Smoking: The Silent Killer [Archives:2001/26/Health]
Tobacco is an insidious danger. Smokers do not keel over after their first cigarette. There is no sudden outbreak of tobacco-caused disease as people start smoking. Instead, the use of tobacco products causes a delayed reaction, with approximately 30 to 40 years passing between smoking initiation and the resulting deaths. Ultimately, the end result is still as devastating. At present, tobacco products kill about 4 million people a year.
In developed countries, where smoking became widespread during the 1940s and 1950s, these effect of past smoking trends can now be seen. About 20% of all deaths currently occurring in developed countries are due to tobacco related products. Unless we reverse current trends, the annual toll will rise to 10 million over the next 30 to 40 years (when the young smokers of today reach middle age), with 70% of those deaths occurring in developing countries. Therefore, a failure to take serious preventive action about tobacco during this decade will result in approximately 100 million people dying unnecessarily and prematurely in the 2020s or 2030s. This number of deaths is more than twice the total of deaths on all sides during the Second World War.
Recent data has confirmed that the risks of smoking are substantially higher than previously thought. With prolonged smoking, smokers have a death rate about three times higher than nonsmokers at all ages from young adulthood. If, as is likely, much of this excess mortality is directly attributable to tobacco use, then this implies that the risk of a smoker being killed by the use of tobacco products is at least 50%. Therefore, a lifelong smoker is as likely to die as a direct result of tobacco use as from all other potential causes of death combined!
Other problems ensue because the negative health consequences of tobacco are not as immediate as with other hazardous substances. The health risks of tobacco are vastly underestimated by the public, and even by many of those who are responsible for protecting and promoting public health. This is a major reason why tobacco products are still widely available, and why lenient tobacco policies have been allowed to occur. But nothing can alter the fact that tobacco use is one of the major public health challenges facing the world as it enters the twenty-first century.
Tobacco products have no safe level of consumption, and are the only legal consumer products that kill when used exactly as the manufacturer intends. Researchers have rated nicotine as even more addictive then heroin, cocaine, marijuana, or alcohol. Yet tobacco products continue to be aggressively marketed by tobacco companies. The result is that global tobacco consumption has doubled since medical science conclusively proved, thirty years ago, that these products were unrivaled killers. And consumption is still increasing in many areas of the world.
The already high prevalence of smoking in developing countries may rise further to the extent that successful economic development makes greater consumption more affordable. This is because in many of these countries, those who smoke are currently unable to afford more than a very few cigarettes per day. With rapid increases in disposable income as economies grow, today’s user of two cigarettes per day can become tomorrow’s two-pack-a-day person.
The trends suggest that there is still substantial risk of consumption rising in developing countries. On an average, 50% of men in developing countries smoke, compared with 41% in developed countries. Smoking in developing countries is still a predominantly male phenomenon, with only 8% of women smoking, compared to 21% in developed countries. However, the phenomenon of female smoking prevalence is rising in many countries. Tobacco companies have proven adept at breaking down the cultural taboos that had previously stopped women from smoking, and are successfully promoting smoking as a sign of women’s increasing independence and equality.
Many developing countries have rapidly expanding populations, with large numbers of children and teenagers. Through a combination of increasing affordability and heavy promotions, the tobacco industry has proven very successful in encouraging these young people – who are the least concerned about long-term health risks – to begin smoking. By the time they realize the deadly consequences of their habit, this new generation of smokers are hooked by a highly addictive drug.