Ending The Tobacco Holocaust Introduction

Introduction: Why Call It The Tobacco Holocaust?

In the wake of September 11, 2001, our nation went to war against terrorism after close to 3,000 innocent people were killed in a sneak attack on the United States. But every day, an equally drastic form of “attack” happens right before our eyes. It appears “normal” to us even while it takes a horrendous toll on our country and our world.

Currently, about one fifth of Americans die in some way because of cigarette smoking. In addition, most of us are seriously affected by the smoking-related death of a family member, a loved one, a friend, or acquaintance—or will be in the future. And certainly all of us feel the impact of its societal costs.

Every single day, more than a thousand Americans—in excess of 8,000 a week or more than 35,000 a month—are killed by the effects of smoking. Its cost in dollars and human lives staggers the imagination.

Yet mostly we as individuals sit by and do nothing.

More than 400,000 Americans die each year directly because of their smoking habit, and according to the Centers for Disease Control, more than 50,000 die from secondhand smoke [1]. Those deaths by far outstrip the annual mortality rates from AIDS, alcoholism, car accidents, fires, illicit drugs, murder, and suicide combined. The U.S. Surgeon General estimates that over 12 million Americans prematurely died from smoking between 1964 and 2004 [2]. And some experts consider those calculations to be conservative. According to World Health Organization estimates, up to 16 million Americans lost their lives to cigarette smoking between 1950 and 2000 [3].

Yet mostly we as individuals sit by and do nothing.

As a nation, we have never faced an external enemy that has wrought such destruction on our population, and yet we act as though this devastation hardly exists. We certainly haven’t mobilized like we did in World War II, the Korean War, the Vietnam War, Desert Storm, or the war on terrorism. Still, more Americans die each year from cigarette smoking than all American soldiers who died in WW II, Korea, Vietnam, and today’s conflicts combined.

Yet mostly we as individuals sit by and do nothing.

Of course, this problem extends far beyond U.S. borders and is growing rapidly. The World Health Organization set the estimate of smokers at 1.3 billion worldwide in 2003. Its projections show that number rising to 1.7 billion by the year 2025 [4]. That represents a 31 percent increase in the number of smokers worldwide over the next 20 years.

Although it seems inconceivable, about 650 million individuals currently alive in the world will die from cigarette-related illnesses. That’s the equivalent of every single man, woman, and child in the United States, the United Kingdom, France, Germany, and Russia dead—a doomsday scenario more horrific than our worst nuclear nightmares. The World Health Organization projects that 450 million people will die from smoking in the next 50 years, and about a billion people in this century. That means more than 5 million people worldwide die each year from smoking—a number that will increase to more than 10 million a year by 2020 [5].

Realize that about 80 percent of all smokers start lighting up before the age of 18. Unless dramatic action is taken, tobacco companies will continue to addict our nation’s and our world’s children to replace the millions of smokers they have finished off.

Yet mostly we as individuals sit by and do nothing.

Wake Up To The Carnage

The death toll that will occur from smoking this century seems incomprehensible, so let me help you understand the carnage that will occur.

Assuming you’ve seen the films Titanic or Apocalypse Now (or similar films), take a few moments to remember and visualize all of the dying people shown. Now get ready to expand that vision. C. Everett Koop, a former U.S. Surgeon General, estimates the number of people currently alive who will die from smoking is roughly equal “to the Titanic sinking every 27 minutes for 25 years, or the U.S. Vietnam War death toll every day for 25 years.” [6]

Now, extend the Titanic or U.S. Vietnam war death toll examples to all the people who will die because of tobacco in this century. According to my calculations, the death toll from tobacco would roughly be equivalent to the Titanic sinking every 38 minutes… of every day… of every week… of every month… of every year… for 47 years, or the U.S. Vietnam War death toll occurring every day… of every week… of every month… of every year… for 47 years [7]. Realize that every one of those people is someone’s parent, grandparent, child, grandchild, family member, co-worker, neighbor, acquaintance, or friend.

Let’s bring in a more recent world event into this estimate, especially because images of death that occurred on 9/11/2001 have been burned into the consciousness of most Americans. The global death toll due to smoking in this century will be roughly equal to all of the deaths from the 9/11 terrorist attacks occurring every 74 minutes… of every day… of every week… of every month… of every year… for 47 years.

On-going Consequences

As a physician and psychiatrist, I am especially appalled by the on-going health consequences of smoking. During my training in psychiatry at the University of California Los Angeles, I spent several months on medical rotations at the Veterans Administration Hospital in West Los Angeles. At the time, 60 percent of all people enrolled for services were smokers. On some days, literally every single patient I treated was suffering from the adverse effects of cigarette smoking.

I have witnessed pain and suffering of unimaginable proportions caused by the effects of smoking: people riddled with lung cancer or other tumors throughout their bodies… or paralyzed from a stroke… or unable to breathe and gasping for air due to emphysema… or experiencing excruciating pain due to their unstable angina… or admitted for a heart attack… or having a limb amputated due to poor circulation… or having liters of fluid drained daily from the lining of their lungs due to a spreading cancer… or hallucinating from tumors that had spread to their brain from elsewhere in the body…or suffering from numerous debilitating illnesses. I know that smoking directly caused all of that suffering. And I know this horrifying reality repeats itself daily in almost every hospital around the world.

Indeed, the 4,000 chemicals released when a cigarette is smoked cause damage throughout the body. By now, we’ve learned that smoking cigarettes causes lung cancer, but did you know that smoking also contributes to blindness, osteoporosis, infertility, and impotence? And that smoking during pregnancy results in more than 1,000 infant deaths in the U.S. annually?

People in our society worry about pesticides, food additives, unsafe drinking water, and West Nile virus, but those issues pale in comparison to the damage perpetrated on the public by cigarette smoking. In contrast, the public raged when deadly accidents due to defective Firestone tires on Ford automobiles killed about 200 people in the 1990s. But how can we compare 200 to the 400,000 American smokers who die before their time each year?

Here’s what I really want to know: Why aren’t we more upset about this?

Defining “Holocaust”

Totality of destruction, especially by fire, has been central to the meaning of the word “holocaust” since it first appeared in Middle English in the 14th century. It’s defined as “great destruction resulting in the extensive loss of human life” (in this case by smoke, not fire, and solely for economic gain). The term can apply to what we’re seeing today as a result of Big Tobacco’s influence on our world. That’s why I’ve chosen to use the phrase Tobacco Holocaust in the title of the book.

The use of the word “Holocaust” in this book is not meant to offend anyone, or to diminish the massive and tragic horrors and death toll the Jews and other groups suffered at the hands of the Nazis in World War II. Nor is it meant to diminish the destruction of other groups throughout history. Rather, it is being used to awaken people to this massive tragedy that is occurring right now, right in our midst, and right before our eyes [8].

An Immense Price That We Pay

In addition to the death toll, all of this pain and suffering comes at a hefty price. According to the U.S. Surgeon General’s study noted earlier, from 1995 to 1999, smoking cost more than $157.7 billion each year in the United States. That included $75.5 billion for direct medical care, $81.9 billion for lost productivity, and $336 million for neonatal care (and all of these figures have increased in the last several years due to rising medical costs and other forms of inflation). Who pays for this? Smokers and non-smokers alike. They pay in the form of health insurance premiums, taxes, national defense budget, Medicare costs, and lost productivity.

According to the Centers for Disease Control (CDC), each pack of cigarettes sold in the U.S. costs the nation an estimated $7.18 in medical costs and lost productivity. Indeed, a Duke University study [9] cites a higher cost of $40 for every pack of cigarettes over the lifetime of a smoker. That $40 includes expenses for cigarettes and excise taxes, life and property insurance, medical care for the smoker and for the smoker’s family, lost earnings due to disability, and costs to society at large [10]. Yet one fact sticks out most: All of this anguish, death, and expense is totally preventable.

Most Smokers Want To Stop

Cigarette smoking is addictive—over the long term, it’s as addictive as using heroin or cocaine, and harder to give up than it is for an alcoholic to give up alcohol [11]. It’s so addictive that 40 percent of smokers who have a tracheotomy continue to puff away after their operations and 50 percent of those who lost a lung to cancer still smoke.

I believe that a much larger percentage of smokers would stop if they could. I have compassion for those who know they are hurting themselves and their families, but can’t quit. I remember one woman who would run outdoors to smoke because her young daughter had asthma. But her hair and clothes still reeked of the stuff, so when she went back inside, her child’s breathing was still adversely affected.

Even if messages from the tobacco industry make smokers believe they can quit whenever they feel like it, insider documents show that tobacco companies have taken a strong hand in discouraging advertising for anti-smoking remedies like nicotine patches and Nicorette [TM] gum. These companies have also engaged in scientific programs to study methods that enhance the addictive potential of cigarettes [12, 13].

In fact, I’ve never met a person on a medical ward who was suffering from a serious smoking-related illness and didn’t want to stop at that time. Seventy percent of smokers each year do want to quit, and 46 percent make an attempt to quit each year [14]. But most don’t succeed because of genetic factors, social and psychological influences, and the biology of addiction that engages reward pathways in the brain.

What a shame to see people walking around connected to an air hose and dragging or carrying oxygen tanks. They suffer from “air hunger”—literally choking to death because their lungs have lost the capacity to provide adequate oxygen due to the destruction of lung tissue caused by smoking.

599 Chemicals Added

The tobacco industry continues to addict us by using chemical gimmicks to hook an unsuspecting public. Only about 90 percent of today’s modern cigarette is actually made of tobacco. People no longer smoke just tobacco with paper wrapped around it. Rather, they’re smoking cigarettes filled with chemical additives and “reconstituted tobacco,” or smoking “elastic cigarettes” that increase the delivery of nicotine the harder a smoker drags on them. They’re smoking cigarettes containing many of the 599 known tobacco industry additives that affect the delivery of nicotine to the body and brain, mask symptoms that smokers would otherwise experience, and decrease the odor, visibility, and irritability of second-hand smoke. That makes all of us, whether we’re smokers or not, less aware of the intense danger that is present to ourselves and our loved ones. (Please read Chapter 4 for an explanation.)

Big Tobacco relies on scientific research to know how to increase addiction via their use of additives that have documented drug actions. Some of the additives have effects unknown outside the tobacco industry. Given these facts, no federal agency would have approved this product for use today. But the tobacco companies have exploited the vast wealth they’ve accumulated over the years to maintain their historical status and sway government rule-makers.

Effect Of Big Tobacco On Politics

Big Tobacco affects not only our health and pocketbooks, but also our political process. Specifically, it fosters a rich lobby that buys, or otherwise influences, legislative outcomes, manipulates politicians, and presents false perceptions to the American public.

For decades, members of Congress have received checks from tobacco lobbyists, and have been given the free use of private jets to conduct their re-election campaigns. Some Big Tobacco lobbyists themselves come from within the political ranks. To be specific, the law firms of former Senators George Mitchell and Howard Baker, and former Texas Governor Ann Richards, were each paid $10,000,000 for these influential politicians to lobby on behalf of the tobacco industry. Even Britain’s Margaret Thatcher received funding from Big Tobacco after her term as the United Kingdom’s prime minister ended. (Please read Chapter 10 for more details.)

Considering the money the tobacco industry has at its disposal, it’s no wonder so many politicians have been influenced by this powerful industry. Even at the grassroots level, tobacco industry front groups lobby state officials under the guise of “smokers’ rights.” Far and wide, they’ve hijacked our political process in nefarious ways.

A Vicious Cycle

Smokers are addicted to the cigarettes, the tobacco companies are “addicted” to the money from the cigarette sales, many politicians appear to be “addicted” to tobacco industry campaign contributions, and most of the states are becoming “addicted” to settlement funds and cigarette tax revenues. Unfortunately, they’re not spending enough of it to prevent or decrease smoking. Rather, they’re using the money for other purposes.

Yet mostly we as individuals sit by and do nothing.

What Is Our Duty, Especially To Our Children?

Residents of the United States are blessed to live in one of the greatest countries in the world, with its great freedoms and (compared with many companies in the world) its economic abundance. People swim through dangerous waters and illegally cross guarded borders to become part of the American Dream.

We are privileged to live in a great democracy, but we also have the responsibility to guard that democracy. In the end, I believe it’s our duty to ensure that the public good is not destroyed by a powerful, wealthy lobby whose intentional actions foster the addiction of our population. It’s a lobby whose actions over decades demonstrate an intention to allow and even foster the addiction of our youth in America and around the world. It also resists public health measures while claiming otherwise.

Our Inaction Opens Doors For Other Wealthy Lobbies

Wake up to realizing that this issue extends beyond the tobacco industry. If we can’t effectively regulate tobacco sales to minors, then we’re opening the door for other wealthy lobbies whose agendas are also counter to the common good. As the author and screenwriter Robert McKee noted, “The absolute depth of injustice is not criminality but ‘legal’ crimes.” [15] He refers to such conditions as “the negation of the negation”—that is, when individuals, groups, corporations, or governments have so much power, they can define evil as right.

For the last 50 years, we have entrusted our politicians to eliminate underage smoking and effectively take care of the tobacco issue. While positive steps have been taken, overall their efforts haven’t eradicated underage smoking or successfully dealt with many other smoking issues.

We the citizens have to wrest our entrusted power back from the politicians. They haven’t been listening to the vast majority of Americans who want underage smoking eliminated—or they can’t produce effective change. At a minimum, we can use our own efforts to help the many politicians who will initiate effective change on these issues.

How have we become habituated to such evils as smoking that we think it is “normal” behavior? Why has it become acceptable for Big Tobacco to inflict this pattern on us and our teenagers?

Perhaps it’s due to our perceptions. We’re easily alerted to dangers that cause quick death or injury, so we quickly activate our fight-or-flight physiological mechanisms (for example, the Firestone tire debacle). However, with cigarette smoking, the problem is chronic; its consequences build slowly and show up decades later. Because illness and death caused by the effects of smoking don’t threaten us immediately, we don’t react strongly—if we react at all. But this book spells out the consequences of a problem that affects all of us—not just smokers and non-smokers who become ill from secondhand smoke.

Consider this: in the majority of cases, nicotine addiction begins as a pediatric disease, with 90 percent of smokers starting before age 18 until recently, and about 80 percent starting before age 18 today [16]. That means if we can convince just 1 percent of teens who would have started smoking not to begin, we will have saved 4,000 lives a year in the U.S. alone.

The teen who is prevented from smoking could be your child.

Yet mostly we as individuals sit by and do nothing.

It’s Time To Take Action As A Caring Community

In this book—specifically in Chapter 12—I show how you can effectively take on Big Tobacco in a surprisingly easy, and important, manner. All it takes is that we take action as a caring community. I’ve written Ending the Tobacco Holocaust to help us achieve that.

Admittedly, few people take action based on impersonal statistics and vague health warnings. But as free individuals, we can act when we understand how tobacco companies have been pulling a number on us. After all, they have been manipulating people to injure (and even kill) themselves for the sake of stockholder profit. And that’s just plain wrong.

This book not only documents and catalogs the Tobacco Holocaust, it also engages you to take actions that are in your and all of our best interests. It gives you specific effortless actions to do immediately… actions that will finally produce the changes we want. It shows us how we can act as a caring community, and by doing so, end today’s all-too-real Tobacco Holocaust.

It’s time for us to act collectively to protect the health and well-being of our children, families, friends, nation and world. It’s time to further the common good.

We can end the Tobacco Holocaust.

Peter Jennings: Burning Buildings, Burning Cigarettes, And Dying People