Monday, May 31, 1999

Killing The Industry

Jonathan Kay
National Post

Today is World No-Tobacco Day, an event sponsored by the World Health Organization to educate smokers about the health risks associated with tobacco use. This year's theme is smoking cessation.

About three quarters of smokers want to quit. For those who succeed, the health benefits are considerable. Studies show that smokers who give up their habit as late as their early 30s have a life expectancy roughly comparable to lifelong non-smokers.

But quitting is difficult because tobacco is powerfully addictive. In 49 out of 50 cases, smokers who attempt to quit without the help of a cessation program find themselves smoking again within one year. A 1988 report from the United States Surgeon General concluded, in fact, that "the pharmacological and behavioral processes that determine tobacco addiction are similar to those that determine addiction to drugs such as heroin and cocaine."

To provide consumers with the means to make more informed choices, Health Canada has investigated the use of new health warnings on cigarette packages. Using focus groups composed of adolescents and young adults, the Office of Tobacco Control has concluded that the most effective warning labels include graphic images -- such as photographs of cancerous mouths, lungs and brains. "The mouth was seen to be the most impressive because the mouth is what we see in a person, whereas the lungs are inside," says the office's report. "Many participants said that if these images were on cigarette packages, they would be afraid to let anyone see their packs and they would be more motivated to try to quit."

Typically, heavy smokers begin using tobacco during adolescence and continue to smoke throughout their adult lives. Of such long-term smokers, half die during middle age, before they reach age 70. In fact, lifelong smokers suffer a higher mortality rate at every point in their life cycle. From young adulthood on, they die at a rate about three times higher than non-smokers.

Unfortunately, many smokers have little or no appreciation of these health risks. In the developing world, where tobacco use is increasing, a majority of smokers mistakenly believe that smoking is not substantially harmful. In China, where 200 million young males aged between zero and 29 are expected to eventually take up tobacco use, 61% of smokers questioned responded that tobacco does "little or no harm." In high and middle income countries, tobacco use is most popular among those least likely to understand the attendant dangers -- namely the poor and the less educated.

Although smoking is dangerous and addictive, tobacco advocates argue that people should be permitted to decide for themselves whether the pleasure of smoking is worth the risk. Informative warning labels are necessary because most consumers are perfectly informed about the benefit of smoking (i.e. delaying the onset of withdrawal symptoms), but are often ignorant or skeptical about the cost to their health. Warning labels also have a special role where children and adolescents are concerned. Not only are members of these groups particularly ignorant of the health consequences of smoking, they also systematically underestimate the difficulty of quitting later in life.

The WHO estimates that 1.1 billion people, one third of the global adult population, are smokers. Almost half of them will eventually die of tobacco-related causes such as stroke, heart disease, lung cancer, leukaemia, emphysema, and tuberculosis. Millions of others will die as a result of second-hand smoke, which causes lung cancer and heart disease in adults, as well as sudden infant death, respiratory illness and middle ear disease in children. This year alone, smoking will kill 45,000 Canadians, and 3.5 million people worldwide. Within 30 years, the number of annual tobacco-related deaths is expected to triple to 10 million -- more lives than will be claimed by HIV, maternal mortality, traffic accidents, suicide and murder combined.