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September
7
[15:30 GMT] -
Why
is it that every study on passive smoke is a piece of junk
science? Rhetorical question, of course -- to set ourselves up to expose
yet another piece of epidemiological trash. We are referring to the
mega-study "Tobacco
use and risk of myocardial infarction in 52 countries in the INTERHEART
study: a case-control study",
much touted in the last two months by the "health authorities" of several
countries as the "conclusive evidence" that passive smoke causes heart
disease. In reality, this meta-analysis is a mega-pile of data containing
almost
all the worst characteristics that distinguish all
passive smoke studies
(regardless of their results) as quintessential junk science.
It took some time to go through it, and we could bore readers with a long
list of flaws, replete with technical terms. Differently than the antis,
however, we don't like to bamboozle people with words. So we’ll cut to the
chase. The study is worthless epidemiological garbage mainly for the
following reasons:
- Overall the study is not credible because of self-reporting
of exposures, the heterogeneity of the input sources and data, the
perfunctory control for biases and confounders, and the absence of
reporting that might have qualified the extent of heterogeneity. More in
detail:
- A case-control study collected data based on the same
protocol, but from sources in 52 countries around the world.
Sources must have differed substantially in medical expertise, training,
facilities, and in the ethnicity and lifestyle of the
populations covered. The indiscriminate summation of obviously
heterogeneous data from all sources is not permissible.
- All exposure data were self-reported, with likely
differentials among regional sources, adding to the
heterogeneity of the entire dataset.
- The tobacco products and their mixes must have been
extremely different in different sources/regions, as must have been
their conditions of use. The mixed use of beedies and other products with
cigarettes, pipes and chew would make for difficult attributions of risk.
The regional differences of type and quality of chew tobacco alone would be
very substantial.
- The only confounders considered were dietary
patterns, physical activity, alcohol consumption, education, income,
psychosocial factors, personal and family history of cardiovascular disease,
hypertension, and diabetes mellitus. No data are given about the different
distribution of confounders in different regions, and no controls for biases
were attempted.
- As already stated, exposure to second hand smoke (SHS) was
self reported and related only to the previous 12
months of exposure.
- As a confirmation of heterogeneity, per cent smokers and
Cardio Pulmonary Disease (CPD) varied considerable among regions, and so did
the prevalence of current and former smokers.
- The reported precise and monotonic relationship of risk and
CPD is suspect, in view of how dirty the input data must be, the mix
of tobacco products used, and the profound underlying heterogeneity.
- The study reports that “Overall, 44% of controls
reported no exposure to SHS, 39% of controls reported exposures of between 1
to 7 hours/week, 8・2% exposed for 8 to 14 hours, 3・6% for 15 to 21 hours and
5・3% for 22 or more hours per week.” On this basis the controls must
have very different lifestyles than cases, thus generating a
strong matching bias. Why did the SHS-exposed
controls not develop Acute Myocardial Infarction (AMI), if that exposure is a
cause?
- It is contradictory to the claimed results that the
AMI risk did not change when exposure to SHS was removed in the control never
smokers.
- The study states that “…use of tobacco is associated
with increased risk of AMI, consistently across all regions.” However the
study is careful not to give results segmented by region or source:
a glaring and major omission that would have defined the extent of
heterogeneity.
- The study only separates young and old subjects, which is
insufficient. A segmentation by actual age would have been necessary.
"Conclusive evidence" indeed - that studies on passive
smoke can only be epidemiological trash, and demonstrating conclusively the
in-grown dishonesty of antitobacco. This "study" is reminiscent
of Marxist economics, where the "experts" were desperately trying to sum or
multiply heterogeneous factors to demonstrate "scientifically" that all goods
can be reduced to hours of unskilled labour! Both the past Marxists and the
current antismoking epidemiological "experts" must have slept through the grade
two class that taught that one cannot sum oranges with apples on the grounds
that they both are round fruits. But in both cases those "small details" must be
set aside to make room for the "great" ideological future!
The real problem? "Health authorities" are either dishonest or
incompetent enough (probably both) to adopt this cheap imitation of science as
the basis for smoking bans and persecution.
Fraud reigns along with
ignorance. What are we prepared to do about it?
-- FORCES International
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