My mom says her friends knew that smoking was harmful long before the Surgeon General’s report in 1962; they smoked anyway. The evidence that smoking causes lung cancer began to be accumulated in the 1950s. At first it was a radical idea. The boss of one of the scientists involved, Ernst Wynder, cut his research budget for continuing to study such a far-fetched notion.
Some of the details, indeed, did not make sense, as this fascinating essay (“The Scientific Scandal of Antismoking”, thanks to Robert Reis) points out. Were I to teach a course in scientific method, I might make this essay the first assignment: “Tell me its strengths and weaknesses.” Its strength is that it brings up new data that challenge a well-known idea (smoking causes lung cancer) that most people don’t give a second thought to. The conventional view that smoking is simply bad is surely wrong. The essay’s weaknesses are a dismissive attitude (“second-rate”) and a failure to learn from facts that don’t fit the authors’s ideas. For example, the big correlation between smoking and lung cancer that Wynder was the first to notice. What causes it? A more subtle lesson is that the big randomized controlled clinical trials are not the wonderful thing that most writers, including the authors of this essay, make them out to be (“the gold standard”). MRFIT was a hugely-expensive controlled clinical trial that produced no difference between the groups. It isn’t clear why. What can we learn from this? I’d ask my students. One lesson is the value of doing the smallest possible study — if they’d figured out the problems with a small study (and designed a better study that avoided them) they would have had a better chance of learning something from their massive study.
i noticed when reading about some of the world’s oldest people, that a couple of them were smokers late into life, though moderately so. a couple people i read about, first jeanne calment:
“She smoked until the age of 117, only five years before her death.[14][1] Calment smoked from the age of 21 (1896), though according to an unspecified source, Calment smoked no more than two cigarettes per day.[15] She ascribed her longevity and relatively youthful appearance for her age to olive oil, which she said she poured on all her food and rubbed onto her skin, as well as a diet of port wine, and ate nearly one kilo of chocolate every week.[10]”
that quote is from https://en.wikipedia.org/wiki/Jeanne_Calment
the oil and chocolate consumption also catch my eyes as seth-robertsian themes–could chocolate consumption be like butter consumption, with its fattiness?
then christian mortensen:
“Mortensen enjoyed an occasional cigar and insisted that smoking in moderation was not unhealthy.”
that quote is from https://en.wikipedia.org/wiki/Christian_Mortensen
certainly not strong evidence for smoking, but it caught my eye. their self restraint could signal high conscientiousness perhaps, which i think correlates with good health. i’ve wondered in the past why people are usually unable to smoke only a couple cigarettes, why they usually seem to do a pack or so a day if at all.
“that Wynder was the first to notice”: no he wasn’t; the discoverers were in Nazi Germany.
“The conventional view that smoking is simply bad is surely wrong.”
Following this style of argumentation I could easily point out that putting a bullet into someones head isn’t bad either – at least it will ultimately and totally prevent suffering from any and all diseases, be it Alzheimers, any cancer, diabetes, HIV etc etc.
We have come a long way to expose all the lies of the tobacco companies and break free from hidden influences and paid pseudo-science (at least in the US, see https://legacy.library.ucsf.edu/ – most other parts of the world are still struggling to break free). I can’t think of any good reason to help those irresponsible criminals out…
Dirk, you write: “Following this style of argumentation…” I linked to a long list of studies that show benefits of smoking. Whereas you are unable to link to a long list of studies that show benefits of “putting a bullet into someone’s head.” I think the benefits of smoking are really important to know because they support a claim I’ve made many times: our immune systems are badly understimulated. With huge health consequences (allergies, etc.) and an easy solution (eat more fermented foods). That’s the “good reason” you can’t think of.
I agree that tobacco companies have horribly lied to and misled the public.
In some settings there are dramatic correlations. Asbestos related health problems are extremely rare outside of two pack a day or more smokers, though they do definitely occur outside of that group. Black lung disease follows a similar pattern. Consider the overall incidence of lung cancer in America over the past twenty years. It has a definite shift.
What is interesting is that you’ve pointed out that people who smoke one or two cigarettes a day may net an overall risk reduction. That is a thought that points to some interesting places, which you have noted, as well as alternatives (fermented foods) which have even fewer risk factors.
But it takes true scientific inquiry rather than emotion driven response to think about things like this.
complete contrast with alcohol. there are plenty of studies and newspaper articles showing that a little bit of wine is good for you, yet everyone agrees that alcohol is addictive and too much alcohol will destroy your body. there is even a contrast with marijuana i suppose — people are willing to look somewhat at its beneficial effects, to a smaller extent.
so why is tobacco the third rail?
(disclaimer: i don’t smoke at all and my father, a long-time smoker, died young of lung cancer.)
One problem is that there are so many “known” causes of lung cancers: arsenic (primarily in our water), radon gas, #1 diesel fuel (others are suspect), asbestos, and so on. Another problem is that the statistical report generators seem to inquire whether the patient is or was a smoker. If so, that’s the cause! Science requires that every possible cause in each case be eliminated as the cause — pretty hard to do with diesel and auto exhaust fumes! Reports from at least three long-gone M.D.s (all my grandparents) had two of them heavy smokers and one of them with life-long exposure to second-hand smoke (she also had anginas from age 15). The two smokers died at 64 and 71 neither from any smoking related disease. The older one had a clear chest x-ray three months before his death — he chain-smoked unfiltered Luckies. The third, the non-smoker, died at 96 with no lung related disorders — her heart finally gave out.
So let’s put Sir Francis Bacon’s scientific method to use on the problem and stop fooling the public. Big Oil is Big Campaign Contributor! It wasn’t until the ’50s that lung cancers became an issue — this ties in nicely with the rise of our trucks, cars and diesel fueled ships. That would be a start!