Epidemiology epidemic hits Third World

by Terence Corcoran
Toronto Globe and Mail
November 5, 1994

After they signed a peace treaty last month, Jordan's King Hussein and Israeli Prime Minister Yitzhak Rabin celebrated - with a cigarette. The image of King Hussein, a Winston dangling from his mouth and holding a lighter for Mr. Rabin, conveyed a sense of friendship and collegiality that looked much more genuine than the traditional handshake. Even enemies shake hands in photo-ops; only friend invite one another so share a smoke.

A few days earlier, another rare instance of public smoking was recorded by CBC television's Prime Time News. Throughout a long, chatty interview, Canadian folk-rock icon Joni Mitchell drew luxuriously on a cigarette, grey smoke drifting evocatively around her handsome features, her bright smile and quick charm suggesting happiness and confidence.

The image was shocking. Laughing and smoking in the same video frame seems almost pornographic these days. The officially approved image for smoking is that of a killer, of grotesque physical deterioration and death. In government antismoking commercials, characters out of Mary Shelley's Frankenstein enact horror movie scenarios designed to spook the population. Like bad sci-fi movies, however, the commercials produced more laughter in audiences than fright, and were pulled as miserable bombs.

The Hussein-Rabin peace smoke seemed even more surprising given the age of the two leaders. How could these two old geezers - Mr. Hussein is almost 60, Mr. Rabin is 72 - still be alive and enjoying themselves? They should be dead from lung cancer by now. And how could Ms. Mitchell, at 50, look so alive and glamourous?

These positives images of smoking didn't last long. A few days later, they were overtaken by the more common smoking message. "Third World lung cancer epidemic feared," said a headline in last Wednesday's The Globe and Mail. The story, a report from the International Cancer Congress in new Delhi, said that as living standards rise in developing countries, more people will take up smoking and a rapid increase in smoking-related health problems will follow. "Developing countries are sitting on a time bomb," said Richard Peto, an Oxford University epidemiologist who warned that tobacco-related deaths could rise to 10 million a year by 2025 from the current three million.

A variety of reasons were offered to explain the increase in smoking in developing countries, including ignorance, illiteracy, heavy marketing and cheap prices. No mention was made of the possibility that people enjoy smoking, and that their new higher incomes provide the wherewithal to increase their enjoyment. In China - where Chairman Mao, The Great Smoker, lived to be 82 - the average male today consumes 10 cigarettes a day compared with four a day in 1972, although more likely the change is a result of increased cigarette production following a breakdown of Communist central planning.

Canada's own David Sweanor, senior legal counsel at the Non-Smokers Rights Association of Ottawa, urged Third World countries to boost cigarette taxes to prevent citizens from enjoying cigarettes, ignoring Canada's disastrous tax-the-poor experiment. Indeed, Mr. Sweanor, operating thousands of kilometres from home, managed to tell a Big White Lie to the conference when he suggested that the recent drop in Canadian tobacco prices has produced an 11-per-cent rise in the sale of cigarettes, and by implication an increase in smoking, a claim for which there Is no evidence.

The main purveyors of Frankensteinian fear across the developed world, and now into the Third World, are epidemiologists who spin statistical correlations into cause-and-effect mythology. Despite the authoritative sound to the numbers, reports of death by smoking are greatly exaggerated. Only 30 per cent of cancer deaths are linked to smoking, which does not mean smoking caused the deaths. Relatively few smokers, moreover, succumb to cancer. King Hussein and Mr. Rabin have not been killed by lung cancer, for example, because only one out of every 250 smokers or former smokers develops the disease.

Another product of epidemiology is the newly created scare of secondary smoke, now used by governments and regulators to expand their anti-smoking crusades. In The Book of Risks: Fascinating Facts About the Chances We Take Every Day, University of Hawaii Professor Larry Laudan outlined the risks associated with second-hand smoke, demonstrating the absurdity of applied epidemiology.

Among Prof. Laudan's findings: Drinking two glasses of milk a day poses a greater threat of death from cancer than a lifetime of exposure to secondary smoke. Eating a smoked pork chop once a week, or driving a small car rather than a large car, is more likely to kill you than secondary smoke. The clincher: If you are exposed to secondary smoke but eat green spinach once a week, you are less likely to die of cancer than if you are never exposed to smoke and eat no spinach.