Quit Tobacco to Save the Nation

Last fall, the CDC released new data on cigarette and tobacco usage, reporting that formal cigarette usage was down but tobacco usage was up.

I shuddered for the United States, and I remembered what the State Health Director and the State Chair of the American Lung Association had asked me to do. When Dr. Cosgrove, CEO of Cleveland Clinic, and I were lucky enough to present to the Ohio State Board of Regents for Higher Education, we talked about banning cigarettes on all public university and college campuses in Ohio. The Regents, after hearing our arguments, voted unanimously to do that.

But when we got a second chance to appear (so that they confirmed their unanimous vote), some advocates had asked us to make it a tobacco ban rather than a cigarette ban. The Regents voted unanimously again to recommend that each state college and university campus ban all tobacco products. Why is that good for Ohio and good for the United States – or conversely why is what the CDC reported bad for jobs and bad health?

Tobacco use contributes more to chronic disease in America than anything else.  You pay a lot even if you don’t smoke: We all suffer from ill health because of tobacco use, and we all suffer because of job discompetetiveness. The United States is not as competitive for jobs because we have four times the medical costs of Japan, Mexico, India and China; most of that increase in medical cost is caused by the four-fold increase in chronic disease caused by tobacco use, food choices and portion sizes, physical inactivity and unmitigated or untreated stress.

And tobacco is the biggest cause of ill health, even a big cause in non-smokers. What happened in Piedmont, Italy, when public smoking was banned? A 10% reduction in heart attacks in the non-smokers. What happened in Scotland? A 17% reduction in heart attacks and acute coronary syndromes in 18 months. What happened in Monroe County, Indiana? A 77% reduction in heart attacks over 2 years in the non-smokers with no other risk factors for heart disease.  What happened in Pueblo, Colorado? A 41% reduction in heart attacks after 36 months.  Thus, not having public smoking has a strong direct benefit to the non-smoker as well. Walking through building entrances laden with smoke causes a lot more problems than we think – and a direct decrease in competitiveness for jobs with other countries. Of course, smokers would stand to benefit directly, too.

So what is the message from this? The message is that it is all of our jobs to try to decrease smoking, physical inactivity, poor food choices, too-big portion sizes, and stress in America. Because, by reducing those, on college campuses, universities – and everywhere –we make America more competitive for jobs and we increase health for all. It is necessary to save Medicare, necessary to balance the budget.  And health care due to chronic disease is so great an expense that this is all we have to do to balance the budget of our states, too.

Why is smoking so expensive? It is not just that the average smoker dies 12 years early. If all they did is die, then it would be their choice. No sweat on you. But the typical smoker suffers through 18 years of disability. We all pay for that disability.

Is it time to speak out – not only about this, but maybe also about those 36-ounces of sugary soft drink, your child’s school’s lack of physical activity and lack of teaching kids appropriately about nutrition, or how to manage stress?

It is only when you speak out about these things and do them yourself that you will make America more competitive for jobs, and improve your health and the resilience of the nation.

-Young Dr. Mike Roizen, The Enforcer