Chapter 10: Is there No Risk?

© 1999, Lauren A. Colby. Version 2.3

Chapter 10: Is there No Risk?

So far, I have argued that the case that smoking causes lung cancer has not been proven. The reader may ask, "Well, if smoking doesn't cause lung cancer, just what does?". Recent studies suggest that the answer lies in the genes of those individuals who develop the disease.

One must be cautious in assessing the genetic evidence, because molecular biologists, many of whom are employed by the rabidly anti tobacco government establishment, are not above the use of techno-babble in support of the establishment position on smoking. In their book on gene therapy, Altered Fates, authors Jeff Lyon and Peter Gorner quote scientist Philp Leder as saying that nicotine is a "mutagen par excellence". A mutagen, according to them, is another way of saying "carcinogen". There are, however, absolutely no studies showing that nicotine is a carcinogen. If it were, the FDA could scarcely have approved the sale of the nicotine patches, used by smokers who choose to quit smoking.

Recently, the press gave much attention to a study by researchers at John Hopkins University School of Medicine, dealing with head and neck cancers and the P53 gene. The P53 gene is called the Guardian Angel gene because it is believed to protect against cells becoming cancerous. According to a report in the March 16, 1995, edition of the Washington Post, the researchers studied tissue samples from 129 people with head and neck cancers. The samples were divided into smokers, smoker/drinkers, and total abstainers. About 58% of the tumors from the smoker/drinkers had P53 gene mutations, as opposed to 33% of the smokers who did not drink, and 17% from the abstainers. What the press reports ignored, however, is that everybody who participated in the study had cancer. 83% of the abstainers had perfect P53 genes; yet they still had become ill. The real lesson of this study, if there is one, is that the P53 gene won't keep a person from getting cancer; at least it won't do so if the person is otherwise genetically predisposed to the disease.

A more informative study is described in the August 1, 1990 edition of the Wall Street Journal. That study was conducted by researchers at Louisiana State University Medical Center in New Orleans and Albert Einstein College in New York. The researchers studied 300 families in Southern Louisiana, who had a history of lung cancer, and compared them with 300 controls. The researchers concluded lung cancer is an inherited disease. Based upon retrospective studies (which I do not necessarily accept as accurate) 35 the researchers concluded that if a person had two copies of the lung cancer gene, his chances of getting lung cancer by the age of 50 would be 14% if he did not smoke, increasing to 27% if he were a heavy smoker. In the more likely case of an individual having only one copy of the gene, the researchers concluded that a non-smoker would have practically no risk of getting lung cancer by age 50, but for a heavy smoker the risk increased to 5% by age 50, 16% by age 60, and 25% by age 75.

In the same WSJ article, there is an interesting quote from Neil E. Caporaso, a researcher at the government-owned National Cancer Institute in Bethesda, MD. According to Mr. Caporaso, one out of eight smokers will be stricken with lung cancer (which is another way of saying that seven out of eight will not). Considering the fact that one out of every five Americans dies from some form of cancer, and that lung cancer is the most common form of cancer in persons between the ages of 45 and 74, and the second commonest form in persons over that age, Mr. Caporaso's estimate of the risk seems very modest and wholly at variance with the position taken by most government scientists, who shriek hysterically that smoking "causes" lung cancer.

The fact remains that inheritance seems to play a major role in cancer. Pancreatic cancer is very rare, but former President Jimmy Carter has seen it in at least four members of his family: his two sisters, his brother and his father. His mother died from breast cancer which metastasized to her pancreas.

Diabetes is the scourge of my family. Three of my four grandparents died from the disease. All were obese and all consumed a diet, which was rich in starches and sugars. As a young man, I was obese and ate a lot of starches and sugars. I chose to go on a life-long diet, in which I refrain from eating starches and sugars. Simply avoiding starches and sugars is enough to control my weight (I weighed 240 lbs when I first went on the diet at the age of 38; now, I weigh 162 lbs). I consider this a sensible precaution. If I had a history of cancer in my family, especially lung cancer, I might choose not to smoke. However, I have no such history, so I puff away.

My wife, who is naturally thin, has no family history of diabetes and regularly consumes huge quantities of starches and sugars. I would never presume to ask her to stop. I certainly would not favor legislation to ban the eating of starches and sugars. Of course, the anti-tobacco crowd sees things differently; they are not content with their personal decision not to smoke; they want to impose their decision on everyone else, through widespread smoking bans. Curiously, however, as revealed in the postings on the Internet, many of the anti-smokers are avid devotees of marijuana smoking, which they consider to be healthy. On a more consistent note, many seek legislation to outlaw or restrict the sale of fatty meats, or red meats or vitamins or whatever. They consider themselves "liberals". Their hero is the dour chief of the FDA, David Kessler.

Quite frankly, I do not know whether there is a risk to smoking, or not. I do know that "risk" is not the same as causation. Philosophers, from Plato to Supreme Court Justice Louis Brandeis, have been fascinated with the word "cause", and have written many learned treatises on the subject. My great grandfather was working on a bridge construction site in 1927, when a careless driver jostled him. My great-grandfather became startled, lost his balance, and fell through a hole in the bridge. Not being able to swim, he drowned in the river below. Was the cause of death (a) drowning; or (b) the actions of the careless driver; or (c) the loss of balance; or (d) the existence of the hole in the bridge flooring; or (e) not being able to swim?

Just about every human activity involves risk. Walking across the street runs the risk of getting hit by a car. Bungee jumping involves the risk that the bungee cord may break or become detached from the supporting structure. If, however, a pedestrian is hit by a car, it is far-fetched to say that the cause of death was walking across the street. If a bungee cord breaks and someone is killed, the newspapers will not say that the deceased died from bungee jumping. Rather, they will report that "Smith died when the bungee cord broke, and he descended 100 feet to the ground below".

Anti-smokers are fond of repeating the mantra: "cigarettes are the only product which, when used for their intended purpose, cause death". Nonsense! Firearms are specifically manufactured to cause death in animals and humans. Automobiles, used carefully and driven properly, can still cause death if a tie rod breaks at 60 mph. I don't know whether starches and sugars can cause death in a person genetically susceptible to diabetes, but from personal observation, I feel there is a risk and, because of the history of diabetes in my family, I choose not to take the risk.

Before leaving this subject of risk, a very interesting study was recently reported, which confirms that if there is a risk, it has been grossly exaggerated by the anti-smoking movement. On May 23, 1995, the Associated Press reported on a study made by Dr. Gary Strauss. Strauss analyzed 685 lung cancer patients seen at Brigham and Women's hospital in Boston between 1988 and 1994. He found that 59% of the patients were non-smokers at the time their cancers were diagnosed. Of these, 8% of the entire sample had never smoked; 51% had smoked at one time but had given it up. Of the 51% who had quit, nearly one fourth had been off cigarettes for more than 20 years. On average, the former smokers had been off cigarettes for six years. As I have previously pointed out, lung cancer is not always diagnosed in non-smokers, because doctors aren't looking for it. Currently, according to the CDC, 25% of the population are smokers. In the study years (1988-1994), the percentage was as high as 30%. Thus, purely on the basis of demography, we would expect between 25 and 30% of the sufferers from lung cancer, or for that matter, hangnails or acne, to be current smokers. 41% of the cases studied by Strauss were current smokers. Given the role of detection bias (doctors more likely to diagnose lung cancer in smokers than non-smokers), the 41% figure suggests that the lung cancer risk for current smokers may be little or no greater than for non-smokers. In the article, Dr. David Burns of the University of California, seems to support the view that giving up smoking is not the "cure" for lung cancer. He is quoted as saying, "These folks have done what we told them to do, yet they are still at substantially increased risk. What can we do for them? We owe these people an answer." Burns suggested that it may be possible to device a genetic test to spot lung cancer. I would go further and suggest a genetic test to spot the likelihood that somebody will get lung cancer. Whether, in such an individual, giving up smoking would do any good, I don't know, but such individuals probably would choose not to smoke, just as I choose not to eat starches and sugars. The same article also reports that deaths from lung cancer have increased by 51% between 1980 and 1994, despite a drop in the percentage of adults who smoke from 42% in 1965, to 25% in 1993. Isn't it about time to stop blindly adhering to the notion that lung cancer will disappear if people simply give up smoking?

Actually, Dr. Burns is not the only medical doctor who has begun to question that simplistic notion. Julian Whitaker, MD, is a practitioner of "alternative medicine", a writer of a monthly newsletter on health and exercise, and no friend of smoking. However, in the October, 1995, issue of his newsletter, "Health and Healing", Doctor Whitaker writes:

"Since 1950, the incidence of all cancers in people between the ages of 50 and 60 years has increased by 44%, with even higher increases in some of the more deadly forms of cancer. Breast and colon cancer went up 60%, prostate up 100% and testicular cancer for men between the ages of 28 and 35 went up 300%. Lung cancer has gone up 262%, an increase that is obviously not related to cigarette smoking, because over the same period the number of people smoking cigarettes dropped from 50% to 25%..."

Doctor Whitaker expresses no opinion as to the reasons for the startling increases in cancer in recent years. I, however, have an opinion. Medicine, over the past 40 years, has grown more and more socialized. As late as 1950, people were largely responsible for paying their own medical bills, and doctors hesitated to order expensive tests and treatments for those who couldn't pay the bills.

Today, almost all medical procedures are paid for by insurance or by federal funds, through Medicaid and Medicare. Physicians, therefore, have a strong incentive to order every possible test and treatment, because they know that they will be paid for doing so. As a result, there are no more undiagnosed cases of cancer. Every case is always diagnosed. This will, in my opinion, show up in future years, in the form of statistics which show a leveling off of the number of cancer cases. Only time will prove whether I'm right or wrong.