Sunday, January 12, 2014

Waging the War on Smoking

Yesterday was the 50th anniversary of Dr. Luther Terry's published warning about the dangers of smoking.

That brought about some immediate changes in American life — i.e., the warning labels on cigarette packages and, a few years later, the ban on tobacco advertising on television — and set in motion some longer–term changes.

Sarah Boseley of The Guardian rightly observes that the war hasn't been won. While the smoking rate has gone down, the number of smokers actually has gone up.

In a world that has long worried about the "population explosion" (people were worried about that when I was a kid, probably before that), that isn't really surprising, is it?

So I guess it's a variation on that age–old question, is the glass half empty or half full?

"The war on tobacco is far from being won," Boseley writes from the half–empty corner. "More than half of men smoke every day in several countries ... (and) [m]ore than a quarter of all women smoke."

As a reformed smoker (nearly seven years now), I feel I have an understanding for both sides. Smokers see what they do as a legal, personal choice, and they resent being treated like criminals (or lepers) for doing it. Nonsmokers believe they have a right to breathe clean air that isn't polluted by cancer–causing smoke.

Irresistible force, meet immoveable object.

I agree with Boseley that the war is not won. But tobacco has a considerable jump on things. Its use on this continent goes back some 3,000 years, and a coordinated public effort to eradicate it has been going on (at some points, dragging) for only a handful of decades.

Yet, in that time, the smoking rate has been cut in half. That is encouraging. (Welcome to the half–full corner.)

"[T]he benefits from the drop in use, accumulated across so many lives, are incalculable," writes the Washington Post.

It's like a conversation I had with a friend in the early days of the Great Recession. He said unemployment was destined to remain high because the jobs that had been lost were not coming back.

(It was like listening to Timothy McVeigh speak of "collateral damage.")

Did that mean we should not even try? I asked. Well, no, he grudgingly admitted.

Just because the war on smoking hasn't been completely won does not mean we should stop fighting it. We just need to be smarter about how we do it.

In the war against smoking, the Post recommends increasing taxes on tobacco products to discourage their use. I'm not sure how I feel about that proposal. One of the arguments against smoking is that it disproportionately affects the poor, but isn't that who will be most adversely affected by increasing the taxes? Wealthy and middle–class smokers will pay the taxes. They may complain about it, but they will pay it, and they will continue to smoke. The poor will continue to smoke, too, but the additional taxes they pay will have a financial domino effect — taking away money the poor would have used for food, clothing, shelter.

I'm more inclined to support the proposal that the FDA exercise its authority and require tobacco companies to reduce the amount of nicotine in their products. That has the potential to give heavy smokers the help they need to break their addiction and keep lighter smokers from becoming addicted.

USA Today says the war on smoking is "one of the nation's greatest public health success stories — but not for everyone."

That's one of those lines that expresses so much more than its words actually do.

America is not a one–size–fits–all nation. We celebrate diversity here, but we don't seem to have as much regard for the diversity of diversity. I'll grant you that money can be a powerful disincentive to smoke, but that assumes that the addict can control his/her addiction — and the nature of addiction is that the affected person has no control over it.

It is that very fact upon which tobacco companies have relied to make their fortunes: Get 'em on the hook, and they're yours.

Does that mean we shouldn't continue to fight the war? No. It does mean we should re–examine our tactics and never take our eyes off the ball.

"Anti–smoking forces have plenty to celebrate this week, having helped avert 8 million premature deaths in the past 50 years," writes USA Today. "But as long as 3,000 adolescents and teens take their first puff each day, the war is not won."

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