Warning Labels

Do warning labels really work?

Consider this pack of Gauloises that I saw on a bench at a nearby dock. It notes that smoking not only kills — quit now! — but also increases the risk of blindness. And to make the point visually, the pack features a large blind eye.

But did the warnings stop the smoker from buying the pack of Gauloises, or cause him to quit the habit that could blind and kill him? Nope! So what did the warnings accomplish, really?

Dreaming About Smoking

It’s been more than a quarter century since I quit smoking.  I gave up the nasty habit back in in the early ’90s, when the kids were little, and I haven’t had a cigarette since.

how-to-get-rid-of-cigarette-smokeLast night, however, I had a very vivid dream about smoking.  I was sitting somewhere, among a group of people, lighting a cigarette and taking a deep puff.  I felt the familiar leaden sensation in my chest as I did so and the harsh, acrid taste in my mouth and throat.  Wherever I was, it was clear that I had been chain-smoking cigarette after cigarette.  My dream self was sadly aware that I had previously successfully quit smoking for a long period of time but had started up again for some reason and was now hooked once more.  As I puffed away, I felt tremendous feelings of regret and guilt and shame and embarrassment that I had been so weak and stupid to retreat and would now have to try to quit all over again.  It was an incredibly realistic, powerful dream that startled me awake in the middle of the night.

I don’t think I’ve ever had a prior dream about smoking — at least, not one that I remember.  I have no idea why I would have such a dream now, as I have zero interest in taking up smoking again.  It’s pretty amazing that a habit I ditched more than 25 years could still call up such vivid images.  I suppose it shows that the smoking memories and my prior smoking self are still in my consciousness somewhere, lurking deep below the surface, ready to be tapped during an unconscious moment.

I was very grateful when I awoke and realized it was all a dream and that I remained contentedly smoke-free.  In fact, I can’t think of a recent dream where I’ve been happier and more relieved to find it was only a dream.  If my subconscious, just to be on the safe side, was trying to send me a message that there should be no backsliding, the message was received.

Coffin Nail Fail

Here’s some good news:  the Centers for Disease Control and Prevention National Center for Health Statistics reported this week that the percentage of the adult population that smokes cigarettes has reached its lowest level since the government began keeping track of that activity.

11034958_web1_m-smoking-edh-171122The CDC report concluded that, in 2017, 13.9 percent of the adult population in the United States smoked cigarettes.  That number is down from 15.5 percent in 2016, and has been steadily declining over the years.  Back in the 1960s, more than 40 percent of American adults smoked.  Ask anyone who was around during the ’60s, and you’ll hear stories that give you an idea about just how dramatically things have changed since then.  When UJ and I went with our grandparents to University of Akron Zips basketball games back in those days, for example, people could smoke in the hallways before entering the seating area.  At halftime when you walked through the hallway to get popcorn or a hot dog, you walked through a thick, gag-inducing wall of smoke emitted by throngs of smokers.  Now — unless you’re in a Las Vegas casino — you almost never encounter even a whiff of smoke in a public place.

Why are the numbers of smokers falling?  Some attribute it to aggressive ad campaigns against smoking and some attribute it to changes in general social mores; others think that a positive feedback loop may have occurred, where the decline in the number of smokers means people see fewer smokers and aren’t tempted to start smoking themselves in the first place.  There’s also another reason for the decline:  call it coincidence, but people who are smokers often seem to have fatal health problems, like the cancers that claimed three of the heavy smokers in my family.

While the overall trends are encouraging, there’s still work to be done.  Even though adult smokers now number less than 14 percent of the population, that still amounts to millions of people who are in the grip of a very bad habit.  And the statistics show a real disparity in the percentage of smokers by location, with city dwellers much less likely to smoke than residents of rural areas.  We need to continue to work on getting current smokers to quit, and convincing potential smokers to never pick up one of those coffin nails in the first place.

Smokers On Ice

Walking home from work tonight, with the temperature plummeting rapidly and already down below 10 degrees, I saw one of the people at the outdoor bus stop in front of the Ohio Statehouse smoking a cigarette.  And I thought:  “Really? Smoking in these ridiculous temperatures?”

a9a4f5381b5f6269a640259f845f9c7f-dart-frogs-cold-handsKish makes fun of me, because as a long reformed ex-smoker — I puffed my last cigarette more than 25 years ago and am forever happy that I quit when I did — I’m always quick to wonder aloud how anyone can smoke, period, even though I smoked off and on for a number of years.  In that regard, I’m like the one-time sinner turned into a holier-than-thou convert.  But if smoking under normal conditions seems crazy, given its abundantly documented health risks, smoking a cigarette outside in these temperatures seems especially insane.  In fact, there is some evidence that smoking outside during freezing temperatures is even worse for you than smoking is generally.

In Columbus, you can’t smoke in most buildings as a matter of law, so at our firm, and in other businesses, the few remaining smokers have to go outside to indulge in their habit.  You’d think that, as the mercury plunges into bitterly cold territory, the smokers would decide to refrain from going outside into the deep freeze and maybe even consider quitting altogether.  But when you pass the smoking area outside, behind our building, there’s always a few people puffing away, even on a day like today.  They look terribly cold, and act like they feel terribly cold, but they’re out there smoking, anyway.  It’s a pretty good indication of how addictive smoking is for some people — and a pretty good advertisement for why you shouldn’t start smoking in the first place.

The Smoking Lounge

My departure gate in the Atlanta airport today is located right next to the B concourse “Smoking Lounge.”  I realized it when I walked past just as someone exited the room and I caught an unmistakable whiff of cigarette smoke.

It’s not much of a “lounge, ” really — just a spartan room where smokers can gather cheek by jowl and puff away like mad.  It seemed like everybody in that room was trying to inhale as much smoke as they could, as fast as they could, and when they walked out they reeked of smoke.  It reminded me of the “teacher’s lounge” in high school, where any teacher walking out would trail a cloud of smoke. 

It’s kind of weird to see a Smokers Lounge in an American airport in our modern, anti-smoking world.

The Canadian Approach To Cigarette Labels

In America, warning labels on cigarette packs are a continuing source of controversy.  Most recently, the Food and Drug Administration had to retreat from requiring cigarette manufacturers to include graphic photos on cigarette packs after an appeals court found the mandatory labels violated the First Amendment.

The FDA photos were macabre, and included pictures of a corpse, diseased lungs, and a man with a tracheotomy puffing away with smoke coming from the hole in his throat. The FDA presumably thought the disgusting images would shock people into not buying cigarettes.  In our culture, however, would the labels actually discourage anyone — or would smokers, would are already used to social exclusion and often seem to smoke to cultivate a rebel image, just try to collect all nine images?  We’ll never know.

IMG_4387In Canada, where Russell (unfortunately) bought a pack of Camels yesterday, the approach is different.  His pack included a picture of a smoker who has emphysema and now must breathe with the help of an oxygen tank, but it also .  included a loose, wallet-sized card with a message (in both French and English, of course) from a smiling woman who successfully quit.  She says quitting was hard, but she was ashamed of being a smoker and felt guilty about her habit.  The first few days were tough, she concedes, but after she made it past the initial cravings she became more proud of herself and her will to quit got stronger.

I don’t know whether smoking labels make a difference.  In America, the number of smokers has fallen, but there remains a solid core of smokers and it is popular with younger people — even after the health issues are described in brutal detail.  I wonder if the Canadian approach, with the sad photo presented side-by-side with a positive story about quitting, is more likely to produce results.

Quitting Smoking

Uncle Mack’s post about reaching age 70 got me thinking about quitting smoking.  It’s one of the things he advises you do to reach that milestone.  Of course, every public health expert and doctor agrees.

I smoked for years.  I started in 1975, after I graduated from high school.  When I was in college everyone smoked, and I did, too.  I continued smoking through my first post-college job at the Toledo Blade because every reporter smoked.  Shortly after Kish and I moved to Washington, D.C., I quit.   After about a year, I went to law school and started smoking again.  I smoked throughout law school, then quit when I began my judicial clerkship after graduation.  When we moved to Columbus and I started at the law firm, I took up smoking again.  In 1992, I quit again — this time for good.  I haven’t smoked a cigarette for about 20 years.

My cigarette of choice was Salem Lights.  I smoked about half a pack a day.  I lit up first thing in the morning because it gave me a kick start (and also seemed to encourage certain plumbing functions, if you know what I mean).  I smoked later in the day, when I would hit that attention wall in mid-afternoon and needed a jolt.  I smoked when I watched crucial football games.  I smoked when I went to bars and parties.  For the most part, it was a method of dealing with stressful situations — but I never felt like I had to have a cigarette. It really was more of a habit than an addiction, one that seemed to help me focus.

It wasn’t hard to quit.  I decided I didn’t want to smoke anymore — the impact of smoking on the longevity of Webner males is horrendous — and I just stopped.  I quit cold turkey, without patches, hypnotism, or gaining 100 pounds.  I avoided temptation for a few weeks, and then really didn’t miss it anymore.

I think people are very different in that regard.  For some people, like me, quitting really isn’t that tough.  For others, who are in thrall to nicotine cravings, it is impossible chore.  I don’t think we should judge those who smoke — they clearly know that it poses health risks, but they either don’t care or are in the grip of a powerful addiction that they just can’t shake.  Either way, it’s not for me to browbeat them about their personal habits.

To those Webners who still smoke, I would only say that I have been a heck of a lot happier since I quit.  I feel better, cleaner, and healthier.  Quitting smoking was one of the very best decisions I ever made, and I recommend it.

 

Fat And Fairness — And The Federal Government

What to do to deal with the obesity epidemic in America?  (And not just in America, either — recent studies also are showing increasing obesity in places like Scotland.)  Normally you might say that the eating and exercise habits of individuals are their own business.  The problem, however, is that obesity, like smoking, is statistically likely to cause significant increases in health care costs.  And when most working people participate in group health care plans, where expensive health problems inevitably produce increased premium costs, individual cases of obesity and cigarette smoking end up being everybody’s problem.

The companies that sponsor group health plans for many Americans have tried to deal with this problem by sponsoring wellness programs and offering incentives to employee participation.  But you can’t force a person to exercise or quit smoking.  Now some companies are taking a harder line, and making obese employees and smokers pay more for health coverage to reflect their increased likelihood of incurring health care costs.  Predictably, those efforts are being met by questions about the legality of distinguishing between people on the basis of weight, whether the programs have a disproportionate impact on the poor, who are said to be unable to afford health clubs and good nutrition, and the propriety of companies getting into the personal lives of  employees.  Those on the other side of the debate argue that non-smoking, non-obese employees should not pay the tab for the risky, costly lifestyles of co-workers who can’t curb their appetites for cigarettes and sugar.

It will be interesting to see how this issue plays out — and even more interesting to see what happens if President Obama’s health care statute is upheld and the federal government becomes increasingly involved in health care.  Does anyone think that federal regulators, having been given the power to require people to buy health insurance, would hesitate to mandate certain kinds of individual behavior — like eating less, quitting smoking, and exercising regularly — and punish non-compliance in an attempt to hold down costs?

A Fat Guy In A Thin Country

Paris makes me want to suck in my gut.

As you walk around the city, you can’t help but notice that there aren’t many overweight people here. Everybody, regardless of their age, seems to be thin, stylishly dressed, and moving fast.  The contrast with America, where you see seriously obese people everywhere, is startling.

Why is this so?  Maybe it is because more Parisians seem to smoke than Americans — at least, that’s the impression I get after a few days here — or maybe it is because food is expensive, and people have cut back a little on the chow-downs as a result.  More likely, it is because this is a city of walkers and cyclists.  On weekdays, you see people hustling down the streets to get to work or riding their bikes as part of their daily commute.  My guess is that few Parisians follow the American model of going to their garage in the morning, hopping in their car, and then driving to a parking garage a block away from their workplace, where they will sit on their butts all day.

I also think there is a strong social disapproval of being overweight — implicit, perhaps, but nevertheless a factor.  Everyone here wears fashionable clothing, from hats down to shoes.  If you want to join everyone else and be part of the haute couture parade, you’ve got to keep the weight off.  It’s hard to look stylish, and Parisian, if you are hauling around an extra 60 pounds.

Give Him A Break

I have been a bit put off by the news reports on the results of President Obama’s recent physical.  How many of us would want our personal health care details announced to the world at large?  Would any rational person care to trumpet their weight or cholesterol counts on the internet, or hear pundits debate whether they should quit smoking on TV or radio “news” programs?  Can’t our President at least enjoy some privacy about medical issues?  Why do we need to know anything about the President’s health other than, as his doctor stated, that he is “fit and ready for duty”?

The detailed nature of the information that is available appears here.  It indicates that the President’s cholesterol and blood pressure have increased.  No surprise there; he has a stressful job that no doubt causes him to eat at odd hours, to lose sleep that he would otherwise have enjoyed, and to experience sustained pressure and strain.  His weight is remarkably good and he obviously exercises regularly.  (I wish I weighed less than 180 pounds, and I bet most American men in the 50 age range share than sentiment.)  President Obama evidently sneaks a cigarette now and then, and his doctor also urges him to exercise moderation in consumption of alcohol.  So what?  Lots of people struggle to quit smoking, and doctors can’t resist the opportunity to lecture virtually every patient about alcohol use.

Some people argue that, given President Obama interest in reducing health care costs, he is hypocritical to smoke because it is a great cause of otherwise avoidable health care costs.  I quit smoking almost 20 years ago; I’m glad I did and I imagine that President Obama would feel the same way if he successfully kicked the habit — but that decision is his business, not ours.  Franklin Roosevelt smoked, and it didn’t seem to hurt his performance.  Indeed, the media’s discretion in not reporting about Roosevelt’s polio-related paralysis and use of braces demonstrates that we really don’t need intimate information about our leaders’ non-life threatening medical conditions.  We should respect that medical exam results are intensely personal information that should not be the subject of needless public scrutiny and gossip — even when they concern the President.

Presidential Puffs

Apparently President Obama likes to sneak a cigarette now and then. I don’t know if he is still doing so now that he has been elected — who could blame him, the ways things have been going? — but if he is taking a few puffs once in a while, does he get to smoke in the Oval Office? Or, does he have to go to some smoking area out in the Rose Garden or the lawn where they have the Easter egg hunt? If the District of Columbia has a smoking ordinance like Columbus does, then smoking indoors is barred in any office building, and you would think the West Wing would qualify.

At our firm, we make all smokers take their smoke breaks in a grim concrete parking garage across the alley at the rear of our buildings. It’s pathetic to see our few remaining smokers out there during the winter, like outcasts, shivering in the cold as they satisfy their habits. Of course, if the President were one of the huddled masses in the smoking area it would go from the realm of outcasts to the spot where the cool people hang out. The Secret Service guys would be out there too, of course, and if you were an ambitious White House staffer eager to get the President’s ear on some obscure policy issue, you might just decide to take up smoking. It would be a good way to try to get a few minutes alone with the President, and I’m sure that smoking together in the cold or rain creates real camaraderie.

The President seems like a pretty suave guy, so he probably is a suave smoker, too. Before I quit smoking some 16 years ago, I was a pretty inept smoker. I couldn’t blow smoke rings, for example. In fact, I never knew how to hold my cigarette in a way that didn’t either cause the smoke to go directly into my face, or someone else’s face. I always ended up in some contorted pose that looked ridiculous. President Obama, on the other hand, is probably the coolest smoker since Humphrey Bogart or James Dean. Let’s hope the media refrains from printing photos of him sucking on a cigarette — it could easily destroy the hard-won gains realized through years of anti-smoking crusades and advertising bans.