Tobacco Documents Online

BOOKS lessons of the past four decades of devel- opment experience in the LDCs clearly demonstrate that market-friendly, out- ward-looking policies lead to growth while state-centered approaches fail. But the contributors ought to have taken up an add{iionai question: What role, if any, is there for foreign assistance if the multi- laterals embrace in practice as well as in rhetoric the neoliberal development model Perpetuating Poverty favors? Since end- ing all aid doesn't seem immediately fea- sible, such a question about the wansfor- marion of aid is crucial. The book could have included, for ex- ample, an essay discussing the merits of aid to soc{al investment funds which per- mit LDCs undergoing market-oriented re- forms to cushion the pains of structural adjustment on the poor. It also could have assessed the role that foreign aid played in the economic success stories of the East Asian tigers (Singapore, South Korea, Taiwan, and Hong Kong) as well as newly industrializing countries such as Chile, Malaysia, Indonesia, and Thailand. While those countries have received signifi- cantly less aid than many LDCs, they nevertheless have received some, and it would be helpful to understand how such assistance helped or hindered them in their adoption of pro-market, neoliberal development strategies. Finally, ~ven the mixed (both diplo- marie and economic) objectives of for- eign-aid policy, it would have been useful for the contributors to have assessed the individual performance of each of the three components of foreign aid--security assistance, development assistance, and humanitarian assistance. Despite these oversights, Perpetuating Poverty is a powerful book that should encourage policy makers to reevaluate the very phrase "foreign aid." Such 1.anguage assumes that concessionary wealth trans- fers from the developed to the underde- veloped countries actually assist the latter in making economic progress. Perpetuat- ing Poverty relentlessly explains why this is often not so. With that matter settled, the way is now clear for an equally rigor- ous, radical rethinking of aid policy that could transform "foreign assistance" into something that actually serves the poor rather than prolongs their agony. "~ Amy L. Sherman is author of Preferential Option: A Christian and Neoliberal Strat- egy for Latin America's Poor (Eerdmans) and a visiting fellow of the Ethics and Public Policy Center. Pinch Me By Jacob Sullurn For Smokers Only: How Smokeless Tobacco Can Save Your Life, by Brad Rodu, New York: Sulzburger & Graham, 210 pages, $I 1.99 paper IN 1972, CoNstr~s UmON .P .UBLISHED a book called Licit and Ilhctt Drugs that devoted several chapters to the tiistory and hazards of tobacco. The au- thors were troubled that smoking had de- clined only slightly in the wake of the sur- geon general's 1964 report. They con- eluded that public health o~icials had un- "[E]fforts sha be made to popularize tine to addicts without filling their lungs with smoke," they wrote. Among other options, they suggested that people con- cemed about the health effects of smok- ing might seek to "popularize chewing to- bacco and snuff." That recommendation was conspicu- ously absent from The Facts About Drug Use, a 1991 Consumers Union book. In- deed, the authors seemed worried by the waysofdellveringfiequentdoses ofnico- rising popularity of smokeless tobacco, Brad Rodu: Against anti-tobacco zealots, he claims, "Smokeless tobacco use has risks, but (it) is unquestionobly much safer than cigareHe smoking." especially among adolescents. "The evi- dence is compelling that smokeless to- bacco produces nicofne levels in the body comparable to those produced by smok- ing and carries additional risk of cancer of the mouth," they said, giving no indica- tion that snuff and chewing tobacco might pose less of a health hazard than ciga- rettes. This change of heart reflects the cur- rent attitude of the anti-smoking establish- ment. In 1986, Surgeon General C. Ev- erett Koop issued a report that condemned smokeless tobacco as carcinogenic and addictive. He warned against "the tragic mistake of replacing the ashtray with the spittoon." Congress followed up by ban- ning broadcast ads for smokeless tobacco and requiring warning labels. One of those labels sums up the prevailing view, ech- oed by publichealth officials, anti-smok- ing activists, self-help books, and news- paper columnists: Smokeless tobacco "is not a safe alternative to cigarettes." But as Brad Rodu observes in For Smokers Only, that advice is hardly help- ful to a smoker who is thinking about switching to snuff or chewing tobacco. "In their zeal to convince the American pub- lic that tobacco is inherently evil, the anti- tohaeco zealots...have created the illusion that all forms of tobacco produce the same health problems," be writes. "'Smokeless tobacco use has risks, lint [it] is unques-

BOOKS ably much safer, resulting in far fewer significantly less serious health risks .oh are more easily managed, than ~rette smoking." ) ODU, CHAIRMAN OF THE ORAL F)ATHOL= • ogy department at the University of tbama at Birmingham, notes that oral .cer is the only major, well-established dth risk associated with the use of okeless tobacco (and even that disease .wice as common among smokers). A ~ 1 study published in The New En- rnd Journal of Medicine found an oral- ~cer rate of 26 per 100,000 among long- m users of smokeless tobacco, com- :ed to 6 per I00,000 among nonusers. ~ting that the survival rate for oral can- : is 50 percent, Rodu estimates that "/f • 46 million smokers used smokeless to- cco instead, the United States would e, at worst, 6,000 deaths from oral can- t" [a yearJ, versus the current 419,000 aths from smoking-related cancers, heart problems, and lung disease.'" (Em- phasis in original.) By this measure, he concludes, smokeless tobacco is 98 per- cent safer than smoking. Rodu and his colleagues estimate that life expectancy for a 35-year-old smokeless-tobacco user is 80.9, virtually the same as for nonusers. The average 35-year-old smoker, by con- trast, lives to be 73.1. Rodu's message to smokers is straight- forward: You can enjoy tobacco flavor and nicotine at a fraction of the risk, with- out the pesky smoke. He reassures the wary that today's moist snuff, placed be- tween the cheek and gum, does not pro- duce unsightly bulges or large quantities of saliva. It can be enjoyed discreetly at work or play, even where smoking is banned, and no one need ever know. Un- like nicotine gum or patches--which, Rodu notes, require a prescription, are relatively expensive, and have modest success rates--switching to smokeless to- bacco is not aimed at weaning smokers from tobacco. '~his book will make de- nial of smoking's dangers impossible," he writes, '"out it does not deny the smoker's pursuit of pleasure. You can have your to- bacco and enjoy it too." Rodu compares smokers to heroin ad- dicts and smokeless tobacco to metha- done. "Just as heroin addicts get treatmen.t with methadone maintenance programs... we must be bold enough to offer smoke- less tobacco (a safer, more acceptable de- livery system for nicotine) to millions of cigarette smokers," he writes. "The smokeless tobacco solution, like metha- done maintenance, is scientifically sound but will generate a lot of controversy based entirely on inappropriate and con- descending attitudes and beliefs." Indeed, the reaction of the anti-smoking establish- ment to Rodu's message has been remi- niscent of the hard-line drug warrior's attitude toward "harm reduction" mea- sures such as methadone maintenance, the distribution of clean needles, and honest The Special People by Tom Mahon In the year 2000, America is barely recognizable as the country it once was. There are no jobs, federal troops patrol every large city, and the authority to allocate scarce resources has become the power of life and death. The cold hand of d.ictatorship reaches acrogs the nation as the people silently witness the twilight of the American dream. On .the brink of a new Dark Age, the people in a quiet little town called Serenity will fight to hold onto the world which is their birthright. Who arc the people of Serenity and what do they believe in? In a series of diary entries, each of the characters expose the secrets which torture and propel them to risk everything for their beliefs. Winston-Derek Publishers Group, Inc. To order call: 1 (800) 826-1888 Also available at local Borders, Crown and Waldenbooks

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Rodu, who speculates that "the antito- bacco crusade has entered a stage where scientific facts are simply ignored as irrel- evant," was clearly shaken by "the strong. emotional reaction that the smokeless to- bacco solution elicits from tobacco cru- saders." He emphasizes that "smokeless tobacco should only provide a viable and comparatively safe damage control mea- sure for the current and last generation o~ nicotine addicts. Forty years or so from now I hope there are no tobacco users left on the planet." Thus Rodu, like his critics, wants not only a smoke-free society but a tobacco- free woflduthough he generally opposes using coercive measures to achieve that goal. He acknowledges that smokers get pleasureuand not just withdrawal-symp- tom relief--from cigarettes. But he does not allow for the possibility that someone could rationally accept the risks of smok- ing (including the difficulty of quitting) in exchange for the benefits. And he insists that even the relatively small risks posed by snuff are acceptable only in compari- son to the h~zards of smoking. For Rodu, it seems, tobacco is funda- mentally different from other products that consumers are free to take or leave, because it is addictive. Nicotine affects the body in such a way that smokers who try to quit often experience cravings, weight gain, headaches, anxiety, and other unpleasant effects. Rodu's "smokeless to- bacco solution" is aimed precisely at tho~ smokers who are deterred by such costs. But although he sometimes describes these individuals as 'kmable'" to give up smoking, it would be more accurate to say that they were unwilling to do so, given the costs involved. As Rodu notes, about 44 million smokers have managed to give up the habif, typically on their own. Rodu's tendency .to view addiction as a chemical compulsion ultimately under- mines his opposition to coercive anti- smoking measures. "I would agree com- pletely that the use of tobacco by adults is a freedom of choice issue," he writes. "I • am concerned here with the 46 million American adults who are addicted to to- bacco, regardless of how they became im- prisoned. Once an individual is addicted, where is his or her freedom of choice?" If smokers are literally unable to stop, if nicotine has robbed them of their will, it is not hard to justify the sort of prohibi- tionist schemeswsuch as FDA Commis- sioner David Kessler's plan to forcibly "detoxify" the nation's smokers by gradu- ally reducing nicotine levels in cigarettes --that Rodu decries. STILL, ~.ODU IS. REFRESHINGLY SKEPTICAL of anta-smoking dogma, even on the issue of addiction. He pokes fun at the no- tion, promoted with a straight face by anti- smoking activists and trial lawyers, that cigarette makers have been concealing the fact that tobacco contains an addictive drug from an unwary public. "Nicotine addiction is no deep dark secret recently blown out of hiding," he writes. The ad- dictive potential of tobacco has been com- mon knowledge for centuries. Nicotine was first chemically purified in 1828, and experiments in the early 1940s confirmed that it relieved smokers' craving for ciga- rettes. By the 1950s, nicotine addiction was being discussed in books aimed at the general public, and thousands of research articles on the topic were published dur- ing the '60s and '70s, when the tobacco companies were supposedly working so hard to suppress the truth. Similarly, Rodu demonstrates the va- cuity of complaints tt~ tobacco compa- nies "manipulate" nicotine levels in ciga- eral different strains of tobacco," he REASON C~TOflER l~X?5

BOOKS tes. '°'l'hus, it is conceivable that ciga- e manufacturers adjust the nicotine .centration to achieve consistency in e--[in] which nicotine plays an impor- ~ role. Even if the amount of nicotine :igarette tobacco is artificially modi- t, you cannot deny that a Marlboro 3ker deserves the same product unifor- :y as a McDonald's, Pizza Hut, or :a-Cola customer." As for reports that )wn & Williamson developed a high- otine tobacco plant, Rodu notes that )pie genuinely concerned about the Llth of smokers should welcome such ovation. Smokers of high-nicotine, /-tar cigarettes (like smokers of high- ency marijuana) would tend to absorb /er levels of toxins while achieving the ~.ct they desire. Rodu also questions the received wis- h about the hazards of environmental .acco smoke, noting that the evidence )pen to question and that the Environ- ntal Protection Agency has been criti- ed for prejudging the issue. But he adds .t fears about ETS, well grounded or not, widespread, feeding hostility against okers and driving the movement to ban oking in restaurants and workplaces. Although Rodu pulls no punches in de- ibing the hazards of smoking, he criti- es the idea that smokers impose huge ;ts "on society" because of the illnesses to which they are prone. After all, every- body dies of something. The smoker who drops dead at 45 from a heart attack will not live to develop Alzheimer's---or col- lect Social Security cheeks. When you look at the long-term savings as well as the short-term costs, Rodu notes, "the ex- cise taxes on cigarettes more than com- pensate for the external costs that smok- ers impose on society's nonsmokers." He is not impressed by popular support for raising tobacco taxes. "Polls currently in- dicate that Americans favor increasing ex- cise taxes on cigarettes by a margin of 3 to 1, which should surprise no one," he writes. '°That's the ratio of nonsmokers to smokers." Rodu's common sense and intellectual honesty are especially striking in light of his strong anti-smoking views. He ques- tions claims ("secondhand smoke kills," "smokers are a burden on society") that he considers shaky or erroneous, even though they would reinforce his argument for switching from cigare.ttes to smokeless tobacco. That kind of rigor is rare in the anti-smoking movement, which could use a few more heretics. @ Senior Editor Jacob Sullum (JSullum@ aol.com) is working on a book about the American anti-smoking movement for The Free Press. Var and Peace Paul A. Rahe the Origins of War and the Preservation of Peace, by Donald Kagan, York: Doubleday, 606 pages, $30.00 FWENTY-..F~. YEARS AGO~ SHORTLY after shi.ftlng, from Cornell to Yale Umverslty, Donald Kagan inched a new lecture course, "Histori- t Studies in the Origins of War." 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