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In conclusion, in studies carried out in the United States and Sweden we detected an association between use of smokeless tobacco products and risk of fatal myocardial infarction and fatal stroke, which is not readily explained by chance. Confounding and other sources of bias, however, cannot be completely excluded on the basis of available data, although we found no strong evidence for their effect. If the association is real, its public health and clinical implications might be substantial, despite the fact that the magnitude of the excess risk is small. Future research should aim to clarify the mechanisms of effect of smokeless tobacco products on deaths from cardiovascular disease and to elucidate whether a similar effect is present for non-fatal myocardial infarction and non-fatal stroke.
What is already known on this topic Smokeless tobacco products are widely used in many populations An association with risk of cardiovascular disease is plausible
What this study adds This systematic review and meta-analysis provided evidence for an association between use of smokeless products and risk of fatal myocardial infarction and stroke . . .
Executive Director, Smokefree Pennsylvania
Pittsburgh, PA USA 15218
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Re: Smokeless tobacco is far less hazardous alternative to cigarettes
If the attributable risk estimates for fatal stroke and heart disease found by this study are correct, the overall mortality risk from using smokeless tobacco products would be 4%- 5% of those from cigarette smoking, or 95%-96% lower risk.
As such, this study confirms the findings by Rodu and Godshall http://www.harmreductionjournal.com/content/3/1/37 that cigarette smokers can sharply reduce their mortality risks by switching to smokeless tobacco products.
Unfortunately, the authors of this study failed to acknowledge that smokeless tobacco users face significantly fewer mortality risks for stroke and MI (and overall mortality) than cigarette smokers.
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While examining patterns of DNA modification in lung cancer, a team of international researchers has discovered what they say is a surprising new mechanism. They say that "silencing" of a single gene in lung cancer led to a general impairment in genome-wide changes in cells, contributing to cancer development and progression.
In the January 1, 2009, issue of Cancer Research, a journal of the American Association for Cancer Research, they also report finding a strong link between modification of the key gene, MTHFR, and tobacco use by lung cancer patients - even if the patient had smoked for a short period of time.
The findings reinforce tobacco's link to lung cancer development, but show that deactivating one specific gene through a process known as hypermethylation causes systemic dysfunction, or hypomethylation, in many genes, said the study's senior investigator, Zdenko Herceg, Ph.D., head of the Epigenetics Group at the International Agency for Research on Cancer (IARC).
Smoke-free policies are reducing heart disease related to smoke exposure, the prevalence of smoking in adults and the exposure of both adults and children to second-hand smoke. Further, such policies do not decrease the business activity of the restaurant and bar industry. A reduction in the lung cancer burden is plausible but relevant evidence will only become available in the future. The findings appear in the latest of a series of Special Reports from the International Agency for Cancer Research (IARC), published exclusively Online and in the July edition of The Lancet Oncology. The issue is dedicated to lung cancer and will be presented at the International Lung Cancer Conference, Liverpool, UK, from 9-12 July. . . .
The group found sufficient evidence for the following: that implementation of smoke-free policies substantially decreases second-hand smoke exposure; that smoke-free workplaces decrease cigarette consumption in continuing smokers; that smoke-free policies do not decrease the business activity of the restaurant and bar industry; that introduction of smoke-free policies decreases respiratory symptoms in workers; that voluntary smoke-free home policies decrease children's second hand smoke-exposure; and that smoke-free home policies decrease adult smoking.
Strong evidence was found that smoke-free workplaces decrease the prevalence of adult smoking; that smoke-free policies decrease tobacco use in youths; that the introduction of smoke-free legislation decreases heart disease morbidity; and that smoke-free home policies decrease smoking in youths. But, because the lead time for lung cancer to be diagnosed after exposure to a carcinogen such as cigarette smoke can be 20 or more years, the group concluded that "data are not yet available regarding the expected decline in lung cancer after implementation of smoke-free policies."
On the basis of the evidence reviewed, the Working Group recommend that governments enact and implement smoke-free policies that conform to the WHO Framework Convention on Tobacco Control (FCTC).
The year was 1987, and the Minister of National Health and Welfare, the Honourable Jake Epp, had recently introduced the draft Tobacco Products Control Act as Bill C-51 in the House of Commons. I was the civil servant responsible for the tobacco legislation file. Very quickly, it became clear that we had a tiger by the tail. The tobacco industry pulled out all the stops to defeat or weaken the government’s proposal to ban tobacco advertising.
Members of Parliament were assaulted with blizzards of letters arriving, seemingly from ordinary citizens protesting the new law. There were various texts, fonts, styles and paper stocks. It seemed like a genuine grassroots protest. In reality, it was an early example of fake write-in grassroots campaign organized by a corporation in its own private interest — a “grasstops” campaign. The tobacco industry hired high-profile lobbyists; they created fake coalitions of influential citizens (“Coalition 51”); and they bombarded us with reports they arranged to have sent to us from all over the world, from organizations like the Children’s Research Unit, the Smokers’ Freedom Society, INFOTAB, the World Federation of Advertising, and Freedom of the Right to Enjoy Smoking Tobacco (FOREST).
These and other petitioners they sent our way were all financed by the tobacco industry. . . . .
It was Sunday, March 8, 1998 and I was at home in Ferney-Voltaire, France, just across the border from Geneva, Switzerland where I worked at the World Health Organization (WHO) in charge of the Tobacco or Health Program. The telephone was ringing non-stop. Journalists and colleagues were calling me at home from all over the world, demanding an explanation of the story on page one of that day’s London Sunday Telegraph. The story began, “The world’s leading health organization [WHO] has withheld from publication a study which shows that not only might there be no link between passive smoking and lung cancer but that it could even have a protective effect.” . . .
Later, Elisa Ong and Stanton Glantz at the University of California researched the circumstances surrounding this event, and discovered that the tobacco industry had been tracking the IARC study since 1993, and spent far more in tracking the study and in planning and executing their masterful disinformation campaign than IARC spent to do the study. Ong and Glantz’s careful research was published in the respected medical journal The Lancet in April 2000, but received scarcely any media attention. Two years after the fact, the story was “old news.”
Tobacco industry misinformation, fanned by a well-oiled public relations machine, operating everywhere in the world, had trumped careful scientific work by well-meaning health professionals working for IARC, WHO and the University of California. To this day, tobacco industry apologists continue to cite the March 8, 1998 edition of the London Sunday Telegraph as “proof” that passive smoking does not cause lung cancer.
These are just two examples of many similar experiences I have had in nearly a quarter-century of full-time work on tobacco control. Now, finally, I am no longer lost in the trees; I can clearly see the forest.
What the tobacco industry was doing to the Canadian government in 1987 and 1988, and to the World Health Organization in 1998 was exactly what it was programmed to do. Tobacco companies are obliged by laws governing corporations to make money for their shareholders. They can only do this by selling more and more cigarettes. So Big Tobacco will never stop beating up on public health policies and public health agencies.
After all, their actions threaten cigarette sales, the only route to shareholder profit for tobacco companies. But the monstrous tragedy of this logic is that the more cigarettes they sell, the more their customers will get sick and die.
As long as we continue to allow tobacco companies to exist as forprofit business enterprises, every attempt we make to curb tobacco industry behaviour in the name of public health improvement control will be met by unceasing tobacco company efforts to defeat, attenuate, mitigate, delay, counter or confuse the new knowledge or new policy measures that tobacco companies think might cut into their sales.
We will never succeed in completely phasing out tobacco consumption until we remove profit-making from the tobacco business.
This book clearly spells out just why this must be done and proposes a variety of workable ways that it could be done.
PERHAPS I shouldn't have been surprised at my reception last week at a Lakewood, Ohio, hearing on banning smoking in restaurants and bars. Such events tend to bring out the penny-ante dictators. After all, when customers can readily find smoke-free facilities and nobody's forced to take a job, such bans are inherently authoritarian. But these people made Mussolini look like freedom's friend. . . .
Specifically, those behind the national jihad against so-called "passive smoking" insisted I must not speak. . . .
I informed the panel that the study that began the crusade, published in 1993 by the Environmental Protection Agency, had actually found no statistically significant link to lung cancer, requiring them to use a new standard for significance to get the "proper" results. . . .
And I told them that the largest of the passive smoking studies (35,000 participants) and longest (39 years) found no "causal relationship between exposure to environmental tobacco smoke (passive smoking) and tobacco-related mortality." . . .
So now you know why there was so much fuss and feathers over my impending testimony. It wasn't the Fumento they were afraid of; it was the facts.
Admitting mistakes can be difficult, correcting them even harder. Labelling cigarette packets with tar yields (plus nicotine and carbon monoxide) was, and is, a mistake. The mistake was not in the conception of the low tar programme, or even in conducting it as a huge experiment with public health. The error was allowing the tobacco industry to control it. . . .
The machine measured figures for tar, nicotine, and carbon monoxide should be removed from the packet, and a realistic measure must be established for regulatory purposes (as Canada has done). The current health warnings deal qualitatively with the risks of smoking very well, and misleading figures on the packet can only do harm.
Labelling cigarette packets with tar yields (plus nicotine and carbon monoxide) was, and is, a mistake. The mistake was not in the conception of the low tar programme, or even in conducting it as a huge experiment with public health. The error was allowing the tobacco industry to control it.
In launching the IARC Monograph on Tobacco Smoke and Involuntary Smoking, the WHO cancer research agency, located in Lyon, France, puts a final stop to all controversies fueled at various degrees by the tobacco industry, and kicks off, in partnership with the French Minister of Health, a new era in tobacco control.
The scientific working group of 29 experts from 12 countries, convened by the respected Monographs Programme of the International Agency for Research on Cancer (IARC) of the World Health Organization, Lyon, France, has reviewed all published evidence related to tobacco smoking and cancer, both active and involuntary. While its conclusions unsurprisingly confirm the cancer-causing effects of active smoking, which an earlier working group had considered back in 1986, it also concludes its evaluation of the carcinogenic risks associated with involuntary smoking, with second-hand smoke also classified as carcinogenic to humans. The long-awaited publication of this close to 1,500 page-monograph provides all references to the studies published on this subject around the world. . . .
Second-hand smoke causes lung cancer
Nonsmokers are exposed to the same carcinogens as active smokers. Even the typical levels of passive exposure have been shown to cause lung cancer among never smokers. Second-hand tobacco smoke IS carcinogenic to humans.
Concern that breast cancer or any other cancer not caused by active smoking might be caused by involuntary smoking is unjustified by the evidence.
Exposure to second-hand smoke from spousal, workplace and social sources confers a 22% increased risk of lung cancer in people who never smoked, according to a pooled analysis of European and American cohorts. . . .
Paul Brennan, PhD, with the International Agency for Research on Cancer, Lyon, France, and colleagues evaluated the risk of lung cancer due to second-hand smoke exposure in non-smokers. . . .
The authors conclude that this study "provides firm evidence for a dose-response relationship between lung cancer risk and duration of exposure to second-hand smoke for the 3 main sources of exposure: spousal, workplace and social." They add that this study "emphasizes the importance of protecting nonsmokers from second-hand smoke."
[This study] provides firm evidence for a dose-response relationship between lung cancer risk and duration of exposure to second-hand smoke for the 3 main sources of exposure: spousal, workplace and social.Paul Brennan, PhD, with the International Agency for Research on Cancer, Lyon, France, and colleagues.
Female patients who smoke are more prone to develop lung cancer than their male counterparts, a new study confirms.
Shinichi Toyooka, MD, department of surgery, Kagawa Prefectural Central Hospital, Takamatsu, Japan, presented the findings here on August 11th at the 10th World Conference on Lung Cancer.
Using the International Agency for Research on Cancer's tumor suppressor gene database, the researchers analyzed 1,775 lung cancer cases for mutations of the TP53 suppressor gene. Specifically, they looked for mutations characterized by an excess of G:C to T:A transversions, which are thought to be characteristic of smoking-related cancers. . . .
Study title: Influence of gender on tobacco exposure related TP53 gene mutations in lung cancer: Analysis of the International Agency for Research on Cancer (IARC) data base.
Global cancer rates are expected to rise by 50 percent to about 15 million new cases in 2020 and developing nations are especially at risk, says a massive report released here by the World Health Organization (WHO).
Countries of the South could be especially hard hit unless they begin implementing strong prevention strategies targeted primarily at discouraging tobacco use and encouraging healthy diets, according to the 351-page World Cancer Report by WHO’s International Agency for Research on Cancer (IARC). . .
The most important change required is to reduce smoking and tobacco use, the report says. Lung cancer is the most common cancer worldwide, accounting for 1.2 million cases every year and responsible for almost 20 percent of cancer’s annual global death toll of more than six million. Roughly 90 percent of lung cancers in both men and women are attributable to smoking in countries where the practice is popular with both genders. . .
The WHO’s proposed Framework Convention on Tobacco Control (FCTC), which is to be submitted for approval to the World Health Assembly (WHA) in May, urges countries to ban all tobacco advertising and increase taxes on sales of tobacco, requires at least 30 percent of a tobacco product’s package to be devoted to health warnings, and calls for all states to enforce bans on the sale of tobacco to minors.
Cancer is a devastating disease - but largely preventable.Its impact can be reduced through basic research and improvements in treatment and care. World Cancer Report presents opportunities for action at the individual, community and national level.
For years, the tobacco industry has been fighting scientific research by the WHO indicating the dangers of second-hand smoking. Laurentien Brinkhorst, now Dutch Princess Laurentien, assisted Philip Morris in the counterattack. A reconstruction of a lobby. . .
But in 1996 the tobacco industry had much more at stake to receive information from the WHO. The office in Bilthoven was revising the “Air Quality Guideline”. A group of specialists led by epidemiologist Dr. Michal Krzyzanowski was working to reconcile the 1987 guideline with current scientific knowledge. . .
Scientists and lawyers employed by Philip Morris in 1996 developed a plan to intercept the conclusions about second-hand smoke and to counter or weaken [attack] them before they got published. . .
Company documents at the Philip Morris website reveal that Laurentien Brinkhorst, in 1996 a 30-year old manager governmental relations at the Philips Morris office in Brussels, was closely involved in the “WHO Europe Plan”. She was even one of the authors of the plan. . .
According to the WHO, tobacco producers used every opportunity to frustrate their “enemy number one”. The WHO concluded that the companies had not succeeded in interfering with the scientific research.
"The tobacco companies were successful, however, in manipulating media accounts of the study results, misleading the public into believing that the study failed to show a relationship between Environmental Tobacco Smoke and lung cancer", states the July 2000 report.
Brinkhorst’s role in the IARC action plan focused on the political lobby. She had to find out which European politicians could be approached by tobacco. . .
Philip Morris spokesperson Jules Wilhelmus states that the company documents “overestimate the truth”.
The documents referred to in this article can be read by clicking on the hyperlinks in the Dutch language version.
Laurentien Brinkhorst, wife of Prince Constantijn, has played a more significant part in the tobacco producer Philip Morris' lobby activities then previously known. Internal company documents reveal that in 1996 she developed an "extremely profitable' contact for the company with a scientist of the WHO. The connection was so important that in 1998, a year after Ms. Brinkhorst had left her job at Philip Morris, the company still wanted to pay her $10,000 to maintain the contact. The document states that only Brinkhorst could maintain the connection. Brinkhorst claims she never received the money.
Laurentien Brinkhorst, a member of the Royal Family since 2001, was employed by Philip Morris from 1995 to 1997 and actively worked in the company's lobbying campaign against publications about the dangers of second-hand smoking. . .
Ms. Brinkhorst's important connection was dr Michal Krzyzanowski at the European Center for Health and Environment, a WHO agency at that time located in Bilthoven. Epidemiologist Krzyzanowski was working on the revision of the WHO guideline for domestic air quality. This document would include, for the first time ever, hard conclusions about the effects of second-hand smoking.
Six months before publication of the guideline, Brinkhorst paid a visit to Krzyzanowski. Philip Morris wanted to get its hands on a draft of the WHO guideline, to attack it. The company also wanted to investigate whether different European WHO-agencies could be played out against each other.
JTI spokesperson, Adam Bryan-Brown, said, “JTI fully acknowledges the risks of smoking and is committed to informing smokers about those risks. When it comes to second hand smoke, however, we do not believe that the scientific evidence, taken as a whole, is sufficient to establish that second hand smoke is a cause of disease.” Bryan-Brown continued, “So far as we are aware, IARC has not produced any new scientific data to support its preliminary statement on second hand smoke. We are therefore somewhat disturbed that many commentators have repeated IARC’s claims without questioning their basis. If IARC is planning to produce new scientific evidence in its final report, we would strongly recommend that commentators wait for that report, and digest IARC’s evidence. To do otherwise is to reach conclusions without facts.”
Notes for editors:
JTI’s publicly stated position on the second hand smoke is as follows:
The claim that ETS is a cause of disease in non-smokers has not been convincingly demonstrated. We do not consider that a reliable and convincing statistical link between exposure to ETS and an increased incidence of any disease in non-smokers has been established. Since ETS diffuses and is highly diluted in the air, the amount of ETS to which non-smokers are exposed tends to be extremely low, whether considered in the light of occupational hygiene standards or in comparison with the smoke intake of smokers.
Smoking around infants or young children presents a separate set of considerations. Adults who are annoyed by ETS can take remedial action - requesting, for example, that smoking be stopped for a time, leaving the area or asking for additional ventilation. Those options tend not to be available to infants and young children. We thus recommend that people do not smoke around infants and young children.
Tobacco smoke is even more cancerous than previously thought, for both smokers and nonsmokers who breathe in the fumes, causing cancer in many more parts of the body than previously believed, a panel of experts has concluded.
Although smoking has been established as a leading cause of cancer, scientists have only now been able to track more than one generation of smokers to develop a clear picture of the dangers of tobacco.
The scientists, convened by the International Agency for Research on Cancer, a branch of the World Health Organization, said Wednesday that for types of cancer already known to be caused by smoking, the risk of tumors is even higher than previously noted. The research also definitively proves that secondhand smoke causes cancer.
The analysis is the first major examination of the accumulated research on tobacco smoke and cancer since 1986. A full report of the findings will be published later this year.
The scientists combined the results of more than 3,000 studies involving millions of people, which allowed them to draw conclusions not possible in smaller studies.
It does look as if it's the cancers that are principally caused by hormones that are not affected by smoking. . . Practically all the cancers of tissues that are exposed to the environment in one way or another are affected by the chemicals distributed throughout the body when you inhale tobacco smoke.IARC panel member Sir Richard Doll. Ross, E.