An economic case for banning smoking?

An economic case for banning smoking?

"The leading cause of premature death among adults in 1985 was not famine [in Africa], warfare, or the attacks of international terrorists: It was cigarette smoking,' says William Chandler, author of a report issued last week by the Worldwatch Institute in Washington, D.C. Already more than a billion people smoke. And the rate at which they consume tobacco --almost 5 trillion cigarettes daily --is growing about 2.1 percent annually, faster than the world population. This obvious difficulty in controlling tobacco's lethal addiction, according to the report, suggests that "stronger medicine' is needed: a banishing of smoking from the workplace and public buildings.

"Almost one-fifth of all U.S. deaths can be traced to cigarette smoke,' reports Chandler, a senior researcher at Worldwatch. Together, lost income associated with those 375,000 deaths and lost work from smoking-related illnesses cost the United States between $27 billion and $61 billion annually, the report says, or $1.25 to $3.15 per pack of cigarettes smoked. (This does not include the cost of the tobacco itself--another $30 billion a year.) Worldwide, the report continues, the cost is much higher: 2 million to 2.5 million smokers die each year from heart disease, lung cancer and emphysema.

Discouraging public support of strong antismoking measures has been the prevailing attitude that smoking, as a habit of choice, conveys health risks that users have consciously accepted. What this attitude doesn't address, Chandler says, is the fact that tobacco is strongly addictive (see p. 44) and that smoke harms more than just the smoker.

Passive smoking (inhaling the smoke of another's cigarette) has been linked to lung cancer in nonsmoking spouses of smokers in more than 10 studies, Chandler notes. A study published last year in ENVIRONMENT INTERNATIONAL (Vol. 11) "estimated that passive smoking in the United States causes more cancer deaths than all regulated industrial air pollutants combined'--perhaps 5,000 people annually, or one-third of the lung cancers not directly attributable to smoking, Chandler reports.

Maternal smoking, the report notes, has been associated with increased rates of miscarriage and low-birthweight babies. Parental smoking also has been linked epidemiologically to other hazards in children, including reduced lung capacity, higher rates of respiratory illness, cancer (SN: 5/18/85, p. 312) and slow intellectual development.

In the United States, the report says, only 14 percent escape involuntary exposure to cigarette smoke both at home and at work. "The rest,' Chandler estimates, "involuntarily "smoke' on average the equivalent of almost 1 cigarette per day,' and for some the number is considerably higher. Though it is theoretically possible to ventilate buildings to remove the passive smoking threat, Chandler cites data indicating that to do so would require replacing the volume of air in affected rooms about 250 times more often than it normally is replaced--measures that would increase heating, cooling and air pumping costs 250-fold.

The most cost-effective way to protect nonsmokers' health is therefore to banish smoking from the workplace and public buildings, he says. And U.S. industry is adopting this strategy increasingly. In 1984, for example, 10 to 25 percent of the top 1,000 businesses engaged in publishing, insurance, finance, pharmaceuticals and scientific equipment either banned smoking or separated smokers from nonsmokers, according to the report. Chandler notes that many of these firms, while responding to the rights of their nonsmoking employees, were doubly encouraged to adopt these policies by potential financial gains.

"Smokers cost employers money,' Chandler says. Surveys indicate that the inefficiency and illness forstered by smoking waste about 7 percent of a smoker's time. More tangible are the data he cites showing that, on average, each smoker costs an employer $650 in additional insurance and cleanup costs.

Scott Staph, a spokesperson for the Tobacco Institute in Washington, D.C., criticized the report's economic projections of smoking's health effects and productivity losses as "fanciful extrapolations that have very little to do with hard, factual data.'