Rookgordijn

‘Rookgordijn’ was de titel van een boek dat Trouw journalist Joop Bouma ooit schreef over de tabaksindustrie. In een alleszins lezenswaardig artikel in de Schotse krant de Belfast Telegraph toont een ooit rokende journalist in een uitgebreid artikel aan hoe dezelfde titel inmiddels net zo makkelijk toegekend zou kunnen worden aan een boek over de anti-roken fanaten.

Volgens deze journalist zijn schromelijke overdrijving, manipulatie met statistieken en pure leugens de gereedschappen waarmee de anti-rokers proberen een voor hun heilige zaak aan het publiek te verkopen.

Rhona Brankin, declared “One in four of all deaths in Scotland is directly attributable to smoking.” In a separate interview she said “one in four of all deaths (is) attributable to smoking. About 13,000 people die every year as a result of smoking.” She was wise to omit the “directly” that sneaked onto Today.

The most recent statistics reveal that 57,382 people died in Scotland in 2001. If one in four of them died for the reasons Rhona Brankin offers that would give a smoking-related death toll of 14,345, not 13,000. So is the minister guilty of modest exaggeration in the service of a noble cause? The one- in-four statistic is more than that; it is an article of faith among anti-smoking campaigners, but it is not as straightforward as it sounds.

These are not just lung-cancer deaths. Brankin’s toll includes every Scot who has died of “smoking-related complaints.” To get into that category alleged victims of smoking do not need to have smoked. They are counted in on the basis that killers including heart disease, strokes and bronchitis can be caused by smoking. Nobody checks the lifestyles of the victims to ascertain that they did smoke.

Some of these dead Scots did smoke, but died at or beyond the average Scottish lifespans of 73 years for men and 78 years for women. The same applies to many of the 140,000 English men and women whom the leading anti-smoking charity, ASH, asserts die each year as a result of smoking. ASH justifies including them on the grounds that deaths from smoking can follow years of painful disability and are thus worth preventing, even if they have not technically shortened a life.

The issue here is not whether smoking kills, but whether it is legitimate to lie in the service of a good cause. Amanda Sandford, the head of research at ASH, offers an intriguing response. “Smoking is the biggest single cause of preventable death, and anti-smokers do not deliberately abuse statistics. But I don’t really want to be drawn into that. It isn’t black and white.” Pushed to explain precisely what she means, Sandford says: “Epidemiology is not a direct science. Our business is promoting public health. It is possible that in certain cases some anti-smoking campaigners do exaggerate [she is adamant that ASH does not] but if statistics lied it would be bad. There needs to be a justification for it. To deliberately distort would not be acceptable. If there is an element of doubt we should express that. Scientists usually express their statements in terms of caution.”

She acknowledges that figures like Rhona Brankin’s 13,000 deaths and ASH’s 140,000 are sometimes “rounded up” but insists that any inflation is slight and is ironed out by annual variations in death rates.

ASH has excellent motives. The problem is that the degree of exaggeration that has converted hostility to tobacco from a health cause to a neo-religious crusade does not look slight when it is exposed to careful analysis. It has created a very misleading impression about the real chance of a smoker dying from lung cancer.

Habitual, lifelong smokers face a 30- to 40-fold higher risk of contracting lung cancer than non-smokers. That sounds massive and many smokers are persuaded to quit because they believe it is. But, since the risk of lung cancer in non-smokers is minuscule it does not amount to an objectively high risk. Amanda Sandford admits “Smokers are more likely to die of heart disease than lung cancer.” The pro-smoking campaigner Joe Jackson argues “Even if you’re a heavy smoker, your chances of NOT getting lung cancer are still more than 99 per cent.”

[…]

Dr Ken Denson, of the Thame Thrombosis and Haemostasis Research Foundation, says: “I simply do not know where they conjure up their statistics. The statistics for passive smoking, in particular, would not be published or even considered in any other scientific discipline. Deaths from smoking in general have been grossly exaggerated, particularly in relation to heart disease. ” Dr Denson is a medical scientist. He has published peer-reviewed research in respected academic journals. He is not funded by tobacco companies.

Is he right? The method by which Rhona Brankin arrived at her “one in four” claim and from which ASH derives its 140,000 deaths categorises 16 diseases as “smoking-related”. Many of them are also caused by poor diet, lack of exercise, obesity and other poverty-related problems that are regrettably common in urban Scotland and similar post-industrial areas. If you use cigarettes and are poor, fat and reluctant to eat vegetables, you are substantially more likely to die young than a smoker who is affluent, active and well-fed. “One in four” includes people who would have died when they did without smoking a single cigarette. It also includes affluent smokers who pass away from heart attacks in their late eighties.

Smoke Screen (Leugentjes om bestwil?)