Anti-smoking laws started cropping up as early as the 1880s, which means smoking has been recognized as a public health epidemic among concerned citizens and medical practitioners for almost a century and a half. In 1964, the U.S. Surgeon General made it official by declaring: “Cigarette smoking is a health hazard of sufficient importance in the United States to warrant appropriate remedial action.”
That may have been a turning point in American history, but smoking tobacco — and the panoply of health complications it’s associated with, from mild to deadly — had seen little abatement by 1979. Indeed, a Surgeon General report from that same year indicated that rates of tobacco use among adolescent males had remained virtually unchanged. And smoking rates among teenage girls had increased.
People young and old still turn to tobacco for many reasons, including defiance of authority, feelings of acceptance among peers and, of course, the physical stimulation and pleasure tobacco users associate with the habit.
But can we let the smoking epidemic continue into the 2020s? Should we? The scope and types of harm visited upon modern society by tobacco are still taking a very real toll.
How Do We Know Smoking Is Still an Epidemic?
At present, 18 percent of citizens in America admit to smoking cigarettes, which is a far lower rate than in previous decades. Between 1976 and 1981, for example, tobacco use among seniors in high school alone dropped from 39.8 percent to 29.4 percent after remaining unchanged for most of the 1980s.
But while progress has been made, it’s not enough. Even as cigarette sales have flattened somewhat, the vaping industry had grown by leaps and bounds into a $10 billion industry by the end of 2017. This shouldn’t be possible in a world that’s long been aware of tobacco’s deleterious effects on public health.
Why not? Because, depending on whom you ask, e-cigarettes are either slightly less harmful than traditional cigarettes or just as harmful. Scientists have even observed up to 50 percent more breakage of DNA strands in human cells exposed to e-cig vapor than cells without such exposure.
It’s worth asking, though: should it matter? A trove of evidence researchers call “large and consistent” seems to indicate vaping is a gateway to smoking cigarettes for young people, even as vaping demonstrates some effectiveness in helping adult smokers quit.
But look at the equivocation necessary to paint vaping as a “lesser evil” alongside combustible cigarettes: “substantial evidence [shows] that completely switching from regular use of combustible tobacco cigarettes to e-cigarettes results in reduced short-term adverse health outcomes in several organ systems.”
The phrase of interest here is “reduced adverse health effects.” They have not been eliminated — merely reduced. They may have possibly been made more palatable, too, thanks to the pleasing industrial design of the average vaping apparatus, which could give any Silicon Valley hardware maker a run for their money.
The Deleterious Health Effects of Smoking — and the Cost to the Public
Even if vaping has successfully lessened tobacco’s impact on our collective health, tobacco use, in general, is here to stay. So are hospitalizations thanks to smoking complications. So is the death toll. By 2030, says the CDC, tobacco use will still be killing eight million people per year.
Presently, secondhand smoke claims 480,000 lives per year in the United States. What else is at stake? Here are some unforgiving facts about the toll tobacco use takes on our health, our economy and our society in general:
- Cigarettes are responsible for 127,700 deaths per year from lung cancer.
- Non-smokers are expected to live, on average, ten years longer than tobacco users.
- Between 2000 and 2004 alone, tobacco use put Americans on the hook, cumulatively, for $96 billion in unnecessary healthcare expenses.
- Over one-third of tobacco users have three or more unresolved dental health problems. One study declared female smokers lose 1.5 teeth every decade, and their male counterparts lose 2.9.
- Low-income smokers in New York spent, on average, 25 percent of their take-home pay on cigarettes in 2012.
Tobacco use feels like a blind spot in our culture — something we try to ignore out of a misplaced concern for “personal freedoms.” But the social and actual cost of turning a blind eye, as we’ve seen, is enormous.
The Turning Point Is Still Turning
Thanks to public advocacy groups, testimony from physicians and a generally heightened awareness of the problem, it’s reasonable to say the epidemic may have reached a turning point — even if it’s still in progress and will be for many more decades. The courts established some time ago, for example, that state attorneys general can bring legal action against cigarette producers to recover billions of dollars toward Medicaid expenses associated with smoking complications.
Additionally, in 2010, the U.S. Department of Health and Human Resources laid out its recommendations to continue reducing tobacco use among the public and especially among adolescents. USDHHS recommended an investment of between $9 and $18 per capita — in the form of counter-marketing campaigns and outreach — plus new regulations and restrictions concerning smoke-free areas, additional restrictions on cigarette advertising and higher taxes.
The goal, ultimately, is to bring down tobacco use among youth to the single digits. It’s trended downward for decades, as we’ve seen, but progress has gotten slower and slower. It’s a matter of practicality as well as morality. It’s practical to invest in anti-smoking campaigns and public awareness when we know the cost to our healthcare system and economy is far higher. And as a moral issue, it’s hard not to see the upside of helping our fellow human beings find their way toward more wholesome pastimes and less obviously self-destructive behavior.
For a last word, let us turn to Gro Harlem Brundtland, whose credentials include director-general of the WHO as well as a stint as Norway’s Prime Minister. She knew the stakes even back in 1999:
“If we do not act decisively today, a hundred years from now our grandchildren and their children will look back and seriously question how people claiming to be committed to public health and social justice allowed the tobacco epidemic to unfold unchecked.”
Kate is a health and political journalist. You can subscribe to her blog, So Well, So Woman, to read more of her work and receive a free subscriber gift! https://sowellsowoman.com/about/subscribe/