How grilling meat really is like a smoking a cigar

In his “Explainer” column at Slate yesterday, Brian Palmer raised alarm about grilled and smoked meats, suggesting that by eating them we may be, as the headline puts it, “Cooking Up Cancer”:

A growing body of research suggests that cooking meats over a flame is linked to cancer. Combusting wood, gas, or charcoal emits chemicals known as polycyclic aromatic hydrocarbons. Exposure to these so-called PAHs is known to cause skin, liver, stomach, and several other types of cancer in lab animals. Epidemiological studies link occupational exposure to PAHs to cancer in humans. When PAHs from a flame mingle with nitrogen, say from a slab of meat, they can form nitrated PAHs, or NPAHs. NPAHs are even more carcinogenic than PAHs in laboratory experiments. The reasonable conclusion is that grilling meat may be hazardous to your health.

The evidence linking cancer to cooking meat over a combustion source has been accumulating for decades. Epidemiologists first noticed a connection between the consumption of smoked foods and stomach cancer in the 1960s. Japan, Russia, and Eastern Europe, where smoking is a popular way to preserve meat and fish, became laboratories for gastric cancer research. Newer studies suggest that eating smoked meats may lead to cancer even outside the gastrointestinal tract. A 2012 study, for example, linked smoked meat consumption with breast cancer.

Palmer then compares current attitudes toward grilled meats to outdated acceptance of tobacco use:

In the mid- to late-19th century, doctors determined that lip and tongue cancer rates were higher among smokers of pipes and cigars. Despite this link, major medical journals mocked those who opposed smoking. The Lancet, the leading journal of the time and still one of the most important medical journals in the world, wrote in 1879, “We have no sympathy with prejudices against … tobacco, used under proper restriction as to the time and amount of the consumption. … A cigar when the mood and the circumstances are propitious [is] not only to be tolerated, but approved.” Moderation, not abstinence, was the order of the day.

[...]

It wasn’t until 1964 that the Report of the Surgeon General finally and firmly declared that smoking was indisputably linked to the surge in lung cancer. By that time, epidemiologists had a complete picture of the long-term effects of the increase in cigarette smoking that began around the time of World War I. The conclusions practically drew themselves. Still, it took the public health community decades to agree that smoking in moderation is a terrible idea.

I learned of the article from my friend Jeff Woodhead on Twitter, who took Palmer to task for sensationalizing the dangers of grilling and noted that habitual cigarette use carries far greater risks than exposure to charred meat. I don’t disagree. However I want to defend Palmer on one point. He is actually correct to compare grilling meats to smoking tobacco, though not in the way he realizes.

That pack-a-day consumption of cigarettes greatly elevates one’s risk of lung cancer is no longer disputed by any sensible person. Moderate use of other forms of tobacco, in contrast, carries much less danger. The Lancet article that Palmer mocks for suggesting that moderation in tobacco use is nothing to worry about overstates the case but was not too far from the truth.

Just how dangerous is it to enjoy an occasional cigar “when the mood and the circumstances are propitious?” A study in Preventive Medicine compared rates of lung cancer among smokers of various kinds of tobacco to those of non-smokers. Cigarette smokers were 16 times more likely than never smokers to get lung cancer. Smokers of cigars only, pipes only, and cigars and pipes all fared much better. Further, lung cancer among pipe and cigar smokers was concentrated among those who were the heaviest consumers. “Among pipe and/or cigar smokers only, patients with lung cancer were more likely than controls to have been long-time smokers of 5 or more cigars or 5 or more pipefuls per day and to have inhaled. The odds ratio for those smoking 5 to 9 cigars or pipes per day was 3.2 and for those smoking 10 or more units 6.7. The odds ratio of those cigar or pipe smokers who inhaled was 12.3.”

A cohort study published in The New England Journal of Medicine followed about 17,000 men enrolled in Kaiser Permanente health plans who reported never smoking pipes or cigarettes. Over a course of more than 20 years, the study compared health outcomes for non-smokers and smokers of cigars. Cigar smokers carried a relative risk of cancer in the aerodigestive tract of 2.02 and in the lungs of 2.14.

A third study in BMJ examined the risks of dying from three smoking-related diseases among former cigarette smokers who had switched to smoking pipes or cigars. Their mortality risk relative to users of pipes and cigars who were never cigarette smokers was 1.51. To put that in perspective, their relative risk compared to people who had never smoked at all was 1.68. In other words, the study found that even former cigarette smokers who switch to pipes and cigars lowered their mortality risk to a level not much above that of never smokers.

Brad Rodu, an advocate of harm reduction approaches in tobacco control, summarizes many of these risks. What it basically comes do is this: Cigarettes are uniquely dangerous because they are inhaled directly into the lungs and are very addictive. Other forms of tobacco that are mainly enjoyed in the mouth and lend themselves less easily to habitual consumption are significantly less dangerous. The risks are real, but much, much lower than those associated with cigarettes.

How does all of this compare to eating meat? Palmer doesn’t cite many sources that specify the dangers, but one study he links to does associate consumption of smoked meat with breast cancer. It finds an adjusted odds ratio of 2.31-3.13. If that’s accurate (and it may be on the high side), then eating lots of grilled meat may actually be a lot like enjoying an occasional cigar — which is to say that it’s a reasonable choice many adults may decide to make.

(Note: Some of the studies cited in this post use relative risk while others use odds ratios. These are not identical measures but should be roughly comparable.)

It’s also interesting to ask how this compares to the dangers of exposure to secondhand tobacco smoke. Smoking bans have proliferated on the justification that workers should not be put at risk. Whatever one’s opinion of these policies, consider the findings from the landmark 2006 report from the Surgeon General. The report concludes without equivocation that environmental tobacco smoke increases the risk of lung cancer in non-smokers. By how much? The reports’ table of meta-analyses of studies estimates relative risks of exposure at home for non-smoking spouses or at work for non-smoking employees in a range of 1.12 at the low end to 1.43 on the high end. Those are low relative risks! If they are enough to justify comprehensive bans on indoor smoking — not to mention the outdooor bans that are now so popular — then one may well question the ethics of allowing restaurant cooks to expose themselves to grill smoke on our behalf.

One of the big problems with reporting on cancer is that it focuses on the wrong question. Journalists ask, “Does X increase the risk of cancer?” The answer is very often yes, but they don’t follow-up with, “By how much?” Lifestyle choices carry trade-offs and better reporting would help readers put them into perspective. Palmer, to his credit, does write that the “risk-reward equation for smoking differs from that of grilling or frying meat” and acknowledges that the epidemiology on the latter is not yet clearly established. His mistake is to carelessly lump all forms of tobacco use into one, ignoring the fact that different types and different use patterns carry substantially different levels of risk.

Of course, few yet advocate completely giving up grilled or smoked meat, much less passing legislation to restrict it. “Everything in moderation,” said one of the toxicologists quoted in the Slate article. One assumes that the toxicologist’s definition of “everything” doesn’t include tobacco, because who would say that these days? But Palmer’s comparison of grilling to smoking isn’t crazy. It just tells us a lot more about contemporary bias against tobacco use than it does about the dangers of meat.

Comments

  1. harleyrider1978 says:

    “Barbecues poison the air with toxins and could cause cancer, research suggests.
    A study by the French environmental campaigning group Robin des Bois found that a typical two-hour barbecue can release the same level of dioxins as up to 220,000 cigarettes.

    Dioxins are a group of chemicals known to increase the likelihood of cancer.

    The figures were based on grilling four large steaks, four turkey cuts and eight large sausages.”

    http://news.bbc.co.uk/1/hi/health/3106039.stm

    • Noelle Robbins says:

      I would like to learn more about the dangers of inhaling second hand meat grilling fumes from a gas grill. Our house is often filled with the grilled meat fumes of nearby gas grills and I do know it burns my eyes and throat. But am having a hard time finding some info on the topic. I cannot imagine having your house filled with a neighbors grilling fumes – and burnt meat smoke – can be conducive to good health.
      And we also have neighbors who burn wood in outdoor pits and fill our house with wood smoke, as well.
      It is the direction the wind blows in our community, over which we have no control. And I know second hand wood smoke is highly toxic.

  2. harleyrider1978 says:

    Reference Manual on Scientific Evidence: Third Edition

    nap.edu

    This sorta says it all

    These limits generally are based on assessments of health risk and calculations of concentrations that are associated with what the regulators believe to be negligibly small risks. The calculations are made after first identifying the total dose of a chemical that is safe (poses a negligible risk) and then determining the concentration of that chemical in the medium of concern that should not be exceeded if exposed individuals (typically those at the high end of media contact) are not to incur a dose greater than the safe one.

    So OSHA standards are what is the guideline for what is acceptable ”SAFE LEVELS”

    OSHA SAFE LEVELS

    All this is in a small sealed room 9×20 and must occur in ONE HOUR.

    For Benzo[a]pyrene, 222,000 cigarettes.

    “For Acetone, 118,000 cigarettes.

    “Toluene would require 50,000 packs of simultaneously smoldering cigarettes.

    Acetaldehyde or Hydrazine, more than 14,000 smokers would need to light up.

    “For Hydroquinone, “only” 1250 cigarettes.

    For arsenic 2 million 500,000 smokers at one time.

    The same number of cigarettes required for the other so called chemicals in shs/ets will have the same outcomes.

    So, OSHA finally makes a statement on shs/ets :

    Field studies of environmental tobacco smoke indicate that under normal conditions, the components in tobacco smoke are diluted below existing Permissible Exposure Levels (PELS.) as referenced in the Air Contaminant Standard (29 CFR 1910.1000)…It would be very rare to find a workplace with so much smoking that any individual PEL would be exceeded.” -Letter From Greg Watchman, Acting Sec’y, OSHA.

    Why are their any smoking bans at all they have absolutely no validity to the courts or to science!

  3. harleyrider1978 says:

    Not 1 Death or Sickness Etiologically Assigned to Tobacco. All the diseases attributed to smoking are also present in non smokers. It means, in other words, that they are multifactorial, that is, the result of the interaction of tens, hundreds, sometimes thousands of factors, either known or suspected contributors – of which smoking can be one.

    Don’t fret over list of cancer ‘risks’
    http://www.dispatch.com/…/…r-list-ofcancer-risks.html

    “We are being bombarded” with messages about the dangers posed by common things in our lives, yet most exposures “are not at a level that are going to cause cancer,” said Dr. Len Lichtenfeld, the American Cancer Society’s deputy chief medical officer.
    Linda Birnbaum agrees. She is a toxicologist who heads the government agency that just declared styrene, an ingredient in fiberglass boats and Styrofoam, a likely cancer risk.
    “Let me put your mind at ease right away about Styrofoam,” she said. Levels of styrene that leach from food containers “are hundreds if not thousands of times lower than have occurred in the occupational setting,” where the chemical in vapor form poses a possible risk to workers.
    Carcinogens are things that can cause cancer, but that label doesn’t mean that they will or that they pose a risk to anyone exposed to them in any amount at any time.

    Now,Im glad to see the ACS admitting to the dose response relationship finally!

    So now we understand why the following is factual:

    are hundreds if not thousands of times lower than have occurred in the occupational setting,” where the chemical in vapor form poses a possible risk to workers.

    Regulatory Toxicology and Pharmacology, Vol. 14, No. 1. (August 1991), pp. 88-105.

    ETS between 10,000- and 100,000-fold less than estimated average MSS-RSP doses for active smokers

    http://www.citeulike.org/user/vmarthia/article/7458828

    OSHA the components in tobacco smoke are diluted below existing Permissible Exposure Levels (PELS.) as referenced in the Air Contaminant Standard (29 CFR 1910.1000)…It would be very rare to find a workplace with so much smoking that any individual PEL would be exceeded

    JUST AMAZING ISNT IT

  4. harleyrider1978 says:

    Mikle McFadden put this together awhile back

    Red Meat and Lung Cancer risk

    Look at http://www.ncbi.nlm.nih.gov/pubmed/11557111?dopt=Abstract and you’ll find a study showing the excess nonsmokers’ lung cancer risk for eating red meat. It’s not as strong a link as direct smoking, but obviously a LOT stronger than ETS. The red meat link just for nonsmokers would come to somewhat over 3.0 once the ex-smokers were removed (since the ex-smokers would move toward the 4.9 smoker rate.)

    That’s a nonsmoker EXCESS risk of more than 2.0 versus the EPA claimed risk of 0.19 for nonsmokers exposed to a lifetime of ETS. The lifetime lung cancer risk (not to even mention all the other more likely digestive cancer risks) for eating red meat is over TEN TIMES HIGHER than the excess risk supposedly caused by constant daily exposure to high levels of secondhand smoke.

    • Thanks Harley! LOL! I’d forgotten all about that! And it’s a good comparison of the claimed relative risks.

      In terms of the title of this article by Jacob Grier though, a more relevant concern has to do with the toxins produced by “grilling” meat…. as in restaurant kitchens. Remember this little video I took just north of Philadelphia outside of a Burger King?

      http://TinyURL.com/FastFoodAromas

      And remember, according to the Antismokers, simply separating a room in which such smoke is produced and having ventilation is of no help in protecting the children. So it seems clear that children need to be banned from Burger Kings, McDonalds, and other such places that are producing such huge volumes of smoke!

      Prof Scammington (Heh, GREAT name btw!), nice link on that French Fry thing. I wonder if the author there actually has something (e.g. the amount of acrylamide in a fry vs. a smoke) to back it up though… sounds like he’s really just repeating something he’d heard. In fairness however, I’d have little doubt that eating a french fry WOULD be worse for your health than being in a McWhopperie where someone was smoking a cigarette! LOL!

      - MJM

  5. This reminded me of the far sillier statement I read recently “…one French fry is worse for your health than one cigarette.” http://www.mydiet.com/5-foods-you-should-never-eat-again/3/

    Although, even if that were true, I would probably still eat French fries. With tartar sauce.

Trackbacks

  1. [...] Is eating grilled meat as unhealthy as smoking a cigar? [...]

  2. [...] In his “Explainer” column at Slate yesterday, Brian Palmer raised alarm about grilled and smoked meats, suggesting that by eating them we may be, as the headline puts it, “Cooking Up Cancer”: Read More… [...]

Leave a Comment

*