Doctors: don't you just love 'em?
Tuesday, October 25, 2011 at 12:33 This morning the Today programme asked 'Are smoking deaths under-reported?'.
According to the programme, "New research has come to light suggesting that doctors are reluctant to cite smoking as a cause of death on death certificates".
There followed an interview with pathologist Dr Ian Proctor who carried out the research.
Presenter John Humphreys, who barely lets me get a word in on the rare occasions I am on the programme, expressed astonishment at the findings and asked Dr Proctor why this should be.
His guest offered the none too convincing argument that doctors don't want to upset relatives of the diseased. (I think that's what he said. You can listen here.)
At no stage did Humphreys put forward the counter argument that the real reason that doctors are reluctant to cite smoking as a cause of death is because most smoking-related diseases are multifactorial and it is very difficult to state conclusively, on a death certificate or anywhere else, that smoking is the primary cause of death.
I'm not denying the serious health risks associated with smoking. It's just a fact.
By coincidence, a letter published in the British Medical Journal on September 30 was brought to my attention an hour or so ago.
The BMJ obviously hoped to stoke up a bit of interest because they issued the following press release which a BBC contact has kindly forwarded to me:
While smoking remains legal, the number of smokers is never going to fall significantly, argues public health doctor in a letter to this week's BMJ.
Dr Paul Jepson suggests the tabloid press publish a list of the names of the more than 250 people killed by smoking related disease each day, as part of a "fundamental re-think" on smoking. "Any other drug causing a fraction of the morbidity and mortality of tobacco would have been outlawed long ago," he says.
He explains that in 2010, mephedrone became a class B drug following widespread media coverage and reports of some deaths in the preceding months, although the evidence surrounding the dangers of mephedrone does not exist. This is in stark contrast to tobacco, he argues, which is responsible for around 100,000 deaths each year in the UK. Why should smoking get special treatment?
"People's attitude towards drugs should be evidence based, and not informed by politics or popular opinion. How must smokers feel when they are encouraged to quit their habit by the same government that welcomes tobacco taxes so gladly?"
He concludes: "While smoking remains legal, the number of smokers is never going to fall significantly - no matter how much taxes rise, how plain cigarette packets become, or how many millions of pounds is spent on cessation."
Frankly, this speaks for itself but in case you missed it I'll repeat the following sentence:
Dr Paul Jepson suggests the tabloid press publish a list of the names of the more than 250 people killed by smoking related disease each day ...
Note "killed by smoking related disease" not "killed by smoking". There is a huge difference, as any doctor who is asked to enter the cause of death on a death certificate will tell you.
See: Is a much more fundamental re-think on smoking needed? (BMJ)
Simon Clark
Curiously, although Dr Jepson's letter was published on September 30, the BBC has decided it is worth reporting now.
Tomorrow morning, therefore, I will be commenting on BBC Radio Essex (7.15), BBC Radio Bristol (7.40), BBC Three Counties (8.05) and BBC Radio Sheffield (9.05).
Pat Nurse will also be interviewed – on BBC Radio Lincolnshire – between 7.30 and 7.40.
Reader Comments (30)
I've been asked to talk about this on local radio tomorrow morning at 8.15am for anyone who wants to listen in. BBC Radio Lincolnshire.
I don't know whether we should be taking much notice of the writer of the letter, Jepson is a vet!
Perhaps doctors should publish the names of those who die each day as the result of medical errors?
"Perhaps doctors should publish the names of those who die each day as the result of medical errors?"
Ha! That'll be the day!
This is Rob Liddle on the money writing about iatrogenesis or death at the hands of the medical profession.
"Iatrogenesis accounts for the deaths of an estimated 72,000 British people every year — or slightly more than the combined numbers of those feckless people dying from smoking, drinking and being very fat. I suppose you could call it the silent killer; there are no government campaigns to educate the public about its lethality."
http://www.spectator.co.uk/essays/3453031/the-smoking-ban-was-always-going-to-be-the-thin-end-of-the-wedge.thtml
You do not die of smoking. Smoking in some cases merely increases your chances of contracting a disease. For example while 84% of lung cancer patients are smokers, 92% of smokers never contract it throughout their lifetime.
On Iatrogenesis (usually medical errors, adverse drug reactions, poor care of the bed-ridden)
http://www.ncbi.nlm.nih.gov/pubmed/9555760?dopt=Abstract
Including more sources of iatrogenesis:
http://www.naturodoc.com/library/public_health/doctors_cause_death.htm
See also Barbara Starfield interview
http://jonrappoport.wordpress.com/2011/06/24/the-starfield-interview/
Including even more sources of iatrogenesis:
http://www.webdc.com/pdfs/deathbymedicine.pdf
‘Global Trigger Tool’ Shows That Adverse Events In Hospitals May Be Ten Times Greater Than Previously Measured
http://content.healthaffairs.org/content/30/4/581.abstract
Institution-wide iatrogenesis attracts very little attention within the medical establishment. Maybe we should have a list of people killed each week (that would be far, FAR easier to identify if it attracts high scrutiny like say….. tobacco-use) by any hospital on the front door of each hospital; maybe even a year-to-date toll; maybe even in the tabloids.
Medicos, like their eugenics predecessors, are becoming dangerously arrogant, haughty, and fascist – AGAIN.
Articles by doctors in the BMJ which use the phrase 'population wide' clearly indicate that the doctors involved are quack doctors. The phrase 'population wide' means STATISTICS. Statistics have no knowledge of individuals. But proper doctors treat INDIVIDUALS and should know that everyone is different. National Statistics show only trends in macro terms.
It beats me that a proper doctor can think in terms of general statistics. I can put it this way - precisely what is the reason for trying to alter the General Statistics? Would it not be better for a 'proper doctor' to spend his time alleviating the suffering of his patients?
Of course, the idea of General Statistics being the most important thing is nonsense. People become ill for various reasons, mostly to do with age. Blaming the Enjoyment of Tobacco for the ailments of old people is like blaming the mind for a stroke.
I'm not denying the serious health risks associated with smoking. It's just a fact.
No, it's not a 'fact'.
Facts are things like 'This stone weighs 3.2 kilograms', or 'This object is blue'. The concept of 'risk' or 'health risk' is not factual in nature, but instead theoretical, because 'risk' is a concept or idea or intellectual construction.
Pah - I was ready for a fight but it was a one sided chat simply asking me whether things had gone too far and smokers were now being marginalised.
"92% of smokers never contract it throughout their lifetime........."
Don't worry, Dave: the Government and its many associates (paymasters and lackeys both) is working on THAT one.
This is one of those areas where we badly need to catch up with America - where cancers (of all sorts) have increased up to 300% since the Eighties.
Probably because they spend so little on 'health care' and pharmaceuticals over there.
Action this day !
Frank, I was referring to the 'fact' that most smoking-related diseases are multifactorial. However, I don't think it helps our cause to play with words or dispute the 'fact' (assertion?) that there are serious health risks associated with smoking.
"Medicos, like their eugenics predecessors, are becoming dangerously arrogant, haughty, and fascist – AGAIN."
The problem is, Magnetic, that too may of them live on a kind of Moral Olympia - high above the clouds. And therefore free from the ethical common sense that motivates the vast bulk of their inferiors down below.
Gods make their own laws, you see.
"You do not die of smoking. Smoking in some cases merely increases your chances of contracting a disease. For example while 84% of lung cancer patients are smokers, 92% of smokers never contract it throughout their lifetime"
What a great phrase Dave - well said!
Report and link HERE if you want to listen again.
However, I don't think it helps our cause to play with words or dispute the 'fact' (assertion?) that there are serious health risks associated with smoking.
Claim?
There are far too many things that are claimed to be 'facts' - such as anthropogenic global warming - which are not facts at all, but are theories. It is not 'playing with words' to point this out. When we speak of facts, we are (or should be) speaking of certainties. And when we are speaking of theories we are not. It is the constant attempt of these people to pretend that their uncertain theories are certain facts, and it is a deceit which ought to be pointed out at every opportunity.
Just going to listen, Pat.
Sorry folks - reckon I allowed the bigoted BBC to set me up . I could have done a lot better and will be better prepared next time. I hope you got on well Simon.
Everyone who has a different point of view is a bigot, eh Pat?
Of course this idea to publish names is a nonsense, and as you said deeply offensive. But you didn't deal with that, instead you went off on some nonsense about no-one you know has died of smoking - instead they die of 'road accidents, motorcycle accidents, and a couple of them suicides..' Even you know that was a pathetic argument. It's not the BBC's fault you did it, and it certainly doesn't make the interviewer a bigot.
But the BBC IS bigoted, simon (nsc), at least from my experience. I get to hear a good deal of R4 and, only once, out of numerous occasions, has an interviewer not questioned from the tacit assumption that the tobacco control position is truthful, proportionate and accurate. It is also noticeable that the tone is respectful towards tobacco control and disdainful towards its critics and tobacco company spokesmen.
Oh - so it's you Simon (nsc) who visits the blog for a fight. I kind of thought it was before when you popped in last year and I told you why I hate anon comments of that nature.
It wasn't one of my best interviews for sure but then it wasn't THAT bad either.
I feel more assured now that I know who came on to tell me how much I am damaging the cause of smokers' rights and that for the good of the cause I should stand down when asked to take part in these things.
oh, and people who have a prejudicial view about smokers and smoking based on their own fears or beliefs are indeed, in my view, bigots.
I know what you mean about bigots, Pat.
For the last three or four days, I have been having a running argument with a bigot on an American (or Canadian) site named 'GnomeAlice'. The article being commented on was about 'Mums' not only not wanting their children to know that they smoke but also not wanting their neighbours and acquaintences to know either, and going to great lengths to avoid being seen.
GnomeAlice was spouting all the usual garbage about addicts and filth and birds killing their chicks by picking up filter tips and using them in their nests and the oceans being awash with tips, etc. I was taking great pleasure in knocking her arguments down one by one, but the site shut down comments this morning!
The bigot bit was her wish to control not only her own children and grandchildren, but also the rest of the world's children as well - all on the basis of her own blind beliefs.
Actually, no, your anonymous commenter wasn't me. Not this time, not last time. Sorry to disappoint.
"You do not die of smoking. Smoking in some cases merely increases your chances of contracting a disease."
That's precisely how to put it! Statistics show it's not the active smokers who die more of smoking, it's the passive ones...!
"Statistics show it's not the active smokers who die more of smoking, it's the passive ones........................."
In fact, 'statistics' can probably be found to show that EVERYONE 'dies of smoking' - sooner or later.
It occurs to me that if NATO were to impose an Al Qaida leadership and Sharia Law upon this nation of the once-relatively-free - as it just has in a certain North African country - there'd be swarms of white, middle-class pscycho-meddlers hailing the event as A Good Thing (whether from a 'Guardian' or a 'Daily Mail' perspective).
In the meantime, let us praise God for not giving sheep claws !
Having read these messages, especially those from Pat Nurse, I have now listened to her interview. Frankly, given the various comments, I was expecting a sprawling mess. How nice to report that Ms Nurse's defence of smokers and her passionate but reasoned argument against our denormalisation came over as cogent and well argued. What a refreshing change from all those programmes about smoking when almost all those in favour of the habit start off with guilty apologies. Ms Nurse you have no need to beat yourself up. You are a media smoking star.
Thanks Simon (nsc) for the clarification.
And thanks Grumpybutterfly. When one has no idea of what one is doing, then it always helps to have feedback and I got a kicking over at my blog for the interview.
My guess now is that it was just someone who wanted to make me feel bad about myself. That is a common occurrence for smokers today in all aspects of life, is it not.
As frank points out about THEORY .A theory is just that a theory until its proven under the microscope! The use of statistics is just that statistics based upon epidemiology that creates relative risks factors and those get fed into a computer to spit out xxxx.
But even when we look at actual causes of deaths,even in the case of lung cancer,We dont find broken down in the cause box
1. Cause of death was cancer ate up lungs and bodily functions ceased due to asphyxiation or whatever happens. What we should be seeing is cancer either began in lung and progressed to xx part of the body or cancer of xx travelled to the lungs!
What I am getting at is we have no clear cause of death and even then,THEY STILL HAVENT PROVED SMOKING CAUSES ANYTHING!
I think we all know about the IARC funded '' we made a throat study and in it we caused cancerous lesions in its lining inducing tobacco smoke............As far as I know the results were never replicated by anyone anywhere, then again,who is looking over the researchers shoulder when they do their ASSAYS of cells!
All to often this is where we find the claims being made,in xx number of assays we saw xxx while in xxx we saw nothing,but xxx showed more xxx than other assays of xxx!
To make claims of cause xxxx should always be the same as xxx across the board!
But because xxx never equals xxx 100% of the time we can understand why 94% or so of smokers dont get cancer!
So if they cant prove xxx causes whatever,they come up with the lies of all lies EPIDEMIOLOGY!
Even the climatoligists got on the voodoo magic train with epidemiology as HEIDI KLUM of the weather channel and vocal advocate for global warming said, epidemiology is our new tool to prove climate change exists!
Weather Warnings For A 'Climate Changed Planet' : NPRwww.npr.org › News › Science › EnvironmentAdd to iGoogleNot helpful? You can block www.npr.org results when you're signed in to search.www.npr.org
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Jul 25, 2011 – In her book The Weather of the Future, climatologist Heidi Cullen writes, "It's time to face the fact ... NPR reviews, interviews and more .... to something like climate change, it's based on techniques that we use in epidemiology. ...
Pat -
Your self-control (I could feel your anger rising) in the face of such belligerent stupidity was a wonder to me. I thought you did admirably.
But it might be wise in future (he says presumptuously) to arm yourself at least with the titles of two or three recent studies (Dave Atherton is particularly brilliant in this area) which confound the Tobacco-As-Totally-Evil thesis.
I've found this particularly effective when dealing with the shrinking number of Global Warming fanatics/gulls/believers (bless ‘em).
Whenever one of their number mentions 'the scientists' or 'consensus', I counter with the likes of Richard Lindzen, Bob Carter, Piers Corbyn, Nils Axel Morner - and the 31,000 scientists who signed the Manhattan Declaration a few years ago.
This also neutralises in advance the tedious (and pointless) "Well, are YOU a scientist/doctor/epidemiologist ?" bit.
It usually shuts them up, I find.
On the subject of Junk Science, some TL veterans might also like to consider the highly readable (and wittily informative) ‘The Great Cholesterol Con’ (2007) by Dr Malcolm Kendrick.
I mean, ‘reducing cholesterol levels’ is A Good Thing, right ? We ALL know that (not least from all those adverts on the telly).
Wrong ! Dead wrong in fact – and Kendrick shows you why.
Want to make big bucks, Young Man ? Then I suggest you think about joining the Fear-Creation Industry. The opportunities are practically limitless. As are the profits.