A crisis arose this fall: Excesses of a relatively severe gastroenteritis were linked to raw spinach consumption. The spinach was contaminated by E. coli. In total, 200 people in the United States became sick, and three people died. As awareness of the crisis spread, grocery stores stopped selling spinach. Throughout the crisis, signs in the stores assured customers that no spinach from the source of the outbreak would be sold.
Grocery stores did not simply warn about spinach contamination; they stopped selling spinach. This was appropriate, given that illness and death were linked to consumption of it. Pharmacies do not sell products that harm people; they don't merely warn people. If the product is shown to be dangerous, it is withdrawn.
In the 60-odd days since contaminated spinach attracted concern, more than 60,000 Americans have died early deaths as a result of cigarettes: cigarettes sold by grocery and drug stores ostensibly dedicated to providing only safe products. In that period, second-hand smoke of cigarettes from those markets and drug stores caused more deaths than contaminated spinach did.
Since this crisis emerged, some 180 Western New Yorkers died early, smoking-induced deaths; 60 times as many as died in the entire United States of contaminated spinach consumption. In that 60-day period, some 200 new smokers were recruited to replace the smokers who quit or who died because of cigarettes. Many of these new smokers bought their cigarettes at grocery stores that would not carry contaminated spinach, or at drug stores assumed to provide only safe products. A tragic irony is that these drug stores will later dispense chemotherapeutic drugs to smokers to treat the cancers they will have developed.
Grocery and drug stores should, in the interest of public health, increase their effort to warn consumers about the dangers of tobacco; customers need to understand that cigarettes are far more likely to kill them than are foods contaminated by animal waste. If groceries and pharmacies were to adhere to the public health principles they articulated during the spinach crisis, they would stop selling cigarettes. Cigarettes cause disease and early death, in the people who smoke them and in the people who breathe air contaminated by cigarette smoke.
Our state legislators should aid retail outlets in weaning themselves from cigarette sales; tax incentives might help them stop selling cigarettes. The savings to New York from decreased disability and death engendered by tobacco would largely offset decreased cigarette tax revenues.
We call on grocery and drug stores in Western New York, in the interest of public health, to stop selling cigarettes.
Dr. James R. Marshall is senior vice president for cancer prevention and population sciences at Roswell Park Cancer Institute. Dr. Maurizio Trevisan is dean of the School of Public Health & Health Professions at the University at Buffalo.