Is smoking finally out of style?

USA Today (Society for the Advancement of Education), Feb, 2005

The U.S.--the country that gave the world tobacco--now is leading it away from cigarettes, according to Earth Policy Institute, Washington, DC. After climbing for nearly a century, the number of cigarettes smoked per person in this country peaked at nearly 2,900 in 1976 and began to decline. By 2003 the figure had dropped to 1,545--a fall of 46%.

As the costs of smoking become clear, pressure to phase out cigarettes is gaining momentum. At its annual meeting in 2003, the American Society of Clinical Oncology called for the total elimination of tobacco. At a broader level, the World Medical Association, which includes organizations representing 10,000,000 physicians from 117 countries, has called for strong measures to reduce smoking. The 4,900,000 annual deaths from inhaling cigarette smoke exceed the 3,000,000 from all other air pollutants combined. Meanwhile, the World Health Organization (WHO) has launched a 'Tobacco Free Initiative.' Its Framework Convention on Tobacco Control was approved unanimously by the 192 countries attending the World Health Assembly. It calls for bans on advertising, higher taxes on cigarettes, and restrictions on smoking in the workplace.

World usage of this addictive product peaked in 1987 at 1,038 cigarettes smoked per person. Though the decline lagged behind trends in the U.S. by roughly a decade, the global figure fell to 887 cigarettes per person in 2002. In France, the number dropped from 1,750 in 1985 to 1,338 in 2003. In Japan, where most men once smoked, the peak came in 1992. Since then, annual consumption has dipped from 2,744 to 2,247 cigarettes in 2003, In China, the world's most populous country, smoking peaked in 1990 at 1,440 cigarettes per person and then fell to 1,330 by 2003. Keep in mind, though, that total tobacco usage worldwide still is growing, as the per person drop is less than the rise in population.

Evidence of the damaging effects of cigarette smoking on human health continues to accumulate. Today, there are at least 25 known tobacco-related diseases. Research findings show that smoking increases breast cancer in women by 30% and contributes to impotence in men. The constriction of small blood vessels that can prevent an erection in men who smoke is a forerunner of the blockage of the larger coronary arteries that leads to heart disease.

The number of deaths per year worldwide from smoking-related illnesses-currently at 4,900,000--is projected by WHO to reach 10,000,000 by 2020. The agency estimates that nearly one-third of all adult smokers will die of smoking-related illnesses.

In addition to the human suffering from lung cancer, heart disease, and other smoking-caused illnesses, the economic cost of cigarette use is high. A study by the U.S. Centers for Disease Control and Prevention indicates that each pack of cigarettes smoked in the U.S. costs society $7.18 in health care and lost employee productivity. It is the economics of smoking that helped convince the World Bank to ally itself with WHO in an effort to stamp out tobacco production and use.

Information campaigns can be particularly effective in rural areas of developing countries, where information on smoking and health is at most nonexistent. Moreover, the state of California is exploiting concerns about impotence in a television commercial in which a man's flirtation with a woman fails when the cigarette in his mouth begins to droop. While teenagers may not be particularly concerned about their mortality, they do worry about their sexuality. In Thailand, cigarette packs carry a warning in large type: "Cigarette smoking causes sexual impotence."

Raising taxes on cigarettes has become commonplace at the state level. This discourages smoking and helps close spiraling fiscal deficits. In 2002, 19 of the 50 states raised cigarette taxes by an average of 42 cents per pack. In 2003, another 13 states raised taxes. A number of countries have done the same.

Legal action holding cigarette manufacturers responsible for the products they market is beginning to gain traction in many nations. This approach is perhaps most advanced in the U.S. In November, 1998, the cigarette industry agreed to pay the 50 state governments a staggering total of $251,000,000,000 to cover past Medicare costs of treating smoking-related illnesses--nearly $1,000 for every American.

Early attempts to protect nonsmokers from the adverse effects of cigarette smoke included segregating smokers on planes and in restaurants. More recently, this has been replaced by outright bans. Local bans on indoor smoking in workplaces and public buildings, planes, trains, buses, restaurants, and bars are commonplace. In 2003, Norway became the first country to approve a national ban on smoking in restaurants and bars. Ireland and the Netherlands are following suit. Bhutan, a small mountainous kingdom between India and China, may become the first country to ban cigarettes completely. Nineteen of its 20 district health officials are working to make the sale of tobacco products illegal and to fine anyone caught smoking in public.