Smoke alarm
'11,000 killed every year by passive smoking', said the UK Mirror, in response to a report published in the British Medical Journal (BMJ). Various estimates of increased risk associated with passive smoking were combined with figures for known deaths, overall populations, and populations working in specific industries. The results suggest passive smoking in workplaces is responsible for 617 deaths per year, with one death per week in the hospitality industry.
The study also concluded that 2,700 deaths of people between 20 and 64 years of age occur due to passive smoking at home, with a further 8,000 deaths in those aged 65 or over. Professor Konrad Jamrozik of Queensland University, who wrote the report, said: 'Adoption of smoke-free policies in all workplaces and reductions in the general prevalence of active smoking would lead to substantial reductions in these avoidable deaths.'
This report doesn't provide us with any new information on the risks of passive smoking. It merely takes existing research and calculates all the number of people who would die if all the suggested risks proved to be accurate. This is an extremely dubious practice, taking uncertain but probably small risks and then multiplying them by very large numbers to produce startling headlines.
The true risks of passive smoking remain as controversial as ever. For example, in 2003 the BMJ published a study of 120,000 adults in California over a 40-year period, which concluded that 'the results do not support a causal association between environmental tobacco smoke and tobacco-related mortality, though they do not rule out a small effect'. As a BMJ editorial concluded at the time, 'the considerable problems with measurement imprecision, confounding, and the small predicted excess risks limit the degree to which conventional observational epidemiology can address the effects of exposure to environmental tobacco smoke'.
For the record, it's worth noting that even if Jamrozik's figures are correct, restricting public smoking will have little impact, as most of the deaths are due to passive smoking in the home. The vast majority of these are people over the age of 65, people who would have lived through much smokier environments than exist today. Clearly, their lives will not have been shortened by much even if Jamrozik's numbers add up. As for the supposed risks to bar and restaurant workers, the most prominent justification for smoking bans these days, we should note that it amounts to 54 deaths per year out of a workforce of well over a million - a risk factor of 21,000-to-one.
What you probably won't read in the papers is Jamrozik's acknowledgement of assistance from Deborah Arnott of Action on Smoking and Health (ASH), the UK's main anti-smoking campaign. Nor will you read his note that 'the calculations in this paper were commissioned by SmokeFree London, a collaboration of 33 local borough councils in London concerned with extension of smoke-free policies in that city'. Jamrozik's report is a piece of advocacy dressed up as science and should be treated with considerable scepticism.
Estimate of deaths attributable to passive smoking among UK adults:database analysis, British Medical Journal, 2 March 2005
We have ways of making you stop smoking, by Dr Michael Fitzpatrick
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