July/August 2002

The Truth about Tobacco

by Richard Maffeo

As soon as Jack's nurse walked into his room, she could hear his lungs gurgle. A glance at the digital display above his bed told her his blood-oxygen level was dangerously low. Pulling latex gloves over her hands, Susan grabbed a suction catheter from its sterile wrapper and snaked the plastic tube through his nostrils into his trachea. Jack gagged and sputtered with such force the bed rocked. When the catheter approached the place where the trachea branches into the left and right mainstem bronchus, Susan applied suction and slowly withdrew the catheter. Thick yellow mucous slurped toward the suction canister, and Jack's face turned crimson as waves of choking wracked his body. The numbers overhead skittered off the scale, and Susan waited until Jack caught his breath. When he settled down, she asked, "Ready?" Jack wiped tears from his eyes, forced a deep breath and nodded. A moment later, the torture started over.

Race, gender, economic status or culture don't matter. The typical smoker loses seven minutes of life for each cigarette -- one year for every ten years they smoked.1 For some smokers, decades pass before tobacco rips its pound of flesh from their lives. For others, it happens much sooner.

Tobacco Use in the West

Widespread use of tobacco in the Western world dates to Christopher Columbus' return to Europe with tobacco-laden ships. By the mid-sixteenth century, physicians hailed tobacco as a cure for illnesses such as cancer, gout, halitosis (bad breath) rheumatism and cataracts.

As English colonies flourished in the Americas, tobacco became the economic backbone of the settlements. The Chesapeake bay region (Maryland and Virginia) imported more than 100,000 slaves to work the tobacco fields, and from 1618 to 1626 Virginia tobacco farmers' exports increased 600 percent.

Tobacco sales soared into the stratosphere during the 20th century, fueled by its use among well-known personalities. Mark Twain, Winston Churchill, John F. Kennedy, Edward G. Robinson, Bette Davis, Sammy Davis, Jr., Frank Sinatra, Marilyn Monroe and John Wayne were only a few of the household icons who, by example, encouraged millions to follow their lead.

Health Risks

But the mid-20th century also brought to light the health risks associated with tobacco use. Medical studies conducted in 1954 demonstrated disease-related death rates among smokers to be triple that for non-smokers. In 1957, the Medical Research Council in Britain identified tobacco as the principle cause of increased rates of lung cancer.2

Today, more than 430,000 people in the U.S. die each year from tobacco-related illnesses, making it more deadly than AIDS, car accidents, homicides, suicides and drug overdoses combined. Smoking is now recognized as responsible for nearly 90 percent of lung cancers and ranks above breast cancer as the leading cause of cancer death in women. Women who smoke during pregnancy have an increased risk of miscarriage, giving birth to babies with low birth weight and putting their infants at risk for serious health problems.

Tobacco is associated with male sexual impotence (because of its constrictive effect on blood vessels), cancers of the mouth, esophagus, pancreas, cervix, kidney and bladder. The rate of heart-attacks among smokers in their thirties and forties is five times greater than their non-smoking peers. Low tar or mentholated cigarette smokers are at greater risk because they inhale more deeply to achieve their nicotine "kick."

In addition to the primary health risks for smokers, multiple scientific studies link passive smoke (secondhand smoke) to chronic respiratory diseases in non-smokers, such as asthma and bronchitis. Non-smokers exposed to secondhand smoke risk a 23 percent increase in heart disease and a 20 percent increase in lung cancer. Each year approximately 40,000 non-smokers die as a result of illnesses caused by secondhand smoke.3

Smokeless tobacco is not any safer. More than 11 million people chew tobacco, yet the risk of death from diseases such as oral cancer by using alleged safer forms of tobacco is 50 percent higher than in non-smokers. Studies show using chewing tobacco 8-10 times a day may be equivalent to smoking 30-40 cigarettes a day.4

With all the scientific and medical evidence implicating tobacco use as the primary cause of multiple life-threatening diseases, why do 50 million people continue to use tobacco? Why do another 3,000 adolescents pick up the habit each day? Confidential tobacco industry documents obtained during litigation reveal some disturbing answers (for a more complete record see http://www.ash.org.uk/?conduct/).

Addiction

Nicotine can be absorbed through the skin, lungs and mucous membranes lining the gums. Once in the blood, nicotine travels to the brain where it increases the release of chemicals such as adrenaline, acetylcholine, dopamine and endorphins. For the overwhelming majority of smokers, these chemicals create physiological and psychological dependency on the drug. Tobacco companies have known this for years and use this addictive property to their economic advantage.

In 1963, Brown and Williamson (e.g. Kool, Viceroy, Pall Mall, Silva Thins) company documents acknowledged: "Nicotine is addictive. We are, then, in the business of selling nicotine -- an addictive drug effective in the release of stress mechanisms."5

In later documents Brown and Williamson add: "Monkeys can be trained to inject themselves with nicotine for its own sake, just as they will inject other dependence-producing drugs, e.g., opiates, caffeine, amphetamine, cocaine. The absorption of nicotine through the lungs is as quick as the junkie's 'fix'."6

Philip Morris (e.g. Marlboro, Virginia Slims, Parliament, Lark) acknowledged in 1969: "We have, then, as our first premise, that the primary motivation for smoking is to obtain the pharmacological effect of nicotine."7 Philip Morris also recognized nicotine to be similar to cocaine and morphine.8

R.J. Reynolds Tobacco (e.g. Camel, Salem, Doral, Winston) stated: "If wemove toward reduction or elimination of nicotine in our products, then we shall eventually liquidate our business. If we intend to remain in business and our business is the manufacture and sale of dosage forms of nicotine, then at some point we must make a stand."9

In 1997, Bennett S. LeBow, Director of Liggett Tobacco, admitted: "Cigarettes were identified as a cause of lung cancer and other diseases as early as 1950(and) we at Liggett know and acknowledge that, as the Surgeon General and respected medical researchers have found, cigarette smoking causes health problems, including lung cancer, heart and vascular disease and emphysema. We at Liggett also know and acknowledge thatnicotine is addictive."10

Nicotine's addictive properties explain the "cold turkey" syndrome when a person suddenly stops smoking. Their body reacts as it would to withdrawal from any addictive drug -- with irritability, anxiety, depression and severe craving for the drug. Symptoms subside over a month, but even a day without nicotine can be a grueling experience.

Seducing Youth to Smoke

Despite their knowledge of the addictive properties and the devastating health effects of tobacco use, industry leaders remain unflustered and continue to recruit new smokers to replace those who die. Their specific target? Young adolescents (14-17 year-olds). More than half of all smokers started smoking before their fourteenth birthday, and most of them don't stop until they are dead.11 This information is well-known and exploited by tobacco companies which spent more than six billion advertising and promotional dollars in 1993 alone to ensure capture of the teenage market.12

Documents from R.J. Reynolds Tobacco reveal, "If our company is to survive and prosper over the long term, we must get our share of the youth market."13

In 1977, Philip Morris attempted to obtain access to school records to identify hyperactive children, considering them a potential market for self-medication with nicotine. Fortunately, laws restricted tobacco's access to those school records.14

In 1978, Lorillard (e.g. Kent, Maverick, Old Gold) executives acknowledged that high school students comprised the "base" of their business.15

In 1981, Philip Morris researcher Myron E. Johnston wrote, "Today's teenager is tomorrow's potential regular customer, and the overwhelming majority of smokers first begin to smoke while in their teens."16

In 1987, at a time when cigarette sales were plummeting in America because of anti-smoking initiatives from the medical and scientific community, the "Joe Camel" campaign hit the streets with billboards and free paraphernalia such as baseball caps, beach towels and T-shirts. Almost immediately, cigarette sales turned around -- especially among the mid-teen population. Of particularly troubling note is the study that reveals an astounding 91 percent of six-year-olds correctly identified Joe Camel with cigarettes.

Successfully promoting a product with a widely accepted reputation for causing death and illness is not an easy task. As one tobacco marketing consultant noted: "The problem is, how do you sell death? How do you sell a poison that kills 350,000 people per year [1988 statistic]? You do it with the great open spacesthe mountains, the open places, the lakes coming up to the shorewith healthy young people. How could a whiff of a cigarette be of any harm in a situation like that? It couldn't be -- there's too much fresh air, too much health, too much absolute exuding of youth and vitality."17

Successfully Kicking the Habit

According to a 2001 Harris Poll, more than 80 percent of smokers believe tobacco use increases their risk of lung cancer and heart disease. Most respondents said they tried to quit an average of eight times, but found nicotine addiction a powerful enemy. However, more than 38 million smokers have been successful. Each year more than 1 million join the ranks of former nicotine addicts and the take-home message is: tobacco is a strong, but not invincible enemy. Those who quit begin almost immediately to reap health benefits (see "Health Benefits of Quitting," page 17). They also realize immediate financial benefits. The average pack-a-day smoker spends about $100 each month on his or her habit, approximately $1,200 a year.

Like their non-Christian counterparts, most Christian smokers know tobacco nibbles incessantly at their health. They can cite the medical reasons to stop. Many understand the spiritual reasons (see "Three Reasons for Christians to Quit Smoking," page 17). They want to quit, yet victory eludes them.

The typical Christian's war against nicotine addiction is just that -- a war. Judy, a Christian who at this writing continues to smoke, said, "The Lord couldn't possibly be pleased with my habit. Not for what it does to my body, but because of the control it has over me. I can go without water, meat, coffee, tea or candynothing else has the hold on me that this nasty habit has."

Like any battle against addiction, the nicotine fight requires physical and spiritual weapons. Physical weapons include medical treatment and counseling. Spiritual weapons revolve around prayer and the support and help of fellow Christians.

Spiritual Battle

We are not alone in our struggles. When one Christian hurts, the whole body hurts (1 Corinthians 12:12-26). Here are some ways Christians can both expect help as they try to overcome smoking, as well as respond to others who are trying to quit this addiction.

· Recognize that tobacco's addictive effects are comparable to cocaine and morphine.18 Although a million smokers succeed in quitting each year, freedom from addiction is not as simple as deciding to quit. Physical or psychological addiction digs its talons into the gut and holds on. But compassionate support from others can help the addict break out into freedom.

· Avoid a spirit of condemnation toward the addict. Most addicts already feel guilty. One Christian smoker confided: "I've known church members who put on a 'holier than thou' hat -- which does nothing to help. It only drives the smoker to 'thumb suck' all the more." We can all have compassion on the nicotine addict because we each are beset with our own failures. The apostle Paul wrote, "If someone is caught in a sin, you who are spiritual should restore him gently. But watch yourself, or you also may be tempted. Carry each other's burdens, and in this way you will fulfill the law of Christ" (Galatians 6:1-2).

· Organize support groups. Another Christian smoker, Laura, said: "Smokers find themselves in a personal trap. It's just like any slow-growing disaster. It seems bigger than life." The local church could establish support or accountability groups for smokers, similar to Alcoholics Anonymous. Web search-engines, such as http://www.google.com (search: Christian smoking recovery groups) provide dozens of Christian resources.

· Provide prayer support. The apostle James wrote, "And the prayer offered in faith will make the sick person well; The Lord will raise him up. If he has sinned, he will be forgiven. Therefore confess your sins to each other and pray for each other so that you may be healed. The prayer of a righteous man is powerful and effective" (James 5:15-16).

The Lord Jesus uses our hands as his hands, our prayers as his medicine, and our compassion as his balm. If we do not "stand in the gap," many of our loved ones might end up in hospitals with nurses like Susan threading a plastic catheter through their nostrils -- slaves of tobacco, manipulated by CEOs and advertising consultants whose lust for money has hardened them to the devastation their product produces. 

Richard Maffeo is a Registered Nurse serving in the U.S. Navy.

Up In Smoke A recent government study reported that each pack of cigarettes sold in the United States costs the nation $7 in medical care and lost productivity. The study by the Centers for Disease Control and Prevention in Atlanta put the nation's total cost of smoking at $3,391 a year for every smoker, or $157.7 billion. Americans buy about 22 billion packs of cigarettes annually. The CDC study is the first to establish a per-pack cost to the nation. The agency estimated the nation's smoking-related medical costs at $3.45 per pack and said job productivity lost because of premature death from smoking amounted to $3.73 per pack, for a total of $7.18. "There's a big difference in the cost to society and what society is getting back in tax," said the CDC's Dr. Terry Pechachek. "We believe society is bearing a burden of the individual behavioral choices of the smokers." On an individual level, if a person smokes 1 pack of cigarettes per day, at $3.50 per pack, approximately $1,165 per year goes up in smoke!

Three Reasons for Christians to Quit Smoking 1. Poor role-model. It is difficult to tell others Christ delivers us from addictions when we are enslaved to smoking. 2. Harming our bodies. Our bodies are temples for the Holy Spirit (1 Corinthians 6:19-20). There is no question that the use of tobacco products harms our bodies. Smoking is estimated to cause more than 430,000 deaths annually in the United States alone and kills some 3,000,000 people annually worldwide. 3. Harming others. Smoking is not a private affair. Besides being annoying, second-hand smoke causes an estimated 40,000 deaths per year. Additionally, second-hand smoke causes as many as 300,000 cases annually of respiratory infections in children under the age of 18 months (figures for U.S., from the E.P.A.).

Health Benefits of Quitting · Within 8 hours of quitting: Blood carbon monoxide levels drop to normal and blood oxygen levels increase to normal. · Within 1 to 9 months of quitting: Symptoms associated with chronic use decrease (such as coughing nasal congestion, shortness of breath and fatigue). Cilia function begins to return to normal, which increase body's ability to handle mucus, clean the respiratory tract and reduce upper respiratory infections (cilia are fine, hairlike projections lining the respiratory tract) . · Within 1 year of quitting: Risk of heart disease decreases to half that of a tobacco user. · Within 5 years of quitting: Lung cancer death rate for a pack/day smoker decreases nearly 50 percent. Risk of cancer of the mouth decreases by 50 percent. · Within 10 years of quitting: Lung cancer death rate reduced to average risk of a non-smoker. Risk of stroke is lowered, possibly to that of a non-smoker. Risk of cancer of mouth, throat, esophagus, bladder, kidney and pancreas significantly reduced. · Within 15 years of quitting: Risk of heart disease is that of a non-user.

Where to find help to quit smoking American Cancer Society 1-800-ACS-2345 or 1-404-320-3333 http://www.cancer.org http://www.ca-journal.org   The American Lung Association: 1-800-LUNG-USA 1-212-315-8700 http://www.lungusa.org   National Cancer Institute 1-800-422-6237 1-301-435- 3848 http://www.nci.nih.gov   Nicotine Anonymous World Services 1-415-750-0328 http//www.nicotine-anonymous.org   American Academy of Addiction Psychiatry 1-913-262-6161 http://www.aaap.org   Agency for Healthcare Research and Quality Publications Clearinghouse 1-800-358-9295 http://www.ahcpr.gov   American Council on Science and Health 1-212-362-7044 http://www.acsh.org   Other useful websites: http://www.tobaccoarchive.com http://www.smokefreekids.com/smoke.htm http://www.quitnet.org http://www.globalink.org/tobacco/ http://www.ash.org.uk/?conduct

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