Passive Smoking – Time to say No: By Q. I. Daudpota

say no to smoking

As Big Tobacco marches into Pakistan, the author describes ways to hold them back

Have you faced a chain smoker at that rare moment when he isn’t stuck to his ciggy? Close enough to get the smell from that foul mouth? We have come to accept this smell without protest. In fact, smokers in Pakistan casually pull out their packets and start smoking without getting permission from those around them. As information about the harm caused to non-smokers from passive smoking becomes widely known, people and anti-tobacco groups around the country are expressing their right to clean air. Attitudes to smoke and smoking have changed worldwide, but it has taken a long time. Much of the change has been due to the scientific evidence about the harmful effects of smoking — on the smoker and those who share his company, willingly or otherwise.

This solid knowledge cannot be denied easily by the tobacco companies. The 35 million pages of their hitherto secret documents, revealed in the process of recent anti-tobacco litigation, show that their in-house scientists were aware of the dangers posed by smoking and passive smoking. These companies ensured that such findings were kept under wraps. In addition, pharmacologists, pathologists, environmental physiologists and consultants from universities were recruited to produce counter claims about the safety of cigarettes. The documents have revealed that many of the scientists who claimed in the 1990’s that unhealthy office workers were the victims of sick building syndrome — allegedly caused by poor ventilation rather than passive smoking — were part of a ‘Whitecoat Project’ financed by tobacco companies to confuse the victims and legislators. Public relations companies on the payroll of this project planted articles about this syndrome in unwary journals. This once again emphasizes the need for caution when reading too much into new medical analyses, advertisement and promotions that appear ever so frequently.

Research Findings

In 1962 and 1964 the Royal College of Physicians in London and the surgeon general of the USA issued landmark reports documenting the causal relationship between smoking and lung cancer. During the intervening period extensive research has shown convincingly that smoking affected virtually every organ system. By 1990, the surgeon general concluded that “smoking represents the most extensively documented cause of disease ever investigated in the history of biomedical research.”

The finding for passive smoking have carried on apace. The 1982 surgeon general report reviewed the first three epidemiological studies published on the relationship between passive smoking and lung cancer. Each showed an increased risk of lung cancer in non-smoking women whose husband smoked. The evidence was however not substantive so the report was cautious in its conclusions. This was to change when new evidence in 1986 led to an entire report by the surgeon general which reviewed 13 studies of spouses, one of whom was a smoker. The report concluded that “involuntary (passive) smoking is a cause of disease, including lung cancer, in healthy non-smokers.” In the same year, reports from other bodies in Britain, France, Australia and also the US came to similar conclusion.

In 1993, the US Environmental Protection Agency issued a comprehensive report on the subject based on 30 international epidemiological studies, 24 of which showed positive association of passive smoking with lung cancer. The EPA classified environmental smoke as a human carcinogen, to which it attributed 3000 lung cancer deaths of non-smokers annually in America. A 1997 report of the California EPA corroborated the finding of the 1993 findings. It also concluded that passive smoking is a cause of heart problems and death, retardation of fetal growth, nasal sinus cancer and the induction of asthma in children.

Daunting Statistics

Until statistics for Pakistan are available, it is worth considering the numbers from the US to see the scale of the problem, which the tobacco companies have systematically tried to deny. In the US alone, environmental smoke is responsible for 3000 death from lung cancer, 35,000 to 62,000 deaths from ischemic (due to deficiency of blood) heart disease, 150,000 to 300,000 cases of bronchitis or pneumonia in infants and children aged 18 months and younger (causing 136 to 212 deaths), 8000 to 26,000 new cases of asthma, exacerbation of asthma in 400,000 to 1 million children, 700,000 to 1.6 million visits to physician offices for middle ear infection, 9700 to 18,600 cases of low birth weight, and 1900 to 2700 sudden infant deaths. These figures make passive smoking one of the leading preventable causes of premature death in the US.

The high overall numbers for deaths caused by direct tobacco use should also be considered. Since the late fifties about 6 million smokers have died prematurely in Britain alone and 60 million worldwide.

Way Forward

Having withheld information about the harmful effects of tobacco for half a century, it is disingenuous of Big Tobacco to cry out for freedom of expression to sell their products. This comes just as governments around the world begin to tighten the noose around the tobacco revenues by banning or censoring advertising.

In Britain, the Labour government is keen to fulfill its promise to ban tobacco advertising and sponsorship of sports, the arts or anything else that adds respectability to the manufacturers. Censorship of tobacco sponsorship and advertising is already legitimized by the European Union. This and the British move are being opposed in the courts by the tobacco industry. One expects appeals against any court decision that may go against the tobacco interests, but eventually governments, when serious, can pass anti-tobacco laws and enforce them. Big tobacco’s tactics can only slow down the inevitable ban in Europe.

Big markets await tobacco companies in South Asia and China and they look forward to even greater profits from new smokers here. In Pakistan we notice the alarming increase in tobacco advertising and sponsorship.

Passive smoking, a problem for non-smokers, arises due to the prevalence of a large number of smokers in our society. This military government is in a strong position to institute laws to ban all tobacco advertising and sponsorship, which will greatly reduce the number of new smokers who are lured to cigarettes due to glamorous advertising and sponsorship of sport events. Such a move can be supported for many reasons, but also for purely financial ones. Just consider the exorbitant health cost incurred in treating diseases connected with tobacco use. This is far higher than the sum of (a) the revenue that the government collects from tobacco companies and (b) the money that they pump into the economy through sponsorship.

The Chief Executive should also enforce a ban on smoking in public and private offices and institutions. Laws are best instituted in one’s home institution, hence let’s immediately have new regulation banning smoking inside all military buildings. Surely this won’t compromise battle readiness!

The health advocates need to continually remind the government of its duty to protect the health of it citizens. It should pursue strategies, including education, legislation, regulation and litigation, that would help end the exploitation by the tobacco companies.

This article was produced circa 2002, and here published for reference. Hence it shows dated data.