Health@Heart
Smoking and cancer
There is no more doubt today that tobacco (cigarette smoking) is the predominant cause of lung cancer, besides other malignancies and cardiovascular diseases that maim, kill men and women and hurt our society. In the United States alone, almost half a million die each year from smoking related illnesses. These are preventable deaths! Demographic studies have shown that smokers are about 10 times more prone to die premature deaths than non-smokers. This unnecessary loss of lives is at an immense direct cost for non-smokers in terms of increased in health insurance premiums and taxes, not to mention personal and family tragedies in all shapes and forms.
As we have alluded to in a previous column, secondhand smoke is even more dangerous. Innocent bystanders are forced to inhale cigarette smoke at their workplaces or in public places, thus increasing their health risk. The Environmental Protection Agency engineers have shown that even the best available ventilation and air-moving equipment were unable to reduce carcinogenic (cancer-causing) air contamination to a safe level for a non-smoker sharing work space with a habitual smoker. Physical isolation of the tobacco addict is most essential as shown by these scientific studies.
Tobacco use leads to four times as many excess deaths annually compared to all other drugs and alcohol abuse combined, ten times more than all automobile fatalities per year, twelve times more than deaths from AIDS, and much more than all the American military casualties (in all wars) in this century put together. That’s how dangerous and damaging tobacco is to the human body and to society as a whole.
At the beginning of the past century, lung cancer was almost an insignificant health problem for the world. It became a minor problem in the 1930s (death rate of 5 per 10,000). Today, it has become the main killer among men and women. Since women started “really” smoking in the 1950s, “because it was glamorized in ads by actresses and models as a sophisticated and fashionable habit,” lung cancer in females has increased at least six-fold, an alarming rate, with death rate comparable to that in males. Women also have added risks: osteoporosis, thrombophlebitis (vein inflammation and blood clot formation), arthritis, infertility, cervical cancer, and menstrual irregularities. Pregnant smokers face miscarriages, stillbirths, low-birth weight and SIDS (Sudden Infant Death Syndrome) babies. Almost 30,000 female lives are snuffed out every year as a result of smoking. Of the 4 billion cigarette-related deaths in the world each year, about half a billion are women. It is now the top killer among women. Today, one woman dies from cigarette-related illness every three minutes! Indeed, “you’ve come a long way Baby!” (as a cigarette ad once proudly proclaimed).
In Marlboro Country where tombstones abound or in Salem, it is a Lucky Strike if one does not develop lung cancer or deadly cardiovascular diseases. Millions of smokers afflicted with blockages in their leg arteries couldn’t walk even for less than a mile for a Camel, and even Philip Morris, Virginia Slims, Benson and Hedges have all conceded now that tobacco, including Low Tar, is addicting and hazardous to health. Smoking is indeed not Kool at all, and even Lord Chesterfield, the Viceroy, and Winston in the Parliament, “Kent” argue with the fact that smoking is self-abuse, a subtle form of suicide. There is a real Advantage in kicking the habit even before it starts. I Hope the future generation will be smarter than us.
But what is puzzling and bothersome to me is the great dichotomy with which our society (and most especially the government!) deals with the cigarette-health risk issue. On one hand, they are most vocal and vigilant against the so called illegal drugs and other substances that pose a moderate public health dilemma, promulgating most aggressive laws and heavy criminal sanctions against their production, distribution or use. On the other hand, society and the government have long subsidized with tax monies the production and distribution of tobacco, which is by far the country’s most serious and deadly substance. Yes, our government and society are peddling drugs, not the moderately dangerous ones but the most deadly one. The one that makes lives miserable. The one that kills the bread winner or the mother in the family, victimizing the children and their future. The one that separates loved ones. The one that destroys hopes and dreams.
When I immigrated to the United States, I thought economics was the reason why the government was quite tolerant of the tobacco industry, from whom it was getting so much revenues in taxes, etc. making it acceptable and even essential for its survival. I later learned that the amount of money the government gets from the tobacco industry is no where near the billions of dollars it spends yearly in research, hospitalization/disability/work loss and treatment of cigarette related diseases. So, it is not economic. With the cigarette industry’s mighty lobbying dollars, the majority of our legislators are obviously scared to stop and eradicate the killing fields. It seems money blinds them to the immoral and unconscionable fact that their harmful legislations, or the appropriate ones they do not have the courage and wisdom to promulgate, are killing the very people they have sworn to represent and to protect.
But the tide appears to be changing, at least in the United States. The courts in Northern America have eventually scratched the surface in bringing about some justice, albeit delayed, in the tobacco death arena. Dying or dead smokers have successfully won handsome awards from some giant tobacco companies, who, finally, after more than seven decades, have officially admitted that tobacco is an addictive drug, carcinogenic, and can kill in more ways than one, and that they had known this fact for decades but had lied about it. The color of money obviously lures even the color blind among our unscrupulous politicians.
Having said that, I strongly feel that people who wish to smoke (or to jump off a tall building to kill themselves) have the right to do that. That is their constitutional right, and while I am against tobacco as an individual and as a physician, I shall defend the right of the cigarette users to smoke, since there is no law against it. The only exception to that right, or any other right under our constitution, is when its exercise adversely affects or conflicts with, or curtails, the rights of others. The smoker has the right to smoke and enjoy it, but he does not have the right to force or expose his loved ones, his friends, or strangers, to the more dangerous and more carcinogenic fumes coming from his cigarettes. This is where the lines have to be drawn, morally, socially and legally.
(Dr. Philip S. Chua is Cardiac Surgeon Emeritus based in Northwest Indiana and Las Vegas, Nevada, and is the Chairman of Cardiovascular Surgery of the Cebu Doctors’ University Hospital in Cebu City. He is also the Vice-President for Far East Operations of the Cardiovascular Hospitals of America, a hospital builder in Wichita, Kansas. His email address is scalpelpen@gmail.com)