I Can't See the Future for the Smoke

by Francis P. Koster, Ed.D.

Long ago, I was a young graduate student in Future Studies, I was nervously walking down the hallway of a fancy conference center in Washington D.C. I had just given my very first presentation at The American Academy For The Advancement of Science. It was on "Why People Do Not Listen To Warnings". I was almost limp with relief. Successful or not, it was over.

Through a small window in a closed auditorium door I glimpsed a slide being shown on the large screen. It was immediately recognizable as two sets of lungs - but one was pink and healthy, the other looked like it has been charred on a grill. Without thinking, I went in, and changed my life. 

The medical doctor speaker was showing autopsy pictures of the lungs of smokers and non-smokers. He then moved on to show autopsy lungs of family members of smokers (what we now call "second hand smoke" victims). I sat horrified as slide after slide of preventable suffering and death marched across the screen.

It took many decades for American laws regarding tobacco use to change to catch up to the science - and we are still not done with that job. The story below illustrates the challenges we face as a society dealing with other issues.

Since 1964, when the U.S. Surgeon General first reported on the link between smoking and health, there have been more than 15 million preventable premature deaths from smoking In America.ⁱ During that time, industry fought back against regulation, arguing that jobs would be lost, that individual liberty infringed, that there was doubt about the science. Tobacco companies fought with citizen volunteer groups in the media as each side tried to change public opinion.

To look at the "bright side", in the 48 years since the release of that first Surgeon General's report, the rate of smoking has been cut in half - today "only" one in five American adults smokeⁱⁱ. Half of these will die prematurely from the habit, living on average 15 years less than non-smokersⁱⁱⁱ . And the smokers cost the economy right at 100 billion dollars every year in health care costs alone, and the costs of healthcare for the victims of "second hand smoke" is another 10 billion.^iv

This 110 billion dollars annually is equal to the annual cost of the United State Air Force, Air National Guard, and Air Force Reserve combined!.^v Or the entire defense budget of China in 2012!.^vi

The tobacco industry spends around ten billion dollars a year persuading people to smoke - roughly one tenth of the annual health costs caused by smoking. ^vii 

The good news is that efforts to persuade youngsters not to smoke are effective. I found lots of examples. To cite just one, done under the supervision of the Centers For Disease Control, almost half a million teens either stopped smoking or decided not to start based on an investment of $245 million spent on ’truth’ television ads aimed at directly at them , which saved an estimated $5.4 billion in tobacco-related health costs ^viii. This is a payback of twenty two dollars in savings for each dollar spent.

The bad news is that cost effective anti-smoking campaigns at the state and federal level have been and continue to be cut. In 2011 the 50 states will collect 25 billion dollars from tobacco taxes and legal settlements meant to discourage smoking. They spend only 2% of that on anti-smoking programs ^ix. In North Carolina, the anti-smoking fund was cut 80% (Fifty Million dollars) between 2009 and 2010. The state lawmakers take money on tobacco taxes meant to discourage consumption and addiction, but their legislators in their wisdom spend it on other things! And the tobacco companies could not be happier. 

This is enough to drive a Futurist crazy. In the case of tobacco, as in many other threats, it has been proven that we can shape our country's future by investing in prevention rather than repair of human health. And we don't. ARGH! 

You can help. Be clear with your kids that smoking is not, and will not, be acceptable behavior. If you know a smoker, lovingly ask what you can do to help them stop (and know you are probably asking them to do the hardest thing they will ever do, because once started tobacco messes with the addiction centers of the brain). Support public and private organizations in their "smoke free" policies. And for goodness sake let your elected officials know that any money collected under the flag of discouraging smoking should be spend that way - an argument that each one dollar spent returns twenty two should appeal to everyone in these lean times.