Tag Archives: carcinogens

Sunday Science Lesson: “carcinogen” is not a useful category

by Carl V Phillips

I was recently asked by a correspondent if we could perhaps make the case that being in the same room as aerosolized cooking oil is more carcinogenic than being exposed to what might be called second-hand vapor.  The context was dealing with the dumb (really really dumb) law in California that requires every venue to post a sign that says, in effect, that being in this facility results in exposure to known carcinogens, and how that whole  California-style “known carcinogens” concept means that e-cigarettes are getting identified as such.

Of course, technically the California law does not require that the sign be posted in every venue, but merely those that have chemical carcinogens floating around in them.  But since this condition is met everywhere that contains, say, furniture or walls, effectively the rule requires posting the sign everywhere.  There is far more that is stupid about this law than I will cover here (e.g., a warning that appears everywhere has zero information content).  I will focus on its very premise: the concept of something dichotomously being either a carcinogen or not.

The only real dichotomy is between exposures that we have evidence that pretty clearly demonstrates that they cause cancer (under particular circumstances, for particular people, in particular doses, and with some possibly very small probability — i.e., the evidence pretty much never suggests that they always create a risk, let alone one that is large enough to matter) and exposures that probably cause cancer (with all those caveats) but the evidence does not exist yet. It is a safe assumption that under the right circumstances, any exposure experienced by a body can cause cancer.

Some of you might notice that this construction sounds disturbingly like the attitude of “public health” people (and sometimes even real public health people) that is epitomized in such statements as “this study failed to demonstrate that the exposure creates any important risks, so more research will have to be done to show that is true.”  But there is a fundamental difference here:  The “public health” people are looking for an excuse to take some action that they have a political/religious desire to take.  The implications of my point are the opposite, that the differences between the many exposures where it is surmised that their is some tiny risk are about the same as all those exposures where no one has chosen to surmise this yet, and in all such cases, almost any proposed actions or restrictions are inappropriate.

Notice that the latter statement applies to only those “known carcinogen” exposures where the guess is that there is some tiny risk of cancer, not exposures that cause important risks.  Just because there is no bright-line dichotomy does not mean that the world does not divide, and some exposures matter, of course.

Most carcinogen exposures — either the “known” ones or the billions of others — cause such a trivial risk that (a) they do not matter and (b) it is only possible to make wild guesses (often dressed up to look like science, but still just wild guesses) about the magnitude of the risk.  If an exposure does not cause a large enough risk, there is no way to detect it, let alone measure it.  It is difficult to imagine ever being able to detect a risk that causes 1  in 100,000 exposed people to get a cancer, even if that cancer were extremely rare and a lot of people were exposed.

You might argue that I should not have even go down to that order of magnitude to make the point, and that the same thing can be said about 1 in 10,000.  In reality, measuring risks in the 1 in 1000 range is beyond practical capabilities.  E.g., while there is no clear evidence that smokeless tobacco causes any risk for oral cancer, it is plausible that there is a relative risk in the order of 1.1 or perhaps even 1.3; these figures would put the risk in that 1 in 1000 range, but despite the exposure and outcome being easy to detect, the outcome being rare, and the great interest by ANTZ in the topic, it is not possible to conclude whether the risk is 1 in 1000 or zero or somewhere in between.  Similarly, any risks from second-hand smoke are down in this barely detectable range.

To the extent that quantification even exists, most of the wild guesses (that get called calculations or extrapolations) about the vast majority of “known carcinogen” exposures put the risks in the order of 1 in a million or 1 in a billion.  To put that in perspective, the risk of dying from driving 1 km is about 1 in a billion.  Yes, you read that right — the lifetime of exposure to some of these “known carcinogenic exposures” that the California-types want you to worry about cause about the same risk of getting a cancer (not even necessarily a bad cancer) as the risk of dying from driving a few blocks.

So with that in mind, there are a couple of key lessons here.

First, the one in the title: Since basically anything is a carcinogen under the right circumstances, merely calling something a carcinogen is uninformative, and quite often is fear-mongering disinformation.  Of course, most of us use the word, but usually we mean something like “carcinogenic, under the relevant circumstances, to a degree that matters or is at least measurable”, and that is how most people interpret it.  Thus, when it is used to describe something that poses a risk that is trivial or speculative, it is terribly misleading.

Second, my last disjunction is a bit misleading because the trivial and the speculative are mostly the same category.  That is, when something is guessed to produce a very small risk, it is never known for sure that this risk exists at all.

Third, given that, it should be clear that it is impossible to compare risks down in that trivial range.  Is the risk from an exposure 1 in a billion, or 1 in a million, or 1 in 10,000 (or zero)?  We will probably never know.  Thus, there is simply no basis for concluding that one exposure that is down in this range is a worse than another.  Of course, all differences among miniscule risks are themselves miniscule, so it does not matter anyway.  Anyone making such comparative claims — unless accompanied by a lot of caveats — is lying.  And, unfortunately, that would include us if we started trying to make such comparisons.

Irrational fear of and despite toward “carcinogens” is the biochemistry equivalent of racism or homophobia.  They are all driven by tendencies toward tribalism (an unconscious desire to find someone to hate) and fear (at the unconscious animal level) that are part of what we inherited from our ancestors.  There is a bit of value in responding to any of these with facts, of course — but the simplest facts (those people are mostly exactly like you; trivial carcinogenic risks are everywhere) probably matter just as much as any details.  There may be a role for the scientific details in, say, court proceedings.  But for changing the general prejudices, even we scientists have to concede that a real solution comes most from in the subconscious release of irrational hatreds and fears that comes from familiarity.

American Cancer Society are liars

by Carl V Phillips

As I have documented, the American Cancer Society (ACS) was one of the most aggressive anti-THR liars of the 2000s, actively campaigning to convince people that smokeless tobacco use was as harmful as smoking.  They have continued to be solidly a part of the anti-THR cabal in the 2010s, but they have not been so aggressive about the propaganda.  So in “honor” of today being the ACS’s “Great American Smokeout”, I thought I would see how much they might have corrected their lies.  It took me about five seconds to figure out the answer was “not much at all”.

Take just this one page, with about one screen’s worth of information.  (Archived here in case they try to memory-hole it, though they do not seem particularly concerned about being caught perpetuating stupid lies.)  It was the top hit from their own search engine, so I cannot be accused of digging through their archives to find obscure, non-prominent lies.

There is nothing here that they have not been corrected on numerous times.  So an intention to mislead people — blatant intentional lying — is the only way to interpret their behavior.  Let’s step through the entire content:

Are spit tobacco and snuff safe alternatives to smoking?

Can the question itself be a lie?  It turns out yes.  Many questions are intentionally designed to distract from the truth.  In this case, “safe alternative” is a strawman to distract the reader away from the relevant question, “is smokeless tobacco use an enormously safer low-risk alternative to smoking”.  No one seriously claims that ST is safe.  Nothing is 100% safe, so they could ask the same question and get the same answer about whether eating apples is a safe alternative to smoking.  People with a poor understanding of risk often think there is some dichotomy between the risky and the safe, which is obviously false, and ACS is blatantly taking advantage of this flaw in our national education, and perpetuating it rather than trying to help correct it.

As for “spit tobacco”, it is not a lie, but it is morally rather similar.  This is a term that was made up by anti-THR activists to try to denigrate ST users.   Can you imagine if they used similar derogatory unprofessional phrasing to describe, say, gay sex acts that increase cancer risk.  It would be a scandal.  Luckily for them, being tobacco-user-phobic is allowed.

Many terms are used to describe tobacco that is put in the mouth, such as spit, oral, smokeless, chewing, and snuff tobacco. Using any kind of spit or smokeless tobacco is a major health risk. It is less lethal than smoking tobacco, but less lethal is a far cry from safe.

Not too long ago, ACS would have said, in one way or another, that the risk is the same.  But the liars have been called on that enough times that only the most clueless still say it.  But instead of changing to the truth that encourage people to quit smoking, they just came up with another version of the anti-THR lie.  While there is no bright-line definition of “major health risk”, I suspect that no one would consider that phrase to include what we know about ST: “risk so small that it is not measurable, and there is no definitive link with any disease”.  This is a rather close cry from safe, it turns out.

More nicotine is absorbed from spit tobacco than is absorbed from one cigarette. Overall, people who dip or chew get about the same amount of nicotine as regular smokers.

Lying with literal truth, one of the classics.  The page is about health effects.  Since nicotine causes very very little or perhaps even none of the health risk from smoking, this is a red herring, meant to trick the average reader (who does not understand about nicotine).  What they say is actually not true because it is nonsense:  users of all products get as much nicotine as they choose to get, so it makes no sense to even make the comparison.

The most harmful cancer-causing substances in spit tobacco are tobacco-specific nitrosamines (TSNAs) which have been found at levels 100 times higher than the nitrosamines that are allowed in bacon, beer, and other foods. These carcinogens cause lung cancer in lab animals, even when injected rather than inhaled.

Another classic, the scary, scary chemicals.  Even if ST use does cause cancer, there is no way anyone can definitively claim what chemicals are responsible, let alone most harmful.  And, yes, mega-doses of those chemicals when injected in particular ways can be used to torture animals to death via cancer.  You know what else that is true of?  Basically everything.

Notice also that clever little “have been found”.  This is designed to distract from what is typical of products that are on the shelf today, with much lower concentrations of these chemicals than what has occasionally been found in the past.  It turns out that acetaminophen capsules have been found with lethal doses of poison in them.  Is that useful to know?

Of course, apart from all of that, the real key is that if the exposure does not cause a measurable level of cancer, then talk about cancer causing chemicals is meaningless.  It is intended to distract the reader from the truth.

The juice from smokeless tobacco is absorbed directly through the lining of the mouth. This causes sores and white patches (called leukoplakia) that often lead to cancer of the mouth.

Actually, if there is any dysplasia (pre-cancerous cellular changes), then the term leukoplakia does not apply.  But the terminology does not matter.  (So why did they include it? Because it sounds scary!)  What matters is that the superficial lesions from ST use do not often cause to cancer of the mouth.  Indeed, based on the science we have, there is not evidence that they ever do so.

People who use spit and other types of smokeless tobacco greatly increase their risk of other cancers, including those of the mouth, pharynx (throat), esophagus (the swallowing tube that connects the mouth and the stomach), stomach, and pancreas. Other effects of using spit tobacco include chronic bad breath, stained teeth and fillings, gum disease, tooth decay, tooth loss, tooth abrasion, and loss of bone in the jaw. Users may also have problems with high blood pressure and may be at increased risk for heart disease.

Should I be petty and point out that their list of “other [than mouth] cancers” starts out with mouth cancer.  Nah.  I will just repeat that none of that sentence is true.  It is not even remotely defensible.  There is no detectable risk for any of those cancers, let alone all of them.  Also unsupported by the science are the tooth and gum disease claims.  (I am not sure there is any research on bad breath, but it actually seems likely that using some mint snus reduces bad breath in much the same way that chewing gum does.)

The last sentence is another classic lie via a truthful statement.  ST users might have high blood pressure and above average risk.  Who else might have these problems?  Non-users.  (“Warning:  If you do not use smokeless tobacco, you may be at increased risk for heart disease and are at risk of high blood pressure.  Half of all non-users have elevated risk for heart disease.”   All true!)

What is snus? Is it safe?  Snus (sounds like “snoose”) is a type of moist snuff first used in Sweden. It’s often flavored with spices or fruit, and is usually packaged like small tea bags. It’s also sold loose, as a moist powder. Like snuff and other spit tobaccos, snus is held between the gum and mouth tissues where the juice is absorbed into the body.

No real health claims here.  But geez, how sloppy can you get and still be allowed to have a website?   (I will leave it as an exercise for the reader to spot the errors.)

Because it’s steam-heated rather than fermented, Swedish snus has fewer tobacco-specific nitrosamines that are known to cause cancer (see above). But this doesn’t mean snus is safe.  Snus users may have a higher risk of cancer of the pancreas than non-users. They also get sores or spots in the mouth (lesions) where the snus is held. It appears that snus users may have mouth cancer more often than non-users, though more studies need to be done to confirm this.

The only part that is correct is the “see above” — as in, see what I wrote about every bit of this being wrong, so I do not have to repeat myself.

Last Medical Review: 11/08/2012
Last Revised: 11/08/2012

In some ways this is the worst bit of all.  The page is current.  These zombie lies are not just some old leftovers.  They claim it was revised and reviewed this month.  Perhaps they should get someone who knows something about science, rather than a medic, to do their reviewing.

So, as the 2012 Great American Smokeout draws to a close, with almost everyone who quit for the day soon to start smoking again, the American Cancer Society can congratulate themselves for doing their part to make sure that those smokers did not switch to a low risk alternative.  After all, if they switched, they would dramatically reduce their cancer risk, and then ACS would not be able to keep using them to bolster its own wealth and importance.

Americans for Nonsmokers’ Rights makes false claims about hazards of electronic cigarettes

posted by Elaine Keller

AUTHORS NOTE: This is Part 2 of 2 addressing the press release issued on September 26 by the anti-smoker group, Americans for Nonsmokers’ Rights (ANR). Yesterday’s post addressed the smoking cessation issue. Today’s post addresses the ANR’s misleading statements about the safety of vapor.

SPRINGFIELD, VA October 2, 2012

E-cigarette users who have achieved smoking abstinence report improvements in their health ranging from a reduction in COPD and asthma symptoms to better markers of cardiovascular health such as blood pressure and lipid measures. Researchers have found no increase in blood pressure or heart rate among subjects trying e-cigarettes for the first time.

“What I find most egregious about the ANR’s recent press release,” stated Elaine Keller, President of The Consumer Advocates for Smoke-free Alternatives Association, “is their statement that e-cigarettes pollute indoor air with ‘detectable levels of carcinogens and other toxic chemicals.’ ANR is trying to manipulate non-smokers into wrongly believing that e-cigarettes threaten the health of bystanders. The truth is that there is absolutely no indication that electronic cigarettes pose any appreciable risk to bystanders. Tragically, these kinds of devious tactics may actually prevent smokers from saving their health and their lives by switching to this low-risk alternative.”

The Indoor Air study cited in the ANR’s press release did report finding six chemicals in the air after a subject used an e-cigarette in a sealed 10 cubic meter stainless steel chamber. The Air was sampled for 15 minutes. However, the highest concentration of any of these chemicals was formaldehyde, measured at 16 micrograms per cubic meter, which equates to 12.86 parts per BILLION (ppb.) The OSHA Short Term Exposure Limit (15 minutes) for workers exposed to formaldehyde in the workplace is 15.5 times higher, at 2 parts per million (ppm), equivalent to 2,000 ppb. In the more restrictive Alberta Ambient Air Quality Objectives (which are equal to or more stringent than existing National Air Quality Objective and Canada Wide Standards) is set to 53 ppb.

The Indoor Air study found no nicotine in the air of the chamber. When the researchers captured exhaled breath directly in a 7 liter glass chamber, they measured 0.007 milligrams of nicotine per cubic meter. The OSHA limit for exposure is 0.5 mg per cubic meter of air—71 times higher. “But the existence of this nicotine is a moot point,” stated Keller, “given the fact that the only way a bystander could be exposed to any nicotine whatsoever from vapor would be to lock lips with an e-cigarette user and inhale while the user is exhaling.”

“ANR would like the public to believe that manufacturers hide information about ingredients in e-cigarette liquid and vapor,” said Keller, “but the major ingredients in e-cigarette liquid are well-known: propylene glycol or glycerin to create the vapor, water, flavoring, and optionally a small amount (typically less than 2%) nicotine. Countless tests have been performed on liquid and vapor. So far none of these tests has ever measured toxins or carcinogens anywhere near hazardous levels. This is probably due to the fact that unlike conventional cigarettes, e-cigarettes are not combusted”

“Discouraging the use of alternative that are up to 99% less hazardous than smoking for the users, and that are essentially harmless to bystanders, shows an appalling disregard for human health and life on the part of groups like ANR,” said Keller.

Anti-Hahn poster

Today’s content is thanks to Kristin Noll-Marsh, who has created CASAA’s direct response to the Ellen Hahn poster that was the topic here for most of last week.  Taking a different tack from our letter to the University, Kristin created a consumer-friendly poster to directly compete with Hahn’s.  So anyone at or near the University of Kentucky, please print out some copies and post them next to Hahn’s!  Kristin’s document covers a lot of the same points that appeared here already, but it makes some additional points.  Moreover, even though it is a catchy poster, it also stands as more of a research paper (with specific sources cited for specific claims, in particular) than the blog — and probably more than anything Hahn has ever written.

Since it is all there at the link, I will not repeat it here.  (Aside:  Remember, the more links we have to the letter, poster, and blog posts, the higher those will be in searches compared to her lies.  Just sayin’.)

I know that a lot of readers are waiting for our response to the anti-THR press release about lung effects that was touted this week.  Since we have higher scientific standards than the author of that press release, it is taking a bit longer to finish.  It should appear in two or three parts starting later this week.

Scary scary formaldehyde

posted by Carl V Phillips with analysis from Elaine Keller and input from CASAA board

We finish up our debunking of Ellen Hahn’s project “Lie to College Students” with her claim,

In the cartridge:  Formaldehyde.  Highly toxic to all animals, including you.  Good for embalming dead bodies.  Causes cancer.

This is obviously another example of the same word games that were analyzed in previous posts, so we will not repeat those points.

The interesting thing about this point is that the chemistry studies of e-cigarettes do find that of all the contaminants, formaldehyde might be the one that is most worth trying to reduce.  Unlike the other chemicals that Hahn mentions, which are at tiny fractions of 1% of what is considered the hazardous level, formaldehyde might be in the neighborhood of 1% of what is considered hazardous level.  Of course, this “merely” 100-fold margin is hardly a cause for worry, and the quantity is similar to the exposure we get from other sources.  (There is also speculation that some of the formaldehyde measured in lab studies is from the vaper, not the vapor — the human body emits a measurable amount of this horrible scary toxic chemical.)  It is certainly a lie to say that this contamination causes cancer, as Hahn claims.

But among all of the trivial contaminants, this trivial contaminant might be worth a bit of engineering effort.  I do not know enough about the chemical engineering to know how practical or easy reducing it would be.  An honest scientist or public health advocate might say “this is unlikely to cause health problems, but it theoretically could be causing a tiny bit of needless risk, so maybe something can be done here to make these low-risk products even lower risk.”

But this is like saying, “seat belts seem to produce a bit more bruising near the clavicle compared to elsewhere when they prevent someone from getting killed in a major crash, so we might want to focus some effort to improve that part of the seat belt.”   You would have to very stupid and/or very dishonest to reason, “A bit of bruising near the clavicle?!!! OMG! Bruises can be fatal! Don’t use seat belts!”


A short post today, but we will make up for it tomorrow, when we publish 26 pages about Hahn’s lies.  Stay tuned.

Those evil nitrosamines

posted by Carl V Phillips (with input from CASAA board)

Continuing the analysis of the lie-filled poster about e-cigarettes that Ellen Hahn and her people have been posting around the University of Kentucky campus:

In the cartridge: Nitrosamines. Known carcinogens.

Nitrosamines, or more particularly, two chemicals in the class known as “tobacco specific nitrosamines” (TSNAs) are a favorite target of anti-THR liars.  Mostly this is focused on anti-smokeless-tobacco efforts (as in the quote from the first entry in the series), which this series will get to later.  Those claims are bad enough, but the nitrosamine claims about e-cigarettes are even more absurd.

The basis for these claims is that when the FDA was seeking to completely ban e-cigarettes in the US (which a federal judge did not let them do), the agency produced a piece of rhetoric, disguised as science, in which they analyzed e-cigarette liquid down to the technological limits of detection, and found a few molecules of TSNAs.  The presence of this trace contamination was inevitable because the medical-grade nicotine used in e-cigarettes is derived from tobacco, and the process of extracting it will pick up a tiny little bit of contamination from other molecules that are also present in the plant.

The contamination is in the parts-per-billion (ppb) range, and it has never been detected in the vapor (though inevitably there are a few molecules there, as there are most everywhere).  To put that in perspective, Western smokeless tobacco, which does not cause cancer to a measurable degree, contains TSNAs in the parts-per-million (ppm) range — that is, about a thousand times as much.

This is another version of the chemophobia ploy, with the added rhetoric of the word “carcinogen”.  The honest statement is, “in very high concentrations these chemicals have been shown to cause cancer in animals, and it is hypothesized (though far from proven) that when they are in smokeless tobacco in the 100 ppm range, they cause a small but detectable risk for cancer; modern Western smokeless tobacco is in the 10 or 1 ppm range, and any cancer risk from it is too small to be measured; the concentration in e-cigarette liquid is in the .01 ppm range.”  But, of course, most people who read this simple statement “contains carcinogens” will think that there is evidence that using this product causes a substantial risk of cancer.  That is what the liars are counting on, whether they are trying to scare people about from tobacco, foods, pesticides, or whatever.

Well, that is what the liars who want to be able to claim “I did not actually say it causes cancer” count on.  Hahn — to her credit, I have to say — was willing to lie overtly rather than playing that weasel game.  The full quote:

In the cartridge: Nitrosamines. Known carcinogens. That means it causes cancer.

There is something a bit refreshing about such an out-and-out lie.

Not so refreshing is the hypocrisy:  Recall that the TSNAs are a trace contaminant of medical-grade nicotine.  What else uses medical grade nicotine?  The pharmaceutical nicotine products — gums, patches, lozenges — that Hahn aggressively pushes smokers to use.  In fact, the level of contamination found in e-cigarettes is about the same as is found in those products, and has never been found to exceed the allowable tolerances for them.

Now that is some seriously bold lying!