Wally, from Buffalo, N.Y., was on the line, with a damned good question.
“Whatever happened to freedom of choice in this country?” he wanted to know last Tuesday on National Public Radio’s “Talk of the Nation.” First, it’s restrictions on tobacco. And then … “What’s really next? Are we going to go after McDonald’s? Or will we go after the alcohol industry?”
Yes, good question. It hangs quietly in the background of public debate, brought forward by people such as Wally, who wonder why there’s such a fuss about cigarette smoking and not nearly the official outcry over alcohol or, for that matter, the deadly obesity of a society that mainlines Big Macs.
“You give zealots an inch, and they take a mile,” Wally warned that afternoon. And if he - a 60-year-old traffic engineer who started smoking when he was 18 or 19 - wants to continue this pleasurable habit, why should the government care any more than if he drinks a beer or three, or greets the dinner hour with a martini under his belt?
You’ll hear this line of reasoning from the Wallys of America, from smokers, the tobacco industry, or anyone else interested in blurring the essential distinctions between one public health concern and another.
Beware: It’s a smoke screen. Dangerous to informed debate.
And to your lungs.
The scourge of cigarette smoking, and the havoc caused by alcohol abuse, can’t be lumped together like measles and the mumps. As the Rev. Jesse Brown, a Philadelphia minister and anti-tobacco, anti-liquor activist, says: “Tobacco, if used as intended, will kill. Alcohol, if used as intended, will not.”
“If used as intended” - that’s the key phrase.
True, nearly twice as many Americans drink alcohol as smoke cigarettes. According to the Substance Abuse and Mental Health Services Administration’s latest figures (dating back to 1995), 52.2 percent acknowledged having at least a drink in the last month, while 28.8 percent had at least a cigarette.
But how many drinkers have a glass of wine with dinner or a beer in a ballpark, and how many down a fifth of Jack Daniels each day?
The 1995 figures show that 15.8 percent were “binge” users - which means they had five or more drinks on the same occasion at least once during the last month. That includes the 5.5 percent defined as heavy users, who repeated that drinking spree at least “five” times during the last 30 days.
It in no way minimizes the tragic consequences of alcohol abuse to state the obvious: Most Americans use alcohol responsibly. That is reinforced by a rough calculation used to contrast the addiction of alcohol and smoking: About 90 percent of smokers are addicted to nicotine, but only about 10 percent of drinkers are addicted to alcohol.
In both cases, the substances kill people with addictions. But while alcohol accounts for an estimated 100,000 deaths a year, tobacco is the cause of about 400,000 - and continues to be the single, leading preventable cause of death and disease in the nation.
(And Wally was right to mention McDonald’s - if tobacco is No. 1, and alcohol No. 3, then poor diet and activity patterns are No. 2, accounting for at least 300,000 preventable deaths a year.)
From the standpoint of someone working in the community to counteract the forces of tobacco “and” alcohol, Brown draws another distinction: industry behavior. “The alcohol folks, bar owners, take some responsibility for how their product is used. There’s some level of liability,” he notes.
But the tobacco industry “claimed for years that their product is totally safe. And they still haven’t been held corporately responsible for the deaths caused by smoking.”
Brown has no love for the alcohol industry, which he says has unfairly targeted poor and minority communities. But he puts the tobacco companies - with their expensive, pervasive advertising campaigns and their outsize influence in Congress - in a separate category. And he’s right.
There’s another reason why some smoking-sympathizers want to talk about alcohol and tobacco in the same, belabored breath: It raises the specter of Prohibition. The p-word! Just the thing to get the Wallys of the world up in arms!
Beware of that ploy, too. It’s a false alarm. Antitobacco stalwarts like Jesse Brown are against prohibition. Even former FDA director David Kessler, whose picture must be the bull’s-eye of dart boards in tobacco headquarters everywhere, is against prohibition.
Education, yes. Higher taxes to discourage youth smoking, yes. Enforcing existing tobacco regulations, yes. Prohibition? C’mon.
Let’s hope we’re a nation sophisticated enough to look at public health dangers for what they are. Alcohol abuse has harmful and sometimes deadly consequences, whether they’re manifested in liver disease, drunken driving, or neglected families.
But alcohol used responsibly can be a pleasure.
Cigarettes, too, give pleasure. They just also happen to be addictive, harmful to others, and undeniably life-threatening. And produced by an industry that for decades has lied about those very dangers.
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