Unhealthful News 151 - Logic and proportion have fallen sloppy dead

I figure I need to do a tobacco example since this is World No Tobacco Day, brought to you by the UN's champions of UN (that is, United Nations' and Unhealthful News, respectively), the World Health Organization.  Over at the tobacco harm reduction blog, Paul Bergen wrote a great translation of this year's WHO statement about WNTD (one might call it a parody, but that would understate how fundamentally accurate it is).  We started TobaccoHarmReduction.org five years ago today, in response to WHO's anti-harm-reduction WNTD that year, and if anything they have only become more unhealthful since then.  Almost as funny was WHO doling out WNTD awards to its own peeps, funny because I saw it reported on twitter with the hashtag #mutualmasturbation.

Today, in keeping with the anti-tobacco extremist mission – attack all forms of nicotine use except smoking, because the popularity of smoking helps support their abstinence-only agenda – their pet reporters seem to have focused on low-risk smokeless alternatives and hookah smoking.  I am writing about the New York Times's "contribution" to this, mostly because it is a great example of the WHO myths, as well as the funniest.

The humor commences with the human interest hook in the lead, about a physics major here at University of Pennsylvania who has become such a fan of hookah smoking that he bought one for his fraternity.  He was quoted:

[He] believes that hookah smoke is less dangerous than cigarette smoke because it “is filtered through water, so you get fewer solid particles.”

Let's think about that.  "Filtered" by moving fairly large bubbles through a couple of inches of water.  Yes, some of the particles will touch the surface of the water and stick or dissolve, but most of them do not.  It is more efficient than trying to clear the smoke in your kitchen from a cooking mishap by running water in the sink, but the same basic idea.  Perhaps physics is not the strong field at our local supposed-part of the Ivy League.  I guess we can hope he specializes in quantum theory rather than something that would educate about everyday physical chemistry.  Or maybe the bit about the fraternity explains the problem.

Anyway, his conclusion that hookah smoking is less harmful than cigarettes is a reasonable guess, though we do not know enough about the risks to say for sure.  But if so, the main reason would be that it is mostly a heat-not-burn system that products fewer combustion products.

After that hook, reporter Douglas Quenqua takes over the misleading claims himself.  He starts with the WHO propaganda (pdf) that an hour-long session of hookah smoking is like smoking 100 cigarettes.  Really?  It is bad enough that NYT (and most other) health reporters do not fact-check, but it is pretty sad when they do not think.  What the WHO report is claiming is not about health effects, because no such information exists, though that is what they are trying to imply.  It is really just about total amount inhaled.  But think about what it would take to inhale the equivalent of the smoke from 100 cigarettes.  About ten breaths a minute times sixty minutes is 600 breaths.  It is hard to smoke an entire cigarette in only six puffs, let alone 100 in a row, so it would be almost impossible to inhale that much in an hour.  And that does not even take into consideration that hookah smoke is usually far less concentrated.

The WHO numbers seem to be based on the total amount of inhaling that someone does in an hour, as if the hookah were being used as a scuba hose.  It might theoretically be possible to smoke a hookah as intensely as the WHO claims is typical, but it would be very difficult, and you would have to have a Nascar-style pit crew to quickly change the tobacco and charcoal when they ran out, several times.  This certainly is in no way similar to actual hookah smoking, by well over an order of magnitude, and probably more like two, as would be obvious to anyone who had bothered to witness it before writing a news story about it.  If he had gone as far as to try it, he would have discovered that each hit from a hookah is far less intense than one from a cigarette.  Doing all of your inhaling for an hour by drawing on a hookah would be unrealistically extreme, but doing it by drawing on cigarettes is completely absurd.

The report goes on:

That study also found that the water in hookahs filters out less than 5 percent of the nicotine.

Well, that is good news, since nicotine is the good part of smoking, not the harmful part.  Though apparently the New York Times is not aware of that, since this is presumably intended to suggest that a bigger number would be better.

Moreover, hookah smoke contains tar, heavy metals and other cancer-causing chemicals.

It might have been useful for the reporter to look up "tar" before writing that conjunction, so that he would know that it refers to the particulate phase of the smoke/vapor – i.e., the bit with the heavy metals and other cancer-causing chemicals.

An additional hazard: the tobacco in hookahs is heated with charcoal, leading to dangerously high levels of carbon monoxide, even for people who spend time in hookah bars without actually smoking, according to a recent University of Florida study.

It is plausible that there is lots of CO produced, but "dangerously high levels" tends to imply acute poisoning, which readers presumably understand, having heard about it occurring in household accidents.  But this scare tactic ignores the lack of any reports, to my knowledge, about adverse acute effects (not that CO is good for your heart and the rest of your body in the medium term).  It would be nice if someone offered some non-propaganda analysis of this, but the press is certainly not going to help with that.

And because hookahs are meant to be smoked communally — hoses attached to the pipe are passed from one smoker to the next — they have been linked with the spread of tuberculosis, herpes and other infections.

Practices vary certainly, but I have only seen situations where everyone has their own mouthpiece they insert for their turn.  In any case, tuberculosis?  If that is floating around the Penn student body (or the other American youth that were the focus of the story), transmission by hookah is not exactly the major concern.

Paul G. Billings, a vice president of the American Lung Association ... calls the emerging anti-hookah legislation a “top priority” for the lung association.

You would think they would be a bit more worried about the cigarettes that certainly cause (as opposed to the weak evidence about hookahs) lung cancer and COPD, and that remain about a thousand times more popular.  But since the ALA is opposed to the use of smoke-free THR products to reduce lung diseases (and other diseases) it is clear that they are not really about lungs, or public health.  They are just pursuing a political agenda that their donors are being tricked into supporting.  Funny that reporters do not know how to probe, as I learned in middle school journalism class, perhaps asking the lung guy how much evidence there is that casual hookah use causes serious risk of lung disease, or maybe why it is the top priority.

The balance of the article goes on to recount how various localities are pursuing various forms of hookah bans, particularly focused on hookah bars, to eliminate what is slowly becoming a more popular pub-like center of social gathering for some young American adults.  Banning is, of course, the preferred and most effective solution when young people are doing other than what they are told.  If the trends and the bans are both popular enough, maybe it will lead to a generation that has a healthy distrust of the honesty and motives of those in power.  Maybe a few of them will become reporters.

(Oh, and in case that title was too obscure, it is a lyric from the Jefferson Airplane's Go Ask Alice, the song with a hookah smoking caterpillar.  The current discourse on tobacco has far too much in common with Alice's adventures.)