I walked down the crowded street, dodging trails of smoke and scanning the crowd for cigarettes expertly wedged between two lips or fingers. I needed to know when it was safe to take another breath.
I had just arrived in Spain from the United States. It was my first time in Europe. I thought the airport’s smoking room was an anomaly or an antiquated remain of a previous era.
Turns out, I was wrong. Approximately 24% of adults in Spain were smoking in 2013.
My life abroad soon consisted of co-workers at our primary school taking smoking breaks, roommates buying bags of tobacco to roll their own cigarettes, and bars selling cigarettes in vending machines. The powerful–and frankly, grotesque–images of tar-filled lungs on cigarette packs went unnoticed.
It was tobacco use at extremes I had never witnessed before.
I couldn’t help but wonder… why was the U.S. so different? How did smoking cessation there become such a success?
CIGARETTES WERE SMOKIN’ HOT
You see, smoking used to be seen everywhere in the U.S. during the mid-20th century– restaurants, bars, buildings, airplanes, and hospitals. My aunt recounts that pregnant women could even smoke in the maternity ward.
If you weren’t physically around smoke, you saw it depicted everywhere. Tobacco companies’ catchy marketing jingles got stuck in people’s heads. Superheroes and cartoon characters smoked.
But people got suspicious.
Scientists began researching and documenting the health effects of smoking. Not until 1964 did the country take an official stance on tobacco use. Dr. Luther Terry, the Surgeon General and a leading voice in public health, made history by being the first to publically announce a strong relationship between smoking and health hazards.
He reported that smokers are 20 times more likely to suffer from lung cancer than non-smokers. TWENTY. The news was spread like fire. It was a turning point for smoking in America.
If smoking is the #1 preventable cause of death, maybe that means we should do something about it.
WE STARTED TO FEEL THE BURN
In the next decade, Americans began to see major policy changes around tobacco. Policies made TV networks offer anti-smoking ads if they offered cigarette ads. Companies introduced filters to reduce the amount of tar inhaled while smoking. They pulled “kid-friendly” fruit and candy flavored cigarettes off the market.
(yes, that actually used to be a thing)
Then, knowledge around the adverse effects of secondhand smoke sparked the government to limit smoking in public places in the 1970s. Many states flat out banned it by 2000.
I still remember my surprise when I went out to eat with my family, and the hostess no longer greeted us with, “Smoking or non-smoking?”
What was arguably the biggest cause of dropping rates?
The federal cigarette tax doubled in 1983 and increased again in 2008. Evidence showed that a 10% spike in price brought down overall consumption by 4%. That’s HUGE. While these reforms impacted all smokers, they specifically meant fewer teens, low-income adults, and minorities were smoking. They simply couldn’t afford it.
Next, community interventions ramped up. Treatment programs, support groups, and quit lines helped cut that burning desire for “just one more.” Learning about the addictive nature of nicotine led to the development of nicotine-replacement options, such as gum, patches, or sprays.
But it doesn’t end there.
CREATIVE MEDIA CAMPAIGNS
HEAT IT UP
Anti-tobacco counter-ads steadily became more rigorous. In 2012, the Center for Disease Control launched a 3-month tobacco education campaign, “Tips.” Former smokers spoke through raspy voices about their tobacco-related health issues. It motivated at least 400,000 smokers to quit.
The Department of Health and Human Services aired “The Real Cost” campaign in 2014 targeting youth. It featured teens paying for cigarettes at convenience stores by painfully pulling out a tooth or pulling off a piece of skin.
They literally paid for cigarettes with their lives.
Changes in social norms inevitably followed these milestones. A society that once viewed a man lighting a woman’s cigarette as a romantic gesture now finds romance thwarted by a partner who smokes. I often hear people referring to cigarettes as “cancer sticks.” Smoking superheroes are routinely recast as the pathetic character or the antagonist. Even real life heros like athletes and celebrities don’t smoke or keep it hidden if they do.
What formerly was seen as a status symbol is now seen as a disgusting habit.
SMOKING RATES CRASH AND BURN
In the words of the famous public health analyst, Snoop Dogg, tobacco rates are droppin’ “like it’s hot. “
In 2015, scientists reported that the percentage of adult smokers in the U.S. had decreased from 42.4% to 15.1% in the last 50 years.
Going against all odds of addiction and corporate economic interest, smoking cessation remains one of the largest public health advances in the U.S. The nation is kicking its smoking habit!
At least the U.S. got something right. Now it’s your turn to step it up, Europe.
Cutting down on tobacco use means saving lives. It means fewer people with heart disease, respiratory complications, cancer, and lung diseases. More parents are around to see their kids grow up. Fewer of these kids will start smoking.
And it means more quality of life. Less hospital visits. Exercising is easier. Cleaner, fresher air and happier pets. Fewer missed punch lines of a comedy gig because someone stepped outside for a smoke break. More sense of taste and smell, so people can fully enjoy a chimichanga. WITH extra guac because of that added spare change.
So… inhale. Exhale. Let’s get more healthy lungs pumping.