Rokersparadox
Slechts schoorvoetend geven de anti-rokers toe dat er ook voordelen aan roken KUNNEN zitten, zoals de mindere vatbaarheid voor Alzheimer en Parkinson. Maar die ziekten kunnen ook, met behulp van de tabaksplant, via farmaceutische middelen worden opgelost, zeggen ze dan. Kassa voor Big Pharma dus.
Maar er lijkt meer aan de hand te zijn. Vaker wordt beweerd dat rokers vatbaarder zijn voor hartziekten. Een nieuw, uitgebreid internationaal onderzoek onder bijna 20.000 ziekenhuisopnames toont aan (hoewel men het in bijgaand ‘abstract’ ontkent) dat rokers minder vaak met dergelijke ziektes worden opgenomen en beter in staat zijn dergelijke opnames te overleven dan niet-rokers en ex-rokers. Dit wordt in de medische wereld de Rokersparadox genoemd.
Forces International analyseerde de bevindingen in het rapport en ontdekte dat de samenvatting van een rapport het tegengestelde kan beweren van het werkelijke rapport.
(Abstract)
Purpose
To determine the impact of cigarette smoking on the presentation, treatment, and in-hospital outcomes of patients admitted with the full spectrum of acute coronary syndromes.
Methods
GRACE is a multinational observational registry involving 94 hospitals in 14 countries. This analysis is based on 19,325 patients aged at least 18 years admitted for acute coronary syndromes as a presumptive diagnosis with at least one of the following: electrocardiographic changes consistent with acute coronary syndromes, serial increases in serum biochemical markers of cardiac necrosis, and/or documentation of coronary artery disease. The main outcomes measured were mode of presentation, treatment and in-hospital death in the ST-segment elevation myocardial infarction, non-ST-segment elevation myocardial infarction, and unstable angina groups to assess the impact of smoking status.
Results
Smokers were more frequently diagnosed with ST-segment elevation myocardial infarction (46.0%) than former smokers (27.4%) and non-smokers (30.2%) (P<0.001). Smokers were mostly men, were younger and more aggressively treated than former smokers and non-smokers across the three acute coronary syndrome groups. Unadjusted in-hospital mortality rates were lower in smokers compared with former smokers and non-smokers in the study population (3.3%, 4.5%, and 6.9%, respectively, P<0.001), and in the ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction groups. However, by multivariate logistic analysis, the adjusted in-hospital mortality rate was similar regardless of smoking status.
Conclusions
There is no survival advantage related to current or prior cigarette smoking in patients admitted with acute coronary syndromes, regardless of presentation. In this large multinational registry, the smokers’ paradox does not exist.
Maar deze eindconclusie staat niet in het feitelijke rapport:
A consistent finding in the GRACE population is the lower risk profile of current smokers compared with former smokers and non-smokers. This was also observed in most previous large-scale studies […], in which the lower risk profile accounted for much of the seemingly improved outcome of smokers compared with former smokers and non-smokers.”
Forces International daarover:
In summation, only one very important and interesting conclusion can be reached: even for cardiovascular disease, smokers seem to enjoy better health than non smokers, which in turn enjoy better health than former smokers, as demonstrated in this and other studies this work refers to in the References.
Two considerations, therefore, come to mind: the revisiting of the senseless belief that “smoking is bad for you” (without ever asking how much smoking, for the belief must be absolute), and the real value for health of quitting smoking. From the data on this and other studies it is apparent that quitting smoking may be even worse than not starting.
It really seems that the only thing to really quit is giving false and biased information to the public – especially when it comes from public institutions; and, perhaps, the only real paradox is the romantic and brainless belief that “smoking is bad for you, no matter what”.
