maximusveritas

longbough, my original comment was "While you could make a case that incidental second hand smoke is not harmful enough to justify the increased public regulations we've seen in recent years, to say it's not a health hazard to anyone makes you a crackpot in my book."

You seem to be making the former case, which is reasonable. Crichton is making the latter. That's why he's a crackpot.

Whatever flaws existed in the EPA report (and that is debatable), it is still ridiculous to claim that second hand smoke is not a health hazard to anyone. Even Philip Morris doesn't make that claim anymore.

longbough

Crichton is certainly wrong in stating that second hand smoke wasn't a health hazard but that's just his overstated interpretation of the history the 1993 EPA review. I was explaining the facts that probably inspired Crichton's hyperbolic extrapolation.

The simple fact is that the 1993 EPA study ERRONEOUSLY related second hand smoke to 3,000 deaths per year. The notion that second hand smoke can lead to asthma exacerbation is not in question - but this is about the extent of "hazard" demonstrated by ETS in the EPA report. However, the claim it makes relating 3,000 deaths is an ABSOLUTE CONTRIVANCE by all scientific and statistical standards.

If you conveniently dismiss this as a "debatable" issue then you're missing the whole point. IT ISN'T A MATTER OF DEBATE. The complete tragedy is that this is a FABRICATED NOTION perpetuated by a political agenda ... NOT BY SCIENTIFIC OR STATISTICAL EVIDENCE.

I first learned about the weakness of the EPA study on a television documentary. I was completely skeptical since I was taught this in medical school. Before studying medicine I was a physics researcher working for the U.S. Department of Energy - and am very familiar with methods of research and statistics - So I examined the raw data myself and was absolutely dumfounded to discover that, in fact, the 1993 EPA report was statistical hogwash (regarding its conclusion about ETS related to 3,000 deaths per year) .... this is not an exaggeration - there's no other way to describe it. I implore you, if you have, even a fundamental familarity with statistical analysis, do look at the data yourself and you will see that I'm not exaggerating.

... it's sad, but I have a strong suspicion that most people will not posess the initiative to call me on the facts but would rather hurl baseless claims about my motives.

Maximusveritas, it isn't your post that provokes my defensive reply but some of the other ones. You, thankfully have been more cordial. And I appreciate that.

Willravel

longbough, he's agreeing with you. maximusveritas called your case reasonable, and I agree. It was Michael Crichton's case that was absurd and shameless. The EPA makes mistakes all the time. The fact that the EPA made a mistake does not change the fact that the article above is fillied with exagerations and erronious information. The EPA was wrong, but smoking is still dangerous and can be very harmful to a persons health. My Aunt died of cancer from smoking. My Uncle was diagnosed with lung cancer despite never actually smoking a cigarette (or being involved in any other high risk activity or vocation that is associated with lung cancer, such as working around dangerous inhalants or a lot of dust). If you ask his doctor, someone who knew him quite well and has all the test from over the years, he will tell you that my Uncle died from second hand smoke. I don't know if second hand smoke kills 3000 people a year. I do know beyond a reasonable doubt that it killed my uncle. That is enough proof for me that at least one person died from second hand smoke. This opens up the possibility that second hand smoke kills more.

raveneye

I don't want to get into another big honking debate about SHS (secondhand smoke) but for longbough I'd like to point out a few things:

--the EPA did appeal the court decision against it, and won the appeal (in 2002). That judge's ruling was completely vacated. Isn't it interesting the Crichton didn't point this out?

--the EPA report did pass peer review. There were over a dozen independent scientists that approved the study. It was and is approved by the American Cancer Society, the Surgeon General, and a slew of other scientific agencies.

--it is not at all correct to say that the CRS panned the study. The CRS report simply was a neutral review of the information at the time, and it neutrally reported the criticisms of the EPA study. It did not perform any statistical analysis that resulted in any negative evaluation of the study.

--the CRS report was not a peer-reviewed published study. It was just a preliminary government report.

--there are several other studies besides the EPA study that demonstrate an increased risk of lung cancer due to SHS. Even if you completely disregard the EPA study, the Fontham et al. study, the largest case control study performed at the time, showed essentially the same results as the EPA study. Their reported median value of lung cancer deaths per year is about 2700 (if I remember right), which is not significantly different from the EPA value. There are several others in addition that corroborate the EPA conclusions.

--there is nothing unusual about a one-tailed statistical test for the effects of environmental toxins. The EPA uses these routinely and nobody questioned them in studies of other toxins. But their other studies did not involve the tobacco industry.

--anybody interested in the politicization of science in this context should consider that, if you want to predict whether any particular study is going to conclude that smoke is harmless, your best predictor is the funding source. If the funding source is the tobacco industry, then the study nearly always predicts no harmful effect. Nearly 3/4 of all studies concluding no effect of SHS were funded by the tobacco industry.

--longbough: you say you have reviewed the methods of the EPA study and found them to be completely invalid. I'm a statistician myself, and have also looked at the methods. It's a 600-page report, and I certainly haven't read every word. But I've looked at the tables and the associated methods, and these indicate to me, clearly, a very highly significant overall effect. They are completely convincing. Even if you use a 95% confidence interval, the effect is still very highly significant. If you'd like to point to me the specific passages in the report that you disagree with, I'd like to see them. To my knowledge none of the critics of this report have done this, including Judge Osteen. So I would be very interested in seeing exactly where in the report you have found any fatal statistical flaw.

Bottom line: the EPA study is just one of many, and it has been completely vindicated by subsequent research. Even if you disagree with it, the overall picture is a clear increase in lung cancer due to SHS exposure. Of course the effect is not as great as with smoking, but it is real, and it increases with exposure. This stands to reason: SHS contains the same carcinogens as cigarette smoke.

longbough

raveneye,

Thank you for your insight. You've clearly given me more food for thought - I really needed a convincing counter argument to what I had learned - and you've given me just that - in spades!

I'm glad to know the story doesn't end with the EPA report as I had understood them. As I mentioned before primary cigarette smoking is a serious problem among my patients who suffer from a variety of associated chronic conditions. I will look into the matter further and reconsider my view.

willravel, personal experiences like yours are enough to shape anyone's personal opinion. There are several forms of lung cancer - each of which is predisposed by different specific risk factors (by far the greatest being primary tobacco smoke exposure in bronchogenic carcinoma) and some of them through no known risk factors. But statistics have absolutely no relevance to an individual and personal experience - I can understand how you feel. My grandfather to whom I was very close died of bronchogenic carcinoma while I was away in medical school. I had returned to visit after his diagnosis and a partial lung resection. He had been the picture of health when I had last seen him. My stay was short. Only a week after I returned to school I received a call that my grandfather had died.

raveneye, thanks again for the information. I will certainly look into your points when I get a moment. Until then I'll have to suspend my prior statement.

maximusveritas

Good job of breaking down the main points raveneye.

If anyone is curious, Medline or BMJ are good places to search for some of the additional studies that point out the possible hazardous effects of second hand smoke.
Just be careful to look out for the tobacco industry's studies. We know from recently released internal memos that the tobacco industry has been waging a full scale misinformation campaign against research on passive smoke similar to the campaign they waged decades ago regarding active smoking. They've funded some bad research and funded organizations like Cato and Hudson in order to trash some good research. Unfortunately, this has created an environment where anyone who comes out on the side of the industry is labelled a stooge when that's not always the case.

In the meantime, you can check out this article about a recent study that was presented at the latest AHA meeting.

raveneye

. . . and just to bring this point back on topic: the title of Crichton's speech is The Disinformation Age. If you really want to discuss this subject, you can't leave out the most egregious example in the recent history of science: the tobacco industry's well-funded and relentless disinformation campaign against honest scientists trying to study the harmful effects of cigarette smoke.

longbough

You must consider the references used for your sources if you are use them to corroborate the findings of the 1993 EPA study. In a surprising number of cases you'll note the prime reference is the 1993 EPA study itself! - that would include opinions of the AHA, American Cancer Society, the American Lung Association and the U.S. Public Health Service. That's what makes it a big deal if one were to call the EPA report into question. The 1993 EPA report is a major the keystone for much of the opinion about ETS.

That is why you must check the references of whatever source you're using (including those of the AHA article mentioned above) - otherwise you could, unknowingly, end up in a circular argument. I have yet to thoroughly evaluate raveneye's post, though.

There's no question that tobbacco smoke is a carcinogen. The question remains if ETS exposure is enough to make a significant impact on one's chances for developing CAD, COPD and/or Lung CA.

I'm still at a loss to explain the following item.
In 1998 the WHO issued the following press release:
PASSIVE SMOKING DOES CAUSE LUNG CANCER, DO NOT LET THEM FOOL YOU - where the WHO uses a study done by the International Agency for Research on Cancer.

However if you look at the study itself it doesn't say that at all. Here's a link to the abstract of the IARC study:
Multicenter case-control study of exposure to environmental tobacco smoke and lung cancer in Europe.
Read the conclusion -"Our results indicate no association between childhood exposure to ETS and lung cancer risk. We did find weak evidence of a dose-response relationship between risk of lung cancer and exposure to spousal and workplace ETS. There was no detectable risk after cessation of exposure."

Though it does mention "weak evidence of a does-response relationship between risk of lung cancer and exposure to spousal and workplace ETS" the statement is clarified in the the body of the publication itself where it says that "There was also a nonsignificant dose-response relationship with duration of exposure. We also found an association of similar strength with workplace exposure. Dose-response relationships were more consistent and risks were higher, although in most cases they were not statistcally significant, with combined indicators of spousal and workplace ETS exposure." Multicenter case-control study of exposure to environmental tobacco smoke and lung cancer in Europe. In other words, it has not reached statistical significance.

The WHO's press release paints a different picture when it infers from the study that "Passive smoking DOES cause lung cancer". That bothers me.

Again, I'm not trying to imply anything by calling to question common beliefs about ETS - my purpose is better described as being a "devil's advocate."

Lebell

THIS is the type of discussion I enjoy reading.

Thank you everyone!

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boatin

I can't say much that hasn't been said, but my 2 cents:

I run in a group of friends that consider themselves rabid environmentalists. This article describes none of them. They (we) understand the savagry of nature, animals and our fellow man. I know exactly no one that buys the 'eden' mythos Chrighton describes. He spends a huge amount of ink on that, and I have no clue where he gets that. Strange. The other issues in this have been handled better by others...

More interesting to me are those for whom this article resonated positively. There is no clearer example that I've seen lately that illustrates the gap in understanding that permeates all issues these days - from both sides. I hope this type of discussion helps fix that.

My personal dilemma is that I feel I work hard to understand where those that I disagree with are coming from. And I don't see that same effort the other way. Crazy bias on my part? I'm sure willing to consider that as a possibility.

Willravel

That's called a strawman fallacy. MC tries to prove the other side wrong by misrepresenting our views and beliefs. http://www.nizkor.org/features/fallacies/straw-man.html
Just keep saying it, eventually someone will listen. That's what I do.

raveneye

longbough, simply citing the EPA study does not necessarily call into question any conclusions of a study; it certainly doesn't call into question the study that maximumus cited.

The WHO memo you are referring to was a response to a disinformation campaign by the tobacco industry, which touted the cited study as "proof" that SHS as completely harmless. I think you'll agree that that interpretation of the study is off base.

Anybody interested in the conclusions of the best, largest studies on this subject can check out these papers I cite below. They are a good starting point. And their conclusions are completely independent of the EPA paper, in case that matters. Note that these are very conservative studies, that include even small exposure to SHS in their risk assessment. The important result is the dose trend response, which is very highly significant. The greater your exposure, the greater your risk of lung cancer.

Brennan, P., P. A. Buffler, et al. (2004). "Secondhand smoke exposure in adulthood and risk of lung cancer among never smokers: A pooled analysis of two large studies." International Journal of Cancer 109(1): 125-131.

The interpretation of the evidence linking exposure to secondhand smoke with lung cancer is constrained by the imprecision of risk estimates. The objective of the study was to obtain precise and valid estimates of the risk of lung cancer in never smokers following exposure to secondhand smoke, including adjustment for potential confounders and exposure misclassification. Pooled analysis of data from 2 previously reported large case-control studies was used. Subjects included 1,263 never smoking lung cancer patients and 2,740 population and hospital controls recruited during 1985-1994 from 5 metropolitan areas in the United States, 11 areas in Germany, Italy, Sweden, United Kingdom, France, Spain and Portugal. Odds ratios (ORs) of lung cancer were calculated for ever exposure and duration of exposure to secondhand smoke from spouse, workplace and social sources. The OR for ever exposure to spousal smoking was 1.18 (95% CI = 1.01-1.37) and for long-term exposure was 1.23 (95% CI = 1.01-1.51). After exclusion of proxy interviews, the OR for ever exposure from the workplace was 1.16 (95% CI = 0.99-1.36) and for long-term exposure was 1.27 (95% CI = 1.03-1.57). Similar results were obtained for exposure from social settings and for exposure from combined sources. A dose-response relationship was present with increasing duration of exposure to secondhand smoke for all 3 sources, with an OR of 1.32 (95% CI = 1.10-1.79) for the long-term exposure from all sources. There was no evidence of confounding by employment in high-risk occupations, education or low vegetable intake. Sensitivity analysis for the effects of misclassification (both positive and negative) indicated that the observed risks are likely to underestimate the true risk. Clear dose-response relationships consistent with a causal association were observed between exposure to secondhand smoke from spousal, workplace and social sources and the development of lung cancer among never smokers. (C) 2003 Wiley-Liss, Inc.

Fontham, E. T. H., P. Correa, et al. (1994). "Environmental Tobacco-Smoke and Lung-Cancer in Nonsmoking Women - a Multicenter Study." Jama-Journal of the American Medical Association 271(22): 1752-1759.

Objective.-To determine the relative risk (RR) of lung cancer in lifetime never smokers associated with environmental tobacco smoke (ETS) exposure. Design.-Multicenter population-based case-control study. Setting.-Five metropolitan areas in the United States: Atlanta, Ga, Houston, Tex, Los Angeles, Calif, New Orleans, La, and the San Francisco Bay Area, Calif. Patients or Other Participants or Other Participants.-Female lifetime never smokers: 653 cases with histologically confirmed lung cancer and 1253 controls selected by random digit dialing and random sampling from the Health Care Financing Administration files for women aged 65 years and older. Main Outcome Measure.-The RR of lung cancer, estimated by adjusted odds ratio (OR) with 95% confidence interval (Cl), associated with ETS exposure. Results.-Tobacco use by spouse(s) was associated with a 30% excess risk of lung cancer: all types of primary lung carcinoma (adjusted OR=1.29; P<.05), pulmonary adenocarcinoma (adjusted OR=1.28; P<.05), and other primary carcinomas of the lung (adjusted OR=1.37; P=.18). An increasing RR of lung cancer was observed with increasing pack-years of spousal ETS exposure (trend P=.03), such that an 80% excess risk of lung cancer was observed for subjects with 80 or more pack-years of exposure from a spouse (adjusted OR=1.79; 95% Cl=0.99 to 3.25). The excess risk of lung cancer among women ever exposed to ETS during adult life in the household was 24%; in the workplace, 39%; and in social settings, 50%. When these sources were considered jointly, an increasing risk of lung cancer with increasing duration of exposure was observed (trend P=.001). At the highest level of exposure, there was a 75% increased risk. No significant association was found between exposure during childhood to household ETS exposure from mother, father, or other household members; however, women who were exposed during childhood had higher RRs associated with adult-life ETS exposures than women with no childhood exposure. At the highest level of adult smoke-years of exposure, the ORs for women with and without childhood exposures were 3.25 (95% Cl, 2.42 to 7.46) and 1.77 (95% Cl, 0.98 to 3.19), respectively. Conclusion.-Exposure to ETS during adult life increases risk of lung cancer in lifetime nonsmokers.

Ustwo

I consider myself an environmentalist too.

I recall a class I had on water ecology in 1993. For some reason the professor was late, but in grad school where you have a class size of about 10-20 people maximum, you don't apply the 15 minute rule like you did as an undergrad.

I recall it quite vividly for two reasons. It was early spring, and a the first real warm day. I discovered the girl I thought was pretty cute, and would have hit on if I was not already dating my future wife didn't like shaving. She was wearing some sort of stockings/dress combination, and her hair was such that it was sticking out all over the stocking. For some reason, that image sticks in my mind. The other reason is as follows.

Well being we had nothing better to do, we started to talk about the environment, problems, and how to fix them. The conclusion reached among those of us who were talking was that the problem for the environment was specifically people. We had too many of them you see. The solution was we needed less of them, and perhaps something like an engineered virus was the best way to achieve this lower number. There was much agreement in this concept.

To me this was a turning point of such, a last straw, and a time to redirect my studies. This incident alone is rather minor, but after years of discovering the nature of the 'environmentalist' the lies, the politics, and in many cases the ignorance of the people involved, I had enough. (I could go on writing about the ignorance and lies that made up Earth Day 1991)

These types of people form the core of groups like Green Peace these days, and other organizations. I have a feeling they are now in charge of the Sierra Club as well, but thats just a hunch based on what I'm reading from them.

On the other hand there are plenty of 'good' environmentalist out there. Hunting and fishing groups have done a lot for habitat restoration, as they have a vested interest in seeing a healthy environment. Unlike some self proclaimed environmentalist, these groups don't view people themselves as the cancer on mother earth.

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Vaultboy

I'm afraid that Crichton dissapoints me as a scientist, but still thrills me as a writer. This article, as misinformative as it is, is very convincing, so it affirms his skill. Its a pity though that as a scientist himself, Chrichton throws objectivity and proper scientific fact out the window of and blatatly lies about a number of subjects (DDT, Gloabal Warming, etc).

If I had the time I'd post exactly how the Climate Change community and peer review is structured. Maybe next week.

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Nimetic

Crichton is in fact neither right nor wrong. Crichton is irrelevant and somewhat of a red herring.

As Ustwo said correctly, most "environmentalists" are not scientists.

However... most novelists and politicians are not scientists either.

In fact there are very few scientists around. I have a science degree. I would not call myself a scientist. Getting back to the topic at hand. Crichton's contribution is to simply muddy the debate.

I do like some of his points. In particular - he is correct. Nature is not the nice safe thing that fringe environmentalists worship. Likewise - hardcore environmentalism is somewhat comparable to religion.

Crichton annoys me somewhat in linking environmentalism groups to those scientists who study the environment. These are seperate groups with different ideals and goals. In particular, scientists are generally supportive of technology. It is science that makes many technologies possible - and it is technology that makes many areas of scientific research possible.

MoonDog

Remember, Crichton is - first and foremost - a writer of fiction. Damn GOOD fiction, in my opinion, but still fiction. I enjoyed that article immensely, but don't agree with it 100%. However, I respect his opinion, because he is - secondly - a scientist. For those of you who "pooh pooh" Crichton as another "celebrity" mouthing off on issues, remember this:

Michael Crichton

• Graduated Harvard University, B.A. (summa cum laude), Anthropology, 1964 (Phi Beta Kappa)
• Visiting Lecturer in Anthropology at Cambridge University, England, 1965.
• Henry Russell Shaw Travelling Fellow, 1964-65.
• Harvard Medical School, M.D., 1969 (never licensed)
• spent one year as a post-doctoral fellow at the Salk Institute for Biological Sciences, La Jolla, California 1969-1970

You can argue that his interpretation of the science behind the argument is wrong, but he does have the credentials to at least argue them without being belittled as a celebrity.

Vaultboy

I've always been perplexed by how Americans put Environmental Scientists and Environmentalists in the same boat. They are two distinct groups of people. Crichton is probably aware of this, but he makes these blanket statements to generate controversy for the benefit of sales.

That's why I'm even more dissapointed in him. Charles Pellegrino is also a SF writer, who is also a scientist (in fact, there are many). Read Pellegrino's novel DUST - Its perhaps the best Ecological thriller ever written, and while Pellegrino embellishes for effect, he avoids blatatly misinforming the reading public. Crichton is well aware that lay people read his books and take what he says as gospel (pun intended). He is a knowledgeable person, who is respected for researching the premise of his novels. If Crichton had written State of Fear without adding in all the references I would have been more forgiving, but in using peer-review references his book becomes a structured ARGUMENT. And he used his reputation to mislead. I have many friends who I had to argue with after they read that book - because they accepted that Crichton is telling the truth. That's also why scientists are tearing into it.

Crichton knew this would happen. He knew the controversy would enhance publicity of his book (or at least whoever gave him the idea to do it knew). At best he was irresponsible. At worst, he's shown himself to be an anti-environmentalist fanatic.

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Ustwo

Sorry Vaultboy but having been in the 'environmentalist' trenches first hand for a number of years, I have to say Crichton is dead on correct in just about everything he wrote. I've been there, been part of them, and turned away in disgust. You may disagree and thats wonderful but that is as much a part of science as politics. You should never argue with a specialist, but recall the history of science is littered with specialists that were completely wrong. Even empirical data can be interpreted in different ways.

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kutulu

He was an anthropology major. It's not like he graduated as a chemist, physicist, engineer or even a biologist.

Nimetic

Ok. That's a fair point. Mind you, I'd still not call him a scientist. To me that word implies a professional researcher with PhD (or working towards same) in pure science.

I quite like the speech. It's construction mixes images, emotion and a dash of reason. Clever, well constructed, appealing. There is nothing wrong with this structure in a political or general context. It is aimed at a broad audience. It is nicely done.

But... the pattern tells a sceptical person that they are being sold something. Does he really have a solid case - if so, why is he padding it with fluff? I'm not particularly paranoid - it is probably because he has an audience to entertain.

The key points made are probably not meant to be taken as absolutes, more I'd say they are logical end points in a story. Just as a film is a story meant for entertainment, so is the speech.

Ultimately, I quite liked it. The danger is that people may take this seriously. Accept the observations that he makes (stated as facts) and go on to discount evironmental agencies, environmental science and all environmentalists.

Sure... the group "environmentalists" includes a number of uneducated kooks, but... we should put this in context. Whether his claims (DDT) are correct or not is barely relevant. There have been a significant number of fairly undeniable - of environmental disasters and issues over centuries. Accepting that these occurred does not mean saying no to all development.

MoonDog

Methinks that mere Anthropology majors are not often invited to be Visiting Lecturers at Cambridge University. Besides, he wasn't just a "major" - he graduated with a BA in the field. He must have done something to distinguish himself enough to lecture at Cambridge.

Many people don't realize that some schools offer an Anthro path as an alternative pre-Med track. That may have been the way Crichton chose to get to medical school.

My uncle is an MD. He is also a psychiatrist. He was a lecturer at a respected northeastern university. He has treated patients, he has done research, he has written papers...he will argue that physicians can be scientists.

Anyhow, my point was not to defend Crichton's viewpoints, but to point out that he does have some educational chops that shouldn't class him as "just another outspoken celebrity".