I used to be annoyed with smokers; now that I'm involved in tobacco control work at The Fenway Institute's Network for LGBT Health Equity, I realize how that thinking is seriously misguided. The epitome of my boorish behavior occurred one New Year's Eve in New York City. I was all dressed up for the New York City Road Runners Midnight Run in Central Park. Walking back, I ran across Peter Jennings, the popular news anchor. He said "Great costume!" My reply to this star sighting? "You shouldn't smoke." I still cringe at the memory.
Yes, Peter Jennings shouldn't smoke, a point that was no doubt driven home by his later death from lung cancer. I, like many others, thought smokers were the problem with smoking. They aren't. Many non-smokers don't realize smoking is actually a pediatric epidemic. The average age of initiation is a tender 11 years old. An addiction researcher friend of mine who's personally experienced heroin and tobacco addiction is very clear: Tobacco is the more addictive of the two, in his opinion. Now, what if companies were legally addicting one-fifth of our kids to heroin at the age of 11? Would our reaction be to just say to all those adults, "You should stop"? Of course not. We'd offer them lots of support and tools to stop while turning back and tackling the root of the problem, as we should with tobacco.
Let's put smoking in its larger context. How many health insurance companies pay for cessation treatment? Too few. How many even pay for nicotine replacement therapies? Again, way too few. (Remember, if you wanted heroin treatment, you can get methadone for free at government-funded clinics.) How much of the hundreds of millions in tobacco taxes are put toward cessation treatment? A recent Massachusetts study estimated 99 percent of their tobacco taxes are funneled to other issues. According to the most recent American Lung Association report, 32 states get an F on their cessation efforts, the feds get a D, and the highest scoring handful of states only get Cs.
Quitting smoking isn't just personal -- public health spending and policies help take down the fences to healthier behavior, and we haven't taken down many for smoking at all. Maybe the $54 million the tobacco industry spent on campaign contributions in the 2012 election cycle is part of the explanation for our national hesitancy?
Now add in one last fact: The tobacco industry by last estimate spends more than $34 million a day in the U.S. promoting its products. These promotions aren't just "buy me" ads. They are highly-scientific campaigns designed to position smoking as "cool," "normal," and "fine" in all of our minds.
So, next time you feel like smokers are the problem with smoking, think again. Truth is, most all smokers want to quit. More than 50 percent try to quit each year. But the tools to help people quit aren't a sure thing and they aren't available to all.
Don't like smoking? Then ask the people who can really stop smoking to stop it now. Ask your health plan if they cover all the recommended cessation services. Educate your legislators on the CDC recommended guidelines on funding smoking cessation. Google your local tobacco free coalition and go to a meeting. I bet they're working on getting clean air rules for more workplaces, apartments, parks, or cars with kids. True, each of these steps takes more than a few minutes, but none is as hard as smoking cessation. If we really want our friends to be able to stop smoking, shouldn't we be trying to stop smoking too?
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