Antismokers grasping at straws:
Lying at any cost, even when all the evidence is against them
The media flooded the country with the anti-smoker claim that smoking increases
osteoporosis  (Danielle HW. Osteoporosis
of the slender smoker. Arch Intern Med 1976;136:298-304).
There was no publicity when the claim was later refuted (Jensen GF. Osteoporosis of the slender smoker
revisited by epidemiologic approach. Eur J Clin Investig 1986;16:239-242).
The Danielle study used two "ill-defined" patient populations; the second
included all 70 year-old women in nine suburbs of Copenhagen, and had more cases, 180
versus 72. The first asserted that there was no relation between weight and bone mass in
non-smokers, while the second, and most other studies, have found correlation in both.
Most importantly, there was no difference between smokers and non-smokers in the
frequency of definite osteoporotic or other fractures. The smokers actually had fewer.
Since all the cases were the same age, there is no way to use age adjustment to manipulate
the data. Referring to smoking, another researcher has admitted, "this factor is a
more manipulable one than some of the other factors which have been shown to be important
in the etiology of fracture."
A number of studies have found that smokers have slightly higher bone mass and density
than non-smokers, both pre- or post-menopausal. "No association between bone mass
and smoking was observed. A subgroup with patterns of substantial combined tobacco and
alcohol use having a lower mean bone mass could not be identified"(MF Sowers et al. Prev Med
1985;14:585-596). "Smoking history in pack years did not correlate with bone
density at either skeletal site," spine or forearm (MM Luckey et al. J Clin
Endocrinol Metab 1989;69:762-770).
In the Framingham Study, Felson et al found that "Cigarette smoking was not
associated with risk of fracture in any analyses including models without alcohol."
This was in 217 cases, 174 of them female, in an ongoing prospective of over 40 years'
duration (Felson DT et al.
Am J Epidemiol 1988;128(5):1102-1110).
And in a study the next year which separately analyzed radiographs of the white, middle
class Framingham subjects, and poorer, more nonwhite HANES I subjects, Felson also found a
borderline statistically significant protective association between smoking and
osteoarthritis, which was strongest in the heaviest smokers (Arthr Rheum 1989;32:166-172).
However, true to their anti-smoker psychosis, they had to find something bad to say
about smoking. Although they admitted that very few of their subjects ever used estrogen,
they claimed that smokers did not benefit from estrogen therapy on the basis of a mere 29
ever-users, 8 of them smokers.
Never mind that this claim was opposite to that of a large 1982 study which claimed
both big risks of fractures, and big benefits from estrogen for smokers. With this study,
the anti-smokers could simultaneously fear-monger against smoking and promote
pharmacological intervention.
But in the "Nurses Study,"(D Hemenway, AJPH Dec 1988;78(12):1554-1558), which is possibly the largest
to date with 925 cases, the researchers said, "We observed no relation between
smoking categories and likelihood of fracture either overall or within any five-year age
category....Most similar-aged women in the study -- whether thin or fat, smoking or
non-smoking, teetotalers or drinkers -- generally had an equivalent chance of sustaining a
hip or forearm fracture."
Meanwhile, the anti-smokers embellished their mythical smokers' osteoporosis with
speculation that this was the result of smoking-induced low estrogen levels. The
wished-for evidence was produced by studies which measured urinary estrogen, which is
known to fluctuate with temperature and even mild exercise (MacMahon NEJM 1982;307:1062-1065 and Michnovitz
NEJM 1986;315(21):1305-1309). Yet many anti-smokers cite these studies as if they are
definitive proof.
Later studies which measured serum levels showed the low estrogen claim was false. "These
results indicate that smoking does not alter the production and metabolism of androgens
and estrogens in pre and postmenopausal women."(Longcope, J Clin Endocrinol Metab 1988;67(2):379-383).
"Mean estrogen levels were higher (though not significantly), rather than
lower, in the smokers than in the nonsmokers"(K-T Khaw NEJM 1988; 318(26):1705-1709).
They rationalized that maybe their assay wasn't sensitive enough. Also Friedman et
al. (Fertil Steril
1987;47:398-401), found no difference, but showed their anti-smoker need to believe the
lies by speculating that "hypercortisolism associated with smoking may increase
the risk of osteoporosis," despite finding higher bone mineral density in
smokers.
Undaunted, the anti-smokers downplayed these adverse findings. Although they found that
"smoking does not lead to reduced serum concentrations of oestrogen in postmenopausal
women," and that "smoking does not interfere with the conversion processes"
of hormones, this was not what we were told.
Instead, they twisted their finding of a minor elevation of a hormone precursor into
the bizarre conclusion -- unwarranted and unsubstantiated in their own study or any other
-- that female smokers are masculinized. Anti-smokers and others who have been worn
down by the repeated mis-interpretations and selective quotes in otherwise sound studies
picked up on this and the discredited earlier claims of reduced estrogen to create a
grotesque, chimerical caricature to degrade women smokers. This isn't science. It
does not even qualify as adequate reading comprehension.
Finally, according to investigators who made daily measurements: "There is now
substantial evidence that smoking does not decrease endogenous serum E2 in either
premenopausal or postmenopausal women...We found no difference in endogneous serum E2
between premenopausal or postmenopausal smokers and non-smokers matched for BMI, in
agreement with previous investigations" [10,13-16].
"The consistency of these results makes it now very unlikely that endogenous E2
differs between smokers and nonsmokers. Our results also suggest that cigarette smoking
has no effect on serum Pg in premenopausal women." (Key TJA et al. Cigarette smoking and steroid
hormones in women. J Steroid Molec Biol 1991;39 (4A):529-534).
Courtesy of Carol Thompson
08/23/93
Smokers' Rights Action Group Smokers' Rights Action Group P.O. Box 259575 Madison, WI
53725-9575 Phone: 608-249-4568 |
