An Arrow-shot Against Antismokers

Author: Elio F. Gagliano, MD
Article Published: 18/07/2008

A study on lung cancer sure to disappoint anti-smoking crusaders comes from the May 26 issue of Archives of Internal Medicine, where we find a study by Ping Yang, MD, a Professor of Epidemiology at the Mayo Clinic, in Rochester, Minnesota, entitled "Alpha1-Antitrypsin Deficiency Carriers, Tobacco Smoke, Chronic Obstructive Pulmonary Disease, and Lung Cancer Risk".
Dr. Yang and his colleagues analyzed the impact of alpha 1-antitrypsin deficiency (AATD) on the incidence of pulmonary carcinoma and found  what I call an arrow-shot against the anti-smokers. That is: AATD is a risk factor for the development of lung cancer independentl of smoking status.  Such a finding contradicts the anti-tobacco activists who claim and propagandize that lung cancer is caused by cigarette smoke, and nothing but.

Alpha 1-antitrypsin is a protective protein produced by the liver. Its function is to protect the lungs from the neutrophil elastase enzyme, which can disrupt connective tissue. Deficiency of this protein is a genetic disorder.

The study starts with the consideration that "Genetic susceptibility in lung cancer risk has long been recognized but remains ill defined, as does the role of tobacco smoke exposure and chronic obstructive pulmonary disease (COPD)". The emphasis added to point out that in the scientific community there are (true) scientists who do not mince words, clearly stating that the debate about lung cancer's causes and risks is not all over, as the General Surgeon and others insist. 

In truth, Dr. Yang did not make a new discovery. It has always been known that  AATD causes lung disorders including asthma, emphysema, COPD  and carcinoma. What I found interesting is the fact that his study indirectly points out that the above diseases are not the hallmark of cigarette smoking, contrary to what the antismoking campaign spreads far and wide. 

The study, which involved 1,856 patients with incident lung cancer, 1,585 community residents as controls, and 902 full siblings of the patients, confirmed the findings of other studies (see: Enstrom and KabatJenkinsBoffettaLeVoisAdlkoferLee  - just to mention a few).

Environmental tobacco smoke did not significantly increase the risk for lung cancer.

Such a statement is unwelcome for institutions like the American Lung Association and the Environmental Protection Agency. Certainly it is unwelcome for the World Health Organization. That august body, influenced (led?) by pharmaceutical manufacturers, started to pester non-smokers by putting the hazy idea in their heads that smoke exhaled by smokers or coming from a burning cigarette lingers in the air and causes non-smokers and their children to get the same diseases that, according to the propaganda, afflict smokers.  This was the new line pursued after the megaflop of the campaign to convince smokers to give up their lifestyle .

But all things come to those who wait. Society, slowly but certainly, is starting to understanding that this devil isn't as black as he's painted. People can't help noticing that everything said about smokers' morbidity and mortality applies to more or less every living soul, whether they smoke or not. The conclusion of Dr. Yang that  "Among [AATD] carriers, the risk of developing lung cancer was similar regardless of smoking history" and that the risk is 70% higher than in non-carriers, puts another crack in the anti-smokers' fabrication (see article). 
Dr. Yang's explanation is that, in the lungs, the noxious substances present in tobacco smoke can be deactivated by the defense mechanisms of the host himself and that these adjustive reactions are hampered in individuals with AATD.  

According to the author, AATD carriers might have a risk of developing lung cancer that is 70% higher than that for non-carriers. The estimates of the World Health Organization are that at least 10 million Americans and 120 million people worldwide are AATD carriers.  

May I conclude with some advice to radical antismokers: Next time you want to use the scarecrow of lung cancer from active and passive smoke, you better check the person's AATD status.

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