Re: Smoke and the Asthma Epidemic: A Reality Check

January 23, 2008

oh my, now how could that be? you mean most people dont set around in

a cubicle with smoke so thick you could cut it with a knife smokeing

cigars all day. you mean the article I read where doctors were

thinking of prescribeing smokeing to their patients with sarcoidosis

might have some merit? do you mean that Oprha's big show yesterday

was nothing but a show and her obvious problem doing going green

shows and lack of doing any on mold exposure and her politocal

standing might be aaa well, just what I think? hollowbommajomma?

do you mean that the article I read in scitox on how the effects of

second hand smoke drastically reduced just between type like regulat

and ultra lights makes a valid point? the articles. do you mean that

all the hoppla pales drasticlly in comparison to other more dangerous

toxins but all the hooplaa on rv might be only for the sake of

sidtracting us from the main issues that need addressed? you mean

that still to this day theres little proof that smoking causes lung

cancer while it's starting to be relized that lots of things in the

indoor environment can? and even some things in consentration

outdoors can be pretty harmful? more so in big citys where buildings

hamper air flow, and well hell our water, air and dirt is probably so

contaminated in mist places maybe smokeing the least of our problems.

--- In , " tigerpaw2c " <tigerpaw2c@...>

wrote:

>

> I think we all have a pretty good idea what may be causing this

> EPIDEMIC

>

> Smoke and the Asthma Epidemic: A Reality Check

> Date of original release: 7/17/00

>

> http://www.forces.org/research/files/asthma.htm

>

> We've all heard that smoking and second-hand smoke cause asthma,

but

> a growing body of evidence is challenging the veracity of this old

> saw.

>

> The most recent study to exonerate smoking and tobacco smoke as a

> cause of asthma was published in the British Medical Journal July

8,

> 2000. [1]

>

> In this 20-year, intergenerational study, researchers found that

the

> rate of asthma had doubled between l976 and l996, even as the

> smoking rate dropped by half during that same period. Asthma and

hay

> fever increased for both smokers and non-smokers, but the increase

> was higher for non-smokers. The steep rise in asthma was

> dramatically underscored by the fact that prescriptions for steroid

> inhalents for treatment of the disease rose more than six-fold

> between l980 and l990 alone.

>

> This pattern of precipitous increases in asthma coupled with

> significantly diminishing smoking rates is not unique to the

> population described by the ish researchers in their BMJ

> article. Asthma and allergy rates are skyrocketing among adults

and

> children in all developed countries, though not in less-developed,

> poorer countries.

>

> Experts are baffled by the asthma epidemic. In most countries it

> strikes hardest at the children of middle-class and wealthy

parents,

> and no one knows why.

>

> " It is very confusing, " said Professor Ulrich Wahn, pediatric

> specialist at Humboldt University in Berlin. " These are middle

> class parents, who have taken on board the need for a healthy

> lifestyle: low rates of smoking in pregnancy, low rates of smoking

> in the home and low levels of pet ownership, together with high

> rates of breast feeding....There is clearly an unidentified factor

> that is so strong it can overcome all the lifestyle changes we

> encourage parents to adopt. " [2]

>

> These good, European middle-class parents have stopped smoking,

> banished it from their homes, and yet their kids are getting

> allergies and asthma far more often than children in more smoking-

> tolerant times ever did.

>

> In the United States, too, the incidence of adult and childhood

> asthma has climbed to an unprecedented high during the past twenty

> years, while smoking and exposure to environmental tobacco smoke

> [ETS] have decreased significantly during the same period.

>

> Between 1980 and l995, the number of people reporting asthma in the

> U.S. more than doubled (from 6.7 million to 13.7 million) [3], a

> 75% increase in the rate per 100,000 population. [4] And, after a

> sharp increase beginning in the early l990s, the rate is still

> climbing. The Centers for Disease Control estimates the l998 rate

> at 17.3 million, a 150% increase since 1980. [5]

>

> Between l980 and l995, the adult smoking rate decreased from 33.2

to

> 24.7, a drop of 25%. [6] In the late l990s the overall smoking

rate

> has remained steady at between 24 and 25 percent of the adult

> population, far less than its peak of 42.6% in l966.

> Though asthma rates have risen uniformly throughout the country,

> there are some regional differences. The inverse relationship

> between asthma rates and smoking and between asthma rates and

> exposure to ETS can be seen quite clearly by comparing extremes at

> the state level.

>

> California has had the second-lowest smoking rate in the U.S. for

> many years. In l998, its adult smoking rate was 19.2. [7] It

also

> has the most draconian smoking bans in the country. Nevertheless,

> California has the largest estimated number of persons with asthma

> in the U.S., with an estimated l998 prevalence of 7.1% [8]

>

> Utah, which has had by far the lowest smoking rate in the U.S. for

> many years but which has not had the sweeping smoking bans so

> characteristic of California, had a l998 adult smoking rate of

> 14.2. The estimated l998 asthma prevalence in the state was 6.7%.

>

> Kentucky has the highest smoking rate in the United States and has

> implemented few restrictions on public smoking. In l998 Kentucky's

> adult smoking rate was 30.8%, but its estimated l998 asthma

> prevalence was only 5.9%.

>

> Asthma, Children and Minorities in the U.S.

>

> Childhood asthma is on the increase in Europe and North America

> alike. According to Dr. Talal Nsouli of the American College of

> Allergy, Asthma and Immunology, the number of U.S. children with

> asthma has doubled in 15 years, and the rate for children under age

> five has increased 160%. [9]

>

> One major difference between the European and American childhood

> asthma epidemics is that in the U.S. the disease strikes

> particularly hard among inner-city children and some of the

> country's ethnic minorities. [10] Blacks and Hispanics have

higher

> rates than do non-hispanic whites.

>

> Neither maternal smoking during pregnancy nor exposure to ETS

> appears to account for the ethnic differences in rates of childhood

> asthma.

>

> " The prevalence of asthma among children of Hispanic (mainly Puerto

> Rican) mothers with one or more children older than 9 mo. of age

was

> 18.4%, for blacks it was 11.3%, and for non-Hispanic whites it was

> 7.4%....In addition, increased risk for asthma in these children

was

> not associated with higher reporting of environmental tobacco smoke

> (ETS) exposure. " [11]

>

> Since l989, when maternal smoking rates during pregnancy began to

be

> compiled nationally, Hispanic mothers have consistently had the

> lowest smoking rates during pregnancy of all three groups, and

white

> non-hispanics have had the highest: [12]

>

> Hispanic - l989: 8.0 1993: 5.0

> Black - l989: 17.1 1993: 12.7

> White - l989: 20.4 1993: 16.8

>

> Note that the rates for all three groups dropped significantly

> between l989 and l993. Overall maternal smoking during pregnancy

> continued to drop in l995 to 14.0 and in l996 to 13.6, a 31%

> decrease from the overall rate of 19.5 in l989.

>

> Given these statistics, it seems clear that even active smoking by

> pregnant women does not play a causitive role in the current

> childhood asthma epidemic. Moreover, if active smoking by the

> mother during pregnancy is not causally involved, then it's

> certainly not plausible that prenatal exposure to ETS would be

> causally involved either.

>

> Occupational Asthma

>

> Just as asthma is rising among children, it is also rising among

> adults in the workplace. One expert summarized it nicely in a book

> review in The New England Journal of Medicine:

>

> " We know of more than 250 substances that can cause occupational

> asthma, and the list is expanding. Occupational asthma not only

> represents a substantial proportion of all cases of asthma but also

> is one of the main occupational diseases. The unsolved scientific

> questions concerning the increasing incidence of occupational

asthma

> in recent decades, the socioeconomic effects of the disease, and

> prevention are the current challenges. " [13]

>

> One thing is certainly true: In recent decades, workplace smoking

> bans have been enacted far and wide throughout the United States,

> particularly since the mid-l980s. By l992, workplace smoking

> restrictions covered about four-fifths of all indoor workers,

> according to a government survey. [14] Since then, many more

> workplace smoking bans have been implemented, often as a result of

> state mandates. In l995, California banned smoking in all

> workplaces except restaurants and bars, and it has since banned

> smoking indoors even in those venues.

>

> Nevertheless, occupational asthma continues to rise, and the

Centers

> for Disease Control estimated that California had more cases of

> asthma in l998 than did any other state.

>

> Asthma and Allergies

>

> Concurrently with the rise in asthma has come an increase in the

> numbers of people with allergies. According to the National

> Institutes of Health, as many as 50 million Americans--roughly 20%

> of the population--now suffer from allergies. [15]

>

> Almost any substance can cause an allergic reaction in those who

are

> sensitized to it, but the substances involved most frequently are

> dust mites, mold, pollen, cockroach droppings and pet dander.

>

> Some people believe they are allergic to tobacco smoke. However,

it

> has not been scientifically demonstrated that tobacco smoke

contains

> antigens which would spark an allergic reaction. [16]

Furthermore,

> since exposure to ETS has decreased dramatically in public places,

> the workplace, and even in the home, while allergies have

increased,

> it isn't plausible that ETS is a factor in the increase in

allergies

> and allergic reactions.

>

> Unlike severe asthma attacks, allergic reactions are not generally

> life threatening, but they can be if they are severe enough to

> provoke anaphylactic shock. According to a recent study published

> in the British Medical Journal, hospital admissions for acute

> anaphylaxis in England increased nearly two-fold between l991 and

> l995. By far the most frequent causes of anaphylaxis in this study

> were allergic reactions to therapeutic drugs and to food. [17]

>

> The relationship between allergy and asthma is not clearly

> understood. Most people with allergies do not have asthma, but

most

> asthmatics do have allergies which can trigger attacks.

>

> The most common triggers for asthma are dust mites, pet dander,

mold

> and cockroach droppings. But emotional stress, viral infections,

> food allergies, and pollen from grass and ragweed also initiate

> attacks in many people.

>

> Merely reducing asthmatics' exposure to suspected triggers doesn't

> solve the problem, however. " Reducing allergen exposure, although

> intuitively obvious as a management approach, has had a less than

> stellar track record when applied to asthma control in clinical

> practice. " [18] Furthermore, in many cases, acute asthma attacks

> frequently occur without an obvious trigger. [19]

>

> What Causes Asthma?

>

> Asthma is not a new phenomenon. It has existed as a known clinical

> syndrome for more than 2000 years, [20] and yet its cause remains

> elusive.

>

> In modern times, theories about its root cause have abounded. Many

> experts have posited that it is primarily a psychosomatic disorder,

> brought on by emotional distress. Others have blamed everything

> from cockroaches to dust mites to air pollution and tobacco smoke.

> But because asthma is increasing so dramatically in the l990s,

> medical scientists are re-thinking the old theories. After all,

> cockroaches, pets, dust, air pollution, stress and ETS were at

least

> as abundant before the asthma epidemic as they are now. Certainly

> ETS was far more pervasive in our society prior to the sudden rise

> in asthma.

>

> Dr. ez, [21] director of respiratory sciences at

> the University of Arizona, is one of a growing number of experts

who

> have completely changed their thinking about asthma.

>

> " Like most people, I assumed tobacco smoke and pollution were the

> problem--this was the politically correct way to think. But these

> factors turned out not to play a major role. In high-pollution

> areas, in low-pollution areas, among all ethnic groups, there was

> asthma. Clearly, something else was involved. " [22]

>

> Dr. ez, like many other asthma specialists, has come to

> believe that the problem lies in the lack of challenge to the

> developing immune systems of the young in modern affluent

> societies. In other words, our children's environment is too

> sterile and they are overly protected from microbial and parasitic

> challenges. He says, " Just as you need to use your eyes to develop

> sight and your legs to develop the muscles to walk, your immune

> system develops through its experience. By legitimately protecting

> our kids from dangerous infections we may have kept parts of their

> immune systems from maturing. " Dr. ez believes that

increased

> use of antibiotics may be part of the problem, given recent

> estimates that 40% of children in the U.S. are treated with

> antibiotics for a month or more before their first birthday. [23]

>

> A variety of new explanations for the rising asthma rates are also

> being put forth by asthma specialists: lack of physical activity,

> changing patterns of diet, genetic predisposition, the increasing

> presence of man-made chemicals, and rising levels of emotional

> stress, among others.

>

> In the midst of all this uncertainty, at least one thing seems

> clear: Whatever is causing more and more of our children and

adults

> to contract and suffer from asthma, it's not tobacco smoke.

>

> ___________________________

> ENDNOTES

>

> 1 - Upton M N, McConnachie A, McSharry C, Hart C L, G D,

> Gillis C R, Watt G C M, " Intergenerational 20 year trends in the

> prevalence of asthma and hay fever in adults: the Midspan family

> study surveys of parents and offspring, " BMJ 2000;321:88-92 (8 July

> 2000)

>

> 2 - Derbyshire, , " Cossetted children more prone to

> allergies, " Electronic Telegraph, 5 July 2000.

>

> 3 - Centers for Disease Control and Prevention, MMWR

> 4/24/98, " Surveillance for Asthma--United States, l960-1995. "

>

> 4 - Centers for Disease Control and Prevention, MMWR

> 12/4/98, " Forecasted State-Specific Estimates of Self-Reported

> Asthma Prevalence--United States, l998. "

>

> 5 - Asthma Prevention Program of the National Center for

> Environmental Health, Centers for Disease Control and

> Prevention, " At-A-Glance, " l999.

>

> 6 - Centers for Disease Control and Prevention, TIPS, " Percentage

of

> adults who were current, former or never smokers...National Health

> Interview Surveys, Selected Years--United States, l965-l995. "

>

> 7 - Centers for Disease Control and Prevention, " Prevalence of

> current cigarette smoking among adults, by state and sex--United

> States, Behavioral Risk Factor Surveillance System, l998. " Smoking

> rates for all three states are from this source.

>

> 8 - CDC, MMWR 12/4/98 47;1022-1025. " Forecasted State-Specific

> Estimates.... " The estimated prevalence data for all three states

> are from this source.

>

> 9 - Kim, Eun-Kyung, " First Lady Launches Asthma Program, "

Associated

> Press, 5/4/99.

>

> 10 - Centers for Disease Control and Prevention, MMWR,

> 4/24/98, " Surveillance for Asthma--United States, l960-1995. Asthma

> Surveillance Summary. "

>

> 11 - Beckett W S, Belanger K, Gent J F, Holdord T R, Leaderer B

> P, " Asthma among Puerto Rican Hispanics: a multi-ethnic comparison

> study of risk factors, " Am J Respir Crit Care Med, l996 Oct 154:4

Pt

> 1 894-9. For this study, 9,276 mothers were interviewed during

> l993-l994.

>

> 12 - National Center for Health Statistics, " Mothers who smoked

> cigarettes during pregnancy, according to mother's detailed race,

> Hispanic origin, educational attainment, and age: Selected States,

> l989-93. "

>

> 13 - Xaver Baur, M.D., Book Review of Asthma in the Workplace [Ed.

> by L. Bernstein, M Chan-Yeung, J Malo and D Bernstein, New York,

> Marcel Dekker, l999], New England Journal of Medicine, 342:15,

April

> 13, 2000.

>

> 14 - J. son, " Smoking Fictions, " Washington Post,

> 2/25/98, p.A17.

>

> 15 - Thoms Goetz, " Don't Inhale: Hotel Air Quality Becomes an Issue

> With Clients, " The Wall St. Journal, 6/18/99.

>

> 16 - O'Connor G T, et al, " The role of allergy and nonspecific

> airway hyperresponsiveness in the pathogenesis of chronic

> obstructive pulmonary disease, " American Review of Respiratory

> Disease, 140:225-252, l989. Several studies have been conducted

> using sham smoke and tobacco smoke with subjects who claimed to be

> allergic to or " sensitive " to tobacco smoke (e.g. Urch B, Shephard

R

> J, Silverman F, " Pulmonary Function Responses to Passive Smoking

and

> the Influence of Suggestibility, " l985, Health & Welfare, Canada),

> but these studies found no significant difference in the subjects'

> reactions to the sham smoke compared to moderate or heavy tobacco

> smoke.

>

> 17 - Sheikh A, Alves B, " Hospital admissions for acute anaphylaxis:

> time trend study, " BMJ 320:1441, 27 May 2000.

>

> 18 - Gelfand E W, " Environmental Control and Immune Modulation in

> Asthma Treatment, " paper presented at the American Lung

> Association/American Thoracic Society International Conference,

> 4/27/99.

>

> 19 - Gianfranco Del Prete, M.D., Book Review of Difficult Asthma

> [Ed. by Holgate S T, Boushey H A, Fabbri L M, London:

Dunitz,

> l999] in The New England Journal of Medicine, 342:5, Feb 3 2000.

>

> 20 - Ibid.

>

> 21 - Dr. ez authored Chapter 7 ( " Passive Smoking and

> Respiratory Disorders Other Than Cancer " ) and co-authored Chapter 8

> ( " Assessment of Increased Risk for Respiratory Illnesses in

Children

> From Environmental Tobacco Smoke " ) of the U.S. EPA report on

> Respiratory Health Effects of Passive Smoking: Lung Cancer and

Other

> Disorders, US EPA, Dec., l992.

>

> 22 - Ellen Ruppel Shell, " Does Civilization Cause Asthma? " Atlantic

> Monthly, May 2000.

>

> 23 - Ibid.

>

January 24, 2008

Wow, you have got to be kidding?

who <jeaninem660@...> wrote: oh my, now

how could that be? you mean most people dont set around in