Tue | May 23, 2017

Martin Henry | The deadly tobacco trade

Published:Sunday | December 18, 2016 | 12:15 AMMartin Henry

Burning cigarette and blazing front page headline, “Deadly Trade”. What? Did a local newspaper find the courage to describe the tobacco trade a deadly trade as its lead story of the day?
The fine print disappoints. The “business” report is on “gangsters using profits from illegally imported cigarettes to buy guns, ammo”.
The country is losing nearly $2 billion in revenue annually from the trade in illegally imported cigarettes by criminals who are using the money earned to buy guns and ammunition, the police advised at a press conference called by the local cigarette company.
I wonder how much is lost through the cost of health care for tobacco-induced diseases and from tobacco-related deaths and impairment?
The local company wants to protect the revenue of the Government as well as protect customers and consumers. Really!
Meanwhile, the American tobacco giant Philip Morris is arranging to expand operations here. And another company is bitterly complaining that even before it has started distribution here by licence, the contraband dealers faking its brand are already in the market. Tobacco is lucrative business. Tobacco is deadly business.
- The United States Centers for Disease Control and Prevention describes tobacco use as "the single most important preventable risk to human health in developed countries and an important cause of premature deaths worldwide.” Tobacco use is the single greatest cause of preventable death globally.

- Describing the The tobacco epidemic as one of the biggest public health threats the world has ever faced, the World Health Organisation is reporting six million deaths per year from tobacco use. The top 20 deadliest countries for armed conflicts in 2014 yielded only an estimated 127,134 deaths. More than 5 million tobacco-induced deaths are as a result of direct tobacco use while more than 600,000 are the result of non-smokers being exposed to second-hand smoke. Tobacco kills half of its users. This is like an infectious disease with a guaranteed 50 per cent mortality rate.

Second-hand smoke

Second-hand smoke is the smoke that fills enclosed spaces when people burn tobacco products. There are more than 4,000 chemicals in tobacco smoke, of which at least 250 are known to be harmful and more than 50 are known to cause cancer. There is no safe level of exposure to second-hand tobacco smoke. In adults, second-hand smoke causes serious cardiovascular and respiratory diseases, including coronary heart disease and lung cancer. In infants, it causes sudden death. In pregnant women, it causes low birth weight.

And just a couple of weeks ago Jamaicans were “warned about third-hand tobacco smoke by the SMO at the National Chest Hospital. Third-hand smoke is residual tobacco smoke contamination that lingers after the cigarette has been extinguished. It permeates fabrics, sticks to surfaces, and sticks around for up to six months. Third-hand smoke is implicated in the early onset of asthma in children.
New World indigenous peoples, including our own Tainos, gave the rest of the world tabaco, which became a major economic product and was sometimes even used as currency in the American colonies. The deadly link between tobacco and disease has been established only slowly, a link which has been fought tooth and nail by the deadly trade. A few decades ago, the graphic warnings which product packaging is now forced to carry by law was legally unthinkable.
The local industry is urging consumers, for their protection, to only purchase cigarettes with the graphic health warnings required by the Government on the front and back panels of each pack. How thoughtful.
In 1950, Richard Doll published research in the British Medical Journal showing a close link between smoking and lung cancer. Four years later, in 1954, the British Doctors Study, a study of some 40,000 doctors over 20 years, confirmed the suggestion, and on that basis the British government issued advice that smoking and lung cancer rates were related.
Tobacco use leads most commonly to diseases affecting the heart, liver and lungs. Smoking is a major risk factor for heart attacks, strokes, chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis, and for cancers, particularly lung cancer, cancers of the larynx and mouth, and pancreatic cancer. It also causes peripheral vascular disease and hypertension.
The effects depend on the number of years that a person smokes and on how much the person smokes. The industry knows the importance of hooking them young and works hard at it. People who don’t get addicted to smoking by age 20 seldom bother later.
The US Surgeon-General is reporting that almost 90 per cent of new smokers smoke their first cigarette by age 18. Despite the fact that 18 is the legal minimum age for purchasing and smoking cigarettes.
Tobacco use is a significant factor in miscarriages among pregnant smokers, and it contributes to a number of other health problems of the foetus such as premature birth, low birth weight, and increases by 1.4 to 3 times the chance of sudden infant death syndrome (SIDS).
Incidence of erectile dysfunction is approximately 85 per cent higher in male smokers compared to non-smokers. And the incidence of impotence is approximately 85 per cent higher in male smokers compared to non-smokers and it is a key cause of erectile dysfunction.
From the WHO: Globally, 12 per cent of all deaths among adults aged 30 years and over can be attributed to tobacco. About 5 million adults aged 30 years and over died from direct tobacco use (smoking and smokeless) around the globe, that is, one death approximately every six seconds. Globally, 5 per cent of all deaths from communicable diseases, and 14 per cent of all deaths from non-communicable diseases among adults aged 30 years and over are attributable to tobacco.
Within communicable diseases, tobacco use is responsible for an estimated 7 per cent of all deaths due to tuberculosis and 12 per cent of deaths due to lower respiratory infections. Within non-communicable diseases, tobacco use is responsible for 10 per cent of all deaths from cardiovascular diseases, 22 per cent of all cancer deaths, and 36 per cent of all deaths from diseases of the respiratory system.
Globally, death from people who died from tobacco-related diseases of the cardiovascular system was more likely to occur among younger adults. Of those adults aged 30-44 years who died from ischemic heart disease, 38 per cent of the deaths were attributable to tobacco. And 71 per cent of all lung cancer deaths are attributable to tobacco use. And 42 per cent of all chronic obstructive pulmonary disease are attributable to tobacco use.
In the United States, cigarette smoking and exposure to tobacco smoke accounts for roughly one in five, or at least 443,000 premature deaths annually. To dramatise the deadly statistics, ABC’s Peter Jennings famously reported that in the US alone, tobacco kills the equivalent of three jumbo jets full of people crashing every day, with no survivors. On a worldwide basis, this amounts to a jumbo jet crashing every hour, killing all its passengers.
Bringing this deadly data home, around 2,000 of the 17,000 Jamaicans dying on average annually for the last few years would have died from tobacco-related causes. This is nearly twice the number murdered with our world-leading high homicide rate. The legal cigarette is deadlier than the illegal gun!
The WHO complains that, while publicly stating its support for action against the illicit trade, the tobacco industry’s behind-the-scenes behaviour has been very different. Internal industry documents released as a result of court cases demonstrate that the tobacco industry has actively fostered the illicit trade globally. It also works to block implementation of tobacco control measures, such as tax increases and pictorial health warnings, by misleadingly arguing they will fuel the illicit trade.
The WHO is pushing plain packaging of cigarettes as part of its comprehensive approach to tobacco control that includes bans on tobacco advertising, promotion and sponsorship and other packaging and labelling measures, such as large graphic health warnings.
The Organisation complains that the tobacco companies have fought plain packaging with a massive misinformation campaign. Internal industry documents show a coordinated industry response designed to resist plain packaging for fear that it will reduce demand. And the industry makes baseless claims that plain packaging is not effective, will increase the illicit trade, push prices down and hurt retailers. These claims are not supported by the evidence.
Fenton Ferguson must be remembered for more than the dead babies scandal which unfairly forced him out as Minister of Health. Through the Public Health (Tobacco Control) Regulations 2013 Act, Dr. Ferguson courageously led the charge to drive smoking out of enclosed places used by the public.
Ferguson, it must not be forgotten, received the Gleaner Honour Award in the Health and Wellness category for 2013, "for the courageous and decisive implementation of a public-smoking ban, with an aim to improve health for many Jamaicans". At the time he told us that "the data coming out of the National Chest Hospital is showing that 70 per cent of the cases of lung cancer are tobacco-related, and, of all the cases, 90 per cent of lung cancer persons were chronic smokers."
In terms of sheer impact, tobacco is the world’s most deadly drug. It kills 2 ½ times more people than alcohol does each year. Smoking kills more people than alcohol, AIDS, car accidents, illegal drugs, murders and suicides combined.
- Martin Henry is a university administrator. Email feedback to columns@gleanerjm.com and medhen@gmail.com.