Physiological and societal effects of smoking cigarettes

Physiological and Societal Effects of Smoking

Smoking cigarettes is the single most dangerous habit that one can adopt from the perspective of human health and longevity. However, smoking is much more than just a problem affecting the personal health of the individual; it is the source of numerous health problems in non-smokers exposed to second-hand and third-hand smoke and it is the source of a tremendous amount of public funds and other healthcare resources that must be devoted to treating disease and illnesses that are easily preventable. Of course, as the single greatest cause of preventable premature human mortality, smoking is also the cause of incalculable human emotional suffering and trauma suffered by the families and loved ones of smokers who die prematurely because of their smoking habit. While outright prohibition of tobacco smoking is likely highly impractical, there are other legislative mechanisms that the government could impose that could help solve this societal and human health problem.

Nature and Scope of the Problem

Smoking is damaging to almost every organ and physiological system in the human body (CDC, 2011). In the United States alone, smoking is directly responsible for 443,000 deaths every year, which is more than all of the human deaths caused by HIV / AIDS, illicit drug use, alcohol, motor vehicle accidents, suicide, and violent crime, combined. Smoking is directly responsible for approximately 85% of all deaths from lung cancer and approximately 90% of deaths from chronic obstructive lung disease (COPD) in the American population. Furthermore, in terms of other specific medical ailments directly attributable to smoking, the list includes doubling to quadrupling the risks of coronary heart disease (the leading cause of death in the U.S.), and stroke; increasing the risk of lung cancer 23 fold in men and 13 fold in women; and death from COPD 12 to 13 times (CDC, 2011).

Smoking also destroys the circulatory system by narrowing the arteries and the capillaries that supply blood to all organs and limbs, often resulting in the development of peripheral vascular disease typically associated with pain, tissue loss, and the need to amputate limbs because of gangrene (CDC, 2011). It causes chronic respiratory diseases such as emphysema and bronchitis (apart from COPD), by destroying the alveoli that are essential for respiration and blood oxygenation (Taylor, Lillis, & LeMone, 2008). According to the U.S. Centers for Disease Control and Prevention (CDC, 2011), cigarette smoking is also a known cause of these other forms of cancers: acute myeloid leukemia, bladder cancer, cancer of the cervix, cancer of the esophagus, kidney cancer, cancer of the larynx, cancer of the oral cavity, cancer of the pharynx, stomach cancer, and cancer of the uterus.

However, cancers are hardly the only medical problems caused by smoking. The CDC (2011) also lists the following common health consequences of cigarette smoking (by mothers): infertility, preterm delivery, stillbirth, low birth weight in infants, and sudden infant death syndrome (CDC, 2011; O'Keefe & Pollay, 1996). It causes low bone density in postmenopausal women and, therefore, is indirectly implicated in death among elderly women by virtue of the known connection between bone density, hip fractures, and mortality following hip fractures in the elderly from the related consequences of hip fractures (CDC, 2011).

In total, cigarette smoking is the cause of a virtually incalculable amount of human disease and reduction in the length and quality of life, in addition to the waste of billions of precious dollars within a national healthcare system that is already desperately incapable of meeting the needs of the population because of the ever-increasing costs of healthcare services. In principle, there is no other single change in human behavior that could benefit the health of individuals, of the national healthcare system, and the nation than simply eliminating cigarette smoking and all of its attendant risks and consequences.

Historical Origin and Cause of the Problem

Nicotine is a mild stimulant that has been used in various forms for many thousands of years by indigenous peoples of regions where tobacco grows, so much so that tobacco was routinely harvested as a tradable commodity throughout the world. In fact, tobacco was the second most important crop (second only to cotton) whose cultivation on farms fueled the demand for African slaves in the American southern states that eventually precipitated the American Civil War in the middle of the 19th century.

Smoking tobacco is highly addictive, primarily because of the nicotine content of tobacco (Taylor, Lillis, & LeMone, 2008). Typically, the individual tries smoking for the first time as a teenager and in social circumstances where peer-pressure is a very significant factor. Many lifelong smokers report that they never intended to become regular smokers and that they tried to quit numerous times throughout their lives without long-term success. That is because nicotine withdrawal produces extremely strong cravings in its addicts and uncomfortable symptoms such as headaches, irritability, inability to concentrate, and insomnia, in addition to increasing caloric intake, frequently resulting in unwanted weight gain among nicotine-addicted individuals who try to quit (Taylor, Lillis, & LeMone, 2008).

Until the second half of the 20th century, the medical community was largely unaware of the health consequences of smoking (Pollay, 2007). At that time, many physicians smoked (even in their offices), and cigarette advertisements frequently featured physicians and other symbols of health and vitality that the tobacco companies used to promote the use of their products (Pollay, 2007). Gradually, the medical community became aware of the connection between smoking and human disease but the tobacco companies expressly denied any such connection through scientific-sounding "research groups" that were nothing more than fronts for the deliberate obfuscation of the truth of the extent of the dangers to human health posed by regularly inhaling concentrated cigarette smoke (Cummings & Pollay, 2002).

For decades, the major tobacco companies spent billions of dollars suppressing the truth from the American public in disinformation campaigns (Cummings & Pollay, 2002) They did so through aggressively lobbying legislators and political representatives and by corrupting physicians who were willing to testify falsely, even directly to the U.S. Congress, such as in the infamous hearings of the 1980s and 1990s in which physician after physician on the payrolls of the tobacco companies perjured themselves by announcing that they were "unaware of any scientific evidence" that nicotine is addictive or linking cigarette smoking to human disease, and to cancer, in particular (Cummings & Pollay, 2002).

Meanwhile, the tobacco companies new without a doubt that smoking causes cancer (Cummings & Pollay, 2002). When the U.S. government began publicizing the evidence linking smoking to cancer (and other human diseases) and requiring that tobacco companies provide information on packages of so-called "light" or "low-tar" cigarettes, the tobacco companies invested millions of dollars developing ways of circumventing those requirements, the most famous of which had to do with the placement or aeration holes in supposedly "low-yield" cigarettes (Anderson, Ling, & Pollay, 2006). Specifically, as part of their research and development program, the major R.J. Reynolds (and other companies) obtained some of the same equipment that the government used to test cigarettes for the purpose of measuring compliance with labeling requirements and for testing the accuracy of the reported information about the concentration of toxins in cigarette smoke.

That research led very quickly to the discovery that the smoking machines held cigarettes very differently from human smokers. By placing small aeration holes in the filters of cigarettes manufacturers managed to reduce their measurable toxic yield substantially (when "smoked" by testing machines) and enough for them to be marketed as "low-yield" or "low-tar" cigarettes. However, the placement of those aeration holes was specifically and deliberately intended to correspond precisely to the places on the filters where smokers typically held their cigarettes, thereby entirely blocking the aeration holes and, in effect, turning cigarettes that were legally marketed as a "safer alternative" back into ordinary cigarettes that delivered the full-yield "satisfaction" and dangers of ordinary cigarettes (Anderson, Ling, & Pollay, 2006).

Similarly, while the tobacco companies were busily assuring the public that their products were safe, they were also deliberately devising chemical processes designed to increase the addictive quality of nicotine even beyond its naturally addictive properties (Cummings & Pollay, 2002). Specifically, ammonia was added to cigarette tobacco as means of intensifying the nicotine rush and its addictive properties through the process of freeing the molecular base of the nicotine molecule. If that sounds familiar, that is because it is precisely the same chemical process used by crack dealers to transform powdered cocaine (which, much like nicotine, is already highly addictive in its natural consumable state) into a free-base vapor that intensifies the experience and addictive nature of cocaine (Cummings & Pollay, 2002).

Furthermore, the patents associated with these chemical processes were deliberately filed in South American countries to limit public knowledge about them through the routine disclosures of U.S. patents published annually by the U.S. Patent and Trademark Office in the U.S. (Cummings & Pollay, 2002). Not until the 1990s did anybody associated with this disinformation campaign come forward, after which the public finally became privy to internal research results, notes, and corporate communication documents within the tobacco companies detailing their unequivocal knowledge of the direct link between smoking and human cancer and of their deliberate manipulation of nicotine content to promote addiction to their products (Cummings & Pollay, 2002).

Conclusion

Currently, the costs of healthcare in the U.S. are rapidly increasing so fast that they are threatening the future solvency of the nation, not mention that adequate healthcare is already unavailable to substantial numbers of Americans because of their inability to afford basic health insurance. Without changing any other aspect of healthcare, eliminating the risks that are directly attributable to smoking would save almost half a million lives annually while reducing the billions spent on the ailments suffered by smokers between the time that they first become ill and die, as well as on all of the human illness caused by smoking that does not necessarily result in death.

Because of its addictive quality and in light of this nation's experience with the Alcohol Prohibition-era approach in the 1920s, it is unlikely that criminalizing cigarettes would provide a feasible means of resolving the problem. However, by dramatically increasing law enforcement efforts and focusing them directly on all of the behaviors associated with and responsible for teenage smoking, it is conceivable that smoking could be very substantially reduced if not eliminated entirely within a few generations. Failure to do so will result in the continued loss of many lives and at the tremendous expense of public funds and other valuable resources.

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