I am not squeamish--I can watch an infant eat a poached egg--but I shudder and avert my gaze when the government deals with tobacco.
The government, which is having a tad of trouble with its budget, subsidizes both the growing of tobacco and the treatment of the many illnesses tobacco causes. Recently, officials of the Department of Health and Human Services endorsed toughening the warning message on cigarette packages and advertising.
Currently the message is: "The Surgeon General has determined that cigarette smoking is dangerous to your health." Congress is considering mandating more specificity: rotating warnings would cite dangers of cancer, heart disease, emphysema and--because nicotine is a substance that crosses the mother's placenta--risks to unborn children. Those are the children the president and many legislators, including some from tobacco states, want the government to protect with anti-abortion measures.
A few days after an administration health official testified for stronger warnings, he was back before Congress, visibly chagrined, saying that the administration was still undecided. Someone with a flair for understatement said that the administration's retreat reflects "the ongoing efforts of the tobacco industry."
This crude political decision in the upper reaches of the executive branch coincided with publication of another surgeon general's report on smoking. The 1982 report, the most powerful since the great report of 1964, says that smoking is the most important public health issue of our time and the chief preventable cause of death, and probably causes nearly one-third of all cancer deaths (129,000 of 430,000 each year).
The report coincided with evidence from cancer epidemiologists that carcinogenic pollutants that enter the environment from industrial and other sources may be less important than once thought as cancer-causing substances. Such evidence underscores the status of tobacco as the only known cause of a cancer epidemic.
Tobacco spokesmen, who seem to have studied the philosophy of science at the same schools where anti- evolutionists matriculate, insist that the case against tobacco is unproven. They say the link with cancer is merely statistical because we cannot yet explain the disease mechanism that makes a cell cancerous.
But given the statistical connection between tobacco use and increased incidence of particular diseases, that argument is comparable to the argument that evolution is unproven because "the missing link" is still missing. As has been well said, tens of millions of Americans have quit smoking, and not one has died because of that.
Naturally (well, Americans think self-interestedness is as "natural" as breathing), tobacco interests say that strengthened warnings would constitute "unwarranted intrusion" into citizens' lives. But a conservative administration, which celebrates consumer sovereignty, should not flinch from measures designed to facilitate rational consumer choices. Conservatives make themselves ridiculous when they countenance calling the provision of scientific information an "intrusion."
In the peak year of 1955, 53 percent of American men smoked; in 1966, 33 percent of American women smoked. Today the figures are 37 percent and 29 percent. The decline is attributable in large measure to government dissemination of information. Perhaps some conservatives are hostile to the government's informing function because it has an extraordinary cost- benefit ratio. This is inconvenient to persons whose "conservatism" is a monomaniacal disdain for government and all its works (other than military works, of course).
The administration retreated from the stronger cigarette warnings when accused of "Califanoism." Joe Califano, the former secretary of health, education and welfare, had a concept of "civil rights" as expansive as Montana, and some of his causes were as small and annoying as chiggers. But in his campaign against smoking he did no more than his duty.
Tobacco, which kills an estimated 340,000 Americans each year through various cancers and heart disease, and through emphysema, has killed, expensively and agonizingly, many more Americans than have been killed in all of America's wars and traffic accidents. More than $13 billion a year is spent on smoking-related health problems, and lost production and wages involve another $25 billion.
Yet in 1980, candidate Ronald Reagan said (in North Carolina) that "my own Cabinet members will be far too busy with substantive matters to waste their time proselytizing against the dangers of cigarette smoking." Anyone who spends as much time as Reagan does proselytizing against declining productivity, soaring budgets, inflation (which is especially virulent in the health industry), and stressing individual responsibility should not dismiss smoking as an insubstantial concern.
His administration--rhetorically indignant about soaring entitlement expenditures, ideologically vociferous against government-by-interest group, and emphatically "pro-life"-- should be blushing.