Smoking does not cause lung cancer...

[Jyoung20]

Here is a very interesting article that was presented at the Lung Cancer Advocacy Summit.

So, one answer to Did he/she smoke? could be "Smoking did not cause my/her/his lung cancer"

What do you think?

Journal of Theoretics Vol.1-4

Oct/Nov 1999 Editorial

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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.

[Kasey]

I so agree with the point the article is making and what Katie has said. 1 out of 10 sounds like quite a low risk UNLESS you are that one!

Kasey

[Connie B]

Aren't those words all smokers would like to hear? "Smoking Does Not Cause Lung Cancer." I would have LOVED to read that article when I was still smoking!!!!!!!!! No not funny, but to us ex-smokers I find it a little humorous!!

I've had several Onc Doc's, Pulm Doc's tell me that smoking is NOT the only cause for lung cancer. It takes a combination of carcinogines to kick lung cancer into gear that includes are DNA. They said it would be SO EASY if smoking was the ONLY thing that caused lung cancer, but it's not that easy. At least if smoking was the ONLY cause, then we would know how to beat it and cure it, but truth be known it's several factor's that add into a lung cancer dx.s. I have always thought that just makes common sense to me. There are so many factor's that go into everyone who gets any kind of cancer. Hence the fact, why we don't have a cure for any of the cancer's as of yet.

Good article Jamie, thanks for sharing.