# smoking
**URL:** https://boards.straightdope.com/t/smoking/830431
**Category:** Cecil's Columns/Staff Reports
**Created:** [March 2, 2019, 2:32pm UTC](https://boards.straightdope.com/t/smoking/830431 "2019-03-02T14:32:42Z")
**Posts on this page:** 20
**Page:** 1
### Author:  [@fedman](https://boards.straightdope.com/u/fedman)
#### Post date: [March 2, 2019, 2:32pm UTC](https://boards.straightdope.com/t/smoking/830431/1 "2019-03-02T14:32:42Z")
despite the fear-mongering (similar to marijuana propaganda) by alleged “objective” health orgs like American Cancer Inst (which depends on funding from it’s scare tactics), the actual risks of smoking is overrated. If it was scientific fact that smoking actually cause cancer, then we would be seeing millions of smoking-related cancer(based on number of smoker), etc rather then the alleged (unproven) estimate of 200-400 thousand deaths, out of current smoking population of 35 million smoker; that works out to 1/2 of 1% chances of dying. When the general population was larger than that where smoking was everywhere and non-smokers ere exposed to second-hand smoke. such as 40-50’s, we still didn’t see millions of smoking relate deaths.
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### Author:  [@cochrane](https://boards.straightdope.com/u/cochrane)
#### Post date: [March 2, 2019, 2:50pm UTC](https://boards.straightdope.com/t/smoking/830431/2 "2019-03-02T14:50:22Z")
Which column is this from?
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### Author:  [@UnwittingAmericans](https://boards.straightdope.com/u/UnwittingAmericans)
#### Post date: [March 2, 2019, 3:22pm UTC](https://boards.straightdope.com/t/smoking/830431/3 "2019-03-02T15:22:43Z")
Sloan-Kettering used to have a risk calculator on its website. They took it down a few years ago and put up a screening calculator instead.
The old calculator said if you were age 60 and never smoked, your risk of getting lung cancer in the next 5 years was 2%. If you smoked a pack a day since you were 20, it was 3%.
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### Author:  [@Channing\_Idaho\_Banks](https://boards.straightdope.com/u/Channing_Idaho_Banks)
#### Post date: [March 2, 2019, 4:50pm UTC](https://boards.straightdope.com/t/smoking/830431/4 "2019-03-02T16:50:04Z")
The real risk is cardiac disease. Not lung cancer.
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### Author:  [@naita](https://boards.straightdope.com/u/naita)
#### Post date: [March 2, 2019, 9:59pm UTC](https://boards.straightdope.com/t/smoking/830431/5 "2019-03-02T21:59:17Z")
> [@fedman](#):
>
> despite the fear-mongering (similar to marijuana propaganda) by alleged “objective” health orgs like American Cancer Inst (which depends on funding from it’s scare tactics), the actual risks of smoking is overrated. If it was scientific fact that smoking actually cause cancer, then we would be seeing millions of smoking-related cancer(based on number of smoker), etc rather then the alleged (unproven) estimate of 200-400 thousand deaths, out of current smoking population of 35 million smoker; that works out to 1/2 of 1% chances of dying. When the general population was larger than that where smoking was everywhere and non-smokers ere exposed to second-hand smoke. such as 40-50’s, we still didn’t see millions of smoking relate deaths.
And we should trust your analysis over trained statisticians because …? Not only are there very clear correlations between smoking and cancer, but smoking related cancers have shown a decline correlated with the reduction in smoking in the last few decades.
Your “we should be seeing millions of deaths” tells us you don’t understand what the status of knowledge is, but are arguing against your own personal interpretation of what “smoking causes cancer” means.
It’s like saying “walking into traffic isn’t dangerous” based on the fact that most people who walk into traffic are fine.
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### Author:  [@Riemann](https://boards.straightdope.com/u/Riemann)
#### Post date: [March 2, 2019, 10:25pm UTC](https://boards.straightdope.com/t/smoking/830431/6 "2019-03-02T22:25:54Z")
The archetypal study of the effect of smoking on mortality was started in 1951 by Doll & Hill. It was a prospective study of 34,000 male British doctors, and it continued for 50 years.
> **[British Doctors Study](https://www.ctsu.ox.ac.uk/research/british-doctors-study)**
All the research papers are linked down the right hand side of that page.
The authors of the later studies are Doll & Peto. The 50-year update (published 2004) is found here:
> **[Mortality in relation to smoking: 50 years' observations on male British doctors](https://www.bmj.com/content/328/7455/1519)**
>
> Objective To compare the hazards of cigarette smoking in men who formed their habits at different periods, and the extent of the reduction in risk when cigarette smoking is stopped at different ages.
>
> Design Prospective study that has continued from...
> [@](#):
>
> **Results**
> The excess mortality associated with smoking chiefly involved vascular, neoplastic, and respiratory diseases that can be caused by smoking. Men born in 1900-1930 who smoked only cigarettes and continued smoking died on average about 10 years younger than lifelong non-smokers. Cessation at age 60, 50, 40, or 30 years gained, respectively, about 3, 6, 9, or 10 years of life expectancy… **The cigarette smoker versus non-smoker probabilities of dying in middle age (35-69)… were 43% ν 15% (a threefold death rate ratio) for those born in the 1920s…**
>
> \*\*Conclusion \*\*
> A substantial progressive decrease in the mortality rates among non-smokers over the past half century (due to prevention and improved treatment of disease) has been wholly outweighed, among cigarette smokers, by a progressive increase in the smoker ν non-smoker death rate ratio due to earlier and more intensive use of cigarettes. Among the men born around 1920, prolonged cigarette smoking from early adult life tripled age specific mortality rates, but cessation at age 50 halved the hazard, and cessation at age 30 avoided almost all of it.
The paper is accessible and non-technical, but you don’t even have to read it - just look at the survival curves that summarize the vast amount of data, showing non-smokers in red and smokers in blue.
Note in particular Fig 4, which shows what happens if you _quit_ smoking. If you quit before ~40 years old, provided that you are not quitting because you are _already_ sick, then your life expectancy is not much worse than someone who never smoked.
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### Author:  [@fedman](https://boards.straightdope.com/u/fedman)
#### Post date: [March 3, 2019, 12:48am UTC](https://boards.straightdope.com/t/smoking/830431/7 "2019-03-03T00:48:17Z")
> [@naita](#):
>
> And we should trust your analysis over trained statisticians because …? Not only are there very clear correlations between smoking and cancer, but smoking related cancers have shown a decline correlated with the reduction in smoking in the last few decades.
>
> Your “we should be seeing millions of deaths” tells us you don’t understand what the status of knowledge is, but are arguing against your own personal interpretation of what “smoking causes cancer” means.
>
> It’s like saying “walking into traffic isn’t dangerous” based on the fact that most people who walk into traffic are fine.
so you’ve never seen ads on TV saying precisely, though now they’re different tack?
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### Author:  [@fedman](https://boards.straightdope.com/u/fedman)
#### Post date: [March 3, 2019, 12:50am UTC](https://boards.straightdope.com/t/smoking/830431/8 "2019-03-03T00:50:49Z")
> [@UnwittingAmericans](#):
>
> Sloan-Kettering used to have a risk calculator on its website. They took it down a few years ago and put up a screening calculator instead.
>
> The old calculator said if you were age 60 and never smoked, your risk of getting lung cancer in the next 5 years was 2%. If you smoked a pack a day since you were 20, it was 3%.
again, it’s risk factor, not cause and effect; going by guestimates (no names or actual empirical evidence), less than 1% of smoking population will die from smoking-related illness
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### Author:  [@Riemann](https://boards.straightdope.com/u/Riemann)
#### Post date: [March 3, 2019, 1:54am UTC](https://boards.straightdope.com/t/smoking/830431/9 "2019-03-03T01:54:32Z")
> [@UnwittingAmericans](#):
>
> Sloan-Kettering used to have a risk calculator on its website. They took it down a few years ago and put up a screening calculator instead.
>
> The old calculator said if you were age 60 and never smoked, your risk of getting lung cancer in the next 5 years was 2%. If you smoked a pack a day since you were 20, it was 3%.
So, you are “citing” something that purportedly comes from Sloan-Kettering that conveniently doesn’t exist any longer?
This is complete nonsense.
From table 1 in the research paper that I cited above, a smoker is about 15 times more likely to die of lung cancer than a non-smoker.
The CDC agrees:
> **[What Are the Risk Factors for Lung Cancer? | CDC](https://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm)**
>
> Tobacco smoke, radon, and other things can increase your risk.
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### Author:  [@Riemann](https://boards.straightdope.com/u/Riemann)
#### Post date: [March 3, 2019, 2:01am UTC](https://boards.straightdope.com/t/smoking/830431/10 "2019-03-03T02:01:21Z")
> [@fedman](#):
>
> again, it’s risk factor, not cause and effect
If something is a risk factor, then by definition there’s a causal relationship. Cause and effect does not mean the effect must _always_ follow the cause. It means the effect is more likely.
> [@fedman](#):
>
> going by guestimates (no names or actual empirical evidence), less than 1% of smoking population will die from smoking-related illness
Again, complete nonsense. Your life expectancy as a smoker is 10 years shorter than a non-smoker, as stated in the massive study that I cited and quoted above.
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### Author:  [@UnwittingAmericans](https://boards.straightdope.com/u/UnwittingAmericans)
#### Post date: [March 3, 2019, 12:25pm UTC](https://boards.straightdope.com/t/smoking/830431/11 "2019-03-03T12:25:36Z")
> [@Riemann](#):
>
> So, you are “citing” something that purportedly comes from Sloan-Kettering that conveniently doesn’t exist any longer?
>
> This is complete nonsense.
Fuck you, it was there.
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### Author:  [@Garak](https://boards.straightdope.com/u/Garak)
#### Post date: [March 3, 2019, 12:39pm UTC](https://boards.straightdope.com/t/smoking/830431/12 "2019-03-03T12:39:59Z")
the risk of addiction is also overstated
I’ve smoked every day for 30 years and never gotten addicted
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### Author:  [@running\_coach](https://boards.straightdope.com/u/running_coach)
#### Post date: [March 3, 2019, 2:05pm UTC](https://boards.straightdope.com/t/smoking/830431/13 "2019-03-03T14:05:07Z")
> [@UnwittingAmericans](#):
>
> Sloan-Kettering used to have a risk calculator on its website. They took it down a few years ago and put up a screening calculator instead.
>
> The old calculator said if you were age 60 and never smoked, your risk of getting lung cancer in the next 5 years was 2%. If you smoked a pack a day since you were 20, it was 3%.
> [@UnwittingAmericans](#):
>
> Fuck you, it was there.
[Internet Archive](https://www.fanfiction.net/u/11667207/nuoccaithuoclathanhnghi) AKA The Wayback Machine.
You should find a link there.
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### Author:  [@Riemann](https://boards.straightdope.com/u/Riemann)
#### Post date: [March 3, 2019, 3:16pm UTC](https://boards.straightdope.com/t/smoking/830431/14 "2019-03-03T15:16:56Z")
nm
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### Author:  [@k9bfriender](https://boards.straightdope.com/u/k9bfriender)
#### Post date: [March 3, 2019, 6:20pm UTC](https://boards.straightdope.com/t/smoking/830431/15 "2019-03-03T18:20:17Z")
By the same token, cyanide isn’t actually hazardous, as you could take a cyanide pill, but then shoot yourself in the head before the cyanide had a chance to have an effect.
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### Author:  [@raventhief](https://boards.straightdope.com/u/raventhief)
#### Post date: [March 3, 2019, 8:58pm UTC](https://boards.straightdope.com/t/smoking/830431/16 "2019-03-03T20:58:50Z")
> [@running\_coach](#):
>
> [Internet Archive](https://www.fanfiction.net/u/11667207/nuoccaithuoclathanhnghi) AKA The Wayback Machine.
> You should find a link there.
Um. I dont think that’s where you meant the link to go.
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### Author:  [@Bone](https://boards.straightdope.com/u/Bone)
#### Post date: [March 3, 2019, 8:59pm UTC](https://boards.straightdope.com/t/smoking/830431/17 "2019-03-03T20:59:39Z")
> [@UnwittingAmericans](#):
>
> Fuck you, it was there.
This is a warning for personal insults. The regular mods for this forum are otherwise occupied so I’m stepping in on this clear violation.
[/moderating
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### Author:  [@x-ray\_vision](https://boards.straightdope.com/u/x-ray_vision)
#### Post date: [March 3, 2019, 9:08pm UTC](https://boards.straightdope.com/t/smoking/830431/18 "2019-03-03T21:08:24Z")
> [@Riemann](#):
>
> If something is a risk factor, then by definition there’s a causal relationship.
Nope.
> [@](#):
>
> Although the underlying concept had been widely discussed and applied, the term “risk factor” was coined by Dr William Kannel, one of the pioneers of the Framingham Heart Study. The term was used in the medical literature by 1961.2 Although the derivation of the word “factor” from the Latin (meaning doer) implies causality, from its initial use, the term risk factor included both causal and predictive factors (Table 1). Hypertension was perhaps the first well established cardiovascular risk factor. Regardless of the underlying cause of high blood pressure (eg, renal artery stenosis, obesity, etc), hypertension directly contributes to cardiovascular disease risk and it predicts cardiovascular disease, according to findings from the Framingham Heart Study. Subsequent clinical trials showed that medications that lower blood pressure reliably reduce cardiovascular disease risk, thus documenting the causal link. In contrast, male sex and age are both also considered classical risk factors, yet these clearly are not causal in the same way as hypertension. Not only are they not amenable to treatment, they also contribute to risk in largely unknown and complex ways.
[https://www.ahajournals.org/doi/pdf/10.1161/01.CIR.0000133446.69171.7d](https://www.ahajournals.org/doi/pdf/10.1161/01.CIR.0000133446.69171.7d)
> [@](#):
>
> Risk Factors versus Causes
> Epidemiologists often use the term “risk factor” to indicate a factor that is associated with a given outcome. However, a risk factor is not necessarily a cause. The term risk factor includes surrogates for underlying causes. For example, consider the following table which summarizes characteristics associated with a high risk of breast cancer and characteristics associated with a low risk.
>
> …
>
> Each of these factors (place of birth, socioeconomic status, and marital status) is associated with an increased risk of breast cancer, but none of these are causes. [Recall Susser’s definition that a cause is something that makes a difference; or recall Rothman’s definition, i.e., that a cause is an event, condition, or characteristic without which the disease would not have occurred.] These risk factors are surrogates or markers for underlying causes, e.g., populations with a higher prevalence of genetic risk from BRCA1 and BRCA2 alleles, or lower parity which in turn is a marker for unopposed estrogen stimulation of breast tissue.) Being born in northern Europe per se is not a cause; it is a marker for populations that may have a greater genetic predisposition to breast cancer.
>
> It is therefore important to distinguish between risk factors and causes. Nevertheless, before one can wrestle with the difficult question of causation, it is first necessary to establish that a valid association exists. Consequently, if we accept Susser’s assertion that a cause is something that makes a difference, one might then ask how to tell if a factor makes a difference. Most epidemiologists would agree that, in a broad sense, this is a two step process.
[http://sphweb.bumc.bu.edu/otlt/MPH-Modules/EP/EP713\_Causality/EP713\_Causality3.html](http://sphweb.bumc.bu.edu/otlt/MPH-Modules/EP/EP713_Causality/EP713_Causality3.html)
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### Author:  [@Riemann](https://boards.straightdope.com/u/Riemann)
#### Post date: [March 3, 2019, 9:33pm UTC](https://boards.straightdope.com/t/smoking/830431/19 "2019-03-03T21:33:54Z")
> [@x-ray\_vision](#):
>
> Nope.
You are completely correct in pointing out my misstatement of what a risk factor is.
However, in the case of smoking, obviously the numerous mechanisms of damage have been extensively studied, and the vast amount of research data involving huge sample sizes allows us to control for confounding variables. So we know beyond a shadow of a doubt that there is a causal relationship between smoking and disease, notwithstanding **fedman** ’s desire to embrace Michael Palin’s optimism in the Parrot Sketch.
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### Author:  [@Darren\_Garrison](https://boards.straightdope.com/u/Darren_Garrison)
#### Post date: [March 3, 2019, 10:22pm UTC](https://boards.straightdope.com/t/smoking/830431/20 "2019-03-03T22:22:53Z")
> [@raventhief](#):
>
> Um. I dont think that’s where you meant the link to go.
[It _is_ smoking related, though](https://translate.google.com/translate?sl=auto&tl=en&u=https%3A%2F%2Fwww.fanfiction.net%2Fu%2F11667207%2Fnuoccaithuoclathanhnghi).
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