Harm Reduction

Executive Summary Cigarette smoking is a very widespread and serious health problem. More than 46 million American adults smoke, and smoking contributes to more than 430,000 deaths in the U.S. each year. Nearly 70% of smokers want to quit, and nearly 41% say that they have attempted to quit at least once in the past year.
A new publication by the American Council on Science and Health (ACSH), Kicking Butts in the Twenty-First Century: What Modern Science Has Learned About Smoking Cessation, summarizes the spectrum of methods that have been proven to help smokers quit. The report also describes smoking cessation techniques currently in development and evaluates alternative methods that have been advocated as aids to smoking cessation. This report is not intended as a stop-smoking guide; instead, it is best used as a source of background information to complement the stop-smoking advice available from local and national health organizations, government agencies, and physicians.
If you vaguely recall hearing that smokeless tobacco (chewing tobacco, etc.) is about as dangerous as cigarettes, you're hardly alone but it isn't true. Smokeless tobacco is only about one sixtieth as likely to kill mainly through oral cancers as cigarettes. Cigarettes cause the premature death of about one third of their users and have a host of other ill effects. See ACSH's newly-revised book, Cigarettes: What the Warning Label Doesn't Tell You for more on the risks.
According to a recent UCLA study, "Environmental Tobacco Smoke and Tobacco-Related Mortality in a Prospective Study of Californians" (reported in the British Medical Journal), environmental tobacco smoke (ETS) is not as harmful as many anti-smoking activists say. The study, which tracked 118,058 individuals over the course of thirty-eight years, found no significant correlation between exposure to secondhand smoke and death due to coronary heart disease or lung cancer. There was a correlation between secondhand smoke and chronic obstructive pulmonary disease, which was more likely to kill spouses of smokers.
The First Comprehensive Guide to the Health Consequences of Smoking
We're fond of the year-old New York Sun newspaper and are no fans of intrusive regulations, but when the Sun chose to chronicle how New Yorkers are coping with Mayor Bloomberg's ban on smoking in bars, it was a reminder how little perspective people have on relative risks. "Smokers Learn Really Bad Habits in Cigarette-Free City Night Spots" was the headline last week, with the subtitle "Some Bite Their Nails; Others Just Drink More." As if those "really" bad habits weren't shocking enough, the lead paragraph told of a man who has taken up picking his cuticles. "Once inlets of sweet if slurry tranquility," rhapsodizes the article, "the city's bars have become dens of scratching, twitching, and fiddling...a collection of ugly anxieties."
The front cover of a recent Time magazine announces a big story on women and heart disease inside. What are the main causes? How does the risk compare to that from other diseases facing women, such as breast cancer? What can be done to prevent heart disease? It's great to see Time tackling the under-reported issue of heart disease in women but another way they could help fight heart disease is by being more careful about what they put on the back cover. No one is forcing them to advertise cigarettes, the leading preventable cause of death in the U.S. and a leading cause of heart disease (see ACSH's booklet Irreversible Health Effects of Cigarette Smoking for a reminder that smoking damages more than lungs).
A New York City ban on smoking in bars goes into effect this coming Sunday, and a statewide ban goes into effect four months later. Some see it as reasonable regulation. Others condemn smoking but question the rationale for the regulations. And some see it as a direct blow against liberty. The differing opinions were nicely summed up by the article "Pataki Inks Strict Smoking Law" in today's New York Sun, which quoted, among others, ACSH's own Jeff Stier:
We know that cigarettes are bad for our health, but there is an indirect way they can kill that we rarely stop to think about. Cigarettes are the number one cause of fatal house fires. The Toll
One brief programming note:
Europeans, out of some romantic rebellion against America and high technology, were shunning U.S.-grown food containing G.M.O.'s [genetically-modified organisms] even though there is no scientific evidence that these are harmful. But practically everywhere we went in Davos, Europeans were smoking cigarettes with their meals, coffee or conversation even though there is indisputable scientific evidence that smoking can kill you. Thomas Friedman, in his February 2 New York Times column. "[J]ust because a chemical can be measured...doesn't mean it causes disease."
Australian researchers note the immense cost to society of smoking compared to illegal drugs... The report, produced for the federal government's national drug strategy, estimates that tobacco accounted for 61.2% of the costs to society of drugs...For the first time the cost calculations included an estimate of the impact of passive smoking and newly available data to assess the effect on the Australian population of absenteeism, drugs, ambulances, fires, crime, and even litter. Alcohol accounted for 22% of total costs...and illegal drugs for 17%...Tangible costs included hospital care, road crashes, loss of productivity and tax revenue, and increased crime and policing. The intangible costs included pain and suffering.