Fate

In common with Frank Davis and some others, I have come to have grave doubts about the findings of studies like Doll’s Hospital Study and his Doctors Study. [There are links to Frank Davis’s blog and the studies in the sidebar] Not being ‘au fait’ with epidemiology, I was feeling my way in the dark. I knew that Hypocrites originated the terms ‘endemic’ and ‘epidemic’. Very roughly, a health condition which affects only a small group of people within a population is ‘endemic’ to that group, whereas a condition which affects all the people in that population is ‘epidemic’ to that population. We hear a lot about epidemics these days but rarely hear about endemics. Why is there not a ‘science’ of ‘endemiology’ alongside ‘epidemiology’? According to my spell checker, there is no such word as ‘endemiology’. Why is that?

Let me say that I have no argument, generally speaking, with the statistics generated by those studies. Despite Doll’s connections with the Rockefeller Foundation (he was a Rockefeller supported student) and his connections with anti-tobacco doctors in Nazi Germany pre-war, I don’t think that he was especially dishonest, though he might have had biases. What I firmly believe is that the idea that smoking causes lung cancer was already firmly entrenched within certain academic and medical circles and that the studies were always intended to find proof of that concept. I also believe that Doll’s studies and similar studies in the USA were planned and coordinated. I have no doubt that the Hospital Study was a ‘proof of concept’, relatively cheap study intended to justify the following Doctors Study, which would be far, far more expensive. Doll himself said that the Doctors Study was intended to be a twenty year study and not a fifty year study. Since the Doctors Study started in 1951, it is clear that the plans intended the study to be completed by 1971. I suspect strongly that the failure of Prohibition figured strongly in the thinking and planning of these proto-Zealots. I think that they knew all along that a frontal assault on Big Tobacco would fail, and that Big Tobacco had to be undermined a bit at a time.

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It is only when you look at the statistics provided by the Doctors Study carefully that you realise that something is wrong. It may be true that heavy smokers died from LC more often and sooner than moderate smokers, and that the same applied to moderate smokers when compared with light smokers, and that non-smokers died the least from LC. Does that prove that smoking actually causes LC? Not in the slightest. It merely suggests that smoking is a factor in the development of LC. You do not need to have doubts about the statistics.

In the McTear Case [see sidebar], Doll and other witnesses were unable to satisfy the Judge that smoking was the cause of McTear’s LC, even merely on the balance of probabilities. That was in 2005. There has been no subsequent court case which has been brought in order to ‘prove’ that smoking caused the LC of any person. Why not? Because no one really knows why one smoker gets LC at the age of 50 while the vast majority of other smokers, who smoke to the same extent, do not. In fact, if you read the reports from the Doctors study, and the Judge’s Opinion from the McTear Case, it is perfectly clear that there are other factors also at work. Perhaps the most important one is genetic, but there are all sorts of other factors, such as the damage which might have been done to one’s lungs if one lived in a smoky, industrial area as a child, or serving as a doctor in the trenches of WW1, or being infected by some virus which damaged one’s lungs before the virus was eliminated. No one knows.

If that is true, then every individual is subject to the unpredictability of FATE. I do not use that word in a semi-religious, demonic way. I mean the simple fact that tens, hundreds or even thousands of factors decide our FATE. FATE being when we die and why we die. What is certain is that we will all die. That is our FATE.

Something that I read today said that around 18% of LCs occur in non-smokers. It suggested that these cancers were caused by eating white bread and other similar things. I suppose that ‘researchers’ must have extracted statistics which show some correlation. The research was published and so it must be true. That is equivalent to “The newspaper said so and it must therefore be true”.

Another result of the Doctors Study was that by far and away, persons who died as a result of COPD were smokers. Right – except that the number of people who died for that reason was TINY in terms of the number of doctors involved.

By far the biggest cause of death was heart failure. Why should anyone be surprised by that? When your heart stops beating, whatever the reason, you become dead. But the statistical strength of the effect of smoking and non-smoking, as regards heart problems, was much less in the Doctors Study than was the LC occurrence. Smoking might have been part of a person’s decision to die.

Decision to die?

Old people become weary eventually. An acquaintance of mine, someone whom I have known for a couple of decades, recently died. During the last several years, he had degenerated to the extent that he hobbled to the pub with a walking stick. Lately, he did not show up. And then he died. His funeral was today. I did not know, but my daughter did, and she went to the funeral. He was a curious character – abrasive but amusing. He was out and out anti-smoking, but he was ‘up front’ about it. He never pretended that it was about health. It was just his dislike of tobacco smoke. I liked him because he could also see the comical side of things.

Human bodies deteriorate. Repair mechanisms deteriorate. That is FATE.

I would rather smoke, drink and enjoy, and accept FATE than try to avoid FATE.

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Our Government does not seem to understand the notion of FATE. Cameron does not understand it. Everything that he says about Brexit suggests that the EU is IN CONTROL of events. It is not and cannot be because it has no power. It is an empire without teeth or purpose. It is nothing more than a ideology.

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I am 76. I might die soon. I do not know. I feel OK. FATE will decide when my heart stops beating. That is all. ASH ET AL will not decide.

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23 Responses to “Fate”

  1. thelastfurlong Says:

    The link between lung cancer and exposure to diesel exhaust has not been studied really. Nor, in Doll’s study, the effect of Smog.

    • junican Says:

      Nor the effect of being involved in the military during WW1 and WW2. Vast numbers of doctors must have served in the military during those wars. To what extent were they subjected to inhaling cordite etc?

  2. Frank J Says:

    Without going in to the large gaps in, and veracity of, individual surveys, nothing was surveyed by Doll, Hill and, latterly, Peto (or since) other than simple smoking. Given that the majority of smokers of whatever number consumed do not develop these complaints, they cannot, possibly, be called a general cause.

    Common sense dictates that it should give rise to further studies into these particular cases i.e. why did they develop the complaints and not others. For some reason it didn’t, which indicates that it was designed only for tobacco and once they thought they had what they wanted, end of.

    If you couple this with the fact that no animal in lab conditions has developed LC despite being clogged with tobacco smoke (a rather curious fact) whilst other cancers have been easily induced, we have reason to be extremely, extremely, sceptical.

    Certainly, in some people it may be a contributory factor as anything in this world will be harmful to somebody but it is, imo, wholesale negligence for these particular cases not to be studied further.

    I await the result of the appeal case in India over plain packaging where the judge(s) have asked for ‘proof’ that smoking causes cancer. Judge Nimmo Smith asked for proof and didn’t receive it. Should be interesting.

    • junican Says:

      I hope that the McTear Case figures strongly in the Indian examination of the facts. As you said, animal experiments have produced no evidence that smoking causes LC. Correlation ‘proves’ that the Sun revolves around the Earth.

  3. garyk30 Says:

    In Doll’s Doc Study LC deaths were also only a small part of the total deaths; that is, they were only 4%.

    Heart Attack Deaths(HAD) were a much greater part at 30%.

    Curious paradox is that never-smokers have a greater percentage of total deaths being heart attack deaths.
    Never-smokers are more likely to die such a death than are smokers.

    The antis claim that smoking ’causes’ HAD because smokers have a much greater rate of HAD per 1,000 people per year.

    Never-smokers HAD rate = 6.19/1,000 compared to smokers’ rate of 10.01/1,000.

    Thus, one might think that smokers had a 60% greater probability of dying a HAD than do never-smokers.

    Antis are stupid enough to think such is true.

    A higher death rate does not mean there is a higher percentage of total deaths.

    But, the 6.19 never-smoker HAD’s are 32% of the never-smokers total of 19.38 deaths.

    Smokers 10.01 HAD’s are only 28% of the total 35.4 deaths.

    Never-smokers have a 13% greater percentage of deaths being from HAD.

    For Stroke deaths, never-smokers have a 12% greater percentage of total deaths.

    For other vascular diseases, the percentages are the same at about 12% of total deaths per year.

    These three diseases are about 55% of total deaths.

    We can not precisely predict our fate; but, it would seem that there is a 50% probability that we will die from one of those diseases.

    • garyk30 Says:

      The deaths from ‘all other neoplasms'(all other cancers) are 74% of the cancer deaths.

      Never-smokers had 17.2% of their total deaths from such diseases and smokers had 13.3% of their deaths from those diseases.

      Thus, never-smokers have 29% more of their deaths from those diseases than smokers.

      Paradox= smokers have higher death rates; but, a lower percentage of deaths from the cancers that cause 74% of cancer deaths.

      • junican Says:

        So does smoking protect against those other cancers? My point is that none of those stats matter, since FATE decides. FATE is the sum of factors which cause a person to have a heart attack or whatever. There are myriad factors.

  4. Tony Says:

    Doll’s hospital study is basically just a copy of Franz Muller’s 1939 study (which Doll knew about) but with a larger sample.

  5. Tony Says:

    Do dead smokers stay dead?

    It seems not, according to Doll.

    Doll, in his “doctors study”, monitored British doctors over a period of 50 years, reporting on mortality vs smoking at intervals. The last two reports were in 1994 and 2004.

    I was looking at these a few years ago when I noticed something truly bizarre. In the ten year period, some 5,000 of his cohort had died. But extraordinarily, it turned out that at least 600 smokers had been brought back from the dead – Hallelujah!

    Comparing accumulated mortality figures given in both studies (1)(2):
    Never smoker deaths 2215 (1994) – 2917 (2004) = 702 new deaths
    Former cig smoker deaths 4802(1994) – 5354 (2004) = 552 new deaths
    Current cig smoker deaths 5280 (1994) – 4680 (2004) = 600 resurrections
    Former pipe/cigar deaths 3187 (1994) – 5713 (2004) = 2526 new deaths
    Current pipe/cigar deaths 5039 (1994) – 6682 (2004) = 1643 new deaths
    This is not just a simple typo because:
    Smokers of 1-14 per day – 317 resurrected
    Smokers of 15-24 per day – 170 resurrected
    Smokers of =>25 per day – 113 resurrected
    All of the 2004 figures are internally consistent as are the 1994 ones.

    References:
    1. The 1994 study – table 5
    http://www.bmj.com/content/309/6959/901/T5.expansion.html
    2. The 2004 study in full (table 1 is the relevant one)
    http://www.bmj.com/content/328/7455/1519.full.pdf

    Isn’t epidemiology wonderful!

    • junican Says:

      Tony, I must honestly admit that my brain is hurting. The Doctors Study commenced in 1951. At intervals of about five years, Doll et al produced ‘reports’ in the BMJ.
      Doll et al had a serious problem in that some doctors stopped smoking. Thus, those deaths had to be moved from ‘smokers’ to ‘ex-smokers’ with the consequent statistical problems.
      The longer that the study went on, the messier it became. All along the way, doctors were retiring, and were hardly likely to be interested in Doll’s study. Who knows how many of them just ticked some boxes?
      Another massive problem was that, as the doctors died, there became less and less of them Thus, as time passed, the statistical strength of the study became less and less secure.

      • Tony Says:

        They could only have been moved from “smoker deaths” to “ex-smoker deaths” if they had given up smoking after death. Lol

      • junican Says:

        Doll did follow up questionnaires every so often. That’s how he knew who had given up smoking and when. An interesting thought: when a doctor said that he had stopped smoking, did Doll send him any more questionnaires? I mean, what would be the point if he had stopped smoking? How then would Doll know if that doctor and started again? Messier and messier.

      • Tony Says:

        I think questionnaires continued to be sent to all doctors regardless of smoking status. The one sent out in 1978 must have been because it included a question about alcohol. The responses formed the basis of his 1994 report on alcohol consumption (and death of course) amongst his doctors.

      • junican Says:

        I knew that he introduced alcohol questions at some stage, but I did not know that it was in 1978. I’m sure that you are right about the questionnaires – I suppose that I was being a bit facetious!

  6. garyk30 Says:

    ” FATE will decide when my heart stops beating. That is all.”

    FATE, a great topic for discussion while sharing a very large bottle of red wine.

    Is FATE another term for GOD?

    If FATE is random, why is it predictable, to a certain extent?

    Why is FATE’s randomness not a 50/50 proposition?

    If you had a Facebook account and a video cam built into your monitor, we could have a videochat while discussing these things.

    We could babble on, drink wine, and smoke to our heart’s content.

    Rather like meeting at a pub; but, the wine is less expensive. 🙂

    • junican Says:

      I’ll have to try to set something up. But there is a problem – time differences!

      I was trying my best not to imply that FATE was some sort of disembodied spirit similar to the fates of Greek myth. Nor do I mean ‘chance’. I mean the certainty of something happening but not knowing when or how. Thus, I am certain to die. It could be tomorrow if I was driving along a busy motorway at 70 mph and I had a blow out. My death at that moment would be my FATE. I drink a lot of red wine and smoke a lot of cigs. I refuse to count. I may die at the age of 85 from a stroke. My death at the age of 85 from a stroke would be my FATE, and my drinking and smoking are not particularly relevant.
      So I would rather enjoy drinking and smoking and accept my eventual fate than worry about ‘risks’.

  7. Rose Says:

    Mullers study “Abuse of Tobacco and Carcinoma of Lungs” published in JAMA 1939, no longer available since tobacco documents shut down.

    He sums up

    “The fact that about one third of the subjects surveyed smoked moderately or not at all indicates the presence of other cancerigenic factors besides smoking, such as influenza and industrial working conditions.
    The great significance of the latter can be inferred from various indications but needs further study.”
    http: //tobaccodocuments.org/ness/4164.html

    But I just found another translation with a lot more information.

    Appendix A. Translation

    Box 1

    Franz H Mueller, Misuse of tobacco and cancer of the lung (Zeitung fuer Krebsforschung, 1939.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3640840/

    Sir Richard Doll in his own words.

    “The issue of Zeitschuft für Krebsforschung in which Schairer and Schöniger’s paper appeared did not reach Britain during the war (although most other issues did) and it is still not held by many libraries and was not indexed in the cumulative medical index.

    It is understandable, therefore, that it was not mentioned at the conference held by the Medical Research Council in 1947 to discuss the reasons for the increase in mortality attributed to lung cancer (Hill, personal communication) and was not referred to when Hill and I published our first paper on the association between cigarette smoking and lung cancer,although we did refer to Müller’s paper that had been published in 1939”
    http://ije.oxfordjournals.org/content/30/1/30.full

    • junican Says:

      Informative as ever, Rose. Clearly, it was a positive decision to ignore any other possibility of the causes of LC and to blame smoking for everything. And so it has gone on for decades.

      • Rose Says:

        According to Proctor, Muller believed in Roffo’s tobacco tar theory, so tobacco smoke condensate was counted as a cause in itself.

        Angel H Roffo: the forgotten father of experimental tobacco carcinogenesis
        Robert N Proctor

        “In 1931, writing in the Zeitschrift für Krebsforschung (he published much of his work in German), he noted that while there were cases in which tobacco was clearly to blame for the onset of certain malignancies (from clinical observations) it was nonetheless useful to document the phenomenon more generally by animal experiments.

        Reasoning by analogy from the production of cancer using coal tars, he argued that the carcinogens in tobacco smoke must be the complex, tarry, polycyclic aromatic hydrocarbons, rather than the (chemically simpler) inorganic constituents or the alkaloid nicotine.”

        “For many of his contemporaries, however, Roffo was a force to be reckoned with. Schairer & Schöniger in 1943 cited Roffo’s experiments as evidence of the carcinogenicity of tobacco tar, as did Franz Hermann Müller in 1939 and Fritz Lickint in his great Tabak und Organismus”
        http://www.who.int/bulletin/volumes/84/6/494.pdf

        Roffo subjected tobacco leaves to destructive distillation at very high temperatures for several hours to obtain a liquid.

        Frank discussed it on his blog.
        https://cfrankdavis.wordpress.com/2015/08/14/a-tobacco-tar-study/

        Richard Doll explains to Parliament

        “Pathologists, meanwhile, continued to argue about the reality of the increase. Some, however, had been sufficiently impressed to try to produce cancer with tobacco tar on the skin of laboratory animals.

        Roffo succeeded in doing so in the Argentine in 1931, using rabbits, but his results were generally dismissed in the UK and the US on the grounds that the tobacco had been burnt at unrealistically high temperatures.

        Experiments in Britain were negative (Leitch, 1928; Passey, 1929) apart from one which produced one cancer in 50 animals and led Cooper et al (1932) to conclude that “tobacco tar is relatively unimportant in the causation of cancers”.
        http: //www.parliament.the-stationery-office.co.uk/pa/cm199900/cmselect/cmhealth/27/9111806.htm

    • Tony Says:

      Thanks for that ncbi translation Rose! I’ve only ever seen the short JAMA one before.

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