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Fifty Smoking Years

I was eating my steak, egg and cheese on a bagel this morning as I listened to the local radio. They were taking calls from listeners to hear their opinions on the last 50 years since the Surgeon General warned that smoking was hazardous to human health. Since that January morning in 1964, the public’s attitude on smoking has changed. There are certainly less smokers now compared to then. People are more accepting of laws against smoking in public places like restaurants and airplanes and laws taxing packs of cigarettes at some pretty high rates. The number of people wanting to quit smoking is also on the rise because of social, economic, and health pressures.

Still, about 20% of deaths in the United States can be directly attributed to smoking. It is responsible for most lung cancers, for causing heart disease, lung disease, stroke. It’s pretty bad. So public health authorities have made every effort to curb it, even if it means a backlash from some segments of the public and some businesses.

I can only imagine how it was back in 1964 for Dr. Terry. He was charged with getting all the evidence together, running it through a committee, and then presenting the findings to the country (and, in a sense, the world). You have to look at it from the point of view of 1964. Back then, the tobacco companies held significant power in Washington. Tobacco was a big cash crop in the American South. Over 40% of US adults smoked. The evidence was there that smoking was bad, but it wasn’t widely known; it wasn’t put together and presented to a lay audience.

In the 50 years since, smoking prevalence has dropped to about 20% of US adults. Millions of lives have been saved.

Today we have the rise of electronic cigarettes, or “e-cigs”. Unlike burning cigarettes, e-cigs vaporize a mixture of nicotine and some sort of flavoring. So all you get is the nicotine rush and none of the carcinogens in tobacco. Nevertheless, there are some problems with e-cigs, especially with younger users and accidental poisonings from the flavored nicotine. And nicotine alone still poses a problem for developing fetuses. These are problems that current and future public health workers will have to address.

In case you didn’t catch it, I mentioned eating a “steak, egg and cheese on a bagel” for a reason. It has to do with us silly humans getting addicted to things that are not good for us and fighting tooth and nail to keep them around. That’s how I see the whole smoking issue. Yes, smoking is bad. It can kill you. But there are still 20% of US adults who smoke and it’s safe to say that all of them are addicted. Unless they live divorced from reality, they know that smoking isn’t all that good. The same goes for those of us who eat too much.

I know that being overweight (or obese) is not good for me. It places me at risk for a lot of diseases and conditions that will eat into my life expectancy. Nevertheless, I stop at fast food places on the way to or from work (hardly ever both ways, to be honest) and buy things like a 600-calorie steak, egg, and cheese on a bagel, or a fried chicken sandwich. The combination of convenience, low cost, deliciousness, and addiction to food do this to me, and they do it to many others.

Thank God for a wife that coaxes me into running and eating healthy.

Anyone who is not divorced from reality knows that being overweight and obese, i.e. fat, is not a good place to be. But we keep buying fast food, eating high-caloric foods, drinking high-caloric drinks, and avoiding physical exertion whenever we can. Why? Because, like nicotine, fat feels good to our brains. Not being sweaty and tired feels good. Not having to jump out of the car is convenient. Paying $1 for a hamburger is great if you’re on a budget.

Congress and public health workers learned the lessons from prohibition when it came to tobacco. They weren’t going to out-right ban it because it would mean an economic disaster to many areas of the South that were already poor and trigger a black market situation (and ensuing crime syndicates) like those seen in the 1920’s and early 30’s. So taxing tobacco, taxing it some more, and then taxing it again became a viable solution that has halved the number of adult smokers.

I wonder if we can do it for food? I wonder if we can end the organized crime chaos in Latin America (and the United States) if we decriminalized the use of marihuana by adults in the privacy of their homes and used the taxing of that drug to treat those addicted to harder drugs? These are things that public health is working on right now, right this instant, 50 years after tobacco was taken on as a threat.

I’m really excited to be here.

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René F. Najera, DrPH

I'm a Doctor of Public Health, having studied at the Johns Hopkins University Bloomberg School of Public Health.
All opinions are my own and in no way represent anyone else or any of the organizations for which I work.
About History of Vaccines: I am the editor of the History of Vaccines site, a project of the College of Physicians of Philadelphia. Please read the About page on the site for more information.
About Epidemiological: I am the sole contributor to Epidemiological, my personal blog to discuss all sorts of issues. It also has an About page you should check out.

3 replies

  1. The chef’s dirty secret is, fat tastes good.
    It’s really a survival trait, as during our hunter-gatherer phase, high fat content foods warded away starvation during the harsh season when food was less plentiful.
    Now, that trait is a liability.

    I don’t have an addiction to food, other than having to eat periodically.
    But, I do have quite the addiction to nicotine, well tobacco. The e-cig units didn’t do anything for me, other than irritate my throat.
    Worse, as you know, I know a fair amount about medicine. But, I smoke old fashioned Lucky Strike cigarettes.
    I’m also quite addicted to caffeine. Tea won’t do it for me, coffee does. Though, I’m quite the tea drinker when the mood strikes, with a cabinet literally filled with nothing but different teas, including all manner of herbal teas (I really love chrysanthemum tea, saffron tea, artichoke tea and even chamomile tea (doesn’t relax me, but it does lower my blood pressure if it’s high for a few hours).

    Question that is totally OT, but has me wondering:
    Have you heard of anything causing an increase in pericarditis? I now have heard from five inlaws who were hospitalized (two repeatedly) with pericarditis. While autoimmune factors can play a role, it’s been both sexes being represented, which makes it less likely for it being autoimmune in that population group.
    Which would lead one to wonder if it’s an infectious agent.
    States represented: Kentucky, Indiana and Ohio.
    None reported influenza infection.
    Possible Lyme? Or is there another likely agent making the rounds over the past three months?


    1. I haven’t heard of anything else making the rounds, but I have heard that plenty of bugs and other things cause pericarditis. One of the biggies is Strep. Undiagnosed Strep from people who get the sore throat and tough it out… But I’ll look around, see if anyone is chatting about it.


      1. Two complained of low fevers, several complained of allergies.
        That might be notable, but for the unseasonably warm weather before that cold snap we had (I’m on Delaware County, PA and saw tulips starting to come up around Christmas). So, allergies could be allergies or an URI. Low fevers definitely implies a possible infection.

        Could be nothing, could be something familial, could be anything.
        Hard to even get a coarse differential when filtered third hand by those, erm, not extremely conversant in anything medical, then filtered by someone with dyslexia.
        Still, five in three months is a bit of a possible spike.
        Fortunately, being married for 32 years to a dyslexic has taught both of us how to work around the problems of perception common with dyslexia.


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