Insight
RISK ASSESSMENT
Risky Business:
Your Eyes
Smoke Gets in
If Introduced Today, Would Cigarettes Be Regulated?
BY FRANKLIN MIRER
Our painful experience with cigarette smoking provides clear
evidence that carcinogenicity at high exposure levels to chemicals
in laboratory studies predicts a cancer risk at much lower exposures
in people. The carcinogenicity of environmental tobacco smoke
shows persistence of the risk over a wide range of exposure.
Those who ignore or denigrate evidence from laboratory studies,
confuse a no-effect level with a population threshold, or insist on
epidemiologic evidence before acting to protect people are placing
them at continuing risk.
The nominee (hopefully confirmed by the time you read this)
for Assistant Secretary of Labor for OSHA, David Michaels, authored a meticulously researched and referenced account of the
culture war over regulation of chemical exposures titled Doubt is
Their Product: How Industry's Assault on Science Threatens Your
Health (Oxford University Press, 2008). The book provides a fully
sourced account of the co-evolution of scientific knowledge, public response and policy change. Dr. Michaels has tapped information beyond the peer-reviewed literature and formal hearing
records to produce new historical knowledge in public health.
I call this a culture war because framing determines the reality
that communities perceive, and frames come from the conflict of
ideas. This conflict takes place among groups with different levels
of engagement with science, including the general public, policy
makers and activists, and the scientifically literate (including, one
hopes, industrial hygienists). People in each of these communities
don’t see something until they believe it.
Science and Spin
Dr. Michaels’ book starts with a history of tobacco science and
counter-science, so I’ll start there as well. The story of cigarettes
is mostly portrayed as a cautionary tale about corporate defense,
but it also has an important scientific side.
The early days of national cigarette promotion in the 1920s are
recounted in The Father of Spin (Crown, 1998), a biography of
Edward Bernays. The nephew of Sigmund Freud and father of
modern public relations techniques, Bernays is best known for
promoting cigarette smoking among women by staging a demonstration on March 31, 1929, in which upscale women puffing on
their Lucky Strike “torches of freedom” joined the New York City
Easter Parade. More importantly, Bernays’ advertising campaigns
included physician testimonials to the healthfulness of cigarettes,
which prefigured the modern corporate defense approach. (For an
example, visit http://naturallygoodmagazine.com/blog/images/
smoking_doctor.jpg.)
Bernays eventually became an anti-smoking activist, saying
that if he’d known in the 1920s what he’d learned by the ’60s,
he’d not have done what he did. He lived to over 100 years and
probably would have agreed with jazz pianist Eubie Blake’s sentiment, “If I’d known I was going to live so long, I would have
taken better care of myself when I was young.”
Studies of Smoking
In the 1990s, I served on the National Toxicology Program (NTP)
Board of Scientific Counselors subcommittee, which reviewed recommendations for listing in the Report on Carcinogens. We were
required to review tobacco smoke for listing, which I thought was a
waste of effort and possibly political—everybody knows cigarette
smoke is carcinogenic, and the devastating impact of cigarettes is
used to deflect concern for involuntary exposures to “industrial”
