Save Children from a Death Mill

by Dr. Hayden Walters - Mercury News - Nov. 6, 2014

[Background info: There is a legislative push by Tasmanian doctors to make it illegal to provide tobacco to anyone born after the year 2000, to create a tobacco-free generation - see http://www.themercury.com.au/news/tasmania/push-grows-to-ban-cigarettes-for-everyone-born-after-2000/story-fnj4f7k1-1227074507679 ].

WHEN I first became a consultant respiratory physician 30 years ago in the heavy-smoking northeast of England I was given the lung cancer clinic to look after.

This was a rite of passage for new guys because it was a pretty unpopular task.

I would see about six new lung cancer cases a week and had to explain to all those patients and their close family that they were likely to die over the next two years, unless we could cut all the tumour out, which was unlikely.

My youngest such patient was a 29-year-old mother of two who had smoked since the age of 12, and I still wake occasionally thinking about her, and the harrowing way she died.

My job was mainly to select those who seemed operable, and with not much in the way of modern technology to help.

It was hit-or-miss, with half of those having a painful operation having too much tumour when they were opened up even to try and resect.

I always felt terribly guilty about those.

And despite a huge amount of stress for all concerned, including me and the rest of the medical and nursing teams, the cure and survival rate in my clinic was typical at just 10 per cent.

You may well ask, what point there was in bothering so much?

About 30 years later in Tasmania, another high-smoking community, other young doctors still run lung cancer clinics.

The disease is still occurring and causing most cancer deaths in both men and women.

There is a better, more professional clinical co-ordination, a multidisciplinary clinic, improved and very expensive technology to at least prevent so many getting needless major operations. But, despite huge effort, skill and cost, the survival rate has not budged at all – still about one in 10, about 90 per cent still die.

This disease is almost completely preventable if only kids did not start smoking tobacco between 12 and 16 years of age.

Want to hit your head against a brick wall?

Lung cancer is not, of course, the only or even most common disease caused by smoking, but the 20 per cent or so of smokers who get lung cancer do leave a huge impact on all involved. But the same could be said for all the heart attacks, strokes, foot gangrene, mouth and throat cancer, not to mention the common-or-garden bronchitis and emphysema they get.

Chronic Obstructive Pulmonary Disease is staple work for respiratory physicians, and has a rather different sort of horror about it – watching someone struggle to breathe for years is no fun.

Once a COPD patient comes in to hospital with an acute attack then on average they have about two years to live, not a lot different to a lung cancer presentation.

More head-banging? Or is there a better way?

All respiratory physicians in Tasmania strongly support the Tobacco Free Generation proposal being put before Parliament by MLC Ivan Dean.

This would at long last see the phasing out of sales of tobacco products to everyone born since 2000. The intention is to prevent the scandal of younger teenagers taking up smoking and becoming lifelong addicts to nicotine.

We know smoking almost always starts in the younger teen years before brain maturation is completed and social competence is attained and hardly ever after the age of 21 years, and little even after age 18.

Most importantly, almost every smoker deeply regrets starting by the time they reach the age of 30.

Tobacco salesmen talk hypocritically about “choice”, but there is no choice in enticing vulnerable young kids to get addicted to a product that is going to cause grief and suffering, will kill half of them and maim others.

The tobacco industry has spent decades lying about the health effects of its products, glossily marketing them as glamorous, and fighting every government and health organisation attempt to eliminate their promotion.

We can make this stop.

This new proposal is not prohibition, as existing smokers of whom there are more than 60,000 in Tasmania, can continue to smoke.

However, we aim to protect the next generation, helping them avoid getting cigarettes while they may still think smoking is “cool”.

And when they become adults and can make a mature choice we already know they will be very thankful.

While we will not see the end of lung cancer, COPD, heart disease and other smoking-related illnesses for decades, even if every Tasmanian quits smoking tomorrow, the Tobacco Free Generation Bill would ensure that eventually future generations of families will not have to endure the heartbreak of caring for loved ones with tobacco-related illnesses, and watching them die slowly and distressingly.

This law is not about “catching” people or punishment, it is about saying it is no longer acceptable to sell cigarettes to our children.

The TFG Bill, which would phase out the commercial sale of tobacco to children born this century, will not penalise adult smokers or even under-age smokers, or cause hardship to retailers who have years to adjust, nor cause an increase in smuggled tobacco because present adult smokers can continue to buy.

Of course there will be no demand for tobacco products among generations to come.

It will save the lives of thousands of Tasmanians long into this century, and prevent them becoming child-fodder for the tobacco industry death mill that constantly needs to replace its dead and dying customers.

It would be nice to think there will eventually be a generation of Tasmanian medical students who do not have to witness the human misery of the tobacco-disease epidemic – it has been going now for more than 60 years, far too long, with far too much avoidable suffering.

Source link: http://www.themercury.com.au/news/opinion/save-children-from-a-death-mill/story-fnj4f64i-1227113968259 

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