by Peter Rodman
A few weeks ago, Dateline ran an article on a small committee formed spontaneously to discuss issues of smoking on the Davis campus. I initiated the discussion because, like all UC campuses, UC Davis has a “Free” policy (See PPM Section 290-10), but despite this, cigarette smoke regularly enters Smoke through the air vents into my office and the classrooms where I teach. This smoke is toxic and its presence inside a building violates Federal and California laws guaranteeing a smoke free workplace. Even in comparatively smoke free California, environmental tobacco smoke contributes to all forms of cancer and other cardiopulmonary disease, exacerbates osteoporosis and other diseases of aging, increases risk of pneumococal infection, increases the suffering of asthmatics, and generally wreaks undeserved havoc on the health of those exposed to it.
So far the comments sent by readers of the article run 5 positive to 1 negative—not an overwhelming response, but interesting. My favorite is the negative, in which the author wrote: “You have no idea of how much discrimination and relentless humiliation smokers have to go through in California. I often feel welcome as a Jew in Nazi Germany. You don’t like the smell of cigarettes, and for that reason only you want to ban us even from open air spaces… And don’t tell me that you care for my health. You couldn’t care less. You just don’t like the smoke.” My correspondent is right. I don’t like the smoke. Where there is the smell of cigarette smoke, the carcinogens are present. ’s smoke, there is ill health. Nicotine is a Class A carcinogen, and nicotine is only one of many carcinogens and other toxins dispersed when tobacco is burned. Some people with allergies suffer very negative consequences from breathing smoke.
But my plaintive correspondent was wrong about my concern for the smoker’s health: I am, and we all should be, concerned for smokers’ health because smokers contribute so disproportionately to health care costs in California. The Centers for Disease Control recently estimated that medical costs related to smoking amount to more than $5 billion per year in California. Medicaid expenditures attributable to smoking in California for fiscal year 1993 amounted to nearly $1.75 billion. Medical benefits are used disproportionately by smokers, and as far as I know, smokers at UC Davis pay no more for health benefits than non-smokers. Calculations of the charges for health benefits necessarily take into account the cost of smoking related illness. In other words, we all pay for the smokers’ risks, whether we smoke or not, whether we can isolate ourselves from the smoke or not, whether we want to or not.
And, darn it, we get none of the pleasures of smoking! I must confess to being a former smoker. The memories linger of that wonderful, relaxing rush that comes with inhaling fresh smoke: as we inhale, the peripheral circulation shuts down, the pulse surges, and blood pressure skyrockets. Somehow this feeling always seemed to enhance a crisp autumn morning in the mountains or a sparkling northwest breeze across the water at the end of a day of sailing—or a dark coffee house encounter of the romantic kind! Happily for me and others who stopped smoking reasonably early in life, quitting by age 40 avoids more than 90% of risks of smoking according to an extensive epidemiological study of smokers in Britain since 1950, published last year by Sir Richard Peto and his co-authors in the British Medical Journal (321: 323-329).
Sadly, our colleagues who continue to smoke throughout life can anticipate many more visits to the doctor, more years of disability, and an acceleration of the diseases of aging as they near death’s door simply because of the smoke. Those who are fortunate may die suddenly of heart attacks or strokes—as we all may– but smokers are likely to do so sooner than non-smokers. Those less fortunate may simply lie in bed hooked to lines of oxygen, or may live a little longer without surgically removed cancerous parts. Strangely, it is likely that the first thing a cancer patient with one less lung, or no larynx and a new tracheotomy, will want after surgery is another cigarette.
A macabre upside for the rest of us to the dire predictions of early death for smokers is that an average of 13.2 years of life are lost for each death due to smoking in California (CDC statistics for1990-1994). This is an “upside” because the early deaths leave that much less tobacco smoke in the air for those of us who live a bit longer.
The last comment is callous to make a point. Smokers, no matter how intelligent, usually are unmoved by the scary truths known about their habit, but those of us who care about any or all of them would rather not share their misery in the future, let alone their smoke today.
Clearly we all would be better off without cigarettes and other tobacco products in our environment. Failing a truly smoke free policy that stops smoking at the campus borders, we can all contribute to a healthier environment by “enforcing” the existing smoke free policy at UC Davis. Those who smoke may comply by conscientiously reading and following the policy, and those who do not smoke may comply by civily reminding smokers of the policy, when appropriate.