In the May 6 edition of the Sunday New York Times Book Review, there was a review of Prof. Allen Brandt's new book, The Cigarette Century: The Rise, Fall, and Deadly Persistence of the Product That Defined America appeared. The review was written by Jonathan Miles who is, oddly enough, a persistent cigarette smoker. In contrast with 70% of smokers, he claims that he smokes because he likes it, and implies that that is the reason most smokers smoke. Mr. Miles apparently knows little about the addictive properties of nicotine: approximately 90% of persons who try cigarettes become addicted to them, especially if they begin smoking at a young age, which is when most smokers begin. (About 20% of persons who try cocaine become addicted to it, but that's another story.)

In contrast with 70% of smokers, he claims that he smokes because he enjoys it. But this column is not about the addictive properties of nicotine and how, for example, the levels in cigarettes have been so cleverly manipulated by the tobacco industry over the years. It is rather about how the industry has so cleverly manipulated the general public and its political representatives and their attitudes towards smoking over the years, and the comparison between the tobacco industry and another big one that trades on an addiction it has created. In so doing, the latter has created a coming international health and public health crisis far larger than even the one that has been created by the tobacco industry.

In his review, Mr. Miles notes that he says, when confronted by a "you shouldn't smoke, you know," message, "I know that I should quit, but there's one problem, I enjoy it." Mr. Miles goes on: "Smokers . . . are midwifed by an array of potent forces: . . . advertising, peer pressure, . . . the addictive properties of nicotine, the industry's pernicious campaign to obfuscate the perils of smoking." He goes on: "Cigarettes were ubiquitous [by the early 20th century]. . . . The tobacco industry . . . . nurtured and exploited that ubiquity. . . . [But then, beginning in mid-century,] faced with damning evidence [of the major and ubiquitous health harms of cigarette smoking [, the industry devised a cagey defense: rather than denying the harms of smoking, it insisted there were ‘two sides' to the story, and corralled skeptical scientists . . . to rebut or at least recast doubt upon the medical consensus. Journalists were urged to consider ‘fairness' and ‘balance' in covering the invented ‘controversy.'"

Oh my. Sound familiar? A created "addiction" to the use of a particular fuel, especially in this country made widely available and very cheap. The conversion of rail transport after World War II from coal to oil power, and then of a major chunk of rail transport to truck transport, which had a double purpose: sell much more oil with the side benefit of putting the single most powerful union in the country, the United Mine Workers, out of business. IN the case of oil, government was a major factor in this process. The massive subsidization of petroleum fueled rubber-tired transport that began in the 1950s with the construction of the Interstate Highway system. The "depletion allowance" subsidies to the oil industry, the destruction of the Federal alternative energy research program, begun by Pres. Carter, by Pres. Reagan on his first full day in office, and so on and so forth right up to the War on Iraq.

And so now we have Global Warming. With it, we have, to paraphrase the oil industry's "cagey defense: rather than directly denying" the harms of petroleum combustion as the major cause of global warming, it insists that "there [are] ‘two sides' to the story and [has] corralled skeptical scientists . . . to rebut or at least recast doubt upon the [international climatological] consensus." Terrifying and horrifying, isn't it? In 1964 (!), the U.S. Surgeon General's Report on Smoking and Health was first published. It was met with the industry campaign, extending over three-plus decades, described by Prof. Brandt. Cigarette smoking has been on the decline in the U.S. since the mid-60s, but it is still the number one killer of Americans. Its devastating effects on health will be with us still for decades. As for other countries around the world where the U.S. tobacco industry has so persistently marketed and sold its product (the industry being far and away the largest addictive-drug exporter on earth), the negative effects will persist even longer.

And here we are, fighting the same fight with an economically and politically powerful industry, which if it is not denying that global warming is a reality, then denies that humans contribute very much if anything to its existence. Which then brings one to wonder if an equivalent internal memorandum to one found in tobacco industry archives, written in 1961 (!), will see the light of day, say 30 years from now, as millions of Africans die from drought and hunger, Bangladesh virtually cease to exist, and New York's Financial District relocates to higher ground. Again quoting from Mr. Miles, the memo states: "‘There are biologically active materials present in cigarette tobacco. These are: a) cancer causing; b) cancer promoting; c) poisonous.'"

Steven Jonas, MD, MPH is a Professor of Preventive Medicine at Stony Brook University (NY), a weekly contributing author for The Political Junkies [1], and contributing editor for The Moving Planet Blog [2].

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