It’s sad when a phrase stands out simply for exhibiting common sense

A recent CBC article Bone drugs may raise throat cancer risk contained the following sentence:

“Esophageal cancer is an uncommon cancer,” said Jane Green, a clinical epidemiologist at the University of Oxford, one of the paper’s authors. “Even a doubled risk is still a very small risk.”

The article was about the possible negative effects associated with taking bone-building pills called bisphosphonates. These pills doubled the risk.

In this other article from U.S. News about smokeless tobacco, the esophageal cancer risk is said to increase by 60%. Fair enough but rather than a similar statement about the rarity, the conclusion is that this is evidence that snuff “is not a safe alternative to smoking” with that conclusion being promoted to headline news.

So in the first case using a drug which can greatly improve the quality of life for a condition that in itself is not fatal but whose taking will increase the risk of getting a very rare cancer is considered a reasonable trade off, but in the second substituting smokeless tobacco for smoking (which entails much higher risks for a number of cancer not to mention the even higher risks of cardiovascular disease) is “not recommended”. This after explicitly stating it is safer.

That is, to belabor the point, the authors tell you that if smokers switch to smokeless tobacco, fewer of them will die, but they do not recommend that course of action.

To return to one of our favourite analogies regarding this inappropriateness consider seat belts (once again). Its as if you looked at all those accidents where people died while in their seat belts and said “well, if they would have been walking instead of driving with their seat belts on then they would still be alive” and then recommended against seat belts in cars on that basis.

All we ask, is to inject a little more common sense into tobacco related reports and comments by those highly educated researchers who should know better, particularly when it comes to discussing options for smokers (see my parody post of what passes for this kind of reporting and the comments which indicate that some did not find its outrageousness much of a stretch at all).

There are a million small risks about us all the time. It doesn’t hurt to know a little about them but we should not make the mistake of letting them distract us from making the proper big decisions.

-Paul L. Bergen

4 thoughts on “It’s sad when a phrase stands out simply for exhibiting common sense

  1. Interesting analogy about the seat belts Paul, though it might work a bit better if the seat belt was NOT being used and someone argued against installing seat belts and airbags on the basis of “people will be healthier walking anyway.”

    Heh… I forget who at the moment, but one of our smoking-activist type bloggers once recommended that the best safety measure for driving might be removing the driver’s belt/bag equipment and replacing it with a foot-long bloody looking sharp ‘n scary spike coming out of the center of the steering wheel and pointing to the driver’s heart. Certainly would discourage careless driving, eh? :>

    Excellent catch on the cancer juxtaposition!! I’ll have to save that one! It makes the point more strongly than pages of general argument would. I’d go one step further than you though: Just as many smokers derive positive life-benefits-enjoyment from smoking, so might many snuff users feel the same way. If that’s true, then the risk of using snuff MIGHT be fully justified for many people just in relation to that enjoyment, regardless of its relation to quitting smoking.

    Michael J. McFadden
    Author of “Dissecting Antismokers’ Brains”

  2. Hey Michael,

    Like your version of the seat belt though I would use it for another purpose….arguments have often been made against promoting smokeless as an alternative on the basis that people won’t do it (which is irrelevant to providing the option). In this case, and maybe I didn’t express myself as well as I should have, the idea is that often the safer alternative (driving with seat belts) is not compared to the more dangerous (driving without) but with the not doing it at all (abstention vs smokeless vs smoking).

    To your second point, I agree wholeheartedly. Though harm reduction was the discussion here, individual welfare choices (and making your own health decisions) are fully justifiable.

  3. Paul, yep! Now I see better what you were saying! 🙂

    Elaine, I just tried to add a note to your AMA comment to help keep it from getting erased but although I clicked on the “Write a note+” button it doesn’t seem to be showing yet:

    Both the AMA and Elaine Keller are correct. There is no safe level of exposure to alcohol (or alcohol fumes if you’re in a drinking restaurant), sunshine, or tobacco. All have Class A Carcinogen status (although Big Alcohol seems to have prevented the actual fumes from alcohol being so classified yet — it would be their bugaboo-monster equivalent to second-hand smoke) and by definition “there is no safe level of exposure” to any of them.

    To be consistent in its mission however, the AMA should come out against daytime patio dining and against alcohol service in restaurants. In reality however I prefer Elaine Keller’s approach: such things, along with low levels of exposure to secondary smoke in decently ventilated facilities and the risk from products such as snuff, are certainly of low enough possible risk that they should be left up to individual choice.

    – MJM

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