an autodidact meets a dilettante…

Recently I was talking about unhealthy habits to my students – I teach academic English to NESB students – and smoking came up. A student from Saudi Arabia piped up: ‘smoking isn’t unhealthy’.
Now, considering that this same student, a married man aged around thirty, had previously told me that, in ancient times, humans lived to be over 900 years old – ‘it says so in the Bible’ – I wasn’t entirely surprised, and didn’t waste too much time in arguing the point. Actually, I think now he probably mentioned the Bible to show or suggest that Moslems and Judeo-Christians might agree on some things!

Of course, this student was a smoker. Many of my male students are. These students are predominantly Chinese, Vietnamese and Arabic speakers, that’s to say from countries whose governments have acted less forcefully in dealing with smoking than has the Australian government. I myself smoked. albeit lightly, until the age of 24 (a long time ago). Now, having been diagnosed with bronchiectasis, I’m extremely intolerant of cigarette smoke, not to say smokers.

I’m currently ploughing though Siddhartha Mukherjee’s classic Emperor of All Maladies, and have just finished the section on smoking and cancer, and the battle with tobacco companies in libertarianism’s heartland, the USA. 

Cigarette smoke contains a number of carcinogens – but what is a carcinogen? It’s basically a product or agent that has a reasonable likelihood of causing cancer, which doesn’t of course mean that it will cause cancer in every instance. You can play Russian roulette with the 60 or more well-established carcinogens in cigarette smoke, and risk-taking young men in particular will continue to do so, but it’s a massive risk, and the dangers increase with age and length and frequency of use. Lung cancer is the most regularly cited outcome, but as the US surgeon-general’s 2010 report shows in vast detail, cancers of the larynx, oral cavity, pharynx, oesophagus, pancreas, bladder, kidney, cervix, stomach and liver can all be induced by this inhaled chemical cocktail. And cancer isn’t the only issue. There is the problem of nicotine addiction, as well as cardiovascular and pulmonary disease, and fertility and foetal developmental effects. 

With all this evidence, why do people still smoke, and why don’t governments step in? Drugs with far less devastating effects are illegal, so what gives?

Of course the role governments should play in determining or influencing public health has always been debated, as has the efficacy of banning particular substances and practices. The situation isn’t helped by the facts on the ground, an ad hoc regime in which relatively harmless substances such as marihuana are banned almost worldwide, while proven carcinogens like tobacco, costing millions in treatment, are merely ‘discouraged’ to varying degrees. Similarly, in some countries you have ‘cults’ like falun gong being treated as highly dangerous and criminal while more mainstream ‘cults’ such as christianity, no less or more nonsensical, being given a free ride. None of which promotes faith in government decision-making regarding our physical or psychological health.
Even so, I believe governments should play a role. We pay taxes to government so that it can organise our particular state more effectively for all of its citizens – and that means subsidising education, health and general welfare, to reduce inequalities of opportunity and outcome. Democratic government and an open society helps to reduce government ineptitude, ignorance and corruption. The science and technology sector in particular – a proudly elitist institution – should play a more significant role in government decision-making. But a real weakness of capitalist democracy is that political leaders are too often swayed by business leaders, and the money and influence they bring to the table, than by knowledge leaders. This obeisance paid to business success, with insufficient regard paid to scientific evidence, is possibly the greatest failing of modern political society.