Lies, Demand Lies, & 400,000 Smoking-Related Deaths
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SMOKING-REA[ED DFATHS
by Robert A. Levy and Rosalind B. Marimont
TRUTH WAS AN EARLY VICTIM in the battle against tobacco.
The big lie, repeated ad nauseam in anti-tobacco circles, is that
smoking causes more than 400,000 premature deaths each year
in the United States. That mantra is the principal justification
for all manner of tobacco regulations and legislation, not to
mention lawsuits by dozens of states for Medicaid recovery,
class actions by seventy-five to eighty union health funds, sim-
ilar litigation by thirty-five Blue Cross plans, twenty-four class
suits by smokers who are not yet ill, sixty class actions by
allegedly ill smokers, five hundred suits for damages from sec-
ondhand smoke, and health-related litigation by twelve cities
and counties-an explosion of adjudication never before expe-
rienced in this country or elsewhere.
The war on smoking started with a kernel of truth-that cig-
arettes are a high risk factor for lung cancer-but has grown
into a monster of deceit and greed, eroding the credibility of
government and subverting the rule of law. Junk science has
replaced honest science and propaganda parades as fact. Our
legislators and judges, in need of dispassionate analysis, are
instead smothered by an avalanche of statistics-tendentious,
inadequately documented, and unchecked by even rudimentary
notions of objectivity. Meanwhile, Americans are indoctrinat-
ed by health professionals bent on imposing their lifestyle
choices on the rest of us and brainwashed by politicians eager
to tap the deep pockets of a pariah industry.
The aim of this paper is to dissect the granddaddy of all
tobacco lies-that smoking causes 400,000 deaths each year.
To set the stage, let's look at two of the many exaggerations,
misstatements, and outright fabrications that have dominated
the tobacco debate from the outset.
THIRD-RATE THINKING ABOUT
SECONDHAND SMOKE
Passive Smoking Does Cause Lung Cancer, Do Not Let
Them Fool You, states the headline of a March 1998 press
release from the World Health Organization. The release
begins by noting that WHO had been accused of suppressing
its own study because it failed to scientifically prove that
there is an association between passive smoking ... and a
number of diseases, lung cancer in particular. Not true, insist-
ed WHO. Smokers themselves are not the only ones who suf-
fer health problems because of their habit; secondhand smoke
can be fatal as well.
The press release went on to report that WHO researchers
found an estimated 16 percent increased risk of lung cancer
among nonsmoking spouses of smokers. For workplace expo-
sure the estimated increase in risk was 17 percent.
Remarkably, the very next line warned: Due to small sample
size, neither increased risk was statistically significant.
Contrast that conclusion with the hype in the headline:
Passive Smoking Does Cause Lung Cancer. Spoken often
enough, the lie becomes its own evidence.
The full study would not see the light of day for seven
more months, until October 1998, when it was finally pub-
lished in the Journal of the National Cancer Institute. News
reports omitted any mention of statistical insignificance.
Instead, they again trumpeted relative risks of 1.16 and 1.17,
corresponding to 16 and 17 percent increases, as if those
ratios were meaningful. Somehow lost in WHO's media blitz
was the National Cancer Institute's own guideline: Relative
risks of less than 2 [that is, a 100 percent increase] are con-
sidered small. . . . Such increases may be due to chance, sta-
tistical bias, or effects of confounding factors that are some-
times not evident. To put the WHO results in their proper
perspective, note that the relative risk of lung cancer for per-
sons who drink whole milk is 2.4. That is, the increased risk
of contracting lung cancer from whole milk is 140 percent-
more than eight times the 17 percent increase from second-
hand smoke.
What should have mattered most to government officials,
the health community and concerned parents is the following
pronouncement from the WHO study: After examining 650
lung cancer patients and 1,500 healthy adults in seven
European countries, WHO concluded that the results indicate
no association between childhood exposure to environmental
tobacco smoke and lung cancer risk.
Robert A. Levy is a senior fellow in constitutional studies at the Cato Institute and an adjunct professor at Georgetown
University Law Center where he teaches Statistics for Lawyers. Rosalind B. Marimont is a mathematician and scientist now
retired after a 37-year career with the National Institute of Standards and Technology (formerly the Bureau of Standards) and
the National Institute of Health.
REGULATION - VOL. 21, NO. 4, 1998
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Lies, Demand Lies, & 400,000 Smoking-Related Deaths
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