Opinion: a Smoke isn't Just a Smoke

Harry Rosenfeld - Times Union

"Mad Men," AMC's recreation of the world of Madison Avenue advertising, is back for its second season, continuing to capture what life was like in the '60s down to the defining details of dress and behavior.

Foremost that means all its characters -- husbands, wives, bosses and workers -- puff ceaselessly. Everyone except the children smokes, evoking the era as it was in those good and bad old days for contemporary audiences who long ago were warned about tobacco's dangers.

As one watched the hit show, one wondered just how dedicated an actor has to be to realistically portray a prior lifestyle. Performers today know full well what people nearly five decades ago did not -- the destructive impact smoking and secondhand smoke have on health. Could even a prize-winning role be worth the price of engaging in risky behavior for art's sake?

So to it came as a great relief to read before the show resumed last Sunday that the program's ubiquitous cigarettes were truly only for show. Instead of containing noxious tobacco, they were actually made from herbs free of nicotine.

When smoking was the thing to do, I consumed a minimum of two packs a day, often more. How can one possibly go through so many butts a day? I managed it in part by lighting up more than one at a time, overlooking the cigarette already poised on an ashtray.

I know how hard it can be to break the addiction. Coughing without let up was part of my everyday life. It took a bleeding ulcer to get me to stop, only to resume briefly while on overseas assignment. But I have been a convinced convert to nonsmoking for years. The aroma that once was so enticing now offends me entirely.

In the East, cigarette smoking is largely banned or at least frowned upon or segregated in public places, including restaurants and bars. Not so apparently in other parts of the country. In a St. Louis restaurant recently, diners were puffing away throughout their meals, fouling the air to a nonsmoker's downright distress. There ought to be a federal law.

On the other hand, the poor addicted souls who have to make their way in a world that has turned hostile to their habit are to be spotted here or there. Sometimes it is a pregnant woman smoking that delivers the greatest shock. This past winter I saw hospital staffers, who should be among the best informed about tobacco's hazards, huddling on the sidewalk outside their institution, attired only in their flimsy scrubs, hugging themselves against the cold as they puffed quickly before resuming their care of the sick.

But smoking is no matter to be contemplated anecdotally. It is a grim business, even in the United States, where smoking is down. According to the Centers for Disease Control and Prevention, almost one of every five deaths in this country is attributable to smoking. There were an estimated 438,000 deaths from cigarettes, which the CDC reports is more than all who died from murders, car crashes, alcohol abuse, illegal drugs and HIV combined.

Cigarettes accounted for 90 percent of men and 80 percent of women who died from lung cancer.

Secondhand smoke, mostly in the home or in the office and other public places, increases the risk of heart disease of exposed nonsmokers by up to 30 percent, the same rate for lung cancer.

It impacts children, particularly to my personal distress and guilty regret, because the CDC says "There is no risk-free level of secondhand smoke exposure. Even brief exposure can be dangerous."

A study in depth reported in the book "The Price of Smoking," published in 2004, made some telling calculations. "The cost per pack over a lifetime of smoking (is) almost $40," the authors wrote.

The lifetime societal costs come to $106,000 for a woman and $220,000 for a man. Personally, a 24-year-old woman smoker spends $86,000 over her life span on cigarettes and a comparable man spends $183,000. That's in 2004 and before, of course, not taking into account any increases since then.

While smoking and its inherent problems are rapidly growing in China and India especially, as their middle class increases, it remains no small matter in the United States.

Tax hikes and public service campaigns pointing out the dangers of smoking have helped to decrease cigarette usage across the board, and more so among the young. Such success calls for more of the same, hopefully leaving forever behind the smoking habits that once marked this nation whose hey day is recalled in a very popular TV show.

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