Do Smokers Have Rights?

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Do Smokers Have Rights"

By Robert J. Samuelson

Wednesday, September 24, 1997; Page A21
The Washington Post

The media are deeply sensitive to the rights of "minorities":the poor, the disabled, blacks, gays and immigrants, among others. But there is one minority much larger than any of these (at least 25 percent of the population) whose rights we deny, ignore or minimize: smokers. The debate over cigarettes has been framed as if smokers are the unwitting victims of the tobacco industry. They lack free will and, therefore, their apparent desires, opinions and interests don't count. They are to be pitied and saved. But they are not to be respected.

This is, once again, pack journalism run amok. We media types fancy ourselves independent and skeptical thinkers. Just the opposite is often true: We're patsies for the latest social crusade or intellectual fad. In this case, the major media have adopted, perhaps unconsciously, the view of the public health community, which sees smoking as a scourge to be eradicated. The "story" is the crusade; the villain is the tobacco industry. Coverage is selective. Lost are issues that ought to inform this debate.

The simplest is whether, in trying to make Americans better off, the anti-smoking crusade would make many Americans worse off. Smokers would clearly suffer from huge price and tax increases. The cost of the $368.5 billion agreement between the tobacco industry and the state attorneys general is estimated at 62 cents a pack. President Clinton suggests raising that to $1.50 a pack -- about six times today's tax (24 cents). The cost would fall most heavily on poorer people. They smoke more than the rich and spend more of their smaller incomes on cigarettes.

Consider. About half (53 percent) of today's cigarette tax is paid by taxpayers with incomes of less than $30,000, estimates the congressional Joint Committee on Taxation. Only one percent is paid by those with incomes over $100,000. Higher prices will deter some people from smoking. But for the rest, would siphoning billions away from poorer people be good policy" Or fair"

The anti-smoking crusaders try to seem fair by arguing three things: (a) there's growing smoking among teenagers who, once they try cigarettes, may become addicted for life; (b) tobacco ads cause much teen smoking -- teens are, therefore, victims; and (c) passive smoking (the inhaling of smoke by non-smokers) in public places is a serious health threat, justifying action against smokers. These assumptions also permeate media coverage, but the first two are open to question and the third is untrue.

Start with teen smoking. One survey from the University of Michigan does show a rise. In 1996, 34 percent of 12th graders reported smoking in the past month: the highest since 1979 (34.4 percent) and higher than in the late l980s (29.2 percent). But the government's survey on drug abuse reports the opposite: In 1996 only 18.3 percent of teens between 12 and 17 had smoked in the past month, the lowest since the question was first asked in 1985 (29 percent). It's hard to know which survey to believe. But neither depicts runaway teen smoking. Evenby the Michigan survey, the smoking rate is below the late 1970s (37 percent).

As for ads, teens do a lot of dangerous things (drugs, early sex) that aren't advertised and are often illegal. The tobacco industry no doubt targets teens; but the ads may affect brand choices more than the decision to smoke. A new, comprehensive study of youth health -- financed by the National Institutes of Health -- suggests that other forces are more important in determining who smokes.

"Time and time again, the home environment emerges as central in shaping health outcomes for American youth," it says. "Children who report feeling connected to a parent are protected against many different kinds of health risks including: emotional distress and suicidal thoughts and attempts; cigarette, alcohol and marijuana use; violent behavior; and early sexual activity."

And even teens who smoke do not necessarily become lifetime smokers. Among 12th graders, about twice as many (63 percent) once smoked as currently smoke. Quit rates are higher for adults. The "addiction" isn't so great that millions haven't broken it.

Finally, passive smoking isn't a big public health risk, as many stories imply. The latest example of misreporting involved a study from the Harvard Medical School. It purported to show that passive smoking doubled the risk of heart attacks, indicating a huge public health problem. That's how both the New York Times and Washington Post reported it. In fact, the study -- at most -- showed that passive smoking doubles a very tiny risk.

Here's why. The study followed 32,046 non-smoking nurses between 1982 and 1992. Of these, four-fifths said they were exposed to passive smoking. But there were only 152 heart attacks (127 non-fatal) among all the nurses: a small number. Many heart attacks would have occurred even if no one had been exposed to smoke. Ichiro Kawachi, the lead investigator, estimates that passive smoking caused perhaps 25 to 30 percent of attacks: that's 38 to 46 cases. If true (and the study has potential flaws), the practical significance of this is negligible. Most exposure to passive smoke is now private or voluntary, because public smoking has been barred in so many places. Are we going to outlaw husbands smoking in front of their wives -- or vice versa"

You don't hear much of any of this, because the press has generally parroted the self-serving assumptions of anti-smoking crusaders. They have a case. Smoking is highly risky for smokers; if no one smoked, more Americans would live longer. But lots of things are risky, and one central question is whether smokers have a right to engage in behavior whose pleasures and pains are mainly theirs without being punished by the rest of society. Or are they to be persecuted"

There is almost no one to make the smokers' case. They have been abandoned by the tobacco industry, which wants a settlement. Most politicians won't defend smokers for fear of being cast as stooges of a bad industry and enemies of good health. And the press has blessed the whole process in its latest spasm of group-think. It has popularized the fiction that this debate is mainly between the tobacco industry and public health. The murkier reality is that, for better or worse, smokers are the main targets. Do they have rights" Apparently not.

© Copyright 1997 The Washington Post Company

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