Why Call It News Any More?

It is good to see you say connection and not cause now... well done.
I do not know why the study came out the way it did, though my theory is that pipe and cigar smokers tend to take time out each week to intentionally relax and stress is the number one killer in America. That does make sense.
The AMA has never said that smoking causes cancer, not once... no medical trial has ever shown that or anything related to second hand smoke, in any way. As I posted earlier, you must not have read that, there has been shown a small elevated risk, nothing more.
I am saying that if a news service lied about it they are not responsible any more than the societies I mentioned.
Is smoking cigarettes laden with chemicals habitually, inhaling them as much as you can, bad... of course it is.
Does it cause cancer, no... is that all there is to tobacco, no... does it make it ok to tell business owners what to do on their private property as long as they comply with OSHA air quality standards, no, not at all.
Propaganda is propaganda, lies are lies, plain and simple.

[tw]

Originally Posted by rkzenrage

The AMA has never said that smoking causes cancer, not once... no medical trial has ever shown that or anything related to second hand smoke, in any way.

A 1964 Surgeon Generals report said smoking kills. It specifically cited lung cancer as created by smoking. Why do you know that 40 years of confirming research was all wrong? Where is that citation?

So again, why do you mention second hand smoke - doing what only Rush Limbaugh types would do? Nobody said anything about second hand smoke. Why do you do what Rush would do?

So again, "Where is this study that claims no relationship between smoking and lung cancer? Where is this study that claims no relationship between smoking and heart complications? Where is this study that so contradicts the Surgeon General after so many generations of science repeatedly confirmed that 1964 report? Where is this study that proves both the AMA and ACS have been lying for two generations? "

So again, "Show us how 40 years of undisputed Surgeon General research got it all wrong. Show us this conspiracy to destroy a patriotic American tobacco industry - that conspired even to addict 14 year olds to nicotine."

Show us how the new serviced have conspired to condemn smoking - and how astronauts never went to the moon - and how Hitler did not kill millions of Jews.

Thank you for making my point, that statement was, and every time the SG made it after that (they have since stopped due to criticism) it was pure propaganda, with no basis in medical science.
Again, No study has ever shown smoking or second hand smoke leads to cancer.
What you are asking for "no relationship" is impossible, you cannot prove a negative and no scientist would try to do so in a clinical trial.
The SG never stated from where or how they are getting their information.
The AMA study from 1968, did not come to that conclusion... it was, in fact, the same study that stated that casual pipe and cigar smokers lived longer than non-smokers, on average.

Epidemiology 101

If you think Statistics is a complex, difficult to understand subject, you're right, but this page will help remove a lot of the mystery. If you think Statistics can be twisted and manipulated to produce just about any desired result, you're right again. But once you know how the numbers are twisted, it is usually easy to spot the dishonesty.

Since almost all studies on health and medicine use epidemiology to reach their conclusions, understanding how it works is the only way to sort out the facts from the deceptions and frauds. Once you learn to pick apart these studies, you'll be able to approach the media with a very different attitude. When some talking head on TV tells you that some study proves that coffee is bad for you, and a week later another head tells you it's good for you, you'll know how to find out which one is reporting the facts. In many cases, you'll find both of them are wrong.

Types of Studies

Fact: Cohort Studies follow a group of people with different exposures to a substance over a period of time. Tracking people before any health effects occur reduces the impact of bias and increases the accuracy of the study, and allows testing for a variety of illnesses. It is the most expensive, time consuming and difficult type of study to conduct.

Cohort Studies are useful for common illnesses, but are too expensive and impractical for studying rare diseases.

Fact: Case Control studies examine two groups of people, those who already have an illness, and a control group. The control group may contain a random sampling of the population, or a sample specifically selected because they don't have the illness being studied.

Case Control studies are more likely to be biased because they start by selecting people who are already sick. For instance, if you wanted to find out if coffee caused stomach cancer, a case control study would start out with a sample of people who already had stomach cancer, leaving out the coffee drinkers who remained healthy. Case Control studies are much less expensive and time consuming, requiring much smaller sample sizes and eliminating the need to track people over long periods of time. They are often the only practical way to study uncommon illnesses.

Fact: Meta Studies (more accurately referred to as Meta Analysis) are analyses of existing studies. The researcher gathers data from other studies, picks the appropriate ones, pools the results and extracts his data.

It is extremely difficult to do this with any degree of accuracy, and extremely easy to twist the results to a predetermined outcome. Simply leaving out one or two studies can skew the data dramatically in one direction or the other. Be highly suspicious of any meta analysis. Carefully check for any researcher bias. If you automatically reject any meta study conducted or financed by someone with a strong agenda, you will almost always be right.

There are other types of studies, but these are the most common.

Relative Risk

Fact: The goal of an epidemiological study is to determine Relative Risk (RR).

Relative risk is determined by first establishing a baseline, an accounting of how common a disease (or condition) is in the general population. This general rate is given a Relative Risk of 1.0, no risk at all. An increase in risk would result in a number larger than 1.0. A decrease in risk would result in a lower number, and indicates a protective effect.

For instance, if a researcher wants to find out how coffee drinking effects foot fungus, he first has to find out how common foot fungus is in the general population. In this fictional example, let's say he determines that 20 out every 1,000 people have foot fungus. That's the baseline, a RR of 1.0. If he discovers that 30 out of 1,000 coffee drinkers have foot fungus, he's discovered a fifty percent increase, which would be expressed as a RR of 1.50.

If he were to find the rate was 40 out of 1,000, it would give him a RR of 2.0.

He might find foot fungus was less common among coffee drinkers. A rate of 15 out of 1,000 would be expressed as a RR of 0.75, indicating that drinking coffee has a protective effect against foot fungus.

The media usually reports RRs as percentages. An RR of 1.40 is usually reported as a 40% increase, while an RR of .90 is reported as a 10% decrease. (In theory, at least. In practice, negative RRs are seldom reported.)

Note: Some studies calculate an Odds Ratio (OR) instead of an RR. The formulas for determining the two numbers are different, but when studying rare diseases the results are approximately the same. When studying more common diseases ORs tend to overstate the RR.

Fact: As a rule of thumb, an RR of at least 2.0 is necessary to indicate a cause and effect relationship, and a RR of 3.0 is preferred.

"As a general rule of thumb, we are looking for a relative risk of 3 or more before accepting a paper for publication." - Marcia Angell, editor of the New England Journal of Medicine"

"My basic rule is if the relative risk isn't at least 3 or 4, forget it." - Robert Temple, director of drug evaluation at the Food and Drug Administration.

"Relative risks of less than 2 are considered small and are usually difficult to interpret. Such increases may be due to chance, statistical bias, or the effect of confounding factors that are sometimes not evident." - The National Cancer Institute

"An association is generally considered weak if the odds ratio [relative risk] is under 3.0 and particularly when it is under 2.0, as is the case in the relationship of ETS and lung cancer." - Dr. Kabat, IAQC epidemiologist

This requirement is ignored in almost all studies of ETS.

While it's important to know the RR, it's also very important to find the actual numbers. When dealing with the mass media, beware of the phrase "times more likely."

For instance, a news story may announce "Banana eaters are four times more likely to get athletes foot!" You find the study, read the abstract and find the RR is, indeed, 4.0. But further digging may reveal that the risk went from 1.5 in 10,000 to 6 in 10,000. Technically, the risk is four times greater, but would you worry about a jump from 0.015% to to 0.06%?

Confidence Intervals

Fact: The Confidence interval (CI) is used to determine the precision of the RR. It is expressed as a range of values that would be considered valid, for instance .90 – 1.43.

The narrower the CI, the more accurate the study. The CI can be narrowed in many ways, including using more accurate data and a larger sample size.


Fact: Confidence intervals are usually calculated to a 95% confidence level. This means the odds of the results occurring by chance are 5% or less.

This is one reason epidemiology is considered a crude science. (Imagine if your brakes failed 5% of the time.) The EPA, in their infamous 1993 SHS study, used a 90% CI, doubling their margin of error to achieve their desired results.

The RR could be any number within the CI. For instance, an RR of 1.15 with a CI of .95 – 1.43 could just as well be a finding of 1.25, an 25% increase, or .96, a 4% decrease, or 1.0, no correlation at all. Pay close attention to any study where the CI includes 1.0. (It does in virtually all ETS studies.) When the CI includes 1.0, the RR is not statistically significant.



Confounders

On average, women live longer than men. Any study on longevity has to account for this fact. This is called a confounder, which is easy to remember because it can confound the results of a study. Some studies use the term "confounding variable." Any study of longevity (usually referred to as a study of morbidity) which doesn't take this confounder into account will be very inaccurate. For instance, when studying the longevity of smokers, it's important to adjust for the gender difference, and adjust for the percentage of men and women in the study.

Sound complicated? It gets worse. Poor people die sooner than rich people. Black people die sooner than white people, even when adjusting for the income confounder. People in some countries live longer than people in others. So if an impoverished black male smoker in Uruguay dies before reaching the median age, is it because of his income, race, gender, smoking, or nationality?


Fact: When studying the effects of tobacco exposure, either to the smoker or to those around him, confounders include age, allergies, nationality, race, medications, compliance with medications, education, gas heating and cooking, gender, socioeconomic status, exposure to other chemicals, occupation, use of alcohol, use of marijuana, consumption of saturated fat and other dietary considerations, family history of cancer and domestic radon exposure, to name a few.

Oct/Nov 1999 Editorial

_________________
Smoking Does Not Cause Lung Cancer

(According to WHO/CDC Data)*
By: James P. Siepmann, MD

Yes, it is true, smoking does not cause lung cancer. It is only one of many risk factors for lung cancer. I initially was going to write an article on how the professional literature and publications misuse the language by saying "smoking causes lung cancer"1,2, but the more that I looked into how biased the literature, professional organizations, and the media are, I modified this article to one on trying to put the relationship between smoking and cancer into perspective. (No, I did not get paid off by the tobacco companies, or anything else like that.)
When the tobacco executives testified to Congress that they did not believe that smoking caused cancer, their answers were probably truthful and I agree with that statement. Now, if they were asked if smoking increases the risk of getting lung cancer, then their answer based upon current evidence should have be "yes." But even so, the risk of a smoker getting lung cancer is much less than anyone would suspect. Based upon what the media and anti-tobacco organizations say, one would think that if you smoke, you get lung cancer (a 100% correlation) or at least expect a 50+% occurrence before someone uses the word "cause."
Would you believe that the real number is < 10% (see Appendix A)? Yes, a US white male (USWM) cigarette smoker has an 8% lifetime chance of dying from lung cancer but the USWM nonsmoker also has a 1% chance of dying from lung cancer (see Appendix A). In fact, the data used is biased in the way that it was collected and the actual risk for a smoker is probably less. I personally would not smoke cigarettes and take that risk, nor recommend cigarette smoking to others, but the numbers were less than I had been led to believe. I only did the data on white males because they account for the largest number of lung cancers in the US, but a similar analysis can be done for other groups using the CDC data.
You don't see this type of information being reported, and we hear things like, "if you smoke you will die", but when we actually look at the data, lung cancer accounts for only 2% of the annual deaths worldwide and only 3% in the US.**
When we look at the data over a longer period, such as 50 years as we did here, the lifetime relative risk is only 8 (see Appendix A). That means that even using the biased data that is out there, a USWM smoker has only an 8x more risk of dying from lung cancer than a nonsmoker. It surprised me too because I had always heard numbers like 20-40 times more risk. Statistics that are understandable and make sense to the general public, what a concept!
The process of developing cancer is complex and multifactorial. It involves genetics, the immune system, cellular irritation, DNA alteration, dose and duration of exposure, and much more. Some of the known risk factors include genetics4,5,6, asbestos exposure7, sex8, HIV status9, vitamin deficiency10, diet11,12,13, pollution14 , shipbuilding15 and even just plain old being lazy.16 When some of these factors are combined they can have a synergistic effect17, but none of these risk factors are directly and independently responsible for "causing" lung cancer!
Look in any dictionary and you will find something like, "anything producing an effect or result."18 At what level of occurrence would you feel comfortable saying that X "causes" Y? For myself and most scientists, we would require Y to occur at least 50% of the time. Yet the media would have you believe that X causes Y when it actually occurs less than 10% of the time.
As ludicrous as that is, the medical and lay press is littered with such pabulum and gobbledygook. Even as web literate physician, it took me over 50 hours of internet time to find enough raw data to write this article. I went through thousands of abstracts and numerous articles, only to find two articles that even questioned the degree of correlation between smoking and lung cancer (British lung cancer rates do not correlating to smoking rates)19,20 and another two articles which questioned the link between second hand smoke (passive smoking) and lung cancer.21,22 Everywhere I looked, the information was hidden in terms like "odds ratio," "relative risk," or "annualized mortality rate." Most doctors probably could not accurately define and interpret them all these terms accurately, let alone someone outside the medical profession. The public relies on the media to interpret this morass of data, but instead they are given politically correct and biased views.
If they would say that smoking increases the incidence of lung cancer or that smoking is a risk factor in the development of lung cancer, then I would agree. The purpose of this article is to emphasize the need to use language appropriately in both the medical and scientific literature (the media, as a whole, may be a lost cause).
Everything in life has risk; just going to work each day has risk. Are we supposed to live our lives in bed, hiding under the blanket in case a tornado should come into our bedroom? We in science, have a duty to give the public accurate information and then let them decide for themselves what risk is appropriate. To do otherwise is a subtle imposition of our biases on the populace.
We must embrace Theoretics as a discipline that strives to bring objectivity and logic back into science. Every article/study has some bias in it, the goal is to minimize such biases and present the facts in a comprehensible and logical manner. Unfortunately, most scientists have never taken a course in logic, and I'm sure that English class was not their favorite. Theoretics is a field of science which focuses on the use of logic and appropriate language in order to develop and communicate scientifically credible theories and ideas which will then have experimental implications. As someone whom I respect says, "Words mean things." Let us use language and logic appropriately in our research and in the way that we communicate information.
* * * * *
Yes, smoking is bad for you, but so is fast-food hamburgers, driving, and so on. We must weigh the risk and benefits of the behavior both as a society and as an individual based on unbiased information. Be warned though, that a society that attempts to remove all risk terminates individual liberty and will ultimately perish. Let us be logical in our endeavors and true in our pursuit of knowledge. Instead of fearful waiting for lung cancer to get me (because the media and much of the medical literature has falsely told me that smoking causes lung cancer), I can enjoy my occasional cigar even more now...now that I know the whole story.
* * * * *

Cont'


The Untold Facts of Smoking (Yes, there is bias in science)
or
"I feel like the Fox Network" (a bastion of truth in a sea of liberalism)
1. USWM smokers have a lifetime relative risk of dying from lung cancer of only 8 (not the 20 or more that is based on an annual death rate and therefore virtually useless).
2. No study has ever shown that casual cigar smoker (<5 cigars/wk, not inhaled) has an increased incidence of lung cancer.
3. Lung cancer is not in even in the top 5 causes of death, it is only #9.**
4. All cancers combined account for only 13% of all annual deaths and lung cancer only 2%.**
5. Occasional cigarette use (<1 pk/wk) has never been shown to be a risk factor in lung cancer.
6. Certain types of pollution are more dangerous than second hand smoke.3
7. Second hand smoke has never been shown to be a causative factor in lung cancer.
8. A WHO study did not show that passive (second hand) smoke statistically increased the risk of getting lung cancer.
9. No study has shown that second hand smoke exposure during childhood increases their risk of getting lung cancer.
10. In one study they couldn't even cause lung cancer in mice after exposing them to cigarette smoke for a long time.23
11. If everyone in the world stopped smoking 50 years ago, the premature death rate would still be well over 80% of what it is today.1 (But I thought that smoking was the major cause of preventable death...hmmm.)
*This article was revised after errors in the data and calculations were noticed by Charles Rotter, Curtis Cameron and Jesse V. Silverman. This is the corrected version. A special thanks to both.
**WHO data of member countries
Keywords: lung cancer, mortality, tobacco, smoking, Theoretics, language, WHO, cigarette, cigar, logic.

References (I back up my statements with facts, will those who respond do the same?)
1. Articles:
• Pisani P, Parkin DM, Bray F, Ferlay J, Estimates of the worldwide mortality from 25 cancers in 1990, Int J Cancer 1999 Sep 24;83(1):18-29; "Tobacco smoking and chewing are almost certainly the major preventable causes of cancer today."
• American Thoracic Society, Cigarette smoking and health.. , Am J Respir Crit Care Med; 153(2):861-5 1996; "Cigarette smoking remains the primary cause of preventable death and morbidity in the United States."
• Nordlund LA, Trends in smoking habits and lung cancer in Sweden, Eur J Cancer Prev 1998 Apr;7(2):109-16; "Tobacco smoking is the most important cause of lung cancer and accounts for about 80-90% of all cases of lung cancer among men and about 50-80% among women."
• JAMA 1997;278:1505-1508; "The chief cause of death included lung cancer, esophageal cancer and liver cancer. The death rate was higher for those who started smoking before age 25. If current smoking patterns persist, tobacco will eventually cause more than two million deaths each year in China."
• JAMA 1997;278:1500-1504; "We have demonstrated that smoking is a major cause of death in China...."
• Hecht SS hecht002@tc.umn.edu, Tobacco smoke carcinogens and lung cancer, J Natl Cancer Inst 1999 Jul 21;91(14):1194-210; "The complexity of tobacco smoke leads to some confusion about the mechanisms by which it causes lung cancer."
• Sarna L, Prevention: Tobacco control and cancer nursing, Cancer Nurs 1999 Feb;22(1):21-8; "In the next century, tobacco will become the number-one cause of preventable death throughout the world, resulting in half a billion deaths."
• Liu BQ, Peto R, Chen ZM, Boreham J, Wu YP, Li JY, Campbell TC, Chen JS, Emerging tobacco hazards in China: 1. Retrospective proportional mortality study of one million deaths, BMJ 1998 Nov 21;317(7170):1411-22; "If current smoking uptake rates persist in China (where about two thirds of men but few women become smokers) tobacco will kill about 100 million...."
• Nordlund LA Trends in smoking habits and lung cancer in Sweden. Eur J Cancer Prev 1998 Apr;7(2):109-16; "Tobacco smoking is the most important cause of lung cancer and accounts for about 80-90% of all cases of lung cancer among men and about 50-80% among women."
• Skurnik Y, Shoenfeld Y Health effects of cigarette smoking, Clin Dermatol 1998 Sep-Oct;16(5):545-56 "Cigarette smoking, the chief preventable cause of illness and death in the industrialized nations."
2. Websites:
• JAMA Website: http://www.ama-assn.org/sci-pubs/sci...96/snr0424.htm [link no longer active as of 2004]; "Yet huge obstacles remain in our path, and new roadblocks are being erected continuously," writes Ronald M. Davis, M.D., director of the Center for Health Promotion and Disease Prevention, Henry Ford Health System, Detroit, Mich., in urging a review of the effort against "the most important preventable cause of death in our society."
• JAMA Website: http://www.ama-assn.org/sci-pubs/sci...03.htm#joc6d99 [link no longer active as of 2004]; "According to the authors, tobacco use has been cited as the chief avoidable cause of death in the U.S., responsible for more than 420,000 deaths annually ...."
• JAMA Website: http://jama.ama-assn.org/issues/v281...wm80010-2.html [link no longer active as of 2004]; "The researchers reported that deaths caused by tobacco...."
3. The World Health Report 1999, chapter 5 and Statistical Annex and CDC data (http://www.cdc.gov/scientific.htm).
4.Mutat Res 1998 Feb 26;398(1-2):43-54 Association of the NAT1*10 genotype with increased chromosome aberrations and higher lung cancer risk in cigarette smokers. Abdel-Rahman SZ, El-Zein RA, Z
5. Schwartz AG, Rothrock M, Yang P, Swanson GM, "Increased cancer risk among relatives of nonsmoking lung cancer cases," Genet Epidemiol 1999;17(1):1-15
6. Amos CI, Xu W, Spitz MR, Is there a genetic basis for lung cancer susceptibility?, Recent Results Cancer Res 1999;151:3-12
7. Silica, asbestos, man-made mineral fibers, and cancer. Author Steenland K; Stayner L Cancer Causes Control, 8(3):491-503 1997 May
8. Lam S, leRiche JC, Zheng Y, Coldman A, MacAulay C, Hawk E, Kelloff G, Gazdar AF, Sex-related differences in bronchial epithelial changes associated with tobacco smoking, J Natl Cancer Inst 1999 Apr 21;91(8):691-6
9. Ignacio I. Wistuba, MD, Comparison of Molecular Changes in Lung Cancers in HIV-Positive and HIV-Indeterminate Subjects, JAMAVol. 279, pp. 1554-1559, May 20, 1998
10. Kumagai Y, Pi JB, Lee S, Sun GF, Yamanushi T, Sagai M, Shimojo N, Serum antioxidant vitamins and risk of lung and stomach cancers in Shenyang, Cancer Lett 1998 Jul 17;129(2):145-9 China.
11. Nyberg F, et al., Dietary factors and risk of lung cancer in never-smokers, Int J Cancer 1998 Nov 9;78(4):430-6
12. Sinha R, Kulldorff M, Curtin J, Brown CC, Alavanja MC, Swanson CA, "Fried, well-done red meat and risk of lung cancer in women." Cancer Causes Control 1998 Dec;9(6):621-30.
13. Young KJ, Lee PN, Statistics and Computing Ltd, Surrey, UK. Intervention studies on cancer, Eur J Cancer Prev 1999 Apr;8(2):91-103
14. Long-term inhalable particles and other air pollutants related to mortality in nonsmokers.
Am J Respir Crit Care Med. 1999 Feb;159(2):373-82.
15. Blot WJ, Fraumeni JF, Lung Cancer Mortality in the US: Shipyard Correlations Source, Ann N Y Acad Sci; 330:313-315 1979 UI: 80659437
16. Lee IM, Sesso HD, Paffenbarger RS Jr, Physical activity and risk of lung cancer. Int J Epidemiol 1999 Aug;28(4):620-5
17. Kamp DW, Greenberger MJ, Sbalchierro JS, Preusen SE, Weitzman SA, Cigarette smoke augments asbestos-induced alveolar epithelial cell injury: role of free radicals, Free Radic Biol Med 1998 Oct;25(6):728-39
18. The Complete Reference Collection, 1996-9, Compton's.
19. Lee PN, Forey BA, Trends in cigarette consumption cannot fully explain trends in British lung cancer rates, J Epidemiol Community Health; 52(2):82-92 1998
20. Pandey M, Mathew A, Nair MK, Global perspective of tobacco habits and lung cancer: a lesson for third world countries. Eur J Cancer Prev 1999 Aug;8(4):271-9
21. Jahn O, [Passive smoking, a risk factor for lung carcinoma?], Wien Klin Wochenschr; 108(18):570-3 1996
22. Nilsson R, Environmental tobacco smoke and lung cancer: a reappraisal, Ecotoxicol Environ Saf; 34(1):2-17 1996
23. Finch GL, Nikula KJ, Belinsky SA, Barr EB, Stoner GD, Lechner JF, Failure of cigarette smoke to induce or promote lung cancer in the A/J mouse, Cancer Lett; 99(2):161-7 1996
Appendix A: US white male data3

________________________________________
For those of you who actually read the whole article...
As long as I'm being controversial by presenting both sides of the story, do I dare tell you that a woman is three times more likely to die from an abortion than from delivering a baby (WHO data).
Journal Home Page

email: mail@journaloftheoretics.com

© Journal of Theoretics, Inc. 1999 (Note: all submissions become the property of the journal)

[xoxoxoBruce]

January '64, CBC broadcast in Canada.

The name of the 1964 surgeon general's report is Smoking and Health. But given many of its conclusions, the long-awaited document might well be titled Smoking and Death. The report says that smoking cigarettes is a hazard to health, and that male smokers in the study were 10 times more likely than non-smokers to die of lung cancer. In this CBC Radio clip, a Canadian tobacco company president says the report won't change things in Canada.
John Keith of Imperial Tobacco calls the report "an interpretation" of already familiar studies, and that it requires further review. But others urge immediate action in light of the report. The American Cancer Society says doctors should advise their patients of the risks of smoking. It also recommends more research to help people quit and to eliminate the cancer-causing agents in cigarettes.
Reached by telephone, Canada's minister of Health and Welfare, Judy LaMarsh, says the Canadian government has already set aside money to research smoking. But her primary goal is to prevent young people from starting the habit. Meanwhile, in a Toronto poolroom, young men say the report means nothing to them and that they're not likely to give it up. "I don't believe in that lung cancer stuff," says one.
The U.S. surgeon general's Advisory Committee on Smoking and Health first met in November 1962. Ten scientists were recruited by the surgeon general's office to review all the evidence about the effects of smoking.

• The committee was careful to keep its findings secret until the final report was released. All the smokers on the committee pledged not to quit smoking during their research. They didn't want to seem to be making a premature statement about their findings.

• The committee was considered more credible than past panels because the tobacco industry had been given the opportunity to vet its members in advance.

• Smoking and Health was released on Jan. 11, 1964 – a Saturday. The committee feared a weekday release would make the stock market plunge but also wanted maximum coverage in Sunday newspapers.

• The committee's study found that compared with non-smokers, "many kinds of damage to body functions and to organs, cells and tissues occur more frequently and severely in smokers."

• It also concluded that "cigarette smoking is causally related to lung cancer in men... The data for women, though far less extensive, points in the same direction." The report also found a less conclusive link to coronary disease in smokers.

• The report also found some benefits in smoking, though they were far outweighed by the risks. According to the book Ashes to Ashes, by Richard Kluger, smoking seemed "to promote 'good intestinal tone and bowel habits,' i.e., had laxative effects, and served to counter obesity."

• Cigarettes also seemed to have a tranquilizing effect, energizing the tired and calming the agitated. It deemed cigarettes "a psychological crutch" for much of the population.

• The surgeon general is a medical doctor appointed to a four-year term by the U.S. president. He or she reports to the country's assistant secretary of health. The Office of the Surgeon General oversees the U.S. Public Health Service and is part of the U.S. Department of Health and Human Services.

• There is no position in Canada equivalent to the surgeon general.

• The surgeon general's report was mostly a confirmation of conclusions the Canadian Medical Association had already drawn. When the 1964 report came out, Dr. William Wigle, president of the CMA, told the Globe and Mail that its position on smoking had not changed since a major Canadian conference in 1963.

• Doctors did feel that the report would bolster Canadian efforts to discourage smoking.

• Dr. Wigle said the most important action was for tobacco companies to restrict advertising so that youth would not take up smoking. "Youngsters should not be led to believe that they will be more socially acceptable, more romantically acceptable and more employable if they smoke," he said.

• Wigle said he favoured education, not prohibition, as a means to decrease smoking among youth.

Only a slight hijack.