‘Roken mechanisme ter voorkoming van gewichtstoename en diabetes 2’

In het British Medical Journal werd in mei van dit jaar een onderzoek
gepubliceerd dat in Nederland nauwelijks de kranten haalde. Op onze site werd er
echter uitgebreid
op ingegaan
.


Deze week kwam de hoofdredacteur in een commentaar op het onderzoek en met
name de reacties daarop terug:


“… with research papers we first ask if we are interested in the question.
We must be interested in whether passive smoking kills, and the question has not
been definitively answered. It’s a hard question, and our methods are
inadequate.”


Wat echter nóg interessanter is aan dit artikel is de reactie van een
wetenschapper uit Zuid-Afrika:


…. nicotine also decreases free radical generation. In other words nicotine
appears to do in animals what exercise does in man without the need for an
increase in exercise


Maar ook de onderzoekers slaan hard terug naar degenen die een hetze tegen
hun ontketenden.



Might the smoking of cigarettes, possibly enhanced to yield higher doses of nicotine and carbon monoxide, be used to prevent weight gain or manage obesity and type 2 diabetes? What then of the increased risk of cancers and other diseases? The manner in which smoking causes cancer and these other diseases is not known. One possibility is that smoking might cause these diseases by precipitating intermittent episodes in which there is an anaerobic or glyoclytic shift in ATP resynthesis. Weight loss is a common feature of carcinoma of the lung and often precedes the development of any clinical evidence of malignant diseases (13). Indeed cachexia, as the profound weight loss in malignant dieases is called, often develops before there has been any loss in nutrient intake and before there is significant tumour burden. It has been proposed, therefore, that whatever it is that causes cachexia might also be the cause of the cancers(14).


De reactie is met name ook zo interessant omdat er wijder gekeken wordt naar roken dan alleen de directe effecten, zoals dat in anti-roken kringen zo de gewoonte is. De positieve effecten van roken kunnen er voor zorgen dat mensen NIET in ander risicogroepen terechtkomen, als overgewicht of suikerziekte.


Heeft de toename van het aantal mensen met overgewicht misschien het succes op het gebied van de bestrijding van roken als oorzaak? Wordt er dan door de anti-rokers niet gedweild met de kraan open?


Ook de onderzoekers zélf reageren nu fel op de hetze die tegen hun is losgebarsten nadat ze het onderzoek publiceerden:

Owing to the charged atmosphere surrounding the issue of passive smoking, our paper provoked strong reactions on bmj.com. The most disturbing reactions have come from the enforcers of political correctness who pose as disinterested scientists but are willing to use base means to trash a study whose results they dislike. They have no qualms about engaging in personal attacks and unfounded insinuations of dishonesty rather than judging research on its merits. The resulting confusion has misled many readers and diverted attention from the facts of the study.


Since 15 May Michael Thun of the American Cancer Society has led a campaign to discredit our study, including his letter above. However, almost every sentence in his letter is misleading, and he disregards key information in the full version of our paper. Contrary to the title of his letter, we have presented an accurate analysis of the California cohort of the cancer prevention study I (CPS I), not disinformation, and it comes from the University of California, Los Angeles, and the State University of New York, Stony Brook, not the tobacco industry.


Regarding the comments of the working group of the International Agency for Research on Cancer (IARC), we have not claimed that our study changes the weight of the worldwide evidence on environmental tobacco smoke and lung cancer, but it does change the US evidence. When our results are included, meta-analysis of US results on environmental tobacco smoke and lung cancer among both men and women yields a summary relative risk of about 1.10 for ever/never exposure, which is just on the border of statistical significance. Our results have an even greater impact with regard to environmental tobacco smoke and coronary heart disease, where meta-analysis of US results, which constititute most of the evidence, yields summary relative risks of about 1.05 for current/never and ever/never exposure.


Duidelijk is in ieder geval dat de wereld van de anti-rokers en hun twijfelachtige methoden steeds meer onder vuur beginnen te komen vanuit het eigen medische circuit. De reactie van een Franse wetenschapper spreekt daarbij boekdelen:


I am horrified by the number of responses and their content. This clearly indicates that good science is of so little value for so many “scientists” involved (blinded) in ideology and lobbies rather than in honest knowledge. Anyone knows that one study does not make a definitive truth. Anyone also knows that rejecting papers and excluding studies (even excellent) just because they are not in accordance with the current claims of lobbies is the worst publication bias, and the best way to maintain fallacies.


Brief hoofdredacteur BMJ
British Medical Journal reactie
Reactie onderzoekers

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