Poisons (Radiation) in Tobacco Exposed, Recast in "Politics of Cancer"
Tobacco plant (Photo from Internet)
A case study in "Politics of Cancer" by Dr. Samuel S. Epstein, MD on tobacco recast under free radical theories of disease
Editing as of March 9,2013
I wrote this Hub when Hubber Melpor had not yet posted his Hub about President Obama having signed a law that mandates the Food and Drug Administration to regulate the cigarette industry in removing radioactive materials in cigarettes. A large part of this Hub argues about the presence of polonium 210 and lead 210 in cigarette and other tobacco products. Now that the cigarette industry has admitted the presence of these poisons, the part that explains how polonium and lead decay, emit alpha particles and alpha radiation and generate free radicals, remains relevant.
There is a radical change in the political will in that whereas Pres. Jimmy Carter supported the tobacco industry, Pres. Obama now supports the consumers of tobacco products. The new law on the removal of polonium will reverberate in the Philippines as multinational cigarette producers are dumping their poisons in the developing countries such as ours. End of editing.
The facts that stare in the face in the case of the consumption of tobacco are: (1) smokers and inhalers of stream smoke contract cancer; (2) smokers and inhalers of stream smoke contract heart disease; and (3) uranium miners who do not smoke and who do not inhale stream smoke contract cancer. The first two statements of fact lead to the conclusion that tobacco is a carcinogen around which environmentalist, health care providers, and victims of cancer and heart disease (and their love ones) argue for the regulation of tobacco. But for a long time, under the framework of risk factors, a cause-and-effect relationship between tobacco smoke and contracting cancer and heart disease has not been demonstrated. The tobacco industry's counter has focused on this weak point arguing that the relationship has been statistical and not direct.
This recast of a case study of Dr. Samuel S. Epstein, MD provides explanations how smoking and inhaling stream smoke contract cancer and heart disease. It provides the hypotheses of how smoke and stream smoke cause cancer and heart disease. It also explains how uranium miners who do not smoke and who do not inhale stream smoke contract cancer.
The book “Politics of Cancer” of Dr. Samuel S. Epstein, MD was published in 1978. Chapter Six, subtitled “Consumer Products: Case Studies” includes tobacco. Absent are entries “free radical,” “radioactive metal,” “polonium 210,” and “lead 210.”
We will recast this case study under the framework of free radical theories of disease. The style is similar to annotation, with direct quotes, and paraphrasing. I provide comments. We will retain the outline of Dr. Epstein so that anyone who has a copy of his book can easily follow our discussion. Dr. Epstein’s study is packed with data, analysis, arguments and recommendations that one is tempted to virtually reprint it and insert comments. But that will be too long for our purposes.
Why the decision to recast Dr. Epstein’s case study on tobacco? The first reason is to show that there is no such thing as harmless tobacco, whether in the form of chewing tobacco, cigar, or cigarette. Another reason is to reiterate Dr. Epstein’s arguments that the cost of tobacco in terms of hospitalization bill, medication, and lost income due to morbidity far outweigh the income derived from tobacco in terms of taxes, and multiplier effect among growers, processors, traders, consultants, advertising service providers, consumable manufacturers, and bureaucracy administrators. Most importantly, to highlight the death toll due to cancer: 300,000 dead per year compared with the casualties of the Vietnam war at 40,000 and the death toll of the Spanish flu pandemic in 1918 on American soldiers deployed in the European theater in World War I at 44,000. Another reason is to show that under the framework of free radical theories of disease the ultimate culprits that cause cancer and heart disease among smokers and stream smoke inhalers are free radicals and X-rays that tobacco contains.
The figures of Dr. Epstein might be outdated but his arguments hold water and one may find it hard to posit some counter arguments. It pays to substitute present figures, personalities, agencies, and industries for Dr. Epstein’s entries.
Dr. Epstein and several other doctors had labored hard to pinpoint how tobacco causes cancer and heart disease under the framework of conventional medicine to no avail. The farthest that they could get is to identify risk factors. However, risk factors are not causes. If they got the right control levers, how come the incidence of cancer and heart disease is still out of control? And if the identified control levers were right how come no explanation is offered for the fact that miners of uranium who do not smoke or do not inhale stream smoke get sick of cancer?
Let’s start this recast following Dr. Epstein’s outline/subheadings.
Smoking originated with the American Indians. They smoked to feel more deeply their incantations. Christopher Columbus picked up smoking, passed it on to Sir Walter Raleigh. Europeans liked smoking and made it a habit; picked up by other people of the world that has exacerbated into a social problem.
“Many people feel that the book on tobacco has been closed, that we know as much as we need to about its cancer-causing properties, and that whatever lessons need to be learned about the prevention of tobacco-related diseases have already been learned.”
But there are at least three reasons to continue studying tobacco, as follows:
"...first, to provide further understanding on how tobacco smoke causes cancer, cardiovascular and other disease; second, to provide information on the interaction of tobacco smoke with other environmental and occupational carcinogens and toxic chemicals; and third, to further educate the public on the hazards of smoking in order to better pressure the government and voluntary health agencies, such as the American Cancer Society, to develop more aggressive approaches to regulating tobacco sales and advertising; and finally, to provide surveillance of the tobacco industry, including monitoring the effects of constantly changing tobacco products and markets."
“Further research would be largely unnecessary if the government were to ban tobacco advertisement and mount a massive campaign to persuade people to give up smoking. An even more effective curtailment of the industry would result if it were forced to accept financial responsibility for each tobacco-related death.”
The number of smokers among the upper socioeconomic groups is declining. However, smokers among teenagers and pre-adolescents is on the rise. Male lung cancer is on the rise although at a lesser rate. Lung cancer in women continue to climb and may soon level up with that of men.
“The Chemistry of Tobacco Smoke”
“The gas phase of the smoke contains a great variety of toxic and carcinogenic gases, some of which are listed in Table 6.1. These include several nitrosamines...which are all potent carcinogens.”
Items in Table 6.1 include: acetaldehyde (ciliotoxic agent or disables the cilia, tiny brooms in the trachea that move up dust and phlegm); acrolein (ciliotoxic); benzene (carcinogen); dimethylnitrosamine (carcinogen); formaldehyde (promoter); hydrazine (carcinogen); hydrazine (carcinogen); hydrogen cyanide (ciliotoxic); nitrosopiperidine, nitrosopyrrolidine, vinyl chloride (all carcinogens). Nitric oxide and toluene are also found in smoke.
The tar of tobacco smoke contains at least 1,200 chemicals, many of them are carcinogenic and tumor promoters.
However, Dr. Epstein did not draw the conclusion that nitrosamine contains free radicals. The nitroso compound contains a free radical (see his case study of nitrosamine in the same book "Politics of Cancer," pages 282-290). I think the reason why Dr. Epstein did not see a free radical is that he was using the conventional framework of medicine, not the free radical theories of disease.
The free radical theories of disease framework was inaugurated by Dr. Denham Harman, MD in 1962 when he made an interpretation that free radicals cause disease and ageing (Cranton, E. MD. and A. Brecher. Bypassing Bypass. 1984). Dr. Cranton considers it a breakthrough in modern medicine, in the same class as the germ theory of diseases advocated by Pasteur in 1881-1984.
A carcinogen contains a free radical.
Dr. Epstein reported in 1978 that out of 130 nitrosamines analyzed 80 percent were carcinogenic.
Nitric oxide and toluene, also found in smoke, are not given activity like carcinogen, or promoter, or ciliotoxic by Epstein.
Toluene is now considered carcinogenic. It has been found as a by-product in the production of saccharin, an artificial sweetener. This might be the reason why the soft drinks that uses saccharin as sweetener is banned in 17 states of the United States.
Formaldehyde causes hardening of tissues. Dr. Jonas Salk used formalin, which is 61 percent formaldehyde, to maintain the shape and size of killed poliovirus in making the Salk vaccine. Formaldehyde causes cross-linkage in molecules, responsible for cirrhosis (scar in the liver) which is a kind of embalming even while the victim is still alive (Cranton, E., MD and A. Brecher. Bypassing Bypass. 1984). End of comment.
“The Epidemiology of Lung Cancer”
“Many factors are involved in the association between tobacco smoking and lung cancer.”
Dr. Epstein was guarded in his use of terms. He used “association” instead of causation. He did not use a short cut like "tobacco smoking causes lung cancer." End of comment.
“Type of Tobacco Product Smoked”
“...Among those few cigar and pipe smokers who inhale, lung cancer and coronary heart disease rates are as high as for cigarette smokers....”
The more a person smoked per day the higher is the cancer risk.
“Duration of the Habit”
The longer a smoker continues to smoke, the greater is the risk of cancer.”
“ ...Inhalation increases the risk of cancer....
” In the West, France has the highest cigarette consumption but has the lowest cancer rate. “...One reason for this is that French smokers favor the government-distributed brand” that uses a black variety instead of the “blond Burley blends...black tobacco smoke is highly alkaline while blond smoke is acidic.
“The nicotine from alkaline smoke is more easily absorbed through the mouth and tongue, allowing the smoker of French cigarettes to satisfy the craving for nicotine without inhaling the carcinogenic smoke.”
Alkalinity or acidity does not prevent inhalation of smoke and collection of tar and nicotine that contain free radicals and radiation, as we will soon see. Smoke at any amount is harmful.
The difference of potency to cause cancer might be due to the difference in the ability of tobacco varieties to absorb and store polonium 210 and lead 210.
The tobacco plant accumulates these radioactive metals. Tobacco gets them from the phosphate fertilizer applied to grow them (Cranton, E. MD and A. Brecher. Bypassing Bypass. 1984). Even when fertilizer were not applied, these metals are available in the soil. Ultimately they come from the sun. Uranium breaks down into radon-222 that goes up to the atmosphere and converts to lead 210. This metal falls to the ground and tobacco picks it up. Polonium 210 is found in the ore of uranium. These metals are found in tobacco roots, stems, leaves and smoke.
Polonium 210 has a half life of 138.4 years, lead 210 has a half life of 22 years. Both are unstable and decay into lead 206 which is stable. When polonium decays, Its 84 protons are reduced to 82 protons. However, the 84 electrons that counterbalance the protons are not reduced in number and remain as 84 electrons. The extra two electrons are free and make polonium 210 a free radical.
The free electrons grab other electrons from molecules of tissues and inflict damage. A molecule in the inner wall of an artery from where several electrons had been grabbed by free radicals sustain injury that may result in atheroma, a benign tumor. The body attempts to repair this damage with collagen, fibrin, elastin, cholesterol, and calcium. But the repair turns awry. The patch turns into a mound, into an occlusion then into a plaque. A plaque in the heart artery lessens flow of blood to the heart which becomes starved for oxygen. Lack of oxygen triggers the production of a chemical that excites pain receptors of heart cells resulting in angina pectoris or chest pain. Now a heart disease had developed.
Lead 210 decays into polonium 210 and settles down to lead 206. Lead 210 has a half life of 22 years. If you have one gram of lead 210, the first 500 mg decays in 22 years, the second half of 500 mg decays in another 22 years.
The radioactive metals in smoke supply free radicals and radiation that injure molecules, eventually tissues, then organs. Either free radicals or radiation or both cause heart disease or cancer. Atheroma or tumor or cancer starts in one cell only.
Halt in smoking reduces risk of cancer.
Reduction of risk does not start at the halt of smoking. If a person stopped smoking in year 2000, the risk will extend up to year 2044 because that is the whole life span of lead 210. Even when the person will have died in 2010, his bones and DNA will keep emitting X-rays up to year 2044. The DNA is usable for thousands of years (I have a Hub "Why Criminals Can Neither Fool Nor Escape From DNA Fingerprinting.") End of comment.
It has long been assumed that the major carcinogen in tobacco smoke are found in the particulate rather than the gas phase.” Filtered cigarettes lead to lower death among smokers. “However, death rates among filter cigarette smokers are in excess of those in nonsmokers.” There is no better way than to stop smoking.
“Histology of Lung Cancer”
There are types of cancer. From the most to the least common caused by smoking are squamous carcinoma, of the trachea and bronchi; oat cell carcinoma; adenocarcinoma, in that order.
Many countries now monitor smoking.
“Recently, a high degree of correlation has been demonstrated between the present lung cancer mortality rate in nineteen different countries and their per capita cigarette consumption thirty years ago.” Exceptions are France, Ireland and Japan. French smokers do not inhale too deeply; Japanese smokers puff. Irish data is unexplained.
“Differing Cancer Rates in Various Groups”
“Until about 1950, few American women smoked.” More women now smoke and the rate of lung cancer among them is on the rise. The smoking habit is now increasing among working men, while it is on the wane among professionals. More black men smoke than whites and smoke nonfilters. Number of black males “is about one-third greater than that for white males.”
The fact that more working men are smoking impacts on lost or diminished income of working men who become ill, hospitalized and given medications. It also impacts on erosion of savings of working men. Dr. Epstein gave figures on this aspect. End of comment.
“Smoking and Air Pollution”
In England and the United States smokers in urban areas have a higher rate of lung cancer than those in unpolluted suburbs. “It seems likely that there is a synergistic interaction between smoking and air pollution.”
“Lung Cancer among None smokers and in Workers”
“About 20 percent of lung cancer deaths occur in nonsmokers....” Lung cancer in nonsmokers is on the rise.
Cancer due to asbestos is called mesothelioma.
“... While there is a marked increase in the incidence of lung cancer in asbestos workers and uranium miners who smoke, there is also an increase, though a lesser one, in nonsmokers who work in these industries.”
Smoking is incriminated in cancer in other sites like lip, tongue, mouth, larynx, esophagus... In addition to cancer, smoking is the major cause of chronic bronchitis and emphysema in the United States. Smoking also has a striking relationship to coronary heart disease, stroke, aortic aneurysm, and other diseases, including peptic ulcers.”
Tobacco is not the only source of free radicals. Our body produces free radicals. The production of energy, adenosine triphosphate, from the metabolism of glucose produces superoxide which is a master free radical because it can produce hydrogen peroxide, lipid peroxide, hydroxyl, and akoxy radical. Ozone from the atmosphere is a free radical. "One quart of ordinary air on a sunny day contains about 1 billion free radicals of a highly dangerous form of ozone" (Cranton, E. MD. Bypassing Bypass. 2nd edition, 1995). Running electrical gadgets and sparks from ignition of car starters produce ozone. Nitrous oxide in pollution is a free radical. Pesticides, herbicides, and herbicides produce reactive oxygen species that act like free radicals. Meat treated with nitrosamines produce free radicals; some preservatives, bologna, hamburger produce free radicals. Ionizing radiation produce hydroxyl and convert molecular oxygen into singlet oxygen in skin that trigger melanoma or skin cancer.
Why do workers in uranium mines who do not smoke and who do not inhale stream smoke get sick of lung cancer? Dr. Epstein did not explain it. To recall, one of the products of the decay of uranium is lead 210. There is no question that uranium miners inhale lead 210 or get it through contact by handling uranium ores just like the way a child gets lead from touching a wall painted with a lead-based paint.
We have earlier explained how lead 210 decays to polonium 210 that emits radiation that causes mutation. Mutation in DNA shows as tumor or cancer (Cummings, M. Human Heritage, Principles and Issues. 2009).
“Lead dust that contaminates easily reachable surfaces is ingested by children through normal hand-to-mouth activity” (Wrinkler, M. editor. “Coalition Building to Prevent Childhood Lead Poisoning.” Community Organizing & Community Building for Health. 1998:279).
Emphysema consists, among others, inflammation and constriction of air passageways, and collapse of air sacs (Walker, M., M.P.D. The Miracle Healing Power of Chelation Therapy. 1984:49). These are caused by free radicals. At the start, the air sac damaged by free radicals is inflamed. Eventually it will collapse. Air sacs are like balloons pricked one by one by needles that are the free radicals and X-rays in the case of tobacco. The collapse of an air sac is irreversible.
The lungs have 200 to 600 million air sacs or alveoli (Astrand, Per-Olof and Kaare Rodahl. Textbook of Work Physiology, Physiological Bases of Exercise. 1977:211).
It takes time to prick the millions of air sacs that is why the victim dies slowly of emphysema. A normal person spends 15 percent of his energy for breathing. One suffering from severe emphysema spends 85 percent of his energy for breathing. By then he is bed-ridden. (I have a Triond content "Enough Time to Stop Slow Death from Emphysema".)
Free radicals are the culprits in the fact that "Smoking also has a striking relationship to coronary heart disease, stroke, aortic aneurysm, and other diseases, including peptic ulcers.”
Free radicals are not very specific as to the kind of disease they cause. Hydroxyl and singlet oxygen can be identified with skin cancer more likely because these are more abundant in the skin. The disease they cause are named after the diseased cells or tissues. For example, skin cancer (melanoma) is named after the tissue "skin" but it could be caused by hydroxyl or singlet oxygen. Breast cancer could be caused by superoxide, or hydrogen peroxide, or lipid peroxide. There are over 200 kinds of cancer but each of them is not caused by a specific free radical or reactive oxygen species. It is the unpaired electrons that grabs electrons of molecules belonging to a tissue that matters most. However, a cancer in the brain can be identified as melanoma because of a protein marker specific to melanoma. End of comment.
This is inhalation of sidestream smoke.The fetus is also a victim.
“Financial Costs of Smoking”
“...These are much greater than the $6 billion annual tax revenues generated. Annual costs in the United States include treatment and deprivation of earnings of the 80,000 or so tobacco-cancer victims and the approximately 200,000 victims of respiratory and cardiovascular diseases caused by smoking...Recent estimates of total annual costs from smoking are in the $20 billion range.”
It is interesting to see the present figures on annual tax revenues; tobacco-cancer victims, and victims of respiratory and cardiovascular diseases. What is the recent annual costs from smoking in the United States? End of comment.
“The Role of Government in Prevention of Tobacco-Related Cancer"
“....The program’s fundamental premise is that since an outright ban on cigarette is not possible now, the best compromise is to develop a ‘less harmful cigarette.’
“Instead of opposing smoking as its main goal, the government program merely seeks to reduce risks entailed in smoking, thereby supporting the industry efforts to persuade smokers to persist in their habit but switch to ‘less harmful’ cigarettes.”
“Less than $2 million a year is spent by the NCI on educational programs, in contrast with $400 million the industry now spends annually on cigarette advertising in magazines and newspapers.”
“The Role of the Government in the Increase of Tobacco-Related Cancer”
“...Federal, state, and local government collect about $6 billion. in tobacco taxes annually. In 1977, $97 million was spent by the government in direct assistance programs and on indirect support of the industry... In December, 1977, President Carter pledged continued support for tobacco growers expressing the view that the assistance programs and health dangers of tobacco should be considered as separate issues.”
Secretary Joseph Califano, Carter’s secretary of Health called smoking “slow motion suicide.” Califano "asked the major broadcasting networks to increase anti smoking commercials; called for a ban on smoking in most public areas of HEW buildings; endorsed the Civil Aeronautics Board proposal to ban cigarettes on commercial airliners, urged an increased tax on cigarettes; asked insurance companies to give premium discounts to nonsmokers; and asked the FDA to amend labeling on oral contraceptives to indicate the even greater risk of strokes and heart attacks for smokers." But an important omission was reference to tobacco subsidies.
Raymond J. Mulligan, President of Liggett Group, Inc. called for the resignation of Califano.
“...It is clear that an administration attack on tobacco price supports would be damaging to the base of Carter’s political support in the South. It is not clear how the administration weighs political expediency against 300,000 American deaths each year.”
“The Role of Industry”
The industry discredited research with adverse results. They forced researchers to support their position. The industry claimed that health researches are based on statistics.
”...If a real cause and effect sequence from cigarette smoking inhalation to cancer could be shown, the industry cried, rather than all these statistics, that indeed would constitute proof.”
A person who inherited a predisposition of susceptibility to cancer due to smoking should be discouraged from smoking was the industry’s favorite theme. In 1977, the industry set up its own Tobacco and Health Research Institute on the campus of the University of Kentucky. It adopted the tactic of “shifting the burden of proof away from themselves and onto the victims.”
In 1977, R.J. Reynolds launched its Real cigarette that it claims to be “natural” and contained “no synthetic flavoring or other additives.”
“The Role of the American Cancer Society”
The American Cancer Society urged “President Kennedy in 1961 to take action against tobacco...In its own words, the Society ‘had used [its] resources to uncover the health risks of smoking. Now it was up to the government to take a stand and to respond accordingly.’”
It is expected that the “Society should develop strong lobbying activities....”
“The Role of the Press”
Advertising has concentrated in the print media. TV commercial is anathema to the industry because of the rule that for every industry advertisement, the antismoking campaign is entitled to a counter commercial for free.
“...The massive coverage given the Vietnam War, with some 40,000 U.S. deaths in all the war years combined, and the violent crime deaths of some 20,000 per year contrasts with the virtual silence of the press on a single agent responsible for about 300,000 preventable death a year. The enormous revenues generated probably account for the apparent lack of interest of the press in devoting proportionate space to tobacco health hazards.”
The Reader’s Digest does not accept cigarette advertisement and has published articles on the dangers of smoking.
“Role of the Courts”
“The courts have not been helpful in the past in gaining legal redress for victims of tobacco cancer.”
There was a case filed in court “Green v. American Tobacco Co. Edwin Green of Miami contracted lung cancer in 1956, after smoking Lucky Strike for thirty years. The court said:
“We are now left in no substantial doubt that under Florida law the decedent was entitled to rely on the implied assurance that the Lucky Strike cigarettes were wholesome and fit for the purpose intended and that under the facts found by the jury [his widow is] entitled to hold the manufacturers absolutely liable for the injuries already found by a prior jury to have been sustained by him”
In 1969, “the U.S. Fifth Circuit Court reversed the decision and found in favor of American Tobacco.”
One offshoot of this decision is that there is now a warning in cigarette labels that smoking is hazardous to health. However, this warning serves to “release tobacco companies from liability and further shift the burden of smoking-induced disease to the victims. “
“Probably one of the most effective ways of decreasing the tobacco death toll would be to make the industry pay for tobacco-caused cancer and other diseases, as well as other national costs....”
Remember Vioxx? Vioxx was formulated, manufactured and marketed by Merck & Co. Inc., then withdrawn from the market in September 2004 “because the drug has been shown to double the risk of heart attacks and strokes in long-term users.” It had sales of US$ 2.5 billion a year and about 20 million people around the world had taken it (Simons, J and D. Stipp. “Will Merck Survive Vioxx? “ Fortune. 2004. Nov.:91-104). Several lawsuits were filed related to Vioxx. If this can be done against a drug company why can't it done against a cigarette maker? Against the recent swine flu, vaccines were manufactured in a rush that no private insurer was willing to provide coverage for the vaccine. Whereupon, the government of the United States foot the bill for insurance coverage. The Guillain-Barre syndrome fiasco occurred -- those vaccinated suffered paralysis, among others. It was found that there were some impurities in the protein used. The government of the United States paid for penalties in lawsuits won by victims. End of comment.
New entries as of August 29,2014
In 1999 the cigarette industry finally admitted the presence of radioactive materials in their product and that they had known about it for over 50 years. Pres. Barack Obama of USA had signed a law mandating the removal of polonium from cigarettes.
Recently, the Supreme court of Florida, USA imposed punitive damages of US$23.6 billion on R. J. Reynolds, a cigarette maker, for the death of Michael Johnson, Jr. Michael died of lung cancer in 1996 owing to smoking. End of new entries.
There is an increase in tobacco consumption in the U.S. The administration “opposes effective regulations of the industry and that it intends to continue subsidies.”
Cigarettes in the U.S. and other countries has 50 percent less tar and nicotine.
“...However, the possible benefits, in terms of reduced cancer risks, are probably counter-balanced by increased tobacco consumption....”
“As the antismoking campaign is beginning to gain ground among professionals and upper socioeconomic classes in developed countries, the tobacco industry is intensifying its promotional campaign in the Third World....”
“...There is growing evidence that switching to filter cigarettes may not reduce cancer risks and may actually increase the risks of cardiovascular disease...Conservative estimates indicate that the costs of smoking approximate 300,000 deaths and $20 billion annually.”
“Artificial colors are highly objectionable on ethical grounds because they deceive, and on hygienic grounds because they injure” (Harvey Wiley, Chief, Bureau of Chemistry, USDA, 1907).
The best move is to ban tobacco. Any exception may be for the extraction of medicinal ingredients, if any. Plants with effects similar to tobacco like marijuana and opium give precedents. Marijuana has been regulated in some countries and banned in others, like the Philippines. Regulated opium growing is allowed only for medical use. End of comment.
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