This month, I am appearing in a series of anti-smoking ads for my agency, the New York City Health Department. As the city's health commissioner, I offer my personal story about how, even as a doctor-in-training, I smoked a pack a day for more than 10 years before eventually quitting.
I started smoking at 16 for the same reason young people pick up their first cigarette today: to fit in, to look cool. The landmark 1964 Surgeon General's report linking tobacco consumption to a host of illnesses had been published, and warning labels were posted on cigarette packs. But they couldn't compete against the miles of billboards, magazine covers, and films that portrayed smoking as sophisticated and alluring. No surprise here: a popular menthol brand was my brand. It was -- and still is -- heavily marketed to blacks. As a teen, smoking menthol seemed almost like an act of solidarity with my community.
But honestly, I didn't keep smoking for the image or for the camaraderie. I smoked because I was addicted. I had become dependent on nicotine to help deal with stress. In medical school, I saw how cigarettes killed and destroyed families; but the well-documented dangers of cigarette smoking didn't matter. Each cigarette had its reason. And I felt edgy and anxious when I didn't have one.
I quit when I realized I had surrendered too much of my freedom and happiness to tobacco. I was wasting time and energy budgeting my small stipend to buy cigarettes and ensuring I had enough to get me through a difficult day. I quit because I knew I didn't want to smoke forever and there was no point putting it off: the only way to stop was to stop. So one day, with the support of a friend who also smoked, I quit - we quit. Yes, I had relapses, as most people do. But I was on the path to quitting forever.
My story is only one of many; it is notable because I was a physician who knew better. Today we should celebrate that there are more former smokers, like myself, than current smokers. And every former smoker should be proud of having quit -- because quitting smoking is the single best step any person can take for their health and that of their family. But we still have a long way to go to support current smokers in their effort to quit, and prevent new smokers from ever lighting up.
Marketing had a lot to do with why I became a smoker, and while methods used by industry have changed, brazen marketing of unhealthy products is still the reason why in 2013 eight percent of high school students reported smoking a cigarette in the last month, and why 16 percent of New Yorkers smoke. In the 1990s, Dr. Harold Freeman, a surgeon who worked tirelessly to educate the black community about the shameful marketing tactics of tobacco companies, helped launch a powerful anti-smoking campaign in New York City. Its slogan was: "They used to make us pick it. Now they want us to smoke it." I still wear a button from that campaign, because that powerful statement is still true. Tobacco companies haven't stopped targeting communities of color and children - even if ads aren't on television or radio.
Cigarettes are more available -- sold at many more places -- in low-income communities and near schools attended primarily by students of color. Black youth are three times more likely to recognize menthol brands than other students, and students who recognize a brand are more likely to start smoking. And the industry has found a new way to create the next generation of smokers: e-cigarettes. E-cigarettes come in a variety of candy and fruit flavors made especially to appeal to young tastes, so it is no surprise that the Centers for Disease Control found e-cigarette use among middle and high school students to be higher than any other tobacco product.
As New York City's doctor, I am outraged that the tobacco industry continues its insidious marketing practices. But as a former smoker, I also know that New Yorkers are smart and can see through these tactics and, with support, can and will quit. Today is the best day - for you and your family -- to quit. We are here to offer support. For free medication and coaching, visit nysmokefree.com or call 311.
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