For three decades, Dr. David M. Burns has written and edited some of the seminal work on tobacco science and the hazards of modern cigarettes: surgeon general’s reports, National Cancer Institute monographs, World Health Organization studies.
And he is hardly a dispassionate scientist. As a pulmonologist who has cared for hundreds of smokers who died of lung cancer, he is an unabashed campaigner against smoking.
That is why, with the Senate just weeks away from a vote on landmark legislation to regulate tobacco, Dr. Burns, 61, is now willing to sidestep the protocols of peer-reviewed science. He wants to sound one more alarm about the dangers of smoking.
Dr. Burns says he has new information, based on two years of study, indicating that cigarettes — even the supposedly safer ones — pose a much higher risk of lung cancer than before the surgeon general first declared them a health hazard in 1964.
He said the risk of a smoker’s developing lung cancer may be twice as high as it was then, even though tar and nicotine have been reduced.
Last Thursday, Dr. Burns presented a “late-breaking abstract” — a summary of his findings — in Dublin at a meeting of the Society for Research on Nicotine and Tobacco. And the Campaign for Tobacco-Free Kids, a Washington advocacy group, has been promoting his work to journalists.
His thesis has not yet been reviewed by a panel of experts, such as the sort who would vet his research if he were to submit it to a medical publication like The New England Journal of Medicine, where his work has been published in the past. He says he plans to submit an article.
But that process can take months — long after the vote on the tobacco bill, which easily passed in the House last month but faces a filibuster threat from tobacco-state senators. Senator Edward M. Kennedy, the Massachusetts Democrat, planned to introduce the Senate version on Tuesday evening, an aide said, and the health committee he leads plans to mark it up next week. Jim Manley, spokesman for Senate Majority Leader Harry Reid of Nevada, said the Senate would probably vote in June.
Dr. Burns, a retired medical school professor at the University of California, San Diego, is highly regarded by his scientific peers. But tobacco companies say that, in this case, it is too soon to judge his science.
“Dr. Burns is a well-known antismoking activist, and we are not surprised that such an abstract — for a study that has not been peer-reviewed — would be released at this time in order to try and support Congressional passage of the F.D.A. bill,” said Michael W. Robinson, a spokesman for Lorillard, which produces Newport, Kent and True.
Dr. Burns notes that the way much tobacco is cured in the United States increases the level of dangerous compounds called nitrosamines. In the past in this country, and in places like Australia, tobacco was cured in the open air. But many American growers now speed it up with nitrogen fertilizers and propane heaters, leading to the formation of nitrosamines. They are among the 47 known animal or human carcinogens in cigarette smoke. Dr. Burns’s co-author was Christy M. Anderson, a statistician at the University of California, San Diego. They have charts indicating that the rate of the most common type of lung cancer among smokers — adenocarcinoma — has increased steadily in the United States in the last 50 years, at a much higher rate than for comparable men in Australia, the other country from which his five decades of data are drawn.
He theorizes a link between higher levels of nitrosamines in American tobacco and a rising incidence of adenocarcinoma lung cancer in American smokers over the last five decades.
Because 400,000 Americans die from smoking-related causes each year, Dr. Burns says it is crucial that the government have the power to regulate how cigarettes are made. The current curing process, he says, has doubled the lung cancer risk in American cigarettes since the 1950s.
“If we could reduce the risk by half of that — 25 percent — that’s 100,000 lives a year,” he said. “The tools exist. This evidence shows why you should use them.”
David B. Sutton, spokesman for Altria, which makes the market-leading Marlboro brand, said Dr. Burns’s presentation in Dublin did not contain enough data to evaluate his conclusions.
Mr. Sutton said Altria had been working with American growers since 2000 to cut nitrosamines “significantly,” but he declined to be more specific. Altria is the one cigarette maker that supports the tobacco legislation.
Under the conventions of medical publishing, Dr. Burns is not permitted to make public more than an abstract, as he did in Dublin, without jeopardizing the chances of a journal accepting his article. He said he had shared his work with a half-dozen prominent researchers. Several of them praised his scientific reputation and credentials. They all said that in tobacco science, it was hard to avoid taking a stand.
Dr. Michael J. Thune, chief epidemiologist for the American Cancer Society, said, “You really can’t work on something that is going to kill a billion people in this century and not be an advocate for tobacco control.”