Smokers Hate Their Children

Over at my favorite hub for science news, good and bad, I came across this article (1) titled, "Parental Warning: Second-hand Smoke May Trigger Nicotine Dependence Symptoms In Kids." Say it's ain't so. That means I'll have to return my tickets for the 76th annual Blow Smoke in a Baby's Face county fair. The article is in reference to this published study (2), which supposedly found that "increased exposure to second-hand smoke, both in cars and homes, was associated with an increased likelihood of children reporting nicotine dependence symptoms, even though these children had never smoked." So of course, results like these call for immediate action, such as the empowering of local governments to exercise control over the behavior of citizens, "these findings support the need for public health interventions that promote non-smoking in the presence of children, and uphold policies to restrict smoking in vehicles when children are present" [my emphasis].

So give it to me guys, how many of these poor 10 year olds have been gripped by the evil hands of nicotine dependence? "Our study found that 5 percent of children who had never smoked a cigarette, but who were exposed to secondhand smoke in cars or their homes, reported symptoms of nicotine dependence." That's it? A measly 5%? (The study actually states 4.6%). Please tell me that the measures of nicotine dependence are fairly rigorous and that these kids have at least something similar subsyndromal nicotine dependence.

"Classroom administered self-report questionnaires" were completed by these obviously bright 10 year olds. What makes these kids bright? Well here are the 7 nicotine dependence questions that they were asked: (i) How often do you have cravings to smoke cigarettes?; (ii) how physically addicted to smoking cigarettes are you?; (iii) how mentally addicted to smoking cigarettes are you?; (iv) how often have you felt like you really need a cigarette?; (v) do you find it difficult not to smoke in places where it is not allowed?; (vi) when you see other kids your age smoking cigarettes, how easy is it for you not to smoke?; (vii) how true is this statement for you? “I sometimes have strong cravings for cigarettes where it feels like I am in the grip of a force that I cannot control.”

You show me a 10 year old kid who knows the physical and mental symptoms of nicotine dependence, and I'll show a 45 year-old midget named Joey. Seriously, those were the questions. There was no mention of headache, tachycardia, sweating, insomnia, or mood changes. Additionally, these questions were not even validated on 10 year olds. They came from this study (3), which was validated on 14-17 year olds who were actual smokers.

Out of a total of 1,488 kids, only 69 (4.6%) endorsed "at least one symptom of nicotine dependence" [my emphasis]. That breaks down to this: 60% (41) endorsed 1 question, 21% (15) endorsed 2, 11% (8) endorsed 3, 4% (3) endorsed 4, and 2% (2) endorsed 6. Endorsing one symptom means nothing. That's why diagnostic criteria have multiple signs and symptoms. Last night I had trouble falling asleep, which is a symptom of depression, therefore I should seek help, right? It's absurd to make the kinds of extrapolations these people are making. When only 2 kids endorse 6 out of 7 questions, that's hardly an epidemic.

How about the fact that 95% of kids exposed to second-hand smoke (SHS) didn't endorse any symptoms of nicotine dependence? To bad they didn't examine the prevalence of these supposed symptoms in children not exposed to SHS. That would create this thing called a "control group," which would allow people to run fancy statistical tests to determine if the actual prevalence of these symptoms in SHS exposed kids has any actual meaning.

In spite of those limitations, the experimenters said this, "exposure to second-hand smoke among non-smokers may cause symptoms that seem to reflect several nicotine withdrawal symptoms: depressed mood, trouble sleeping, irritability, anxiety, restlessness, trouble concentrating and increased appetite." 'Cough, bull sh*t, cough.'

I don't know if these people actually read the diagnostic criteria, but nicotine dependence is a syndrome characterized primarily by both the development of tolerance and withdrawal (not just cravings alone). None of which are thoroughly addressed by those 7 questions.

In the discussion section, it is said "it is of course possible that participants misinterpreted the questions on nicotine dependence or that either social role modeling or expectations about what participants should experience (rather than what they actually experience) influenced reports of nicotine dependence symptoms. However, we did take susceptibility to initiating smoking and peer smoking into account in this analysis, which presumably took at least some of the effects of social role modeling and expectation into account." Too bad those data are not included in published report. So presumably, it is of course possible that experimenters misinterpreted the data (I can play with semantics too).

They even go on to admit that "there are no 'gold standard' measures of nicotine dependence symptoms in children. Although the items used in this study are psychometrically strong and show content as well as convergent construct validity (That's in adolescents by the way), it is possible that they do not measure nicotine dependence symptoms. Never-smokers could report symptoms they expect by simply smelling cigarette smoke or observing others smoking, rather than those they actually experience. Our measures of SHS exposure were not validated with biomarkers" [my emphasis]. Additionally, since these data are cross-sectional (not longitudinal), cause and effect cannot be determined either.

So what do we have here? A self-report measure of a complex physiological and psychological state that was administered to kids, data that were pooled together so as to appear significant, important data that were omitted from the actual article, and researchers who drew conclusions far beyond the scope of the actual results in an attempt to make their data appear meaningful. If this study were funded by Pfizer, and antidepressants were substituted for tobacco, and depression was substituted for dependence, then we would have something very similar to a typical pharmaceutical sponsored study.

So that begs the questions, who funded this study anyway? These guys did (4), the Canadian Tobacco Control Research Initiative, whose goal is "to catalyze, coordinate and sustain research that has a direct impact on programs and policies aimed at reducing tobacco abuse and nicotine addiction" [my emphasis]. I think I smell a big, stinking pile of bias. No where in that mission statement do I get the sense that these people are adherents of the the scientific method. Science is about discovery, not enforcing an agenda. What if their research findings didn't support reducing tobacco use? Huh? I have a hard time believing that they would support any of the research promoted by these people (5). And seriously, could they have found an easier target to generate bad press about other than tobacco? Pedophiles maybe? Personally, I wish somebody would fund research on how to get these people (6) to shut up.

And just as an aside, Coke Zero (7) is Diet Coke (8) in a black can! Diet Coke has zero calories and zero carbs just like Coke Zero. All the ingredients are identical except for one, the artificial sweetener. Other than that, it's still Diet Coke! And to all you d-bags who claim that you can "taste the difference," you're not allowed to read this blog anymore. Seriously, get away from me, "Unwelcome touching! Unwelcome touching!" Go here instead (9).