The guy that smokes has been told all the warnings on earth that it is going to kill you, and I think the same thing. I think it is going to kill you. I think any fool that takes smoke down in his belly is going to suffer. I have never smoked a cigarette in my life. I have made a fortune on it. . . . The only way that we built this country is by selling the rest of the fools in the world tobacco.”—James Sharp, longtime tobacco grower in Kentucky, in Merchants of Death—The American Tobacco Industry, by Larry C. White.
THAT candid remark speaks volumes but leaves several questions unanswered. Why do more than a billion people around the world smoke? What induces them to continue with a habit that is known to be death-dealing? After all, the tobacco story is basically the same as the drug story—supply and demand. If there is no profitable market, then the supply dries up. So why do people smoke?
Addiction is the key word. Once nicotine establishes a foothold in the body, there is a daily need for regular fixes of nicotine. Combined with the addiction is habit. Certain situations, established by habit, trigger the desire for a cigarette. It might be as soon as a person gets up or with the first cup of morning coffee, the after-lunch drink, the pressure and social interchange at work, or in recreation. Dozens of apparently insignificant habits can be the “on” switch for a smoke.

Why Did They Smoke?
Awake! interviewed several ex-smokers to try to understand the motivation behind smoking. For example, there is Ray, in his 50’s, a former quartermaster in the U.S. Navy. He explained: “I was about 9 years old when I first started smoking, but I got serious about it when I was 12. I recall that I was kicked out of the Boy Scouts for smoking.”

Awake!: “What got you interested in smoking?”
Ray: “It was the macho thing to do. You know, it was manly to smoke. I remember that the ads in those days showed firemen and policemen smoking. Then later in the Navy, I had a high-pressure job in navigation, and I felt that smoking helped me ride through the stress.

“I used to smoke about a pack and a half a day [30 cigarettes] and would not start a day without my cigarette. Of course, I inhaled. There’s no point in smoking if you don’t inhale.”
Bill, a professional artist from New York, also in his 50’s, tells a similar story:

“I started as a kid of 13. I wanted to be like the grown-ups. Once I was in its grip, I couldn’t stop. Having a cigarette was like having a friend. In fact, if I was going to bed and realized I had no cigarettes in the house, I would get dressed again and, regardless of the weather, go out and buy a pack for the next day. I was smoking from one to two packs a day. I admit that I was addicted. And I was a heavy drinker at the same time. The two just seemed to go together, especially in the bars where I spent a lot of my time.”

Amy, young and outgoing, started to smoke when she was 12 years old. “It was peer pressure at first. Then, my dad died when I was 15, and the stress of that pushed me further. But as I got older, the ads influenced me, especially that one, ‘You’ve come a long way, baby.’ I was a career girl, studying to be a surgical nurse. I was soon smoking three packs a day. My favorite time to smoke was after dinner and whenever I was on the phone, which was often.” Did she notice any ill effects? “I had morning cough and headaches, and I was no longer physically fit. Just climbing the stairs to my apartment left me breathless. And I was only 19!”

Harley, a former Navy flyer, now in his 60’s, started smoking during the Depression at the age of 5! Why did he do it? “All the kids smoked in Aberdeen, South Dakota, where I came from. If you smoked, you were tough.”
Harley minces no words about why he smoked. “It was pure pleasure for me. I would inhale the smoke deep down into my lungs and hold it there. Then I used to love to puff out smoke rings. I got where I could not live without my cigarette. I started and ended the day with a cigarette. In the Navy, I was smoking two to three packs a day and a box of cigars each month.”

Bill, Ray, Amy, and Harley gave up smoking. So have millions of others—over 43 million in the United States alone. But the tobacco salesmen have not given up. They are targeting new markets all the time.

Are YOU a Target?
With many male smokers giving up smoking in the industrialized nations, plus the loss of customers through natural and smoking-induced death, the tobacco companies have had to look for new markets. In some cases they have changed their advertising strategies in an effort to bolster their sales. Sponsorship of sports events, such as tennis and golf tournaments, is an effective way of giving a supposedly clean image to smoking. Another strategy adjustment is the markets to be targeted. Are you one of their potential customers?

Target number one: Women. A minority of women have smoked for decades, aided and abetted by the example of film actresses such as Gloria Swanson, who back in 1917 was smoking as an 18-year-old. In fact, she got one of her first film roles because, as the director explained: “Your hair, your face, the way you sit, the way you smoke a cigarette . . . You’re exactly what I want.”
In the 1940’s Lauren Bacall, who featured in films with her husband, heavy smoker Humphrey Bogart, also set a glamorous lead in smoking. But the female side of the cigarette market was always lagging way behind the male market. And so were the cancer statistics for women. Now they are catching up fast—in smoking and in lung cancer.

In recent years a new trend in advertising has developed, in part due to the more competitive role of women in society together with the subtle influence of tobacco advertising. What is the message being sent to women? The Philip Morris company, which manufactures a variety of cigarette brands, produces “Virginia Slims,” aimed at the modern woman. Their slogan is the one that attracted Amy: “You’ve come a long way, baby.” The ad portrays a sophisticated, modern woman with a cigarette between her fingers. But some women must be asking themselves now how far they have come. Over the last two years, lung cancer has exceeded breast cancer in the mortality rate for women.

Another cigarette brand offers women a bargain: “5 free per pack!” “50 free per carton!” Some women’s magazines even include coupons for free packs!
Sex is another easy way to make cigarettes seem attractive. One brand invites: “Find More Pleasure.” The message includes a want ad, stating: “WANTED—Tall, dark stranger for long lasting relationship. Good looks, great taste a must. Signed, Eagerly Seeking Smoking Satisfaction.” The cigarette being presented comes “tall” and in dark paper. A subtle connection?

Links with fashion are another hook used for women. One brand is hailed as “A celebration of style and taste by YVES SAINT LAURENT.” Another bait is used for weight-conscious women. The advertisement features a photo of a slim model, and the cigarettes are defined as “Ultra Lights—The lightest style.”

Why are the cigarette manufacturers targeting the women of the world? The World Health Organization gives an obvious clue with its estimate that “more than 50 per cent of men but only five per cent of women smoke in developing countries compared to about 30 per cent of both sexes in the industrialised world.” There is a huge untapped market out there for tobacco profits, regardless of the ultimate price in health that may have to be paid. And the tobacco salesmen are having success. According to The New York Times, the U.S. surgeon general’s report, released in January 1989, stated that ‘children, especially girls, are smoking at younger ages’ and that includes elementary-school children.

Another source says that in recent years the number of female teenage smokers in the United States has increased by 40 percent. But women are not the only target for the salesmen of death and disease.

The Racial Target
In his book Merchants of Death—The American Tobacco Industry, Larry C. White states: “Blacks are a good market for the cigarette makers. The National Center for Health Statistics showed that as of 1986, a higher percentage of blacks smoked than whites [in the United States] . . . It’s not surprising that blacks smoke in higher proportions than whites, because they are special targets of cigarette promotion.” Why are they special targets? According to The Wall Street Journal, they are “a group that lags behind the general population in kicking the habit.” Therefore, a black client is often a “loyal” client, ‘until death do us part.’

How do the tobacco companies concentrate on the black population? Author White states: “Cigarettes are heavily advertised in black-oriented magazines such as Ebony, Jet, and Essence. In 1985 cigarette companies spent $3.3 million on advertisements in Ebony alone.” One tobacco company also promotes a yearly fashion show directed to the black women’s market. Free cigarettes are handed out. Another company at one time regularly sponsored a jazz festival and continues to support music festivals popular with blacks. How special a target is the black population? A spokesman for Philip Morris stated: “The black market is very important. It’s a very powerful one.”
But there is an even more important market for the tobacco giants—not just races or groups but whole nations!

“Having a cigarette was like having a friend”

SMOKING and Buerger’s Disease
A recent case in Canada, reported by Maclean’s, highlights yet another disease attributed to smoking. Roger Perron started smoking at the age of 13. By the age of 27, he was suffering from Buerger’s disease and had to have one leg amputated below the knee. He was warned that if he continued smoking, the disease could attack again. Maclean’s reports: “But Perron ignored the warning, and in 1983 doctors had to amputate his other leg. After that, Perron . . . finally quit smoking.” Now he is suing a tobacco company for damages.

What is Buerger’s disease? It “occurs most often in men who smoke. The disease is characterized by an inflammatory response in the arteries, veins, and nerves, which leads to a thickening of the blood vessel walls caused by infiltration of white cells. The first symptoms are usually a bluish cast to a toe or finger and a feeling of coldness in the affected limb. Since the nerves are also inflamed, there may be severe pain and constriction of the small blood vessels controlled by them. Overactive sympathetic nerves also may cause the feet to sweat excessively, even though they feel cold. . . . Ischemic ulcers and gangrene are common complications of progressive Buerger’s disease.

“The cause of Buerger’s disease is unknown, but since it occurs mostly in young men who smoke, it is thought to be a reaction to something in cigarettes. The most important treatment is to stop smoking.” (Italics ours.)—The Columbia University College of Physicians and Surgeons Complete Home Medical Guide.

SMOKING and Heart Attacks
“Although most people are well aware of the association between cigarette smoking and lung cancer and other pulmonary diseases, many still do not realize that smoking is also a major risk factor in heart attacks. In fact, the . . . Surgeon General’s report on Smoking and Health estimates that 225,000 of the American [U.S.] deaths from cardiovascular disease each year are directly related to smoking—many more than the total number of cancer and pulmonary disease deaths attributed to smoking.

“Smokers often ask whether low-tar, low nicotine cigarettes reduce the cardiovascular risk. The answer appears to be ‘no.’ In fact, some of the filter cigarettes increase the amount of carbon monoxide that is inhaled, making them even worse for the heart than unfiltered brands.” (Italics ours.)—The Columbia University College of Physicians and Surgeons Complete Home Medical Guide.

Can the Smoking of Others Hurt You?
Millions of persons suffer serious, and often fatal, harm because someone else smoked. For example, if a mother smokes, her unborn baby is often damaged. In fact, it may be killed even before it can be born.
“How can that be?” you may ask. “How can the smoke hurt the child in the protected environment inside its mother?”

HOW THE UNBORN ARE HURT
Almost immediately after inhaling, nicotine from the smoke enters the smoking mother’s bloodstream. This powerful drug constricts the blood vessels and arteries in her uterus, thus depriving the baby of oxygen and nutrients. At the same time, carbon monoxide easily passes through the placenta to the baby. It replaces some of the vital oxygen in the baby’s blood that is needed for normal growth and development.
Of interest in this regard is a study made by English doctors at Oxford University. They said that when its mother smokes, the baby can “be seen to gasp in the womb, . . . almost certainly suffering a temporary oxygen shortage.”

The sad results are well documented. “Smoking during pregnancy can cause congenital malformations so severe that either the fetus dies, or the infant does shortly after birth,” Family Health magazine observes. Babies born of smoking mothers face a third higher risk of dying soon after birth. And they are twice as likely to be smaller than normal at birth.

In addition, the likelihood of “crib death” (sudden infant death syndrome) is increased when mothers smoke—by 52 percent researchers say. Apparently babies born to mothers who smoke have subtle abnormalities in their brain stem, and this may interfere with breathing and lead to sudden death.
If smoking by its mother can hurt an unborn baby, how is a child affected by the smoke after it is born?

EFFECT ON YOUNG CHILDREN
Actually, parents who smoke are indirectly forcing their children to smoke. “The effect on young children of parental smoking is estimated at about the same as if the child smoked three to five cigarettes a day,” explained lung specialist Dr. Alfred Munzer. And for the sensitive lungs of a young child, that is a lot of poison! Surely, as a parent, you would be very unhappy to learn that someone was making your child smoke five cigarettes a day!

But are children really hurt by the smoke of smoking parents? The Journal of the American Medical Association summarized the medical research on this question, saying:
“Infants whose mothers smoke are more likely to be admitted to hospitals with bronchitis or pneumonia than are infants whose mothers do not smoke. Another study showed that the chances of pneumonia or bronchitis developing in an infant are almost doubled if both parents smoke. . . . Other studies showed that the frequency of respiratory symptoms in children is directly proportional to the amount of tobacco smoke in the child’s environment. Also, children exposed to tobacco smoke have increases in heart rate and blood pressure that are similar to those changes that occur in smokers.”

A smoker may, for the pleasure he feels he derives from smoking, choose to damage his own health. But do you consider it morally right that he also damages the health of his children?

EFFECT ON ADULTS
What if you are a nonsmoking adult? Are you harmed by the smoke of others?
When you sit near a person who is smoking, the effect can be almost the same as though you were smoking. “Studies have shown,” noted Today’s Health, “that since the average smoker actively smokes his cigarette for only a small portion of the time it is lit, a nonsmoker may actually be forced against his will to breathe almost as much carbon monoxide, tar and nicotine as the active smoker sitting next to him.”

Dr. John L. Pool commented regarding the effect of only a slight increase of carbon monoxide in the air. He said that when carbon monoxide levels are “above eight parts per million (clean air has one to four), there is a definite decrease in oxygen reaching heart and lungs.” How much carbon monoxide may there be in the air of a smoke-filled room?

Philip Abelson, as editor of Science, wrote in an editorial of that magazine: “In a poorly ventilated, smoke-filled room, concentrations of carbon monoxide can easily reach several hundred parts per million, thus exposing smokers and nonsmokers present to a toxic hazard.” Such levels of carbon monoxide are far above the legal limits permitted.

Yet can this smoke really harm you? Indeed it can! Perhaps breathing the smoke makes you feel sick. Smokers should not be surprised by this, since, when smoking for the first time, many of them became sick, even vomiting.
The fact is, for persons with heart disease, breathing the air in a smoke-filled room can be dangerous. “It is a definite health hazard.” That was the conclusion reached from a federal study directed by Dr. Wilbert S. Aronow in California.

A more recent study of 2,100 middle-aged men and women reveals that even healthy adults are harmed when they are forced regularly to breathe the smoke of others. These nonsmokers were found to suffer the same kind of damage to small airways deep inside the lungs as do smokers. “This is permanent damage occurring in people who have chosen not to smoke,” explained physiologist James R. White.
Further emphasizing the danger of being forced to breathe tobacco smoke is a study in Erie County, Pennsylvania. According to the New York Times, this study “revealed that the nonsmoking wives of men who smoke die on the average four years younger than women whose husbands are also nonsmokers.”

WHAT THE EVIDENCE SHOWS
The evidence is conclusive: If you are a nonsmoker who must breathe the smoke of others, it can hurt you. As time goes on, this is becoming a generally recognized fact. Thus most states in the United States and hundreds of cities have some kind of ban on smoking in public facilities. Also, some companies restrict smoking to designated areas. And due to losses in productivity from smoking, a number of employers have offered employees bonuses of hundreds of dollars if they will quit.

Many lawsuits have been filed by nonsmokers in an effort to seek relief from the pollution caused by smokers. In one case, the judge noted that smoking had been banned in a certain company’s computer room because the equipment malfunctioned when exposed to cigarette smoke. So he ruled that, if smoking could be curtailed for a machine, it could be also for the sake of humans.

Some smokers now feel harassed because of such legislation against their habit. They consider it unjustified. As one said: “Smoking, after all, is not a sin.” Yet is this really true?

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