SAMMEC is the basis of the "smoking costs" to individual states. It is also the basis of the "costs" in "Smoking and Health. A National Status Report, 2nd Ed., A Report to Congress" (DHHS pub. no. (CDC) 87-8396, 1990):
"The theoretical bases for the calculations used in SAMMEC are found in a 1986 paper by Rice (Rice et al., 1986). The method used by Rice involves calculating smoking-attributable fractions (SAFS) of total mortality due to 21 diseases known to be caused by or associated with smoking in adults. This calculation has three components: the relative risks (RR) (defined as the mortality rate among exposed persons divided by the mortality rate among un-exposed persons) of smoking-related disease in current and former smokers, the prevalence of smoking among men and women 20 years of age and older, and the crude mortality data for the population under study. For these calculations, the RR estimates used are weighted averages derived from four longitudinal studies of smoking-related illness (Hammond, 1966; Doll and Peto, 1976; Cederlof et al., 1977; Doll et al., 1980)."

This SAMMEC program is a multiple fraud.

1. It falsely attributes diseases to smoking in which the association is clearly accountable to socioeconomic disadvantage: tuberculosis [in men only, with no difference by smoking status in women]; ulcers and cancer of the stomach [now known to be caused by Helicobacter pylori]; cervical cancer [caused by human papillomavirus, with fewer Pap smears as a contributing factor]; pneumonia/influenza; and all of the pediatric conditions [short gestation [shortening is nonexistent in populations with low rates of intra-amniotic infection]/low birth weight [in the absence of actual disease, of negligible significance]; respiratory distress syndrome [contradicted by studies finding less RDS among smokers' babies]; respiratory conditions of newborn [attributable to intraamniotic infection]; sudden infant death syndrome [the risk factors for which are identical with plain socioeconomic disadvantage, and which is not even a specific disease but just an unexplained death].

2. It falsely attributes heart disease to smoking. Analysis of the final mortality data same Doll and Peto "British Doctors" study used by SAMMEC has proven that the number of heart disease deaths is increased in non-smokers (RR West. Journal of the Royal College of Physicians of London 1992;26(4):357-366). There is no decrease whatsoever. The new version of SAMMEC even extends the fraud to passive smoking.

3. It ignores the costs and the very existence of diseases associated with non-smoking: Alzheimer's disease, Parkinson's disease, ulcerative colitis and diseases associated with it (colon, liver and gallbladder cancer, primary sclerosing cholangitis, being the major ones).

4. It ignores non-smokers' excess old age costs (pensions, Social Security, etc.). The report misrepresents the impact of these costs as "slight," when they have been known to be enormous since Atkinson & Townsend (Lancet 1977 Sep 3;492-494). Neither it nor the study by Manning et al. (JAMA 1989;261:1604-1609), which considered old age costs and found a net savings of 91 cents per pack, were mentioned in the report.

5. It falsely claims costs paid by smokers themselves as "social costs."

6. It falsely claims wages that smokers didn't receive as "social costs."

This is money that came out of nobody's pocket and paid for nothing.

The majority of the supposed "economic costs to society" were actually in categories 5 and 6, and were paid by smokers themselves. The anti-smokers misrepresent this as money that came out of non-smokers' pockets and paid for smokers' doctor bills.

The most nauseating spectacle of all is that these liars, cheats, and bullies pretend that the money itself doesn't really matter, and smarmily portray themselves as noble, self-sacrificing Albert Schweitzers concerned above all with preventing human suffering. In their warped ethics, this consists of forcing themselves on unwilling "patients" in the name of suffering which either doesn't exist, or isn't due to smoking, or would happen anyway. They even boast of how they deliberately make smokers' lives as miserable as possible.

The report's conclusion that "Smoking causes large numbers of deaths and a very large dollar cost to society," is an outright lie to Congress, because smoking results in net economic savings to society. Everybody has heard them lie that smokers cost society $52 billion, oblivious to their own disclaimer that "They do not describe a net cost effect nor do they indicate the potential savings [sic] if tobacco use were eliminated in the United States."

It is our opinion that the officials responsible (Louis W Sullivan, former secretary, USDHHS; James O Mason, former Assistant Secretary for Health, USDHHS; John L Bagrosky, former Associate Director of the Office of Smoking and Health; and Ronald M Davis, former Director of the Office of Smoking and Health) should be prosecuted and punished for this misrepresentation, along with those responsible for the 1987 report, and of the 1985 Office of Technology Assessment Staff Memo (Karl Kronebusch, chief author, and 17 others), and C Everett Koop.

We are pointing out that "Smoking and Health" and the SAMMEC program are a blatant fraud. That they have gotten away with so many lies for so long is once again proof of massive, out-of-control anti-smoker corruption and conspiracy in the US government and the media.

Courtesy of Carol Thompson 08/23/93
Smokers' Rights Action Group
P.O. Box 259575
Madison, WI 53725-9575
Phone: 608-249-4568