Smoking myths leave me fuming
The notice was not only unnecessary, but also had a hectoring and bullying tone
Campaigners are celebrating the 10th anniversary of the ban on smoking in pubs, restaurants and other public places. Two recollections of the crusade against passive smoking might explain why I will not be joining them.
In 2004, a couple of years before the ban was introduced, I attended a historic presentation by Prof Sir Richard Doll, who co-authored the famous 1954 study that established the causative link between cigarette smoking and lung cancer. In a 50-year follow-up study, published the year before his death at the age of 92, Prof Doll confirmed that, on average, smoking reduced life expectancy by about 10 years.
In the Q&A after his lecture, Prof Doll annoyed campaigners against “passive smoking” by conceding that the evidence for its health risks was “very weak”. Subsequently, as a guest on Desert Island Discs, he told Sue Lawley that “the effects of other people smoking in my presence are so small that it doesn’t worry me”.
Statistical sleights of hand are now being used to claim dramatic benefits from the smoking ban on levels of smoking and death rates from heart disease, both of which have been declining for decades. Smoking rates, in fact, declined more rapidly in the Seventies and Eighties before the introduction of coercive anti-smoking measures. The fact that the smoking ban coincided with a continuing decline in fatalities from heart disease does not justify the claim that the former caused the latter – a familiar epidemiological fallacy.
Shortly after the introduction of the smoking ban, I arrived at my health centre surgery to find that the authorities had installed notices instructing patients that they were not allowed to smoke on the premises. Inquiries with colleagues confirmed that, for at least the previous decade, nobody could remember any patient lighting up in the waiting room. The notice was not only unnecessary, but also had a hectoring and bullying tone, reflecting the paternalistic and condescending outlook that pervades public health.
No doubt, smoking is not good for health and patients would be well advised to stop. Yet there is something insidious in the way the anti-smoking campaign has increasingly curtailed the autonomy of the individual in making decisions related to health.
Mind games
While it is closing down most of its adult social care services, including day centres for sufferers from dementia, our local council in Haringey, north London, is devoting considerable resources to promoting exercise as a means of preventing Alzheimer’s disease. It is offering subsidised gym membership, free swimming sessions, and organised walks and exercise classes, claiming that these are “evidence-based” initiatives.
Now a major study suggests that our senior citizens might as well put their feet up and take things easy.
Using data gathered over three decades from 10,000 British civil servants, epidemiologist Séverine Sabia and colleagues in Paris have found that exercise does not have a beneficial effect on cognitive function. They conclude that “the inclusion of physical activity in guidelines to tackle the burden of dementia seems not be based on robust evidence of a protective effect of physical activity”. There are On average, smoking reduces life expectancy by about 10 years many good reasons why older people might enjoy a walk in the park or even more strenuous exertions. But while they do not need the council to exhort them to keep fit, they may still need support services should they experience symptoms of dementia.
Cruellest cut
Having received requests for referral for the surgical procedure known as the “designer vagina” (but more accurately as labiaplasty), I share the alarm of adolescent gynaecologist Dr Naomi Crouch at the growing demand for this operation from younger girls. According to Dr Crouch, last year about 200 girls under the age of 18 underwent labiaplasty – and 150 were under 15.
Dr Crouch draws a parallel between the fashion for labiaplasty and ritual female genital mutilation. Though the former is fashionable, the latter (though in my experience less commonly practised, at least in the UK) is universally condemned.