Wednesday, 24 March 2010

Just open the window!


I was interviewed on BBC Scotland radio this morning on the subject of banning smoking in cars (listen here for 7 days, 2.17 hours in). Sleepy though I was—and coming off the back of a hilariously one-sided vox pop—I tried to make the point that the simple act of opening a window in a moving vehicle provides ample ventilation to disperse secondhand smoke.

Prof John Britton had earlier told the BBC that levels of secondhand smoke in cars are twenty times higher than in smoky bars. As a medical man, his opinion naturally trumped mine as far as the presenter was concerned. Nevertheless, it's worth finding out this '20 times higher' claim comes from.

A good place to start is a heavily referenced report from ASH (UK). It claims that:

According to a report by the Ontario Medical Association, secondhand smoke levels in cars can be 23 times greater than in a house.

ASH give a citation of this report from the Ontario Medical Association, which says:

Based on the evidence that exposure to SHS in a vehicle is 23-times more toxic than in a house due to the smaller enclosed space, the state of Colorado drafted a bill that would impose fines on adults caught smoking in cars when a child is present.

But what evidence is this? Their only reference turns out to be a news story from the Rocky Mountain News, not exactly a reliable scientific source.

ASH do, however, have another source:

A study comparing secondhand smoke particle concentrations in a vehicle with those in a bar which allowed smoking, found in-vehicle concentrations 20-times greater than inside the bar.

Again there is a citation, this time to an actual scientific journal, but the article in question does not measure secondhand smoke in cars, nor does it attempt to. It certainly doesn't give any estimate of how much more secondhand smoke is in cars than other locations, and it doesn't cite any references that might lead us to find an article that does.

And there the trail ends. Such is the game of Chinese whispers that passes for evidence-based medicine these days.

If you want to find some real science on this issue, you have to turn to an American Journal of Preventive Medicine study from 2006, which measured particulate matter (PM2.5) in vehicles.

Bearing in mind that the EPA's 'hazardous' level for 24 hour exposure is 250 ng/m3, this study found average peak concentrations of 271 ng/m3. But they did so by keeping the windows closed. When a window was opened, the level was only 51 ng/m3. This is a fraction of what would be found in a smoky bar (200-500 ng/m3) and is well within the EPA's limit (which, remember, is for 24 hour exposures, not the occasional car journey). And after smoking, levels quickly fell to the same found in a nonsmokers' car.



The study also measured carbon monoxide levels, with even less impressive results. When the window was opened, levels barely changed at all.



Another study sometimes cited carried out a similar experiment but only opened the window by 3 inches. Even with this restricted ventilation, average levels of PM2.5 were 119 ng/m3—well below the EPA's hazardous level.
All of which suggests that—if smoking in cars is a problem at all—it is one that can be simply solved by opening the window. And that, of course, is what everyone already does. 

Would I agree with a law forcing people to open the window whilst smoking? I probably would, if I thought that would be the end of the matter, but we all know that it won't be because protecting people from secondhand smoke is not the purpose of the Royal College of Physicians' latest 'demands'. By calling for a total ban on smoking in cars, even when no one else is present, they have finally given the game away. This issue isn't about science and it's not about 'protecting' nonsmokers. It never has been.


UPDATE

While I was on BBC Scotland, Tony Blows was on Radio 5, making his point rather more forcefully. He called Deborah Arnott a liar which, considering she brought up the Scottish heart scam, I suppose is fair comment. F2C have the audio. 

Incidentally, I was told that the producers wanted me to debate with a spokesman from an anti-smoking group but the spokesman refused! I bet Arnott now wishes she'd ducked out as well.



24 comments:

Anonymous said...

Interestingly most of the reader comments on newspaper articles that permit them (Daily Mail and the Independent)are pretty negative towards such legisilation. This is curious as the claim has been made that there is overwhelming public support for these and other restrictions. It is important to note that the spokesperson cited in the newspapers also refers to banning smoking in outdoor areas "Where children gather". Making an issue of outdoor smoking in the light of recent reports on air quality is likely to blow up in the faces of the (less and less) esteemed medical community. At least we can hope so.

TheBigYin said...

Recorded John Britton's diatribe this morning on Nicky Campbells five live breakfast show. Also recorded, from the same show, Tony Blows, pub landlord who was bankrupted by the smoking ban, call Deborah Arnott a liar.

They also started with a one sided vox pops.

I put the recordings on the F-2-C blog here.

Anonymous said...

Hello dear Author,
do you have children?
would you expose them to 51ng/m3?
If they develop asthma or cancer how woud you explain that your opinion outweighted the risks?
would you pay every cent of the cost throughout their life of medication, operations, rehab?
If you cannot answer these questions without resorting to diktats on personal freedom then a) you are unfit to be a parent b) you are unfit to considir yourself a useful member of society c) you are blind, deaf and dumb, as in the three monkeys.
I am not trying to be offensive here. But I have incredible difficulty in overcoming my feeling that ego and a misplaced sense of self is driving this. Life does not begin and end just with personal freedom; it equally begins and ends with personal responsibility.
Thank you.
Tony Perth Australia.

Fredrik Eich said...

"without resorting to diktats on personal freedom"
Anonymous,
I think the author was resorting to science and reason. Maybe you should try reading it before writing about it.

Anonymous said...

Hello Dear Fredrik,
I concede that the immediate context was to do with claims to science and reason. But the tenor of the argument from those opposed to the ban, including Tony Blows on Five radio which I heard on BBC World service is that adults have the right to choose - the personal freedom argument. No mention of the personal responsibility argument from them, do you have any contribution to make in this regard?
Thanks
Tony Perth Australia

Anonymous said...

Dear Tony of Perth, For someone who isn't trying to be offensive you are doing a damn good job of it. Please explain to me why people without children will be subjected to the same restrictions?

Heretic

Anonymous said...

Nobody wants to talk about personal responsibility. Come on lads - surely somebody can rip my argument to shreds?
Heretic :
Smokers clothes, car upholstery, living rooms, all stink. I am a life long smoker, I know. Windows open, windows closed - no difference. Why do they stink? Because smoke particles are sticky. They stick to everything, and the point here is that they stick to young lungs, young gums, young nose cavities ...

I think Heretic that you would be in a class of your own if your car were used by you and you alone.
Law by nature is general in application: it has to be in order to work. For example take steak knives : we dont allow them to be carried in public by anybody, irrespective of the fact that you Heretic are totally benign, and just want to bring it over to a meal at your beloved's flat. Get the point?

Now can anybody talk on the issue I raised - personal responsibility?

Thanks
Tony Perth Australia

Fredrik Eich said...

Tony,
Ok. If the state needs to intervene to protect children from cancer and asthma risk caused by parental smoking; how far do you think the state should go? Should the state take children into care if the parents persist in exposing their child to tobacco smoke - as a last resort in order to save that child? After all, children at risk of death usually are taken into care. What do you think?

Anonymous said...

Well if you considir that knowingly harming a child is reason to do just that - for example physical or mental abuse, then in my opinion yes. I have no problem with that. In the real world, taking children in to care is something that happens only after society's agent, the social services, have a very high level of proof. Unfortunately, in the real world, this intervention happens very often only after severe damage has been done to the child, and indeed very often the intervention does not happen in time -t he child is killed.
Failure to take responsibility for the safe upbringing of children is in my mind justifiable reason to remove the child in to care.
Thanks
Tony Perth Australia

Anonymous said...

Erm Tony, you might try washing yourself and your clothes a bit more frequently. Redecorating from time to time also helps. For your information the particlates released from cooking are also sticky and also attach themselves to everything as well as containing a vast array of chemicals. Cooking with a child in the kitchen should be banned too I suppose. There are people, many people, who never have a child in the car with them. That is on planet reality, somewhere you have clearly not visited recently.

Best Wishes for a Speedy Recovery

Heretic

Fredrik Eich said...

Tony,
Just to clarify.
Do you, Tony, think that the state should take children into care if the parents of those persist in exposing their children to tobacco smoke?

Anonymous said...

Hi Chris,
Great article. Have just emailed Tony Livesey, asking him to invite you as a guest on his R5Live show tonight. Hope he gives you a call.
All the best, JB.

Anonymous said...

'They stick to everything, and the point here is that they stick to young lungs, young gums, young nose cavities ...'

Weird how my brothers and myself are all in our 70's with all that gunge sticking in every orifice.
The cheeeeldren need some muck around to get their body immunity working.

No wonder they are all weak and sickly. Wait until outdoor pollution really hits them in the not too distant future.. The kids that will survive are the ones who's parents were kind enough to know that smoking around them was offering great protection for things to come.

Bucko said...

Tony - Your argument is only about children, something I dont care about. I have none and come into contact with none as much as I am able. I certainly never have any in my car.
The only people who use my car are myself and my wife, both smokers.
If anyone wants a lift and they are not smokers then they have a chioce to make. Accept the hospitality of smokers or look elswhere.
I have always smoked in my car and will always continue to do so, regardless of any new petty regulations as my actions harm no one but myself.

TheBigYin said...

Chris, I have edited the Radio Scotland segment just to include your interview, very intersting and my readers would like to listen to it.

I have updated our blog item to include your interview with the other two.

If you have any problems with me adding it you can drop me an email. (I suppose I should have asked first.) :¬)

Anonymous said...

"do you have children? would you expose them to 51ng/m3?
If they develop asthma or cancer how woud you explain that your opinion outweighted the risks?"

I can't answer for CS, but I can tell you that if I had children, I wouldn't be worried about 51ng/m3 at all. As CS clearly indicated: "the EPA's 'hazardous' level for 24 hour exposure is 250 ng/m3, this study found average peak concentrations of 271 ng/m3. But they did so by keeping the windows closed. When a window was opened, the level was only 51 ng/m3."

What's the use of having the EPA provide a "hazardous level" guideline if the guideline has no meaning? You, Tony, are invoking the precautionary principle. In your mind, if one doesn't consistently apply a "better safe than sorry" standard to everything they do, then they are unfit for this and that and "deaf, blind, and dumb".


Your steak knife example is a straw man argument--people generally have little desire to go walking about carrying a steak knife. If on the other hand, they've got an appointment with some pork roast on the other side of town, what do I care if they're carrying a steak knife?


Meanwhile, you seem to entirely miss that driving itself presents greater risks than anything going on with the air quality within the car.

You speak of personal responsibility, but you then present this fantasy scenario of asthmatic, cancer-stricken, children needing medication, operations and rehabilitation. And this comes from Mom or Dad smoking in the car with the window rolled down, right?

By definition, personal responsibility means having to deal with reality, not demanding that the world be viewed through your slippery-slope prism where every non-existent risk is transformed into a justification for intruding upon the personal freedoms that you appear willing to blithely toss aside.

Not sure why I bothered.

WS.

Fredrik Eich said...

"Now can anybody talk on the issue I raised - personal responsibility?" - Tony.
Tony, you seemed to have disappeared.

Anonymous said...

Kids in Cars. The real Story

Comments to the article and to the CBC Ombudsman;

"In 1975 Sir George Goober, British delegate to the World Health organization
presented his blueprint for eliminating tobacco use worldwide by changing
social attitudes.

"..it would be essential to foster an atmosphere where it was perceived that
active smokers would injure those around them, especially their families and
any infants or young children who would be exposed involuntarily to EST.."

http://lieberaldictators.blogspot.com/


I am extremely disappointed with the obvious decline of credibility and journalistic integrity at the CBC of late. The obvious promotion of the new bandwagon craze to stick it to anyone who smokes, whenever and where ever we can, will permanently place the CBC at the level of the National Inquirer and the infamous reputation of the British scandal rags we love to laugh at.

BTW the smokers being stigmatized and stereotyped here, and in a host of stories you produce, are most significantly; the elderly, Racial minorities and always the poorest in our communities. That I consider a shameful and reprehensible act on your part.

My comments and observations are in respect to the all too often seen tendency of publishing, whatever comes off the news wires, without even a precursory investigation of the source or validity of what you will report.

Today I read an article which reported Doctors are supporting a ban in cars where children are present. The backup to the piece at first glance seemed to indicate a child would be in dire need of protection from hazards of tobacco smoke in high levels inside a vehicle.

The research cited was a name I had never heard of so I thought I would check them out. The group is actually a subset of the American CDC who are responsible for a number of major blunders over the years in connection with fear mongering and exaggerations to a large degree embarrassing themselves and the American government in a number of damage controlled fiascoes.

I took another look at what was being reported in your article and noticed some finely crafted authorship; the 35 ug/m3 was actually particulate not cigarette smoke at all, but of total particulate. The report cited demonstrated no effort to separate the particulate and identify what originated from a cigarette and what was pre-existing in the ambient air. Further the implied health risk did not mention the norm or the allowable levels so I had to help you out again, a quick search demonstrates from more reliable sources the average air quality annual measurements in outdoor air in 1997 was 36.5 ug/m3 and the strictest control regulations are now at 60ug/m3 annual average.

Further there was no discussion of the volumes children actually inhale, of the total volume available. A child's lung capacity @ 6 inhalations a minute of 1/2 liter inhalations, would take 5.6 hours in the car at the stated levels to inhale only 35ug of the total particulate reported, which hardly increases the health risk of that child to any degree. [ug = one Millionth of a gram; One gram = approximately 1 cubic millimeter of water]

What is being proposed by "protecting children" in cars, is an air quality standard inside a car which is far lower than the unavoidable average particulate levels measured outside the vehicle.

Anonymous said...

Which makes the CBC and anyone else promoting this legislation appear to be; as the CDC has done on many occasions, the dupes who listened to them once again and the scapegoats who will carry the embarrassment when the truth comes to light.

This article amounts to no less than emotional blackmail, utilizing the "protection of children" to sell smoking patches and higher taxation of an addiction incredibly.

The CBC is promoting the punishment of a medical dependency, and lists beside every incident other promotions of that lack of good judgment, as though it were something to be proud of?

I guess it just goes to prove you can't believe anything you hear today and the CBC is no different from the rest. Propaganda and irresponsible fear mongering, will take it's toll. I for one will never again speak in favor of preserving a national broadcaster. We are just paying to subsidize another big business mouthpiece protecting them, by "protecting" us from ourselves.

Just to educate the Editors and their staff;
http://www.cbc.ca/health/story/2008/02/15/smoking-ban.html#skip300x250

http://oldfraser.lexi.net/media/media_releases/2000/20000414.html

http://www.nature.com/jes/index.html

http://www.smokershistory.com/

Anonymous said...

About Kids in cars.
They are using the wrong standard to compare the results to. The EPA standard is to be used for OUTSIDE ambient air quality and it is the average over a period of 3 years.

The proper standard to compare to is the OSHA standard for indoor air quality for respirable particulate (not otherwise specified) for nuisance dusts and smoke. That standard is 5000 ug/m3 on a time-weighted average (8 hours a day, 5 days a week) and is intended to be protective of health over an average working life of 30 years!

See my comments on the link below

Michelle
http://www.associatedcontent.com/article/366678/stanford_explores_health_risks_of_smoking.html?page=2

This from Stanford university ... again, with the windows opened, the results were just like a bar pre smoking ban ...not a bad situation, at all. Particularly since bars pre ban were already using lots of air changes. Dave K

Further, the EPA standard for ambient OUTSIDE air is NOT established for instantaneous readings or even readings averaged over 8 hours. The EPA standard for ambient OUTSIDE air is established for an average over 3 years! Why did the "scientists" at Stanford University choose the wrong standard to compare the results of the study to? Why did the "scientists" at Stanford University not provide a control sample of respirable particulates in cars WITHOUT smoking? Do they imaging that only respirable particulates from tobacco smoke are harmful? That particulate from ordinary vehicle exhaust are "vitamin-packed" and good for your health? To all smokers and their children. Congratulations! You are NOT part of the 640 % increase in the incidence of childhood asthma that has occurred in direct correlation with the decrease in the smoking rate of the general population! http://www.data-yard.net/30/asthma.htm To all others: Try getting a life instead of wasting your time, try.

There is only one problem with this whole study! It ain't science! The standard to which the particulate matter is being compared to is for outside ambient air. The EPA sets the quality standard for OUTSIDE air very high. Why? Well its because outside air is the mother of inside air! Fine respirable particulate in outside air cannot be easily vented from inside an enclosed space (like a home). It tends to accumulate and concentrate in inside air. The reasonable standard for INSIDE air quality is the standard established by OSHA for workplaces. This standard is for respirable particulate (not otherwise specified) and includes unspecified dusts and smoke. The standard for respirable particulate is a time-weighted average over a period of 8 hours. The standard for respirable particulate for inside air is 5000 ug/m3. Further, the EPA standard for ambient OUTSIDE air is NOT established for instantaneous readings or even readings averaged over 8 hours.

DaveA said...

"Incidentally, I was told that the producers wanted me to debate with a spokesman from an anti-smoking group but the spokesman refused!"

As I say Chris down the pub that is your influence. ASH refuse to debate me too, as they now full well on the science they will be tied up in knots.

Dave Atherton

DaveA said...

While I am here, 2 papers on smoking nd driving.

Smoking while driving is far from proven as being a cause of accidents, being responsible for 0.9% of accidents, by comparison: "Outside person, object, or event, 29.4%, Adjusting radio/cassette/CD, 11.4%, Other occupant, 10.9%.."

http://www.drivers.com/article/423/

This paper from the Australian State Of Victoria suggests 2% and out of 11 risks is the least problem. Pages 19 and 20.

http://www.parliament.vic.gov.au/rsc/distraction/Distraction_Final_Report.pdf

DaveA said...

@Tony

Being Australian I am sure you have the odd barbecue, but think of the chiiiiiildren.

"Barbecues poison the air with toxins and could cause cancer, research suggests.
A study by the French environmental campaigning group Robin des Bois found that a typical two-hour barbecue can release the same level of dioxins as up to 220,000 cigarettes.

Dioxins are a group of chemicals known to increase the likelihood of cancer.

The figures were based on grilling four large steaks, four turkey cuts and eight large sausages."

Dave Atherton


http://news.bbc.co.uk/1/hi/health/3106039.stm

Standard-Issue State-Funded Troll said...

In a recent test, scientific experts discovered that if you made a child hold his or her face 30cm from an active exhaust pipe for an hour, and then made them smoke a cigarette, by the time they'd finished smoking the cigarette they were dead! This proves beyond doubt that second-hand smoke causes AIDS, and all selfish smelly smokers should be sterilized the moment they take up this disgusting habit!!!