Second-hand smoke in cars: How did the “23 times more toxic” myth turn into fact?

Ross MacKenzie; Becky Freeman

doi:10.1503/cmaj.090993

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Re: Second-hand smoke in cars: How did the �23 times more toxic� myth turn into fact?
Dr. Suzanne Strasberg

Posted on: 19 April 2010
The authors respond to Dr. Strasberg
Ross MacKenzie

Posted on: 16 April 2010
Re: Second-hand smoke in cars: How did the �23 times more toxic� myth turn into fact?
Dr. Suzanne Strasberg

Posted on: 14 April 2010

Posted on: (19 April 2010)

Re: Second-hand smoke in cars: How did the �23 times more toxic� myth turn into fact?
Dr. Suzanne Strasberg, Toronto, Ont.
We are concerned with this article, particularly the title, as it implies that the danger to kids in tobacco-smoke-filled automobiles is a myth.
We are similarly concerned that the authors of this piece seemingly ignored the fact that in 2008, the OMA released new evidence that found in -car second-hand smoke particle concentrations to be up to 60 times greater than in a smoke-free home, not 23 times.
...
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We are concerned with this article, particularly the title, as it implies that the danger to kids in tobacco-smoke-filled automobiles is a myth.
We are similarly concerned that the authors of this piece seemingly ignored the fact that in 2008, the OMA released new evidence that found in -car second-hand smoke particle concentrations to be up to 60 times greater than in a smoke-free home, not 23 times.
The OMA’s 2008 release was based on the easily found and well- referenced work of the California Air Resources Board (June 2005) and the work of experts in the field, Drs. Wayne Ott, Neil Klepeis and Paul Switzer, published in the Journal of Exposure Science and Environmental Epidemiology (July 2007). As public health issues like this one gain momentum, more evidence becomes available and it is the responsibility of the media reporting such information, and the researchers doing retrospective analysis, to keep up with the new evidence. It is important to point out that it is indisputable that second-hand smoke is harmful for everyone, regardless of what the actual numbers are.
Contrary to the authors’ attempt to portray the OMA position paper as an example of inaccurate reporting, the paper is quoted in their article as clearly explaining the context of the reference, as part of the discussion surrounding the draft legislation in Colorado. The citation of the newspaper article accurately referenced that description.
As we presented in our 2004 paper and again in our 2008 release, there is lots of other evidence supporting a ban on smoking in cars with kids, and we are thrilled that our ongoing advocacy resulted in such a ban in Ontario, that allows our children to breathe easier.
Suzanne Strasberg, MD President, Ontario Medical Association
Conflict of Interest:
None declared
Show Less

Competing Interests: None declared.
Posted on: (16 April 2010)

The authors respond to Dr. Strasberg
Ross MacKenzie, Sydney, Australia
Editor;
Dr Strasberg’s suggestion that our article implies that health risks associated with second-hand smoke exposure in cars is a myth seemingly overlooks our stated position that banning smoking in cars represents an “extremely important public health policy that has the potential to dramatically reduce the amount of exposure to second-hand smoke experienced by children.”
The myth referred to i...
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Editor;
Dr Strasberg’s suggestion that our article implies that health risks associated with second-hand smoke exposure in cars is a myth seemingly overlooks our stated position that banning smoking in cars represents an “extremely important public health policy that has the potential to dramatically reduce the amount of exposure to second-hand smoke experienced by children.”
The myth referred to is the ‘23 times more toxic’ figure; and how it came to be widely accepted is the crux of our article. While the OMA’s 2008 report did use a different set of figures in its assessment of second -hand smoke in cars, the organisation’s 2004 report, which cited an unsubstantiated Denver newspaper article as the source for its use of the 23 times figure, played a key role in the progress of this media-friendly sound bite into broadly quoted ‘fact’.
We unreservedly concur with Dr Strasberg’s position on the importance of raising awareness of the indisputable health risks posed by exposure to second-hand smoke, but disagree with her assertion that this be done “regardless of what the actual numbers are.”
The inherent problem with using an unsubstantiated figure is that the advances made in tobacco control in recent decades has been based on reliable scientific evidence; using inaccurate information runs the risk of alienating what has been overwhelmingly public support for greater regulation of tobacco use and its promotion.
A further concern is that using such inaccurate information runs the risk of providing ammunition for opponents of tobacco control, and we cite one such example in our paper. More recently, the 23 times figure has been specifically attacked in a broader critique of the tobacco control movement, see http://velvetgloveironfist.blogspot.com/2010/03/just-open- window.html
Ross MacKenzie, Becky Freeman
Conflict of Interest:
None declared
Show Less

Competing Interests: None declared.
Posted on: (14 April 2010)

Re: Second-hand smoke in cars: How did the �23 times more toxic� myth turn into fact?
Dr. Suzanne Strasberg, Toronto, ON
We are concerned with this article, particularly the title, as it implies that the danger to kids in tobacco-smoke-filled automobiles is a myth.
We are similarly concerned that the authors of this piece seemingly ignored the fact that in 2008, the OMA released new evidence that found in -car second-hand smoke particle concentrations to be up to 60 times greater than in a smoke-free home, not 23 times. The OMA’...
Show More

We are concerned with this article, particularly the title, as it implies that the danger to kids in tobacco-smoke-filled automobiles is a myth.
We are similarly concerned that the authors of this piece seemingly ignored the fact that in 2008, the OMA released new evidence that found in -car second-hand smoke particle concentrations to be up to 60 times greater than in a smoke-free home, not 23 times. The OMA’s 2008 release was based on the easily found and well-referenced work of the California Air Resources Board (June 2005) and the work of experts in the field, Drs. Wayne Ott, Neil Klepeis and Paul Switzer, published in the Journal of Exposure Science and Environmental Epidemiology (July 2007).
As public health issues like this one gain momentum, more evidence becomes available and it is the responsibility of the media reporting such information, and the researchers doing retrospective analysis, to keep up with the new evidence. It is important to point out that it is indisputable that second-hand smoke is harmful for everyone, regardless of what the actual numbers are.
As we presented in our 2004 paper and again in our 2008 release, there is lots of other evidence supporting a ban on smoking in cars with kids, and we are thrilled that our ongoing advocacy resulted in such a ban in Ontario, that allows our children to breathe easier.
Suzanne Strasberg, MD President, Ontario Medical Association
Conflict of Interest:
None declared
Show Less

Competing Interests: None declared.