On the front page...
Okay, you're at NIH, and the learned professor comes
to town to deliver the lecture titled, "Does the Government Really
Need to Do More to Educate the Public About the Risks of Smoking?" It's
not simply that Dr. K. Michael Cummings' answer was obvious before
he spoke a word, but the manner in which he skewered the tobacco-use
habit that also proved entertaining. Even a committed nonsmoker
had to ask, following his hour-long talk at Executive Plaza North
on Nov. 30, "How do smokers continue to do such a disgusting thing
Granted, Cummings was preaching to the choir — a group of
NCI cancer prevention and control fellows, not one of whom looked
familiar with a nic fit. And maybe humor is the only sane response
to the baldness of the pseudoscientific balderdash issued by tobacco
industry propagandists in the past few decades.
Owing largely to extensive federal litigation against the tobacco
industry, we now know that its campaign to sidestep or discredit
decades of scientific findings damning tobacco use has been deliberate
Only two weeks after then Surgeon General Dr. Luther Terry issued
the landmark 1964 report linking smoking to a variety of health
ills including lung cancer, a memo circulated at the top of one
of the largest cigarette manufacturers, declaring: "We must give
smokers.a psychological crutch and self-rationale to continue smoking."
Cummings, who is chair of the department of health behavior in
the division of cancer prevention and population sciences at Roswell
Park Comprehensive Cancer Center in Buffalo, spent much of his
lecture illuminating how Big Tobacco has cleverly offered a variety
of crutches to succeeding generations of potential smokers.
The first crutch was filters; adding them to popular brands gave
the illusion of a safer smoke. Next came so-called "light" cigarettes
promising less tar, in the early 1970's, which initially were not
embraced by consumers, but gradually grew in popularity, especially
with female smokers, whom the ads targeted. Cummings paused to
decry the recent "celebration" of the 50th anniversary of the Marlboro
cigarette brand: "How can you legitimately celebrate the anniversary
of a product — Marlboro — that alone has caused an
estimated 2.3 million American deaths over the past 50 years — more
than the number of Americans killed in all wars combined? Marlboro
is the only product I know of where the flavor outlasts the customer."
Cummings does not fault the mass media campaigns of the past 30
years with failing to acquaint Americans with the dangers of smoking.
To the contrary, they have been highly effective, he said, and
the overwhelming majority of people know that smoking is risky
behavior. The problem today is that smoking's true dangers have
been soft-pedaled by industry and largely unexplored by major ad
For example, how many people know that smoking damages small blood
vessels in the eye, and is the leading cause of preventable blindness
in the U.S.? Smoking raises risk of heart attack, stroke, lung
cancer and other cancers and impotence, yet one survey showed that
40 percent of smokers believed they were at no greater risk of
these ailments than someone their age who doesn't smoke. Fifty
to 60 percent of survey respondents thought that modern cigarettes
are less dangerous than they used to be, which Cummings said is
One of the three major studies Cummings cited sought to learn
what smokers know about the ingredients in their smokes. Most were
aware of nicotine and carbon monoxide, but few were aware that
cigarettes contain lead, ammonia, urea ("a pee in every pack" said
one wag), arsenic, cyanide and radioactive material. "Once smokers
learn the truth about their smokes, they can begin to make an informed
decision about smoking and most will choose to quit," Cummings
said. "Of course, quitting smoking isn't easy because smokers get
hooked on nicotine, but knowing and appreciating the risks of smoking
is the first step towards helping smokers beat their nicotine addiction.We're
talking about the most lethal consumer product ever marketed."
Many cigarettes today are contaminated with plastic (the cellulose
acetate used in filter production often finds its way into smokers' lungs,
a condition known as "filter-fiber fallout"), shoe polish (used
to paint the normally clear cellulose acetate white) and fake tobacco
(studies have shown that 20-30 percent of a typical cigarette is
actually "reconstituted" material containing random ingredients
ranging from whatever's been shoveled off the tobacco barn floor
to stale tobacco recycled from unsold packs of cigarettes.) Adding
insult to injury is the fact that a pack of cigarettes costs only
a nickel to manufacture; compare that with whatever you paid for
your last pack.
Another tobacco industry ruse is that cigarette filters are "vented," allowing
fresh air to mix with each inhaled puff. Problem is, the vents
are not only invisible but also are almost microscopically small.
And because they are located near the filter's end, they are normally
blocked by the holder's fingertips, Cummings showed.
In the main, people know smoking is bad for you (though many are
unaware, for example, that nicotine is not the cancer-causing aspect
of a cigarette). And most who smoke (more than 56 percent, in one
international study) intend to quit sooner or later. But the industry
gives them just enough optimism to believe they are doing less
harm to themselves than they actually are, and continues to tout
the canard that smoking is not addictive and can be set aside painlessly
at any time.
So, to answer his lecture's title, Cummings gives a resounding "No!" It's
not enough to communicate smoking's risk in scanty detail, especially
when it is countered by massively opposing messages issued by the
tobacco industry (there is an entire science of measuring advertising
impact, based on such arcana as GRPs, or gross rating points, which
both sides in the battle employ).
His solution? Yes to more ads — they work. Yes to graphic
warnings on cigarette packages — studies show that the more
frankly the damage is presented, the more the product repels potential
users. Yes to more harm-reduction efforts, more extensive use of
NRT (nicotine replacement therapy, usually by gum, patch or lozenge),
more clever advertising (especially educational kits that mimic
the artwork of popular cigarette brands) and laws banning indoor
Concluded Cummings, "You can't make someone quit smoking, but
educating people so they can make an informed choice is where we
should start. Requiring cigarette companies to limit the nicotine
in their cigarettes to non-addictive levels would help, too, since
it would make it easier for addicted smokers to be able to exercise
their choice to quit." According to Cummings, most smokers would
try to quit if they knew the truth about their cigarettes.