Thank you very much, Roberto, for your careful reading and for your thoughtful comments. I sincerely appreciate them.
I agree: Norma Broin’s experience was an extreme occupational exposure and should not be taken as representative of every instance of environmental tobacco smoke.
My intention was not to use her case as an epidemiological average, but as a historical and legal turning point illustrating how public health came to recognize involuntary exposure as a matter of collective responsibility.
I should have acknowledged more explicitly that the intensity of exposure varies enormously across different settings.
I also think your observation about smoke-free versus clean air is well taken. The point is that commercial aircraft are no longer filled with tobacco smoke, not that cabin air is free from every possible contaminant.
I also share your concern that tobacco control should not be romanticized or treated as beyond criticism.
One of the essay’s central arguments is precisely that successful institutions develop habits of perception that are in part historically justified but may also become overly reliant on analogy.
Institutional memory is indispensable, but it can sometimes compress meaningful differences between old and new products.
Where I would probably differ is in how far that criticism should be taken. I do not think the history of secondhand smoke is simply a case of sacred or unquestionable knowledge. The evidence supporting the harms is substantial, even though some studies have produced different estimates and prompted legitimate methodological debate.
Likewise, I believe it is possible to criticize excesses, overreach, or the treatment of scientific dissent without concluding that the entire evidentiary foundation is unsound.
Your comment about Enstrom and Kabat raises an interesting question that is somewhat distinct from the essay’s main argument: how scientific and regulatory communities handle dissent, particularly in fields shaped by decades of documented industry deception. That history shapes institutional mentalities, and I agree that this dynamic warrants careful examination.
Ultimately, the essay is less concerned with defending or criticizing tobacco control than with asking a prior question. How do institutions learn what to see, and under what conditions can historically successful categories begin to obscure as well as illuminate new evidence?
I believe that question benefits precisely from the kind of critical engagement you have offered.
A typo inn the last paragraph previous post: "While this moralistic absolutist zeal could be justified because smoking is so harmful, tobacco control is NOW applying same moralistic absolutist zeal against vaping, pouches and non-combustible alternatives. Now they have no justification of acting for the "common good", now tobacco control is a major peddler of harm and death. It said "not" it is "NOW"
Some omissions in this thread. Protecting Norma Broin is well justified, but you cannot take this case as representative of exposure to environmental tobacco smoke (ETS). She was exposed to a lot of ETS released by many smokers in a small closed volume almost every day for years. This an extreme case that is not representative. Typically exposure to ETS happens in much more open indoor spaces, for less time and not involving so many smokers, in restaurants, bars and specially homes in couples in which one spouse smokes. However, "smoke-free" does not imply "clean". Although air in airplane cabins is not in general toxic and is better without ETS, it is far from clean, it is too dry and does not filter all biological contaminants. Also, while protecting Norma Broin is commendable, the prohibition to smoke in large open spaces (parks, windy beaches) is health Fascism and arrogant puritanism that stigmatizes and shames smokers, not dissimilar with homophobia and racism that shame their hate targets. We should not romanticize tobacco control and take at face value without criticism all its policies and arguments.
Another omission. A major epidemiological study was conducted by James Enstrom and Geoffrey Kabat, following tens of thousands of such couples for 40 years to examine if passive smoking lead to incidence of lung cancer. The study was funded by the American Cancer Society, which withdrew funding when the results were coming negative. Enstrom and Kabbat had to ask the tobacco industry for help to cover expenses. Unfortunately, all tobacco control academics launched a moral lynching campaign against Enstrom and Kabbat, accusing them of doing the bidding of the hated tobacco industry. Passive smoking has become for tobacco control a sort of sacred knowledge that cannot be subjected to any nuances, dissent or critique. While this moralistic absolutist zeal could be justified because smoking is so harmful, tobacco control is not applying same moralistic absolutist zeal against vaping, pouches and non-combustible alternatives. Now they have no justification of acting for the "common good", now tobacco control is a major peddler of harm and death.
Thank you very much, Roberto, for your careful reading and for your thoughtful comments. I sincerely appreciate them.
I agree: Norma Broin’s experience was an extreme occupational exposure and should not be taken as representative of every instance of environmental tobacco smoke.
My intention was not to use her case as an epidemiological average, but as a historical and legal turning point illustrating how public health came to recognize involuntary exposure as a matter of collective responsibility.
I should have acknowledged more explicitly that the intensity of exposure varies enormously across different settings.
I also think your observation about smoke-free versus clean air is well taken. The point is that commercial aircraft are no longer filled with tobacco smoke, not that cabin air is free from every possible contaminant.
I also share your concern that tobacco control should not be romanticized or treated as beyond criticism.
One of the essay’s central arguments is precisely that successful institutions develop habits of perception that are in part historically justified but may also become overly reliant on analogy.
Institutional memory is indispensable, but it can sometimes compress meaningful differences between old and new products.
Where I would probably differ is in how far that criticism should be taken. I do not think the history of secondhand smoke is simply a case of sacred or unquestionable knowledge. The evidence supporting the harms is substantial, even though some studies have produced different estimates and prompted legitimate methodological debate.
Likewise, I believe it is possible to criticize excesses, overreach, or the treatment of scientific dissent without concluding that the entire evidentiary foundation is unsound.
Your comment about Enstrom and Kabat raises an interesting question that is somewhat distinct from the essay’s main argument: how scientific and regulatory communities handle dissent, particularly in fields shaped by decades of documented industry deception. That history shapes institutional mentalities, and I agree that this dynamic warrants careful examination.
Ultimately, the essay is less concerned with defending or criticizing tobacco control than with asking a prior question. How do institutions learn what to see, and under what conditions can historically successful categories begin to obscure as well as illuminate new evidence?
I believe that question benefits precisely from the kind of critical engagement you have offered.
Thank you again for your careful reading.
A typo inn the last paragraph previous post: "While this moralistic absolutist zeal could be justified because smoking is so harmful, tobacco control is NOW applying same moralistic absolutist zeal against vaping, pouches and non-combustible alternatives. Now they have no justification of acting for the "common good", now tobacco control is a major peddler of harm and death. It said "not" it is "NOW"
Some omissions in this thread. Protecting Norma Broin is well justified, but you cannot take this case as representative of exposure to environmental tobacco smoke (ETS). She was exposed to a lot of ETS released by many smokers in a small closed volume almost every day for years. This an extreme case that is not representative. Typically exposure to ETS happens in much more open indoor spaces, for less time and not involving so many smokers, in restaurants, bars and specially homes in couples in which one spouse smokes. However, "smoke-free" does not imply "clean". Although air in airplane cabins is not in general toxic and is better without ETS, it is far from clean, it is too dry and does not filter all biological contaminants. Also, while protecting Norma Broin is commendable, the prohibition to smoke in large open spaces (parks, windy beaches) is health Fascism and arrogant puritanism that stigmatizes and shames smokers, not dissimilar with homophobia and racism that shame their hate targets. We should not romanticize tobacco control and take at face value without criticism all its policies and arguments.
Another omission. A major epidemiological study was conducted by James Enstrom and Geoffrey Kabat, following tens of thousands of such couples for 40 years to examine if passive smoking lead to incidence of lung cancer. The study was funded by the American Cancer Society, which withdrew funding when the results were coming negative. Enstrom and Kabbat had to ask the tobacco industry for help to cover expenses. Unfortunately, all tobacco control academics launched a moral lynching campaign against Enstrom and Kabbat, accusing them of doing the bidding of the hated tobacco industry. Passive smoking has become for tobacco control a sort of sacred knowledge that cannot be subjected to any nuances, dissent or critique. While this moralistic absolutist zeal could be justified because smoking is so harmful, tobacco control is not applying same moralistic absolutist zeal against vaping, pouches and non-combustible alternatives. Now they have no justification of acting for the "common good", now tobacco control is a major peddler of harm and death.