By Elizabeth M. Whelan, Sc.D., M.P.H.
Posted: Wednesday, May 31, 2006

EDITORIAL
Publication Date: May 31, 2006

This piece appeared May 31, 2006 on the site IntellectualConservative.com and in the July 2006 issue of Environment News:

In recognition of World No Tobacco Day, May 31, 2006, the World Heath Organization (WHO) published a lengthy document entitled "Tobacco: Deadly In Any Form or Disguise." The publication misleads at least as much as it informs, and distorting the health risks of various modes of tobacco usage may cause more harm than it prevents.

To understand the WHO disinformation campaign on tobacco, one has to know and accept the fact that tobacco products are not always inherently dangerous to health. The dangers of tobacco are directly related to the how the product is used -- and how often.

Generally speaking, before cigarettes were introduced (which happened mainly in the first two decades of the twentieth century, with a huge surge in use after WWI), tobacco was used in a relatively safe manner. With pipes, cigars, and "chew," the health risks were real but in most cases small. Certainly there were exceptions (yes, the premature death of President Ulysses Grant was directly attributable to his habitual use of cigars), but in most cases tobacco in the pre-cigarette days did not cause substantial morbidity and mortality -- and it rarely caused systemic diseases like lung cancer, emphysema, and heart disease. The fact that portable matches were not widely available until early in the twentieth century limited the use of pipes and cigars, which were most likely lit by fires and candles after dinner.

The cigarette and pocket matches changed all of that. Cigarettes could be smoked during all waking hours -- and they were inhaled, dramatically increasing the risk of systemic diseases in the lungs, cardiovascular system, and beyond.

Thus for the WHO to prepare a purportedly educational document stating that _all_ tobacco is harmful in any form without mentioning dose (frequency of use) and form (cigarettes versus other forms of tobacco) is irresponsible and outrageous.

The publication blatantly tells the occasional cigar and/or pipe users that any use of this product puts him/her at risk of lung and oral cancers. Surely, if one smokes cigars in the same way as one does cigarettes -- round the clock, regularly inhaling -- one assumes the same risks as a cigarette smoker. But smoking a celebratory cigar or occasionally smoking a pipe pose very little health risk. WHO never states that truth.

WHO condemns all forms of smokeless tobacco, lamenting that this product is used widely in Scandinavia and increasingly in the United States. What the health agency did not reveal is that the use of smokeless tobacco in Sweden and other countries -- as a form of harm reduction for addicted cigarette smokers -- led to a precipitous decline in lung cancer. WHO omits data showing that encouraging a switch from cigarettes to smokeless can save countless lives among those who are addicted to smoking and have not been able to quit with other approaches. WHO rejecting smokeless as a means of harm reduction is saying to the smoker: quit or die -- you have no alternative.

The document is shameless in other ways as well. For example, seeking to terrify people about cigarettes, the agency reproduces an Australian anti-smoking ad blaring the message that there are toxic chemicals in cigarettes, citing specifically DDT, ammonia (which they helpfully remind us is a floor cleaner), acetone ("a paint stripper"), methanol ("rocket fuel"), and arsenic ("white ant poison"). This is outrageous. It is not the mere presence of the trace levels of chemicals that make cigarettes deadly -- it is the lighting, burning, and inhalation that wreaks havoc with health. Why WHO felt compelled to use baseless hype to scare us is a mystery given that there is already overwhelming and irrefutable evidence from countless epidemiological studies confirming the unprecedented health hazards of cigarette smoking.

WHO threatens the credibility of the whole public health profession. Physicians and scientists who know better should demand that WHO correct the record, emphasizing the unique and spectacular dangers of cigarette smoking -- and the much less significant risks of other forms of tobacco use -- presenting risks on a spectrum from negligible risk to severe risk. The best way to lose an argument is to overstate it. And by telling consumers that there is no safe level of exposure to tobacco WHO has indeed lost its argument.

Dr. Elizabeth M. Whelan is president of the American Council on Science and Health (ACSH.org, HealthFactsAndFears.com).