Cigars, Surfaces, Conspiracies, and Grandkids

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Cigars and Pipes and Chewing Tobacco, Oh My!
An article in the Annals of Internal Medicine concludes, “Pipe and cigar smoking increased urine cotinine levels and was associated with decreased lung function consistent with obstructive lung disease. Physicians should consider pipe and cigar smoking a risk factor and counsel cessation regardless of cigarette smoking history.”

“Of course pipe and cigar smokers will have tobacco byproducts, including cotinine, in their blood and urine,” says ACSH's Dr. Gilbert Ross. “It's also not surprising that they had increased risk of obstructive lung disease, though not to same extent as cigarette smokers. The take-home message is you should not be smoking pipes and cigars under the impression that they are a safe alternative to cigarettes. They produce byproducts of the combustion of tobacco, including toxins and carcinogens that lead to the many diseases that we associate with tobacco use. Contrast this with the real risks of smokeless products of various types, including approved cessation products, smokeless tobacco, and e-cigarettes, and there are much less harmful options than pipes and cigars.”

ABC News's Dr. Timothy Johnson fails to make this distinction in his “medical minute” video discussing the study. He reports, “Experts say the focus on cigarettes has allowed tobacco companies to fly under the radar when marketing alternative products, which in turn leads to the false public perception that cigars, pipes, and chewing tobacco do not carry the same health risks.”

“These products should not have been grouped together with cigarettes,” says ACSH's Dr. Elizabeth Whelan. “We need to consider the reality that when a cigarette smoker turns to pipes and cigars to quit smoking cigarettes, they often use them as substitute cigarettes and inhale deeply. They therefore assume risks that are not traditionally associated with pipes and cigars.”

“Yes, that is 100% true, but that is only a small portion of those who use pipes and cigars,” says ACSH's Jeff Stier. “If you use a cigar like a cigarette, it is like a cigarette, but most people do not use cigars that way. Most people who smoke cigars do it rarely and do not inhale. Dr. Johnson's report is problematic from a policy perspective. If regulators subscribe to the mentality that all tobacco -- no matter how it's used -- is equal, they'll be giving people unscientific advice. There's a continuum of risk, with cigarettes at one far end and smokeless tobacco towards the other end -- not totally safe, but towards the other end. Dr Johnson lumps them all together.”

Proof by Induction: Dangers of 2nd, 3rd...Nth Hand Smoke
On his Tobacco Analysis blog, ACSH Advisor Dr. Michael Siegel of the Boston University School of Public Health deconstructs the arguments of the anti-smoking group Action on Smoking and Health (ASH) in their latest press release, which claims that residues left on surfaces from cigarette smoke (“third-hand smoke”) are as dangerous as smoking itself.

“ASH's Executive Director, a law professor named John Banzhaf III, keeps sending out these statements about e-cigarettes and smokeless tobacco, imploring people to ignore them as options since they are not proven to be 100% safe,” says Dr. Ross. “Basically, what he's saying is that they should stick to cigarettes. His latest missive says that third-hand smoke may well be as dangerous as actual smoking, despite the fact that the amount of carcinogens in this residue is obviously orders of magnitude lower than that in cigarette smoke. Dr. Siegel's point is that by issuing these statements, Banzhaf is undercutting the important messages of science, public health, and quitting smoking.”

ACSH's Todd Seavey adds, “We received a message from a Morning Dispatch reader who suggests that maybe we should also worry about ninth-hand smoke, which is when you talk on the phone with someone who used to smoke.”

Viral Conspiracy Theories
According to the Associated Press, health officials at the CDC say that the H1N1 influenza's cumulative impact has grown to 57 million U.S. illnesses, 257,000 hospitalizations, and 11,690 deaths from the time H1N1 was first identified in April through mid-January.

“The important point is that those who claim in retrospect that the danger of H1N1 was overstated for various reasons are wrong,” says Dr. Whelan. “Twelve thousand people died.”

“There are conspiracy theories aplenty about why the disease turned out not to be as dangerous as was originally feared,” says Dr. Ross. “While this was an extensive pandemic, it seems the H1N1 virus was not as lethal as previous epidemic strains, which is something we should be thankful for. Clearly, having extra vaccine available is preferable to not having enough in the event that the virus had a lethality even approaching that of the 1918 H1N1 pandemic. Unfortunately, those things are almost impossible to predict.”

News Flash: Grandparents Tend to Dote on Their Grandchildren
A study published in the International Journal of Obesity suggests that children who are regularly looked after by their grandparents have an increased risk of being overweight.

“This is interesting,” says Dr. Whelan. “Here we have a popular wisdom being supported by a scientific study, as well as a case of love and food being hopelessly intertwined.”

Curtis Porter is a research intern at the American Council on Science and Health (