The end is nigh?

[RlCO 0]

17% drop in heart attacks after the ban

 

http://news.bbc.co.uk/1/hi/scotland/edinbu...ast/6986554.stm

 

 

100% increase in dodgy statistics IMO.

 

9 hospitals over an 18 month period isn't a very large sample to begin with, but a 17% total drop and a 20% drop in non-smoker heart attack admissions is a HUGE drop for such a time scale.

 

(although interestingly this is another example of the "stop smoking and you will live forever" thing IMO)

 

So either there's some bias or fluctuation within the figures (given the small sample and time scale, that is fairly likely) or there's something else (possibly fishy) going on.

 

 

the previous yearly drops have been 3% at most, presumably on the same amount of samples and the same recording methods

[Fop 1]

a 17% drop in heart attack admissions is far too big a drop to ever have occurred purely due to the smoking ban (within a year anyway).

 

Cynically I wouldn't be surprised if there wasn't some "new" way of recording heart attack admissions brought in around the time as the Scottish ban.

 

why? what else caused the drop?

 

Pure yearly variation (given the small sample size and time scale, very possible).

 

 

But 17% over all and 20% reductions in non-smokers is a HUGE reduction in 12-18 months, beyond anything even widely dreamed.

So either smoking (and especially casual exposure to second hand smoke) is more dangerous to ones health than even the most rabid anti-smoker has ever, ever, ever dreamed OR there's something "wrong"/missed out/misleading with those stats.

 

Also if this were the case then why have figures of a similar scale (20%+) NOT been seen else where?

 

 

 

 

and rubbish.

 

You DO understand how Labour largely "shortened" NHS waiting lists don't you?

 

Or indeed how inflation is now recorded at a lower level (as a significant part is now conveniently ignored in the new measure)?

 

 

Politicians changing the rules of measurement for political headlines/gain, who would have thought it?

[Fop 1]

17% drop in heart attacks after the ban

 

http://news.bbc.co.uk/1/hi/scotland/edinbu...ast/6986554.stm

 

 

100% increase in dodgy statistics IMO.

 

9 hospitals over an 18 month period isn't a very large sample to begin with, but a 17% total drop and a 20% drop in non-smoker heart attack admissions is a HUGE drop for such a time scale.

 

(although interestingly this is another example of the "stop smoking and you will live forever" thing IMO)

 

So either there's some bias or fluctuation within the figures (given the small sample and time scale, that is fairly likely) or there's something else (possibly fishy) going on.

 

 

the previous yearly drops have been 3% at most,

 

Where do they say that? (never mind from the Scotland.gov website, a 3% annual reduction for the last decade prior to the ban, but still no other details there - although perhaps not surprisingly the person that coordinated this research was the principal Public Health Adviser at Health Scotland, so no self interest in "good" results there at all )

 

And are there any links to the data (and methods of collection) itself?

 

 

presumably on the same amount of samples and the same recording methods

 

Presume nothing where political spin and headline grabbing is concerned.

Edited September 10, 2007 by Fop

[Renton 17767]

Regarding smoking, it's easily the most important avoidable health hazard which is why there is a determined policy to erradicate it.

 

Well except second hand smoke isn't actually a real health risk to most people in most situations, at all (which is the biggest issue I have with the campaign/ban, pretty much outright lying by a Government to its voters - in most other circumstance there would be a scandal and heads would roll for a similar thing - it's easily a bigger and more co-ordinated misleading than say the dodgy dossier etc.) .

 

No-one is saying you will live forever in perfect health if you don't smoke though.

 

Yes because that would be silly, but still the implication is often there (especially in the context of second hand smoke and the impact it will have on a non-smokers health, or in fact that by breathing in 2nd hand smoke people may as well be stabbing you in the throat and chest with a carving knife etc.).

 

 

I agree that economically it makes little sense as it will lead to an increased elderly population, but disagree that it's an example of non-joined up thinking. You never know, it could just be possible that the government and health service actually want us to live longer lives.

 

Only for more votes though, and only until they realise they have no money to actually PAY for it.

 

You've only got to go and see how bad elderly care is at the moment, never mind in another 10, 20 or 30 years time when there's even more to look after with even less money.

 

In an economic sense for a Government the best citizen are those that work and pay taxes until retirement age (be it 60, 65 or 70+ soon) and then drop dead the day after retirement.

 

 

The way things are going we may well eventually start to see elderly people left to die on the streets once they've used up all their savings and credit for care, either that or more direct euthanasia (it may sound impossible, but frankly it kinda occurs in nursing homes even now in a way).

 

 

It's certainly pretty cynical to advocate smoking should be encouraged to actually kill people at a younger age.

 

I'm not saying that, but I suspect things at least as harsh as that will eventually be agreed upon due to economic issues.

 

 

Interestingly btw, there is already evidence from Scotland that the smoking ban has significantly reduced CVD deaths.

 

I've seen that.

 

The stats are as spurious as hell IMO, for one the time period is basically 1 repetition (which isn't a repetition at all, and therefore has no validity - even though they claim "year on year" the period is actually 18 months or 1.5 years and so it is clearly pure political spin-doctoring) and secondly a 17% drop in heart attack admissions is far too big a drop to ever have occurred purely due to the smoking ban (within a year anyway). Even more so the 20% drop in non-smoker admissions for heart attacks.

 

It needs a longer time period to see if it is just a one off yearly fluctuation, but even if it is not then there is still clearly other factors there working at least as much (if not more) than any smoking ban in public places as even if second hand smoking WAS as dangerous as it it implied to be, there'd still be a longer drop off period for health effects to be seen than just 1 year, even more so with smokers who wouldn't suddenly become low heart attack risks after a life time of smoking, even if they did quit within a 12 month period.

 

Cynically I wouldn't be surprised if there wasn't some "new" way of recording heart attack admissions brought in around the time as the Scottish ban.

 

 

You're confusing a lack of good evidence with evidence that shows no effect. There's no way of designing ethical controlled trials to test the hypothesis of the harms of second hand smoke. Probably the best we can hope for is a before and after type trial, such as the one seen in Scotland, but these will always be open to criticism (from people like yourself) and confounding factors.

 

I would say, however, that its very plausible that inhaling cardiotoxic and carcinogenic chemicals is likely to be injurous to health. How could it not be? Anecdotally second hand smoke has triggered asthma attacks in me too. This is not to mention the other benefits of a smoking ban, such as not having to wash your clothes every time you visit a pub.

[RlCO 0]

a 17% drop in heart attack admissions is far too big a drop to ever have occurred purely due to the smoking ban (within a year anyway).

 

Cynically I wouldn't be surprised if there wasn't some "new" way of recording heart attack admissions brought in around the time as the Scottish ban.

 

why? what else caused the drop?

 

Pure yearly variation (given the small sample size and time scale, very possible).

 

 

But 17% over all and 20% reductions in non-smokers is a HUGE reduction in 12-18 months, beyond anything even widely dreamed.

So either smoking (and especially casual exposure to second hand smoke) is more dangerous to ones health than even the most rabid anti-smoker has ever, ever, ever dreamed OR there's something "wrong"/missed out/misleading with those stats.

 

Also if this were the case then why have figures of a similar scale (20%+) NOT been seen else where?

 

 

 

 

and rubbish.

 

You DO understand how Labour largely "shortened" NHS waiting lists don't you?

 

Or indeed how inflation is now recorded at a lower level (as a significant part is now conveniently ignored in the new measure)?

 

 

Politicians changing the rules of measurement for political headlines/gain, who would have thought it?

 

What a cynical man you are

 

Just tell me how you remove 17% of heart attacks from the list. What are they now classified as, severe pins and needles?

[Renton 17767]

a 17% drop in heart attack admissions is far too big a drop to ever have occurred purely due to the smoking ban (within a year anyway).

 

Cynically I wouldn't be surprised if there wasn't some "new" way of recording heart attack admissions brought in around the time as the Scottish ban.

 

why? what else caused the drop?

 

Pure yearly variation (given the small sample size and time scale, very possible).

 

 

But 17% over all and 20% reductions in non-smokers is a HUGE reduction in 12-18 months, beyond anything even widely dreamed.

So either smoking (and especially casual exposure to second hand smoke) is more dangerous to ones health than even the most rabid anti-smoker has ever, ever, ever dreamed OR there's something "wrong"/missed out/misleading with those stats.

 

Also if this were the case then why have figures of a similar scale (20%+) NOT been seen else where?

 

 

 

 

and rubbish.

 

You DO understand how Labour largely "shortened" NHS waiting lists don't you?

 

Or indeed how inflation is now recorded at a lower level (as a significant part is now conveniently ignored in the new measure)?

 

 

Politicians changing the rules of measurement for political headlines/gain, who would have thought it?

 

It's not a controlled trial. Many things could have contributed, not least the increased prescribing in statins. Do you think this is a good thing or not?

[Fop 1]

You're confusing a lack of good evidence with evidence that shows no effect. There's no way of designing ethical controlled trials to test the hypothesis of the harms of second hand smoke. Probably the best we can hope for is a before and after type trial, such as the one seen in Scotland, but these will always be open to criticism (from people like yourself) and confounding factors.

 

They won't be open to criticism if done correctly and sensible conclusions drawn from them.

 

But this is clearly a headline grabbing one based upon.... well who knows really, and equally a 20% drop in non-smoker heart attack cases (and 17% over all) should have shown up in places like California etc.

 

I'm a bit bemused at the clinical reasons and reasoning behind such a thing as well, even the people involved in this report seem a little worried by their language that this is "too good".

 

We'll have to see, over the next few years and indeed if a similar trend occurs again in England/Wales/NI etc. (as it should with figures like 17% and 20% even if they only remotely accurate to an underlying trend).

 

 

 

I would say, however, that its very plausible that inhaling cardiotoxic and carcinogenic chemicals is likely to be injurous to health. How could it not be?

 

It is, BUT out side direct inhalation (being a smoker) or massive exposure long term exposure to second hand smoke (working in a bar 40+ hours a week), or being a child (with developing lungs), the dilution of the chemicals in even the most enclose atmosphere reduces the effect to such a low level almost instantly that you should be more scared of paint drying and cars going by (especially if they have "eco-fuel" with significant amounts of ethanol in it).

 

No one has suggested that a smoking ban would come anything close to 20% reduction in non-smoker heart attacks (or has anyone found it to be the case elsewhere with smoking bans), because clinically second hand smoke simply isn't that big a factor on non-smoker heat attacks.

 

The 17% overall drop might well be possible, over a few years (accelerating the 3% drop - although again along with other things still), but a even if every Scottish smoker quit with the ban (never mind just maybe smoked less) a 17% reduction is frankly amazing given how heart disease and smoking works physiologically especially within 12-18 month of said ban (which again smacks back to the "stop smoking and live forever" thing for me).

 

 

 

 

Anecdotally second hand smoke has triggered asthma attacks in me too.

 

As can many irritants, but if you're an asthma sufferer (or even not) what you should be worried about are the new "eco"-fuels as they produce a lot of by-products that are very nasty for human lungs when combusted.

 

Although this is something that is amazingly hard to actually find out about, despite it being a fairly well known issue (you'll find a billion articles about how fossil fuels can screw up your lung but very few about the output "eco-fuel" despite most of the current methods resulting in very, very nasty air issues from the bio-fuel combusted.

 

 

This is not to mention the other benefits of a smoking ban, such as not having to wash your clothes every time you visit a pub.

 

This is great, I agree.

 

But it's not much cop for a legislative ban though really.

 

As I've said before I like the ban in a purely personal sense, I just don't like they way they've gone about it, or the precedents set for the future by it.

[ChezGiven 0]

Unlike smokers, this debate will never die.

[Fop 1]

What a cynical man you are

 

 

I'm just realistic (I also note you deleted your post and didn't answer my points ), only a fool believes what a politician says (or anyone employed by one) unless all doubt has been ferreted away.

 

Although equally said politicians do rely upon mugs to stay in power, without them they might even have to earn their money.

 

 

Just tell me how you remove 17% of heart attacks from the list. What are they now classified as, severe pins and needles?

 

It may not be that, yearly variation over the general 3% reduction could account for quite a bit or all of it, and I'd suspect that is probably the most likely answer.

 

 

But yes they could be classified as many things other than heart attack admissions directly, this could be done by reclassifying condition from one catch all to several closely related things, or indeed by massaging the admission figure in other way such as not including certain types of admission, GP referral or whatever.

Such things are no more amazing than "reducing" waiting lists by introducing waiting lists to get ON waiting lists or indeed ignoring perhaps 45%+ of inflationary pressure for political reasons.

[Fop 1]

It's not a controlled trial. Many things could have contributed, not least the increased prescribing in statins.

 

Exactly, but it's being presented as if it is (which goes back to what I've said).

 

Do you think this is a good thing or not?

Of course it's a good thing (from the point of view of someones personal health) if it is correct, but that's not the issue here.

 

 

 

 

 

 

Unlike smokers, this debate will never die.

 

Fortunately us non-smokers will LIVE FOREVVVVVVOOOOOOOOOOOORRRR.........

[Renton 17767]

It's not a controlled trial. Many things could have contributed, not least the increased prescribing in statins.

 

Exactly, but it's being presented as if it is (which goes back to what I've said).

 

Do you think this is a good thing or not?

Of course it's a good thing (from the point of view of someones personal health) if it is correct, but that's not the issue here.

 

 

 

 

 

 

Unlike smokers, this debate will never die.

 

Fortunately us non-smokers will LIVE FOREVVVVVVOOOOOOOOOOOORRRR.........

 

It's just bad journalism rather than a government conspiracy. Besides,I doubt most the public would know/care about the difference. You need to take a chill pill man, and this is coming from me ffs!

[RlCO 0]

What a cynical man you are

 

 

I'm just realistic (I also note you deleted your post and didn't answer my points ), only a fool believes what a politician says (or anyone employed by one) unless all doubt has been ferreted away.

 

Although equally said politicians do rely upon mugs to stay in power, without them they might even have to earn their money.

 

 

Just tell me how you remove 17% of heart attacks from the list. What are they now classified as, severe pins and needles?

 

It may not be that, yearly variation over the general 3% reduction could account for quite a bit or all of it, and I'd suspect that is probably the most likely answer.

 

 

But yes they could be classified as many things other than heart attack admissions directly, this could be done by reclassifying condition from one catch all to several closely related things, or indeed by massaging the admission figure in other way such as not including certain types of admission, GP referral or whatever.

Such things are no more amazing than "reducing" waiting lists by introducing waiting lists to get ON waiting lists or indeed ignoring perhaps 45%+ of inflationary pressure for political reasons.

 

Closely related things? Like what? Why would this have escaped the researchers attention? And how on earth does variation on a 3% trend produce a one off result of 17%?

[Fop 1]

It's just bad journalism rather than a government conspiracy. Besides,I doubt most the public would know/care about the difference. You need to take a chill pill man, and this is coming from me ffs!

 

Nah read the scotland.gov one, it's not so dissimilar to the BBC version (although it is bad journalism that perhaps the BBC has swallowed it quite so unquestioningly).

 

The thing is it is stuff like this that leads the public astray; when it's about some issues people do care, but about others they just don't..... even when in the end the longterm precedents and effects could be worse to their way of life.

 

Chill pill or not it's always worth pointing such stuff out IMO.

[Fop 1]

Closely related things? Like what? Why would this have escaped the researchers attention?

 

Many things, especially as they like just received data to crunch (they weren't there checking every admission I'm 100% sure, or even any admission most likely).

 

Even as Renton rightly points out release or wide spread prescription of drugs such as statins (Scotland's NHS is much richer per head since devolution than say England or even Wales).

 

 

 

 

And how on earth does variation on a 3% trend produce a one off result of 17%?

 

Clearly the closest you've ever come to stats was once misspelling SATs.

 

Without looking at the data I'd imagine it was a -3% annual trend across the last decade, BUT that does NOT mean that it was a regular ,regimented and uniform 3% drop each year.

 

Most likely the actual figure (each year) would have been anything from a large decrease (-10%) well ABOVE 3% to even a large INCREASE (+10%+) in some years.

 

Only when you smoothed out such yearly variation would a 3% annual reduction appear, in this case they are comparing a POINT EFFECT with a 10 year average.... which even in the most controlled situations is difficult to really do, and in this case may well be highly misleading indeed.

[Renton 17767]

Closely related things? Like what? Why would this have escaped the researchers attention?

 

Many things, especially as they like just received data to crunch (they weren't there checking every admission I'm 100% sure, or even any admission most likely).

 

Even as Renton rightly points out release or wide spread prescription of drugs such as statins (Scotland's NHS is much richer per head since devolution than say England or even Wales).

 

 

 

 

And how on earth does variation on a 3% trend produce a one off result of 17%?

 

Clearly the closest you've ever come to stats was once misspelling SATs.

 

Without looking at the data I'd imagine it was a -3% annual trend across the last decade, BUT that does NOT mean that it was a regular ,regimented and uniform 3% drop each year.

 

Most likely the actual figure (each year) would have been anything from a large decrease (-10%) well ABOVE 3% to even a large INCREASE (+10%+) in some years.

 

Only when you smoothed out such yearly variation would a 3% annual reduction appear, in this case they are comparing a POINT EFFECT with a 10 year average.... which even in the most controlled situations is difficult to really do, and in this case may well be highly misleading indeed.

 

So what, you want them to wait 10 years before publishing the results?

 

What they should have said is that there has been a significant drop in cardiovascular disease since the smoking ban although it is possible that not all the observed decrease is due to the ban. That would be fair enough.

[Fop 1]

So what, you want them to wait 10 years before publishing the results?

 

No, but I would like to see the data, as I said (it could very well be there had been a large drop the year before the ban). Just a basic graph of processed results would give an idea - in fact the LACK of such a very visual addition in such a media age only tends to make me more suspicious tbh.

 

 

What they should have said is that there has been a significant drop in cardiovascular disease since the smoking ban although it is possible that not all the observed decrease is due to the ban. That would be fair enough.

 

Yup that would, but it would have also been buried as an of interest at page 15 in some papers and never got any media headlines/coverage.

[Renton 17767]

So what, you want them to wait 10 years before publishing the results?

 

No, but I would like to see the data, as I said (it could very well be there had been a large drop the year before the ban). Just a basic graph of processed results would give an idea - in fact the LACK of such a very visual addition in such a media age only tends to make me more suspicious tbh.

 

 

What they should have said is that there has been a significant drop in cardiovascular disease since the smoking ban although it is possible that not all the observed decrease is due to the ban. That would be fair enough.

 

Yup that would, but it would have also been buried as an of interest at page 15 in some papers and never got any media headlines/coverage.

 

I'm sure you can be provided with the data if you ask the authors for it. It's a news article man, they work on headlines not graphs.

[Fop 1]

I'm sure you can be provided with the data if you ask the authors for it. It's a news article man, they work on headlines not graphs.

 

Out of interest I've actually seen if I can find it in the journals they are supposedly published in, but it seems the 17%/20% "study" isn't actually going to be published.

 

Just the 4 other studies mentioned into exposure in children/adults and the home and social attitudes.

 

Which to me suggests the 17%/20% on is just a self-back patting civil service statistical exercise and probably explains a LOT.

 

 

 

 

But I disagree on graphs, these days, especially on the web, it's usually a big thing to get something visual in to support your claim, unless there's a reason (see above) not too do so.

Edited September 10, 2007 by Fop

[RlCO 0]

Closely related things? Like what? Why would this have escaped the researchers attention?

 

Many things, especially as they like just received data to crunch (they weren't there checking every admission I'm 100% sure, or even any admission most likely).

 

Even as Renton rightly points out release or wide spread prescription of drugs such as statins (Scotland's NHS is much richer per head since devolution than say England or even Wales).

 

 

 

 

And how on earth does variation on a 3% trend produce a one off result of 17%?

 

Clearly the closest you've ever come to stats was once misspelling SATs.

 

Without looking at the data I'd imagine it was a -3% annual trend across the last decade, BUT that does NOT mean that it was a regular ,regimented and uniform 3% drop each year.

 

Most likely the actual figure (each year) would have been anything from a large decrease (-10%) well ABOVE 3% to even a large INCREASE (+10%+) in some years.

 

Only when you smoothed out such yearly variation would a 3% annual reduction appear, in this case they are comparing a POINT EFFECT with a 10 year average.... which even in the most controlled situations is difficult to really do, and in this case may well be highly misleading indeed.

 

 

As I said before, it was a maximum of 3% drop previously, not a trend

[Fop 1]

As I said before, it was a maximum of 3% drop previously, not a trend

 

 

Where did you see that?

 

All I can find mentioned of the 3% is on the Scotland.gov site where it says:

 

a 17 per cent reduction in heart attack admissions to nine Scottish hospitals. This compares with an annual reduction in Scottish admissions for heart attack of 3 per cent per year in the decade before the ban.

 

Which suggests an averaged decrease to me.

 

 

 

 

 

Furthermore as I said whilst I can find published papers for 4 of the claims in that article there seems to be NO published data at all for the 17%/20% claims.

 

Not surprisingly as it would seem to be a civil service statistical compilation spuriously comparing a point effect against an average 10 year trend.......... or to put it more concisely, A LOAD OF BOLLOCKS.

[ChezGiven 0]

The 17% redcution in MI in non-smokers due to the ban is what we call in the business, a load of shite.

 

There may well be a reduced rate of MI in the 9 hospitals but to attribute that to the ban is the worse piece of politics in medical science i think i have ever seen. We had to recruit 20,000 patients to detect a similar reduction in reinfarction in one MI trial i worked on.

 

This study involved 2000 people didnt it? Not all the MI population either.

 

As i said, load of shite. The reason it isnt in the public domain is because its going to be presented in a conference.

[sweetleftpeg 0]

We'll all get canny tans and London will be underwater. Champion.

[Fop 1]

The 17% redcution in MI in non-smokers due to the ban is what we call in the business, a load of shite.

 

There may well be a reduced rate of MI in the 9 hospitals but to attribute that to the ban is the worse piece of politics in medical science i think i have ever seen. We had to recruit 20,000 patients to detect a similar reduction in reinfarction in one MI trial i worked on.

 

This study involved 2000 people didnt it? Not all the MI population either.

 

As i said, load of shite. The reason it isnt in the public domain is because its going to be presented in a conference.

 

Yep it's marketing figures to be honest no more, no less, and just as (un)factual and (un)reliable.

 

 

All the other studies mentioned in the articles are published and seem reasonably well done, but they only really show the obvious cotinine level decreases which translates to very little in a direct applicable (to media and politics) sense (although should translate to small "health boosts" over time, just not headline grabbing ones maybe) and have very little "sexyness"

 

 

The 17%/20% things seem to just be some nicely massaged statistics meant to "sell" it and get some juicy headlines, but wouldn't stand up to the slightest scrutiny.

[RlCO 0]

This news story exists because of the conference happening today. Are they all in on it then? Or do they just not watch the news?

[Fop 1]

This news story exists because of the conference happening today. Are they all in on it then? Or do they just not watch the news?

 

Can you actually read? (I guess not given the whole 3% thing)

 

 

See above, there's about 4 published studies being presented on the effects it (the ban) has had, none of which are particularly unexpected, dramatic or headline grabbing (this is actually the meat of the story and most of the conference I guess).

 

 

Then there is the "17%/20%" thing which is not published (at all) and seems to be just a PR headline grabber of a completely spurious and massaged statistical comparison of things that cannot really be compared (i.e. as said a load of bollocks).

 

 

Exactly what part of that is beyond your capability to grasp?

Edited September 10, 2007 by Fop