Scrubbing In: Our president-elect and his lethal puffing
When President-elect Barack Obama takes office this week, we will have another health-nut-in-chief, like our last leader. Obama played pickup basketball on primary election days, ate salmon, rice and broccoli on the road, and often jogged three miles without huffing. The svelte president seems to be a role model in all ways but one: his smoking.
When President-elect Barack Obama takes office this week, we will have another health-nut-in-chief, like our last leader. Obama played pickup basketball on primary election days, ate salmon, rice and broccoli on the road, and often jogged three miles without huffing. The svelte president seems to be a role model in all ways but one: his smoking.
Obama tried to quit during the campaign, but "fell off the wagon," as he put it. What then will it mean to have a smoker-in-chief?
Will he try to quit again? Should he? One op-ed writer argues that quitting will make him more agitated and less clearheaded. Others fear that his vice will encourage teens and adults to partake of this deadly habit. Whatever his struggles with the toxic butts, I hope his policies will reflect the antismoking zeitgeist of our times.
Antismoking laws are spreading like wildfire. Taiwan recently implemented a smoking ban in all indoor public places. Virginia's governor is pushing for a smoking ban in restaurants. In Ontario, Canada, new legislation prohibits smoking in cars with kids under 16 present. And in California, one city council has banned smoking inside your home if you live in an apartment complex.
Last summer, Pennsylvania joined 24 other states in enacting a law to prohibit smoking at work and in public places.
But we can do better. Activists rightly pooh-poohed the state law for its loopholes, including an exemption for casinos and private clubs.
As a physician, I applaud the advances. It was horrifying to learn in medical school what cigarettes contain: carbon monoxide (car exhaust), butane (lighter fluid), and toluene (paint thinner), among more than 200 toxic compounds. On the wards, I saw the devastation caused by tobacco: cancer, emphysema, heart attacks and strokes, all preventable.
Smoking steals an estimated 435,000 lives a year in the United States, making it the leading cause of preventable death. Smokers die up to 15 years earlier than nonsmokers and often spend their twilight years in pain and short of breath.
Smoking contributes greatly to low birth weight and infant mortality, and to the two leading causes of sight loss in working and elderly Americans. It is implicated in cancers of the lungs, throat, esophagus, bladder, pancreas, cervix, kidney, stomach and blood.
Even secondhand smoke kills 50,000 people a year. Now, researchers are saying "thirdhand smoke" is worrisome. The particles trapped in hair, fingernails, coats and carpets put at risk anyone who's exposed. So it's not OK, moms and dads, to smoke on the stoop and go back inside. You're still putting your little ones at risk.
During medical school I was puzzled to see some classmates smoking outside after class, just as many people are surprised about Obama's habit. Tobacco's addictive power is mind-boggling. Former addicts say heroin can be easier to quit than cigarettes.
Seventy percent of smokers want to quit. Sometimes it takes a life-changing event. My grandfather Jack, who smoked four packs a day, noticed his leg turning white in 1962. He was diagnosed with Buerger's disease, an inflammation of blood vessels related to smoking, and was told he could lose his leg. He never had another cigarette. But he later died prematurely of a heart attack. I never got to know him.
Nowadays, some people find success with smoking cessation groups and medication. Recently a patient came in for a regular eye check. He told me he had survived a heart attack the year before and had stopped smoking with the help of a new drug, Chantix, which has its own side effects. Pfizer, the drug's maker, offered a Web course to help undo his learned behaviors with cigarettes.
Smoking costs the United States about $200 billion a year, which amounts to $4,260 for each adult smoker, according to the American Lung Association. We could pay for better schools or provide health care to the uninsured with that extra cash. Obama knows this as well as anyone. Let's support him and everyone else who is willing to try to quit. It shouldn't take a brush with death to break a lethal habit.
Scrubbing In:
Rachel K. Sobel, a second-year ophthalmology resident at the Wills Eye Institute at Thomas Jefferson University, will be writing about
her experiences every other week.