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    Monday, January 23, 2006

    Health Totalitarians: The Spanish writer Javier Marias on anti-smoking laws, democracy, and totalitarianism:

    A totalitarian state is one that sticks its nose where it doesn't belong and attempts to intervene in every aspect of its citizens' private lives, and many governments today, whether left, right or center, have developed this practice of behaving like busybodies. The old notion that only dictatorships can be totalitarian seems terribly naïve nowadays. And that is the worst thing about this antismoking law and others of the same ilk: they unfortunately prove that totalitarianism is no longer incompatible with the democratic systems that once guaranteed our freedoms.
     

    posted by Sydney on 1/23/2006 07:03:00 AM 6 comments

    6 Comments:

    What rubbish.

    He agrees that where you are exposing others to secondhand smoke, it is unacceptable, but contradicts himself later in the "article". This is called protecting the health of asthmatics, children, ANYONE who chooses not smoke. That choice should be respected, too.

    Smoke in the privacy of your own home. But if you have small children, this is a form of abuse.

    The right of others to be free from your carcinogenic output overrides this freedom.

    Stick your head in the microwave, if you want. Just don't go around microwaving at others. Same principle.

    I feel saddened by those who zealously defend their addiction...they don't even know they're addicted one suspects. They "choose" each cigarette. Right.

    Sorry for the rant....what's your opinion on this, Dr S ???

    By Blogger Dr Dork, at 9:25 AM  

    Dr. Dork,

    I think he has a point. He's defending the right to smoke in his own office, away from others. Though public spaces can be a problem, having a separate smoking area that's walled off and separate from the non-smoking section seems a better choice than completely banning smoking altogether.

    I worry about the next step. What freedoms will be restricted next in the name of health? The right to choose your own food? (Even if you choose badly.) The right to sit down and relax at the end of a hard day instead of going to the gym and running a mile? The right to have a glass of wine or a glass of beer?

    After all, in some way, those choices affect others, too. Especially the drinking.

    By Blogger Sydney, at 11:56 AM  

    The evidence that cigarette smoke is dangerous to the smoker is scientifically accepted, is non-controversial and has been commonly accepted for more than 50 years. My parents warned me about health risks of smoking (mostly lung cancer) back in the 1950's.

    I don't know whether the evidence for the health risks of so-called "second-hand" smoke is as well decided. It certainly seems much more controversial.

    Are you aware of a persuasive body of evidence relating to the risks of second-hand smoke? All I have been able to find (other than political statements) seem equivocal and not very conclusive. That includes information that I could find that has been published by EPA, WHO, and CDC. Maybe I'm not looking in the right places?

    Stella Baskomb
    New York

    By Anonymous Anonymous, at 12:46 PM  

    Anonymous,

    I haven't found anything that's shown second hand smoke to be as dangerous as it's portrayed, either.

    It's certainly true that asthmatics and others with respiratory problems can be triggered by the second smoke, but as far as its ability to cause emphysema and lung cancer and heart disease it isn't so clear that it's any worse than the other air pollution encountered in an industrial society.

    By Blogger Sydney, at 7:38 AM  

    Stella,

    Here's a few refs I just pulled off Medline.

    Cardiovascular effects of secondhand smoke: nearly as large as smoking.
    Circulation. 2005 May 24;111(20):2684-98. Review.

    Passive smoking: secondhand smoke does cause respiratory disease.
    BMJ. 2003 Aug 30;327(7413):502; author reply 504-5.

    The association between secondhand smoke and the risk of developing acute coronary syndromes, among non-smokers, under the presence of several cardiovascular risk factors: The CARDIO2000 case-control study.
    BMC Public Health. 2002 May 24;2:9.


    Passive smoking induces atherogenic changes in low-density lipoprotein.
    Circulation. 1998 May 26;97(20):2012-6.


    What's so passive about passive smoking? Secondhand smoke as a cause of atherosclerotic disease.
    JAMA. 1998 Jan 14;279(2):157-8. No abstract available

    Lung cancer in nonsmokers.
    Cancer. 1984 Mar 1;53(5):1214-21.


    The evidence is quite overwhelming. This is what I found in a 5 minute search. You can get the full text from a medical library or online from many of the journal websites.

    Thanks for your thoughts, Dr S. I found the article hypocritical as he seems to be defending smoking in public places, not just the privacy of ones own home.

    To me it is also an issue of whether "individual freedom" allows one to harm others. That is where I draw the line. Drunks who crash cars or assualt others are treated as criminals.

    I think a solution is to be proactively positive in terms of government activity...such as subsidising healthy food initiatives. And directing the high taxes from alcohol and tobacco to programs that counteract the harm these things do to society as a whole...including helping to fund care for the diseases they produce, as well as primary prevention campaigns to combat the insidious effect, especially on impressionable youth, of advertising by these industries.

    Dr D

    By Blogger Dr Dork, at 7:55 AM  

    My grandmother died of emphysema in 1976. That was long before any study about secondhand smoke. Of course, she grew up before central heating and therefore, was exposed to wood smoke but her family always suspected her close contact with my grandfather and his three pack a day addiction to camel cigarettes. As a family we had little medical knowledge but we always suspected the long number of years that she lived with a smoker had a lot to do with her disease. Scientific? NO! Based on fact? NO! Kept one granddaughter from picking up that first pack of cigarettes? Yes!

    By Anonymous Anonymous, at 8:44 AM  

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