From: ((Steven B. Harris))
Subject: Re: Question: If only 10% of smokers
Date: 18 Jun 1995

In <3rvtbp$jta@ixnews6.ix.netcom.com> linn@ix.netcom.com (Judith A.
Linn) writes:


>so the question would be then, if only 10% of smokers (over long
>periods of time) get lung cancer, how come?
>
>Why not 50%?  Why not 100%?
>
>Could susceptability play a role greater than the outside stimulus?


I'm sure it does for any given disease caused by smoking.  There are two
problems with this insight however: 1) we still have no way of knowing
who is susceptible and who is not, and 2) To get your overall "outside
stimulous" effect you need to add up not only lung cancer stats, but
also extra heart disease stats, extra chance of having a stroke,
extra chance of being impotent or incontinent in your later years, extra
chance of getting other cancers, extra chance of having crippling
chronic lung disease (emphysema, chronic bronchitis), extra skin
wrinkles and osteroporosis for women, etc, etc.  By the time you get all
done, the number of smokers who escape without any damage from a
lifetime of smoking is _way_ under 50%.  Looking at it from this point,
it no longer becomes as natural to regard extrinsic effects as being
less important than intrinsic susceptabilities.

                                       Steve Harris, M.D.

From: sbharris@ix.netcom.com (Steven B. Harris )
Subject: Re: Those Horrid Unreal "Diseases"
Date: 29 Aug 1995
Newsgroups: misc.health.aids

In <41ufv6$bak@nnrp.ucs.ubc.ca> stncoder@unixg.ubc.ca (Stephen) writes:

>>god, this guy can be a pompus satarist can't he ...<<

Takes one to know one :-)

>>I noted that in the Skeptic article that there was some attempt at
relating smoking/cancer causation to the HIV debate in the same satirical
vein.<<

That wasn't satirical.  I've HAD those conversations with
smokers.  And folks who work for tobacco companies.

>>Let's see, comparing the mounting evidence for smoking/cancer
causation, all of which pretty well developed a body of evidence
for a consistent pretty singular toxicological mechanism over the
years<<

BZZZT!  Wrong.  Nobody knows what the toxicological mechanism in
cigarette induced cancer is.  Could be polonium alpha rays, any
of a zillion poly-aromatic hydrocarbons, even some smoked
pesticides, if you believe the organic folks.

>> ---to the development of a body of evidence for a *consistent*
mechanism for HIV, let's see:The Saga of the Consistent Mechani-
sm: (as consistent as nicotene tar causing lung cancer kids !) <<

Nicotene tar??  Two separate and very different things.  Yes,
we're doing even better with HIV.  Put HIV in a dish with normal
CD4 lymphocytes and it blasts them to smithereens.  Only way you
can grow it without that is in Gallo's H9 line.  In the body, I
assume it blasts things to smithereens.

HIV-1's sister viruses HIV-2 and SIV kill monkeys also (by slow
immune destruction).  And they don't need cofactors to do it.
Obviously if they kill monkeys they have a mechanism.  Really
doesn't matter for our purposes what it is.  It's not a great
leap of faith to figure that human AIDS from HIV-1 has a similar
one.


                              Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Subject: Re: What is the actual incidence of smoking related disease?
Date: 26 Jun 1997
Newsgroups: sci.med

>On Wed, 25 Jun 1997, netac wrote:
>
>> > Yes, but they would die later, after a longer and more productive
>> > life as a contributing member of society. Someone who smokes two or
>> > more packs per day has a life expectancy of 8-9 years shorter than a
>> > comparable nonsmoker.
>>
>> What? They would simply live longer, eating up more Social Security and
>> Medicare money, you talk as if they would live longer and pay taxes?
>> Most are retirees anyway. I am not trying to be heartless, all I am
>> saying is that it is a myth to say that "smokers cost the govt more
>> money in healthcare than non-smokers". This is not true...


   According to a recent RAND Corp study, it is indeed true.  Less
social security payments make up partially for more medicare dollars,
but not entirely.   However, the same RAND study concludes that the 25
cent tax on tobacco is about right, and shouldn't be raised, as the
Senate is proposing to do.

From: sbharris@ix.netcom.com(Steven B. Harris)
Subject: Re: What is the actual incidence of smoking related disease?
Date: 28 Jun 1997
Newsgroups: sci.med

In <33AED25C.467B@worldnet.att.net> netac <netac@worldnet.att.net>
writes:

>I won't quarrel with you stats, but what they fail to reflect is that if
>these people didn't die of cancer, they would die of something else. The
>assertion that it costs the gov't more to pay in medical costs for a
>smoker dying of cancer than a non smoker sying of cancer, or dying of
>heart disease is nonsense. My grandfather (smoker) died of cancer in his
>early 70s. The govt (Medicare) paid for the costs associated with his car
>and ultimate death (it took 1 year from the time he was diagnosed). My
>grandmother (non smoker, currently 86 years old) had to have triple
>bypass surgery last year. The govt (Medicare) costs associated with her
>care, surgery, hospitalization post-op nursing, etc is far more in
>dollars than what it cost for my grandfather. Who costs the society more
>money, my smoker grandfather who died or my non smoker grandmother who
>needed heart surgery and is alive? The answer is obvious. This is just
>another gov't lie to shakedown the tobacco companies for money...


   Yes and no.   Smokers do indeed cost society more over a lifetime.
This can be measured directly by looking at total medical costs and
social security outlays over a lifetime for smokers vs nonsmokers
(which are available for some people who haven't moved, have been
tracked and cared for by single medical systems, etc, etc).  The answer
is that smokers cost more.  This isn't something you can "figure out"
apriori, because there are a lot of factors that go into it.  It needs
to be measured.  It HAS been measured.  If you don't like the answer,
you can argue with RAND Corp., which did the studies.

   WHY did smokers cost more?  Essentially because early chronic heart
and lung disease are pretty expensive.  They often take off the last
few years of work productivity.  And people who get them at younger
ages manage often to hang on quite a long time with them, due to the
vitality of relative youth (relative, in that they are 50 or 60, not 70
or 80).  People in their 70's and 80's get the same diseases without
smoking, to be sure, but as relatively frail elderly, they die of them
quite quickly.  Generally speaking, the older people die, the less
their terminal decline and death costs.  This due to the fact that a
goodly amount of aging before a terminal illness causes everything to
sort of all fall apart at once at the end, like the Deacon's
Masterpiece (Holmes' poem about a "wonderful one-hoss shay" that had no
weakest part, and thus lasted 100 years until one day it just disolved
in a cloud of little broken parts-- poof).  There's no death quite so
slow and horrible and expensive as a relatively young person with a bad
disease of just one or two vital organ systems.

                                     Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.math,sci.skeptic,sci.physics,sci.engr
Subject: Re: Smoking was Re: Mathematician Jokes
Date: 9 Nov 1999 01:34:30 GMT

In <Pine.LNX.4.10.9911081401350.14333-100000@titania.math.ukans.edu>
Fred Galvin <galvin@math.ukans.edu> writes:
>
>On 7 Nov 1999, Steven B. Harris wrote:
>
>> Stopping smoking decreases your chances of dying in the near-term, but
>> obviously increases your chances of dying later. But assuming you'd
>> rather die later than sooner, it's something every smoker will want to
>> consider. The excess risk from lung cancer takes sometime to go away
>> after a smoker quits (half gone in 5-7 years, most of it gone by 15-20
>> years), but the excess heart attack death risk, which is at least as
>> large, mostly goes away over the course of the first year after
>> quiting, and is almost entirely gone in two years. Possibly this
>> represents damaged endothelial cells in arteries being remodeled and
>> replaced. In the case of cancer, there are a lot of damaged cells which
>> have to die without deciding to go wild, before your excess risk of
>> cancer goes back to baseline. Apparently, this takes a much longer
>> time.
>>
>>                                            Steve Harris, M.D.
>
>You didn't say, but I'm guessing that you're a nonsmoker, maybe an
>antismoker. Let's try a thought experiment, Dr. Harris. Let's imagine
>that new research (NOT funded by the tobacco industry) proved beyond
>reasonable doubt that smoking is *good* for you: that hitherto
>unsuspected health benefits (e.g. anticarcinogenic for some kinds of
>cancer) outweighed the health risks, to the net effect that smoking 5
>cigarettes a day increases your life expectancy by a couple of months.
>Would you do it?


   For a couple of months?  Probably not.  For 5 to 7 years, I'd
consider it, especially if I could keep the smell off my breath and
clothes.

   Rarely have I met a smoker who really consitantly smokes 5 to 7
cigarettes a day.  I'm met many who SAY they do, but their spouses sit
in the corner and shake their heads silently.  Most amusing.

   A smoker with NO other cardiovascular risk factors who smokes 5 to 7
a day might not get a lot of benefit from quitting.  We all take risks.
However, a little smoking acts synergistically, rather than additively,
with a number of other risk factors, so for people with a number of
them, the bit extra can be more than a bit extra.  As a doctor, I'm
concerned only in telling people about their true risks, not about
twisting their arms on which ones to take.

   I'm antismoking the same way I'm anti-high-blood pressure and
anti-high blood cholesterol and anti-Geo-Metro.  Perhaps a bit worse,
as I've seen many, many smokers suffer from COPD, and in general it
seems to be (on the whole-- and of course there's wide overlap) a
higher plane of suffering than that experienced by vascularly
compromized people.  It's a little like drowning, or being on Mt.
Everest, ALL the time.  And since I'm not an orthopedist or spine-rehab
guy or plastic surgeon, I don't have to take care of people who make
the "small, sporty car" mistake or the motorcycle mistake.  So that
certainly biases me.  I freely admit this.

From: "Steve Harris" <sbharris@ix.RETICULATEDOBJECTcom.com>
Newsgroups: alt.support.cancer,misc.health.alternative,sci.med
Subject: Re: 'THE CANCER RACKET' by Gavin Phillips
Date: Wed, 13 Mar 2002 16:21:45 -0700
Message-ID: <a6on4q$o4q$1@slb7.atl.mindspring.net>

<sleazy@scummyISP.com> wrote in message
news:jfhv8u8smmo9h2csm6kmshcr34pmhus1ue@4ax.com...
>
> Lung cancer and cardiovascular problems are just transient
> side-effects (although the missing alveoli are permanent), having
> nothing to do with the main problem: how to restore chemical balance
> at the synapse. Do receptors re-grow? It appears no one knows but the
> lifelong craving of ex-smokers seems to suggest that they don't.


I'm skeptical that they don't. We know receptors turn over normally.  A lot
of the residual craving that remains with smokers is just memories of
pleasure-- no different than you craving for that once-loved junk food that
you can no longer eat because you're on a diet.

> And let's not forget the reason for smoking in the first place: that
> (probably genetic) depression and anxiety. How are you going to cure
> the teenager so he will have no need of self-medication with
> cigarettes?


I know, I know!  Ritalin-SR !


SBH

From: "Steve Harris" <sbharris@ix.RETICULATEDOBJECTcom.com>
Newsgroups: alt.support.cancer,misc.health.alternative,sci.med
Subject: Re: 'THE CANCER RACKET' by Gavin Phillips
Date: Wed, 13 Mar 2002 21:41:27 -0700
Message-ID: <a6p9sb$1fl$1@nntp9.atl.mindspring.net>

<sleazy@scummyISP.com> wrote in message
news:jc609uou3hask40dh6nnuc5svivfv9fpgl@4ax.com...

> >> And let's not forget the reason for smoking in the first place: that
> >> (probably genetic) depression and anxiety. How are you going to cure
> >> the teenager so he will have no need of self-medication with
> >> cigarettes?
>
> >I know, I know!  Ritalin-SR !
>
> I presume you're not serious. Unfortunately that lack of seriousness
> in this area is something we have to work on.


ROFL.  You're going to work on me to make me serious, are you?

No, there's the plan, Stan. Ritalin SR for all those kids who don't get the
grades their parents think they're smart enough to get, which is just about
all of them. Besides, the kids who are getting really good grades are all
using it for their supposed ADD, so it's arms race time at the mental
olympics. Except doping is allowed in this one.  This will freak out a lot
of kids-- their anxiety and paranoia and borderline traits if they have any,
will all get worse! Watch-- with enough Ritalin, soon even the mildest will
begin to have paranoid thoughts about some stressful event.  Zowie, PTSD.
So now, Paxil for all. And we need a Prozac, Jr.

The school nurse will be hoppin', baby, trying to dispense it all. That
which she's not using herself, that is.

And if they smoke, Junior Zyban cannot be far off. All we need's a new name
for it.

SBH

From: "Steve Harris" <sbharris@ix.RETICULATEDOBJECTcom.com>
Newsgroups: alt.support.cancer,misc.health.alternative,sci.med
Subject: Re: 'THE CANCER RACKET' by Gavin Phillips
Date: Thu, 14 Mar 2002 21:07:57 -0700
Message-ID: <a6rscg$lvu$1@slb5.atl.mindspring.net>

<sleazy@scummyISP.com> wrote in message
news:eep29uo09bg1o15t23c2dgsuaaqjnh6h9p@4ax.com...
> All you're pointing out is our woefully poor knowledge of the CNS and
> the brain. Besides I doubt Ritalin is the answer to the mild
> depression and anxiety that are the main items relieved by smoking.


No, actually Wellbrutrin and Paxil are. <g>

Look, we don't know how these things work for sure. But we don't know how
smoking works, either. We simply know that they do. And that smoking is
incredibly bad for you. So do something (anything) else.

SBH

From: "Steve Harris" <sbharris@ix.RETICULATEDOBJECTcom.com>
Newsgroups: sci.med,sci.life-extension,sci.med.nutrition
Subject: Re: Multivitamin Scares. (was Re: How about supplemental calcium??)
Date: Tue, 6 May 2003 12:43:07 -0700
Message-ID: <b993ee$54h$1@slb0.atl.mindspring.net>

"Sherdan" <D96S@AOL.com> wrote in message
news:bd9e1543.0305060746.56a28215@posting.google.com...
> "Steve Harris" <sbharris@ix.RETICULATEDOBJECTcom.com> wrote in message n
>
> > 1) Pre-formed vitamin A is more toxic than we thought, with problems
> > occurring in supplementation very near the RDI dose. 2) Vitamin E
> > supposedly increases stroke risk.
> > 
> > The first is interesting but old news, in a sense. We all knew
> > pre-formed retinyl palmitate type vitamin A supplements were not that
> > great an idea, and that is why the best supplements (Twinlab Daily
> > One, for example, which I take) have the A as beta-carotene. There are
> > large safety studies on beta carotene, and it's not dangerous except
> > possibly in smokers.
> >
> Dr. Harris,
> Got to ask this 'cause I've been curious.  I am an ex-smoker - going on
> 15 years since I quit.  In the above senario would I still be considered
> a smoker since the threat of cancer never really ever goes away in
> someone who smoked and then quit?????
> Thanks much!
> Sherdan


Short answer: nobody knows.

If I had to guess, I'd guess that the risk from beta
carotene goes down at about the same rate as the excess lung
cancer risk after you quit-- half of it 7 years after
quitting, and much of the rest in the next 7. By the time
you're out at 15 you're probably okay, and missed the
bullet.

On the other hand, why risk it, though? If you have a
computer, you're not likely vitamin A deficient in your
diet. Beta carotene is not that hot a preventive for
anything in comparatively rich healthy Westerners.

SBH

From: "Steve Harris" <sbharris@ix.RETICULATEDOBJECTcom.com>
Newsgroups: sci.med,sci.life-extension,sci.med.nutrition
Subject: Re: Multivitamin Scares. (was Re: How about supplemental calcium??)
Date: Tue, 6 May 2003 14:48:49 -0700
Message-ID: <b99ajv$q0g$1@slb3.atl.mindspring.net>

"Sherdan" <D96S@AOL.com> wrote in message
news:bd9e1543.0305060746.56a28215@posting.google.com...
> Dr. Harris,
> Got to ask this 'cause I've been curious.  I am an ex-smoker - going on
> 15 years since I quit.  In the above senario would I still be considered
> a smoker since the threat of cancer never really ever goes away in
> someone who smoked and then quit?????


As noted, the excess risk of cancer DOES go away after you
quit, with a "half-life" of about 7 years. By now, after 15
years of quitting *at least* 3/4ths of your excess risk of
cancer due to smoking is gone.

So it really is good to quit.

BTW, most of your excess risk for heart problems goes away
in the first two years after quitting. Much faster.

SBH

From: "Steve Harris" <sbharris@ix.RETICULATEDOBJECTcom.com>
Newsgroups: sci.econ,sci.med
Subject: Re: Catastrophic Collapse of Socialism: limits to life expectancy
Date: Fri, 6 Jun 2003 10:51:30 -0700
Message-ID: <bbqkb3$u14$1@slb0.atl.mindspring.net>

<royls@telus.net> wrote in message
news:3edfbf96.19392478@news.telus.net...
> On Wed, 4 Jun 2003 14:42:34 +0000 (UTC), Jim Blair
> <jeblair@facstaff.wisc.edu> wrote:
> It's obvious.  Almost all medical costs are incurred in the final
> months of life spent in chronic care,


An urban myth.


>and lung cancer makes those
> final months of care much fewer.

If all smokers died of lung cancer and in hospice, that
might be true.

Alas, for every smoker that dies of lung cancer there is
another one that dies of heart disease only after an
expensive bypass, and yet another who spends multiple days
on a ventilator in an ICU due to some combination of COPD
and pneumonia (not to mention CHF).

ICU ventilator days are the single worst contributor to high
medical expenses in the country.  Guess what fraction of ICU
ventilator patients (most of whom do NOT have lung cancer)
have been smokers?

SBH