Young taking up smoking in spite of danger

Press, 16 March 1982, Page 19

Young taking up smoking in spite of danger

... By

DR J.. S. ROXBURGH

of Nelson

It is now 30 years since Sir Richard Doll, at present visiting New Zealand, and his colleague Bradford Hill proved conclusively by their survey of British doctors that cigarette smoking was a serious hazard to health. Smoking is now often referred to as the greatest theoretically removable hazard to health in most advanced countries. A vast amount of health education has been carried out over the past 30 years, especially to school children; but in spite of that, more than ever young people, especially girls and young women, are taking up the habit. The very persuasive and colourful advertisements in the print media, and in cinemas, are usual!}' aimed at the young, because it is well known that it is an addictive habit, and, once “hooked” an appreciable., number of these youngsters, will be customers for life.

Various surveys have shown that the. great majority of smokers would like to stop, and many have tried repeatedly without success. The group who have shown perhaps the best example in our community are the doctors, who see the final results of the “smoking diseases.” In some districts only about four to five per cent of the doctors smoke. Middle-aged men, especially in the business and professional groups, have also “seen the light” in large numbers, and summoned up sufficient motivation to stop this habit.

Women are not doing so well, and, ironically enough, nurses show up badly. Surveys around this district within the past year show that up to two-thirds of the nurses in some hospitals are smoking cigarettes! It is disappointing that this is still the case. If we cannot persuade health workers — among whom nurses are numerically the biggest group — what hope have we

of getting through to the public at large? I have asked many nurses why they smoke, and the almost invariable answer is “because of the stress of the job”; but I'm still convinced that the reason is social rather than pharmacological. It seems that in certain nursing circles, smoking is still “the thing to do.” At a time when it is being emphasised that we all have a personal responsibility to look after our own health, it is surely time that conforming behaviour should be healthy behaviour — especially among health workers of any kind. No drug addiction is easy to overcome, but it is amazing what positive peer pressure can do. There are encouraging signs that nonsmokers are beginning to become more assertive about their rights. This applies to nurses too, and I was heartened to hear that non-smok-ing nurses in at least one hospital are beginning to put pressure on those who do. May they soon be in the majority! It is still not generally realised that at least 25 per cent of all internal cancers — some specialists consider it is nearer 30 per cent — are caused by cigarette smokipg. Everyone knows about lung cancer now — but several other quite common cancers are very .much more common in smokers, including bladder, pancreas, throat and larynx. (But an amazing number seem to have a distant relative who never smoked and developed lung cancer, and a grandfather or uncle who smoked like a chimey and lived to the age of 93. Such cases do occur, but are relatively rare.) Other "smoking diseases” are coronary thrombosis — much more common in smokers — other arterial diseases, chronic bronchitis and emphysema.

Another fact that is not generally realised, especially by youngster ••’a.--.''' -mo';

ing, is just how extremely addictive it is for most people. I attended a clinical meeting recently at which five cases of arterial disease due to smoking were presented. All were quite young people — 38 to 45 years old. All carried on smoking, against strong medical advice and surgical advice, throughout a period of years during which they developed gangrene of fingers or toes, had repeated operations to. either dilate the arteries, replace narrowed parts with grafts, or amputate parts of limbs, or whole limbs. At least one of them ended with a succession of amputations — a toe, then a foot, then lower leg, and finally the whole leg. And still they all carried on smoking! All were strongly and ' repeatedly advised to stop smoking if they wanted to save their limbs — but all carried on.

I tell this story merely to illustrate the addictiveness of the habit, not to try to introduce any scare tactics, which I fully realise generally don’t work in health education. I do not suggest for one minute that more than a small percentage of smokers will get this particular form of arterial disease, but it is a very well-recog-nised smoking disease — and no discriminator of persons. King George VI suffered from it shortly before he died.

Recently I saw a picture of a British heart surgeon with four patients on whom he had done heart transplant operations. All but one had; cigarettes in their hands, including the surgeon.-1 won-, dered if a smoking surgeon had told these patients to stop smoking to., improve '-ci- ;r culation before going

to the extreme of transplanting their hearts. It constantly amazes me how many regulations we have to protect us from trifling health risks, but .no statutory regulations to putrestrictions on the advertising of cigarettes in the print media, when we know that they are so extremely addictive, and also have such an adverse effect on health that they are killing thousands of New Zealanders annually and putting thousands more into hospital. Most of the English-speak-ing countries are at a similar stage, and it certainly .shows the enormous power of the tobacco-vested interests. The Surgeon-General of the United States has estimated that 160,000 Americans died last year from smoking diseases. But one of the finest Secretaries of Health, Education and Welfare in recent times, Joseph Califano, lost his job because he challenged the tobacco companies. Acclaimed by the professionals for his capability, courage and sincerity, he tried to do something constructive to reduce the toll of death and disease from smoking. It proved more than dangerous to his political health. It actually finished his political career. Here is What he said before he disappeared from 'public .view: “I asked my staff to gather facts on smoking and health. What disturbed me about cigarette smoking was learning that 75 per cent of the adults who smoke cigarettes were addicted before they were aged 21. Virtually all were addicted by 25. The number of teen-age smokers had increased from 3 million to 4.5 million between 1968 and 1974, and over that period the percentage of teen-age -■girls who smoked had .doubled. At least 100,000 children under 13 were regular smokers. The tobacco companies were spending about $1 billion of tax-deductible money annually to advertise

the pleasure of smoking cigarettes and get these youngsters hooked. How were we 4.0 mount a truly successful anti-smoking campaign against that nionumentaL effort? Ninety .per cent of adult sihokers want to quit. Virtually all of them at some time or other have tried.” So far I have mentioned only some of the health risks involved. There , is, for example, a proved risk to the infants and young children of heavy-smoking parents; they have more respiratory infections. There is a risk to the unborn baby of heavy-smok-ing pregnant Women (just as there is if they drink too much alcohol).

Smokers are a nuisance. Many non-smokers find that their eyes are affected, or their sinuses, if they have to inhale others’ smoke for long. Some get headaches; a few even have anginal attacks precipitated. Yet is is possible to have a non-smoking seat in a Friendship and have five smokers within 1.5 metres of one. Surely even the worst tobacco addicts can do without their drug for the 20 to 40 minutes of most Friendship flights?

Some of the Scandinavian, countries see that nonsmokers get a much fairer deal. For example, Finland has reversed the rule that used to apply. Instead of smoking being allowed in public places except where specifically forbidden, it is now forbidden except where specifically allowed. Perhaps if people who like to breathe at least reasonably clean air were more assertive and put pressure on M.P.s some worth-while aims could be achieved — a reduction in the “pushing” of cigarettes to youngsters; some persuasion that smoking is in fact a highly addictive and expensive habit that will certainly affect people’s health, and may eventually be fatal; and a few more places, such as public transport, in which the air can be kept free of smoke.