My friend's dad was a chain smoker since he was like 16 yrs old. He quit at the age of 62 yrs old. He is now on his 65th year. Just saying that he is still alive..lol

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A question re # 10, It is interesting to me that the military veterans have a higher rate of death, and I'm wondering if that is more likely to be attributed to the combination of smoking + trauma, as there are several studies that suggest that trauma reduces immune function and increases things like heart and cardiovascular disease? (skip to 'findings' http://xnet.kp.org/permanen..., while this article talks about child hood experiences that are adverse, it is likely that similar things are at play) (this article talks about PTSD and reduction in immune function http://books.google.com/boo...

Anyway, I'm curious about what your thoughts are on those findings, and what role they may also play in the death rate of smokers?

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I think it maybe time to rename this blog "Confirming Bias".

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COPD is not obscure jargon for "weak lungs." It's chronic bronchitis and emphysema-- the 4th leading cause of death in the US.

I do appreciate your dogged pursuit of your position. I recommend you add this topic to your health econ class. It has certainly helped me evaluate how committed you are to your putative quest for truth.

Glad you didn't quit blogging back a year back when you kept bringing it up. Would've missed out on near v far and dreamtime.

But you've definitely dipped permanently below the "high status" meridian on this one, so my desire to affiliate w you is at an end. ;)

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Robin --- dose-response curve is a term in any introductory text on epidemiology, statistics, or causal inference. It basically means the more you smoke, the higher your risk --- people who smoke less have less risk. I would say its an "expert term" as much as "opportunity cost", "supply-demand", or "variance" are "expert terms"

FYI I've cited the original studies --- you can find their modern updates yourself with google. Its already clear you can't be bothered to look at a review article, you can look some thing up yourself.

HEH this point is utterly classic -- you should be EMBARRASSED. Your “review” article is by Cornfield, one of the main partisans in this dispute, so it is hardly neutral, and it doesn’t mention randomized trials of any sort.

That's after you post studies funded by the Tobacco Industry and say they are "professional". Seriously you should be ashamed of yourself.

I guess reviews paid for by the Tobacco industry can be taken seriously, but those that believe smoking is linked to cancer and increased mortality aren't to be taken seriously.

I think the first step to "overcoming bias" -- would be to get over your childish need to be contrarian.

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diogenese, this is why experts use big words - I say "weak lungs", a phrase my readers will understand, and you say I know nothing because I do not call it "COPD". (Apparently you also want me to throw out phrases like "dose-response curve" too.) I've focused initially on recent and randomized data, so naturally I haven't been discussing your four non-randomized studies from the 1950s. Your "review" article is by Cornfield, one of the main partisans in this dispute, so it is hardly neutral, and it doesn't mention randomized trials of any sort.

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Robin -- you have not cited ONE review article in any of your threads. Have you even bothered to look at one? There are thousands of studies on smoking ---- randomly selecting 10 studies without rhyme or reason doesn't make an argument. For a topic this BROAD --- you have to start at a review article to find important studies (then of course you can argue against them with other studies you find yourself).

Studies: 1. Doll R, Hill AB. Lung cancer and other causes of death in relation to smoking; a second report on the mortality of British doctors. Brit M J (1956) 2:1071–1081.

2.) Schwartz D, Denoix P. L’enquette francaise sur l’etiologie du cancer broncho-pulmonaire: role du tabac. La Semaine des Hopitaux de Paris (1957) 33:424–437

3.) egi M, Fukushima I, Fugisaku S, et al. An epidemiological study on cancer in Japan. Gann (1957) 48:63.

4.) Dorn H. Tobacco consumption and mortality from cancer and other diseases. Acta Unio internat contra cancrum. In press.

5.) Hammond EC, Horn D. Smoking and death rates – report on forty-four months of follow-up of 187,783 men. JAMA (1958) 166:1159–1172. and 1294–1308.

Historical prospective and review of data can be found @ http://ije.oxfordjournals.o...

Or start @ Surgeon Generals 2004 update report on smoking risk.

BTW --- Obviously as this thread indicated you somehow had no idea what COPD was, it seems equally clear you don't know what a dose-response curve is. I don't feel like its my job to educate you on pack-years and risk of disease.

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I will not dismiss these reviews because their authors work for a tobacco company.

IIRC, you had quite a different attitude about the pharmaceutical company-sponsored research used to justify FDA approval of SSRI's for treatment of depression, as well as other pharmaceutical claims. Frankly, I'm stunned that you, with no expertise whatever in the fields of oncology or pulmonary physiology, would accept industry-sponsored information because "they seem professional" (to you). One of the first steps a rationalist would take to "overcome bias" is the elimination of conflict of interest.

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I will not dismiss these reviews because their authors work for a tobacco company. I've read them and they seem professional. There has been plenty of foul play on all sides in this history; if we used that to ignore folks affiliated with some side, we'd be ignoring all sides.

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Well that got even me to sit up and say "What?" And the first thing I noticed about those studies is who does them:

Lorillard Tobacco Co., Greensboro, North Carolina

The tobacco companies have a reputation for playing very dirty with science. That was actually one of the first thoughts that occurred to me on reading your research summary - "Are results like this rather more likely to pop up with tobacco-company-funded research?"

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That is indeed a nice chapter. Your mention of animal studies inspired me to search for such. There are two reviews saying we do not find that smoking causes cancer in animals.

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Glymour et al.'s "Causation, Prediction and Search" (p239) contains a fascinating discussion of the history of debates concerning scientific evidence for smoking's effects on mortality. IIRC they discuss the skepticism of Fisher and others about smoking causing lung cancer, which were grounded partly inthe empiricist dogmas of the time but also on Fisher's strong genetic determinism. They are critical of the medical establishment who pushed the causal hypothesis; they argue that the studies the establishment cited did not justify their conclusions (at least relative to their standards for statistical rigor). They say that what drove medical consensus (at least early on) was not unquestionable evidence of causation from the studies but rather the observational evidence + very strong priors for smoking being the cause rather than there being a common cause.

IIRC they also mention intervention studies in which monkeys were made to smoke and had correspondingly higher lung cancer rates. This sort of study might be useful relative to the RCT's discussed above in which it may be hard to measure how much those who reducing their smoking actually smoked.

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"former cult members who advocate freezing noggins but drive ragtops"

why discredit yourself like this?

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But counteracted by some serious methodological problems - using time in the service as a proxy for smoking. That results in lots of smokers in the "nonsmoker" group. And, interestingly they estimate that smoking is causing 37-79% of excess deaths, which includes the range for conventional wisdom.

MRFIT can't say diddly about never-smokers. There are never-smokers, but they are selected for other serious health issues.

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That example has the same logical structure as the one discusses, but it's wildly implausible for smoking at the time studies first came out. For one thing, the fraction of smokers in the population is MUCH greater than that of anchor owners and was much more-so then than now. More importantly, no-one takes up smoking because they have lung cancer or know they are going to get it. Standard numbers amount to the claim that almost everyone who gets lung cancer is a smoker, and that this was even more true in the past. The causal assumption also strongly suggests that lung cancer rates should have fallen precipitously over the last few decades, as smoking became less common, independently from other cancer death rate changes.

It seems more than slightly surprising that smoking could constitute an extremely strong predictor of some other behavior or cluster of behaviors which would selectively increase lung cancer risks by a huge factor while having only modest impacts on other risks while it is extremely a-priori plausible that smoking could damage the lungs and introduce carcinogens to them.

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The WWII veteran study should include the effects of not starting to smoke, as should the randomized trials that include non-smokers, such as MFIRT.

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