Sometimes a statistic is more than just a number.
Take the recently released Centers for Disease Control and Prevention (CDC) figures on the societal costs of smoking. Each pack of cigarettes sold in the United States costs the nation an estimated $7.18 in medical care and lost productivity. That adds up to a total of $150 billion each year, or about $3,391 per smoker per year.
Or consider their statistics on premature death from smoking. Between 1995 and 1999, an estimated 440,000 people died annually from diseases related to cigarette smoking. Among adults, most deaths (124, 813 of them within that time frame) were from lung cancer, followed by heart disease (81,976 deaths) and lung disease (64,735 deaths). These adult men and women smokers, on average, reduced their time on earth by 13.2 and 14.5 years, respectively, because they smoked.
On May 23, these abstract numbers became sadly real when my ex-husband, James F. Battle -- father of our three adult children, and grandfather to a toddler -- died of lung cancer.
A Lifelong Smoker
Jim was a lifelong smoker. For more than six decades he smoked two to three packs of cigarettes each day, and he proudly collected Camel cigarette coupons from each pack. It was only after he was diagnosed with inoperable cancer that he quit the habit. It was too late. He died three months later.
We had become friends after the animosity of the divorce faded, and I witnessed the symptoms leading to his diagnosis and the fierce pain that accompanied his dying process. I was shocked by the rapid progression of his disease and I watched our family helplessly stand by as the cancer consumed his body.
But what haunts me most was the sight of two of our children lighting cigarettes after Jim's funeral.
A Disease of Denial
My two sons continue to smoke, even after watching their father cough up blood, suffer debilitating pain, and waste away to skeletal proportions. They lit up after watching their father as he was nauseated, weak, and unable to hold down food after radiation treatments. And they lit up after watching him become progressively more unable to get out of bed, feed himself, or find the right words for what he wanted to say.
What will it take to get them to put down cigarettes? Do they not believe the evidence of their eyes and heart? Or do they think this will never happen to them?
I remember one of the first stories Jim told me when we were dating. His father -- also a lifelong smoker -- was dying of lung cancer and Jim left his bedside to take a cigarette break. A nurse saw him smoking and asked him if he understood what his father was dying from. Jim said yes.
Three generations of Battle men have smoked, despite glaring evidence of the killer nature of this addiction. And I must say that three generations of non-smoking Battle wives have enabled their own denial by purchasing cigarettes for their husbands and silently inhaling secondary smoke.
What does it take to break the cycle; to get my sons -- and other mothers' sons and daughters -- to put out the cigarette they are smoking and let it be their last? Just as importantly, how can we help children in this country and around the world not take the first puff?
The Sad Facts
According to the World Health Organization (WHO), about 12 percent of women throughout the world smoke, compared with about 48 percent of men. That is nearly one out of every eight women and one out of every two men.
A report in the June 2002 issue of the American Journal of Public Health predicts that worldwide deaths from tobacco-related illnesses will increase from 4 million in 1999 to 10 million by the 2030s.
The European Respiratory Society, in their meeting in Berlin last year, reported that if current trends continue, lung cancer will become the world's No. 1 killer of women within the next 20 years. Currently, breast cancer holds this distinction.
In our own country, every day more than 2,200 young people under the age of 18 become daily smokers. None of them thinks this addiction may lead to a shortened life or painful death.
The good news is that some of the lost life expectancy can be regained no matter when in the life cycle a person stops smoking. Even if a person quits during his or her senior years, life span can still be increased.
Dr. Donald H. Taylor, Jr., of Duke University conducted research indicating that men who quit smoking at age 35 were estimated to live about 8.5 years longer than men who were current smokers. Men who quit at age 65 gained two additional years.
Women who stopped at age 35 were expected to gain an additional 7.7 years, while older women who quit could expect an additional four years.
For Jim Battle, these additional years would have allowed him to see our soon-to-be-newest grandchild whose birth is imminent. It would have allowed him to kiss the bride when our eldest son marries next year and to watch our daughter begin a career as a nurse.
No Simple Answers
The question remains: How can the deadly consequences of smoking, as well as the promise of increased health from quitting cigarettes, be communicated to the relevant populations?
There are no simple answers. Prevention experts have chipped away at the youth smoking rate by developing strategies to limit cigarette access by minors. Per-pack taxes have increased and clear laws regarding sales are now enforced.
Yet peer and family influence appear to be unaddressed factors.
Investigators at Tulane University recently released research findings indicating that middle-school students are more likely to try cigarettes if they have a best friend, parent, or sibling who smokes. Eighth graders with a family member who smoked were more than twice as likely to smoke than their peers living in non-smoking homes.
How can we encourage existing smokers to quit so the intergenerational cycle of smokers begetting smokers does not continue unchecked?
Would it help if there were more "cinema veritas" renditions of real families coping with the emotionally and financially wracking process of losing a loved one to a "smoker's disease"? Periodically, public broadcasting networks show documentaries of a terminal patient and the suffering family, but what if the major networks presented these shows, regularly and in prime time?
How many more mortality statistics will become family tragedies before increased government and community monies are allocated to develop creative solutions to this complex problem?
For all our sakes, I hope the statistic is small.
Judy Shepps Battle is a NJ resident, addictions specialist, consultant and freelance writer. She can be reached by e-mail at firstname.lastname@example.org. Additional information on this topic is available on her website at www.writeaction.com
WRITTEN MAY 2002
© 2006Judy Shepps Battle. All rights reserved.