BU Today

Opinion

POV: Antismoking Movement Has Been Co-Opted

Half a century after hazardous-to-health warning, smoking kills too many

18

On January 11, 1964—50 years ago—Surgeon General Luther Terry released his landmark report on smoking and health, concluding that smoking causes lung cancer and chronic bronchitis and may also cause heart disease and other forms of cancer. Since that time, smoking prevalence among adults has dropped from 42 percent to 19 percent, tobacco companies have been found guilty of fraud and racketeering, and the Food and Drug Administration has assumed jurisdiction over tobacco products, all contributing towards the public perception that the tobacco problem has largely been solved.

While most of the national tobacco control organizations are boasting about the amazing progress since the 1964 Surgeon General’s report on smoking—progress that they claim has continued to this day—there is another side to this story, one that the public doesn’t readily see.

In recent years, the tobacco control movement has squandered the opportunity to reduce smoking-related disease and death. Instead of continued progress, the tobacco control movement has largely been co-opted by a bureaucracy of national organizations that seem more concerned about bolstering their funding streams than fighting the tobacco industry. Both the government and the national tobacco control organizations have largely abandoned the fight against the tobacco industry and smoking, and instead have dedicated themselves to seeking funding for research or policy that makes little or no further contribution to the protection of the public’s health.

How has the tobacco control movement squandered opportunities to reduce smoking-related morbidity and mortality?

  • In 1998, the state attorneys general abandoned their lawsuits against Big Tobacco, essentially being bought off by the tobacco companies. The signing of the Master Settlement Agreement was motivated by the desire for political gain for the attorneys general and money for the states. Furthermore, between 1998 and 2013, the states have squandered the money, spending only 4 percent on smoking prevention and cessation. The Master Settlement Agreement made the states partners with Big Tobacco by tying state revenues to the continued sale of cigarettes and removing any incentive for states to pass laws or establish programs that would make a serious dent in cigarette consumption. As a result, state-level tobacco control programs are largely dead.
  • In 2009, Congress enacted legislation that gave the FDA limited regulatory authority over cigarettes. However, the FDA is ill-equipped to regulate a deadly product and has limited ability to do anything that would actually make a dent in cigarette consumption. Adding insult to injury, the tobacco companies can now claim that they are concerned, socially responsible companies that are contributing to the protection of the public’s health. They can say, with honesty, that their products are approved by the FDA and that they comply with “stringent” federal regulations intended to protect the public’s health. However, the FDA has yet to take a single action that either makes cigarettes safer or reduces youth smoking. In fact, by trying to ban electronic cigarettes, the FDA actually protected cigarette profits at the expense of smokers who desired to quit. It was Philip Morris who wanted the FDA legislation—to institutionalize their products, protect their market share by stifling competition from potentially safer products, and give the public the perception that cigarettes are now safer because they are federally regulated.
  • In 2014, antismoking organizations are spending more time trying to prevent smokers from quitting (by trying to prohibit or discourage the use of electronic cigarettes) than they are attempting to enhance the options available to smokers who are unsuccessful with available drug treatments. Financially tied to Big Pharma, they are trying to force drugs down the throats of every smoker, even though research has demonstrated that cold turkey unassisted quitting is far more effective than reliance on drugs.

Tobacco control organizations have become addicted to money and the movement’s actions are designed to promote funding streams to these groups rather than to attempt to end the tobacco epidemic. Moreover, the grassroots nature of the tobacco control movement has largely disappeared, having been replaced by a few large national organizations that tell the local groups what to do.

On the 50th anniversary of the 1964 report, Alan Blum, director of the Center for the Study of Tobacco and Society at the University of Alabama, released a documentary that highlights what he calls “the persistent foot-dragging, fear, and squandering of funds by public health agencies, universities, and medical associations alike in ending the smoking pandemic.” This is the real story of the modern-day tobacco control movement. It demonstrates that the tobacco problem is far from over, and that today’s leading antismoking groups have squandered the opportunity to continue Terry’s legacy.

While the tremendous decline in smoking since the 1964 Surgeon General’s report is worthy of celebration, the actual number of smokers has declined only from 53 million to 45 million. Clearly, the problem of cigarette smoking remains one of the most critical public health issues of our time. But to succeed, we need to rebuild a tobacco control movement that, unlike the current one, cares more about saving lives than gaining dollars.

Michael Siegel, a School of Public Health professor of community health sciences, can be reached at mbsiegel@bu.edu.

“POV” is an opinion page that provides timely commentaries from students, faculty, and staff on a variety of issues: on-campus, local, state, national, or international. Anyone interested in submitting a piece, which should be about 700 words long, should contact Rich Barlow at barlowr@bu.edu.

18 Comments

18 Comments on POV: Antismoking Movement Has Been Co-Opted

  • Jim Belna on 02.11.2014 at 1:43 pm

    I am trying to figure out exactly why I should care that people still choose to smoke. We allow people to make all kinds of lifestyle choices that entail the risk of injury, illness, and death. It is far more dangerous for a BU student to ride a bike on Comm Ave than to smoke a cigarette, but we not only tolerate bike riding, we actually provide the bikes. Drinking is a health risk, as is mountain climbing, whitewater rafting, snowboarding, fast food, promiscuous sex, and (at least in Boston) just crossing the street. Are these next on your list of activities that must be extirpated from society?

    There is a reason why people smoke, and it obviously has nothing to do with being scammed by “Big Tobacco”. Everyone knows that cigarette smoking carries serious long-term health risks, and that it is an expensive and inconvenient habit. I presume that people smoke now for the same reason that people have been smoking for the past half-millenium – because it gives them pleasure to do so. Apart from the wildly exaggerated risks of “second-hand smoke” (when was the last time that anyone was forced to be exposed to cigarette smoke in a public place?), and unlike the function-impairing use of alcohol and drugs, smoking is a blessedly private vice that should be of no one else’s concern but the smoker’s. I would be curious to know if you can provide us with some principled reason why smoking should be the one and only recreational activity that must be completely eliminated, even as far more dangerous and socially-destructive endeavors are tolerated and in some cases encouraged?

    • Katarina on 02.11.2014 at 4:21 pm

      @Jim Belna
      BRAVO !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

    • Well on 02.11.2014 at 5:12 pm

      I’d guess economics. I don’t want to pay your higher premiums for health issues you developed courtesy of a habit you know better than to indulge in. It’s the same reason we encourage people not to eat only junk food, and we make a big deal about exercising. A healthy populous is more economical because of fewer drains on medical funds and more healthy, active workers making more money and then spending it.

      I wouldn’t say second-hand smoke issues are all that exaggerated. Without the positive steps that *have* been taken, it would be awful to be a non-smoker (I remember the days, and not fondly).

      And the marketing to kids issue is pretty abhorrent. Then again, lots of products marketed to kids are addicting and bad for them, but it’s one of a list of easy targets for things we ought to eliminate.

      Sending a message to the up-and-coming generations that good habits and healthy choices can enhance your quality of life isn’t exactly a bad idea. I get why you want people (esp govt) to stay out, and I also think we can afford to be a bit more hands-off in many respects, yet I still find anti-smoking sentiments to be among the least offensive rhetoric. Like, don’t touch this hot burner, you guys, because it’s hot.

    • Peter on 02.11.2014 at 7:13 pm

      I understand what you are saying, but the examples you named are very different situations from smoking. Risks like riding a bike or crossing the street can be eliminated by being careful, as with activities such as mountain-climbing and snowboarding. By being vigilant and not taking major risks, these activities can deliver thrills without risk of horrible injury. There is no equivalent safe way to smoke that allows the pleasure without the risk (except e-cigarettes but it’s not the same thing, is it?). Fast food is encouraged against, and the risks are way lower than smoking and fast food can be balanced nutritious food with exercise, unlike smoking. Trans fats made fast food dangerous, so they were banned. A comparison to promiscuous or unprotected sex does not help your point because it is quite strongly discouraged by everyone.

      There is also the more tragic point of how cigarettes kill people in a very different way from extreme sports or accidents. Clearly you’ve never lost a family member to lung cancer because you wouldn’t be asking if you had to see them deteriorate slowly over years. People can live over 5 years with lung cancer or COPD, and they will be very difficult years for the smoker and their family. Smoking is a selfish activity, because if you get sick, your entire family has to experience your decline from cancer. Not to mention the huge medical bills and financial cost. It could ruin you or your family. Unlike crossing the street, were the risks, if mitigated, are low and the payoff (of being able to go outside) is high, the downsides of cigarettes far outweigh the risks. If you have no one that cares about you and you are going to smoke somewhere so other people don’t have to inhale it (read: not right outside a doorway), that’s fine. If you are that person you can also free-climb and snowboard without a helmet. But if you have friends and family, remember that a death from cancer or COPD is different from being hit by a car and breaking a hip. Not to mention the tremendous financial cost to society that you will incur.

      • Michael J. McFadden on 02.14.2014 at 4:58 pm

        “Risks like riding a bike or crossing the street can be eliminated by being careful, as with activities such as mountain-climbing and snowboarding. By being vigilant and not taking major risks, these activities can deliver thrills without risk of horrible injury.”

        Nonsense. I’ve been riding a bicycle as a primary means of transportation since my early 20s, and it is TERRIBLY risky, no matter HOW careful you are. Your bicycle weighs 30 pounds and travels at five or ten miles an hour. The average car weighs about 3,000 pounds and travels at 30 to 60 miles an hour. If a driver’s attention is distracted for a quarter of a second by a cell phone ringing, or a passenger spilling a drink or by a loud honk behind them, they can swerve that killing machine into the bike lane and instantly kill or seriously injure a bicyclist. You can NOT “eliminate” the risks of bicycling unless you eliminate cars from the streets that bicyclists use to travel. Would you be supportive of that?

        - MJM
        (And technically, even then, the risks wouldn’t be *truly* eliminated: people’s bikes DO slip on ice, hit potholes, etc.)

    • Beatrice on 02.11.2014 at 9:09 pm

      I care. People who smoke cigarettes affect those around them, not just themselves. I can’t walk around campus without walking by a carcinogenic miasma. So I disagree on your point that no one is ever forced to be around secondhand smoke. Am I expected to never go outside? Just walk around campus, and you’ll notice that people are smoking all over the place–even where there are clearly posted signs prohibiting it. It’s not okay. I think this piece is important. I really couldn’t care less whether any decides to smoke, but when they do it like they do here, it affects me. I shouldn’t have to deal with the repercussions of smokers’ actions.

    • Michael J. McFadden on 02.14.2014 at 4:31 pm

      Jim, you ask for “some principled reason why smoking should be the one and only recreational activity that must be completely eliminated, even as far more dangerous and socially-destructive endeavors are tolerated and in some cases encouraged?”

      Simple: $500 million to $900 million dollars a year spent by “Tobacco Control” (as defined by the American Medical Association) from the MSA taxes levied upon smokers.

      Add in the money pumped through the NicoGummyPatchyPeople trying to drum up customers for their products (probably another hundred million or so) and the various charities that know heart-string-plucking pictures of cute little children being enveloped in clouds of evil smoke is a GREAT way to get pocketbooks opened and charity checks written …

      … and you’ve got all the “principled reasons” the world could ask for in promoting this campaign.

      - MJM

  • epiphany on 02.13.2014 at 8:30 am

    @Beatrice. You should be relieved that your fears of encountering “carcinogenic miasma” by passing smokers outside on campus are unwarranted. You may, however, be in danger of those carcinogenic miasmas by simply standing on the street corner or walking down Boston streets due to the traffic fumes you inhale daily. The World Health Organization can give you the stats for that. Although you may be offended by the sight of someone enjoying a cigarette outside, there is no chance of you being struck with cancer because of this. If you want to avoid “carcinogenic miasma” you should seriously consider turning Amish and moving to a place where cars and buses and trucks never assault and endanger you. It would be interesting to know that if you do not face any real danger from speeding past people smoking outdoors what is it that you fear, and how does it really affect you? What are those repercussions other than you being offended by the sight of someone smoking a cigarette? In case you missed it, here is a summary and analysis of the latest study of secondhand smoke and the absence of risk to you and other anti-smokers http://velvetgloveironfist.blogspot.com/2013/12/new-study-finds-no-link-between.html

  • Ili on 02.13.2014 at 11:58 am

    I agree with Jim. However, you all forget something. What has today’s society struggled for the most? What is the issue mostly fought for in the last 4-5 years? It’s all about peoples rights. Why is everyone respecting different races, different sexual orientations, religious beliefs, taste in food etc.? It happens because people deserve to make their own choices as long as tgey don’t affect anyone around them. The truth is that all the examples I gave above may have some impact (viewed as negative by many people) but they are all accepted by the society. This antismoking movement has done nothing more than antisocializing smokers, making them feel like the black sheep. Why accept all these things and not smoking? Because of second-hand smoke? There is no possible way unless your husband, wife gf or bf being a chain smoker and smoking more than 30 ciggaretes around you indoors. Its not just exaggerated, its overexaggerated and not only that, but also the act of smoking itself! My grandfather is 78 and smoked from his 20′s to 65, 5 packs a day which is 100 ciggaretes. He is completely healthy and still is enjoying his tasty cigars. What is wrong with letting people make their own choices? If you are so scared of smokers just make places for them. Do you make someone go outside
    To drink because you don’t like alcohol? NO. Respect for smokers has been lost and it is a shame of everyone who hasn’t even thought of that.

  • Magnetic11 on 02.13.2014 at 2:12 pm

    It’s America that’s popularized antismoking insanity – again, and which other countries are following suit. The problem with Americans is that they are clueless to even their own recent history. America has a terrible history with this sort of “health” fanaticism/zealotry/extremism or “clean living” hysteria – including antismoking – that goes back more than a century.

    Antismoking is not new. It has a long, sordid, 400+ year history, much of it predating even the semblance of a scientific basis or the more recent concoction of secondhand smoke “danger”. Antismoking crusades typically run on inflammatory propaganda, i.e., lies, in order to get law-makers to institute bans. Statistics and causal attribution galore are conjured. The current antismoking rhetoric has all been heard before. All it produces is irrational fear and hatred, discord, enmity, animosity, social division, oppression, and bigotry. One of the two major antismoking (and anti-alcohol, dietary prescriptions/proscriptions, physical exercise) crusades early last century was in America. [The other crusade was in WWII Germany and the two crusades were intimately connected by physician-led eugenics]. The USA has been down this twisted, divisive path before. Consider the following: The bulk of claims made about smoking/tobacco were erroneous, baseless, but highly inflammatory. Unfortunately, the propaganda did its destructive job in the short term, producing mass hysteria or a bigotry bandwagon. When supported by the State, zealots seriously mess with people’s minds on a mass scale.
    http://www.americanheritage.com/content/thank-you-not-smoking
    http://community.seattletimes.nwsource.com/archive/?date=19981129&slug=2786034
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2352989/pdf/bmj00571-0040.pdf

  • Magnetic11 on 02.13.2014 at 2:14 pm

    The current antismoking crusade, very much in the eugenics tradition – involving the same personnel and methodology, is much like crusades over the previous 400 years. It is a moralizing, social-engineering, eradication/prohibition crusade decided upon in the 1970s by a small, self-installed clique of [medically-oriented] fanatics operating under the auspices of the World Health Organization and sponsored by the American Cancer Society (see the Godber Blueprint http://www.rampant-antismoking.com ). This little, unelected group, using much the same inflammatory rhetoric of its fanatical predecessors, decided for everyone that tobacco-use should be eradicated from the world – for a “better” (according to them) world. These fanatics were speaking of secondhand smoke “danger” and advocating indoor and OUTDOOR smoking bans years before the first study on SHS: In the 1970s, populations – particularly in relatively free societies – weren’t interested in elitist social-engineering, particularly by a group (medically-aligned) that had a horrible recent track record (eugenics). Given that their antismoking crusade would have otherwise stalled, the zealots conjured secondhand smoke “danger” to advance the social-engineering agenda, i.e., inflammatory propaganda. Until only recently the zealots claimed they weren’t doing social engineering, that they weren’t moralizing. Well, that’s a lie that’s been told many times over the last few decades.

    The zealots’ goal this time is not to ban the sale of tobacco but to ban smoking in essentially all the places that people smoke (combined with extortionate taxes). Up until recently the social-engineering intent has been masqueraded as protecting nonsmokers from secondhand smoke “danger”. But even this fraud can no longer be hidden in that bans are now being instituted for large outdoor areas such as parks, beaches, campuses where there is no demonstrable “health” issue for nonsmokers. This dangerous mix of the medically-aligned attempting social engineering is a throwback to a century ago. We seem to have learned nothing of value from very painful lessons of only the recent past.

  • Magnetic11 on 02.13.2014 at 2:17 pm

    THE THEN AND THE NOW

    Then: “In 1904, for example, a New York judge ordered a woman to jail for 30 days for smoking in front of her children.”
    http://community.seattletimes.nwsource.com/archive/?date=19981129&slug=2786034
    Now: Parents warned they could face court for lighting up at home in front of kids
    http://www.thesun.co.uk/scotsol/homepage/news/4980962/Parents-warned-they-could-face-court-for-lighting-up-at-home-in-front-of-kids.html

    Then: A few years later [early 1900s], a Seattle woman won a divorce on the grounds that her husband was “a cigarette fiend.”
    http://community.seattletimes.nwsource.com/archive/?date=19981129&slug=2786034
    Now: Saudi Women Add Divorce To List Of Smoking Dangers
    40% of university graduates reject marriage
    proposals from smokers
    According to a report published on Monday in Saudi
    Arabia, more than 100 women in the Western city of
    Madinah have filed for divorce after their husbands
    refused or were unable to quit smoking.
    http://gulfnews.com/news/gulf/saudi-arabia/saudi-women-add-divorce-to-list-of-smoking-dangers-1.1123015

    Then: “Many companies, large and small, refused to hire cigarette smokers. Workers who indulged even on their own time could lose their jobs. When a rural Washington school board found out that one of its teachers had been smoking in the schoolyard after class, it fired him; the teacher sued for reinstatement but lost. Likewise, a teacher in Secaucus, N.J., failed to get her job back after she was fired for cigarette smoking in 1923, despite an appeal that reached the state Supreme Court.”
    http://community.seattletimes.nwsource.com/archive/?date=19981129&slug=2786034
    Now: There are now many similar examples of employment discrimination against smokers, particularly in America.

    Then: “….an anti-cigarette activist proposed that each package be stamped with the word “poison” in capital letters above a skull and crossbones.”
    http://community.seattletimes.nwsource.com/archive/?date=19981129&slug=2786034
    Now: Currently we have “plain packaging” draped with medical pornography, including skull and crossbones (e.g., Australia).

    Then: “The effects of “secondhand smoke” on nonsmokers were being debated in the 1920s.”
    http://community.seattletimes.nwsource.com/archive/?date=19981129&slug=2786034
    Now: The concoction of secondhand smoke “danger” has been the basis for the current antismoking crusade (see Godber Blueprint). Contemporary zealots are now in the process of manufacturing thirdhand smoke “danger”.

    Then: Her [Gaston] goal was “a smokeless America by 1925”.
    http://community.seattletimes.nwsource.com/archive/?date=19981129&slug=2786034
    Now: There are currently many “endgame” claims being made. A smokefree society by 2000?, 2020?, 2034? Etc.

  • Don on 02.14.2014 at 10:19 am

    Aging is still the biggest risk of all.

  • smartin on 02.14.2014 at 11:14 am

    The saddest thing to come from the Champagne Tower of Tobacco Control is the creation of the largest group of flat out lying “researchers” and scientists that the world has ever known. If a pharma company gave them a quarter to prove the earth was flat, by golly, they would DO IT! And with much fanfare and enthusiasm!

    Rather like the tailors of the Emperor’s new suit, they make complete fools of themselves continuing and expanding their total BS.

    Another thing I find abhorrent in this is that these “researchers” are teaching those eager fresh faced college kids how to lie for grants and how to get around the truth and integrity.

    It should be noted that the origination/funding of the most recent second hand smoke myth started with the “philanthropic arm” of the from company that sells the patches and gums.

    You may want to read the cumbersome 990 of the Robert Wood Johnson Foundation, a 501c3, who holds over 13,000,000 shares of Johnson and Johnson stock, and who funds lobbying for smoking bans.

    You may also find interesting that on the CDC Foundation Board, sits Dr Satcher, a Board member of J&J. The CDC has been the government’s conduit in the funding of illegal lobbying for smoking bans, and THEN they promote patches and gums!

    Look at the CDC site and SEE what they say “works best!” (This, after the Harvard study came out saying that cold turkey is more effective than patches and gums!)

    I consider these activities as fraud on American tax payers. I cannot understand how the CDC is funding illegal lobbying with federal funds, and how a 501c3 is getting away with lobbying and funding lobbying to other once respected “charities” who proclaim they are “trying to find a cure” while sitting on a $5 billion interest earning savings account! (And, when you go to their site, they tell you to contact your elected officials and tell them to give funding to THEM to find a cure! So they’re using donations to find a cure to lobby the government for money to find a cure, and getting grants from pharma to illegally lobby for smoking bans!)

    Truth is stranger than fiction. But the Champagne Tower must be maintained, as we don’t want grant moochers and spongers (and liars) to be unemployed!

  • smartin on 02.14.2014 at 11:22 am

    I always forget something!!! Could anyone please direct me to to ONE researcher who spouts the second hand smoke myth, who has NOT received grants, directly or indirectly, from RWJF? I have not been able to find one.

  • random on 02.18.2014 at 4:23 pm

    Do you people realize how ridiculous you sound arguing for smoking? Second hand smoke is a very serious issue. Have any of you read any scientific papers on effects of first and second hand smoke? Using blogspot as a resource is pathetic

  • yikes on 03.22.2014 at 6:13 am

    Second-hand smoke is a big deal not just in the long term (contributing factor- lung cancer, #1 cancer worldwide), also in the short-term for at least the subpopulation of people with respiratory conditions (transient or chronic, total numbers growing in the population for chronic).

    I disagree with previous posters…there are so many people that smoke in public places in our area (e.g. bus stops) where I and many others are “forced” to be exposed to their decision to smoke. Other air pollutants (e.g. previous given example as exhaust from cars, buses) may also be bad for general health, but I can tell you that generally, people with respiratory conditions are immediately more affected by tobacco smoke then many of those outdoor air pollutants.

    Is it fair for other people’s choices to negatively impact others? Generally, those types of situation are when the justice system gets involved.

    I realize some people are addicted, but there are so many benefits for them to quit/never start (besides no longer impacting others who have “no say” in being affected)… including their health & decreased expenses related to cigarettes and insurance costs (higher rates for smokers, and health issues down the line associated with smoking).

  • Becky on 04.02.2014 at 10:36 am

    Discrimination against smokers should not be discounted either!

    This discrimination in the workplace and in relationships is very real. But unfair. Some of us smokers really are too addicted to quit! When you smoke nearly three packs a day like I have since I was a teenager, it doesnt make quitting easy. Ive been smoking since I was twelve years old, almost twenty years now, and no matter how hard I try I can’t quit. Last time I tried to cut back, I could barely make it smoking only two packs a day, and even then I was having withdrawls and headaches.

    Look, Im not entirely against the anti-smoking movement. I know its bad for my health. My blood pressure is sky high, despite being a fairly petite woman with slight build, but my lung capacity is terrible and my doctor has already warned me that I am at high risk for early onset emphesyema. I can barely make it up a flight of stairs without wheezing and gasping for air.Its really frightening to think that in my early thirties I might already be showing signs of lung disease, but I can’t stop my addiction to cigarettes. But I shouldn’t be banned from working certian places just cause I need to smoke. Thats dscrimination!

    So, while I do think its ok if city counsels or state legislatures want to pass laws or ordinances banning smoking in public places, they need to be respectful of smokers rights too!

    I’ve had employers who commented on me smoking too much before they ended up firing me, and I was a model employee. I never missed work, was always on time, always completed my assignments, and always helped others when asked, and tried to always be cheerful in the office. Thats alot more than some others in the office who didn’t get fired, but then again they were non smokers.

    The discrimination that smokers face is very real, and very unfair. Most of us are too addicted to ever quit. Even when most smokers try to quit, we fail. Given that consideration, shouldnt we be more understanding and supportive of preventing unreasonable discrimination against non-smokers?

Post Your Comment

(never shown)