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.
Featured image source: http://commons.wikimedia.org/wiki/File:Ambiente_libre_de_humo_de_tabaco_-_Gobierno_de_Santa_Fe.jpg
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.
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