Tobacco Documents Online

I Statement by John 3. .°.or.3ni, ?h..,. I L I am ~ohn H. Romani of Ann Arbor and appear today :n a dual c-a^acity. c'irst is as a private citizen concerned with the dangers to our health which arise frca cigarette smoking and the use of tobacco products. Second is as the :==ediate Past President of the lmerican r,:blic Health Association which is a professional organization composed of over 30,000 public health workers throu3hout the countrf. Since 1959 when it adotted its first official policy on the health problems related to cigarette smoking, the Association has been on record as having a deep concern with the threats to the public health posed by the use of tobacco products. This first statement of APy.a policy has been exranded and refined by subsequent resolutions, each one reflecting our in- creased scientif~c understanding of the risks to human health uhich come from smoking. The data on which ve have taken these actions are those with •rhich I am certain you are most faailiar. `.lot only is cigarette smoking implicated as a significant factor in contributing to lung disease, it is also a^,a,+,or element in increasing risks for heart disease and associated circulato rf disorders. Moreover, as recent studies have suggested, it is not only the individual smoker who is at risk, but also the aany smokers exposed to tobacco smoke. As pointed out in the retort of the Surgeon General, Healthy People, issued last year: "Cigarette smoking is the single most preventable cause of death." This, if nothing else, should urge us to develop public policies which will lead to a reduction in smoking among all segments of our population. The issues raised by cigarette smoking and health are, in .:.any respects, comparable to those we have confronted in other areas where the health of the public is a major consideration. A basic principle of public health is to erect, by one means or another, barriers between the agent which causes illness, and the individuals who, in the absence of such barriers, would be exposed to such threats to their health. Further, such action is generally undertaken as a collective effort by the state or the community in the dis- charge of their responsibilities to protect the public health, safety and welfare of their citizens. This is the principle we use to support immuniza- tion against communicable diseases, purification of our water supplies, develop- ment of aaste disposal systems and other comparable public health measures. In each of these cases there was clear ard demonstrable scientific evidence that the actions undertaken would result in a reduction in morbidity and mortality from the disease agent involved. Such actions, by their nature, iWmosed restric- tions on individuals and groups - children vere required to be im=unized prior to entering school; householders could not dispose of waste as they saw fit; and lia;.tations were placed on sources of water. ~ ?re-,ared for mresentat;on to the Governor's Citizens' ?anel on Saoking and 3eaith, October 8, 1980. -187-

I -2- +Then we attempt to applf these principles to the questiorn of ci3srette smoking, the objection is frequently raised that control of smo'r.ing is an unnecessary curtailaAnt of one's freedo:a. :t is argued that _ ndiv:duals have a right to be as healthy or unhealthy as they choose, particularly :.° their behavior does not affect others. Smoking, it is suggested, is such a behavior. This argument breaks down for at least three different reasons. First, as I have noted, exposure to tobacco smoke constitutes a hazard to the health of many of those exposed. Thus, curtailWent o.° smoking is an appropriate measure to take in protecting the tublic health. Second, those who become ill as a consequence of smoking constitute an economic burden which is not solely borne-by the person directly involved. The costs of treating the lung cancer patient, the heart disease patient, among other illnesses of smoking, are reflected in the higher premiums we pay for health ins-urance, both as individuals and as taxpayers when our taxes are used to subsidize coverage for certain people in need. Thirdly, -re have found it appropriate for government - either by taxation, prohibition, or some other measure - to restrict the use of drugs or other substances which have been demonstrated as being dangerous to individual health. The same logic, at least from my perspective, applies in the case of smoking. The other argument frequently raised is that additional restrictions on the use of cigarettes would unfairly impact on certain businesses and related enterprises. No doubt this would happen and it is not something we should dismiss out of hand. There is no question that the economic well-being of some firms may be adversely affected by additional regulation in this area. Again, however, the issue is one of balancing public interests against private interests. The question must always be what will be best for the state or community as a whole. The long term gains which would come from actions to restrict smoking are, at least in my judgment, greater than the shorter term problem of adjustment which speci.*ic enterprises might face. In summary, there are strong arguments in support of strengthening the existing laws regulating smokiz13 in public places and to provide for their enforcement. ~e most effecti`~s~trateKr in this area is to prevent people from starting to smoke in the first instance, and here, expanded efforts among young adults who are most susceptible to the idea of cigarette use are greatly needed. Also required are more vigorous endeavors to inform people about the adverse effects of smoking on health. Governor Milliken and the Panel are to be commended for focusing the attention of the citizens of Michigan on this critical public health issue. i 1 I I I I I d I I I ~ L -188-