Timeless Knowledge from an Insightful Mathematician

 

I recently read on X (Twitter) a tribute to the book, “A Mathematician Reads the Newspaper,” by John Allen Paulos. 

The author is a professor of mathematics at Temple University, and his bio, here, is impressive.  The book, still in print and available on Kindle, was originally published in 1995.  More importantly, it remains relevant today, especially, as the reviewer put it, if you want to “become smarter and a better consumer of information who will not fall into [the] many traps of the media.”

I don’t recall having contact with Paulos, but his tome includes these two insightful paragraphs:

“More than 400,000 Americans die annually from the effects of smoking, but there is some intriguing evidence that the number could be drastically reduced by the widespread use of smokeless chewing tobacco.  Professors Brad Radu [sic] and Philip Cole recently published a note in Nature in which they claimed that the average life expectancy for a thirty-five-year-old smokeless tobacco user would be fifteen days shorter than that for a thirty-five-year-old smoker.  This is in contrast to 7.8 years lost by smokers.  The authors estimate that a wholesale switch to smokeless tobacco would result in a 98 percent reduction in tobacco-related deaths.

“Since a small amount of tobacco lasts all day, tobacco companies would likely oppose smokeless chewing tobacco.  There has already been strong opposition to it from some antismoking groups because of an increase in the risk of oral cancer (which is much rarer than lung cancer, emphysema, and heart disease).  I suspect that another reason is a certain misguided sense of moral purity – not unlike opposing the use of condoms because, unlike abstinence, they’re not 100 percent effective.  If the numbers presented here are confirmed, however, recommending a switch to smokeless tobacco for those smokers (and only those) who can’t quit would seem like sound public policy.”

Paulos has a knack for interpreting numbers, and he understands the “misguided sense of moral purity” that has dominated tobacco policy – and killed millions of smokers – for nearly 30 years.

 

 

*Nota bene: Phil Cole and I never claimed that a “wholesale switch” to smokeless would result in a 98 percent reduction in smoking-related deaths, as that would not have accounted for residual deaths from former smoking among those switchers.  Rather, we based the 98 percent reduction on the following premise: “If, instead of smoking, smokers had used smokeless tobacco.”  It is a subtle but crucial distinction, but it does not detract from the huge risk reduction available to individual smokers who switch.

 

Nature Nurtures Nicotine Nonsense

 

The prestigious scientific journal Nature draws considerable attention to its articles from scientists and others worldwide.  That makes it imperative that we point out the many serious flaws in a recent article, misleadingly titled, “Is nicotine bad for long-term health? Scientists aren’t sure yet.”

At this writing, MEDLINE, “the world's leading bibliographic source for biomedical scholarly literature and research,” offers citations to 28,241 articles with the keyword “nicotine”.  While it is true that science always demands additional research, one can reasonably assume that there is sufficient data on nicotine effects to draw meaningful conclusions about its safety.

Apparently, the authors of the Nature article went to great lengths to secure comments from what is surely a minuscule community of “unsure” scientists and from entrenched opponents of recreational nicotine consumption and tobacco harm reduction. 

Aruni Bhatnagar, who runs a tobacco regulation and addiction center sponsored by the American Heart Association, is quoted saying, “We believe that much of the cardiovascular effects of smoking are because of nicotine,” and he postulates that the drug can change the timing of electrical signals in the heart.  This sounds ominous, but the article includes a refutation of these comments by Neal Benowitz, a recognized nicotine authority: “Nicotine is a minor player with respect to smoking-induced cardiovascular disease.”  Benowitz points to “studies of snus – a chewable tobacco product that is popular mainly among men in Sweden and is gaining traction elsewhere – which do not generally show a detectable rise in heart problems among people who use it.”

Maciej Goniewicz of the Roswell Park Cancer Center in Buffalo offers insignificant insights, such as, “[Nicotine] changes lots of functions in our bodies, it’s not a harmless compound.”  That can be said of everything humans consume.  Goniewicz also muses, “Someone chronically exposed to nicotine might have chronic inflammation. There is speculation that it might contribute to increased risk of cancer. [Emphasis added] From animal and cell studies, yes, nicotine is doing something. How this translates into a risk for the [human] user, we don’t know.”  Benowitz counters: “the evidence, for me, is not convincing in tying [nicotine] to cancer in humans.”  The evidence for a nicotine-cancer link is next to nil.

Frequent nicotine critic Laura Crotty-Alexander of the University of California San Diego notes, “We’ve underplayed the role that nicotine has in the health effects of tobacco products.”  Basing her opinion on her own research, in which cells and animals are tortured with nicotine (more info here and here), she offers a weak indictment of the drug, saying, “I’ve been more and more surprised at the changes I’m seeing when I expose cells to nicotine.”

One of the most extreme views in the Nature article comes from Kjersti Aagaard, a maternal-fetal doctor at Houston’s Baylor College of Medicine: “No amount of nicotine is known to be safe in pregnancy. None. If you are exposed to nicotine in the womb, there could be lifelong consequences.”  Aargaard implies that failure to meet that standard could have criminal consequences for the pregnant woman, but the journal contrasts those remarks with the position of the UK National Health Service, which “describes e-cigarettes as safer than smoking for pregnant women, but it notes that there is little research to support the safety of e-cigarettes beyond that. It recommends pregnant women use nicotine patches and gums to stop smoking.”  This is but one example of the startling differences between prohibitionist American and science-based British positions on vaping.

Despite the Nature article’s complaint that “the lack of knowledge about whether nicotine contributes to the damaging health effects of smoking is becoming more worrying,” there is a wealth of knowledge supporting the finding that the effects of nicotine on health are minimal to nonexistent.