It is a thrill to perch atop Angel’s Landing in Zion National Park — only a small knob really, with no sharp edges demarcating the edges, but only slippery, rounded sides between you and a sheer drop on all sides of over a thousand feet. Climbing the Angel’s Landing trail can be frightening because it is so narrow at some points — less than 2 feet wide — that intermittently placed steel chains seem to be all there is between you and a long plunge to death. Given the dangers, if the Park Service were considering granting public access for the first time, would it do so? It very well might not. But our society allows some dangerous conditions to exist mostly because it’s always been that way.
Smoking is an analogous case. If tobacco had just been discovered, would we allow the sale of tobacco products? I seriously doubt it. But let’s consider the pros and cons.
First, tobacco’s benefits: Hmmm? None!
OK, what are its downsides? All the statistics I cite (unless otherwise indicated) come from the Centers for Disease Control and Prevention website.
“Cigarette smoking is responsible for more than 480,000 deaths per year in the United States. ...” Yes, half a million Americans die every year because of tobacco use, or about 1 in 5 deaths.
“Smoking is the leading cause of preventable death.”
Of the top 10 causes of death in the U.S., smoking plays a major role in eight of them (all but accidents and suicide). Tobacco either causes or significantly contributes to the rest: heart disease, many cancers, lung disease, stroke, dementia, pneumonia and kidney disease. “On average, smokers die 10 years earlier than nonsmokers.”
Smoking is a personal choice, but hardly victimless. One of the most compelling arguments against tobacco use is that nearly 45,000 Americans die every year of secondhand smoke. “Even brief exposure can be harmful to health. Since 1964, approximately 2,500,000 nonsmokers have died from health problems caused by exposure to secondhand smoke.” Moreover, we all pay a heavy financial toll as the huge costs of treating tobacco-related disease are spread throughout our private and public health systems.
Fortunately, we have made big progress in reducing smoking; the rate plummeted from 43 percent of U.S. adults in 1965 to 17 percent in 2014. Still, 1 in 6 American adults smokes. While Utah has the nation’s lowest smoking rate of 11.3 percent of adults, that translates to an amazing 220,000 current smokers.
Sadly, states use only a fraction of the billions they collect (about 2 percent) from tobacco taxes and legal settlements on prevention and cessation programs. "Spending less than 13 percent of these taxes and settlements would fund every state tobacco control program at CDC-recommended levels.” Utah is no exception.
Although 80 percent of Utah adult smokers want to quit and despite the risks and social taboos, thousands of young people start smoking cigarettes every day.
The emergence of e-cigarettes or “vaping” is very disturbing, especially among young people. The main appeal is that vaping avoids the carcinogens developed in combustion. But one still ingests plenty of harmful chemicals by vaping.
E-cigs are touted as a viable step-down cessation therapy for smokers, and evidently they do help some people. Conversely, e-cigs may be a gateway to smoking.
Of a new study published in the Journal of the American Medical Association, Dr. Nancy Rigotti, director of the Tobacco Research and Treatment Unit at Massachusetts General Hospital, said the study "is the strongest evidence to date that e-cigarettes might pose a health hazard by encouraging adolescents to start smoking conventional tobacco products…."
One of the study’s co-authors said "14-year-olds who had used e-cigarettes for recreational purposes were four times more likely to start smoking at least one harmful tobacco product … over the next year."
Utah has so far chosen not to tax e-cigarettes and vaping substances. That must change.
Considering all the personal and societal costs associated with tobacco, especially the horrible reality that nearly 45,000 people die of secondhand smoke annually, we should do everything possible to reduce consumption. We can’t ban tobacco altogether because it’s so entrenched in our society and economy. But we ought to make it more expensive, less available and less appealing.
Greg Bell is the current president and CEO of the Utah Hospital Association. He is the former Republican lieutenant governor of Utah.