Environmental Problems, Their Causes, and Sustainability 1

19 andRisk, Toxicology,Human HealthCASE STUDYThe Big KillerWhat is roughly the diameter of a 30-caliber bullet,can be bought almost anywhere, is highly addictive,and kills about 13,700 people every day, or one every6 seconds? It is a cigarette. Cigarette smoking is theworld’s most preventable major cause of suffering and prematuredeath among adults.According to the World Health Organization(WHO), tobacco helped kill about 80 million peoplebetween 1950 and 2004. This is 2.6 times more than the30 million people killed in battle in all wars during the20th century!The WHO estimates that each year tobacco contributesto the premature deaths of at least 5 millionpeople (about half from developed countries and halffrom developing countries) from 34 illnesses includingheart disease, lung cancer, other cancers, bronchitis,emphysema, and stroke. By 2030 the annual death tollfrom smoking-related diseases is projected to reach10 million (Figure 1-15, p. 17)—an average of about27,400 preventable deaths per day or 1 death every3 seconds. About 70% of these deaths are expected tooccur in developing countries.According to a 2002 study by the Centers forDisease Control and Prevention, smoking kills about442,000 Americans per year prematurely, an averageof 1,211 deaths per day (Figure 19-1). This death toll isroughly equivalent to three fully loaded 400-passengerjumbo jets crashing every day with no survivors!Cause of DeathTobacco use 442,000Excess weightAccidentsAlcohol useInfectiousdiseasesPollutants/toxinsSuicidesHomicides85,00075,000 (14,200 from AIDS)55,00030,60020,622Illegal drug use 17,000Deaths101,500 (43,450 auto)400,000Yet, this ongoing major human tragedy rarely makesthe news.The overwhelming consensus in the scientificcommunity is that the nicotine inhaled in tobaccosmoke is highly addictive. Only 1 in 10 people who tryto quit smoking succeed, about the same relapse rateas for recovering alcoholics and those addicted toheroin or crack cocaine. A British government studyshowed that adolescents who smoke more than onecigarette have an 85% chance of becoming smokers.People can also be exposed to secondhand smokefrom others, called passive smoking.According to a 2002 study by the Centers forDisease Control and Prevention, smoking in the UnitedStates costs about $158 billion a year for medical bills,increased insurance costs, disability, lost earnings andproductivity because of illness, and property damagefrom smoking-caused fires. This is an average of about$7 per pack of cigarettes sold in the United States.Many health experts urge that a $3–5 federal taxbe added to the price of a pack of cigarettes in theUnited States. Such a tax would mean that the usersof cigarettes (and other tobacco products), not the restof society, would pay a much greater share of thehealth, economic, and social costs associated withtheir smoking.Other suggestions for reducing the death toll andhealth effects of smoking in the United States (and inother countries) include banning all cigarette advertising,prohibiting the sale of cigarettes and other tobaccoproducts to anyone under 21 (with strict penalties forviolators), and banning cigarette vending machines.Analysts also call for classifying and regulatingthe use of nicotine as an addictive and dangerousdrug, eliminating all federal subsidies andtax breaks to tobacco farmers and tobacco companies,and using cigarette tax income to financean aggressive antitobacco advertisingand education program.So far, the U.S. Congress has not enactedsuch reforms. Critics say this is mostly becausetobacco companies donated tens of millions ofdollars to candidates running for Congress andthe presidency.Figure 19-1 Annual deaths in the United States from tobaccouse and eight other causes in 2003. Smoking is by far thenation’s leading cause of preventable death. (U.S. NationalCenter for Health Statistics and Centers for Disease Controland Prevention and U.S. Surgeon General)