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A nation that helped introduce tobacco to the world is taking the lead in warning of its dangers.

"TOBACCO," a historian wrote, "has no literal history prior to the discovery of America." Natives in the Caribbean offered it to Columbus. Its export ensured the survival of Jamestown, the first permanent British settlement in North America. Its sale helped finance the American Revolution. And the early U.S. presidents George Washington and Thomas Jefferson were tobacco growers.

In more recent times, Hollywood used cigarettes as a symbol of romance, charm, and manhood. American soldiers gave them to people they met in countries where they fought. And it is said that following the second world war, cigarettes were currency "from Paris to Peking."

It has been "estimated that during the 1990s in developed countries, tobacco will cause approximately 30 percent of all deaths among those 35 to 69 years of age, making it the largest single cause of premature death in the developed world."
—NEW ENGLAND JOURNAL OF MEDICINE

But things changed. On January 11, 1964, the U.S. surgeon general released a 387-page report linking smoking with emphysema, lung cancer, and other serious diseases. Soon federal law required the warning "Caution: Cigarette Smoking May Be Hazardous to Your Health" on all cigarette packages sold in the United States. Now, smoking is said to be responsible for an estimated 434,000 deaths a year in the United States. That is more than the number of all the Americans killed in battle during the past century!
Restrictions Imposed

Over ten years ago, Aspen, Colorado, a popular winter resort, prohibited smoking in its restaurants. Since then, nonsmoking sections have become more common in restaurants, the workplace, and other public places. Several years ago, a Californian asked his daughter where the nonsmoking section was in a Virginia restaurant. "Dad," she replied, "this is tobacco country!" By the time of his next visit, half of that restaurant had been reserved for nonsmokers. Recently, he saw no one smoking there.

CANCER WARNINGS

The following warnings are from the American Cancer Society's brochures Facts on Lung Cancer and Cancer Facts & Figures—1995:
Skull with cigarette

* "Nonsmoking wives have a 35% higher risk of lung cancer if their husbands smoke."
* "An estimated 90% of lung cancer cases in men and 79% in women are caused by cigarette smoking."
* "For a 2-pack a day smoker who has smoked over 40 years, the lung cancer mortality rate is about 22 times higher than a nonsmoker."
* "The best safeguard against lung cancer is never to start to smoke, or to stop immediately."
* "There is no such thing as a safe cigarette."
* "The use of chewing tobacco or snuff increases risk of cancer of the mouth, larynx, throat, and esophagus and is a highly addictive habit."
* "The excess risk of cancer of the cheek and gum may reach nearly fiftyfold among long-term snuff users."
* "People who quit smoking, regardless of age, live longer than people who continue to smoke. Smokers who quit before age 50 have half the risk of dying in the next 15 years compared with those who continue to smoke."

But having separate sections for smokers has not solved the problem. Large state-sponsored billboards along major California highways asked: "Do you think smoke knows how to stay in the smoking section?"

When New York City banned smoking in its larger restaurants, owners protested that this would alienate tourists from Europe where, they said, few regulations govern smoking. Yet, an earlier survey had found that 56 percent of Americans would be more likely to go to a nonsmoking restaurant, while only 26 percent would be less inclined to do so.

A sign in New York City's subway cars says: "In any language the message is the same: No smoking anytime, anywhere, in our stations or on our trains. Thank you." The sign states this message not just in English but also in 15 other languages.

Is the matter really that serious? Yes. If 300 people were to die in a major catastrophe, it would be on the news for days, perhaps even weeks. But an article in The Journal of the American Medical Association said it has been estimated that 53,000 Americans die each year from the long-term results of breathing the smoke of other people's cigarettes. That, it said, would make breathing such secondhand, or environmental, tobacco smoke "the third leading preventable cause of death, after active smoking and alcohol."


Pregnant woman smoking

Smoking during pregnancy accounts for about 10 percent of all infant deaths

Children—Defenseless Victims

What about smoking in the home? Healthy People 2000, a U.S. government publication that set goals for reducing "premature death and needless disease and disability," said: "Tobacco use is responsible for more than one of every six deaths in the United States and is the most important single preventable cause of death and disease in our society."

It added: "Cigarette smoking during pregnancy accounts for 20 to 30 percent of low birth weight babies, up to 14 percent of preterm deliveries, and about 10 percent of all infant deaths." Mothers who smoke, it said, can pass on the constituents of tobacco smoke, not only by breast-feeding the infant or by smoking around the infant but also by "putting the infant in a room where smoking occurred recently."

Fathers too are involved. The same publication advised: "If people who have contact with children must smoke, they should smoke outdoors or in areas that do not contribute air to places where the child might be." The risk increases with the number of adults smoking in the same room and with the number of cigarettes smoked. Thus, Joycelyn Elders, former U.S. surgeon general, said: "Your children are the innocent victims of your addictions."

Other people are also at risk. A state-sponsored television commercial in California showed an old man sitting alone. He said that his wife was always 'getting on his case' about smoking. "She even threatened to stop kissing me if I didn't quit. I said it's my lungs, and it's my life. But I was wrong. I didn't quit. I had no idea the life I'd lose wasn't mine . . . It was hers." Looking sadly at her picture, the old man added: "My wife was my life."

THE FARMER'S DILEMMA

For generations tobacco has supported families whose farms are too small to provide a living wage with any other crop. This fact obviously presents a conscience problem for many people. Stanley Hauerwas, professor of theological ethics at Duke University, a school that was founded by a tobacco baron, said: "I think the great agony of people who grow tobacco is . . . when they started growing it, they didn't know it would kill anyone."
Changed View

Such warnings have contributed to a major decline in smoking in the United States. Amazingly, an estimated 46 million Americans—49.6 percent of those who ever smoked—have quit!

However, tobacco companies have huge advertising budgets and are fighting back. The decrease in smoking has slowed. Joseph A. Califano, Jr., of the Center on Addiction and Substance Abuse at New York's Columbia University, said: "The biggest threat to the public health from the tobacco industry [is] its use of advertising and marketing aimed at children and teenagers who represent a fresh crop of addicts to its deadly products."

The Journal of the American Medical Association said: "An estimated 3000 young people, mostly children and adolescents, become regular smokers each day. This represents about 1 million new smokers each year who partially replace the approximate 2 million smokers who either quit or die each year."

Smoke doesn't stay in the smoking section
Restaurant scene

More than half of all U.S. smokers start by the age of 14. David Kessler, commissioner of the U.S. Food and Drug Administration, said that of the 3,000 children who begin smoking each day, almost 1,000 will eventually die from smoking-related illnesses.

If such figures trouble you, it would be well to remember that our children follow our example. If we don't want them to smoke, we must not do so either.
Overseas Sales

Although U.S. cigarette consumption has fallen, the foreign market grows. The Los Angeles Times reported that "exports have more than tripled and sales from U.S. tobacco plants abroad have surged." The New England Journal of Medicine said that in developing countries "little emphasis is placed on the hazards of smoking," allowing tobacco companies "to penetrate foreign markets rapidly."

Yet, Patrick Reynolds, son of R. J. Reynolds, Jr., and descendant of the founder of the company that produces Camel and Winston cigarettes, said that 1 out of 5 deaths in the United States is due to smoking. Reynolds was also reported as saying that smoking causes more deaths annually than cocaine, alcohol, heroin, fire, suicide, homicide, AIDS, and auto accidents combined and that it is the single most preventable cause of death, disease, and addiction in our era.

Does it seem strange that the nation that helped the world learn to smoke has developed a growing national opposition to tobacco? If so, it might be well to ask ourselves, 'Who best should know?'

Modern Maturity magazine told of a woman who had smoked for more than 50 years. She said: "When you are hooked, you are hooked." But she got rid of the mystique that had started her smoking in the first place, analyzed her excuses for continuing, and quit.

"Try it," she wrote. "It feels wonderful."