Killer epidemic that claims 1 victim every 8 seconds is regarded as a social necessity, especially by youth
An equal number to those who drowned with the Titanic will die every 78 minutes by 2030 as a result of smoking, an Athens University professor has said. In an interview with Kathimerini, Professor Haralambos Roussos of Pneumology and Intensive Care at Athens University Medical School castigates the attempt to downplay the smoking epidemic and to inculcate the belief that smoking is a social need. Cigarettes, he pointed out, were the only product that, when used in accordance to the manufacturer’s instructions, killed both the user and the people he lived with. Figures on smoking deaths look black Mr Roussos, can you give us any idea of the size of the smoking epidemic? Smoking is recognized as a major cause of death and disease. Today, smoking kills 4 million people a year, that is one person every eight seconds. By 2030, annual deaths from smoking will have reached 10 million, with the rise concentrated mainly in developing countries – the equivalent of a whole Titanic sinking every 78 minutes. The latest figures from the World Health Organization (WHO) estimate that between 2000-2025, victims of smoking will reach 150 million and increase to 300 million in the following decade. This number is eight times greater than the highest estimates for deaths during World War II. The figures are even more dismal for young people: One in two adolescents who start smoking and continue the habit will die of it, after losing 15-20 years off their lives. The tobacco industry loves to downplay the effects of the smoking epidemic with references to «other problems.» This resembles the public’s exaggerated obsession with AIDS, rather than with hepatitis B, which claims many more victims. In the same way, public opinion is much more occupied with nuclear weapons and the victims of a possible nuclear war than the 550,000 annual deaths from smoking in the EU alone – a figure greater than deaths from road accidents, alcohol, drugs, homicides and suicides put together. What effect does smoking have on the body? Smoking is the chief cause of 30 percent of cancers, including lung, stomach, pharyngeal, laryngeal, esophageal, bladder and kidney cancers. In lung cancer in particular, smoking is responsible for 85-90 percent of all cases. It is also responsible for chronic bronchitis, emphysema, asthma and heart problems, with a corresponding effect on life expectancy and the quality of life. Chronic obstructive pulmonary disease, dubbed «the smoker’s disease,» will, in a few years’ time, be the third to fifth cause of death worldwide. In women, smoking is responsible for loss of fertility, while it increases the danger of premature menopause and contributes to osteoporosis. During pregnancy, a mother’s smoking habit is linked to an increased risk of miscarriage, embryo deaths, premature labor, problems during childbirth and retarded embryo growth. Moreover, babies run a greater risk of dying – 100 a year die in the United Kingdom – and in the long term it is linked to greater frequency of febrile spasms, decreased lung function and a greater number of infections. How vulnerable are children to cigarette smoke? Children whose parents are both smokers run a 72 percent greater danger of respiratory problems such as bronchitis, pneumonia and bronchiolitis (viral infection of the lower respiratory tract). In addition, the severity and frequency of seizures in asthmatic children is increased, as is the danger of new asthma cases among children who have not displayed any prior symptoms. According to the UK Royal Medical College, parents’ smoking habits are responsible for 17,000 hospital admissions of children under the age of 6 in Britain. Moreover, there are indications that asthma is more frequent in children whose mothers have been exposed to environmental smoke during pregnancy. Why is smoking so widespread in society today? The basic thrust of tobacco marketing is to establish smoking as a normal habit for most of society. Because smoking is widespread in all areas of daily life, the mass media, and the arts as well, help to establish it and thus encourage people to overestimate its spread and underestimate the extent of social rejection. This picture is instilled in people from a very young age, so as to facilitate the onset of smoking when other, later factors come into play. One of them is the vulnerability of adolescence. Let’s not forget that regular smokers became such under the age of 18. Advertising sells cigarettes as a necessary growing-up ritual. Beginning to smoke is a symbolic act of independence by adolescents. When the effect of the psychological symbolism wears off, the pharmacological effect of nicotine will maintain the habit. We can also see acceptance of smoking promoted by numerous persuasive and attractive models and idols who smoke on television and in movies, as well as by society, which makes access to cigarettes easy for teenagers. Social acceptance and the availability of smoking, in contrast to other substance addictions, creates a social environment in which smoking can be presented as socially functional. Do you think that the Health Ministry’s anti-smoking measures will be successful, given that Greeks are the most fanatical smokers in Europe? Perhaps the measures should also be extended to outdoor areas where there are crowds? The anti-smoking measures, without making any claim to global originality, are clearly a step in the right direction. Taking even more extreme measures, such as banning smoking in outdoor areas, would risk defeating their whole purpose. That Greeks are the most fanatical of smokers makes taking the above measures even more necessary and urgent. Turning to the essence of the measures, I would say their main aim, apart from protecting non-smokers, is to withdraw acceptance of smoking as a socially necessary habit. The overwhelming majority of Greeks, especially children… have formed the impression that smoking is something natural and normal, which everyone does. Promoting a smoking ban in public places also has a direct effect on the behavior of smokers themselves. Studies have shown that the adoption of such measures, especially in places of work, decreases the number of smokers and the number of cigarettes consumed, while increasing the number of attempts to quit smoking. It is estimated that in California, restrictions on smoking in places of work costs the tobacco industry $203 million a year. The rights of the passive smoker are well known. Do smokers have rights? The tobacco industry has promoted itself as the protector of individual freedoms and claims that it is the indivisible right of each individual to smoke and do what he likes with his body. In addition, it declares that free societies have the acquired right to trade and advertise their legal products. On the other hand, legislation on controlling smoking can be either protective or promotional of human health. This is exploited by the industry in order to damn these efforts as threatening to human freedoms. However, all societies accept the necessity of restrictions on individual liberties in the public interest, e.g. speed limits on the roads, controlling weapons trafficking, banning child pornography. Moreover, in democracies, the exercise of a right such as smoking carries with it responsibility. As a result, every adult needs to know about the consequences of their habit, so that they can consciously take responsibility for continuing it. But this does not happen, since tobacco is the one product that kills the user and the people with whom he lives when he uses it in accordance with the manufacturer’s instructions. For adults, the dependence induced by smoking has clearly abrogated any notion of freedom of choice. The need for information is all the more necessary for children, who are the chief target of the tobacco industry’s advertising campaign. And tell me, who has the right to play lottery with people’s lives, when one in two will lose their lives as a result of smoking? The tobacco industry engages in danger-mongering to the effect that other bans will follow that on cigarettes, such as on coffee or meat. The argument is stale and misleading. Controlling consumption of a product is the result of calculating its potential dangers and whether people can use it safely. Drinking alcohol in moderate amounts is safe. But there are no safe levels for smoking. The individual can drink, but not drink and drive. By the same token, the individual can smoke, but not where he can harm others. What role can doctors play in the fight against smoking? The unique relationship a doctor has with the patient makes him the ideal person to give advice on smoking [and]… urge patients to give it up, and not only in cases of smoking-related diseases, e.g. heart disease. Of course, doctors must set a good example, something which has been achieved to a large extent in other countries. In Greece, quite a few doctors still smoke. Thus doctors bear a huge and primary responsibility. Passive smokers are also at risk What are the effects of smoking on passive smokers? The direct effects are sore eyes, nasal irritation, headaches, coughing, sore throat, dizziness and nausea. Lung function in asthmatics has been observed to weaken, as well as the emergence of new asthma cases in children whose parents both smoke. Generally, exposure to environmental smoke effects the functioning of the respiratory system which is qualitatively the same, though quantitatively more limited to that of active smokers. Passive smokers are at more risk of developing lung cancer or heart disease by up to 25 percent. Two to 3 percent of lung cancer cases are the result of passive smoking, especially during childhood and adolescence. Research on a clinical sample in Greece found that while the chances of lung cancer in women whose husbands do not smoke is 1 percent, this increased to 1.8 percent if spouses had stopped smoking less than five years previously, to 2.4 percent if husbands smoked up to 20 cigarettes a day and to 3.4 percent if they smoked over 20 cigarettes daily. Moreover, passive smoking increased the dangers of ischaemic cardiac arrests, by 23 percent in women and 25 percent in men.
