Tobacco (19) Do people understand the health, socio-economic and environmental harms of using tobacco products? (3)

27 February, 2023

I can speak mainly on my home country (U.S.), where spending on tobacco control is fairly abysmal - only two states meet the CDC minimum funding recommendations. Fortunately there are federal education programs that have been shown to be effective. In my work I've found that while everyone is aware smoking is dangerous, there are fundamental misconceptions about that danger. Most seem to think that, if you smoke, you simply drop dead when you are 70 rather than 80. They don't understand that for every death there are many people suffering for years with tobacco-related illnesses, or that the years lost come from the middle of life, not the end (i.e., people who smoke will decline with age more rapidly than non-smokers, on average).

We also need to update our facts. Nearly everyone in our field still says "smoking kills up to half of its long-term users," but more recent research shows that the key number is 2/3, not half. And for too many decades we focused on death and disease but not at all on addiction. Vaping has changed that slightly, but not enough. Kids think they will simply quit later.

But the biggest problem with tobacco education is that government, which provides most of the education, completely undermines its own message by allowing the sale of the world's most deadly consumer product nearly everywhere, while implying via policy that it magically becomes safe for anyone on their 21st birthday. After society learned that lead paint is deadly, what if instead of banning it we had spent billions urging people not to use it, but left it on the market completely unhindered? That would have been ludicrous.

We need to question the question itself. Knowledge of the dangers of tobacco is irrelevant in one important way: Most adults who smoke became addicted as children, and we don't trust children with making life-altering decisions such as whether to become addicted to a deadly substance. The vast majority of people who smoke want to quit, so mission accomplished from an education standpoint. But many cannot because they are addicted to nicotine.

Cigarettes are unreasonably dangerous. They should be removed from the market.

Chris Bostic, Policy Director


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HIFA profile: Chris Bostic is Action on Smoking and Health’s Policy Director. Since 2001, Chris has worked in tobacco policy at the local, state, national and international levels. Prior to joining ASH, he worked at the Campaign for Tobacco-Free Kids and the American Lung Association. He has also served as a public health law clinical instructor at the University of Maryland Francis King Carey School of Law and was a founding board member of the Human Rights and Tobacco Control Network (HRTCN). bosticc AT