Is tobacco smoke in a vehicle 23 times more toxic then in a home?

Ever heard the one about tobacco smoke in a vehicle being “23 times more toxic than in a house”? You’ll see it rear its ugly head in jurisdictions where tobacco control groups are pushing for a ban on smoking in cars.

In Ontario, Canada, the Ontario Medical Association is given as the reliable source of this data(1). The problem is the OMA cites a newspaper article(3) as the source of this ‘evidence.’

An exhaustive search for scientific support for this claim has found two studies that have measured in-vehicle particulate concentrations associated with tobacco smoke. One, the paper published in 2007 by Ott el al and a 2002 paper by Offermann et al(5) presented at a 2002 International Conference on Indoor Air Quality and Climate. The later paper by Offermann is the likely source of the ’23 times’ claim since Offermann claims tobacco smoke in vehicles is “25 times more toxic than in a house.”

The 2007 Ott study was funded by Flight Attendant Medical Research Institute (FAMRI). FAMRI is “funded through a settlement from a class action lawsuit against tobacco companies on behalf of flight attendants who sustained health problems due to exposure to second hand smoke in their job.”

The 2004 Offermann study was funded by “the Tobacco Free Project, San Francisco Department of Public Health, paid for by Proposition 99, the 1988 Tobacco Tax Initiative, under Contract 89-97927.”

Both studies measured particulate matter inside a vehicle with a smoker and found:

• particle levels smaller than 3 microns peaked between 2000 and 3000 ug/m3 for a very few seconds when a cigarette was first lit. These peak measurements occurred only when the vehicle’s windows were closed and the fan was turned off with a resultant low air exchange rate (about five complete air exchanges per hour). The average ug/m3 while the cigarette was smoked in this sealed vehicle was around 1200.

• turning the fan in the vehicles on increased the air exchange rate to about one complete exchange every minute thus reducing the particulate count inside the vehicle. The average ug/m3 during while the cigarette was smoked in this sealed vehicle with the fan on was around 700.

• opening one window (3” in Ott’s study) increased the air exchange rate even further with an additional decrease in particulates inside the vehicle. The average ug/m3 during while the cigarette was smoked in this windows open/fan off vehicle was around 92.

• The actual volume of the inside compartment of the vehicle is a critical measurement when determining concentrations. Offermann’s 2004 study estimated the volume inside a ‘1996 mini-van’ at 2.0 m3. Ott’s 2007 study estimated the volume of the much smaller ‘2005 Toyota Corolla’ at 2.6 m3.

In addition to their questionable objectivity both studies suffer serious methodological flaws.

• the difficulty in accurately determining the actual volume of air inside a vehicle as evidenced by the estimated air volume inside the compact Toyota Corolla being greater than the volume of air inside the mini-van.

• the particulate measurements obtained by Offermann incorrectly refers to particulates as ets. He counted all particles under 3 microns in diameter. Equipment cannot differentiate between tobacco smoke, road dust, pollen, diesel exhaust, paint pigment, carpet fibres, skin cells, soot and viruses that are less than 3 microns diameter. Therefore his measurements include other sources of particulates inside the vehicle. How much did these others sources contribute?

• no particle measurements were taken inside a car with non-smoking passengers to determine background levels of particulates inside the vehicle. Any movement can be expected to send particulate matter from engine exhaust, carpets, clothes, skin and a myriad of other sources into the air of the vehicle.

• the Dusttrak measuring equipment used in the Offermann’s 2004 study is well known to give readings up to 3 times higher than actual(8).

• humidity also give readings(9) higher than actual and no adjustment was made to account for this (ie drying tubes). In addition, the highest measurements were recorded inside a vehicle with windows closed and fan off which one would expect would increase humidity inside the vehicle.

• Offerman’s measurements of air quality inside a vehicle were not used to compare to air quality inside a home. Rather the air quality for vehicles was estimated and then compared to the air of a home. A far more appropriate comparison would be to OSHA indoor air quality standards(10) which consider up to 5000 ug/m3 per hour for an 8 hour day/40 hour work week over the course of a workers employment life to be safe.

• Another more suitable comparison would be fine particulates inside a bus which have been measured to peak at 1732 ug/m3 in the middle of the bus with extraordinarily high peaks around 12000 ug/m3 near the door to the bus(11) Both studies compare air quality inside a vehicle to outdoor air quality standards. The irrationality of this is apparent. Compare the EPA’s outdoor air quality standards for particulate matter under 2.5 microns(12) (currently 35 ug/m3 over 24 hours) to OSHA indoor air quality standards that ensures a safe indoor workplace((10) above). If EPA standards dictated workplace air quality no workplace would be considered safe.

The Canadian Charter of Rights and Freedoms protects Canadians from the unreasonable interference of government in the lives of people in a free and democratic society. While the Charter does allow the government to legally limit an individual's freedoms it does so within clearly defined reasonable limits. Surely the evidence above that is now being used to press for limits to Canadian’s privacy and existing freedoms cannot be helpful to any sincere considerations to limit these civil liberties.

References

1 Witmer Stands Up For Children. http://www.elizabethwitmermpp.ca/news/show_news.php?subaction=showfull&id=1201190349&archive=&template=sidebar

2 OMA Position Paper, Exposure to second-hand smoke: are we protecting our kids? https://www.oma.org/Health/tobacco/smoke2004.pdf

3 Sanko J. Bill targets smokers in cars: Boulder Senator says state should step in on behalf of children. Rocky Mountain News (Denver, Colorado) 1998 Jan 10:6A.

4 Wayne Ott, Neil Klepeis and Paul Switzer, "Air change rates of motor vehicles and in-vehicle pollutant concentrations from secondhand smoke". Journal of Exposure Science and Environmental Epidemiology, 18 July 2007; doi: 10.1038/sj.jes.7500601 http://www.nature.com/jes/journal/vaop/ncurrent/abs/7500601a.html

5 Offermann F.J., Colfer R., Radzinski P., and Robertson J. Exposure to environmental tobacco smoke in an automobile. Proceedings of the 9^th International Conference on Indoor Air Quality and Climate, Monterey, CA,

June 30-July 5, 2002. Paper No. 2C3p1, pp. 2002, 506. http://www.iee-sf.com/resources/pdf/ETSincars.pdf

6 M Nebot¹, M J López¹, G Gorini², M Neuberger³, S Axelsson⁴, M Pilali⁵, C Fonseca⁶, K Abdennbi⁷, A Hackshaw⁸, H Moshammer³, A M Laurent⁹, J Salles¹⁰, M Georgouli⁵, M C Fondelli², E Serrahima¹⁰, F Centrich¹⁰, S K Hammond¹¹ Environmental tobacco smoke exposure in public places of European cities Tobacco Control 2005;14:60-63 http://tobaccocontrol.bmj.com/cgi/content/abstract/14/1/60

7 Air quality testing and secondhand smoke.....an update http://cleanairquality.blogspot.com/2006/02/air-quality-testing-and-secondhand.html

8 Chung, A. Chang, D.P.Y., Kleeman, M.J., Perry, K.D., Cahill, T.A., Dutcher, D., McDougall, E.M. and Stroud, K. (2001). Comparison of real-time instruments used to monitor airborne particulate matter. Journal of the Air And Waste Management Association., v. 51, p.109-120.

9 Chang et al (2001) Laboratory and Field Evaluation of Measurement Methods for One-Hour Exposures to O3, PM2.5 , and CO; Journal of the Air and Waste Management Association, vol. 51, pp. 1414-1422.

10 TABLE Z-1 Limits for Air Contaminants http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9992

11 A Multi-City Investigation of the Effectiveness of Retrofit Emissions Controls in Reducing Exposures to Particulate

Matter in School Buses http://www.catf.us/publications/reports/CATF-Purdue_Multi_City_Bus_Study.pdf

12 EPA National Ambient Air Quality Standards http://www.epa.gov/particles/standards.html

Where are the health benefits of prevention?

In our asbestos insulated elementary school, when we weren’t cowering under our desks or in the hallways seeking shelter from a fake nuclear attack, we crafted puppets out of asbestos mixed with water and glue. We marveled in our radioactive glow of our watches in the dark attic of our asbestos insulated wartime homes. We breathed the asbestos fibres spewed into the air every time the brakes on nearby automobiles were applied and inhaled numerous long lasting radioactive elements from above ground nuclear testing. We ate and drank the same radioactivity that had settled on our food and infiltrated our milk. Many of us spent decades working in asbestos filled workplaces. Even cooking at home exposed us to fraying asbestos oven mitts.

Those who share similar memories should be able to take some comfort in recent reports from International Early Lung Cancer Action Program (ELCAP) investigators confirming lung cancer is a rare disease - even among those deemed most at risk.

Screening of 31,567 asymptomatic high risk persons for lung cancer from 1993 through 2005 did not find the disease in 98.5% of those screened. When lung cancer was found and surgically removed within a month of its discovery the researchers concluded “annual spiral CT screening can detect lung cancer that is curable.”

Our medical gurus can’t tell us what causes lung cancer – nobody can. Some surmise that one asbestos fibre or radioactive particle trapped deep in a lung is all it takes to initiate a process that results in a cancerous growth years later. ELCAP investigators defined those at high risk for lung cancer if they were over 55, had a history of cigarette smoking, occupational exposure to asbestos, the radioactive isotopes beryllium, uranium and radon, or exposure to secondhand smoke.

Anti-tobacco groups don’t tell us lung cancer is a rare disease. They’d have us believe self-inflicted diseases are ravaging our society at a cost of thousands of deaths annually – some anti-tobacco nuts are up to billions of deaths - added to billions in economic devastation.

Statistics are used to tell us smoking increases the risk of lung cancer 400%. Groups touting prevention strategies promote this flawed assessment of chance to sell both the fear of disease and tickets to their lotteries. Buy five tickets instead of one to increase your relative risk of winning the 649 lottery by 400% - to a whopping absolute risk of five out of 14 million.

Over the past three decades billions of health care dollars have been diverted to smoking prevention. We were told reduced smoking would almost totally eliminate lung cancer, prevent many other cancers and heart diseases. In response to these claims between 1970 and 2003 smoking rates among those 15 and older has dropped from 55% to 35% in men and 39% to 21% in women.

Yet despite this significant reduction in smoking the age standardized incidence of lung cancer has continued to increase. Lung cancer incidence in men in 2001 was the same as it was in 1976. During the same period the incidence of lung cancer in women increased steadily from 16.3 to 44.5 per 100,000. In fact in men and women the incidence of cancer and the prevalence of heart disease have steadily increased for the past thirty years.

Where are the health benefits we’ve been promised?

Let’s not think for a moment prevention advice is benign. Expensive prevention campaigns have diverted scarce funding away from the valuable research, treatments and facilities needed for all our serious ills. That a lung cancer patient doesn’t get the timely treatment ELCP researchers tell us may cure the disease is only one shameful example of a huge problem in obtaining timely health care.

Next time you’re waiting for a health care service consider how much more could be accomplished if money spent creating frightening or just plain silly prevention messages was used to train more doctors and nurses, provide better equipped facilities and fund real research devoted to finding more effective treatments or, as ELCAP researchers are claiming, maybe even a cure or two.

Risks of smoking exaggerated

The risks of smoking are greatly exaggerated Too much is made of the 4,000 chemicals in tobacco smoke. We're told these chemicals are so harmful that they are responsible for the deaths of millions worldwide. Untold in this "war on tobacco" is that each of the plants we consume consists of an equally daunting thousands of chemicals many of which are recognized poisons or suspected cancer-causing agents. Cayenne peppers, carrots and strawberries each contain six suspected carcinogens; onions, grapefruit and tomato each contain five -- some the same as the seven suspected carcinogens found in tobacco.High-heat cooking creates yet more dietary carcinogens from otherwise harmless chemical constituents. Sure, these plant chemicals are measured in infinitesimal amounts. An independent study calculated 222,000 smoking cigarettes would be needed to reach unacceptable levels of benzo(a)pyrene. One million smoking cigarettes would be needed to produce unacceptable levels of toluene. To reach these estimated danger levels, the cigarettes must be smoked simultaneously and completely in a sealed 20-square-foot room with a nine-foot ceiling. Many other chemicals in tobacco smoke can also be found in normal diets. Smoking 3,000 packages of cigarettes would supply the same amount of arsenic as a nutritious 200 gram serving of sole. Half a bottle of now healthy wine can supply 32 times the amount of lead as one pack of cigarettes. The same amount of cadmium obtained from smoking eight packs of cigarettes can be enjoyed in half a pound of crab. That's one problem with the anti-smoking crusade. The risks of smoking are greatly exaggerated. So are the costs. An in-depth analysis of 400,000 U.S. smoking-related deaths by National Institute of Health mathematician Rosalind Marimont and senior fellow in constitutional studies at the Cato Institute Robert Levy identified a disturbing number of flaws in the methodology used to estimate these deaths. Incorrectly classifying some diseases as smoking-related and choosing the wrong standard of comparison each overstated deaths by more than 65 per cent. Failure to control for confounding variables such as diet and exercise turned estimates more into a computerized shell game than reliable estimates of deaths. Marimont and Levy also found no adjustments were made to the costs of smoking resulting from the benefits of smoking -- reduced Alzheimer's and Parkinson's disease, less obesity, depression and breast cancer. If it were possible to estimate 45,000 smoking-related Canadian deaths as some health activists imagine -- and Marimont, Levy and other respected researchers think it is not -- then applying an identical methodology to other lifestyle choices would yield 57,000 Canadian deaths due to lack of exercise and 73,000 Canadian deaths blamed on poor diets. If both the chemical constituents of tobacco smoke and the numbers of smoking-related deaths are overstated -- and clearly they are -- how can we trust the claim that tobacco smoke is harmful to non-smokers? The 1993 bellwether study by the Environmental Protection Agency that selectively combined the results of a number of previous studies and found a small increase in lung cancer risk in those exposed to environmental tobacco smoke has been roundly criticized as severely flawed by fellow researchers and ultimately found invalid in a court of law. In 1998, the World Health Organization reported a small, but not statistically significant, increase in the risk of lung cancer in non-smoking women married to smokers. Despite these invalidating deficiencies, the Environmental Protection Agency and World Health Organization both concluded tobacco smoke causes lung cancer in non-smokers. One wonders whether the same conclusions would have been announced if scientific fraud were a criminal offence. When confronted with the scientific uncertainty, the inconsistency of results and the incredible misrepresentation of present-day knowledge, those seeking to abolish tobacco invoke a radical interpretation of the Precautionary Principle: "Where potential adverse effects are not fully understood, the activity should not proceed." This unreasonable exploitation of the ever-present risks of living infiltrates our schools to indoctrinate trusting and eager minds with the irrational fears of today. Instead of opening minds to the wondrous complexities of living, it opens the door to peer ridicule and intolerance while cultivating the trendy cynics of tomorrow. If we continue down this dangerous path of control and prohibition based on an unreliable or remote chance of harm, how many personal freedoms will remain seven generations from now?

First published KW Record Wednesday November 20, 2002