Wednesday, January 29, 2014

Exploiting the 50th Anniversary of the Surgeon General’s Report on Smoking

Fifty years ago, U.S. Surgeon General Luther Terry issued a landmark report describing the health risks of cigarette smoking.  Tobacco prohibitionists are using the anniversary to promote onerous measures aimed at the tobacco industry and consumers (here).

American Heart Association president Dr. Mariell Jessup claims that “taxes, strong smoke-free laws and fully funding state tobacco prevention programs… can reduce the number of adult smokers to less than 10 percent of the population in 10 years.”

Similarly unfounded assertions have been made for decades. In 1984, Surgeon General C. Everett Koop declared that the U.S. could be smoke-free by the year 2000 (here).

NBC reported that “raising the legal age to buy tobacco products to 21 would go a long way to stopping kids from ever getting addicted in the first place,” and it cites the American Heart Association, American Lung Association, American Cancer Society and the Campaign for Tobacco-Free Kids for support.  Unable to obtain an outright tobacco ban, these groups hope to impose rules similar to those for alcohol.  

Dr. Michael Fiore of the University of Wisconsin’s Center for Tobacco Research and Intervention, says tougher tobacco age restrictions make sense: “We do it with booze yet we don’t do it with cigarettes, when cigarettes kill about 10 times more people than alcohol does.”  That argument disguises the fact that alcohol has proven far more deadly for teenagers.

The current age requirement for cigarette purchase is 18 years, and the smoking prevalence for high school seniors is 16%.  In contrast, the requirement for alcohol purchase is 21 years; 39% of high school seniors currently drink and 26% have been drunk recently (here).

Dr. Fiore bemoans the lack of physician engagement with smokers; he thinks they should be nagged: “I would never dream of letting a patient with high blood pressure leave my office without treating it.  But every day in America, millions of Americans go in and out of a physician’s office and their smoking is not treated.”

The past 50 years have witnessed an increasingly aggressive tobacco control movement, with declining returns.  Tobacco control may have contributed, as the media suggests, to the saving of eight million smokers lives (abstract here), but tobacco prohibitionists also share responsibility for the 17.7 million smokers who died prematurely because they were denied factual information about safer smoke-free tobacco products.  

Instead of exploiting the 50th anniversary, all public health groups should endorse rational, science-based tobacco harm reduction.  America’s 45 million smokers deserve nothing less.

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