Blowing Smoke

Sometimes I read the paper and get the feeling that I'm supposed to be outraged or indignant, and yet I just can't get myself all worked up.  So it was today upon reading a front-page article about how cigar manufacturers entice the young and impressionable (i.e., the stupid) by peddling tobacco products in a variety of flavors that would make Bertie Botts proud (just google it).  Grape cigars! Cherry cigars!  Chocolate cigars!  If my stepfather--a true cigar aficionado--were alive today, he'd be rolling over in his grave at such sacrilege--or at the very least yuckiness.

The point of the article, though, was that cigar manufacturers were finding ways to sidestep federal laws against marketing tobacco products to minors by selling Wonka-esque cigarillos, which are not subject to congressional regulation.  The FDA has discretion to regulate such products, and the agency has promised to introduce new rules, but as yet no such rules have been promulgated.  And frankly, I just don't care.

As a lifelong non-smoker, I have no love for the tobacco industry.  I would certainly discourage people from smoking.  At the same time, I just think the government has more important things to do than pass ever more laws protecting people from their own self-destructive behaviors.  By this time, everybody knows smoking will kill you.  If people choose to do it anyway, isn't that their business?  Why does the government need to get involved?

Laws against smoking in public places make sense: They protect the innocent bystander from the toxic effects of other people's personal behavior.  But it seems to me at best hypocritical for the government to say, on the one hand, that a product is perfectly legal, but, on the other hand, that the makers of this product cannot attempt to sell it to the broadest clientele possible.  And after all, if you own a business, and the product you sell reliably kills a large portion of your customers, then you need to do all the marketing you can.  That's just the American way!

The Lunatics Are on the Grass--Or, At Least, the Leaves

A medical facility that encourages smoking?!?  Have we somehow traveled to Backwards World, where Republicans care about poor people and randy salmon spawn downstream?  Surprisingly, no.  For, while frowned upon in most houses of healing, cigarettes have long provided solace to patients in psychiatric hospitals.  Cigarettes reward good behavior, provide incentives to comply with treatment, and often soothe the troubled minds of schizophrenics and other sufferers.

Now, however, anti-smoking activists and medical professionals have suggested that smoking in mental hospitals should go the way of smoking in. . .  well, everywhere.  What use treating the mind if the body will soon succumb to emphysema?  Fair enough, but when it comes to the issue of whether or not to provide cigaretees to schizophrenics, I have to say I'm of two minds about it.

Sorry.

Seriously, though, I'm no great fan of the tobacconist's art.  I've never smoked, and I derive no pleasure from the second-hand variety.  I applaud most campaigns to eliminate smoking in public places, and I certainly understand the desire among medical professionals to ban smoking at hospitals, if for no other reason than the prevalence of oxygen tanks.  At the same time, if one advocates (as I do) for the legalization of marijuana for medical reasons (I advocate full legalization, but that's another story)--if one feels people should alleviate their pain through whatever means available, as long as those means don't harm others--then how can I sanction the prohibition of smoking among those who actually do derive significant benefit from it?

Let these people smoke!

An Addiction by Any Other Name. . .

When is an addiction not an addiction?  When it's a cure.

New research suggests that nicotine patches and gum don't increase the likelihood of someone's quitting smoking; indeed, among heavy smokers, nicotine replacement therapy was associated with a higher likelihood of relapsing than using nothing at all ("Nicotine Gum and Skin Patch Face New Doubt").

I've always thought that nicotine patches and other medicinal addiction cures posed a sort of logical quandary: If you need a drug in order to keep from using a drug, aren't you just substituting one addiction for another?  If you get hooked on methadone to keep yourself from using heroin, are you qualtitatively better off?  The answer depends on whether the replacement addiction is better for you--or less harmful--than the addiction of choice.  I suppose nicotine patches are better for one's lungs--and for the lungs of those around one--than smoking.  And rehabilitative drugs like methadone, suboxone, and others certainly provide social benefits if nothing else: Prescribed legally, they provide an imprimatur of social acceptability, suggesting that one has made the decision to improve one's life and battle one's demons.  This is no small thing.

The study cited today, however, reinforces the notion that, ultimately, the only way to kick a habit is, indeed, to kick it.  I don't minimize the difficulties faced by those who battle addictions.  But this study suggests that, when it comes to smoking at least, substitutes for cigarettes don't help one quit, and may simply lead one back to the real thing.  Maybe the problem is inherent in the very purpose of nicotine patches and similar "crutches": to minimize the suffering of those trying to quit an addictive habit.  I am not suggesting that addicts somehow "deserve" to suffer, but maybe suffering strengthens one's resolve to stay away from the addictive substance.  The more pain one has to go through to achieve a goal, the less likely he is to casually relapse--no one wants to suffer needlessly.

Obviously, I'm not a psychiatrist, and I have been lucky enough to avoid addictions.  I can certainly be accused of an "easy for him to say" attitude.  But if scientific studies cast doubt on scientific (pharmacological) solutions, maybe it is time to face the logic of the situation.

Don't Smoke If You Got 'Em

Let us stipulate that smokers are the scum of the earth--

(WOS: "What did you just say?" "Nothing, Hon.")

--OK, everybody we have to keep it down.

Where were we? Ah, yes: Smokers.

--loathsome bottom-dwellers unfit for membership in polite society--does that mean they can't get a job?

Some companies--frequently hospitals and other health-related entities, but others as well--have taken the idea of a "smoke-free workplace" to the next level, refusing even to hire smokers. These companies reason that smokers cost too much money, in the form of both higher healthcare costs and reduced productivity. Furthermore, particularly in the case of the healthcare industry, employers feel that employees should practice the healthy lifestyle choices that these industries promote.

On the face of it, these companies have a point. Why should they pay higher costs to subsidize the destructive behavior of their employees? Smokers hardly strike us as a "protected class." Racial and sex discrimination is reprehensible--and rightly outlawed--because employers must not discriminate against people because of innate or, in the case of many disabilities, acquired characteristics. On the other hand, when a behavior is chosen--smoking, drinking, homosexuality--a privately owned company would seem to have the right to weigh it disfavorably in its hiring preferences.

(Digression: Yes, we know: It was a joke. EOD)

Still, much as we personally dislike smoking, and much as we wish everyone would just stop doing it, we have a problem with this policy. Yes, one could argue that smoking is a choice, and one could just as easily choose not to do it if one truly wanted a job at a non-smoking firm. At the same time, though, smoking is a legal activity, and as long as one's smoking does not incovenience other employees (which the near-universality of smoke-free workplaces generally ensures), one should not automatically be banned from a job because of a smoking habit. (Well, OK, maybe from the position of Chairman of Stop Smoking America, but otherwise. . . .)

What about the argument that companies are simply trying to promote health? As Dr. Michael Siegel of the Boston University School of Public Health (no fan of cigarettes himself) said, "Unemployment is also bad for health." We sympathize with the economic argument: We, too, have a problem with the idea that non-smokers must bear an additional burden for the bad habits of their fellow citizens, but the solution seems quite simple: According to federal estimates, a smoker costs an employer approximately $3,400 a year in additional health-care expenses. Why not just deduct $3,400 from the annual salary of a smoker?

Call it a Start-Your-New-Year's-Resolution Early tax.

Solipsistography
"Hospitals Shift Smoking Bans to Smoker Ban"

Sometimes a Watermelon-Flavored Cigarette Is Just a Cigar

When is a cigarette not a cigarette? When it's a jar!

Oh, wait, that's a door.

The above question becomes positively talmudic in light of new FDA regulations banning the sale of flavored cigarettes. ("Flavors Banned From Cigarettes to Deter Youths") The concern is that flavored cigarettes with names like "Twista Line," "Kauai Kolada," "Warm Winter Toffee," and "Smoky Quesadilla" (only one of those is made up) serve as "gateway" products enticing kids to smoke. As if phallic-nosed cartoon camels weren't enough. The problem? "The legislation left some details vague. For instance, the agency is required to ban flavored cigarettes, but the law did not clearly define what constituted a cigarette."

Not quite as ludicrous as it sounds. Not all tobacco products are cigarettes--cigars and "cigarillos," for instance, the latter of which are "larger than a small cigar, but smaller than a premium hand-rolled cigar." Get out your tape measures, FDA! Because in theory the legislation permits the sale of flavored tobacco products that are not cigarettes. When your local mafioso wants to unwind after whacking a member of a rival family, he can purchase a Tutti-Frutti Hand-wrapped Havana without fear of FDA reprisal. But this puts FDA agents in the difficult position of having to determine, if you will, when a cigarette is not just a cigarette. As one tobacconist reports, she (and let's hear it for female tobacconists!) was told by an agent "to remove every flavored tobacco product from her shelves that 'looked like a cigarette' but [the agent] could not define what that meant."

Paging Dr. Freud.