TOBACCO FOES HAVE COME A LONG WAY, BABY

IT is said that those who do not study the mistakes made in history are
doomed to repeat them. But when it comes to understanding society's ongoing
efforts to reduce the human cost of tobacco and smoking, we need to
carefully scrutinize historical accounts held by the cigarette industry and
compare it to history written by public-health authorities or other more
objective authors. We know so much more about tobacco and its addictive
properties in 1998 than we did in 1598 or 1898. Moreover, the tobacco
industry has significantly changed the way it markets and even delivers
products. So, while it is important to have a historical perspective on how
society has tried to limit the harm caused by tobacco, it is also important
to understand tobacco's impact on public health as we approach the 21st
century. Unfortunately, Cassandra Tate's review in The Seattle Times ("The
Endless War Against Tobacco," Nov. 29) contains a number of misperceptions
or myths that sound similar to recent arguments given by the cigarette
industry.

Myth No. 1: Tobacco use has not changed for the past 400 years. While Tate
stated that consumption of tobacco around the world has not changed in the
past four centuries, the reality is that consumption has radically changed.
More children, women and minority populations are using tobacco today. More
importantly, the way that they are consuming tobacco is drastically
different. To occasionally pass around a tobacco pipe or snort some snuff is
much less harmful to your health than inhaling 1-2 packs of cigarettes a
day.

Myth No. 2: Tobacco use is a choice. In fact, most people who smoke tobacco,
do so because they are addicted to the nicotine contained within the
tobacco. This is true whether the tobacco is smoked or chewed. When an
individual is addicted to a drug, they no longer have choice about its use.

Myth No. 3: Everyone in the U.S. has been smoking cigarettes since the
Pilgrims arrived and began exporting tobacco. The fact is that until the end
of the 19th century, with the invention of the self-lighting match,
automatic cigarette rolling machine and mass media advertising, cigarette
use in the U.S. was relatively uncommon. In reality, few people within the
early colonies and even among the Native American tribal populations inhaled
tobacco smoke on a regular basis until the 20th century. While tobacco
exports proved to be a source of capital in the 17th century, cigarettes
were not a popular habit. People in those days chewed, sniffed or puffed
tobacco products. Very few actually inhaled cigarette smoke.

Myth No. 4: Public-health efforts to reduce tobacco use today are similar to
those used in the last 400 years. In fact, the most serious efforts by the
public-health community to reduce tobacco use started in 1964 with the
release of the first Surgeon General's Report. This report and subsequent
publications published over the past 34 years have made use of biologic,
epidemiological and psychological studies on the impact of tobacco. This is
not a battle over etiquette or morals. It is a mandate that governments have
to protect the lives of their citizens from the harm caused by tobacco.

The fact is that scientists today know more about the toxicity of tobacco
and the addictive qualities of tobacco products than they have ever known
before. Prior to the 1950s, we had not identified the cancer-causing
chemicals in tobacco, showed how tobacco contributes to heart and
blood-vessel diseases, nor understood the addictive qualities of nicotine.
We also know how tobacco companies are able to target specific members of
our community and we know how to use public-health campaigns to help at-risk
populations remain healthy.

Myth No. 5: Public-health authorities are trying to make tobacco illegal and
plan to launch another prohibition campaign. The fact is that most people
within the tobacco-control community realize that prohibition will not work.
Instead, the goal is to better educate the community and lower the number
people who become addicted to tobacco, improve access to cessation programs
for those who want it, and prevent our children from experimenting with
tobacco.

Broad-based tobacco-control efforts in California and Massachusetts have
shown that by using better educational interventions and making use of mass
media to educate people at risk for smoking, they can successfully lower
tobacco-addiction rates in their communities compared with the general
population.

Attorney General Christine Gregoire's lawsuit on behalf of the people of
Washington is the first step in renewed efforts to continually lower tobacco
use rates in our state. It is now up to our governor and legislators to do
the right thing and fund a broad-based educational campaign to make our
communities healthier.

While it is important to understand the history of tobacco-control efforts,
it is naive to assume that times don't change and that our ability to reduce
the harm caused by tobacco is no different than those made by King James 1
or Pope Innocent X. The tobacco-control movement in the U.S. is relatively
young. We still need to learn more about how to best approach this
public-health issue with youth, minority populations and others who continue
to start using tobacco despite their knowledge that it is very harmful.

One out of every three children who become regular smokers will die from it.
Globally, the World Health Organization expects about 400 million people who
are presently alive on earth to die from this one preventable cause of
illness. I hope that the efforts being made by public-health officials in
this century are more effective at saving future generations from the harm
caused by tobacco.

Dr. Robert Jaffe is director of policy at Washington DOC and chair of the
Tobacco Control Task Force, Washington State Medical Association.

Checked-by: Don Beck