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Passive Smoking debate driven more by fashion than science

Posted on 12th Feb 2014 @ 2:08 AM

The Passive smoking debate continues, with this month's political focus on the effects up on children of smoking in cars. This author would love it if the sound-bite-health-experts among our elected representatives might provide some defining research from which they might more properly opine! 

The only such work published by bodies such as the Royal Colleges, provides only indications that 'passive smokers' will ingest some pollutants associated with tobacco smoke. No attempt is made to define toxic thresholds, or levels of toxicity in the way that has become standard practice in fields of occupational health - such as is published in EH/40-. 
There appears no government or otherwise august body with an appetite for truth, perhaps in case that the truth might dispel politically fashionable myth.

The WHO suggests carbonaceous PM10 dangerous above concentrations of 200 microgrammes/Metre, whereas the maximum suggested under current occupational rules (EMAS; based on 80 years worth of actual research in to pathogenic morbidity) suggests levels of 5000 microgrammes/Metre are safe for a daily exposure of up to eight hours. This figure: twenty-five times greater than the 'finger-in-the-air' assertions of the WHO: well exceeds the concentrations experienced when smoking in a moving car, with the windows closed. 

Under Blair's Health Supremo, Liam Donaldson, a few years back, prior to the 'pub-ban', this initiative was supported by the RCP, which august body published a paper supporting the ban. The trouble was that the paper made absolutely no scientific or quantitative references other than to mention some work in the USA, on a small population sample. All the RCP's published papers are of an anecdotal nature, never straying in to the realms of actually measuring what might be considered toxic doses.

Campaigners have also carefully avoided mention of the Richard Doll survey, involving more than 30,000 UK medics, between 1951 and 2001, (the biggest 'qualitative' survey ever - involving 17 million patients) in which morbidity in smokers was noted profound compared with non-smokers BUT in which; amongst non-smokers; there was found no difference in cardio-pulmonary morbidity between those who lived as 'passive smokers' and those who were never or rarely exposed to tobacco smoke!

Until the RCP is prepared to amalgamate proper research in to toxic dose thresholds - as EMAS has already done - this voice piece of health-care fashion cannot possibly make convincing assertions that 'passive smoking' is pathogenic. After all, you can't make predictions without having taken the trouble to measure!

That said: it is of course socially popular to rid public places of the unpleasantness of tobacco smoke. But that is social fashion. It is not science.

http://www.bmj.com/content/328/7455/1519