11 ms·

Smoking Causes Cancer

89 points by alexmolas 3y ago

aldarion 3y ago
Didn't know that there was anyone arguing it doesn't, but... nice article.
- dekhn 3y ago
  Fisher, one of the great statisticians, argued that insufficient evidence existed to conclude with certainty that smoking causes cancer. https://pubmed.ncbi.nlm.nih.gov/2000852/ https://pubmed.ncbi.nlm.nih.gov/2000852/ After that, a number of well-designed experiments on rodents demonstrated that smoking causes (strong causation) cancer (in rodents) beyond a reasonable doubt (as in, if you disagree, you'd better bring some impeccable data).
  - alexmolas 3y ago
    Is this Fisher the one that proposed the "p<0.05" rule?
    - dekhn 3y ago
      Yes... are you going to criticize him for that? It's worth reading the whole backstory (start here: https://en.wikipedia.org/wiki/Ronald_Fisher https://en.wikipedia.org/wiki/Ronald_Fisher) A flawed genius
      - alexmolas 3y ago
        No, why should I criticize him for that? Btw, I just learned that he made the Iris dataset famous.
        dekhn 3y ago
        Many people criticize p=0.05, https://sites.uw.edu/stlab/2016/03/09/the-arbitrary-magic-of-p-0-05/ https://sites.uw.edu/stlab/2016/03/09/the-arbitrary-magic-of...
        jldugger 3y ago
        > No, why should I criticize him for that? Because after that academia made it the gold standard of research in most disciplines, leading to what many describe as a "replication crisis" in social sciences. But surely anyone criticizing him for that would have to prove they've already sufficiently criticized him for the whole eugenics thing.
        kragen 3y ago
        you seem to adhere to the intellectual norms of the great leap forward rather than those of science or philosophy in science nobody ever has to 'prove they've already sufficiently criticized' anyone or anything they just provide evidence enjoy your auto-da-fe but please do it somewhere else, only involving people who are into that kind of thing
        jldugger 3y ago
        I'm sorry you feel triggered in mentioning that the guy was a leader in the eugenics movement?
  - hughw 3y ago
    Judea Pearl wrote a book, Causality, introducing Bayesian networks to address the inadequacy, even refusal, of Fisher's statistics to model causes and effects. Here's a lecture he gave almost 30 years ago [1] that's entertaining and accessible. He mentions the tobacco issue and Fisher specifically. [1] http://bayes.cs.ucla.edu/BOOK-2K/causality2-epilogue.pdf http://bayes.cs.ucla.edu/BOOK-2K/causality2-epilogue.pdf
    - dekhn 3y ago
      Thanks. I've never been able to understand the math behind Pearl but I appreciated the little diagram in the Fisher smoking section that clearly lays out causality of models diagrammatically.
    - jldugger 3y ago
      I think it was Pearl's Book of Why that went into far more detail about how it was decided that tobacco causes cancer from purely observational data. The technique was... relatively convoluted, and supposedly Fischer fought tooth and nail against Bayesian techniques required to adequately answer any such causal questions.
  - rdedev 3y ago
    Fisher was a smoker too right? Pretty sure his bosses played a part too
    - dekhn 3y ago
      he was a consultant for the tobacco industry. I think he may have raised some legitimate questions of what constitutes "sufficient evidence" for making large-scale public health policy. But yes, I think his position mostly came from his biases.
latchkey 3y ago
Both my parents are lifelong smokers from their early teens and were a year or two apart in age. My mom died of lung cancer at 54. My dad is still going strong at 77 and smokes Camel unfiltered. Humans are weird. Regardless, you don't want to die from lung cancer. It is pretty horrible. Your body attacks itself, fluid collects in the lungs, it is painful, and you basically drown from within. Your only option is high doses of morphine and one day you just don't wake up. I wouldn't wish that on anyone.
- NikolaNovak 3y ago
  We are, sadly,practically twins in this. My mom died from lung cancer at 50. Horrible horrible way to go. My dad is 79 and (thankfully) going reasonably well. Bit started smoking in early early teens ;-(
  - gerdesj 3y ago
    My mum never really smoked. She died from cancer (a rather cruel, ladies only one to start with. A reprieve with all clear and then it re-appeared after 18 months, and went berserk) around 30 years ago. My dad did smoke for around 30 years but just stopped in the mid eighties. He's still with us but at one point a few years back a surgeon gave him a heart massage - as in heart in hand - and he came back. Long story! I am 53 as of Pearl Harbour day. I smoked for around 30 years (I've double checked all these 30 year timescales). I gave up April 2018. My personal message is that the effects of smoking can be rather insidious. You don't notice the shortness of breath for years until you realise it isn't normal. You might blame it on getting older or less active or whatever but it isn't. I gave up when I had obvious trouble breathing in bed after yet another chest infection. Five and a half years later I am much better off but still have snags. I will be visiting a doc soon and expecting a diagnosis of a variety of COPD. I will also be asking for a PSA test sigh. I can run up hill a way etc but I run out of puff very quickly. Even if you avoid cancer itself, the other side effects are ... insidious. On the bright side, I'm roughly £3-4000 per year better off, have a sense of smell and taste and still going 8)
    - 3y ago
WolfeReader 3y ago
Also, alcohol causes cancer. https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/alcohol-and-cancer/how-does-alcohol-cause-cancer https://www.cancerresearchuk.org/about-cancer/causes-of-canc...
- tensor 3y ago
  Also food causes heart disease, and cancer.
  - WolfeReader 3y ago
    "Alcohol" and "smoking" are pretty specific terms, in a way that "food" is not. The first two refer to IARC Group 1 carcinogens, specifically.
  - monero-xmr 3y ago
    I agree that alcohol increases cancer but can you find any statistics of the increase of each cancer vs. non-drinkers? Like “cancer X is 1% for non-drinkers and 3% for drinkers” but I can never find this.
    - happytiger 3y ago
      It’s not all cancers it’s specific cancers. Cancers aren’t monolithic: each type has different characteristics and risk factors, aka “Cancer is cancers not just a cancer.” > Drinking about 3.5 drinks a day doubles or even triples your risk of developing cancer of the mouth, pharynx, larynx and esophagus. Drinking about 3.5 drinks a day increases your risk of developing colorectal cancer and breast cancer by 1.5 times. The less alcohol you drink, the lower your cancer risk. https://cancer.ca/en/cancer-information/reduce-your-risk/limit-alcohol/some-sobering-facts-about-alcohol-and-cancer-risk#:~:text=Drinking%20about%203.5%20drinks%20a,the%20lower%20your%20cancer%20risk https://cancer.ca/en/cancer-information/reduce-your-risk/lim.... > Nearly 4% of cancers diagnosed worldwide in 2020 can be attributed to alcohol consumption, according to the World Health Organization. In the United States alone, about 75,000 cancer cases and 19,000 cancer deaths are estimated to be linked to alcohol each year. https://www.cancer.gov/news-events/cancer-currents-blog/2023/cancer-alcohol-link-public-awareness#:~:text=Nearly%204%25%20of%20cancers%20diagnosed,linked%20to%20alcohol%20each%20year https://www.cancer.gov/news-events/cancer-currents-blog/2023.... Most of the research is linked to specific types of cancers and alchohol: oropharynx, larynx, esophagus, liver, colon, rectum and breast cancer. Others, like skin cancers, pancreatic and prostate are in the “probably” category.
pelagicAustral 3y ago
I quit for the longest of time...(started at 16), all of the sudden I found myself in Colombia, and all the restrictions I've gotten used to (no smoking in public places, etc) where non-existent. Further more, the packing of the cigarettes was still all branded, almost no warnings, and all kinds of 'clicky' flavored types. Don't want a whole pack? no problem, we got you! Buy singles on every corner... Needless to say I started smoking again... I then quit again for a few years... went to northern Africa, and guess what? People literally smoking at the airport, £1 packs of camel, etc... I haven't had one in a bit now... People think the restrictions don't work, but they absolutely do.
- hankchinaski 3y ago
  I stopped smoking when I moved to the uk. A pack of 20 is 4 times as much as it is back in Spain or Italy. That alone made the trick
  - pelagicAustral 3y ago
    Absolutely, and I love it. No branded packs, no flavored cigarettes, no menthol, huge horrendous depictions of what you're exposing yourself to, £12 a pack, cannot smoke near public buildings, cannot smoke in public places, etc... This is beautiful. I will never stop saying, please, tax me on this crap, tax me more.
- jkubicek 3y ago
  > People think the restrictions don't work, but they absolutely do It's wild to me that people make assertions like this. We can (and should) argue about the effectiveness of smoking restrictions on decreasing cancer and heart disease, but to make the argument that they have no effect is just silliness. You hear the same arguments from the right whenever gun control, environmental protections or really any sort of government regulation comes up, and from the left (though to a much lesser degree) on the topic of tax rates. We should all be able to agree that any sort of regulation will have a marginal effect, and be able to have a discussion about the level of that effect.
  - 3y ago
ternus 3y ago
Tangential, but if you haven't had your house tested for radon, I strongly recommend it. Radon is a radioactive decay product of uranium in rock and soil, naturally accumulates in houses, and is the second leading cause of lung cancer in the US after smoking. I got a RadonEye meter to check the levels in my old place. It was around 4 pCi/l, which is apparently equivalent to smoking a pack a day in terms of relative cancer risk. After adding some ventilation, it dropped to lower than 1. Great. The next place I moved into had a radon level of 14+ (!!) pCi/l. I couldn't believe the meter reading, so double-checked with another meter, which produced the same result. Got a radon mitigation system installed. Seriously, check it out, especially if your place sits below grade or you live in a risk area. It could save your life.
- 000ooo000 3y ago
  Thank you for posting this. Had never heard of such things.
  - zdragnar 3y ago
    This and the sibling comment boggle my mind. Around here, it seems like requesting a radon test is standard when looking at buying a house. Installing radon mitigation is likewise relatively straight forward. Are basements less common out there? Maybe it's just because we tend to have basements that are made into livable space, where the risk of exposure is higher.
    - 000ooo000 3y ago
      Ah, it's because I'm in Australia. >Average radon levels in Australian homes are only a little larger than the radon levels in outside air and are of minimal concern to the health. >The average concentration of radon in Australian homes is about 10 Bq m³. This is less than in many other countries and compares to a global average indoor value of 40 Bq m³. I checked a Radon map and my area is only 5-10Bqm3.
      - zdragnar 3y ago
robwwilliams 3y ago
> If you think that’s the stupidest thing you’ve ever heard, you can take it up with Sir Ronald Fisher, who actually made this argument with apparent sincerity in a 1957 letter to the British Medical Journal. I mention this in case you didn’t already know what an ass he was. Not only did Fisher state this, and not only was he an ass, but it is almost embarrassing —it turns out he was partly right. You can read all about it in Pearl’s gem The Book of Why. In essence Fisher argued that there could be a confound between the neurochemical and behavioral propensity to smoke, and the risk of developing lung cancer. And strange as it seems to me, the DNA variant in CHRNA5 that is most highly associated with higher risk of nicotine addiction also modulates (independently) lung cancer risk. His principle was kinda-sorta defensible for an avid smoker. Mendelian randomization of people by their CHRNA5 gene status can indeed demonstrate that Fisher was wrong. The majority causal risk is in fact smoking.
- npunt 3y ago
  Interesting! Within almost every truth there lurks a valid but ultimately very minor counter-point. Sorta a tangent here, but it's annoying that this is the very thing that causes people biased to not believe to latch onto as evidence they're right. Once introduced, further reasoning or curiosity about the subject tends to stop before weighing matters of degree, which leads to missing the big picture. To generalize a lot, this is kinda where we are in the current meta of truth fracturing. Our biases drive us to discover nuances we grasp onto to avoid believing what we don't want to.
- gweinberg 3y ago
  The idea that there's some confounding factor isn't in itself implausible, but a factor of 16 increase in risk is huge. Of course, to really be sure you should also look at how lung cancer risk and smoking correlates between countries, and within a country over time. And you can segment the population by sex and ethnicity. Oh and also look for a dose-dependent effect, very important. Heavier smokers should be at a higher risk. Of course, the link between cancer is smoking is even stronger if some of the "non-smokers" were exposed to an increased level of cigarette smoke.
  - 3y ago
neonate 3y ago
https://web.archive.org/web/20231212174055/https://www.allendowney.com/blog/2023/12/12/smoking-causes-cancer-2/ https://web.archive.org/web/20231212174055/https://www.allen...
andrewinardeer 3y ago
I think the question of our time is does vaping cause cancer?
- Zaskoda 3y ago
  We'll find out.
- bottled_poe 3y ago
  I’d put my money on yes, but at a far lower risk than smoking.
Zaskoda 3y ago
I think it has to be said, correlation is not causation. While I believe that in this case it's almost certainly true, it's still not scientific to claim that it is indeed true until you can prove causation. When you do the math, it turns out that 100% of people who confuse correlation with causation end up dead. Dangerous stuff.
- YokoZar 3y ago
  The author addresses both of the possible reasons that correlation and causation could be unlinked here (reverse causality and common cause). Did you have a comment about them?
_cs2017_ 3y ago
The author is a PhD in CS from Berkeley and teaches data science at a (decent I think?) college. And yet, he writes completely incorrect statements about statistics. Why? > "(1) that the supposed effect is really the cause, or in this case that incipient cancer, or a pre-cancerous condition with chronic inflammation, is a factor in inducing the smoking of cigarettes, or (2) that cigarette smoking and lung cancer, though not mutually causative, are both influenced by a common cause, in this case the individual genotype." > If you think that’s the stupidest thing you’ve ever heard, you can take it up with Sir Ronald Fisher, who actually made this argument with apparent sincerity in a 1957 letter to the British Medical Journal. I mention this in case you didn’t already know what an ass he was. Of course, it's very possible that there's a common cause. For example, people who are very depressed may choose to smoke, and depression may also cause cancer. I'm not saying it does, I'm just saying it's clearly a possibility that needs experiments to disprove. The author's claim is so wrong, and yet he seems to genuinely believe it.
- YokoZar 3y ago
  Wouldn't we need, like, evidence or something to believe that possibility? We have mountains of direct evidence with underlining theory for the straightforward explanation. Sometimes we need to believe that evidence.
  - _cs2017_ 3y ago
    No, you don't need evidence to prove that this is a possibility. You only need evidence to claim that this is impossible.
- jll29 3y ago
  It also seems unprofessional to call Sir Fisher an "ass", which is called an ad-hominem attack (attack on the person is obviously not a valid logical argument), and one of a dead person at that. Fact is: Fisher made fundamental contributions and the poster himself uses these on a daily basis: "Student" [Gossett]'s t-distribution, Fisher's linear discriminant, a precursor of linear discriminant analysis, ANOVA, Fisher information, Fisher's scoring, Minimum Fisher information, the F-distribution, Fisher–Tippett–Gnedenko theorem, the Fisher-Yates shuffle algorithm, the von Mises–Fisher distribution, inverse probability, Fisher's permutation test Fisher's inequality, sufficiency of a statistic, and more. His contribution to biology are even more impactful. It also happens that Fisher was a proponent of the "Frequentist" interpretation of probabilities, whereas the poster belongs to the recently more popular "Bayesian" camp of ideology (yes, ideology, if you think statistics as a part of mathematics is free from that, welcome to real life!). He further held strong views about races, perhaps because he was a professor of eugenics (which we today know as incorrect unscientific nonsense, but obviously that was not the state at the time), and there is am ongoing controversy regarding whether he was a racist or not. What I read about him suggests to me I may not have liked him, but to just stamp him as "ass" wihtout elaborating is too cheap for a statistcs professional in my view. But then this is a personal blog, where the poster can write whatever he wants under US law.
seccess 3y ago
"Finally, looking at that figure you might wonder why the relative risk of smoking has increased so much. Based on my first pass through the literature, it seems like no one knows. There are at least three possibilities: - Over this period, cigarettes have been reformulated in ways that might make them more dangerous. - As the prevalence of smoking has decreased, it’s possible that the number of casual smokers has decreased more quickly, leaving a higher percentage of heavy smokers. - Or maybe the denominator of the ratio — the risk for non-smokers — has decreased." My first thought was "second hand smoke". My logic is, when smoking was more normalized, non-smokers were exposed to some of the same risk as smokers due to smoking indoors, etc, resulting in higher rates of lung cancer among non-smokers.
crdrost 3y ago
Slight change to the description: "Sometimes interpreting data is easy. For example, one of the reasons we know that smoking causes lung cancer is that when only -6dB of the population smoked, +6dB of people with lung cancer were smokers. If you are a doctor who treats patients with lung cancer, it does not take long to notice numbers like that." What was the change? +12dB or 10^1.2, which is 16x. This ties into the odds form of Bayes' theorem given in the post; this representation of probability is dB(p) = 10*log10(p/(1-p)) p(dB) = 10^(dB/10) / (1 + 10^(dB/10)) so roughly 0dB = 50%, 5dB = 75%, 10dB = 90%, 20dB = 99%, 30dB = 99.9%...
bentt 3y ago
"...the pre-cancerous condition with chronic inflammation, is a factor in inducing the smoking of cigarettes," The author mocks this possibility, but the causes of chronic inflammation are not entirely understood, and it is linked with depression, cancer, obesity, stress, and a lot of other human conditions. We can't rule out that a stressed out person might want to smoke, be more likely to get addicted, and also have chronic inflammation which opens the door to the development of uncontrolled malignancies. Still, don't smoke.
yread 3y ago
Note that vaping also causes DNA damage and cancer (and addiction). https://www.pnas.org/doi/10.1073/pnas.1718185115 https://www.pnas.org/doi/10.1073/pnas.1718185115 Smoking actually kills more people by causing heart disease than by causing cancer. But the risk isn't that much increased.

89 points by alexmolas 3y ago

aldarion 3y ago

Didn't know that there was anyone arguing it doesn't, but... nice article.

dekhn 3y ago
Fisher, one of the great statisticians, argued that insufficient evidence existed to conclude with certainty that smoking causes cancer. https://pubmed.ncbi.nlm.nih.gov/2000852/ https://pubmed.ncbi.nlm.nih.gov/2000852/ After that, a number of well-designed experiments on rodents demonstrated that smoking causes (strong causation) cancer (in rodents) beyond a reasonable doubt (as in, if you disagree, you'd better bring some impeccable data).
- alexmolas 3y ago
  Is this Fisher the one that proposed the "p<0.05" rule?
  - dekhn 3y ago
    Yes... are you going to criticize him for that? It's worth reading the whole backstory (start here: https://en.wikipedia.org/wiki/Ronald_Fisher https://en.wikipedia.org/wiki/Ronald_Fisher) A flawed genius
    - alexmolas 3y ago
      No, why should I criticize him for that? Btw, I just learned that he made the Iris dataset famous.
      - dekhn 3y ago
        Many people criticize p=0.05, https://sites.uw.edu/stlab/2016/03/09/the-arbitrary-magic-of-p-0-05/ https://sites.uw.edu/stlab/2016/03/09/the-arbitrary-magic-of...
      - jldugger 3y ago
        > No, why should I criticize him for that? Because after that academia made it the gold standard of research in most disciplines, leading to what many describe as a "replication crisis" in social sciences. But surely anyone criticizing him for that would have to prove they've already sufficiently criticized him for the whole eugenics thing.
        kragen 3y ago
        you seem to adhere to the intellectual norms of the great leap forward rather than those of science or philosophy in science nobody ever has to 'prove they've already sufficiently criticized' anyone or anything they just provide evidence enjoy your auto-da-fe but please do it somewhere else, only involving people who are into that kind of thing
        jldugger 3y ago
        I'm sorry you feel triggered in mentioning that the guy was a leader in the eugenics movement?
- hughw 3y ago
  Judea Pearl wrote a book, Causality, introducing Bayesian networks to address the inadequacy, even refusal, of Fisher's statistics to model causes and effects. Here's a lecture he gave almost 30 years ago [1] that's entertaining and accessible. He mentions the tobacco issue and Fisher specifically. [1] http://bayes.cs.ucla.edu/BOOK-2K/causality2-epilogue.pdf http://bayes.cs.ucla.edu/BOOK-2K/causality2-epilogue.pdf
  - dekhn 3y ago
    Thanks. I've never been able to understand the math behind Pearl but I appreciated the little diagram in the Fisher smoking section that clearly lays out causality of models diagrammatically.
  - jldugger 3y ago
    I think it was Pearl's Book of Why that went into far more detail about how it was decided that tobacco causes cancer from purely observational data. The technique was... relatively convoluted, and supposedly Fischer fought tooth and nail against Bayesian techniques required to adequately answer any such causal questions.
- rdedev 3y ago
  Fisher was a smoker too right? Pretty sure his bosses played a part too
  - dekhn 3y ago
    he was a consultant for the tobacco industry. I think he may have raised some legitimate questions of what constitutes "sufficient evidence" for making large-scale public health policy. But yes, I think his position mostly came from his biases.

latchkey 3y ago

Both my parents are lifelong smokers from their early teens and were a year or two apart in age. My mom died of lung cancer at 54. My dad is still going strong at 77 and smokes Camel unfiltered. Humans are weird. Regardless, you don't want to die from lung cancer. It is pretty horrible. Your body attacks itself, fluid collects in the lungs, it is painful, and you basically drown from within. Your only option is high doses of morphine and one day you just don't wake up. I wouldn't wish that on anyone.

NikolaNovak 3y ago
We are, sadly,practically twins in this. My mom died from lung cancer at 50. Horrible horrible way to go. My dad is 79 and (thankfully) going reasonably well. Bit started smoking in early early teens ;-(
- gerdesj 3y ago
  My mum never really smoked. She died from cancer (a rather cruel, ladies only one to start with. A reprieve with all clear and then it re-appeared after 18 months, and went berserk) around 30 years ago. My dad did smoke for around 30 years but just stopped in the mid eighties. He's still with us but at one point a few years back a surgeon gave him a heart massage - as in heart in hand - and he came back. Long story! I am 53 as of Pearl Harbour day. I smoked for around 30 years (I've double checked all these 30 year timescales). I gave up April 2018. My personal message is that the effects of smoking can be rather insidious. You don't notice the shortness of breath for years until you realise it isn't normal. You might blame it on getting older or less active or whatever but it isn't. I gave up when I had obvious trouble breathing in bed after yet another chest infection. Five and a half years later I am much better off but still have snags. I will be visiting a doc soon and expecting a diagnosis of a variety of COPD. I will also be asking for a PSA test sigh. I can run up hill a way etc but I run out of puff very quickly. Even if you avoid cancer itself, the other side effects are ... insidious. On the bright side, I'm roughly £3-4000 per year better off, have a sense of smell and taste and still going 8)
  - 3y ago

WolfeReader 3y ago

Also, alcohol causes cancer. https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/alcohol-and-cancer/how-does-alcohol-cause-cancer https://www.cancerresearchuk.org/about-cancer/causes-of-canc...

tensor 3y ago
Also food causes heart disease, and cancer.
- WolfeReader 3y ago
  "Alcohol" and "smoking" are pretty specific terms, in a way that "food" is not. The first two refer to IARC Group 1 carcinogens, specifically.
- monero-xmr 3y ago
  I agree that alcohol increases cancer but can you find any statistics of the increase of each cancer vs. non-drinkers? Like “cancer X is 1% for non-drinkers and 3% for drinkers” but I can never find this.
  - happytiger 3y ago
    It’s not all cancers it’s specific cancers. Cancers aren’t monolithic: each type has different characteristics and risk factors, aka “Cancer is cancers not just a cancer.” > Drinking about 3.5 drinks a day doubles or even triples your risk of developing cancer of the mouth, pharynx, larynx and esophagus. Drinking about 3.5 drinks a day increases your risk of developing colorectal cancer and breast cancer by 1.5 times. The less alcohol you drink, the lower your cancer risk. https://cancer.ca/en/cancer-information/reduce-your-risk/limit-alcohol/some-sobering-facts-about-alcohol-and-cancer-risk#:~:text=Drinking%20about%203.5%20drinks%20a,the%20lower%20your%20cancer%20risk https://cancer.ca/en/cancer-information/reduce-your-risk/lim.... > Nearly 4% of cancers diagnosed worldwide in 2020 can be attributed to alcohol consumption, according to the World Health Organization. In the United States alone, about 75,000 cancer cases and 19,000 cancer deaths are estimated to be linked to alcohol each year. https://www.cancer.gov/news-events/cancer-currents-blog/2023/cancer-alcohol-link-public-awareness#:~:text=Nearly%204%25%20of%20cancers%20diagnosed,linked%20to%20alcohol%20each%20year https://www.cancer.gov/news-events/cancer-currents-blog/2023.... Most of the research is linked to specific types of cancers and alchohol: oropharynx, larynx, esophagus, liver, colon, rectum and breast cancer. Others, like skin cancers, pancreatic and prostate are in the “probably” category.

pelagicAustral 3y ago

I quit for the longest of time...(started at 16), all of the sudden I found myself in Colombia, and all the restrictions I've gotten used to (no smoking in public places, etc) where non-existent. Further more, the packing of the cigarettes was still all branded, almost no warnings, and all kinds of 'clicky' flavored types. Don't want a whole pack? no problem, we got you! Buy singles on every corner... Needless to say I started smoking again... I then quit again for a few years... went to northern Africa, and guess what? People literally smoking at the airport, £1 packs of camel, etc... I haven't had one in a bit now... People think the restrictions don't work, but they absolutely do.

hankchinaski 3y ago
I stopped smoking when I moved to the uk. A pack of 20 is 4 times as much as it is back in Spain or Italy. That alone made the trick
- pelagicAustral 3y ago
  Absolutely, and I love it. No branded packs, no flavored cigarettes, no menthol, huge horrendous depictions of what you're exposing yourself to, £12 a pack, cannot smoke near public buildings, cannot smoke in public places, etc... This is beautiful. I will never stop saying, please, tax me on this crap, tax me more.
jkubicek 3y ago
> People think the restrictions don't work, but they absolutely do It's wild to me that people make assertions like this. We can (and should) argue about the effectiveness of smoking restrictions on decreasing cancer and heart disease, but to make the argument that they have no effect is just silliness. You hear the same arguments from the right whenever gun control, environmental protections or really any sort of government regulation comes up, and from the left (though to a much lesser degree) on the topic of tax rates. We should all be able to agree that any sort of regulation will have a marginal effect, and be able to have a discussion about the level of that effect.
- 3y ago

ternus 3y ago

Tangential, but if you haven't had your house tested for radon, I strongly recommend it. Radon is a radioactive decay product of uranium in rock and soil, naturally accumulates in houses, and is the second leading cause of lung cancer in the US after smoking. I got a RadonEye meter to check the levels in my old place. It was around 4 pCi/l, which is apparently equivalent to smoking a pack a day in terms of relative cancer risk. After adding some ventilation, it dropped to lower than 1. Great. The next place I moved into had a radon level of 14+ (!!) pCi/l. I couldn't believe the meter reading, so double-checked with another meter, which produced the same result. Got a radon mitigation system installed. Seriously, check it out, especially if your place sits below grade or you live in a risk area. It could save your life.

000ooo000 3y ago
Thank you for posting this. Had never heard of such things.
- zdragnar 3y ago
  This and the sibling comment boggle my mind. Around here, it seems like requesting a radon test is standard when looking at buying a house. Installing radon mitigation is likewise relatively straight forward. Are basements less common out there? Maybe it's just because we tend to have basements that are made into livable space, where the risk of exposure is higher.
  - 000ooo000 3y ago
    Ah, it's because I'm in Australia. >Average radon levels in Australian homes are only a little larger than the radon levels in outside air and are of minimal concern to the health. >The average concentration of radon in Australian homes is about 10 Bq m³. This is less than in many other countries and compares to a global average indoor value of 40 Bq m³. I checked a Radon map and my area is only 5-10Bqm3.
    - zdragnar 3y ago

robwwilliams 3y ago

> If you think that’s the stupidest thing you’ve ever heard, you can take it up with Sir Ronald Fisher, who actually made this argument with apparent sincerity in a 1957 letter to the British Medical Journal. I mention this in case you didn’t already know what an ass he was. Not only did Fisher state this, and not only was he an ass, but it is almost embarrassing —it turns out he was partly right. You can read all about it in Pearl’s gem The Book of Why. In essence Fisher argued that there could be a confound between the neurochemical and behavioral propensity to smoke, and the risk of developing lung cancer. And strange as it seems to me, the DNA variant in CHRNA5 that is most highly associated with higher risk of nicotine addiction also modulates (independently) lung cancer risk. His principle was kinda-sorta defensible for an avid smoker. Mendelian randomization of people by their CHRNA5 gene status can indeed demonstrate that Fisher was wrong. The majority causal risk is in fact smoking.

npunt 3y ago
Interesting! Within almost every truth there lurks a valid but ultimately very minor counter-point. Sorta a tangent here, but it's annoying that this is the very thing that causes people biased to not believe to latch onto as evidence they're right. Once introduced, further reasoning or curiosity about the subject tends to stop before weighing matters of degree, which leads to missing the big picture. To generalize a lot, this is kinda where we are in the current meta of truth fracturing. Our biases drive us to discover nuances we grasp onto to avoid believing what we don't want to.
gweinberg 3y ago
The idea that there's some confounding factor isn't in itself implausible, but a factor of 16 increase in risk is huge. Of course, to really be sure you should also look at how lung cancer risk and smoking correlates between countries, and within a country over time. And you can segment the population by sex and ethnicity. Oh and also look for a dose-dependent effect, very important. Heavier smokers should be at a higher risk. Of course, the link between cancer is smoking is even stronger if some of the "non-smokers" were exposed to an increased level of cigarette smoke.
- 3y ago

neonate 3y ago

https://web.archive.org/web/20231212174055/https://www.allendowney.com/blog/2023/12/12/smoking-causes-cancer-2/ https://web.archive.org/web/20231212174055/https://www.allen...

andrewinardeer 3y ago

I think the question of our time is does vaping cause cancer?

Zaskoda 3y ago
We'll find out.
bottled_poe 3y ago
I’d put my money on yes, but at a far lower risk than smoking.

Zaskoda 3y ago

I think it has to be said, correlation is not causation. While I believe that in this case it's almost certainly true, it's still not scientific to claim that it is indeed true until you can prove causation. When you do the math, it turns out that 100% of people who confuse correlation with causation end up dead. Dangerous stuff.

YokoZar 3y ago
The author addresses both of the possible reasons that correlation and causation could be unlinked here (reverse causality and common cause). Did you have a comment about them?

_cs2017_ 3y ago

The author is a PhD in CS from Berkeley and teaches data science at a (decent I think?) college. And yet, he writes completely incorrect statements about statistics. Why? > "(1) that the supposed effect is really the cause, or in this case that incipient cancer, or a pre-cancerous condition with chronic inflammation, is a factor in inducing the smoking of cigarettes, or (2) that cigarette smoking and lung cancer, though not mutually causative, are both influenced by a common cause, in this case the individual genotype." > If you think that’s the stupidest thing you’ve ever heard, you can take it up with Sir Ronald Fisher, who actually made this argument with apparent sincerity in a 1957 letter to the British Medical Journal. I mention this in case you didn’t already know what an ass he was. Of course, it's very possible that there's a common cause. For example, people who are very depressed may choose to smoke, and depression may also cause cancer. I'm not saying it does, I'm just saying it's clearly a possibility that needs experiments to disprove. The author's claim is so wrong, and yet he seems to genuinely believe it.

YokoZar 3y ago
Wouldn't we need, like, evidence or something to believe that possibility? We have mountains of direct evidence with underlining theory for the straightforward explanation. Sometimes we need to believe that evidence.
- _cs2017_ 3y ago
  No, you don't need evidence to prove that this is a possibility. You only need evidence to claim that this is impossible.
jll29 3y ago
It also seems unprofessional to call Sir Fisher an "ass", which is called an ad-hominem attack (attack on the person is obviously not a valid logical argument), and one of a dead person at that. Fact is: Fisher made fundamental contributions and the poster himself uses these on a daily basis: "Student" [Gossett]'s t-distribution, Fisher's linear discriminant, a precursor of linear discriminant analysis, ANOVA, Fisher information, Fisher's scoring, Minimum Fisher information, the F-distribution, Fisher–Tippett–Gnedenko theorem, the Fisher-Yates shuffle algorithm, the von Mises–Fisher distribution, inverse probability, Fisher's permutation test Fisher's inequality, sufficiency of a statistic, and more. His contribution to biology are even more impactful. It also happens that Fisher was a proponent of the "Frequentist" interpretation of probabilities, whereas the poster belongs to the recently more popular "Bayesian" camp of ideology (yes, ideology, if you think statistics as a part of mathematics is free from that, welcome to real life!). He further held strong views about races, perhaps because he was a professor of eugenics (which we today know as incorrect unscientific nonsense, but obviously that was not the state at the time), and there is am ongoing controversy regarding whether he was a racist or not. What I read about him suggests to me I may not have liked him, but to just stamp him as "ass" wihtout elaborating is too cheap for a statistcs professional in my view. But then this is a personal blog, where the poster can write whatever he wants under US law.

seccess 3y ago

"Finally, looking at that figure you might wonder why the relative risk of smoking has increased so much. Based on my first pass through the literature, it seems like no one knows. There are at least three possibilities: - Over this period, cigarettes have been reformulated in ways that might make them more dangerous. - As the prevalence of smoking has decreased, it’s possible that the number of casual smokers has decreased more quickly, leaving a higher percentage of heavy smokers. - Or maybe the denominator of the ratio — the risk for non-smokers — has decreased." My first thought was "second hand smoke". My logic is, when smoking was more normalized, non-smokers were exposed to some of the same risk as smokers due to smoking indoors, etc, resulting in higher rates of lung cancer among non-smokers.

crdrost 3y ago

Slight change to the description: "Sometimes interpreting data is easy. For example, one of the reasons we know that smoking causes lung cancer is that when only -6dB of the population smoked, +6dB of people with lung cancer were smokers. If you are a doctor who treats patients with lung cancer, it does not take long to notice numbers like that." What was the change? +12dB or 10^1.2, which is 16x. This ties into the odds form of Bayes' theorem given in the post; this representation of probability is dB(p) = 10*log10(p/(1-p)) p(dB) = 10^(dB/10) / (1 + 10^(dB/10)) so roughly 0dB = 50%, 5dB = 75%, 10dB = 90%, 20dB = 99%, 30dB = 99.9%...

bentt 3y ago

"...the pre-cancerous condition with chronic inflammation, is a factor in inducing the smoking of cigarettes," The author mocks this possibility, but the causes of chronic inflammation are not entirely understood, and it is linked with depression, cancer, obesity, stress, and a lot of other human conditions. We can't rule out that a stressed out person might want to smoke, be more likely to get addicted, and also have chronic inflammation which opens the door to the development of uncontrolled malignancies. Still, don't smoke.

yread 3y ago

Note that vaping also causes DNA damage and cancer (and addiction). https://www.pnas.org/doi/10.1073/pnas.1718185115 https://www.pnas.org/doi/10.1073/pnas.1718185115 Smoking actually kills more people by causing heart disease than by causing cancer. But the risk isn't that much increased.