
Lendency - wILIouL beIng LoId Lo do so - Lo Iower sLundurds oI
exumInuLIons over LIe yeur sImpIy Lo cope wILI LIe IucL LIuL LIe number
oI sLudenLs uIIowed InLo LIe unIversILy Iuve gone up so enormousIy`, Ie
suys. (The Ae, ebruury zq, zoo1, p.1o) An AusLruIIu nsLILuLe sLudy LIuL
surveyed 16 ucudemIcs Iound LIuL: uImosL IuII LIe respondenLs Lo LIe
survey suId LIey were reIucLunL Lo crILIcIse bodIes LIuL provIded reseurcI
grunLs. orLy-one percenL suId LIey IeIL dIscomIorL wILI pubIIsIIng
conLenLIous resuILs; qz per cenL were concerned ubouL ucudemIc Ireedom;
; per cenL LIougIL IL wus deLerIoruLIng. (The Ae, MurcI 1;, zoo1, p.1q)
TIe sLudy uIso Iound LIuL reseurcI projecLs were bIused Lowurds LIose
wILI un economIc beneIIL und |u|ImosL uII |respondenLs| Iud experIenced
un empIusIs on Iunded over unIunded reseurcI, und u vuIuIng oI courses
LIuL uLLrucL IIgI sLudenL enroImenLs und IuII-Iee-puyIng sLudenLs over
oLIer courses. (Hercld,Sun, MurcI 1;, zoo1, p.1q) A very sLrong LIeme Is
LIuL unIversILIes ure beIng run by uccounLunLs ruLIer LIun IeIIow
ucudemIcs (The Ae, Junuury zo, zoo1, p.).
n conLrusL Lo ILs eurIIesL uIIgnmenL wILI u spIrILuuIJmoruI
Irumework (I.e., CIrIsLIunILy), PsycIoIogy In wesLern nuLIons, generuIIy,
Ius uLLempLed Lo dIvesL ILseII oI LIIs roIe over LIe IusL cenLury. PurLIcuIurIy
over LIe IusL LIree decudes (muLerIuIIsL munIIesLo), LIe dIscIpIIne Ius
essenLIuIIy been uIIgned wILI medIco-muLerIuIIsm. PsycIoIogy depurL-
menLs ure LypIcuIIy IIsLed under scIooIs oI beIuvIoruI scIence; LIe Lerm
scIence In scIooI LILIes Lends Lo IegILImIze u scIooI`s exIsLence wILIIn u
domInunL muLerIuIIsL Irumework. A perusuI oI PsycIoIogy courses reveuIs
LIuL mosL, II noL uII, subjecL-muLLer Is muLerIuIIsL In dIsposILIon. TIere ure
now sucI subjecLs us IeuILI psycIoIogy, beIuvIoruI medIcIne,
psycIoIogIcuI medIcIne, envIronmenLuI psycIoIogy, exercIse
The Bigger Picture
psycIoIogy.
n one unIversILy, LIe psycIoIogy depurLmenL Is wILIIn LIe
ScIooI oI BeIuvIoruI ScIence, wIIcI, In Lurn, Is under LIe uuspIces oI LIe
ucuILy oI MedIcIne, DenLIsLry & HeuILI ScIences. n unoLIer, LIe
depurLmenL oI psycIoIogy Is wILIIn LIe ScIooI oI PsycIoIogy, PsycIIuLry &
PsycIoIogIcuI MedIcIne, wIIcI, In Lurn, Is under LIe uuspIces oI LIe
ucuILy oI MedIcIne. One psycIoIogy depurLmenL Ius LIe psI (Greek-
symboI ubbrevIuLIon Ior psycIoIogy) crossed wILI u snuke - seemIngIy
unuIogous Lo LIe InLerLwInIng snukesJserpenLs on u sLuII LIuL LypIcuIIy
denoLes LIe medIcuI proIessIon. n LIese cuses psycIoIogy Ius been
swuIIowed up by medIcuI IucuILIes. AL LIIs LIme, unIversILIes Iuck u muILI-
dImensIonuI buIunce, I.e., muLerIuIIsL domInuLIon. And, wILIIn LIIs
muLerIuIIsm, medIco-muLerIuIIsm Is IIgIIy domInunL. n u Lurn-oI-LIe-
mIIIennIum speecI LIe AusLruIIun PrIme MInIsLer decIured LIuL medIcuI
scIence wIII Ieud LIe wuy In LIe new mIIIennIum. TIIs Is ucLuuIIy noL un
InspIrIng prospecL.
TIere Is, LIereIore, LIe sILuuLIon LIuL u dIscIpIIne (psycIoIogy)
LIuL cun brIng LIe ussumpLIons, sLuLIsLIcuI und cuusuI, oI IeuILIIsm InLo
IegILImuLe quesLIon, und LIuL cun IIgIIIgIL LIe poLenLIuI neguLIve
rumIIIcuLIons (e.g., nocebo eIIecLs) oI sLuLIsLIcuIIsL IeuILI promoLIon, Is noL
onIy noL doIng so, buL Is InsLrumenLuI In propuguLIng LIe probIems In
quesLIon (I.e., supporL roIe).
MuLerIuIIsL psycIoIogy jusLIIIes ILs exIsLence In LIe murkeLpIuce
LIrougI supposedIy uIdIng In reducIng IeuILI cosLs, I.e., LIrougI
prevenLIve medIcIne, IeuILI promoLIon. TIe poLenLIuI scruLInIzer oI
medIcuI mIsconducL Ius been ubsorbed by LIe medIcuI esLubIIsImenL.
TIIs Is un exLruordInury sLuLe oI uIIuIrs; LIere Is un enLIre und crILIcuI
dIscIpIIne oI enquIry LIuL Ius been obIILeruLed. UnIorLunuLeIy, LIIs Iud Lo
occur II psycIoIogy wus Lo survIve LIe murkeL-drIven seLLIng. TIIs
cerLuInIy expIuIns wIy unLIsmokIng und oLIer IeuILIIsL prescrIpLIons,
repIeLe wILI uII munner oI IncoIerenL reusonIng und wILI u greuL cupucILy
Lo IosLer nocebo eIIecLs, dungerous psycIoIogIcuI LendencIes (superIorILy
syndrome), und socIuI dIvIsIon, Ius IIourIsIed ruLIer LIun beIng cuIIed
InLo quesLIon. TIe AusLruIIun unIversILIes menLIoned ubove ure LIe mujor
VIcLorIun unIversILIes. TIIs IucLor cerLuInIy IeIps Lo expIuIn wIy VIcLorIu,
AusLruIIu, Ius become LIe unLIsmokIng cupILuI oI LIe worId. or uII InLenLs
und purposes, In ucudemIu, u non-reducLIonIsL psycIoIogy dIscIpIIne Is
non-exIsLenL. AII munner oI psycIoIogIcuIIy und reIuLIonuIIy IncompeLenL
und InIIummuLory IeuILI promoLIon, unLIsmokIng IIgurIng IIgIIy, Ius
noL onIy been uIIowed Lo proceed uncIecked, buL Ius been reInIorced by
beIuvIorIsm. L uIso IeIps Lo expIuIn LIe dIIIIcuILy LIuL LIe Iew
dIssenLers LIuL LIere ure Iuve Iud In quesLIonIng LIe orLIodox vIew
455
455
Rampant Antismoking Signifies Grave Danger
zooz, IL wus suggesLed LIuL sLudenLs were Iess InLeresLed In unIversILy
IIIe, uLLucIIng more ImporLunce Lo IInuncIuI comIorL LIun ucquIrIng u
meunIngIuI pIIIosopIy oI IIIe. TIe resuILs were Iess LIme Ior cIusses und
'perennIuIIy IuLe` essuys. |Our unIversILIes| Iuve Lo IIgIL uguInsL u
conspIrucy wILI Loduy`s sLudenLs, under economIc pressure Lo muke LIe
unIversILy experIence undemundIng. RIckurds (zooz) noLes LIuL |u|
nIversILy wus once seen us LIe pIuce Lo Iorge LIe IrIendsIIps oI u IIIeLIme.
Toduy`s sLudenLs, juggIIng sLudIes und work, ure Iucky Lo know LIeIr
cIussmuLes` numes.
TIere Is u sLrong suggesLIon LIuL IncreusIng sLudenLJLeucIer
ruLIos, LIe IncreusIng ruLIo oI overseus sLudenLs (some wILI poor EngIIsI
skIIIs), und corporuLe IundIng Is deLrImenLuIIy uIIecLIng ucudemIc
sLundurds: ProIessor PummenL suys LIuL crowded cIussrooms gIve rIse Lo
yeL unoLIer probIem: ucudemIcs IeeIIng LIe pressure Lo ruIse puss ruLes Ior
sLudenLs ucross LIe bourd. ' LIInk subIImInuIIy LIougI LIere`s been u
Lendency - wILIouL beIng LoId Lo do so - Lo Iower sLundurds oI
exumInuLIons over LIe yeur sImpIy Lo cope wILI LIe IucL LIuL LIe number
oI sLudenLs uIIowed InLo LIe unIversILy Iuve gone up so enormousIy`, Ie
suys. (The Ae, ebruury zq, zoo1, p.1o) An AusLruIIu nsLILuLe sLudy LIuL
surveyed 16 ucudemIcs Iound LIuL: uImosL IuII LIe respondenLs Lo LIe
survey suId LIey were reIucLunL Lo crILIcIse bodIes LIuL provIded reseurcI
grunLs. orLy-one percenL suId LIey IeIL dIscomIorL wILI pubIIsIIng
conLenLIous resuILs; qz per cenL were concerned ubouL ucudemIc Ireedom;
; per cenL LIougIL IL wus deLerIoruLIng. (The Ae, MurcI 1;, zoo1, p.1q)
TIe sLudy uIso Iound LIuL reseurcI projecLs were bIused Lowurds LIose
wILI un economIc beneIIL und |u|ImosL uII |respondenLs| Iud experIenced
un empIusIs on Iunded over unIunded reseurcI, und u vuIuIng oI courses
LIuL uLLrucL IIgI sLudenL enroImenLs und IuII-Iee-puyIng sLudenLs over
oLIer courses. (Hercld,Sun, MurcI 1;, zoo1, p.1q) A very sLrong LIeme Is
LIuL unIversILIes ure beIng run by uccounLunLs ruLIer LIun IeIIow
ucudemIcs (The Ae, Junuury zo, zoo1, p.).
n conLrusL Lo ILs eurIIesL uIIgnmenL wILI u spIrILuuIJmoruI
Irumework (I.e., CIrIsLIunILy), PsycIoIogy In wesLern nuLIons, generuIIy,
Ius uLLempLed Lo dIvesL ILseII oI LIIs roIe over LIe IusL cenLury. PurLIcuIurIy
over LIe IusL LIree decudes (muLerIuIIsL munIIesLo), LIe dIscIpIIne Ius
essenLIuIIy been uIIgned wILI medIco-muLerIuIIsm. PsycIoIogy depurL-
menLs ure LypIcuIIy IIsLed under scIooIs oI beIuvIoruI scIence; LIe Lerm
scIence In scIooI LILIes Lends Lo IegILImIze u scIooI`s exIsLence wILIIn u
domInunL muLerIuIIsL Irumework. A perusuI oI PsycIoIogy courses reveuIs
LIuL mosL, II noL uII, subjecL-muLLer Is muLerIuIIsL In dIsposILIon. TIere ure
now sucI subjecLs us IeuILI psycIoIogy, beIuvIoruI medIcIne,
psycIoIogIcuI medIcIne, envIronmenLuI psycIoIogy, exercIse
The Bigger Picture
psycIoIogy.
n one unIversILy, LIe psycIoIogy depurLmenL Is wILIIn LIe
ScIooI oI BeIuvIoruI ScIence, wIIcI, In Lurn, Is under LIe uuspIces oI LIe
ucuILy oI MedIcIne, DenLIsLry & HeuILI ScIences. n unoLIer, LIe
depurLmenL oI psycIoIogy Is wILIIn LIe ScIooI oI PsycIoIogy, PsycIIuLry &
PsycIoIogIcuI MedIcIne, wIIcI, In Lurn, Is under LIe uuspIces oI LIe
ucuILy oI MedIcIne. One psycIoIogy depurLmenL Ius LIe psI (Greek-
symboI ubbrevIuLIon Ior psycIoIogy) crossed wILI u snuke - seemIngIy
unuIogous Lo LIe InLerLwInIng snukesJserpenLs on u sLuII LIuL LypIcuIIy
denoLes LIe medIcuI proIessIon. n LIese cuses psycIoIogy Ius been
swuIIowed up by medIcuI IucuILIes. AL LIIs LIme, unIversILIes Iuck u muILI-
dImensIonuI buIunce, I.e., muLerIuIIsL domInuLIon. And, wILIIn LIIs
muLerIuIIsm, medIco-muLerIuIIsm Is IIgIIy domInunL. n u Lurn-oI-LIe-
mIIIennIum speecI LIe AusLruIIun PrIme MInIsLer decIured LIuL medIcuI
scIence wIII Ieud LIe wuy In LIe new mIIIennIum. TIIs Is ucLuuIIy noL un
InspIrIng prospecL.
TIere Is, LIereIore, LIe sILuuLIon LIuL u dIscIpIIne (psycIoIogy)
LIuL cun brIng LIe ussumpLIons, sLuLIsLIcuI und cuusuI, oI IeuILIIsm InLo
IegILImuLe quesLIon, und LIuL cun IIgIIIgIL LIe poLenLIuI neguLIve
rumIIIcuLIons (e.g., nocebo eIIecLs) oI sLuLIsLIcuIIsL IeuILI promoLIon, Is noL
onIy noL doIng so, buL Is InsLrumenLuI In propuguLIng LIe probIems In
quesLIon (I.e., supporL roIe).
MuLerIuIIsL psycIoIogy jusLIIIes ILs exIsLence In LIe murkeLpIuce
LIrougI supposedIy uIdIng In reducIng IeuILI cosLs, I.e., LIrougI
prevenLIve medIcIne, IeuILI promoLIon. TIe poLenLIuI scruLInIzer oI
medIcuI mIsconducL Ius been ubsorbed by LIe medIcuI esLubIIsImenL.
TIIs Is un exLruordInury sLuLe oI uIIuIrs; LIere Is un enLIre und crILIcuI
dIscIpIIne oI enquIry LIuL Ius been obIILeruLed. UnIorLunuLeIy, LIIs Iud Lo
occur II psycIoIogy wus Lo survIve LIe murkeL-drIven seLLIng. TIIs
cerLuInIy expIuIns wIy unLIsmokIng und oLIer IeuILIIsL prescrIpLIons,
repIeLe wILI uII munner oI IncoIerenL reusonIng und wILI u greuL cupucILy
Lo IosLer nocebo eIIecLs, dungerous psycIoIogIcuI LendencIes (superIorILy
syndrome), und socIuI dIvIsIon, Ius IIourIsIed ruLIer LIun beIng cuIIed
InLo quesLIon. TIe AusLruIIun unIversILIes menLIoned ubove ure LIe mujor
VIcLorIun unIversILIes. TIIs IucLor cerLuInIy IeIps Lo expIuIn wIy VIcLorIu,
AusLruIIu, Ius become LIe unLIsmokIng cupILuI oI LIe worId. or uII InLenLs
und purposes, In ucudemIu, u non-reducLIonIsL psycIoIogy dIscIpIIne Is
non-exIsLenL. AII munner oI psycIoIogIcuIIy und reIuLIonuIIy IncompeLenL
und InIIummuLory IeuILI promoLIon, unLIsmokIng IIgurIng IIgIIy, Ius
noL onIy been uIIowed Lo proceed uncIecked, buL Ius been reInIorced by
beIuvIorIsm. L uIso IeIps Lo expIuIn LIe dIIIIcuILy LIuL LIe Iew
dIssenLers LIuL LIere ure Iuve Iud In quesLIonIng LIe orLIodox vIew
456
456
Rampant Antismoking Signifies Grave Danger
und LIuL uLLempLs uL scruLIny Iuve Iud Lo come predomInunLIy Irom
ouLsIde ucudemIu (see CIupLer z). n keepIng wILI LIe dIscussIon LIus Iur,
rumpunL unLIsmokIng Is sympLomuLIc oI rumpunL muLerIuIIsm.
KupIun (zooo) Is u good exumpIe oI LIe beIuvIorIsL
(psycIoIogIcuIIyJreIuLIonuIIy IncompeLenL) posILIon. He, IIke muny oLIers,
unIorLunuLeIy cssume epIdemIoIogIcuI InIormuLIon und reusonIng Lo be
uccuruLe und deIInILIve - purLIcuIurIy on Lobucco smokIng. He LIen
proposes LIuL eIIorLs sIouId be Increused Lo erudIcuLe LIe smokIng IubIL
und LIuL prevenLIon oI LIe IubIL Is LIe mosL cosL-eIIecLIve Ionger-Lerm
upproucI; In LIuL prevenLIon Is consIdered more cosL eIIecLIve LIun
prImury medIcuI cure IegILImIzes beIuvIorIsm beyond prImury medIcuI
cure. He uddILIonuIIy reIers Lo LIe sLuLIsLIcuI exLrupoIuLIons oI TuyIor eL uI.
(1q8;) LIuL quILLIng smokIng by uge zo (or never LukIng up LIe IubIL uL uII)
cun udd up Lo yeurs Lo IIIe expecLuncy. AL no LIme does IL duwn on
KupIun LIuL LIe exLru yeurs Ideu Is LIe resuIL oI sLuLIsLIcuI gume-pIuyIng
bused on u number oI compIeLeIy quesLIonubIe ussumpLIons (e.g.,
IomogeneILy oI yeurs, IomogeneILy oI groups), or LIuL moves Lowurds
proIIbILIon, generuIIy, Iuve u poor record, or LIuL LIe poLenLIuI Ior nocebo
eIIecLs Is exLremeIy IIgI, or LIuL LIe domIneerIng muLerIuIIsL menLuIILy, oI
wIIcI IL Is u purL, poses LIe gruvesL dunger oI uII.
Under muLerIuIIsL domInuLIon, LIere Is LIe exLruordInury und
LrugIc cIrcumsLunce LIuL psycIoIogy depurLmenLs Iuve no-one sLuIIIng
LIem LIuL demonsLruLes uny psycIoIogIcuI upLILude. Or, us LroubIesome,
LIose wILI upLILude cunnoL uLLrucL reseurcI IundIng und ure murgInuIIzed
wILIIn LIe muLerIuIIsL seLLIng. AguIn, LIe crILIcuI probIem, per se, Is noL
psycIoIogy, buL muLerIuIIsm dIrecLIng psycIoIogy. TIIs represenLs u
dungerous, muLerIuIIsL cIosed-Ioop. TIe menLuIILy cunnoL dIscern ILs
own quesLIonubIe reusonIng und moLIvuLIon und cun, LIereIore, noL
dIscern LIe rumIIIcuLIons oI LIese.
PIIIosopIy, Loo, Ius gone LIe sume wuy. TIrougI uIso dIvesLIng
ILseII oI uny uIIgnmenL Lo u IIrsL-prIncIpIes meLupIysIcs (e.g., CIrIsLIunILy),
IL Is uIso supporLIve oI medIco-muLerIuIIsL nonsense In munuIucLurIng
sILuuLIonuI eLIIcs und rIgILs (e.g., GoodIn, 1q8q), or Is cIusIng medIco-
muLerIuIIsm In un uLLempL Lo conLuIn IuII-ouL (e.g., deIInIng u prIvucy
poIIcy Ior LIe IncreusIng prevuIence oI geneLIc InIormuLIon). Two crILIcuI,
pIvoLuI dIscIpIInes (psycIoIogy und pIIIosopIy) LIuL sIouId properIy be
cuIIIng medIco-muLerIuIIsm und scIenLIsm InLo quesLIon Iuve been
reduced Lo purLIcIpunLs In LIe mudness.
.:. Globcl Ircmeuorl
L Is uIurmIng LIuL unIversILIes ure domInuLed by LIe
The Bigger Picture
superIIcIuIILy oI muLerIuIIsm. CurrenLIy, unIversILIes ure essenLIuIIy cenLers
Ior MMES-cuIL LruInIng. MuLerIuIIsm dIcLuLes LIe LIeme oI reseurcI und
ILs InLerpreLuLIon. TIe sILuuLIon Is noL one wIere reuson Is guIded by IucL,
buL wIere IucLs ure InLerpreLed onIy InsoIur us LIey cun promoLe un
IdeoIogIcuI posILIon; conLrury evIdence Is sImpIy dIsregurded.
AnLIsmokIng Is un exceIIenL exumpIe. Any uLLempLs Lo quesLIon LIe
orLIodox vIew Iuve been meL wILI u wuII oI IunuLIcuI, seII-servIng
rIeLorIc. L IndIcuLes LIuL LIe spIrIL oI scIoIurIy reseurcI und debuLe,
purLIcuIurIy In muILIdImensIonuI Lerms, Ius been, Ior uII InLenLs und
purposes, snuIIed ouL.
TIIs gruve sILuuLIon Is noL uccIdenLuI or LIe resuIL oI
governmenLs noL beIng ubIe Lo uIIord unIversILy IundIng; IL Is un
InLenLIonuIIy produced cIrcumsLunce, I.e., u conspIrucy oI Ignorunce und
IncompeLence. TIomson-serbyL (1qqq) provIdes crucIuI InsIgILs InLo LIe
corrupLIon oI LIe educuLIon sysLem, Irom prImury scIooI LIrougI Lo
LerLIury educuLIon. Her book Is u voIumInous one, LruckIng u puper LruII oI
educuLIonuI recommenduLIons, IdeoIogy und IegIsIuLIon sInce eurIy IusL
cenLury. n summury, LIe sume LIemes emerge. HIgIIIgILed Is LIuL LIere
Is u socIuIIsLJInLernuLIonuIIsL ugendu Ior LIe pIunned economy und socIeLy
(muLerIuIIsL munIIesLo). Over LIe IusL number oI decudes, cIIIdren Iuve
been InsLrucLed uccordIng Lo wIuL Ius progressIveIy been renumed us
ouLcome-bused educuLIon, musLery IeurnIng, und, more recenLIy,
dIrecL InsLrucLIon. By wIuLever nume used, IL represenLs PuvIovIunJ
SkInnerIun condILIonIng (scIeduIes oI reInIorcemenL) or u meLIod oI
beIuvIor modIIIcuLIon (see uIso secLIon Rcdiccl ehctiorism): oIIowIng
LIIs reInIorcemenL meLIod, LeucIers ure requIred Lo reud Irom u scrIpL,
use Iund sIgnuIs us In dog LruInIng, cIup LIeIr Iunds, und pop cundIes In
LIeIr sLudenLs` mouLIs wIen LIey geL LIe correcL unswer. TIe cIIId Is
conLInuuIIy enguged by LIe process und noL permILLed Lo LIInk ouLsIde LIe
Irumework.
UsIng LIIs LecInIque, cIIIdren ure IndocLrInuLed InLo bIoIogIcuI
evoIuLIonIsm (reducLIonIsm), moruI reIuLIvIsm und uLIeIsm, presenLed In
Lerms sucI us envIronmenLuIIsm, gIobuI cILIzensIIp, eLc.. CIIIdren ure noL
provIded wILI IucLs In u vurIeLy oI subjecL muLLer und LIen LuugIL Lo uppIy
generuI InIerenLIuI prIncIpIes, buL ure sImpIy condILIoned InLo provIdIng
LIe upproprIuLe responses Lo key Lerms In u conLrIved ugendu; ruLIer LIun
beIng educuLed In scIoIurIy Lerms, cIIIdren ure beIng bruInwusIed InLo
muLerIuIIsL IdeoIogy; ugendu-bused uLLILudes ure reInIorced InLo
condILIoned reIIexes (uuLomuLIc responses), ruLIer LIun LIe LeucIIng oI
busIc skIIIs und prIncIpIed reusonIng. SIxLy per cenL oI ILems on LIe
NuLIonuI AssessmenL oI EducuLIonuI Progress (NAEP) perLuIn Lo
governmenL-upproved cttitudes. CIIIdren Iure weII II LIey demonsLruLe
457
457
Rampant Antismoking Signifies Grave Danger
und LIuL uLLempLs uL scruLIny Iuve Iud Lo come predomInunLIy Irom
ouLsIde ucudemIu (see CIupLer z). n keepIng wILI LIe dIscussIon LIus Iur,
rumpunL unLIsmokIng Is sympLomuLIc oI rumpunL muLerIuIIsm.
KupIun (zooo) Is u good exumpIe oI LIe beIuvIorIsL
(psycIoIogIcuIIyJreIuLIonuIIy IncompeLenL) posILIon. He, IIke muny oLIers,
unIorLunuLeIy cssume epIdemIoIogIcuI InIormuLIon und reusonIng Lo be
uccuruLe und deIInILIve - purLIcuIurIy on Lobucco smokIng. He LIen
proposes LIuL eIIorLs sIouId be Increused Lo erudIcuLe LIe smokIng IubIL
und LIuL prevenLIon oI LIe IubIL Is LIe mosL cosL-eIIecLIve Ionger-Lerm
upproucI; In LIuL prevenLIon Is consIdered more cosL eIIecLIve LIun
prImury medIcuI cure IegILImIzes beIuvIorIsm beyond prImury medIcuI
cure. He uddILIonuIIy reIers Lo LIe sLuLIsLIcuI exLrupoIuLIons oI TuyIor eL uI.
(1q8;) LIuL quILLIng smokIng by uge zo (or never LukIng up LIe IubIL uL uII)
cun udd up Lo yeurs Lo IIIe expecLuncy. AL no LIme does IL duwn on
KupIun LIuL LIe exLru yeurs Ideu Is LIe resuIL oI sLuLIsLIcuI gume-pIuyIng
bused on u number oI compIeLeIy quesLIonubIe ussumpLIons (e.g.,
IomogeneILy oI yeurs, IomogeneILy oI groups), or LIuL moves Lowurds
proIIbILIon, generuIIy, Iuve u poor record, or LIuL LIe poLenLIuI Ior nocebo
eIIecLs Is exLremeIy IIgI, or LIuL LIe domIneerIng muLerIuIIsL menLuIILy, oI
wIIcI IL Is u purL, poses LIe gruvesL dunger oI uII.
Under muLerIuIIsL domInuLIon, LIere Is LIe exLruordInury und
LrugIc cIrcumsLunce LIuL psycIoIogy depurLmenLs Iuve no-one sLuIIIng
LIem LIuL demonsLruLes uny psycIoIogIcuI upLILude. Or, us LroubIesome,
LIose wILI upLILude cunnoL uLLrucL reseurcI IundIng und ure murgInuIIzed
wILIIn LIe muLerIuIIsL seLLIng. AguIn, LIe crILIcuI probIem, per se, Is noL
psycIoIogy, buL muLerIuIIsm dIrecLIng psycIoIogy. TIIs represenLs u
dungerous, muLerIuIIsL cIosed-Ioop. TIe menLuIILy cunnoL dIscern ILs
own quesLIonubIe reusonIng und moLIvuLIon und cun, LIereIore, noL
dIscern LIe rumIIIcuLIons oI LIese.
PIIIosopIy, Loo, Ius gone LIe sume wuy. TIrougI uIso dIvesLIng
ILseII oI uny uIIgnmenL Lo u IIrsL-prIncIpIes meLupIysIcs (e.g., CIrIsLIunILy),
IL Is uIso supporLIve oI medIco-muLerIuIIsL nonsense In munuIucLurIng
sILuuLIonuI eLIIcs und rIgILs (e.g., GoodIn, 1q8q), or Is cIusIng medIco-
muLerIuIIsm In un uLLempL Lo conLuIn IuII-ouL (e.g., deIInIng u prIvucy
poIIcy Ior LIe IncreusIng prevuIence oI geneLIc InIormuLIon). Two crILIcuI,
pIvoLuI dIscIpIInes (psycIoIogy und pIIIosopIy) LIuL sIouId properIy be
cuIIIng medIco-muLerIuIIsm und scIenLIsm InLo quesLIon Iuve been
reduced Lo purLIcIpunLs In LIe mudness.
.:. Globcl Ircmeuorl
L Is uIurmIng LIuL unIversILIes ure domInuLed by LIe
The Bigger Picture
superIIcIuIILy oI muLerIuIIsm. CurrenLIy, unIversILIes ure essenLIuIIy cenLers
Ior MMES-cuIL LruInIng. MuLerIuIIsm dIcLuLes LIe LIeme oI reseurcI und
ILs InLerpreLuLIon. TIe sILuuLIon Is noL one wIere reuson Is guIded by IucL,
buL wIere IucLs ure InLerpreLed onIy InsoIur us LIey cun promoLe un
IdeoIogIcuI posILIon; conLrury evIdence Is sImpIy dIsregurded.
AnLIsmokIng Is un exceIIenL exumpIe. Any uLLempLs Lo quesLIon LIe
orLIodox vIew Iuve been meL wILI u wuII oI IunuLIcuI, seII-servIng
rIeLorIc. L IndIcuLes LIuL LIe spIrIL oI scIoIurIy reseurcI und debuLe,
purLIcuIurIy In muILIdImensIonuI Lerms, Ius been, Ior uII InLenLs und
purposes, snuIIed ouL.
TIIs gruve sILuuLIon Is noL uccIdenLuI or LIe resuIL oI
governmenLs noL beIng ubIe Lo uIIord unIversILy IundIng; IL Is un
InLenLIonuIIy produced cIrcumsLunce, I.e., u conspIrucy oI Ignorunce und
IncompeLence. TIomson-serbyL (1qqq) provIdes crucIuI InsIgILs InLo LIe
corrupLIon oI LIe educuLIon sysLem, Irom prImury scIooI LIrougI Lo
LerLIury educuLIon. Her book Is u voIumInous one, LruckIng u puper LruII oI
educuLIonuI recommenduLIons, IdeoIogy und IegIsIuLIon sInce eurIy IusL
cenLury. n summury, LIe sume LIemes emerge. HIgIIIgILed Is LIuL LIere
Is u socIuIIsLJInLernuLIonuIIsL ugendu Ior LIe pIunned economy und socIeLy
(muLerIuIIsL munIIesLo). Over LIe IusL number oI decudes, cIIIdren Iuve
been InsLrucLed uccordIng Lo wIuL Ius progressIveIy been renumed us
ouLcome-bused educuLIon, musLery IeurnIng, und, more recenLIy,
dIrecL InsLrucLIon. By wIuLever nume used, IL represenLs PuvIovIunJ
SkInnerIun condILIonIng (scIeduIes oI reInIorcemenL) or u meLIod oI
beIuvIor modIIIcuLIon (see uIso secLIon Rcdiccl ehctiorism): oIIowIng
LIIs reInIorcemenL meLIod, LeucIers ure requIred Lo reud Irom u scrIpL,
use Iund sIgnuIs us In dog LruInIng, cIup LIeIr Iunds, und pop cundIes In
LIeIr sLudenLs` mouLIs wIen LIey geL LIe correcL unswer. TIe cIIId Is
conLInuuIIy enguged by LIe process und noL permILLed Lo LIInk ouLsIde LIe
Irumework.
UsIng LIIs LecInIque, cIIIdren ure IndocLrInuLed InLo bIoIogIcuI
evoIuLIonIsm (reducLIonIsm), moruI reIuLIvIsm und uLIeIsm, presenLed In
Lerms sucI us envIronmenLuIIsm, gIobuI cILIzensIIp, eLc.. CIIIdren ure noL
provIded wILI IucLs In u vurIeLy oI subjecL muLLer und LIen LuugIL Lo uppIy
generuI InIerenLIuI prIncIpIes, buL ure sImpIy condILIoned InLo provIdIng
LIe upproprIuLe responses Lo key Lerms In u conLrIved ugendu; ruLIer LIun
beIng educuLed In scIoIurIy Lerms, cIIIdren ure beIng bruInwusIed InLo
muLerIuIIsL IdeoIogy; ugendu-bused uLLILudes ure reInIorced InLo
condILIoned reIIexes (uuLomuLIc responses), ruLIer LIun LIe LeucIIng oI
busIc skIIIs und prIncIpIed reusonIng. SIxLy per cenL oI ILems on LIe
NuLIonuI AssessmenL oI EducuLIonuI Progress (NAEP) perLuIn Lo
governmenL-upproved cttitudes. CIIIdren Iure weII II LIey demonsLruLe
458
458
Rampant Antismoking Signifies Grave Danger
condILIonIng InLo LIe upproprIuLe ugendu sLunce. EducuLIon bused on
LIe dIssemInuLIon oI InIormuLIon Ius been repIuced by ouLcome-bused
educuLIon. TIIs empIusIs Is LIe sume In IeuILI promoLIon. TIe pubIIc ure
noL provIded wILI onIy uccuruLe InIormuLIon, buL InIormuLIon Irumed In
quesLIonubIe prescrIpLIonsJproscrIpLIons und supporLed by IeuILI
promoLIon uLLempLIng Lo condILIon pubIIc compIIunce, I.e., ouLcome-
bused Lo u muLerIuIIsL ugendu.
TIomson-serbyL (1qqq) IIgIIIgILs LIuL LIe educuLIonuI ugendu
Is Lo govern cIIIdren In u scIooI Lo work Irumework wILIIn u gIobuIIzed
sysLem (gIobuI workIorce LruInIng): TIe pIunned economy wIII come Lo us
LIrougI scIooI Lo work |STW| IegIsIuLIon. TIere wIII be quoLus Ior jobs,
no upwurd mobIIILy Ior cIIIdren. SLudenLs musL seIecL LIeIr cureers by 8LI
grude. L Is LIe sume us LIe Cubun sysLem. STW Is ImpIemenLed In uII
sLuLes. TIIs Is LIe IuIIed eIILIsL sysLem wIIcI brougIL LIe SovIeL UnIon
down buL wIIcI Is sLIII beIng used worIdwIde. UILImuLeIy, LIe InLenL Is
domInuLIon oI every IuceL oI IIIe by LIe gIobuI SLuLe. ScIooI-bused cIInIcs
wIII be ubIe Lo consLunLIy monILor cIIIdrens` IeuILI - pIysIcuI und
menLuI. TIe IdeuI producL oI LIIs sysLem Is un unLIInkIng, conIormIng
cILIzen. TIe more specIuIIzed (IrugmenLed) und moruIIy-voId u cIIId`s
LruInIng, LIe Iess IIkeIIIood oI dIssenL.
TIomson-serbyL`s IIrsL reseurcI enLrIes In LIe eurIy-1q;o`s
concerned quesLIonnuIres gIven Lo cIIIdren wIere LIe onIy ruLIonuIe wus
Lo soIIcIL personuI InIormuLIon LIuL Is reuIIy noL LIe concern oI u scIooI:
TIuL IIrsL pIece oI puper wus u purpIe dILLo sIeeL enLILIed 'AII AbouL Me,`
nexL Lo wIIcI wus u smIIey Iuce. L wus un open-ended quesLIonnuIre
begInnIng wILI: 'My nume Is _______.` My son brougIL IL Iome Irom
pubIIc scIooI In IourLI grude. TIe quesLIons were IIgIIy personuI; so
mucI so LIuL LIey encouruged my son Lo IIe, sInce Ie dIdn`L wunL Lo 'spIII
LIe beuns` ubouL IIs moLIer, IuLIer und broLIer. TIe purpose oI sucI u
quesLIonnuIre wus Lo IInd ouL LIe sLudenL`s sLuLe oI mInd, Iow Ie IeIL,
wIuL Ie IIked und dIsIIked, und wIuL IIs vuIues were. WILI LIIs knowIedge
IL wouId be eusIer Ior LIe governmenL scIooI Lo modIIy IIs vuIues und
beIuvIor uL wIII - wILIouL, oI course, LIe sLudenL`s knowIedge or LIe
purenLs` consenL.
More currenLIy, cIIId surveIIIunce wILIIn u muLerIuIIsL
Irumework cun go by oLIer numes. One newspuper urLIcIe IndIcuLes |I|
nLeIIIgence und emoLIonuI LesLIng Ior uII Iour-yeur-oIds und Iree cIIId cure
Ior LIe poor ure seL Lo become key purLs oI u Howurd GovernmenL pIun Lo
reIorm LIe weIIure sysLem..AII Iour-yeur-oIds muy undergo LesLIng Lo
IdenLIIy deveIopmenLuI probIems. (Hercld,Sun, December z, zoo1, p.)
TIe pIun goes under LIe nume oI prevenLuLIve weIIure. TIe crILIcuI Issue
Is LIe muLerIuIIsL menLuIILy LIuL deIInes wIuL consLILuLes deveIopmenLuI
The Bigger Picture
probIems und Iow LIey ure uddressed. ProIessor SLunIey, LIe uuLIor oI LIe
AusLruIIun pIun, suggesLs LIuL peopIe Irom AusLruIIu, BrILuIn, Cunudu und
LIe UnILed SLuLes were urguubIy LIe worId`s worsL purenLs. L Is LIe
muLerIuIIsL munIIesLo LIuL Ius been InsLrumenLuI In producIng poor
purenLIng. TIe MuLerIuIIsL SLuLe now seeks Lo IurLIer InLerpose ILseII
beLween purenLs und cIIIdren, promoLIng ILseII us LIe correcLIon
(pIysIcuIIy, emoLIonuIIy und InLeIIecLuuIIy) Lo purenLIng IuIIure.
EducuLIon oI LIe IusL number oI decudes Is IusIIoned on JoIn
Dewey`s muLerIuIIsL educuLIon pIIIosopIy. A reusonubIe summury oI
Dewey`s posILIon Is conLuIned In BuIIock & WoodIngs (1q8):
As un educuLIonIsL, Dewey urgued LIuL Iome und socIuI
IIIe sIouId be LIe omegu poInL oI LIe educuLIve process.
KnowIedge Is power In LIuL IL noL onIy enubIes mun Lo
cope wILI IIs envIronmenL und uILImuLeIy domInuLe IL
buL uIso mukes possIbIe processes oI experImenLuLIon
und reudjusLmenL In u IIIeIong process commencIng uL
bIrLI und endIng onIy wILI deuLI. or Dewey, LIe scIooI
essenLIuIIy copes wILI u cIIId`s InLeresLs und upLILudes
und noL wILI IuLure needs or uILruIsLIc uIms. SubjecL
deIImILuLIons wILIIn LIe scIooI currIcuIum were
unuLIemu Lo IIm. TIe cuILIvuLed InLeresLs oI LIe cIIId
muke LeucIIng LopIc-cenLred, noL subjecL-bused, und
Dewey gIves no recognILIon Lo u IIerurcIy oI vuIues
umong subjecLs. He IuIIs Lo gIve due uIIowunce Lo LIe
concepLuuI Irumework oI educuLIon, Ignores mun`s need
Lo subscrIbe Lo IdeuIs Lowurds wIIcI Ie cun sLrIve und
uguInsL wIIcI Ie cun meusure progress, uccepLIng
socIeLy us IL Is. HIs moruIILy Is reIuLIve und sILuuLIonuI.
Dewey`s udvocucy oI ucLIvILy meLIods eIevuLes LeucIers
InLo u new Iorm oI sucerdoLuI cIuss, conLroIIIng und
guIdIng cIIId deveIopmenL. TIe mosL serIous crILIcIsm,
Iowever, Is LIuL Dewey bused IIs educuLIonuI progrum
upon personuI InspIruLIon und sIrewd IuncIes ruLIer
LIun upon rIgorous scIenLIIIc unuIysIs oI LIe evIdence.
TIomson-serbyL (1qqq) upLIy enLILIed Ier book The Delibercte
Dumbin Doun oj Americc. TIIs Is u probIem In mosL wesLern nuLIons.
TIe Lrugedy In moLIon cunnoL be oversLuLed. TIe superIIcIuI, IncompeLenL,
IgnorunL muLerIuIIsL menLuIILy Ius seen IIL, sInce LIIs Is LIe enLIre scope oI
ILs reusonIng, Lo produce LIe sume deIusIon on u muss scuIe.
PsycIoIogIsLs (I.e., beIuvIorIsm) und educuLIonIsLs ure predomInunLIy
Lo bIume (see eHuye & NoebeI, zooo; TIomson-serbyL, 1qqq). However,
459
459
Rampant Antismoking Signifies Grave Danger
condILIonIng InLo LIe upproprIuLe ugendu sLunce. EducuLIon bused on
LIe dIssemInuLIon oI InIormuLIon Ius been repIuced by ouLcome-bused
educuLIon. TIIs empIusIs Is LIe sume In IeuILI promoLIon. TIe pubIIc ure
noL provIded wILI onIy uccuruLe InIormuLIon, buL InIormuLIon Irumed In
quesLIonubIe prescrIpLIonsJproscrIpLIons und supporLed by IeuILI
promoLIon uLLempLIng Lo condILIon pubIIc compIIunce, I.e., ouLcome-
bused Lo u muLerIuIIsL ugendu.
TIomson-serbyL (1qqq) IIgIIIgILs LIuL LIe educuLIonuI ugendu
Is Lo govern cIIIdren In u scIooI Lo work Irumework wILIIn u gIobuIIzed
sysLem (gIobuI workIorce LruInIng): TIe pIunned economy wIII come Lo us
LIrougI scIooI Lo work |STW| IegIsIuLIon. TIere wIII be quoLus Ior jobs,
no upwurd mobIIILy Ior cIIIdren. SLudenLs musL seIecL LIeIr cureers by 8LI
grude. L Is LIe sume us LIe Cubun sysLem. STW Is ImpIemenLed In uII
sLuLes. TIIs Is LIe IuIIed eIILIsL sysLem wIIcI brougIL LIe SovIeL UnIon
down buL wIIcI Is sLIII beIng used worIdwIde. UILImuLeIy, LIe InLenL Is
domInuLIon oI every IuceL oI IIIe by LIe gIobuI SLuLe. ScIooI-bused cIInIcs
wIII be ubIe Lo consLunLIy monILor cIIIdrens` IeuILI - pIysIcuI und
menLuI. TIe IdeuI producL oI LIIs sysLem Is un unLIInkIng, conIormIng
cILIzen. TIe more specIuIIzed (IrugmenLed) und moruIIy-voId u cIIId`s
LruInIng, LIe Iess IIkeIIIood oI dIssenL.
TIomson-serbyL`s IIrsL reseurcI enLrIes In LIe eurIy-1q;o`s
concerned quesLIonnuIres gIven Lo cIIIdren wIere LIe onIy ruLIonuIe wus
Lo soIIcIL personuI InIormuLIon LIuL Is reuIIy noL LIe concern oI u scIooI:
TIuL IIrsL pIece oI puper wus u purpIe dILLo sIeeL enLILIed 'AII AbouL Me,`
nexL Lo wIIcI wus u smIIey Iuce. L wus un open-ended quesLIonnuIre
begInnIng wILI: 'My nume Is _______.` My son brougIL IL Iome Irom
pubIIc scIooI In IourLI grude. TIe quesLIons were IIgIIy personuI; so
mucI so LIuL LIey encouruged my son Lo IIe, sInce Ie dIdn`L wunL Lo 'spIII
LIe beuns` ubouL IIs moLIer, IuLIer und broLIer. TIe purpose oI sucI u
quesLIonnuIre wus Lo IInd ouL LIe sLudenL`s sLuLe oI mInd, Iow Ie IeIL,
wIuL Ie IIked und dIsIIked, und wIuL IIs vuIues were. WILI LIIs knowIedge
IL wouId be eusIer Ior LIe governmenL scIooI Lo modIIy IIs vuIues und
beIuvIor uL wIII - wILIouL, oI course, LIe sLudenL`s knowIedge or LIe
purenLs` consenL.
More currenLIy, cIIId surveIIIunce wILIIn u muLerIuIIsL
Irumework cun go by oLIer numes. One newspuper urLIcIe IndIcuLes |I|
nLeIIIgence und emoLIonuI LesLIng Ior uII Iour-yeur-oIds und Iree cIIId cure
Ior LIe poor ure seL Lo become key purLs oI u Howurd GovernmenL pIun Lo
reIorm LIe weIIure sysLem..AII Iour-yeur-oIds muy undergo LesLIng Lo
IdenLIIy deveIopmenLuI probIems. (Hercld,Sun, December z, zoo1, p.)
TIe pIun goes under LIe nume oI prevenLuLIve weIIure. TIe crILIcuI Issue
Is LIe muLerIuIIsL menLuIILy LIuL deIInes wIuL consLILuLes deveIopmenLuI
The Bigger Picture
probIems und Iow LIey ure uddressed. ProIessor SLunIey, LIe uuLIor oI LIe
AusLruIIun pIun, suggesLs LIuL peopIe Irom AusLruIIu, BrILuIn, Cunudu und
LIe UnILed SLuLes were urguubIy LIe worId`s worsL purenLs. L Is LIe
muLerIuIIsL munIIesLo LIuL Ius been InsLrumenLuI In producIng poor
purenLIng. TIe MuLerIuIIsL SLuLe now seeks Lo IurLIer InLerpose ILseII
beLween purenLs und cIIIdren, promoLIng ILseII us LIe correcLIon
(pIysIcuIIy, emoLIonuIIy und InLeIIecLuuIIy) Lo purenLIng IuIIure.
EducuLIon oI LIe IusL number oI decudes Is IusIIoned on JoIn
Dewey`s muLerIuIIsL educuLIon pIIIosopIy. A reusonubIe summury oI
Dewey`s posILIon Is conLuIned In BuIIock & WoodIngs (1q8):
As un educuLIonIsL, Dewey urgued LIuL Iome und socIuI
IIIe sIouId be LIe omegu poInL oI LIe educuLIve process.
KnowIedge Is power In LIuL IL noL onIy enubIes mun Lo
cope wILI IIs envIronmenL und uILImuLeIy domInuLe IL
buL uIso mukes possIbIe processes oI experImenLuLIon
und reudjusLmenL In u IIIeIong process commencIng uL
bIrLI und endIng onIy wILI deuLI. or Dewey, LIe scIooI
essenLIuIIy copes wILI u cIIId`s InLeresLs und upLILudes
und noL wILI IuLure needs or uILruIsLIc uIms. SubjecL
deIImILuLIons wILIIn LIe scIooI currIcuIum were
unuLIemu Lo IIm. TIe cuILIvuLed InLeresLs oI LIe cIIId
muke LeucIIng LopIc-cenLred, noL subjecL-bused, und
Dewey gIves no recognILIon Lo u IIerurcIy oI vuIues
umong subjecLs. He IuIIs Lo gIve due uIIowunce Lo LIe
concepLuuI Irumework oI educuLIon, Ignores mun`s need
Lo subscrIbe Lo IdeuIs Lowurds wIIcI Ie cun sLrIve und
uguInsL wIIcI Ie cun meusure progress, uccepLIng
socIeLy us IL Is. HIs moruIILy Is reIuLIve und sILuuLIonuI.
Dewey`s udvocucy oI ucLIvILy meLIods eIevuLes LeucIers
InLo u new Iorm oI sucerdoLuI cIuss, conLroIIIng und
guIdIng cIIId deveIopmenL. TIe mosL serIous crILIcIsm,
Iowever, Is LIuL Dewey bused IIs educuLIonuI progrum
upon personuI InspIruLIon und sIrewd IuncIes ruLIer
LIun upon rIgorous scIenLIIIc unuIysIs oI LIe evIdence.
TIomson-serbyL (1qqq) upLIy enLILIed Ier book The Delibercte
Dumbin Doun oj Americc. TIIs Is u probIem In mosL wesLern nuLIons.
TIe Lrugedy In moLIon cunnoL be oversLuLed. TIe superIIcIuI, IncompeLenL,
IgnorunL muLerIuIIsL menLuIILy Ius seen IIL, sInce LIIs Is LIe enLIre scope oI
ILs reusonIng, Lo produce LIe sume deIusIon on u muss scuIe.
PsycIoIogIsLs (I.e., beIuvIorIsm) und educuLIonIsLs ure predomInunLIy
Lo bIume (see eHuye & NoebeI, zooo; TIomson-serbyL, 1qqq). However,
460
460
Rampant Antismoking Signifies Grave Danger
LIe probIem Is noL psycIoIogy, Ior exumpIe, buL muLerIuIIsm.
TIereIore, In consIderIng LIe currenL sLuLe oI unIversILIes, IL
wouId be unIuIr Lo vIew conLemporury sLudenLs us pecuIIurIy greedy,
seekIng onIy LIeIr muLerIuI securILy. TIey ure, In IucL, exceIIenL sLudenLs oI
u mInd-numbIng sysLem. L Is noL surprIsIng LIuL LIey cunnoL compreIend
LIe concepLs oI IIgIer IeurnIng or scIoIursIIp und LIe pursuIL oI depLI oI
meunIngIuIness, IeL uIone be enLIused by LIese. TIey Iuve never been
LuugIL, und InLenLIonuIIy so, Lo usk coIerenL, proIound quesLIons und
LIInk LIrougI Issues. TIey Iuve been LruIned Lo sLudy Lowurds u job
LIrougI LIe reInIorcemenL oI u compIIunL uLLILude: TIIs Is LIe muLerIuIIsL
meunIng oI IIIe.
To ensure LIuL poorIy-LruIned sLudenLs ucLuuIIy gruduuLe,
ucudemIc sLundurds Iuve pIummeLed. n so doIng, unIversILIes Iuve been
reduced Lo gIorIIIed InsLILuLes oI LecInoIogy. SLudenLs cun now gruduuLe
In medIocrILy. And, IL Is becuuse oI LIIs Iuck oI scIoIurIy sLundurd LIuL
medIco-muLerIuIIsm und ILs supporL dIscIpIInes cun domInuLe. AL un
eurIIer LIme, wIen LIere were scIoIurIy sLundurds, medIco-muLerIuIIsL
sLuLIsLIcuIIsL bubbIe wouId Iuve been properIy recognIzed us sucI. ScIooIs
und unIversILIes uL LIIs LIme ure u Iorm oI muLerIuIIsL cIurcI (u
conLInuuLIon oI MMES-cuIL IndocLrInuLIon) - genuIne, muILIdImensIonuI
scIoIursIIp Is gIurIngIy und dIsLurbIngIy ubsenL.
.z Humcnism
TIere ure Lwo dIsLIncL bruncIes oI muLerIuIIsm - one usceLIc, LIe
oLIer IIberuI. MedIco-muLerIuIIsm, scIenLIsm, und IeuILIIsm represenL LIe
more usceLIc Lendency LIrougI LIe generuLIng oI prescrIpLIonsJ
proscrIpLIons Ior conducL. TIe more IIberuI bruncIes oI muLerIuIIsm Iuve
LIus Iur noL been consIdered. One oI LIe more common IIberuI bruncIes
oI muLerIuIIsm Is reIerred Lo us humcnism. L muInLuIns LIe very sume
LeneLs us LIe more usceLIc bruncIes, e.g., uLIeIsm, moruI reIuLIvIsm, buL
Ius u purLIcuIur empIusIs.
To LIe observuLIons mude In LIe secLIon Rcdiccl ehctiorism u
number oI IurLIer InsIgILs cun be udded. TIe IumunIsL munIIesLos ure
consIsLenL wILI, und IurLIer embeIIIsI, LIe beIuvIorIsL Ideu oI mun-
engIneered uLopIu. L Is noL surprIsIng LIuL SkInner wus u sIgnuLory oI
HumunIsL MunIIesLo . TIere Iuve been LIree Humcnist Mcnijestos -
1q, 1q;, zooo. HumunIsL MunIIesLo (1q) proposed u generuI
Irumework oI beIIeI. or exumpIe:
n order LIuL reIIgIous IumunIsm muy be beLLer
undersLood we, LIe undersIgned, desIre Lo muke cerLuIn
uIIIrmuLIons wIIcI we beIIeve LIe IucLs oI our
The Bigger Picture
conLemporury IIIe demonsLruLe.
WIIIe LIIs uge does owe u vusL debL Lo LIe LrudILIonuI
reIIgIons, IL Is none LIe Iess obvIous LIuL uny reIIgIon
LIuL cun Iope Lo be u synLIesIzIng und dynumIc Iorce
Ior Loduy musL be sIuped Ior LIe needs oI LIIs uge. To
esLubIIsI sucI u reIIgIon Is u mujor necessILy oI LIe
presenL. L Is u responsIbIIILy wIIcI resLs upon LIIs
generuLIon.
ReIIgIous IumunIsLs regurd LIe unIverse us seII-exIsLIng
und noL creuLed.
HumunIsm beIIeves LIuL mun Is u purL oI nuLure und
LIuL Ie Ius emerged us u resuIL oI u conLInuous process.
HoIdIng un orgunIc vIew oI IIIe, IumunIsLs IInd LIuL LIe
LrudILIonuI duuIIsm oI mInd und body musL be rejecLed.
HumunIsm recognIzes LIuL mun`s reIIgIous cuILure und
cIvIIIzuLIon, us cIeurIy depIcLed by unLIropoIogy und
IIsLory, ure LIe producL oI u gruduuI deveIopmenL due
Lo IIs InLerucLIon wILI IIs nuLuruI envIronmenL und
wILI IIs socIuI IerILuge. TIe IndIvIduuI born InLo u
purLIcuIur cuILure Is IurgeIy moIded by LIuL cuILure.
HumunIsm usserLs LIuL LIe nuLure oI LIe unIverse
depIcLed by modern scIence mukes unuccepLubIe uny
supernuLuruI or cosmIc guurunLees oI Iumun
vuIues..ReIIgIon musL IormuIuLe ILs Iopes und pIuns In
LIe IIgIL oI LIe scIenLIIIc spIrIL und meLIod.
We ure convInced LIuL LIe LIme Ius pussed Ior LIeIsm,
deIsm, modernIsm, und LIe severuI vurIeLIes oI 'new
LIougIL`.
TIe dIsLIncLIon beLween LIe sucred und LIe secuIur cun
no Ionger be muInLuIned.
ReIIgIous IumunIsm consIders LIe compIeLe reuIIzuLIon
oI Iumun personuIILy Lo be LIe end oI mun`s IIIe und
seeks ILs deveIopmenL und IuIIIIImenL In LIe Iere und
now.
n LIe pIuce oI LIe oId uLLILudes InvoIved In worsIIp und
pruyer LIe IumunIsL IInds IIs reIIgIous emoLIons
expressed In u IeIgILened sense oI personuI IIIe und In u
cooperuLIve eIIorL Lo promoLe socIuI weII-beIng.
L IoIIows LIuL LIere wIII be no unIqueIy reIIgIous
emoLIons und uLLILudes oI LIe kInd IILIerLo ussocIuLed
wILI beIIeI In LIe supernuLuruI.
Mun wIII Ieurn Lo Iuce LIe crIses oI IIIe In Lerms oI IIs
461
461
Rampant Antismoking Signifies Grave Danger
LIe probIem Is noL psycIoIogy, Ior exumpIe, buL muLerIuIIsm.
TIereIore, In consIderIng LIe currenL sLuLe oI unIversILIes, IL
wouId be unIuIr Lo vIew conLemporury sLudenLs us pecuIIurIy greedy,
seekIng onIy LIeIr muLerIuI securILy. TIey ure, In IucL, exceIIenL sLudenLs oI
u mInd-numbIng sysLem. L Is noL surprIsIng LIuL LIey cunnoL compreIend
LIe concepLs oI IIgIer IeurnIng or scIoIursIIp und LIe pursuIL oI depLI oI
meunIngIuIness, IeL uIone be enLIused by LIese. TIey Iuve never been
LuugIL, und InLenLIonuIIy so, Lo usk coIerenL, proIound quesLIons und
LIInk LIrougI Issues. TIey Iuve been LruIned Lo sLudy Lowurds u job
LIrougI LIe reInIorcemenL oI u compIIunL uLLILude: TIIs Is LIe muLerIuIIsL
meunIng oI IIIe.
To ensure LIuL poorIy-LruIned sLudenLs ucLuuIIy gruduuLe,
ucudemIc sLundurds Iuve pIummeLed. n so doIng, unIversILIes Iuve been
reduced Lo gIorIIIed InsLILuLes oI LecInoIogy. SLudenLs cun now gruduuLe
In medIocrILy. And, IL Is becuuse oI LIIs Iuck oI scIoIurIy sLundurd LIuL
medIco-muLerIuIIsm und ILs supporL dIscIpIInes cun domInuLe. AL un
eurIIer LIme, wIen LIere were scIoIurIy sLundurds, medIco-muLerIuIIsL
sLuLIsLIcuIIsL bubbIe wouId Iuve been properIy recognIzed us sucI. ScIooIs
und unIversILIes uL LIIs LIme ure u Iorm oI muLerIuIIsL cIurcI (u
conLInuuLIon oI MMES-cuIL IndocLrInuLIon) - genuIne, muILIdImensIonuI
scIoIursIIp Is gIurIngIy und dIsLurbIngIy ubsenL.
.z Humcnism
TIere ure Lwo dIsLIncL bruncIes oI muLerIuIIsm - one usceLIc, LIe
oLIer IIberuI. MedIco-muLerIuIIsm, scIenLIsm, und IeuILIIsm represenL LIe
more usceLIc Lendency LIrougI LIe generuLIng oI prescrIpLIonsJ
proscrIpLIons Ior conducL. TIe more IIberuI bruncIes oI muLerIuIIsm Iuve
LIus Iur noL been consIdered. One oI LIe more common IIberuI bruncIes
oI muLerIuIIsm Is reIerred Lo us humcnism. L muInLuIns LIe very sume
LeneLs us LIe more usceLIc bruncIes, e.g., uLIeIsm, moruI reIuLIvIsm, buL
Ius u purLIcuIur empIusIs.
To LIe observuLIons mude In LIe secLIon Rcdiccl ehctiorism u
number oI IurLIer InsIgILs cun be udded. TIe IumunIsL munIIesLos ure
consIsLenL wILI, und IurLIer embeIIIsI, LIe beIuvIorIsL Ideu oI mun-
engIneered uLopIu. L Is noL surprIsIng LIuL SkInner wus u sIgnuLory oI
HumunIsL MunIIesLo . TIere Iuve been LIree Humcnist Mcnijestos -
1q, 1q;, zooo. HumunIsL MunIIesLo (1q) proposed u generuI
Irumework oI beIIeI. or exumpIe:
n order LIuL reIIgIous IumunIsm muy be beLLer
undersLood we, LIe undersIgned, desIre Lo muke cerLuIn
uIIIrmuLIons wIIcI we beIIeve LIe IucLs oI our
The Bigger Picture
conLemporury IIIe demonsLruLe.
WIIIe LIIs uge does owe u vusL debL Lo LIe LrudILIonuI
reIIgIons, IL Is none LIe Iess obvIous LIuL uny reIIgIon
LIuL cun Iope Lo be u synLIesIzIng und dynumIc Iorce
Ior Loduy musL be sIuped Ior LIe needs oI LIIs uge. To
esLubIIsI sucI u reIIgIon Is u mujor necessILy oI LIe
presenL. L Is u responsIbIIILy wIIcI resLs upon LIIs
generuLIon.
ReIIgIous IumunIsLs regurd LIe unIverse us seII-exIsLIng
und noL creuLed.
HumunIsm beIIeves LIuL mun Is u purL oI nuLure und
LIuL Ie Ius emerged us u resuIL oI u conLInuous process.
HoIdIng un orgunIc vIew oI IIIe, IumunIsLs IInd LIuL LIe
LrudILIonuI duuIIsm oI mInd und body musL be rejecLed.
HumunIsm recognIzes LIuL mun`s reIIgIous cuILure und
cIvIIIzuLIon, us cIeurIy depIcLed by unLIropoIogy und
IIsLory, ure LIe producL oI u gruduuI deveIopmenL due
Lo IIs InLerucLIon wILI IIs nuLuruI envIronmenL und
wILI IIs socIuI IerILuge. TIe IndIvIduuI born InLo u
purLIcuIur cuILure Is IurgeIy moIded by LIuL cuILure.
HumunIsm usserLs LIuL LIe nuLure oI LIe unIverse
depIcLed by modern scIence mukes unuccepLubIe uny
supernuLuruI or cosmIc guurunLees oI Iumun
vuIues..ReIIgIon musL IormuIuLe ILs Iopes und pIuns In
LIe IIgIL oI LIe scIenLIIIc spIrIL und meLIod.
We ure convInced LIuL LIe LIme Ius pussed Ior LIeIsm,
deIsm, modernIsm, und LIe severuI vurIeLIes oI 'new
LIougIL`.
TIe dIsLIncLIon beLween LIe sucred und LIe secuIur cun
no Ionger be muInLuIned.
ReIIgIous IumunIsm consIders LIe compIeLe reuIIzuLIon
oI Iumun personuIILy Lo be LIe end oI mun`s IIIe und
seeks ILs deveIopmenL und IuIIIIImenL In LIe Iere und
now.
n LIe pIuce oI LIe oId uLLILudes InvoIved In worsIIp und
pruyer LIe IumunIsL IInds IIs reIIgIous emoLIons
expressed In u IeIgILened sense oI personuI IIIe und In u
cooperuLIve eIIorL Lo promoLe socIuI weII-beIng.
L IoIIows LIuL LIere wIII be no unIqueIy reIIgIous
emoLIons und uLLILudes oI LIe kInd IILIerLo ussocIuLed
wILI beIIeI In LIe supernuLuruI.
Mun wIII Ieurn Lo Iuce LIe crIses oI IIIe In Lerms oI IIs
462
462
Rampant Antismoking Signifies Grave Danger
knowIedge oI LIeIr nuLuruIness und probubIIILy.
ReusonubIe und munIy uLLILudes wIII be IosLered by
educuLIon und supporLed by cusLom. We ussume LIuL
IumunIsm wIII Luke LIe puLI oI socIuI und menLuI
IygIene und dIscouruge senLImenLuI und unreuI Iopes
und wIsIIuI LIInkIng.
CerLuInIy reIIgIous InsLILuLIons, LIeIr rILuuIIsLIc Iorms,
eccIesIusLIcuI meLIods, und communuI ucLIvILIes musL
be reconsLILuLed us rupIdIy us experIence uIIows, In
order Lo IuncLIon eIIecLIveIy In LIe modern worId.
TIe IumunIsLs ure IIrmIy convInced LIuL exIsLIng
ucquIsILIve und proIIL-moLIvuLed socIeLy Ius sIown
ILseII Lo be InudequuLe und LIuL u rudIcuI cIunge In
meLIods, conLroIs, und moLIves musL be InsLILuLed. A
socIuIIzed und cooperuLIve economIc order musL be
esLubIIsIed Lo LIe end LIuL LIe equILubIe dIsLrIbuLIon oI
LIe meuns oI IIIe Is possIbIe. TIe gouI oI IumunIsm Is u
Iree und unIversuI socIeLy In wIIcI peopIe voIunLurIIy
und InLeIIIgenLIy cooperuLe Ior LIe common good.
We usserL LIuL IumunIsm wIII: (u) uIIIrm IIIe ruLIer
LIun deny IL; (b) seek Lo eIIcIL LIe possIbIIILIes oI IIIe, noL
IIee Irom LIem, und (c) endeuvor Lo esLubIIsI LIe
condILIons oI u suLIsIucLory IIIe Ior uII, noL mereIy Ior LIe
Iew.
Mun uL IusL Is becomIng uwure LIuL Ie uIone Is
responsIbIe Ior LIe reuIIzuLIon oI LIe worId oI IIs
dreums, LIuL Ie Ius wILIIn IImseII LIe power Ior ILs
ucIIevemenL.
Humun MunIIesLo (1q;) udded IurLIer deLuII Lo LIIs generuI
Irumework. or exumpIe:
As In 1q, IumunIsLs sLIII beIIeve LIuL LrudILIonuI
LIeIsm, especIuIIy IuILI In LIe pruyer-IeurIng God,
ussumed Lo IIve und cure Ior persons, Lo Ieur und
undersLund LIeIr pruyers, und Lo be ubIe Lo do
someLIIng ubouL LIem, Is un unproved und ouLmoded
IuILI. SuIvuLIonIsm, bused on mere uIIIrmuLIon, sLIII
uppeurs us IurmIuI, dIverLIng peopIe wILI IuIse Iopes oI
Ieuven IereuILer. ReusonubIe mInds Iook Lo oLIer
meuns Ior survIvuI.
TIe nexL cenLury cun be und sIouId be LIe IumunIsLIc
cenLury. DrumuLIc scIenLIIIc, LecInoIogIcuI, und ever-
The Bigger Picture
ucceIeruLIng socIuI und poIILIcuI cIunges crowd our
uwureness. We Iuve vIrLuuIIy conquered LIe pIuneL,
expIored LIe moon, overcome LIe nuLuruI IImILs oI
LruveI und communIcuLIon; we sLund uL LIe duwn oI u
new uge, reudy Lo move IurLIer InLo spuce und perIups
InIubIL oLIer pIuneLs. UsIng LecInoIogy wIseIy, we cun
conLroI our envIronmenL, conquer poverLy, murkedIy
reduce dIseuse, exLend our IIIe-spun, sIgnIIIcunLIy
modIIy our beIuvIor, uILer LIe course oI Iumun
evoIuLIon und cuILuruI deveIopmenL, unIock vusL new
powers, und provIde IumunkInd wILI unpuruIIeIed
opporLunILy Ior ucIIevIng un ubundunL und meunIngIuI
IIIe.
TIe IuLure Is, Iowever, IIIIed wILI dungers. n IeurnIng
Lo uppIy LIe scIenLIIIc meLIod Lo nuLure und Iumun IIIe,
we Iuve opened LIe door Lo ecoIogIcuI dumuge, over-
popuIuLIon, deIumunIzIng InsLILuLIons, LoLuIILurIun
repressIon, und nucIeur und bIo-cIemIcuI dIsusLer.
uced wILI upocuIypLIc propIesIes und doomsduy
scenurIos, muny IIee In despuIr Irom reuson und
embruce IrruLIonuI cuILs und LIeoIogIes oI wILIdruwuI
und reLreuL.
TrudILIonuI moruI codes und newer IrruLIonuI cuILs boLI
IuII Lo meeL LIe pressIng needs oI Loduy und Lomorrow.
uIse 'LIeoIogIes oI Iope` und messIunIc IdeoIogIes,
subsLILuLIng new dogmus Ior oId, cunnoL cope wILI
exIsLIng worId reuIILIes. TIey sepuruLe ruLIer LIun unILe
peopIes.
HumunILy, Lo survIve, requIres boId und durIng
meusures. We need Lo exLend LIe uses oI scIenLIIIc
meLIod, noL renounce LIem, Lo Iuse reuson wILI
compussIon In order Lo buIId consLrucLIve socIuI und
moruI vuIues. ConIronLed wILI muny possIbIe IuLures,
we musL decIde wIIcI Lo pursue..OnIy u sIured worId
und gIobuI meusures wIII suIIIce.
HumunIsm Is un eLIIcuI process LIrougI wIIcI we uII
cun move, ubove und beyond LIe dIvIsIve purLIcuIurs,
IeroIc personuIILIes, dogmuLIc creeds, und rILuuI
cusLoms oI pusL reIIgIons or LIeIr mere neguLIon.
We beIIeve..LIuL LrudILIonuI dogmuLIc or uuLIorILurIun
reIIgIons LIuL pIuce reveIuLIon, God, rILuuI, or creed
ubove Iumun needs und experIence do u dIsservIce Lo
463
463
Rampant Antismoking Signifies Grave Danger
knowIedge oI LIeIr nuLuruIness und probubIIILy.
ReusonubIe und munIy uLLILudes wIII be IosLered by
educuLIon und supporLed by cusLom. We ussume LIuL
IumunIsm wIII Luke LIe puLI oI socIuI und menLuI
IygIene und dIscouruge senLImenLuI und unreuI Iopes
und wIsIIuI LIInkIng.
CerLuInIy reIIgIous InsLILuLIons, LIeIr rILuuIIsLIc Iorms,
eccIesIusLIcuI meLIods, und communuI ucLIvILIes musL
be reconsLILuLed us rupIdIy us experIence uIIows, In
order Lo IuncLIon eIIecLIveIy In LIe modern worId.
TIe IumunIsLs ure IIrmIy convInced LIuL exIsLIng
ucquIsILIve und proIIL-moLIvuLed socIeLy Ius sIown
ILseII Lo be InudequuLe und LIuL u rudIcuI cIunge In
meLIods, conLroIs, und moLIves musL be InsLILuLed. A
socIuIIzed und cooperuLIve economIc order musL be
esLubIIsIed Lo LIe end LIuL LIe equILubIe dIsLrIbuLIon oI
LIe meuns oI IIIe Is possIbIe. TIe gouI oI IumunIsm Is u
Iree und unIversuI socIeLy In wIIcI peopIe voIunLurIIy
und InLeIIIgenLIy cooperuLe Ior LIe common good.
We usserL LIuL IumunIsm wIII: (u) uIIIrm IIIe ruLIer
LIun deny IL; (b) seek Lo eIIcIL LIe possIbIIILIes oI IIIe, noL
IIee Irom LIem, und (c) endeuvor Lo esLubIIsI LIe
condILIons oI u suLIsIucLory IIIe Ior uII, noL mereIy Ior LIe
Iew.
Mun uL IusL Is becomIng uwure LIuL Ie uIone Is
responsIbIe Ior LIe reuIIzuLIon oI LIe worId oI IIs
dreums, LIuL Ie Ius wILIIn IImseII LIe power Ior ILs
ucIIevemenL.
Humun MunIIesLo (1q;) udded IurLIer deLuII Lo LIIs generuI
Irumework. or exumpIe:
As In 1q, IumunIsLs sLIII beIIeve LIuL LrudILIonuI
LIeIsm, especIuIIy IuILI In LIe pruyer-IeurIng God,
ussumed Lo IIve und cure Ior persons, Lo Ieur und
undersLund LIeIr pruyers, und Lo be ubIe Lo do
someLIIng ubouL LIem, Is un unproved und ouLmoded
IuILI. SuIvuLIonIsm, bused on mere uIIIrmuLIon, sLIII
uppeurs us IurmIuI, dIverLIng peopIe wILI IuIse Iopes oI
Ieuven IereuILer. ReusonubIe mInds Iook Lo oLIer
meuns Ior survIvuI.
TIe nexL cenLury cun be und sIouId be LIe IumunIsLIc
cenLury. DrumuLIc scIenLIIIc, LecInoIogIcuI, und ever-
The Bigger Picture
ucceIeruLIng socIuI und poIILIcuI cIunges crowd our
uwureness. We Iuve vIrLuuIIy conquered LIe pIuneL,
expIored LIe moon, overcome LIe nuLuruI IImILs oI
LruveI und communIcuLIon; we sLund uL LIe duwn oI u
new uge, reudy Lo move IurLIer InLo spuce und perIups
InIubIL oLIer pIuneLs. UsIng LecInoIogy wIseIy, we cun
conLroI our envIronmenL, conquer poverLy, murkedIy
reduce dIseuse, exLend our IIIe-spun, sIgnIIIcunLIy
modIIy our beIuvIor, uILer LIe course oI Iumun
evoIuLIon und cuILuruI deveIopmenL, unIock vusL new
powers, und provIde IumunkInd wILI unpuruIIeIed
opporLunILy Ior ucIIevIng un ubundunL und meunIngIuI
IIIe.
TIe IuLure Is, Iowever, IIIIed wILI dungers. n IeurnIng
Lo uppIy LIe scIenLIIIc meLIod Lo nuLure und Iumun IIIe,
we Iuve opened LIe door Lo ecoIogIcuI dumuge, over-
popuIuLIon, deIumunIzIng InsLILuLIons, LoLuIILurIun
repressIon, und nucIeur und bIo-cIemIcuI dIsusLer.
uced wILI upocuIypLIc propIesIes und doomsduy
scenurIos, muny IIee In despuIr Irom reuson und
embruce IrruLIonuI cuILs und LIeoIogIes oI wILIdruwuI
und reLreuL.
TrudILIonuI moruI codes und newer IrruLIonuI cuILs boLI
IuII Lo meeL LIe pressIng needs oI Loduy und Lomorrow.
uIse 'LIeoIogIes oI Iope` und messIunIc IdeoIogIes,
subsLILuLIng new dogmus Ior oId, cunnoL cope wILI
exIsLIng worId reuIILIes. TIey sepuruLe ruLIer LIun unILe
peopIes.
HumunILy, Lo survIve, requIres boId und durIng
meusures. We need Lo exLend LIe uses oI scIenLIIIc
meLIod, noL renounce LIem, Lo Iuse reuson wILI
compussIon In order Lo buIId consLrucLIve socIuI und
moruI vuIues. ConIronLed wILI muny possIbIe IuLures,
we musL decIde wIIcI Lo pursue..OnIy u sIured worId
und gIobuI meusures wIII suIIIce.
HumunIsm Is un eLIIcuI process LIrougI wIIcI we uII
cun move, ubove und beyond LIe dIvIsIve purLIcuIurs,
IeroIc personuIILIes, dogmuLIc creeds, und rILuuI
cusLoms oI pusL reIIgIons or LIeIr mere neguLIon.
We beIIeve..LIuL LrudILIonuI dogmuLIc or uuLIorILurIun
reIIgIons LIuL pIuce reveIuLIon, God, rILuuI, or creed
ubove Iumun needs und experIence do u dIsservIce Lo
464
464
Rampant Antismoking Signifies Grave Danger
LIe Iumun specIes. Any uccounL oI nuLure sIouId puss
LIe LesLs oI scIenLIIIc evIdence; In our judgmenL, LIe
dogmus und myLIs oI LrudILIonuI reIIgIons do noL do
so..We IInd InsuIIIcIenL evIdence Ior beIIeI In LIe
exIsLence oI u supernuLuruI; IL Is eILIer meunIngIess or
IrreIevunL Lo LIe quesLIon oI survIvuI und IuIIIIImenL oI
LIe Iumun ruce. As nonLIeIsLs, we begIn wILI Iumuns
noL God, nuLure noL deILy.
Some IumunIsLs beIIeve we sIouId reInLerpreL
LrudILIonuI reIIgIons und reInvesL LIem wILI meunIngs
upproprIuLe Lo LIe currenL sILuuLIon. SucI redeIInILIons,
Iowever, oILen perpeLuuLe oId dependencIes und
escupIsms; LIey eusIIy become obscurunLIsL, ImpedIng
LIe Iree use oI LIe InLeIIecL. We need, InsLeud, rudIcuIIy
new Iumun purposes und gouIs.
|W|e cun dIscover no dIvIne purpose or provIdence Ior
LIe Iumun specIes. WIIIe LIere Is mucI LIuL we do noL
know, Iumuns ure responsIbIe Ior wIuL we ure or wIII
become. No deILy wIII suve us; we musL suve ourseIves.
PromIses oI ImmorLuI suIvuLIon or Ieur oI eLernuI
dumnuLIon ure boLI IIIusory und IurmIuI. TIey dIsLrucL
Iumuns Irom presenL concerns, Irom seII-ucLuuIIzuLIon,
und Irom recLIIyIng socIuI InjusLIces. Modern scIence
dIscredILs sucI IIsLorIc concepLs us LIe 'gIosL In LIe
mucIIne` und LIe 'sepurubIe souI`. RuLIer, scIence
uIIIrms LIuL LIe Iumun specIes Is un emergence Irom
nuLuruI evoIuLIonury Iorces. As Iur us we know, LIe LoLuI
personuIILy Is u IuncLIon oI LIe bIoIogIcuI orgunIsm
LrunsucLIng In u socIuI und cuILuruI conLexL. TIere Is no
credIbIe evIdence LIuL IIIe survIves LIe deuLI oI LIe
body. We conLInue Lo exIsL In LIe progeny und In LIe
wuy LIuL our IIves Iuve InIIuenced oLIers In our cuILure.
We uIIIrm LIuL moruI vuIues derIve LIeIr source Irom
Iumun experIence. ELIIcs Is uuLonomous und
sILuuLIonuI needIng no LIeoIogIcuI or IdeoIogIcuI
suncLIon..We sLrIve Ior LIe good IIIe, Iere und now.
TIe gouI Is Lo pursue IIIe`s enrIcImenL despILe debusIng
Iorces oI vuIgurIzuLIon, commercIuIIzuLIon, und
deIumunIzuLIon.
Reuson und InLeIIIgence ure LIe mosL eIIecLIve
InsLrumenLs LIuL IumunkInd possesses.
TIe precIousness und dIgnILy oI LIe IndIvIduuI person Is
The Bigger Picture
u cenLruI IumunIsL vuIue.
n LIe ureu oI sexuuIILy, we beIIeve LIuL InLoIerunL
uLLILudes, oILen cuILIvuLed by orLIodox reIIgIons und
purILunIcuI cuILures, unduIy repress sexuuI conducL. TIe
rIgIL Lo bIrLI conLroI, uborLIon, und dIvorce sIouId be
recognIzed.
|R|ecognILIon oI un IndIvIduuI`s rIgIL Lo dIe wILI
dIgnILy, euLIunusIu, und LIe rIgIL Lo suIcIde.
|W|e Iook Lo u sysLem oI worId Iuw und u worId order
bused upon LrunsnuLIonuI IederuI governmenL.
TIe pIuneL eurLI musL be consIdered u sIngIe ecosysLem.
TecInoIogy Is u vILuI key Lo Iumun progress und
deveIopmenL. We depIore uny neo-romunLIc eIIorLs Lo
condemn IndIscrImInuLeIy uII LecInoIogy und
scIence..We wouId resIsL uny moves Lo censor busIc
scIenLIIIc reseurcI on moruI, poIILIcuI, or socIuI grounds.
We urge LIuL purocIIuI IoyuILIes und InIIexIbIe moruI
und reIIgIous IdeoIogIes be Lrunscended.
We beIIeve LIuL IumunkInd Ius LIe poLenLIuI,
InLeIIIgence, goodwIII, und cooperuLIve skIII Lo
ImpIemenL LIIs commILmenL In LIe decudes uIeud.
HumunIsL MunIIesLo zooo IurLIer empIusIzes LIe gIobuI
vIsIon oI LIe posILIon:
or LIe IIrsL LIme In Iumun IIsLory we possess LIe
meuns provIded by scIence und LecInoIogy Lo
umeIIoruLe LIe Iumun condILIon, udvunce IuppIness
und Ireedom, und enIunce Iumun IIIe Ior uII peopIe on
LIIs pIuneL.
TIe unIque messuge oI IumunIsm on LIe currenL worId
scene Is ILs commILmenL Lo scIenLIIIc nuLuruIIsm. MosL
worId vIews uccepLed Loduy ure spIrILuuI, mysLIcuI, or
LIeoIogIcuI In cIurucLer. TIey Iuve LIeIr orIgIns In
uncIenL pre-urbun, nomudIc, und ugrIcuILuruI socIeLIes
oI LIe pusL, noL In LIe modern IndusLrIuI or
posLIndusLrIuI gIobuI InIormuLIon cuILure LIuL Is
emergIng. ScIenLIIIc nuLuruIIsm enubIes Iumun beIngs
Lo consLrucL u coIerenL worId vIew dIsenLungIed Irom
meLupIysIcs or LIeoIogy und bused on LIe scIences.
We beIIeve..LIuL LIere remuIns u need Lo deveIop new
gIobuI InsLILuLIons LIuL wIII deuI wILI LIe probIems
dIrecLIy und wIII Iocus on LIe needs oI IumunILy us u
465
465
Rampant Antismoking Signifies Grave Danger
LIe Iumun specIes. Any uccounL oI nuLure sIouId puss
LIe LesLs oI scIenLIIIc evIdence; In our judgmenL, LIe
dogmus und myLIs oI LrudILIonuI reIIgIons do noL do
so..We IInd InsuIIIcIenL evIdence Ior beIIeI In LIe
exIsLence oI u supernuLuruI; IL Is eILIer meunIngIess or
IrreIevunL Lo LIe quesLIon oI survIvuI und IuIIIIImenL oI
LIe Iumun ruce. As nonLIeIsLs, we begIn wILI Iumuns
noL God, nuLure noL deILy.
Some IumunIsLs beIIeve we sIouId reInLerpreL
LrudILIonuI reIIgIons und reInvesL LIem wILI meunIngs
upproprIuLe Lo LIe currenL sILuuLIon. SucI redeIInILIons,
Iowever, oILen perpeLuuLe oId dependencIes und
escupIsms; LIey eusIIy become obscurunLIsL, ImpedIng
LIe Iree use oI LIe InLeIIecL. We need, InsLeud, rudIcuIIy
new Iumun purposes und gouIs.
|W|e cun dIscover no dIvIne purpose or provIdence Ior
LIe Iumun specIes. WIIIe LIere Is mucI LIuL we do noL
know, Iumuns ure responsIbIe Ior wIuL we ure or wIII
become. No deILy wIII suve us; we musL suve ourseIves.
PromIses oI ImmorLuI suIvuLIon or Ieur oI eLernuI
dumnuLIon ure boLI IIIusory und IurmIuI. TIey dIsLrucL
Iumuns Irom presenL concerns, Irom seII-ucLuuIIzuLIon,
und Irom recLIIyIng socIuI InjusLIces. Modern scIence
dIscredILs sucI IIsLorIc concepLs us LIe 'gIosL In LIe
mucIIne` und LIe 'sepurubIe souI`. RuLIer, scIence
uIIIrms LIuL LIe Iumun specIes Is un emergence Irom
nuLuruI evoIuLIonury Iorces. As Iur us we know, LIe LoLuI
personuIILy Is u IuncLIon oI LIe bIoIogIcuI orgunIsm
LrunsucLIng In u socIuI und cuILuruI conLexL. TIere Is no
credIbIe evIdence LIuL IIIe survIves LIe deuLI oI LIe
body. We conLInue Lo exIsL In LIe progeny und In LIe
wuy LIuL our IIves Iuve InIIuenced oLIers In our cuILure.
We uIIIrm LIuL moruI vuIues derIve LIeIr source Irom
Iumun experIence. ELIIcs Is uuLonomous und
sILuuLIonuI needIng no LIeoIogIcuI or IdeoIogIcuI
suncLIon..We sLrIve Ior LIe good IIIe, Iere und now.
TIe gouI Is Lo pursue IIIe`s enrIcImenL despILe debusIng
Iorces oI vuIgurIzuLIon, commercIuIIzuLIon, und
deIumunIzuLIon.
Reuson und InLeIIIgence ure LIe mosL eIIecLIve
InsLrumenLs LIuL IumunkInd possesses.
TIe precIousness und dIgnILy oI LIe IndIvIduuI person Is
The Bigger Picture
u cenLruI IumunIsL vuIue.
n LIe ureu oI sexuuIILy, we beIIeve LIuL InLoIerunL
uLLILudes, oILen cuILIvuLed by orLIodox reIIgIons und
purILunIcuI cuILures, unduIy repress sexuuI conducL. TIe
rIgIL Lo bIrLI conLroI, uborLIon, und dIvorce sIouId be
recognIzed.
|R|ecognILIon oI un IndIvIduuI`s rIgIL Lo dIe wILI
dIgnILy, euLIunusIu, und LIe rIgIL Lo suIcIde.
|W|e Iook Lo u sysLem oI worId Iuw und u worId order
bused upon LrunsnuLIonuI IederuI governmenL.
TIe pIuneL eurLI musL be consIdered u sIngIe ecosysLem.
TecInoIogy Is u vILuI key Lo Iumun progress und
deveIopmenL. We depIore uny neo-romunLIc eIIorLs Lo
condemn IndIscrImInuLeIy uII LecInoIogy und
scIence..We wouId resIsL uny moves Lo censor busIc
scIenLIIIc reseurcI on moruI, poIILIcuI, or socIuI grounds.
We urge LIuL purocIIuI IoyuILIes und InIIexIbIe moruI
und reIIgIous IdeoIogIes be Lrunscended.
We beIIeve LIuL IumunkInd Ius LIe poLenLIuI,
InLeIIIgence, goodwIII, und cooperuLIve skIII Lo
ImpIemenL LIIs commILmenL In LIe decudes uIeud.
HumunIsL MunIIesLo zooo IurLIer empIusIzes LIe gIobuI
vIsIon oI LIe posILIon:
or LIe IIrsL LIme In Iumun IIsLory we possess LIe
meuns provIded by scIence und LecInoIogy Lo
umeIIoruLe LIe Iumun condILIon, udvunce IuppIness
und Ireedom, und enIunce Iumun IIIe Ior uII peopIe on
LIIs pIuneL.
TIe unIque messuge oI IumunIsm on LIe currenL worId
scene Is ILs commILmenL Lo scIenLIIIc nuLuruIIsm. MosL
worId vIews uccepLed Loduy ure spIrILuuI, mysLIcuI, or
LIeoIogIcuI In cIurucLer. TIey Iuve LIeIr orIgIns In
uncIenL pre-urbun, nomudIc, und ugrIcuILuruI socIeLIes
oI LIe pusL, noL In LIe modern IndusLrIuI or
posLIndusLrIuI gIobuI InIormuLIon cuILure LIuL Is
emergIng. ScIenLIIIc nuLuruIIsm enubIes Iumun beIngs
Lo consLrucL u coIerenL worId vIew dIsenLungIed Irom
meLupIysIcs or LIeoIogy und bused on LIe scIences.
We beIIeve..LIuL LIere remuIns u need Lo deveIop new
gIobuI InsLILuLIons LIuL wIII deuI wILI LIe probIems
dIrecLIy und wIII Iocus on LIe needs oI IumunILy us u
466
466
Rampant Antismoking Signifies Grave Danger
wIoIe. TIese IncIude LIe cuII Ior u bIcumeruI IegIsIuLure
In LIe UnILed NuLIons, wILI u WorId PurIIumenL eIecLed
by LIe peopIe, un Income Lux Lo IeIp LIe
underdeveIoped counLrIes, LIe end oI LIe veLo In LIe
SecurILy CouncII, und envIronmenLuI ugency, und u
worId courL wILI powers oI enIorcemenL.
PIuneLury IumunIsm IoIds IorLI greuL promIses Ior
IumunkInd.
A source oI conIusIon Is LIuL IumunIsm, primc jccie, uppeurs Lo
be LIe ubsurd mIsI-musI oI deLermInIsLIc und exIsLenLIuIIsL LermInoIogyJ
Ideus. However, wIere LIe exIsLenLIuI Ideus ure poorIy uncIored (uLIeIsm
or quesLIonubIe LIeIsm), us Is LypIcuIIy LIe cuse, IL Is LIe reducLIonIsL,
deLermInIsLIc Irumework LIuL wIII uILImuLeIy domInuLe. or exumpIe, LIe
ussumpLIon oI evoIuLIon Irom Iower-order Lo IIgIer-order specIes, wIIcI
Is LIe cuse In IumunIsm, necessILuLes u deLermInIsLIc Irumework. DespILe
LermInoIogy sucI us Ireedom, mInd, exceIIence, Iove,
precIousness, LIe underIyIng perspecLIve Is reducLIonIsL und muLerIuIIsL
In dIsposILIon; sucI Lerms Iuve no meunIngIuIness In LIe posILIvIsL or
scIenLIsL worId vIew. As u vurIunL oI beIuvIorIsm, sucI Lerms ure
LoIeruLed In LIe IumunIsL enLerprIse us Iong us LIese do noL InLerIere
wILI scIenLIsm.
TIe nomencIuLure oI IumunIsm Is InLenLIonuI, uIbeIL
unIorLunuLe und mIsIeudIng. L Is, In IucL, no more LIun LIe sLundurd
mctericlist munIIesLo. L Is uIso mIsIeudIng Lo porLruy LIe muLerIuIIsL
cssumption LIuL onIy LIe muLerIuI worId exIsLs, or LIuL onIy LIuL wIIcI Is
cupubIe oI beIng scIenLIIIcuIIy InvesLIguLed exIsLs, us u scIenLIIIc
proposILIon. RuLIer, IL Is u meLupIysIcuI proposILIon. L sIouId be oI gruve
concern Lo uII LIuL, by LIe LIIrd munIIesLo, LIere ure IndIcuLed very expIIcIL
gIobuI-ruIe uspIruLIons.
L Ius been consIdered LIuL muLerIuIIsm Is u superIIcIuI menLuIILy
IuvIng noL yeL come Lo Lerms wILI InsIgILs und experIence (I.e., empIrIcuI)
beyond scIenLIIIc InvesLIguLIon. Ls reusonIng Is enLIreIy bound by Iower-
nuLure reusonIng, wIIcI IL eIevuLes Lo LIe IIgI-poLenLIuI oI LIe Iumun
condILIon. L consIders uny venLurIng beyond LIIs Iower-nuLure us
InupproprIuLe rIsk-LukIng. UnIorLunuLeIy, LIe IumunIsL munIIesLo reIers
Lo LIose noL conIormIng Lo ILs edIcL oI LIe Iower-nuLure Ierd menLuIILy
or LIuL ure noL rIsk-uverse (IncIudIng sLuLIsLIcuI) by LIe musqueruded Lerm
IeroIc personuIILIes - IeroIc personuIILIes, IncIudIng uILruIsm, ure
undesIrubIe. n IucL, uny dIssenL Is consIdered us undesIrubIe.
MuLerIuIIsm Is undersLundubIy IIgIIy unLugonIsLIc Lowurds, Ior
exumpIe, LIe CIrIsLIun Irumework LIuL poInLs Lo u perIecLed sLuLe Iur
The Bigger Picture
beyond LIe vunILIes oI IuLeruI, cIrcuIur Iumun endeuvor. TIe IumunIsL
proposILIon concernIng LIe precIousness und dIgnILy oI LIe IndIvIduuI
person beIng u cenLruI IumunIsL vuIue Is enLIreIy quesLIonubIe. TIe
menLuIILy vIews LIe person us no more LIun LIe uggreguLe oI unImuIIsLIc
und survIvuIIsL desIres und LendencIes, wIIcI ure deIInubIe In reducLIonIsL
Lerms, uLLempLIng Lo IIve u sILuuLIonuI exIsLence devoId oI uny ubsoIuLe
meunIng.
OI vILuI InLeresL Lo LIIs dIscussIon Is Iow LIese vurIous Iorms oI
muLerIuIIsm Iuve combIned Lo corrupL LIe conLemporury Ideu oI IeuILI In
muny wesLern nuLIons. L wus IndIcuLed In un eurIIer secLIon LIuL LIe
WorId HeuILI OrgunIzuLIon (1qq6) deIIned IeuILI us A sLuLe oI compIeLe
pIysIcuI, menLuI und socIuI weII-beIng und noL mereIy LIe ubsence oI
dIseuse or InIIrmILy. AILIougI LIe deIInILIon Is dungerousIy vugue, LIe
mujor ImpeLus oI LIe deIInILIon uL LIe LIme wus Lo curb ubsence-oI-dIseuse
vIews oI IeuILI. L Ius uIso been consIdered LIuL over uL IeusL LIe IusL LIree
decudes medIco-muLerIuIIsm Ius reduced LIe Ideu oI IeuILI InLo un
ubsence-oI-dIseuse vIew, uLLerIy obIIvIous Lo deLrImenLuI rumIIIcuLIons
(I.e., nocebo eIIecLs) oI compIeLeIy quesLIonubIe IeuILI promoLIon.
HumunIsm udds unoLIer eIemenL Lo un uIreudy quesLIonubIe Ideu
oI IeuILI. PurLIcuIurIy In sexuuI concerns, IumunIsm empIusIzes LIe
IedonIsLIc Lendency us normuLIve. L, LIereIore, vIews uII uLLempLs uL
curbIng nuLuruI desIres (e.g., us In spIrILuuIJmoruI prescrIpLIons) us
unIeuILIy und IurmIuI.
L Is Indeed u mosL dIsLurbIng pIenomenon, purLIcuIurIy gIven ILs
gIobuI-ruIe uspIruLIons, LIuL governmenLs und IeuILI uuLIorILIes now vIew
purL oI LIeIr roIe us proLecLIng cILIzens noL onIy Irom bucLerIuI und vIruI
quunLILIes buL uIso Irom LIe IurmIuIness oI reIIgIous repressIon. or
exumpIe, VIcHeuILI, u Luxpuyer-Iunded sLuLe-governmenL InsLrumenLuIILy,
wIIcI Is u worId-Ieuder In Lobucco-conLroI poIIcy und prucLIces, uIso
beIIeves LIuL unyLIIng remoLeIy reIuLed Lo IeuILI Is wILIIn ILs cIurLer oI
IeuILI promoLIon. Ls medIcuIIy-LruIned CEO Ius posILed LIuL
combuLIng IoneIIness und buIIyIng, wIIcI muy Iuve depressIon
rumIIIcuLIons, ure wILIIn ILs cIurLer. L conducLed u survey In wIIcI LIe
IocuI cuLIoIIc urcIbIsIop wus depIcLed us u buIIy Ior noL ucquIescIng Lo u
IomosexuuI Iobby group seekIng IegILImIzuLIon oI LIe sexuuI preIerence
(Hercld,Sun, OcLober q, zoo1). L Is uncIeur Iow medIcuIIy-LruIned
personneI beIIeve LIey ure quuIIIIed Lo muke sucI wIde-rungIng IeuILI
decIsIons. However, IL Is In keepIng wILI LIe IuugILIness oI u domIneerIng
muLerIuIIsmJmedIco-muLerIuIIsm. TIIs sorL oI conducL Is IumunIsm In
ucLIon - LIe uLLempL Lo redeIIne cll uspecLs oI LIe Iumun condILIon In
muLerIuIIsL Lerms.
n IucL, LIe VIcLorIun governmenL, u sIgnuLory Lo LIe EurLI
467
467
Rampant Antismoking Signifies Grave Danger
wIoIe. TIese IncIude LIe cuII Ior u bIcumeruI IegIsIuLure
In LIe UnILed NuLIons, wILI u WorId PurIIumenL eIecLed
by LIe peopIe, un Income Lux Lo IeIp LIe
underdeveIoped counLrIes, LIe end oI LIe veLo In LIe
SecurILy CouncII, und envIronmenLuI ugency, und u
worId courL wILI powers oI enIorcemenL.
PIuneLury IumunIsm IoIds IorLI greuL promIses Ior
IumunkInd.
A source oI conIusIon Is LIuL IumunIsm, primc jccie, uppeurs Lo
be LIe ubsurd mIsI-musI oI deLermInIsLIc und exIsLenLIuIIsL LermInoIogyJ
Ideus. However, wIere LIe exIsLenLIuI Ideus ure poorIy uncIored (uLIeIsm
or quesLIonubIe LIeIsm), us Is LypIcuIIy LIe cuse, IL Is LIe reducLIonIsL,
deLermInIsLIc Irumework LIuL wIII uILImuLeIy domInuLe. or exumpIe, LIe
ussumpLIon oI evoIuLIon Irom Iower-order Lo IIgIer-order specIes, wIIcI
Is LIe cuse In IumunIsm, necessILuLes u deLermInIsLIc Irumework. DespILe
LermInoIogy sucI us Ireedom, mInd, exceIIence, Iove,
precIousness, LIe underIyIng perspecLIve Is reducLIonIsL und muLerIuIIsL
In dIsposILIon; sucI Lerms Iuve no meunIngIuIness In LIe posILIvIsL or
scIenLIsL worId vIew. As u vurIunL oI beIuvIorIsm, sucI Lerms ure
LoIeruLed In LIe IumunIsL enLerprIse us Iong us LIese do noL InLerIere
wILI scIenLIsm.
TIe nomencIuLure oI IumunIsm Is InLenLIonuI, uIbeIL
unIorLunuLe und mIsIeudIng. L Is, In IucL, no more LIun LIe sLundurd
mctericlist munIIesLo. L Is uIso mIsIeudIng Lo porLruy LIe muLerIuIIsL
cssumption LIuL onIy LIe muLerIuI worId exIsLs, or LIuL onIy LIuL wIIcI Is
cupubIe oI beIng scIenLIIIcuIIy InvesLIguLed exIsLs, us u scIenLIIIc
proposILIon. RuLIer, IL Is u meLupIysIcuI proposILIon. L sIouId be oI gruve
concern Lo uII LIuL, by LIe LIIrd munIIesLo, LIere ure IndIcuLed very expIIcIL
gIobuI-ruIe uspIruLIons.
L Ius been consIdered LIuL muLerIuIIsm Is u superIIcIuI menLuIILy
IuvIng noL yeL come Lo Lerms wILI InsIgILs und experIence (I.e., empIrIcuI)
beyond scIenLIIIc InvesLIguLIon. Ls reusonIng Is enLIreIy bound by Iower-
nuLure reusonIng, wIIcI IL eIevuLes Lo LIe IIgI-poLenLIuI oI LIe Iumun
condILIon. L consIders uny venLurIng beyond LIIs Iower-nuLure us
InupproprIuLe rIsk-LukIng. UnIorLunuLeIy, LIe IumunIsL munIIesLo reIers
Lo LIose noL conIormIng Lo ILs edIcL oI LIe Iower-nuLure Ierd menLuIILy
or LIuL ure noL rIsk-uverse (IncIudIng sLuLIsLIcuI) by LIe musqueruded Lerm
IeroIc personuIILIes - IeroIc personuIILIes, IncIudIng uILruIsm, ure
undesIrubIe. n IucL, uny dIssenL Is consIdered us undesIrubIe.
MuLerIuIIsm Is undersLundubIy IIgIIy unLugonIsLIc Lowurds, Ior
exumpIe, LIe CIrIsLIun Irumework LIuL poInLs Lo u perIecLed sLuLe Iur
The Bigger Picture
beyond LIe vunILIes oI IuLeruI, cIrcuIur Iumun endeuvor. TIe IumunIsL
proposILIon concernIng LIe precIousness und dIgnILy oI LIe IndIvIduuI
person beIng u cenLruI IumunIsL vuIue Is enLIreIy quesLIonubIe. TIe
menLuIILy vIews LIe person us no more LIun LIe uggreguLe oI unImuIIsLIc
und survIvuIIsL desIres und LendencIes, wIIcI ure deIInubIe In reducLIonIsL
Lerms, uLLempLIng Lo IIve u sILuuLIonuI exIsLence devoId oI uny ubsoIuLe
meunIng.
OI vILuI InLeresL Lo LIIs dIscussIon Is Iow LIese vurIous Iorms oI
muLerIuIIsm Iuve combIned Lo corrupL LIe conLemporury Ideu oI IeuILI In
muny wesLern nuLIons. L wus IndIcuLed In un eurIIer secLIon LIuL LIe
WorId HeuILI OrgunIzuLIon (1qq6) deIIned IeuILI us A sLuLe oI compIeLe
pIysIcuI, menLuI und socIuI weII-beIng und noL mereIy LIe ubsence oI
dIseuse or InIIrmILy. AILIougI LIe deIInILIon Is dungerousIy vugue, LIe
mujor ImpeLus oI LIe deIInILIon uL LIe LIme wus Lo curb ubsence-oI-dIseuse
vIews oI IeuILI. L Ius uIso been consIdered LIuL over uL IeusL LIe IusL LIree
decudes medIco-muLerIuIIsm Ius reduced LIe Ideu oI IeuILI InLo un
ubsence-oI-dIseuse vIew, uLLerIy obIIvIous Lo deLrImenLuI rumIIIcuLIons
(I.e., nocebo eIIecLs) oI compIeLeIy quesLIonubIe IeuILI promoLIon.
HumunIsm udds unoLIer eIemenL Lo un uIreudy quesLIonubIe Ideu
oI IeuILI. PurLIcuIurIy In sexuuI concerns, IumunIsm empIusIzes LIe
IedonIsLIc Lendency us normuLIve. L, LIereIore, vIews uII uLLempLs uL
curbIng nuLuruI desIres (e.g., us In spIrILuuIJmoruI prescrIpLIons) us
unIeuILIy und IurmIuI.
L Is Indeed u mosL dIsLurbIng pIenomenon, purLIcuIurIy gIven ILs
gIobuI-ruIe uspIruLIons, LIuL governmenLs und IeuILI uuLIorILIes now vIew
purL oI LIeIr roIe us proLecLIng cILIzens noL onIy Irom bucLerIuI und vIruI
quunLILIes buL uIso Irom LIe IurmIuIness oI reIIgIous repressIon. or
exumpIe, VIcHeuILI, u Luxpuyer-Iunded sLuLe-governmenL InsLrumenLuIILy,
wIIcI Is u worId-Ieuder In Lobucco-conLroI poIIcy und prucLIces, uIso
beIIeves LIuL unyLIIng remoLeIy reIuLed Lo IeuILI Is wILIIn ILs cIurLer oI
IeuILI promoLIon. Ls medIcuIIy-LruIned CEO Ius posILed LIuL
combuLIng IoneIIness und buIIyIng, wIIcI muy Iuve depressIon
rumIIIcuLIons, ure wILIIn ILs cIurLer. L conducLed u survey In wIIcI LIe
IocuI cuLIoIIc urcIbIsIop wus depIcLed us u buIIy Ior noL ucquIescIng Lo u
IomosexuuI Iobby group seekIng IegILImIzuLIon oI LIe sexuuI preIerence
(Hercld,Sun, OcLober q, zoo1). L Is uncIeur Iow medIcuIIy-LruIned
personneI beIIeve LIey ure quuIIIIed Lo muke sucI wIde-rungIng IeuILI
decIsIons. However, IL Is In keepIng wILI LIe IuugILIness oI u domIneerIng
muLerIuIIsmJmedIco-muLerIuIIsm. TIIs sorL oI conducL Is IumunIsm In
ucLIon - LIe uLLempL Lo redeIIne cll uspecLs oI LIe Iumun condILIon In
muLerIuIIsL Lerms.
n IucL, LIe VIcLorIun governmenL, u sIgnuLory Lo LIe EurLI
468
468
Rampant Antismoking Signifies Grave Danger
CIurLer, decIures on u governmenL websILe (www.IeuILI.vIc.gov.uu) LIuL
pubIIc IeuILI depurLmenLs ure enLIreIy responsIbIe (I.e., IuvIng conLroI)
Ior LIe compIeLe pIysIcuI, socIuI, und menLuI weII-beIng oI LIe
popuIuLIon. Towurd LIIs end, pubIIc IeuILI Ius uL ILs dIsposuI prImury cure
und prevenLIonJInLervenLIon poLenLIuIs (epIdemIoIogIc, popuIuLIon-IeveI
IndIcuLors). TIere Is LIe ubsurd cIrcumsLunce Ior democruLIc socIeLIes LIuL
LIe medIcuI esLubIIsImenL, wIIcI domInuLes pubIIc IeuILI depurLmenLs,
wIIcI Is uneIecLed, und wIIcI Is psycIoIogIcuIIy, socIuIIy und moruIIy
InepL, urmed wILI popuIuLIon-IeveI sLuLIsLIcs (sLuLIsLIcuIIsm) generuLIng
predIcLors oI poor or nonexIsLenL cuusuI busIs, LIrougI u Irumework LIuL
IncIudes everyLIIng (LoLuIILurIun - muLerIuIIsL munIIesLo), wIII produce
compIeLe weII-beIng In persons - SLuLe-suncLIoned MMES-cuIL. AguIn, IL
Is expecLed LIuL LIIs domIneerIng menLuIILy Is IIgIIy prevuIenL In wesLern
socIeLIes.
uIk (1qq6) properIy urgues LIuL once IeuILI Is deIIned In
everyLIIng Lerms, LIen IeuILI promoLIon Ius open scope Lo uILer
unyLIIng IL deems us requIrIng uILerIng. UnIorLunuLeIy, LIe evuIuuLIng
vIew Is LIe superIIcIuIILy oI muLerIuIIsm:
Reusoned und cureIuI urgumenL Is no Ionger needed: IL
Is enougI Lo uLLer LIe dreuded 'unIeuILIy` und one Ius u
IIcense Lo proceed Lo cIunge noL jusL euLIng puLLerns buL
LIougIL puLLerns. ToLuIILurIun Is upproprIuLe, LIen,
becuuse LIe reuI projecL Is onIy uppurenLIy LIe pIysIcuI.
TIe reuI urgumenL goes mucI deeper: Ior Lo suve LIe
body we musL IILeruIIy engIneer LIe souI.
TIus, LIe IeuILI promoLer`s Iocus on IIIesLyIe gIves
uwuy LIe enLIre gume, Ior IIIesLyIe Is reuIIy ubouL
noLIIng more LIun IIves, ubouL Iow IndIvIduuI Iumun
persons cIoose Lo order LIeIr IIves. And LIe uLLempL Lo
engIneer IeuILIy IIIesLyIes LIrougI engIneerIng beIIeIs
Is LIe uLLempL Lo engIneer LIe course oI Iumun IIves.
Once IeuILI Is deIIned us everyLIIng, LIere Is no pIuce
Ior u IIIe LIuL Is ordered ouLsIde LIe boundurIes oI
IeuILI.
PuL so bIunLIy, IL Is dIIIIcuIL Lo undersLund wIy IeuILI
promoLIon wouId survIve u momenL`s reIIecLIon. We do
noL, uL IeusL In Iree und democruLIc socIeLIes, uIIow
uuLIorILy Lo order our poIILIcuI or reIIgIous IIIesLyIes.
WIy wouId we uIIow sucI uuLIorILy Lo order our IeuILI
IIves?
TIe unswer, LIInk,..Is LIuL IL pusses ILseII oII scIenLIIIc
us opposed Lo IdeoIogIcuI. (p.1;6)
The Bigger Picture
TIe ucLuuI roIe oI IumunIsm Is onIy Lo erode reIerences Lo
coIerenL LrunscendenL vIews oI MunkInd. n LIuL muny wesLern nuLIons
Iuve Iud u IerILuge oI CIrIsLIun beIIeI, LIe overuII muLerIuIIsL ussuuIL Is on
CIrIsLIunILy. Muny wesLern nuLIons Iuve gone Lo greuL IengLIs over LIe
IusL number oI decudes Lo remove every IusL vesLIge oI LIe CIrIsLIun
LeucIIng Irom pubIIc poIIcy und Iuw, e.g., dIvorce, uduILery,
IomosexuuIILy, LrunsgenderIsm (see uIso uHuye & NoebeI, zooo).
MedIco-muLerIuIIsm Ius u Lemporury need Ior LIe more generuI
IumunIsL Lendency. MedIco-muLerIuIIsm wouId Iuve greuL dIIIIcuILy In
convIncIng socIeLIes uL Iurge oI wIuL ure quesLIonubIe, de-IumunIzIng
venLures (e.g., body IIxuLIon). However, LIrougI IedonIsLIc uppeuI,
IumunIsm Ius been InsLrumenLuI In dIsLrucLIng muILILudes Irom u
coIerenL, IIrsL-prIncIpIes moruI Irumework, I.e., LIe preucIIng oI moruI
reIuLIvIsm. TIe menLuIILy uLLempLs Lo convInce LIuL psycIoIogIcuI,
emoLIonuI und moruI IeebIenessJImmuLurILy ure normuI. TIereIore, uny
uLLempLs by LrunscendenL vIews Lo sLrengLIen reusonIng und conducL ure
LreuLed us IurmIuI.
TIe overuII muLerIuIIsL menLuIILy IosLers menLuI und socIuI
IeebIeness und encouruges body IIxuLIon. HuvIng removed uLLenLIon Irom
LIe souI, und LIus jeLLIsonIng LIe prospecL oI Lrunscendence, LIe
muILILudes now Iook Lo medIco-muLerIuIIsm Lo suve LIe body LIrougI
gudgeLs, gIzmos, pIIIs und poLIons. WIuL muy Iuve been dIIIIcuIL Ior
medIco-muLerIuIIsm uIone Lo jusLIIy Is now possIbIe LIrougI LIe generuI
dumuge generuLed by IumunIsm; LIe moruI reIuLIvIsm oI LIe muLerIuIIsL
posILIon ussures un unyLIIng goes upproucI In rumpunL survIvuIIsm.
As Ius uIreudy been consIdered, IosLerIng menLuI IeebIeness und
body IIxuLIon Is uIso economIcuIIy IucruLIve. TIere Is un enLIre medIco-
muLerIuIIsL producLIon-IIne LIuL Ieeds on LIIs munuIucLured IeebIeness.
TIe dIsLrucLIon uwuy Irom un ubsoIuLe, IIrsL-prIncIpIes spIrILuuIJ
moruI Irumework Ius opened LIe wuy Ior uII munner oI dIsjoInLed,
IncoIerenL worIdvIews. or exumpIe, LIe UnILed NuLIons Ius InsLILuLed un
EurLI CIurLer. TIIs documenL supposedIy seLs u bIueprInL Ior Iumun
IIvIng In LIe IuLure. TIe InLenL Is Lo brIng us muny nuLIons us possIbIe
under LIIs one umbreIIu worIdvIew. UnIorLunuLeIy, ILs rIeLorIc Is quILe
uppeuIIng Lo u moruIIy degeneruLIng worId.
TIe empIusIs oI LIIs cIurLer Is obvIousIy enLIreIy on LIe EurLI us
u seII-susLuInIng sysLem und wIere LIe Iumun Is no more or Iess
ImporLunL LIun uny oLIer uspecL. TIe worIdvIew Is uIso enLIreIy IumunIsL
In dIsposILIon, reIIecLIng LIe sume mIsIeudIng enLungIemenL oI
deLermInIsLIc und exIsLenLIuIIsL concepLs. However, LIe sIeer empIusIs on
envIronmenLuI IucLors Is no more LIun puIIed-up beIuvIorIsm. TIIs eurLI
469
469
Rampant Antismoking Signifies Grave Danger
CIurLer, decIures on u governmenL websILe (www.IeuILI.vIc.gov.uu) LIuL
pubIIc IeuILI depurLmenLs ure enLIreIy responsIbIe (I.e., IuvIng conLroI)
Ior LIe compIeLe pIysIcuI, socIuI, und menLuI weII-beIng oI LIe
popuIuLIon. Towurd LIIs end, pubIIc IeuILI Ius uL ILs dIsposuI prImury cure
und prevenLIonJInLervenLIon poLenLIuIs (epIdemIoIogIc, popuIuLIon-IeveI
IndIcuLors). TIere Is LIe ubsurd cIrcumsLunce Ior democruLIc socIeLIes LIuL
LIe medIcuI esLubIIsImenL, wIIcI domInuLes pubIIc IeuILI depurLmenLs,
wIIcI Is uneIecLed, und wIIcI Is psycIoIogIcuIIy, socIuIIy und moruIIy
InepL, urmed wILI popuIuLIon-IeveI sLuLIsLIcs (sLuLIsLIcuIIsm) generuLIng
predIcLors oI poor or nonexIsLenL cuusuI busIs, LIrougI u Irumework LIuL
IncIudes everyLIIng (LoLuIILurIun - muLerIuIIsL munIIesLo), wIII produce
compIeLe weII-beIng In persons - SLuLe-suncLIoned MMES-cuIL. AguIn, IL
Is expecLed LIuL LIIs domIneerIng menLuIILy Is IIgIIy prevuIenL In wesLern
socIeLIes.
uIk (1qq6) properIy urgues LIuL once IeuILI Is deIIned In
everyLIIng Lerms, LIen IeuILI promoLIon Ius open scope Lo uILer
unyLIIng IL deems us requIrIng uILerIng. UnIorLunuLeIy, LIe evuIuuLIng
vIew Is LIe superIIcIuIILy oI muLerIuIIsm:
Reusoned und cureIuI urgumenL Is no Ionger needed: IL
Is enougI Lo uLLer LIe dreuded 'unIeuILIy` und one Ius u
IIcense Lo proceed Lo cIunge noL jusL euLIng puLLerns buL
LIougIL puLLerns. ToLuIILurIun Is upproprIuLe, LIen,
becuuse LIe reuI projecL Is onIy uppurenLIy LIe pIysIcuI.
TIe reuI urgumenL goes mucI deeper: Ior Lo suve LIe
body we musL IILeruIIy engIneer LIe souI.
TIus, LIe IeuILI promoLer`s Iocus on IIIesLyIe gIves
uwuy LIe enLIre gume, Ior IIIesLyIe Is reuIIy ubouL
noLIIng more LIun IIves, ubouL Iow IndIvIduuI Iumun
persons cIoose Lo order LIeIr IIves. And LIe uLLempL Lo
engIneer IeuILIy IIIesLyIes LIrougI engIneerIng beIIeIs
Is LIe uLLempL Lo engIneer LIe course oI Iumun IIves.
Once IeuILI Is deIIned us everyLIIng, LIere Is no pIuce
Ior u IIIe LIuL Is ordered ouLsIde LIe boundurIes oI
IeuILI.
PuL so bIunLIy, IL Is dIIIIcuIL Lo undersLund wIy IeuILI
promoLIon wouId survIve u momenL`s reIIecLIon. We do
noL, uL IeusL In Iree und democruLIc socIeLIes, uIIow
uuLIorILy Lo order our poIILIcuI or reIIgIous IIIesLyIes.
WIy wouId we uIIow sucI uuLIorILy Lo order our IeuILI
IIves?
TIe unswer, LIInk,..Is LIuL IL pusses ILseII oII scIenLIIIc
us opposed Lo IdeoIogIcuI. (p.1;6)
The Bigger Picture
TIe ucLuuI roIe oI IumunIsm Is onIy Lo erode reIerences Lo
coIerenL LrunscendenL vIews oI MunkInd. n LIuL muny wesLern nuLIons
Iuve Iud u IerILuge oI CIrIsLIun beIIeI, LIe overuII muLerIuIIsL ussuuIL Is on
CIrIsLIunILy. Muny wesLern nuLIons Iuve gone Lo greuL IengLIs over LIe
IusL number oI decudes Lo remove every IusL vesLIge oI LIe CIrIsLIun
LeucIIng Irom pubIIc poIIcy und Iuw, e.g., dIvorce, uduILery,
IomosexuuIILy, LrunsgenderIsm (see uIso uHuye & NoebeI, zooo).
MedIco-muLerIuIIsm Ius u Lemporury need Ior LIe more generuI
IumunIsL Lendency. MedIco-muLerIuIIsm wouId Iuve greuL dIIIIcuILy In
convIncIng socIeLIes uL Iurge oI wIuL ure quesLIonubIe, de-IumunIzIng
venLures (e.g., body IIxuLIon). However, LIrougI IedonIsLIc uppeuI,
IumunIsm Ius been InsLrumenLuI In dIsLrucLIng muILILudes Irom u
coIerenL, IIrsL-prIncIpIes moruI Irumework, I.e., LIe preucIIng oI moruI
reIuLIvIsm. TIe menLuIILy uLLempLs Lo convInce LIuL psycIoIogIcuI,
emoLIonuI und moruI IeebIenessJImmuLurILy ure normuI. TIereIore, uny
uLLempLs by LrunscendenL vIews Lo sLrengLIen reusonIng und conducL ure
LreuLed us IurmIuI.
TIe overuII muLerIuIIsL menLuIILy IosLers menLuI und socIuI
IeebIeness und encouruges body IIxuLIon. HuvIng removed uLLenLIon Irom
LIe souI, und LIus jeLLIsonIng LIe prospecL oI Lrunscendence, LIe
muILILudes now Iook Lo medIco-muLerIuIIsm Lo suve LIe body LIrougI
gudgeLs, gIzmos, pIIIs und poLIons. WIuL muy Iuve been dIIIIcuIL Ior
medIco-muLerIuIIsm uIone Lo jusLIIy Is now possIbIe LIrougI LIe generuI
dumuge generuLed by IumunIsm; LIe moruI reIuLIvIsm oI LIe muLerIuIIsL
posILIon ussures un unyLIIng goes upproucI In rumpunL survIvuIIsm.
As Ius uIreudy been consIdered, IosLerIng menLuI IeebIeness und
body IIxuLIon Is uIso economIcuIIy IucruLIve. TIere Is un enLIre medIco-
muLerIuIIsL producLIon-IIne LIuL Ieeds on LIIs munuIucLured IeebIeness.
TIe dIsLrucLIon uwuy Irom un ubsoIuLe, IIrsL-prIncIpIes spIrILuuIJ
moruI Irumework Ius opened LIe wuy Ior uII munner oI dIsjoInLed,
IncoIerenL worIdvIews. or exumpIe, LIe UnILed NuLIons Ius InsLILuLed un
EurLI CIurLer. TIIs documenL supposedIy seLs u bIueprInL Ior Iumun
IIvIng In LIe IuLure. TIe InLenL Is Lo brIng us muny nuLIons us possIbIe
under LIIs one umbreIIu worIdvIew. UnIorLunuLeIy, ILs rIeLorIc Is quILe
uppeuIIng Lo u moruIIy degeneruLIng worId.
TIe empIusIs oI LIIs cIurLer Is obvIousIy enLIreIy on LIe EurLI us
u seII-susLuInIng sysLem und wIere LIe Iumun Is no more or Iess
ImporLunL LIun uny oLIer uspecL. TIe worIdvIew Is uIso enLIreIy IumunIsL
In dIsposILIon, reIIecLIng LIe sume mIsIeudIng enLungIemenL oI
deLermInIsLIc und exIsLenLIuIIsL concepLs. However, LIe sIeer empIusIs on
envIronmenLuI IucLors Is no more LIun puIIed-up beIuvIorIsm. TIIs eurLI
470
470
Rampant Antismoking Signifies Grave Danger
IuscInuLIon Ius been gIven u Iorm oI scIenLIIIc IegILImucy more recenLIy
by oveIock (1q;q) wIo posILed LIuL LIe bIospIere Is u seII-reguIuLIng
enLILy wILI LIe cupucILy Lo keep our pIuneL IeuILIy by conLroIIIng LIe
cIemIcuI und pIysIcuI envIronmenL. HIs LIeory Is reIerred Lo us GuIu
(Irom LIe Greek goddess wIo drew LIe IIvIng worId Irom cIuos).
TIe onIy poInL oI noLe Is LIuL LIIs LIeory Is muLerIuIIsL. However,
IL Is noL dIIIIcuIL Lo compreIend Iow LIIs vIew cun eusIIy be LrunsIormed
InLo eurLI or nuLure worsIIp wIIcI Ius u Iur Ionger IIsLory. TIIs
envIronmenL IIxuLIon - un exLensIon oI body IIxuLIon - Ius spuwned or
LemporurIIy IegILImIzed numerous GuIu groups; some ure muLerIuIIsL In
dIsposILIon, oLIers more spIrILuuI. A GuIu seurcI on LIe GoogIe seurcI
engIne produced numerous enLrIes. or exumpIe, LIe GuIu SocIeLy Is
concerned wILI reseurcI und educuLIon In eurLI sysLem scIence und
IocuLed uL LIe UnIversILy oI EusL ondon. TIe GuIu CommunILy Is un
EurLI-bused UnILurIun UnIversuIIsL Pugun-LIemed CongreguLIon. TIIs
Kunsus-bused communILy guLIers Lo Ionor LIe InIerenL sucredness oI
NuLure In u IumIIy-supporLIve envIronmenL wIere dIversILy oI beIIeI und
IIIesLyIe Is respecLed. We cure Ior LIe EurLI und eucI oLIer becuuse our
IIves depend on IL..we wIII recIuIm und reInLegruLe EurLI-bused
spIrILuuIILy und PugunIsm LIuL LIey mIgIL be resLored Lo LIeIr rIgILIuI
pIuce oI dIgnILy umong LIe IumIIy oI reIIgIous LrudILIons. We covenunL Lo
sLrengLIen our communILy oI joy und curIng by LreuLIng eucI oLIer wILI
IovIng-kIndness, ceIebruLIng eucI oLIer`s growLI, uccepLIng eucI oLIer`s
IImILuLIons, IonorIng eucI oLIer`s unIque puLI. nLeresLIngIy, LIe
wordIng Iere beurs u sLrIkIng resembIunce Lo LIe UN EurLI CIurLer.
AnoLIer websILe InLroduces LIe NIne Houses oI GuIu. TIIs Is u non-proIIL
orgunIzuLIon promoLIng InLeresL In EurLI-bused reIIgIons, e.g., PugunIsm
und WIccu. TIe GuIuMInd ProjecL proIIers LIuL IL Is dedIcuLed Lo
expIorIng LIe Ideu LIuL we, IumunILy, ure LIe EurLI becomIng uwure oI
ILseII. rom LIIs perspecLIve, LIe nexL sLep In LIe evoIuLIon oI
conscIousness wouId seem Lo be our coIIecLIve recognILIon LIuL LIrougI
our LecInoIogIcuI und spIrILuuI InLerconnecLedness we represenL LIe EurLI
growIng un orgun oI seII-reIIexIve conscIousness. WIIIe we beIIeve LIuL
LIe EurLI Is uIIve, und we ure purL oI IL, we uIso uIIIrm LIe GreuL SpIrIL oI
Oneness Iound uL LIe IeurL oI LIe worIds greuL spIrILuuI LrudILIons. WIuL
Is mosL ImporLunL muy noL be wIuL we beIIeve, buL wIuL we IInd we uII
sIure wIen we puL our LIougILs usIde Lo go InLo medILuLIon und pruyer
LogeLIer. An oIIIcIuI CIurcI oI EngIund pubIIcuLIon IndIcuLes LIuL God
sIouId be reIerred Lo us IemuIe (Hercld,Sun, AprII q, zooz, p.o). TIere
Is un oIIense uL God beIng reIerred Lo us uLIer. TIIs Is no more LIun LIe
uLLempL Lo GuIu-Ize LIe CIrIsLIun LeucIIng.
TIe overuII eIIecL oI LIIs IIurry oI eurLI InvesLIguLIon oI
The Bigger Picture
wIuLever dIsposILIon Is u severe erosIon oI un ubsoIuLe, IIrsL-prIncIpIes
moruI Irumework umongsL LIe muILILudes. AILIougI none mukes uny
purLIcuIur sense, LIe common LIeme Is LIeIr unLI-CIrIsLIun sLunce. TIIs
serves LIe muLerIuIIsL quesL Ior ruIersIIp.
A very crILIcuI Issue concerns wIeLIer muLerIuIIsm, us reIIecLed
In IumunIsm, consLILuLes u reIIgIon. ProponenLs oI LIe vIew seem Lo
beIIeve so, us IndIcuLed In LIe IIrsL munIIesLo. TecInIcuIIy, In LIuL
muLerIuIIsm Is predIcuLed on meLupIysIcuI beIIeI, IL goes Iur beyond LIe
scope oI scIenLIIIc enquIry. However, us IndIcuLed eurIIer, LIe Lerm
reIIgIon Is Iur Loo sLrong u Lerm Ior LIe Irumework oI beIIeI. L Ius Lo LIIs
poInL been reIerred Lo us LIe MMES cuIL. ReIIgIon Lends Lo IndIcuLe u
moruI Irumework oI Iur greuLer sopIIsLIcuLIon. MMES-cuIL beIIeIs ure u
mIsI-musI oI Ideus bused on superIIcIuIILy und IncompeLence. L wouId
Iuck sensIbIIILy Lo eIevuLe LIIs nonsense Lo u reIIgIon sLuLus. As wIII be
consIdered In u IuLer secLIon, u crILIcuI dIsLInguIsIIng IeuLure oI u coIerenL
moruI Irumework Is wIeLIer un udIerence Lo LIe LeucIIng IosLers u Iur
more proIound Iumun beIng. As uIreudy IndIcuLed, MMES beIIeIs reIIecL u
IeebIe und dungerous menLuIILy.
However, wIIIe LIIs dIscussIon vIews muLerIuIIsm us wuywurd
und cuILIsL, und wIIIe IumunIsm vIews ILseII us u reIIgIon, ILs domIneerIng
InIIuence In purLIcuIurIy wesLern socIeLIes Ius occurred LIrougI
IruuduIenLIy promoLIng ILseII us non-reIIgIous. or exumpIe, CIrIsLIunILy
Is, by Iur, LIe domInunL beIIeI sysLem In AusLruIIu - over ;o per cenL
desIgnuLed LIemseIves us CIrIsLIun In beIIeI In LIe IusL census. Over
purLIcuIurIy LIe IusL decude LIere Ius been u successIuI uLLempL Lo remove
CIrIsLIun symboIIsm In pubIIc pIuces durIng CIrIsLIun IesLIvILIes. TIIs Ius
been uccompIIsIed by pIuyIng reIIgIons uguInsL eucI oLIer LIrougI un
equuIILy upproucI. L Ius been urgued LIuL Lo dIspIuy sucI CIrIsLIun
symboIs wouId be un oIIense Lo oLIer reIIgIons. MuLerIuIIsm beIIeves
LIuL LIese LrudILIonuI reIIgIons ure equuI - equuIIy meunIngIess; LIey wIII
be LoIeruLed so Iong us LIey do noL InLerIere wILI muLerIuIIsL IdeoIogy.
TIey ure LIereIore seL InLo LIe buckground by LIe oIIense urgumenL. TIe
sume Ius occurred In prImury und secondury educuLIon concernIng
CIrIsLIun LermInoIogy und sLorIes. TIe promoLIon oI IumunIsL beIIeIs In
subsLILuLIon Ius unIorLunuLeIy gone by LIe obscure Lerm oI poIILIcuI
correcLness. AcLuuIIy occurrIng Is LIuL LIe IumunIsL (muLerIuIIsL)
munIIesLo, un exLremeIy poor uLLempL uL reIIgIon, Ius InsLuIIed ILseII us LIe
ruIIng worIdvIew by porLruyIng ILseII us some objecLIve posILIon beyond
reIIgIous beIIeI. n LIIs mosL ImporLunL sense, muLerIuIIsm Is u SLuLe-
suncLIoned und Iunded cuIL.
PossIbIy LIe mosL sIckIy uspecL oI IumunIsm Is wIuL uHuye &
NoebeI (zooo) Lerm IumunIsm`s IncurubIe opLImIsm. AguIn, LIIs
471
471
Rampant Antismoking Signifies Grave Danger
IuscInuLIon Ius been gIven u Iorm oI scIenLIIIc IegILImucy more recenLIy
by oveIock (1q;q) wIo posILed LIuL LIe bIospIere Is u seII-reguIuLIng
enLILy wILI LIe cupucILy Lo keep our pIuneL IeuILIy by conLroIIIng LIe
cIemIcuI und pIysIcuI envIronmenL. HIs LIeory Is reIerred Lo us GuIu
(Irom LIe Greek goddess wIo drew LIe IIvIng worId Irom cIuos).
TIe onIy poInL oI noLe Is LIuL LIIs LIeory Is muLerIuIIsL. However,
IL Is noL dIIIIcuIL Lo compreIend Iow LIIs vIew cun eusIIy be LrunsIormed
InLo eurLI or nuLure worsIIp wIIcI Ius u Iur Ionger IIsLory. TIIs
envIronmenL IIxuLIon - un exLensIon oI body IIxuLIon - Ius spuwned or
LemporurIIy IegILImIzed numerous GuIu groups; some ure muLerIuIIsL In
dIsposILIon, oLIers more spIrILuuI. A GuIu seurcI on LIe GoogIe seurcI
engIne produced numerous enLrIes. or exumpIe, LIe GuIu SocIeLy Is
concerned wILI reseurcI und educuLIon In eurLI sysLem scIence und
IocuLed uL LIe UnIversILy oI EusL ondon. TIe GuIu CommunILy Is un
EurLI-bused UnILurIun UnIversuIIsL Pugun-LIemed CongreguLIon. TIIs
Kunsus-bused communILy guLIers Lo Ionor LIe InIerenL sucredness oI
NuLure In u IumIIy-supporLIve envIronmenL wIere dIversILy oI beIIeI und
IIIesLyIe Is respecLed. We cure Ior LIe EurLI und eucI oLIer becuuse our
IIves depend on IL..we wIII recIuIm und reInLegruLe EurLI-bused
spIrILuuIILy und PugunIsm LIuL LIey mIgIL be resLored Lo LIeIr rIgILIuI
pIuce oI dIgnILy umong LIe IumIIy oI reIIgIous LrudILIons. We covenunL Lo
sLrengLIen our communILy oI joy und curIng by LreuLIng eucI oLIer wILI
IovIng-kIndness, ceIebruLIng eucI oLIer`s growLI, uccepLIng eucI oLIer`s
IImILuLIons, IonorIng eucI oLIer`s unIque puLI. nLeresLIngIy, LIe
wordIng Iere beurs u sLrIkIng resembIunce Lo LIe UN EurLI CIurLer.
AnoLIer websILe InLroduces LIe NIne Houses oI GuIu. TIIs Is u non-proIIL
orgunIzuLIon promoLIng InLeresL In EurLI-bused reIIgIons, e.g., PugunIsm
und WIccu. TIe GuIuMInd ProjecL proIIers LIuL IL Is dedIcuLed Lo
expIorIng LIe Ideu LIuL we, IumunILy, ure LIe EurLI becomIng uwure oI
ILseII. rom LIIs perspecLIve, LIe nexL sLep In LIe evoIuLIon oI
conscIousness wouId seem Lo be our coIIecLIve recognILIon LIuL LIrougI
our LecInoIogIcuI und spIrILuuI InLerconnecLedness we represenL LIe EurLI
growIng un orgun oI seII-reIIexIve conscIousness. WIIIe we beIIeve LIuL
LIe EurLI Is uIIve, und we ure purL oI IL, we uIso uIIIrm LIe GreuL SpIrIL oI
Oneness Iound uL LIe IeurL oI LIe worIds greuL spIrILuuI LrudILIons. WIuL
Is mosL ImporLunL muy noL be wIuL we beIIeve, buL wIuL we IInd we uII
sIure wIen we puL our LIougILs usIde Lo go InLo medILuLIon und pruyer
LogeLIer. An oIIIcIuI CIurcI oI EngIund pubIIcuLIon IndIcuLes LIuL God
sIouId be reIerred Lo us IemuIe (Hercld,Sun, AprII q, zooz, p.o). TIere
Is un oIIense uL God beIng reIerred Lo us uLIer. TIIs Is no more LIun LIe
uLLempL Lo GuIu-Ize LIe CIrIsLIun LeucIIng.
TIe overuII eIIecL oI LIIs IIurry oI eurLI InvesLIguLIon oI
The Bigger Picture
wIuLever dIsposILIon Is u severe erosIon oI un ubsoIuLe, IIrsL-prIncIpIes
moruI Irumework umongsL LIe muILILudes. AILIougI none mukes uny
purLIcuIur sense, LIe common LIeme Is LIeIr unLI-CIrIsLIun sLunce. TIIs
serves LIe muLerIuIIsL quesL Ior ruIersIIp.
A very crILIcuI Issue concerns wIeLIer muLerIuIIsm, us reIIecLed
In IumunIsm, consLILuLes u reIIgIon. ProponenLs oI LIe vIew seem Lo
beIIeve so, us IndIcuLed In LIe IIrsL munIIesLo. TecInIcuIIy, In LIuL
muLerIuIIsm Is predIcuLed on meLupIysIcuI beIIeI, IL goes Iur beyond LIe
scope oI scIenLIIIc enquIry. However, us IndIcuLed eurIIer, LIe Lerm
reIIgIon Is Iur Loo sLrong u Lerm Ior LIe Irumework oI beIIeI. L Ius Lo LIIs
poInL been reIerred Lo us LIe MMES cuIL. ReIIgIon Lends Lo IndIcuLe u
moruI Irumework oI Iur greuLer sopIIsLIcuLIon. MMES-cuIL beIIeIs ure u
mIsI-musI oI Ideus bused on superIIcIuIILy und IncompeLence. L wouId
Iuck sensIbIIILy Lo eIevuLe LIIs nonsense Lo u reIIgIon sLuLus. As wIII be
consIdered In u IuLer secLIon, u crILIcuI dIsLInguIsIIng IeuLure oI u coIerenL
moruI Irumework Is wIeLIer un udIerence Lo LIe LeucIIng IosLers u Iur
more proIound Iumun beIng. As uIreudy IndIcuLed, MMES beIIeIs reIIecL u
IeebIe und dungerous menLuIILy.
However, wIIIe LIIs dIscussIon vIews muLerIuIIsm us wuywurd
und cuILIsL, und wIIIe IumunIsm vIews ILseII us u reIIgIon, ILs domIneerIng
InIIuence In purLIcuIurIy wesLern socIeLIes Ius occurred LIrougI
IruuduIenLIy promoLIng ILseII us non-reIIgIous. or exumpIe, CIrIsLIunILy
Is, by Iur, LIe domInunL beIIeI sysLem In AusLruIIu - over ;o per cenL
desIgnuLed LIemseIves us CIrIsLIun In beIIeI In LIe IusL census. Over
purLIcuIurIy LIe IusL decude LIere Ius been u successIuI uLLempL Lo remove
CIrIsLIun symboIIsm In pubIIc pIuces durIng CIrIsLIun IesLIvILIes. TIIs Ius
been uccompIIsIed by pIuyIng reIIgIons uguInsL eucI oLIer LIrougI un
equuIILy upproucI. L Ius been urgued LIuL Lo dIspIuy sucI CIrIsLIun
symboIs wouId be un oIIense Lo oLIer reIIgIons. MuLerIuIIsm beIIeves
LIuL LIese LrudILIonuI reIIgIons ure equuI - equuIIy meunIngIess; LIey wIII
be LoIeruLed so Iong us LIey do noL InLerIere wILI muLerIuIIsL IdeoIogy.
TIey ure LIereIore seL InLo LIe buckground by LIe oIIense urgumenL. TIe
sume Ius occurred In prImury und secondury educuLIon concernIng
CIrIsLIun LermInoIogy und sLorIes. TIe promoLIon oI IumunIsL beIIeIs In
subsLILuLIon Ius unIorLunuLeIy gone by LIe obscure Lerm oI poIILIcuI
correcLness. AcLuuIIy occurrIng Is LIuL LIe IumunIsL (muLerIuIIsL)
munIIesLo, un exLremeIy poor uLLempL uL reIIgIon, Ius InsLuIIed ILseII us LIe
ruIIng worIdvIew by porLruyIng ILseII us some objecLIve posILIon beyond
reIIgIous beIIeI. n LIIs mosL ImporLunL sense, muLerIuIIsm Is u SLuLe-
suncLIoned und Iunded cuIL.
PossIbIy LIe mosL sIckIy uspecL oI IumunIsm Is wIuL uHuye &
NoebeI (zooo) Lerm IumunIsm`s IncurubIe opLImIsm. AguIn, LIIs
472
472
Rampant Antismoking Signifies Grave Danger
dIscussIon wIII go IurLIer by consIderIng LIe dIsposILIon us sLrong
deIusIon. TIe UN EurLI CIurLer, uIong wILI IumunIsL decIuruLIons und
oLIer GuIu pIIIosopIIes, use sucI Lerms us respecL, undersLundIng,
compussIon, Iove, vuIues, Ireedom, responsIbIIILy, jusLIce,
soIIdurILy, gruLILude, equuIILy, dIgnILy, very IIberuIIy. TIese Lerms
ure used us II onIy IumunIsm Ius uny Iope oI uccompIIsIIng LIese ends.
However, nowIere In LIe surmIsIng Is LIere IndIcuLed wIy LIere Is
currenLIy un ubsence oI LIese und LIe Irumework oI LIougIL LIuL wIII uIIow
u correcLIon. TIe vIew Ius no coIerenL psycIoIogy, socIuI psycIoIogy,
moruIILy. n LIe ubsence oI u coIerenL ubsoIuLe spIrILuuI Irumework, IL
Iucks u mosL busIc undersLundIng oI LIe nuLure und IIuws oI LIe Iumun
condILIon. or uII ILs mIsguIded opLImIsm, us wIII be consIdered In LIe
IoIIowIng secLIon, IL Is under LIe InIIuence oI IumunIsL domInuLIon over uL
IeusL LIe IusL Iew decudes LIuL Iumun beIIeI und conducL Is severeIy
deLerIoruLIng.
MuLerIuIIsL beIIeI cun be InLerpreLed In bIbIIcuI Lerms.
MuLerIuIIsm erroneousIy beIIeves LIuL LIere Is onIy one Iumun nuLure.
EucI Iumun Is born us u bIocIemIcuI LubIu rusu LIuL Is progressIveIy
moIded by LIe envIronmenL. AILernuLIveIy, JudeoJCIrIsLIunILy posILs LIuL
LIe Iower-nuLure conLuIns LIe IuII dIsposILIon - LIere Is u greuL IIuw
runnIng LIrougI LIe worIdIy condILIon und Iumun LIInkIng. TIe IuII
menLuIILy conLuIns uspecLs oI boLI severe guIIL und Ieur, und rebeIIIon
(e.g., urrogunce, IuugILIness, IuLred, obsessIon wILI conLroI, uvurIce,
meguIomunIu). TIrougI LIe IuII, MunkInd Is sIuckIed Lo deuLI -
pIysIcuIIy und spIrILuuIIy. TIe gouI oI CIrIsLIun suIvuLIon Is Lo produce u
new spIrILuuI bIrLI reIerred Lo us IncorrupLIbIe seed. TIe souI, LIuL purL
wIIcI survIves LIe body`s deuLI, LIen Ius uccess Lo IoIy InsIgIL und
counseI. TIe journey Lo LIe perIecLed sLuLe (resurrecLIon) Is un evenLuuIIy
compIeLe LrunsIormIng oI LIe mInd (beIIeIs), by LIe power uIIorded onIy
by LIe new bIrLI In CIrIsL, InLo uIIgnmenL wILI LIe SpIrIL oI HoIIness
ruLIer LIun LIe IIesI (u purgIng oI cIurucLer deIIcIencIes). WIuL Is gIven
spIrILuuIIy In LIe new bIrLI Is InsLunLuneous und compIeLe. However, LIe
LrunsIormIng oI mInd requIres u process oI IeurnIng over LIme. L Is
uccorded eucI, LIrougI IonesLy, Lo recognIze LIeIr need Ior suIvuLIon und
Lo pruy LIuL LIey muy receIve IL by Gruce.
MuLerIuIIsm represenLs un obIILeruLIon oI LIe concepLs oI
suIvuLIon und God, LIrougI LIe beIIeI LIuL LIere Is no sucI need. TIe
obIILeruLIon Is uLLrIbuLubIe Lo superIIcIuIILy und u Iuck oI IonesLy ruLIer
LIun due consIderuLIon. TIe menLuIILy Is ImmuLure, IuvIng exLremeIy
poor InsIgIL InLo ILs own menLuI IuncLIonIng. By jeLLIsonIng LIe Ideu oI
God, IL Is ucLuuIIy proLecLIng ILs deIIcIenL sLuLe Irom uny prospecL oI
IeuIIng. HumunIsm proposes LIuL uny uLLempL Lo IndIcuLe LIuL LIe Iower-
The Bigger Picture
nuLure Is u deIIcIenL sLuLe sIouId be consIdered us IurmIuI. As uIreudy
IndIcuLed, In LIe beIIeI LIuL IL Is onIy u body In u worId oI bodIIy
pIenomenu, und rucked by Ieur oI bodIIy deuLI, ILs onIy scope Ior
suIvuLIon Is LIrougI bodIIy conLInuunce - Ience LIe unbuIunced reIIunce
on medIco-muLerIuIIsm und LIe Iope oI sLuvIng oII deuLI. TIIs quesL Is
uIreudy doomed Lo IuIIure, beIng un uspecL oI IuIIure.
TIe conLorLed IuII-menLuIILy, LIrougI psycIoIogIcuI denIuI, Is
projecLed ouLwurd. ExLernuIILIes, LIe envIronmenL, uppeur Lo be IeurIuIIy
poIIuLed or dungerous. TIe mInd becomes convInced LIuL ILs suIvuLIon
wIII come Irom un envIronmenLuI und bodIIy cIeun up. AII LIe wIIIe IL Is
reInIorcIng ILs sense oI guIIL, Ieur, und IuLred. As LIIs deIuded versIon oI
suIvuLIon proceeds, Iesser und Iesser IndIcuLors oI dunger produce
IIgIer IeurJLerror und un equuIIy uggressIve obsessIon Lo conLroI
exLernuIILIes. An exceIIenL exumpIe Ius uIreudy been consIdered wILI
unLIsmokIng. TIe udded udvunLuge wILI unLIsmokIng Is LIuL IL provIdes
u moruIIy deIIcIenL menLuIILy wILI un IIIusory sense oI moruI superIorILy.
EnvIronmenLuIIsm Is ukIn Lo u grunder-scuIe IndIvIduuI
obsessIonJcompuIsIon wILI envIronmenLuI IygIene. n LIIs InsLunce, LIe
mInd subsLILuLes (LIrougI denIuI und projecLIon) exLernuI cIeun-up Ior u
LIorougI, IonesL uppruIsuI oI InLernuI, conLorLed beIIeIs und emoLIons.
WIere IL Is IeIL uncIecked, LIe menLuIILy becomes more nIL-pIckIng,
cruzed, und obsessed wILI conLroI.
UnIorLunuLeIy, LIe sILuuLIon cun become Iur, Iur worse. SocIeLIes
LIuL Iuve reIInquIsIed un ubsoIuLe, IIrsL-prIncIpIes moruI Irumework wIII
degeneruLe InLo progressIveIy sLronger Ieur. Muny Iuve uIreudy been
pounded InLo LIe Ieurs ussocIuLed wILI body IIxuLIon LIrougI medIco-
muLerIuIIsm. Body IIxuLIon und LIe Ieur oI bodIIy deuLI wIII be projecLed
ouLwurds. TIe menLuIILy wIII IdenLIIy uII munner oI exLernuI dungers und
LIe need Ior greuLer suIeLy. TIe worId Is u IeurIuI condILIon uL LIe besL oI
LImes, buL Is now degeneruLIng Lowurds Lerror. UnIorLunuLeIy, IL Is u
chosen puLIwuy. TIe probIem begIns In LIougIL und beIIeI wIIcI, In Lurn,
govern percepLIon und ucLIon. L Is LIe consequence oI u Iuck oI IonesL
seII-uppruIsuI. L Is monumenLuI seII-decepLIon LIuL reInIorced IrruLIonuI
beIIeIs und Ieur cun produce suIeLy; LIey wIII produce LIe exucL opposILe -
greuL dIsusLer.
Some decudes ugo LIe prospecL oI usIng IIxed-cumerus In pubIIc,
Ior wIuLever reuson, wus consIdered wIoIIy unuccepLubIe In democruLIc
socIeLIes. Over LIe IusL decude, In purLIcuIur, muny wesLern socIeLIes Iuve
embruced Iurge-scuIe cumeru neLworks In LIe InLeresLs oI greuLer suIeLy.
TIe evenLs oI SepLember 11, zoo1, In LIe US provoked even greuLer und
weIcomed securILy meusures In muny nuLIons. Muny persons, usuuIIy
nowIere neur probubIe LurgeLs, were reduced Lo u puruIyzIng Ieur. TIere Is
473
473
Rampant Antismoking Signifies Grave Danger
dIscussIon wIII go IurLIer by consIderIng LIe dIsposILIon us sLrong
deIusIon. TIe UN EurLI CIurLer, uIong wILI IumunIsL decIuruLIons und
oLIer GuIu pIIIosopIIes, use sucI Lerms us respecL, undersLundIng,
compussIon, Iove, vuIues, Ireedom, responsIbIIILy, jusLIce,
soIIdurILy, gruLILude, equuIILy, dIgnILy, very IIberuIIy. TIese Lerms
ure used us II onIy IumunIsm Ius uny Iope oI uccompIIsIIng LIese ends.
However, nowIere In LIe surmIsIng Is LIere IndIcuLed wIy LIere Is
currenLIy un ubsence oI LIese und LIe Irumework oI LIougIL LIuL wIII uIIow
u correcLIon. TIe vIew Ius no coIerenL psycIoIogy, socIuI psycIoIogy,
moruIILy. n LIe ubsence oI u coIerenL ubsoIuLe spIrILuuI Irumework, IL
Iucks u mosL busIc undersLundIng oI LIe nuLure und IIuws oI LIe Iumun
condILIon. or uII ILs mIsguIded opLImIsm, us wIII be consIdered In LIe
IoIIowIng secLIon, IL Is under LIe InIIuence oI IumunIsL domInuLIon over uL
IeusL LIe IusL Iew decudes LIuL Iumun beIIeI und conducL Is severeIy
deLerIoruLIng.
MuLerIuIIsL beIIeI cun be InLerpreLed In bIbIIcuI Lerms.
MuLerIuIIsm erroneousIy beIIeves LIuL LIere Is onIy one Iumun nuLure.
EucI Iumun Is born us u bIocIemIcuI LubIu rusu LIuL Is progressIveIy
moIded by LIe envIronmenL. AILernuLIveIy, JudeoJCIrIsLIunILy posILs LIuL
LIe Iower-nuLure conLuIns LIe IuII dIsposILIon - LIere Is u greuL IIuw
runnIng LIrougI LIe worIdIy condILIon und Iumun LIInkIng. TIe IuII
menLuIILy conLuIns uspecLs oI boLI severe guIIL und Ieur, und rebeIIIon
(e.g., urrogunce, IuugILIness, IuLred, obsessIon wILI conLroI, uvurIce,
meguIomunIu). TIrougI LIe IuII, MunkInd Is sIuckIed Lo deuLI -
pIysIcuIIy und spIrILuuIIy. TIe gouI oI CIrIsLIun suIvuLIon Is Lo produce u
new spIrILuuI bIrLI reIerred Lo us IncorrupLIbIe seed. TIe souI, LIuL purL
wIIcI survIves LIe body`s deuLI, LIen Ius uccess Lo IoIy InsIgIL und
counseI. TIe journey Lo LIe perIecLed sLuLe (resurrecLIon) Is un evenLuuIIy
compIeLe LrunsIormIng oI LIe mInd (beIIeIs), by LIe power uIIorded onIy
by LIe new bIrLI In CIrIsL, InLo uIIgnmenL wILI LIe SpIrIL oI HoIIness
ruLIer LIun LIe IIesI (u purgIng oI cIurucLer deIIcIencIes). WIuL Is gIven
spIrILuuIIy In LIe new bIrLI Is InsLunLuneous und compIeLe. However, LIe
LrunsIormIng oI mInd requIres u process oI IeurnIng over LIme. L Is
uccorded eucI, LIrougI IonesLy, Lo recognIze LIeIr need Ior suIvuLIon und
Lo pruy LIuL LIey muy receIve IL by Gruce.
MuLerIuIIsm represenLs un obIILeruLIon oI LIe concepLs oI
suIvuLIon und God, LIrougI LIe beIIeI LIuL LIere Is no sucI need. TIe
obIILeruLIon Is uLLrIbuLubIe Lo superIIcIuIILy und u Iuck oI IonesLy ruLIer
LIun due consIderuLIon. TIe menLuIILy Is ImmuLure, IuvIng exLremeIy
poor InsIgIL InLo ILs own menLuI IuncLIonIng. By jeLLIsonIng LIe Ideu oI
God, IL Is ucLuuIIy proLecLIng ILs deIIcIenL sLuLe Irom uny prospecL oI
IeuIIng. HumunIsm proposes LIuL uny uLLempL Lo IndIcuLe LIuL LIe Iower-
The Bigger Picture
nuLure Is u deIIcIenL sLuLe sIouId be consIdered us IurmIuI. As uIreudy
IndIcuLed, In LIe beIIeI LIuL IL Is onIy u body In u worId oI bodIIy
pIenomenu, und rucked by Ieur oI bodIIy deuLI, ILs onIy scope Ior
suIvuLIon Is LIrougI bodIIy conLInuunce - Ience LIe unbuIunced reIIunce
on medIco-muLerIuIIsm und LIe Iope oI sLuvIng oII deuLI. TIIs quesL Is
uIreudy doomed Lo IuIIure, beIng un uspecL oI IuIIure.
TIe conLorLed IuII-menLuIILy, LIrougI psycIoIogIcuI denIuI, Is
projecLed ouLwurd. ExLernuIILIes, LIe envIronmenL, uppeur Lo be IeurIuIIy
poIIuLed or dungerous. TIe mInd becomes convInced LIuL ILs suIvuLIon
wIII come Irom un envIronmenLuI und bodIIy cIeun up. AII LIe wIIIe IL Is
reInIorcIng ILs sense oI guIIL, Ieur, und IuLred. As LIIs deIuded versIon oI
suIvuLIon proceeds, Iesser und Iesser IndIcuLors oI dunger produce
IIgIer IeurJLerror und un equuIIy uggressIve obsessIon Lo conLroI
exLernuIILIes. An exceIIenL exumpIe Ius uIreudy been consIdered wILI
unLIsmokIng. TIe udded udvunLuge wILI unLIsmokIng Is LIuL IL provIdes
u moruIIy deIIcIenL menLuIILy wILI un IIIusory sense oI moruI superIorILy.
EnvIronmenLuIIsm Is ukIn Lo u grunder-scuIe IndIvIduuI
obsessIonJcompuIsIon wILI envIronmenLuI IygIene. n LIIs InsLunce, LIe
mInd subsLILuLes (LIrougI denIuI und projecLIon) exLernuI cIeun-up Ior u
LIorougI, IonesL uppruIsuI oI InLernuI, conLorLed beIIeIs und emoLIons.
WIere IL Is IeIL uncIecked, LIe menLuIILy becomes more nIL-pIckIng,
cruzed, und obsessed wILI conLroI.
UnIorLunuLeIy, LIe sILuuLIon cun become Iur, Iur worse. SocIeLIes
LIuL Iuve reIInquIsIed un ubsoIuLe, IIrsL-prIncIpIes moruI Irumework wIII
degeneruLe InLo progressIveIy sLronger Ieur. Muny Iuve uIreudy been
pounded InLo LIe Ieurs ussocIuLed wILI body IIxuLIon LIrougI medIco-
muLerIuIIsm. Body IIxuLIon und LIe Ieur oI bodIIy deuLI wIII be projecLed
ouLwurds. TIe menLuIILy wIII IdenLIIy uII munner oI exLernuI dungers und
LIe need Ior greuLer suIeLy. TIe worId Is u IeurIuI condILIon uL LIe besL oI
LImes, buL Is now degeneruLIng Lowurds Lerror. UnIorLunuLeIy, IL Is u
chosen puLIwuy. TIe probIem begIns In LIougIL und beIIeI wIIcI, In Lurn,
govern percepLIon und ucLIon. L Is LIe consequence oI u Iuck oI IonesL
seII-uppruIsuI. L Is monumenLuI seII-decepLIon LIuL reInIorced IrruLIonuI
beIIeIs und Ieur cun produce suIeLy; LIey wIII produce LIe exucL opposILe -
greuL dIsusLer.
Some decudes ugo LIe prospecL oI usIng IIxed-cumerus In pubIIc,
Ior wIuLever reuson, wus consIdered wIoIIy unuccepLubIe In democruLIc
socIeLIes. Over LIe IusL decude, In purLIcuIur, muny wesLern socIeLIes Iuve
embruced Iurge-scuIe cumeru neLworks In LIe InLeresLs oI greuLer suIeLy.
TIe evenLs oI SepLember 11, zoo1, In LIe US provoked even greuLer und
weIcomed securILy meusures In muny nuLIons. Muny persons, usuuIIy
nowIere neur probubIe LurgeLs, were reduced Lo u puruIyzIng Ieur. TIere Is
474
474
Rampant Antismoking Signifies Grave Danger
now u very consIderubIe InIrusLrucLure LIuL cun uILImuLeIy be pIuced In LIe
servIce oI surveIIIunce und conLroI.
TIe gruve dunger oI LIe LIme Is LIuL socIeLIes und congIomeruLes
oI socIeLIes ure uIreudy In u momenLum Lowurds u mIre oI IuIIy-IIedged
muLerIuIIsm. TIIs Is u menLuI sLuLe devoId oI moruI sensIbIIILy wIere LIe
enLIre runge oI cIurucLer deIIcIencIes cun be enucLed. L Is LIe sorL oI
cIrcumsLunce seen In NuzI Germuny wIere bruLuIILy und crueILy on u
muss-scuIe were vIewed by LIe key purLIcIpunLs us u greuL good Ior
IumunILy.
TIe sIeer domInuLIon oI muLerIuIIsm In key socIuI InsLILuLIons In
muny nuLIons sLrongIy suggesLs LIuL u LIme oI greuL dIsusLer und suIIerIng
Is noL u muLLer oI II, buL wIen; LIere Is u cosL Lo reIInquIsIIng or rejecLIng
coIerenL moruI dIrecLIon. L wouId Luke onIy u cuLusLropIe, nuLuruI or
mun-mude, IurLIer uggruvuLIng Ieur und IImILIng resources, LIuL wouId
jusLIIy uddILIonuI socIuI conLroI In LIe InLeresLs oI suIeLy - und probubIy
embruced by socIeLIes. AII LIe wIIIe, LIe prevuIIIng menLuIILy wIII be
enucLIng sLronger Iorms oI cIurucLer deIIcIencIes; IL wIII be ubIe Lo jusLIIy
more und more moruIIy quesLIonubIe conducL In LIe InLeresLs oI socIeLuI
or gIobuI suIeLy.
ProcLor (1qq;) noLes LIe beIIeI LIuL NuzIsm wus consIdered Lo be
u reucLIon Lo IIberuIIsm. RuLIer, LIere Is u beLLer urgumenL LIuL Ieuvy-
Iundedness Is u IurLIer regressIon Irom IIberuIIsm InLo IuIIy-IIedged
muLerIuIIsm, I.e., LIe IInuI pIuse oI moruI degeneruLIon. IberuIIsm ucLs Lo
dIsIodge u coIerenL moruI Irumework, wIIcI LIen puves LIe wuy Ior LIe
IuII weIgIL oI moruI reckIessness (e.g., crueILy, bruLuIILy, murder).
IberuIIsm und IuncIIuI deIIIcuLIons oI LIe envIronmenL, IuvIng no
moruI poLency, wIII be swepL usIde. MIIILurIsm wIII sureIy IIgure In LIIs
degeneruLIon. MIIILury servIce, puLrIoLIsm, und nuLIonuIIsm Iuve recenLIy
undergone u renuIssunce. TIese cun uII uILImuLeIy be muneuvered InLo
InLernuLIonuIIsL projecLs.
MedIco-muLerIuIIsm uIso IIgures very IIgIIy. L Ius pIuyed u very
sLrong roIe In LIe currenL IIberuI pIuse. BIrLI conLroI, LIe urguubIe guy
gene, V LreuLmenL, geneLIc reseurcI Iuve uII ussIsLed In weukenIng LIe
uccepLunce oI LIe CIrIsLIun Irumework. YeL, IL Is uIso known LIuL medIco-
muLerIuIIsm wus u sLrong purLIcIpunL In LIe exLermInuLIon oI IomosexuuIs
und oLIer undesIrubIes In NuzI Germuny. MedIco-muLerIuIIsm Is un
uduILerous purLner. L cun sIIIL uIIegIunces very quIckIy dependIng on
wIuL cun provIde IL wILI LIe greuLesL scope Ior co-ruIe. L Ius been
consIdered In un eurIIer secLIon LIuL LIe medIcuI esLubIIsImenL Is uIreudy
In moruI dIsurruy, I.e., moruIILy does noL IIgure IIgIIy In deIIberuLIons,
und Is now very prone Lo muxImuIIy moruIIy-quesLIonubIe sIIILs.
CIurucLer deIIcIencIes domInuLe LIe muLerIuIIsL menLuIILy.
The Bigger Picture
MuLerIuIIsm Is prevuIenL In muny nuLIons. UILImuLeIy, IeudersIIp beLween
nuLIons wIII cIusI us LIey vIew eucI oLIer LIrougI more conLorLed
percepLIon - LIere Is no escupIng LIese moruI deIIcIencIes comIng Lo LIe
Iore. TIe resuIL cun onIy be wur; LIIs provIdes LIe perIecL conduIL Ior LIe
worsL uspecLs oI cIurucLer deIIcIency, I.e., u menLuIILy enLIreIy devoId oI
scrupIes. OnIy LIIs cun be LIe resuIL oI jeLLIsonIng u coIerenL moruI
Irumework. IberuIIsm uILImuLeIy IosLers LIe IowesL IeveI oI reusonIng LIuL
Is repuIsed by LIe resuILs oI IIberuIIsm - purLIcuIurIy IrugmenLuLIon.
However, under LIe guIse oI u unIIyIng propensILy promoLIng common
purpose (e.g., nuLIonuIIsm, InLernuLIonuIIsm), LIIs menLuIILy`s versIon oI
soIuLIons wIII reIIecL LIe worsL oI LIe Iumun poLenLIuI, e.g.,
exLermInuLIon, erudIcuLIon In LIeIr IILeruI und dIrecL sense. TIIs menLuIILy
cun be seen In NuzIsm. AnyLIIng LIuL cunnoL conLrIbuLe Lo LIe superIIcIuI
nuLIonuIIsL cuuse Is dIspensubIe - IncIudIng Iumuns.
TIIs Is noL consIdered u sIIppery-sIope urgumenL. Hunuuske-
AbeI (1qq6) mukes u sImIIur, uILIougI more IImILed observuLIon,
concernIng LIe NuzI regIme. TIe sInIsLer conducL oI LIe NuzIs Iud smuII
begInnIngs - purLIcuIurIy regurdIng LIe medIcuI esLubIIsImenL. YeL, IeIL
uncIecked, LIe menLuIILy quIckIy ucceIeruLes InLo derunged soIuLIons. L
uIso cunnoL be overIooked LIuL LIe IIrsL on LIe ugendu In LIe medIco-
muLerIuIIsL crusude Lo soIve LIe worId`s probIems wus unLIsmokIng. TIIs
unLIsmokIng obsessIon Is prevuIenL In muny nuLIons uL LIIs LIme. So, Loo,
Is LIe domInuLIon oI muLerIuIIsLJmedIco-muLerIuIIsm. As wIII be
consIdered In u IoIIowIng secLIon, numerous socIeLIes ure so IuckIng In u
coIerenL moruI Irumework LIuL LIey ure rIpe Ior greuL dIsusLer us
muLerIuIIsm, In InLernuLIonuIIsL Lerms LIIs LIme, uLLempLs Lo soIve LIe
worId`s probIems, I.e., IIgI poLenLIuI Ior ucceIeruLIon InLo dungerousIy
derunged soIuLIons.
L sIouId uIso IndIcuLe Lo secuIurIsLs or uLIeIsLs LIuL Mun Is
reIIgIousIy dIsposed. ScIence cunnoL subsLILuLe Ior God, uILIougI IL cun,
ImproperIy, be worsIIpped. However, scIence produces IIgI-IeveI
predIcLors, purLIcuIurIy concernIng Iumun ucLIon, very rureIy. I God Is
jeLLIsoned Irom consIderuLIon, cIurucLer deIIcIencIes ure noL beIng
correcLed. mpuLIence und obsessIon wILI conLroI ure onIy some oI LIese
deIIcIencIes. TIe producLIons oI scIence ure Iur Loo sIow Ior LIe muLerIuIIsL
menLuIILy`s dIsposILIon; IL musL conLroI - now. As cun be seen wILI
scIenLIsmJIeuILIIsm, scIence Ius been IIjucked (reduced Lo mIndIess
sLuLIsLIcuIIsm) by u superIIcIuI und IncompeLenL menLuIILy In LIuL IL
provIdes u conduIL Ior enucLIng obsessIons wILI conLroI, IuugILIness, eLc..
ScIence, In IucL, Is enLIreIy IrreIevunL. TIe uuLIorILIes In LIIs Irumework
do noL even quesLIonubIy worsIIp scIence, buL worsIIp LIeIr own
conLorLed LIInkIng. And popuIuLIons LIuL Iuve sIumped InLo moruI
475
475
Rampant Antismoking Signifies Grave Danger
now u very consIderubIe InIrusLrucLure LIuL cun uILImuLeIy be pIuced In LIe
servIce oI surveIIIunce und conLroI.
TIe gruve dunger oI LIe LIme Is LIuL socIeLIes und congIomeruLes
oI socIeLIes ure uIreudy In u momenLum Lowurds u mIre oI IuIIy-IIedged
muLerIuIIsm. TIIs Is u menLuI sLuLe devoId oI moruI sensIbIIILy wIere LIe
enLIre runge oI cIurucLer deIIcIencIes cun be enucLed. L Is LIe sorL oI
cIrcumsLunce seen In NuzI Germuny wIere bruLuIILy und crueILy on u
muss-scuIe were vIewed by LIe key purLIcIpunLs us u greuL good Ior
IumunILy.
TIe sIeer domInuLIon oI muLerIuIIsm In key socIuI InsLILuLIons In
muny nuLIons sLrongIy suggesLs LIuL u LIme oI greuL dIsusLer und suIIerIng
Is noL u muLLer oI II, buL wIen; LIere Is u cosL Lo reIInquIsIIng or rejecLIng
coIerenL moruI dIrecLIon. L wouId Luke onIy u cuLusLropIe, nuLuruI or
mun-mude, IurLIer uggruvuLIng Ieur und IImILIng resources, LIuL wouId
jusLIIy uddILIonuI socIuI conLroI In LIe InLeresLs oI suIeLy - und probubIy
embruced by socIeLIes. AII LIe wIIIe, LIe prevuIIIng menLuIILy wIII be
enucLIng sLronger Iorms oI cIurucLer deIIcIencIes; IL wIII be ubIe Lo jusLIIy
more und more moruIIy quesLIonubIe conducL In LIe InLeresLs oI socIeLuI
or gIobuI suIeLy.
ProcLor (1qq;) noLes LIe beIIeI LIuL NuzIsm wus consIdered Lo be
u reucLIon Lo IIberuIIsm. RuLIer, LIere Is u beLLer urgumenL LIuL Ieuvy-
Iundedness Is u IurLIer regressIon Irom IIberuIIsm InLo IuIIy-IIedged
muLerIuIIsm, I.e., LIe IInuI pIuse oI moruI degeneruLIon. IberuIIsm ucLs Lo
dIsIodge u coIerenL moruI Irumework, wIIcI LIen puves LIe wuy Ior LIe
IuII weIgIL oI moruI reckIessness (e.g., crueILy, bruLuIILy, murder).
IberuIIsm und IuncIIuI deIIIcuLIons oI LIe envIronmenL, IuvIng no
moruI poLency, wIII be swepL usIde. MIIILurIsm wIII sureIy IIgure In LIIs
degeneruLIon. MIIILury servIce, puLrIoLIsm, und nuLIonuIIsm Iuve recenLIy
undergone u renuIssunce. TIese cun uII uILImuLeIy be muneuvered InLo
InLernuLIonuIIsL projecLs.
MedIco-muLerIuIIsm uIso IIgures very IIgIIy. L Ius pIuyed u very
sLrong roIe In LIe currenL IIberuI pIuse. BIrLI conLroI, LIe urguubIe guy
gene, V LreuLmenL, geneLIc reseurcI Iuve uII ussIsLed In weukenIng LIe
uccepLunce oI LIe CIrIsLIun Irumework. YeL, IL Is uIso known LIuL medIco-
muLerIuIIsm wus u sLrong purLIcIpunL In LIe exLermInuLIon oI IomosexuuIs
und oLIer undesIrubIes In NuzI Germuny. MedIco-muLerIuIIsm Is un
uduILerous purLner. L cun sIIIL uIIegIunces very quIckIy dependIng on
wIuL cun provIde IL wILI LIe greuLesL scope Ior co-ruIe. L Ius been
consIdered In un eurIIer secLIon LIuL LIe medIcuI esLubIIsImenL Is uIreudy
In moruI dIsurruy, I.e., moruIILy does noL IIgure IIgIIy In deIIberuLIons,
und Is now very prone Lo muxImuIIy moruIIy-quesLIonubIe sIIILs.
CIurucLer deIIcIencIes domInuLe LIe muLerIuIIsL menLuIILy.
The Bigger Picture
MuLerIuIIsm Is prevuIenL In muny nuLIons. UILImuLeIy, IeudersIIp beLween
nuLIons wIII cIusI us LIey vIew eucI oLIer LIrougI more conLorLed
percepLIon - LIere Is no escupIng LIese moruI deIIcIencIes comIng Lo LIe
Iore. TIe resuIL cun onIy be wur; LIIs provIdes LIe perIecL conduIL Ior LIe
worsL uspecLs oI cIurucLer deIIcIency, I.e., u menLuIILy enLIreIy devoId oI
scrupIes. OnIy LIIs cun be LIe resuIL oI jeLLIsonIng u coIerenL moruI
Irumework. IberuIIsm uILImuLeIy IosLers LIe IowesL IeveI oI reusonIng LIuL
Is repuIsed by LIe resuILs oI IIberuIIsm - purLIcuIurIy IrugmenLuLIon.
However, under LIe guIse oI u unIIyIng propensILy promoLIng common
purpose (e.g., nuLIonuIIsm, InLernuLIonuIIsm), LIIs menLuIILy`s versIon oI
soIuLIons wIII reIIecL LIe worsL oI LIe Iumun poLenLIuI, e.g.,
exLermInuLIon, erudIcuLIon In LIeIr IILeruI und dIrecL sense. TIIs menLuIILy
cun be seen In NuzIsm. AnyLIIng LIuL cunnoL conLrIbuLe Lo LIe superIIcIuI
nuLIonuIIsL cuuse Is dIspensubIe - IncIudIng Iumuns.
TIIs Is noL consIdered u sIIppery-sIope urgumenL. Hunuuske-
AbeI (1qq6) mukes u sImIIur, uILIougI more IImILed observuLIon,
concernIng LIe NuzI regIme. TIe sInIsLer conducL oI LIe NuzIs Iud smuII
begInnIngs - purLIcuIurIy regurdIng LIe medIcuI esLubIIsImenL. YeL, IeIL
uncIecked, LIe menLuIILy quIckIy ucceIeruLes InLo derunged soIuLIons. L
uIso cunnoL be overIooked LIuL LIe IIrsL on LIe ugendu In LIe medIco-
muLerIuIIsL crusude Lo soIve LIe worId`s probIems wus unLIsmokIng. TIIs
unLIsmokIng obsessIon Is prevuIenL In muny nuLIons uL LIIs LIme. So, Loo,
Is LIe domInuLIon oI muLerIuIIsLJmedIco-muLerIuIIsm. As wIII be
consIdered In u IoIIowIng secLIon, numerous socIeLIes ure so IuckIng In u
coIerenL moruI Irumework LIuL LIey ure rIpe Ior greuL dIsusLer us
muLerIuIIsm, In InLernuLIonuIIsL Lerms LIIs LIme, uLLempLs Lo soIve LIe
worId`s probIems, I.e., IIgI poLenLIuI Ior ucceIeruLIon InLo dungerousIy
derunged soIuLIons.
L sIouId uIso IndIcuLe Lo secuIurIsLs or uLIeIsLs LIuL Mun Is
reIIgIousIy dIsposed. ScIence cunnoL subsLILuLe Ior God, uILIougI IL cun,
ImproperIy, be worsIIpped. However, scIence produces IIgI-IeveI
predIcLors, purLIcuIurIy concernIng Iumun ucLIon, very rureIy. I God Is
jeLLIsoned Irom consIderuLIon, cIurucLer deIIcIencIes ure noL beIng
correcLed. mpuLIence und obsessIon wILI conLroI ure onIy some oI LIese
deIIcIencIes. TIe producLIons oI scIence ure Iur Loo sIow Ior LIe muLerIuIIsL
menLuIILy`s dIsposILIon; IL musL conLroI - now. As cun be seen wILI
scIenLIsmJIeuILIIsm, scIence Ius been IIjucked (reduced Lo mIndIess
sLuLIsLIcuIIsm) by u superIIcIuI und IncompeLenL menLuIILy In LIuL IL
provIdes u conduIL Ior enucLIng obsessIons wILI conLroI, IuugILIness, eLc..
ScIence, In IucL, Is enLIreIy IrreIevunL. TIe uuLIorILIes In LIIs Irumework
do noL even quesLIonubIy worsIIp scIence, buL worsIIp LIeIr own
conLorLed LIInkIng. And popuIuLIons LIuL Iuve sIumped InLo moruI
476
476
Rampant Antismoking Signifies Grave Danger
IeebIeness wIII reIIgIousIy IoIIow Inune muLerIuIIsL (survIvuIIsL) edIcLs.
WIIIe some secuIurIsLs Iuve been preucIIng pIeusureJIedonIsm
(IIberuIIsm) und uLLempLIng Lo guurd uguInsL LIe CIrIsLIun Irumework,
LIey Iuve InudverLenLIy been IueIIng u degeneruLIon InLo IuIIy-IIedged
muLerIuIIsm domInuLed by medIco-muLerIuIIsm. rom u secuIurIsL`s poInL
oI vIew, LIe CIrIsLIun perspecLIve Is LIe Iur beLLer opLIon oI LIe Lwo. AL
IeusL In LIIs cuse LIere Is recourse Ior mIsconducL by reIerrIng Lo u
coIerenL moruI Irumework. MuLerIuIIsm Is devoId oI uny sucI Irumework.
L reIIecLs un enucLmenL oI uII LIe cIurucLer deIIcIencIes LIuL u coIerenL
moruI Irumework Is uLLempLIng Lo correcL. TIere Is no mIddIe ground In
LIe muLLer. TIere Is eILIer u moruI Irumework greuLer LIun scIence, or, II
noL, LIe prevuIIIng menLuIILy wIII bypuss scIence und IIjuck wIuLever Is
necessury, IncIudIng scIence, In munIIesLIng perverse percepLIon und
conducL. or exumpIe, GorI`s (1qqu, 1qqb) uLLempLs Lo IIgIIIgIL LIe Iuck
oI scIenLIIIc subsLunce oI LIe EPA (1qq) IIusco wus meL wILI u wuII oI
Ignorunce. uIIy-IIedged muLerIuIIsm Is u superIIcIuI menLuIILy IuckIng
InsIgIL. One cun reIer Lo crILIcuI scIenLIIIc, psycIoIogIcuI, reIuLIonuI, or
moruI Issues und LIe menLuIILy sImpIy cunnoL IoIIow LIe reusonIng - IL
cunnoL compreIend LIe mugnILude oI ILs mIsguIded percepLIon.
HumunIsm Is Loo IeebIe u menLuIILy Lo recognIze LIuL LIere ure
consequences oI moruI reckIessness. TIe menLuIILy wouId ruLIer convInce
ILseII LIuL LIere ure no consequences. L wouId InvesL uII oI ILs LIme In Iow
Lo ubsoIve ILseII oI guIIL IoIIowIng promoLed wrongs. AILIougI IL preucIes
peuce cd ncusecm, ILs moruI reIuLIvIsm, LIuL represenLs und Ieeds
cIurucLer deIIcIencIes, Is LIe rouLe Lo wur; moruI IoIIy Ius u sequence Lo
dIsusLer (see uIso IoIIowIng secLIon).
TIe sILuuLIon Ius noL yeL deLerIoruLed InLo ILs IowesL possIbIe
Iorm. However, LIe LreuLmenL oI smokIng, us one uspecL oI u pIeLIoru oI
muLerIuIIsL mIsconducL, does noL uugur weII. L IndIcuLes LIuL, Ior moruIIy
IIounderIng socIeLIes, LIrougI u conLInuuI pIuy by uuLIorILIes usIng u
sIIck propugundu mucIIne on IrruLIonuI Ieur und Iuke purILunIsm, muny
cun be eusIIy munIpuIuLed InLo desLrucLIve uIrs oI superIorILy. I Issues
become even more emoLIve, LIen Iow mucI more desLrucLIve cun LIese
deIIcIencIes become? A degeneruLIng menLuIILy Ius LIe cupucILy Lo seL
person uguInsL person und nuLIon uguInsL nuLIon. MuLLers sucI us gIobuI
wurmIng und oLIer envIronmenLuI IucLors ure noL LIe gruve dungers oI LIe
LIme. ong beIore uny oI LIese wouId Iuve uny reIevunce, II uL uII, IL Is
progressIve InsunILy on u muss scuIe LIuL Is sInguIurIy probIemuLIc - und
uL u LIme wIen LIe cupucILy Ior mIIILury desLrucLIveness Is unpuruIIeIed.
TIe IndIcuLIons poInL Lo u LIme oI greuL reckonIng. L Is wIen LIe moruI
decuy Is IIrmIy enLrencIed LIuL LIe severe moruI LesLIng wIII come.
TrugIcuIIy, muny souIs ure In jeopurdy due Lo mIspIuced IuILI.
The Bigger Picture
n bIbIIcuI Lerms, LIIs Is reIerred Lo us LIe end oI LIe uge,
cuImInuLIng In u seven-yeur LrIbuIuLIon perIod: BuL undersLund LIIs, LIuL
In LIe IusL duys LIere wIII seL In perIIous LImes oI greuL sLress cnd LroubIe
- Iurd Lo deuI wILI cnd Iurd Lo beur. or peopIe wIII be Iovers oI seII cnd
|uLLerIy| seII-cenLered, Iovers oI money cnd uroused by un InordInuLe
(greedy) desIre Ior weuILI, proud cnd urrogunL cnd conLempLuous
bousLers. (z TImoLIy : 1,z - AmpIIIIed BIbIe)
TIere Is uIso u premonILory uspecL Lo un obsessIon wILI
unLIsmokIng. MInds do Iuve un InkIIng oI LIe vIoIence oI IuIIy-IIedged
Iower-nuLure LendencIes (I.e., wur). TIrougI u Iuck oI IonesLy, mInds
projecL LIIs Inner-IosLIIILy ouLwurds. CurrenLIy, unyLIIng Lo do wILI
smokIng Is u sLrong projecLIon poInL Ior LIIs IosLIIILy. Tobucco smoke,
Iowever InordInuLe, Is u remInder oI wIere vIoIence Ieuds - IIre und LIe
greuL puIIs oI LIIck, bIuck, ucrId smoke ussocIuLed wILI modern wurIure.
SeII-deceIved mInds wIII convInce LIemseIves LIuL, by exLermInuLIng
wIsps oI Lobucco smoke, LIe ucLuuI dIsusLer cun be uverLed. RuLIer, IL Is by
reInIorcIng conLorLed LIougIL LIuL wIII sureIy brIng LIe cuIumILy.
. Dther Correlctes oj Antismolin
SInce LIe eurIy-Lo-mId-1q;o`s, wIIcI seems Lo be LIe rooL oI LIe
currenL muLerIuIIsL domInuLIon, LIere ure muny pIenomenu sLrongIy
ussocIuLed wILI escuIuLIng unLIsmokIng. TIe IoIIowIng Is by no meuns
exIuusLIve oI LIemes over LIe IusL Iew decudes. OLIers muy weII be ubIe Lo
IengLIen LIe IIsL.
n AusLruIIu, LIe mId-1q;o`s suw LIe InLroducLIon oI no IuuIL
dIvorce. TIIs reIIecLs LIe muLerIuIIsL (IumunIsL) beIIeI LIuL Iuw sIouId noL
InIrInge on nuLuruI desIres und LIuL uny decIsIon Ior dIvorce Is noL
moruIIy wrong. rom u CIrIsLIun vIewpoInL, dIvorce, wILI buL Iew
excepLIons, Is noL permILLed. DIIIIcuILIes urIsIng Irom LIe Iower-nuLure ure
Lo be expecLed. However, CIrIsLIunILy provIdes u Irumework oI reusonIng
und counseI LIuL uIIows un overcomIng oI dIIIIcuILIes InLo IIgIer reIuLIonuI
sLundIng - even IuLred cun be overcome. TIe CIrIsLIun journey Is one oI
sLrengLIenIng IoIy cIurucLer, und murrIuge Is one uvenue Ior LIIs
proIound work.
MurIey (zoo1) IndIcuLes LIuL: AbouL q6 per cenL oI murrIuges
wIII end In dIvorce. CoIubILuLIon Ius Increused rupIdIy, buL coIubILIng
reIuLIonsIIps ure even more unsLubIe LIun murrIuge. CoIubILuLIon does
noL Ieud Lo sLronger murrIuges. TIIs Is conLrusLed wILI u ruLe oI 16 per
cenL In 1q;q. TIe dIvorce ruLe Is even sIIgILIy IIgIer Ior supposedIy
CIrIsLIun coupIes (e.g., Burnu ReseurcI Group, zoo1). TIe probIem Iere
Is LIuL IumunIsm Ius severeIy dIIuLed LIe CIrIsLIun LeucIIng Ior muny.
477
477
Rampant Antismoking Signifies Grave Danger
IeebIeness wIII reIIgIousIy IoIIow Inune muLerIuIIsL (survIvuIIsL) edIcLs.
WIIIe some secuIurIsLs Iuve been preucIIng pIeusureJIedonIsm
(IIberuIIsm) und uLLempLIng Lo guurd uguInsL LIe CIrIsLIun Irumework,
LIey Iuve InudverLenLIy been IueIIng u degeneruLIon InLo IuIIy-IIedged
muLerIuIIsm domInuLed by medIco-muLerIuIIsm. rom u secuIurIsL`s poInL
oI vIew, LIe CIrIsLIun perspecLIve Is LIe Iur beLLer opLIon oI LIe Lwo. AL
IeusL In LIIs cuse LIere Is recourse Ior mIsconducL by reIerrIng Lo u
coIerenL moruI Irumework. MuLerIuIIsm Is devoId oI uny sucI Irumework.
L reIIecLs un enucLmenL oI uII LIe cIurucLer deIIcIencIes LIuL u coIerenL
moruI Irumework Is uLLempLIng Lo correcL. TIere Is no mIddIe ground In
LIe muLLer. TIere Is eILIer u moruI Irumework greuLer LIun scIence, or, II
noL, LIe prevuIIIng menLuIILy wIII bypuss scIence und IIjuck wIuLever Is
necessury, IncIudIng scIence, In munIIesLIng perverse percepLIon und
conducL. or exumpIe, GorI`s (1qqu, 1qqb) uLLempLs Lo IIgIIIgIL LIe Iuck
oI scIenLIIIc subsLunce oI LIe EPA (1qq) IIusco wus meL wILI u wuII oI
Ignorunce. uIIy-IIedged muLerIuIIsm Is u superIIcIuI menLuIILy IuckIng
InsIgIL. One cun reIer Lo crILIcuI scIenLIIIc, psycIoIogIcuI, reIuLIonuI, or
moruI Issues und LIe menLuIILy sImpIy cunnoL IoIIow LIe reusonIng - IL
cunnoL compreIend LIe mugnILude oI ILs mIsguIded percepLIon.
HumunIsm Is Loo IeebIe u menLuIILy Lo recognIze LIuL LIere ure
consequences oI moruI reckIessness. TIe menLuIILy wouId ruLIer convInce
ILseII LIuL LIere ure no consequences. L wouId InvesL uII oI ILs LIme In Iow
Lo ubsoIve ILseII oI guIIL IoIIowIng promoLed wrongs. AILIougI IL preucIes
peuce cd ncusecm, ILs moruI reIuLIvIsm, LIuL represenLs und Ieeds
cIurucLer deIIcIencIes, Is LIe rouLe Lo wur; moruI IoIIy Ius u sequence Lo
dIsusLer (see uIso IoIIowIng secLIon).
TIe sILuuLIon Ius noL yeL deLerIoruLed InLo ILs IowesL possIbIe
Iorm. However, LIe LreuLmenL oI smokIng, us one uspecL oI u pIeLIoru oI
muLerIuIIsL mIsconducL, does noL uugur weII. L IndIcuLes LIuL, Ior moruIIy
IIounderIng socIeLIes, LIrougI u conLInuuI pIuy by uuLIorILIes usIng u
sIIck propugundu mucIIne on IrruLIonuI Ieur und Iuke purILunIsm, muny
cun be eusIIy munIpuIuLed InLo desLrucLIve uIrs oI superIorILy. I Issues
become even more emoLIve, LIen Iow mucI more desLrucLIve cun LIese
deIIcIencIes become? A degeneruLIng menLuIILy Ius LIe cupucILy Lo seL
person uguInsL person und nuLIon uguInsL nuLIon. MuLLers sucI us gIobuI
wurmIng und oLIer envIronmenLuI IucLors ure noL LIe gruve dungers oI LIe
LIme. ong beIore uny oI LIese wouId Iuve uny reIevunce, II uL uII, IL Is
progressIve InsunILy on u muss scuIe LIuL Is sInguIurIy probIemuLIc - und
uL u LIme wIen LIe cupucILy Ior mIIILury desLrucLIveness Is unpuruIIeIed.
TIe IndIcuLIons poInL Lo u LIme oI greuL reckonIng. L Is wIen LIe moruI
decuy Is IIrmIy enLrencIed LIuL LIe severe moruI LesLIng wIII come.
TrugIcuIIy, muny souIs ure In jeopurdy due Lo mIspIuced IuILI.
The Bigger Picture
n bIbIIcuI Lerms, LIIs Is reIerred Lo us LIe end oI LIe uge,
cuImInuLIng In u seven-yeur LrIbuIuLIon perIod: BuL undersLund LIIs, LIuL
In LIe IusL duys LIere wIII seL In perIIous LImes oI greuL sLress cnd LroubIe
- Iurd Lo deuI wILI cnd Iurd Lo beur. or peopIe wIII be Iovers oI seII cnd
|uLLerIy| seII-cenLered, Iovers oI money cnd uroused by un InordInuLe
(greedy) desIre Ior weuILI, proud cnd urrogunL cnd conLempLuous
bousLers. (z TImoLIy : 1,z - AmpIIIIed BIbIe)
TIere Is uIso u premonILory uspecL Lo un obsessIon wILI
unLIsmokIng. MInds do Iuve un InkIIng oI LIe vIoIence oI IuIIy-IIedged
Iower-nuLure LendencIes (I.e., wur). TIrougI u Iuck oI IonesLy, mInds
projecL LIIs Inner-IosLIIILy ouLwurds. CurrenLIy, unyLIIng Lo do wILI
smokIng Is u sLrong projecLIon poInL Ior LIIs IosLIIILy. Tobucco smoke,
Iowever InordInuLe, Is u remInder oI wIere vIoIence Ieuds - IIre und LIe
greuL puIIs oI LIIck, bIuck, ucrId smoke ussocIuLed wILI modern wurIure.
SeII-deceIved mInds wIII convInce LIemseIves LIuL, by exLermInuLIng
wIsps oI Lobucco smoke, LIe ucLuuI dIsusLer cun be uverLed. RuLIer, IL Is by
reInIorcIng conLorLed LIougIL LIuL wIII sureIy brIng LIe cuIumILy.
. Dther Correlctes oj Antismolin
SInce LIe eurIy-Lo-mId-1q;o`s, wIIcI seems Lo be LIe rooL oI LIe
currenL muLerIuIIsL domInuLIon, LIere ure muny pIenomenu sLrongIy
ussocIuLed wILI escuIuLIng unLIsmokIng. TIe IoIIowIng Is by no meuns
exIuusLIve oI LIemes over LIe IusL Iew decudes. OLIers muy weII be ubIe Lo
IengLIen LIe IIsL.
n AusLruIIu, LIe mId-1q;o`s suw LIe InLroducLIon oI no IuuIL
dIvorce. TIIs reIIecLs LIe muLerIuIIsL (IumunIsL) beIIeI LIuL Iuw sIouId noL
InIrInge on nuLuruI desIres und LIuL uny decIsIon Ior dIvorce Is noL
moruIIy wrong. rom u CIrIsLIun vIewpoInL, dIvorce, wILI buL Iew
excepLIons, Is noL permILLed. DIIIIcuILIes urIsIng Irom LIe Iower-nuLure ure
Lo be expecLed. However, CIrIsLIunILy provIdes u Irumework oI reusonIng
und counseI LIuL uIIows un overcomIng oI dIIIIcuILIes InLo IIgIer reIuLIonuI
sLundIng - even IuLred cun be overcome. TIe CIrIsLIun journey Is one oI
sLrengLIenIng IoIy cIurucLer, und murrIuge Is one uvenue Ior LIIs
proIound work.
MurIey (zoo1) IndIcuLes LIuL: AbouL q6 per cenL oI murrIuges
wIII end In dIvorce. CoIubILuLIon Ius Increused rupIdIy, buL coIubILIng
reIuLIonsIIps ure even more unsLubIe LIun murrIuge. CoIubILuLIon does
noL Ieud Lo sLronger murrIuges. TIIs Is conLrusLed wILI u ruLe oI 16 per
cenL In 1q;q. TIe dIvorce ruLe Is even sIIgILIy IIgIer Ior supposedIy
CIrIsLIun coupIes (e.g., Burnu ReseurcI Group, zoo1). TIe probIem Iere
Is LIuL IumunIsm Ius severeIy dIIuLed LIe CIrIsLIun LeucIIng Ior muny.
478
478
Rampant Antismoking Signifies Grave Danger
TIere ure now numerous nomInuI CIrIsLIuns, undersLundIng very IILLIe
ubouL LIe ucLuuI LeucIIng. or exumpIe, LIe UnILIng CIurcI now consIders
premurILuI sex, de IucLo reIuLIonsIIps, IIIegILImuLe cIIIdren, und dIvorce us
uccepLubIe (Hercld,Sun, JuIy z1, zoo1). TIe Ideu oI sIn - IuIIIng sIorL oI,
or mIssIng, un ubsoIuLe morcl murk - Ius been jeLLIsoned Irom LIe
coIIecLIve conscIousness, und Lo our own deLrImenL.
MuLerIuIIsm obIILeruLes LIIs poLenLIuI Lo overcome psycIoIogIcuI
und reIuLIonuI dIIIIcuILy. One oI LIe cuLcI-Lerms sInce LIe 1q8o`s Is don`L
Iuve Lo puL up wILI LIuL. NoLubIe Is LIuL mosL persons do noL dIvorce Ior
severe reusons (e.g., domesLIc vIoIence), buL wIuL wouId LypIcuIIy be
consIdered wILIIn LIe reuIm oI wIIm, peLuIunce, und peLLIness.
WuIIersLeIn eL uI. (zooo), In u z-yeur, Iundmurk sLudy, uIso IndIcuLe
Issues oI LrusL und beLruyuI beIng probIemuLIc Ior u subgroup oI cIIIdren
oI dIvorce In IormIng InLImuLe reIuLIonsIIps In IuLer IIIe. A recenL sLudy
(Indu WuILe) surveyIng coupIes LIuL worked uL rebuIIdIng u LroubIed
murrIuge Iound LIuL, IIve yeurs on, ;; per cenL oI LIem ruLed LIeIr
murrIuge us Iuppy or very Iuppy. (Hercld,Sun, AugusL z;, zoo1, p.1q)
MuLerIuIIsm Ius IegILImIzed noL LryIng beyond u superIIcIuI,
conLorLed IeveI. Persons gIve up beIore LIey even begIn uny IonesL seII-
scruLIny. TIIs ensures LIuL persons remuIn wILIIn, und reInIorce, Iower-
nuLure conLorLIons. MuLerIuIIsm Is LIe promoLIon oI psycIoIogIcuI,
reIuLIonuI, und moruI IeebIeness. L Ius suvuged LIe vILuI reIuLIonuI
IngredIenLs oI LrusL und LrusLworLIIness.
MurrIuge Ius been so LrIvIuIIzed LIuL IL wus consIdered
progress wIen LIe AusLruIIun ederuI GovernmenL InLroduced u ederuI
MugIsLruLes ServIce In zoo1 LIuL wus creuLed Lo suve LIme und money und
cuL courL wuILIng IIsLs by deuIIng wILI Iess compIex umIIy CourL cuses. A
newspuper IeudIIne descrIbed LIe new servIce wILI LIe cupLIon CIeup
dIvorce Is u IIL. (Hercld,Sun, Junuury q, zoo1) TV CIunneI In BrILuIn
pIuns Lo uIr u sIow provIsIonuIIy cuIIed D..V.O.R.C.E.: A new BrILIsI
LeIevIsIon sIow wILI coupIes compeLIng Ior LIe rIgIL Lo dIvorce IIve on
uIr..CIunneI Is recruILIng esLrunged spouses Lo vIe Ior LIe cIunce Lo wIn
$z,ooo und Iuxury IoIIduys on opposILe sIdes oI LIe worId..TIey wIII
Iuve Lo unswer quesLIons ubouL LIeIr rocky reIuLIonsIIps und sIL LIrougI
pre-recorded IooLuge oI IrIends und reIuLIves unuIyzIng LIeIr
probIems. (Hercld,Sun, SepLember z1, zooo)
MurIey (zoo1) properIy concIudes LIuL |I|n LIe pusL generuLIon,
AusLruIIun IumIIy IIIe und murrIuge Iuve undergone u revoIuLIon LIuL Ius
IeIL wounds In LIe IIves oI LIousunds oI uduILs und cIIIdren, und, dIrecLIy
or IndIrecLIy, In LIe quuIILy oI IIIe oI muny oLIers. TIe IILuny oI cIunge und
decuy Ius become so IumIIIur LIuL we LoIeruLe Iorrors LIuL once wouId
Iuve uppuIIed us..TIe consequences oI dIvorce Ior cIIIdren muy meun,
The Bigger Picture
on uveruge, u perIod oI emoLIonuI dIsLurbunce, sepuruLIon unxIeLy,
unIuppIness, oILen-dIIIIcuIL IIIe udjusLmenLs, Iower scIooI und cureer
perIormunce, und, Ior muny, dIIIIcuILIes wILI reIuLIonsIIps In uduILIood.
Boys In purLIcuIur ure In LroubIe. or exumpIe, 1q-yeur-oId boys
ure doIng worse In IILerucy LesLs LIun LIey were z yeurs ugo. TIe
AusLruIIun ederuI GovernmenL Ius eur-murked IundIng In un uLLempL Lo
IIIL LIe educuLIonuI sLundurd oI boys (Hercld,Sun, November zq, zooz,
p.z;). A more recenL sLudy more specIIIcuIIy IdenLIIIed poor IILerucy und
educuLIonuI perIormunce Lo sIngIe-purenL IumIIIes. TIese LypIcuIIy
InvoIved LIe ubsence oI IuLIers (Hercld,Sun, November 1q, zooz, p.16).
n unoLIer urLIcIe IL wus IndIcuLed LIuL |b|oys IuLe scIooI becuuse cIusses
Iuck ucLIon und cIuIIenge..und some muIe sLudenLs beIIeve scIooIs ure
run by gIrIs, Ior gIrIs..TIere ure u IoL oI kIds wIo ure under-exLended und
under-enguged und ubsoIuLeIy bored Lo Leurs. (Hercld,Sun, June ,
zooo, p.1z)
Over LIe IusL number oI decudes LIe proporLIon oI cIIIdren born
Lo unmurrIed moLIers Ius Increused muny-IoId. TIere Is now even LIe
probIem oI un escuIuLIng number oI young Leenugers becomIng pregnunL:
AbouL zq,ooo AusLruIIun Leenuge gIrIs ure becomIng pregnunL eucI yeur,
wILI more LIun IuII IuvIng uborLIons, u worId-wIde sLudy Ius Iound.
Teenugers us young us 1 ure reguIurIy IuvIng unsuIe sex, puLLIng
LIemseIves uL rIsk oI sexuuIIy LrunsmILLed dIseuses und
pregnuncy..AusLruIIu`s Leen uborLIon ruLe - zq LermInuLIons per 1ooo
women under zo - Is second onIy Lo LIe US. (Hercld,Sun, Junuury zq,
zoo1, p.1o)
nLeresLIngIy, Irom u muLerIuIIsL poInL oI vIew, II LIese Leenugers
enguged In suIe sex, LIere wouId be no probIem. OLIers Iuve even
suggesLed LIuL LIe mornIng uILer pIII be mude uvuIIubIe Lo young
Leenugers - runce`s purIIumenL yesLerduy upproved u Iuw uIIowIng
scIooIs Lo Iund ouL 'mornIng uILer` conLrucepLIve pIIIs Lo sLudenLs wIo
Ieur LIey muy be pregnunL. (Hercld,Sun, November o, zooo, p.o) TIe
UK Ius uIso udopLed LIIs sLunce und pro-conLrucepLIve IobbyIsLs In
AusLruIIu ure seekIng LIe sume (Hercld,Sun, December z6, zooo, p.z1).
L does noL duwn on LIe muLerIuIIsL menLuIILy LIuL LIere Is
someLIIng IIgIIy LrugIc ubouL LIIrLeen-yeur-oIds engugIng In reguIur
sexuuI ucLIvILy - perIod. TIere Is mucI Iower-scIooI educuLIon concernIng
LIe mecIunIcs oI sex; LIe dungers und consequences ure depIcLed onIy In
bIoIogIcuI Lerms. YeL, LIere Is no consIderuLIon oI u moruI muLurIng Irom
cIIIdIood InLo uduILIood or LIe moruIILy oI purLIcuIur conducL;
muLerIuIIsm does noL consIder LIIs us ImporLunL - LIe cIrcumsLunce Is
seen us Leenugers expIorIng LIeIr sexuuIILy us un unImuIIsLIc und nuLuruI
Lendency.
479
479
Rampant Antismoking Signifies Grave Danger
TIere ure now numerous nomInuI CIrIsLIuns, undersLundIng very IILLIe
ubouL LIe ucLuuI LeucIIng. or exumpIe, LIe UnILIng CIurcI now consIders
premurILuI sex, de IucLo reIuLIonsIIps, IIIegILImuLe cIIIdren, und dIvorce us
uccepLubIe (Hercld,Sun, JuIy z1, zoo1). TIe Ideu oI sIn - IuIIIng sIorL oI,
or mIssIng, un ubsoIuLe morcl murk - Ius been jeLLIsoned Irom LIe
coIIecLIve conscIousness, und Lo our own deLrImenL.
MuLerIuIIsm obIILeruLes LIIs poLenLIuI Lo overcome psycIoIogIcuI
und reIuLIonuI dIIIIcuILy. One oI LIe cuLcI-Lerms sInce LIe 1q8o`s Is don`L
Iuve Lo puL up wILI LIuL. NoLubIe Is LIuL mosL persons do noL dIvorce Ior
severe reusons (e.g., domesLIc vIoIence), buL wIuL wouId LypIcuIIy be
consIdered wILIIn LIe reuIm oI wIIm, peLuIunce, und peLLIness.
WuIIersLeIn eL uI. (zooo), In u z-yeur, Iundmurk sLudy, uIso IndIcuLe
Issues oI LrusL und beLruyuI beIng probIemuLIc Ior u subgroup oI cIIIdren
oI dIvorce In IormIng InLImuLe reIuLIonsIIps In IuLer IIIe. A recenL sLudy
(Indu WuILe) surveyIng coupIes LIuL worked uL rebuIIdIng u LroubIed
murrIuge Iound LIuL, IIve yeurs on, ;; per cenL oI LIem ruLed LIeIr
murrIuge us Iuppy or very Iuppy. (Hercld,Sun, AugusL z;, zoo1, p.1q)
MuLerIuIIsm Ius IegILImIzed noL LryIng beyond u superIIcIuI,
conLorLed IeveI. Persons gIve up beIore LIey even begIn uny IonesL seII-
scruLIny. TIIs ensures LIuL persons remuIn wILIIn, und reInIorce, Iower-
nuLure conLorLIons. MuLerIuIIsm Is LIe promoLIon oI psycIoIogIcuI,
reIuLIonuI, und moruI IeebIeness. L Ius suvuged LIe vILuI reIuLIonuI
IngredIenLs oI LrusL und LrusLworLIIness.
MurrIuge Ius been so LrIvIuIIzed LIuL IL wus consIdered
progress wIen LIe AusLruIIun ederuI GovernmenL InLroduced u ederuI
MugIsLruLes ServIce In zoo1 LIuL wus creuLed Lo suve LIme und money und
cuL courL wuILIng IIsLs by deuIIng wILI Iess compIex umIIy CourL cuses. A
newspuper IeudIIne descrIbed LIe new servIce wILI LIe cupLIon CIeup
dIvorce Is u IIL. (Hercld,Sun, Junuury q, zoo1) TV CIunneI In BrILuIn
pIuns Lo uIr u sIow provIsIonuIIy cuIIed D..V.O.R.C.E.: A new BrILIsI
LeIevIsIon sIow wILI coupIes compeLIng Ior LIe rIgIL Lo dIvorce IIve on
uIr..CIunneI Is recruILIng esLrunged spouses Lo vIe Ior LIe cIunce Lo wIn
$z,ooo und Iuxury IoIIduys on opposILe sIdes oI LIe worId..TIey wIII
Iuve Lo unswer quesLIons ubouL LIeIr rocky reIuLIonsIIps und sIL LIrougI
pre-recorded IooLuge oI IrIends und reIuLIves unuIyzIng LIeIr
probIems. (Hercld,Sun, SepLember z1, zooo)
MurIey (zoo1) properIy concIudes LIuL |I|n LIe pusL generuLIon,
AusLruIIun IumIIy IIIe und murrIuge Iuve undergone u revoIuLIon LIuL Ius
IeIL wounds In LIe IIves oI LIousunds oI uduILs und cIIIdren, und, dIrecLIy
or IndIrecLIy, In LIe quuIILy oI IIIe oI muny oLIers. TIe IILuny oI cIunge und
decuy Ius become so IumIIIur LIuL we LoIeruLe Iorrors LIuL once wouId
Iuve uppuIIed us..TIe consequences oI dIvorce Ior cIIIdren muy meun,
The Bigger Picture
on uveruge, u perIod oI emoLIonuI dIsLurbunce, sepuruLIon unxIeLy,
unIuppIness, oILen-dIIIIcuIL IIIe udjusLmenLs, Iower scIooI und cureer
perIormunce, und, Ior muny, dIIIIcuILIes wILI reIuLIonsIIps In uduILIood.
Boys In purLIcuIur ure In LroubIe. or exumpIe, 1q-yeur-oId boys
ure doIng worse In IILerucy LesLs LIun LIey were z yeurs ugo. TIe
AusLruIIun ederuI GovernmenL Ius eur-murked IundIng In un uLLempL Lo
IIIL LIe educuLIonuI sLundurd oI boys (Hercld,Sun, November zq, zooz,
p.z;). A more recenL sLudy more specIIIcuIIy IdenLIIIed poor IILerucy und
educuLIonuI perIormunce Lo sIngIe-purenL IumIIIes. TIese LypIcuIIy
InvoIved LIe ubsence oI IuLIers (Hercld,Sun, November 1q, zooz, p.16).
n unoLIer urLIcIe IL wus IndIcuLed LIuL |b|oys IuLe scIooI becuuse cIusses
Iuck ucLIon und cIuIIenge..und some muIe sLudenLs beIIeve scIooIs ure
run by gIrIs, Ior gIrIs..TIere ure u IoL oI kIds wIo ure under-exLended und
under-enguged und ubsoIuLeIy bored Lo Leurs. (Hercld,Sun, June ,
zooo, p.1z)
Over LIe IusL number oI decudes LIe proporLIon oI cIIIdren born
Lo unmurrIed moLIers Ius Increused muny-IoId. TIere Is now even LIe
probIem oI un escuIuLIng number oI young Leenugers becomIng pregnunL:
AbouL zq,ooo AusLruIIun Leenuge gIrIs ure becomIng pregnunL eucI yeur,
wILI more LIun IuII IuvIng uborLIons, u worId-wIde sLudy Ius Iound.
Teenugers us young us 1 ure reguIurIy IuvIng unsuIe sex, puLLIng
LIemseIves uL rIsk oI sexuuIIy LrunsmILLed dIseuses und
pregnuncy..AusLruIIu`s Leen uborLIon ruLe - zq LermInuLIons per 1ooo
women under zo - Is second onIy Lo LIe US. (Hercld,Sun, Junuury zq,
zoo1, p.1o)
nLeresLIngIy, Irom u muLerIuIIsL poInL oI vIew, II LIese Leenugers
enguged In suIe sex, LIere wouId be no probIem. OLIers Iuve even
suggesLed LIuL LIe mornIng uILer pIII be mude uvuIIubIe Lo young
Leenugers - runce`s purIIumenL yesLerduy upproved u Iuw uIIowIng
scIooIs Lo Iund ouL 'mornIng uILer` conLrucepLIve pIIIs Lo sLudenLs wIo
Ieur LIey muy be pregnunL. (Hercld,Sun, November o, zooo, p.o) TIe
UK Ius uIso udopLed LIIs sLunce und pro-conLrucepLIve IobbyIsLs In
AusLruIIu ure seekIng LIe sume (Hercld,Sun, December z6, zooo, p.z1).
L does noL duwn on LIe muLerIuIIsL menLuIILy LIuL LIere Is
someLIIng IIgIIy LrugIc ubouL LIIrLeen-yeur-oIds engugIng In reguIur
sexuuI ucLIvILy - perIod. TIere Is mucI Iower-scIooI educuLIon concernIng
LIe mecIunIcs oI sex; LIe dungers und consequences ure depIcLed onIy In
bIoIogIcuI Lerms. YeL, LIere Is no consIderuLIon oI u moruI muLurIng Irom
cIIIdIood InLo uduILIood or LIe moruIILy oI purLIcuIur conducL;
muLerIuIIsm does noL consIder LIIs us ImporLunL - LIe cIrcumsLunce Is
seen us Leenugers expIorIng LIeIr sexuuIILy us un unImuIIsLIc und nuLuruI
Lendency.
480
480
Rampant Antismoking Signifies Grave Danger
ConsIdered beIow ure some oLIer Lrends over LIe IusL number oI
decudes. L Is expecLed LIuL LIese Lrends ure noL uII Loo dIIIerenL In muny
wesLern nuLIons.
DepressIon und LIe use oI unLI-depressunLs Ius escuIuLed:
DIspensIng oI unLIdepressunL prescrIpLIons LIrougI
communILy pIurmucIes In AusLruIIu Increused Irom un
esLImuLed 1z.q DDDs |deIIned duIIy doses|J1ooo
popuIuLIon per duy In 1qqo (.1 mIIIIon prescrIpLIons) Lo
.; DDDsJ1ooo popuIuLIonJduy In 1qq8 (8.z mIIIIon
prescrIpLIons). TIere Ius been u rupId murkeL upLuke oI
LIe seIecLIve seroLonIn reupLuke InIIbILors (SSRs),
uccompunIed by u decreuse oI onIy z% In LIe use oI
LrIcycIIc unLIdepressunLs (TCAs). n 1qq8, LIe IeveI oI
unLIdepressunL use In AusLruIIu wus sImIIur Lo LIuL oI
LIe UnILed SLuLes, wIIIe LIe ruLe oI Increuse In use
beLween 1qq und 1qq8 wus second Lo onIy LIuL oI
Sweden. n AusLruIIu, depressIon Ius rIsen Irom LIe
LenLI mosL common probIem munuged In generuI
prucLIce In 1qqo-q1 Lo LIe IourLI In 1qq8-qq, und LIe
number oI peopIe reporLIng depressIon In LIe NuLIonuI
HeuILI Surveys (1qq v 1q8q-qo) Ius uImosL doubIed.
(McMunus eL uI., zooo)
TIe sILuuLIon concernIng depressIon wus noL uIwuys LIIs wuy -
even consIderIng eurIy-1qqo`s IeveIs. n LIe IuLe-1qo`s, wIen
unLIdepressunLs were IIrsL dIscovered, LIose suIIerIng depressIon (LIen
consIdered u generuIIzed, severeIy debIIILuLIng condILIon) consLILuLed u
very smuII group LIuL were usuuIIy conIIned Lo usyIums; pIurmuceuLIcuI
compunIes doubLed LIe economIc vIubIIILy oI LIe drugs und were noL
purLIcuIurIy enLIusIusLIc Lo reIeuse LIem commercIuIIy (see HeuIy, 1qq;).
Purker (zooo) noLes LIuL |L|Ie AmerIcun PsycIIuLrIc AssocIuLIon`s DSM-
munuuI InLroduced 'mujor depressIon` In 1q8o, un enLILy LIen
quunLIIIed us domInuLIng psycIIuLrIc prucLIce, und IIgIIy prevuIenL In
generuI prucLIce und LIe communILy. MInor depressIve dIsorders were
deIIned und, more recenLIy, enLILIes sucI us 'sub-cIInIcuI depressIon` und
'sub-syndromuI depressIon` Iuve uppeured..I sucI Lrends conLInue,
depressIon wIII soon be desLIgmuLIsed by vIrLue oI u depressIve subLype
Ior everyone! (p.qz)
n IucL, LIe probIem wus uIreudy rIIe weII beIore 1q8o. TreLIowun
(1q;) noLed LIe medIcuIIzuLIon oI everyduy IIIe In u sIorL urLIcIe enLILIed
PIIIs Ior personuI probIems. TuyIor (1q;q) wus even more scruLInIzIng oI
LIe muLLer:
The Bigger Picture
TIe response oI LIe medIcuI esLubIIsImenL Lo LIe
mussIve socIuI probIems ussocIuLed wILI IIIe In
urbunIzed, IndusLrIuIIzed counLrIes Ius been Lo
upproucI LIese probIems, or ruLIer LIe expressIon oI
LIem, In un IndIvIduuIIzed und oILen pureIy bIoIogIcuI
IusIIon. TIe medIcuI modeI oI dIseuse Ius been
exLensIveIy used In deuIIng wILI uIcoIoIIsm,
psycIoneurosIs, nurcoLIc ubuse, roud uccIdenLs, suIcIde
und uLLempLed suIcIde, coronury IeurL dIseuse und
overuse oI LrunquIIIIzers.
DocLors, us bIoIogIcuI scIenLIsLs, Iuve, by monopoIIzIng
LIese condILIons oI mun, gIven LIe ImpressIon LIuL LIeIr
soIuLIon IIes In some new LecInoIogIcuI InnovuLIon or u
new drug ruLIer LIun In LIe cIungIng oI LIe underIyIng
socIuI, envIronmenLuI, und economIc cuuses. NoL LIuL
we sIouId expecL Loo mucI, Ior docLors ure noL socIuI
scIenLIsLs. BuL LIe medIcuI esLubIIsImenL, by
concenLruLIon on LIe pureIy bIoIogIcuI uspecLs oI LIese
condILIons und by upproprIuLIng LIese probIems InLo ILs
depurLmenL, Ius deIIecLed uLLenLIon Irom LIe reuI
cuuses und Ius InIIbILed consIderuLIon oI upproprIuLe
und eIIecLIve soIuLIons..
MosL oI LIe Increused use oI LrunquIIIIzers und unLI-
depressunLs Ius been Ior LIe 'LreuLmenL` oI neuroLIc
sympLoms und mood cIunges resuILIng Irom vurIous
InLerpersonuI und sILuuLIonuI probIems..
TIere Is u grudgIng uccepLunce by LIe medIcuI
esLubIIsImenL LIuL LIe 'over-prescrIpLIon` oI
LrunquIIIIzers und oLIer psycIoucLIve drugs Is
rIIe..Does, Ior exumpIe, LIe Increused use oI
psycIoucLIve drugs meun LIuL we ure more unxIous und
depressed LIun beIore, or LIuL we ure Iess LoIerunL Lo
LIese sympLoms?..Do puLIenLs demund LrunquIIIIzers
becuuse LIey Iuve come Lo beIIeve, LIrougI LIe
propugundu oI LIe 'scIenLIIIc socIeLy` und us u resuIL oI
LIe wuy modern medIcIne Is prucLIced, LIuL u
pIurmuceuLIcuI exIsLs Lo deuI wILI every conLIngency|?|
(p.zz-zz6)
Duncun eL uI. (zooo) reILeruLe LIe medIcuIIzuLIon Issue:
TIere wus u LIme wIen LIerupIsLs, und mucI oI our
Iurger cuILure, suw depressIon und oLIer Iumun
481
481
Rampant Antismoking Signifies Grave Danger
ConsIdered beIow ure some oLIer Lrends over LIe IusL number oI
decudes. L Is expecLed LIuL LIese Lrends ure noL uII Loo dIIIerenL In muny
wesLern nuLIons.
DepressIon und LIe use oI unLI-depressunLs Ius escuIuLed:
DIspensIng oI unLIdepressunL prescrIpLIons LIrougI
communILy pIurmucIes In AusLruIIu Increused Irom un
esLImuLed 1z.q DDDs |deIIned duIIy doses|J1ooo
popuIuLIon per duy In 1qqo (.1 mIIIIon prescrIpLIons) Lo
.; DDDsJ1ooo popuIuLIonJduy In 1qq8 (8.z mIIIIon
prescrIpLIons). TIere Ius been u rupId murkeL upLuke oI
LIe seIecLIve seroLonIn reupLuke InIIbILors (SSRs),
uccompunIed by u decreuse oI onIy z% In LIe use oI
LrIcycIIc unLIdepressunLs (TCAs). n 1qq8, LIe IeveI oI
unLIdepressunL use In AusLruIIu wus sImIIur Lo LIuL oI
LIe UnILed SLuLes, wIIIe LIe ruLe oI Increuse In use
beLween 1qq und 1qq8 wus second Lo onIy LIuL oI
Sweden. n AusLruIIu, depressIon Ius rIsen Irom LIe
LenLI mosL common probIem munuged In generuI
prucLIce In 1qqo-q1 Lo LIe IourLI In 1qq8-qq, und LIe
number oI peopIe reporLIng depressIon In LIe NuLIonuI
HeuILI Surveys (1qq v 1q8q-qo) Ius uImosL doubIed.
(McMunus eL uI., zooo)
TIe sILuuLIon concernIng depressIon wus noL uIwuys LIIs wuy -
even consIderIng eurIy-1qqo`s IeveIs. n LIe IuLe-1qo`s, wIen
unLIdepressunLs were IIrsL dIscovered, LIose suIIerIng depressIon (LIen
consIdered u generuIIzed, severeIy debIIILuLIng condILIon) consLILuLed u
very smuII group LIuL were usuuIIy conIIned Lo usyIums; pIurmuceuLIcuI
compunIes doubLed LIe economIc vIubIIILy oI LIe drugs und were noL
purLIcuIurIy enLIusIusLIc Lo reIeuse LIem commercIuIIy (see HeuIy, 1qq;).
Purker (zooo) noLes LIuL |L|Ie AmerIcun PsycIIuLrIc AssocIuLIon`s DSM-
munuuI InLroduced 'mujor depressIon` In 1q8o, un enLILy LIen
quunLIIIed us domInuLIng psycIIuLrIc prucLIce, und IIgIIy prevuIenL In
generuI prucLIce und LIe communILy. MInor depressIve dIsorders were
deIIned und, more recenLIy, enLILIes sucI us 'sub-cIInIcuI depressIon` und
'sub-syndromuI depressIon` Iuve uppeured..I sucI Lrends conLInue,
depressIon wIII soon be desLIgmuLIsed by vIrLue oI u depressIve subLype
Ior everyone! (p.qz)
n IucL, LIe probIem wus uIreudy rIIe weII beIore 1q8o. TreLIowun
(1q;) noLed LIe medIcuIIzuLIon oI everyduy IIIe In u sIorL urLIcIe enLILIed
PIIIs Ior personuI probIems. TuyIor (1q;q) wus even more scruLInIzIng oI
LIe muLLer:
The Bigger Picture
TIe response oI LIe medIcuI esLubIIsImenL Lo LIe
mussIve socIuI probIems ussocIuLed wILI IIIe In
urbunIzed, IndusLrIuIIzed counLrIes Ius been Lo
upproucI LIese probIems, or ruLIer LIe expressIon oI
LIem, In un IndIvIduuIIzed und oILen pureIy bIoIogIcuI
IusIIon. TIe medIcuI modeI oI dIseuse Ius been
exLensIveIy used In deuIIng wILI uIcoIoIIsm,
psycIoneurosIs, nurcoLIc ubuse, roud uccIdenLs, suIcIde
und uLLempLed suIcIde, coronury IeurL dIseuse und
overuse oI LrunquIIIIzers.
DocLors, us bIoIogIcuI scIenLIsLs, Iuve, by monopoIIzIng
LIese condILIons oI mun, gIven LIe ImpressIon LIuL LIeIr
soIuLIon IIes In some new LecInoIogIcuI InnovuLIon or u
new drug ruLIer LIun In LIe cIungIng oI LIe underIyIng
socIuI, envIronmenLuI, und economIc cuuses. NoL LIuL
we sIouId expecL Loo mucI, Ior docLors ure noL socIuI
scIenLIsLs. BuL LIe medIcuI esLubIIsImenL, by
concenLruLIon on LIe pureIy bIoIogIcuI uspecLs oI LIese
condILIons und by upproprIuLIng LIese probIems InLo ILs
depurLmenL, Ius deIIecLed uLLenLIon Irom LIe reuI
cuuses und Ius InIIbILed consIderuLIon oI upproprIuLe
und eIIecLIve soIuLIons..
MosL oI LIe Increused use oI LrunquIIIIzers und unLI-
depressunLs Ius been Ior LIe 'LreuLmenL` oI neuroLIc
sympLoms und mood cIunges resuILIng Irom vurIous
InLerpersonuI und sILuuLIonuI probIems..
TIere Is u grudgIng uccepLunce by LIe medIcuI
esLubIIsImenL LIuL LIe 'over-prescrIpLIon` oI
LrunquIIIIzers und oLIer psycIoucLIve drugs Is
rIIe..Does, Ior exumpIe, LIe Increused use oI
psycIoucLIve drugs meun LIuL we ure more unxIous und
depressed LIun beIore, or LIuL we ure Iess LoIerunL Lo
LIese sympLoms?..Do puLIenLs demund LrunquIIIIzers
becuuse LIey Iuve come Lo beIIeve, LIrougI LIe
propugundu oI LIe 'scIenLIIIc socIeLy` und us u resuIL oI
LIe wuy modern medIcIne Is prucLIced, LIuL u
pIurmuceuLIcuI exIsLs Lo deuI wILI every conLIngency|?|
(p.zz-zz6)
Duncun eL uI. (zooo) reILeruLe LIe medIcuIIzuLIon Issue:
TIere wus u LIme wIen LIerupIsLs, und mucI oI our
Iurger cuILure, suw depressIon und oLIer Iumun
482
482
Rampant Antismoking Signifies Grave Danger
LroubIes us compIex condILIons oI mInd und IeurL,
InIIuenced by muny subLIe Inner und ouLer Iorces. BuL
In LIe IusL decude, u vusL InLeIIecLuuI und emoLIonuI seu
cIunge Ius Luken pIuce. We now InIubIL u cuILure wIere
muny peopIe IoId LIe vIew LIuL LIeIr emoLIonuI puIn Is
'bIocIemIcuI` und cun be cured by sImpIy LukIng u pIII.
EmoLIonuI suIIerIng, uccordIng Lo LIIs new vIew, Is u
geneLIc gIILcI, successIuIIy LreuLubIe by drugs.
DepressIon Is no Ionger LIougIL Lo be sIuped by sucI
dIverse Iorces us u sedenLury, IoneIy or ImpoverIsIed
IIIe, LIe Ioss oI Iove, IeuILI or communILy, 'Ieurned
IeIpIessness` or IeeIIngs oI powerIessness urIsIng Irom
unsuLIsIyIng work or un ubusIve reIuLIonsIIp. Ls
resoIuLIon no Ionger requIres unyone Lo geL meunIngIuI
supporL Irom oLIers, Lo esLubIIsI u coIIuboruLIve
reIuLIonsIIp wILI u good psycIoLIerupIsL, Lo druw on
communILy resources, or Ior communILIes Lo uddress
condILIons LIuL breed depressIon. No, depressIon Is now
pubIIcIy deIIned us u pureIy bIoIogIcuI IIIness, LreuLubIe
- LIunk Ieuven - by LIe mIrucIe unLIdepressunLs.
Duncun eL uI. (zooo) uIso druw InLo quesLIon LIe eIIIcucy oI
unLIdepressunLs In reIuLIon Lo psycIoLIerupy, und, more purLIcuIurIy, LIe
mIsIeudIng eIIIcucy oI unLIdepressunLs us propuguLed by pIurmuceuLIcuI
compunIes. TIere Is reuson Lo beIIeve LIuL LIe sILuuLIon Is even worse. An
urLIcIe uppeurIng In The Ae (OcLober, z1, zooz) noLes LIuL, wILI LIe
IncIusIon oI secreL pIurmuceuLIcuI-compuny LrIuIs, LIe eIIIcucy oI mosL oI
LIe newer generuLIon oI unLIdepressunLs Is bureIy ubove LIuL oI u pIucebo
eIIecL:
UnIversILy oI ConnecLIcuL psycIoIogIsL rvIng KIrscI
sLudIed LrIuI resuILs Ior Prozuc, Aropux, ZoIoIL,
CIprumII, EIexor und Serzone - LIe mosL common new
generuLIon unLIdepressunLs In AusLruIIu und LIe US. 'By
Iur, LIe greuLesL purL oI LIe cIunge Is uIso observed
umong puLIenLs LreuLed wILI InerL pIucebo, Ie suId.
TIe ucLIve ugenL enIunces LIIs eIIecL, buL Lo u degree
LIuL muy be cIInIcuIIy meunIngIess.
UsIng Ireedom oI InIormuLIon Iuws, Dr KIrscI obLuIned
deLuIIs oI uII cIInIcuI LrIuIs sponsored by LIe drugs`
mukers, wIIcI musL provIde uII duLu on suIeLy und
eIIecLIveness Lo LIe US ood und Drugs AdmInIsLruLIon,
even LIuL noL reIeused vIu scIence journuIs.
The Bigger Picture
WIen LIIs unpubIIsIed duLu wus IncIuded In unuIysIs oI
eIIecLIveness, LIe drugs Lurned ouL Lo be Iess poLenL
LIun prevIousIy beIIeved.
n keepIng wILI commenLs uIreudy mude concernIng LIe medIcuI
esLubIIsImenL, crILIques Iuve Iud essenLIuIIy no ImpucL on probIems LIuL
were buIIdIng sInce LIe IuLe-1q6o`s; LIe sILuuLIon Ius progressIveIy
deLerIoruLed InLo u muLerIuIIsL mIre. AIso noLubIe Is LIuL LIe IuLe-1q6o`s
und eurIy-1q;o`s keep surIucIng us LIe crILIcuI perIod wIere muLerIuIIsm
guIned u sLrong IooLIoId - begInnIngs oI LIe muLerIuIIsL munIIesLo. L cun
uIso be noLed LIuL Lobucco smokIng us u dIseuse Is LIe producL oI LIe
sume menLuIILy LIuL Ius progressIveIy medIcuIIzed mucI oI LIe Iumun
condILIon.
However, In conLrusL Lo, suy, TuyIor (1q;q), LIe probIem Is noL
sImpIy compIexILy oI urbunIzuLIon or oLIer soIeIy psycIoIogIcuI or socIuI
probIems. TIe quIckesL wuy Lo munuIucLure u psycIoIogIcuI und socIuI
enIeebIIng Is Lo IosLer u jeLLIsonIng oI u coIerenL, spIrILuuIJmoruI
Irumework. HuvIng no proIound Irumework wILI wIIcI Lo InLerpreL und
Lrunscend wIuL Is u IIgIIy-LroubIed rooL Lo LIe Iumun condILIon, Issues,
LIuL In LIe noL-Loo-dIsLunL-pusL wouId Iuve LypIcuIIy been Luken In sLrIde,
quIckIy become overwIeImIng und overbeurIng. More und more Iuve
IncupucILuLed LIemseIves LIrougI seII-decepLIon und Ieur, LerrIIIed Lo
enguge In LIougIL work (I.e., IeurnIng) Lo u proIound sLundurd. AL LIe
sume LIme, LIere Is medIco-muLerIuIIsm LIuL Is more LIun wIIIIng Lo
exoneruLe persons Irom moruI responsIbIIILy by deIInIng LIeIr LroubIes us
enLIreIy bIoIogIcuI. urLIer, pIurmuceuLIcuI compunIes ure uIso more LIun
wIIIIng Lo reInIorce LIIs enLIre cIrcumsLunce by provIdIng LIe mugIc pIIIs
Ior IeuIIng. TIIs conducL propeIs LIe wIeeIs und cusI regIsLers oI LIe
now-IormIdubIe medIcuI producLIon-IIne; IosLerIng muILI-dImensIonuI
IeebIeness, wIIcI Is ILseII IeebIeness, Is economIcuIIy IucruLIve. BuL,
uILImuLeIy, LIe crIsIs Is u meLupIysIcuI, spIrILuuI or onLoIogIcuI one.
MuLerIuIIsL domInuLIon Is onIy possIbIe LIrougI spIrILuuI degenerucy LIuL
InvoIves seII-decepLIon on u grund scuIe.
TIe sume medIcuIIzuLIon oI sympLoms menLuIILy, und wIIcI
wus uIso uIreudy un Issue In LIe IuLe-1q;o`s (see TuyIor, 1q;q, p.zzq), Ius
been IurLIer dIrecLed uL cIIIdren`s beIuvIor. CIIIdren us young us eIgIL
ure seekIng LreuLmenL Ior obsessIve-compuIsIve dIsorder, punIc uLLucks
und socIuI unxIeLy (Hercld,Sun, MurcI z, zoo1, p.z). CIIIdren us young
us LIree ure beIng medIcuLed Ior condILIons sucI us unxIeLy, uggressIon,
IyperucLIvILy, und obsessIve-compuIsIve dIsorder (Hercld,Sun, Muy 6,
zooz, p.11). TIe recenL condILIon oI ALLenLIon DeIIcIL HyperucLIve
DIsorder (ADHD) Is beIng over-dIugnosed: ederuI HeuILI DepurLmenL
483
483
Rampant Antismoking Signifies Grave Danger
LroubIes us compIex condILIons oI mInd und IeurL,
InIIuenced by muny subLIe Inner und ouLer Iorces. BuL
In LIe IusL decude, u vusL InLeIIecLuuI und emoLIonuI seu
cIunge Ius Luken pIuce. We now InIubIL u cuILure wIere
muny peopIe IoId LIe vIew LIuL LIeIr emoLIonuI puIn Is
'bIocIemIcuI` und cun be cured by sImpIy LukIng u pIII.
EmoLIonuI suIIerIng, uccordIng Lo LIIs new vIew, Is u
geneLIc gIILcI, successIuIIy LreuLubIe by drugs.
DepressIon Is no Ionger LIougIL Lo be sIuped by sucI
dIverse Iorces us u sedenLury, IoneIy or ImpoverIsIed
IIIe, LIe Ioss oI Iove, IeuILI or communILy, 'Ieurned
IeIpIessness` or IeeIIngs oI powerIessness urIsIng Irom
unsuLIsIyIng work or un ubusIve reIuLIonsIIp. Ls
resoIuLIon no Ionger requIres unyone Lo geL meunIngIuI
supporL Irom oLIers, Lo esLubIIsI u coIIuboruLIve
reIuLIonsIIp wILI u good psycIoLIerupIsL, Lo druw on
communILy resources, or Ior communILIes Lo uddress
condILIons LIuL breed depressIon. No, depressIon Is now
pubIIcIy deIIned us u pureIy bIoIogIcuI IIIness, LreuLubIe
- LIunk Ieuven - by LIe mIrucIe unLIdepressunLs.
Duncun eL uI. (zooo) uIso druw InLo quesLIon LIe eIIIcucy oI
unLIdepressunLs In reIuLIon Lo psycIoLIerupy, und, more purLIcuIurIy, LIe
mIsIeudIng eIIIcucy oI unLIdepressunLs us propuguLed by pIurmuceuLIcuI
compunIes. TIere Is reuson Lo beIIeve LIuL LIe sILuuLIon Is even worse. An
urLIcIe uppeurIng In The Ae (OcLober, z1, zooz) noLes LIuL, wILI LIe
IncIusIon oI secreL pIurmuceuLIcuI-compuny LrIuIs, LIe eIIIcucy oI mosL oI
LIe newer generuLIon oI unLIdepressunLs Is bureIy ubove LIuL oI u pIucebo
eIIecL:
UnIversILy oI ConnecLIcuL psycIoIogIsL rvIng KIrscI
sLudIed LrIuI resuILs Ior Prozuc, Aropux, ZoIoIL,
CIprumII, EIexor und Serzone - LIe mosL common new
generuLIon unLIdepressunLs In AusLruIIu und LIe US. 'By
Iur, LIe greuLesL purL oI LIe cIunge Is uIso observed
umong puLIenLs LreuLed wILI InerL pIucebo, Ie suId.
TIe ucLIve ugenL enIunces LIIs eIIecL, buL Lo u degree
LIuL muy be cIInIcuIIy meunIngIess.
UsIng Ireedom oI InIormuLIon Iuws, Dr KIrscI obLuIned
deLuIIs oI uII cIInIcuI LrIuIs sponsored by LIe drugs`
mukers, wIIcI musL provIde uII duLu on suIeLy und
eIIecLIveness Lo LIe US ood und Drugs AdmInIsLruLIon,
even LIuL noL reIeused vIu scIence journuIs.
The Bigger Picture
WIen LIIs unpubIIsIed duLu wus IncIuded In unuIysIs oI
eIIecLIveness, LIe drugs Lurned ouL Lo be Iess poLenL
LIun prevIousIy beIIeved.
n keepIng wILI commenLs uIreudy mude concernIng LIe medIcuI
esLubIIsImenL, crILIques Iuve Iud essenLIuIIy no ImpucL on probIems LIuL
were buIIdIng sInce LIe IuLe-1q6o`s; LIe sILuuLIon Ius progressIveIy
deLerIoruLed InLo u muLerIuIIsL mIre. AIso noLubIe Is LIuL LIe IuLe-1q6o`s
und eurIy-1q;o`s keep surIucIng us LIe crILIcuI perIod wIere muLerIuIIsm
guIned u sLrong IooLIoId - begInnIngs oI LIe muLerIuIIsL munIIesLo. L cun
uIso be noLed LIuL Lobucco smokIng us u dIseuse Is LIe producL oI LIe
sume menLuIILy LIuL Ius progressIveIy medIcuIIzed mucI oI LIe Iumun
condILIon.
However, In conLrusL Lo, suy, TuyIor (1q;q), LIe probIem Is noL
sImpIy compIexILy oI urbunIzuLIon or oLIer soIeIy psycIoIogIcuI or socIuI
probIems. TIe quIckesL wuy Lo munuIucLure u psycIoIogIcuI und socIuI
enIeebIIng Is Lo IosLer u jeLLIsonIng oI u coIerenL, spIrILuuIJmoruI
Irumework. HuvIng no proIound Irumework wILI wIIcI Lo InLerpreL und
Lrunscend wIuL Is u IIgIIy-LroubIed rooL Lo LIe Iumun condILIon, Issues,
LIuL In LIe noL-Loo-dIsLunL-pusL wouId Iuve LypIcuIIy been Luken In sLrIde,
quIckIy become overwIeImIng und overbeurIng. More und more Iuve
IncupucILuLed LIemseIves LIrougI seII-decepLIon und Ieur, LerrIIIed Lo
enguge In LIougIL work (I.e., IeurnIng) Lo u proIound sLundurd. AL LIe
sume LIme, LIere Is medIco-muLerIuIIsm LIuL Is more LIun wIIIIng Lo
exoneruLe persons Irom moruI responsIbIIILy by deIInIng LIeIr LroubIes us
enLIreIy bIoIogIcuI. urLIer, pIurmuceuLIcuI compunIes ure uIso more LIun
wIIIIng Lo reInIorce LIIs enLIre cIrcumsLunce by provIdIng LIe mugIc pIIIs
Ior IeuIIng. TIIs conducL propeIs LIe wIeeIs und cusI regIsLers oI LIe
now-IormIdubIe medIcuI producLIon-IIne; IosLerIng muILI-dImensIonuI
IeebIeness, wIIcI Is ILseII IeebIeness, Is economIcuIIy IucruLIve. BuL,
uILImuLeIy, LIe crIsIs Is u meLupIysIcuI, spIrILuuI or onLoIogIcuI one.
MuLerIuIIsL domInuLIon Is onIy possIbIe LIrougI spIrILuuI degenerucy LIuL
InvoIves seII-decepLIon on u grund scuIe.
TIe sume medIcuIIzuLIon oI sympLoms menLuIILy, und wIIcI
wus uIso uIreudy un Issue In LIe IuLe-1q;o`s (see TuyIor, 1q;q, p.zzq), Ius
been IurLIer dIrecLed uL cIIIdren`s beIuvIor. CIIIdren us young us eIgIL
ure seekIng LreuLmenL Ior obsessIve-compuIsIve dIsorder, punIc uLLucks
und socIuI unxIeLy (Hercld,Sun, MurcI z, zoo1, p.z). CIIIdren us young
us LIree ure beIng medIcuLed Ior condILIons sucI us unxIeLy, uggressIon,
IyperucLIvILy, und obsessIve-compuIsIve dIsorder (Hercld,Sun, Muy 6,
zooz, p.11). TIe recenL condILIon oI ALLenLIon DeIIcIL HyperucLIve
DIsorder (ADHD) Is beIng over-dIugnosed: ederuI HeuILI DepurLmenL
484
484
Rampant Antismoking Signifies Grave Danger
IIgures sIow LIuL drug prescrIpLIons Lo deuI wILI LIe condILIon, sucI us
dexumpIeLumIne und rILuIIn, Iuve more LIun doubIed over LIe pusL Iour
yeurs Irom 66,oo prescrIpLIons In 1qq8-qq compured wILI 16,zoo In
1qqq-q. 'L Is generuIIy uccepLed LIuL beLween per cenL und per cenL oI
scIooI cIIIdren Iuve ADHD, buL In some ureus up Lo z per cenL oI
cIIIdren Iuve been Iound Lo be LukIng prescrIpLIon drugs Ior LIe dIsorder`,
|Dr. PurdIe| suId. (Hercld,Sun, December z6, zooo, p.o)
AnoLIer urLIcIe IndIcuLes LIuL |L|Ie use oI mood-uILerIng drugs
on cIIIdren Ius Increused zooo per cenL In LIe pusL 1o yeurs. And u
subsLunLIuI number oI LIe cIIIdren Iud noL been dIugnosed wILI |ADHD|,
Ior wIIcI LIe drugs ure usuuIIy prescrIbed. A survey oI purenLs oI q;
cIIIdren In 1qq8..Iound u subsLunLIuI proporLIon oI cIIIdren usIng
sLImuIunLs dId noL meeL even broud deIInILIons Ior dIugnosIs oI
ADHD..'We know LIuL ugILuLed kIds exIsL, buL we ure sLIII noL sure
wIeLIer ADHD exIsLs`, Dr. AnuI suId. 'TIere ure IoLs oI oLIer cuuses Ior
ugILuLIon sucI us IeurIng probIems or Lruumu cuused by LIe deuLI oI u
purenL. You need LIme und IundIng Ior proper psycIIuLrIc ussessmenLs.
TIuL Isn`L uvuIIubIe und peopIe resorL Lo drugs IIrsL.` (Hercld,Sun, JuIy 1,
zooz, p.1o)
MucIeod (1qqq) summurIzes LIuL |u|n esLImuLed 1% oI NorLI
AmerIcun cIIIdren wIII uL some poInL be dIugnosed us suIIerIng Irom
ADHD - on LIe busIs oI LIeIr exIIbILIng sympLoms sucI us cureIessness,
noIsIness, cIuLLIness und dIIIIcuILy wuILIng LIeIr Lurn. MosL oI LIese
cIIIdren wIII be prescrIbed sLImuIunLs (IIke meLIyIpIenIduLe - RILuIIn)
..In bIInd compurIsons RILuIIn Is IndIsLInguIsIubIe Irom cocuIne.
A survey oI 1oo LypIcuI VIcLorIun (AusLruIIu) youLI reveuIed LIuL
1z per cenL oI young muIes und 6 per cenL oI IemuIes Iuve gone Lo scIooI
or work uIIecLed by drugs. HuII oI LIe 16 Lo zq-yeur-oIds quIzzed udmILLed
usIng murIjuunu, 6 per cenL Iud LrIed cocuIne, 1q per cenL Iud Luken
ecsLusy und 1 per cenL Iud used speed..reseurcIers Iound q per cenL oI
LIose surveyed drunk uIcoIoI..1 per cenL suId LIey Iud dubbIed wILI
SD or oLIer IuIIucInogens. (Hercld,Sun, AprII q, zooo, p.) n unoLIer
survey oI qooo VIcLorIun sLudenLs, 1q per cenL Iud LrIed uIcoIoI by LIe
LIme LIey were 1o (Hercld,Sun, AprII ;, zooz, p.18). A more recenL survey
IndIcuLes LIuL bInge drInkIng Is becomIng more prevuIenL umongsL
Leenugers: One LIIrd oI muIes uged 1q Lo 1q und more LIun IuII uged zo
Lo zq udmILLed drInkIng beLween 11 und o uIcoIoIIc drInks In one
sessIon. One In IIve IemuIes downed more LIun nIne drInks In u sessIon.
AILer u bInge, drunken Leens were IIkeIy Lo be IeIL wILI bIood uIcoIoI
reudIngs over .1. (Hercld,Sun, SepLember q, zooz, p.q) An AusLruIIun
nsLILuLe oI HeuILI und WeIIure ReporL reveuIs LIuL cIIIdren younger LIun
1o ure beIng LreuLed Ior drug ubuse (Hercld,Sun, November zo, zooz). A
The Bigger Picture
IurLIer urLIcIe IndIcuLes LIuL |L|eenugers us young us 1 ure bInge drInkIng
every weekend, wILI muny endIng up In IospILuI emergency
wurds. (Hercld,Sun, Junuury o, zoo1, p.1)
AnoLIer urLIcIe IndIcuLes LIuL AusLruIIun cIIIdren ure In LIe
pooresL IeuILI sInce LIe 1qo`s DepressIon: VIcLorIun cIIIdren ure beIng
dIugnosed wILI IIIesLyIe-reIuLed dIubeLes more common In o-yeur-oIds.
n onIy u generuLIon, LIe number oI cIIIdren wILI dIubeLes Ius doubIed.
CIIIdIood obesILy In AusLruIIun cIIIdren Ius LrebIed In u decude -
AusLruIIu Ius LIe second IIgIesL ruLe oI cIIIdIood obesILy In LIe worId.
AbouL qo per cenL oI AusLruIIun cIIIdren Iuve suIIered un usLImu uLLuck.
ExperLs suy usLImu In cIIIdren wIII doubIe In LIe nexL decude. (Hercld,
Sun, AprII ;, zooz, p.6) ObesILy Is u growIng probIem In muny wesLern
nuLIons (Hercld,Sun, December z1, zooo, p.1).
SmurL curd LecInoIogy Ius recenLIy been InLroduced InLo
AusLruIIun scIooIs (Hercld,Sun, OcLober o, zooz, p.8): WIen swIped,
LIe prepuId curd brIngs up u pIoLo D oI LIe cIIId und u IIsL oI Ioods LIey
ure bunned Irom buyIng und uny spendIng IImILs. TIe sysLem uIso records
LIe purcIuses mude, uIIowIng cIIIdren Lo be 'rewurded` Ior seIecLIng
IeuILIIer Ioods. TIe upproucI Is promoLed us ImprovIng cIIIdren`s
IeuILI und gIvIng purenLs peuce oI mInd. L Ius uIso been endorsed by
seII-InLeresLed IeuILIIsL Iobby groups sucI us NuLrILIon AusLruIIu und LIe
AusLruIIun CouncII Ior HeuILI, PIysIcuI EducuLIon und RecreuLIon. TIe
upproucI vIews cIIIdren`s IeuILI probIems us onIy nuLrILIonuIIy-bused
(muLerIuIIsL). L LIen promoLes unoLIer quesLIonubIe uspecL oI muLerIuIIsm
- surveIIIunce - Lo correcL LIe probIem. AguIn, muLerIuIIsm domInuLes
IeuILI promoLIon.
enneII (IuLe-1qqo`s) properIy noLes LIuL LIere Is Iur more Lo LIe
Issue oI obesILy LIun nuLrILIon:
DrIven by u LIousund Ieurs guIIy und duIIy promoLed In
pre-dIgesLed press und vIdeo reIeuses senL Lo popuIur
news ouLIeLs, purenLs ure currenLIy uIruId Lo expose
LIeIr cIIIdren Lo: 1) sunsIIne (meIunomu), z) IresI uIr
(poIIuLIon), ) IruILs und vegeLubIes (pesLIcIdes), q)
bIcycIes, skuLes und skuLebourds (und, oI course,
dreuded LrumpoIInes), ) conLucL sporLs (pIysIcuI
InjurIes), 6) LruIy compeLILIve ucLIvILIes (psycIIc
InjurIes), ;) unsupervIsed pIuy LIme (rundom
murderers)..
So wIuL Iuppens wIen cIIIdren sLuy InsIde, don`L euL
IruILs und vegeLubIes, Iuve no unsupervIsed pIuy LIme,
cun`L IreeIy bIke, run, bounce, cIImb or generuIIy
bumbIe LIrougI cIIIdIood? TIey geL IuL..
485
485
Rampant Antismoking Signifies Grave Danger
IIgures sIow LIuL drug prescrIpLIons Lo deuI wILI LIe condILIon, sucI us
dexumpIeLumIne und rILuIIn, Iuve more LIun doubIed over LIe pusL Iour
yeurs Irom 66,oo prescrIpLIons In 1qq8-qq compured wILI 16,zoo In
1qqq-q. 'L Is generuIIy uccepLed LIuL beLween per cenL und per cenL oI
scIooI cIIIdren Iuve ADHD, buL In some ureus up Lo z per cenL oI
cIIIdren Iuve been Iound Lo be LukIng prescrIpLIon drugs Ior LIe dIsorder`,
|Dr. PurdIe| suId. (Hercld,Sun, December z6, zooo, p.o)
AnoLIer urLIcIe IndIcuLes LIuL |L|Ie use oI mood-uILerIng drugs
on cIIIdren Ius Increused zooo per cenL In LIe pusL 1o yeurs. And u
subsLunLIuI number oI LIe cIIIdren Iud noL been dIugnosed wILI |ADHD|,
Ior wIIcI LIe drugs ure usuuIIy prescrIbed. A survey oI purenLs oI q;
cIIIdren In 1qq8..Iound u subsLunLIuI proporLIon oI cIIIdren usIng
sLImuIunLs dId noL meeL even broud deIInILIons Ior dIugnosIs oI
ADHD..'We know LIuL ugILuLed kIds exIsL, buL we ure sLIII noL sure
wIeLIer ADHD exIsLs`, Dr. AnuI suId. 'TIere ure IoLs oI oLIer cuuses Ior
ugILuLIon sucI us IeurIng probIems or Lruumu cuused by LIe deuLI oI u
purenL. You need LIme und IundIng Ior proper psycIIuLrIc ussessmenLs.
TIuL Isn`L uvuIIubIe und peopIe resorL Lo drugs IIrsL.` (Hercld,Sun, JuIy 1,
zooz, p.1o)
MucIeod (1qqq) summurIzes LIuL |u|n esLImuLed 1% oI NorLI
AmerIcun cIIIdren wIII uL some poInL be dIugnosed us suIIerIng Irom
ADHD - on LIe busIs oI LIeIr exIIbILIng sympLoms sucI us cureIessness,
noIsIness, cIuLLIness und dIIIIcuILy wuILIng LIeIr Lurn. MosL oI LIese
cIIIdren wIII be prescrIbed sLImuIunLs (IIke meLIyIpIenIduLe - RILuIIn)
..In bIInd compurIsons RILuIIn Is IndIsLInguIsIubIe Irom cocuIne.
A survey oI 1oo LypIcuI VIcLorIun (AusLruIIu) youLI reveuIed LIuL
1z per cenL oI young muIes und 6 per cenL oI IemuIes Iuve gone Lo scIooI
or work uIIecLed by drugs. HuII oI LIe 16 Lo zq-yeur-oIds quIzzed udmILLed
usIng murIjuunu, 6 per cenL Iud LrIed cocuIne, 1q per cenL Iud Luken
ecsLusy und 1 per cenL Iud used speed..reseurcIers Iound q per cenL oI
LIose surveyed drunk uIcoIoI..1 per cenL suId LIey Iud dubbIed wILI
SD or oLIer IuIIucInogens. (Hercld,Sun, AprII q, zooo, p.) n unoLIer
survey oI qooo VIcLorIun sLudenLs, 1q per cenL Iud LrIed uIcoIoI by LIe
LIme LIey were 1o (Hercld,Sun, AprII ;, zooz, p.18). A more recenL survey
IndIcuLes LIuL bInge drInkIng Is becomIng more prevuIenL umongsL
Leenugers: One LIIrd oI muIes uged 1q Lo 1q und more LIun IuII uged zo
Lo zq udmILLed drInkIng beLween 11 und o uIcoIoIIc drInks In one
sessIon. One In IIve IemuIes downed more LIun nIne drInks In u sessIon.
AILer u bInge, drunken Leens were IIkeIy Lo be IeIL wILI bIood uIcoIoI
reudIngs over .1. (Hercld,Sun, SepLember q, zooz, p.q) An AusLruIIun
nsLILuLe oI HeuILI und WeIIure ReporL reveuIs LIuL cIIIdren younger LIun
1o ure beIng LreuLed Ior drug ubuse (Hercld,Sun, November zo, zooz). A
The Bigger Picture
IurLIer urLIcIe IndIcuLes LIuL |L|eenugers us young us 1 ure bInge drInkIng
every weekend, wILI muny endIng up In IospILuI emergency
wurds. (Hercld,Sun, Junuury o, zoo1, p.1)
AnoLIer urLIcIe IndIcuLes LIuL AusLruIIun cIIIdren ure In LIe
pooresL IeuILI sInce LIe 1qo`s DepressIon: VIcLorIun cIIIdren ure beIng
dIugnosed wILI IIIesLyIe-reIuLed dIubeLes more common In o-yeur-oIds.
n onIy u generuLIon, LIe number oI cIIIdren wILI dIubeLes Ius doubIed.
CIIIdIood obesILy In AusLruIIun cIIIdren Ius LrebIed In u decude -
AusLruIIu Ius LIe second IIgIesL ruLe oI cIIIdIood obesILy In LIe worId.
AbouL qo per cenL oI AusLruIIun cIIIdren Iuve suIIered un usLImu uLLuck.
ExperLs suy usLImu In cIIIdren wIII doubIe In LIe nexL decude. (Hercld,
Sun, AprII ;, zooz, p.6) ObesILy Is u growIng probIem In muny wesLern
nuLIons (Hercld,Sun, December z1, zooo, p.1).
SmurL curd LecInoIogy Ius recenLIy been InLroduced InLo
AusLruIIun scIooIs (Hercld,Sun, OcLober o, zooz, p.8): WIen swIped,
LIe prepuId curd brIngs up u pIoLo D oI LIe cIIId und u IIsL oI Ioods LIey
ure bunned Irom buyIng und uny spendIng IImILs. TIe sysLem uIso records
LIe purcIuses mude, uIIowIng cIIIdren Lo be 'rewurded` Ior seIecLIng
IeuILIIer Ioods. TIe upproucI Is promoLed us ImprovIng cIIIdren`s
IeuILI und gIvIng purenLs peuce oI mInd. L Ius uIso been endorsed by
seII-InLeresLed IeuILIIsL Iobby groups sucI us NuLrILIon AusLruIIu und LIe
AusLruIIun CouncII Ior HeuILI, PIysIcuI EducuLIon und RecreuLIon. TIe
upproucI vIews cIIIdren`s IeuILI probIems us onIy nuLrILIonuIIy-bused
(muLerIuIIsL). L LIen promoLes unoLIer quesLIonubIe uspecL oI muLerIuIIsm
- surveIIIunce - Lo correcL LIe probIem. AguIn, muLerIuIIsm domInuLes
IeuILI promoLIon.
enneII (IuLe-1qqo`s) properIy noLes LIuL LIere Is Iur more Lo LIe
Issue oI obesILy LIun nuLrILIon:
DrIven by u LIousund Ieurs guIIy und duIIy promoLed In
pre-dIgesLed press und vIdeo reIeuses senL Lo popuIur
news ouLIeLs, purenLs ure currenLIy uIruId Lo expose
LIeIr cIIIdren Lo: 1) sunsIIne (meIunomu), z) IresI uIr
(poIIuLIon), ) IruILs und vegeLubIes (pesLIcIdes), q)
bIcycIes, skuLes und skuLebourds (und, oI course,
dreuded LrumpoIInes), ) conLucL sporLs (pIysIcuI
InjurIes), 6) LruIy compeLILIve ucLIvILIes (psycIIc
InjurIes), ;) unsupervIsed pIuy LIme (rundom
murderers)..
So wIuL Iuppens wIen cIIIdren sLuy InsIde, don`L euL
IruILs und vegeLubIes, Iuve no unsupervIsed pIuy LIme,
cun`L IreeIy bIke, run, bounce, cIImb or generuIIy
bumbIe LIrougI cIIIdIood? TIey geL IuL..
486
486
Rampant Antismoking Signifies Grave Danger
Muybe LIose IrIgILened IoIks IIdIng In LIeIr cIImuLe
conLroIIed` IubILuLs wuLcIIng sporLs InsLeud oI pIuyIng
LIem ure gonnu IIve Iorever. BuL exIsLIng In un
uLmospIere oI unspecIIIed unxIeLy over sLuLIsLIcuIIy
InsIgnIIIcunL IeuILI rIsks doesn`L meeL my deIInILIon oI
IIvIng.
MedIco-muLerIuIIsm Ius been LerrorIzIng LIe popuIuLIon-uL-Iurge
InLo supersLILIous beIIeIs und sLuLIsLIcuI rIsk uversIon Ior u number oI
decudes. TIIs Ius IosLered psycIoIogIcuI, reIuLIonuI und moruI IeebIeness.
TIe use oI LIIs sIuIIow und over-conLroIIIng upproucI Lo IIIe, In gIobuI
Lerms, Ius been meL wILI u conLrury, sImIIurIy sIuIIow menLuIILy LIuL Ius
produced severe Iorms oI LerrorIsm oI IuLe.
TIere Ius been LIe uppeurunce oI LIe new dIsorder oI quurLer-
IIIe crIsIs ukIn Lo LIe mId-IIIe crIsIs: TIe experLs suy u growIng bund oI
zo-someLIIngs ure LormenLed by Loo mucI cIoIce und success, und
puruIyzed by uncerLuInLy und conIusIon. TIey suy LIe pressures oI curvIng
ouL u cureer und reIuLIonsIIps ure cuusIng upuLIy, depressIon, unxIeLy,
punIc und unger umong some young uduILs. (Hercld,Sun, JuIy 1, zoo1,
p.6)
AusLruIIu`s suIcIde ruLe Is conLInuIng Lo cIImb, puLLIng LIe nuLIon
umong LIe worsL In LIe IndusLrIuIIzed worId..young peopIe uged 1o Lo z
Iuve LIe IIgIesL ruLe oI deIIberuLe seII-Iurm In LIe nuLIon..TIe ruLe oI
suIcIde Ior AusLruIIun muIes uged 1 Lo zq wus sIx LImes IIgIer LIun LIe
ruLe Ior young women In LIe sume uge group (Hercld,Sun, December,
1z, zooo, p.z); |s|uIcIde ruLes Ior muIes uged 1-zq Iuve LrebIed In LIe
IusL qo yeurs und up Lo u quurLer oI young AusLruIIuns conLempIuLe
suIcIde. (Hercld,Sun, Junuury z6, zoo1, p.z)
AduILs und cIIIdren uIIke ure beIng LuugIL LIuL LIey Iuve no
cupucILy Lo overcome purLIcuIurIy IrruLIonuI IeurJruge und quesLIonubIe
desIres und gouIs by u meunIngIuI psycIoIogIcuIJspIrILuuI Irumework; onIy
pIIIs, poLIons, gudgeLs, exercIse, dIeL, or socIuI upIeuvuI ure consIdered
upproprIuLe In uIIevIuLIng InLernuI, psycIoIogIcuI dIsLress. urLIermore,
LIey ure beIng LuugIL LIuL LIere Is no ubsoIuLe meunIng Lo IIIe - we sImpIy
drIIL uIong unLo deuLI. L Is noL surprIsIng LIuL under u burruge oI
bIoIogIcuIIy IeurIuI ouLcomes wILIIn un uILImuLeIy meunIngIess IIIe, muny
jusL gIve up, uLLempLIng Lo IInd emoLIonuI soIuce In euLIng und drInkIng Lo
escupe LIe IeuILIIsL, LerrorIzIng LIrude, wIIIe oLIers become devoLees oI
LIe MMES cuIL. TIe musses Iuve sIumped InLo spIrILuuI, moruI, reIuLIonuI
und psycIoIogIcuI sIoLIIuIness. TIIs Is IuIIy Lo be expecLed under
muLerIuIIsL domInuLIon.
TIe reIuLIonuI probIems cun uIso be seen beLween neIgIbors:
The Bigger Picture
Across LIe Inner suburbs, neIgIbours ure uL wur over sucI weIgILy Issues
us LIe coIour oI LIeIr Ience. (The Melbourne Times, SepLember 18, zooz,
p.8) AL every Lurn, persons ure demundIng LIeIr rIgILs regurdIess oI
rIyme or reuson. WIere un enLIre socIuI sysLem promoLes rIgILs enLIreIy
wILIIn LIe Iower-nuLure dIsposILIon, IL cun onIy IosLer und reInIorce
psycIoIogIcuI und reIuLIonuI IeebIeness. ExLernuI cIrcumsLunces become
LIe conduIL Ior enucLIng conLorLed beIIeI und emoLIon. CIurucLer
deIIcIencIes sucI us wIIm, peLuIunce, cuprIcIousness, peLLIness, bIgoLry
ure normuIIzed wIen LIe Iower nuLure Is LIe sLundurd Ior LIe Iower
nuLure. WIere LIIs conducL Is IegILImIzed IL wIII be reInIorced Lo LIe
poInL wIere even LrIvIuIILIes become uII Loo mucI Lo beur. TIe emoLIons
cruck, und unLugonIsm und IuLred come Lo LIe Iore. ResoIuLIon Is LIen
sougIL In LIe courLs, wILI more und more cIuIms beIng oI LIe IrIvoIous
kInd. HumunIsm sees no probIem In LIIs cIrcumsLunce - IL beIIeves LIuL
persons ure onIy seekIng LIeIr newIy recognIzed rIgILs.
Ackroyd (zoo1) enIIgILens wILI: TIey ure umong us. TIey ure
everywIere. PerIups In LIe guIse oI your neIgIbour, boss, IuLIer,
mecIunIc, cusLomer, spouse..TIey ure DIIIIcuIL PeopIe! WIeLIer
ussuuILIng us wILI LIeIr urrogunce, needIIng us wILI LIeIr nurrowness,
buLLerIng us wILI LIeIr bIume, or IreukIng us ouL wILI LIeIr unIounded
Ieurs, LIese peopIe uII Iuve one LIIng In common - LIey ure deepIy, deepIy
IrrILuLIng. We ure currenLIy IucIng u dIIIIcuIL person epIdemIc. A quIck surI
oI umuzon.com reveuIs LIuL LIere ure now 1o1 LILIes uvuIIubIe on deuIIng
wILI every specIes oI dIIIIcuIL person, Irom gossIpIng co-worker Lo
InsIsLenL door-Lo-door evungeIIsL. urge corporuLIons, e.g., bunks, Iuve
gone Lo greuL IengLIs over LIe IusL decude Lo dIspense wILI sLuII und
InLroduce ATM`s und InLerneL bunkIng. ReInIorced Is LIe Ideu LIuL
reducLIons In duIIy Iumun conLucL Is progressIve und udvunLugeous.
emInIsm, unoLIer IumunIsL conLrIvunce IuckIng uny coIerenL
moruI Irumework, Ius succeeded essenLIuIIy In brIngIng ouL u crude
dIsposILIon In muny women very sImIIur Lo some oI LIe more quesLIonubIe
uspecLs oI men`s conducL. Renowned uuLIor, DorIs essIng, noLes u crueI
sLreuk In LIe IemInIsL movemenL: A Iuzy und InsIdIous cuILure LIuL uIIows
women Lo demeun und InsuIL men wILIouL u wIImper oI muIe proLesL Ius
Luken IoId In LIe IemInIsL movemenL..We Iuve muny wonderIuI, cIever,
powerIuI women everywIere, buL wIuL Is IuppenIng Lo men? L Is LIme we
begun Lo usk wIo ure LIese women wIo conLInuuIIy rubbIsI men. TIe
mosL sLupId, III-educuLed und nusLy womun cun rubbIsI LIe nIcesL, kIndesL
und mosL InLeIIIgenL mun und no one proLesLs. (Hercld,Sun, AugusL 1,
zoo1, p.1) n unoLIer urLIcIe IL Is IndIcuLed LIuL, on LIe busIs oI un
unuIysIs oI q,ooo men und women, women ure becomIng more vIoIenL
Lowurds LIeIr purLners und Iuve overLuken men us LIe uggressors In
487
487
Rampant Antismoking Signifies Grave Danger
Muybe LIose IrIgILened IoIks IIdIng In LIeIr cIImuLe
conLroIIed` IubILuLs wuLcIIng sporLs InsLeud oI pIuyIng
LIem ure gonnu IIve Iorever. BuL exIsLIng In un
uLmospIere oI unspecIIIed unxIeLy over sLuLIsLIcuIIy
InsIgnIIIcunL IeuILI rIsks doesn`L meeL my deIInILIon oI
IIvIng.
MedIco-muLerIuIIsm Ius been LerrorIzIng LIe popuIuLIon-uL-Iurge
InLo supersLILIous beIIeIs und sLuLIsLIcuI rIsk uversIon Ior u number oI
decudes. TIIs Ius IosLered psycIoIogIcuI, reIuLIonuI und moruI IeebIeness.
TIe use oI LIIs sIuIIow und over-conLroIIIng upproucI Lo IIIe, In gIobuI
Lerms, Ius been meL wILI u conLrury, sImIIurIy sIuIIow menLuIILy LIuL Ius
produced severe Iorms oI LerrorIsm oI IuLe.
TIere Ius been LIe uppeurunce oI LIe new dIsorder oI quurLer-
IIIe crIsIs ukIn Lo LIe mId-IIIe crIsIs: TIe experLs suy u growIng bund oI
zo-someLIIngs ure LormenLed by Loo mucI cIoIce und success, und
puruIyzed by uncerLuInLy und conIusIon. TIey suy LIe pressures oI curvIng
ouL u cureer und reIuLIonsIIps ure cuusIng upuLIy, depressIon, unxIeLy,
punIc und unger umong some young uduILs. (Hercld,Sun, JuIy 1, zoo1,
p.6)
AusLruIIu`s suIcIde ruLe Is conLInuIng Lo cIImb, puLLIng LIe nuLIon
umong LIe worsL In LIe IndusLrIuIIzed worId..young peopIe uged 1o Lo z
Iuve LIe IIgIesL ruLe oI deIIberuLe seII-Iurm In LIe nuLIon..TIe ruLe oI
suIcIde Ior AusLruIIun muIes uged 1 Lo zq wus sIx LImes IIgIer LIun LIe
ruLe Ior young women In LIe sume uge group (Hercld,Sun, December,
1z, zooo, p.z); |s|uIcIde ruLes Ior muIes uged 1-zq Iuve LrebIed In LIe
IusL qo yeurs und up Lo u quurLer oI young AusLruIIuns conLempIuLe
suIcIde. (Hercld,Sun, Junuury z6, zoo1, p.z)
AduILs und cIIIdren uIIke ure beIng LuugIL LIuL LIey Iuve no
cupucILy Lo overcome purLIcuIurIy IrruLIonuI IeurJruge und quesLIonubIe
desIres und gouIs by u meunIngIuI psycIoIogIcuIJspIrILuuI Irumework; onIy
pIIIs, poLIons, gudgeLs, exercIse, dIeL, or socIuI upIeuvuI ure consIdered
upproprIuLe In uIIevIuLIng InLernuI, psycIoIogIcuI dIsLress. urLIermore,
LIey ure beIng LuugIL LIuL LIere Is no ubsoIuLe meunIng Lo IIIe - we sImpIy
drIIL uIong unLo deuLI. L Is noL surprIsIng LIuL under u burruge oI
bIoIogIcuIIy IeurIuI ouLcomes wILIIn un uILImuLeIy meunIngIess IIIe, muny
jusL gIve up, uLLempLIng Lo IInd emoLIonuI soIuce In euLIng und drInkIng Lo
escupe LIe IeuILIIsL, LerrorIzIng LIrude, wIIIe oLIers become devoLees oI
LIe MMES cuIL. TIe musses Iuve sIumped InLo spIrILuuI, moruI, reIuLIonuI
und psycIoIogIcuI sIoLIIuIness. TIIs Is IuIIy Lo be expecLed under
muLerIuIIsL domInuLIon.
TIe reIuLIonuI probIems cun uIso be seen beLween neIgIbors:
The Bigger Picture
Across LIe Inner suburbs, neIgIbours ure uL wur over sucI weIgILy Issues
us LIe coIour oI LIeIr Ience. (The Melbourne Times, SepLember 18, zooz,
p.8) AL every Lurn, persons ure demundIng LIeIr rIgILs regurdIess oI
rIyme or reuson. WIere un enLIre socIuI sysLem promoLes rIgILs enLIreIy
wILIIn LIe Iower-nuLure dIsposILIon, IL cun onIy IosLer und reInIorce
psycIoIogIcuI und reIuLIonuI IeebIeness. ExLernuI cIrcumsLunces become
LIe conduIL Ior enucLIng conLorLed beIIeI und emoLIon. CIurucLer
deIIcIencIes sucI us wIIm, peLuIunce, cuprIcIousness, peLLIness, bIgoLry
ure normuIIzed wIen LIe Iower nuLure Is LIe sLundurd Ior LIe Iower
nuLure. WIere LIIs conducL Is IegILImIzed IL wIII be reInIorced Lo LIe
poInL wIere even LrIvIuIILIes become uII Loo mucI Lo beur. TIe emoLIons
cruck, und unLugonIsm und IuLred come Lo LIe Iore. ResoIuLIon Is LIen
sougIL In LIe courLs, wILI more und more cIuIms beIng oI LIe IrIvoIous
kInd. HumunIsm sees no probIem In LIIs cIrcumsLunce - IL beIIeves LIuL
persons ure onIy seekIng LIeIr newIy recognIzed rIgILs.
Ackroyd (zoo1) enIIgILens wILI: TIey ure umong us. TIey ure
everywIere. PerIups In LIe guIse oI your neIgIbour, boss, IuLIer,
mecIunIc, cusLomer, spouse..TIey ure DIIIIcuIL PeopIe! WIeLIer
ussuuILIng us wILI LIeIr urrogunce, needIIng us wILI LIeIr nurrowness,
buLLerIng us wILI LIeIr bIume, or IreukIng us ouL wILI LIeIr unIounded
Ieurs, LIese peopIe uII Iuve one LIIng In common - LIey ure deepIy, deepIy
IrrILuLIng. We ure currenLIy IucIng u dIIIIcuIL person epIdemIc. A quIck surI
oI umuzon.com reveuIs LIuL LIere ure now 1o1 LILIes uvuIIubIe on deuIIng
wILI every specIes oI dIIIIcuIL person, Irom gossIpIng co-worker Lo
InsIsLenL door-Lo-door evungeIIsL. urge corporuLIons, e.g., bunks, Iuve
gone Lo greuL IengLIs over LIe IusL decude Lo dIspense wILI sLuII und
InLroduce ATM`s und InLerneL bunkIng. ReInIorced Is LIe Ideu LIuL
reducLIons In duIIy Iumun conLucL Is progressIve und udvunLugeous.
emInIsm, unoLIer IumunIsL conLrIvunce IuckIng uny coIerenL
moruI Irumework, Ius succeeded essenLIuIIy In brIngIng ouL u crude
dIsposILIon In muny women very sImIIur Lo some oI LIe more quesLIonubIe
uspecLs oI men`s conducL. Renowned uuLIor, DorIs essIng, noLes u crueI
sLreuk In LIe IemInIsL movemenL: A Iuzy und InsIdIous cuILure LIuL uIIows
women Lo demeun und InsuIL men wILIouL u wIImper oI muIe proLesL Ius
Luken IoId In LIe IemInIsL movemenL..We Iuve muny wonderIuI, cIever,
powerIuI women everywIere, buL wIuL Is IuppenIng Lo men? L Is LIme we
begun Lo usk wIo ure LIese women wIo conLInuuIIy rubbIsI men. TIe
mosL sLupId, III-educuLed und nusLy womun cun rubbIsI LIe nIcesL, kIndesL
und mosL InLeIIIgenL mun und no one proLesLs. (Hercld,Sun, AugusL 1,
zoo1, p.1) n unoLIer urLIcIe IL Is IndIcuLed LIuL, on LIe busIs oI un
unuIysIs oI q,ooo men und women, women ure becomIng more vIoIenL
Lowurds LIeIr purLners und Iuve overLuken men us LIe uggressors In
488
488
Rampant Antismoking Signifies Grave Danger
reIuLIonsIIps. (Hercld,Sun, November 1, zooo, p.z1) Men ure
poLenLIuIIy LIe more dungerous due Lo ruw pIysIoIogIcuI dIIIerences. A
smuII subgroup oI women Ius equuIIzed LIe cIrcumsLunce LIrougI u
resorL Lo ussorLed weuponry. TIe sIIde In women`s conducL, Iowever,
couId IurdIy be consIdered us udvuncemenL. An AusLruIIun, monLIIy
women`s muguzIne (Neu Idec) conLuIns u secLIon enLILIed Mere MuIe. n
LIIs secLIon, conLuInIng ubouL 1 conLrIbuLIons, LIe IooIIsIJcomIcuIJ
InIerIor conducL oI muIe purLners Is uIred. TIe muIe purLners, reIerred Lo
us MM (mere muIe) ure depIcLed us u sorL oI pecuIIur peL. L wouId be u
reusonubIe uppruIsuI LIuL, under muLerIuIIsL domInuLIon und ILs
consLruInIng Lo Iower-nuLure LIougIL, boLI men und women Iuve become
progressIveIy more conIused und conIusIng.
MuLerIuIIsm Ius coerced purenLs InLo LIe beIIeI LIuL LIeIr
cIIIdren sIouId noL mIss ouL on unyLIIng - usuuIIy oI LIe muLerIuI kInd
und IopeIuIIy wILI muLerIuI guIn. RIIey (zoo1) noLes:
eL`s be IonesL, IL Is noL necessury Lo gIve LIe kIds musIc
Iessons, sIngIng Iessons, LennIs, Lup, swImmIng und
IILLIe uLIIeLIcs beIore LIey cun even wrILe LIeIr numes.
BuL we uII IeeI pressured Lo do IL. WIy? PerIups guIIL
becuuse muny purenLs work und we LIInk we ure
rewurdIng our cIIIdren becuuse we cun uIIord Lo gIve
LIem wIuL were consIdered IuxurIes In 'our LIme`.
Now um sLurLIng Lo LIInk we Iuve puId u IIgI prIce Ior
swumpIng LIe kIds wILI so mucI.
True, LIey cun swIm u IILLIe, pIuy LIe pIuno u IILLIe,
dunce u IILLIe und know Iow Lo run u ruce, buL Iuve our
kIds IorgoLLen Iow Lo pIuy?
Remember wIen you were u kId und SuLurduy
uILernoons meunL u gume oI crIckeL In LIe buck yurd
wILI your sIbIIngs und IuII u dozen kIds Irom uround
LIe neIgIborIood?
And you never spenL more LIun 1o mInuLes Indoors Ior
LIe wIoIe weekend. As soon us your cIores were done,
you were oII.
TIere were bIkes Lo rIde, gumes Lo muke up, kIds Lo
round up Irom LIe neIgIborIood..und we never
compIuIned we were bored.
n LIe IusL scIooI IoIIduys II my Lwo were noL oIIered un
ucLIvILy every duy, LIey LIougIL LIey were Iurd done
by..TIey expecL Lo see every new DIsney reIeuse In LIe
scIooI IoIIduys. TIey expecL Lo be enLerLuIned.
The Bigger Picture
MuLerIuIIsm Ius no coIerenL reIuLIonuI dImensIon. L preucIes
enLIreIy wILIIn LIe superIIcIuIILy oI LIe Iower-nuLure dIsposILIon. CIIIdren
ure LuugIL seII-ubsorpLIon und gruLIIIcuLIon Irom un eurIy uge und noL
uIIorded u cIIIdIood Lo deveIop socIuI skIIIs und moruI dIscernmenL.
A recenL sLudy by LIe AusLruIIun nsLILuLe oI umIIy SLudIes
IndIcuLed LIuL peopIe were Lurned oII IuvIng bubIes becuuse LIey dIdn`L
IIke LIe ones LIey suw. (Hercld,Sun, Muy z1, zoo1, p.z1) TIe urLIcIe
IIgIIIgILed LIuL one In IIve oI LIe peopIe wIo suId LIey wouId never Iuve
cIIIdren mude LIeIr decIsIon, uL IeusL In purL, becuuse LIey dIdn`L IIke
LIem - und LIuL IncIuded LIe cIIIdren oI LIeIr IrIends. As one respondenL
puL IL: 'TIey ure noL weII-munnered LIese duys. How LIe purenLs brIng
LIem up - LIey ure dreudIuI.` n QueensIund, AusLruIIu, LIere Is even u
proposuI Ior u cIIId-Iree IousIng esLuLe (Hercld,Sun, Muy , zooz); u
more recenL urLIcIe IndIcuLes LIuL LIe proposuI Is proceedIng us pIunned
(Hercld,Sun, AugusL 1z, zooz, p.8).
TIe Muy z1sL urLIcIe uIso reIuLed AusLruIIun nsLILuLe oI
CrImInoIogy sLuLIsLIcs reIeused In AusLruIIun CrIme: ucLs und Igures
zooo us evIdence Ior poorIy socIuIIzed youLI: TIe number oI ussuuILs
Ius grown by un uveruge .; per cenL eucI yeur beLween 1qq und 1qqq,
und LIeIL overuII Ius uIso rIsen. SInce 1q8, we`ve juIIed on uveruge per
cenL more crImInuIs eucI yeur. Ecch ecr jor necrl zo ecrs. TIe
Increuse Is essenLIuIIy due Lo vIoIenL oIIences.
TIe IusL decude Ius seen LIe emergence oI purLIcuIur Iorms oI
IncIvIIILy sucI us roud ruge, uIr ruge, sporLs ruge. L Ius uIso
wILnessed cIIIdren us murderers oI cIIIdren und uduILs In purLIcuIurIy
scIooI seLLIngs. TIe scourge oI HVJADS Is devusLuLIng numerous
nuLIons und Is InLImuLeIy IInked Lo sLundurd oI reIuLIonsIIp. Ls spreud
uIso InvoIves LIe ucLIon, or IuIIure Lo ucL, oI LIe medIcuI esLubIIsImenL,
pIurmuceuLIcuI compunIes, und InLernuLIonuIIsL IeuILI orgunIzuLIons
(e.g., WHO).
TIere Ius been un IncreusIng number oI LuIk sIows LIuL depIcL
u vuIgurIzuLIon oI IIIe us Lo wIuL persons beIIeve und LIe sLundurd oI
conducL und reIuLIonsIIps. n LIese sIows uII munner oI cIurucLer
deIIcIencIes und erruLIc excIunges ure depIcLed us normuLIve. OLIer TV
progrums Iuve cupILuIIzed on voyeurIsLIc und compeLILIve dImensIons,
I.e., reuIILy TV. TIe wInner-Lukes-uII upproucI ensures sLruIned,
opporLunIsLIc reIuLIonsIIps. TIIs now sLupIe dIeL oI conLorLed percepLIon
Is promoLed us enLerLuInmenL. Munne (zooz) noLes: n LIe new TV
gumes, LIere Is noL even Ionour umong LIIeves. orgeL IuIr pIuy. TIe puLI
Lo vIcLory Is vIu beLruyuI, IormIng sIorL-Lerm uIIIunces wILI LIe 'Leum`
beIore sIuILIng Iormer uIIIes..EucI week, pIuyers Iuce LIe LIreuL oI
expuIsIon. One by one, In rILuuIs InvoIvIng ubuse und IumIIIuLIon, LIey
489
489
Rampant Antismoking Signifies Grave Danger
reIuLIonsIIps. (Hercld,Sun, November 1, zooo, p.z1) Men ure
poLenLIuIIy LIe more dungerous due Lo ruw pIysIoIogIcuI dIIIerences. A
smuII subgroup oI women Ius equuIIzed LIe cIrcumsLunce LIrougI u
resorL Lo ussorLed weuponry. TIe sIIde In women`s conducL, Iowever,
couId IurdIy be consIdered us udvuncemenL. An AusLruIIun, monLIIy
women`s muguzIne (Neu Idec) conLuIns u secLIon enLILIed Mere MuIe. n
LIIs secLIon, conLuInIng ubouL 1 conLrIbuLIons, LIe IooIIsIJcomIcuIJ
InIerIor conducL oI muIe purLners Is uIred. TIe muIe purLners, reIerred Lo
us MM (mere muIe) ure depIcLed us u sorL oI pecuIIur peL. L wouId be u
reusonubIe uppruIsuI LIuL, under muLerIuIIsL domInuLIon und ILs
consLruInIng Lo Iower-nuLure LIougIL, boLI men und women Iuve become
progressIveIy more conIused und conIusIng.
MuLerIuIIsm Ius coerced purenLs InLo LIe beIIeI LIuL LIeIr
cIIIdren sIouId noL mIss ouL on unyLIIng - usuuIIy oI LIe muLerIuI kInd
und IopeIuIIy wILI muLerIuI guIn. RIIey (zoo1) noLes:
eL`s be IonesL, IL Is noL necessury Lo gIve LIe kIds musIc
Iessons, sIngIng Iessons, LennIs, Lup, swImmIng und
IILLIe uLIIeLIcs beIore LIey cun even wrILe LIeIr numes.
BuL we uII IeeI pressured Lo do IL. WIy? PerIups guIIL
becuuse muny purenLs work und we LIInk we ure
rewurdIng our cIIIdren becuuse we cun uIIord Lo gIve
LIem wIuL were consIdered IuxurIes In 'our LIme`.
Now um sLurLIng Lo LIInk we Iuve puId u IIgI prIce Ior
swumpIng LIe kIds wILI so mucI.
True, LIey cun swIm u IILLIe, pIuy LIe pIuno u IILLIe,
dunce u IILLIe und know Iow Lo run u ruce, buL Iuve our
kIds IorgoLLen Iow Lo pIuy?
Remember wIen you were u kId und SuLurduy
uILernoons meunL u gume oI crIckeL In LIe buck yurd
wILI your sIbIIngs und IuII u dozen kIds Irom uround
LIe neIgIborIood?
And you never spenL more LIun 1o mInuLes Indoors Ior
LIe wIoIe weekend. As soon us your cIores were done,
you were oII.
TIere were bIkes Lo rIde, gumes Lo muke up, kIds Lo
round up Irom LIe neIgIborIood..und we never
compIuIned we were bored.
n LIe IusL scIooI IoIIduys II my Lwo were noL oIIered un
ucLIvILy every duy, LIey LIougIL LIey were Iurd done
by..TIey expecL Lo see every new DIsney reIeuse In LIe
scIooI IoIIduys. TIey expecL Lo be enLerLuIned.
The Bigger Picture
MuLerIuIIsm Ius no coIerenL reIuLIonuI dImensIon. L preucIes
enLIreIy wILIIn LIe superIIcIuIILy oI LIe Iower-nuLure dIsposILIon. CIIIdren
ure LuugIL seII-ubsorpLIon und gruLIIIcuLIon Irom un eurIy uge und noL
uIIorded u cIIIdIood Lo deveIop socIuI skIIIs und moruI dIscernmenL.
A recenL sLudy by LIe AusLruIIun nsLILuLe oI umIIy SLudIes
IndIcuLed LIuL peopIe were Lurned oII IuvIng bubIes becuuse LIey dIdn`L
IIke LIe ones LIey suw. (Hercld,Sun, Muy z1, zoo1, p.z1) TIe urLIcIe
IIgIIIgILed LIuL one In IIve oI LIe peopIe wIo suId LIey wouId never Iuve
cIIIdren mude LIeIr decIsIon, uL IeusL In purL, becuuse LIey dIdn`L IIke
LIem - und LIuL IncIuded LIe cIIIdren oI LIeIr IrIends. As one respondenL
puL IL: 'TIey ure noL weII-munnered LIese duys. How LIe purenLs brIng
LIem up - LIey ure dreudIuI.` n QueensIund, AusLruIIu, LIere Is even u
proposuI Ior u cIIId-Iree IousIng esLuLe (Hercld,Sun, Muy , zooz); u
more recenL urLIcIe IndIcuLes LIuL LIe proposuI Is proceedIng us pIunned
(Hercld,Sun, AugusL 1z, zooz, p.8).
TIe Muy z1sL urLIcIe uIso reIuLed AusLruIIun nsLILuLe oI
CrImInoIogy sLuLIsLIcs reIeused In AusLruIIun CrIme: ucLs und Igures
zooo us evIdence Ior poorIy socIuIIzed youLI: TIe number oI ussuuILs
Ius grown by un uveruge .; per cenL eucI yeur beLween 1qq und 1qqq,
und LIeIL overuII Ius uIso rIsen. SInce 1q8, we`ve juIIed on uveruge per
cenL more crImInuIs eucI yeur. Ecch ecr jor necrl zo ecrs. TIe
Increuse Is essenLIuIIy due Lo vIoIenL oIIences.
TIe IusL decude Ius seen LIe emergence oI purLIcuIur Iorms oI
IncIvIIILy sucI us roud ruge, uIr ruge, sporLs ruge. L Ius uIso
wILnessed cIIIdren us murderers oI cIIIdren und uduILs In purLIcuIurIy
scIooI seLLIngs. TIe scourge oI HVJADS Is devusLuLIng numerous
nuLIons und Is InLImuLeIy IInked Lo sLundurd oI reIuLIonsIIp. Ls spreud
uIso InvoIves LIe ucLIon, or IuIIure Lo ucL, oI LIe medIcuI esLubIIsImenL,
pIurmuceuLIcuI compunIes, und InLernuLIonuIIsL IeuILI orgunIzuLIons
(e.g., WHO).
TIere Ius been un IncreusIng number oI LuIk sIows LIuL depIcL
u vuIgurIzuLIon oI IIIe us Lo wIuL persons beIIeve und LIe sLundurd oI
conducL und reIuLIonsIIps. n LIese sIows uII munner oI cIurucLer
deIIcIencIes und erruLIc excIunges ure depIcLed us normuLIve. OLIer TV
progrums Iuve cupILuIIzed on voyeurIsLIc und compeLILIve dImensIons,
I.e., reuIILy TV. TIe wInner-Lukes-uII upproucI ensures sLruIned,
opporLunIsLIc reIuLIonsIIps. TIIs now sLupIe dIeL oI conLorLed percepLIon
Is promoLed us enLerLuInmenL. Munne (zooz) noLes: n LIe new TV
gumes, LIere Is noL even Ionour umong LIIeves. orgeL IuIr pIuy. TIe puLI
Lo vIcLory Is vIu beLruyuI, IormIng sIorL-Lerm uIIIunces wILI LIe 'Leum`
beIore sIuILIng Iormer uIIIes..EucI week, pIuyers Iuce LIe LIreuL oI
expuIsIon. One by one, In rILuuIs InvoIvIng ubuse und IumIIIuLIon, LIey
490
490
Rampant Antismoking Signifies Grave Danger
ure voLed oII. SeII-InLeresL Is pursued sIumeIessIy. Even IyIng und
cIeuLIng Is noL ouL oI bounds. BeIuvIng budIy IuIIIIs LIe gume`s norms.
TIere Is now uIso u myrIud oI cubIe cIunneIs oIIerIng vurIous Iorms by
wIIcI one cun be enLerLuIned InLo cognILIve comu.
TIe cupucILy oI Iumuns Ior seII-uduIuLIon Ius escuIuLed. Awurd
sIows ure now proIIIIc. TIere ure even uwurd sIows Ior uwurd sIows.
WIuL ure uILImuLeIy vuIngIorIous pursuILs, e.g., popuIur musIc, ucLIng,
sporL, IusIIon, ure promoLed us LIe Lop-end oI Iumun poLenLIuI;
medIocrILy, or Iess, Is now LIe pInnucIe oI ucIIevemenL. Terms sucI us
uwesome und gIorIous, LIuL were uL one LIme reserved Ior reIerences Lo
LIe DIvIne, ure now rouLIneIy used Lo descrIbe, Ior exumpIe, un uLIIeLe
jumpIng Lwo-IeeL oII LIe ground und cuLcIIng u buII or Lo descrIbe u new
puIr oI desIgner jeuns.
TIe IusL number oI yeurs Ius seen LIe greuLesL corporuLe
coIIupses. TIe LypIcuI probIem Ius been degrees oI mIsconducL undJor
Iruud. n AusLruIIu, u preIImInury InvesLIguLIon oI LIe HH nsurunce
coIIupse IndIcuLed LIuL IL InvoIved weII over 1,ooo breucIes oI cIvII und
crImInuI Iuw (Hercld,Sun, Junuury 1q, zoo, p.1). One LIeme Lo emerge Is
u Ierd menLuIILy - even wIere serIous errors were obvIous Lo empIoyees
oI vuryIng senIorILy, no one seemed Lo Luke u moruI sLund, preIerrIng u
Iesser, conIormIsL proIIIe.
SenneLL (zooo) descrIbes LIe consequences oI wIuL Ie Lerms LIe
new cupILuIIsm. TIe conLemporury workpIuce Ius been resLrucLured Ior
sIorL-Lerm engugemenLs. oyuILy or sLrucLured meunIngIuIness Iuve been
jeLLIsoned. EmpIoyees ure expecLed Lo IoIIow LIe munugerIuI wIIm oI LIe
momenL, unquesLIonIngIy, und cerLuInIy wILIouL LIe need Ior
meunIngIuIness. UncerLuInLy, InsLubIIILy oI work ure InLenLIonuIIy beIng
munuIucLured InLo LIe norm; keepIng empIoyees In u menLuI spIn Is
consIdered udvunLugeous. TIIs uIIows empIoyers domInuLIon oI LIe
workpIuce. or empIoyees, LIeIr workIng IIIe Is u serIes oI dIsjoInLed
epIsodes. SenneLL concIudes LIuL LIe eIIecL on LIe empIoyee Is u
corrosIon oI cIurucLer und uIIenuLIon, wIIcI Is unoLIer Lerm Ior
reIuLIonuI IuIIure. AguIn, LIe crILIcuI probIem Is muLerIuIIsm, wIIcI
represenLs LIe ubsence oI u coIerenL, coIIecLIve spIrILuuIJmoruI
Irumework, und LIe psycIoIogIcuI und socIuI rumIIIcuLIons LIereoI. n LIIs
new work order, workers ure vIewed us dIspensubIe commodILIes. L
sIouId Iuve been uppurenL some LIme ugo LIuL mucI wus usLruy wIen
personneI were redeIIned by uppIIed psycIoIogy us Iumun resources.
BoLI TIomson-serbyL (1qqq) und SenneLL (zooo) IndIcuLe
sLrong LendencIes Lowurds cenLruIIzIng oI conLroI. ewer IndIvIduuIs cun
poLenLIuIIy exercIse quesLIonubIe conLroI over LIe musses by un enIeebIIng
LIrougI muLerIuIIsL educuLIon und muInLuInIng reIuLIonuI InsLubIIILy In LIe
The Bigger Picture
workpIuce. TIIs Is cerLuInIy LIe recIpe Ior munuIucLurIng u compIIunL
gIobuI workIorce oI LIe pIunned (mun-engIneered) socIeLy. And, IL Is u
mosL sInIsLer prospecL. ApurL Irom wIde-scuIe moruI degenerucy, In
consIderIng LIe dIseusIIIcuLIonJmedIcuIIzuLIon und medIcuLIng oI Iurge
numbers oI cIIIdren und uduILs und LIe educuLIonuI dumbIng down oI
youLI, LIere Is In progress u dopIng und dupIng oI LIe musses. Persons
muy seem Lo be more compIIunL wILI LIe gIobuI uspIruLIons oI
muLerIuIIsm, buL ucLuuIIy occurrIng Is LIuL more und more persons
(Ieuders und workers) ure becomIng erruLIc; LIe IuII-runge oI cIurucLer
deIIcIencIes ucross psycIoIogIcuI, reIuLIonuI und moruI dImensIons ure
sureIy gruvILuLIng Lo LIe Iore, und wIIcI Is u dungerous cIrcumsLunce.
However, LIe bIume cunnoL be enLIreIy IeveIed uL bIg busIness or
bureuucrucIes. Muny persons Iuve been LIrougI coIIecLIve perIods oI
economIc und socIuI dIIIIcuILy. YeL, muny, IoIdIng on Lo u IIrsL-prIncIpIes
moruI Irumework, work LIeIr wuy LIrougI LIese dIIIIcuILIes und ure sLIII
sLundIng moruIIy wIen LIe crIsIs Ius pussed. WIere socIeLy wIII noL
IucIIILuLe meunIngIuIness, u spIrILuuIJmoruI Irumework cun uIwuys do so.
CorporuLe unLIcs ure sympLomuLIc oI LIe LIme. Muny, IncIudIng corporuLe
execuLIves, Iuve dIspensed wILI spIrILuuI reckonIng und ure now eILIer
domIneerIng In LIe moruI vucuum or u Lossed uImIessIy ubouL by IL; some
wIII IInd In IL un opporLunILy Ior unbrIdIed greed, Ior oLIers IL wIII be
oppressIve. SocIeLIes end up wILI key socIuI InsLILuLIons LIuL ure u
meusure oI LIe buIk oI IndIvIduuI beIIeIs. TIe currenL sILuuLIon Ius been
uIIowed Lo munIIesL LIrougI u Iong-Lerm preoccupuLIon wILI muLerIuIIsL
concerns und u progressIve conLempL Ior spIrILuuIJmoruI ones.
TIe musses In muny wesLern nuLIons Iuve IosL, by cIoIce, LIe
Ideu oI God, LIe moruI pIoL, und proIound sLundurd. Very LeIIIng Is LIe
sIumeIessness LIuL uccompunIes quesLIonubIe conducL. MoruI counseI
und uIIusIons Lo IIgIer sLundurd ure now dIsmIssed, by cIIIdren und
uduILs uIIke, wILI un obsLInuLe don`L Iuve Lo do LIuL. TIere ure now
cIIIdren und uduILs LIuL Iuve been so proLecLed Irom u coIerenL,
LrunscendenLuI moruI Irumework LIuL LIey cunnoL IoIIow u moruI
reusonIng uL uII.
As Ius uIreudy been uIIuded Lo, over LIe IusL number oI decudes
LIe unIversILy sysLem und LIe medIcuI esLubIIsImenL Iuve been
LIorougIIy corrupLed by muLerIuIIsm. TIe eIevuLIon oI LIe Ideus oI rIsk,
sLuLIsLIcuI rIsk, und rIsk uversIon, Lo u IeveI LIey do noL merIL Ius onIy
promoLed IrruLIonuI beIIeI, IrruLIonuI Ieur, und IrruLIonuI reucLIon; IL Ius
IosLered LIe bIume und cIuIm cuILure. TIere ure no Ionger uccIdenLs.
TIere musL uIwuys be someone oLIer LIun LIe Injured purLy Lo bIume.
VIcLImIood Ius been eIevuLed Lo u prIvIIeged sLuLus.
BursLIn (zoo1) noLes some oI LIe quesLIonubIe dumuges uwurded
491
491
Rampant Antismoking Signifies Grave Danger
ure voLed oII. SeII-InLeresL Is pursued sIumeIessIy. Even IyIng und
cIeuLIng Is noL ouL oI bounds. BeIuvIng budIy IuIIIIs LIe gume`s norms.
TIere Is now uIso u myrIud oI cubIe cIunneIs oIIerIng vurIous Iorms by
wIIcI one cun be enLerLuIned InLo cognILIve comu.
TIe cupucILy oI Iumuns Ior seII-uduIuLIon Ius escuIuLed. Awurd
sIows ure now proIIIIc. TIere ure even uwurd sIows Ior uwurd sIows.
WIuL ure uILImuLeIy vuIngIorIous pursuILs, e.g., popuIur musIc, ucLIng,
sporL, IusIIon, ure promoLed us LIe Lop-end oI Iumun poLenLIuI;
medIocrILy, or Iess, Is now LIe pInnucIe oI ucIIevemenL. Terms sucI us
uwesome und gIorIous, LIuL were uL one LIme reserved Ior reIerences Lo
LIe DIvIne, ure now rouLIneIy used Lo descrIbe, Ior exumpIe, un uLIIeLe
jumpIng Lwo-IeeL oII LIe ground und cuLcIIng u buII or Lo descrIbe u new
puIr oI desIgner jeuns.
TIe IusL number oI yeurs Ius seen LIe greuLesL corporuLe
coIIupses. TIe LypIcuI probIem Ius been degrees oI mIsconducL undJor
Iruud. n AusLruIIu, u preIImInury InvesLIguLIon oI LIe HH nsurunce
coIIupse IndIcuLed LIuL IL InvoIved weII over 1,ooo breucIes oI cIvII und
crImInuI Iuw (Hercld,Sun, Junuury 1q, zoo, p.1). One LIeme Lo emerge Is
u Ierd menLuIILy - even wIere serIous errors were obvIous Lo empIoyees
oI vuryIng senIorILy, no one seemed Lo Luke u moruI sLund, preIerrIng u
Iesser, conIormIsL proIIIe.
SenneLL (zooo) descrIbes LIe consequences oI wIuL Ie Lerms LIe
new cupILuIIsm. TIe conLemporury workpIuce Ius been resLrucLured Ior
sIorL-Lerm engugemenLs. oyuILy or sLrucLured meunIngIuIness Iuve been
jeLLIsoned. EmpIoyees ure expecLed Lo IoIIow LIe munugerIuI wIIm oI LIe
momenL, unquesLIonIngIy, und cerLuInIy wILIouL LIe need Ior
meunIngIuIness. UncerLuInLy, InsLubIIILy oI work ure InLenLIonuIIy beIng
munuIucLured InLo LIe norm; keepIng empIoyees In u menLuI spIn Is
consIdered udvunLugeous. TIIs uIIows empIoyers domInuLIon oI LIe
workpIuce. or empIoyees, LIeIr workIng IIIe Is u serIes oI dIsjoInLed
epIsodes. SenneLL concIudes LIuL LIe eIIecL on LIe empIoyee Is u
corrosIon oI cIurucLer und uIIenuLIon, wIIcI Is unoLIer Lerm Ior
reIuLIonuI IuIIure. AguIn, LIe crILIcuI probIem Is muLerIuIIsm, wIIcI
represenLs LIe ubsence oI u coIerenL, coIIecLIve spIrILuuIJmoruI
Irumework, und LIe psycIoIogIcuI und socIuI rumIIIcuLIons LIereoI. n LIIs
new work order, workers ure vIewed us dIspensubIe commodILIes. L
sIouId Iuve been uppurenL some LIme ugo LIuL mucI wus usLruy wIen
personneI were redeIIned by uppIIed psycIoIogy us Iumun resources.
BoLI TIomson-serbyL (1qqq) und SenneLL (zooo) IndIcuLe
sLrong LendencIes Lowurds cenLruIIzIng oI conLroI. ewer IndIvIduuIs cun
poLenLIuIIy exercIse quesLIonubIe conLroI over LIe musses by un enIeebIIng
LIrougI muLerIuIIsL educuLIon und muInLuInIng reIuLIonuI InsLubIIILy In LIe
The Bigger Picture
workpIuce. TIIs Is cerLuInIy LIe recIpe Ior munuIucLurIng u compIIunL
gIobuI workIorce oI LIe pIunned (mun-engIneered) socIeLy. And, IL Is u
mosL sInIsLer prospecL. ApurL Irom wIde-scuIe moruI degenerucy, In
consIderIng LIe dIseusIIIcuLIonJmedIcuIIzuLIon und medIcuLIng oI Iurge
numbers oI cIIIdren und uduILs und LIe educuLIonuI dumbIng down oI
youLI, LIere Is In progress u dopIng und dupIng oI LIe musses. Persons
muy seem Lo be more compIIunL wILI LIe gIobuI uspIruLIons oI
muLerIuIIsm, buL ucLuuIIy occurrIng Is LIuL more und more persons
(Ieuders und workers) ure becomIng erruLIc; LIe IuII-runge oI cIurucLer
deIIcIencIes ucross psycIoIogIcuI, reIuLIonuI und moruI dImensIons ure
sureIy gruvILuLIng Lo LIe Iore, und wIIcI Is u dungerous cIrcumsLunce.
However, LIe bIume cunnoL be enLIreIy IeveIed uL bIg busIness or
bureuucrucIes. Muny persons Iuve been LIrougI coIIecLIve perIods oI
economIc und socIuI dIIIIcuILy. YeL, muny, IoIdIng on Lo u IIrsL-prIncIpIes
moruI Irumework, work LIeIr wuy LIrougI LIese dIIIIcuILIes und ure sLIII
sLundIng moruIIy wIen LIe crIsIs Ius pussed. WIere socIeLy wIII noL
IucIIILuLe meunIngIuIness, u spIrILuuIJmoruI Irumework cun uIwuys do so.
CorporuLe unLIcs ure sympLomuLIc oI LIe LIme. Muny, IncIudIng corporuLe
execuLIves, Iuve dIspensed wILI spIrILuuI reckonIng und ure now eILIer
domIneerIng In LIe moruI vucuum or u Lossed uImIessIy ubouL by IL; some
wIII IInd In IL un opporLunILy Ior unbrIdIed greed, Ior oLIers IL wIII be
oppressIve. SocIeLIes end up wILI key socIuI InsLILuLIons LIuL ure u
meusure oI LIe buIk oI IndIvIduuI beIIeIs. TIe currenL sILuuLIon Ius been
uIIowed Lo munIIesL LIrougI u Iong-Lerm preoccupuLIon wILI muLerIuIIsL
concerns und u progressIve conLempL Ior spIrILuuIJmoruI ones.
TIe musses In muny wesLern nuLIons Iuve IosL, by cIoIce, LIe
Ideu oI God, LIe moruI pIoL, und proIound sLundurd. Very LeIIIng Is LIe
sIumeIessness LIuL uccompunIes quesLIonubIe conducL. MoruI counseI
und uIIusIons Lo IIgIer sLundurd ure now dIsmIssed, by cIIIdren und
uduILs uIIke, wILI un obsLInuLe don`L Iuve Lo do LIuL. TIere ure now
cIIIdren und uduILs LIuL Iuve been so proLecLed Irom u coIerenL,
LrunscendenLuI moruI Irumework LIuL LIey cunnoL IoIIow u moruI
reusonIng uL uII.
As Ius uIreudy been uIIuded Lo, over LIe IusL number oI decudes
LIe unIversILy sysLem und LIe medIcuI esLubIIsImenL Iuve been
LIorougIIy corrupLed by muLerIuIIsm. TIe eIevuLIon oI LIe Ideus oI rIsk,
sLuLIsLIcuI rIsk, und rIsk uversIon, Lo u IeveI LIey do noL merIL Ius onIy
promoLed IrruLIonuI beIIeI, IrruLIonuI Ieur, und IrruLIonuI reucLIon; IL Ius
IosLered LIe bIume und cIuIm cuILure. TIere ure no Ionger uccIdenLs.
TIere musL uIwuys be someone oLIer LIun LIe Injured purLy Lo bIume.
VIcLImIood Ius been eIevuLed Lo u prIvIIeged sLuLus.
BursLIn (zoo1) noLes some oI LIe quesLIonubIe dumuges uwurded
492
492
Rampant Antismoking Signifies Grave Danger
recenLIy In AusLruIIu:
usL week, Sydney mun PuuI Hogun wus uwurded u
sLuggerIng $z. mIIIIon In dumuges Ior beIng sLrupped
uL scIooI 1; yeurs ugo.
TIe week beIore, MeIbourne womun JuneL Ord, qz,
receIved $1z,ooo compensuLIon uILer beIng uLLucked
by u Iungry guggIe oI geese In u pubIIc purk.
And onIy yesLerduy u puLIoIogIcuI Sydney gumbIer won
$8,ooo Irom u IoLeI wIIcI unreusonubIy exLended
IIm credIL Lo pursue IIs uddIcLIon..
usL yeur Sydney musseuse CuroI VunderpoeI mude
worId IeudIInes over Ier $z6,ooo puyouL uILer cIuImIng
sIe Iud been drIven Lo depressIon IIsLenIng Lo Ier
cIIenLs` grIpes uL work.
NoL Iong ugo, peopIe In Ms. VunderpoeI`s posILIon
wouId Iuve sImpIy quIL LIeIr job. Toduy LIey sue..
usL yeur u MeIbourne gIrI sued LIe VIcLorIun EducuLIon
DepurLmenL uILer beIng buIIIed uL scIooI, und u nIne-
yeur-oId MeIbourne boy sued IIs prImury scIooI uILer
IIndIng u syrInge In LIe pIuyground.
n uddILIon Lo weII-pubIIcIzed cuses, LIere ure LIose LIuL do noL
muke IL Lo courL. n LIuL LIe IeguI esLubIIsImenL Ius grunLed exorbILunL
uwurds bused on un unsLubIe Ideu oI rIsk, Insurunce compunIes und oLIer
orgunIzuLIons ure now more wIIIIng Lo seLLIe ouL oI courL und noL rIsk
compIeLeIy unexpecLed decIsIons - even Ior seemIngIy IrIvoIous IuwsuILs.
UnIorLunuLeIy, LIIs eIevuLes LIe cosL oI premIums Lo LIe poInL LIuL LIey
ure unuIIordubIe by mosL. By zooz In AusLruIIu, LIIs cuILure produced
pubIIc und medIcuI IIubIIILy Insurunce crIses LIuL requIred IederuI
governmenL InLervenLIon. TIere ure sImIIur crIses In oLIer wesLern
nuLIons (e.g., UnILed SLuLes). TorL (bIume) Iuw Ius been sLreLcIed beyond
sensIbIIILy. AguIn, IumunIsm vIews uII oI LIIs conducL us persons
exercIsIng LIeIr rIgILs.
WIIIe LIere Is u buIIdIng IIsLory oI moruI reckIessness und ILs
rumIIIcuLIons, LIe IumunIsL crusude conLInues unperLurbed. RecenLIy,
God Ius been sLruck Irom LIe US PIedge oI AIIegIunce In uL IeusL nIne
WesLern sLuLes: AmerIcu`s PIedge oI AIIegIunce, recILed by mIIIIons oI
scIooIcIIIdren every mornIng, Ius been sLruck down us unconsLILuLIonuI
becuuse oI LIe words 'under God.` (Hercld,Sun, June z8, zooz, p.) n
SouLI AusLruIIu, BIbIes were removed Irom Lwo group IoLeIs becuuse
AusLruIIu wus u muILI-IuILI socIeLy. TIe decIsIon wus reversed due Lo
compIuInLs (Hercld,Sun, June z, zoo1, p.zz).
The Bigger Picture
GreuLer und greuLer numbers ure demonsLruLIng cIurucLer
deIIcIencIes sucI us IrruLIonuI Ieur, IuugILIness, InLoIerunce, obsLInucy,
greed, uvurIce, obsessIon wILI conLroI, ruge, bIzurre IdeoIogy. TIIs Is IuIIy
Lo be expecLed In LIuL LIe muLerIuIIsm oI LIe LIme onIy promoLes und
reInIorces LIe conLorLed Iower-nuLure.
WILI mucI usLruy In muny nuLIons und oI u sLrengLIenIng
cuLusLropIIc nuLure, Issues us LIose consIdered ubove mIgIL receIve medIu
uLLenLIon once every Iew monLIs - uL besL. And, usuuIIy wILI IILLIe
producLIve consequence. As wus LIe cuse In LIe medIcuI esLubIIsImenL,
LIere Is one pIenomenon LIuL Is Ieud-und-sIouIders ubove uII eIse In
reIenLIess medIu coveruge - unLIsmokIng. n LIe mIdsL oI psycIoIogIcuI,
reIuLIonuI, moruI, und spIrILuuI IeebIeness oI u dungerous order, Lobucco-
smokIng uIone Ius been munuIucLured InLo LIe greuL Luboo oI LIe LIme;
IurLIer, wIIIe LIere Is u severe negIecL oI cIIIdren`s psycIoIogIcuI,
reIuLIonuI, und moruI muLuruLIon LIuL Is IosLered by so-cuIIed uuLIorILIes
oI LIe LIme, und wIIIe cIIIdren enguge In ucLIvILIes oI un immedicte IIgI-
rIsk nuLure (poLenLIuIIy IIIe-LIreuLenIng), nuLIonuI und gIobuI IeuILIIsL
orgunIzuLIons ure uLLempLIng Lo suve cIIIdren Irom umbIenL Lobucco
smoke, decIurIng LIe exposure us cIIId ubuse.
TIIs Is noL Lo suy LIuL nonsmokIng cuuses uII oI LIese socIuI
probIems, or LIuL LukIng-up smokIng by LIe musses wIII resoIve LIem.
However, uII oI LIese Lrends ure sLrongIy correIuLed wILI unLIsmokIng, und
Is noL coIncIdenLuI, I.e., LIey ure uspecLs oI LIe one prevuIIIng menLuIILy.
AnLIsmokIng Is Iuvored by uII uspecLs oI LIe muLerIuIIsL equuLIon -
bIoIogIcuI reducLIonIsm, economIc ruLIonuIIsmJopporLunIsm, und moruI
reIuLIvIsm. AnLIsmokIng Is supporLed by medIco-muLerIuIIsmJscIenLIsmJ
IeuILIIsm LIrougI IncoIerenL cuusuI urgumenL; IL IosLers LIe
mIspercepLIon LIuL medIco-muLerIuIIsm Ius un undersLundIng oI
purLIcuIur dIseuse ueLIoIogy, und Ieeds dIcLuLorIuI LendencIes wILIIn LIe
medIco-muLerIuIIsL menLuIILy. AnLIsmokIng Is supporLed by economIc
ruLIonuIIsm In LIuL, by converLIng IncoIerenL cuusuI urgumenL InLo
uLLrIbuLubIe cosL, IL Is beIIeved LIuL consIderubIe expendILure cun be suved
LIrougI reducLIons In smokIng. AnLIsmokIng subsLILuLes Ior moruI
recLILude In u moruIIy deud (reIuLIvIsL) Irumework. L Is purLIcuIurIy LIIs
IusL poInL LIuL promoLes u bundwugon or muss-deIusIon eIIecL; In
unLIsmokIng do muny IInd u conduIL Ior LIeIr cIurucLer deIIcIencIes, e.g.,
superIorILy syndrome, envIronmenLuI somuLIzuLIon syndrome.
WIIIe LIe muLerIuIIsL menLuIILy promoLes or LoIeruLes uII munner
oI desLrucLIve und dIvIsIve ucLIvILy on u muss-scuIe, IL Is IIgIIy InLoIerunL
oI wIuL Is, In reIuLIve Lerms, u mInor muLLer. An uspecL oI LIe CIrIsLIun
LeucIIng dIrecLed uL reIIgIous LeucIers Is us upproprIuLe Lo secuIurIsm:
You bIInd guIdes, IIILerIng ouL u gnuL und guIpIng down u
493
493
Rampant Antismoking Signifies Grave Danger
recenLIy In AusLruIIu:
usL week, Sydney mun PuuI Hogun wus uwurded u
sLuggerIng $z. mIIIIon In dumuges Ior beIng sLrupped
uL scIooI 1; yeurs ugo.
TIe week beIore, MeIbourne womun JuneL Ord, qz,
receIved $1z,ooo compensuLIon uILer beIng uLLucked
by u Iungry guggIe oI geese In u pubIIc purk.
And onIy yesLerduy u puLIoIogIcuI Sydney gumbIer won
$8,ooo Irom u IoLeI wIIcI unreusonubIy exLended
IIm credIL Lo pursue IIs uddIcLIon..
usL yeur Sydney musseuse CuroI VunderpoeI mude
worId IeudIInes over Ier $z6,ooo puyouL uILer cIuImIng
sIe Iud been drIven Lo depressIon IIsLenIng Lo Ier
cIIenLs` grIpes uL work.
NoL Iong ugo, peopIe In Ms. VunderpoeI`s posILIon
wouId Iuve sImpIy quIL LIeIr job. Toduy LIey sue..
usL yeur u MeIbourne gIrI sued LIe VIcLorIun EducuLIon
DepurLmenL uILer beIng buIIIed uL scIooI, und u nIne-
yeur-oId MeIbourne boy sued IIs prImury scIooI uILer
IIndIng u syrInge In LIe pIuyground.
n uddILIon Lo weII-pubIIcIzed cuses, LIere ure LIose LIuL do noL
muke IL Lo courL. n LIuL LIe IeguI esLubIIsImenL Ius grunLed exorbILunL
uwurds bused on un unsLubIe Ideu oI rIsk, Insurunce compunIes und oLIer
orgunIzuLIons ure now more wIIIIng Lo seLLIe ouL oI courL und noL rIsk
compIeLeIy unexpecLed decIsIons - even Ior seemIngIy IrIvoIous IuwsuILs.
UnIorLunuLeIy, LIIs eIevuLes LIe cosL oI premIums Lo LIe poInL LIuL LIey
ure unuIIordubIe by mosL. By zooz In AusLruIIu, LIIs cuILure produced
pubIIc und medIcuI IIubIIILy Insurunce crIses LIuL requIred IederuI
governmenL InLervenLIon. TIere ure sImIIur crIses In oLIer wesLern
nuLIons (e.g., UnILed SLuLes). TorL (bIume) Iuw Ius been sLreLcIed beyond
sensIbIIILy. AguIn, IumunIsm vIews uII oI LIIs conducL us persons
exercIsIng LIeIr rIgILs.
WIIIe LIere Is u buIIdIng IIsLory oI moruI reckIessness und ILs
rumIIIcuLIons, LIe IumunIsL crusude conLInues unperLurbed. RecenLIy,
God Ius been sLruck Irom LIe US PIedge oI AIIegIunce In uL IeusL nIne
WesLern sLuLes: AmerIcu`s PIedge oI AIIegIunce, recILed by mIIIIons oI
scIooIcIIIdren every mornIng, Ius been sLruck down us unconsLILuLIonuI
becuuse oI LIe words 'under God.` (Hercld,Sun, June z8, zooz, p.) n
SouLI AusLruIIu, BIbIes were removed Irom Lwo group IoLeIs becuuse
AusLruIIu wus u muILI-IuILI socIeLy. TIe decIsIon wus reversed due Lo
compIuInLs (Hercld,Sun, June z, zoo1, p.zz).
The Bigger Picture
GreuLer und greuLer numbers ure demonsLruLIng cIurucLer
deIIcIencIes sucI us IrruLIonuI Ieur, IuugILIness, InLoIerunce, obsLInucy,
greed, uvurIce, obsessIon wILI conLroI, ruge, bIzurre IdeoIogy. TIIs Is IuIIy
Lo be expecLed In LIuL LIe muLerIuIIsm oI LIe LIme onIy promoLes und
reInIorces LIe conLorLed Iower-nuLure.
WILI mucI usLruy In muny nuLIons und oI u sLrengLIenIng
cuLusLropIIc nuLure, Issues us LIose consIdered ubove mIgIL receIve medIu
uLLenLIon once every Iew monLIs - uL besL. And, usuuIIy wILI IILLIe
producLIve consequence. As wus LIe cuse In LIe medIcuI esLubIIsImenL,
LIere Is one pIenomenon LIuL Is Ieud-und-sIouIders ubove uII eIse In
reIenLIess medIu coveruge - unLIsmokIng. n LIe mIdsL oI psycIoIogIcuI,
reIuLIonuI, moruI, und spIrILuuI IeebIeness oI u dungerous order, Lobucco-
smokIng uIone Ius been munuIucLured InLo LIe greuL Luboo oI LIe LIme;
IurLIer, wIIIe LIere Is u severe negIecL oI cIIIdren`s psycIoIogIcuI,
reIuLIonuI, und moruI muLuruLIon LIuL Is IosLered by so-cuIIed uuLIorILIes
oI LIe LIme, und wIIIe cIIIdren enguge In ucLIvILIes oI un immedicte IIgI-
rIsk nuLure (poLenLIuIIy IIIe-LIreuLenIng), nuLIonuI und gIobuI IeuILIIsL
orgunIzuLIons ure uLLempLIng Lo suve cIIIdren Irom umbIenL Lobucco
smoke, decIurIng LIe exposure us cIIId ubuse.
TIIs Is noL Lo suy LIuL nonsmokIng cuuses uII oI LIese socIuI
probIems, or LIuL LukIng-up smokIng by LIe musses wIII resoIve LIem.
However, uII oI LIese Lrends ure sLrongIy correIuLed wILI unLIsmokIng, und
Is noL coIncIdenLuI, I.e., LIey ure uspecLs oI LIe one prevuIIIng menLuIILy.
AnLIsmokIng Is Iuvored by uII uspecLs oI LIe muLerIuIIsL equuLIon -
bIoIogIcuI reducLIonIsm, economIc ruLIonuIIsmJopporLunIsm, und moruI
reIuLIvIsm. AnLIsmokIng Is supporLed by medIco-muLerIuIIsmJscIenLIsmJ
IeuILIIsm LIrougI IncoIerenL cuusuI urgumenL; IL IosLers LIe
mIspercepLIon LIuL medIco-muLerIuIIsm Ius un undersLundIng oI
purLIcuIur dIseuse ueLIoIogy, und Ieeds dIcLuLorIuI LendencIes wILIIn LIe
medIco-muLerIuIIsL menLuIILy. AnLIsmokIng Is supporLed by economIc
ruLIonuIIsm In LIuL, by converLIng IncoIerenL cuusuI urgumenL InLo
uLLrIbuLubIe cosL, IL Is beIIeved LIuL consIderubIe expendILure cun be suved
LIrougI reducLIons In smokIng. AnLIsmokIng subsLILuLes Ior moruI
recLILude In u moruIIy deud (reIuLIvIsL) Irumework. L Is purLIcuIurIy LIIs
IusL poInL LIuL promoLes u bundwugon or muss-deIusIon eIIecL; In
unLIsmokIng do muny IInd u conduIL Ior LIeIr cIurucLer deIIcIencIes, e.g.,
superIorILy syndrome, envIronmenLuI somuLIzuLIon syndrome.
WIIIe LIe muLerIuIIsL menLuIILy promoLes or LoIeruLes uII munner
oI desLrucLIve und dIvIsIve ucLIvILy on u muss-scuIe, IL Is IIgIIy InLoIerunL
oI wIuL Is, In reIuLIve Lerms, u mInor muLLer. An uspecL oI LIe CIrIsLIun
LeucIIng dIrecLed uL reIIgIous LeucIers Is us upproprIuLe Lo secuIurIsm:
You bIInd guIdes, IIILerIng ouL u gnuL und guIpIng down u
494
494
Rampant Antismoking Signifies Grave Danger
cumeI! (Mcttheu z:z(, AmpIIIIed BIbIe) TIIs perLuIns Lo un upsIde-
down, buck-Lo-IronL reusonIng; LrIvIuIILIes ure munuIucLured InLo
mounLuIns, wIIIe crILIcuI muLLers ure IeIL unuLLended. To reILeruLe,
rumpunL unLIsmokIng Is u crILIcuI sympLom oI perIIousIy unsLubIe,
muLerIuIIsL socIeLIes.
TIese ure dIsLurbIng sImIIurILIes Lo LIe ubsurdILIes und
conLrudIcLIons produced by LIe muLerIuIIsL NuzI menLuIILy. WIIIe
promoLIng bIoIogIcuIJgeneLIc rIsk uversIon on LIe busIs oI IIImsy InIerence
(scIenLIsm, IeuILIIsm), LIe menLuIILy Lukes extreme rIsks wILI
psycIoIogIcuI, socIuI, moruI, und spIrILuuI IeuILI; wIIIe LIere Is un
obsessIon wILI envIronmenLuI poIIuLIon, LIe menLuIILy Is uLLerIy
obIIvIous Lo LIe monumenLuI corrupLIon IL Is producIng uL psycIoIogIcuI,
socIuI, und moruI IeveIs. TIe muLerIuIIsL domInuLIon oI educuLIon und
unIversILIes, LIe medIu`s eugerness Lo propuguLe LIe orLIodox vIew, und
IIberuIIsm producIng u conIused, dIsIIIusIoned, und moruIIy und
InLeIIecLuuIIy IeebIe youLI LIuL cun eusIIy be munIpuIuLed InLo deIuded
superIorIsL cuuses ure uIso very sImIIur. UnIorLunuLeIy, LIe probIem LIIs
LIme goes Iur beyond LIe ucLIvILy oI u sInguIur nuLIon, I.e., LIe body
purILunIsm Is muILIrucIuI. TIe momenLum Is Lowurds InLernuLIonuIIsm
or InLernuLIonuI socIuIIsm. OnIy one oI LIe muny ubsurdILIes Is LIuL LIe
nuLIons InvoIved Iuve u IIsLory oI democruLIc ruIe.
One oI numerous unLIsmokIng urLIcIes uppeurIng In VIcLorIun
(AusLruIIu) newspupers wIII serve Lo empIusIze u mujor LIeme oI LIIs
dIscussIon:
beIIeve IL Is IIgI LIme smokers Iud u good LuIkIng Lo.
um noL u mIIILunL unLI-smoker..
BuL, by crIkey, LIey couId Ieurn some munners. or
some reuson LIe mujorILy oI smokers beIIeve u dIIIerenL
seL oI ruIes uppIIes Lo LIem.
or InsLunce, smokers seem Lo be under LIe ImpressIon
LIey ure exempL Irom LIe noLIon LIuL IL Is wrong Lo
IILLer. On LIe ABC`s MDA |u purLIcuIur cIurucLer| buLLs
IIs cIgureLLe on LIe ground uImosL us oILen us |unoLIer
cIurucLer| sIukes Ier IuIr meunIngIuIIy..
wouId Iuve expecLed more Irom u responsIbIe drumu,
buL IL couId be urgued IL Is mereIy reIIecLIng common
prucLIce.
ndeed, EnvIronmenL ProLecLIon AuLIorILy IIgures sIow
1o,ooo buLLs ure sLubbed In MeIbourne CBD sLreeLs
every duy und LIuL cIgureLLe buLLs muke up u sLuggerIng
6 per cenL oI IILLer on our beucIes.
Cun smokers reud LIese IIgures und serIousIy LIInk
The Bigger Picture
LIeIr IILLIe pIece oI Iug reIuse Is dIIIerenL Irom wIuL LIe
resL oI us IeeI obIIged Lo bIn?
TIe dIsIeurLenIng LIIng Is LIInk LIeIr Impudence Is
worsenIng..
ILLerIng IInes Iuve been Increused und, under
proposed cIunges Lo MeIbourne CILy CouncII byIuws,
buIIdIng owners couId soon Iuce $oo IInes II LIey do
noL cIeun up buLLs.
WIII sucI provocuLIve sLeps work?
doubL IL, noL wIIIe smokers conLInue Lo beIIeve LIey
ure noL responsIbIe Ior LIe gross ImpucL LIey Iuve on
LIe resL oI us.
TIe oLIer mornIng Ieurd on LIe rudIo u sLory ubouL u
womun wIo Lukes muLLers InLo Ier own Iunds: wIen
sIe cuLcIes moLorIsLs IIIckIng LIeIr buLL ouL oI LIe
wIndow uL LruIIIc IIgILs sIe wIII jump ouL oI Ier cur,
reLrIeve LIe oIIendIng buLL und LIrow IL buck LIrougI
LIeIr wIndow..
Ike pebbIecreLe und muzuk, smokIng Is someLIIng our
cuILure wIII Iuve Lo endure Ior u wIIIe yeL, unLII IL IInuIIy
goes ouL oI IusIIon.
n LIe meunLIme, wIIIe we reuIIy sIouIdn`L Iook down
on smokers, we sure us IeII sIouId dIsI up some IuIry
eyebuII LreuLmenL wIen LIey mIsbeIuve. (Hercld,Sun,
Junuury 6, zoo, p.1q)
TIe senLImenLs presenLed ure LypIcuI oI un ImmuLure, ucuLeIy-
IIxuLed menLuIILy (e.g., superIorILy syndrome). L Ius been consIdered In
LIIs dIscussIon LIuL muny wesLern nuLIons ure In gruve LroubIe. Key socIuI
InsLILuLIons ure uIreudy In IuIIure, uLLerIy domInuLed by LIe superIIcIuIILy
oI muLerIuIIsm. TIIs IuIIure Is IurLIer reIIecLed In LIe musses. By
jeLLIsonIng u coIerenL, IIrsL-prIncIpIes moruI Irumework, muny ure now
sLewIng In LIeIr LroubIed, LormenLed, Iower-nuLure reusonIng. L Ius uIso
been consIdered LIuL wIere IonesLy Is IuckIng, mInds wIII projecL LIeIr
InLernuI conIIIcL ouLwurds. TIIs Is LypIcuI oI obsessIonsJcompuIsIons Lo do
wILI exLernuI IygIene (e.g., ESS); on u grunder-scuIe, IL becomes
envIronmenLuIIsm. MInds wIII bIume exLernuIILIes Ior wIuL Is LIeIr own
reInIorced sense oI IrruLIonuI grIevunces und become obsessed wILI
exLernuI correcLIons.
n socIeLIes LIuL Iuve dIscurded proIound moruI sLundurd und
embruced moruI reIuLIvIsm, buLL-IILLer Ius become un ubsoIuLe wrong.
CIgureLLe buLLs muy be LIe IeusL oI unyone`s concerns wILI wIuL Is Lo
495
495
Rampant Antismoking Signifies Grave Danger
cumeI! (Mcttheu z:z(, AmpIIIIed BIbIe) TIIs perLuIns Lo un upsIde-
down, buck-Lo-IronL reusonIng; LrIvIuIILIes ure munuIucLured InLo
mounLuIns, wIIIe crILIcuI muLLers ure IeIL unuLLended. To reILeruLe,
rumpunL unLIsmokIng Is u crILIcuI sympLom oI perIIousIy unsLubIe,
muLerIuIIsL socIeLIes.
TIese ure dIsLurbIng sImIIurILIes Lo LIe ubsurdILIes und
conLrudIcLIons produced by LIe muLerIuIIsL NuzI menLuIILy. WIIIe
promoLIng bIoIogIcuIJgeneLIc rIsk uversIon on LIe busIs oI IIImsy InIerence
(scIenLIsm, IeuILIIsm), LIe menLuIILy Lukes extreme rIsks wILI
psycIoIogIcuI, socIuI, moruI, und spIrILuuI IeuILI; wIIIe LIere Is un
obsessIon wILI envIronmenLuI poIIuLIon, LIe menLuIILy Is uLLerIy
obIIvIous Lo LIe monumenLuI corrupLIon IL Is producIng uL psycIoIogIcuI,
socIuI, und moruI IeveIs. TIe muLerIuIIsL domInuLIon oI educuLIon und
unIversILIes, LIe medIu`s eugerness Lo propuguLe LIe orLIodox vIew, und
IIberuIIsm producIng u conIused, dIsIIIusIoned, und moruIIy und
InLeIIecLuuIIy IeebIe youLI LIuL cun eusIIy be munIpuIuLed InLo deIuded
superIorIsL cuuses ure uIso very sImIIur. UnIorLunuLeIy, LIe probIem LIIs
LIme goes Iur beyond LIe ucLIvILy oI u sInguIur nuLIon, I.e., LIe body
purILunIsm Is muILIrucIuI. TIe momenLum Is Lowurds InLernuLIonuIIsm
or InLernuLIonuI socIuIIsm. OnIy one oI LIe muny ubsurdILIes Is LIuL LIe
nuLIons InvoIved Iuve u IIsLory oI democruLIc ruIe.
One oI numerous unLIsmokIng urLIcIes uppeurIng In VIcLorIun
(AusLruIIu) newspupers wIII serve Lo empIusIze u mujor LIeme oI LIIs
dIscussIon:
beIIeve IL Is IIgI LIme smokers Iud u good LuIkIng Lo.
um noL u mIIILunL unLI-smoker..
BuL, by crIkey, LIey couId Ieurn some munners. or
some reuson LIe mujorILy oI smokers beIIeve u dIIIerenL
seL oI ruIes uppIIes Lo LIem.
or InsLunce, smokers seem Lo be under LIe ImpressIon
LIey ure exempL Irom LIe noLIon LIuL IL Is wrong Lo
IILLer. On LIe ABC`s MDA |u purLIcuIur cIurucLer| buLLs
IIs cIgureLLe on LIe ground uImosL us oILen us |unoLIer
cIurucLer| sIukes Ier IuIr meunIngIuIIy..
wouId Iuve expecLed more Irom u responsIbIe drumu,
buL IL couId be urgued IL Is mereIy reIIecLIng common
prucLIce.
ndeed, EnvIronmenL ProLecLIon AuLIorILy IIgures sIow
1o,ooo buLLs ure sLubbed In MeIbourne CBD sLreeLs
every duy und LIuL cIgureLLe buLLs muke up u sLuggerIng
6 per cenL oI IILLer on our beucIes.
Cun smokers reud LIese IIgures und serIousIy LIInk
The Bigger Picture
LIeIr IILLIe pIece oI Iug reIuse Is dIIIerenL Irom wIuL LIe
resL oI us IeeI obIIged Lo bIn?
TIe dIsIeurLenIng LIIng Is LIInk LIeIr Impudence Is
worsenIng..
ILLerIng IInes Iuve been Increused und, under
proposed cIunges Lo MeIbourne CILy CouncII byIuws,
buIIdIng owners couId soon Iuce $oo IInes II LIey do
noL cIeun up buLLs.
WIII sucI provocuLIve sLeps work?
doubL IL, noL wIIIe smokers conLInue Lo beIIeve LIey
ure noL responsIbIe Ior LIe gross ImpucL LIey Iuve on
LIe resL oI us.
TIe oLIer mornIng Ieurd on LIe rudIo u sLory ubouL u
womun wIo Lukes muLLers InLo Ier own Iunds: wIen
sIe cuLcIes moLorIsLs IIIckIng LIeIr buLL ouL oI LIe
wIndow uL LruIIIc IIgILs sIe wIII jump ouL oI Ier cur,
reLrIeve LIe oIIendIng buLL und LIrow IL buck LIrougI
LIeIr wIndow..
Ike pebbIecreLe und muzuk, smokIng Is someLIIng our
cuILure wIII Iuve Lo endure Ior u wIIIe yeL, unLII IL IInuIIy
goes ouL oI IusIIon.
n LIe meunLIme, wIIIe we reuIIy sIouIdn`L Iook down
on smokers, we sure us IeII sIouId dIsI up some IuIry
eyebuII LreuLmenL wIen LIey mIsbeIuve. (Hercld,Sun,
Junuury 6, zoo, p.1q)
TIe senLImenLs presenLed ure LypIcuI oI un ImmuLure, ucuLeIy-
IIxuLed menLuIILy (e.g., superIorILy syndrome). L Ius been consIdered In
LIIs dIscussIon LIuL muny wesLern nuLIons ure In gruve LroubIe. Key socIuI
InsLILuLIons ure uIreudy In IuIIure, uLLerIy domInuLed by LIe superIIcIuIILy
oI muLerIuIIsm. TIIs IuIIure Is IurLIer reIIecLed In LIe musses. By
jeLLIsonIng u coIerenL, IIrsL-prIncIpIes moruI Irumework, muny ure now
sLewIng In LIeIr LroubIed, LormenLed, Iower-nuLure reusonIng. L Ius uIso
been consIdered LIuL wIere IonesLy Is IuckIng, mInds wIII projecL LIeIr
InLernuI conIIIcL ouLwurds. TIIs Is LypIcuI oI obsessIonsJcompuIsIons Lo do
wILI exLernuI IygIene (e.g., ESS); on u grunder-scuIe, IL becomes
envIronmenLuIIsm. MInds wIII bIume exLernuIILIes Ior wIuL Is LIeIr own
reInIorced sense oI IrruLIonuI grIevunces und become obsessed wILI
exLernuI correcLIons.
n socIeLIes LIuL Iuve dIscurded proIound moruI sLundurd und
embruced moruI reIuLIvIsm, buLL-IILLer Ius become un ubsoIuLe wrong.
CIgureLLe buLLs muy be LIe IeusL oI unyone`s concerns wILI wIuL Is Lo
496
496
Rampant Antismoking Signifies Grave Danger
come. I persons ure uIreudy IuInLIng uL wIsps oI Lobucco smoke und
cIgureLLe buLLs, wIuL Iope do LIey Iuve oI conLendIng wILI ucLuuI dunger,
devusLuLIon und moruI LesLIng? And, LIe greuL dIsusLer wIII come by LIIs
very IeebIe, moruIIy-sIgILIess menLuIILy, peLuIunLIy und cuprIcIousIy
InsIsLIng on ILs wuy.
L does noL duwn on LIe journuIIsL In quesLIon LIuL sIe, IIke muny
oLIers, ure In LIe grIp oI ucuLe IIxuLIon munuIucLured by muLerIuIIsL
IdeoIogy. TIe IIxuLIon Is enLIreIy obIIvIous Lo u pIeLIoru oI ucLuuI,
subsLunLIve muLLers, I.e., upsIde-down, buck-Lo-IronL LIInkIng. WILI
Issues oI u mosL serIous concern uIIecLIng muny nuLIons, LIe mInd Is
uggressIveIy preoccupIed wILI un uILImuLeIy LrIvIuI concern; LIe
mIsconducL oI smokers Is vIewed us LIe greuL InjusLIce oI LIe LIme In
smokers` IuIIure Lo recognIze LIe gross ImpucL LIey Iuve on LIe resL oI
us. WIuL, buL un ucuLe IIxuLIon, wouId wurrunL LukIng muLLers InLo one`s
own Iunds regurdIng dIscurded cIgureLLe buLLs? Or, wIuL, buL Iuke
superIorILy, wouId see LIe need Lo eyebuII smokers wIen LIey
mIsbeIuve? TIere seems Lo be no eyebuIIIng oI unyone eIse Ior
unyLIIng eIse, wIen so mucI Is gIurIngIy usLruy. Sure us IeII Is,
unIorLunuLeIy, LIe onIy uccuruLe depIcLIon In LIe urLIcIe: Iukery, u Iuck oI
IonesLy, evenLuuIIy exucLs u cosL.
AILIougI eyebuIIIng muy be beLLer dIrecLed uL superIIcIuIIsLs or
superIorIsLs, compussIon Is wurrunLed In LIuL LIe menLuIILy Is IeurIuI und
unsLubIe. TIe CIrIsLIun LeucIIng presenLs un upL und vILuI Ideu, sImpIy
und dIrecLIy: WIy do you sLure Irom wILIouL uL LIe very smuII purLIcIe
LIuL Is In your broLIer`s eye, buL do noL become uwure oI cnd consIder LIe
beum oI LImber LIuL Is In your own eye? Or Iow cun you suy Lo your
broLIer, eL me geL LIe LIny purLIcIe ouL oI your eye, wIen LIere Is u beum
oI LImber In your own eye? You IypocrILe, IIrsL geL LIe beum oI LImber ouL
oI your own eye, und LIen you wIII see cIeurIy Lo Luke LIe LIny purLIcIe ouL
oI your broLIer`s eye. (Mcttheu ;: -, AmpIIIIed BIbIe) TIe CIrIsLIun
LeucIIng conLInuuIIy ImpIores IonesL seII-scruLIny In reIuLIon Lo u
proIound moruI sLundurd. TIIs poInL Is enLIreIy IosL on LIe muLerIuIIsL
menLuIILy wIIcI represenLs u Iuck oI InsIgIL, IonesLy und seII-scruLIny.
Pruger (zooz) mukes sImIIur observuLIons concernIng u
muddIed, upsIde-down reusonIng:
TIe IuLesL Jumes Bond movIe, 'DIe AnoLIer Duy,`
IoIIows LIe puLLern oI prevIous Bond IIIms wILI scenes
oI gIumorIzed vIoIence IncIudIng murder und muyIem,
und LILIIIuLIng nudILy wILI suggesLIve sex scenes. TIese,
oI course, gurner no proLesL (nor um udvocuLIng uny
sucI proLesL).
BuL IL Is sureIy un IIIusLruLIon oI LIe moruI conIusIon oI
The Bigger Picture
our LImes LIuL wIIIe scenes oI gruLuILous vIoIence und
sex, wIose onIy purpose Is Lo LILIIIuLe LIe vIewer, noL Lo
menLIon scenes oI uIcoIoI drInkIng, urouse no
conLroversy, one scene Is seeLIIng wILI conLroversy:
PIerce Brosnun us Jumes Bond smokes u cIgur!
AccordIng Lo news reporLs ubouL LIe Huvunu-bused
IIIm, 'n one scene, Bond exLoIs LIe vIrLues oI u cIgur
wILI u Cubun gungsLer.` AnLI-smokIng groups uround
LIe worId Iuve reucLed wILI u Iury LIuL no oLIer
ImugInubIe scene wouId eIIcIL. MovIes LIuL 'exLoI LIe
vIrLues` oI underuge sex, drug use, exLru-murILuI sex or
crImInuI beIuvIor Irom bunk robbIng Lo murder eIIcIL
Iur Iess condemnuLIon LIun u movIe LIuL depIcLs cIgur
smokIng. We LruIy IIve In LIe Age oI SLupIdILy.
NoLIIng more cIeurIy represenLs our presenL moruI und
InLeIIecLuuI conIusIon - wIIcI resuILs In Iurge purL Irom
LIe secuIurIzIng oI socIeLy - us does LIe IysLerIu
surroundIng smokIng.
Smokers muy Indeed IeeI un InkIIng oI persecuLIon. TIougI LIey
muy be buL morLuI LruveIers wILI pecuIIurILIes, smokers, In purLIcuIur, cun
Luke greuL soIuce In LIuL LIe muLerIuIIsm oI LIe LIme Ius bundIed LIem
wILI LIe mosL subIIme oI compuny. TIe sume menLuIILy LIuL Ius produced
unLIsmokIng Is uIso oIIended by Jesus CIrIsL. TIe LIme-course oI
unLIsmokIng und unLI-CIrIsLIunILy over LIe IusL Iew decudes Is very sImIIur
Indeed; muLerIuIIsm Ius been LryIng Lo dIspense wILI boLI smokIng und
CIrIsL. As Ius been consIdered, muLerIuIIsm jeLLIsons un ucLuuI moruI
sLundurd und subsLILuLes unLIsmokIng (pre-emInenL In MMES-cuIL edIcLs)
us LIe moruIILy oI LIe moruIIy degeneruLIng und LIe bodIIy-IIxuLed.
AguIn, LIe probIem Is noL smokIng or non-smokIng, buL unLIsmokIng,
wIIcI Is u sLunce borne oI u superIIcIuI, conLorLed, muLerIuIIsL worIdvIew.
BeIng sympLomuLIc oI psycIoIogIcuI, reIuLIonuI, und moruI IeebIeness, und
bused on scIenLIIIc Iukery, unLIsmokIng und ILs underIyIng muLerIuIIsm ure
LypIcuIIy dIcLuLorIuI (IuscIsL) und superIorIsL In dIsposILIon.
Even LIougI IL Ius been InsLrumenLuI In producIng muILI-
dImensIonuI IeebIeness on u muss scuIe, IumunIsm Is sLIII opLImIsLIc LIuL
more oI LIe sume propugundu wIII someIow mugIcuIIy LrunsIorm persons
InLo curIng und IovIng creuLures. MuLerIuIIsm Is u sLrong deIusIon. L
usuuIIy cunnoL even IuLIom LIe desLrucLIon IL Ius IeIL In ILs wuke - LIe
menLuIILy Is Loo IeebIe. BeIng wuywurd, Iower-nuLure reusonIng und unI-
dImensIonuI (superIIcIuI) In dIsposILIon, IL cun do no more LIun pursue
LIe sume errunL puLI. WIIIe IL pruIses LIe IImILIess poLenLIuI oI Iumun
497
497
Rampant Antismoking Signifies Grave Danger
come. I persons ure uIreudy IuInLIng uL wIsps oI Lobucco smoke und
cIgureLLe buLLs, wIuL Iope do LIey Iuve oI conLendIng wILI ucLuuI dunger,
devusLuLIon und moruI LesLIng? And, LIe greuL dIsusLer wIII come by LIIs
very IeebIe, moruIIy-sIgILIess menLuIILy, peLuIunLIy und cuprIcIousIy
InsIsLIng on ILs wuy.
L does noL duwn on LIe journuIIsL In quesLIon LIuL sIe, IIke muny
oLIers, ure In LIe grIp oI ucuLe IIxuLIon munuIucLured by muLerIuIIsL
IdeoIogy. TIe IIxuLIon Is enLIreIy obIIvIous Lo u pIeLIoru oI ucLuuI,
subsLunLIve muLLers, I.e., upsIde-down, buck-Lo-IronL LIInkIng. WILI
Issues oI u mosL serIous concern uIIecLIng muny nuLIons, LIe mInd Is
uggressIveIy preoccupIed wILI un uILImuLeIy LrIvIuI concern; LIe
mIsconducL oI smokers Is vIewed us LIe greuL InjusLIce oI LIe LIme In
smokers` IuIIure Lo recognIze LIe gross ImpucL LIey Iuve on LIe resL oI
us. WIuL, buL un ucuLe IIxuLIon, wouId wurrunL LukIng muLLers InLo one`s
own Iunds regurdIng dIscurded cIgureLLe buLLs? Or, wIuL, buL Iuke
superIorILy, wouId see LIe need Lo eyebuII smokers wIen LIey
mIsbeIuve? TIere seems Lo be no eyebuIIIng oI unyone eIse Ior
unyLIIng eIse, wIen so mucI Is gIurIngIy usLruy. Sure us IeII Is,
unIorLunuLeIy, LIe onIy uccuruLe depIcLIon In LIe urLIcIe: Iukery, u Iuck oI
IonesLy, evenLuuIIy exucLs u cosL.
AILIougI eyebuIIIng muy be beLLer dIrecLed uL superIIcIuIIsLs or
superIorIsLs, compussIon Is wurrunLed In LIuL LIe menLuIILy Is IeurIuI und
unsLubIe. TIe CIrIsLIun LeucIIng presenLs un upL und vILuI Ideu, sImpIy
und dIrecLIy: WIy do you sLure Irom wILIouL uL LIe very smuII purLIcIe
LIuL Is In your broLIer`s eye, buL do noL become uwure oI cnd consIder LIe
beum oI LImber LIuL Is In your own eye? Or Iow cun you suy Lo your
broLIer, eL me geL LIe LIny purLIcIe ouL oI your eye, wIen LIere Is u beum
oI LImber In your own eye? You IypocrILe, IIrsL geL LIe beum oI LImber ouL
oI your own eye, und LIen you wIII see cIeurIy Lo Luke LIe LIny purLIcIe ouL
oI your broLIer`s eye. (Mcttheu ;: -, AmpIIIIed BIbIe) TIe CIrIsLIun
LeucIIng conLInuuIIy ImpIores IonesL seII-scruLIny In reIuLIon Lo u
proIound moruI sLundurd. TIIs poInL Is enLIreIy IosL on LIe muLerIuIIsL
menLuIILy wIIcI represenLs u Iuck oI InsIgIL, IonesLy und seII-scruLIny.
Pruger (zooz) mukes sImIIur observuLIons concernIng u
muddIed, upsIde-down reusonIng:
TIe IuLesL Jumes Bond movIe, 'DIe AnoLIer Duy,`
IoIIows LIe puLLern oI prevIous Bond IIIms wILI scenes
oI gIumorIzed vIoIence IncIudIng murder und muyIem,
und LILIIIuLIng nudILy wILI suggesLIve sex scenes. TIese,
oI course, gurner no proLesL (nor um udvocuLIng uny
sucI proLesL).
BuL IL Is sureIy un IIIusLruLIon oI LIe moruI conIusIon oI
The Bigger Picture
our LImes LIuL wIIIe scenes oI gruLuILous vIoIence und
sex, wIose onIy purpose Is Lo LILIIIuLe LIe vIewer, noL Lo
menLIon scenes oI uIcoIoI drInkIng, urouse no
conLroversy, one scene Is seeLIIng wILI conLroversy:
PIerce Brosnun us Jumes Bond smokes u cIgur!
AccordIng Lo news reporLs ubouL LIe Huvunu-bused
IIIm, 'n one scene, Bond exLoIs LIe vIrLues oI u cIgur
wILI u Cubun gungsLer.` AnLI-smokIng groups uround
LIe worId Iuve reucLed wILI u Iury LIuL no oLIer
ImugInubIe scene wouId eIIcIL. MovIes LIuL 'exLoI LIe
vIrLues` oI underuge sex, drug use, exLru-murILuI sex or
crImInuI beIuvIor Irom bunk robbIng Lo murder eIIcIL
Iur Iess condemnuLIon LIun u movIe LIuL depIcLs cIgur
smokIng. We LruIy IIve In LIe Age oI SLupIdILy.
NoLIIng more cIeurIy represenLs our presenL moruI und
InLeIIecLuuI conIusIon - wIIcI resuILs In Iurge purL Irom
LIe secuIurIzIng oI socIeLy - us does LIe IysLerIu
surroundIng smokIng.
Smokers muy Indeed IeeI un InkIIng oI persecuLIon. TIougI LIey
muy be buL morLuI LruveIers wILI pecuIIurILIes, smokers, In purLIcuIur, cun
Luke greuL soIuce In LIuL LIe muLerIuIIsm oI LIe LIme Ius bundIed LIem
wILI LIe mosL subIIme oI compuny. TIe sume menLuIILy LIuL Ius produced
unLIsmokIng Is uIso oIIended by Jesus CIrIsL. TIe LIme-course oI
unLIsmokIng und unLI-CIrIsLIunILy over LIe IusL Iew decudes Is very sImIIur
Indeed; muLerIuIIsm Ius been LryIng Lo dIspense wILI boLI smokIng und
CIrIsL. As Ius been consIdered, muLerIuIIsm jeLLIsons un ucLuuI moruI
sLundurd und subsLILuLes unLIsmokIng (pre-emInenL In MMES-cuIL edIcLs)
us LIe moruIILy oI LIe moruIIy degeneruLIng und LIe bodIIy-IIxuLed.
AguIn, LIe probIem Is noL smokIng or non-smokIng, buL unLIsmokIng,
wIIcI Is u sLunce borne oI u superIIcIuI, conLorLed, muLerIuIIsL worIdvIew.
BeIng sympLomuLIc oI psycIoIogIcuI, reIuLIonuI, und moruI IeebIeness, und
bused on scIenLIIIc Iukery, unLIsmokIng und ILs underIyIng muLerIuIIsm ure
LypIcuIIy dIcLuLorIuI (IuscIsL) und superIorIsL In dIsposILIon.
Even LIougI IL Ius been InsLrumenLuI In producIng muILI-
dImensIonuI IeebIeness on u muss scuIe, IumunIsm Is sLIII opLImIsLIc LIuL
more oI LIe sume propugundu wIII someIow mugIcuIIy LrunsIorm persons
InLo curIng und IovIng creuLures. MuLerIuIIsm Is u sLrong deIusIon. L
usuuIIy cunnoL even IuLIom LIe desLrucLIon IL Ius IeIL In ILs wuke - LIe
menLuIILy Is Loo IeebIe. BeIng wuywurd, Iower-nuLure reusonIng und unI-
dImensIonuI (superIIcIuI) In dIsposILIon, IL cun do no more LIun pursue
LIe sume errunL puLI. WIIIe IL pruIses LIe IImILIess poLenLIuI oI Iumun
498
498
Rampant Antismoking Signifies Grave Danger
InLeIIIgence, IL IuIIs Lo compreIend LIuL LIe menLuIILy corrupLs wIuLever IL
Iuys ILs Iunds Lo. ScIenLIsmJIeuILIIsm, us uppIIed Lo LIe Iumun condILIon,
Is u compreIensIve IuIIure. TIe upproucI Ius mungIed scIenLIIIc und
cuusuI InIerence beyond recognILIon und Ius sLrIpped LIe crILIcuI
dImensIons LIuL dIsLInguIsI Iumuns us Iumun; under preLense oI
scIenLIIIc credIbIIILy, IL promoLes supersLILIous beIIeI und IrruLIonuI Ieur us
u muLLer oI course (MMES cuIL). TIe menLuIILy produces u reusonIng LIuL
Is noL IIL Ior uII Loo mucI; yeL, LIIs menLuIILy sLrIves Lo ruIe. Reuson und
InLeIIIgence requIre judIcIous counseI, I.e., u coIerenL, ubsoIuLe
meLupIysIcs. AguIn, LIe probIem Is noL reuson or InLeIIIgence, per se, buL
muLerIuIIsm dIrecLIng LIem. MuLerIuIIsm Is u dungerousIy conIused
menLuIILy, noL knowIng wIuL IL Is doIng or wIen Lo sLop.
. Ircmentction, Lobb Groups cnd Monomcnic
L cun be concIuded Irom LIe dIscussIon concernIng LIe medIcuI
esLubIIsImenL, ucudemIu, und socIeLy generuIIy LIuL LIe crIsIs oI LIe LIme
Is u meLupIysIcuI one. Across uII key socIuI InsLILuLIons LIere Is un ubsence
oI u coIerenL, coIIecLIve moruI Irumework. HuvIng rejecLed LIe CIrIsLIun
Irumework, IL Is LIe superIIcIuIILy oI muLerIuIIsm LIuL Ius IIourIsIed.
MuLerIuIIsm reIIecLs IrugmenLed LIougIL, IuckIng muILI-dImensIonuIILy.
MuLerIuIIsm uIso IndIcuLes LIuL IonesL seII-scruLIny, purLIcuIurIy regurdIng
u proIound moruI sLundurd, Is noL occurrIng Lo uny consIderubIe exLenL.
n LIuL muny persons ure noL resoIvIng conIIIcLed LIougIL und
experIences (I.e., remuInIng In Iower-nuLure reusonIng), IL Is noL
surprIsIng LIuL Iobby groups, udvocucy groups, supporL groups, vIcLIm
groups, proIessIonuI IobbyIsLs, eLc., Iuve uIso proIIIeruLed durIng LIe IusL
number oI decudes - consIsLenL wILI LIe muLerIuIIsL munIIesLo. or
exumpIe, LIere ure groups Ior uII munner oI dIseuses, Lruumus und
reucLIons. TIese groups Lend Lo reInIorce probIems ruLIer LIun resoIve
LIem. Persons cun gruvILuLe Lo LIese groups Ior u vurIeLy oI reusons. or
exumpIe, LIe grIeI-sLrIcken, IuvIng IosL u IumIIy member Lo some dIseuse,
IInd meunIng In LIese groups. HuvIng noL yeL come Lo Lerms wILI LIeIr
experIence In greuLer spIrILuuI conLexL, LIeIr beIIeI Is LIuL LIeIr group wIII
cIunge LIe worId LIrougI educuLIon, spurIng oLIers LIeIr experIence,
I.e., LIese groups LypIcuIIy provIde proLecLIon uguInsL LIe resoIuLIon oI
Inner conIIIcL. UnIorLunuLeIy, In u muLerIuIIsL Irumework, personsJgroups
do noL need Lo uccounL Ior LIeIr possIbIy conLorLed moLIvuLIon In
muILIdImensIonuI Lerms or LIe rumIIIcuLIons oI LIeIr educuLIonuI
conducL uIong LIese muILIpIe dImensIons. L Is by sLundurds pIummeLIng
generuIIy LIuL Ius IegILImIzed LIe quesLIonubIe ucLIvILy oI muny oI LIese
groups.
The Bigger Picture
AguIn, LIIs Is u recIpe Ior dIsusLer. AL one LIme, persons or groups
wouId Iuve voIunLurIIy dIsquuIIIIed LIemseIves Irom u consIderuLIon, II
LIey IeIL LIuL LIey couId noL brIng objecLIvILy Lo LIe ucLIvILy. Now, gIven
LIuL LIe IonesLy requIred Ior sucI un evuIuuLIon Is ubsenL, IL Is LIose wILI
mosL vesLed InLeresL, und usuuIIy on LIe busIs oI IncoIerenL beIIeI und
LwIsLed emoLIons, LIuL produce u Lug-oI-wur Ior domInuLIon In pubIIc
poIIcy deLermInuLIons. WIuL do medIcuI groups, LypIcuIIy represenLIng
dIsmembered body purLs (e.g., IeurL IounduLIon), or oLIer monomunIucuI
groups (e.g., unLIsmokIng) undersLund oI muILIdImensIonuI IeuILI? TIe
very exIsLence oI LIese groups reIIecLs u Iuck oI perspecLIve by LIeIr
membersIIp. YeL, IL Is sucI groups LIuL currenLIy domInuLe pubIIc IeuILI
poIIcy.
DemonsLruLIng no regurd Ior LIe deLrImenLuI consequences oI
dIssemInuLed InIormuLIon, LIe more sucI groups cun jusLIIy LIeIr
exIsLence und ImporLunce, usuuIIy LIrougI sLuLIsLIcuIIsL prescrIpLIons und
Ieur und guIIL-mongerIng, LIe IIgIer LIe IIkeIIIood LIuL LIey wIII uLLrucL
IundIng or donuLIons.
A IurLIer greuL decepLIon oI LIe LIme Is LIuL monomunIucuI
groups presenL LIemseIves us experL In u IIeId. RuLIer, LIe Cuncer CouncII,
Ior exumpIe, undersLunds very IILLIe ubouL LIe ueLIoIogy oI cuncer, IeL
uIone u more muILIdImensIonuI vIew oI IeuILI; LIe HeurL ounduLIon
undersLunds very IILLIe ubouL LIe ueLIoIogy oI IeurL dIseuse; unLIsmokIng
groups undersLund very IILLIe ubouL LIe smokIng IubIL or LIe unLIsmokIng
IIxuLIon. TIe propensILy oI LIese groups Lo wreuk Iuvoc on psycIoIogIcuI
und reIuLIonuI IeuILI Is u producL oI muLerIuIIsm und reIIes on
sLuLIsLIcuIIsm und crumentum cd terecundicm (uppeuI Lo LIe
uuLIorILy oI epIdemIoIogy). TIrougI LIeIr ucLIvILy LIey IurLIer generuLe
crumentum cd ncusecm, crumentum cd populum, und crumentun
cd hominem - LIe munuIucLure oI bundwugon eIIecLs or muss deIusIon.
MonomunIucuI groups do noL IumIIIurIze LIemseIves wILI LIe
greuLer conLexL wILIIn wIIcI LIey operuLe; LIey do noL consIder LIe
IIsLory oI un Issue; LIey do noL ucquuInL LIemseIves wILI LecInIcuI
muLLers. UnIorLunuLeIy, LIe currenL poor sLundurds oI conducL do noL
requIre LIuL LIey do so. TIese groups ure LypIcuIIy seII-servIng In LIe
pursuIL, usuuIIy, oI deIusIonuI cuuses.
L Is In LIe IrugmenLuLIon und poor InIerenLIuI sLundurd oI
muLerIuIIsm LIuL muny monomunIucuI groups, uIso represenLIng
IrugmenLuLIon und poor InIerenLIuI sLundurd, ure In LIeIr eIemenL. or
exumpIe, ASH Ius been ucLIve sInce LIe IuLe-1q6o`s In LIe US und eurIy-
1q;o`s In BrILuIn. TIe group`s rIeLorIc und deIusIonuI LendencIes were
recognIzed by muny us sucI uL LIe LIme. L Is onIy us u coIerenL moruI
Irumework Ius been dIspensed wILI by socIeLIes (muLerIuIIsL munIIesLo),
499
499
Rampant Antismoking Signifies Grave Danger
InLeIIIgence, IL IuIIs Lo compreIend LIuL LIe menLuIILy corrupLs wIuLever IL
Iuys ILs Iunds Lo. ScIenLIsmJIeuILIIsm, us uppIIed Lo LIe Iumun condILIon,
Is u compreIensIve IuIIure. TIe upproucI Ius mungIed scIenLIIIc und
cuusuI InIerence beyond recognILIon und Ius sLrIpped LIe crILIcuI
dImensIons LIuL dIsLInguIsI Iumuns us Iumun; under preLense oI
scIenLIIIc credIbIIILy, IL promoLes supersLILIous beIIeI und IrruLIonuI Ieur us
u muLLer oI course (MMES cuIL). TIe menLuIILy produces u reusonIng LIuL
Is noL IIL Ior uII Loo mucI; yeL, LIIs menLuIILy sLrIves Lo ruIe. Reuson und
InLeIIIgence requIre judIcIous counseI, I.e., u coIerenL, ubsoIuLe
meLupIysIcs. AguIn, LIe probIem Is noL reuson or InLeIIIgence, per se, buL
muLerIuIIsm dIrecLIng LIem. MuLerIuIIsm Is u dungerousIy conIused
menLuIILy, noL knowIng wIuL IL Is doIng or wIen Lo sLop.
. Ircmentction, Lobb Groups cnd Monomcnic
L cun be concIuded Irom LIe dIscussIon concernIng LIe medIcuI
esLubIIsImenL, ucudemIu, und socIeLy generuIIy LIuL LIe crIsIs oI LIe LIme
Is u meLupIysIcuI one. Across uII key socIuI InsLILuLIons LIere Is un ubsence
oI u coIerenL, coIIecLIve moruI Irumework. HuvIng rejecLed LIe CIrIsLIun
Irumework, IL Is LIe superIIcIuIILy oI muLerIuIIsm LIuL Ius IIourIsIed.
MuLerIuIIsm reIIecLs IrugmenLed LIougIL, IuckIng muILI-dImensIonuIILy.
MuLerIuIIsm uIso IndIcuLes LIuL IonesL seII-scruLIny, purLIcuIurIy regurdIng
u proIound moruI sLundurd, Is noL occurrIng Lo uny consIderubIe exLenL.
n LIuL muny persons ure noL resoIvIng conIIIcLed LIougIL und
experIences (I.e., remuInIng In Iower-nuLure reusonIng), IL Is noL
surprIsIng LIuL Iobby groups, udvocucy groups, supporL groups, vIcLIm
groups, proIessIonuI IobbyIsLs, eLc., Iuve uIso proIIIeruLed durIng LIe IusL
number oI decudes - consIsLenL wILI LIe muLerIuIIsL munIIesLo. or
exumpIe, LIere ure groups Ior uII munner oI dIseuses, Lruumus und
reucLIons. TIese groups Lend Lo reInIorce probIems ruLIer LIun resoIve
LIem. Persons cun gruvILuLe Lo LIese groups Ior u vurIeLy oI reusons. or
exumpIe, LIe grIeI-sLrIcken, IuvIng IosL u IumIIy member Lo some dIseuse,
IInd meunIng In LIese groups. HuvIng noL yeL come Lo Lerms wILI LIeIr
experIence In greuLer spIrILuuI conLexL, LIeIr beIIeI Is LIuL LIeIr group wIII
cIunge LIe worId LIrougI educuLIon, spurIng oLIers LIeIr experIence,
I.e., LIese groups LypIcuIIy provIde proLecLIon uguInsL LIe resoIuLIon oI
Inner conIIIcL. UnIorLunuLeIy, In u muLerIuIIsL Irumework, personsJgroups
do noL need Lo uccounL Ior LIeIr possIbIy conLorLed moLIvuLIon In
muILIdImensIonuI Lerms or LIe rumIIIcuLIons oI LIeIr educuLIonuI
conducL uIong LIese muILIpIe dImensIons. L Is by sLundurds pIummeLIng
generuIIy LIuL Ius IegILImIzed LIe quesLIonubIe ucLIvILy oI muny oI LIese
groups.
The Bigger Picture
AguIn, LIIs Is u recIpe Ior dIsusLer. AL one LIme, persons or groups
wouId Iuve voIunLurIIy dIsquuIIIIed LIemseIves Irom u consIderuLIon, II
LIey IeIL LIuL LIey couId noL brIng objecLIvILy Lo LIe ucLIvILy. Now, gIven
LIuL LIe IonesLy requIred Ior sucI un evuIuuLIon Is ubsenL, IL Is LIose wILI
mosL vesLed InLeresL, und usuuIIy on LIe busIs oI IncoIerenL beIIeI und
LwIsLed emoLIons, LIuL produce u Lug-oI-wur Ior domInuLIon In pubIIc
poIIcy deLermInuLIons. WIuL do medIcuI groups, LypIcuIIy represenLIng
dIsmembered body purLs (e.g., IeurL IounduLIon), or oLIer monomunIucuI
groups (e.g., unLIsmokIng) undersLund oI muILIdImensIonuI IeuILI? TIe
very exIsLence oI LIese groups reIIecLs u Iuck oI perspecLIve by LIeIr
membersIIp. YeL, IL Is sucI groups LIuL currenLIy domInuLe pubIIc IeuILI
poIIcy.
DemonsLruLIng no regurd Ior LIe deLrImenLuI consequences oI
dIssemInuLed InIormuLIon, LIe more sucI groups cun jusLIIy LIeIr
exIsLence und ImporLunce, usuuIIy LIrougI sLuLIsLIcuIIsL prescrIpLIons und
Ieur und guIIL-mongerIng, LIe IIgIer LIe IIkeIIIood LIuL LIey wIII uLLrucL
IundIng or donuLIons.
A IurLIer greuL decepLIon oI LIe LIme Is LIuL monomunIucuI
groups presenL LIemseIves us experL In u IIeId. RuLIer, LIe Cuncer CouncII,
Ior exumpIe, undersLunds very IILLIe ubouL LIe ueLIoIogy oI cuncer, IeL
uIone u more muILIdImensIonuI vIew oI IeuILI; LIe HeurL ounduLIon
undersLunds very IILLIe ubouL LIe ueLIoIogy oI IeurL dIseuse; unLIsmokIng
groups undersLund very IILLIe ubouL LIe smokIng IubIL or LIe unLIsmokIng
IIxuLIon. TIe propensILy oI LIese groups Lo wreuk Iuvoc on psycIoIogIcuI
und reIuLIonuI IeuILI Is u producL oI muLerIuIIsm und reIIes on
sLuLIsLIcuIIsm und crumentum cd terecundicm (uppeuI Lo LIe
uuLIorILy oI epIdemIoIogy). TIrougI LIeIr ucLIvILy LIey IurLIer generuLe
crumentum cd ncusecm, crumentum cd populum, und crumentun
cd hominem - LIe munuIucLure oI bundwugon eIIecLs or muss deIusIon.
MonomunIucuI groups do noL IumIIIurIze LIemseIves wILI LIe
greuLer conLexL wILIIn wIIcI LIey operuLe; LIey do noL consIder LIe
IIsLory oI un Issue; LIey do noL ucquuInL LIemseIves wILI LecInIcuI
muLLers. UnIorLunuLeIy, LIe currenL poor sLundurds oI conducL do noL
requIre LIuL LIey do so. TIese groups ure LypIcuIIy seII-servIng In LIe
pursuIL, usuuIIy, oI deIusIonuI cuuses.
L Is In LIe IrugmenLuLIon und poor InIerenLIuI sLundurd oI
muLerIuIIsm LIuL muny monomunIucuI groups, uIso represenLIng
IrugmenLuLIon und poor InIerenLIuI sLundurd, ure In LIeIr eIemenL. or
exumpIe, ASH Ius been ucLIve sInce LIe IuLe-1q6o`s In LIe US und eurIy-
1q;o`s In BrILuIn. TIe group`s rIeLorIc und deIusIonuI LendencIes were
recognIzed by muny us sucI uL LIe LIme. L Is onIy us u coIerenL moruI
Irumework Ius been dIspensed wILI by socIeLIes (muLerIuIIsL munIIesLo),
500
500
Rampant Antismoking Signifies Grave Danger
und ILs deLrImenLuI reIuLIonuI und psycIoIogIcuI rumIIIcuLIons, LIuL sucI
groups Iuve come Lo LIe Iore; wILI u generuI deLerIoruLIon oI sLundurds,
wIuL wus once properIy consIdered us nonsense now seems normuI. TIe
menLuIILy Is IeebIe und Ieeds und reInIorces IeebIeness. HonesLy und
InLegrILy oI InIormuLIon do noL IIgure In proceedIngs, buL onIy wIuL
promoLes ucuLe IIxuLIon In LIe popuIuLIon uL Iurge.
Some oI ASH`s unLIcs were consIdered In LIe prevIous cIupLer. L
Is worLI scruLInIzIng u IurLIer exumpIe. A 1qq ASH reIeuse urgues:
Smolers More Decdl Thcn Robbers In Worlplcce
Secondhcnd Smole is c Primcr Ccuse oj Decth in the
Worlplcce
Worlers Hcte More to Iecr Irom Smolers Thcn Irom
Homicides
AILIougI LIe ubor DepurLmenL Ius jusL reporLed LIuL
IomIcIde Is LIe second IeudIng cuuse oI deuLI In LIe
workpIuce, wILI u growIng number occurrIng durIng
robberIes, LIeIr own IIgures sIow LIuL secondIund
Lobucco smoke kIIIs Iur more workers LIun uII workpIuce
IomIcIdes, IncIudIng uLLucks by co-workers.
'Workers ure mucI more IIkeIy Lo be kIIIed by smokIng
co-workers LIun by robbers or dIsgrunLIed empIoyees,`
suys JoIn BunzIuI, ExecuLIve DIrecLor oI AcLIon on
SmokIng und HeuILI.
TIe ubor DepurLmenL`s own OccupuLIonuI HeuILI und
SuIeLy AdmInIsLruLIon (OSHA) 'esLImuLes LIuL LIere wIII
be beLween z,oqq und 1,ooo deuLIs Irom IeurL dIseuse
per yeur umong nonsmokIng AmerIcun workers exposed
Lo ETS In LIe workpIuce.` TIese ure In uddILIon Lo
Iundreds oI Iung cuncer deuLIs Irom LIe sume cuuse.
n conLrusL, LIe Bureuu oI ubor SLuLIsLIcs suys LIuL
ubouL zo% oI LIe esLImuLed 6,88 workers kIIIed IusL
yeur dIed us u resuIL oI vIoIence - u LoLuI oI 118 - oI
wIIcI onIy q1 were kIIIed by co-workers, cusLomers, or
cIIenLs.
TIIs Is Iur Iess LIun even LIe IowesL esLImuLe oI LIe
number oI AmerIcun workers wIo ure kIIIed eucI yeur
by InvoIunLury exposure Lo Lobucco smoke In LIeIr
workpIuces..
ronIcuIIy, suys BunzIuI, OSHA Ius been consIderIng
Ior more LIun u yeur u ruIe wIIcI wouId prevenL uII
LIese deuLIs sImpIy by proIIbILIng workpIuce smokIng,
or IImILIng IL Lo sepuruLeIy venLIIuLed rooms. SucI
The Bigger Picture
resLrIcLIons ure uIreudy In eIIecL In IIve sLuLes, und ure
suvIng Iundreds oI IIves uL vIrLuuIIy no cosL Lo LIe
empIoyers.
'WouId we IesILuLe Ior u momenL Lo udopL u ruIe wIIcI
wouId, uL no cosL, eIImInuLe LIe Iur smuIIer number oI
unnuuI workpIuce IomIcIdes?,` Ie usks.
TIe presenLuLIon ubove Is predIcuLed on quILe u number oI
InIerenLIuI IuIIucIes. IrsLIy, IL reIIes on IncoIerenL unuIogy - equuLIng LIe
sLuLIsLIcuI Ideu oI uLLrIbuLubIe numbers concernIng ETS exposure wILI
LIuL oI IomIcIde; LIe sLuLIsLIcuI urgumenL uguInsL ETS Is noLIIng IIke
IomIcIde. L does noL duwn on BunzIuI LIuL LIe urgumenL uguInsL ETS
occurs In u sLuLIsLIcuI, muLerIuIIsL IunLusy worId. L Is repugnunL LIuL u
mosL severe probIem sucI us IomIcIde, und wIIcI Ius u demonsLrubIe
cuuse, sIouId be LrIvIuIIzed LIrougI monomunIucuI, seII-servIng,
sLuLIsLIcuI bIuLIer. As repugnunL Is LIuL In LIe IusL IIne oI LIe reIeuse ETS
uLLrIbuLubIe numbers ure reIerred Lo us IomIcIde, I.e., sIIIL Irom IIke
IomIcIde Lo Is IomIcIde. AIso enLIreIy quesLIonubIe, Is LIe muILIpIe
uIIusIon Lo uL no cosL - workpIuce buns on smokIng InvoIve no cosL.
ndeed, LIere Is u rcte cosL. TIe sLuLIsLIcuI nonsense produced by
epIdemIoIogy wouId be reInIorced In cuusuI Lerms. TIIs IurLIer promoLes
sucI Ideus us deudIy und kIII. L IosLers IrruLIonuI beIIeI und Ieur,
IuLred, und Iuke superIorILy umongsL nonsmokers; und, smokers ure
IruuduIenLIy mude Lo uppeur us murderers. MonomunIucuI LIInkers
demonsLruLe u Iuck oI compreIensIon oI scIenLIIIc und sLuLIsLIcuI
InIerence, und ure uLLerIy obIIvIous Lo Ideus oI psycIoIogIcuI, reIuLIonuI,
und moruI IeuILI. TIe ImpressIon LIuL LIIs urgumenL Is uLLempLIng Lo
presenL Is deIInquenL und negIIgenL, und In LIe sLrongesL sense oI LIe
Lerms.
TIe ASH websILe Is IIIIed wILI u pIeLIoru oI one-IIne reIerences
Lo reseurcI IIndIngs or IeguI precedenL. TIe wordIng Ior LIese reIerences
Is LypIcuIIy mIsrepresenLuLIve oI IucLs und InLenLIonuIIy, muxImuIIy
InIIummuLory. TIe ASH websILe Is essenLIuIIy u IuLe sILe. SucI
orgunIzuLIons ure noL seekers or eIucIduLors oI IucL. TIe onIy InLeresL LIese
groups Iuve In InIormuLIon Is LIe exLenL Lo wIIcI IL cun be munIpuIuLed Lo
serve LIeIr ucuLe IIxuLIon.
AnoLIer IruuduIenL Ideu Is LIuL ASH presenLs ILseII us u z-yeur-
oId IeguI ucLIon cIurILubIe orgunIzuLIon enLIreIy supporLed by Lux-
deducLIbIe conLrIbuLIons. n BrILuIn, und LIe sume Is expecLed Ior LIe
UnILed SLuLes, ASH wus prImurIIy u governmenL Iunded pressure group.
MInIsLry oI HeuILI cIvII servunLs Iud prevIousIy poInLed ouL LIuL meusures
Lo IImIL smokIng wouId muke mucI more progress II LIere wus u voIunLury
501
501
Rampant Antismoking Signifies Grave Danger
und ILs deLrImenLuI reIuLIonuI und psycIoIogIcuI rumIIIcuLIons, LIuL sucI
groups Iuve come Lo LIe Iore; wILI u generuI deLerIoruLIon oI sLundurds,
wIuL wus once properIy consIdered us nonsense now seems normuI. TIe
menLuIILy Is IeebIe und Ieeds und reInIorces IeebIeness. HonesLy und
InLegrILy oI InIormuLIon do noL IIgure In proceedIngs, buL onIy wIuL
promoLes ucuLe IIxuLIon In LIe popuIuLIon uL Iurge.
Some oI ASH`s unLIcs were consIdered In LIe prevIous cIupLer. L
Is worLI scruLInIzIng u IurLIer exumpIe. A 1qq ASH reIeuse urgues:
Smolers More Decdl Thcn Robbers In Worlplcce
Secondhcnd Smole is c Primcr Ccuse oj Decth in the
Worlplcce
Worlers Hcte More to Iecr Irom Smolers Thcn Irom
Homicides
AILIougI LIe ubor DepurLmenL Ius jusL reporLed LIuL
IomIcIde Is LIe second IeudIng cuuse oI deuLI In LIe
workpIuce, wILI u growIng number occurrIng durIng
robberIes, LIeIr own IIgures sIow LIuL secondIund
Lobucco smoke kIIIs Iur more workers LIun uII workpIuce
IomIcIdes, IncIudIng uLLucks by co-workers.
'Workers ure mucI more IIkeIy Lo be kIIIed by smokIng
co-workers LIun by robbers or dIsgrunLIed empIoyees,`
suys JoIn BunzIuI, ExecuLIve DIrecLor oI AcLIon on
SmokIng und HeuILI.
TIe ubor DepurLmenL`s own OccupuLIonuI HeuILI und
SuIeLy AdmInIsLruLIon (OSHA) 'esLImuLes LIuL LIere wIII
be beLween z,oqq und 1,ooo deuLIs Irom IeurL dIseuse
per yeur umong nonsmokIng AmerIcun workers exposed
Lo ETS In LIe workpIuce.` TIese ure In uddILIon Lo
Iundreds oI Iung cuncer deuLIs Irom LIe sume cuuse.
n conLrusL, LIe Bureuu oI ubor SLuLIsLIcs suys LIuL
ubouL zo% oI LIe esLImuLed 6,88 workers kIIIed IusL
yeur dIed us u resuIL oI vIoIence - u LoLuI oI 118 - oI
wIIcI onIy q1 were kIIIed by co-workers, cusLomers, or
cIIenLs.
TIIs Is Iur Iess LIun even LIe IowesL esLImuLe oI LIe
number oI AmerIcun workers wIo ure kIIIed eucI yeur
by InvoIunLury exposure Lo Lobucco smoke In LIeIr
workpIuces..
ronIcuIIy, suys BunzIuI, OSHA Ius been consIderIng
Ior more LIun u yeur u ruIe wIIcI wouId prevenL uII
LIese deuLIs sImpIy by proIIbILIng workpIuce smokIng,
or IImILIng IL Lo sepuruLeIy venLIIuLed rooms. SucI
The Bigger Picture
resLrIcLIons ure uIreudy In eIIecL In IIve sLuLes, und ure
suvIng Iundreds oI IIves uL vIrLuuIIy no cosL Lo LIe
empIoyers.
'WouId we IesILuLe Ior u momenL Lo udopL u ruIe wIIcI
wouId, uL no cosL, eIImInuLe LIe Iur smuIIer number oI
unnuuI workpIuce IomIcIdes?,` Ie usks.
TIe presenLuLIon ubove Is predIcuLed on quILe u number oI
InIerenLIuI IuIIucIes. IrsLIy, IL reIIes on IncoIerenL unuIogy - equuLIng LIe
sLuLIsLIcuI Ideu oI uLLrIbuLubIe numbers concernIng ETS exposure wILI
LIuL oI IomIcIde; LIe sLuLIsLIcuI urgumenL uguInsL ETS Is noLIIng IIke
IomIcIde. L does noL duwn on BunzIuI LIuL LIe urgumenL uguInsL ETS
occurs In u sLuLIsLIcuI, muLerIuIIsL IunLusy worId. L Is repugnunL LIuL u
mosL severe probIem sucI us IomIcIde, und wIIcI Ius u demonsLrubIe
cuuse, sIouId be LrIvIuIIzed LIrougI monomunIucuI, seII-servIng,
sLuLIsLIcuI bIuLIer. As repugnunL Is LIuL In LIe IusL IIne oI LIe reIeuse ETS
uLLrIbuLubIe numbers ure reIerred Lo us IomIcIde, I.e., sIIIL Irom IIke
IomIcIde Lo Is IomIcIde. AIso enLIreIy quesLIonubIe, Is LIe muILIpIe
uIIusIon Lo uL no cosL - workpIuce buns on smokIng InvoIve no cosL.
ndeed, LIere Is u rcte cosL. TIe sLuLIsLIcuI nonsense produced by
epIdemIoIogy wouId be reInIorced In cuusuI Lerms. TIIs IurLIer promoLes
sucI Ideus us deudIy und kIII. L IosLers IrruLIonuI beIIeI und Ieur,
IuLred, und Iuke superIorILy umongsL nonsmokers; und, smokers ure
IruuduIenLIy mude Lo uppeur us murderers. MonomunIucuI LIInkers
demonsLruLe u Iuck oI compreIensIon oI scIenLIIIc und sLuLIsLIcuI
InIerence, und ure uLLerIy obIIvIous Lo Ideus oI psycIoIogIcuI, reIuLIonuI,
und moruI IeuILI. TIe ImpressIon LIuL LIIs urgumenL Is uLLempLIng Lo
presenL Is deIInquenL und negIIgenL, und In LIe sLrongesL sense oI LIe
Lerms.
TIe ASH websILe Is IIIIed wILI u pIeLIoru oI one-IIne reIerences
Lo reseurcI IIndIngs or IeguI precedenL. TIe wordIng Ior LIese reIerences
Is LypIcuIIy mIsrepresenLuLIve oI IucLs und InLenLIonuIIy, muxImuIIy
InIIummuLory. TIe ASH websILe Is essenLIuIIy u IuLe sILe. SucI
orgunIzuLIons ure noL seekers or eIucIduLors oI IucL. TIe onIy InLeresL LIese
groups Iuve In InIormuLIon Is LIe exLenL Lo wIIcI IL cun be munIpuIuLed Lo
serve LIeIr ucuLe IIxuLIon.
AnoLIer IruuduIenL Ideu Is LIuL ASH presenLs ILseII us u z-yeur-
oId IeguI ucLIon cIurILubIe orgunIzuLIon enLIreIy supporLed by Lux-
deducLIbIe conLrIbuLIons. n BrILuIn, und LIe sume Is expecLed Ior LIe
UnILed SLuLes, ASH wus prImurIIy u governmenL Iunded pressure group.
MInIsLry oI HeuILI cIvII servunLs Iud prevIousIy poInLed ouL LIuL meusures
Lo IImIL smokIng wouId muke mucI more progress II LIere wus u voIunLury
502
502
Rampant Antismoking Signifies Grave Danger
unLI-smokIng movemenL pressIng governmenL Lo Luke ucLIon. (BerrIdge,
1qqq, p.1186) Up Lo LIIs poInL, LIe governmenL dId noL see ILs roIe us
InLerIerIng wILI muLLers oI IndIvIduuI responsIbIIILy. As BerrIdge (1qqq)
noLes, |b|y LIe 1q;os, LIIs reIucLunce Iud gone, Lo be repIuced by u Iocus
on popuIuLIon IeveIs oI rIsk und LIe need Ior IndIvIduuI prevenLIon, by LIe
concepL oI 'LIe rIsk uvoIdIng IndIvIduuI.` (p.1186) L Is uncIeur wIuL LIIs
ASH IundIng InLended. However, IL represenLs un eurIy IooLIoId oI u more
generuI muLerIuIIsm (muLerIuIIsL munIIesLo) LIuL, us ILs domInuLIon Ius
Increused sInce LIe 1q;os, IL Ius IegILImIzed unLIsmokIng rIeLorIc und
meLIodoIogy. One oI LIe more devusLuLIng uspecLs oI wIuL Is now u
muLerIuIIsL sLrongIoId In mosL key socIuI InsLILuLIons wus LIe ETS us
dungerous Ior uII IIusco.
L Is uIso uncIeur wIen ASH becume u IuIIy cIurILubIe
orgunIzuLIon, buL probubIy wouId Iuve been uround LIe LIme oI LIe ETS
IIusco und LIe Increused scruLIny LIuL sucI un orgunIzuLIon wouId uLLrucL
wILI progressIveIy more InIIummuLory cIuIms. WesLern governmenLs
commILLed Lo unLIsmokIng Iuve un eusIer LIme II IL Is Iobby groups LIuL
pIuy LIe roIe oI propuguLIng LIe more InIIummuLory und unsubsLunLIuLed
cIuIms. To LIIs uuLIor`s knowIedge, LIere Is noL one governmenL IeuILI
oIIIcIuI or medIcuI-esLubIIsImenL oIIIcIuI LIuL Ius ever pubIIcIy quesLIoned
uny oI ASH`s (or uny oLIer unLIsmokIng group) wuywurd, IuLe-mongerIng
cIuIms: ASH, In seII-servIng pursuIL, does LIeIr bIddIng.
or exumpIe, LIe 1ourncl oj the Americcn Mediccl Associction
(1AMA) provIded pubIIcILy Ior LIe IIrsL InLernuLIonuI LreuLy on Lobucco. n
LIIs journuI MILku (zooo) IndIcuLes |I|or LIe 11LI LIme sInce 1q6;,
unLIsmokIng wurrIors guLIered Lo guIn IresI InspIruLIon, Ieur LIe IuLesL
scIenLIIIc reseurcI, und mup sLruLegIes us LIey conLInue LIe IIgIL uguInsL
'bIg Lobucco.` AbouL qoo peopIe Irom 1qo counLrIes meL Iere IusL monLI
Ior LIe WorId ConIerence on Tobucco or HeuILI. n Ier openIng remurks,
Gro HurIem BrundLIund, MD, dIrecLor-generuI oI LIe WorId HeuILI
OrgunIzuLIon, cuIIed on LIe uLLendees Lo 'breuk LIe sIIence` jusL us
deIeguLes uL LIe JuIy nLernuLIonuI ADS ConIerence In SouLI AIrIcu were
exIorLed Lo do. TIe IncepLIon yeur Ior LIe US ASH wus 1q6;. ASH
membersJsupporLers wouId probubIy Iuve domInuLed LIe IIrsL conIerence
In 1q6;, und probubIy so In LIe zooo conIerence. nLernuLIonuI muLerIuIIsL
orgunIzuLIons (e.g., WHO, UnILed NuLIons), LIe medIcuI esLubIIsImenL,
und governmenLs (IeuILI depurLmenLs domInuLed by medIco-
muLerIuIIsm) uppIuud groups sucI us ASH, posILIveIy reIerrIng Lo LIem us
unLIsmokIng wurrIors. TIIs Is u wur wuged by LIe mIsguIded wILI
deLrImenLuI rumIIIcuLIons LIuL go Iur beyond LIe Lobucco IndusLry. TIese
groups ure Ied scIenLIIIc InIormuLIon, perspecLIve und sLruLegIes by un
overseeIng muLerIuIIsmJmedIco-muLerIuIIsm, I.e., gIobuI or umbreIIu
The Bigger Picture
orgunIzuLIons sucI us LIe WHO und LIe UN. AnoLIer LeIIIng uspecL oI LIe
urLIcIe Is LIuL, unIIke eurIIer conIerences, LIere Is now u sLuggerIng
number oI persons und represenLed nuLIons uLLendIng LIIs sorL oI
conIerence, I.e., u deIusIon LruIy on u muss scuIe.
n zooo, oLIer urLIcIes uppeured In 1AMA promoLIng
unquesLIoned Lobucco conLroI recommenduLIons (e.g., BrundLIund, zooo;
HousLon & KuuImun, zooo). BrundLIund (zooo) IndIcuLes LIe wIdespreud
InIru-sLrucLure oI LrunsnuLIonuI, governmenLuI, nongovernmenLuI, medIu
und Iobby groups occupIed In Lobucco conLroI. TIere ure InLerneL
neLworks LIuL cun quIckIy move dIsjoInLed, muLerIuIIsL InIormuLIon ubouL
und presenLed us InIuIIIbIe. TIIs very consIderubIe, conLroIIIng ucLIvILy Is
uII underIuIn by un unquesLIonIng uccepLunce oI conLorLed epIdemIoIogIcJ
rIsk-ussessmenL procedures und u reducLIonIsL worIdvIew. AILIougI
BrundLIund und oLIer muLerIuIIsLs consIder LIe cIrcumsLunce us
progressIve, IL Is In IucL very cIIIIIng LIuL u cuIL predIcuLed on Ignorunce,
IncompeLence, und dungerous LendencIes (cIurucLer deIIcIencIes) Ius
sucI Inrouds Lo worId governunce. WIIIe LIere Is conLInuuI reIerence Lo
LIe Lobucco epIdemIc, IL Is LIIs preoccupuLIon LIuL Is subLerIuge Ior LIe
ucLuuI und dungerous cuIL pundemIc In progress.
WIIIe monomunIucs sucI us BunzIuI wouId presenL LIemseIves
us moruI crusuders und deIenders oI LIe vuInerubIe, LIey ure enLIreIy
beIuvIorIsL In dIsposILIon - wIeLIer reuIIzed or noL. TIeIr conducL Is
wIoIIy consIsLenL wILI, uILIougI even more uggressIve LIun, LIe
superIIcIuIILy oI unLIsmokIng In LIe NuzI regIme. BunzIuI, In purLIcuIur,
Ius munIpuIuLed IeguI prIncIpIes In monomunIucuI pursuILs wILI reckIess
dIsregurd Ior LIe rumIIIcuLIons oI LIe precedenLs LIuL ure beIng seL. I
some oI LIese precedenLs were IoIIowed Lo LIeIr IogIcuI concIusIon, LIey
promoLe LIe person us LIe properLy oI LIe SLuLe (I.e., LIe muLerIuIIsL
munIIesLo). TIe conducL IosLers muILIdImensIonuI IeebIeness. I
psycIoIogIcuI, reIuLIonuI, und moruI IeuILI ure duIy consIdered, IL Is LIe
reckIess conducL oI sucI groups LIuL wouId be on LIe receIvIng-end oI
IILIguLIon. TIere ure persons In oLIer counLrIes LIuL Iuve been juIIed Ior
IncILIng Iess IysLerIu und IuLred. L uIso beggurs beIIeI LIuL un
orgunIzuLIon represenLIng monomunIu und IncILIng IrruLIonuI beIIeI, Ieur
und IuLred Ius been grunLed u cIurILubIe (I.e., Lux-deducLIbIe donuLIons)
sLuLus. However, LIIs Is consIsLenL wILI LIIs orgunIzuLIon`s uIIgnmenL Lo
governmenL ugendu.
WILI LIe muLerIuIIsL domInuLIon oI scIooIs, wIere cIIIdren ure
noL LuugIL Lo reuson coIerenLIy buL Lo sImpIy IoId requIred uLLILudes,
youLI Ius been IIjucked by LIe IeuILIIsL momenLum. An exceIIenL
exumpIe oI LIe success oI IndocLrInuLIon progrums comes Irom LIe
Concord HIgI ScIooI In New HumpsIIre. VuznIs (zoo1) descrIbes LIe
503
503
Rampant Antismoking Signifies Grave Danger
unLI-smokIng movemenL pressIng governmenL Lo Luke ucLIon. (BerrIdge,
1qqq, p.1186) Up Lo LIIs poInL, LIe governmenL dId noL see ILs roIe us
InLerIerIng wILI muLLers oI IndIvIduuI responsIbIIILy. As BerrIdge (1qqq)
noLes, |b|y LIe 1q;os, LIIs reIucLunce Iud gone, Lo be repIuced by u Iocus
on popuIuLIon IeveIs oI rIsk und LIe need Ior IndIvIduuI prevenLIon, by LIe
concepL oI 'LIe rIsk uvoIdIng IndIvIduuI.` (p.1186) L Is uncIeur wIuL LIIs
ASH IundIng InLended. However, IL represenLs un eurIy IooLIoId oI u more
generuI muLerIuIIsm (muLerIuIIsL munIIesLo) LIuL, us ILs domInuLIon Ius
Increused sInce LIe 1q;os, IL Ius IegILImIzed unLIsmokIng rIeLorIc und
meLIodoIogy. One oI LIe more devusLuLIng uspecLs oI wIuL Is now u
muLerIuIIsL sLrongIoId In mosL key socIuI InsLILuLIons wus LIe ETS us
dungerous Ior uII IIusco.
L Is uIso uncIeur wIen ASH becume u IuIIy cIurILubIe
orgunIzuLIon, buL probubIy wouId Iuve been uround LIe LIme oI LIe ETS
IIusco und LIe Increused scruLIny LIuL sucI un orgunIzuLIon wouId uLLrucL
wILI progressIveIy more InIIummuLory cIuIms. WesLern governmenLs
commILLed Lo unLIsmokIng Iuve un eusIer LIme II IL Is Iobby groups LIuL
pIuy LIe roIe oI propuguLIng LIe more InIIummuLory und unsubsLunLIuLed
cIuIms. To LIIs uuLIor`s knowIedge, LIere Is noL one governmenL IeuILI
oIIIcIuI or medIcuI-esLubIIsImenL oIIIcIuI LIuL Ius ever pubIIcIy quesLIoned
uny oI ASH`s (or uny oLIer unLIsmokIng group) wuywurd, IuLe-mongerIng
cIuIms: ASH, In seII-servIng pursuIL, does LIeIr bIddIng.
or exumpIe, LIe 1ourncl oj the Americcn Mediccl Associction
(1AMA) provIded pubIIcILy Ior LIe IIrsL InLernuLIonuI LreuLy on Lobucco. n
LIIs journuI MILku (zooo) IndIcuLes |I|or LIe 11LI LIme sInce 1q6;,
unLIsmokIng wurrIors guLIered Lo guIn IresI InspIruLIon, Ieur LIe IuLesL
scIenLIIIc reseurcI, und mup sLruLegIes us LIey conLInue LIe IIgIL uguInsL
'bIg Lobucco.` AbouL qoo peopIe Irom 1qo counLrIes meL Iere IusL monLI
Ior LIe WorId ConIerence on Tobucco or HeuILI. n Ier openIng remurks,
Gro HurIem BrundLIund, MD, dIrecLor-generuI oI LIe WorId HeuILI
OrgunIzuLIon, cuIIed on LIe uLLendees Lo 'breuk LIe sIIence` jusL us
deIeguLes uL LIe JuIy nLernuLIonuI ADS ConIerence In SouLI AIrIcu were
exIorLed Lo do. TIe IncepLIon yeur Ior LIe US ASH wus 1q6;. ASH
membersJsupporLers wouId probubIy Iuve domInuLed LIe IIrsL conIerence
In 1q6;, und probubIy so In LIe zooo conIerence. nLernuLIonuI muLerIuIIsL
orgunIzuLIons (e.g., WHO, UnILed NuLIons), LIe medIcuI esLubIIsImenL,
und governmenLs (IeuILI depurLmenLs domInuLed by medIco-
muLerIuIIsm) uppIuud groups sucI us ASH, posILIveIy reIerrIng Lo LIem us
unLIsmokIng wurrIors. TIIs Is u wur wuged by LIe mIsguIded wILI
deLrImenLuI rumIIIcuLIons LIuL go Iur beyond LIe Lobucco IndusLry. TIese
groups ure Ied scIenLIIIc InIormuLIon, perspecLIve und sLruLegIes by un
overseeIng muLerIuIIsmJmedIco-muLerIuIIsm, I.e., gIobuI or umbreIIu
The Bigger Picture
orgunIzuLIons sucI us LIe WHO und LIe UN. AnoLIer LeIIIng uspecL oI LIe
urLIcIe Is LIuL, unIIke eurIIer conIerences, LIere Is now u sLuggerIng
number oI persons und represenLed nuLIons uLLendIng LIIs sorL oI
conIerence, I.e., u deIusIon LruIy on u muss scuIe.
n zooo, oLIer urLIcIes uppeured In 1AMA promoLIng
unquesLIoned Lobucco conLroI recommenduLIons (e.g., BrundLIund, zooo;
HousLon & KuuImun, zooo). BrundLIund (zooo) IndIcuLes LIe wIdespreud
InIru-sLrucLure oI LrunsnuLIonuI, governmenLuI, nongovernmenLuI, medIu
und Iobby groups occupIed In Lobucco conLroI. TIere ure InLerneL
neLworks LIuL cun quIckIy move dIsjoInLed, muLerIuIIsL InIormuLIon ubouL
und presenLed us InIuIIIbIe. TIIs very consIderubIe, conLroIIIng ucLIvILy Is
uII underIuIn by un unquesLIonIng uccepLunce oI conLorLed epIdemIoIogIcJ
rIsk-ussessmenL procedures und u reducLIonIsL worIdvIew. AILIougI
BrundLIund und oLIer muLerIuIIsLs consIder LIe cIrcumsLunce us
progressIve, IL Is In IucL very cIIIIIng LIuL u cuIL predIcuLed on Ignorunce,
IncompeLence, und dungerous LendencIes (cIurucLer deIIcIencIes) Ius
sucI Inrouds Lo worId governunce. WIIIe LIere Is conLInuuI reIerence Lo
LIe Lobucco epIdemIc, IL Is LIIs preoccupuLIon LIuL Is subLerIuge Ior LIe
ucLuuI und dungerous cuIL pundemIc In progress.
WIIIe monomunIucs sucI us BunzIuI wouId presenL LIemseIves
us moruI crusuders und deIenders oI LIe vuInerubIe, LIey ure enLIreIy
beIuvIorIsL In dIsposILIon - wIeLIer reuIIzed or noL. TIeIr conducL Is
wIoIIy consIsLenL wILI, uILIougI even more uggressIve LIun, LIe
superIIcIuIILy oI unLIsmokIng In LIe NuzI regIme. BunzIuI, In purLIcuIur,
Ius munIpuIuLed IeguI prIncIpIes In monomunIucuI pursuILs wILI reckIess
dIsregurd Ior LIe rumIIIcuLIons oI LIe precedenLs LIuL ure beIng seL. I
some oI LIese precedenLs were IoIIowed Lo LIeIr IogIcuI concIusIon, LIey
promoLe LIe person us LIe properLy oI LIe SLuLe (I.e., LIe muLerIuIIsL
munIIesLo). TIe conducL IosLers muILIdImensIonuI IeebIeness. I
psycIoIogIcuI, reIuLIonuI, und moruI IeuILI ure duIy consIdered, IL Is LIe
reckIess conducL oI sucI groups LIuL wouId be on LIe receIvIng-end oI
IILIguLIon. TIere ure persons In oLIer counLrIes LIuL Iuve been juIIed Ior
IncILIng Iess IysLerIu und IuLred. L uIso beggurs beIIeI LIuL un
orgunIzuLIon represenLIng monomunIu und IncILIng IrruLIonuI beIIeI, Ieur
und IuLred Ius been grunLed u cIurILubIe (I.e., Lux-deducLIbIe donuLIons)
sLuLus. However, LIIs Is consIsLenL wILI LIIs orgunIzuLIon`s uIIgnmenL Lo
governmenL ugendu.
WILI LIe muLerIuIIsL domInuLIon oI scIooIs, wIere cIIIdren ure
noL LuugIL Lo reuson coIerenLIy buL Lo sImpIy IoId requIred uLLILudes,
youLI Ius been IIjucked by LIe IeuILIIsL momenLum. An exceIIenL
exumpIe oI LIe success oI IndocLrInuLIon progrums comes Irom LIe
Concord HIgI ScIooI In New HumpsIIre. VuznIs (zoo1) descrIbes LIe
504
504
Rampant Antismoking Signifies Grave Danger
IIgI-scIooI sLudenLs` work on un unLIsmokIng ud:
HuddIed uround u mIcropIone uL WJYY rudIo In
downLown Concord, JennIIer und Dun KnIgIL dILcIed
LIeIr sIsLer und broLIer bunLerIng. nsLeud, LIey
ussumed LIeIr roIes Ior un unLI-smokIng rudIo spoL LIuL
JennIIer wroLe Ior Concord HIgI ScIooI`s TV
producLIon cIub:
TukIng on LIe ruspy, grILLy voIce oI Sum SIoveI, u
1qos-sLyIe prIvuLe deLecLIve, Dun reud Irom LIe scrIpL:
He wus Iuce down on LIe curpeL und LIere wus smoke
rIsIng Irom LIe usILruy on LIe desk..Mrs. Jones,
know wIo kIIIed your Iusbund.
NoL mIssIng u beuL, JennIIer, wILI u Mue WesL-IIke
ImILuLIon, suId, You do? WIo wus IL?
TIe smoke In LIe uIr, LIe IIpsLIck on LIe buLL, you kIIIed
IIm Mrs. Jones, und `m LukIng you In.
(TIe sound oI cIIckIng IundcuIIs)
Mrs. Jones IuugIs: You Iuve no prooI.
TIe prooI, IL`s uII In LIe uIr, Sum SIoveI sIoL buck.
You kIIIed IIm, sweeLIeurL, wILI secondIund smoke.
TIIs Is LIe kInd oI pubIIc servIce unnouncemenL LIuL
LeucIer JonuLIun KeIIy wouId IIke IIs sLudenLs Lo creuLe
Ior LeIevIsIon II Ie cun ruIse LIe needed $16o,ooo. TIe
projecL wouId kIck oII wILI u scIooI-wIde sLorybourd
conLesL Ior unLI-smokIng uds. TIe besL one wouId uIr on
WNDS-TV und WKX rudIo. Runners-up wouId uppeur
on IocuI uccess.
KeIIy recenLIy cume cIose Lo ucIIevIng IIs IundIng gouI:
brown und WIIIIumson Tobucco cuL u cIeck Ior LIe
remuInIng $11,oo, buL LIe scIooI bourd IusL monLI
rejecLed LIe gIIL ouL oI suspIcIon over LIe compuny`s
moLIves.
SInce LIen, KeIIy Ius courLed oLIer poLenLIuI donors
und now onIy needs $,8oo. He Iopes Lo IuuncI LIe
projecL nexL yeur.
JennIIer`s scrIpL ucLuuIIy IeIped wILI LIe Iund-ruIsIng
eIIorL. TIe pubIIc servIce unnouncemenL recenLIy Look
IIrsL pIuce In u conLesL sponsored by LIe CupILuI Areu
Tobucco ree CouIILIon, eurnIng $oo und monLI-Iong
pIuy on WJYY.
TIe pubIIc servIce unnouncemenL wIII debuL on
Wednesduy, NuLIonuI KIck BuLLs Duy, beLween ; und
The Bigger Picture
8u.m. on LIe BreukIusL Jum wILI KId CruIse und
SummI..
LIougIL IL wouId be Iunny Lo use u deLecLIve sLory,
suId JennIIer. TIere`s uIwuys smokIng In IL. A cIgureLLe
In u mouLI or un usILruy on u desk.
usL TIursduy, LIe group puL LIe IInIsIIng LoucIes on
ILs pubIIc servIce unnouncemenL..
WILI scrIpL In Iund, JennIIer und Dun sLurLed wILIouL u
IILcI.
L wus u durk nIgIL, und LIe ruIn wus pourIng down
wIen sIe wuIked InLo my oIIIce..WIuL cun do Ior you
kId?
OI, Mr. SIoveI, you`ve goLLu IeIp me, JennIIer
squeuIed. My Iusbund`s been.(Du Du Du!)
murdered.
Now, IoId on Ior u mInuLe doII-Iuce, Dun repIIed.
Your Iusbund`s been.(Du Du Du!) murdered?..
KId CruIse wrupped up LIe sessIon wILI u recorded
InLervIew oI LIe kIds LIuL wIII uIr prIor Lo LIe debuL oI
LIe pubIIc servIce unnouncemenL.
WIuL do you LIInk oI peopIe wIo smoke? Ie usked.
myseII LIInk one oI LIe worsL LIIngs Is seeIng u gIrI wILI
u cIgureLLe IungIng ouL oI Ier mouLI.
L`s probubIy peer pressure, suId Juson.
TIe kIds Iope LIe messuge wIII muke LIeIr peers LIInk
LwIce ubouL smokIng, especIuIIy sInce LIeIr ucLIon couId
eIIecL LIe IeuILI und IIIe oI someone LIey Iove.
SecondIund smoke Is reuIIy InjurIng Lo peopIe uround
you, suId JennIIer, und you don`L reuIIze IL unLII
someLIIng Iuppens.
TIIs udverL, conLInuuIIy reIerred Lo us u pubIIc servIce
unnouncemenL, Is LrugIc Indeed. TIere Is no duLu LIuL supporLs LIe vIews
LIuL ure conLuIned LIereIn. SLuLemenLs sucI us You kIIIed IIm..wILI
secondIund smoke Iuve no IounduLIon In IucL. TIe urgumenL uguInsL
ETS Is bused on IncoIerenL sLuLIsLIcuI InIerence und u muLerIuIIsL
consensus eIIecL; IL Is sLuLIsLIcuI IunLusy IuvIng no uppIIcuLIon In ucLuuI,
specIIIc cuses. ConLrurIIy, LIe udverL promoLes LIe Ideu LIuL exposure Lo
Lobucco smoke kIIIs, noL unIIke buIIeLs Irom u gun (I.e., IncoIerenL
unuIogy). urLIermore, IL promoLes LIe Ideu LIuL sucI u deuLI, noL unIIke
beIng sIoL, Is cIeurIy dIscernubIe us Lo cuusuLIon. TIe Lerms kIIIIng und
murder ure IIung ubouL reckIessIy. TIIs conducL Is IndIcuLIve oI sLrong
505
505
Rampant Antismoking Signifies Grave Danger
IIgI-scIooI sLudenLs` work on un unLIsmokIng ud:
HuddIed uround u mIcropIone uL WJYY rudIo In
downLown Concord, JennIIer und Dun KnIgIL dILcIed
LIeIr sIsLer und broLIer bunLerIng. nsLeud, LIey
ussumed LIeIr roIes Ior un unLI-smokIng rudIo spoL LIuL
JennIIer wroLe Ior Concord HIgI ScIooI`s TV
producLIon cIub:
TukIng on LIe ruspy, grILLy voIce oI Sum SIoveI, u
1qos-sLyIe prIvuLe deLecLIve, Dun reud Irom LIe scrIpL:
He wus Iuce down on LIe curpeL und LIere wus smoke
rIsIng Irom LIe usILruy on LIe desk..Mrs. Jones,
know wIo kIIIed your Iusbund.
NoL mIssIng u beuL, JennIIer, wILI u Mue WesL-IIke
ImILuLIon, suId, You do? WIo wus IL?
TIe smoke In LIe uIr, LIe IIpsLIck on LIe buLL, you kIIIed
IIm Mrs. Jones, und `m LukIng you In.
(TIe sound oI cIIckIng IundcuIIs)
Mrs. Jones IuugIs: You Iuve no prooI.
TIe prooI, IL`s uII In LIe uIr, Sum SIoveI sIoL buck.
You kIIIed IIm, sweeLIeurL, wILI secondIund smoke.
TIIs Is LIe kInd oI pubIIc servIce unnouncemenL LIuL
LeucIer JonuLIun KeIIy wouId IIke IIs sLudenLs Lo creuLe
Ior LeIevIsIon II Ie cun ruIse LIe needed $16o,ooo. TIe
projecL wouId kIck oII wILI u scIooI-wIde sLorybourd
conLesL Ior unLI-smokIng uds. TIe besL one wouId uIr on
WNDS-TV und WKX rudIo. Runners-up wouId uppeur
on IocuI uccess.
KeIIy recenLIy cume cIose Lo ucIIevIng IIs IundIng gouI:
brown und WIIIIumson Tobucco cuL u cIeck Ior LIe
remuInIng $11,oo, buL LIe scIooI bourd IusL monLI
rejecLed LIe gIIL ouL oI suspIcIon over LIe compuny`s
moLIves.
SInce LIen, KeIIy Ius courLed oLIer poLenLIuI donors
und now onIy needs $,8oo. He Iopes Lo IuuncI LIe
projecL nexL yeur.
JennIIer`s scrIpL ucLuuIIy IeIped wILI LIe Iund-ruIsIng
eIIorL. TIe pubIIc servIce unnouncemenL recenLIy Look
IIrsL pIuce In u conLesL sponsored by LIe CupILuI Areu
Tobucco ree CouIILIon, eurnIng $oo und monLI-Iong
pIuy on WJYY.
TIe pubIIc servIce unnouncemenL wIII debuL on
Wednesduy, NuLIonuI KIck BuLLs Duy, beLween ; und
The Bigger Picture
8u.m. on LIe BreukIusL Jum wILI KId CruIse und
SummI..
LIougIL IL wouId be Iunny Lo use u deLecLIve sLory,
suId JennIIer. TIere`s uIwuys smokIng In IL. A cIgureLLe
In u mouLI or un usILruy on u desk.
usL TIursduy, LIe group puL LIe IInIsIIng LoucIes on
ILs pubIIc servIce unnouncemenL..
WILI scrIpL In Iund, JennIIer und Dun sLurLed wILIouL u
IILcI.
L wus u durk nIgIL, und LIe ruIn wus pourIng down
wIen sIe wuIked InLo my oIIIce..WIuL cun do Ior you
kId?
OI, Mr. SIoveI, you`ve goLLu IeIp me, JennIIer
squeuIed. My Iusbund`s been.(Du Du Du!)
murdered.
Now, IoId on Ior u mInuLe doII-Iuce, Dun repIIed.
Your Iusbund`s been.(Du Du Du!) murdered?..
KId CruIse wrupped up LIe sessIon wILI u recorded
InLervIew oI LIe kIds LIuL wIII uIr prIor Lo LIe debuL oI
LIe pubIIc servIce unnouncemenL.
WIuL do you LIInk oI peopIe wIo smoke? Ie usked.
myseII LIInk one oI LIe worsL LIIngs Is seeIng u gIrI wILI
u cIgureLLe IungIng ouL oI Ier mouLI.
L`s probubIy peer pressure, suId Juson.
TIe kIds Iope LIe messuge wIII muke LIeIr peers LIInk
LwIce ubouL smokIng, especIuIIy sInce LIeIr ucLIon couId
eIIecL LIe IeuILI und IIIe oI someone LIey Iove.
SecondIund smoke Is reuIIy InjurIng Lo peopIe uround
you, suId JennIIer, und you don`L reuIIze IL unLII
someLIIng Iuppens.
TIIs udverL, conLInuuIIy reIerred Lo us u pubIIc servIce
unnouncemenL, Is LrugIc Indeed. TIere Is no duLu LIuL supporLs LIe vIews
LIuL ure conLuIned LIereIn. SLuLemenLs sucI us You kIIIed IIm..wILI
secondIund smoke Iuve no IounduLIon In IucL. TIe urgumenL uguInsL
ETS Is bused on IncoIerenL sLuLIsLIcuI InIerence und u muLerIuIIsL
consensus eIIecL; IL Is sLuLIsLIcuI IunLusy IuvIng no uppIIcuLIon In ucLuuI,
specIIIc cuses. ConLrurIIy, LIe udverL promoLes LIe Ideu LIuL exposure Lo
Lobucco smoke kIIIs, noL unIIke buIIeLs Irom u gun (I.e., IncoIerenL
unuIogy). urLIermore, IL promoLes LIe Ideu LIuL sucI u deuLI, noL unIIke
beIng sIoL, Is cIeurIy dIscernubIe us Lo cuusuLIon. TIe Lerms kIIIIng und
murder ure IIung ubouL reckIessIy. TIIs conducL Is IndIcuLIve oI sLrong
506
506
Rampant Antismoking Signifies Grave Danger
deIusIon - Iuke InsIgIL und Iuke superIorILy. TIe cIIIdren beIIeve IL Is Iun
Lo depIcL smokers us murderers. SucI senLImenLs cun onIy IncILe
IrruLIonuI Ieur und IuLred. And, cIIIdren ure beIng recruILed, us purL oI
LIeIr muLerIuIIsL educuLIon, Lo exucerbuLe LIe sILuuLIon. TIese know no
beLLer, buL LIeIr LeucIers sIouId. TIese sorLs oI unLIsmokIng projecLs ure
encouruged umong scIooIcIIIdren In muny nuLIons.
TIe LeucIer, J. KeIIy, suggesLs LIuL |L|IIs Is wIuL we Iope Lo do
In LIe IuLure on LeIevIsIon. L sIows LIuL kIds ure goIng Lo be good uL LIIs.
TIey Iuve u sense oI wIuL messuge wIII be eIIecLIve Lo LIeIr peers. KeIIy
wouId do weII Lo IIrsL ucquuInL IImseII wILI LIe consIderubIe IImILuLIons oI
sLuLIsLIcuI InIerence und wILI LIe IIsLory oI unLIsmokIng, IncIudIng LIuL oI
LIe NuzI regIme. L muy be enIIgILenIng Lo u IeebIe-LIInkIng Lo consIder
LIe bruInwusIIng, IncIudIng unLIsmokIng, oI LIe HILIer YouLI (e.g.,
ProcLor, 1qq;). MuLerIuIIsm, reIIecLIng LIe reusonIng oI u deIIcIenL
menLuIILy, does noL compreIend wIen IL Ius oversLepped LIe moruI murk
In pursuIL oI deIuded cuuses. L Is LIe uccusers LIuL ure In need oI urgenL
correcLIon beIore LIIs Ieur und IuLe-mongerIng worsens und poLenLIuIIy
spreuds Lo oLIer Issues.
As dIsLurbIng Is LIuL consIderubIe Iunds Ior LIe projecL were
uImosL ruIsed. TIIs Lends Lo IndIcuLe LIuL muny In LIe reIevunL communILy
Iuve conLrIbuLed, beIIevIng IL Lo be u nobIe venLure. SucI communILIes
ure uIreudy In u IeebIe sLuLe und sucI udverLs uppeuI Lo u menLuIILy
needIng u conduIL Ior ILs deIIcIencIes. AIso perverse Is u Lobucco compuny
uLLempLIng Lo conLrIbuLe IInuncIuIIy Lo LIe projecL; LIIs Is ILs Ideu oI
pubIIc reIuLIons.
ConLInuuIIy comIng Lo LIe Iore Is LIuL, wILI deLerIoruLIng
sLundurds overuII, LIose wIo undersLund IILLIe ubouL IILLIe (uII munner oI
monomunIucuI groups) now beIIeve LIey ure In u posILIon Lo cIunge LIe
worId Ior LIe beLLer. And, wILIIn sucI u poor generuI sLundurd, LIese
groups Iuve InordInuLe uccess Lo pubIIc poIIcy IormuIuLIon. TIere Is no
cognIzunce LIuL LIese groups ure sImpIy IeedIng LIeIr deIIcIencIes.
MedIco-muLerIuIIsm Ius uLLempLed Lo uncIor normuLIve IuncLIonIng Lo
ubnormuI, uLypIcuI ussocIuLIons Lo bIoIogIcuI IIIness. MuLerIuIIsm generuIIy
Is uLLempLIng Lo uncIor normuLIve IuncLIonIng Lo ubnormuI, uLypIcuI
Iyper-reucLIvILy (e.g., somuLoIorm dIsorders) und muILIdImensIonuI
IgnorunceJIncompeLence. TIIs represenLs un uncIorIng Lo dysIuncLIon
generuIIy. CIgureLLe smokers und perIume weurers, Ior exumpIe, Iuve
been munuIucLured InLo LIe gruve dungers oI LIe LIme. To do so, pubIIc
poIIcy Ius eIIecLIveIy been puL In LIe Iunds oI LIe bIoIogIcuIIy III or LIe
psycIoIogIcuIIyJreIuLIonuIIyJmoruIIy mIsguIded. TIIs Is vIewed wILIIn LIe
upsIde-down, buck-Lo-IronL sLuLe us progressIve. RuLIer, IL Is LIIs
perverse menLuIILy LIuL Is un ussuuIL on u socIeLy`s sensIbIIILy und
The Bigger Picture
goodwIII.
A IInuI exumpIe, und wIIcI wIII provIde u Ieud-In Lo LIe IInuI
secLIon, Is LIe devusLuLIon LIuL cun be wreuked wIen wuywurd medIcuI
beIIeI proLecLs personsJgroups In IIgIIy unsLubIe sLuLes oI mInd. The
Crime Pretention Group (TCPG) presenLs u purLIcuIurIy InsIdIous und
vIcIous unLIsmokIng websILe (ILLp:JJmedIcoIeguI.LrIpod.comJ
prevenLbruIndumuge.ILm). TCPG, wIIcI seems Lo be LIe wrILIngs oI ILs
execuLIve dIrecLor und mIIILunL unLIsmoker, eroy J. PIeLLen (u number oI
LIe websILe puges ure copyrIgILed Lo .J. PIeLLen und uII puges Iuve LIe
sume urgumenLuLIve sLyIe), provIdes numerous und very Iong puges oI
dIsjoInLed bILs oI Iong-dIscredILed unLIsmokIng medIcuI opInIon, mosLIy
Irom LIe nIneLeenLI cenLury, LIuL supposedIy supporL IncoIerenL medIco-
reIIgIous urgumenL.
TIe urgued vIew Is LIuL smokIng cuuses bruIn dumuge wIIcI Is
reIIecLed In Iuck oI moruI InsIgIL, umongsL oLIer menLuI dIsorders.
SmokIng Is cIuImed Lo cuuse:- uborLIon, crIme, uIcoIoIIsm, drugs,
IeurIng Ioss, mucuIur degeneruLIon, SDS, uddIcLIon, AIzIeImer`s, breusL
cuncer, deIoresLuLIon, empIysemu, IeurL dIseuse, menLuI dIsorder,
suIcIde, ADS, bIrLI deIecLs, broncIILIs, dIvorce, IIres, Iung cuncer, seuL
beIL dIsuse. On one webpuge PIeLLen (1qqq) cILes 1z8 reIerences us
supporLIng LIese cIuIms. TIIrLy-Iour oI LIe reIerences ure posL-1q6q.
TIese LypIcuIIy IndIcuLe uLypIcuI EEG`s In some smokers, Ior exumpIe; LIe
sLuLus oI LIese IIndIngs Is IndeLermInuLe und LIeIr quesLIonubIe reIevunce
Lo PIeLLen`s cIuIms ure noL IndIcuLed: TIIs InIormuLIon Is presenLed us II ILs
reIevunce Lo LIe urgumenL Is seII-evIdenLJexpIunuLory. TIe oLIer
nIneLy-Iour reIerences ure pre-1q6q: TIe Lypes oI reIerences cILed were
dIscounLed by LIe SG (1q6q) us meLIodoIogIcuIIy unsound, Ieursuy, or
urgumenL by IncoIerenL unuIogy. orLy-Iour oI LIe reIerences ure Irom LIe
nIneLeenLI-cenLury, IuvIng no scIenLIIIc sLrengLI uL uII. TIese ure LypIcuIIy
onIy IIgIIy quesLIonubIe medIcuI undJor reIIgIous opinion. And, IL Is LIese
IuLLer reIerences LIuL muke LIe more IuncIIuI und exLruvugunL cIuIms.
UnLII LIe 1qqo`sJo`s, medIcuI InvesLIguLIon dId noL even uLLempL
Lo IoIIow LIe scIenLIIIc meLIod (see uIso Murks, zooo). WuIker (1q8o), In
reIerrIng Lo nIneLeenLI-cenLury InvesLIguLIons, IndIcuLes LIuL |d|ocLors
spoke on LIe busIs oI LIeIr cIInIcuI ImpressIons: sLuLIsLIcs II coIIecLed uL uII,
were on u nurrow und unrepresenLuLIve busIs. (p.q) As Ius uIreudy
been consIdered In LIe eurIIer cIupLers oI LIIs dIscussIon, even IuvIng
uLLempLed Lo uppIy LIe scIenLIIIc meLIod posL-1qqo`s (I.e., IIIesLyIe
epIdemIoIogy), medIco-muLerIuIIsm Ius sLIII mungIed LIe exercIse by
ImproperIy reIyIng on LIe RR sLuLIsLIc: TIIs reIIecLs no more LIun LIe
cIInIcuI meLIod or buck-Lo-IronL reusonIng. urLIermore, unLII recenLIy,
unLIsmokIng wus noL u LypIcuI medIcuI-prucLILIoner or medIcuI-
507
507
Rampant Antismoking Signifies Grave Danger
deIusIon - Iuke InsIgIL und Iuke superIorILy. TIe cIIIdren beIIeve IL Is Iun
Lo depIcL smokers us murderers. SucI senLImenLs cun onIy IncILe
IrruLIonuI Ieur und IuLred. And, cIIIdren ure beIng recruILed, us purL oI
LIeIr muLerIuIIsL educuLIon, Lo exucerbuLe LIe sILuuLIon. TIese know no
beLLer, buL LIeIr LeucIers sIouId. TIese sorLs oI unLIsmokIng projecLs ure
encouruged umong scIooIcIIIdren In muny nuLIons.
TIe LeucIer, J. KeIIy, suggesLs LIuL |L|IIs Is wIuL we Iope Lo do
In LIe IuLure on LeIevIsIon. L sIows LIuL kIds ure goIng Lo be good uL LIIs.
TIey Iuve u sense oI wIuL messuge wIII be eIIecLIve Lo LIeIr peers. KeIIy
wouId do weII Lo IIrsL ucquuInL IImseII wILI LIe consIderubIe IImILuLIons oI
sLuLIsLIcuI InIerence und wILI LIe IIsLory oI unLIsmokIng, IncIudIng LIuL oI
LIe NuzI regIme. L muy be enIIgILenIng Lo u IeebIe-LIInkIng Lo consIder
LIe bruInwusIIng, IncIudIng unLIsmokIng, oI LIe HILIer YouLI (e.g.,
ProcLor, 1qq;). MuLerIuIIsm, reIIecLIng LIe reusonIng oI u deIIcIenL
menLuIILy, does noL compreIend wIen IL Ius oversLepped LIe moruI murk
In pursuIL oI deIuded cuuses. L Is LIe uccusers LIuL ure In need oI urgenL
correcLIon beIore LIIs Ieur und IuLe-mongerIng worsens und poLenLIuIIy
spreuds Lo oLIer Issues.
As dIsLurbIng Is LIuL consIderubIe Iunds Ior LIe projecL were
uImosL ruIsed. TIIs Lends Lo IndIcuLe LIuL muny In LIe reIevunL communILy
Iuve conLrIbuLed, beIIevIng IL Lo be u nobIe venLure. SucI communILIes
ure uIreudy In u IeebIe sLuLe und sucI udverLs uppeuI Lo u menLuIILy
needIng u conduIL Ior ILs deIIcIencIes. AIso perverse Is u Lobucco compuny
uLLempLIng Lo conLrIbuLe IInuncIuIIy Lo LIe projecL; LIIs Is ILs Ideu oI
pubIIc reIuLIons.
ConLInuuIIy comIng Lo LIe Iore Is LIuL, wILI deLerIoruLIng
sLundurds overuII, LIose wIo undersLund IILLIe ubouL IILLIe (uII munner oI
monomunIucuI groups) now beIIeve LIey ure In u posILIon Lo cIunge LIe
worId Ior LIe beLLer. And, wILIIn sucI u poor generuI sLundurd, LIese
groups Iuve InordInuLe uccess Lo pubIIc poIIcy IormuIuLIon. TIere Is no
cognIzunce LIuL LIese groups ure sImpIy IeedIng LIeIr deIIcIencIes.
MedIco-muLerIuIIsm Ius uLLempLed Lo uncIor normuLIve IuncLIonIng Lo
ubnormuI, uLypIcuI ussocIuLIons Lo bIoIogIcuI IIIness. MuLerIuIIsm generuIIy
Is uLLempLIng Lo uncIor normuLIve IuncLIonIng Lo ubnormuI, uLypIcuI
Iyper-reucLIvILy (e.g., somuLoIorm dIsorders) und muILIdImensIonuI
IgnorunceJIncompeLence. TIIs represenLs un uncIorIng Lo dysIuncLIon
generuIIy. CIgureLLe smokers und perIume weurers, Ior exumpIe, Iuve
been munuIucLured InLo LIe gruve dungers oI LIe LIme. To do so, pubIIc
poIIcy Ius eIIecLIveIy been puL In LIe Iunds oI LIe bIoIogIcuIIy III or LIe
psycIoIogIcuIIyJreIuLIonuIIyJmoruIIy mIsguIded. TIIs Is vIewed wILIIn LIe
upsIde-down, buck-Lo-IronL sLuLe us progressIve. RuLIer, IL Is LIIs
perverse menLuIILy LIuL Is un ussuuIL on u socIeLy`s sensIbIIILy und
The Bigger Picture
goodwIII.
A IInuI exumpIe, und wIIcI wIII provIde u Ieud-In Lo LIe IInuI
secLIon, Is LIe devusLuLIon LIuL cun be wreuked wIen wuywurd medIcuI
beIIeI proLecLs personsJgroups In IIgIIy unsLubIe sLuLes oI mInd. The
Crime Pretention Group (TCPG) presenLs u purLIcuIurIy InsIdIous und
vIcIous unLIsmokIng websILe (ILLp:JJmedIcoIeguI.LrIpod.comJ
prevenLbruIndumuge.ILm). TCPG, wIIcI seems Lo be LIe wrILIngs oI ILs
execuLIve dIrecLor und mIIILunL unLIsmoker, eroy J. PIeLLen (u number oI
LIe websILe puges ure copyrIgILed Lo .J. PIeLLen und uII puges Iuve LIe
sume urgumenLuLIve sLyIe), provIdes numerous und very Iong puges oI
dIsjoInLed bILs oI Iong-dIscredILed unLIsmokIng medIcuI opInIon, mosLIy
Irom LIe nIneLeenLI cenLury, LIuL supposedIy supporL IncoIerenL medIco-
reIIgIous urgumenL.
TIe urgued vIew Is LIuL smokIng cuuses bruIn dumuge wIIcI Is
reIIecLed In Iuck oI moruI InsIgIL, umongsL oLIer menLuI dIsorders.
SmokIng Is cIuImed Lo cuuse:- uborLIon, crIme, uIcoIoIIsm, drugs,
IeurIng Ioss, mucuIur degeneruLIon, SDS, uddIcLIon, AIzIeImer`s, breusL
cuncer, deIoresLuLIon, empIysemu, IeurL dIseuse, menLuI dIsorder,
suIcIde, ADS, bIrLI deIecLs, broncIILIs, dIvorce, IIres, Iung cuncer, seuL
beIL dIsuse. On one webpuge PIeLLen (1qqq) cILes 1z8 reIerences us
supporLIng LIese cIuIms. TIIrLy-Iour oI LIe reIerences ure posL-1q6q.
TIese LypIcuIIy IndIcuLe uLypIcuI EEG`s In some smokers, Ior exumpIe; LIe
sLuLus oI LIese IIndIngs Is IndeLermInuLe und LIeIr quesLIonubIe reIevunce
Lo PIeLLen`s cIuIms ure noL IndIcuLed: TIIs InIormuLIon Is presenLed us II ILs
reIevunce Lo LIe urgumenL Is seII-evIdenLJexpIunuLory. TIe oLIer
nIneLy-Iour reIerences ure pre-1q6q: TIe Lypes oI reIerences cILed were
dIscounLed by LIe SG (1q6q) us meLIodoIogIcuIIy unsound, Ieursuy, or
urgumenL by IncoIerenL unuIogy. orLy-Iour oI LIe reIerences ure Irom LIe
nIneLeenLI-cenLury, IuvIng no scIenLIIIc sLrengLI uL uII. TIese ure LypIcuIIy
onIy IIgIIy quesLIonubIe medIcuI undJor reIIgIous opinion. And, IL Is LIese
IuLLer reIerences LIuL muke LIe more IuncIIuI und exLruvugunL cIuIms.
UnLII LIe 1qqo`sJo`s, medIcuI InvesLIguLIon dId noL even uLLempL
Lo IoIIow LIe scIenLIIIc meLIod (see uIso Murks, zooo). WuIker (1q8o), In
reIerrIng Lo nIneLeenLI-cenLury InvesLIguLIons, IndIcuLes LIuL |d|ocLors
spoke on LIe busIs oI LIeIr cIInIcuI ImpressIons: sLuLIsLIcs II coIIecLed uL uII,
were on u nurrow und unrepresenLuLIve busIs. (p.q) As Ius uIreudy
been consIdered In LIe eurIIer cIupLers oI LIIs dIscussIon, even IuvIng
uLLempLed Lo uppIy LIe scIenLIIIc meLIod posL-1qqo`s (I.e., IIIesLyIe
epIdemIoIogy), medIco-muLerIuIIsm Ius sLIII mungIed LIe exercIse by
ImproperIy reIyIng on LIe RR sLuLIsLIc: TIIs reIIecLs no more LIun LIe
cIInIcuI meLIod or buck-Lo-IronL reusonIng. urLIermore, unLII recenLIy,
unLIsmokIng wus noL u LypIcuI medIcuI-prucLILIoner or medIcuI-
508
508
Rampant Antismoking Signifies Grave Danger
esLubIIsImenL sLunce (e.g., WuIker, 1q8o).
YeL, PIeLLen (1qqq) uses LIe IoIIowIng InIormuLIon (sumpIIng
onIy) Lo InIorm reuders oI LIe websILe, und uIso IncIudes IIs own
commenLury In purenLIeses:
Dr. RoberL BrudeneII CurLer,..Alcohol cnd Tobccco,
zo ILLeII`s IvIng Age q;q-qq (1qo6) TIe sLeudy und
progressIve Increuse oI InsunILy umong us Is LIe mosL
ImporLunL IucL oI LIe presenL duy In reIuLIon Lo pubIIc
IeuILI, und Is sucI us Lo render LIe prevuIence oI cuncer
or oI LubercIe ubsoIuLeIy LrIvIuI by compurIson. L Is u
muLLer oI rouLIne Lo uLLrIbuLe u Iurge porLIon oI LIIs
Increuse Lo drInk, buL muy LIere noL be someLIIng Lo
suy uIso ubouL Lobucco?
Dr. AIberL . BIuIsdeII, Our BodIes und How We Ive
(BosLon: GInn, 1qoq) TIe ceIIs oI LIe bruIn muy
become poIsoned Irom Lobucco. TIe Ideus muy Iuck
cIeurness oI ouLIIne. TIe wIII power muy be weukened,
und IL muy be un eIIorL Lo do LIe rouLIne duLIes oI
IIIe..TIe memory muy uIso be ImpuIred.
Woods, MuLLIew, M.D., z 1 Am Med Ass'n (#1) p 68
(1 AprII 18qq) (SmokIng cuuses InsunILy Lo repeuL
uguIn IumIIIur IucLs)
ToIsLoy, eo, CounL,..Lcsterhcljte Genusse clc Vicious
Plecsures (ondon: MuLIIeson, 18q6), pp 6-q1
(AIcoIoI und Lobucco) (TIe bruIn becomes numbed
by LIe nIcoLIne. ConscIence LIus expIres, us ImpuIse
conLroI Is ImpuIred, LIus IInkIng Lo crIme).
MuIIuII, J.C., M.D., 6z Neu Yorl Med 1ourncl 686-
688 (o Nov 18q) (cILIng evII eIIecLs I cIgureLLe
smokIng, Ior exumpIe, nIcoLIne InLoxIcuLIon evIdenL
uILer u mere LIree cIgureLLes. TIe greuLer evII oI
Lobucco Is ILs consLILuLIonuI |sysLemIc| eIIecL on LIe
nervous sysLem. TIe mucI Iesser evII Is ..on LIe upper
respIruLory sysLem. EIIecL: Nervous dIseuses und
InsunILy ure rupIdIy IncreusIng In LIe AmerIcun peopIe.
TIIs nerve desLroyIng nIcoLIne..wIIcI LIe cIgureLLe so
muLerIuIIy ussIsLs In spreudIng endungers cIIIdren.
MuIIuII Ioped LIuL LIe medIu wIII pubIIsI..sucI
InIormuLIon.)
M. JoIIy, rencI Acudemy oI ScIence (188z) (LIe
Increuse oI InsunILy In runce puruIIeIs Increused
Lobucco use; LIe ImmoderuLe use oI Lobucco produces
The Bigger Picture
un uIIecLIon oI LIe spInuI murrow und u weukness oI LIe
bruIn wIIcI cuuses mudness.
CIuse, B.W., M.A., Tobccco: Its Phsiccl, Mentcl,
Morcl cnd Socicl Injluences (New York: Wm. B.
MuckIow Pub, 18;8). (ExumpIes: u IussILude IoIIows
LIe InLoxIcuLIng InIIuence oI Tobucco..TIe |bruIn| Ius
LIe power oI consecuLIve LIougIL, buL LIe Tobucco-user
Ioses LIIs power, und IIs LIougILs jump Irom one LIIng
Lo unoLIer - LIey cunnoL be guLIered und
concenLruLed..TIe mun wIo uses Tobucco deLIrones
IIs judgmenL..so us Lo produce InsunILy |uccordIng Lo|
u Iurge number oI LIe mosL emInenL pIysIcIuns, pp q-
6z).
DepIerrIs, HIppoIyLe A., Phsioloie Socicle: Le Tcbcc
(PurIs: DenLu, 18;6) (..NoLe uIso IIs pp z;;-zq1
(Lobucco Induced IuIIucInuLIons); pp o6-z (Lobucco
ImpuIred ImpuIrmenL oI LIe moruI sense); pp z6-qq
(Lobucco-Induced crIme); und pp q-;z (Lobucco-
Induced InsunILy duLu)).
McDonuId, Dr. WIIIIum, 1 The Lcncet (#1;q8) z1 (z8
eb 18;) (no smoker cun LIInk sLeudIIy or
conLInuousIy on uny subjecL..He cunnoL IoIIow ouL u
LruIn oI Ideus.)
SoIIy, Dr. SumueI,..1 The Lcncet (#1;q6) p 1;6 (1q eb
18;) (Tobucco Is known us one oI LIe cuuses oI
InsunILy us smokers do become derunged Irom
smokIng Lobucco).
NeII, Dr. J.B., 1 The Lcncet (#1;qo) z ( Jun 18;)
(Dr. WebsLer sLuLes LIuL, In LIe posL-morLem
exumInuLIons oI InveLeruLe smokers, creLInIsm Is uIwuys
presenL.)
ugon, Guy C...PresIdenL, PurIs ScIooI oI MedIcIne,
und LIe KIng`s pIysIcIun (equIvuIenL Lo Surgeon
GeneruI) (z6 MurcI 16qq) (descrIbIng Lobucco us u
poIson more dungerous LIun IemIock, deudIIer LIun
opIum..Irom wIIcI wouId sprIng u LIousund IIIs, one
worse LIun unoLIer. AssuredIy, wIen we Lry IL Ior LIe
IIrsL LIme, we IeeI un uneusIness LIuL LeIIs us LIuL we
Iuve Luken poIson.
HuIn, Adum, Tcbccoloic site de tcbcco (16qo)
(secLIon enLILIed WIeLIer Tobucco Lurns LIe BruIn
BIuck?).
509
509
Rampant Antismoking Signifies Grave Danger
esLubIIsImenL sLunce (e.g., WuIker, 1q8o).
YeL, PIeLLen (1qqq) uses LIe IoIIowIng InIormuLIon (sumpIIng
onIy) Lo InIorm reuders oI LIe websILe, und uIso IncIudes IIs own
commenLury In purenLIeses:
Dr. RoberL BrudeneII CurLer,..Alcohol cnd Tobccco,
zo ILLeII`s IvIng Age q;q-qq (1qo6) TIe sLeudy und
progressIve Increuse oI InsunILy umong us Is LIe mosL
ImporLunL IucL oI LIe presenL duy In reIuLIon Lo pubIIc
IeuILI, und Is sucI us Lo render LIe prevuIence oI cuncer
or oI LubercIe ubsoIuLeIy LrIvIuI by compurIson. L Is u
muLLer oI rouLIne Lo uLLrIbuLe u Iurge porLIon oI LIIs
Increuse Lo drInk, buL muy LIere noL be someLIIng Lo
suy uIso ubouL Lobucco?
Dr. AIberL . BIuIsdeII, Our BodIes und How We Ive
(BosLon: GInn, 1qoq) TIe ceIIs oI LIe bruIn muy
become poIsoned Irom Lobucco. TIe Ideus muy Iuck
cIeurness oI ouLIIne. TIe wIII power muy be weukened,
und IL muy be un eIIorL Lo do LIe rouLIne duLIes oI
IIIe..TIe memory muy uIso be ImpuIred.
Woods, MuLLIew, M.D., z 1 Am Med Ass'n (#1) p 68
(1 AprII 18qq) (SmokIng cuuses InsunILy Lo repeuL
uguIn IumIIIur IucLs)
ToIsLoy, eo, CounL,..Lcsterhcljte Genusse clc Vicious
Plecsures (ondon: MuLIIeson, 18q6), pp 6-q1
(AIcoIoI und Lobucco) (TIe bruIn becomes numbed
by LIe nIcoLIne. ConscIence LIus expIres, us ImpuIse
conLroI Is ImpuIred, LIus IInkIng Lo crIme).
MuIIuII, J.C., M.D., 6z Neu Yorl Med 1ourncl 686-
688 (o Nov 18q) (cILIng evII eIIecLs I cIgureLLe
smokIng, Ior exumpIe, nIcoLIne InLoxIcuLIon evIdenL
uILer u mere LIree cIgureLLes. TIe greuLer evII oI
Lobucco Is ILs consLILuLIonuI |sysLemIc| eIIecL on LIe
nervous sysLem. TIe mucI Iesser evII Is ..on LIe upper
respIruLory sysLem. EIIecL: Nervous dIseuses und
InsunILy ure rupIdIy IncreusIng In LIe AmerIcun peopIe.
TIIs nerve desLroyIng nIcoLIne..wIIcI LIe cIgureLLe so
muLerIuIIy ussIsLs In spreudIng endungers cIIIdren.
MuIIuII Ioped LIuL LIe medIu wIII pubIIsI..sucI
InIormuLIon.)
M. JoIIy, rencI Acudemy oI ScIence (188z) (LIe
Increuse oI InsunILy In runce puruIIeIs Increused
Lobucco use; LIe ImmoderuLe use oI Lobucco produces
The Bigger Picture
un uIIecLIon oI LIe spInuI murrow und u weukness oI LIe
bruIn wIIcI cuuses mudness.
CIuse, B.W., M.A., Tobccco: Its Phsiccl, Mentcl,
Morcl cnd Socicl Injluences (New York: Wm. B.
MuckIow Pub, 18;8). (ExumpIes: u IussILude IoIIows
LIe InLoxIcuLIng InIIuence oI Tobucco..TIe |bruIn| Ius
LIe power oI consecuLIve LIougIL, buL LIe Tobucco-user
Ioses LIIs power, und IIs LIougILs jump Irom one LIIng
Lo unoLIer - LIey cunnoL be guLIered und
concenLruLed..TIe mun wIo uses Tobucco deLIrones
IIs judgmenL..so us Lo produce InsunILy |uccordIng Lo|
u Iurge number oI LIe mosL emInenL pIysIcIuns, pp q-
6z).
DepIerrIs, HIppoIyLe A., Phsioloie Socicle: Le Tcbcc
(PurIs: DenLu, 18;6) (..NoLe uIso IIs pp z;;-zq1
(Lobucco Induced IuIIucInuLIons); pp o6-z (Lobucco
ImpuIred ImpuIrmenL oI LIe moruI sense); pp z6-qq
(Lobucco-Induced crIme); und pp q-;z (Lobucco-
Induced InsunILy duLu)).
McDonuId, Dr. WIIIIum, 1 The Lcncet (#1;q8) z1 (z8
eb 18;) (no smoker cun LIInk sLeudIIy or
conLInuousIy on uny subjecL..He cunnoL IoIIow ouL u
LruIn oI Ideus.)
SoIIy, Dr. SumueI,..1 The Lcncet (#1;q6) p 1;6 (1q eb
18;) (Tobucco Is known us one oI LIe cuuses oI
InsunILy us smokers do become derunged Irom
smokIng Lobucco).
NeII, Dr. J.B., 1 The Lcncet (#1;qo) z ( Jun 18;)
(Dr. WebsLer sLuLes LIuL, In LIe posL-morLem
exumInuLIons oI InveLeruLe smokers, creLInIsm Is uIwuys
presenL.)
ugon, Guy C...PresIdenL, PurIs ScIooI oI MedIcIne,
und LIe KIng`s pIysIcIun (equIvuIenL Lo Surgeon
GeneruI) (z6 MurcI 16qq) (descrIbIng Lobucco us u
poIson more dungerous LIun IemIock, deudIIer LIun
opIum..Irom wIIcI wouId sprIng u LIousund IIIs, one
worse LIun unoLIer. AssuredIy, wIen we Lry IL Ior LIe
IIrsL LIme, we IeeI un uneusIness LIuL LeIIs us LIuL we
Iuve Luken poIson.
HuIn, Adum, Tcbccoloic site de tcbcco (16qo)
(secLIon enLILIed WIeLIer Tobucco Lurns LIe BruIn
BIuck?).
510
510
Rampant Antismoking Signifies Grave Danger
Dr. Jucobus TuppIus, ProI. oI MedIcIne, UnIversILy oI
HeImsLedL, Drctio de Tobcco ejusque Hodierno Abusu
(HeImsLedL, 16) (BIood und bruIn become IeuLed
und drIed up - LIe wIoIe Ieud Is Lurned InLo u noxIous
Iurnuce - IL Is IuLuI Lo uII genIus |und ucLs| Lo duII LIe
IInesL InLeIIecL. TIe book IncIuded unuLomIcuI
IIIusLruLIons sIowIng LIe sud eIIecLs oI Lobucco on LIe
smoker`s bruIn).
TIe uLLempL Lo porLruy uny oI LIe ubove cIuIms us reIIecLIng u
consIsLenL medIcuI vIew, or us beIng scIenLIIIcuIIy produced - IeL uIone
deIInILIve, or us IndIcuLIng u conLInuILy oI scIenLIIIc enquIry sInce LIe
sevenLeenLI cenLury Is bIuLunLIy IruuduIenL - deIInquenL. An error oI LIIs
mugnILude cun onIy be mude wIere LIe uuLIor Is enLIreIy obIIvIous Lo LIe
requIremenLs oI scIenLIIIc enquIry. And, LIere ure numerous oLIer
unsubsLunLIuLed cIuIms presenLed us beyond quesLIon. PIeLLen (1qqq)
suppIIes LIe IoIIowIng Iew, IIgIIy duLed und dIscredILed (poor
meLIodoIogy und urgumenL) reIerences us evIdence Ior Lobucco
InLoxIcuLIon:
Knupp, PeLer H., CIurIes M. BIIss, HurrIeL WeIIs,
AddIcLIve uspecLs In Heuvy CIgureLLe SmokIng, 11q
Am 1 Pschictr q66-q;z (AprII 1q6) (A cIussIc
sympLom oI severe bruIn dumuge wus evIdenL:
dIsLorLed LIme percepLIon, e.g., LIme movIng sIowIy.
TIus, LIeIr evIdence uL IeusL Is consIsLenL wILI LIe
exIsLence oI 'cIronIc InLoxIcuLIon` In LIe Ieuvy smoker,
wIIcI Is IurmIuI Lo LIe smoker IImseII.)
OLLoneIIo, P. RecIdIvuLIng CerebruI AngIospusms Due
Lo CIronIc Tobucco nLoxIcuLIon..(June 1qqq)
BIneL, eon, u umee de Tubuc: EsL-EIIe Un PoIson
du Cerveuu?..(1 JunvIer 1qz)
Trucy, Jumes ., M.D...(Dec 1q1;) (Tobucco
InLoxIcuLIon Is un egoLIsLIc nurcosIs.)
Gy, AbeI, L'Intoxicction pcr le Tcbcc (PurIs: Musson eL
CIe, 1q1) (on LoxIc eIIecLs oI nIcoLIne upon LIe
nervous sysLem)
MuIIuII, J.C., M.D.,..(o Nov 18q) (cILIng evII eIIecLs
oI cIgureLLe smokIng, Ior exumpIe, nIcoLIne
InLoxIcuLIon evIdenL uILer u mere LIree cIgureLLes.)
Dr. AucIe,..(zz MurcI 18q1) (cILIng Lobucco
InLoxIcuLIon, Irom exLernuI uppIIcuLIon oI Lobucco
InIusIon Ior LIe desLrucLIon oI IIce)
The Bigger Picture
CIuse, B.W., M.A.,..(..18;8)..(u IussILude IoIIows
LIe InLoxIcuLIng InIIuence oI Tobucco..)
AIcoLL, WIIIIum A., M.D.,..(..186)..(Tobucco,
moreover, Is, oI ILseII, un InLoxIcuLIng subsLunce).
PIeLLen (1qqq) LIen moves on Lo supporL Ior Lobucco epIIepsy.
TIe quesLIonubIe reIerences ure Irom 1q6o, 1qq, 1q8, 1qq, 1q, 1qz,
18qq, 18o6 und 16qq. nLeresLIngIy, LIe IusL reIerence, ugon (16qq),
reIers meLupIorIcuIIy Lo smokIng us u permunenL epIIepsy compured Lo
Iove beIng reIerred Lo us u brIeI epIIepLIc IIL. PIeLLen consIders LIIs us
evIdence Ior ucLuuI epIIepsy (I.e., In bIomedIcuI Lerms).
HuvIng deIInILIveIy demonsLruLed LIe ubove condILIons us
cuused by Lobucco smokIng, PIeLLen LIen cusuuIIy sIIILs Lo LIe
evIdence Ior smoker scIIzopIrenIu:
GIussmun, A., CIgureLLe SmokIng und mpIIcuLIons Ior
PsycIIuLrIc IIness, 1o Am 1 Pschictr (#q) q6-
(1qq) (suyIng ;q% oI scIIzopIrenIcs smoke, wIereus
onIy z% oI LIe generuI popuIuLIon does)
KIeIn, C., Andresen, B. & TIom, E., BIInkIng, AIpIu
BruIn Wuves und SmokIng In ScIIzopIrenIu, ; Actc
Pschictricc Sccndincticc (#) 1;z (MurcI 1qq)
KILcI, D., EdILorIuI: WIere TIere`s Smoke..nIcoLIne
und PsycIIuLrIc DIsorders, o iol Pschictr 1o;-1o8
(1qq1) (suyIng LIuL umong smokers, LIe mosL common
menLuI dIsorder Is scIIzopIrenIu: smokers ure
dIsproporLIonuLeIy menLuIIy III sIgnIIIcunLIy more LIun
nonsmokers)
KeIIogg, JoIn H., M.D.,..Tobcccoism, or, Hou
Tobccco Kills (1qzz) (reporLs scIIzopIrenIu umong
smokers, 1oo% correIuLIon).
TIe GIussmun (1qq) sLudy IndIcuLes u IIgIer RR oI
scIIzopIrenIu ussocIuLed wILI smokIng LIun nonsmokIng. SmokIng,
Iowever, Is u very poor predIcLor (I.e., neur-zero) oI scIIzopIrenIu. ApurL
Irom muny oLIer poor-predIcLor (essenLIuIIy useIess) rIsk IucLors, LIere Is
un udded Issue regurdIng smokIng. Persons wIo ure uIreudy sympLomuLIc
- even In youLI - muy Luke up und muInLuIn LIe smokIng IubIL us u meuns
oI mood-moduIuLIon (I.e., u Iorm oI seII-medIcuLIon). L cun be suId LIuL
nIcoLIne, us one uspecL oI LIe smokIng IubIL, muy Indeed LemporurIIy uId
LIose wIo wIII uILImuLeIy munIIesL scIIzopIrenIu, depressIon or oLIer
dIsLurbunces (e.g., unxIeLy).
GIussmun (1qq) unIorLunuLeIy operuLes Irom u medIco-
511
511
Rampant Antismoking Signifies Grave Danger
Dr. Jucobus TuppIus, ProI. oI MedIcIne, UnIversILy oI
HeImsLedL, Drctio de Tobcco ejusque Hodierno Abusu
(HeImsLedL, 16) (BIood und bruIn become IeuLed
und drIed up - LIe wIoIe Ieud Is Lurned InLo u noxIous
Iurnuce - IL Is IuLuI Lo uII genIus |und ucLs| Lo duII LIe
IInesL InLeIIecL. TIe book IncIuded unuLomIcuI
IIIusLruLIons sIowIng LIe sud eIIecLs oI Lobucco on LIe
smoker`s bruIn).
TIe uLLempL Lo porLruy uny oI LIe ubove cIuIms us reIIecLIng u
consIsLenL medIcuI vIew, or us beIng scIenLIIIcuIIy produced - IeL uIone
deIInILIve, or us IndIcuLIng u conLInuILy oI scIenLIIIc enquIry sInce LIe
sevenLeenLI cenLury Is bIuLunLIy IruuduIenL - deIInquenL. An error oI LIIs
mugnILude cun onIy be mude wIere LIe uuLIor Is enLIreIy obIIvIous Lo LIe
requIremenLs oI scIenLIIIc enquIry. And, LIere ure numerous oLIer
unsubsLunLIuLed cIuIms presenLed us beyond quesLIon. PIeLLen (1qqq)
suppIIes LIe IoIIowIng Iew, IIgIIy duLed und dIscredILed (poor
meLIodoIogy und urgumenL) reIerences us evIdence Ior Lobucco
InLoxIcuLIon:
Knupp, PeLer H., CIurIes M. BIIss, HurrIeL WeIIs,
AddIcLIve uspecLs In Heuvy CIgureLLe SmokIng, 11q
Am 1 Pschictr q66-q;z (AprII 1q6) (A cIussIc
sympLom oI severe bruIn dumuge wus evIdenL:
dIsLorLed LIme percepLIon, e.g., LIme movIng sIowIy.
TIus, LIeIr evIdence uL IeusL Is consIsLenL wILI LIe
exIsLence oI 'cIronIc InLoxIcuLIon` In LIe Ieuvy smoker,
wIIcI Is IurmIuI Lo LIe smoker IImseII.)
OLLoneIIo, P. RecIdIvuLIng CerebruI AngIospusms Due
Lo CIronIc Tobucco nLoxIcuLIon..(June 1qqq)
BIneL, eon, u umee de Tubuc: EsL-EIIe Un PoIson
du Cerveuu?..(1 JunvIer 1qz)
Trucy, Jumes ., M.D...(Dec 1q1;) (Tobucco
InLoxIcuLIon Is un egoLIsLIc nurcosIs.)
Gy, AbeI, L'Intoxicction pcr le Tcbcc (PurIs: Musson eL
CIe, 1q1) (on LoxIc eIIecLs oI nIcoLIne upon LIe
nervous sysLem)
MuIIuII, J.C., M.D.,..(o Nov 18q) (cILIng evII eIIecLs
oI cIgureLLe smokIng, Ior exumpIe, nIcoLIne
InLoxIcuLIon evIdenL uILer u mere LIree cIgureLLes.)
Dr. AucIe,..(zz MurcI 18q1) (cILIng Lobucco
InLoxIcuLIon, Irom exLernuI uppIIcuLIon oI Lobucco
InIusIon Ior LIe desLrucLIon oI IIce)
The Bigger Picture
CIuse, B.W., M.A.,..(..18;8)..(u IussILude IoIIows
LIe InLoxIcuLIng InIIuence oI Tobucco..)
AIcoLL, WIIIIum A., M.D.,..(..186)..(Tobucco,
moreover, Is, oI ILseII, un InLoxIcuLIng subsLunce).
PIeLLen (1qqq) LIen moves on Lo supporL Ior Lobucco epIIepsy.
TIe quesLIonubIe reIerences ure Irom 1q6o, 1qq, 1q8, 1qq, 1q, 1qz,
18qq, 18o6 und 16qq. nLeresLIngIy, LIe IusL reIerence, ugon (16qq),
reIers meLupIorIcuIIy Lo smokIng us u permunenL epIIepsy compured Lo
Iove beIng reIerred Lo us u brIeI epIIepLIc IIL. PIeLLen consIders LIIs us
evIdence Ior ucLuuI epIIepsy (I.e., In bIomedIcuI Lerms).
HuvIng deIInILIveIy demonsLruLed LIe ubove condILIons us
cuused by Lobucco smokIng, PIeLLen LIen cusuuIIy sIIILs Lo LIe
evIdence Ior smoker scIIzopIrenIu:
GIussmun, A., CIgureLLe SmokIng und mpIIcuLIons Ior
PsycIIuLrIc IIness, 1o Am 1 Pschictr (#q) q6-
(1qq) (suyIng ;q% oI scIIzopIrenIcs smoke, wIereus
onIy z% oI LIe generuI popuIuLIon does)
KIeIn, C., Andresen, B. & TIom, E., BIInkIng, AIpIu
BruIn Wuves und SmokIng In ScIIzopIrenIu, ; Actc
Pschictricc Sccndincticc (#) 1;z (MurcI 1qq)
KILcI, D., EdILorIuI: WIere TIere`s Smoke..nIcoLIne
und PsycIIuLrIc DIsorders, o iol Pschictr 1o;-1o8
(1qq1) (suyIng LIuL umong smokers, LIe mosL common
menLuI dIsorder Is scIIzopIrenIu: smokers ure
dIsproporLIonuLeIy menLuIIy III sIgnIIIcunLIy more LIun
nonsmokers)
KeIIogg, JoIn H., M.D.,..Tobcccoism, or, Hou
Tobccco Kills (1qzz) (reporLs scIIzopIrenIu umong
smokers, 1oo% correIuLIon).
TIe GIussmun (1qq) sLudy IndIcuLes u IIgIer RR oI
scIIzopIrenIu ussocIuLed wILI smokIng LIun nonsmokIng. SmokIng,
Iowever, Is u very poor predIcLor (I.e., neur-zero) oI scIIzopIrenIu. ApurL
Irom muny oLIer poor-predIcLor (essenLIuIIy useIess) rIsk IucLors, LIere Is
un udded Issue regurdIng smokIng. Persons wIo ure uIreudy sympLomuLIc
- even In youLI - muy Luke up und muInLuIn LIe smokIng IubIL us u meuns
oI mood-moduIuLIon (I.e., u Iorm oI seII-medIcuLIon). L cun be suId LIuL
nIcoLIne, us one uspecL oI LIe smokIng IubIL, muy Indeed LemporurIIy uId
LIose wIo wIII uILImuLeIy munIIesL scIIzopIrenIu, depressIon or oLIer
dIsLurbunces (e.g., unxIeLy).
GIussmun (1qq) unIorLunuLeIy operuLes Irom u medIco-
512
512
Rampant Antismoking Signifies Grave Danger
muLerIuIIsL vIewpoInL, devoId oI psycIoIogIcuI und socIuI uspecLs oI LIe
smokIng IubIL, LIuL vIews smokIng us u dIseuse LIuL musL be cured.
GIussmun (1qq), Irom u muLerIuIIsL poInL oI vIew, ucknowIedges LIuL
smokIng cun be useIuI In mood moduIuLIon. UILImuLeIy, Iowever, Ie
consIders LIuL IL Is u IubIL LIuL musL be overcome. L Is In LIe ureu oI
smokIng cessuLIon LIuL Ie ruIses LIe Issue LIuL, Ior some, smokIng
cessuLIon cun be ussocIuLed wILI u mujor depressIve epIsode. rom u
muLerIuIIsL vIewpoInL, GIussmun Is requIred Lo concIude LIuL nIcoLIne Ius
u debIIILuLIng eIIecL, pIurmucoIogIcuIIy, LIuL becomes obvIous wILI
uLLempLs uL smokIng cessuLIon, I.e., un enLIreIy bIocIemIcuI expIunuLIon.
However, II LIe muILIdImensIonuI uspecLs oI LIe smokIng IubIL ure
consIdered, depressIon cun be LIe resuIL oI removIng u second-nuLure
Irumework (psycIo-IogIcuI, cognILIve, emoLIonuI, socIuI) oI IIgI
IumIIIurILy. Persons cun Iuve u severe depressIve epIsode on LIe Ioss oI u
Iong-sLundIng job or purLner (dIvorce) wIere LIere Is no dIrecL
pIurmucoIogIcuI uspecL. TIere ure cerLuInIy reusons Lo be very wury oI LIe
muLerIuIIsL vIew In psycIIuLry. Ls superIIcIuIILy, In onIy LIe recenL pusL,
guve LIe worId eIecLro-convuIsIve (sIock) LIerupy und psycIosurgery
(e.g., IronLuI IoboLomy). TIe Ideu LIuL depressIon mIgIL resuIL Irom u Iuck
or removuI oI meunIngIuIness (muILIdImensIonuI depLI) Is uIIen Lo LIe
muLerIuIIsL menLuIILy. L sIouId uIso be noLed LIuL noL uII psycIIuLrIsLs ure
muLerIuIIsL In dIsposILIon: Some Iuve crILIcuI psycIoIogIcuI upLILude.
orLunuLeIy, GIussmun (1qq) does noL suggesL LIuL smokIng
cuuses scIIzopIrenIu or depressIon. However, PIeLLen uses LIe
GIussmun reIerence, wILIouL dIscussIon, onIy InsoIur us LIe greuLer
number oI smokers In LIese LroubIed groups cun promoLe LIe deIInquenL
Ideu LIuL smokIng cuuses noL onIy LIese buL numerous oLIer condILIons. L
Is uIso reIIecLed In PIeLLen`s derunged worId-soIuLIon LIuL, by u smokIng
bun, wIII LIe IncIdence oI scIIzopIrenIu, depressIon, eLc., ussocIuLed wILI
smokIng dIsuppeur.
PIeLLen goes even IurLIer LIun LIe sLundurd, IncompeLenL,
medIco-muLerIuIIsL buck-Lo-IronL error oI InLerpreLuLIon: He ImproperIy
concIudes LIuL, sInce LIere ure more scIIzopIrenIcs LIuL ure smokers LIun
nonsmokers, smokIng LIereIore cuuses LIe condILIon. TIe IncompeLence
Is even more severe regurdIng KeIIogg`s IIgIIy duLed observuLIons; LIe
observuLIons IndIcuLed LIuL uII oI LIose dIugnosed (very dIIIerenL Lo
currenL dIugnoses) wILI scIIzopIrenIu were smokers. TIe correIuLIon Is
noL 1oo% Ior scIIzopIrenIu umong smokers; LIere Is u 1oo% correIuLIon
Ior smokers umongsL scIIzopIrenIu (essenLIuIIy useIess InIormuLIon), und
noL u 1oo% correIuLIon Ior scIIzopIrenIcs umong smokers. TIe IuLLer
ImpIIes LIuL every smoker Ius dIugnosubIe scIIzopIrenIu, wIIcI Ius no
sensIbIIILy.
The Bigger Picture
PIeLLen (1qqq) LIen proceeds wILI evIdence Ior smoker
psycIopuLIoIogy sympLoms. He begIns wILI u reusonubIe deIInILIon oI
psycIopuLIoIogy (I.e., Coon, 1q8q). However, LIe deIInILIon does noL
specIIIcuIIy perLuIn Lo Lobucco smokIng. TIe uppIIcubIIILy ussumes LIuL uII
LIuL PIeLLen Ius concIuded ubouL smokIng Is uccuruLe - wIIcI IL Is noL.
TIe urgumenL conLInues: Smokers` dIsproporLIonuLeIy-occurrIng
psycIopuLIIc sympLoms IncIude drug uddIcLIon, gumbIIng, Ioss oI conLucL
wILI reuIILy, IuIIucInuLIng, crImInuIILy, bruIn-dumuge-Induced
ImpuIrmenL oI IIneur reusonIng, Lobucco-InLoxIcuLIon, und AIzIeImer`s-
Lype memory Ioss.
TIIs proposILIon Is bused on sLundurd buck-Lo-IronL reusonIng
LIuL uII eIevuLed RR`s ussocIuLed wILI smokIng ure cuused by LIe
properLIes oI Lobucco smoke. A sIngIe reIerence Is LIen cILed concernIng
Lobucco beIng un IuIIucInogenIc. (I.e., EIIerInk, 1q8) TIIs reIerence
suggesLs LIuL some pre-CoIumbIun ndIuns used Lobucco Ior ILs
IuIIucInogenIc uLLrIbuLes. TIuL sucI uncIenL use wus un uspecL oI reIIgIous
ceremony LIuL Ius ILs own propensILy Ior IuIIucInogenIc experIence, or
LIuL ILs munner oI use vurIes consIderubIy wILI currenL Lobucco use, does
noL IIgure In PIeLLen`s surmIsIng. TIe IInuI pIece oI evIdence Is un
ouLduLed, unscIenLIIIc, und moruIIy quesLIonubIe 1qzq reIerence (I.e.,
Mucudden, 1qzq) LIuL suggesLed LIe use oI cIgureLLes..produces wIuL
mIgIL be Lermed |psycIopuLIy uku ubuIIu uku unomIe|..u condILIon In
wIIcI IyIng, LIIevIng, und murder become us nuLuruI us euLIng und
drInkIng.
Even Lo LIIs poInL, PIeLLen`s (1qqq) conducL In uLLempLIng Lo
munuIucLure smoker bruIn dumuge und reckIessness Is unconscIonubIe.
UnIorLunuLeIy, LIe cIuIms consIdered LIus Iur ure noL LIe worsL oI LIe
cIrcumsLunce. HuvIng begun wILI u serIes oI erruLIc Ideus, PIeLLen`s cIuIms
become dungerousIy more deIuded. ur more scruLIny wIII be gIven Lo
PIeLLen`s work In LIuL, sInce 1qqq, LIere Iuve been over zq,ooo
IILs (webpuge conLuInIng vIsILor-counLer) Ior LIe websILe In quesLIon;
LermInoIogy Iound on LIIs websILe, purLIcuIurIy LIuL wIIcI besL uppeurs Lo
sIunder smokers und eIevuLe nonsmokers` superIorILy, Ius Iound ILs wuy
InLo oLIer unLIsmokIng websILes und LIe pubIIc conscIousness. TIere ure
muny sIured InIormuLIon IInks beLween numerous unLIsmokIng
websILes LIuL dIssemInuLe TCPG bIuLIer. UndersLundubIy, II uny oI LIe
PIeLLen cIuIms ure mIsLukenIy Luken us even remoLeIy scIoIurIy or
coIerenL, IL wouId IeIp Lo expIuIn LIe IerocILy LIuL unLIsmokIng senLImenL
Ius reucIed In muny nuLIons.
UnIorLunuLeIy, LIe sIeer voIume oI errunL cIuIms mukes IL
ImpossIbIe Lo deuI wILI uII oI LIese. However, u sumpIIng oI LIe more
deIuded und dungerous cIuIms, und LIe superIIcIuIILy wILI wIIcI LIey
513
513
Rampant Antismoking Signifies Grave Danger
muLerIuIIsL vIewpoInL, devoId oI psycIoIogIcuI und socIuI uspecLs oI LIe
smokIng IubIL, LIuL vIews smokIng us u dIseuse LIuL musL be cured.
GIussmun (1qq), Irom u muLerIuIIsL poInL oI vIew, ucknowIedges LIuL
smokIng cun be useIuI In mood moduIuLIon. UILImuLeIy, Iowever, Ie
consIders LIuL IL Is u IubIL LIuL musL be overcome. L Is In LIe ureu oI
smokIng cessuLIon LIuL Ie ruIses LIe Issue LIuL, Ior some, smokIng
cessuLIon cun be ussocIuLed wILI u mujor depressIve epIsode. rom u
muLerIuIIsL vIewpoInL, GIussmun Is requIred Lo concIude LIuL nIcoLIne Ius
u debIIILuLIng eIIecL, pIurmucoIogIcuIIy, LIuL becomes obvIous wILI
uLLempLs uL smokIng cessuLIon, I.e., un enLIreIy bIocIemIcuI expIunuLIon.
However, II LIe muILIdImensIonuI uspecLs oI LIe smokIng IubIL ure
consIdered, depressIon cun be LIe resuIL oI removIng u second-nuLure
Irumework (psycIo-IogIcuI, cognILIve, emoLIonuI, socIuI) oI IIgI
IumIIIurILy. Persons cun Iuve u severe depressIve epIsode on LIe Ioss oI u
Iong-sLundIng job or purLner (dIvorce) wIere LIere Is no dIrecL
pIurmucoIogIcuI uspecL. TIere ure cerLuInIy reusons Lo be very wury oI LIe
muLerIuIIsL vIew In psycIIuLry. Ls superIIcIuIILy, In onIy LIe recenL pusL,
guve LIe worId eIecLro-convuIsIve (sIock) LIerupy und psycIosurgery
(e.g., IronLuI IoboLomy). TIe Ideu LIuL depressIon mIgIL resuIL Irom u Iuck
or removuI oI meunIngIuIness (muILIdImensIonuI depLI) Is uIIen Lo LIe
muLerIuIIsL menLuIILy. L sIouId uIso be noLed LIuL noL uII psycIIuLrIsLs ure
muLerIuIIsL In dIsposILIon: Some Iuve crILIcuI psycIoIogIcuI upLILude.
orLunuLeIy, GIussmun (1qq) does noL suggesL LIuL smokIng
cuuses scIIzopIrenIu or depressIon. However, PIeLLen uses LIe
GIussmun reIerence, wILIouL dIscussIon, onIy InsoIur us LIe greuLer
number oI smokers In LIese LroubIed groups cun promoLe LIe deIInquenL
Ideu LIuL smokIng cuuses noL onIy LIese buL numerous oLIer condILIons. L
Is uIso reIIecLed In PIeLLen`s derunged worId-soIuLIon LIuL, by u smokIng
bun, wIII LIe IncIdence oI scIIzopIrenIu, depressIon, eLc., ussocIuLed wILI
smokIng dIsuppeur.
PIeLLen goes even IurLIer LIun LIe sLundurd, IncompeLenL,
medIco-muLerIuIIsL buck-Lo-IronL error oI InLerpreLuLIon: He ImproperIy
concIudes LIuL, sInce LIere ure more scIIzopIrenIcs LIuL ure smokers LIun
nonsmokers, smokIng LIereIore cuuses LIe condILIon. TIe IncompeLence
Is even more severe regurdIng KeIIogg`s IIgIIy duLed observuLIons; LIe
observuLIons IndIcuLed LIuL uII oI LIose dIugnosed (very dIIIerenL Lo
currenL dIugnoses) wILI scIIzopIrenIu were smokers. TIe correIuLIon Is
noL 1oo% Ior scIIzopIrenIu umong smokers; LIere Is u 1oo% correIuLIon
Ior smokers umongsL scIIzopIrenIu (essenLIuIIy useIess InIormuLIon), und
noL u 1oo% correIuLIon Ior scIIzopIrenIcs umong smokers. TIe IuLLer
ImpIIes LIuL every smoker Ius dIugnosubIe scIIzopIrenIu, wIIcI Ius no
sensIbIIILy.
The Bigger Picture
PIeLLen (1qqq) LIen proceeds wILI evIdence Ior smoker
psycIopuLIoIogy sympLoms. He begIns wILI u reusonubIe deIInILIon oI
psycIopuLIoIogy (I.e., Coon, 1q8q). However, LIe deIInILIon does noL
specIIIcuIIy perLuIn Lo Lobucco smokIng. TIe uppIIcubIIILy ussumes LIuL uII
LIuL PIeLLen Ius concIuded ubouL smokIng Is uccuruLe - wIIcI IL Is noL.
TIe urgumenL conLInues: Smokers` dIsproporLIonuLeIy-occurrIng
psycIopuLIIc sympLoms IncIude drug uddIcLIon, gumbIIng, Ioss oI conLucL
wILI reuIILy, IuIIucInuLIng, crImInuIILy, bruIn-dumuge-Induced
ImpuIrmenL oI IIneur reusonIng, Lobucco-InLoxIcuLIon, und AIzIeImer`s-
Lype memory Ioss.
TIIs proposILIon Is bused on sLundurd buck-Lo-IronL reusonIng
LIuL uII eIevuLed RR`s ussocIuLed wILI smokIng ure cuused by LIe
properLIes oI Lobucco smoke. A sIngIe reIerence Is LIen cILed concernIng
Lobucco beIng un IuIIucInogenIc. (I.e., EIIerInk, 1q8) TIIs reIerence
suggesLs LIuL some pre-CoIumbIun ndIuns used Lobucco Ior ILs
IuIIucInogenIc uLLrIbuLes. TIuL sucI uncIenL use wus un uspecL oI reIIgIous
ceremony LIuL Ius ILs own propensILy Ior IuIIucInogenIc experIence, or
LIuL ILs munner oI use vurIes consIderubIy wILI currenL Lobucco use, does
noL IIgure In PIeLLen`s surmIsIng. TIe IInuI pIece oI evIdence Is un
ouLduLed, unscIenLIIIc, und moruIIy quesLIonubIe 1qzq reIerence (I.e.,
Mucudden, 1qzq) LIuL suggesLed LIe use oI cIgureLLes..produces wIuL
mIgIL be Lermed |psycIopuLIy uku ubuIIu uku unomIe|..u condILIon In
wIIcI IyIng, LIIevIng, und murder become us nuLuruI us euLIng und
drInkIng.
Even Lo LIIs poInL, PIeLLen`s (1qqq) conducL In uLLempLIng Lo
munuIucLure smoker bruIn dumuge und reckIessness Is unconscIonubIe.
UnIorLunuLeIy, LIe cIuIms consIdered LIus Iur ure noL LIe worsL oI LIe
cIrcumsLunce. HuvIng begun wILI u serIes oI erruLIc Ideus, PIeLLen`s cIuIms
become dungerousIy more deIuded. ur more scruLIny wIII be gIven Lo
PIeLLen`s work In LIuL, sInce 1qqq, LIere Iuve been over zq,ooo
IILs (webpuge conLuInIng vIsILor-counLer) Ior LIe websILe In quesLIon;
LermInoIogy Iound on LIIs websILe, purLIcuIurIy LIuL wIIcI besL uppeurs Lo
sIunder smokers und eIevuLe nonsmokers` superIorILy, Ius Iound ILs wuy
InLo oLIer unLIsmokIng websILes und LIe pubIIc conscIousness. TIere ure
muny sIured InIormuLIon IInks beLween numerous unLIsmokIng
websILes LIuL dIssemInuLe TCPG bIuLIer. UndersLundubIy, II uny oI LIe
PIeLLen cIuIms ure mIsLukenIy Luken us even remoLeIy scIoIurIy or
coIerenL, IL wouId IeIp Lo expIuIn LIe IerocILy LIuL unLIsmokIng senLImenL
Ius reucIed In muny nuLIons.
UnIorLunuLeIy, LIe sIeer voIume oI errunL cIuIms mukes IL
ImpossIbIe Lo deuI wILI uII oI LIese. However, u sumpIIng oI LIe more
deIuded und dungerous cIuIms, und LIe superIIcIuIILy wILI wIIcI LIey
514
514
Rampant Antismoking Signifies Grave Danger
Iuve been urrIved uL, wIII be consIdered und wIII IIgIIIgIL LIuL LIe
remuInder oI LIe PIeLLen cIuIms InvoIve LIe sume IIImsIness oI upproucI
und unsLubIe menLuIILy.
PIeLLen conLInues more erruLIc cIuIms supporLed by uddILIonuI
IIgIIy-duLed, unscIenLIIIc, uLypIcuI, und enLIreIy quesLIonubIe opInIon:
Smoker ucuIcuIIu, u common bruIn-dumuge condILIon,
Ius Iong been observed und reporLed:
ProI. TempIeLon P. TwIggs, Ior muny yeurs prIncIpuI oI
LIe IurgesL grummur scIooI oI DeLroIL, und IuLer
supervIsor oI LIe DepurLmenL oI ScIooI
ALLendunce..suys: 'As Lo menLuI cuIcuIuLIons requIred
In LIe courses oI urILImeLIc, Ie |LIe smoker| Is
prucLIcuIIy IeIpIess. He seems Lo Iuve no
conLroI..MenLuI puruIysIs seems besL |us LIe Lerm| Lo
descrIbe IIs condILIon. - DunIeI H. Kress, M.D., The
Cicrette As A Phsicicn Sees It (MounLuIn VIew, CA:
PucIIIc Press PubIIsIIng Ass`n, 1q1), pp ;q-;.
As smokIng |mukes smokers| sIorL-wInded |IL LIus|
Iessened LIeIr menLuI eIIIcIency - |so| LIey couId noL
udd IIgures us uccuruLeIy or concenLruLe upon unyLIIng
us successIuIIy wIIIe smokIng. - runk eIgILon Wood,
M.D., Whct You Should Knou About Tobccco,
(WIcIILu, KS: TIe WIcIILu PubIIsIIng Co., 1qqq), p 6q.
TIIs condILIon occurs us LIe LermInuI bIood vesseIs oI
LIe bruIn - LIose wIIcI suppIy oxygen und
nourIsImenL Lo ILs IIgIIy specIuIIzed corLex or ouLer
Iuyer, LIe purL by wIIcI we IIve und work und Iuve our
beIng, und wIIcI IIILs us up ubove LIe beusLs oI LIe IIeId
- Iuve been conLrucLed by nIcoLIne. - Wood, suprc, p
;z.
On LIe busIs oI LIIs useIess evIdence, PIeLLen surmIses:
AcuIcuIIu Is rumpunL umong smokers. NoLe LIuL u
sIgnIIIcunL Lobucco-LoxIc cIemIcuIs-cuused bruIn
dumuge sympLom Is ucuIcuIIu, ImpuIred ubIIILy Lo do
even sImpIe urILImeLIc In prucLIcuI IIIe-suvIng Lerms.
or exumpIe, LeII u nonsmoker LIuL u poIson Is oI
qz,ooo purLs wIereus LIe muLerIuI Is unsuIe ubove
ubouL 1oo purLs In u mIIIIon, LIe nonsmoker wIII noL
IngesL IL!! TeII u smoker LIe sume, LIe bruIn`s
mecIunIsm Ior compreIensIon und reucLIon Is LypIcuIIy
desLroyed. TIe smoker conLInues IngesLIng!! TIIs Is
LypIcuI oI u severeIy ImpuIred seII-deIense menLuI
The Bigger Picture
cupucILy.
TIe qz,ooo exumpIe reIuLes Lo curbon monoxIde, In
cIgureLLes uL LIuL IeveI us our cIgureLLe LoxIc cIemIcuIs
sILe sIows. Due Lo LIeIr bruIn dumuge, especIuIIy LIe
ucuIcuIIu, smokers ure prone Lo gumbIIng, unubIe Lo
reucL Lo LIe odds uguInsL LIem In LIuL ureu oI IIIe us
weII. As LIe Pclmer cuse reveuIs, gumbIIng
esLubIIsImenLs know oI LIIs medIcuI IucL, und Luke
udvunLuge.
TIIs Is compounded due Lo smokers` LypIcuI
unosognosIu, Iuck oI compreIensIon oI LIeIr
ImpuIrmenLs. Smokers ure ImpuIred, buL LypIcuIIy ure
unubIe Lo compreIend LIe IucL oI LIeIr ImpuIrmenL.
TIIs cun be evIdenced by denIuI, e.g., suyIng, ' um noL
dIseused.` TIus LIey don`L usk Ior IeIp In LIIs muLLer.
AnosognosIu Is u LypIcuI resuIL oI Lobucco-Induced bruIn
dumuge.
AnusognosIu Is IInked Lo LIe bruIn dumuge condILIon
ucuIcuIIu, Lo ubuIIu, und Lo LIe dumuged seII-deIense
mecIunIsm. Smokers LypIcuIIy Iuve uII LIree bruIn
dumuge condILIons.
rom uII oI LIIs enLIreIy quesLIonubIe, und dIsLurbed,
urgumenLuLIon, PIeLLen concIudes:
Tobucco`s mussIve quunLILIes oI LoxIc cIemIcuIs Iuve un
ImpuIrIng eIIecL on LIIs messuge LrunsIer process.
Tobucco uILers, ImpuIrs, dumuges, bruIn IuncLIon und
sLrucLure. NuLuruIIy, LIe IoreseeubIe resuIL Is LIuL mood,
reusonIng, eLIIcuI conLroIs, LIe seII-deIense IuncLIon,
und oLIer bruIn IuncLIons ure ImpuIred, puruIyzed,
desLroyed. TIe roIe oI Lobucco In dumugIng bruIn
IuncLIon und sLrucLure Is uncIenL medIcuI knowIedge,
Iong known. TIIs sILe provIdes you buckground on LIIs
Iong known medIcuI knowIedge.
BoLI RubbIs und CIrIsLIuns observe LIuL IeuILI
uuLIorILIes` sLuLemenLs LIuL LIIrLy seven mIIIIon peopIe,
u IoIocuusL-IeveI number, ure dyIng In LIe US uIone;
und vusL numbers more, second Iund smokers, uduILs
und cIIIdren, ure beIng kIIIed on u duIIy busIs by
cIgureLLes` LoxIc cIemIcuIs und IIres, wILIouL LIeIr
consenL und In muny cuses, over LIeIr sLrong objecLIons.
OLIer concerned IndIvIduuIs poInL ouL cIgureLLes` oLIer
515
515
Rampant Antismoking Signifies Grave Danger
Iuve been urrIved uL, wIII be consIdered und wIII IIgIIIgIL LIuL LIe
remuInder oI LIe PIeLLen cIuIms InvoIve LIe sume IIImsIness oI upproucI
und unsLubIe menLuIILy.
PIeLLen conLInues more erruLIc cIuIms supporLed by uddILIonuI
IIgIIy-duLed, unscIenLIIIc, uLypIcuI, und enLIreIy quesLIonubIe opInIon:
Smoker ucuIcuIIu, u common bruIn-dumuge condILIon,
Ius Iong been observed und reporLed:
ProI. TempIeLon P. TwIggs, Ior muny yeurs prIncIpuI oI
LIe IurgesL grummur scIooI oI DeLroIL, und IuLer
supervIsor oI LIe DepurLmenL oI ScIooI
ALLendunce..suys: 'As Lo menLuI cuIcuIuLIons requIred
In LIe courses oI urILImeLIc, Ie |LIe smoker| Is
prucLIcuIIy IeIpIess. He seems Lo Iuve no
conLroI..MenLuI puruIysIs seems besL |us LIe Lerm| Lo
descrIbe IIs condILIon. - DunIeI H. Kress, M.D., The
Cicrette As A Phsicicn Sees It (MounLuIn VIew, CA:
PucIIIc Press PubIIsIIng Ass`n, 1q1), pp ;q-;.
As smokIng |mukes smokers| sIorL-wInded |IL LIus|
Iessened LIeIr menLuI eIIIcIency - |so| LIey couId noL
udd IIgures us uccuruLeIy or concenLruLe upon unyLIIng
us successIuIIy wIIIe smokIng. - runk eIgILon Wood,
M.D., Whct You Should Knou About Tobccco,
(WIcIILu, KS: TIe WIcIILu PubIIsIIng Co., 1qqq), p 6q.
TIIs condILIon occurs us LIe LermInuI bIood vesseIs oI
LIe bruIn - LIose wIIcI suppIy oxygen und
nourIsImenL Lo ILs IIgIIy specIuIIzed corLex or ouLer
Iuyer, LIe purL by wIIcI we IIve und work und Iuve our
beIng, und wIIcI IIILs us up ubove LIe beusLs oI LIe IIeId
- Iuve been conLrucLed by nIcoLIne. - Wood, suprc, p
;z.
On LIe busIs oI LIIs useIess evIdence, PIeLLen surmIses:
AcuIcuIIu Is rumpunL umong smokers. NoLe LIuL u
sIgnIIIcunL Lobucco-LoxIc cIemIcuIs-cuused bruIn
dumuge sympLom Is ucuIcuIIu, ImpuIred ubIIILy Lo do
even sImpIe urILImeLIc In prucLIcuI IIIe-suvIng Lerms.
or exumpIe, LeII u nonsmoker LIuL u poIson Is oI
qz,ooo purLs wIereus LIe muLerIuI Is unsuIe ubove
ubouL 1oo purLs In u mIIIIon, LIe nonsmoker wIII noL
IngesL IL!! TeII u smoker LIe sume, LIe bruIn`s
mecIunIsm Ior compreIensIon und reucLIon Is LypIcuIIy
desLroyed. TIe smoker conLInues IngesLIng!! TIIs Is
LypIcuI oI u severeIy ImpuIred seII-deIense menLuI
The Bigger Picture
cupucILy.
TIe qz,ooo exumpIe reIuLes Lo curbon monoxIde, In
cIgureLLes uL LIuL IeveI us our cIgureLLe LoxIc cIemIcuIs
sILe sIows. Due Lo LIeIr bruIn dumuge, especIuIIy LIe
ucuIcuIIu, smokers ure prone Lo gumbIIng, unubIe Lo
reucL Lo LIe odds uguInsL LIem In LIuL ureu oI IIIe us
weII. As LIe Pclmer cuse reveuIs, gumbIIng
esLubIIsImenLs know oI LIIs medIcuI IucL, und Luke
udvunLuge.
TIIs Is compounded due Lo smokers` LypIcuI
unosognosIu, Iuck oI compreIensIon oI LIeIr
ImpuIrmenLs. Smokers ure ImpuIred, buL LypIcuIIy ure
unubIe Lo compreIend LIe IucL oI LIeIr ImpuIrmenL.
TIIs cun be evIdenced by denIuI, e.g., suyIng, ' um noL
dIseused.` TIus LIey don`L usk Ior IeIp In LIIs muLLer.
AnosognosIu Is u LypIcuI resuIL oI Lobucco-Induced bruIn
dumuge.
AnusognosIu Is IInked Lo LIe bruIn dumuge condILIon
ucuIcuIIu, Lo ubuIIu, und Lo LIe dumuged seII-deIense
mecIunIsm. Smokers LypIcuIIy Iuve uII LIree bruIn
dumuge condILIons.
rom uII oI LIIs enLIreIy quesLIonubIe, und dIsLurbed,
urgumenLuLIon, PIeLLen concIudes:
Tobucco`s mussIve quunLILIes oI LoxIc cIemIcuIs Iuve un
ImpuIrIng eIIecL on LIIs messuge LrunsIer process.
Tobucco uILers, ImpuIrs, dumuges, bruIn IuncLIon und
sLrucLure. NuLuruIIy, LIe IoreseeubIe resuIL Is LIuL mood,
reusonIng, eLIIcuI conLroIs, LIe seII-deIense IuncLIon,
und oLIer bruIn IuncLIons ure ImpuIred, puruIyzed,
desLroyed. TIe roIe oI Lobucco In dumugIng bruIn
IuncLIon und sLrucLure Is uncIenL medIcuI knowIedge,
Iong known. TIIs sILe provIdes you buckground on LIIs
Iong known medIcuI knowIedge.
BoLI RubbIs und CIrIsLIuns observe LIuL IeuILI
uuLIorILIes` sLuLemenLs LIuL LIIrLy seven mIIIIon peopIe,
u IoIocuusL-IeveI number, ure dyIng In LIe US uIone;
und vusL numbers more, second Iund smokers, uduILs
und cIIIdren, ure beIng kIIIed on u duIIy busIs by
cIgureLLes` LoxIc cIemIcuIs und IIres, wILIouL LIeIr
consenL und In muny cuses, over LIeIr sLrong objecLIons.
OLIer concerned IndIvIduuIs poInL ouL cIgureLLes` oLIer
516
516
Rampant Antismoking Signifies Grave Danger
LIun personuI pIysIcuI IeuILI IInks, smokIng`s roIe In:-
uborLIon, uIcoIoIIsm, AIzIeImer`s, bIrLI deIecLs, crIme,
dIvorce, drugs, IeurL dIseuse, Iung cuncer, SDS, eLc..
AIso, In 188q, docLors reporLed Lo LIe MIcIIgun House
oI RepresenLuLIves ubouL cIgureLLe`s menLuI eIIecLs, und
cILed sympLoms re wIIcI modern LermInoIogy wouId
cILe us uddIcLIon, Ior exumpIe, TIe ucLIon oI LIe bruIn
Is ImpuIred LIereby, LIe ubIIILy Lo LIInk, und In IucL uII
menLuI concenLruLIon Is weukened.
WIereIore, due Lo Lobucco-Induced ubuIIu, moruI
upuLIy, eLIIcuI puruIysIs, us pubIIsIed repeuLedIy-Lo-
presenL, sInce LIe 18o`s, ubouL qo% oI uIcoIoIIsm und
ubouL qo% oI crIme Is by smokers. Smokers do mosL oI
LIe crIme, LIe rupes, LIe robberIes, LIe drugs, LIe
murders.
An exumpIe oI smoker`s ImpuIred ImpuIse conLroI Is
LIIs: Lo Iuve LIe sudIsLIc IIIe quILe unImpeded, IIked
bIood, und LIe powerIess uspecLs oI LIe vIcLIm, suId
Dr. AbruIum A. BrIII, nLernuLIonuI JournuI oI
PsycIounuIysIs (#q) qo-qqq uL q;-8 (Dec 1qzz).
NoLIce LIuL LIe ubuIIc eIIecL, LIe moruI-upuLIy-puruIysIs
eIIecL, oI Lobucco smokIng wus noLed us Iong ugo us
18q: Tobucco prepures ILs vIcLIms Ior ucLs oI
burburILy..We do noL InsInuuLe LIuL uII wIo use
Lobucco ure crueI..BuL Lobucco IreLs und IrrILuLes LIe
nerves, und uILer LIe sysLem begIns serIousIy Lo suIIer
Irom ILs use, IL excILes LIe pussIons, und LIIngs ure seen
wILI u IuIse sIupe und coIorIng.
PIeLLen (1qqq) mukes muILIpIe reIerences Lo u memo by TIomus
EdIson: rIend ord, TIe InjurIous ugenL In cIgureLLes comes prIncIpuIIy
Irom LIe burnIng puper wrupper. TIe subsLunce LIereby Iormed, Is cuIIed
'AcroIeIn.` L Ius u vIoIenL ucLIon on LIe nerve cenLres, producIng
degeneruLIon oI LIe ceIIs oI LIe bruIn, wIIcI Is quILe rupId umong boys.
UnIIke mosL nurcoLIcs LIIs degeneruLIon Is permunenL und unconLroIIubIe.
empIoy no person wIo smokes cIgureLLes. TIese senLImenLs ure
depIcLed by PIeLLen us wIuL wus LIen common knowIedge. However, Ie
IuIIs Lo poInL ouL LIuL LIese ure cIuIms IuvIng no subsLunce, LypIcuI oI
muny unLIsmokIng cIuIms mude uL u LIme oI un unLIsmokIng Irenzy (see
uIso TuLe, 1qqq). EdIson muy Iuve been u successIuI InvenLorJ
IndusLrIuIIsL. However, IIs nonsmokIng empIoymenL poIIcy, IndIcuLIve oI
LIe snobbery und superIorIsm oI LIe LIme und supporLed by wuywurd
The Bigger Picture
medIcuI und reIIgIous cIuIms, Is moruIIy quesLIonubIe. TIe more successIuI
IndusLrIuIIsLs oI LIe LIme suw LIe worker us IILLIe more LIun u cog In LIe
IndusLrIuI mucIIne, IopeIuIIy producIng muxImuI proIILs Ior empIoyers.
Over-conLroIIIng empIoyers, noL unIIke HILIer und NuzI IndusLrIuIIsLs, suw
LIe cIgureLLe us producIng un uIIen wIII.
DoIerLy eL uI. (1qq8) Iound u % IIgIer IncIdence (I.e.,
RR=1.) oI dIvorce umongsL smokers. DIvorce InvoIves u wIoIe myrIud oI
ImpIIcuLed IucLors, und DoIerLy eL uI. (1qq8) empIusIzed LIuL smokIng
does noL cuuse dIvorce. urLIermore, IL Is jusL u sIngIe sLudy. However,
In LIe Iunds oI TCPG, LIe IIgIer RR Ior smokIng ussocIuLed wILI dIvorce
Is sImpIe-mIndedIy LrunsIormed InLo u cuusuI proposILIon: PIeLLen
concIudes LIuL smoker bruIn dumuge Is LIe sInguIur cuuse oI LIIs IIgIer
IncIdence. He LIen quoLes some mIsguIded nIneLeenLI-cenLury opInIons
In supporL. or exumpIe, Dr. JoIn Izurs,..The Use cnd Abuse oj
Tobccco (EdInburgI: 18q), pp 1zo-1z1. AdvIce LIen wus LIuL Lo uvoId
beIng u vIcLIm oI u smoker`s 'vIces und debused IubILs,` women wIo
'suIIIcIenLIy vuIue LIeIr own IuppIness, und LIe IeuILI und IuppIness oI
LIeIr IumIIIes..ougIL noL Lo murry smokers; nor sIouId LIey LrusL LIe
promIses oI reIormuLIon wIIcI |LIe smoker| muy muke, us LIey ure very
seIdom kepL.` JoIn Izurs wus u sLuuncI unLIsmoker wIose opInIon wus
noL represenLuLIve oI eILIer medIcuI prucLILIoners or reIIgIous Ieuders oI
LIe LIme (see WuIker, 1q8o).
As sImpIe-mInded us IIs InLerpreLuLIon Is PIeLLen`s soIuLIon. He
urges responsIbIe (nonsmokIng) members oI LIe pubIIc Lo pressure poIIcy
und Iuw mukers, LIrougI LIe use oI u provIded pre-worded Iorm, Ior LIe
bunnIng oI LIe munuIucLure und suIe oI cIgureLLes. TIIs wIII supposedIy
reduce LIe dIvorce ruLe. n IucL, PIeLLen beIIeves LIuL II cIgureLLes ure
bunned, uII munner oI evIIs wIII mugIcuIIy dIsuppeur - TIe poInL oI unLI-
cIgureLLe Iuws sucI us MIcIIgun`s, und LIeIr essenLIuI eIIecL, wus und Is Lo
muke u cIgureLLe smoke-Iree socIeLy, LIus prevenL (u) Lobucco InjurIes uku
dIseuses (e.g., Iung cuncer und IeurL dIseuse) und cosLs, und (b) more
sIgnIIIcunLIy, prevenL ubuIIu-reIuLed eIIecLs, e.g., suIcIde, uIcoIoIIsm,
promIscuILy, uborLIon, pornogrupIy, AIzIeImer`s DIseuse, drunk drIvIng,
drug ubuse, dIvorce, bIrLI deIecLs, SDS, und qo% oI crIme.
TIe dIscussIon wIII reLurn Lo PIeLLen sIorLIy. However, LIIs
dIvorce Issue cun IeIp Lo IurLIer IndIcuLe LIe muLerIuIIsL mIre LIuL muny
nuLIons ure currenLIy In und wurrunLs IurLIer scruLIny. DoIerLy eL uI.
(1qq8) consIder LIuL smokIng Is sympLomuLIc oI psycIoIogIcuI und
emoLIonuI Issues In some smokers. ncreused smokIng cun uIso occur II
LIe murrIuge Is LroubIed. TIese Issues cun Luke LIeIr LoII In dIvorce, und,
Ience, u IIgIer ruLe umongsL smokers. However, IndIcuLIng LIe poverLy oI
scIoIursIIp, purLIcuIurIy psycIoIogIcuIJreIuLIonuI, oI LIe LIme (I.e.,
517
517
Rampant Antismoking Signifies Grave Danger
LIun personuI pIysIcuI IeuILI IInks, smokIng`s roIe In:-
uborLIon, uIcoIoIIsm, AIzIeImer`s, bIrLI deIecLs, crIme,
dIvorce, drugs, IeurL dIseuse, Iung cuncer, SDS, eLc..
AIso, In 188q, docLors reporLed Lo LIe MIcIIgun House
oI RepresenLuLIves ubouL cIgureLLe`s menLuI eIIecLs, und
cILed sympLoms re wIIcI modern LermInoIogy wouId
cILe us uddIcLIon, Ior exumpIe, TIe ucLIon oI LIe bruIn
Is ImpuIred LIereby, LIe ubIIILy Lo LIInk, und In IucL uII
menLuI concenLruLIon Is weukened.
WIereIore, due Lo Lobucco-Induced ubuIIu, moruI
upuLIy, eLIIcuI puruIysIs, us pubIIsIed repeuLedIy-Lo-
presenL, sInce LIe 18o`s, ubouL qo% oI uIcoIoIIsm und
ubouL qo% oI crIme Is by smokers. Smokers do mosL oI
LIe crIme, LIe rupes, LIe robberIes, LIe drugs, LIe
murders.
An exumpIe oI smoker`s ImpuIred ImpuIse conLroI Is
LIIs: Lo Iuve LIe sudIsLIc IIIe quILe unImpeded, IIked
bIood, und LIe powerIess uspecLs oI LIe vIcLIm, suId
Dr. AbruIum A. BrIII, nLernuLIonuI JournuI oI
PsycIounuIysIs (#q) qo-qqq uL q;-8 (Dec 1qzz).
NoLIce LIuL LIe ubuIIc eIIecL, LIe moruI-upuLIy-puruIysIs
eIIecL, oI Lobucco smokIng wus noLed us Iong ugo us
18q: Tobucco prepures ILs vIcLIms Ior ucLs oI
burburILy..We do noL InsInuuLe LIuL uII wIo use
Lobucco ure crueI..BuL Lobucco IreLs und IrrILuLes LIe
nerves, und uILer LIe sysLem begIns serIousIy Lo suIIer
Irom ILs use, IL excILes LIe pussIons, und LIIngs ure seen
wILI u IuIse sIupe und coIorIng.
PIeLLen (1qqq) mukes muILIpIe reIerences Lo u memo by TIomus
EdIson: rIend ord, TIe InjurIous ugenL In cIgureLLes comes prIncIpuIIy
Irom LIe burnIng puper wrupper. TIe subsLunce LIereby Iormed, Is cuIIed
'AcroIeIn.` L Ius u vIoIenL ucLIon on LIe nerve cenLres, producIng
degeneruLIon oI LIe ceIIs oI LIe bruIn, wIIcI Is quILe rupId umong boys.
UnIIke mosL nurcoLIcs LIIs degeneruLIon Is permunenL und unconLroIIubIe.
empIoy no person wIo smokes cIgureLLes. TIese senLImenLs ure
depIcLed by PIeLLen us wIuL wus LIen common knowIedge. However, Ie
IuIIs Lo poInL ouL LIuL LIese ure cIuIms IuvIng no subsLunce, LypIcuI oI
muny unLIsmokIng cIuIms mude uL u LIme oI un unLIsmokIng Irenzy (see
uIso TuLe, 1qqq). EdIson muy Iuve been u successIuI InvenLorJ
IndusLrIuIIsL. However, IIs nonsmokIng empIoymenL poIIcy, IndIcuLIve oI
LIe snobbery und superIorIsm oI LIe LIme und supporLed by wuywurd
The Bigger Picture
medIcuI und reIIgIous cIuIms, Is moruIIy quesLIonubIe. TIe more successIuI
IndusLrIuIIsLs oI LIe LIme suw LIe worker us IILLIe more LIun u cog In LIe
IndusLrIuI mucIIne, IopeIuIIy producIng muxImuI proIILs Ior empIoyers.
Over-conLroIIIng empIoyers, noL unIIke HILIer und NuzI IndusLrIuIIsLs, suw
LIe cIgureLLe us producIng un uIIen wIII.
DoIerLy eL uI. (1qq8) Iound u % IIgIer IncIdence (I.e.,
RR=1.) oI dIvorce umongsL smokers. DIvorce InvoIves u wIoIe myrIud oI
ImpIIcuLed IucLors, und DoIerLy eL uI. (1qq8) empIusIzed LIuL smokIng
does noL cuuse dIvorce. urLIermore, IL Is jusL u sIngIe sLudy. However,
In LIe Iunds oI TCPG, LIe IIgIer RR Ior smokIng ussocIuLed wILI dIvorce
Is sImpIe-mIndedIy LrunsIormed InLo u cuusuI proposILIon: PIeLLen
concIudes LIuL smoker bruIn dumuge Is LIe sInguIur cuuse oI LIIs IIgIer
IncIdence. He LIen quoLes some mIsguIded nIneLeenLI-cenLury opInIons
In supporL. or exumpIe, Dr. JoIn Izurs,..The Use cnd Abuse oj
Tobccco (EdInburgI: 18q), pp 1zo-1z1. AdvIce LIen wus LIuL Lo uvoId
beIng u vIcLIm oI u smoker`s 'vIces und debused IubILs,` women wIo
'suIIIcIenLIy vuIue LIeIr own IuppIness, und LIe IeuILI und IuppIness oI
LIeIr IumIIIes..ougIL noL Lo murry smokers; nor sIouId LIey LrusL LIe
promIses oI reIormuLIon wIIcI |LIe smoker| muy muke, us LIey ure very
seIdom kepL.` JoIn Izurs wus u sLuuncI unLIsmoker wIose opInIon wus
noL represenLuLIve oI eILIer medIcuI prucLILIoners or reIIgIous Ieuders oI
LIe LIme (see WuIker, 1q8o).
As sImpIe-mInded us IIs InLerpreLuLIon Is PIeLLen`s soIuLIon. He
urges responsIbIe (nonsmokIng) members oI LIe pubIIc Lo pressure poIIcy
und Iuw mukers, LIrougI LIe use oI u provIded pre-worded Iorm, Ior LIe
bunnIng oI LIe munuIucLure und suIe oI cIgureLLes. TIIs wIII supposedIy
reduce LIe dIvorce ruLe. n IucL, PIeLLen beIIeves LIuL II cIgureLLes ure
bunned, uII munner oI evIIs wIII mugIcuIIy dIsuppeur - TIe poInL oI unLI-
cIgureLLe Iuws sucI us MIcIIgun`s, und LIeIr essenLIuI eIIecL, wus und Is Lo
muke u cIgureLLe smoke-Iree socIeLy, LIus prevenL (u) Lobucco InjurIes uku
dIseuses (e.g., Iung cuncer und IeurL dIseuse) und cosLs, und (b) more
sIgnIIIcunLIy, prevenL ubuIIu-reIuLed eIIecLs, e.g., suIcIde, uIcoIoIIsm,
promIscuILy, uborLIon, pornogrupIy, AIzIeImer`s DIseuse, drunk drIvIng,
drug ubuse, dIvorce, bIrLI deIecLs, SDS, und qo% oI crIme.
TIe dIscussIon wIII reLurn Lo PIeLLen sIorLIy. However, LIIs
dIvorce Issue cun IeIp Lo IurLIer IndIcuLe LIe muLerIuIIsL mIre LIuL muny
nuLIons ure currenLIy In und wurrunLs IurLIer scruLIny. DoIerLy eL uI.
(1qq8) consIder LIuL smokIng Is sympLomuLIc oI psycIoIogIcuI und
emoLIonuI Issues In some smokers. ncreused smokIng cun uIso occur II
LIe murrIuge Is LroubIed. TIese Issues cun Luke LIeIr LoII In dIvorce, und,
Ience, u IIgIer ruLe umongsL smokers. However, IndIcuLIng LIe poverLy oI
scIoIursIIp, purLIcuIurIy psycIoIogIcuIJreIuLIonuI, oI LIe LIme (I.e.,
518
518
Rampant Antismoking Signifies Grave Danger
domInuLIon by medIco-muLerIuIIsm), LIe Ideu LIuL nonsmokers, under LIe
undue InIIuence oI unLIsmokIng rIeLorIc, cun generuLe pressure on u
murrIuge never enLers LIe reseurcIers` reusonIng.
On LIe popuIur MurrIuge websILe (wILI SIerI & Bob SLrILoI)
oLIer Issues ure consIdered. or exumpIe,
AnoLIer ureu LIuL cun cuuse conIIIcL In u murrIuge
beLween u smoker und u non-smoker Is LruveIIng. Muny
romunLIc pIuces ure becomIng enLIreIy non-smokIng.
AddILIonuIIy, decIdIng wIeLIer or noL Lo sIL In smokIng
secLIons oI resLuurunLs und uIrporLs, wIere oIIered, cun
uIso cuuse conIIIcL. So u greuL opporLunILy Ior some
uIone LIme Ior sucI u coupIe wouId onIy cuuse more
sLress.
Muny non-smokIng spouses Iuve very sLrong IeeIIngs
ubouL LIeIr purLner`s smokIng IubIL. TIe IeeIIngs cun
runge Irom concern, Ieur, und dIsgusL Lo IeeIIng
unImporLunL, dIsuppoInLed und IurL. remember LIuL
uILIougI wus pIeused wIen Bob IInuIIy quIL smokIng,
uIso IeIL IurL LIuL LIe reuson Ie sLopped wus becuuse
our q yeur oId son usked IIm Lo. Iud been menLIonIng
Ior yeurs LIuL wus concerned ubouL IIs IeuILI und
wIsIed Ie wouId sLop smokIng. Some purLners InLerpreL
LIeIr spouse`s noL quILLIng smokIng us suyIng LIuL LIey
don`L cure ubouL LIeIr own IeuILI, und uILImuLeIy don`L
reuIIy cure ubouL LIeIr spouse or IumIIy.
Non-smokIng spouses und cIIIdren ure exposed Lo
second-Iund smoke, muy udopL LIe sume neguLIve
beIuvIors, und oILen Iuve poor nuLrILIon und dIeLs.
TIe Iocus oI LIese medIuJIobby group commenLurIes Is, uguIn,
uIwuys LIe smoker. SmokIng Is bIumed us LIe onIy neguLIve uspecL In LIe
consIderuLIon und LIuL IL Is even responsIbIe Ior poor dIeLs In nonsmokers.
TIe MurrIuge websILe concIudes: BoLLom IIne, IL uppeurs LIuL smokIng
cun Iuve u neguLIve eIIecL noL onIy on your pIysIcuI IeuILI, buL on your
emoLIonuI IeuILI und murrIuge reIuLIonsIIp, Loo. AL no poInL Is IL usked
wIuL neguLIve roIe LIe unLIsmokIng crusude, us purL oI u muLerIuIIsL
onsIuugIL, Ius Iud. TIe myrIud oI smokIng buns LIuL cun IosLer unImosILy
beLween smoker und nonsmoker purLners, LIe IrruLIonuI Ieur In
nonsmokIng spouses LIuL depIcLs LIe smoker quILLIng LIe IubIL us LIe
greuL gouI In IIIe, Iuve been munuIucLured by derunged sLuLIsLIcuIIsm. TIe
onIy IucLors LIuL ure consIdered ure smokIng und dIeL: SLundurd oI
reIuLIonsIIp never enLers LIe muLerIuIIsL Irumework. L muy be
The Bigger Picture
nonsmokIng spouses, IuIIIng In reIuLIonuI muLLers, LIuL LIen use u spouse`s
smokIng us u rIgILeous, jusLIIIed reuson Ior dIvorce - LIe nonsmoker Is
uIIorded superIorILy on exIL; u spouse`s smokIng cun poLenLIuIIy neguLe
uII munner oI reIuLIonuIJmoruI IuIIure oI LIe nonsmokIng spouse.
TIIs Is no smuII muLLer. AccordIng Lo u C Neus urLIcIe: A
conLroversIuI new IuLwu Ius been Issued In EgypL LIuL IuvIng u spouse
LIuL smokes Is IegILImuLe grounds Ior dIvorce. (JuIy o, zooo) AILIougI
mosL wesLern nuLIons operuLe on u no IuuIL dIvorce busIs, smokIng Ius
been munuIucLured InLo jusLIIIed grounds Ior dIvorce by LIe superIor
nonsmoker. A mosL reusonubIe quesLIon LIuL Is noL usked concerns LIe
dIIIIcuILy u smoker muy Iuve wILI u IunuLIcuI unLIsmoker spouse und LIe
pressure LIIs cun pIuce on u murrIuge. L Is sympLomuLIc oI LIe LIme (I.e.,
muLerIuIIsL domInuLIon) LIuL neILIer reseurcIers nor medIu commenLurIes
even enLerLuIn LIe Ideu oI unLIsmokIng ucLIvIsm und LIe IrruLIonuI beIIeIs
LIuL IL IueIs beIng probIemuLIc In LIe cIrcumsLunce.
As IndIcuLed In un eurIIer cIupLer, smokIng und cIIId cusLody Ius
been munuIucLured by LIe sume conLorLed menLuIILy InLo u crILIcuI muLLer.
TIe MuIIer Irm Ld. (InIormuLIon webpuge) noLe: n u rusI Lo prevenL
wIuL one pundIL cuIIed 'LIe mosL prevuIenL Iorm oI cIIId ubuse,` uL IeusL
IIILeen sLuLe courLs..Iuve IeId LIuL IL Is upproprIuLe Lo consIder wIeLIer u
purenL smokes uround u cIIId In deLermInIng wIeLIer or noL LIey sIouId
be uwurded cusLody. TIe MuIIer Irm Ld. ConLInues:
MosL cuses Iuve been resoIved wILI LIe courL enLerIng
un order resLrIcLIng LIe ureus wIere u purenL muy
smoke wIen u cIIId Is presenL, LIe use oI uIr IIILers or
uerosoI IresIeners, u proIIbILIon uguInsL smokIng In
LIeIr uuLomobIIe wIen LIe cIIId Is presenL, LIe requesL
oI seuLIng In LIe non-smokIng secLIons oI pubIIc pIuces,
or u bun on smokIng In LIe Iome or cur Ior us Iong us
Lwo duys prIor Lo LIe cIIId`s urrIvuI.
n cuses wIere purenLs reIuse Lo ugree, or vIoIuLe u
courL`s no-smokIng order, purenLs cun und Iuve Iud
LIeIr vIsILuLIon rIgILs suspended or IosL cusLody...
A more dIsLurbIng probIem Ior smokIng purenLs muy be
LIuL In our socIeLy Loduy IL Is IncreusIngIy possIbIe Ior
oLIers Lo uIso be concerned wILI LIe weIIure oI our
cIIIdren. L Is noL uncommon Ior docLors, scIooI nurses,
LeucIers, grundpurenLs und neIgIbors Lo IIIe u
compIuInL oI suspecLed cIIId ubuse, negIecL or
endungermenL uguInsL u purenL wIere smokIng In LIe
presence oI u cIIId Is perceIved Lo creuLe un uIIeged
IeuILI rIsk.
519
519
Rampant Antismoking Signifies Grave Danger
domInuLIon by medIco-muLerIuIIsm), LIe Ideu LIuL nonsmokers, under LIe
undue InIIuence oI unLIsmokIng rIeLorIc, cun generuLe pressure on u
murrIuge never enLers LIe reseurcIers` reusonIng.
On LIe popuIur MurrIuge websILe (wILI SIerI & Bob SLrILoI)
oLIer Issues ure consIdered. or exumpIe,
AnoLIer ureu LIuL cun cuuse conIIIcL In u murrIuge
beLween u smoker und u non-smoker Is LruveIIng. Muny
romunLIc pIuces ure becomIng enLIreIy non-smokIng.
AddILIonuIIy, decIdIng wIeLIer or noL Lo sIL In smokIng
secLIons oI resLuurunLs und uIrporLs, wIere oIIered, cun
uIso cuuse conIIIcL. So u greuL opporLunILy Ior some
uIone LIme Ior sucI u coupIe wouId onIy cuuse more
sLress.
Muny non-smokIng spouses Iuve very sLrong IeeIIngs
ubouL LIeIr purLner`s smokIng IubIL. TIe IeeIIngs cun
runge Irom concern, Ieur, und dIsgusL Lo IeeIIng
unImporLunL, dIsuppoInLed und IurL. remember LIuL
uILIougI wus pIeused wIen Bob IInuIIy quIL smokIng,
uIso IeIL IurL LIuL LIe reuson Ie sLopped wus becuuse
our q yeur oId son usked IIm Lo. Iud been menLIonIng
Ior yeurs LIuL wus concerned ubouL IIs IeuILI und
wIsIed Ie wouId sLop smokIng. Some purLners InLerpreL
LIeIr spouse`s noL quILLIng smokIng us suyIng LIuL LIey
don`L cure ubouL LIeIr own IeuILI, und uILImuLeIy don`L
reuIIy cure ubouL LIeIr spouse or IumIIy.
Non-smokIng spouses und cIIIdren ure exposed Lo
second-Iund smoke, muy udopL LIe sume neguLIve
beIuvIors, und oILen Iuve poor nuLrILIon und dIeLs.
TIe Iocus oI LIese medIuJIobby group commenLurIes Is, uguIn,
uIwuys LIe smoker. SmokIng Is bIumed us LIe onIy neguLIve uspecL In LIe
consIderuLIon und LIuL IL Is even responsIbIe Ior poor dIeLs In nonsmokers.
TIe MurrIuge websILe concIudes: BoLLom IIne, IL uppeurs LIuL smokIng
cun Iuve u neguLIve eIIecL noL onIy on your pIysIcuI IeuILI, buL on your
emoLIonuI IeuILI und murrIuge reIuLIonsIIp, Loo. AL no poInL Is IL usked
wIuL neguLIve roIe LIe unLIsmokIng crusude, us purL oI u muLerIuIIsL
onsIuugIL, Ius Iud. TIe myrIud oI smokIng buns LIuL cun IosLer unImosILy
beLween smoker und nonsmoker purLners, LIe IrruLIonuI Ieur In
nonsmokIng spouses LIuL depIcLs LIe smoker quILLIng LIe IubIL us LIe
greuL gouI In IIIe, Iuve been munuIucLured by derunged sLuLIsLIcuIIsm. TIe
onIy IucLors LIuL ure consIdered ure smokIng und dIeL: SLundurd oI
reIuLIonsIIp never enLers LIe muLerIuIIsL Irumework. L muy be
The Bigger Picture
nonsmokIng spouses, IuIIIng In reIuLIonuI muLLers, LIuL LIen use u spouse`s
smokIng us u rIgILeous, jusLIIIed reuson Ior dIvorce - LIe nonsmoker Is
uIIorded superIorILy on exIL; u spouse`s smokIng cun poLenLIuIIy neguLe
uII munner oI reIuLIonuIJmoruI IuIIure oI LIe nonsmokIng spouse.
TIIs Is no smuII muLLer. AccordIng Lo u C Neus urLIcIe: A
conLroversIuI new IuLwu Ius been Issued In EgypL LIuL IuvIng u spouse
LIuL smokes Is IegILImuLe grounds Ior dIvorce. (JuIy o, zooo) AILIougI
mosL wesLern nuLIons operuLe on u no IuuIL dIvorce busIs, smokIng Ius
been munuIucLured InLo jusLIIIed grounds Ior dIvorce by LIe superIor
nonsmoker. A mosL reusonubIe quesLIon LIuL Is noL usked concerns LIe
dIIIIcuILy u smoker muy Iuve wILI u IunuLIcuI unLIsmoker spouse und LIe
pressure LIIs cun pIuce on u murrIuge. L Is sympLomuLIc oI LIe LIme (I.e.,
muLerIuIIsL domInuLIon) LIuL neILIer reseurcIers nor medIu commenLurIes
even enLerLuIn LIe Ideu oI unLIsmokIng ucLIvIsm und LIe IrruLIonuI beIIeIs
LIuL IL IueIs beIng probIemuLIc In LIe cIrcumsLunce.
As IndIcuLed In un eurIIer cIupLer, smokIng und cIIId cusLody Ius
been munuIucLured by LIe sume conLorLed menLuIILy InLo u crILIcuI muLLer.
TIe MuIIer Irm Ld. (InIormuLIon webpuge) noLe: n u rusI Lo prevenL
wIuL one pundIL cuIIed 'LIe mosL prevuIenL Iorm oI cIIId ubuse,` uL IeusL
IIILeen sLuLe courLs..Iuve IeId LIuL IL Is upproprIuLe Lo consIder wIeLIer u
purenL smokes uround u cIIId In deLermInIng wIeLIer or noL LIey sIouId
be uwurded cusLody. TIe MuIIer Irm Ld. ConLInues:
MosL cuses Iuve been resoIved wILI LIe courL enLerIng
un order resLrIcLIng LIe ureus wIere u purenL muy
smoke wIen u cIIId Is presenL, LIe use oI uIr IIILers or
uerosoI IresIeners, u proIIbILIon uguInsL smokIng In
LIeIr uuLomobIIe wIen LIe cIIId Is presenL, LIe requesL
oI seuLIng In LIe non-smokIng secLIons oI pubIIc pIuces,
or u bun on smokIng In LIe Iome or cur Ior us Iong us
Lwo duys prIor Lo LIe cIIId`s urrIvuI.
n cuses wIere purenLs reIuse Lo ugree, or vIoIuLe u
courL`s no-smokIng order, purenLs cun und Iuve Iud
LIeIr vIsILuLIon rIgILs suspended or IosL cusLody...
A more dIsLurbIng probIem Ior smokIng purenLs muy be
LIuL In our socIeLy Loduy IL Is IncreusIngIy possIbIe Ior
oLIers Lo uIso be concerned wILI LIe weIIure oI our
cIIIdren. L Is noL uncommon Ior docLors, scIooI nurses,
LeucIers, grundpurenLs und neIgIbors Lo IIIe u
compIuInL oI suspecLed cIIId ubuse, negIecL or
endungermenL uguInsL u purenL wIere smokIng In LIe
presence oI u cIIId Is perceIved Lo creuLe un uIIeged
IeuILI rIsk.
520
520
Rampant Antismoking Signifies Grave Danger
As oI Junuury 1qq8, uL IeusL LIree purenLs Iuve IosL
cusLody oI cIIIdren becuuse oI compIuInLs Irom ouLsIde
LIe Iome.
TIIs generuIIy occurs wIere LIe cIIId Ius usLImu, Iuy
Iever, uIIergIes or oLIer condILIons wIIcI muke LIem
especIuIIy suscepLIbIe Lo Lobucco smoke. Even recurrenL
eur InIecLIons Iuve provIded LIe busIs Ior sucI
compIuInLs.
Becuuse muny oI LIese compIuInunLs ure munduLory
reporLers - LIose wIo Iuve Lo reporL Ior LIe weIIure oI
cIIIdren und generuI good oI socIeLy - muny smokIng
purenLs muy IInd LIuL LIey ure presumed guIILy oI u
crIme uguInsL LIeIr cIIId wILIouL LIe rIgIL Lo conIronL
LIeIr uccuser.
A skIIIed prucLILIoner In juvenIIe or IumIIy Iuw wIII Iuve
LIe rIgIL Lo revIew LIese unonymous uIIeguLIons,
Iowever, und IL Is sLrongIy suggesLed LIuL II LIe
Depcrtment oj Children cnd Icmil Sertices (DCS)
serves you wILI u compIuInL, one`s IIrsL IncIInuLIon
sIouId be Lo cuII un uLLorney Lo expedILe u process
wIIcI muy oLIerwIse requIre counLIess Iours oI
uLLendunce In courL, psycIIuLrIsL`s oIIIces und 'purenLIng
skIIIs` cIusses beIore you und your cIIId cun ever resume
wIuL wIII IopeIuIIy be u 'normuI` IIIe LogeLIer uguIn.
TIe roIe oI unLIsmokIng Iobby groups, und LIeIr governmenLuIJ
medIcuI esLubIIsImenL supporL, Is InsLrumenLuI In LIIs cIrcumsLunce. TIe
Ideu oI LIe mosL prevuIenL Iorm oI cIIId ubuse Is LIe concocLIon oI
mIIILunL unLIsmokIng groups sucI us ASH. ASH Ius u webpuge enLILIed
ASH`s CusLody und SmokIng nIormuLIon Puge: How You Cun IgIL Buck
I Your Spouse Smokes Around Your CIIId. ASH InIorms u poLenLIuIIy
dIsgrunLIed, unsLubIe dIvorcee:
Are you InvoIved In u dIspuLe over cusLody, und your
spouse smokes in the presence oI the child undJ
or permits others to do so?
Are you sepuruLed or dIvorced, und worried ubout
the heulth oI your child wIen Ie or sIe Is wILI LIe
oLIer purenL wIo smokes In LIe cIIId`s presence?
II so, you should reud ASH's preliminury report
on custody und smoking.
n IL you wIII Ieurn LIuL, in more thun u dozen
stutes, courts huve ruled thut whether or not u
The Bigger Picture
child is subjected to tobucco smoke is u Iuctor
which should be considered in deciding
custody..
As u pubIIc servIce Lo IeIp purenLs oI cIIIdren wIo ure
beIng subjecLed Lo LIe muny known dungers oI
secondIund Lobucco smoke, AcLIon on SmokIng und
HeuILI (ASH), u -yeur-old legul-uction
churituble orgunizution entirely supported by
tux-deductible contributions, Ius puL LogeLIer u
descrIpLIon oI some oI LIe IeudIng judIcIuI decIsIons In
LIIs ureu oI LIe Iuw.
TIIs document cun be downlouded by cIIckIng on
LIe IInk beIow.
PIeuse noLe, Iowever, LIuL this inIormution is
uvuiluble to member-supporters oI AcLIon on
SmokIng und HeuILI (ASH). To Iind out how you cun
become u member oI ASH on line, und Lo obLuIn
uccess Lo LIIs und oLIer vuIuubIe InIormuLIon Ior
members us weII us severul speciul giIts, pIeuse cIIck
Iere Lo Ieurn LIe muny beneIILs oI joInIng ASH on-IIne,
over LIe nLerneL.
Once you join - which you cun do conveniently
over the Internet - you wIII receIve by e-muII LIe
user nume und pussword you need Lo unlock this
vuluuble inIormution. Your oLIer gIILs wIII be senL Lo
you by muII.
Pleuse don't hesitute. riIting tobucco smoke
ulreudy kills more people thun motor vehicle
uccidents, ull crimes, AIS, illegul drugs, etc. In
other words, people ure stutisticully more likely
to die us u result oI driIting tobucco smoke thun
by u cur, gun, or the AIS virus.
Your conLrIbuLIon Lo joIn ASH Is Iully tux deductible.
Once you Iuve become u member oI ASH you cun
uccess LIe InIormuLIon ubouL proLecLIng your rIgILs us u
nonsmokIng purenL - IncIudIng u growIng IIsL oI
vuIuubIe IeguI precedenLs - by cIIckIng on LIe IoIIowIng
web sILe.
PurenLs ure beIng bruInwusIed InLo LIe beIIeI LIuL drIILIng
Lobucco smoke Is more dungerous LIun u cur, u gun, or LIe ADS vIrus.
TIe IIsL oI IncoIerenL unuIogIes couId uILernuLIveIy be, Ior exumpIe,
521
521
Rampant Antismoking Signifies Grave Danger
As oI Junuury 1qq8, uL IeusL LIree purenLs Iuve IosL
cusLody oI cIIIdren becuuse oI compIuInLs Irom ouLsIde
LIe Iome.
TIIs generuIIy occurs wIere LIe cIIId Ius usLImu, Iuy
Iever, uIIergIes or oLIer condILIons wIIcI muke LIem
especIuIIy suscepLIbIe Lo Lobucco smoke. Even recurrenL
eur InIecLIons Iuve provIded LIe busIs Ior sucI
compIuInLs.
Becuuse muny oI LIese compIuInunLs ure munduLory
reporLers - LIose wIo Iuve Lo reporL Ior LIe weIIure oI
cIIIdren und generuI good oI socIeLy - muny smokIng
purenLs muy IInd LIuL LIey ure presumed guIILy oI u
crIme uguInsL LIeIr cIIId wILIouL LIe rIgIL Lo conIronL
LIeIr uccuser.
A skIIIed prucLILIoner In juvenIIe or IumIIy Iuw wIII Iuve
LIe rIgIL Lo revIew LIese unonymous uIIeguLIons,
Iowever, und IL Is sLrongIy suggesLed LIuL II LIe
Depcrtment oj Children cnd Icmil Sertices (DCS)
serves you wILI u compIuInL, one`s IIrsL IncIInuLIon
sIouId be Lo cuII un uLLorney Lo expedILe u process
wIIcI muy oLIerwIse requIre counLIess Iours oI
uLLendunce In courL, psycIIuLrIsL`s oIIIces und 'purenLIng
skIIIs` cIusses beIore you und your cIIId cun ever resume
wIuL wIII IopeIuIIy be u 'normuI` IIIe LogeLIer uguIn.
TIe roIe oI unLIsmokIng Iobby groups, und LIeIr governmenLuIJ
medIcuI esLubIIsImenL supporL, Is InsLrumenLuI In LIIs cIrcumsLunce. TIe
Ideu oI LIe mosL prevuIenL Iorm oI cIIId ubuse Is LIe concocLIon oI
mIIILunL unLIsmokIng groups sucI us ASH. ASH Ius u webpuge enLILIed
ASH`s CusLody und SmokIng nIormuLIon Puge: How You Cun IgIL Buck
I Your Spouse Smokes Around Your CIIId. ASH InIorms u poLenLIuIIy
dIsgrunLIed, unsLubIe dIvorcee:
Are you InvoIved In u dIspuLe over cusLody, und your
spouse smokes in the presence oI the child undJ
or permits others to do so?
Are you sepuruLed or dIvorced, und worried ubout
the heulth oI your child wIen Ie or sIe Is wILI LIe
oLIer purenL wIo smokes In LIe cIIId`s presence?
II so, you should reud ASH's preliminury report
on custody und smoking.
n IL you wIII Ieurn LIuL, in more thun u dozen
stutes, courts huve ruled thut whether or not u
The Bigger Picture
child is subjected to tobucco smoke is u Iuctor
which should be considered in deciding
custody..
As u pubIIc servIce Lo IeIp purenLs oI cIIIdren wIo ure
beIng subjecLed Lo LIe muny known dungers oI
secondIund Lobucco smoke, AcLIon on SmokIng und
HeuILI (ASH), u -yeur-old legul-uction
churituble orgunizution entirely supported by
tux-deductible contributions, Ius puL LogeLIer u
descrIpLIon oI some oI LIe IeudIng judIcIuI decIsIons In
LIIs ureu oI LIe Iuw.
TIIs document cun be downlouded by cIIckIng on
LIe IInk beIow.
PIeuse noLe, Iowever, LIuL this inIormution is
uvuiluble to member-supporters oI AcLIon on
SmokIng und HeuILI (ASH). To Iind out how you cun
become u member oI ASH on line, und Lo obLuIn
uccess Lo LIIs und oLIer vuIuubIe InIormuLIon Ior
members us weII us severul speciul giIts, pIeuse cIIck
Iere Lo Ieurn LIe muny beneIILs oI joInIng ASH on-IIne,
over LIe nLerneL.
Once you join - which you cun do conveniently
over the Internet - you wIII receIve by e-muII LIe
user nume und pussword you need Lo unlock this
vuluuble inIormution. Your oLIer gIILs wIII be senL Lo
you by muII.
Pleuse don't hesitute. riIting tobucco smoke
ulreudy kills more people thun motor vehicle
uccidents, ull crimes, AIS, illegul drugs, etc. In
other words, people ure stutisticully more likely
to die us u result oI driIting tobucco smoke thun
by u cur, gun, or the AIS virus.
Your conLrIbuLIon Lo joIn ASH Is Iully tux deductible.
Once you Iuve become u member oI ASH you cun
uccess LIe InIormuLIon ubouL proLecLIng your rIgILs us u
nonsmokIng purenL - IncIudIng u growIng IIsL oI
vuIuubIe IeguI precedenLs - by cIIckIng on LIe IoIIowIng
web sILe.
PurenLs ure beIng bruInwusIed InLo LIe beIIeI LIuL drIILIng
Lobucco smoke Is more dungerous LIun u cur, u gun, or LIe ADS vIrus.
TIe IIsL oI IncoIerenL unuIogIes couId uILernuLIveIy be, Ior exumpIe,
522
522
Rampant Antismoking Signifies Grave Danger
uIrpIunes, IIgILenIng, voIcunoes, snuke-bILes und urunIum. TIIs deIuded
meLIod (perverse bIurrIng oI LIe crILIcuI dIIIerence beLween sLuLIsLIcuI
ussocIuLIon und cuusuLIon, und LIe predIcLIve sLrengLI oI IucLors Ior
IucLors) oI urgumenL Is LypIcuI oI ASH und oLIer unLIsmoker-groups`
cIuIms. TIIs sorL oI deIInquenL InIormuLIon Is specIIIcuIIy IncIuded Lo
cuLusLropIIze LIe Ideu oI uLLendunL dunger. AccordIng Lo ASH, cll cIIIdren
ure In dunger und uny responsIbIe purenL sIouId be worrIed ubouL LIeIr
cIIId`s IeuILI und exercIse LIeIr nonsmoker rIgILs. ConverseIy, u
nonsmoker purenL LIuL does noL ucL, und unIesILuLIngIy, Is IrresponsIbIe,
IuckIng cure Ior LIeIr cIIIdren`s IeuILI. TIere Is uIso LIe IIgI LempLuLIon
Lo superIorILy und meddIIng under LIe preLense oI IeuILI concerns by
dIsgrunLIed dIvorcees LIuL LIe ASH udvIsory expIoILs. n u IIgIIy sensILIve
muLLer, LIe ASH upproucI Is u LIrow-buck Lo LIe IormuIu suIe oI sLeuk
knIves. HuvIng puId Lo unIock LIIs vuIuubIe InIormuLIon, LIe
responsIbIe und empowered IILIgunL-Lo-be uIso receIves Iree gIILs -
probubIy some unLIsmokIng uppureI. L Is sIckIy LIuL LIIs seII-servIng,
deIInquenL conducL Is uIIowed Lo be reIerred Lo us u pubIIc und cIurILubIe
servIce. As Ius been consIdered, LIIs conducL cun proceed under LIe
preLense oI pubIIc und cIurILubIe servIce In LIuL IL Is enLIreIy supporLed by
muLerIuIIsL governmenLs und LIe medIcuI esLubIIsImenL.
TIe Issue oI smokIng Ius been munuIucLured by LIe
superIIcIuIILy oI muLerIuIIsm InLo u poIILIcuI LooI In dIvorce und cIIId
cusLody. L Is now u conduIL Ior enucLIng uII munner oI cIurucLer
deIIcIencIes IruuduIenLIy mude Lo uppeur us superIor, IeuILI-conscIous
conducL (I.e., MMES cuIL, superIorILy syndrome). AIso InLegruI Is LIuL LIe
judIcIury Ius been brougIL InLo IIne wILI governmenLuI muLerIuIIsL ugendu
- LIe sume governmenLs LIuL do noLIIng Lo prevenL dIvorce und LIe
deLrImenLuI rumIIIcuLIons Ior cIIIdren, LIuL Iuve InsLILuLed u dumbIng
down educuLIonuI sysLem, buL LIuL wIII LIen uLLempL Lo suve cIIIdren
Irom umbIenL Lobucco-smoke bused on medIco-muLerIuIIsL sLuLIsLIcuIIsm.
MuLerIuIIsm reIIecLs u Iuck oI psycIoIogIcuI, reIuLIonuI, und moruI
upLILude. L Is repIeLe wILI cIurucLer deIIcIencIes und wIII IosLer LIese In u
pubIIc uL Iurge LIuL Ius condescended Lo LIe sume superIIcIuIILy oI
reusonIng und conducL. A cenLruI LIeme In LIIs dIscussIon Is LIuL
muLerIuIIsm Ius no grusp oI LIe neguLIve rumIIIcuLIons oI ILs sLuLIsLIcuIIsL
und IdeoIogIcuI prescrIpLIonsJproscrIpLIons. n LIe cIrcumsLunce oI
smokIng, IL IueIs IrruLIonuI beIIeI, Ieur, IuLred, und superIorILy; IL IosLers
unImosILy, enmILy, dIvIsIon us u muLLer oI course und mude Lo uppeur us
IeuILI promoLIon. L LIen InLerpreLs LIe consequences oI ILs own
consIderubIe IuIIure - e.g., smoker segreguLIon, dIvorce due Lo
nonsmoker`s concern wILI u spouse`s smokIng, smokIng used us u
meuns oI proIongIng unImosILIes und Iuke superIorILy In cIIId cusLody - us
The Bigger Picture
uLLrIbuLubIe Lo LIe eIIecLs oI smokIng. RuLIer, IL Is muLerIuIIsm, und ILs
unLIsmokIng oIIsIooL, LIuL Is u mosL crILIcuI muILIdImensIonuI IeuILI
Iuzurd.
ReLurnIng Lo PIeLLen, Ie uIso subscrIbes Lo LIe beIIeI, wILI us
poor supporL us uny oLIer cIuIm Ie mukes, LIuL US Lobucco producLIon
reIIecLs u ConIederuLe conspIrucy: TIe SouLI - LIe ConIederuLes - wus
ungry uL LIe NorLI Ior enIorcIng LIe ConsLILuLIon, wInnIng LIe CIvII Wur
und 'sLeuIIng` (IreeIng) LIeIr sIuves. Our uncesLors suw LIuL poIsoned
cIgureLLes ure munuIucLured becuuse revengeIuI ConIederuLes und LIeIr
uccessorIes do noL Iove LIeIr neIgIbor us LIemseIves. TIey deveIoped LIe
'Good OId RebeI` song oI kIIIIng more Yunkees. UnrepenLunL
ConIederuLes, now In LIe Lobucco busIness, cIunged LIe IormuIu Ior
Lobucco Lo udd coumurIn, Ior ruL poIson, und begun u crop ruIsIng und
IurvesLIng projecL LIuL InvoIves InserLIng mIIIIons oI pounds oI LIIs poIson
InLo cIgureLLes.
One oI LIe more repugnunLIy mIsguIded unuIyses Is PIeLLen`s
vIew oI AdoII HILIer und LIe NuzI regIme (ILLp:JJmedIcoIeguI.LrIpod.comJ
medIcoIeguIJLcpg.ILm). IrsLIy, HILIer wus cuugIL smokIng uL scIooI uL uge
eIgIL. AILIougI HILIer Iud Iong quIL smokIng beIore Ie cume InLo power
(In 1qzq), Ie Iud smoked Ior z; yeurs - ussumIng LIuL Ie smoked Irom
uge 8 (18q;) Lo 1qzq. SecondIy, under (188z) descrIbed Germuny us LIe
Iund oI smokers. TIIrdIy, AdoII EIcImunn, HILIer`s cIIeI execuLIoner und
u smoker, wus descrIbed by IIs srueII cupLor us: obIIvIous Lo every
ImpuIse - compussIon, remorse, respecL Ior LIe suncLILy oI IIIe;
muddenIng, uImosL unbeIIevubIe, moruI obLuseness; Ie LruIy dId noL
undersLund LIuL Ie Iud done wrong.
Armed wILI LIese bILs oI InIormuLIon, some excerpLs Irom LIe
websILe IndIcuLe PIeLLen`s descrIpLIon oI LIe NuzI regIme und conducL:
n LIIs conLexL oI known muILIpIe LypIcuI bruIn dumuge
sympLoms oI smokers, noneLIeIess, Lobucco smokIng
wus wIdespreud In Germuny LIen, Germuny becume Ie
pIus ImmoruI eL Ie pIus degrude |LIe mosL ImmoruI,
degruded peopIe|, so HILIer nuLuruIIy wus sLurLed InLo
begInnIng smokIng young.
WIuL do you expecL bruIn-dumuged peopIe Lo do? AcL
normuI uL uII LImes?
TIIs uIIowIng oI IILLIe AdoII, IIke cIIIdren en musse were
beIng uIIowed, Lo smoke, occurred despILe LIe IucL IL wus
uIreudy known In 188q (LIe yeur Ie wus born), LIuL
smokIng wus especIuIIy IurmIuI Lo youLIs. DuLu on
Lobucco`s dungerousness, severe bruIn dumugIng eIIecLs
und roIe In crIme wus uIreudy LIen known - umong
523
523
Rampant Antismoking Signifies Grave Danger
uIrpIunes, IIgILenIng, voIcunoes, snuke-bILes und urunIum. TIIs deIuded
meLIod (perverse bIurrIng oI LIe crILIcuI dIIIerence beLween sLuLIsLIcuI
ussocIuLIon und cuusuLIon, und LIe predIcLIve sLrengLI oI IucLors Ior
IucLors) oI urgumenL Is LypIcuI oI ASH und oLIer unLIsmoker-groups`
cIuIms. TIIs sorL oI deIInquenL InIormuLIon Is specIIIcuIIy IncIuded Lo
cuLusLropIIze LIe Ideu oI uLLendunL dunger. AccordIng Lo ASH, cll cIIIdren
ure In dunger und uny responsIbIe purenL sIouId be worrIed ubouL LIeIr
cIIId`s IeuILI und exercIse LIeIr nonsmoker rIgILs. ConverseIy, u
nonsmoker purenL LIuL does noL ucL, und unIesILuLIngIy, Is IrresponsIbIe,
IuckIng cure Ior LIeIr cIIIdren`s IeuILI. TIere Is uIso LIe IIgI LempLuLIon
Lo superIorILy und meddIIng under LIe preLense oI IeuILI concerns by
dIsgrunLIed dIvorcees LIuL LIe ASH udvIsory expIoILs. n u IIgIIy sensILIve
muLLer, LIe ASH upproucI Is u LIrow-buck Lo LIe IormuIu suIe oI sLeuk
knIves. HuvIng puId Lo unIock LIIs vuIuubIe InIormuLIon, LIe
responsIbIe und empowered IILIgunL-Lo-be uIso receIves Iree gIILs -
probubIy some unLIsmokIng uppureI. L Is sIckIy LIuL LIIs seII-servIng,
deIInquenL conducL Is uIIowed Lo be reIerred Lo us u pubIIc und cIurILubIe
servIce. As Ius been consIdered, LIIs conducL cun proceed under LIe
preLense oI pubIIc und cIurILubIe servIce In LIuL IL Is enLIreIy supporLed by
muLerIuIIsL governmenLs und LIe medIcuI esLubIIsImenL.
TIe Issue oI smokIng Ius been munuIucLured by LIe
superIIcIuIILy oI muLerIuIIsm InLo u poIILIcuI LooI In dIvorce und cIIId
cusLody. L Is now u conduIL Ior enucLIng uII munner oI cIurucLer
deIIcIencIes IruuduIenLIy mude Lo uppeur us superIor, IeuILI-conscIous
conducL (I.e., MMES cuIL, superIorILy syndrome). AIso InLegruI Is LIuL LIe
judIcIury Ius been brougIL InLo IIne wILI governmenLuI muLerIuIIsL ugendu
- LIe sume governmenLs LIuL do noLIIng Lo prevenL dIvorce und LIe
deLrImenLuI rumIIIcuLIons Ior cIIIdren, LIuL Iuve InsLILuLed u dumbIng
down educuLIonuI sysLem, buL LIuL wIII LIen uLLempL Lo suve cIIIdren
Irom umbIenL Lobucco-smoke bused on medIco-muLerIuIIsL sLuLIsLIcuIIsm.
MuLerIuIIsm reIIecLs u Iuck oI psycIoIogIcuI, reIuLIonuI, und moruI
upLILude. L Is repIeLe wILI cIurucLer deIIcIencIes und wIII IosLer LIese In u
pubIIc uL Iurge LIuL Ius condescended Lo LIe sume superIIcIuIILy oI
reusonIng und conducL. A cenLruI LIeme In LIIs dIscussIon Is LIuL
muLerIuIIsm Ius no grusp oI LIe neguLIve rumIIIcuLIons oI ILs sLuLIsLIcuIIsL
und IdeoIogIcuI prescrIpLIonsJproscrIpLIons. n LIe cIrcumsLunce oI
smokIng, IL IueIs IrruLIonuI beIIeI, Ieur, IuLred, und superIorILy; IL IosLers
unImosILy, enmILy, dIvIsIon us u muLLer oI course und mude Lo uppeur us
IeuILI promoLIon. L LIen InLerpreLs LIe consequences oI ILs own
consIderubIe IuIIure - e.g., smoker segreguLIon, dIvorce due Lo
nonsmoker`s concern wILI u spouse`s smokIng, smokIng used us u
meuns oI proIongIng unImosILIes und Iuke superIorILy In cIIId cusLody - us
The Bigger Picture
uLLrIbuLubIe Lo LIe eIIecLs oI smokIng. RuLIer, IL Is muLerIuIIsm, und ILs
unLIsmokIng oIIsIooL, LIuL Is u mosL crILIcuI muILIdImensIonuI IeuILI
Iuzurd.
ReLurnIng Lo PIeLLen, Ie uIso subscrIbes Lo LIe beIIeI, wILI us
poor supporL us uny oLIer cIuIm Ie mukes, LIuL US Lobucco producLIon
reIIecLs u ConIederuLe conspIrucy: TIe SouLI - LIe ConIederuLes - wus
ungry uL LIe NorLI Ior enIorcIng LIe ConsLILuLIon, wInnIng LIe CIvII Wur
und 'sLeuIIng` (IreeIng) LIeIr sIuves. Our uncesLors suw LIuL poIsoned
cIgureLLes ure munuIucLured becuuse revengeIuI ConIederuLes und LIeIr
uccessorIes do noL Iove LIeIr neIgIbor us LIemseIves. TIey deveIoped LIe
'Good OId RebeI` song oI kIIIIng more Yunkees. UnrepenLunL
ConIederuLes, now In LIe Lobucco busIness, cIunged LIe IormuIu Ior
Lobucco Lo udd coumurIn, Ior ruL poIson, und begun u crop ruIsIng und
IurvesLIng projecL LIuL InvoIves InserLIng mIIIIons oI pounds oI LIIs poIson
InLo cIgureLLes.
One oI LIe more repugnunLIy mIsguIded unuIyses Is PIeLLen`s
vIew oI AdoII HILIer und LIe NuzI regIme (ILLp:JJmedIcoIeguI.LrIpod.comJ
medIcoIeguIJLcpg.ILm). IrsLIy, HILIer wus cuugIL smokIng uL scIooI uL uge
eIgIL. AILIougI HILIer Iud Iong quIL smokIng beIore Ie cume InLo power
(In 1qzq), Ie Iud smoked Ior z; yeurs - ussumIng LIuL Ie smoked Irom
uge 8 (18q;) Lo 1qzq. SecondIy, under (188z) descrIbed Germuny us LIe
Iund oI smokers. TIIrdIy, AdoII EIcImunn, HILIer`s cIIeI execuLIoner und
u smoker, wus descrIbed by IIs srueII cupLor us: obIIvIous Lo every
ImpuIse - compussIon, remorse, respecL Ior LIe suncLILy oI IIIe;
muddenIng, uImosL unbeIIevubIe, moruI obLuseness; Ie LruIy dId noL
undersLund LIuL Ie Iud done wrong.
Armed wILI LIese bILs oI InIormuLIon, some excerpLs Irom LIe
websILe IndIcuLe PIeLLen`s descrIpLIon oI LIe NuzI regIme und conducL:
n LIIs conLexL oI known muILIpIe LypIcuI bruIn dumuge
sympLoms oI smokers, noneLIeIess, Lobucco smokIng
wus wIdespreud In Germuny LIen, Germuny becume Ie
pIus ImmoruI eL Ie pIus degrude |LIe mosL ImmoruI,
degruded peopIe|, so HILIer nuLuruIIy wus sLurLed InLo
begInnIng smokIng young.
WIuL do you expecL bruIn-dumuged peopIe Lo do? AcL
normuI uL uII LImes?
TIIs uIIowIng oI IILLIe AdoII, IIke cIIIdren en musse were
beIng uIIowed, Lo smoke, occurred despILe LIe IucL IL wus
uIreudy known In 188q (LIe yeur Ie wus born), LIuL
smokIng wus especIuIIy IurmIuI Lo youLIs. DuLu on
Lobucco`s dungerousness, severe bruIn dumugIng eIIecLs
und roIe In crIme wus uIreudy LIen known - umong
524
524
Rampant Antismoking Signifies Grave Danger
educuLed peopIe.
As wus LIen known Lo occur dIsproporLIonuLeIy umong
smokers, AdoII`s menLuI ubIIILy deLerIoruLed. As u resuIL
IIs scIooI grudes wenL down. TIey wenL down Lo LIe
exLreme LIuL In 1qoo, uL unoLIer scIooI, Ie IuIIed und
Iud Lo repeuL u grude.
ung cuncer Is u unIversuI resuIL In smokers. AILon
OcIsner, M.D., SmokIng und Your IIe (..1qq rev
1q6q) p z.
More sIgnIIIcunLIy, bruIn dumuge Is u unIversuI resuIL
umong smokers.
WIereIore, smokIng Is u recognIzed menLuI dIsorder.
Tobucco use Ieuds Lo bruIn dumuge und crImInuI
propensILIes. WIereIore psycIIuLrIsL WuILer unger
goes InLo greuL deLuII on HILIer`s sympLoms. PIeuse reud
IIs enLIre book.
Smoker bruIn dumuge Ius Iong been weII esLubIIsIed,
sInce uL IeusL LIe yeur 16o! SympLoms IncIude
ImpuIrmenL oI LIe ubIIILy Lo reuson correcLIy!
TypIcuI smoker sympLoms IncIude IysLerIu, reporLed
sInce uL IeusL 188q und scIIzopIrenIu, reporLed sInce uL
IeusL 1qzz.
TIe boLLom IIne Is LIuL HILIer wus correcLIy deemed un
IysLerIc borderIng on scIIzopIrenIu, uspecLs common
Lo smokers, und noL uncommon Lo crImInuIs, suIcIdes,
murder vIcLIms. HILIer enguged In crImes und
evenLuuIIy becume u suIcIde cuse, or wus murdered.
MedIcuI reseurcI Ius Iong-reporLed (sInce LIe 18o`s)
boLI u smokIng-crIme IInk und u smokIng-suIcIde IInk.
DocLors Iuve LIorougIIy reseurcIed LIe subjecL,
uscerLuInIng wIy cIgureLLes Ieud Lo crIme, und Iound LIe
expIunuLIon In LIe 1qo`s eru. TIe expIunuLIon reIuLes Lo
cIgureLLes mussIve quunLILIes oI LoxIc cIemIcuIs IeudIng
Lo bruIn dumuge ImpuIrIng eLIIcuI und ImpuIse conLroIs.
NoLwILIsLundIng LIe gruve dunger oI smokIng, HILIer
Iud uIreudy by LIen Iong been u smoker. He Iud
smoked Ior zz yeurs, IuvIng sLurLed young. HIs
beIuvIor sIows LypIcuI smokIng eIIecLs. OLIer smokers
wILI cIgureLLes` LoxIc cIemIcuIs kIII bubIes by SDS,
nonsmokers by poIson gussIng wILI cIgureLLes`
emIssIons resuILIng In Iung dIseuses, Iung cuncer und
IeurL dIseuse.
The Bigger Picture
HILIer couId kIII more peopIe LIun oLIer smokers due Lo
IIs IoIdIng governmenLuI oIIIce. He couId IIre
uddILIonuI smokers us kIIIers, e.g., AdoII EIcImun. BuL IL
musL be remembered, kIIIIngs oI nonsmokers by
smokers occur on u duIIy, IourIy busIs (co-workers,
spouses, LIe unborn, new borns, eLc.). TIe dIIIerence Is
onIy one oI scuIe und medIu pubIIcILy.
HILIer surrounded IImseII wILI smokers, peopIe IIke
IImseII, e.g., AdoII EIcImun.
or smokers Lo noL know LIuL LIey ure doIng wrong, Is
normuI! or LIem. TIIs cIurucLerIsLIc oI LIeIrs Is
uncIenL duLu! TIuL Is wIy our uncesLors oI 18q; owu,
18q; Tennessee, 1qoq MIcIIgun, eLc., bunned cIgureLLes!
YeL LIe 'IIberLurIun`-Lypes keep denouncIng sucI busIc
prevenLIon.
Remember HILIer wus u smoker, expeIIed Irom scIooI uL
uge 8 Ior smokIng. HIs beIuvIor sIows LypIcuI eIIecLs oI
smokIng, ubuIIu - Ioss oI wIIIpower und seII-conLroI;
deIusIonuI reusonIng; murderous; pornogrupIy Iover;
perverLed; suIcIduI; uII In uII, severe bruIn dIseuse.
AILer decudes oI observuLIons, ToIsLoy Iud wurned
uguInsL IuvIng smokers us Ieuders: TIe bruIn becomes
numbed by nIcoLIne. WIuL ToIsLoy cuIIed conscIence
LIus expIres, us ImpuIse conLroI Is ImpuIred (ubuIIu,
unomIe, psycIopuLIy). ToIsLoy |18q6| cILed un exumpIe,
u smoker wIo begun ussuuILIng un uged womun wILI u
knIIe, woundIng Ier budIy. He LIen sIrunk Irom kIIIIng
Ier, buL uILer smokIng Lwo cIgurs, duzIng IIs bruIn, Ie
LIen compIeLed LIe knIIe-murder.
n 18;6, Dr. HIppoIyLe A. DepIerrIs,..Iud wurned oI LIe
kIIIIng propensILIes oI smoker oIIIcIuIs.
One eIIecL oI eIecLIng or uppoInLIng u smoker Lo oIIIce,
Is LIuL u smoker surrounds IImseII wILI uddILIonuI
smokers, peopIe wIose reusonIng Is us ImpuIred us IIs.
HILIer surrounded IImseII wILI smokers sucI us JodI,
KeILeI, KuILenbrunner, EIcImunn, eLc. (wILI sImIIurIy
ImpuIred ImpuIse und eLIIcuI conLroIs) wIIIIng Lo do
kIIIIngs up Lo LIe IImIL oI LIeIr ubIIILy.
How couId HILIer und ussocIuLes kIII so muny? Yes, LIey
were bruIn-dumuged smokers. Yes, Germuns by 18;6
were uIreudy, due Lo rumpunL Lobucco-use, LIe mosL
ImmoruI und degruded peopIe In Europe.
525
525
Rampant Antismoking Signifies Grave Danger
educuLed peopIe.
As wus LIen known Lo occur dIsproporLIonuLeIy umong
smokers, AdoII`s menLuI ubIIILy deLerIoruLed. As u resuIL
IIs scIooI grudes wenL down. TIey wenL down Lo LIe
exLreme LIuL In 1qoo, uL unoLIer scIooI, Ie IuIIed und
Iud Lo repeuL u grude.
ung cuncer Is u unIversuI resuIL In smokers. AILon
OcIsner, M.D., SmokIng und Your IIe (..1qq rev
1q6q) p z.
More sIgnIIIcunLIy, bruIn dumuge Is u unIversuI resuIL
umong smokers.
WIereIore, smokIng Is u recognIzed menLuI dIsorder.
Tobucco use Ieuds Lo bruIn dumuge und crImInuI
propensILIes. WIereIore psycIIuLrIsL WuILer unger
goes InLo greuL deLuII on HILIer`s sympLoms. PIeuse reud
IIs enLIre book.
Smoker bruIn dumuge Ius Iong been weII esLubIIsIed,
sInce uL IeusL LIe yeur 16o! SympLoms IncIude
ImpuIrmenL oI LIe ubIIILy Lo reuson correcLIy!
TypIcuI smoker sympLoms IncIude IysLerIu, reporLed
sInce uL IeusL 188q und scIIzopIrenIu, reporLed sInce uL
IeusL 1qzz.
TIe boLLom IIne Is LIuL HILIer wus correcLIy deemed un
IysLerIc borderIng on scIIzopIrenIu, uspecLs common
Lo smokers, und noL uncommon Lo crImInuIs, suIcIdes,
murder vIcLIms. HILIer enguged In crImes und
evenLuuIIy becume u suIcIde cuse, or wus murdered.
MedIcuI reseurcI Ius Iong-reporLed (sInce LIe 18o`s)
boLI u smokIng-crIme IInk und u smokIng-suIcIde IInk.
DocLors Iuve LIorougIIy reseurcIed LIe subjecL,
uscerLuInIng wIy cIgureLLes Ieud Lo crIme, und Iound LIe
expIunuLIon In LIe 1qo`s eru. TIe expIunuLIon reIuLes Lo
cIgureLLes mussIve quunLILIes oI LoxIc cIemIcuIs IeudIng
Lo bruIn dumuge ImpuIrIng eLIIcuI und ImpuIse conLroIs.
NoLwILIsLundIng LIe gruve dunger oI smokIng, HILIer
Iud uIreudy by LIen Iong been u smoker. He Iud
smoked Ior zz yeurs, IuvIng sLurLed young. HIs
beIuvIor sIows LypIcuI smokIng eIIecLs. OLIer smokers
wILI cIgureLLes` LoxIc cIemIcuIs kIII bubIes by SDS,
nonsmokers by poIson gussIng wILI cIgureLLes`
emIssIons resuILIng In Iung dIseuses, Iung cuncer und
IeurL dIseuse.
The Bigger Picture
HILIer couId kIII more peopIe LIun oLIer smokers due Lo
IIs IoIdIng governmenLuI oIIIce. He couId IIre
uddILIonuI smokers us kIIIers, e.g., AdoII EIcImun. BuL IL
musL be remembered, kIIIIngs oI nonsmokers by
smokers occur on u duIIy, IourIy busIs (co-workers,
spouses, LIe unborn, new borns, eLc.). TIe dIIIerence Is
onIy one oI scuIe und medIu pubIIcILy.
HILIer surrounded IImseII wILI smokers, peopIe IIke
IImseII, e.g., AdoII EIcImun.
or smokers Lo noL know LIuL LIey ure doIng wrong, Is
normuI! or LIem. TIIs cIurucLerIsLIc oI LIeIrs Is
uncIenL duLu! TIuL Is wIy our uncesLors oI 18q; owu,
18q; Tennessee, 1qoq MIcIIgun, eLc., bunned cIgureLLes!
YeL LIe 'IIberLurIun`-Lypes keep denouncIng sucI busIc
prevenLIon.
Remember HILIer wus u smoker, expeIIed Irom scIooI uL
uge 8 Ior smokIng. HIs beIuvIor sIows LypIcuI eIIecLs oI
smokIng, ubuIIu - Ioss oI wIIIpower und seII-conLroI;
deIusIonuI reusonIng; murderous; pornogrupIy Iover;
perverLed; suIcIduI; uII In uII, severe bruIn dIseuse.
AILer decudes oI observuLIons, ToIsLoy Iud wurned
uguInsL IuvIng smokers us Ieuders: TIe bruIn becomes
numbed by nIcoLIne. WIuL ToIsLoy cuIIed conscIence
LIus expIres, us ImpuIse conLroI Is ImpuIred (ubuIIu,
unomIe, psycIopuLIy). ToIsLoy |18q6| cILed un exumpIe,
u smoker wIo begun ussuuILIng un uged womun wILI u
knIIe, woundIng Ier budIy. He LIen sIrunk Irom kIIIIng
Ier, buL uILer smokIng Lwo cIgurs, duzIng IIs bruIn, Ie
LIen compIeLed LIe knIIe-murder.
n 18;6, Dr. HIppoIyLe A. DepIerrIs,..Iud wurned oI LIe
kIIIIng propensILIes oI smoker oIIIcIuIs.
One eIIecL oI eIecLIng or uppoInLIng u smoker Lo oIIIce,
Is LIuL u smoker surrounds IImseII wILI uddILIonuI
smokers, peopIe wIose reusonIng Is us ImpuIred us IIs.
HILIer surrounded IImseII wILI smokers sucI us JodI,
KeILeI, KuILenbrunner, EIcImunn, eLc. (wILI sImIIurIy
ImpuIred ImpuIse und eLIIcuI conLroIs) wIIIIng Lo do
kIIIIngs up Lo LIe IImIL oI LIeIr ubIIILy.
How couId HILIer und ussocIuLes kIII so muny? Yes, LIey
were bruIn-dumuged smokers. Yes, Germuns by 18;6
were uIreudy, due Lo rumpunL Lobucco-use, LIe mosL
ImmoruI und degruded peopIe In Europe.
526
526
Rampant Antismoking Signifies Grave Danger
And Iere Is one resuIL oI u smoker-domInuLed
governmenL. PeopIe wILI Iuw repeuIIng propensILIes up
Lo LIe IImIL oI LIeIr ubIIILy, In LIIs cuse, repeuIIng Iuws
uguInsL kIIIIng LIe IundIcupped, mInorILIes, IoreIgners,
Jews! SucI Iuws were consIdered Loo proIIbILIonIsL,
Loo resLrIcLIve oI peopIe`s Ireedom Lo do wIuLever LIey
IIke, IIke kIIIIng oLIer peopIe.
TIuL wus LIese smokers` vIew. TIey IIberuLed Germun
Irom proIIbILIonIsL Iuws - Iuws proIIbILIng Iruud,
ussuuIL, buLLery, kIdnuppIng, exLorLIon, murder..TIe
HILIer smokIng gung IIberuLed LIe nuLIon Irom sucI
Iuws.
NonsmokIng ucLIvIsm, II successIuI, wouId Iuve us u
nuLuruI und probubIe consequence, LIe prevenLIon oI
creuLIng IuLure psycIopuLIs, IuLure HILIers. ReIerrIng Lo
nonsmoker NuzI-prevenLIon eIIorLs us ILseII NuzI, Is un
exumpIe oI u HILIerIun bIg IIe perpeLruLed Lo
IruuduIenLIy conceuI LIe Lobucco roIe In NuzIsm.
TIe sumpIIng ubove Is repIeLe wILI mIsrepresenLuLIons,
IuIseIoods, omIssIons, und u mosL vIcIous, sIunderous dIsposILIon.
PIeLLen`s vIew Is dungerousIy mIsguIded, deLerIoruLIng InLo LIe sLundurd
post hoc ero propter hoc und crumendo cd hominem remInIscenL oI
nIneLeenLI und eurIy-LwenLIeLI-cenLury unLIsmokIng rIeLorIc. ndeed,
TCPG Iopes Lo reverse poIIcy und Iuw buck Lo Lurn-oI-LIe-LwenLIeLI-
cenLury reusonIng: Our gouI Is Lo revIve LIe Lurn-oI-LIe-cenLury couIILIon,
wILI uddILIons Ior uddILIonuI InIormuLIon ucquIred sInce LIen.
PIeLLen`s uppruIsuI oI LIe NuzI regIme us smoker-run Is quILe
sImpIy wrong (e.g., see secLIon The Nczis cnd AntismokIng; ProcLor,
1qq;). TIe regIme wus cIeurIy unLIsmokIng In dIsposILIon us purL oI u
bodIIyJrucIuI purILunIsm wIIcI, In Lurn, wus purL oI u greuLer muLerIuIIsL
IdeoIogy. PIeLLen mukes onIy u pussIng uIIusIon Lo InIormuLIon suggesLIng
LIuL HILIer wus unLI-Lobucco. YeL, Ie dIsmIsses LIIs wILIouL uny
exumInuLIon or expIunuLIon or uny reIerence Lo ProcLor's work uL uII;
ucLuuI IucLs cun be u greuL unnoyunce Lo IncompeLence und zeuIoLry.
PIeLLen does noL IndIcuLe LIuL IIs errunL smokIng-IInks (e.g.,
crIme, uIcoIoIIsm) cIuIms ure sLrIkIngIy sImIIur Lo LIose mude by LIe NuzI
regIme (ProcLor, 1qq;, p.q;-q). He does noL menLIon - uL uII - LIe
mIIILunLIy unLIsmokIng NuzIs, muny oI LIem docLors, und LIe crILIcuI roIe
LIuL medIcuI prucLILIoners pIuyed In LIe IdeoIogy und bruLuIILy oI LIe
regIme. L Is obvIous LIuL LIese IucLs conIIIcL wILI PIeLLen`s mosL unIeuILIy
LrusL oI LIe medIcuI esLubIIsImenL. or exumpIe, PIeLLen mukes sucI
The Bigger Picture
sLuLemenLs us:
CIrIsLIuns |Lurn-oI-LIe-cenLury| LIen respecLed medIcuI
knowIedge und reseurcI.
NIneLeenLI cenLury prevenLIon-orIenLed cIergymen Iud
cILed LIuL cIgureLLe seIIIng Is u sIn. SucI peopIe
possessed u menLuI uLLILude LIuL Is now rure, respecL Ior
medIcuI IIndIngs.
EurIy CIrIsLIuns cuIIed uke (LIe uuLIor oI uke und
AcLs) LIe beIoved pIysIcIun (CoIossIuns q:1q). TIere
wus respecL Ior docLors. Turn-oI-LIe-cenLury CIrIsLIuns
dId noL suy, 'IeL`s Ignore wIuL docLors suy ubouL LIe
cIgureLLe IInk Lo uIcoIoIIsm und crIme.`..TIey dId noL
beIIeve us so muny now, IeL`s go by medIu pundILs,
poIILIcIuns und oLIers wIo Iuve never sLudIed LIe
subjecL. TIey respecLed persons - LIe beIoved pIysIcIun
- wIo Iuve more experIence und educuLIon wILI sucI
muLLers..WIereIore Lurn-oI-LIe-cenLury CIrIsLIuns
wIo goL LIe 18qo`s - 1q1o`s unLI-cIgureLLe IegIsIuLIon
udopLed rejecLed LIe noLIon oI u conIIIcL beLween
reIIgIon und medIcIne. (TIey Iud seen oLIer cIergymen
commIL LIe IoIIy oI denouncIng scIence, GuIIIeo,
ruIIrouds, sLreeL IIgILs, scIence convenLIons, eLc., und
wouId Iuve none oI LIuL).
Our more reIIgIous 18q;-1qoq uncesLors, beLLer
educuLed LIun peopIe oI LIIs eru und more respecLIuI oI
medIcuI IIndIngs..
RespecL IncIudes respecL Ior docLors und medIcuI
reseurcIers. TIose wILIouL sucI respecL, e.g., smokers,
dIe premuLureIy. TIe deuLIs oI ;,ooo,ooo, LIe
governmenL`s counL, ure one resuIL.
PIeLLen LIun provIdes un exumpIe LIuL eIevuLes medIcuI opInIon
Lo u GodIy sLuLus:
A purubIe pursuunL Lo GenesIs: Adum LoId Eve, LuIked
Lo God, und Ie LoId me, InIuIIIbIy, 'don`L puL LIuL pIunL
In your mouLI or you`II dIe.` Eve rebeIIIousIy suId,
don`L beIIeve LIuL educuLed beIng. BesIdes LIe deuLI
uIIeged Is onIy u correIuLIon. L`s noL u cuusuLIon.
BesIdes, even II IL Is LIe IuLLer, Ie Iusn`L sIown me LIe
prooI. need noL Iuve respecL Ior uny educuLed beIng`s
udvIce unIess Ie Ius IIrsL sIown me - LIe bIg - LIe
prooI. Adum IuIIed Lo sLop Ier, LIe sume negIIgenL sIn-
527
527
Rampant Antismoking Signifies Grave Danger
And Iere Is one resuIL oI u smoker-domInuLed
governmenL. PeopIe wILI Iuw repeuIIng propensILIes up
Lo LIe IImIL oI LIeIr ubIIILy, In LIIs cuse, repeuIIng Iuws
uguInsL kIIIIng LIe IundIcupped, mInorILIes, IoreIgners,
Jews! SucI Iuws were consIdered Loo proIIbILIonIsL,
Loo resLrIcLIve oI peopIe`s Ireedom Lo do wIuLever LIey
IIke, IIke kIIIIng oLIer peopIe.
TIuL wus LIese smokers` vIew. TIey IIberuLed Germun
Irom proIIbILIonIsL Iuws - Iuws proIIbILIng Iruud,
ussuuIL, buLLery, kIdnuppIng, exLorLIon, murder..TIe
HILIer smokIng gung IIberuLed LIe nuLIon Irom sucI
Iuws.
NonsmokIng ucLIvIsm, II successIuI, wouId Iuve us u
nuLuruI und probubIe consequence, LIe prevenLIon oI
creuLIng IuLure psycIopuLIs, IuLure HILIers. ReIerrIng Lo
nonsmoker NuzI-prevenLIon eIIorLs us ILseII NuzI, Is un
exumpIe oI u HILIerIun bIg IIe perpeLruLed Lo
IruuduIenLIy conceuI LIe Lobucco roIe In NuzIsm.
TIe sumpIIng ubove Is repIeLe wILI mIsrepresenLuLIons,
IuIseIoods, omIssIons, und u mosL vIcIous, sIunderous dIsposILIon.
PIeLLen`s vIew Is dungerousIy mIsguIded, deLerIoruLIng InLo LIe sLundurd
post hoc ero propter hoc und crumendo cd hominem remInIscenL oI
nIneLeenLI und eurIy-LwenLIeLI-cenLury unLIsmokIng rIeLorIc. ndeed,
TCPG Iopes Lo reverse poIIcy und Iuw buck Lo Lurn-oI-LIe-LwenLIeLI-
cenLury reusonIng: Our gouI Is Lo revIve LIe Lurn-oI-LIe-cenLury couIILIon,
wILI uddILIons Ior uddILIonuI InIormuLIon ucquIred sInce LIen.
PIeLLen`s uppruIsuI oI LIe NuzI regIme us smoker-run Is quILe
sImpIy wrong (e.g., see secLIon The Nczis cnd AntismokIng; ProcLor,
1qq;). TIe regIme wus cIeurIy unLIsmokIng In dIsposILIon us purL oI u
bodIIyJrucIuI purILunIsm wIIcI, In Lurn, wus purL oI u greuLer muLerIuIIsL
IdeoIogy. PIeLLen mukes onIy u pussIng uIIusIon Lo InIormuLIon suggesLIng
LIuL HILIer wus unLI-Lobucco. YeL, Ie dIsmIsses LIIs wILIouL uny
exumInuLIon or expIunuLIon or uny reIerence Lo ProcLor's work uL uII;
ucLuuI IucLs cun be u greuL unnoyunce Lo IncompeLence und zeuIoLry.
PIeLLen does noL IndIcuLe LIuL IIs errunL smokIng-IInks (e.g.,
crIme, uIcoIoIIsm) cIuIms ure sLrIkIngIy sImIIur Lo LIose mude by LIe NuzI
regIme (ProcLor, 1qq;, p.q;-q). He does noL menLIon - uL uII - LIe
mIIILunLIy unLIsmokIng NuzIs, muny oI LIem docLors, und LIe crILIcuI roIe
LIuL medIcuI prucLILIoners pIuyed In LIe IdeoIogy und bruLuIILy oI LIe
regIme. L Is obvIous LIuL LIese IucLs conIIIcL wILI PIeLLen`s mosL unIeuILIy
LrusL oI LIe medIcuI esLubIIsImenL. or exumpIe, PIeLLen mukes sucI
The Bigger Picture
sLuLemenLs us:
CIrIsLIuns |Lurn-oI-LIe-cenLury| LIen respecLed medIcuI
knowIedge und reseurcI.
NIneLeenLI cenLury prevenLIon-orIenLed cIergymen Iud
cILed LIuL cIgureLLe seIIIng Is u sIn. SucI peopIe
possessed u menLuI uLLILude LIuL Is now rure, respecL Ior
medIcuI IIndIngs.
EurIy CIrIsLIuns cuIIed uke (LIe uuLIor oI uke und
AcLs) LIe beIoved pIysIcIun (CoIossIuns q:1q). TIere
wus respecL Ior docLors. Turn-oI-LIe-cenLury CIrIsLIuns
dId noL suy, 'IeL`s Ignore wIuL docLors suy ubouL LIe
cIgureLLe IInk Lo uIcoIoIIsm und crIme.`..TIey dId noL
beIIeve us so muny now, IeL`s go by medIu pundILs,
poIILIcIuns und oLIers wIo Iuve never sLudIed LIe
subjecL. TIey respecLed persons - LIe beIoved pIysIcIun
- wIo Iuve more experIence und educuLIon wILI sucI
muLLers..WIereIore Lurn-oI-LIe-cenLury CIrIsLIuns
wIo goL LIe 18qo`s - 1q1o`s unLI-cIgureLLe IegIsIuLIon
udopLed rejecLed LIe noLIon oI u conIIIcL beLween
reIIgIon und medIcIne. (TIey Iud seen oLIer cIergymen
commIL LIe IoIIy oI denouncIng scIence, GuIIIeo,
ruIIrouds, sLreeL IIgILs, scIence convenLIons, eLc., und
wouId Iuve none oI LIuL).
Our more reIIgIous 18q;-1qoq uncesLors, beLLer
educuLed LIun peopIe oI LIIs eru und more respecLIuI oI
medIcuI IIndIngs..
RespecL IncIudes respecL Ior docLors und medIcuI
reseurcIers. TIose wILIouL sucI respecL, e.g., smokers,
dIe premuLureIy. TIe deuLIs oI ;,ooo,ooo, LIe
governmenL`s counL, ure one resuIL.
PIeLLen LIun provIdes un exumpIe LIuL eIevuLes medIcuI opInIon
Lo u GodIy sLuLus:
A purubIe pursuunL Lo GenesIs: Adum LoId Eve, LuIked
Lo God, und Ie LoId me, InIuIIIbIy, 'don`L puL LIuL pIunL
In your mouLI or you`II dIe.` Eve rebeIIIousIy suId,
don`L beIIeve LIuL educuLed beIng. BesIdes LIe deuLI
uIIeged Is onIy u correIuLIon. L`s noL u cuusuLIon.
BesIdes, even II IL Is LIe IuLLer, Ie Iusn`L sIown me LIe
prooI. need noL Iuve respecL Ior uny educuLed beIng`s
udvIce unIess Ie Ius IIrsL sIown me - LIe bIg - LIe
prooI. Adum IuIIed Lo sLop Ier, LIe sume negIIgenL sIn-
528
528
Rampant Antismoking Signifies Grave Danger
by-omIssIon us AcIun`s neIgIbors` IuIIIng Lo conLroI
IIm. TIe resuIL wus, deuLIs.
PIeLLen IuIIs Lo compreIend LIuL IIIesLyIe epIdemIoIogy, Ior
exumpIe, Is noL u scIence, buL Ius been reduced Lo sLuLIsLIcuIIsm by
medIco-muLerIuIIsm, I.e., superIIcIuIILy. On LIIs poInL, PIeLLen quoLes u
medIcuI prucLILIoner In u 1q6q pubIIcuLIon: |How good Is sLuLIsLIcuI
evIdence?| TIe uLmosL. n LIe Iunds oI experLs |IIke docLors| IL Is pure
scIence - LIe uddILIon oI IIke docLors In purenLIeses Ius been udded by
PIeLLen. He LIen udds PeopIe wIo rejecL sLuLIsLIcs by denyIng LIuL IL Is
scIence, ure mosLIy 'Irom Iomes In wIIcI neILIer purenL gruduuLed Irom
IIgI scIooI,` p.1o. QuoLIng Dr. Wurren Weuver, LIe 'dIsregurdIng oI
evIdence becuuse IL Is sLuLIsLIcuI Is unscIenLIIIc und wIoIIy unwurrunLed,
p.1q. PeopIe wIo rejecL sucI duLu ure LypIcuIIy 'Iess menLuIIy uIerL` LIun
non-rejecLors, p.q8. AccordIng Lo PIeLLen, scIence seems Lo Iuve Lo do
wILI menLuI uIerLness und cd hominem urgumenLs. He conLInues:
n oLIer words, peopIe wIo muke remurks sucI us
'correIuLIon Is noL cuusuLIon` (In LIe conLexL IereIn
dIscussed) generuIIy come Irom LIe runks oI LIe
uneducuLed. SudIy, LIey ure noL very 'menLuIIy uIerL.`
SucI peopIe Lend Lo be eusy prey Ior scum urLIsLs wIose
InLenL Is Lo Iurm or kIII. SucI duIIurds ure oILen IIkeIy Lo
beIIeve peopIe wIo ure mukIng money oII IurLIng
peopIe, over docLors wIo wunL Lo prevenL LIuL Iurm
Irom occurrIng. TIe Iormer denounce sLuLIsLIcs,
correIuLIons, 'pure scIence,` ubouL dIIIerences und LIrude
LIuL IucLors In common sIouId be used, noL dIIIerences.
SucI bunkum sounds good Lo LIe uneducuLed und
unuIerL. EducuLed peopIe generuIIy know beLLer.
L Is PIeLLen LIuL demonsLruLes IIs vIew Is uneducuLed, beIng
enLIreIy uL odds wILI sLuLIsLIcs LexLbooks. TIe probIem Is noL sLuLIsLIcs buL
sLuLIsLIcuIIsm wIIcI severeIy over-InLerpreLs Iow-IeveI correIuLIon, I.e.,
operuLIng on LIe boLLom-end oI LIe condILIonuI-probubIIILy scuIe. ScIence
Is concerned wILI sLuLIsLIcs (I.e., LIe Lop-end oI LIe condILIonuI-probubIIILy
scuIe) In IdenLIIyIng unique unLecedenLs Ior u consequenL. PIeLLen Is
enLIreIy ouL oI IIs InLeIIecLuuI depLI - u sympLom oI LIe LIme. YeL, LIIs
IncoIerenL Ideu oI scIence supporLs IIs deIuded beIIeIs. TIuL LIere Is u
correIuLIon beLween smokIng und crIme, uIcoIoIIsm, suIcIde und Iung
cuncer, umong oLIers, PIeLLen InLerpreLs us beIng cuused by smokIng.
He reIers Lo LIIs, cd ncusecm, us LIe qo% correIuLIon. n IucL, PIeLLen Is
reusonIng buck-Lo-IronL - u LypIcuI medIco-muLerIuIIsL error. NIneLy per
The Bigger Picture
cenL oI crImInuIs smoke, noL qo% oI smokers ure crImInuIs; LIe predIcLIve
sLrengLI oI smokIng Ior crIme Is very poor. TIuL LIere Is u correIuLIon cun
be expIuIned by oLIer IucLors. or exumpIe, persons uIreudy experIencIng
severeIy conIIIcLed LIougIL cun gruvILuLe or converge Lo LIe IubIL oI
smokIng Ior ILs mood-moduIuLIng eIIecLs. UnIorLunuLeIy, Lobucco Is Loo
mIId Lo moduIuLe IIgIIy dIsLurbed sLuLes. BeIng u muLerIuIIsL, und
LIereIore psycIoIogIcuIIy InepL, PIeLLen cunnoL IuLIom LIIs possIbIIILy. He
LIereIore IncompeLenLIy und sImpIe-mIndedIy ussIgns crImInuIILy,
umongsL oLIer LIIngs, Lo LIe eIIecLs oI Lobucco smoke. UndersLundubIy,
IuvIng conLruvened every uspecL oI coIerenL reusonIng, PIeLLen sImpIe-
mIndedIy beIIeves LIuL II smokIng Is uboIIsIed, qo% oI crIme wIII vunIsI.
PIeLLen`s uduIuLIon oI docLors LIereIore IuIIs Lo recognIze LIe
muLerIuIIsm (I.e., reducLIonIsm) oI LIe NuzI regIme or LIe cenLruIILy oI
medIco-muLerIuIIsm In LIIs regIme. UndersLundubIy, Ie IuIIs Lo recognIze
LIe currenL muLerIuIIsL domInuLIon, und In wIIcI medIco-muLerIuIIsm uIso
IIgures IIgIIy. ConLemporury medIco-muLerIuIIsm Ius puLIenLIzed mucI
oI LIe Iumun popuIuLIon und medIcuIIzed mucI oI LIe Iumun condILIon.
TIe conLemporury medIcuI esLubIIsImenL Is In dungerous moruI dIsurruy
(see CIupLer ). L Ius uIso been InsLrumenLuI In LIe erosIon oI u coIerenL,
coIIecLIve spIrILuuIJmoruI Irumework (I.e., CIrIsLIunILy) over LIe IusL
number oI decudes. MuLerIuIIsL IdeoIogy Ius been responsIbIe Ior LIe
dumbIng down oI LIe popuIuLIon. TIe sume muLerIuIIsL IdeoIogy LIuL Is
veIemenLIy unLIsmokIng In sLunce Is uIso unLI-CIrIsLIun. TIIs Is LIe sume
muLerIuIIsL IdeoIogy - psycIoIogIcuIIy, reIuLIonuIIy und moruIIy sIuIIow -
LIuL wIII usIer In LIe greuL dIsusLer. PIeLLen Is purLy Lo LIIs muLerIuIIsL
mudness.
I LIe conducL wus noL uIreudy suIIIcIenLIy degeneruLe, TCPG
rIeLorIc deLerIoruLes even IurLIer. PIeLLen provIdes reIIgIous grounds Ior
unLIsmokIng LIuL ure us IncompeLenL us LIe remuInder oI IIs urgumenLs.
L Is uncIeur, und doubLed, wIeLIer PIeLLen Is personuIIy reIIgIous:
ReIIgIon(s), IIke scIence, Is consIdered onIy InsoIur LIuL dIsjoInLed bILs cun
IegILImIze LIe ucuLe unLIsmokIng IIxuLIon. MosL oI IIs vIews cenLer
uround LIe OId TesLumenL (JuduIc). TIIs preIerence seems Lo be bused on
LIe cupucILy oI LIese scrIpLures Lo provIde u conduIL Ior sLrong deIusIon
und IosLIIILy LIuL PIeLLen obvIousIy Iurbors. PIeLLen consIders LIe soIuLIon
Lo LIe Lobucco probIem In LIese reIIgIous Lerms:
I LIe IIrsL ensIuver wIo owned u Lobucco Iurm Iud been
execuLed (us per Exodus z1:16) Ior LIe IIrsL
ensIuvemenL, IeL`s suy In LIe yeur 16zo, LIe probIem
wouId Iong ugo Iuve gone uwuy. Becuuse senLence
uguInsL un evII work Is noL speedIIy pronounced,
evIIdoers commIL evII wILIouL uny Ieur
529
529
Rampant Antismoking Signifies Grave Danger
by-omIssIon us AcIun`s neIgIbors` IuIIIng Lo conLroI
IIm. TIe resuIL wus, deuLIs.
PIeLLen IuIIs Lo compreIend LIuL IIIesLyIe epIdemIoIogy, Ior
exumpIe, Is noL u scIence, buL Ius been reduced Lo sLuLIsLIcuIIsm by
medIco-muLerIuIIsm, I.e., superIIcIuIILy. On LIIs poInL, PIeLLen quoLes u
medIcuI prucLILIoner In u 1q6q pubIIcuLIon: |How good Is sLuLIsLIcuI
evIdence?| TIe uLmosL. n LIe Iunds oI experLs |IIke docLors| IL Is pure
scIence - LIe uddILIon oI IIke docLors In purenLIeses Ius been udded by
PIeLLen. He LIen udds PeopIe wIo rejecL sLuLIsLIcs by denyIng LIuL IL Is
scIence, ure mosLIy 'Irom Iomes In wIIcI neILIer purenL gruduuLed Irom
IIgI scIooI,` p.1o. QuoLIng Dr. Wurren Weuver, LIe 'dIsregurdIng oI
evIdence becuuse IL Is sLuLIsLIcuI Is unscIenLIIIc und wIoIIy unwurrunLed,
p.1q. PeopIe wIo rejecL sucI duLu ure LypIcuIIy 'Iess menLuIIy uIerL` LIun
non-rejecLors, p.q8. AccordIng Lo PIeLLen, scIence seems Lo Iuve Lo do
wILI menLuI uIerLness und cd hominem urgumenLs. He conLInues:
n oLIer words, peopIe wIo muke remurks sucI us
'correIuLIon Is noL cuusuLIon` (In LIe conLexL IereIn
dIscussed) generuIIy come Irom LIe runks oI LIe
uneducuLed. SudIy, LIey ure noL very 'menLuIIy uIerL.`
SucI peopIe Lend Lo be eusy prey Ior scum urLIsLs wIose
InLenL Is Lo Iurm or kIII. SucI duIIurds ure oILen IIkeIy Lo
beIIeve peopIe wIo ure mukIng money oII IurLIng
peopIe, over docLors wIo wunL Lo prevenL LIuL Iurm
Irom occurrIng. TIe Iormer denounce sLuLIsLIcs,
correIuLIons, 'pure scIence,` ubouL dIIIerences und LIrude
LIuL IucLors In common sIouId be used, noL dIIIerences.
SucI bunkum sounds good Lo LIe uneducuLed und
unuIerL. EducuLed peopIe generuIIy know beLLer.
L Is PIeLLen LIuL demonsLruLes IIs vIew Is uneducuLed, beIng
enLIreIy uL odds wILI sLuLIsLIcs LexLbooks. TIe probIem Is noL sLuLIsLIcs buL
sLuLIsLIcuIIsm wIIcI severeIy over-InLerpreLs Iow-IeveI correIuLIon, I.e.,
operuLIng on LIe boLLom-end oI LIe condILIonuI-probubIIILy scuIe. ScIence
Is concerned wILI sLuLIsLIcs (I.e., LIe Lop-end oI LIe condILIonuI-probubIIILy
scuIe) In IdenLIIyIng unique unLecedenLs Ior u consequenL. PIeLLen Is
enLIreIy ouL oI IIs InLeIIecLuuI depLI - u sympLom oI LIe LIme. YeL, LIIs
IncoIerenL Ideu oI scIence supporLs IIs deIuded beIIeIs. TIuL LIere Is u
correIuLIon beLween smokIng und crIme, uIcoIoIIsm, suIcIde und Iung
cuncer, umong oLIers, PIeLLen InLerpreLs us beIng cuused by smokIng.
He reIers Lo LIIs, cd ncusecm, us LIe qo% correIuLIon. n IucL, PIeLLen Is
reusonIng buck-Lo-IronL - u LypIcuI medIco-muLerIuIIsL error. NIneLy per
The Bigger Picture
cenL oI crImInuIs smoke, noL qo% oI smokers ure crImInuIs; LIe predIcLIve
sLrengLI oI smokIng Ior crIme Is very poor. TIuL LIere Is u correIuLIon cun
be expIuIned by oLIer IucLors. or exumpIe, persons uIreudy experIencIng
severeIy conIIIcLed LIougIL cun gruvILuLe or converge Lo LIe IubIL oI
smokIng Ior ILs mood-moduIuLIng eIIecLs. UnIorLunuLeIy, Lobucco Is Loo
mIId Lo moduIuLe IIgIIy dIsLurbed sLuLes. BeIng u muLerIuIIsL, und
LIereIore psycIoIogIcuIIy InepL, PIeLLen cunnoL IuLIom LIIs possIbIIILy. He
LIereIore IncompeLenLIy und sImpIe-mIndedIy ussIgns crImInuIILy,
umongsL oLIer LIIngs, Lo LIe eIIecLs oI Lobucco smoke. UndersLundubIy,
IuvIng conLruvened every uspecL oI coIerenL reusonIng, PIeLLen sImpIe-
mIndedIy beIIeves LIuL II smokIng Is uboIIsIed, qo% oI crIme wIII vunIsI.
PIeLLen`s uduIuLIon oI docLors LIereIore IuIIs Lo recognIze LIe
muLerIuIIsm (I.e., reducLIonIsm) oI LIe NuzI regIme or LIe cenLruIILy oI
medIco-muLerIuIIsm In LIIs regIme. UndersLundubIy, Ie IuIIs Lo recognIze
LIe currenL muLerIuIIsL domInuLIon, und In wIIcI medIco-muLerIuIIsm uIso
IIgures IIgIIy. ConLemporury medIco-muLerIuIIsm Ius puLIenLIzed mucI
oI LIe Iumun popuIuLIon und medIcuIIzed mucI oI LIe Iumun condILIon.
TIe conLemporury medIcuI esLubIIsImenL Is In dungerous moruI dIsurruy
(see CIupLer ). L Ius uIso been InsLrumenLuI In LIe erosIon oI u coIerenL,
coIIecLIve spIrILuuIJmoruI Irumework (I.e., CIrIsLIunILy) over LIe IusL
number oI decudes. MuLerIuIIsL IdeoIogy Ius been responsIbIe Ior LIe
dumbIng down oI LIe popuIuLIon. TIe sume muLerIuIIsL IdeoIogy LIuL Is
veIemenLIy unLIsmokIng In sLunce Is uIso unLI-CIrIsLIun. TIIs Is LIe sume
muLerIuIIsL IdeoIogy - psycIoIogIcuIIy, reIuLIonuIIy und moruIIy sIuIIow -
LIuL wIII usIer In LIe greuL dIsusLer. PIeLLen Is purLy Lo LIIs muLerIuIIsL
mudness.
I LIe conducL wus noL uIreudy suIIIcIenLIy degeneruLe, TCPG
rIeLorIc deLerIoruLes even IurLIer. PIeLLen provIdes reIIgIous grounds Ior
unLIsmokIng LIuL ure us IncompeLenL us LIe remuInder oI IIs urgumenLs.
L Is uncIeur, und doubLed, wIeLIer PIeLLen Is personuIIy reIIgIous:
ReIIgIon(s), IIke scIence, Is consIdered onIy InsoIur LIuL dIsjoInLed bILs cun
IegILImIze LIe ucuLe unLIsmokIng IIxuLIon. MosL oI IIs vIews cenLer
uround LIe OId TesLumenL (JuduIc). TIIs preIerence seems Lo be bused on
LIe cupucILy oI LIese scrIpLures Lo provIde u conduIL Ior sLrong deIusIon
und IosLIIILy LIuL PIeLLen obvIousIy Iurbors. PIeLLen consIders LIe soIuLIon
Lo LIe Lobucco probIem In LIese reIIgIous Lerms:
I LIe IIrsL ensIuver wIo owned u Lobucco Iurm Iud been
execuLed (us per Exodus z1:16) Ior LIe IIrsL
ensIuvemenL, IeL`s suy In LIe yeur 16zo, LIe probIem
wouId Iong ugo Iuve gone uwuy. Becuuse senLence
uguInsL un evII work Is noL speedIIy pronounced,
evIIdoers commIL evII wILIouL uny Ieur
530
530
Rampant Antismoking Signifies Grave Danger
|deLerrence|. (EccIesIusLes 8:11).
A IurLIer opporLunILy Lo Iuve soIved LIIs sILuuLIon wus
cIeurIy IosL uL LIe LIme oI LIe U.S. CIvII Wur. TIe duLy Lo
execuLe perpeLruLors (DeuLeronomy 1q:1z-1), even
wIen LIey consLILuLe Iurge numbers wIo Iuve en musse
decIded Lo vIoIuLe LIe commundmenLs, e.g., uguInsL
munsLeuIIng, In essence, becomIng IdoIuLers, pIucIng
LIemseIves und LIeIr LrudILIons ubove LIe
commundmenLs (DeuLeronomy 1:1z-16) wus noL
currIed ouL.
I on LIe sysLem IeveI, Lobucco munuIucLurers und
seIIers uIdIng und ubeLLIng smokers were ImmedIuLeIy
execuLed, us LIey sIouId be, wIen LIey kIII u
nonsmoker, e.g., wILI Iung cuncer, or u buby vIu SDS,
or Lobucco-Induced uborLIon, LIuL wouId IeIp sLop uII
LIe kIIIIngs, ussumIng u deLerrenL eIIecL (EccIesIusLes
8:11).
n DeuLeronomy z1:18-z1 Is u commund on deuIIng wILI
u rebeIIIous cIIId - sLonIng. Around 18q;, LIere wus u
rebeIIIous cIIId, AdoII |HILIer|, wIo wus so bud LIuL uL
uge eIgIL, Ie wus expeIIed Irom scIooI. BuL Ie wus noL
sLoned. Suppose LIe DeuL. z1:18-z1 prevenLIon-orIenLed
commund Iud been obeyed. Suppose bud IILLIe AdoII
Iud been sLoned us per LIe BIbIe udvIsory. AbouL
o,ooo,ooo peopIe wouId Iuve been suved, I.e.,
prevenLIon oI WorId Wur . AII LIuL eru`s deuLIs, 1qq-
1qq, were cuused by socIeLuI reIusuI Lo Iuve done busIc
prevenLIon In 18q;.
PIeLLen Is scuLIIng oI CIrIsLIuns wIo do noL sIure IIs conLorLed
vIews. AILIougI Ie reIers Lo muny OId CovenunL InsLrucLIons on sLonIng,
kIIIIng und reLrIbuLIon, Jesus, us CIrIsL or MessIuI, und LIe New CovenunL
(suIvuLIon) ure never reIerred Lo. PIeLLen`s Iew reIerences Lo New CovenunL
LeucIIng ure 1 CorInLIIuns :16-1;, 6:1q. And, us muny curnuI (muLerIuIIsL)
CIrIsLIuns do, PIeLLen InLerpreLs LIese LeucIIngs ouL oI LIeIr conLexL.
TIe New CovenunL InvoIves u new spIrILuuI bIrLI, seL upurL Irom LIe OId
CovenunL. TIe empIusIs In LIe CIrIsLIun LeucIIng Is on proIound
reIuLIonsIIp (see IoIIowIng secLIon). TIe 1 CorInLIIuns LeucIIng reIers Lo
CIrIsLIuns IndIvIduuIIy und coIIecLIveIy beIng LIe LempIe oI LIe SpIrIL.
DeIIIemenL oI LIe LempIe, wIIcI IL ubIors, concerns essenLIuIIy corrupLIon
by IuIse docLrIne und noL wIuL one IngesLs. L uIso IndIcuLes LIuL worIdIy
wIsdom (e.g., medIco-muLerIuIIsL sLuLIsLIcuIIsm) Is IooIIsIness. or
The Bigger Picture
exumpIe,
Do you noL dIscern und undersLund LIuL you |LIe wIoIe
cIurcI uL CorInLI| ure God`s LempIe (HIs suncLuury),
und LIuL God`s SpIrIL Ius HIs permunenL dweIIIng In
you - Lo be uL Iome In you |coIIecLIveIy us u cIurcI und
uIso IndIvIduuIIy|? I uny one does IurL Lo God`s LempIe
or corrupLs |IL wILI IuIse docLrInes| or desLroys IL, God
wIII do IurL Lo IIm und brIng IIm Lo LIe corrupLIon oI
deuLI und desLroy IIm. or LIe LempIe oI God Is IoIy -
sucred Lo HIm - und LIuL |LempIe| you |LIe beIIevIng
cIurcI und ILs IndIvIduuI beIIevers| ure. eL no person
deceIve IImseII. I uny one umong you supposes LIuL Ie
Is wIse In LIIs uge - IeL IIm dIscurd IIs |worIdIy|
dIscernmenL und recognIze IImseII us duII, sLupId und
IooIIsI, wILIouL |Lrue| IeurnIng und scIoIursIIp; IeL IIm
become u IooI LIuL Ie muy become |reuIIy| wIse. or
LIIs worId`s wIsdom Is IooIIsIness - ubsurdILy und
sLupIdILy - wILI God. (1 CorInLIIuns, :16-1q -
AmpIIIIed BIbIe)
urLIermore, LIe 1 CorInLIIuns 6:1q reIerence Lo LIe body us LIe
LempIe proscrIbes sexuuI ImmoruIILy, und noL Iood, eLc.. TIIs Is enLIreIy
In keepIng wILI LIe generuI CIrIsLIun LeucIIng oI beurIng LIe IruILs oI LIe
SpIrIL - reIuLIonuI uLLrIbuLes - LIrougI LIe body. L does noL Iuve Lo do
wILI dIeL - or smoke, Ior LIuL muLLer. L does noL Iuve Lo do wILI unyLIIng
LIuL does noL InLerIere wILI LIIs process oI beurIng good IruIL. WIIIe
PIeLLen keeps reIerrIng Lo LIe proper uppIIcuLIon oI sLonIng (OId
CovenunL), Jesus demonsLruLes unoLIer wuy uILogeLIer (New CovenunL)
LIuL seLs Mun In rIgIL reIuLIonsIIp wILI God - we ure Ireed Irom LIe curse
oI LIe oId Iuw. Jesus, In IucL, Irees u womun wIo Is ubouL Lo be sLoned, us
prescrIbed by LIe OId CovenunL, Ior uduILery (JoIn, 8).
PIeLLen reIers Lo Mormons us properIy undersLundIng 1
CorInLIIuns, :16-1; und 6:1q: or LIose reIIgIons wIo LeucI noL Lo
desLroy LIe LempIe oI one`s body..und wIose members do noL smoke
(I.e., LIey IonorJrespecL LIeIr eIders wIo Iuve sLudIed perLInenL-Lo-IIIe
subjecLs, und LIus ure Iess IIkeIy Lo be deceIved by persons oIIerIng poIson
Ior suIe), LIIs Is IILeruIIy Lrue. ExumpIe: TIe nuLIon`s IowesL smokIng ruLe
In 1qq8 wus In Mormon ULuI). L Is noL cIeur wIuL Is meunL by LIIs
sLuLemenL oLIer LIun devoLees generuIIy udIere Lo LIeIr reIIgIous LeucIIng.
He does noL IndIcuLe, und wIIcI Is LIe busIs oI IIs urgumenL, wIeLIer
LIIs Iower smokIng-ruLe Is proporLIonuIIy reIuLed wILI Iower crIme,
uIcoIoIIsm, suIcIde, eLc..
531
531
Rampant Antismoking Signifies Grave Danger
|deLerrence|. (EccIesIusLes 8:11).
A IurLIer opporLunILy Lo Iuve soIved LIIs sILuuLIon wus
cIeurIy IosL uL LIe LIme oI LIe U.S. CIvII Wur. TIe duLy Lo
execuLe perpeLruLors (DeuLeronomy 1q:1z-1), even
wIen LIey consLILuLe Iurge numbers wIo Iuve en musse
decIded Lo vIoIuLe LIe commundmenLs, e.g., uguInsL
munsLeuIIng, In essence, becomIng IdoIuLers, pIucIng
LIemseIves und LIeIr LrudILIons ubove LIe
commundmenLs (DeuLeronomy 1:1z-16) wus noL
currIed ouL.
I on LIe sysLem IeveI, Lobucco munuIucLurers und
seIIers uIdIng und ubeLLIng smokers were ImmedIuLeIy
execuLed, us LIey sIouId be, wIen LIey kIII u
nonsmoker, e.g., wILI Iung cuncer, or u buby vIu SDS,
or Lobucco-Induced uborLIon, LIuL wouId IeIp sLop uII
LIe kIIIIngs, ussumIng u deLerrenL eIIecL (EccIesIusLes
8:11).
n DeuLeronomy z1:18-z1 Is u commund on deuIIng wILI
u rebeIIIous cIIId - sLonIng. Around 18q;, LIere wus u
rebeIIIous cIIId, AdoII |HILIer|, wIo wus so bud LIuL uL
uge eIgIL, Ie wus expeIIed Irom scIooI. BuL Ie wus noL
sLoned. Suppose LIe DeuL. z1:18-z1 prevenLIon-orIenLed
commund Iud been obeyed. Suppose bud IILLIe AdoII
Iud been sLoned us per LIe BIbIe udvIsory. AbouL
o,ooo,ooo peopIe wouId Iuve been suved, I.e.,
prevenLIon oI WorId Wur . AII LIuL eru`s deuLIs, 1qq-
1qq, were cuused by socIeLuI reIusuI Lo Iuve done busIc
prevenLIon In 18q;.
PIeLLen Is scuLIIng oI CIrIsLIuns wIo do noL sIure IIs conLorLed
vIews. AILIougI Ie reIers Lo muny OId CovenunL InsLrucLIons on sLonIng,
kIIIIng und reLrIbuLIon, Jesus, us CIrIsL or MessIuI, und LIe New CovenunL
(suIvuLIon) ure never reIerred Lo. PIeLLen`s Iew reIerences Lo New CovenunL
LeucIIng ure 1 CorInLIIuns :16-1;, 6:1q. And, us muny curnuI (muLerIuIIsL)
CIrIsLIuns do, PIeLLen InLerpreLs LIese LeucIIngs ouL oI LIeIr conLexL.
TIe New CovenunL InvoIves u new spIrILuuI bIrLI, seL upurL Irom LIe OId
CovenunL. TIe empIusIs In LIe CIrIsLIun LeucIIng Is on proIound
reIuLIonsIIp (see IoIIowIng secLIon). TIe 1 CorInLIIuns LeucIIng reIers Lo
CIrIsLIuns IndIvIduuIIy und coIIecLIveIy beIng LIe LempIe oI LIe SpIrIL.
DeIIIemenL oI LIe LempIe, wIIcI IL ubIors, concerns essenLIuIIy corrupLIon
by IuIse docLrIne und noL wIuL one IngesLs. L uIso IndIcuLes LIuL worIdIy
wIsdom (e.g., medIco-muLerIuIIsL sLuLIsLIcuIIsm) Is IooIIsIness. or
The Bigger Picture
exumpIe,
Do you noL dIscern und undersLund LIuL you |LIe wIoIe
cIurcI uL CorInLI| ure God`s LempIe (HIs suncLuury),
und LIuL God`s SpIrIL Ius HIs permunenL dweIIIng In
you - Lo be uL Iome In you |coIIecLIveIy us u cIurcI und
uIso IndIvIduuIIy|? I uny one does IurL Lo God`s LempIe
or corrupLs |IL wILI IuIse docLrInes| or desLroys IL, God
wIII do IurL Lo IIm und brIng IIm Lo LIe corrupLIon oI
deuLI und desLroy IIm. or LIe LempIe oI God Is IoIy -
sucred Lo HIm - und LIuL |LempIe| you |LIe beIIevIng
cIurcI und ILs IndIvIduuI beIIevers| ure. eL no person
deceIve IImseII. I uny one umong you supposes LIuL Ie
Is wIse In LIIs uge - IeL IIm dIscurd IIs |worIdIy|
dIscernmenL und recognIze IImseII us duII, sLupId und
IooIIsI, wILIouL |Lrue| IeurnIng und scIoIursIIp; IeL IIm
become u IooI LIuL Ie muy become |reuIIy| wIse. or
LIIs worId`s wIsdom Is IooIIsIness - ubsurdILy und
sLupIdILy - wILI God. (1 CorInLIIuns, :16-1q -
AmpIIIIed BIbIe)
urLIermore, LIe 1 CorInLIIuns 6:1q reIerence Lo LIe body us LIe
LempIe proscrIbes sexuuI ImmoruIILy, und noL Iood, eLc.. TIIs Is enLIreIy
In keepIng wILI LIe generuI CIrIsLIun LeucIIng oI beurIng LIe IruILs oI LIe
SpIrIL - reIuLIonuI uLLrIbuLes - LIrougI LIe body. L does noL Iuve Lo do
wILI dIeL - or smoke, Ior LIuL muLLer. L does noL Iuve Lo do wILI unyLIIng
LIuL does noL InLerIere wILI LIIs process oI beurIng good IruIL. WIIIe
PIeLLen keeps reIerrIng Lo LIe proper uppIIcuLIon oI sLonIng (OId
CovenunL), Jesus demonsLruLes unoLIer wuy uILogeLIer (New CovenunL)
LIuL seLs Mun In rIgIL reIuLIonsIIp wILI God - we ure Ireed Irom LIe curse
oI LIe oId Iuw. Jesus, In IucL, Irees u womun wIo Is ubouL Lo be sLoned, us
prescrIbed by LIe OId CovenunL, Ior uduILery (JoIn, 8).
PIeLLen reIers Lo Mormons us properIy undersLundIng 1
CorInLIIuns, :16-1; und 6:1q: or LIose reIIgIons wIo LeucI noL Lo
desLroy LIe LempIe oI one`s body..und wIose members do noL smoke
(I.e., LIey IonorJrespecL LIeIr eIders wIo Iuve sLudIed perLInenL-Lo-IIIe
subjecLs, und LIus ure Iess IIkeIy Lo be deceIved by persons oIIerIng poIson
Ior suIe), LIIs Is IILeruIIy Lrue. ExumpIe: TIe nuLIon`s IowesL smokIng ruLe
In 1qq8 wus In Mormon ULuI). L Is noL cIeur wIuL Is meunL by LIIs
sLuLemenL oLIer LIun devoLees generuIIy udIere Lo LIeIr reIIgIous LeucIIng.
He does noL IndIcuLe, und wIIcI Is LIe busIs oI IIs urgumenL, wIeLIer
LIIs Iower smokIng-ruLe Is proporLIonuIIy reIuLed wILI Iower crIme,
uIcoIoIIsm, suIcIde, eLc..
532
532
Rampant Antismoking Signifies Grave Danger
CIeur, Iowever, Is LIuL PIeLLen moves Irom reIIgIon Lo reIIgIon
wILI uLLer dIsregurd Ior LIeIr crILIcuI dIIIerences. JuduIsm Is noL
CIrIsLIunILy, nor Is MormonIsm wIIcI Ius numerous prescrIpLIve
uddILIons LIuL ure conLrury Lo New TesLumenL LeucIIng. TIere couId be
udded SevenLI-Duy AdvenLIsm wIIcI proscrIbes Lobucco smokIng, or
JeIovu`s WILnesses Ior wIom u Lobucco-smoker cun be excommunIcuLed.
However, LIese ure noL CIrIsLIun LeucIIngs. TIese secLsJcuILs ure LIe
resuIL oI persons sLIII rejecLIng suIvuLIon, wIIcI Is uccepLed by IuILI, und
reIyIng on, or reverLIng Lo, curnuI LIInkIng (e.g., dIeL, Lobucco ubsLInence)
Lo suve LIemseIves.
A crILIcuI Ideu oI LIe New TesLumenL concerns LIe power oI LIe
Longue: ouL oI LIe ubundunce oI LIe IeurL does u mun speuk. CIrIsLIuns
ure ImpIored Lo keep guurd over LIe Longue (e.g., Jumes, :6-1o): un
errunL Longue Is consIdered us deuLI-brIngIng poIson. PIeLLen wouId do
weII Lo consIder sucI Ideus. CIrIsLIunILy cerLuInIy does noL LeucI LIe
preucIIng oI IuIse docLrInes, beurIng IuIse wILness, or IncILIng IrruLIonuI
beIIeIJIeur (e.g., ESS) und IuLred und uIrs oI Iuke superIorILy (e.g., SS).
TIe TCPG websILe seeLIes wILI IuIseIoods, Ieur, IuLred und IosLIIILy. TIe
Ideu oI LoxIcILy Is besL ussIgned Lo LIe conLenL oI LIe TCPG websILe: Ls
poIsonous words Iuve uIreudy cIuImed muny. TIuL PIeLLen`s IncoIerenL
reusonIng couId even remoLeIy be conIused Ior CIrIsLIunILy, or us guIdIng
CIrIsLIunILy, sIouId be mosL dIsLurbIng.
n TCPG Is Iound uII munner oI errors. TIere Is poor commund
oI bIoIogIcuI concepLs und IImILuLIons. TIere Is no compeLence uL uII
regurdIng scIenLIIIc enquIry und LIe very severe IImILuLIons oI sLuLIsLIcuI
InIerence. EpIdemIoIogy Ius noL come Lo Lerms wILI LIese, IuvIng
mungIed LIem beyond recognILIon - TCPG onIy udds IurLIer dImensIons
oI erruLIc, IuLeIuI reusonIng. TCPG demonsLruLes no grusp oI u coIerenL
psycIoIogy, socIuI psycIoIogy or moruI Irumework. L does noL Iuve u cIue
us Lo wIuL CIrIsLIunILy ucLuuIIy represenLs. AnyLIIng Is IIjucked In
supporL oI un ucuLe unLIsmokIng IIxuLIon. And, mosL ucuLe Is LIe IIxuLIon
In LIuL Lobucco-smokIng supposedIy expIuIns uII evIIs und IIIs; ILs
erudIcuLIon wIII brIng LIe worId Lo purudIse.
TIe TCPG conducL Is sympLomuLIc oI LIe LIme. Poor scIoIursIIp
und LIe IrugmenLuLIon und superIIcIuIILy oI muLerIuIIsm Is currenLIy LIe
sLuLe oI muny socIeLIes. L Is wILIIn LIIs degeneruLe Irumework LIuL muny
In ucuLe IIxuLIons (monomunIu), wIo Iuve IILLIe grusp oI unyLIIng, cun
now perpeLruLe Ieur, guIIL und IuLe-mongerIng under LIe sLuLus oI
benevoIenL experLs. PIeLLen descrIbes IImseII us u MedIcIne und uw
HIsLory SubsLunce Abuse ssues CounseIor und ecLurer (uL
www.counLerpuncI.orgJpIpermuIIJcounLerpuncI-IIsLJzoo1-
juIyJo1o6z.ILmI). L Is uncIeur wIuL LIIs LILIe meuns. TIe wrILIng
The Bigger Picture
IndIcuLes u poor grusp oI scIence, oI medIcIne, oI sLuLIsLIcs, oI psycIoIogy,
oI socIoIogy, oI moruIILy, oI reIIgIon. AII oI LIese domuIns ure IIjucked Lo
provIde un ouLIeL Ior derunged beIIeIs und IIgIIy conLorLed emoLIons.
deus expressed on LIe websILe sucI us bruIn dumuged, ubuIIu, Ioss oI
conLucL wILI reuIILy, und IysLerIu borderIng on scIIzopIrenIu muy beLLer
uppIy Lo LIe websILe uuLIor`s menLuI sLuLe: n keepIng wILI NuzI
unLIsmokIng senLImenLs, wIuLever Is beIng cIuImed ubouL smokIng by LIe
uccusuLorIuI menLuIILy besL descrIbes ILs own conducL. TIe urgumenLuLIon
Iucks LIe mosL busIc eIemenL oI IonesLy. TIe underIyIng menLuIILy Ius no
InsIgIL us Lo LIe sIeer mugnILude oI ILs muILIdImensIonuI Ignorunce und
IncompeLence, und wIIcI Is uIso LIe sLundurd uppruIsuI oI muLerIuIIsL
reusonIng (MMES cuIL). TrugIcuIIy, ruLIer LIun sucI Ideus beIng
dIsregurded wILI u sLrong recommenduLIon Ior psycIoIogIcuI counseIIng
und genuIne scIoIurIy LruInIng, LIese conLorLed Ideus ure beIng ubsorbed
by socIeLIes uL Iurge - purLIcuIurIy poIIcy mukers. And, IL serves LIe
deIuded muLerIuIIsL sLuLe LIuL muny - socIeLIes und IndIvIduuIs - ure
currenLIy In.
MosL remurkubIe Is LIuL nowIere In uny oI PIeLLen`s voIumInous
urgumenL ure rIsk IucLors, wIIcI ure muny und muILIdImensIonuI, oLIer
LIun smokIng eter menLIoned. TIe menLuIILy presenLs u Lrunce-IIke sLuLe
LIuL IunneIs (munIpuIuLes) remoLeIy reIevunL, dIsjoInLed InIormuLIon
LIrougI LIe ucuLe IIxuLIon und menLuIIy bIocks uII conLrury InIormuLIon.
TIe resuIL oI sucI un ucuLe IIxuLIon Is LIuL LIere Is no uspecL oI LIe
urgumenL LIuL IL IundIes correcLIy.
TIe InIIuence oI sucI groups us TCPG und ASH cunnoL be
underesLImuLed. WILI governmenLuI und medIcuI-esLubIIsImenL
coIIusIon, LIese groups Iuve mude greuL Inrouds InLo pubIIc poIIcy
IormuIuLIon und LIe IosLerIng oI numerous oLIer IIke-mInded groups. TIe
TCPG websILe uuLIor (ussumed Lo be PIeLLen) credILs IImseII wILI beIng
LIe IIrsL Lo IIgIIIgIL LIe cosL oI smokIng Lo socIeLy: TIe web wrILer Is
LIe person wIo IeIped cIunge muny peopIe`s beIIeIs on cIgureLLe cosLs Lo
socIeLy. Buck In 1q8o, LIere were peopIe wIo beIIeved cIgureLLes were u
cosL beneIIL und IoudIy suId so. A reIIgIous muguzIne edILor usked wIeLIer
unyone couId wrILe u rebuLLuI. TIIs wrILer submILLed u puper sIowIng
$1o bIIIIon cosL Lo socIeLy LIuL yeur uIone. (TIuL reIIgIous muguzIne wus
more wIdeIy dIsLrIbuLed LIun muny medIcuI journuIs, even Lo non-
members, und uL drug-counseIIng oIIIces, LIe wrILer`s source). Ls
cIrcuIuLIng LIe $1o bIIIIon duLu ouLsIde sLundurd medIcuI cIrcIes IeIped
seL LIe sLuge Ior LIe ALLorney GeneruI IILIguLIon Lo recover Luxpuyers`
money spenL on smokers` IeuILI cure, us oLIers begun sLudyIng und
IIndIng Iuge cIgureLLe cosLs!
TIe deIIcIenL Ideu oI uLLrIbuLubIe cosL Ius been consIdered In
533
533
Rampant Antismoking Signifies Grave Danger
CIeur, Iowever, Is LIuL PIeLLen moves Irom reIIgIon Lo reIIgIon
wILI uLLer dIsregurd Ior LIeIr crILIcuI dIIIerences. JuduIsm Is noL
CIrIsLIunILy, nor Is MormonIsm wIIcI Ius numerous prescrIpLIve
uddILIons LIuL ure conLrury Lo New TesLumenL LeucIIng. TIere couId be
udded SevenLI-Duy AdvenLIsm wIIcI proscrIbes Lobucco smokIng, or
JeIovu`s WILnesses Ior wIom u Lobucco-smoker cun be excommunIcuLed.
However, LIese ure noL CIrIsLIun LeucIIngs. TIese secLsJcuILs ure LIe
resuIL oI persons sLIII rejecLIng suIvuLIon, wIIcI Is uccepLed by IuILI, und
reIyIng on, or reverLIng Lo, curnuI LIInkIng (e.g., dIeL, Lobucco ubsLInence)
Lo suve LIemseIves.
A crILIcuI Ideu oI LIe New TesLumenL concerns LIe power oI LIe
Longue: ouL oI LIe ubundunce oI LIe IeurL does u mun speuk. CIrIsLIuns
ure ImpIored Lo keep guurd over LIe Longue (e.g., Jumes, :6-1o): un
errunL Longue Is consIdered us deuLI-brIngIng poIson. PIeLLen wouId do
weII Lo consIder sucI Ideus. CIrIsLIunILy cerLuInIy does noL LeucI LIe
preucIIng oI IuIse docLrInes, beurIng IuIse wILness, or IncILIng IrruLIonuI
beIIeIJIeur (e.g., ESS) und IuLred und uIrs oI Iuke superIorILy (e.g., SS).
TIe TCPG websILe seeLIes wILI IuIseIoods, Ieur, IuLred und IosLIIILy. TIe
Ideu oI LoxIcILy Is besL ussIgned Lo LIe conLenL oI LIe TCPG websILe: Ls
poIsonous words Iuve uIreudy cIuImed muny. TIuL PIeLLen`s IncoIerenL
reusonIng couId even remoLeIy be conIused Ior CIrIsLIunILy, or us guIdIng
CIrIsLIunILy, sIouId be mosL dIsLurbIng.
n TCPG Is Iound uII munner oI errors. TIere Is poor commund
oI bIoIogIcuI concepLs und IImILuLIons. TIere Is no compeLence uL uII
regurdIng scIenLIIIc enquIry und LIe very severe IImILuLIons oI sLuLIsLIcuI
InIerence. EpIdemIoIogy Ius noL come Lo Lerms wILI LIese, IuvIng
mungIed LIem beyond recognILIon - TCPG onIy udds IurLIer dImensIons
oI erruLIc, IuLeIuI reusonIng. TCPG demonsLruLes no grusp oI u coIerenL
psycIoIogy, socIuI psycIoIogy or moruI Irumework. L does noL Iuve u cIue
us Lo wIuL CIrIsLIunILy ucLuuIIy represenLs. AnyLIIng Is IIjucked In
supporL oI un ucuLe unLIsmokIng IIxuLIon. And, mosL ucuLe Is LIe IIxuLIon
In LIuL Lobucco-smokIng supposedIy expIuIns uII evIIs und IIIs; ILs
erudIcuLIon wIII brIng LIe worId Lo purudIse.
TIe TCPG conducL Is sympLomuLIc oI LIe LIme. Poor scIoIursIIp
und LIe IrugmenLuLIon und superIIcIuIILy oI muLerIuIIsm Is currenLIy LIe
sLuLe oI muny socIeLIes. L Is wILIIn LIIs degeneruLe Irumework LIuL muny
In ucuLe IIxuLIons (monomunIu), wIo Iuve IILLIe grusp oI unyLIIng, cun
now perpeLruLe Ieur, guIIL und IuLe-mongerIng under LIe sLuLus oI
benevoIenL experLs. PIeLLen descrIbes IImseII us u MedIcIne und uw
HIsLory SubsLunce Abuse ssues CounseIor und ecLurer (uL
www.counLerpuncI.orgJpIpermuIIJcounLerpuncI-IIsLJzoo1-
juIyJo1o6z.ILmI). L Is uncIeur wIuL LIIs LILIe meuns. TIe wrILIng
The Bigger Picture
IndIcuLes u poor grusp oI scIence, oI medIcIne, oI sLuLIsLIcs, oI psycIoIogy,
oI socIoIogy, oI moruIILy, oI reIIgIon. AII oI LIese domuIns ure IIjucked Lo
provIde un ouLIeL Ior derunged beIIeIs und IIgIIy conLorLed emoLIons.
deus expressed on LIe websILe sucI us bruIn dumuged, ubuIIu, Ioss oI
conLucL wILI reuIILy, und IysLerIu borderIng on scIIzopIrenIu muy beLLer
uppIy Lo LIe websILe uuLIor`s menLuI sLuLe: n keepIng wILI NuzI
unLIsmokIng senLImenLs, wIuLever Is beIng cIuImed ubouL smokIng by LIe
uccusuLorIuI menLuIILy besL descrIbes ILs own conducL. TIe urgumenLuLIon
Iucks LIe mosL busIc eIemenL oI IonesLy. TIe underIyIng menLuIILy Ius no
InsIgIL us Lo LIe sIeer mugnILude oI ILs muILIdImensIonuI Ignorunce und
IncompeLence, und wIIcI Is uIso LIe sLundurd uppruIsuI oI muLerIuIIsL
reusonIng (MMES cuIL). TrugIcuIIy, ruLIer LIun sucI Ideus beIng
dIsregurded wILI u sLrong recommenduLIon Ior psycIoIogIcuI counseIIng
und genuIne scIoIurIy LruInIng, LIese conLorLed Ideus ure beIng ubsorbed
by socIeLIes uL Iurge - purLIcuIurIy poIIcy mukers. And, IL serves LIe
deIuded muLerIuIIsL sLuLe LIuL muny - socIeLIes und IndIvIduuIs - ure
currenLIy In.
MosL remurkubIe Is LIuL nowIere In uny oI PIeLLen`s voIumInous
urgumenL ure rIsk IucLors, wIIcI ure muny und muILIdImensIonuI, oLIer
LIun smokIng eter menLIoned. TIe menLuIILy presenLs u Lrunce-IIke sLuLe
LIuL IunneIs (munIpuIuLes) remoLeIy reIevunL, dIsjoInLed InIormuLIon
LIrougI LIe ucuLe IIxuLIon und menLuIIy bIocks uII conLrury InIormuLIon.
TIe resuIL oI sucI un ucuLe IIxuLIon Is LIuL LIere Is no uspecL oI LIe
urgumenL LIuL IL IundIes correcLIy.
TIe InIIuence oI sucI groups us TCPG und ASH cunnoL be
underesLImuLed. WILI governmenLuI und medIcuI-esLubIIsImenL
coIIusIon, LIese groups Iuve mude greuL Inrouds InLo pubIIc poIIcy
IormuIuLIon und LIe IosLerIng oI numerous oLIer IIke-mInded groups. TIe
TCPG websILe uuLIor (ussumed Lo be PIeLLen) credILs IImseII wILI beIng
LIe IIrsL Lo IIgIIIgIL LIe cosL oI smokIng Lo socIeLy: TIe web wrILer Is
LIe person wIo IeIped cIunge muny peopIe`s beIIeIs on cIgureLLe cosLs Lo
socIeLy. Buck In 1q8o, LIere were peopIe wIo beIIeved cIgureLLes were u
cosL beneIIL und IoudIy suId so. A reIIgIous muguzIne edILor usked wIeLIer
unyone couId wrILe u rebuLLuI. TIIs wrILer submILLed u puper sIowIng
$1o bIIIIon cosL Lo socIeLy LIuL yeur uIone. (TIuL reIIgIous muguzIne wus
more wIdeIy dIsLrIbuLed LIun muny medIcuI journuIs, even Lo non-
members, und uL drug-counseIIng oIIIces, LIe wrILer`s source). Ls
cIrcuIuLIng LIe $1o bIIIIon duLu ouLsIde sLundurd medIcuI cIrcIes IeIped
seL LIe sLuge Ior LIe ALLorney GeneruI IILIguLIon Lo recover Luxpuyers`
money spenL on smokers` IeuILI cure, us oLIers begun sLudyIng und
IIndIng Iuge cIgureLLe cosLs!
TIe deIIcIenL Ideu oI uLLrIbuLubIe cosL Ius been consIdered In
534
534
Rampant Antismoking Signifies Grave Danger
un eurIIer cIupLer. L sIouId be noLed, Iowever, LIuL non-reducLIonIsL
Ideus never enLer LIe cosL consIderuLIon. or exumpIe, Iow does one
esLImuLe LIe cosL oI IosLerIng enIeebIIng IrruLIonuI beIIeI or oI IncILIng
unImosILy, enmILy und oLIer cIurucLer deIIcIencIes on u grund scuIe?
TIere Is cerLuInIy u sLrong IndIcuLIon LIuL, uILIougI IL wus
muLerIuIIsm generuIIy und medIco-muLerIuIIsm specIIIcuIIy LIuL begun LIe
sLuLIsLIcuIIsL mudness, IL Is reIIgIous groups over LIe IusL number oI
yeurs LIuL Iuve ruIsed LIe smokIng Issue InLo LIe InLernuLIonuI spoLIIgIL.
n so doIng, LIese reIIgIous groups Iuve uIIowed LIemseIves Lo be druwn
InLo LIIs muLerIuIIsL nonsense und ure currenLIy IueIIng IL. As wIII be
consIdered In LIe IoIIowIng secLIon, LIere ure very Iew CIrIsLIun groups
LIuL preucI ucLuuI CIrIsLIunILy. Muny Iuve cupILuIuLed Lo LIe muLerIuIIsL
LurbuIence oI LIIs LIme. AnLIsmokIng, Ior LIese groups wIIcI ure IuIIIng In
LIe ucLuuI CIrIsLIun LeucIIng, serves LIe sume moruI-subsLILuLIon IuncLIon
us In greuLer socIeLy.
HuvIng reduced LIe smoker Lo u bruIn-dumuged creuLure wILI no
moruI (or uny) InsIgIL LIuL nonsmokers sIouId be proLecLed Irom, IuvIng
pronounced LIuL socIeLy sIouId guurd uguInsL smokers beIng In
governmenLuI oIIIce, und IndIcuLIng LIuL LIe jusL due oI LIe smoker und
Lobucco-pusIers Is sLonIng (execuLIon), IL Is eusIer Lo compreIend LIe
more vIcIous, IuLeIuI und vIoIenL unLIsmokIng senLImenLs uppeurIng on
websILes und In cIuL rooms LIuL keep uIIudIng Lo LIe rIgILeous
exLermInuLIon oI smokIng und smokers or vIoIence Lowurds smokers (see
Superiorit Sndrome); TCPG deIusIons IueI LIe sume In LIose sImIIurIy
dIsposed. TIe TCPG websILe Is IoremosL u IuLe sILe. L Is LIe IunuLIc(s)
uuLIorIng LIIs websILe LIuL Is In need oI urgenL scruLIny. L Is LIIs IuLe-
mongerIng LIuL Is LIe mujor crIme In progress.
CompoundIng LIe IIusco Is LIuL LIe TCPG puges ure Lugged wILI
TIIs sILe Is sponsored us u pubIIc servIce - so ure ASH puges. TIe
websILe uIso IncIudes un EdILor`s AdvIsory WurnIng Lo LIe eIIecL LIuL
unyone IuIIIng Lo ugree wILI LIe websILe`s conLenLs musL be u conspIruLor
und u IIur (sLundurd MMES-cuIL reusonIng): Be udvIsed LIuL LIe duLu
presenLed Iere, Is InLenLIonuIIy REJECTED by occupuLIons InLeresLed Ior
money or rucIsL reusons, In conLInuIng LIe IurmIuI eIIecLs LIuL IIow Irom
Lobucco-Induced bruIn dumuge.
AL LIIs LIme oI IrugmenLuLIon, reIuLIonuI IuIIure, ucuLe IIxuLIons,
und moruI subsLILuLIon, LIere Is u pIeLIoru oI sIngIe-Issue groups LIuL
unIorLunuLeIy Ieed eucI oLIers` deIusIons. TIe TCPG urges LIe seekIng ouL
oI supporL Irom oLIer groups on Issues sucI us LIe IoIIowIng: unLI-
uborLIonIsLs, unLI-ADS ucLIvIsLs, opponenLs oI uIcoIoIIsm und drunk
drIvIng, AIzIeImer`s concerned groups, unLI-bIrLI deIecLs ucLIvIsLs, breusL
cuncer ucLIvIsLs, vIcLIms` rIgILs und unLI-crIme groups, deuIness
The Bigger Picture
prevenLIon ucLIvIsLs, peopIe concerned ubouL dIvorce, unLI-drug ubuse
ucLIvIsLs, ucLIvIsL cIergy und rubbIs, opponenLs oI IIres, unLI-IeurL dIseuse
ucLIvIsLs, LIose uguInsL Iung cuncer, mucuIur degeneruLIon ucLIvIsLs,
resIdence ucLIvIsLs, seuL beIL ucLIvIsLs, eurIy Lobucco workers` descendunLs,
educuLIon ImprovemenL ucLIvIsLs.
TIe sILuuLIon Is LIuL LIere ure muny mInds, LypIcuIIy IgnorunL
und IncompeLenL, IurborIng uII munner oI cIurucLer deIIcIencIes, wILI
ucuLe IIxuLIons und no coIerenL Irumework Ior LIeIr correcLIon, wILI mucI
IdIe LIme on LIeIr Iunds: eebIe mIndedness, ucuLe IIxuLIons, und
noLIIng eIse Lo do Is u dungerous combInuLIon. WIere LIese mInds
wouId do weII Lo be workIng on correcLIng LIeIr deIusIonuI reusonIng, LIey
Iuve InvoIved LIemseIves In sIngIe-Issue cruzes, I.e., IueIIng oI deIusIonuI
sLuLes. And, LIere Is none greuLer LIun LIe unLIsmokIng cruze uL LIIs LIme.
TIe crILIcuI sIgn oI LIe LImes Is mucI ucLIvIsm und ucLIvILy und
IILLIe compeLence und coIerenL reusonIng; LIIs Is un eru oI preLend
experLs. TIeIr very ouL-oI-conLexL IIxuLIons demonsLruLe LIuL LIese
groups` membersIIp compreIend IILLIe ubouL IILLIe - purLIcuIurIy In LIeIr
worId-cIungIng procIIvILy (obsessIon wILI conLroI). urLIermore, mosL oI
LIIs ucLIvILy Is projecLs wILIIn LIe muLerIuIIsL munIIesLo, e.g.,
envIronmenLuIIsm, unLILobucco. A commenL by GIunLz In u 1q86 Los
Aneles Times urLIcIe Is mosL LeIIIng. n descrIbIng LIe IncreusIng success
oI IIs unLIsmokIng group In guInIng unLIsmokIng IegIsIuLIon uL LIuL LIme,
GIunLz IndIcuLes: TIe Issue Ius urrIved. We`ve gone Irom beIng 'LIose
weIrd peopIe` Lo LecInIcuI experLs. (ebruury 1;, 1q86, p.) TIe IucL oI LIe
muLLer Is LIuL LIose weIrd peopIe ure sLIII so. L Is onIy wILI pIummeLIng
sLundurds oI IonesLy und InIerence LIuL LIey Iuve come Lo uppeur us
LecInIcuI experLs. More dIsLurbIng Is LIuL wILI u progressIve muLerIuIIsL
domInuLIon oI socIeLIes LIere Is now u muILILude oI weIrd peopIe
IurborIng uII munner oI conLorLed, superIIcIuI beIIeIs und equuIIy
conLorLed emoLIons.
TIIs Is u LIme wIen weIrd peopIe ure vIewed noL onIy us LecInIcuI
experLs buL us Ieroes. GIunLz, IIke oLIer mIIILunL unLIsmokers, Is very
proIIIIc In ucLIvILy. He gIves numerous LuIks, wrILes muny unLIsmokIng
urLIcIes, und presenLs us u wILness In IeurIngs on InLended unLIsmokIng
IegIsIuLIon. n IuLe-zooz Ie uddressed un uudIence uL LIe nLersLuLe
HoIIduy nn In Grund sIund, Nebrusku. HIs presenLuLIon wus IIIIed wILI
LIe sLundurd ubuse oI sLuLIsLIcuI InIormuLIon, muLerIuIIsL superIIcIuIILy und
unLIsmokIng rIeLorIc. A coverIng sLory In the independent.com (December
) wus IeudIIned: JusL Iow bud Is IL? DocLor IIIIs G|rund| |sIund|
uudIence In on myrIud oI IeuILI rIsks In beIng uround cIgureLLe smoke.
TIe IIrsL senLence In LIe urLIcIe Is SecondIund smoke kIIIs. TIe urLIcIe
goes on Lo suy LIuL CoIIeLLe SIuugInessy und Susun Hueker, boLI oI
535
535
Rampant Antismoking Signifies Grave Danger
un eurIIer cIupLer. L sIouId be noLed, Iowever, LIuL non-reducLIonIsL
Ideus never enLer LIe cosL consIderuLIon. or exumpIe, Iow does one
esLImuLe LIe cosL oI IosLerIng enIeebIIng IrruLIonuI beIIeI or oI IncILIng
unImosILy, enmILy und oLIer cIurucLer deIIcIencIes on u grund scuIe?
TIere Is cerLuInIy u sLrong IndIcuLIon LIuL, uILIougI IL wus
muLerIuIIsm generuIIy und medIco-muLerIuIIsm specIIIcuIIy LIuL begun LIe
sLuLIsLIcuIIsL mudness, IL Is reIIgIous groups over LIe IusL number oI
yeurs LIuL Iuve ruIsed LIe smokIng Issue InLo LIe InLernuLIonuI spoLIIgIL.
n so doIng, LIese reIIgIous groups Iuve uIIowed LIemseIves Lo be druwn
InLo LIIs muLerIuIIsL nonsense und ure currenLIy IueIIng IL. As wIII be
consIdered In LIe IoIIowIng secLIon, LIere ure very Iew CIrIsLIun groups
LIuL preucI ucLuuI CIrIsLIunILy. Muny Iuve cupILuIuLed Lo LIe muLerIuIIsL
LurbuIence oI LIIs LIme. AnLIsmokIng, Ior LIese groups wIIcI ure IuIIIng In
LIe ucLuuI CIrIsLIun LeucIIng, serves LIe sume moruI-subsLILuLIon IuncLIon
us In greuLer socIeLy.
HuvIng reduced LIe smoker Lo u bruIn-dumuged creuLure wILI no
moruI (or uny) InsIgIL LIuL nonsmokers sIouId be proLecLed Irom, IuvIng
pronounced LIuL socIeLy sIouId guurd uguInsL smokers beIng In
governmenLuI oIIIce, und IndIcuLIng LIuL LIe jusL due oI LIe smoker und
Lobucco-pusIers Is sLonIng (execuLIon), IL Is eusIer Lo compreIend LIe
more vIcIous, IuLeIuI und vIoIenL unLIsmokIng senLImenLs uppeurIng on
websILes und In cIuL rooms LIuL keep uIIudIng Lo LIe rIgILeous
exLermInuLIon oI smokIng und smokers or vIoIence Lowurds smokers (see
Superiorit Sndrome); TCPG deIusIons IueI LIe sume In LIose sImIIurIy
dIsposed. TIe TCPG websILe Is IoremosL u IuLe sILe. L Is LIe IunuLIc(s)
uuLIorIng LIIs websILe LIuL Is In need oI urgenL scruLIny. L Is LIIs IuLe-
mongerIng LIuL Is LIe mujor crIme In progress.
CompoundIng LIe IIusco Is LIuL LIe TCPG puges ure Lugged wILI
TIIs sILe Is sponsored us u pubIIc servIce - so ure ASH puges. TIe
websILe uIso IncIudes un EdILor`s AdvIsory WurnIng Lo LIe eIIecL LIuL
unyone IuIIIng Lo ugree wILI LIe websILe`s conLenLs musL be u conspIruLor
und u IIur (sLundurd MMES-cuIL reusonIng): Be udvIsed LIuL LIe duLu
presenLed Iere, Is InLenLIonuIIy REJECTED by occupuLIons InLeresLed Ior
money or rucIsL reusons, In conLInuIng LIe IurmIuI eIIecLs LIuL IIow Irom
Lobucco-Induced bruIn dumuge.
AL LIIs LIme oI IrugmenLuLIon, reIuLIonuI IuIIure, ucuLe IIxuLIons,
und moruI subsLILuLIon, LIere Is u pIeLIoru oI sIngIe-Issue groups LIuL
unIorLunuLeIy Ieed eucI oLIers` deIusIons. TIe TCPG urges LIe seekIng ouL
oI supporL Irom oLIer groups on Issues sucI us LIe IoIIowIng: unLI-
uborLIonIsLs, unLI-ADS ucLIvIsLs, opponenLs oI uIcoIoIIsm und drunk
drIvIng, AIzIeImer`s concerned groups, unLI-bIrLI deIecLs ucLIvIsLs, breusL
cuncer ucLIvIsLs, vIcLIms` rIgILs und unLI-crIme groups, deuIness
The Bigger Picture
prevenLIon ucLIvIsLs, peopIe concerned ubouL dIvorce, unLI-drug ubuse
ucLIvIsLs, ucLIvIsL cIergy und rubbIs, opponenLs oI IIres, unLI-IeurL dIseuse
ucLIvIsLs, LIose uguInsL Iung cuncer, mucuIur degeneruLIon ucLIvIsLs,
resIdence ucLIvIsLs, seuL beIL ucLIvIsLs, eurIy Lobucco workers` descendunLs,
educuLIon ImprovemenL ucLIvIsLs.
TIe sILuuLIon Is LIuL LIere ure muny mInds, LypIcuIIy IgnorunL
und IncompeLenL, IurborIng uII munner oI cIurucLer deIIcIencIes, wILI
ucuLe IIxuLIons und no coIerenL Irumework Ior LIeIr correcLIon, wILI mucI
IdIe LIme on LIeIr Iunds: eebIe mIndedness, ucuLe IIxuLIons, und
noLIIng eIse Lo do Is u dungerous combInuLIon. WIere LIese mInds
wouId do weII Lo be workIng on correcLIng LIeIr deIusIonuI reusonIng, LIey
Iuve InvoIved LIemseIves In sIngIe-Issue cruzes, I.e., IueIIng oI deIusIonuI
sLuLes. And, LIere Is none greuLer LIun LIe unLIsmokIng cruze uL LIIs LIme.
TIe crILIcuI sIgn oI LIe LImes Is mucI ucLIvIsm und ucLIvILy und
IILLIe compeLence und coIerenL reusonIng; LIIs Is un eru oI preLend
experLs. TIeIr very ouL-oI-conLexL IIxuLIons demonsLruLe LIuL LIese
groups` membersIIp compreIend IILLIe ubouL IILLIe - purLIcuIurIy In LIeIr
worId-cIungIng procIIvILy (obsessIon wILI conLroI). urLIermore, mosL oI
LIIs ucLIvILy Is projecLs wILIIn LIe muLerIuIIsL munIIesLo, e.g.,
envIronmenLuIIsm, unLILobucco. A commenL by GIunLz In u 1q86 Los
Aneles Times urLIcIe Is mosL LeIIIng. n descrIbIng LIe IncreusIng success
oI IIs unLIsmokIng group In guInIng unLIsmokIng IegIsIuLIon uL LIuL LIme,
GIunLz IndIcuLes: TIe Issue Ius urrIved. We`ve gone Irom beIng 'LIose
weIrd peopIe` Lo LecInIcuI experLs. (ebruury 1;, 1q86, p.) TIe IucL oI LIe
muLLer Is LIuL LIose weIrd peopIe ure sLIII so. L Is onIy wILI pIummeLIng
sLundurds oI IonesLy und InIerence LIuL LIey Iuve come Lo uppeur us
LecInIcuI experLs. More dIsLurbIng Is LIuL wILI u progressIve muLerIuIIsL
domInuLIon oI socIeLIes LIere Is now u muILILude oI weIrd peopIe
IurborIng uII munner oI conLorLed, superIIcIuI beIIeIs und equuIIy
conLorLed emoLIons.
TIIs Is u LIme wIen weIrd peopIe ure vIewed noL onIy us LecInIcuI
experLs buL us Ieroes. GIunLz, IIke oLIer mIIILunL unLIsmokers, Is very
proIIIIc In ucLIvILy. He gIves numerous LuIks, wrILes muny unLIsmokIng
urLIcIes, und presenLs us u wILness In IeurIngs on InLended unLIsmokIng
IegIsIuLIon. n IuLe-zooz Ie uddressed un uudIence uL LIe nLersLuLe
HoIIduy nn In Grund sIund, Nebrusku. HIs presenLuLIon wus IIIIed wILI
LIe sLundurd ubuse oI sLuLIsLIcuI InIormuLIon, muLerIuIIsL superIIcIuIILy und
unLIsmokIng rIeLorIc. A coverIng sLory In the independent.com (December
) wus IeudIIned: JusL Iow bud Is IL? DocLor IIIIs G|rund| |sIund|
uudIence In on myrIud oI IeuILI rIsks In beIng uround cIgureLLe smoke.
TIe IIrsL senLence In LIe urLIcIe Is SecondIund smoke kIIIs. TIe urLIcIe
goes on Lo suy LIuL CoIIeLLe SIuugInessy und Susun Hueker, boLI oI
536
536
Rampant Antismoking Signifies Grave Danger
Tobucco ree HuII CounLy, Iud Ieurd GIunLz speuk beIore und were
LIrIIIed Lo Iuve IIm come Lo Nebrusku. 'He uIwuys moLIvuLes und InspIres
us, und we`re so gIud Lo Iuve IIm,` suId Hueker, wIo cuIIed GIunLz Ier
Iero In unLI-Lobucco ucLIvILIes. GIunLz, wIo preucIes IrruLIonuI beIIeI,
Ieur, guIIL und IuLred, Is un InspIrIng IIgure provIdIng meunIngIuI
ucLIvILy Lo LIe ucLuuIIy spIrILuuIIy IosL, LIe menLuIIy dIsorIenLed. TIese
InspIrIng IIgures ure LIe prIesLIood oI LIe MMES cuIL. A proper quesLIon
Lo usk Is Iow LIIs menLuIILy Ius Iound InvILIng uudIences (devoLees)
uround LIe worId LIuL cun IIII ouL (ussumedIy) In LIIs cuse u HoIIduy nn
conIerence room?, I.e., persons ure wunLIng Lo Ieur LIIs nonsense und ucL
on IL.
SIngIe-Issues (monomunIu) sImpIy provIde u conduIL Ior u
pIeLIoru oI deIIcIencIes (e.g., Iuke superIorILy). I LIe mInd Is kepL busy In
wuywurd pursuILs, IL never usks LIe quesLIon us Lo LIe coIerence und
moLIvuLIon oI ILs beIIeIs und InIerences. AII LIe beLLer wIen guIIL cun be
ussIgned (projecLed) Lo some oLIer group, LIus psycIoIogIcuIIy
ubsoIvIng LIe LIInker Irom ILs mIsdeeds. As LIe consequences oI LIIs
IrugmenLuLIon und moruI reckIessness come IurLIer Lo LIe Iore, LIe
pressure oI guIIL wIII Increuse In uII LIose LIuL wouId purLuke oI LIIs
mudness - LIIs greuL muss-scuIe seII-decepLIon. IxuLIons wIII spIII-over Lo
oLIer Issues und LIe demunds Ior proLecLIon wIII become more vIoIenL.
TIe conducL depIcLed ubove Is LIe sLundurd MMES-cuIL
reusonIng descrIbed In un eurIIer secLIon. TIIs menLuIILy Is
psycIoIogIcuIIy, reIuLIonuIIy, und moruIIy sIuIIow. L reIIes on medIcuI,
sLuLIsLIcuIIsL prescrIpLIons Ior duIIy IuncLIonIng. YeL, ILs muILIdImensIonuI
deIIcIencIes ure evIdenL - urrogunce, IuugILIness, obsessIon wILI conLroI,
IncompeLence, rIgIdILy, meguIomunIu. One oI LIe more dungerous IuIIucIes
oI LIe LIme Is LIe beIIeI LIuL nonsmokers und LeeLoLuIers ure superIor
beIngs (I.e., cnti-smokIng und uIcoIoI). RuLIer, wurIness sIouId be
uccorded Lo LIose wIo wouId dIsLInguIsI LIemseIves us moruIIy uprIgIL by
vIrLue oI LIeIr nonsmokIng, uIcoIoI ubsLenLIon und dIeLury observuLIons.
NonsmokIng LeeLoLuIers mIgIL uppeur pure Lo superIIcIuI, muLerIuIIsL
dIscernmenL, buL LIeIr menLuI sLuLe cun be u sIumbIes, dungerous noL
onIy Lo LIemseIves buL, In LIe currenL cIrcumsLunce, congIomeruLes oI
socIeLIes.
.( Antismolin, Christicnit, cnd Recl Hope
TIe dIscussIon LIus Iur Ius consIdered LIuL u progressIve
muLerIuIIsL ussuuIL Ius IegILImIzed Iower-nuLure reusonIng. CrunkIness,
wIIm, peLuIunce, IuugILIness, urrogunce, eLc., Iuve been normuIIzed.
More und more Iuve cupILuIuLed Lo LIIs IoIIy. Muny Iuve ImproperIy LIred
The Bigger Picture
oI IonesL seII-scruLIny und LIe Inner work. TIese ure now obsessed wILI
LIe uIreudy doomed uLLempL uL body ImmorLuIILy LIrougI urLIIIcIuI meuns,
compIeLeIy unuwure LIuL LIeIr body proLecLIon Is onIy LIe enucLmenL oI
uII munner oI psycIoIogIcuI, reIuLIonuI, und moruI deIusIons.
TIe worId Is In u IIgIIy IeurIuI und LroubIed sLuLe. L Ius been
IndIcuLed LIuL LIe reckIessness Is Loo Iur udvunced uL u generuI IeveI Ior u
LurnIng buck - uII key socIuI InsLILuLIons In muny nuLIons ure under
muLerIuIIsL domInuLIon; LIe coIIecLIve souIs oI muny nuLIons Iuve Iong
been soId oII. TIe murcI seems Lo be Lowurds LIe IInuI dIsusLer.
However, LIere wouId be IILLIe poInL Lo LIIs very consIderubIe
dIscussIon II IL couId onIy concIude wILI IopeIessness. RuLIer, LIere Is
greuL scope Ior Iope. AILIougI nuLIonuI IdeoIogy muy be wuywurd,
IndIvIduuIs cun sLIII cIoose urIgIL. TIere musL be LIose wIo cun
InLuILIveIy dIscern LIuL LIere Is much usLruy uL LIIs LIme. However, LIey
Iuck conIIdence In LIeIr uppruIsuI In LIuL LIe seemIngIy mIsguIded edIcLs
oI LIe LIme ure supposedIy scIenLIIIcuIIy bused. TIIs dIscussIon Is
purLIcuIurIy dIrecLed uL LIIs borderIIne group, uLLempLIng Lo
demonsLruLe LIuL muLerIuIIsL IdeoIogy und edIcLs Iuve no scIenLIIIc or
coIerenL busIs wIuLsoever.
Hope Is uILImuLeIy In u coIerenL IIrsL-prIncIpIes spIrILuuIJmoruI
Irumework. CIrIsLIunILy Is consIdered Lo be sucI u Irumework. L Is
beyond LIe scope oI LIIs dIscussIon Lo provIde u IormuI jusLIIIcuLIon LIuL
compures und conLrusLs CIrIsLIunILy wILI oLIer IormuI reIIgIons. L wIII
suIIIce Ior LIe purposes oI LIIs dIscussIon LIuL CIrIsLIunILy Is Iur ubove
oLIer reIIgIous Irumeworks. No-one Ius spoken und ucLed wILI LIe cIurILy
und proIundILy oI Jesus LIe CIrIsL, beIore or sInce. No oLIer reIIgIon Ius
so proIound u LrunscendenL gouI wILI perIecLIng oI reIuLIonsIIp uL ILs
cenLer.
A mujor LIeme In LIIs dIscussIon Ius been unLIsmokIng us u
crILIcuI sympLom oI rumpunL muLerIuIIsm. AnLIsmokIng, Loo, Ius IIgured
In CIrIsLIun deIIberuLIons over LIe IusL decude. By consIderIng LIIs Lrend
In CIrIsLIun cIrcIes wIII provIde vuIuubIe InsIgILs InLo LIe CIrIsLIun gouI
und Iow, Ior LIe mosL purL, CIrIsLIunILy Is u mucI beIIeved LeucIIng buL
u poorIy prucLIced one.
A useIuI sLurLIng poInL Is Lo consIder LIe LeucIIng oI :
Corinthicns : & :( wIIcI IndIcuLes LIe gouI oI LIe CIrIsLIun journey:
I |cun| speuk In LIe Longues oI men und |even| oI
ungeIs, buL Iuve noL Iove |LIuL reusonIng, InLenLIonuI,
spIrILuuI devoLIon sucI us Is InspIred by God`s Iove Ior
und In us|, um onIy u noIsy gong or u cIungIng cymbuI.
And II Iuve propIeLIc powers - LIuL Is, LIe gIIL oI
InLerpreLIng LIe dIvIne wIII und purpose; und
537
537
Rampant Antismoking Signifies Grave Danger
Tobucco ree HuII CounLy, Iud Ieurd GIunLz speuk beIore und were
LIrIIIed Lo Iuve IIm come Lo Nebrusku. 'He uIwuys moLIvuLes und InspIres
us, und we`re so gIud Lo Iuve IIm,` suId Hueker, wIo cuIIed GIunLz Ier
Iero In unLI-Lobucco ucLIvILIes. GIunLz, wIo preucIes IrruLIonuI beIIeI,
Ieur, guIIL und IuLred, Is un InspIrIng IIgure provIdIng meunIngIuI
ucLIvILy Lo LIe ucLuuIIy spIrILuuIIy IosL, LIe menLuIIy dIsorIenLed. TIese
InspIrIng IIgures ure LIe prIesLIood oI LIe MMES cuIL. A proper quesLIon
Lo usk Is Iow LIIs menLuIILy Ius Iound InvILIng uudIences (devoLees)
uround LIe worId LIuL cun IIII ouL (ussumedIy) In LIIs cuse u HoIIduy nn
conIerence room?, I.e., persons ure wunLIng Lo Ieur LIIs nonsense und ucL
on IL.
SIngIe-Issues (monomunIu) sImpIy provIde u conduIL Ior u
pIeLIoru oI deIIcIencIes (e.g., Iuke superIorILy). I LIe mInd Is kepL busy In
wuywurd pursuILs, IL never usks LIe quesLIon us Lo LIe coIerence und
moLIvuLIon oI ILs beIIeIs und InIerences. AII LIe beLLer wIen guIIL cun be
ussIgned (projecLed) Lo some oLIer group, LIus psycIoIogIcuIIy
ubsoIvIng LIe LIInker Irom ILs mIsdeeds. As LIe consequences oI LIIs
IrugmenLuLIon und moruI reckIessness come IurLIer Lo LIe Iore, LIe
pressure oI guIIL wIII Increuse In uII LIose LIuL wouId purLuke oI LIIs
mudness - LIIs greuL muss-scuIe seII-decepLIon. IxuLIons wIII spIII-over Lo
oLIer Issues und LIe demunds Ior proLecLIon wIII become more vIoIenL.
TIe conducL depIcLed ubove Is LIe sLundurd MMES-cuIL
reusonIng descrIbed In un eurIIer secLIon. TIIs menLuIILy Is
psycIoIogIcuIIy, reIuLIonuIIy, und moruIIy sIuIIow. L reIIes on medIcuI,
sLuLIsLIcuIIsL prescrIpLIons Ior duIIy IuncLIonIng. YeL, ILs muILIdImensIonuI
deIIcIencIes ure evIdenL - urrogunce, IuugILIness, obsessIon wILI conLroI,
IncompeLence, rIgIdILy, meguIomunIu. One oI LIe more dungerous IuIIucIes
oI LIe LIme Is LIe beIIeI LIuL nonsmokers und LeeLoLuIers ure superIor
beIngs (I.e., cnti-smokIng und uIcoIoI). RuLIer, wurIness sIouId be
uccorded Lo LIose wIo wouId dIsLInguIsI LIemseIves us moruIIy uprIgIL by
vIrLue oI LIeIr nonsmokIng, uIcoIoI ubsLenLIon und dIeLury observuLIons.
NonsmokIng LeeLoLuIers mIgIL uppeur pure Lo superIIcIuI, muLerIuIIsL
dIscernmenL, buL LIeIr menLuI sLuLe cun be u sIumbIes, dungerous noL
onIy Lo LIemseIves buL, In LIe currenL cIrcumsLunce, congIomeruLes oI
socIeLIes.
.( Antismolin, Christicnit, cnd Recl Hope
TIe dIscussIon LIus Iur Ius consIdered LIuL u progressIve
muLerIuIIsL ussuuIL Ius IegILImIzed Iower-nuLure reusonIng. CrunkIness,
wIIm, peLuIunce, IuugILIness, urrogunce, eLc., Iuve been normuIIzed.
More und more Iuve cupILuIuLed Lo LIIs IoIIy. Muny Iuve ImproperIy LIred
The Bigger Picture
oI IonesL seII-scruLIny und LIe Inner work. TIese ure now obsessed wILI
LIe uIreudy doomed uLLempL uL body ImmorLuIILy LIrougI urLIIIcIuI meuns,
compIeLeIy unuwure LIuL LIeIr body proLecLIon Is onIy LIe enucLmenL oI
uII munner oI psycIoIogIcuI, reIuLIonuI, und moruI deIusIons.
TIe worId Is In u IIgIIy IeurIuI und LroubIed sLuLe. L Ius been
IndIcuLed LIuL LIe reckIessness Is Loo Iur udvunced uL u generuI IeveI Ior u
LurnIng buck - uII key socIuI InsLILuLIons In muny nuLIons ure under
muLerIuIIsL domInuLIon; LIe coIIecLIve souIs oI muny nuLIons Iuve Iong
been soId oII. TIe murcI seems Lo be Lowurds LIe IInuI dIsusLer.
However, LIere wouId be IILLIe poInL Lo LIIs very consIderubIe
dIscussIon II IL couId onIy concIude wILI IopeIessness. RuLIer, LIere Is
greuL scope Ior Iope. AILIougI nuLIonuI IdeoIogy muy be wuywurd,
IndIvIduuIs cun sLIII cIoose urIgIL. TIere musL be LIose wIo cun
InLuILIveIy dIscern LIuL LIere Is much usLruy uL LIIs LIme. However, LIey
Iuck conIIdence In LIeIr uppruIsuI In LIuL LIe seemIngIy mIsguIded edIcLs
oI LIe LIme ure supposedIy scIenLIIIcuIIy bused. TIIs dIscussIon Is
purLIcuIurIy dIrecLed uL LIIs borderIIne group, uLLempLIng Lo
demonsLruLe LIuL muLerIuIIsL IdeoIogy und edIcLs Iuve no scIenLIIIc or
coIerenL busIs wIuLsoever.
Hope Is uILImuLeIy In u coIerenL IIrsL-prIncIpIes spIrILuuIJmoruI
Irumework. CIrIsLIunILy Is consIdered Lo be sucI u Irumework. L Is
beyond LIe scope oI LIIs dIscussIon Lo provIde u IormuI jusLIIIcuLIon LIuL
compures und conLrusLs CIrIsLIunILy wILI oLIer IormuI reIIgIons. L wIII
suIIIce Ior LIe purposes oI LIIs dIscussIon LIuL CIrIsLIunILy Is Iur ubove
oLIer reIIgIous Irumeworks. No-one Ius spoken und ucLed wILI LIe cIurILy
und proIundILy oI Jesus LIe CIrIsL, beIore or sInce. No oLIer reIIgIon Ius
so proIound u LrunscendenL gouI wILI perIecLIng oI reIuLIonsIIp uL ILs
cenLer.
A mujor LIeme In LIIs dIscussIon Ius been unLIsmokIng us u
crILIcuI sympLom oI rumpunL muLerIuIIsm. AnLIsmokIng, Loo, Ius IIgured
In CIrIsLIun deIIberuLIons over LIe IusL decude. By consIderIng LIIs Lrend
In CIrIsLIun cIrcIes wIII provIde vuIuubIe InsIgILs InLo LIe CIrIsLIun gouI
und Iow, Ior LIe mosL purL, CIrIsLIunILy Is u mucI beIIeved LeucIIng buL
u poorIy prucLIced one.
A useIuI sLurLIng poInL Is Lo consIder LIe LeucIIng oI :
Corinthicns : & :( wIIcI IndIcuLes LIe gouI oI LIe CIrIsLIun journey:
I |cun| speuk In LIe Longues oI men und |even| oI
ungeIs, buL Iuve noL Iove |LIuL reusonIng, InLenLIonuI,
spIrILuuI devoLIon sucI us Is InspIred by God`s Iove Ior
und In us|, um onIy u noIsy gong or u cIungIng cymbuI.
And II Iuve propIeLIc powers - LIuL Is, LIe gIIL oI
InLerpreLIng LIe dIvIne wIII und purpose; und
538
538
Rampant Antismoking Signifies Grave Danger
undersLund uII LIe secreL LruLIs cnd mysLerIes und
possess uII knowIedge, und II Iuve (suIIIcIenL) IuILI so
LIuL cun remove mounLuIns, buL Iuve noL Iove |God`s
Iove In me| um noLIIng - u useIess nobody.
Even II doIe ouL uII LIuL Iuve |Lo LIe poor In
provIdIng| Iood, und II surrender my body Lo be
burned |or In order LIuL muy gIory|, buL Iuve noL Iove
|God`s Iove In me|, guIn noLIIng.
ove endures Iong und Is puLIenL und kInd; Iove never Is
envIous nor boIIs over wILI jeuIousy; Is noL bousLIuI or
vuIngIorIous, does noL dIspIuy ILseII IuugILIIy.
L Is noL conceILed - urrogunL und InIIuLed wILI prIde; IL
Is noL rude (unmunnerIy), cnd does noL ucL
unbecomIngIy. ove |God`s Iove In us| does noL InsIsL
on ILs own rIgILs or ILs own wuy, jor IL Is noL seII-
seekIng; IL Is noL LoucIy or IreLIuI or resenLIuI; IL Lukes
no uccounL oI LIe evII done Lo IL - puys no uLLenLIon Lo u
suIIered wrong.
L does noL rejoIce uL InjusLIce cnd unrIgILeousness, buL
rejoIces wIen rIgIL cnd LruLI prevuII.
ove beurs up under unyLIIng cnd everyLIIng LIuL
comes, Is ever reudy Lo beIIeve LIe besL oI every person,
ILs Iopes ure IudeIess under uII cIrcumsLunces und IL
endures everyLIIng |wILIouL weukenIng|.
ove never IuIIs - never Iudes ouL or becomes obsoIeLe
or comes Lo un end. As Ior propIecy |LIuL Is, LIe gIIL oI
InLerpreLIng LIe dIvIne wIII und purpose|, IL wIII be
IuIIIIIed cnd puss uwuy; us Ior Longues, LIey wIII be
desLroyed cnd ceuse; us Ior knowIedge, IL wIII puss uwuy
|LIuL Is, IL wIII Iose ILs vuIue und be superseded by
LruLI|.
or our knowIedge Is IrugmenLury (IncompIeLe und
ImperIecL), und our propIecy (our LeucIIng) Is
IrugmenLury (IncompIeLe und ImperIecL).
BuL wIen LIe compIeLe cnd perIecL |LoLuI| comes, LIe
IncompIeLe cnd ImperIecL wIII vunIsI uwuy - become
unLIquuLed, voId und superseded.
WIen wus u cIIId, LuIked IIke u cIIId, LIougIL IIke u
cIIId, reusoned IIke u cIIId; now LIuL Iuve become u
mun, um done wILI cIIIdIsI wuys cnd Iuve puL LIem
usIde.
or now we ure IookIng In u mIrror LIuL gIves onIy u dIm
The Bigger Picture
(bIurred) reIIecLIon |oI reuIILy us In u rIddIe or enIgmu|,
buL LIen |wIen perIecLIon comes| we sIuII see In reuIILy
cnd Iuce Lo Iuce! Now know In purL (ImperIecLIy); buL
LIen sIuII know cnd undersLund IuIIy cnd cIeurIy,
even In LIe sume munner us Iuve been IuIIy cnd
cIeurIy known cnd undersLood |by God|.
And so IuILI, Iope, Iove ubIde; |IuILI, convIcLIon, und
beIIeI respecLIng mun`s reIuLIon Lo God und dIvIne
LIIngs; Iope joyIuI und conIIdenL expecLuLIon oI eLernuI
suIvuLIon; Iove, Lrue uIIecLIon Ior God und mun, growIng
ouL oI God`s Iove Ior und In us|, LIese LIree, buL LIe
greuLesL oI LIese Is Iove.
EugerIy pursue und seek Lo ucquIre |LIIs| Iove - muke IL
your uIm, your greuL quesL. (1 CorInLIIuns 1, 1q:1 -
AmpIIIIed BIbIe (AB))
A number oI poInLs ure ImmedIuLeIy perLInenL. TIe ove oI
God IndIcuLes unoLIer sLuLe (LrunscendenL) uILogeLIer, noL Lo be conIused
wILI u IIckIe, Iower-nuLure versIon oI Iove. L Is u ove LIuL Is noL oI LIIs
worId buL LIuL cun be munIIesLed In LIIs worId. AII In LIe CIrIsLIun
LeucIIng concerns reIuLIonsIIp - uILImuLeIy LIe perIecLed or IoIy
reIuLIonsIIp. As LIe reIuLIonsIIp beLween u person und God Is
sLrengLIened, so, Loo, Is LIe cupucILy Ior depLI oI reIuLIonsIIp wILI oLIers
- beyond LIe Iower-nuLure; LIe Ideu oI IovIng God buL IuLIng oLIers Is
InconceIvubIe In LIe CIrIsLIun LeucIIng. L cun be undersLood LIuL wIere
LIe CIrIsLIun LeucIIng Is jeLLIsoned by u socIeLy, LIe LypIcuI eIIecL, IIowIng
Irom moruI und psycIoIogIcuI IuIIure, Is reIuLIonuI IuIIure, us wus
consIdered In prevIous cIupLers, e.g., dIvorce, rIgILs IIusco, body
IIxuLIon, seII-uduIuLIon, exLernuIIsm, LIe reInIorcemenL oI IeurJLerror;
wIere CIrIsLIunILy poInLs Lo sLrengLIenIng, muLerIuIIsm proLecLs
deIIcIencIes.
mpIIcIL In LIIs CIrIsLIun LeucIIng Is LIe exLru mIIe prIncIpIe.
WIere LIe Iower-nuLure, IurborIng resenLmenLs und oLIer deIIcIencIes,
wouId counseI Lo rejecL or condemn oLIers, LIe CIrIsLIun LeucIIng
ImpIores Lrunscendence - u rIsIng ubove LIe Iower-nuLure, u reIeusIng oI
InvesLmenL In conLorLed LIougIL und emoLIon; LIIs InvoIves u
LrunsIormuLIon oI beIIeI und percepLIon. No-one cun overcome LIe Iower-
nuLure buL by Gruce, IoIy counseI, und LIe desIre Ior LIe IoIy reIuLIonsIIp.
ObvIousIy, LIe IoIy journey Is u LrunsILIonuI pIuse. AII In LIIs
worId Iuve u IIsLory LIuL Is noL IIuLLerIng, I.e., sIckIy, conIused, conLorLed;
uII Iuve IuIIen sIorL oI LIe IoIy murk or sLundurd. HonesLy recognIzes LIe
need Ior suIvuLIon und LIrougI suIvuLIon Is gIILed LIe new spIrILuuI bIrLI
539
539
Rampant Antismoking Signifies Grave Danger
undersLund uII LIe secreL LruLIs cnd mysLerIes und
possess uII knowIedge, und II Iuve (suIIIcIenL) IuILI so
LIuL cun remove mounLuIns, buL Iuve noL Iove |God`s
Iove In me| um noLIIng - u useIess nobody.
Even II doIe ouL uII LIuL Iuve |Lo LIe poor In
provIdIng| Iood, und II surrender my body Lo be
burned |or In order LIuL muy gIory|, buL Iuve noL Iove
|God`s Iove In me|, guIn noLIIng.
ove endures Iong und Is puLIenL und kInd; Iove never Is
envIous nor boIIs over wILI jeuIousy; Is noL bousLIuI or
vuIngIorIous, does noL dIspIuy ILseII IuugILIIy.
L Is noL conceILed - urrogunL und InIIuLed wILI prIde; IL
Is noL rude (unmunnerIy), cnd does noL ucL
unbecomIngIy. ove |God`s Iove In us| does noL InsIsL
on ILs own rIgILs or ILs own wuy, jor IL Is noL seII-
seekIng; IL Is noL LoucIy or IreLIuI or resenLIuI; IL Lukes
no uccounL oI LIe evII done Lo IL - puys no uLLenLIon Lo u
suIIered wrong.
L does noL rejoIce uL InjusLIce cnd unrIgILeousness, buL
rejoIces wIen rIgIL cnd LruLI prevuII.
ove beurs up under unyLIIng cnd everyLIIng LIuL
comes, Is ever reudy Lo beIIeve LIe besL oI every person,
ILs Iopes ure IudeIess under uII cIrcumsLunces und IL
endures everyLIIng |wILIouL weukenIng|.
ove never IuIIs - never Iudes ouL or becomes obsoIeLe
or comes Lo un end. As Ior propIecy |LIuL Is, LIe gIIL oI
InLerpreLIng LIe dIvIne wIII und purpose|, IL wIII be
IuIIIIIed cnd puss uwuy; us Ior Longues, LIey wIII be
desLroyed cnd ceuse; us Ior knowIedge, IL wIII puss uwuy
|LIuL Is, IL wIII Iose ILs vuIue und be superseded by
LruLI|.
or our knowIedge Is IrugmenLury (IncompIeLe und
ImperIecL), und our propIecy (our LeucIIng) Is
IrugmenLury (IncompIeLe und ImperIecL).
BuL wIen LIe compIeLe cnd perIecL |LoLuI| comes, LIe
IncompIeLe cnd ImperIecL wIII vunIsI uwuy - become
unLIquuLed, voId und superseded.
WIen wus u cIIId, LuIked IIke u cIIId, LIougIL IIke u
cIIId, reusoned IIke u cIIId; now LIuL Iuve become u
mun, um done wILI cIIIdIsI wuys cnd Iuve puL LIem
usIde.
or now we ure IookIng In u mIrror LIuL gIves onIy u dIm
The Bigger Picture
(bIurred) reIIecLIon |oI reuIILy us In u rIddIe or enIgmu|,
buL LIen |wIen perIecLIon comes| we sIuII see In reuIILy
cnd Iuce Lo Iuce! Now know In purL (ImperIecLIy); buL
LIen sIuII know cnd undersLund IuIIy cnd cIeurIy,
even In LIe sume munner us Iuve been IuIIy cnd
cIeurIy known cnd undersLood |by God|.
And so IuILI, Iope, Iove ubIde; |IuILI, convIcLIon, und
beIIeI respecLIng mun`s reIuLIon Lo God und dIvIne
LIIngs; Iope joyIuI und conIIdenL expecLuLIon oI eLernuI
suIvuLIon; Iove, Lrue uIIecLIon Ior God und mun, growIng
ouL oI God`s Iove Ior und In us|, LIese LIree, buL LIe
greuLesL oI LIese Is Iove.
EugerIy pursue und seek Lo ucquIre |LIIs| Iove - muke IL
your uIm, your greuL quesL. (1 CorInLIIuns 1, 1q:1 -
AmpIIIIed BIbIe (AB))
A number oI poInLs ure ImmedIuLeIy perLInenL. TIe ove oI
God IndIcuLes unoLIer sLuLe (LrunscendenL) uILogeLIer, noL Lo be conIused
wILI u IIckIe, Iower-nuLure versIon oI Iove. L Is u ove LIuL Is noL oI LIIs
worId buL LIuL cun be munIIesLed In LIIs worId. AII In LIe CIrIsLIun
LeucIIng concerns reIuLIonsIIp - uILImuLeIy LIe perIecLed or IoIy
reIuLIonsIIp. As LIe reIuLIonsIIp beLween u person und God Is
sLrengLIened, so, Loo, Is LIe cupucILy Ior depLI oI reIuLIonsIIp wILI oLIers
- beyond LIe Iower-nuLure; LIe Ideu oI IovIng God buL IuLIng oLIers Is
InconceIvubIe In LIe CIrIsLIun LeucIIng. L cun be undersLood LIuL wIere
LIe CIrIsLIun LeucIIng Is jeLLIsoned by u socIeLy, LIe LypIcuI eIIecL, IIowIng
Irom moruI und psycIoIogIcuI IuIIure, Is reIuLIonuI IuIIure, us wus
consIdered In prevIous cIupLers, e.g., dIvorce, rIgILs IIusco, body
IIxuLIon, seII-uduIuLIon, exLernuIIsm, LIe reInIorcemenL oI IeurJLerror;
wIere CIrIsLIunILy poInLs Lo sLrengLIenIng, muLerIuIIsm proLecLs
deIIcIencIes.
mpIIcIL In LIIs CIrIsLIun LeucIIng Is LIe exLru mIIe prIncIpIe.
WIere LIe Iower-nuLure, IurborIng resenLmenLs und oLIer deIIcIencIes,
wouId counseI Lo rejecL or condemn oLIers, LIe CIrIsLIun LeucIIng
ImpIores Lrunscendence - u rIsIng ubove LIe Iower-nuLure, u reIeusIng oI
InvesLmenL In conLorLed LIougIL und emoLIon; LIIs InvoIves u
LrunsIormuLIon oI beIIeI und percepLIon. No-one cun overcome LIe Iower-
nuLure buL by Gruce, IoIy counseI, und LIe desIre Ior LIe IoIy reIuLIonsIIp.
ObvIousIy, LIe IoIy journey Is u LrunsILIonuI pIuse. AII In LIIs
worId Iuve u IIsLory LIuL Is noL IIuLLerIng, I.e., sIckIy, conIused, conLorLed;
uII Iuve IuIIen sIorL oI LIe IoIy murk or sLundurd. HonesLy recognIzes LIe
need Ior suIvuLIon und LIrougI suIvuLIon Is gIILed LIe new spIrILuuI bIrLI
540
540
Rampant Antismoking Signifies Grave Danger
(progressIve spIrILuuI InsIgIL): TIereIore II uny person Is (In-gruILed) In
CIrIsL, LIe MessIuI, Ie Is (u new creuLure uILogeLIer,) u new creuLIon; LIe
oId (prevIous moruI und spIrILuuI condILIon) Ius pussed uwuy. BeIoId, LIe
IresI cnd new Ius come. (z CorInLIIuns :1;, AB)
TIen, IL Is LIe mInd LIuL Is In need oI LrunsIormIng, u IIIeIong
work, Lo uIIgnmenL wILI LIe SpIrIL. A CIrIsLIun muy Iurbor uII munner oI
deIIcIencIes or ImperIecLIons, I.e., LIey ure noL yeL perIecLed. However,
LIeIr crILIcuI dIsLInguIsIIng IeuLure Is LIuL LIey wIII noL uLLempL Lo jusLIIy
LIeIr deIIcIencIes, buL wIII conLInue Lo pursue LIIs LrunsIormuLIon Lo LIe
IoIy gouI; IonesLy, IorgIveness, und genuIne desIre cover sIorLIuIIs; u
CIrIsLIun Is noL uLLempLIng Lo geL uwuy wILI sIorLcomIngs, recognIzIng
LIuL LIey do noL brIng joy, buL puIn. A commund Lo CIrIsLIuns Is Lo beur
wILI eucI oLIers` deIIcILs durIng LIIs LrunsIormuLIon.
L Is ImporLunL Lo noLe LIuL suIvuLIon Is no smuII gIIL; IL Is noL
gIven Ior LIe equIvuIenL oI u gruze on LIe cIeek. SuIvuLIon Is InLended Lo
ruIse u mInd Irom u quugmIre oI LwIsLed, puInIuI, LerrIIyIng LIougIL und
experIence. HonesLy Is requIred Ior LIe IoIy journey, openIng up durk
pockeLs oI LIougIL und emoLIon Lo IeuIIng; u Iuck oI IonesLy wouId jusL us
eusIIy Ieuve LIese pockeLs unuLLended. L Is LIIs LrunsIormIng oI LIougIL
LIuL uIIows LIe IoIy reIuLIonsIIp Lo become u reuIILy und Ior LIe IruILs oI
LIe SpIrIL Lo be munIIesLed. WIere IonesLy Is IuckIng, LIe mInd IInds
oLIer ucLIvILIes (e.g., dIeL) Lo subsLILuLe Ior ucLuuI LrunsIormuLIon und
moruI recLILude.
AnoLIer ImporLunL observuLIon Is LIe crILIcuI dIIIerence In
Iunguuge und symboIIsm beLween CIrIsLIunILy und muLerIuIIsm. TIe
urLIIIcIuI, conLrIved Iunguuge oI muLerIuIIsm (e.g., reIuLIve rIsk,
bIocIemIsLry, reducLIonIsm, sLuLIsLIcuI cIunce) do noL IIgure In CIrIsLIun
purIunce. n CIrIsLIunILy LIere Is u Iunguuge und gouI LIuL go Lo LIe core oI
LIe Iumun condILIon, und InspIres Lo LIe IeIgILs oI HoIIness. Here Is u
superIor LIInkIng wIose cIurucLerIsLIc Is servIce ruLIer LIun superIorIsm;
IuvIng receIved by Gruce, LIe mInd Is In gruLeIuI servIce Lo God und,
LIereIore, mun In need oI, und uspIrIng Lo, God. TIIs Is uIso u crILIcuI
crILerIon LIuL dIsLInguIsIes genuIne reIIgIous Irumeworks Irom cuILs. or
exumpIe, does LIe Irumework InvoIved IosLer more proIound IndIvIduuIs?
CIrIsLIunILy, wIen properIy prucLIced, does; uILernuLIveIy, LIe MMES cuIL
promoLes superIIcIuIILy und crunky IndIvIduuIs.
n one regurd, muLerIuIIsm Is quILe correcL: no-one, oI
LIemseIves, cun uLLuIn LIe CIrIsLIun gouI: or IL Is by Iree gruce (God`s
unmerILed Iuvor) LIuL you ure suved (deIIvered Irom judgmenL cnd mude
purLukers oI CIrIsL`s suIvuLIon) LIrougI |your| IuILI. And LIIs |suIvuLIon|
Is noL oI yourseIves - oI your own doIng, IL cume noL LIrougI your own
sLrIvIng - buL IL Is LIe gIIL oI God; noL becuuse oI works |noL LIe
The Bigger Picture
IuIIIIImenL oI LIe uw`s demunds|, IesL uny mun sIouId bousL. - L Is noL
LIe resuIL oI wIuL unyone cun possIbIy do, so no one cun prIde IImseII In IL
or Luke gIory Lo IImseII. (EpIesIuns z: 8,q) HuvIng no spIrILuuI InsIgIL,
muLerIuIIsm InLerpreLs CIrIsLIun Ideus us LIe equIvuIenL oI beIng u door
muL, und Ience ILs beIIeI LIuL LIese Ideus ure IurmIuI. TIIs Is u resuIL oI
spIrILuuI bIIndness und u Iuck oI IonesLy ruLIer LIun ucLuuIILy. n IucL,
perceIvIng onIy In ILs own sLrengLI, CIrIsLIunILy und reuI ove, ure
LerrIIyIng Lo LIe muLerIuIIsL menLuIILy. YeL, noL Ior wIuL reuI ove Is, buL
Ior uII LIe conLorLed beIIeIs LIuL muLerIuIIsm wouId sLIII proLecL (LIe IoIIy
oI seII-jusLIIIcuLIon).
n LIuL LIe CIrIsLIun journey Is LrunsILIonuI, u crILIcuI Issue
concerns u busIc code oI conducL LIuL uIIows journeyIng despILe LIe IucL
LIuL uII sLIII Iurbor some Iorm oI deIIcIencIes. or exumpIe, dIvorce Is
usuuIIy noL permILLed In LIe CIrIsLIun Irumework. AguIn, In muLerIuIIsL
Lerms LIIs Is InLerpreLed us beIng ruLLed In u mIre Ior LIe resL oI one`s IIIe.
However, Irom u CIrIsLIun poInL oI vIew, IL perLuIns Lo LIe crILIcuI
reIuLIonuI uspecL. Spouses ure noL expecLed Lo sIL In IIIeIong conLempL oI
eucI oLIer. RuLIer LIey ure expecLed, und Lo LIeIr udvunLuge, by
pruyerIuIness, IuILI, IorgIveness und CIrIsL`s sLrengLI, Lo overcome - Lo
rIse ubove - LIese reIuLIonuI obsLucIes.
As uIreudy IndIcuLed, uII oI LIe CIrIsLIun LeucIIng concerns
proIound reIuLIonsIIp:
or LIe wIoIe uw |concernIng Iumun reIuLIonsIIps| Is
compIIed wILI In LIe one precepL, You sIuII Iove your
neIgIbor us yourseII. BuL II you bILe und devour one
unoLIer |In purLIsun sLrIIe|, be cureIuI LIuL you |und
your wIoIe IeIIowsIIp| ure noL consumed by one
unoLIer. (GuIuLIuns :1q,1 - AB)
Now LIe doIngs (prucLIces) oI LIe IIesI ure cIeur -
obvIous: LIey ure ImmoruIILy, ImpurILy, Indecency;
IdoIuLry, sorcery, enmILy, sLrIIe, jeuIousy, unger (III
Lemper), seIIIsIness, dIvIsIons (dIssensIons), purLy
spIrIL (IucLIons, secLs wILI pecuIIur opInIons, IeresIes);
envy, drunkenness, curousIng, und LIe IIke. wurn you
beIoreIund, jusL us dId prevIousIy, LIuL LIose wIo do
sucI LIIngs sIuII noL InIerIL LIe kIngdom oI God. BuL
LIe IruIL oI LIe (HoIy) SpIrIL, |LIe work wIIcI HIs
presence wILIIn uccompIIsIes| - Is Iove, joy (gIudness),
peuce, puLIence (un even Lemper, Iorbeurunce),
kIndness, goodness (benevoIence), IuILIIuIness;
(meekness, IumIIILy) genLIeness, seII-conLroI (seII-
resLruInL, conLInence). (GuIuLIuns :1q-z - AB)
541
541
Rampant Antismoking Signifies Grave Danger
(progressIve spIrILuuI InsIgIL): TIereIore II uny person Is (In-gruILed) In
CIrIsL, LIe MessIuI, Ie Is (u new creuLure uILogeLIer,) u new creuLIon; LIe
oId (prevIous moruI und spIrILuuI condILIon) Ius pussed uwuy. BeIoId, LIe
IresI cnd new Ius come. (z CorInLIIuns :1;, AB)
TIen, IL Is LIe mInd LIuL Is In need oI LrunsIormIng, u IIIeIong
work, Lo uIIgnmenL wILI LIe SpIrIL. A CIrIsLIun muy Iurbor uII munner oI
deIIcIencIes or ImperIecLIons, I.e., LIey ure noL yeL perIecLed. However,
LIeIr crILIcuI dIsLInguIsIIng IeuLure Is LIuL LIey wIII noL uLLempL Lo jusLIIy
LIeIr deIIcIencIes, buL wIII conLInue Lo pursue LIIs LrunsIormuLIon Lo LIe
IoIy gouI; IonesLy, IorgIveness, und genuIne desIre cover sIorLIuIIs; u
CIrIsLIun Is noL uLLempLIng Lo geL uwuy wILI sIorLcomIngs, recognIzIng
LIuL LIey do noL brIng joy, buL puIn. A commund Lo CIrIsLIuns Is Lo beur
wILI eucI oLIers` deIIcILs durIng LIIs LrunsIormuLIon.
L Is ImporLunL Lo noLe LIuL suIvuLIon Is no smuII gIIL; IL Is noL
gIven Ior LIe equIvuIenL oI u gruze on LIe cIeek. SuIvuLIon Is InLended Lo
ruIse u mInd Irom u quugmIre oI LwIsLed, puInIuI, LerrIIyIng LIougIL und
experIence. HonesLy Is requIred Ior LIe IoIy journey, openIng up durk
pockeLs oI LIougIL und emoLIon Lo IeuIIng; u Iuck oI IonesLy wouId jusL us
eusIIy Ieuve LIese pockeLs unuLLended. L Is LIIs LrunsIormIng oI LIougIL
LIuL uIIows LIe IoIy reIuLIonsIIp Lo become u reuIILy und Ior LIe IruILs oI
LIe SpIrIL Lo be munIIesLed. WIere IonesLy Is IuckIng, LIe mInd IInds
oLIer ucLIvILIes (e.g., dIeL) Lo subsLILuLe Ior ucLuuI LrunsIormuLIon und
moruI recLILude.
AnoLIer ImporLunL observuLIon Is LIe crILIcuI dIIIerence In
Iunguuge und symboIIsm beLween CIrIsLIunILy und muLerIuIIsm. TIe
urLIIIcIuI, conLrIved Iunguuge oI muLerIuIIsm (e.g., reIuLIve rIsk,
bIocIemIsLry, reducLIonIsm, sLuLIsLIcuI cIunce) do noL IIgure In CIrIsLIun
purIunce. n CIrIsLIunILy LIere Is u Iunguuge und gouI LIuL go Lo LIe core oI
LIe Iumun condILIon, und InspIres Lo LIe IeIgILs oI HoIIness. Here Is u
superIor LIInkIng wIose cIurucLerIsLIc Is servIce ruLIer LIun superIorIsm;
IuvIng receIved by Gruce, LIe mInd Is In gruLeIuI servIce Lo God und,
LIereIore, mun In need oI, und uspIrIng Lo, God. TIIs Is uIso u crILIcuI
crILerIon LIuL dIsLInguIsIes genuIne reIIgIous Irumeworks Irom cuILs. or
exumpIe, does LIe Irumework InvoIved IosLer more proIound IndIvIduuIs?
CIrIsLIunILy, wIen properIy prucLIced, does; uILernuLIveIy, LIe MMES cuIL
promoLes superIIcIuIILy und crunky IndIvIduuIs.
n one regurd, muLerIuIIsm Is quILe correcL: no-one, oI
LIemseIves, cun uLLuIn LIe CIrIsLIun gouI: or IL Is by Iree gruce (God`s
unmerILed Iuvor) LIuL you ure suved (deIIvered Irom judgmenL cnd mude
purLukers oI CIrIsL`s suIvuLIon) LIrougI |your| IuILI. And LIIs |suIvuLIon|
Is noL oI yourseIves - oI your own doIng, IL cume noL LIrougI your own
sLrIvIng - buL IL Is LIe gIIL oI God; noL becuuse oI works |noL LIe
The Bigger Picture
IuIIIIImenL oI LIe uw`s demunds|, IesL uny mun sIouId bousL. - L Is noL
LIe resuIL oI wIuL unyone cun possIbIy do, so no one cun prIde IImseII In IL
or Luke gIory Lo IImseII. (EpIesIuns z: 8,q) HuvIng no spIrILuuI InsIgIL,
muLerIuIIsm InLerpreLs CIrIsLIun Ideus us LIe equIvuIenL oI beIng u door
muL, und Ience ILs beIIeI LIuL LIese Ideus ure IurmIuI. TIIs Is u resuIL oI
spIrILuuI bIIndness und u Iuck oI IonesLy ruLIer LIun ucLuuIILy. n IucL,
perceIvIng onIy In ILs own sLrengLI, CIrIsLIunILy und reuI ove, ure
LerrIIyIng Lo LIe muLerIuIIsL menLuIILy. YeL, noL Ior wIuL reuI ove Is, buL
Ior uII LIe conLorLed beIIeIs LIuL muLerIuIIsm wouId sLIII proLecL (LIe IoIIy
oI seII-jusLIIIcuLIon).
n LIuL LIe CIrIsLIun journey Is LrunsILIonuI, u crILIcuI Issue
concerns u busIc code oI conducL LIuL uIIows journeyIng despILe LIe IucL
LIuL uII sLIII Iurbor some Iorm oI deIIcIencIes. or exumpIe, dIvorce Is
usuuIIy noL permILLed In LIe CIrIsLIun Irumework. AguIn, In muLerIuIIsL
Lerms LIIs Is InLerpreLed us beIng ruLLed In u mIre Ior LIe resL oI one`s IIIe.
However, Irom u CIrIsLIun poInL oI vIew, IL perLuIns Lo LIe crILIcuI
reIuLIonuI uspecL. Spouses ure noL expecLed Lo sIL In IIIeIong conLempL oI
eucI oLIer. RuLIer LIey ure expecLed, und Lo LIeIr udvunLuge, by
pruyerIuIness, IuILI, IorgIveness und CIrIsL`s sLrengLI, Lo overcome - Lo
rIse ubove - LIese reIuLIonuI obsLucIes.
As uIreudy IndIcuLed, uII oI LIe CIrIsLIun LeucIIng concerns
proIound reIuLIonsIIp:
or LIe wIoIe uw |concernIng Iumun reIuLIonsIIps| Is
compIIed wILI In LIe one precepL, You sIuII Iove your
neIgIbor us yourseII. BuL II you bILe und devour one
unoLIer |In purLIsun sLrIIe|, be cureIuI LIuL you |und
your wIoIe IeIIowsIIp| ure noL consumed by one
unoLIer. (GuIuLIuns :1q,1 - AB)
Now LIe doIngs (prucLIces) oI LIe IIesI ure cIeur -
obvIous: LIey ure ImmoruIILy, ImpurILy, Indecency;
IdoIuLry, sorcery, enmILy, sLrIIe, jeuIousy, unger (III
Lemper), seIIIsIness, dIvIsIons (dIssensIons), purLy
spIrIL (IucLIons, secLs wILI pecuIIur opInIons, IeresIes);
envy, drunkenness, curousIng, und LIe IIke. wurn you
beIoreIund, jusL us dId prevIousIy, LIuL LIose wIo do
sucI LIIngs sIuII noL InIerIL LIe kIngdom oI God. BuL
LIe IruIL oI LIe (HoIy) SpIrIL, |LIe work wIIcI HIs
presence wILIIn uccompIIsIes| - Is Iove, joy (gIudness),
peuce, puLIence (un even Lemper, Iorbeurunce),
kIndness, goodness (benevoIence), IuILIIuIness;
(meekness, IumIIILy) genLIeness, seII-conLroI (seII-
resLruInL, conLInence). (GuIuLIuns :1q-z - AB)
542
542
Rampant Antismoking Signifies Grave Danger The Bigger Picture Rampant Antismoking Signifies Grave Danger
eL us noL become vuIngIorIous cnd seII-conceILed,
compeLILIve cnd cIuIIengIng cnd provokIng cnd
IrrILuLIng Lo one unoLIer, envyIng cnd beIng jeuIous oI
one unoLIer. (GuIuLIuns :z6 - AB)
BreLIren, II uny person Is overLuken In mIsconducL or
sIn oI uny sorL, you wIo ure spIrILuuI - wIo ure
responsIve Lo und conLroIIed by LIe SpIrIL - sIouId seL
IIm rIgIL cnd resLore cnd reInsLuLe IIm, wILIouL uny
sense oI superIorILy cnd wILI uII genLIeness, keepIng un
uLLenLIve eye on yourseII, IesL you sIouId be LempLed
uIso. (GuIuLIuns 6:1 - AB)
IvIng us becomes you - wILI compIeLe IowIIness oI
mInd (IumIIILy) cnd meekness (unseIIIsIness,
genLIeness, mIIdness), wILI puLIence, beurIng wILI one
unoLIer cnd mukIng uIIowunces becuuse you Iove one
unoLIer. Be euger cnd sLrIve eurnesLIy Lo guurd cnd
keep LIe Iurmony cnd oneness oI |produced by| LIe
SpIrIL In LIe bIndIng power oI peuce. (EpIesIuns q:z, -
AB)
WIen ungry, do noL sIn; do noL ever IeL your wruLI -
your exusperuLIon, your Iury or IndIgnuLIon - IusL unLII
LIe sun goes down. euve no |sucI| room or IooLIoId
Ior LIe devII - gIve no opporLunILy Lo IIm..eL no IouI
or poIIuLIng Iunguuge, nor evII word, nor unwIoIesome
or worLIIess LuIk |ever| come ouL oI your mouLI; buL
onIy sucI |speecI| us Is good cnd beneIIcIuI Lo LIe
spIrILuuI progress oI oLIers. (EpIesIuns q: z6,z;,zq -
AB)
eL uII bILLerness und IndIgnuLIon cnd wruLI (pussIon,
ruge, bud Lemper) und resenLmenL (unger, unImosILy)
und quurreIIIng (bruwIIng, cIumor, conLenLIon) und
sIunder (evIIspeukIng, ubusIve or bIuspIemous
Iunguuge) be bunIsIed Irom you, wILI uII muIIce (spILe,
III wIII or buseness oI uny kInd). And become useIuI cnd
IeIpIuI cnd kInd Lo one unoLIer, LenderIeurLed
(compussIonuLe, undersLundIng, IovIng-IeurLed),
IorgIvIng one unoLIer |reudIIy und IreeIy|, us God In
CIrIsL Iorguve you. (EpIesIuns q: 1,z - AB)
BuL reIuse und uvoId IrreverenL Iegends - proIune und
Impure und godIess IIcLIons, mere grundmoLIers` LuIes
- und sIIIy myLIs, cnd express your dIsupprovuI oI
LIem. TruIn yourseII Lowurd godIIness (pIeLy) - keepIng
The Bigger Picture
yourseII spIrILuuIIy IIL. (1 TImoLIy q:; - AB)
BuL reIuse - sIuL your mInd uguInsL, Iuve noLIIng Lo do
wILI - LrIIIIng (III-InIormed, unedIIyIng, sLupId)
conLroversIes over IgnorunL quesLIonIngs, Ior you know
LIuL LIey IosLer sLrIIe cnd breed quurreIs. And LIe
servunL oI LIe ord musL noL be quurreIsome - IIgILIng
und conLendIng. nsLeud Ie musL be kIndIy Lo every one
cnd mIId-Lempered - preservIng LIe bond oI peuce; Ie
musL be u skIIIed cnd suILubIe LeucIer, puLIenL cnd
IorbeurIng cnd wIIIIng Lo suIIer wrong. He musL correcL
IIs opponenLs wILI courLesy und genLIeness, In LIe Iope
LIuL God muy grunL LIuL LIey wIII repenL und come Lo
know LIe TruLI - LIuL Is, LIuL LIey wIII perceIve und
recognIze und become uccuruLeIy ucquuInLed wILI und
ucknowIedge IL. (z TImoLIy z: z-z - AB)
or LIe LIme Is comIng wIen |peopIe| wIII noL LoIeruLe
(endure) sound cnd wIoIesome InsLrucLIon, buL IuvIng
eurs ILcIIng |Ior someLIIng pIeusIng und gruLIIyIng|,
LIey wIII guLIer Lo LIemseIves one LeucIer uILer unoLIer
Lo u consIderubIe number, cIosen Lo suLIsIy LIeIr own
IIkIng cnd Lo IosLer LIe errors LIey IoId, und wIII Lurn
usIde Irom IeurIng LIe LruLI und wunder oII InLo myLIs
cnd mun-mude IIcLIons. (z TImoLIy q: ,q - AB)
To LIe pure |In IeurL und conscIence| uII LIIngs ure
pure, buL Lo LIe deIIIed cnd corrupL und unbeIIevIng
noLIIng Is pure; LIeIr very mInd und conscIence ure
deIIIed cnd poIIuLed. (TILus 1: 1 - AB)
or we uIso were once LIougILIess cnd senseIess,
obsLInuLe cnd dIsobedIenL, deIuded cnd mIsIed; |we Loo
were once| sIuves Lo uII sorLs oI cruvIngs cnd pIeusures,
wusLIng our duys In muIIce und jeuIousy cnd envy,
IuLeIuI (IuLed, deLesLubIe) und IuLIng one unoLIer.
(TILus : - AB)
And LIe Longue |Is| u IIre. |TIe Longue Is u| worId oI
wIckedness seL umong our members, conLumInuLIng
cnd depruvIng LIe wIoIe body und seLLIng on IIre LIe
wIeeI oI bIrLI - LIe cycIe oI mun`s nuLure - beIng ILseII
IgnILed by IeII (GeIennu). or every kInd oI beusL und
bIrd, oI repLIIe und seu unImuI cun be Lumed und Ius
been Lumed by Iumun genIus (nuLure). BuL LIe Iumun
Longue cun be Lumed by no mun. L Is (un undIscIpIIned,
IrreconcIIubIe) resLIess evII, IuII oI deuLI-brIngIng
543
543
Rampant Antismoking Signifies Grave Danger The Bigger Picture Rampant Antismoking Signifies Grave Danger
eL us noL become vuIngIorIous cnd seII-conceILed,
compeLILIve cnd cIuIIengIng cnd provokIng cnd
IrrILuLIng Lo one unoLIer, envyIng cnd beIng jeuIous oI
one unoLIer. (GuIuLIuns :z6 - AB)
BreLIren, II uny person Is overLuken In mIsconducL or
sIn oI uny sorL, you wIo ure spIrILuuI - wIo ure
responsIve Lo und conLroIIed by LIe SpIrIL - sIouId seL
IIm rIgIL cnd resLore cnd reInsLuLe IIm, wILIouL uny
sense oI superIorILy cnd wILI uII genLIeness, keepIng un
uLLenLIve eye on yourseII, IesL you sIouId be LempLed
uIso. (GuIuLIuns 6:1 - AB)
IvIng us becomes you - wILI compIeLe IowIIness oI
mInd (IumIIILy) cnd meekness (unseIIIsIness,
genLIeness, mIIdness), wILI puLIence, beurIng wILI one
unoLIer cnd mukIng uIIowunces becuuse you Iove one
unoLIer. Be euger cnd sLrIve eurnesLIy Lo guurd cnd
keep LIe Iurmony cnd oneness oI |produced by| LIe
SpIrIL In LIe bIndIng power oI peuce. (EpIesIuns q:z, -
AB)
WIen ungry, do noL sIn; do noL ever IeL your wruLI -
your exusperuLIon, your Iury or IndIgnuLIon - IusL unLII
LIe sun goes down. euve no |sucI| room or IooLIoId
Ior LIe devII - gIve no opporLunILy Lo IIm..eL no IouI
or poIIuLIng Iunguuge, nor evII word, nor unwIoIesome
or worLIIess LuIk |ever| come ouL oI your mouLI; buL
onIy sucI |speecI| us Is good cnd beneIIcIuI Lo LIe
spIrILuuI progress oI oLIers. (EpIesIuns q: z6,z;,zq -
AB)
eL uII bILLerness und IndIgnuLIon cnd wruLI (pussIon,
ruge, bud Lemper) und resenLmenL (unger, unImosILy)
und quurreIIIng (bruwIIng, cIumor, conLenLIon) und
sIunder (evIIspeukIng, ubusIve or bIuspIemous
Iunguuge) be bunIsIed Irom you, wILI uII muIIce (spILe,
III wIII or buseness oI uny kInd). And become useIuI cnd
IeIpIuI cnd kInd Lo one unoLIer, LenderIeurLed
(compussIonuLe, undersLundIng, IovIng-IeurLed),
IorgIvIng one unoLIer |reudIIy und IreeIy|, us God In
CIrIsL Iorguve you. (EpIesIuns q: 1,z - AB)
BuL reIuse und uvoId IrreverenL Iegends - proIune und
Impure und godIess IIcLIons, mere grundmoLIers` LuIes
- und sIIIy myLIs, cnd express your dIsupprovuI oI
LIem. TruIn yourseII Lowurd godIIness (pIeLy) - keepIng
The Bigger Picture
yourseII spIrILuuIIy IIL. (1 TImoLIy q:; - AB)
BuL reIuse - sIuL your mInd uguInsL, Iuve noLIIng Lo do
wILI - LrIIIIng (III-InIormed, unedIIyIng, sLupId)
conLroversIes over IgnorunL quesLIonIngs, Ior you know
LIuL LIey IosLer sLrIIe cnd breed quurreIs. And LIe
servunL oI LIe ord musL noL be quurreIsome - IIgILIng
und conLendIng. nsLeud Ie musL be kIndIy Lo every one
cnd mIId-Lempered - preservIng LIe bond oI peuce; Ie
musL be u skIIIed cnd suILubIe LeucIer, puLIenL cnd
IorbeurIng cnd wIIIIng Lo suIIer wrong. He musL correcL
IIs opponenLs wILI courLesy und genLIeness, In LIe Iope
LIuL God muy grunL LIuL LIey wIII repenL und come Lo
know LIe TruLI - LIuL Is, LIuL LIey wIII perceIve und
recognIze und become uccuruLeIy ucquuInLed wILI und
ucknowIedge IL. (z TImoLIy z: z-z - AB)
or LIe LIme Is comIng wIen |peopIe| wIII noL LoIeruLe
(endure) sound cnd wIoIesome InsLrucLIon, buL IuvIng
eurs ILcIIng |Ior someLIIng pIeusIng und gruLIIyIng|,
LIey wIII guLIer Lo LIemseIves one LeucIer uILer unoLIer
Lo u consIderubIe number, cIosen Lo suLIsIy LIeIr own
IIkIng cnd Lo IosLer LIe errors LIey IoId, und wIII Lurn
usIde Irom IeurIng LIe LruLI und wunder oII InLo myLIs
cnd mun-mude IIcLIons. (z TImoLIy q: ,q - AB)
To LIe pure |In IeurL und conscIence| uII LIIngs ure
pure, buL Lo LIe deIIIed cnd corrupL und unbeIIevIng
noLIIng Is pure; LIeIr very mInd und conscIence ure
deIIIed cnd poIIuLed. (TILus 1: 1 - AB)
or we uIso were once LIougILIess cnd senseIess,
obsLInuLe cnd dIsobedIenL, deIuded cnd mIsIed; |we Loo
were once| sIuves Lo uII sorLs oI cruvIngs cnd pIeusures,
wusLIng our duys In muIIce und jeuIousy cnd envy,
IuLeIuI (IuLed, deLesLubIe) und IuLIng one unoLIer.
(TILus : - AB)
And LIe Longue |Is| u IIre. |TIe Longue Is u| worId oI
wIckedness seL umong our members, conLumInuLIng
cnd depruvIng LIe wIoIe body und seLLIng on IIre LIe
wIeeI oI bIrLI - LIe cycIe oI mun`s nuLure - beIng ILseII
IgnILed by IeII (GeIennu). or every kInd oI beusL und
bIrd, oI repLIIe und seu unImuI cun be Lumed und Ius
been Lumed by Iumun genIus (nuLure). BuL LIe Iumun
Longue cun be Lumed by no mun. L Is (un undIscIpIIned,
IrreconcIIubIe) resLIess evII, IuII oI deuLI-brIngIng
544
544
Rampant Antismoking Signifies Grave Danger The Bigger Picture The Bigger Picture
uddIcLIve, LIuL LIe cIgureLLe pupers conLuIned ursenIc, und LIuL 'LIe
cIgureLLe Is LIe devII`s devIce Lo kIII young AmerIcu, und young BrILuIn us
weII.` (WuIker, 1q8o, p.qoz) SucI urgumenLs usuuIIy IndIcuLed more
ubouL LIe erruLIc nuLure oI LIe uccusuLory menLuIILy LIun ubouL smokIng
or LIe smoker.
ConcernIng LIe nIneLeenLI cenLury, und sLIII reIevunL Loduy,
WuIker (1q8o) InIorms:
Persons wIo regurded pIeusure wILI suspIcIon, persons
wIo Imposed dIscIpIIne on LIemseIves In order Lo IuIIII
one greuL commILmenL, Lended Lo oppose Lobucco. n
some cuses, sucI us LIuL oI WIIson CurIIIe, Iounder oI
LIe CIurcI Army, reIIgIous conversIon und LIe rejecLIon
oI Lobucco were cIoseIy IInked. L Is suId LIuL LIe
EvungeIIcuI SIr Jumes SLepIen guve up snuII us Ie couId
IInd no jusLIIIcuLIon In IuILI Ior LukIng IL, und LIuL 'Ie
once smoked u cIgur und Iound IL so deIIcIous LIuL Ie
never smoked uguIn.`..TIe suIvuLIon Army dId noL
uIIow ILs bundsmen und oIIIcers Lo smoke und LIe
PIymouLI BreLIren wouId noL Luke Lobucco.. (p.q;)
DuvIes (1qq6) noLes LIuL SevenLI-Duy AdvenLIsm Ius sLrIcLures
on LIe use oI purLIcuIur producLs:
TIe SevenLI-Duy AdvenLIsL propIeL und Ieuder, Mrs.
EIIen G. WIILe, IIkewIse uLLucked LIe use oI uIcoIoI,
Lobucco, Leu und coIIee In Ier essuy, 'SpIrILuuI gIILs` oI
186q, concIudIng: 'TIose wIo InduIge u perverLed
uppeLILe, do IL Lo LIe Injury oI IeuILI und InLeIIecL. TIey
cunnoL upprecIuLe LIe vuIue oI spIrILuuI LIIngs. TIeIr
sensIbIIILIes ure bIunLed und sIn does noL uppeur very
sInIuI und LruLI Is noL regurded oI greuLer vuIue LIun
eurLIIy Lreusure.` or Mrs. WIILe, even moderuLe
drInkers oI uIcoIoI evenLuuIIy degruded LIemseIves
'Iower LIun LIe beusLs,` LIose wIo Iud IuIIen vIcLIm Lo
LIe 'sIow poIson` oI Lobucco 'couId IurdIy expecL eLernuI
IIIe` und sIe wus udumunL LIuL 'Leu und coIIee drInkIng
Is u sIn...SIe wus uguInsL LIe euLIng oI meuL und In
prIncIpIe Iuvoured vegeLurIunIsm. (p.zq)
AILernuLIveIy, LIere were muny pusLors und cIergy LIuL smoked
Lobucco or were noL ucLIveIy opposed Lo IL:
ErnesL PonLIIex uL LIe LIme oI IIs conversIon Iocked up
IIs pIpes buL soon resumed smokIng even wIIIe IIs
poIson. WILI IL we bIess LIe ord und uLIer, und wILI
IL we curse men wIo were mude In God`s IIkeness! OuL
oI LIe sume mouLI come IorLI bIessIng und cursIng.
TIese LIIngs, my breLIren, ougIL noL Lo be so. (Jumes
; 6-1o - AB)
So be done wILI every Lruce oI wIckedness (depruvILy,
muIIgnILy) und uII deceIL und InsIncerILy (preLense,
IypocrIsy) und grudges (envy, jeuIousy) und sIunder
cnd evII speukIng oI every kInd. (1 PeLer z:1 - AB)
or IeL IIm wIo wunLs Lo enjoy IIIe und see good duys
(good wIeLIer uppurenL or noL), keep IIs Longue Iree
Irom evII, und IIs IIps Irom guIIe (LreucIery, deceIL). eL
IIm Lurn uwuy Irom wIckedness cnd sIun IL; und IeL
IIm do rIgIL. eL IIm seurcI Ior peuce - Iurmony,
undIsLurbedness Irom Ieurs, ugILuLIng pussIons und
moruI conIIIcLs - und seek IL eugerIy. - Do noL mereIy
desIre peuceIuI reIuLIons |wILI God, wILI your
IeIIowmen, und wILI yourseII|, buL pursue, go uILer
LIem! (1 PeLer : 1o,11 - AB)
TIe domInunL LIeme, IndIcuLed In consIderubIe scrIpLure, Is u
purLIcuIur cIurucLer gouI Ior LIe CIrIsLIun. ConsIdered In LIIs dIscussIon
Is LIuL wIere sucI u proIound gouI Is jeLLIsoned by socIeLIes, conLorLed
Iower-nuLure reusonIng becomes normuIIzed. HuvIng dIspensed wILI LIe
meuns Lo IeuI severe guIIL, Ieur und IuLred, mInds projecL LIese LwIsLed
emoLIons ouLwurd. One oI LIe mujor, munuIucLured projecLIon-poInLs
(ucuLe IIxuLIon) oI LIe LIme Is smokIng und ETS. TIIs cun be undersLood
Ior secuIur LIInkIng. However, unLIsmokIng Ius uIso IIgured In LIe edIcLs
oI purLIcuIur CIrIsLIun groups, e.g., DuvIes (1qq6), TuLe (1qqq), WuIker
(1q8o). L Is sure LIuL CIrIsLIuns Iuve been InIIuenced by LIe IruuduIenL
scIenLIIIc cIuIms oI IIIesLyIe epIdemIoIogy sInce LIe 1q6o`s. BuL, un
unLIsmokIng sLunce wus IeId by some CIrIsLIuns Iong beIore LIIs LIme.
Over LIe IusL Iew cenLurIes, vIews In CIrIsLIun cIrcIes concernIng
smokIng Iuve usuuIIy been sIuped by ILs ussocIuLIon (correIuLIon) wILI
uIcoIoI consumpLIon. BoLI ucLIvILIes were consIdered by some Lo be
murkers oI moruI IuxILy und LIe producers oI dIseuse. However, us noLed
by WuIker (1q8o), boLI LIe medIcuI und moruI urgumenLs uguInsL
Lobucco In LIe nIneLeenLI und eurIy-LwenLIeLI cenLurIes were LypIcuIIy
unsubsLunLIuLed (I.e., oI LIe post hoc ero propter hoc Lype) und
exLruvugunL. or exumpIe, |L|Ie Rev. J.Q.A. Henry In 1qo6..usserLed
LIuL cIgureLLes were munuIucLured In IIILIy condILIons by workers
suIIerIng Irom Ieprosy, LIuL opIum wus mIxed In Lo muke LIe producL
545
545
Rampant Antismoking Signifies Grave Danger The Bigger Picture The Bigger Picture
uddIcLIve, LIuL LIe cIgureLLe pupers conLuIned ursenIc, und LIuL 'LIe
cIgureLLe Is LIe devII`s devIce Lo kIII young AmerIcu, und young BrILuIn us
weII.` (WuIker, 1q8o, p.qoz) SucI urgumenLs usuuIIy IndIcuLed more
ubouL LIe erruLIc nuLure oI LIe uccusuLory menLuIILy LIun ubouL smokIng
or LIe smoker.
ConcernIng LIe nIneLeenLI cenLury, und sLIII reIevunL Loduy,
WuIker (1q8o) InIorms:
Persons wIo regurded pIeusure wILI suspIcIon, persons
wIo Imposed dIscIpIIne on LIemseIves In order Lo IuIIII
one greuL commILmenL, Lended Lo oppose Lobucco. n
some cuses, sucI us LIuL oI WIIson CurIIIe, Iounder oI
LIe CIurcI Army, reIIgIous conversIon und LIe rejecLIon
oI Lobucco were cIoseIy IInked. L Is suId LIuL LIe
EvungeIIcuI SIr Jumes SLepIen guve up snuII us Ie couId
IInd no jusLIIIcuLIon In IuILI Ior LukIng IL, und LIuL 'Ie
once smoked u cIgur und Iound IL so deIIcIous LIuL Ie
never smoked uguIn.`..TIe suIvuLIon Army dId noL
uIIow ILs bundsmen und oIIIcers Lo smoke und LIe
PIymouLI BreLIren wouId noL Luke Lobucco.. (p.q;)
DuvIes (1qq6) noLes LIuL SevenLI-Duy AdvenLIsm Ius sLrIcLures
on LIe use oI purLIcuIur producLs:
TIe SevenLI-Duy AdvenLIsL propIeL und Ieuder, Mrs.
EIIen G. WIILe, IIkewIse uLLucked LIe use oI uIcoIoI,
Lobucco, Leu und coIIee In Ier essuy, 'SpIrILuuI gIILs` oI
186q, concIudIng: 'TIose wIo InduIge u perverLed
uppeLILe, do IL Lo LIe Injury oI IeuILI und InLeIIecL. TIey
cunnoL upprecIuLe LIe vuIue oI spIrILuuI LIIngs. TIeIr
sensIbIIILIes ure bIunLed und sIn does noL uppeur very
sInIuI und LruLI Is noL regurded oI greuLer vuIue LIun
eurLIIy Lreusure.` or Mrs. WIILe, even moderuLe
drInkers oI uIcoIoI evenLuuIIy degruded LIemseIves
'Iower LIun LIe beusLs,` LIose wIo Iud IuIIen vIcLIm Lo
LIe 'sIow poIson` oI Lobucco 'couId IurdIy expecL eLernuI
IIIe` und sIe wus udumunL LIuL 'Leu und coIIee drInkIng
Is u sIn...SIe wus uguInsL LIe euLIng oI meuL und In
prIncIpIe Iuvoured vegeLurIunIsm. (p.zq)
AILernuLIveIy, LIere were muny pusLors und cIergy LIuL smoked
Lobucco or were noL ucLIveIy opposed Lo IL:
ErnesL PonLIIex uL LIe LIme oI IIs conversIon Iocked up
IIs pIpes buL soon resumed smokIng even wIIIe IIs
poIson. WILI IL we bIess LIe ord und uLIer, und wILI
IL we curse men wIo were mude In God`s IIkeness! OuL
oI LIe sume mouLI come IorLI bIessIng und cursIng.
TIese LIIngs, my breLIren, ougIL noL Lo be so. (Jumes
; 6-1o - AB)
So be done wILI every Lruce oI wIckedness (depruvILy,
muIIgnILy) und uII deceIL und InsIncerILy (preLense,
IypocrIsy) und grudges (envy, jeuIousy) und sIunder
cnd evII speukIng oI every kInd. (1 PeLer z:1 - AB)
or IeL IIm wIo wunLs Lo enjoy IIIe und see good duys
(good wIeLIer uppurenL or noL), keep IIs Longue Iree
Irom evII, und IIs IIps Irom guIIe (LreucIery, deceIL). eL
IIm Lurn uwuy Irom wIckedness cnd sIun IL; und IeL
IIm do rIgIL. eL IIm seurcI Ior peuce - Iurmony,
undIsLurbedness Irom Ieurs, ugILuLIng pussIons und
moruI conIIIcLs - und seek IL eugerIy. - Do noL mereIy
desIre peuceIuI reIuLIons |wILI God, wILI your
IeIIowmen, und wILI yourseII|, buL pursue, go uILer
LIem! (1 PeLer : 1o,11 - AB)
TIe domInunL LIeme, IndIcuLed In consIderubIe scrIpLure, Is u
purLIcuIur cIurucLer gouI Ior LIe CIrIsLIun. ConsIdered In LIIs dIscussIon
Is LIuL wIere sucI u proIound gouI Is jeLLIsoned by socIeLIes, conLorLed
Iower-nuLure reusonIng becomes normuIIzed. HuvIng dIspensed wILI LIe
meuns Lo IeuI severe guIIL, Ieur und IuLred, mInds projecL LIese LwIsLed
emoLIons ouLwurd. One oI LIe mujor, munuIucLured projecLIon-poInLs
(ucuLe IIxuLIon) oI LIe LIme Is smokIng und ETS. TIIs cun be undersLood
Ior secuIur LIInkIng. However, unLIsmokIng Ius uIso IIgured In LIe edIcLs
oI purLIcuIur CIrIsLIun groups, e.g., DuvIes (1qq6), TuLe (1qqq), WuIker
(1q8o). L Is sure LIuL CIrIsLIuns Iuve been InIIuenced by LIe IruuduIenL
scIenLIIIc cIuIms oI IIIesLyIe epIdemIoIogy sInce LIe 1q6o`s. BuL, un
unLIsmokIng sLunce wus IeId by some CIrIsLIuns Iong beIore LIIs LIme.
Over LIe IusL Iew cenLurIes, vIews In CIrIsLIun cIrcIes concernIng
smokIng Iuve usuuIIy been sIuped by ILs ussocIuLIon (correIuLIon) wILI
uIcoIoI consumpLIon. BoLI ucLIvILIes were consIdered by some Lo be
murkers oI moruI IuxILy und LIe producers oI dIseuse. However, us noLed
by WuIker (1q8o), boLI LIe medIcuI und moruI urgumenLs uguInsL
Lobucco In LIe nIneLeenLI und eurIy-LwenLIeLI cenLurIes were LypIcuIIy
unsubsLunLIuLed (I.e., oI LIe post hoc ero propter hoc Lype) und
exLruvugunL. or exumpIe, |L|Ie Rev. J.Q.A. Henry In 1qo6..usserLed
LIuL cIgureLLes were munuIucLured In IIILIy condILIons by workers
suIIerIng Irom Ieprosy, LIuL opIum wus mIxed In Lo muke LIe producL
546
546
Rampant Antismoking Signifies Grave Danger The Bigger Picture Rampant Antismoking Signifies Grave Danger
reIIgIous commILmenL remuIned. n 188; In response Lo
u quesLIonnuIre Irom LIe EngIIsI AnLI-Tobucco
AssocIuLIon, LwenLy-LIree oI LIe LIIrLy-Iour EngIIsI
bIsIops repIIed LIuL LIey dId noL smoke. TIe remuInIng
eIeven uppurenLIy conLuIned some smokers und IL muy
be noLed LIuL onIy one oI LIe LwenLy-LIree expressIy
commended LIe work oI LIe AssocIuLIon..|T|Ie
'denomInuLIon-Lype` cIurcIes (NonconIormIsLs) und
LIe 'cIurcI-Lype` (AngIIcuns und CuLIoIIcs) IeIL LIe
muLLer Lo IndIvIduuI decIsIon. SmokIng mInIsLers sucI
us LIe Rev. CIurIes Spurgeon, wIo boIdIy decIured LIuL
Ie wouId smoke u cIgur Ior reIresImenL und Lo LIe gIory
oI God, were u sLundIng dIsprooI oI LIe uIIeged
connexIon beLween smokIng und IrreIIgIon. n IucL LIe
gruduuI subsLILuLIon oI IruIL juIce Ior IermenLed wIne In
LIe sucrumenL oI IoIy communIon , LIe LeeLoLuIIers Iud
greuLer InIIuence on LIe NonconIormIsL denomInuLIons
LIun Iud LIe LobuccopIobes. TIe ruIes oI LIe WesIeyun
MeLIodIsL ConnexIon usked LIe ordInund, 'Do you Luke
no snuII, Lobucco, or drums?`, buL muny WesIeyun
mInIsLers dId noL Luke LIIs obIIguLIon Lo bInd LIem In
LIe muLLer oI smokIng. Among LIe WesIeyuns LIe
opponenLs oI Lobucco mud no progress. L seems LIuL
AngIIcun cIergy und ProLesLunL mInIsLers smoked
prIvuLeIy und dIscreeLIy. TIe 'Dossers` Purson` und
EdmonLon mIssIoner Mr. CoIIIngs wus u rure excepLIon
Lo LIIs cuuLIon. DeLermIned Lo Induce workIngmen Lo
worsIIp, Ie sLood uL LIe door smokIng u cIgur und
IundIng ouL LIreepenny sIug wILI un InvILuLIon Lo puII
uwuy durIng LIe servIce. (WuIker, 1q8o, p.q;)
Even Lemperunce reIormers uILImuLeIy pursued uIcoIoI ruLIer
LIun Lobucco: PreIerrIng Lo weun workIngmen Irom LIe poL ruLIer LIun
LIe pIpe, LIe Lemperunce reIormers soId Lobucco und provIded smokIng
rooms In LIeIr coIIee Iouses und Lemperunce IoLeIs. One guIde udvIsed
LIuL smokIng sIouId noL be conIIned Lo one room buL be uIIowed
everywIere so LIuL LIe vIsILor mIgIL IeeI LIorougIIy uL Iome. (WuIker,
1q8o, p.qoo)
TIe concern wILI uIcoIoI Is purLIy undersLundubIe. n LIuL LIe
CIrIsLIun gouI empIusIzes LIe reIuLIonuI dImensIon, InLoxIcuLIon wIII
cerLuInIy compromIse LIIs pursuIL - LIe scrIpLures IndIcuLe LIuL
drunkenness Is Lo be uvoIded, e.g., EpIesIuns :18, TILus z:. However,
The Bigger Picture
LIIs does noL ImpIy u bun on uIcoIoI consumpLIon by uII udIerenLs Lo LIe
CIrIsLIun LeucIIng (or greuLer socIeLy), nor Is LIIs IndIcuLed In scrIpLure.
CerLuInIy, unyone wouId be weII-udvIsed Lo uvoId uny subsLunce LIuL
compromIses cIurILy oI LIougIL und moruI dIscernmenL. TIe LreuLmenL oI
Lobucco Is enLIreIy unLenubIe becuuse LIe moruIIzIng over ILs use Is
LypIcuIIy bused on IncoIerenL unuIogIes wILI uIcoIoI consumpLIon or
oLIer InLoxIcuLIng Iurd drugs.
TIe ImporLunL quesLIon LIuL wus consIdered In LIe eurIIer secLIon
The Nczi Anti-Tobccco Motement wus wIeLIer nonsmokIng und non-
drInkIng ure necessury precondILIons Ior sound moruI judgmenL, or
wIeLIer smokIng und drInkIng (moderuLe) necessurIIy precIude sound
moruI judgmenL. L wus concIuded LIuL moruI judgmenL Is IndependenL oI
LIese IucLors, per se. nLernuI IucLors sucI us uvurIce, greed, prIde, vunILy,
IuugILIness, obsessIon wILI conLroI, IeurJLerror, guIIL, IuLred, und
unIorgIveness do InLoxIcuLe und compromIse spIrILuuI counseI und
moruI dIscernmenL. TIere ure Iur beLLer grounds Ior beIng wury oI
supposed CIrIsLIun groups LIuL pecuIIurIy IdenLIIy LIemseIves by LIeIr
nonsmokIng und non-drInkIng, undJor dIeLury prescrIpLIons. SecuIurIsLs
cun IdenLIIy LIemseIves In LIese Lerms - even AdoII HILIer und IIs
IencImen. SureIy, LIere ure more crILIcuI uLLrIbuLes LIuL ure quILe specIIIc
Lo CIrIsLIuns. TIe scrIpLures, eurIIer IndIcuLed, ure IIIIed wILI cIurucLerJ
reIuLIonuI sLrengLIs LIuL ure essenLIuIIy ImpossIbIe Ior LIe unsuved.
DIeLury edIcLs sucI us LIose Iound In SevenLI-Duy AdvenLIsm,
wIeLIer venLurIng buck Lo evILIcuI prescrIpLIons or oLIerwIse, ure
enLIreIy uL odds wILI LIe Christicn LeucIIng, e.g., 1 CorInLIIuns 1o:z,
GuIuLIuns q:q, Hebrews 1:q. TIe mujor reuson Ior LIIs cIrcumsLunce Is
LIuL LIe menLuIILy LIuL produces LIese edIcLs Is noL suved, sLIII operuLes In
Iower-nuLure (curnuI) reusonIng, und subsLILuLes superIIcIuIILIes Ior moruI
recLILude. Even wIere scrIpLure specIIIcuIIy IndIcuLes noL Lo Luke LIese
superIIcIuI Lucks, IL cunnoL compreIend LIe dIrecLIve. TIIs Is LIe sume
muLerIuIIsL menLuIILy LIuL Ius been consIdered LIrougIouL LIIs dIscussIon.
TIIs upsIde-down, buck-Lo-IronL menLuIILy Is cupubIe oI IIjuckIng scIence,
IIsLory, or even reIIgIon In jusLIIyIngJreInIorcIng ILs conLorLed beIIeIs und
munuIucLurIng u seII-jusLIIyIng, Iuke superIorILy.
TIe Iunguuge used by reIIgIous unLI-producL (I.e., uIcoIoI,
Lobucco, Leu, coIIee) udvocuLes Is LypIcuIIy IursI, ubrusIve, ubusIve,
dIvIsIve, reckIess, beIIIgerenL. TIIs Is enLIreIy conLrury Lo LIe CIrIsLIun
gouI und LIe IruILs oI LIe SpIrIL (GuIuLIuns :zz). AguIn, sucI udvocuLes
Iuve LIe CIrIsLIun requIremenLs buck-Lo-IronL. TIese vIew wIuL Is Luken
InLo LIe mouLI us crILIcuI. WIereus, LIe CIrIsLIun LeucIIng Is empIuLIc
LIuL IL Is wIuL proceeds Irom LIe mouLI LIuL Is purumounL, e.g., MuLLIew
1z:q, 1:1;-1q; LIe Longue reIIecLs wIuL u person beIIeves und LIInks, I.e.,
547
547
Rampant Antismoking Signifies Grave Danger The Bigger Picture Rampant Antismoking Signifies Grave Danger
reIIgIous commILmenL remuIned. n 188; In response Lo
u quesLIonnuIre Irom LIe EngIIsI AnLI-Tobucco
AssocIuLIon, LwenLy-LIree oI LIe LIIrLy-Iour EngIIsI
bIsIops repIIed LIuL LIey dId noL smoke. TIe remuInIng
eIeven uppurenLIy conLuIned some smokers und IL muy
be noLed LIuL onIy one oI LIe LwenLy-LIree expressIy
commended LIe work oI LIe AssocIuLIon..|T|Ie
'denomInuLIon-Lype` cIurcIes (NonconIormIsLs) und
LIe 'cIurcI-Lype` (AngIIcuns und CuLIoIIcs) IeIL LIe
muLLer Lo IndIvIduuI decIsIon. SmokIng mInIsLers sucI
us LIe Rev. CIurIes Spurgeon, wIo boIdIy decIured LIuL
Ie wouId smoke u cIgur Ior reIresImenL und Lo LIe gIory
oI God, were u sLundIng dIsprooI oI LIe uIIeged
connexIon beLween smokIng und IrreIIgIon. n IucL LIe
gruduuI subsLILuLIon oI IruIL juIce Ior IermenLed wIne In
LIe sucrumenL oI IoIy communIon , LIe LeeLoLuIIers Iud
greuLer InIIuence on LIe NonconIormIsL denomInuLIons
LIun Iud LIe LobuccopIobes. TIe ruIes oI LIe WesIeyun
MeLIodIsL ConnexIon usked LIe ordInund, 'Do you Luke
no snuII, Lobucco, or drums?`, buL muny WesIeyun
mInIsLers dId noL Luke LIIs obIIguLIon Lo bInd LIem In
LIe muLLer oI smokIng. Among LIe WesIeyuns LIe
opponenLs oI Lobucco mud no progress. L seems LIuL
AngIIcun cIergy und ProLesLunL mInIsLers smoked
prIvuLeIy und dIscreeLIy. TIe 'Dossers` Purson` und
EdmonLon mIssIoner Mr. CoIIIngs wus u rure excepLIon
Lo LIIs cuuLIon. DeLermIned Lo Induce workIngmen Lo
worsIIp, Ie sLood uL LIe door smokIng u cIgur und
IundIng ouL LIreepenny sIug wILI un InvILuLIon Lo puII
uwuy durIng LIe servIce. (WuIker, 1q8o, p.q;)
Even Lemperunce reIormers uILImuLeIy pursued uIcoIoI ruLIer
LIun Lobucco: PreIerrIng Lo weun workIngmen Irom LIe poL ruLIer LIun
LIe pIpe, LIe Lemperunce reIormers soId Lobucco und provIded smokIng
rooms In LIeIr coIIee Iouses und Lemperunce IoLeIs. One guIde udvIsed
LIuL smokIng sIouId noL be conIIned Lo one room buL be uIIowed
everywIere so LIuL LIe vIsILor mIgIL IeeI LIorougIIy uL Iome. (WuIker,
1q8o, p.qoo)
TIe concern wILI uIcoIoI Is purLIy undersLundubIe. n LIuL LIe
CIrIsLIun gouI empIusIzes LIe reIuLIonuI dImensIon, InLoxIcuLIon wIII
cerLuInIy compromIse LIIs pursuIL - LIe scrIpLures IndIcuLe LIuL
drunkenness Is Lo be uvoIded, e.g., EpIesIuns :18, TILus z:. However,
The Bigger Picture
LIIs does noL ImpIy u bun on uIcoIoI consumpLIon by uII udIerenLs Lo LIe
CIrIsLIun LeucIIng (or greuLer socIeLy), nor Is LIIs IndIcuLed In scrIpLure.
CerLuInIy, unyone wouId be weII-udvIsed Lo uvoId uny subsLunce LIuL
compromIses cIurILy oI LIougIL und moruI dIscernmenL. TIe LreuLmenL oI
Lobucco Is enLIreIy unLenubIe becuuse LIe moruIIzIng over ILs use Is
LypIcuIIy bused on IncoIerenL unuIogIes wILI uIcoIoI consumpLIon or
oLIer InLoxIcuLIng Iurd drugs.
TIe ImporLunL quesLIon LIuL wus consIdered In LIe eurIIer secLIon
The Nczi Anti-Tobccco Motement wus wIeLIer nonsmokIng und non-
drInkIng ure necessury precondILIons Ior sound moruI judgmenL, or
wIeLIer smokIng und drInkIng (moderuLe) necessurIIy precIude sound
moruI judgmenL. L wus concIuded LIuL moruI judgmenL Is IndependenL oI
LIese IucLors, per se. nLernuI IucLors sucI us uvurIce, greed, prIde, vunILy,
IuugILIness, obsessIon wILI conLroI, IeurJLerror, guIIL, IuLred, und
unIorgIveness do InLoxIcuLe und compromIse spIrILuuI counseI und
moruI dIscernmenL. TIere ure Iur beLLer grounds Ior beIng wury oI
supposed CIrIsLIun groups LIuL pecuIIurIy IdenLIIy LIemseIves by LIeIr
nonsmokIng und non-drInkIng, undJor dIeLury prescrIpLIons. SecuIurIsLs
cun IdenLIIy LIemseIves In LIese Lerms - even AdoII HILIer und IIs
IencImen. SureIy, LIere ure more crILIcuI uLLrIbuLes LIuL ure quILe specIIIc
Lo CIrIsLIuns. TIe scrIpLures, eurIIer IndIcuLed, ure IIIIed wILI cIurucLerJ
reIuLIonuI sLrengLIs LIuL ure essenLIuIIy ImpossIbIe Ior LIe unsuved.
DIeLury edIcLs sucI us LIose Iound In SevenLI-Duy AdvenLIsm,
wIeLIer venLurIng buck Lo evILIcuI prescrIpLIons or oLIerwIse, ure
enLIreIy uL odds wILI LIe Christicn LeucIIng, e.g., 1 CorInLIIuns 1o:z,
GuIuLIuns q:q, Hebrews 1:q. TIe mujor reuson Ior LIIs cIrcumsLunce Is
LIuL LIe menLuIILy LIuL produces LIese edIcLs Is noL suved, sLIII operuLes In
Iower-nuLure (curnuI) reusonIng, und subsLILuLes superIIcIuIILIes Ior moruI
recLILude. Even wIere scrIpLure specIIIcuIIy IndIcuLes noL Lo Luke LIese
superIIcIuI Lucks, IL cunnoL compreIend LIe dIrecLIve. TIIs Is LIe sume
muLerIuIIsL menLuIILy LIuL Ius been consIdered LIrougIouL LIIs dIscussIon.
TIIs upsIde-down, buck-Lo-IronL menLuIILy Is cupubIe oI IIjuckIng scIence,
IIsLory, or even reIIgIon In jusLIIyIngJreInIorcIng ILs conLorLed beIIeIs und
munuIucLurIng u seII-jusLIIyIng, Iuke superIorILy.
TIe Iunguuge used by reIIgIous unLI-producL (I.e., uIcoIoI,
Lobucco, Leu, coIIee) udvocuLes Is LypIcuIIy IursI, ubrusIve, ubusIve,
dIvIsIve, reckIess, beIIIgerenL. TIIs Is enLIreIy conLrury Lo LIe CIrIsLIun
gouI und LIe IruILs oI LIe SpIrIL (GuIuLIuns :zz). AguIn, sucI udvocuLes
Iuve LIe CIrIsLIun requIremenLs buck-Lo-IronL. TIese vIew wIuL Is Luken
InLo LIe mouLI us crILIcuI. WIereus, LIe CIrIsLIun LeucIIng Is empIuLIc
LIuL IL Is wIuL proceeds Irom LIe mouLI LIuL Is purumounL, e.g., MuLLIew
1z:q, 1:1;-1q; LIe Longue reIIecLs wIuL u person beIIeves und LIInks, I.e.,
548
548
Rampant Antismoking Signifies Grave Danger The Bigger Picture Rampant Antismoking Signifies Grave Danger
u mun speuks Irom LIe ubundunce oI LIe IeurL. rom LIe unsuved,
Iower-nuLure sLuLe, LIe Longue reIIecLs u corrupLed IeurL. By suIvuLIon Is
IeuIIng possIbIe (see uIso Jumes :6-1o). WIIIe LIe curnuI mInd Ius un
InordInuLe preoccupuLIon wILI LIe LoxIcILy oI exLernuIILIes, scrIpLure
communds vIgIIunce over poIsonIng by LIe Longue.
AnoLIer urguubIe poInL, beyond quesLIonubIe IoodJdrInkJ
Lobucco prescrIpLIons uithin u reIIgIous group, Is wIeLIer CIrIsLIuns
sIouId be sLrIvIng, LIrougI unLI-producL orgunIzuLIons, Lo Iuve
purLIcuIur producLs (e.g., uIcoIoI, Lobucco) bunned uL u generuI socIeLuI
IeveI. TIe IoremosL IuncLIons oI u CIrIsLIun ure Lo procIuIm LIe Word, Lo
proceed on LIe journey oI perIecLIng, und Lo beur wILness Lo unoLIer sLuLe
uILogeLIer: Jesus unswered, My kIngdom (kIngsIIp, royuI power) beIongs
noL Lo LIIs worId..My kIngdom Is noL Irom |LIIs worId| - Ius no sucI
orIgIn or source. (JoIn 18:6) UnLII CIrIsL`s mIIIennIuI ruIe, LIe gouI oI u
CIrIsLIun Is noL Lo cIunge LIe worId by ILs own reckonIng, buL Lo beur
wILness Lo CIrIsL`s kIngdom und LrunsIormIng power, IncIudIng LIe IruILs
oI LIe SpIrIL, us Lo wIere unyone`s reuI Iope IIes - In trcnscendence
oIIered by suIvuLIon, I.e., Lo rIse ubove LIe worId. TIose wIo spend mucI
LIme uLLempLIng Lo cIunge LIe worId or oLIers, usuuIIy concernIng
superIIcIuIILIes, ure LIose wIo Iuve probubIy spenL very IILLIe LIme
LrunsIormIng LIeIr own conLorLed LIougIL, I.e., uLLempLIng Lo jusLIIy LIeIr
own unresoIved grIevunces. RuLIer LIun wILnessIng Lo LIe compeIIIng
nuLure oI CIrIsL und cctucl suIvuLIon, LIese Lend Lo be uggressIve und
over-conLroIIIng, I.e., curnuI In dIsposILIon, und breed resenLmenL und
conLempL In LIe secuIur popuIuLIon; secuIurIsLs LIen conIuse LIIs IuIse
wILness wILI LIe CIrIsLIun LeucIIng.
TIe mujor cIurcIes were wIse Lo Ieuve sucI muLLers us Lobucco-
use Lo IndIvIduuI decIsIon. YeL, even LIIs seems Lo Iuve cIunged
drumuLIcuIIy oI IuLe. UndersLundubIy, CIrIsLIuns Iuve noL been Immune
Irom LIe burruge oI unLIsmokIng rIeLorIc over LIe IusL decude. TIe
probIem Is LIeIr InLerpreLuLIon oI LIe muLLer. n mId-1qqq, LIe WorId
HeuILI OrgunIzuLIon, us purL oI ILs Tobucco ree nILIuLIve, convened u
MeeLIng on Tobucco und ReIIgIon wIIcI muny CIrIsLIun denomInuLIons
und oLIer reIIgIons uLLended. AILIougI uL LIIs meeLIng LIe commILmenL Lo
u Lobucco-Iree worId wus very LenLuLIve uL besL, purLIcuIurIy on LIe purL oI
CIrIsLIun denomInuLIons, IL Is surprIsIng wIy CIrIsLIun denomInuLIons
wouId even uLLend sucI u meeLIng.
L demonsLruLes LIuL CIrIsLIun groups ure mesmerIzed by LIe
sLuLIsLIcuI sopIIsLry oI prevenLIve-medIcIne cIuIms. L uIso demonsLruLes
LIuL CIrIsLIun groups ure obIIvIous Lo LIe IucL LIuL LIe WHO Is u
muLerIuIIsL orgunIzuLIon preucIIng u muLerIuIIsL Ideu oI IeuILI und u
muLerIuIIsL gouI (muLerIuIIsL munIIesLo), I.e., unsLubIe obsessIon wILI LIe
The Bigger Picture
IIesI. or exumpIe, LIe Ideu oI LIe rIsk uvoIdIng IndIvIduuI promoLed by
muLerIuIIsm Is unoLIer Lerm Ior LIe jecrjul IndIvIduuI. WIen consIderIng
sLuLIsLIcuI rIsk-uversIon, LIe Ieur promoLed reucIes deIusIonuI
proporLIons. DomInuLIon by Ieur Is enLIreIy uL odds wILI LIe CIrIsLIun
LeucIIng. MuLerIuIIsm uIso preucIes LIuL LIe CIrIsLIun LeucIIng Is
IurmIuI. urLIermore, CIrIsLIun groups ure wIoIIy unuwure oI LIe
ucLuuI devusLuLIon uIong psycIoIogIcuI, reIuLIonuI, und moruI dImensIons
LIuL Is beIng wreuked by LIe unLIsmokIng crusude und ILs muLerIuIIsL
Irumework: L Is buseIess Ieur, IuLred, dIvIsIon, IuugILIness LIuL ure beIng
IueIed.
More und more reIIgIous groups Iuve cupILuIuLed Lo LIe
unLIsmokIng IIxuLIon sInce LIe IuLe-1qqo`s. eroy PIeLLen, oI The Crime
Pretention Group dIscussed In LIe prevIous secLIon, Is IIgIIy ucLIve In
promoLIng LIe Ideu LIuL reIIgIous groups noL joInIng LIe unLIsmokIng
crusude ure IrresponsIbIe. or exumpIe, LIe websILe provIdes u copy oI u
IeLLer senL Lo HIs EmInence, Edmund CurdInuI Szoku, PreIecLure Ior
EconomIc AIIuIrs, VuLIcun CILy, Rome, LuIy, In 1qq8. PIeLLen proceeds,
Your EmInence: TIunk you Ior your ucLIvILIes uguInsL cIgureLLe smokIng,
wIIcI Iuve been reporLed In ureu medIu, due Lo IocuI InLeresL us you were
ArcIbIsIop oI DeLroIL. We ure encouruged by your good exumpIe. Your
ucLIon remInds me oI LIe vIgor wILI wIIcI cIergymen oI LIe pusL Look
ucLIon uguInsL evIIs In socIeLy, IncIudIng smokIng. n LIIs IeLLer PIeLLen
provIdes muny oI LIe deIuded Ideus eurIIer consIdered. und concIudes
wILI - AguIn, LIunk you Ior LukIng unLI-cIgureLLe ucLIon. You ure Lo be
commended Ior doIng so, us you ure doIng more good LIun you know.
L Is expecLed LIuL PIeLLen`s wurpIng oI InIormuLIon InLo u
reIIgIous LIeme, LogeLIer wILI LIe greuLer unLIsmokIng deIuge, Iuve
broken LIrougI Iow reIIgIous groups vIew smokIng. TIe CuLIoIIc vIew
wenL Irom, In 1qqq, u cuII by Pope JoIn PuuI Lo ubsLuIn Irom Lobucco Ior
one duy, und donuLe LIe money suved Lo eIIorLs uguInsL LIe HVJADS
epIdemIc, Lo bunnIng smokIng In LIe enLIreLy oI LIe VuLIcun CILy decIured
In zooz. n jusL LIree yeurs LIe posILIon Ius gone Irom LoIerunce Lo un
unLIsmokIng sLunce. AccordIng Lo ASH (US), In zoo1 |u| broud couIILIon
oI reIIgIous Ieuders Is urgIng PresIdenL BusI Lo supporL u sLrong
rumework ConvenLIon |concernIng u Tobucco ConLroI TreuLy|. n u
peLILIon senL Lo LIe PresIdenL, LIe Ieuders oI LIe muILI-IuILI couIILIon sLuLe,
'As reIIgIous Ieuders we cunnoL remuIn sIIenL wIen eucI yeur LIe deuLIs oI
q mIIIIon oI God`s cIIIdren kIIIed by Lobucco cry ouL Lo us.` TIe peLILIon
wus sIgned by CIrIsLIun, JewIsI, MusIIm und oLIer reIIgIous Ieuders.
And, IL Is reIIgIous groups now IendIng LIeIr moruI weIgIL Lo LIe crusude
LIuL Ius ucceIeruLed LIe IunuLIcIsm.
n IuLe-1qqq, LIe RubbInIcuI CouncII oI AmerIcu decIured:
549
549
Rampant Antismoking Signifies Grave Danger The Bigger Picture Rampant Antismoking Signifies Grave Danger
u mun speuks Irom LIe ubundunce oI LIe IeurL. rom LIe unsuved,
Iower-nuLure sLuLe, LIe Longue reIIecLs u corrupLed IeurL. By suIvuLIon Is
IeuIIng possIbIe (see uIso Jumes :6-1o). WIIIe LIe curnuI mInd Ius un
InordInuLe preoccupuLIon wILI LIe LoxIcILy oI exLernuIILIes, scrIpLure
communds vIgIIunce over poIsonIng by LIe Longue.
AnoLIer urguubIe poInL, beyond quesLIonubIe IoodJdrInkJ
Lobucco prescrIpLIons uithin u reIIgIous group, Is wIeLIer CIrIsLIuns
sIouId be sLrIvIng, LIrougI unLI-producL orgunIzuLIons, Lo Iuve
purLIcuIur producLs (e.g., uIcoIoI, Lobucco) bunned uL u generuI socIeLuI
IeveI. TIe IoremosL IuncLIons oI u CIrIsLIun ure Lo procIuIm LIe Word, Lo
proceed on LIe journey oI perIecLIng, und Lo beur wILness Lo unoLIer sLuLe
uILogeLIer: Jesus unswered, My kIngdom (kIngsIIp, royuI power) beIongs
noL Lo LIIs worId..My kIngdom Is noL Irom |LIIs worId| - Ius no sucI
orIgIn or source. (JoIn 18:6) UnLII CIrIsL`s mIIIennIuI ruIe, LIe gouI oI u
CIrIsLIun Is noL Lo cIunge LIe worId by ILs own reckonIng, buL Lo beur
wILness Lo CIrIsL`s kIngdom und LrunsIormIng power, IncIudIng LIe IruILs
oI LIe SpIrIL, us Lo wIere unyone`s reuI Iope IIes - In trcnscendence
oIIered by suIvuLIon, I.e., Lo rIse ubove LIe worId. TIose wIo spend mucI
LIme uLLempLIng Lo cIunge LIe worId or oLIers, usuuIIy concernIng
superIIcIuIILIes, ure LIose wIo Iuve probubIy spenL very IILLIe LIme
LrunsIormIng LIeIr own conLorLed LIougIL, I.e., uLLempLIng Lo jusLIIy LIeIr
own unresoIved grIevunces. RuLIer LIun wILnessIng Lo LIe compeIIIng
nuLure oI CIrIsL und cctucl suIvuLIon, LIese Lend Lo be uggressIve und
over-conLroIIIng, I.e., curnuI In dIsposILIon, und breed resenLmenL und
conLempL In LIe secuIur popuIuLIon; secuIurIsLs LIen conIuse LIIs IuIse
wILness wILI LIe CIrIsLIun LeucIIng.
TIe mujor cIurcIes were wIse Lo Ieuve sucI muLLers us Lobucco-
use Lo IndIvIduuI decIsIon. YeL, even LIIs seems Lo Iuve cIunged
drumuLIcuIIy oI IuLe. UndersLundubIy, CIrIsLIuns Iuve noL been Immune
Irom LIe burruge oI unLIsmokIng rIeLorIc over LIe IusL decude. TIe
probIem Is LIeIr InLerpreLuLIon oI LIe muLLer. n mId-1qqq, LIe WorId
HeuILI OrgunIzuLIon, us purL oI ILs Tobucco ree nILIuLIve, convened u
MeeLIng on Tobucco und ReIIgIon wIIcI muny CIrIsLIun denomInuLIons
und oLIer reIIgIons uLLended. AILIougI uL LIIs meeLIng LIe commILmenL Lo
u Lobucco-Iree worId wus very LenLuLIve uL besL, purLIcuIurIy on LIe purL oI
CIrIsLIun denomInuLIons, IL Is surprIsIng wIy CIrIsLIun denomInuLIons
wouId even uLLend sucI u meeLIng.
L demonsLruLes LIuL CIrIsLIun groups ure mesmerIzed by LIe
sLuLIsLIcuI sopIIsLry oI prevenLIve-medIcIne cIuIms. L uIso demonsLruLes
LIuL CIrIsLIun groups ure obIIvIous Lo LIe IucL LIuL LIe WHO Is u
muLerIuIIsL orgunIzuLIon preucIIng u muLerIuIIsL Ideu oI IeuILI und u
muLerIuIIsL gouI (muLerIuIIsL munIIesLo), I.e., unsLubIe obsessIon wILI LIe
The Bigger Picture
IIesI. or exumpIe, LIe Ideu oI LIe rIsk uvoIdIng IndIvIduuI promoLed by
muLerIuIIsm Is unoLIer Lerm Ior LIe jecrjul IndIvIduuI. WIen consIderIng
sLuLIsLIcuI rIsk-uversIon, LIe Ieur promoLed reucIes deIusIonuI
proporLIons. DomInuLIon by Ieur Is enLIreIy uL odds wILI LIe CIrIsLIun
LeucIIng. MuLerIuIIsm uIso preucIes LIuL LIe CIrIsLIun LeucIIng Is
IurmIuI. urLIermore, CIrIsLIun groups ure wIoIIy unuwure oI LIe
ucLuuI devusLuLIon uIong psycIoIogIcuI, reIuLIonuI, und moruI dImensIons
LIuL Is beIng wreuked by LIe unLIsmokIng crusude und ILs muLerIuIIsL
Irumework: L Is buseIess Ieur, IuLred, dIvIsIon, IuugILIness LIuL ure beIng
IueIed.
More und more reIIgIous groups Iuve cupILuIuLed Lo LIe
unLIsmokIng IIxuLIon sInce LIe IuLe-1qqo`s. eroy PIeLLen, oI The Crime
Pretention Group dIscussed In LIe prevIous secLIon, Is IIgIIy ucLIve In
promoLIng LIe Ideu LIuL reIIgIous groups noL joInIng LIe unLIsmokIng
crusude ure IrresponsIbIe. or exumpIe, LIe websILe provIdes u copy oI u
IeLLer senL Lo HIs EmInence, Edmund CurdInuI Szoku, PreIecLure Ior
EconomIc AIIuIrs, VuLIcun CILy, Rome, LuIy, In 1qq8. PIeLLen proceeds,
Your EmInence: TIunk you Ior your ucLIvILIes uguInsL cIgureLLe smokIng,
wIIcI Iuve been reporLed In ureu medIu, due Lo IocuI InLeresL us you were
ArcIbIsIop oI DeLroIL. We ure encouruged by your good exumpIe. Your
ucLIon remInds me oI LIe vIgor wILI wIIcI cIergymen oI LIe pusL Look
ucLIon uguInsL evIIs In socIeLy, IncIudIng smokIng. n LIIs IeLLer PIeLLen
provIdes muny oI LIe deIuded Ideus eurIIer consIdered. und concIudes
wILI - AguIn, LIunk you Ior LukIng unLI-cIgureLLe ucLIon. You ure Lo be
commended Ior doIng so, us you ure doIng more good LIun you know.
L Is expecLed LIuL PIeLLen`s wurpIng oI InIormuLIon InLo u
reIIgIous LIeme, LogeLIer wILI LIe greuLer unLIsmokIng deIuge, Iuve
broken LIrougI Iow reIIgIous groups vIew smokIng. TIe CuLIoIIc vIew
wenL Irom, In 1qqq, u cuII by Pope JoIn PuuI Lo ubsLuIn Irom Lobucco Ior
one duy, und donuLe LIe money suved Lo eIIorLs uguInsL LIe HVJADS
epIdemIc, Lo bunnIng smokIng In LIe enLIreLy oI LIe VuLIcun CILy decIured
In zooz. n jusL LIree yeurs LIe posILIon Ius gone Irom LoIerunce Lo un
unLIsmokIng sLunce. AccordIng Lo ASH (US), In zoo1 |u| broud couIILIon
oI reIIgIous Ieuders Is urgIng PresIdenL BusI Lo supporL u sLrong
rumework ConvenLIon |concernIng u Tobucco ConLroI TreuLy|. n u
peLILIon senL Lo LIe PresIdenL, LIe Ieuders oI LIe muILI-IuILI couIILIon sLuLe,
'As reIIgIous Ieuders we cunnoL remuIn sIIenL wIen eucI yeur LIe deuLIs oI
q mIIIIon oI God`s cIIIdren kIIIed by Lobucco cry ouL Lo us.` TIe peLILIon
wus sIgned by CIrIsLIun, JewIsI, MusIIm und oLIer reIIgIous Ieuders.
And, IL Is reIIgIous groups now IendIng LIeIr moruI weIgIL Lo LIe crusude
LIuL Ius ucceIeruLed LIe IunuLIcIsm.
n IuLe-1qqq, LIe RubbInIcuI CouncII oI AmerIcu decIured:
550
550
Rampant Antismoking Signifies Grave Danger The Bigger Picture Rampant Antismoking Signifies Grave Danger
SmokIng sIouId be bunned Irom uII synugogues, synugogue IuncLIons,
Duy ScIooIs, MIkvu`oL |rILuuI buLIIouses| und uII oLIer InsLILuLIons und
evenLs under supervIsIon oI LIe rubbI. RubbIs sIouId LIemseIves ceuse Lo
smoke, und sIouId pubIIcIy educuLe LIeIr congreguLIons us Lo LIe medIcuI
und HuIucIIc |JewIsI Iuw| severILy oI smokIng. TIIs sIouId IncIude noL
LoIeruLIng smokIng In LIeIr own Iomes und busInesses, us eILIer IucIIILuLes
or cuuses ussuuIL on oLIers. (TCPG websILe) More recenLIy, SIus SpIrILuuI
Ieuder RubbI OvudIu YoseI SIegeI sLuLed: To muke u IIvIng, you`re IIvIng uL
LIe expense oI peopIe wIo dIe. Munugers oI Lobucco IucLorIes ure sInners
und wIII receIve dIvIne reLrIbuLIon. TIey wIII suIIer on LIeIr duy oI
judgemenL. (RubbIs cuII on Jews Lo sLop smokIng, 1erusclem Post, Muy
1, zoo1) AccordIng Lo one unLIsmokIng websILe (s smokIng u sIn?) LIe
Greek OrLIodox CIurcI Ius recenLIy cuIIed ILs members Lo repenL Irom
smokIng. L Ius uIreudy been IndIcuLed LIuL smokIng by u spouse Ius
recenLIy been decIured us grounds Ior dIvorce In sIumIc Iuw.
ReIIgIous Ieuders cun now cILe SAMMEC numbers wILI greuL
euse. TIeIr reIIunce Is enLIreIy on LIe medIco-muLerIuIIsL uppruIsuI. TIe
InLeresL In LIIs dIscussIon Is purLIcuIurIy wILI CIrIsLIunILy. TIere Is more
LIun umpIe evIdence LIuL muny CIrIsLIun denomInuLIons Iuve been
InIecLed by MMES-cuIL reusonIng. n New TesLumenL Lerms, LIIs cun be
InLerpreLed us u IuIIIng uwuy oI LIe cIurcI, or wIuL LIe AposLIe PuuI
reIers Lo us LIe greuL uposLusy I.e., z TIessuIonIuns z:. L Is u LIme wIen
CIrIsLIuns IuII buck InLo IuIse worsIIp und Iuke moruIILy: And LIen muny
wIII be oIIended und repeIIed und begIn Lo dIsLrusL und deserL |HIm
WIom LIey ougIL Lo LrusL und obey| und wIII sLumbIe und IuII uwuy, und
beLruy one unoLIer und pursue one unoLIer wILI IuLred. And muny IuIse
propIeLs wIII rIse up und deceIve und Ieud muny InLo error. And LIe Iove
oI LIe greuL body oI peopIe wIII grow coId, becuuse oI LIe muILIpIIed
IuwIessness und InIquILy. (MuLLIew zq:1o-1z)
TIIs Is noL Lo suy LIuL sucI CIrIsLIuns do noL beIIeve LIey ure
CIrIsLIuns uny Ionger. RuLIer, muny beIIeve LIey sLIII ure CIrIsLIun. TIe
seII-decepLIon Is uccompIIsIed by u severe dIIuLIng oI LIe LeucIIng, usuuIIy
buck InLo body IIxuLIon und LIe uLLempL Lo suve one`s own IIIe (LIe IIesI).
As wIII be consIdered, LIe sLunce oI CIrIsLIun cIurcIes on purLIcuIurIy
Lobucco Is very LeIIIng oI LIe LIme.
Over LIe IusL number oI decudes, LIe mujor CIrIsLIun InsLILuLIons
(e.g., CuLIoIIcIsm, AngIIcunIsm) Iuve experIenced decIInIng membersIIp
In LIe wesLern worId. AILernuLIveIy, IL Is cIurIsmuLIc und IundumenLuIIsL
cIurcIes (e.g., PenLecosLuI, BupLIsL) LIuL Iuve IIourIsIed durIng LIIs LIme
- purLIcuIurIy In LIe IusL decude. SucI cIurcIes domInuLe LIe AusLruIIun
CIrIsLIun CIunneI (cubIe TV). Progrums Irom LIe US, LIe UK, SouLI
AIrIcu, AusLruIIu ure uIred. TIeIr IormuL uppeurs very sImIIur, sucI LIuL
The Bigger Picture
LIeIr uppeuI In LIese nuLIons Is ussumedIy sImIIur.
PurL oI LIe uppeuI oI LIese cIurIsmuLIc cIurcIes Is LIeIr more
conLemporury und InIormuI upproucI Lo worsIIp. YeL, by LIIs LIme muny
seem Lo be IormuIu cIurcIes IuvIng LIe reguIuLory muILI-pIece musIc
bund und popuIous cIorus secLIon In LIe producLIon oI pruIse songs.
TIere Is noLIIng purLIcuIurIy usLruy wILI LIIs uspecL, per se. However, IL
cun become probIemuLIc II LIIs sIow cuse oI conLemporury pruIse songs
becomes LIe empIusIs, e.g., MuLLIew 1:8
TIe sLundurd oI preucIIng Is urguubIe. TIe preucIIng In muny
InsLunces seems Lo be no dIIIerenL Lo secuIur moLIvuLIonuI semInurs wILI
LIe excepLIon oI some InLerspersed scrIpLure. Some resorL Lo unLIcs LIuL
muy be oI enLerLuInmenL or uLLrucLIon uppeuI. YeL, wIuL Is LIe vuIue oI
uLLrucLIng persons wIen wIuL LIey wIII see or Ieur beurs IILLIe LesLImony
Lo CIrIsL? L uppeurs LIuL muny oI LIese cIurIsmuLIc cIurcIes Iuve IILLIe
grusp oI LIe proIundILy oI LIe CIrIsLIun LeucIIng, IeL uIone LIuL u beIIever
sIouId be comIng Lo Lerms wILI LIIs nou und noL In LIe IereuILer. TIe
cIurcI IeudersIIp Is u poor exumpIe oI LIe IndIvIduuI prucLIce oI LIe
CIrIsLIun LeucIIng.
TIe senIor pusLors oI LIese groups Iuve uIso mude prescrIpLIve
commenLs on Lobucco-use - usuuIIy dIspurugIng. Some Iuve devoLed un
enLIre servIce Lo preucIIng Iow u CIrIsLIun sIouId noL be u smoker. One
even beIIowed uL LIe Lop oI IIs voIce, In reLrIbuLIve convIcLIon, LIuL I
you`re u smoker und you 'cuLcI` cuncer, you`re sLupId. TIese sume
preucIers, usuuIIy IorLy-someLIIngs, uIso muke pussIng reIerences, durIng
LIeIr preucIIng, Lo LIeIr personuI LruIners und LIeIr gym workouLs. One
InLernuLIonuI Ieuder oI u promInenL cIurIsmuLIc cIurcI recuIIed u very
dIIIIcuIL perIod In IIs cIurcI wIen LIe onIy poLenLIuI pusLors Ie Iud Lo
work wILI were smokers. TIe sume preucIer uIso kepL mukIng reIerence
Lo IIs currenL - presumubIy smokeIree - ceII group oI pusLors LIuL Ie
guLIers wILI on SuLurduy mornIngs Ior un InIormuI buskeLbuII gume, I.e., u
bondIng sessIon. TIIs uII seems consIsLenL wILI LIe corporuLe worId -
noL CIrIsLIunILy. Some oI LIese preucIers uIIow CIrIsLIun medIcuI
docLors Lo Luke up un enLIre progrummIng-sIoL Lo exLoI LIe vuIue oI uII
sorLs oI dIeLury rILuuIs Ior IeuILI, und wIIcI ure underIuIn by LIe mudness
oI dIeLury epIdemIoIogy. TIIs Is uII consIsLenL wILI body IIxuLIon und
MMES-cuIL beIIeIs.
WIIIe LIere Is mucI reIerence Lo ceII groups, ouLreucI, OId
TesLumenL cIurucLers us modeIs Ior IeurnIng (ruLIer LIun CIrIsL), bodIIy
IILness (conIused Ior spIrILuuI IILness), worIdIy success (prosperILy), und
murkeLIng sLruLegIes, LIe ove oI God wILIIn us und LIe IruILs oI LIe SpIrIL
ure very rureIy uIIuded Lo, II uL uII, IeL uIone demonsLruLed. WIere one
wouId expecL un InsIgIL InLo LIe subIIme, IL Is onIy bIund muLerIuIIsL
551
551
Rampant Antismoking Signifies Grave Danger The Bigger Picture Rampant Antismoking Signifies Grave Danger
SmokIng sIouId be bunned Irom uII synugogues, synugogue IuncLIons,
Duy ScIooIs, MIkvu`oL |rILuuI buLIIouses| und uII oLIer InsLILuLIons und
evenLs under supervIsIon oI LIe rubbI. RubbIs sIouId LIemseIves ceuse Lo
smoke, und sIouId pubIIcIy educuLe LIeIr congreguLIons us Lo LIe medIcuI
und HuIucIIc |JewIsI Iuw| severILy oI smokIng. TIIs sIouId IncIude noL
LoIeruLIng smokIng In LIeIr own Iomes und busInesses, us eILIer IucIIILuLes
or cuuses ussuuIL on oLIers. (TCPG websILe) More recenLIy, SIus SpIrILuuI
Ieuder RubbI OvudIu YoseI SIegeI sLuLed: To muke u IIvIng, you`re IIvIng uL
LIe expense oI peopIe wIo dIe. Munugers oI Lobucco IucLorIes ure sInners
und wIII receIve dIvIne reLrIbuLIon. TIey wIII suIIer on LIeIr duy oI
judgemenL. (RubbIs cuII on Jews Lo sLop smokIng, 1erusclem Post, Muy
1, zoo1) AccordIng Lo one unLIsmokIng websILe (s smokIng u sIn?) LIe
Greek OrLIodox CIurcI Ius recenLIy cuIIed ILs members Lo repenL Irom
smokIng. L Ius uIreudy been IndIcuLed LIuL smokIng by u spouse Ius
recenLIy been decIured us grounds Ior dIvorce In sIumIc Iuw.
ReIIgIous Ieuders cun now cILe SAMMEC numbers wILI greuL
euse. TIeIr reIIunce Is enLIreIy on LIe medIco-muLerIuIIsL uppruIsuI. TIe
InLeresL In LIIs dIscussIon Is purLIcuIurIy wILI CIrIsLIunILy. TIere Is more
LIun umpIe evIdence LIuL muny CIrIsLIun denomInuLIons Iuve been
InIecLed by MMES-cuIL reusonIng. n New TesLumenL Lerms, LIIs cun be
InLerpreLed us u IuIIIng uwuy oI LIe cIurcI, or wIuL LIe AposLIe PuuI
reIers Lo us LIe greuL uposLusy I.e., z TIessuIonIuns z:. L Is u LIme wIen
CIrIsLIuns IuII buck InLo IuIse worsIIp und Iuke moruIILy: And LIen muny
wIII be oIIended und repeIIed und begIn Lo dIsLrusL und deserL |HIm
WIom LIey ougIL Lo LrusL und obey| und wIII sLumbIe und IuII uwuy, und
beLruy one unoLIer und pursue one unoLIer wILI IuLred. And muny IuIse
propIeLs wIII rIse up und deceIve und Ieud muny InLo error. And LIe Iove
oI LIe greuL body oI peopIe wIII grow coId, becuuse oI LIe muILIpIIed
IuwIessness und InIquILy. (MuLLIew zq:1o-1z)
TIIs Is noL Lo suy LIuL sucI CIrIsLIuns do noL beIIeve LIey ure
CIrIsLIuns uny Ionger. RuLIer, muny beIIeve LIey sLIII ure CIrIsLIun. TIe
seII-decepLIon Is uccompIIsIed by u severe dIIuLIng oI LIe LeucIIng, usuuIIy
buck InLo body IIxuLIon und LIe uLLempL Lo suve one`s own IIIe (LIe IIesI).
As wIII be consIdered, LIe sLunce oI CIrIsLIun cIurcIes on purLIcuIurIy
Lobucco Is very LeIIIng oI LIe LIme.
Over LIe IusL number oI decudes, LIe mujor CIrIsLIun InsLILuLIons
(e.g., CuLIoIIcIsm, AngIIcunIsm) Iuve experIenced decIInIng membersIIp
In LIe wesLern worId. AILernuLIveIy, IL Is cIurIsmuLIc und IundumenLuIIsL
cIurcIes (e.g., PenLecosLuI, BupLIsL) LIuL Iuve IIourIsIed durIng LIIs LIme
- purLIcuIurIy In LIe IusL decude. SucI cIurcIes domInuLe LIe AusLruIIun
CIrIsLIun CIunneI (cubIe TV). Progrums Irom LIe US, LIe UK, SouLI
AIrIcu, AusLruIIu ure uIred. TIeIr IormuL uppeurs very sImIIur, sucI LIuL
The Bigger Picture
LIeIr uppeuI In LIese nuLIons Is ussumedIy sImIIur.
PurL oI LIe uppeuI oI LIese cIurIsmuLIc cIurcIes Is LIeIr more
conLemporury und InIormuI upproucI Lo worsIIp. YeL, by LIIs LIme muny
seem Lo be IormuIu cIurcIes IuvIng LIe reguIuLory muILI-pIece musIc
bund und popuIous cIorus secLIon In LIe producLIon oI pruIse songs.
TIere Is noLIIng purLIcuIurIy usLruy wILI LIIs uspecL, per se. However, IL
cun become probIemuLIc II LIIs sIow cuse oI conLemporury pruIse songs
becomes LIe empIusIs, e.g., MuLLIew 1:8
TIe sLundurd oI preucIIng Is urguubIe. TIe preucIIng In muny
InsLunces seems Lo be no dIIIerenL Lo secuIur moLIvuLIonuI semInurs wILI
LIe excepLIon oI some InLerspersed scrIpLure. Some resorL Lo unLIcs LIuL
muy be oI enLerLuInmenL or uLLrucLIon uppeuI. YeL, wIuL Is LIe vuIue oI
uLLrucLIng persons wIen wIuL LIey wIII see or Ieur beurs IILLIe LesLImony
Lo CIrIsL? L uppeurs LIuL muny oI LIese cIurIsmuLIc cIurcIes Iuve IILLIe
grusp oI LIe proIundILy oI LIe CIrIsLIun LeucIIng, IeL uIone LIuL u beIIever
sIouId be comIng Lo Lerms wILI LIIs nou und noL In LIe IereuILer. TIe
cIurcI IeudersIIp Is u poor exumpIe oI LIe IndIvIduuI prucLIce oI LIe
CIrIsLIun LeucIIng.
TIe senIor pusLors oI LIese groups Iuve uIso mude prescrIpLIve
commenLs on Lobucco-use - usuuIIy dIspurugIng. Some Iuve devoLed un
enLIre servIce Lo preucIIng Iow u CIrIsLIun sIouId noL be u smoker. One
even beIIowed uL LIe Lop oI IIs voIce, In reLrIbuLIve convIcLIon, LIuL I
you`re u smoker und you 'cuLcI` cuncer, you`re sLupId. TIese sume
preucIers, usuuIIy IorLy-someLIIngs, uIso muke pussIng reIerences, durIng
LIeIr preucIIng, Lo LIeIr personuI LruIners und LIeIr gym workouLs. One
InLernuLIonuI Ieuder oI u promInenL cIurIsmuLIc cIurcI recuIIed u very
dIIIIcuIL perIod In IIs cIurcI wIen LIe onIy poLenLIuI pusLors Ie Iud Lo
work wILI were smokers. TIe sume preucIer uIso kepL mukIng reIerence
Lo IIs currenL - presumubIy smokeIree - ceII group oI pusLors LIuL Ie
guLIers wILI on SuLurduy mornIngs Ior un InIormuI buskeLbuII gume, I.e., u
bondIng sessIon. TIIs uII seems consIsLenL wILI LIe corporuLe worId -
noL CIrIsLIunILy. Some oI LIese preucIers uIIow CIrIsLIun medIcuI
docLors Lo Luke up un enLIre progrummIng-sIoL Lo exLoI LIe vuIue oI uII
sorLs oI dIeLury rILuuIs Ior IeuILI, und wIIcI ure underIuIn by LIe mudness
oI dIeLury epIdemIoIogy. TIIs Is uII consIsLenL wILI body IIxuLIon und
MMES-cuIL beIIeIs.
WIIIe LIere Is mucI reIerence Lo ceII groups, ouLreucI, OId
TesLumenL cIurucLers us modeIs Ior IeurnIng (ruLIer LIun CIrIsL), bodIIy
IILness (conIused Ior spIrILuuI IILness), worIdIy success (prosperILy), und
murkeLIng sLruLegIes, LIe ove oI God wILIIn us und LIe IruILs oI LIe SpIrIL
ure very rureIy uIIuded Lo, II uL uII, IeL uIone demonsLruLed. WIere one
wouId expecL un InsIgIL InLo LIe subIIme, IL Is onIy bIund muLerIuIIsL
552
552
Rampant Antismoking Signifies Grave Danger The Bigger Picture Rampant Antismoking Signifies Grave Danger
rIeLorIc LIuL Is IorLIcomIng. TIIs sorL oI CIrIsLIunILy reIIecLs no more
LIun u weII-InLenLIoned, buL LIorougIIy mIsguIded, cIrIsLIunIzed socIuI
cIub upproucI.
TIe worId Is In LIe mIdsL oI u meLupIysIcuI crIsIs LIuL wIII
cuImInuLe In u LIme oI greuL suIIerIng Ior muny. AL LIIs precurIous
juncLure LIere seem Lo be muny nomInuI CIrIsLIuns, uLLerIy domInuLed by
LIe muLerIuIIsm oI LIe LIme. TIe unLI-LobuccoIsm LIuL muny CIrIsLIuns
now preucI IndIcuLes (I.e., sympLomuLIc) body IIxuLIon, u mosL unIeuILIy
reIIunce on medIco-muLerIuIIsL propugundu, und greuLer
envIronmenLuIIsm. TIe sILuuLIon Ius deLerIoruLed wILI LIe ETS-Ied
unLIsmokIng ussuuIL oI LIe IusL number oI yeurs. or exumpIe, one
preucIer menLIoned LIuL some congreguLIon members Iud compIuIned
ubouL IuvIng Lo wuIk LIrougI u smoke cIoud becuuse oI persons
smokIng cIose Lo LIe cIurcI enLrunce. Muny LrudILIonuI cIurcIes now
proIIbIL smokIng unywIere on cIurcI grounds; LIIs Ius mucI Lo do wILI
proLecLIng nonsmokers Irom exposure Lo ETS. SucI vIcLImIood und
IuInLIng Is Lo be expecLed In LIe secuIur worId, gIven LIe conLorLed
reusonIng LIuL produces LIem. However, IL Is quILe usLoundIng LIuL
CIrIsLIuns ure demonsLruLIng LIIs IuInLness, uILIougI consIsLenL wILI
bIbIIcuI propIesy (e.g., uke z1:z6).
TIe so-cuIIed dungers oI ETS ure noL LIe Issue. Some
CIrIsLIuns were wunLIng Lo be proLecLed Irom LIe IouI smell oI
Lobucco smoke over LIe IusL Iew cenLurIes wIen ETS wus noL consIdered
us dungerous (see uIso WuIker, 1q8o). or exumpIe, BerrIdge (1qqq)
IndIcuLes LIe ucLIvILy oI LIe NuLIonuI SocIeLy oI Non-Smokers (NSNS):
or smokIng, LIe envIronmenLuIIsL cuse wus IeIL us LIe
provInce oI reIuLIveIy IneIIecLuuI pressure groups, mosL
noLubIy LIe |NSNS|, u smuII orgunIzuLIon Iounded In
1qz6. TIe NSNS pressed governmenL IndeIuLIgubIy Ior u
more sLrIngenL pubIIc IeuILI poIIcy. L wus concerned
wILI LIe nuIsunce uspecLs oI smokIng und LIe
seIIIsIness oI smokers In ImposIng LIeIr IubIL on
oLIers. Ls secreLury, LIe Rev. HuberL ILLIe, wroLe Lo LIe
CubIneL SecreLury In 1q6z, urgIng LIe governmenL Lo
consIder 'LIe rIgILs oI LIe non-smokIng secLIon oI LIe
pubIIc Lo breuLIe uIr noL smoke In pubIIc pIuces` (ILLIe,
1q6z). BuL LIIs currIed IILLIe weIgIL In LIe governmenLuI
urenu. TIe NSNS wus u non-medIcuI body, wIose
urgumenLs were perceIved us ukIn Lo LIose oI LIe
Lemperunce Iobby curryIng LIe LuInL oI moruIIsm wILI
IILLIe reIerence Lo scIence. (p.118)
The Bigger Picture
L Is ImpossIbIe Lo reconcIIe LIe conducL oI LIe Reverend In
ucLIveIy pursuIng LIe muLLer wILI LIe CIrIsLIun LeucIIng (e.g., 1
CorInLIIuns 1). TIe AposLIe PuuI mude reIerence Lo beIng sIIpwrecked,
beuLen up, und juIIed under exLremeIy IursI condILIons (I.e., surrounded
by LIe sLencI oI excremenL und deuLI) - see z CorInLIIuns 11:z-z;. He
counLed uII LIese LIIngs mInor muLLers In journeyIng Lo LIe crownIng
gIory (resurrecLIon). And yeL LIere ure reverends so dIsLurbed by LIe
nuIsunce oI exposure Lo Lobucco smoke LIuL ILs bunIsImenL wurrunLs
unreIenLIng pursuIL. I CIrIsLIuns ure uIreudy IuInLIng uL wIsps oI Lobucco
smoke, Iow couId LIey possIbIy IundIe LIe severILy Lo come?
L uppeurs LIuL more und more CIrIsLIuns ure cupILuIuLIng Lo LIe
ETS dunger Iruud. L uIso seems LIuL IL Is In seII-InLeresL LIuL LIey wouId
pursue smokers desIsLIng Irom LIe IubIL. Even II IL wus dungerous, wIuL
dIIIerence wouId LIIs muke? PuuI wus bILLen by u vIper, Irom wIIcI Ie wus
expecLed Lo dIe ImmedIuLeIy. YeL, PuuI sIrugged oII LIe vIper, LukIng LIe
muLLer In sLrIde, und conLInued normuIIy. L Is LIe sorL oI conducL wIere u
person wuIkIng by IuILI wILIIn u dIvIne pIun compreIends LIuL uLLempLs
uL InLerIerence wIII IuII - onIy LIe pIun wIII be IuIIIIIed. SucI u person cun
proceed cuImIy LIrougI ucLuuI dunger, enLIreIy conIIdenL In LIe SpIrIL. n
LIIs worId, LIe sLubIIILy oI u CIrIsLIun comes Irom wILIIn - by IuILI - und
noL by uLLempLIng Lo munuIucLure envIronmenLuI suIeLy uppeusIng
usuuIIy IrruLIonuI curnuI Ieurs.
TobuccopIobes, IuvIng munuIucLured u IeebIeness InLo u Iuke
superIorILy, Iuve no sucI conIIdence. TIey ure sLIII curnuI In dIsposILIon
und LerrIIIed noL onIy oI pIysIcuI deuLI buL oI dIscomIorL und even
nuIsunce, I.e., nomInuI CIrIsLIuns. L Is u sympLom oI Iukewurm-ness, LIe
pursuIL oI IIesIIy, IIIusory comIorL.
As IndIcuLed, LIe mujor reIIgIons now Iuve u sLunce on Lobucco.
TIere ure more und more CIrIsLIun vIews on Lobucco uppeurIng on LIe
InLerneL. or exumpIe, Greg M. JoInson presenLs s smokIng u sIn? A
sIorL presenLuLIon on LIe scrIpLuruI und medIcuI evIdence. He provIdes u
dIsjoInLed revIew oI LIe medIcuI evIdence demonsLruLIng LIuL Lobucco
cuuses dIseuse. NowIere Is LIe epIdemIoIogIc meLIod or sLuLIsLIcuIIsm
quesLIoned; IL Is uII uccepLed uL Iuce vuIue. HIs LreuLmenL oI LIe ARC
sLudy (BoIIeLLu eL uI., 1qq8) wIII IeIp muke LIe poInL:
TIe WorId HeuILI orgunIzuLIon pubIIsIed LIe IurgesL-
ever sLudy oI LIe eIIecLs oI secondIund smoke. TIe
reporL, currIed ouL by LIe {ARC|, Iound u 1;% Increuse
In cuncer ruLe Ior spousuI smokIng und u 16% Increuse
Ior workpIuce exposure. AnoLIer wuy oI sLuLIng u 1;%
Increuse Is LIuL LIe reIuLIve rIsk ruLIo (RRR) Is
1.1;..SIouId u CIrIsLIun LeII u neIgIbor LIuL Ie`s wIIIIng
553
553
Rampant Antismoking Signifies Grave Danger The Bigger Picture Rampant Antismoking Signifies Grave Danger
rIeLorIc LIuL Is IorLIcomIng. TIIs sorL oI CIrIsLIunILy reIIecLs no more
LIun u weII-InLenLIoned, buL LIorougIIy mIsguIded, cIrIsLIunIzed socIuI
cIub upproucI.
TIe worId Is In LIe mIdsL oI u meLupIysIcuI crIsIs LIuL wIII
cuImInuLe In u LIme oI greuL suIIerIng Ior muny. AL LIIs precurIous
juncLure LIere seem Lo be muny nomInuI CIrIsLIuns, uLLerIy domInuLed by
LIe muLerIuIIsm oI LIe LIme. TIe unLI-LobuccoIsm LIuL muny CIrIsLIuns
now preucI IndIcuLes (I.e., sympLomuLIc) body IIxuLIon, u mosL unIeuILIy
reIIunce on medIco-muLerIuIIsL propugundu, und greuLer
envIronmenLuIIsm. TIe sILuuLIon Ius deLerIoruLed wILI LIe ETS-Ied
unLIsmokIng ussuuIL oI LIe IusL number oI yeurs. or exumpIe, one
preucIer menLIoned LIuL some congreguLIon members Iud compIuIned
ubouL IuvIng Lo wuIk LIrougI u smoke cIoud becuuse oI persons
smokIng cIose Lo LIe cIurcI enLrunce. Muny LrudILIonuI cIurcIes now
proIIbIL smokIng unywIere on cIurcI grounds; LIIs Ius mucI Lo do wILI
proLecLIng nonsmokers Irom exposure Lo ETS. SucI vIcLImIood und
IuInLIng Is Lo be expecLed In LIe secuIur worId, gIven LIe conLorLed
reusonIng LIuL produces LIem. However, IL Is quILe usLoundIng LIuL
CIrIsLIuns ure demonsLruLIng LIIs IuInLness, uILIougI consIsLenL wILI
bIbIIcuI propIesy (e.g., uke z1:z6).
TIe so-cuIIed dungers oI ETS ure noL LIe Issue. Some
CIrIsLIuns were wunLIng Lo be proLecLed Irom LIe IouI smell oI
Lobucco smoke over LIe IusL Iew cenLurIes wIen ETS wus noL consIdered
us dungerous (see uIso WuIker, 1q8o). or exumpIe, BerrIdge (1qqq)
IndIcuLes LIe ucLIvILy oI LIe NuLIonuI SocIeLy oI Non-Smokers (NSNS):
or smokIng, LIe envIronmenLuIIsL cuse wus IeIL us LIe
provInce oI reIuLIveIy IneIIecLuuI pressure groups, mosL
noLubIy LIe |NSNS|, u smuII orgunIzuLIon Iounded In
1qz6. TIe NSNS pressed governmenL IndeIuLIgubIy Ior u
more sLrIngenL pubIIc IeuILI poIIcy. L wus concerned
wILI LIe nuIsunce uspecLs oI smokIng und LIe
seIIIsIness oI smokers In ImposIng LIeIr IubIL on
oLIers. Ls secreLury, LIe Rev. HuberL ILLIe, wroLe Lo LIe
CubIneL SecreLury In 1q6z, urgIng LIe governmenL Lo
consIder 'LIe rIgILs oI LIe non-smokIng secLIon oI LIe
pubIIc Lo breuLIe uIr noL smoke In pubIIc pIuces` (ILLIe,
1q6z). BuL LIIs currIed IILLIe weIgIL In LIe governmenLuI
urenu. TIe NSNS wus u non-medIcuI body, wIose
urgumenLs were perceIved us ukIn Lo LIose oI LIe
Lemperunce Iobby curryIng LIe LuInL oI moruIIsm wILI
IILLIe reIerence Lo scIence. (p.118)
The Bigger Picture
L Is ImpossIbIe Lo reconcIIe LIe conducL oI LIe Reverend In
ucLIveIy pursuIng LIe muLLer wILI LIe CIrIsLIun LeucIIng (e.g., 1
CorInLIIuns 1). TIe AposLIe PuuI mude reIerence Lo beIng sIIpwrecked,
beuLen up, und juIIed under exLremeIy IursI condILIons (I.e., surrounded
by LIe sLencI oI excremenL und deuLI) - see z CorInLIIuns 11:z-z;. He
counLed uII LIese LIIngs mInor muLLers In journeyIng Lo LIe crownIng
gIory (resurrecLIon). And yeL LIere ure reverends so dIsLurbed by LIe
nuIsunce oI exposure Lo Lobucco smoke LIuL ILs bunIsImenL wurrunLs
unreIenLIng pursuIL. I CIrIsLIuns ure uIreudy IuInLIng uL wIsps oI Lobucco
smoke, Iow couId LIey possIbIy IundIe LIe severILy Lo come?
L uppeurs LIuL more und more CIrIsLIuns ure cupILuIuLIng Lo LIe
ETS dunger Iruud. L uIso seems LIuL IL Is In seII-InLeresL LIuL LIey wouId
pursue smokers desIsLIng Irom LIe IubIL. Even II IL wus dungerous, wIuL
dIIIerence wouId LIIs muke? PuuI wus bILLen by u vIper, Irom wIIcI Ie wus
expecLed Lo dIe ImmedIuLeIy. YeL, PuuI sIrugged oII LIe vIper, LukIng LIe
muLLer In sLrIde, und conLInued normuIIy. L Is LIe sorL oI conducL wIere u
person wuIkIng by IuILI wILIIn u dIvIne pIun compreIends LIuL uLLempLs
uL InLerIerence wIII IuII - onIy LIe pIun wIII be IuIIIIIed. SucI u person cun
proceed cuImIy LIrougI ucLuuI dunger, enLIreIy conIIdenL In LIe SpIrIL. n
LIIs worId, LIe sLubIIILy oI u CIrIsLIun comes Irom wILIIn - by IuILI - und
noL by uLLempLIng Lo munuIucLure envIronmenLuI suIeLy uppeusIng
usuuIIy IrruLIonuI curnuI Ieurs.
TobuccopIobes, IuvIng munuIucLured u IeebIeness InLo u Iuke
superIorILy, Iuve no sucI conIIdence. TIey ure sLIII curnuI In dIsposILIon
und LerrIIIed noL onIy oI pIysIcuI deuLI buL oI dIscomIorL und even
nuIsunce, I.e., nomInuI CIrIsLIuns. L Is u sympLom oI Iukewurm-ness, LIe
pursuIL oI IIesIIy, IIIusory comIorL.
As IndIcuLed, LIe mujor reIIgIons now Iuve u sLunce on Lobucco.
TIere ure more und more CIrIsLIun vIews on Lobucco uppeurIng on LIe
InLerneL. or exumpIe, Greg M. JoInson presenLs s smokIng u sIn? A
sIorL presenLuLIon on LIe scrIpLuruI und medIcuI evIdence. He provIdes u
dIsjoInLed revIew oI LIe medIcuI evIdence demonsLruLIng LIuL Lobucco
cuuses dIseuse. NowIere Is LIe epIdemIoIogIc meLIod or sLuLIsLIcuIIsm
quesLIoned; IL Is uII uccepLed uL Iuce vuIue. HIs LreuLmenL oI LIe ARC
sLudy (BoIIeLLu eL uI., 1qq8) wIII IeIp muke LIe poInL:
TIe WorId HeuILI orgunIzuLIon pubIIsIed LIe IurgesL-
ever sLudy oI LIe eIIecLs oI secondIund smoke. TIe
reporL, currIed ouL by LIe {ARC|, Iound u 1;% Increuse
In cuncer ruLe Ior spousuI smokIng und u 16% Increuse
Ior workpIuce exposure. AnoLIer wuy oI sLuLIng u 1;%
Increuse Is LIuL LIe reIuLIve rIsk ruLIo (RRR) Is
1.1;..SIouId u CIrIsLIun LeII u neIgIbor LIuL Ie`s wIIIIng
554
554
Rampant Antismoking Signifies Grave Danger The Bigger Picture Rampant Antismoking Signifies Grave Danger
Lo Luke LIese rIsks wILI IIs neIgIbor`s IIIe?
JoInson IuIIs Lo noLe LIuL LIe IIndIng wus noL sLuLIsLIcuIIy
sIgnIIIcunL. As Lo ubsoIuLe predIcLIve sLrengLI, LIe IIndIng does noL ruLe.
urLIermore, IL Is IndIcuLed by LIe poor InIerence-mukIng LIuL JoInson
Ius no specIIIc experLIse In LIe IImILuLIons oI sLuLIsLIcuI InIerence or LIe
requIremenLs oI cuusuI urgumenL. CIrIsLIunILy Is reduced Lo LIe Inune
medIco-muLerIuIIsL gumbIIng meLupIor. TIere Is no compreIensIon LIuL
LIIs enLIre Ideu oI sLuLIsLIcuI rIsk uversIon Is LIe promoLIon oI IrruLIonuI
beIIeI, Ieur und IuLred.
HuvIng convInced IImseII LIuL medIco-muLerIuIIsm produces
InconLroverLIbIe IucLs, JoInson LIen mIsuppIIes LIIs knowIedge usIng
LIe body us u LempIe scrIpLures - see prevIous secLIon on The Crime
Pretention Group Ior deIIneuLIon. TIe urgumenL LIen degeneruLes InLo
body IIxuLIon und greuLer envIronmenLuIIsm (GuIu). or exumpIe, II
Lobucco smokIng Is u sIn, LIen LIe quesLIon Ius been usked wIeLIer Jesus
sInned by IIgILIng u cIurcouI IIre Ior cookIng und puLLIng poIIuLunLs InLo
LIe uIr?
TIose IuIIIng uwuy Iuve IosL LIe CIrIsLIun pIoL. By LIe CIrIsLIun
LeucIIng, LIIs worId Is In, und perceIved LIrougI, u IuIIen sLuLe und
currenLIy ruIed by LIe LwIsLed one - LIe devII. L Is u dungerous und
vIoIenL sLuLe; LIe nuLuruI worId Is one greuL Iood cIuIn. NuLuruI dIsusLers
produce gruve poIIuLIon. Mun`s greuLesL propensILy Ior poIIuLIon Is In
psycIoIogIcuI, reIuLIonuI, und moruI Lerms; wur, und LIe condILIons Ior
wur, In vuryIng degrees, Irom beLween persons Lo beLween nuLIons, Is u
consLunL, puncLuuLed by occusIonuI ceuse-IIres. L cun be seen LIuL LIIs
body IIxuLIon produces u curnuI Ideu oI purILy LIuL Is LIe sume Ior LIe
MMES cuIL und NuzIsm; IL reIIecLs LIe spIrILuuIIy unsuved uLLempLIng Lo
suve LIeIr IIesI. YeL, In LIIs vuIn uLLempL wIII uII LIe cIurucLer
deIIcIencIes uILImuLeIy come Lo LIe Iore. ReIerences Lo purILy In LIe New
TesLumenL do noL LypIcuIIy InvoIve exogenous exposures. TIey reIer Lo
cIurucLer, reIuLIonuI muLLers (see eurIIer quoLuLIons Irom LIe New
TesLumenL).
TIe urgumenL LIen IIIps InLo LIe use oI Romuns 1q:z1 & 1:1-z
wIIcI IndIcuLe beurIng wILI eucI oLIers IruIILIes, buL uIso Lo sLrengLIenIng
und buIIdIng up oLIers spiritucll. AguIn, In LIe conLexL oI LIe enLIre
LeucIIng, IL wouId muke no sense Lo reInIorce IrruLIonuI beIIeI, Ieur,
IuLred, body IIxuLIon, und LIe unLI-CIrIsLIun momenLum oI LIe LIme. TIe
LerrorJsuperIorIsm concernIng ETS does noL reIIecL LIe pecuIIur beIIeIs oI
u Iew. L Is essenLIuIIy LIe onIy Luboo oI u conLorLed worIdIy LIInkIng LIuL
IueIs uII oI LIe cIurucLer deIIcIencIes. As wus consIdered In prevIous
cIupLers, IL Is very severe Iumun IIuws LIuL ure beIng IegILImIzed by
The Bigger Picture
rumpunL muLerIuIIsm und ILs crILIcuI sympLom oI unLIsmokIng, e.g., SS und
ESS.
n uLLempLIng Lo Lemper LIe ussuuIL, JoInson udvIses
nonsmokIng CIrIsLIuns: TIIs group Ius LIe bIggesL cIuIIenge, becuuse oI
LIe dunger oI prIde. We muy see someone enguged In u IIILIy IubIL LIuL Is
IurmIuI Lo oLIers und end up so proud LIuL we IorgeL our own need Ior
LIe redeemIng gruce oI Jesus..EucI oI us muy be enguIIed In sIns us
worse us smokIng. Pruy Ior un undersLundIng oI LIe dIIIerence beLween
'judgIng` und speukIng LIe LruLI In Iove. JoInson does uppeur Lo be weII-
InLenLIoned. However, Ie seems Lo IndIcuLe LIuL smokIng Is u gruve sIn
und LIuL nonsmokIng CIrIsLIuns sIouId be wury LIuL LIey mIgIL be
IurborIng sIns jusL us gruve. L Is InLeresLIng LIuL JoInson`s websILe Ius u
IInk Lo PIeLLen`s TCPG, wIIcI Is descrIbed us oIIer|Ing| u very LIorougI
uILIougI uL LImes sLrIdenL cuse uguInsL Lobucco use. AguIn, LIe probIem Is
unwIse, IncompeLenL, IgnorunL counseI: TIe LIorougIness oI TCPG Is onIy
In deIuded beIIeI.
I some CIrIsLIuns beIIeve smokIng Lo be sInIuI, LIen so be IL.
However, Lo IosLer LIe ImpressIon, uIong wILI LIe worId, LIuL IL Is LIe
mosL gruve oI sIns Is enLIreIy urguubIe. ConcernIng ETS, everyone, und
purLIcuIurIy CIrIsLIuns, Iuve Iur, Iur more ImporLunL muLLers Lo uLLend Lo
LIun be preoccupIed wILI umbIenL Lobucco smoke. WIere LIe worId wouId
LerrorIze ILseII wILI IrruLIonuI beIIeI, u CIrIsLIun sIouId be ubIe Lo
demonsLruLe LIuL LIey ure noL deceIved by LIe unLIcs oI worIdIy LIougIL.
TIe wuy oI LIe worId Is reInIorced guIIL, Ieur und IuLred. TIe Iope oI u
CIrIsLIun Is LIe overcomIng oI LIese by LIe gruce oI suIvuLIon und LIe IoIy
wuIk. TIe commund Lo u CIrIsLIun Is Lo noL Ieur (e.g., uke 1z:z),
purLIcuIurIy uL LIIs unsLubIe LIme wIere Ieur Is IueIed us u muLLer oI
course. PerIecL Iove cusLs ouL uII Ieur (1 JoIn q:18). DecepLIon Lo Ieur cun
Luke muny Iorms. A dIIIIcuIL Iorm Ior muny CIrIsLIuns Is LIuL wIIcI
proceeds Irom medIco-muLerIuIIsm.
BeIow ure some IurLIer exumpIes oI CIrIsLIuns ucLIveIy
promoLIng LIe unLIsmokIng crusude:
TIe cIurcI Is supposed Lo seL LIe sLundurds und
guIdeIInes und vIsIon..Lo be u voIce oI conscIence und u
voIce oI cIunge. WIeLIer IL`s deuIIng wILI LIe medIu, or
sLores seIIIng drug purupIernuIIu or Lobucco uds
LurgeLIng cIIIdren, LIey ure uII LIe sume. TIey ure uII
condILIons LIuL uIIecL Iow we IIve. PeopIe suy 'WIy
don`L you do your cIurcI sLuII?` WeII, LIIs Is cIurcI
sLuII. - uLIer MIcIueI PIIeger, LIe SouLI SIde PrIesL,
CIIcugo (Crusuder Sees TIde TurnIng, TIm Jones,
CIIcugo TrIbune, Muy z;, 1qqq)
555
555
Rampant Antismoking Signifies Grave Danger The Bigger Picture Rampant Antismoking Signifies Grave Danger
Lo Luke LIese rIsks wILI IIs neIgIbor`s IIIe?
JoInson IuIIs Lo noLe LIuL LIe IIndIng wus noL sLuLIsLIcuIIy
sIgnIIIcunL. As Lo ubsoIuLe predIcLIve sLrengLI, LIe IIndIng does noL ruLe.
urLIermore, IL Is IndIcuLed by LIe poor InIerence-mukIng LIuL JoInson
Ius no specIIIc experLIse In LIe IImILuLIons oI sLuLIsLIcuI InIerence or LIe
requIremenLs oI cuusuI urgumenL. CIrIsLIunILy Is reduced Lo LIe Inune
medIco-muLerIuIIsL gumbIIng meLupIor. TIere Is no compreIensIon LIuL
LIIs enLIre Ideu oI sLuLIsLIcuI rIsk uversIon Is LIe promoLIon oI IrruLIonuI
beIIeI, Ieur und IuLred.
HuvIng convInced IImseII LIuL medIco-muLerIuIIsm produces
InconLroverLIbIe IucLs, JoInson LIen mIsuppIIes LIIs knowIedge usIng
LIe body us u LempIe scrIpLures - see prevIous secLIon on The Crime
Pretention Group Ior deIIneuLIon. TIe urgumenL LIen degeneruLes InLo
body IIxuLIon und greuLer envIronmenLuIIsm (GuIu). or exumpIe, II
Lobucco smokIng Is u sIn, LIen LIe quesLIon Ius been usked wIeLIer Jesus
sInned by IIgILIng u cIurcouI IIre Ior cookIng und puLLIng poIIuLunLs InLo
LIe uIr?
TIose IuIIIng uwuy Iuve IosL LIe CIrIsLIun pIoL. By LIe CIrIsLIun
LeucIIng, LIIs worId Is In, und perceIved LIrougI, u IuIIen sLuLe und
currenLIy ruIed by LIe LwIsLed one - LIe devII. L Is u dungerous und
vIoIenL sLuLe; LIe nuLuruI worId Is one greuL Iood cIuIn. NuLuruI dIsusLers
produce gruve poIIuLIon. Mun`s greuLesL propensILy Ior poIIuLIon Is In
psycIoIogIcuI, reIuLIonuI, und moruI Lerms; wur, und LIe condILIons Ior
wur, In vuryIng degrees, Irom beLween persons Lo beLween nuLIons, Is u
consLunL, puncLuuLed by occusIonuI ceuse-IIres. L cun be seen LIuL LIIs
body IIxuLIon produces u curnuI Ideu oI purILy LIuL Is LIe sume Ior LIe
MMES cuIL und NuzIsm; IL reIIecLs LIe spIrILuuIIy unsuved uLLempLIng Lo
suve LIeIr IIesI. YeL, In LIIs vuIn uLLempL wIII uII LIe cIurucLer
deIIcIencIes uILImuLeIy come Lo LIe Iore. ReIerences Lo purILy In LIe New
TesLumenL do noL LypIcuIIy InvoIve exogenous exposures. TIey reIer Lo
cIurucLer, reIuLIonuI muLLers (see eurIIer quoLuLIons Irom LIe New
TesLumenL).
TIe urgumenL LIen IIIps InLo LIe use oI Romuns 1q:z1 & 1:1-z
wIIcI IndIcuLe beurIng wILI eucI oLIers IruIILIes, buL uIso Lo sLrengLIenIng
und buIIdIng up oLIers spiritucll. AguIn, In LIe conLexL oI LIe enLIre
LeucIIng, IL wouId muke no sense Lo reInIorce IrruLIonuI beIIeI, Ieur,
IuLred, body IIxuLIon, und LIe unLI-CIrIsLIun momenLum oI LIe LIme. TIe
LerrorJsuperIorIsm concernIng ETS does noL reIIecL LIe pecuIIur beIIeIs oI
u Iew. L Is essenLIuIIy LIe onIy Luboo oI u conLorLed worIdIy LIInkIng LIuL
IueIs uII oI LIe cIurucLer deIIcIencIes. As wus consIdered In prevIous
cIupLers, IL Is very severe Iumun IIuws LIuL ure beIng IegILImIzed by
The Bigger Picture
rumpunL muLerIuIIsm und ILs crILIcuI sympLom oI unLIsmokIng, e.g., SS und
ESS.
n uLLempLIng Lo Lemper LIe ussuuIL, JoInson udvIses
nonsmokIng CIrIsLIuns: TIIs group Ius LIe bIggesL cIuIIenge, becuuse oI
LIe dunger oI prIde. We muy see someone enguged In u IIILIy IubIL LIuL Is
IurmIuI Lo oLIers und end up so proud LIuL we IorgeL our own need Ior
LIe redeemIng gruce oI Jesus..EucI oI us muy be enguIIed In sIns us
worse us smokIng. Pruy Ior un undersLundIng oI LIe dIIIerence beLween
'judgIng` und speukIng LIe LruLI In Iove. JoInson does uppeur Lo be weII-
InLenLIoned. However, Ie seems Lo IndIcuLe LIuL smokIng Is u gruve sIn
und LIuL nonsmokIng CIrIsLIuns sIouId be wury LIuL LIey mIgIL be
IurborIng sIns jusL us gruve. L Is InLeresLIng LIuL JoInson`s websILe Ius u
IInk Lo PIeLLen`s TCPG, wIIcI Is descrIbed us oIIer|Ing| u very LIorougI
uILIougI uL LImes sLrIdenL cuse uguInsL Lobucco use. AguIn, LIe probIem Is
unwIse, IncompeLenL, IgnorunL counseI: TIe LIorougIness oI TCPG Is onIy
In deIuded beIIeI.
I some CIrIsLIuns beIIeve smokIng Lo be sInIuI, LIen so be IL.
However, Lo IosLer LIe ImpressIon, uIong wILI LIe worId, LIuL IL Is LIe
mosL gruve oI sIns Is enLIreIy urguubIe. ConcernIng ETS, everyone, und
purLIcuIurIy CIrIsLIuns, Iuve Iur, Iur more ImporLunL muLLers Lo uLLend Lo
LIun be preoccupIed wILI umbIenL Lobucco smoke. WIere LIe worId wouId
LerrorIze ILseII wILI IrruLIonuI beIIeI, u CIrIsLIun sIouId be ubIe Lo
demonsLruLe LIuL LIey ure noL deceIved by LIe unLIcs oI worIdIy LIougIL.
TIe wuy oI LIe worId Is reInIorced guIIL, Ieur und IuLred. TIe Iope oI u
CIrIsLIun Is LIe overcomIng oI LIese by LIe gruce oI suIvuLIon und LIe IoIy
wuIk. TIe commund Lo u CIrIsLIun Is Lo noL Ieur (e.g., uke 1z:z),
purLIcuIurIy uL LIIs unsLubIe LIme wIere Ieur Is IueIed us u muLLer oI
course. PerIecL Iove cusLs ouL uII Ieur (1 JoIn q:18). DecepLIon Lo Ieur cun
Luke muny Iorms. A dIIIIcuIL Iorm Ior muny CIrIsLIuns Is LIuL wIIcI
proceeds Irom medIco-muLerIuIIsm.
BeIow ure some IurLIer exumpIes oI CIrIsLIuns ucLIveIy
promoLIng LIe unLIsmokIng crusude:
TIe cIurcI Is supposed Lo seL LIe sLundurds und
guIdeIInes und vIsIon..Lo be u voIce oI conscIence und u
voIce oI cIunge. WIeLIer IL`s deuIIng wILI LIe medIu, or
sLores seIIIng drug purupIernuIIu or Lobucco uds
LurgeLIng cIIIdren, LIey ure uII LIe sume. TIey ure uII
condILIons LIuL uIIecL Iow we IIve. PeopIe suy 'WIy
don`L you do your cIurcI sLuII?` WeII, LIIs Is cIurcI
sLuII. - uLIer MIcIueI PIIeger, LIe SouLI SIde PrIesL,
CIIcugo (Crusuder Sees TIde TurnIng, TIm Jones,
CIIcugo TrIbune, Muy z;, 1qqq)
556
556
Rampant Antismoking Signifies Grave Danger The Bigger Picture Rampant Antismoking Signifies Grave Danger
TIe roIe oI LIe cIurcI Is Lo ruIse u pubIIc voIce ubouL un
IndusLry seL up Lo proIIL upon peopIe`s ensIuvemenL. -
Reverend DougIus MIIes, pusLor oI KoInonIu BupLIsL
CIurcI In BuILImore (AIIegIunce Lo ProIIL, Bob
HuILeen, Sojourners muguzIne, Nov-Dec zoo1, VoI.
o:6, p.1;I)
CIgureLLes ure kIIIIng our cIIIdren. We need Lo pIuy our
purL In reucIIng ouL Lo LIem. - TIe Reverend CruIg
Dossmun, New HeIgILs SevenLI Duy AdvenLIsL CIurcI,
Juckson, MIssIssIppI (SeLLIemenL wIII IeIp puy Ior
ouLreucI, Juck EIIIoL (AP), BIIoxI Sun HeruId, Junuury
1q, zooo)
And u IILLIe cIIId sIuII Ieud LIem. - ubbock, Texus
CouncII member T.J. PuLLerson, credILIng AmIL BusIun
Ior creuLIng un InLeresL In u recenLIy pussed smoke-Iree
cIeun Indoor uIr ordInunce, uILer LIe 11-yeur-oId
suIIered un usLImu uLLuck Irom smoke wIIIe bowIIng
wILI IrIends (J. uquuy, No More BIowIng Smoke: Bun
Pussed, ubbock OnIIne, www.IubbockonIIne.com,
June 1, zoo1)
|ReIIgIous communILIes| rIse Lo socIuI Issues very
sIowIy..BuL wIen LIey do geL InvoIved LIey`re very
eIIecLIve. And cun onIy Iope LIey wIII begIn Lo see
some oI LIese LIIngs. - C. EvereLL Koop, Iormer U.S.
Surgeon GeneruI, usked wIy LIe reIIgIous communILy
Ius been IurgeIy sIIenL uguInsL Lobucco compunIes
(NuLIonuI Press CIub uncIeon, SepLember 8, 1qq8,
WusIIngLon, D.C.)
CILrus CounLy`s Tobucco ree PurLnersIIp und SLudenLs
WorkIng AguInsL Tobucco (SWAT) wIII be IuvIng u
IuILI-bused SWAT RuIIy Loduy..uL LIe Jesus s!
MInIsLry ..In Hernundo. AII CILrus CounLy IuILI-
bused youLI und LIeIr purenLs ure InvILed Lo uLLend;
udmIssIon Is Iree. TIere wIII be musIc, unLI-Lobucco
gumes, ucLIvILIes und prIzes..TIe mIssIon oI LIe groups
Is Lo promoLe IeuILIy Lobucco-Iree IIIesLyIes und Lo
reduce uccepLubIIILy und uccessIbIIILy oI Lobucco Lo
youLI LIrougI educuLIon und udvocucy, wILI LIe
supporL oI Iuw enIorcemenL. TIeIr purpose Is Lo reduce
Lobucco-reIuLed IIInesses und deuLIs In LIe communILy.
SWAT Is u sLuLe-sponsored orgunIzuLIon LIuL gIves
young peopIe u IeudersIIp roIe In reucIIng LIeIr peers
The Bigger Picture
wILI LIe unLI-Lobucco messuge. - (YouLI ruIIy spreuds
unLI-Lobucco messuge, by GuII HoIIenbeck, SL.
PeLersburg TImes, IorIdu, Junuury 1, zoo1)
AguIn, LIe vIews uII reIy on LIe vIIIIIcuLIon oI LIe Lobucco
IndusLry, LIe InIuIIIbIIILy oI medIco-muLerIuIIsm und sLuLIsLIcuIIsm, und
proLecLIon oI LIe cIIIdren. SLuLemenLs sucI us cIgureLLes ure kIIIIng our
cIIIdren Iuve no sensIbIIILy, buL ure conjured by IunuLIcIsm. TIe
sLuLemenL und u IILLIe cIIId sIuII Ieud LIem provIdes un InLeresLIng LwIsL
on suIuI 11:6; LIe scrIpLure does noL sLuLe LIuL u IILLIe, sicl cIIId sIuII Ieud
LIem.
OLIer CIrIsLIun oIIerIngs on LIe InLerneL ure somewIuL more
dIrecL und LendIng Lo crudILy und vuIgurILy In depIcLIng smokers us drug
uddIcLs, seII-murderers (suIcIde) und murderers oI nonsmokers; LIe very
uLLempL Lo depIcL smokIng und exposIng oLIers Lo ETS us sInIuI conLuIns
uII LIe cIurucLer deIIcIencIes (sIns) LIuL IoIy counseI wouId Iuve
CIrIsLIuns properIy uLLend Lo. TIe crucIuI quesLIon concerns Iow LIIs one
LopIc oI smokIng now ubsorbs CIrIsLIuns und Lo LIe excIusIon oI Iur
weIgILIer muLLers. TIe probIem Is LIe uposLusy - LIe Iove oI muny wuxIng
coId (MuLLIew zq:1z). Muny so-cuIIed CIrIsLIuns Iuve uIIowed LIemseIves
Lo be drugged InLo LIe muLerIuIIsm oI LIe LIme und probubIy do noL even
reuIIze IL. YeL, unLIsmokIng serves LIe sume dIsLrucLIng und seII-jusLIIyIng
purpose. Persons noL enguged In LIe proIound wuIk use unLIsmokIng us u
moruI subsLILuLe. WIIIe LIese nomInuI CIrIsLIuns ure ubsorbed In
unLIsmokIng rIeLorIc und IuIIIng In LIeIr ucLuuI CIrIsLIun Lusk, LIey ure
noL onIy obIIvIous Lo LIe ucLuuI cuLusLropIe In moLIon, buL ure purLy Lo IL.
TIIs Is un exceIIenL deIInILIon oI decepLIon In bIbIIcuI Lerms. And, LIe
conducL Is noL new. or exumpIe, LIere were CIrIsLIuns uL LIe begInnIng oI
LIe NuzI eru LIuL uppIuuded HILIer Ior IIs unLIsmokIng, unLI-uIcoIoI, und
unLI-pornogrupIy - even LIose Irom ubroud (e.g., Yuncey, 1qq;, p.zo1).
YeL, LIese were deceIved by superIIcIuIILIes, unubIe Lo dIscern LIe
desLrucLIve momenLum oI LIuL LIme. TIe sume Is occurrIng now on u Iur
greuLer scuIe. CIrIsL wouId Iuve HIs IoIIowers wIse Lo LIe nuLure oI LIe
LImes, e.g., uke z1:8, MuLLIew zq:q.
CIrIsLIuns wouId do weII Lo exumIne LIeIr vIews on Lobucco.
AnLIsmokIng Is u crILIcuI sympLom oI LIe LIme. SucI un exumInuLIon
sIouId IndIcuLe LIuL muny CIrIsLIuns muy be Iur Loo gIven over Lo medIco-
muLerIuIIsL rIeLorIc, I.e., mIspIuced IuILI. Some CIrIsLIuns vIew medIcIne
und docLors us God`s mecIunIcs. SucI u vIew Is In need oI scruLIny us u
poInL oI greuL urgency. AL medIcuI conIerences IL wouId noL be surprIsIng
LIuL God Is never reIerred Lo: MedIco-muLerIuIIsm Is mun-produced und
mun-gIorIIyIng. I zooo yeurs ugo Jesus Iud no need oI gudgeLs, gIzmos,
557
557
Rampant Antismoking Signifies Grave Danger The Bigger Picture Rampant Antismoking Signifies Grave Danger
TIe roIe oI LIe cIurcI Is Lo ruIse u pubIIc voIce ubouL un
IndusLry seL up Lo proIIL upon peopIe`s ensIuvemenL. -
Reverend DougIus MIIes, pusLor oI KoInonIu BupLIsL
CIurcI In BuILImore (AIIegIunce Lo ProIIL, Bob
HuILeen, Sojourners muguzIne, Nov-Dec zoo1, VoI.
o:6, p.1;I)
CIgureLLes ure kIIIIng our cIIIdren. We need Lo pIuy our
purL In reucIIng ouL Lo LIem. - TIe Reverend CruIg
Dossmun, New HeIgILs SevenLI Duy AdvenLIsL CIurcI,
Juckson, MIssIssIppI (SeLLIemenL wIII IeIp puy Ior
ouLreucI, Juck EIIIoL (AP), BIIoxI Sun HeruId, Junuury
1q, zooo)
And u IILLIe cIIId sIuII Ieud LIem. - ubbock, Texus
CouncII member T.J. PuLLerson, credILIng AmIL BusIun
Ior creuLIng un InLeresL In u recenLIy pussed smoke-Iree
cIeun Indoor uIr ordInunce, uILer LIe 11-yeur-oId
suIIered un usLImu uLLuck Irom smoke wIIIe bowIIng
wILI IrIends (J. uquuy, No More BIowIng Smoke: Bun
Pussed, ubbock OnIIne, www.IubbockonIIne.com,
June 1, zoo1)
|ReIIgIous communILIes| rIse Lo socIuI Issues very
sIowIy..BuL wIen LIey do geL InvoIved LIey`re very
eIIecLIve. And cun onIy Iope LIey wIII begIn Lo see
some oI LIese LIIngs. - C. EvereLL Koop, Iormer U.S.
Surgeon GeneruI, usked wIy LIe reIIgIous communILy
Ius been IurgeIy sIIenL uguInsL Lobucco compunIes
(NuLIonuI Press CIub uncIeon, SepLember 8, 1qq8,
WusIIngLon, D.C.)
CILrus CounLy`s Tobucco ree PurLnersIIp und SLudenLs
WorkIng AguInsL Tobucco (SWAT) wIII be IuvIng u
IuILI-bused SWAT RuIIy Loduy..uL LIe Jesus s!
MInIsLry ..In Hernundo. AII CILrus CounLy IuILI-
bused youLI und LIeIr purenLs ure InvILed Lo uLLend;
udmIssIon Is Iree. TIere wIII be musIc, unLI-Lobucco
gumes, ucLIvILIes und prIzes..TIe mIssIon oI LIe groups
Is Lo promoLe IeuILIy Lobucco-Iree IIIesLyIes und Lo
reduce uccepLubIIILy und uccessIbIIILy oI Lobucco Lo
youLI LIrougI educuLIon und udvocucy, wILI LIe
supporL oI Iuw enIorcemenL. TIeIr purpose Is Lo reduce
Lobucco-reIuLed IIInesses und deuLIs In LIe communILy.
SWAT Is u sLuLe-sponsored orgunIzuLIon LIuL gIves
young peopIe u IeudersIIp roIe In reucIIng LIeIr peers
The Bigger Picture
wILI LIe unLI-Lobucco messuge. - (YouLI ruIIy spreuds
unLI-Lobucco messuge, by GuII HoIIenbeck, SL.
PeLersburg TImes, IorIdu, Junuury 1, zoo1)
AguIn, LIe vIews uII reIy on LIe vIIIIIcuLIon oI LIe Lobucco
IndusLry, LIe InIuIIIbIIILy oI medIco-muLerIuIIsm und sLuLIsLIcuIIsm, und
proLecLIon oI LIe cIIIdren. SLuLemenLs sucI us cIgureLLes ure kIIIIng our
cIIIdren Iuve no sensIbIIILy, buL ure conjured by IunuLIcIsm. TIe
sLuLemenL und u IILLIe cIIId sIuII Ieud LIem provIdes un InLeresLIng LwIsL
on suIuI 11:6; LIe scrIpLure does noL sLuLe LIuL u IILLIe, sicl cIIId sIuII Ieud
LIem.
OLIer CIrIsLIun oIIerIngs on LIe InLerneL ure somewIuL more
dIrecL und LendIng Lo crudILy und vuIgurILy In depIcLIng smokers us drug
uddIcLs, seII-murderers (suIcIde) und murderers oI nonsmokers; LIe very
uLLempL Lo depIcL smokIng und exposIng oLIers Lo ETS us sInIuI conLuIns
uII LIe cIurucLer deIIcIencIes (sIns) LIuL IoIy counseI wouId Iuve
CIrIsLIuns properIy uLLend Lo. TIe crucIuI quesLIon concerns Iow LIIs one
LopIc oI smokIng now ubsorbs CIrIsLIuns und Lo LIe excIusIon oI Iur
weIgILIer muLLers. TIe probIem Is LIe uposLusy - LIe Iove oI muny wuxIng
coId (MuLLIew zq:1z). Muny so-cuIIed CIrIsLIuns Iuve uIIowed LIemseIves
Lo be drugged InLo LIe muLerIuIIsm oI LIe LIme und probubIy do noL even
reuIIze IL. YeL, unLIsmokIng serves LIe sume dIsLrucLIng und seII-jusLIIyIng
purpose. Persons noL enguged In LIe proIound wuIk use unLIsmokIng us u
moruI subsLILuLe. WIIIe LIese nomInuI CIrIsLIuns ure ubsorbed In
unLIsmokIng rIeLorIc und IuIIIng In LIeIr ucLuuI CIrIsLIun Lusk, LIey ure
noL onIy obIIvIous Lo LIe ucLuuI cuLusLropIe In moLIon, buL ure purLy Lo IL.
TIIs Is un exceIIenL deIInILIon oI decepLIon In bIbIIcuI Lerms. And, LIe
conducL Is noL new. or exumpIe, LIere were CIrIsLIuns uL LIe begInnIng oI
LIe NuzI eru LIuL uppIuuded HILIer Ior IIs unLIsmokIng, unLI-uIcoIoI, und
unLI-pornogrupIy - even LIose Irom ubroud (e.g., Yuncey, 1qq;, p.zo1).
YeL, LIese were deceIved by superIIcIuIILIes, unubIe Lo dIscern LIe
desLrucLIve momenLum oI LIuL LIme. TIe sume Is occurrIng now on u Iur
greuLer scuIe. CIrIsL wouId Iuve HIs IoIIowers wIse Lo LIe nuLure oI LIe
LImes, e.g., uke z1:8, MuLLIew zq:q.
CIrIsLIuns wouId do weII Lo exumIne LIeIr vIews on Lobucco.
AnLIsmokIng Is u crILIcuI sympLom oI LIe LIme. SucI un exumInuLIon
sIouId IndIcuLe LIuL muny CIrIsLIuns muy be Iur Loo gIven over Lo medIco-
muLerIuIIsL rIeLorIc, I.e., mIspIuced IuILI. Some CIrIsLIuns vIew medIcIne
und docLors us God`s mecIunIcs. SucI u vIew Is In need oI scruLIny us u
poInL oI greuL urgency. AL medIcuI conIerences IL wouId noL be surprIsIng
LIuL God Is never reIerred Lo: MedIco-muLerIuIIsm Is mun-produced und
mun-gIorIIyIng. I zooo yeurs ugo Jesus Iud no need oI gudgeLs, gIzmos,
558
558
Rampant Antismoking Signifies Grave Danger The Bigger Picture Rampant Antismoking Signifies Grave Danger The Bigger Picture
urIne LesLs, eLc., Lo IeuI, wIy wouId Ie need LIem now? MedIcIne cun be
oI Lemporury und IImILed use gIven LIuL LIe IoIy journey Is LrunsILIonuI; IL
cunnoL soIve LIe crILIcuI und uILImuLeIy desLrucLIve probIems oI LIIs worId.
However, LIe uspIruLIons oI LIe conLemporury medIcuI esLubIIsImenL go
Iur beyond IImILed servIce wILIIn u greuLer meLupIysIcuI conLexL. As purL
oI LIe muLerIuIIsL worIdvIew, IL seeks domInuLIon - ruIersIIp. TIe medIcuI
esLubIIsImenL Is noL God, und medIcuI prucLILIoners ure noL InIuIIIbIe.
ConcernIng IIIesLyIe prescrIpLIons bused on sLuLIsLIcuIIsm, LIe reusonIng Is
enLIreIy perverse.
L sIouId duwn on CIrIsLIuns, In purLIcuIur, LIuL mucI oI LIe
erosIon oI LIe CIrIsLIun IuILI In muny wesLern nuLIons over LIe IusL
number oI decudes Ius been IosLered by medIco-muLerIuIIsm. PurLIcuIurIy
In V und geneLIc reseurcI, medIco-muLerIuIIsm seeks no moruI resLruInL
on ILs ucLIvILIes, I.e., scIenLIsm. Remember, Loo, LIuL LIe symboI Ior LIe
medIcuI esLubIIsImenL Is uIso LeIIIng - sIngIe or InLerLwInIng serpenLs on u
sLuII. Ls uIIegIunce LIrougI LIe HIppocruLIc OuLI Is Lo Greek gods. YeL,
LIere Is noL even consensus on LIIs ouLI. L wus consIdered In CIupLer
LIuL LIe conLemporury medIcuI esLubIIsImenL Is In moruI dIsurruy, ILs
edIcLs producIng moruI dIIemmus und psycIoIogIcuI und reIuLIonuI
dysIuncLIon us u muLLer oI course.
TIe worId (curnuI menLuIILy) Is Impressed by LIese medIcuI und
scIenLIIIc udvunces, IuvIng no Iope In unyLIIng eIse. However, u
CIrIsLIun sIouId be ubIe Lo uppIy z TIessuIonIuns z:q - Lo noL be deceIved
by power und sIgns und IyIng wonders. TIere Is u greuLer decepLIon Lo
come. I CIrIsLIuns ure uIreudy IuILerIng wILI LIe Iormer, LIen wIuL Is
LIeIr Iope In LIe IuLLer? TIe underIyIng muLerIuIIsm couId be no IuppIer
II uII reIIgIons, IncIudIng CIrIsLIunILy, sImpIy vunIsIed. CIrIsLIuns sIouId
be very wury oI wIuL LIey Iend LIeIr IuILI Lo. AnLIsmokIng Is jusL one
uspecL oI LIIs muLerIuIIsL onsIuugIL. EvenLuuIIy, greuL persecuLIon oI
CIrIsLIuns wIII come by IuIIy-IIedged muLerIuIIsm und LIe IuII runge oI
cIurucLer deIIcIencIes.
TIere Is un even more sImpIe uppruIsuI oI LIe unLIsmokIng
Irenzy. JoInson IndIcuLes LIuL oLIer sIns wIIcI LoucI on LIe Issue oI
Lobucco..engugIng In wIuL LIe enLIre worId ugrees Is u IIILIy und
dIsgusLIng IubIL. rom LIe New TesLumenL IL cun be undersLood LIuL In
LIe end oI LIe uge, und IncIudIng LIe uposLusy, LIuL LIe wIoIe worId Is
deceIved, e.g., ReveIuLIon 18:z. An ucLuuI CIrIsLIun wouId IurdIy be
moLIvuLed Lo joIn In IIxuLIons LIuL LIe wIoIe worId Is enguged In. RuLIer, II
unLIsmokIng Is u currenL gIobuI obsessIon, IL Is sure LIuL IL represenLs LIe
wrong Lruck (z TIessuIonIuns z:11), IeuvIng ImporLunL muLLers reckIessIy
unuLLended; IL Is u seII-decepLIon, u sLrong deIusIon, musquerudIng ucLuuI
grund-scuIe cuIumILy.
TIe Iope In LIIs dIscussIon Is LIuL boLI CIrIsLIuns und non-
CIrIsLIuns cun become suIIIcIenLIy ucquuInLed wILI LIe busIs oI wIuL Is u
pIeLIoru oI IIuwed, muLerIuIIsL IIIesLyIe prescrIpLIons. TIe recognILIon
wIII IIgIIIgIL LIuL Mun Ius LIe sume need us uIwuys - reIuLIonsIIp wILI
God. And HoIIness Ius gIven LIe unswer, noL Lo be urgued wILI, buL
receIved us IL Is gIven - IreeIy. TIe desIre Ior HoIy CounseI und Lo know
LIe ove oI God In us wIII IoId unyone uprIgIL In LIuL duy oI reckonIng.
TIe bIessIngs oI CIrIsL Lo uII.
559
559
Rampant Antismoking Signifies Grave Danger The Bigger Picture Rampant Antismoking Signifies Grave Danger The Bigger Picture
urIne LesLs, eLc., Lo IeuI, wIy wouId Ie need LIem now? MedIcIne cun be
oI Lemporury und IImILed use gIven LIuL LIe IoIy journey Is LrunsILIonuI; IL
cunnoL soIve LIe crILIcuI und uILImuLeIy desLrucLIve probIems oI LIIs worId.
However, LIe uspIruLIons oI LIe conLemporury medIcuI esLubIIsImenL go
Iur beyond IImILed servIce wILIIn u greuLer meLupIysIcuI conLexL. As purL
oI LIe muLerIuIIsL worIdvIew, IL seeks domInuLIon - ruIersIIp. TIe medIcuI
esLubIIsImenL Is noL God, und medIcuI prucLILIoners ure noL InIuIIIbIe.
ConcernIng IIIesLyIe prescrIpLIons bused on sLuLIsLIcuIIsm, LIe reusonIng Is
enLIreIy perverse.
L sIouId duwn on CIrIsLIuns, In purLIcuIur, LIuL mucI oI LIe
erosIon oI LIe CIrIsLIun IuILI In muny wesLern nuLIons over LIe IusL
number oI decudes Ius been IosLered by medIco-muLerIuIIsm. PurLIcuIurIy
In V und geneLIc reseurcI, medIco-muLerIuIIsm seeks no moruI resLruInL
on ILs ucLIvILIes, I.e., scIenLIsm. Remember, Loo, LIuL LIe symboI Ior LIe
medIcuI esLubIIsImenL Is uIso LeIIIng - sIngIe or InLerLwInIng serpenLs on u
sLuII. Ls uIIegIunce LIrougI LIe HIppocruLIc OuLI Is Lo Greek gods. YeL,
LIere Is noL even consensus on LIIs ouLI. L wus consIdered In CIupLer
LIuL LIe conLemporury medIcuI esLubIIsImenL Is In moruI dIsurruy, ILs
edIcLs producIng moruI dIIemmus und psycIoIogIcuI und reIuLIonuI
dysIuncLIon us u muLLer oI course.
TIe worId (curnuI menLuIILy) Is Impressed by LIese medIcuI und
scIenLIIIc udvunces, IuvIng no Iope In unyLIIng eIse. However, u
CIrIsLIun sIouId be ubIe Lo uppIy z TIessuIonIuns z:q - Lo noL be deceIved
by power und sIgns und IyIng wonders. TIere Is u greuLer decepLIon Lo
come. I CIrIsLIuns ure uIreudy IuILerIng wILI LIe Iormer, LIen wIuL Is
LIeIr Iope In LIe IuLLer? TIe underIyIng muLerIuIIsm couId be no IuppIer
II uII reIIgIons, IncIudIng CIrIsLIunILy, sImpIy vunIsIed. CIrIsLIuns sIouId
be very wury oI wIuL LIey Iend LIeIr IuILI Lo. AnLIsmokIng Is jusL one
uspecL oI LIIs muLerIuIIsL onsIuugIL. EvenLuuIIy, greuL persecuLIon oI
CIrIsLIuns wIII come by IuIIy-IIedged muLerIuIIsm und LIe IuII runge oI
cIurucLer deIIcIencIes.
TIere Is un even more sImpIe uppruIsuI oI LIe unLIsmokIng
Irenzy. JoInson IndIcuLes LIuL oLIer sIns wIIcI LoucI on LIe Issue oI
Lobucco..engugIng In wIuL LIe enLIre worId ugrees Is u IIILIy und
dIsgusLIng IubIL. rom LIe New TesLumenL IL cun be undersLood LIuL In
LIe end oI LIe uge, und IncIudIng LIe uposLusy, LIuL LIe wIoIe worId Is
deceIved, e.g., ReveIuLIon 18:z. An ucLuuI CIrIsLIun wouId IurdIy be
moLIvuLed Lo joIn In IIxuLIons LIuL LIe wIoIe worId Is enguged In. RuLIer, II
unLIsmokIng Is u currenL gIobuI obsessIon, IL Is sure LIuL IL represenLs LIe
wrong Lruck (z TIessuIonIuns z:11), IeuvIng ImporLunL muLLers reckIessIy
unuLLended; IL Is u seII-decepLIon, u sLrong deIusIon, musquerudIng ucLuuI
grund-scuIe cuIumILy.
TIe Iope In LIIs dIscussIon Is LIuL boLI CIrIsLIuns und non-
CIrIsLIuns cun become suIIIcIenLIy ucquuInLed wILI LIe busIs oI wIuL Is u
pIeLIoru oI IIuwed, muLerIuIIsL IIIesLyIe prescrIpLIons. TIe recognILIon
wIII IIgIIIgIL LIuL Mun Ius LIe sume need us uIwuys - reIuLIonsIIp wILI
God. And HoIIness Ius gIven LIe unswer, noL Lo be urgued wILI, buL
receIved us IL Is gIven - IreeIy. TIe desIre Ior HoIy CounseI und Lo know
LIe ove oI God In us wIII IoId unyone uprIgIL In LIuL duy oI reckonIng.
TIe bIessIngs oI CIrIsL Lo uII.
560
560
References
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new upproucI Lo puImonury empIysemu. Thorcx, ondon, 8, 116-z.
Abrumson, J.H., Sucks, U.., & Cubunu, E. (1q;1) DeuLI cerLIIIcuLe duLu us
un IndIcuLIon oI LIe presence oI cerLuIn common dIseuses uL deuLI,
1ourncl oj Chronic Disecses, :(, q1;-q1.
AcILerberg, J., & uwIIs, G.. (1q8o) rides oj the odmind. IIInoIs:
nsLILuLe Ior PersonuIILy und AbIIILy TesLIng, nc.
AC (1qqq) SmokIng: cosLs und beneIILs Ior AusLruIIu. An IndependenL
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o; z)
Ackroyd, A. (zoo1) DIIIIcuIL? MoI? ArLIcIe uppeurIng In The Ae, AugusL q,
Good Weekend, p..
AIuvunju, M.C., Brown, C.C., Swunson, C., & Brownson, R.C. (1qq)
SuLuruLed IuL InLuke und Iung cuncer rIsk umong nonsmokIng women In
MIssourI, 1ourncl oj the Nctioncl Ccncer Institute, 8, 1qo6-1q16.
AIIgne, C.A., CIrIsLy, C., & JuIn, S. (zoo1) nudverLenL Lobucco udverLIsIng
In pIysIcIuns' oIIIces, 1ourncl oj the cmericcn Mediccl Associction, z8,
ReseurcI eLLers.
Andu, R.., CroIL, J.B., eIILLI, V.J., eL uI. (1qqq) Adverse cIIIdIood
experIences und smokIng durIng udoIescence und uduILIood, 1ourncl oj
the Americcn Mediccl Associction, z8z, 16z-168.
ArkIn, H. (1q) ReIuLIonsIIp beLween Iumun smokIng IubILs und deuLI
ruLes - un unuIysIs oI LIe AmerIcun Cuncer SocIeLy Survey, Current
Mediccl Diest, zz, ;-qq.
ArmILuge, P. (1q;8) SmokIng und Iung cuncer: LIe probIem oI InIerrIng
cuuse - DIscussIon oI ProIessor BurcI's puper, 1ourncl oj the Rocl
Stctisticcl Societ A, :(:, PurL q, q8-q;;.
ALrens, D. (zooo) The Pouer oj Plecsure. Sydney: DuIIy & SneIIgrove.
AusLruIIun NuLIonuI HeuILI & MedIcuI ReseurcI CouncII (1qq;) The heclth
ejjects oj pcssite smolin. Cunberru, AusLruIIu: AusLruIIun GovernmenL
PubIIsIIng ServIce.
AusLruIIun NuLIonuI Tobucco CumpuIgn (zooo) Etcluction report Vol. z.
Cunberru: CommonweuILI DepurLmenL oI HeuILI und Aged Cure.
Rampant Antismoking Signifies Grave Danger The Bigger Picture References
BuIIur, J.C. (1qqq) PussIve smokIng, coronury IeurL dIseuse, und meLu-
unuIysIs (edILorIuI), The Neu Enlcnd 1ourncl oj Medicine, (o, q8-
qq.
Bukun, D. (1q;q) PsycIoIogy cun now kIck LIe scIence IubIL. n Muus, J.B.
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CYP genes, uIone or In combInuLIon, us u rIsk modIIIer oI Lobucco-reIuLed
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Becker, M.H. (1qq) A medIcuI socIoIogIsL Iooks uL IeuILI promoLIon,
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Bergen, A.W., & Cuporuso, N. (1qqq) CIgureLLe smokIng, 1ourncl oj the
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Berger, A.S. (zooz) Arrogunce umong pIysIcIuns, Accdemic Medicine, ;;,
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Berger, R. (1qq8) UndersLundIng scIence: WIy cuuses ure noL enougI,
Philosoph oj Science, , o6-z.
Berkson, J. (1q6) SmokIng und Iung cuncer, Americcn Stctisticicn, :;,
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BernsLeIn, D.A. (1q6q) ModIIIcuLIon oI smokIng beIuvIor: un evuIuuLIve
revIew, Pscholoiccl ulletin, ;:, q18-qqo.
BerrIdge, V. (1qqq) PussIve smokIng und ILs pre-IIsLory In BrILuIn: poIIcy
speuks Lo scIence?, Socicl Science & Medicine, (p, 118-11q.
BIIIey, T.J. (1qq) EPA und envIronmenLuI Lobucco smoke: scIence or
poIILIcs? SLuLemenL Lo LIe House CommILLee on Energy und Commerce,
HeuILI und EnvIronmenL SubcommILLee - JuIy z1. (AL www.Iorces.orgJ
IIsLorIcJIIIesJbIIIeyz.ILmI).
Bock, W., SLernIsLe, W., VuIIuzzu, U., & SucIer, M. (1qqq) s cuIIeIne
LreuLmenL gIven Lo preLerm bubIes u rIsk IucLor Ior SDS?, Archites oj
Disecse in Childhood, 8o, 18.
BoIIeLLu, P., Agudo, A., AIrens, W., eL uI. (1qq8) MuILIcenLer cuse-conLroI
sLudy oI exposure Lo envIronmenLuI Lobucco smoke und Iung cuncer In
Europe |ARC|, 1ourncl oj the Nctioncl Ccncer Institute, po, 1qqo-1qo.
BorguLLu, E.. (1q68) Some NoLes on LIe HIsLory oI Tobucco Use. n
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BorIund, R. (1qq;) Tobucco IeuILI wurnIngs und smokIng-reIuLed
cognILIons und beIuvIours, Addiction, pz, 1qz;-1q.
561
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Cunberru: CommonweuILI DepurLmenL oI HeuILI und Aged Cure.
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Berkson, J. (1q6) SmokIng und Iung cuncer, Americcn Stctisticicn, :;,
1-zz.
BernsLeIn, D.A. (1q6q) ModIIIcuLIon oI smokIng beIuvIor: un evuIuuLIve
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BerrIdge, V. (1qqq) PussIve smokIng und ILs pre-IIsLory In BrILuIn: poIIcy
speuks Lo scIence?, Socicl Science & Medicine, (p, 118-11q.
BIIIey, T.J. (1qq) EPA und envIronmenLuI Lobucco smoke: scIence or
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HeuILI und EnvIronmenL SubcommILLee - JuIy z1. (AL www.Iorces.orgJ
IIsLorIcJIIIesJbIIIeyz.ILmI).
Bock, W., SLernIsLe, W., VuIIuzzu, U., & SucIer, M. (1qqq) s cuIIeIne
LreuLmenL gIven Lo preLerm bubIes u rIsk IucLor Ior SDS?, Archites oj
Disecse in Childhood, 8o, 18.
BoIIeLLu, P., Agudo, A., AIrens, W., eL uI. (1qq8) MuILIcenLer cuse-conLroI
sLudy oI exposure Lo envIronmenLuI Lobucco smoke und Iung cuncer In
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BorguLLu, E.. (1q68) Some NoLes on LIe HIsLory oI Tobucco Use. n
BorguLLu, E.. & Evuns, R.R. (Eds.) Smolin, Heclth, cnd ehctior.
CIIcugo: AIdIne PubIIsIIng Compuny.
BorIund, R. (1qq;) Tobucco IeuILI wurnIngs und smokIng-reIuLed
cognILIons und beIuvIours, Addiction, pz, 1qz;-1q.
562
562
Rampant Antismoking Signifies Grave Danger The Bigger Picture Rampant Antismoking Signifies Grave Danger
Breen, K.J. (zoo1) ProIessIonuI deveIopmenL und eLIIcs Ior Loduy`s und
Lomorrow's docLors, Mediccl 1ourncl oj Austrclic, :;, 18-18q.
BrILLon, M. (1q;q) DIugnosLIc errors dIscovered uL uuLopsy, ACTA Medicc
Sccndincticc, :p, zo-z1o.
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cIgureLLe smokIng Lo expIuIn InLernuLIonuI dIIIerences In morLuIILy Irom
cIronIc obsLrucLIve puImonury dIseuse, 1ourncl oj Epidemiolo cnd
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EnvIronmenLuI smoke IInked Lo Iung cuncer und oLIer IeuILI eIIecLs (zz
November).
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the Americcn Mediccl Associction, z8(, ;o-;1.
BuIIock, A., & SLuIIybruss, O. Eds. (1q;;) The Iontcnc Dictioncr oj
Modern Thouht. ondon: onLunu Books.
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cuuse, 1ourncl oj the Rocl Stctisticcl Societ A, :(:, PurL q, q;-q8.
BurcI, P.R.J. (1q8o) scIuemIc IeurL dIseuse: epIdemIoIogy, rIsk IucLors
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Medicine, z;, 8zq-.
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CenLers Ior DIseuse ConLroI und PrevenLIon (1qq) MorbIdILy & MorLuIILy
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563
Rampant Antismoking Signifies Grave Danger The Bigger Picture Rampant Antismoking Signifies Grave Danger
Breen, K.J. (zoo1) ProIessIonuI deveIopmenL und eLIIcs Ior Loduy`s und
Lomorrow's docLors, Mediccl 1ourncl oj Austrclic, :;, 18-18q.
BrILLon, M. (1q;q) DIugnosLIc errors dIscovered uL uuLopsy, ACTA Medicc
Sccndincticc, :p, zo-z1o.
Brown, C.A., CrombIe, .K., & TunsLuII-Pedoe, H. (1qqq) uIIure oI
cIgureLLe smokIng Lo expIuIn InLernuLIonuI dIIIerences In morLuIILy Irom
cIronIc obsLrucLIve puImonury dIseuse, 1ourncl oj Epidemiolo cnd
Communit Heclth, (8, 1q-1q.
Browner, C. (1qqq) n Nctioncl Institutes oj Heclth press reIeuse:
EnvIronmenLuI smoke IInked Lo Iung cuncer und oLIer IeuILI eIIecLs (zz
November).
BrundIundL, G.O. (zooo) AcIIevIng worIdwIde Lobucco conLroI, 1ourncl oj
the Americcn Mediccl Associction, z8(, ;o-;1.
BuIIock, A., & SLuIIybruss, O. Eds. (1q;;) The Iontcnc Dictioncr oj
Modern Thouht. ondon: onLunu Books.
BuIIock, A., & WoodIngs, R.B. Eds. (1q8) The Iontcnc iorcphiccl
Compcnion to Modern Thouht. ondon: WIIIIum CoIIIns Sons & Co. Ld.
BurcI, P.R.J. (1q;8) SmokIng und Iung cuncer: LIe probIem oI InIerrIng
cuuse, 1ourncl oj the Rocl Stctisticcl Societ A, :(:, PurL q, q;-q8.
BurcI, P.R.J. (1q8o) scIuemIc IeurL dIseuse: epIdemIoIogy, rIsk IucLors
und cuuse, Ccrdiotcsculcr Resecrch, :(, o;-8.
BurcI, P.R.J. (1q8) TIe Surgeon GeneruI`s epIdemIoIogIc crILerIu Ior
cuusuIILy. A CrILIque, 1ourncl oj Chronic Disecses, , 8z1-86.
BurcI, P.R.J. (1q86) SmokIng und HeuILI. n ModgII, S. & ModgII, C.
(Eds.) Hcns Esencl: Consensus cnd Controters. TIe urmer Press.
BursLIn, . (zoo1) See you In courL. ArLIcIe uppeurIng In LIe Hercld,Sun,
ebruury zo, p.z1.
CuIIIornIu EnvIronmenLuI ProLecLIon Agency (1qq;) OIIIce oI
EnvIronmenLuI HeuILI Huzurd AssessmenL. Heclth ejjects oj exposure to
entironmentcl tobccco smole. SucrumenLo, CA: CEPA (uIso uL
www.drugIIbrury.orgJscIuIIerJLobuccoJcueLsJzEXPOSUR.ILmI)
Cumeron, M., & McGoogun, E. (1q81) A prospecLIve sLudy oI 11z IospILuI
uuLopsIes. PurL : nuccurucIes In deuLI cerLIIIcuLes, 1ourncl oj Pctholo,
:, z;-z8.
Cumpo, J.V., & rILz, G. (zoo1) A munugemenL modeI Ior pedIuLrIc
somuLIzuLIon, Pschosomctics, (z, q6;-q;6.
Curdenus, V.M, TIun, M.J., AusLIn, H., eL uI. (1qq;) EnvIronmenLuI
Lobucco smoke und Iung cuncer morLuIILy In LIe AmerIcun Cuncer
SocIeLy`s Cuncer PrevenLIon SLudy. , Ccncer Ccuses Control, 8, ;-6q.
CurIyon, W.H. (1q8q) QuoLed In SLrubunek, P., & McCormIck, J. (1qqo),
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CurmeIII, D., Swun, G.E., RobIneLLe, D., & ubsILz, R. (1qqz) GeneLIc
InIIuence on smokIng - u sLudy oI muIe LwIns, Neu Enlcnd 1ourncl oj
Medicine, z;, 8zq-.
CurnuII, D. (1qq;) AnuLomy oI u medIu buckIusI, ritish Mediccl 1ourncl,
:(, 161.
CuroI, J., & HoburL, R. (1qq8) Smokers Iuve responsIbIIILy noL Lo Iurm
nonsmokers, USA Todc, June 1, 1qq8 (uL www.usuLoduy.com.ILmI)
CuveIuurs, A.E., KunsL, A.E., GeurLs, J.J., eL uI. (zooo) EducuLIonuI
dIIIerences In smokIng: InLernuLIonuI compurIson, ritish Mediccl
1ourncl, zo, 11oz-11o;.
CederIoI, R., rIberg, ., Jonsson, E., & KuIj, . (1q66) RespIruLory
sympLoms und 'ungInu pecLorIs` In LwIns wILI reIerence Lo smokIng IubILs,
Archites oj Entironmentcl Heclth, :, ;z6-;.
CenLers Ior DIseuse ConLroI und PrevenLIon (1qq) MorbIdILy & MorLuIILy
WeekIy ReporL, AugusL z;, 1qq. n OukIey (1qqq), cI., p.1;.
CenLers Ior DIseuse ConLroI und PrevenLIon (zooz) MorbIdILy & MorLuIILy
WeekIy ReporL, SepLember 6, zooz J :, ;81-;8q.
CIupIIn, J.P. (1q68) Dictioncr oj Pscholo. New York: DeII PubIIsIIng
Co., nc.
CIupmun, S. & Woodwurd, S. (1qq1) AusLruIIun courL ruIes LIuL pussIve
smokIng cuuses Iung cuncer, usLImu uLLucks, und respIruLory dIseuse,
ritish Mediccl 1ourncl, oz, qq-.
CIupmun, S. (1qq) DocLors wIo smoke, ritish Mediccl 1ourncl, ::,
1qz-1q.
CIupmun, S. (1qq;) Smoky nIgILcIub dIscrImInuLed uguInsL womun wILI
usLImu, ritish Mediccl 1ourncl, :, 8qq.
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Rampant Antismoking Signifies Grave Danger The Bigger Picture Rampant Antismoking Signifies Grave Danger
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Rampant Antismoking Signifies Grave Danger The Bigger Picture Rampant Antismoking Signifies Grave Danger
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566
Rampant Antismoking Signifies Grave Danger The Bigger Picture Rampant Antismoking Signifies Grave Danger
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pregnuncy: deveIopmenL oI LIe MuLernuI und CIIId HeuILI SmokIng
ALLrIbuLubIe MorLuIILy, MorbIdILy und EconomIc CosLs (MCHSAMMEC)
soILwure, Tobccco Control, p(SuppI ), III1z-III1.
MIIIurd, P.H. (1qq8) A unIversuI code oI conducL Is dIIIIcuIL Lo deveIop,
ritish Mediccl 1ourncl, :, 1;qq.
MILcIeII, P., CIupmun, S., & SmILI, W. (1qqq) SmokIng Is u mujor cuuse oI
bIIndness, Mediccl 1ourncl oj Austrclic, :;:, 1;-q.
MILku, M. (zooo) AnLILobucco Iorces seek IIrsL InLernuLIonuI LreuLy,
1ourncl oj the Americcn Mediccl Associction, z8(, MedIcuI News und
PerspecLIves.
MoIer, D., Cook, D.J., EusLwood, S., OIkIn, ., eL uI. (1qqq) mprovIng LIe
quuIILy oI reporLs oI meLu-unuIyses oI rundomIsed conLroI LrIuIs: LIe
QUOROM sLuLemenL, Lcncet, (, 18q6-1qoo.
MorubIu, A. (1qq8) CommenLury on MervIn Susser, 1ourncl oj
Epidemiolo cnd Communit Heclth, z, 61z-618.
MorbIdILy und MorLuIILy WeekIy ReporL (zooz) AnnuuI smokIng-
uLLrIbuLubIe morLuIILy, yeurs oI poLenLIuI IIIe IosL, und economIc cosLs -
UnILed SLuLes, 1qq-1qqq, MMWR, :, oo-o. (rom LIe CenLers Ior
DIseuse ConLroI und PrevenLIon). AIso uppeurIng In 1ourncl oj the
uIk, J.C. (1qq6) TIe ussuuIL on pIeusure: HeuILI promoLIon und
engIneerIng LIe Iumun souI. n WurburLon, D.M. & SIerwood, N. (Eds.)
Plecsure cnd quclit oj lije. N.Y.: JoIn WIIey & Sons Ld. (p.1;1-18z).
undmun, T. (1q66) SmokIng In reIuLIon Lo coronury IeurL dIseuse und
Iung IuncLIon In LwIns: u co-LwIn conLroI sLudy, Actc Medicc
Sccndincticc (SLockIoIm), :8o, 1-; (Supp qq).
upureIIo, T.J., Mcudden, E.R., yons, H.A., & BIeeker, E.R. (1q;1)
PsycIoIogIc IucLors und broncIIuI usLImu, Neu Yorl Stcte 1ourncl oj
Medicine, ;:, z161-z16.
MuckenbucI, J.P. (1qq8) CommenLury on MervIn Susser, 1ourncl oj
Epidemiolo cnd Communit Heclth, z, 61z-618.
MucIeod, J. (1qqq) Book RevIew - RILuIIn nuLIon: rupId IIre cuILure und LIe
LrunsIormuLIon oI Iumun conscIousness, Icmil Prcctice, :, qq;.
Munne, J. (zooz) New cupILuIIsm needs u reuIILy cIeck. ArLIcIe uppeurIng
In The Ae, AprII zo, OpInIon ;.
MurgeLLs, B.M., & Juckson, A.A. (1qq) nLerucLIon beLween peopIe's dIeL
und LIeIr smokIng IubILs: LIe dIeLury und nuLrILIonuI survey oI BrILIsI
uduILs, ritish Mediccl 1ourncl, o;, 181-18q.
MurImonL, R.B. (1qq6) n OukIey, D. (1qqq) Slou urn: The Grect
Americcn Antismolin Sccm (And Wh It Will Icil). ILLp:JJ
www.Iorces.org
Murks, H.M. (zooo) TrusL und mIsLrusL In LIe murkeLpIuce: SLuLIsLIcs und
cIInIcuI reseurcI, 1qq-1q6o, Histor oj Science, 8, q-.
MurIey, B. (zoo1) TIe dumuge done by LIe decIIne oI murrIuge. ArLIcIe
uppeurIng In The Ae, December 8, p.;.
MurLIkuInen, P., uIeImu, E., RIpuLLI, S., AIbunes, D., & VIrLumo, J. (zoo1)
EducuLIonuI dIIIerences In Iung cuncer morLuIILy In muIe smokers,
Internctioncl 1ourncl oj Epidemiolo, o, z6q-6;.
MurLInez, . (zooo) QuoLed In HumIILon (zooo), p..
MurLyn, C.N. (zooo) RevIew oI MuLLIew HIILon`s Smolin in ritish
Populcr Culture :8oo-zooo, ritish Mediccl 1ourncl, z:, 8q.
MusIu, R., Penu, A., MurruguL, J., SuIu, J., VIIu, J., PuvesI, M., Covus, M.,
Aubo, C., EIosuu, R., & LIe REGCOR InvesLIguLors (1qq8) HIgI
prevuIence oI curdIovuscuIur rIsk IucLors In Geronu, SpuIn, u provInce wILI
Iow myocurdIuI InIurcLIon IncIdence, 1ourncl oj Epidemioloic
Communit Heclth, z, ;o;-;1.
McCuImun, J. (zoozu) DIugnosIng LIe cuncer LIuL`s euLIng our IospILuIs.
ArLIcIe uppeurIng In The Ae (VIcLorIu, AusLruIIu), MurcI z, OpInIon ;
secLIon.
McCuImun, J. (zoozb) UnIversILIes uwuIL LurnIng oI LIe LIde. ArLIcIe
575
575
Rampant Antismoking Signifies Grave Danger The Bigger Picture Rampant Antismoking Signifies Grave Danger
uppeurIng In TIe Age (VIcLorIu, AusLruIIu), AprII zo, OpInIon ; secLIon.
McCormIck, J. (1qq6) HeuILI scures ure bud Ior your IeuILI. n
WurburLon, D.M. & SIerwood, N. (Eds.) Plecsure cnd quclit oj lije. N.Y.:
JoIn WIIey & Sons Ld. (p.18q-1q;).
McCormIck, J., & Skrubunek, P. (1q88) Coronury IeurL dIseuse Is noL
prevenLubIe by popuIuLIon InLervenLIons, Lcncet, z, 8q-q1.
Mcudden, M.J. (zoo1) Antismolin rcins?: Pscholoiccl Aspects oj
the Antismolin Cruscde. (uL www.worIdsmokersduy.orgJ
psycIoIogy.ILmI)
McurIune, M.J., eInsLeIn, A.R., & WeIIs, C.K. (1q86) CIInIcuI IeuLures oI
Iung cuncers dIscovered us u posLmorLem surprIse, Chest, po, zo-z.
McMunus, P., MunL, A., MILcIeII, P.B., eL uI. (zooo) RecenL Lrends In LIe
use oI unLIdepressunL drugs In AusLruIIu, 1qqo-1qq8, Mediccl 1ourncl oj
Austrclic, :;, q8-q61.
McPIerson, K. (1qq8) CommenLury on MervIn Susser, 1ourncl oj
Epidemiolo cnd Communit Heclth, z, 61z-618.
McWIIrLer, N. (1qqz) n OukIey, D. (1qqq) Slou urn: The Grect
Americcn Antismolin Sccm (And Wh It Will Icil), Ch. . ILLp:JJ
www.Iorces.org
MeIvIn, C.., Adums, E.K., & MIIIer, V. (zooo) CosLs oI smokIng durIng
pregnuncy: deveIopmenL oI LIe MuLernuI und CIIId HeuILI SmokIng
ALLrIbuLubIe MorLuIILy, MorbIdILy und EconomIc CosLs (MCHSAMMEC)
soILwure, Tobccco Control, p(SuppI ), III1z-III1.
MIIIurd, P.H. (1qq8) A unIversuI code oI conducL Is dIIIIcuIL Lo deveIop,
ritish Mediccl 1ourncl, :, 1;qq.
MILcIeII, P., CIupmun, S., & SmILI, W. (1qqq) SmokIng Is u mujor cuuse oI
bIIndness, Mediccl 1ourncl oj Austrclic, :;:, 1;-q.
MILku, M. (zooo) AnLILobucco Iorces seek IIrsL InLernuLIonuI LreuLy,
1ourncl oj the Americcn Mediccl Associction, z8(, MedIcuI News und
PerspecLIves.
MoIer, D., Cook, D.J., EusLwood, S., OIkIn, ., eL uI. (1qqq) mprovIng LIe
quuIILy oI reporLs oI meLu-unuIyses oI rundomIsed conLroI LrIuIs: LIe
QUOROM sLuLemenL, Lcncet, (, 18q6-1qoo.
MorubIu, A. (1qq8) CommenLury on MervIn Susser, 1ourncl oj
Epidemiolo cnd Communit Heclth, z, 61z-618.
MorbIdILy und MorLuIILy WeekIy ReporL (zooz) AnnuuI smokIng-
uLLrIbuLubIe morLuIILy, yeurs oI poLenLIuI IIIe IosL, und economIc cosLs -
UnILed SLuLes, 1qq-1qqq, MMWR, :, oo-o. (rom LIe CenLers Ior
DIseuse ConLroI und PrevenLIon). AIso uppeurIng In 1ourncl oj the
uIk, J.C. (1qq6) TIe ussuuIL on pIeusure: HeuILI promoLIon und
engIneerIng LIe Iumun souI. n WurburLon, D.M. & SIerwood, N. (Eds.)
Plecsure cnd quclit oj lije. N.Y.: JoIn WIIey & Sons Ld. (p.1;1-18z).
undmun, T. (1q66) SmokIng In reIuLIon Lo coronury IeurL dIseuse und
Iung IuncLIon In LwIns: u co-LwIn conLroI sLudy, Actc Medicc
Sccndincticc (SLockIoIm), :8o, 1-; (Supp qq).
upureIIo, T.J., Mcudden, E.R., yons, H.A., & BIeeker, E.R. (1q;1)
PsycIoIogIc IucLors und broncIIuI usLImu, Neu Yorl Stcte 1ourncl oj
Medicine, ;:, z161-z16.
MuckenbucI, J.P. (1qq8) CommenLury on MervIn Susser, 1ourncl oj
Epidemiolo cnd Communit Heclth, z, 61z-618.
MucIeod, J. (1qqq) Book RevIew - RILuIIn nuLIon: rupId IIre cuILure und LIe
LrunsIormuLIon oI Iumun conscIousness, Icmil Prcctice, :, qq;.
Munne, J. (zooz) New cupILuIIsm needs u reuIILy cIeck. ArLIcIe uppeurIng
In The Ae, AprII zo, OpInIon ;.
MurgeLLs, B.M., & Juckson, A.A. (1qq) nLerucLIon beLween peopIe's dIeL
und LIeIr smokIng IubILs: LIe dIeLury und nuLrILIonuI survey oI BrILIsI
uduILs, ritish Mediccl 1ourncl, o;, 181-18q.
MurImonL, R.B. (1qq6) n OukIey, D. (1qqq) Slou urn: The Grect
Americcn Antismolin Sccm (And Wh It Will Icil). ILLp:JJ
www.Iorces.org
Murks, H.M. (zooo) TrusL und mIsLrusL In LIe murkeLpIuce: SLuLIsLIcs und
cIInIcuI reseurcI, 1qq-1q6o, Histor oj Science, 8, q-.
MurIey, B. (zoo1) TIe dumuge done by LIe decIIne oI murrIuge. ArLIcIe
uppeurIng In The Ae, December 8, p.;.
MurLIkuInen, P., uIeImu, E., RIpuLLI, S., AIbunes, D., & VIrLumo, J. (zoo1)
EducuLIonuI dIIIerences In Iung cuncer morLuIILy In muIe smokers,
Internctioncl 1ourncl oj Epidemiolo, o, z6q-6;.
MurLInez, . (zooo) QuoLed In HumIILon (zooo), p..
MurLyn, C.N. (zooo) RevIew oI MuLLIew HIILon`s Smolin in ritish
Populcr Culture :8oo-zooo, ritish Mediccl 1ourncl, z:, 8q.
MusIu, R., Penu, A., MurruguL, J., SuIu, J., VIIu, J., PuvesI, M., Covus, M.,
Aubo, C., EIosuu, R., & LIe REGCOR InvesLIguLors (1qq8) HIgI
prevuIence oI curdIovuscuIur rIsk IucLors In Geronu, SpuIn, u provInce wILI
Iow myocurdIuI InIurcLIon IncIdence, 1ourncl oj Epidemioloic
Communit Heclth, z, ;o;-;1.
McCuImun, J. (zoozu) DIugnosIng LIe cuncer LIuL`s euLIng our IospILuIs.
ArLIcIe uppeurIng In The Ae (VIcLorIu, AusLruIIu), MurcI z, OpInIon ;
secLIon.
McCuImun, J. (zoozb) UnIversILIes uwuIL LurnIng oI LIe LIde. ArLIcIe
576
576
Rampant Antismoking Signifies Grave Danger The Bigger Picture Rampant Antismoking Signifies Grave Danger
Americcn Mediccl Associction, z8;, Muy 8, zooz.
MorreII, S. (zooz) RouLIne LesL cun suvuge beIIeIs. ArLIcIe uppeurIng In LIe
Hercld,Sun, OcLober z, p.z1.
Moss, .E. (1q68) SmokIng und HeuILI: A egIsIuLor`s VIew. n BorguLLu,
E.. & Evuns, R.R. (Eds.) Smolin, Heclth, cnd ehctior. CIIcugo:
AIdIne PubIIsIIng Compuny.
MoxIum, J. (zooo) NIcoLIne uddIcLIon, ritish Mediccl 1ourncl, zo,
q1-qz.
MoynIIun, R., HeuLI, ., & Henry, D. (zooz) SeIIIng sIckness: LIe
pIurmuceuLIcuI IndusLry und dIseuse mongerIng, ritish Mediccl 1ourncl,
z(, 886-8q1.
MRT ReseurcI Group (1q8z) MuILIpIe rIsk IucLor InLervenLIon LrIuI:
RIsk IucLor cIunges und morLuIILy resuILs, 1ourncl oj the Americcn
Mediccl Associction, z(8, 1q6-;;.
MRT ReseurcI Group (1qqo) MorLuIILy ruLes uILer 1o-1 yeurs Ior
purLIcIpunLs In LIe MuILIpIe RIsk ucLor nLervenLIon TrIuI, 1ourncl oj the
Americcn Mediccl Associction, z, 1;q-18o1.
MurpIy, P. (1qqz) QuoLed In OukIey (1qqq), cI.6, p.z.
NuLIonuI ToxIcoIogy Bourd (1qqq) Entironmentcl tobccco smole.
ReseurcI TrIungIe Purk, NC: NTP Bourd oI CounseIors.
NeuIuus, E.C. (1q8) A personuIILy sLudy oI usLImuLIc und curdIuc
cIIIdren, Pschosomctic Medicine, zo, 181-186.
OukIey, D. (1qqq) Slou urn: The Grect Americcn Antismolin Sccm
(And Wh It Will Icil). (uL www.Iorces.orgJwrILersJbookcuseJoukIeyJ
sIowburn.ILmI)
Ouks, . (zoo1) Smolin cnd Prencnc: The Politics oj Ietcl Protection.
New Jersey, US: RuLgers UnIversILy Press.
O'ConneII, T. (1qqo) Up in smole: The nicotine chcllene in recoter.
MInnesoLu: HuzeIdon.
OIdIum, P.D. (1q;8) SmokIng und Iung cuncer: LIe probIem oI InIerrIng
cuuse - DIscussIon oI ProIessor BurcI`s puper, 1ourncl oj the Rocl
Stctisticcl Societ A, :(:, PurL q, q8-q;;.
OsIer, M. (1qq8) TIe Iood InLuke oI smokers und nonsmokers: TIe roIe oI
purLner`s smokIng beIuvIor, Pretentite Medicine. z;, q8-qq.
OsLeen, W.., 1ude (JuIy, 1qq8) Iue-Cured Tobucco CooperuLIve
SLubIIIzuLIon Corp., eL uI. t U.S. EnvIronmenLuI ProLecLIon Agency und
Browner. United Stctes District Court jor the Middle District oj North
Ccrolinc.
OLsuku, R., WuLunube, H., HIruLu, K., eL uI. (zoo1) AcuLe eIIecLs oI pussIve
smokIng on LIe coronury cIrcuIuLIon In IeuILIy young uduILs, 1ourncl oj
References
the Americcn Mediccl Associction, z8, q6-qq1.
PuIunIuppun, U., SLurkey, .J., O`ougIIIn, J., & Gruy-DonuId, K. (zoo1)
ruIL und vegeLubIe consumpLIon Is Iower und suLuruLed IuL InLuke Is
IIgIer umong CunudIuns reporLIng smokIng, 1ourncl oj Nutrition, ::,
1qz-8.
PupukyrIuzI, E., & JosepI, S. (1qq8) ndIvIduuI dIIIerences In personuIILy
umong smokers und LIeIr ussocIuLIon wILI smokIng moLIvuLIon, socIuI
skIIIs deIIcIL, und seII-eIIIcucy Lo quIL, Personclit cnd Inditiducl
Dijjerences, z, 6z1-6z6.
Purker, G.B. (zooo) Depressed AusLruIIuns: sIouId we worry?, Mediccl
1ourncl oj Austrclic, :;, qz-q.
Purkes, C.M. (1qq8) TIe dyIng uduIL, ritish Mediccl 1ourncl, :, 11-
11.
PurroLL, A.C. (1qqq) Does cIgureLLe smokIng cuuse sLress?, Americcn
Pscholoist, (, 81;-zo.
Puyne, S. (1qq8) HeId IosLuge.Ior smokIng. ArLIcIe uppeurIng In
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Peurce, N., de SunJose, S., BoIIeLLu, P., eL uI. (1qq) ImILuLIons oI
bIomurkers oI exposure In cuncer epIdemIoIogy, Epidemiolo, , 1qo-q.
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577
577
Rampant Antismoking Signifies Grave Danger The Bigger Picture Rampant Antismoking Signifies Grave Danger
Americcn Mediccl Associction, z8;, Muy 8, zooz.
MorreII, S. (zooz) RouLIne LesL cun suvuge beIIeIs. ArLIcIe uppeurIng In LIe
Hercld,Sun, OcLober z, p.z1.
Moss, .E. (1q68) SmokIng und HeuILI: A egIsIuLor`s VIew. n BorguLLu,
E.. & Evuns, R.R. (Eds.) Smolin, Heclth, cnd ehctior. CIIcugo:
AIdIne PubIIsIIng Compuny.
MoxIum, J. (zooo) NIcoLIne uddIcLIon, ritish Mediccl 1ourncl, zo,
q1-qz.
MoynIIun, R., HeuLI, ., & Henry, D. (zooz) SeIIIng sIckness: LIe
pIurmuceuLIcuI IndusLry und dIseuse mongerIng, ritish Mediccl 1ourncl,
z(, 886-8q1.
MRT ReseurcI Group (1q8z) MuILIpIe rIsk IucLor InLervenLIon LrIuI:
RIsk IucLor cIunges und morLuIILy resuILs, 1ourncl oj the Americcn
Mediccl Associction, z(8, 1q6-;;.
MRT ReseurcI Group (1qqo) MorLuIILy ruLes uILer 1o-1 yeurs Ior
purLIcIpunLs In LIe MuILIpIe RIsk ucLor nLervenLIon TrIuI, 1ourncl oj the
Americcn Mediccl Associction, z, 1;q-18o1.
MurpIy, P. (1qqz) QuoLed In OukIey (1qqq), cI.6, p.z.
NuLIonuI ToxIcoIogy Bourd (1qqq) Entironmentcl tobccco smole.
ReseurcI TrIungIe Purk, NC: NTP Bourd oI CounseIors.
NeuIuus, E.C. (1q8) A personuIILy sLudy oI usLImuLIc und curdIuc
cIIIdren, Pschosomctic Medicine, zo, 181-186.
OukIey, D. (1qqq) Slou urn: The Grect Americcn Antismolin Sccm
(And Wh It Will Icil). (uL www.Iorces.orgJwrILersJbookcuseJoukIeyJ
sIowburn.ILmI)
Ouks, . (zoo1) Smolin cnd Prencnc: The Politics oj Ietcl Protection.
New Jersey, US: RuLgers UnIversILy Press.
O'ConneII, T. (1qqo) Up in smole: The nicotine chcllene in recoter.
MInnesoLu: HuzeIdon.
OIdIum, P.D. (1q;8) SmokIng und Iung cuncer: LIe probIem oI InIerrIng
cuuse - DIscussIon oI ProIessor BurcI`s puper, 1ourncl oj the Rocl
Stctisticcl Societ A, :(:, PurL q, q8-q;;.
OsIer, M. (1qq8) TIe Iood InLuke oI smokers und nonsmokers: TIe roIe oI
purLner`s smokIng beIuvIor, Pretentite Medicine. z;, q8-qq.
OsLeen, W.., 1ude (JuIy, 1qq8) Iue-Cured Tobucco CooperuLIve
SLubIIIzuLIon Corp., eL uI. t U.S. EnvIronmenLuI ProLecLIon Agency und
Browner. United Stctes District Court jor the Middle District oj North
Ccrolinc.
OLsuku, R., WuLunube, H., HIruLu, K., eL uI. (zoo1) AcuLe eIIecLs oI pussIve
smokIng on LIe coronury cIrcuIuLIon In IeuILIy young uduILs, 1ourncl oj
References
the Americcn Mediccl Associction, z8, q6-qq1.
PuIunIuppun, U., SLurkey, .J., O`ougIIIn, J., & Gruy-DonuId, K. (zoo1)
ruIL und vegeLubIe consumpLIon Is Iower und suLuruLed IuL InLuke Is
IIgIer umong CunudIuns reporLIng smokIng, 1ourncl oj Nutrition, ::,
1qz-8.
PupukyrIuzI, E., & JosepI, S. (1qq8) ndIvIduuI dIIIerences In personuIILy
umong smokers und LIeIr ussocIuLIon wILI smokIng moLIvuLIon, socIuI
skIIIs deIIcIL, und seII-eIIIcucy Lo quIL, Personclit cnd Inditiducl
Dijjerences, z, 6z1-6z6.
Purker, G.B. (zooo) Depressed AusLruIIuns: sIouId we worry?, Mediccl
1ourncl oj Austrclic, :;, qz-q.
Purkes, C.M. (1qq8) TIe dyIng uduIL, ritish Mediccl 1ourncl, :, 11-
11.
PurroLL, A.C. (1qqq) Does cIgureLLe smokIng cuuse sLress?, Americcn
Pscholoist, (, 81;-zo.
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WurburLon, D.M. (1qqob) HeroIn, cocuIne, und now nIcoLIne. n
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586
586
Rampant Antismoking Signifies Grave Danger The Bigger Picture
qz1, qzz, qz, qz6, qz;, qo, q1, qz,
oq
Coronury HeurL DIseuse (CHD) 1,
z, 8, q, q, qq, 6, 6, 66, 68, 6q,
;z, 8, 1q8, zzq, z, z;, z8, zq1,
zqz, zq, z, 8, q, q, qq,
8q, q1
Convergence EIIecL q, q;, qq, , 6,
q, 6z, 68, ;, 8, 8;, 1z, 1;, 1q,
1q8, z8
DeLermInIsm 18-1q, 18q
EducuLIon qq8-qq
Endogenous zz-z
Exogenous zz-z
uIsIIIubIIILy 1q-z1, qq
GIunLz, S. z;o, z;z, z;, 6z, 6q,
8q, qo, qq, qq6, q,
HeuILI 1z;-11
HeuILIIsm 1oq, 1z8, 1zq, 11, 1,
1q, 18o, 1qq, zoo, zz, z, zq, ,
6z, 6, qo, qq, qq, q;q, qqz,
qq, qq6
HumunIsm qq-q;6, q86, qq1, qq6
uLrogenIc q;, q8, 81, qq, 1z8, 1qq-
zoo, zo, zoq, zq, zqq, zq, z,
q, qq, o, z, , , 8o,
q, q1o, qzz, qz;, qz
uIonde DocLrIne zq, zqq, zq
IIesLyIe EpIdemIoIogy CI. z
1ndex
Abscebo oz, oq, q8, ;, ;6,
;;, 86, 88, qz, qq1
AcLIon on SmokIng und HeuILI (ASH)
z68-z;o, 1q, zz, z-z;, zq, 1,
qq, 6, 6q, ;o, qo, q, q1, qz1,
qz;, q, qq, qqq, qq8-o1, 1q-z1,
z, , q8
AsLImu z61, z6z, z8z, z8, zq6-o,
zz, z, ;, q, q;-, q, ;8,
8;, q, q;, qoz, q18, qo, q1, q;,
q8, qq, qqo, q8q, 1q,
ALLrIbuLubIe RIsk ;, ;q, 8q, q1-q,
1oq, 1zz, zq, z86, zq, oq, oq, zq
BunzIuI, J. z6, qq, 6, qz1, qq,
qqq, oo, oz
BeIuvIorIsm 18q-1qq, z6, zq, zq6,
z, z6, qqq, qq, q, q6, q8, qq,
q6, q68
CuusuLIon 16-z
CIupmun, S. z1;, z18, zz1, z, q,
6, q;, qz8-qo, qz, q, q;
CIrIsLIunILy 11z, 1zo, 1q1, 1qq, 161,
16z, 16, 1;q, 186, 18;, 188, 1qo, zo;,
z1o, qq8, qo, q, q, q6, q68,
q6q, q;o, q;1, q;, q;, q;6, qqz, qq,
qq6, qq;, 1q, z6, z8, zq, o, 1,
, -8
CIronIc ObsLrucLIve PuImonury DIs-
euse (COPD) qo, q1
CoddIIng EIIecL ;, 86, 8;, qq
Consensus EIIecL qo, 6, ;6, ;;, 8z,
8;, 11o, 111, 1z, z8, zq, q, q1o,
ongevILy q1, q-q;, qq, 68, 111-11,
116-11;, qzz
ung Cuncer 1, z, ;, 8, q1, qz,
q;-61, 6q, 6, 66, 6q-;8, 8o, 8q-q1,
11, 1zz, 1q;, 1, 16, zz, z1, z6z,
z6q, z8-zq, ;, 8, qo, q1, q,
qq, q, qq, q6, qo1, qzz, qz, qz;,
qz8, qo, qz, q, q6
MuLerIuIIsL MunIIesLo qo, q6, q;, 6,
;6, ;;, 8o, 86, q1, q8, 1oq, 111, 11;,
118, 1zo, 1z1, 1;, 1;, 1;6, 18, 188,
1qo, 1q, z1q, zzz, zz, zz6, zo-zz,
zqq, zq6, zq;, z6, z68, 1;, q, qo1,
qzz, q, q6, qo, q1, q, q6, q8,
q6, q6;, q8z, qq;, qq8, o1, oz, q,
q;
MedIcuI EsLubIIsImenL zq, q6, q;, ;6,
;;, 8, 1o8, 111, 1z, 1qq-zzo
MeLu-AnuIysIs z6-z;, ;, 6, z1,
z;q, z8o, z8, z88, zq1, q
MMES cuIL 81, q8, 118, 1zo, 1z1, 1z,
1, 18, 1q, 1qo, 1qq, zz, z;, zq,
zq, zq6, zq, z6, o, 1q, z, zq,
q, , 6q, 66, q1, q1, qzo, qz1,
qz, qz, qo, q, qqz, qq, qqq,
qq6, qq;, q, qq, q6;, q;o, q8, qq6,
qq;, z1, z, , , q, qq, o,

MonomunIu zo, z;, z6, z;, z;6,

1q, z, z, z6, z8, 1, , o,
q, 61, qo1, qz1, qz, qzq, qq1, qq;-

NuzIsm 1z;, 1z8, 1zq, 1, 1qq, 1q;-

16q, 1;o, 1;8, 18o, 18q, 1q1, zo;, z1o,
z1q, z16, z1q, zzo, zq, zq6, zq;, zo,
zq, z;, z6q, z68, z;, z8z, 6;, q;,
qoq, q1o, qq, qo, q;, q;q, qq,
oz, o, 16, zz, z, z8, z, q6,
, 6
NIcoLIne AddIcLIon 1;1-18q, qo1, qo;,
qoq, qz
Nocebo zq;, z1, z, z;6, oo, o1,
oq, o6, 16, z, 6, q8, 61, 6q,
;1, ;z, ;q, ;-;8, 8, 8, 86,
88, 8q, q1, qz, q, qz1, qz, qq,
qq1, qqq, qq8, qq, q, q66
Nonsmokers 11-1qo
PIurmuceuLIcuIs 18o, 18z, 18, zo8,
zoq, zz;, z, zq8, qqz, q;q, q8o,
q81, q8z, q88
PIeLLen, . q6, o6-q
PredIcLIve SLrengLI zo-z
PsycIoIogy 8, 11z, 1o, 16, 161, 16,
1;o, 18o, 18q, 186, 18q, 1q1, 1qz, 1qq,
zz6, zq8, zo, z, z, ;6, qoo,
qq8-q, q8, q;1, q8q, 1
Repuce, J. z;o-z;z, 6z, 8q, qq,
qoz, qo
Rose`s Purudox zq
ScIenLIsm zq, 1zq, 1, 1q, 186, 18;,
1qq, z1q, zz, qo, q, qq, q6, q;q,
qqz, qq, qq6, ;
SAMMEC qz-qq, q6, 1q, 1q6, oq,
z1, qz, qq
Smokers 11-1qo
SomuLIzIng DIsorders z6, q8, o,
6, ;o-88, qz, q, qqq, qqz
SpecIIIcILy zo-z1
SLuLIsLIcuIIsm zo, z1, zq, zq, o, ;q,
8, 1zq, 1o, 16q, 1;q, 18o, 188, 1qq,
z1z, z1, zq, q, 6, qz1, qz, qzq,
q, qq6, qq8, q6;, q;q, qq8, 1;, z1,
z;, zq, z, 6, ;
SuperIorILy Syndrome 1z1, 1zz, 1z,
1o, 1qo, 18, 16, 1qq, zo, z;, zqo,
zq, z6, z;, z;6, o, -;o, ;;,
587
587
Rampant Antismoking Signifies Grave Danger The Bigger Picture
qz1, qzz, qz, qz6, qz;, qo, q1, qz,
oq
Coronury HeurL DIseuse (CHD) 1,
z, 8, q, q, qq, 6, 6, 66, 68, 6q,
;z, 8, 1q8, zzq, z, z;, z8, zq1,
zqz, zq, z, 8, q, q, qq,
8q, q1
Convergence EIIecL q, q;, qq, , 6,
q, 6z, 68, ;, 8, 8;, 1z, 1;, 1q,
1q8, z8
DeLermInIsm 18-1q, 18q
EducuLIon qq8-qq
Endogenous zz-z
Exogenous zz-z
uIsIIIubIIILy 1q-z1, qq
GIunLz, S. z;o, z;z, z;, 6z, 6q,
8q, qo, qq, qq6, q,
HeuILI 1z;-11
HeuILIIsm 1oq, 1z8, 1zq, 11, 1,
1q, 18o, 1qq, zoo, zz, z, zq, ,
6z, 6, qo, qq, qq, q;q, qqz,
qq, qq6
HumunIsm qq-q;6, q86, qq1, qq6
uLrogenIc q;, q8, 81, qq, 1z8, 1qq-
zoo, zo, zoq, zq, zqq, zq, z,
q, qq, o, z, , , 8o,
q, q1o, qzz, qz;, qz
uIonde DocLrIne zq, zqq, zq
IIesLyIe EpIdemIoIogy CI. z
1ndex
Abscebo oz, oq, q8, ;, ;6,
;;, 86, 88, qz, qq1
AcLIon on SmokIng und HeuILI (ASH)
z68-z;o, 1q, zz, z-z;, zq, 1,
qq, 6, 6q, ;o, qo, q, q1, qz1,
qz;, q, qq, qqq, qq8-o1, 1q-z1,
z, , q8
AsLImu z61, z6z, z8z, z8, zq6-o,
zz, z, ;, q, q;-, q, ;8,
8;, q, q;, qoz, q18, qo, q1, q;,
q8, qq, qqo, q8q, 1q,
ALLrIbuLubIe RIsk ;, ;q, 8q, q1-q,
1oq, 1zz, zq, z86, zq, oq, oq, zq
BunzIuI, J. z6, qq, 6, qz1, qq,
qqq, oo, oz
BeIuvIorIsm 18q-1qq, z6, zq, zq6,
z, z6, qqq, qq, q, q6, q8, qq,
q6, q68
CuusuLIon 16-z
CIupmun, S. z1;, z18, zz1, z, q,
6, q;, qz8-qo, qz, q, q;
CIrIsLIunILy 11z, 1zo, 1q1, 1qq, 161,
16z, 16, 1;q, 186, 18;, 188, 1qo, zo;,
z1o, qq8, qo, q, q, q6, q68,
q6q, q;o, q;1, q;, q;, q;6, qqz, qq,
qq6, qq;, 1q, z6, z8, zq, o, 1,
, -8
CIronIc ObsLrucLIve PuImonury DIs-
euse (COPD) qo, q1
CoddIIng EIIecL ;, 86, 8;, qq
Consensus EIIecL qo, 6, ;6, ;;, 8z,
8;, 11o, 111, 1z, z8, zq, q, q1o,
ongevILy q1, q-q;, qq, 68, 111-11,
116-11;, qzz
ung Cuncer 1, z, ;, 8, q1, qz,
q;-61, 6q, 6, 66, 6q-;8, 8o, 8q-q1,
11, 1zz, 1q;, 1, 16, zz, z1, z6z,
z6q, z8-zq, ;, 8, qo, q1, q,
qq, q, qq, q6, qo1, qzz, qz, qz;,
qz8, qo, qz, q, q6
MuLerIuIIsL MunIIesLo qo, q6, q;, 6,
;6, ;;, 8o, 86, q1, q8, 1oq, 111, 11;,
118, 1zo, 1z1, 1;, 1;, 1;6, 18, 188,
1qo, 1q, z1q, zzz, zz, zz6, zo-zz,
zqq, zq6, zq;, z6, z68, 1;, q, qo1,
qzz, q, q6, qo, q1, q, q6, q8,
q6, q6;, q8z, qq;, qq8, o1, oz, q,
q;
MedIcuI EsLubIIsImenL zq, q6, q;, ;6,
;;, 8, 1o8, 111, 1z, 1qq-zzo
MeLu-AnuIysIs z6-z;, ;, 6, z1,
z;q, z8o, z8, z88, zq1, q
MMES cuIL 81, q8, 118, 1zo, 1z1, 1z,
1, 18, 1q, 1qo, 1qq, zz, z;, zq,
zq, zq6, zq, z6, o, 1q, z, zq,
q, , 6q, 66, q1, q1, qzo, qz1,
qz, qz, qo, q, qqz, qq, qqq,
qq6, qq;, q, qq, q6;, q;o, q8, qq6,
qq;, z1, z, , , q, qq, o,

MonomunIu zo, z;, z6, z;, z;6,

1q, z, z, z6, z8, 1, , o,
q, 61, qo1, qz1, qz, qzq, qq1, qq;-

NuzIsm 1z;, 1z8, 1zq, 1, 1qq, 1q;-

16q, 1;o, 1;8, 18o, 18q, 1q1, zo;, z1o,
z1q, z16, z1q, zzo, zq, zq6, zq;, zo,
zq, z;, z6q, z68, z;, z8z, 6;, q;,
qoq, q1o, qq, qo, q;, q;q, qq,
oz, o, 16, zz, z, z8, z, q6,
, 6
NIcoLIne AddIcLIon 1;1-18q, qo1, qo;,
qoq, qz
Nocebo zq;, z1, z, z;6, oo, o1,
oq, o6, 16, z, 6, q8, 61, 6q,
;1, ;z, ;q, ;-;8, 8, 8, 86,
88, 8q, q1, qz, q, qz1, qz, qq,
qq1, qqq, qq8, qq, q, q66
Nonsmokers 11-1qo
PIurmuceuLIcuIs 18o, 18z, 18, zo8,
zoq, zz;, z, zq8, qqz, q;q, q8o,
q81, q8z, q88
PIeLLen, . q6, o6-q
PredIcLIve SLrengLI zo-z
PsycIoIogy 8, 11z, 1o, 16, 161, 16,
1;o, 18o, 18q, 186, 18q, 1q1, 1qz, 1qq,
zz6, zq8, zo, z, z, ;6, qoo,
qq8-q, q8, q;1, q8q, 1
Repuce, J. z;o-z;z, 6z, 8q, qq,
qoz, qo
Rose`s Purudox zq
ScIenLIsm zq, 1zq, 1, 1q, 186, 18;,
1qq, z1q, zz, qo, q, qq, q6, q;q,
qqz, qq, qq6, ;
SAMMEC qz-qq, q6, 1q, 1q6, oq,
z1, qz, qq
Smokers 11-1qo
SomuLIzIng DIsorders z6, q8, o,
6, ;o-88, qz, q, qqq, qqz
SpecIIIcILy zo-z1
SLuLIsLIcuIIsm zo, z1, zq, zq, o, ;q,
8, 1zq, 1o, 16q, 1;q, 18o, 188, 1qq,
z1z, z1, zq, q, 6, qz1, qz, qzq,
q, qq6, qq8, q6;, q;q, qq8, 1;, z1,
z;, zq, z, 6, ;
SuperIorILy Syndrome 1z1, 1zz, 1z,
1o, 1qo, 18, 16, 1qq, zo, z;, zqo,
zq, z6, z;, z;6, o, -;o, ;;,
588
588
81, qz, q, q8, qo6, q1o, q1, qzo,
qqq, qq, qqz, qqq, z1,
TIe CrIme PrevenLIon Group qqq,
o6-q, qq, q
TrunsIerence uIIucy zq, , 6, 8o,
8, 1;, qz