"Do you mind if I smoke?" my traveling companion asked me.
"Not at all," I replied. "In fact, I should be most pleased if you would. It would be good for my business."
"What do you do?"
"I am a cancer specialist, and I look after patients with lung cancer."
He seemed utterly taken aback.
This is a most tasteless anecdote. But would it be any less crass were I to have said that I was a heart surgeon repairing vessels damaged by cigarettes? Or an undertaker?
Or would it have been more acceptable if the pleasure that I took in his smoking being good for my business had related to my work as a tobacco farmer in southwestern Ontario, to my work as a tobacconist, a tobacco company executive, the receiver of revenue benefiting from a tobacco tax, or a social agency anticipating a reduced payout on his old-age-security pension because of his early death?
Would it have been more acceptable were I an organizer of a sporting event or an arts festival dependent on a tobacco sponsorship?
When 350 people died in a plane crash last summer, there was appropriate concern and consternation. The police were involved, government agencies were involved, CNN provided 24-hour coverage, and the airline company may yet be in serious trouble as a result.
Three hundred and fifty people died yesterday, another 350 people the day before and 350 the day before that -- all in North America and all from diseases directly attributable to smoking. Three hundred and fifty people will die today and tomorrow and the day after tomorrow -- all from the same cause and all involving the same industry. Does anybody care?
There seems to be a remarkable lack of concern for the deadly implications of tobacco smoking that does not apply to other areas. Were an aircraft company to build airplanes with the sole problem that one plane each day, filled with 350 people, crashed, killing all aboard, this would undoubtedly evoke a response. There would be concern even if the company could justify its existence on the basis that jobs are provided building the plane, flying the plane, servicing the plane, taxing ticket sales and gasoline sales and generally supporting the economy.
It would not be acceptable if the company were to claim that there was no proof that the planes, or the pilots or maintenance policies, were in any way at fault; or if it were able to show that many other planes fly without any problems at all. It would not be acceptable if the company promised to build a lighter plane with possibly fewer consequences of the crash.
The equivalent toll on human life consequent on cigarette sales is ignored -- seemingly on the basis that we need the tax money, need the tobacco sponsorship to promote the arts or sporting events, need the jobs the industry provides, need the conviviality of smoking in bars and restaurants.
Do the people who want these benefits know that they are riding on the backs of the three or four hundred people who die each day as a result of smoking? Do they care? Are we blind to the connection between the economic benefits on one side and the human suffering on the other side of this equation?
I recently consulted on a mother of three young girls. She had begun smoking when she was 12. Now she had a large lump in her neck, her liver was enlarged, her abdomen swollen, her breathing gasping. The patient had lung cancer. Could I justify this to her 12-year-old daughter on the basis that her mother was dying for the economic good of society, for a tennis tournament, for a concert?
Today I saw a man of 39 who had smoked 25 cigarettes a day since his early teens. He is paralyzed from the spread of lung cancer to his spinal cord. Can I reassure him that his cigarette smoking has benefited farmers and tobacco-company employees?
My mother died a few years ago with evidence of widespread lung cancer. Should I feel comforted that over time she spent a lot of money at the local drugstore where she bought her daily packet of cigarettes, that she had a short-lived illness which cost the health-care system very little and that she no longer needs her old-age-security payments?
In my view, nothing justifies the growing of tobacco, the making, advertising and selling of cigarettes and the exploitation of the people who smoke them.
When I see one patient after another dying of lung cancer, of heart disease, of chronic lung disease, I am filled with rage and not at all concerned that smoking is good for my business.
DR. DAVID GINSBURG is a medical oncologist at Kingston Regional Cancer Centre and Queen's University in Kingston, Ont.
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