1 00:00:02,400 --> 00:00:05,400 Speaker 1: This is Alec Baldwin, and you were listening to Here's 2 00:00:05,400 --> 00:00:10,920 Speaker 1: the Thing from iHeartRadio. These days, a pack of Marlboroughs 3 00:00:10,920 --> 00:00:14,840 Speaker 1: could set you back thirteen dollars. If you actually want 4 00:00:14,880 --> 00:00:17,880 Speaker 1: to smoke them, You've got to stand in a designated 5 00:00:17,960 --> 00:00:21,200 Speaker 1: area twenty five feet from the building's entrance, and the 6 00:00:21,200 --> 00:00:25,360 Speaker 1: package will contain the most dire warnings of illness and death. 7 00:00:26,320 --> 00:00:30,560 Speaker 1: Overcoming these hurdles requires a true commitment to the habit. 8 00:00:31,160 --> 00:00:35,640 Speaker 1: It's enough to ask who is still smoking? My guest today, 9 00:00:35,840 --> 00:00:39,159 Speaker 1: Doctor Lin Koslowski is here to shed some light on 10 00:00:39,280 --> 00:00:43,280 Speaker 1: this question. Doctor Kozlowski is an expert on tobacco use 11 00:00:43,720 --> 00:00:48,760 Speaker 1: and nicotine policy and his professor Emeritus and Dean Emeritus 12 00:00:48,800 --> 00:00:53,800 Speaker 1: of Community Health and Health Behavior at the University at Buffalo. 13 00:00:54,160 --> 00:00:57,400 Speaker 1: He is also a founding member of the Society for 14 00:00:57,520 --> 00:01:01,560 Speaker 1: Nicotine and Tobacco Research and has contributed to four US 15 00:01:01,640 --> 00:01:05,640 Speaker 1: Surgeon General's Reports of smoking. I wanted to know if 16 00:01:05,680 --> 00:01:09,280 Speaker 1: doctor Kozlowski was ever tempted to pick up a pack himself. 17 00:01:10,360 --> 00:01:13,600 Speaker 2: I certainly tried to be a smoker, so in high 18 00:01:13,600 --> 00:01:17,360 Speaker 2: school I experimented. In college, I had roommates who were 19 00:01:17,360 --> 00:01:21,080 Speaker 2: devoted heavy smokers. I tried to smoke. There was no 20 00:01:21,959 --> 00:01:23,800 Speaker 2: moral sense had got in the way. I just kept 21 00:01:23,800 --> 00:01:26,640 Speaker 2: getting sick from smoking, so it wasn't worth it to me. 22 00:01:27,200 --> 00:01:30,520 Speaker 2: But so it's fair to say I was tempted. I tried. 23 00:01:31,240 --> 00:01:34,720 Speaker 2: I experimented with packs of cigarettes and pipes and cigars 24 00:01:34,760 --> 00:01:38,360 Speaker 2: and so on. But I never became a regular smoker. 25 00:01:39,360 --> 00:01:43,600 Speaker 1: I smoked, never heavily, never habitually. I'd smoke usually when 26 00:01:43,600 --> 00:01:45,800 Speaker 1: I was shooting a film, because filmmaking is such a 27 00:01:45,840 --> 00:01:48,920 Speaker 1: boring process. You work for ten or fifteen minutes, then 28 00:01:48,960 --> 00:01:50,720 Speaker 1: you go away for an hour while they get ready 29 00:01:50,760 --> 00:01:52,640 Speaker 1: for the next angle, and so forth. And I smoked 30 00:01:53,440 --> 00:01:55,960 Speaker 1: out of boredom on the sets of films and so forth, 31 00:01:56,000 --> 00:01:58,280 Speaker 1: And whenever the project was over and I went home, 32 00:01:58,400 --> 00:02:01,480 Speaker 1: quote unquote, I stopped because the people in my life 33 00:02:01,640 --> 00:02:02,600 Speaker 1: wouldn't tolerate that. 34 00:02:03,360 --> 00:02:06,120 Speaker 2: So when you were smoking, how early in the morning 35 00:02:06,120 --> 00:02:07,400 Speaker 2: did you have your first cigarette? 36 00:02:07,440 --> 00:02:09,960 Speaker 1: Probably in the afternoon, Like when I was doing films 37 00:02:10,000 --> 00:02:12,480 Speaker 1: and shooting, I didn't have the taste for it. And 38 00:02:12,560 --> 00:02:14,360 Speaker 1: one thing I did for a period of time, I 39 00:02:14,400 --> 00:02:17,240 Speaker 1: smoked cigars. To give up cigarette smoking. I would be 40 00:02:17,280 --> 00:02:20,280 Speaker 1: on the road shooting films, traveling and I'd be making 41 00:02:20,320 --> 00:02:23,760 Speaker 1: films and I could smoke cigars there unrepentantly because my 42 00:02:23,800 --> 00:02:26,960 Speaker 1: wife was miles away, and I'd fire up and there 43 00:02:27,000 --> 00:02:29,200 Speaker 1: was a period where I was smoking three of these 44 00:02:29,240 --> 00:02:32,079 Speaker 1: big fat boomers every day. Well, I want to ask 45 00:02:32,120 --> 00:02:34,880 Speaker 1: you in terms of I can probably guess what the 46 00:02:35,000 --> 00:02:37,560 Speaker 1: order is in terms of the number of people who 47 00:02:37,600 --> 00:02:40,640 Speaker 1: were consuming the following. But I was wondering, from your 48 00:02:40,880 --> 00:02:44,680 Speaker 1: research and from your work, are they all equivalently bad 49 00:02:44,880 --> 00:02:49,160 Speaker 1: in their own way? And I'm talking about cigarettes, pipes, cigars, 50 00:02:49,400 --> 00:02:50,239 Speaker 1: chewing tobacco. 51 00:02:50,680 --> 00:02:54,120 Speaker 2: It's very different in terms of harm, right, And cigarettes 52 00:02:54,120 --> 00:02:57,480 Speaker 2: are at the pinnacle of risk, and cigars if you 53 00:02:57,560 --> 00:03:02,480 Speaker 2: inhale them, or pipes you inhale them, are also pretty risky. 54 00:03:02,919 --> 00:03:06,640 Speaker 2: So inhalation is a key issue with tobacco products. The 55 00:03:06,720 --> 00:03:09,399 Speaker 2: key factors I think about and talking about different types 56 00:03:09,440 --> 00:03:12,960 Speaker 2: of tobacco use. For it to be popular, it's got 57 00:03:13,040 --> 00:03:16,400 Speaker 2: to get nicotine to the brain. Secondly, it's got to 58 00:03:16,480 --> 00:03:19,160 Speaker 2: taste good. It's got to be pleasant for the user 59 00:03:19,200 --> 00:03:22,200 Speaker 2: to be using. Often non users don't like it, but 60 00:03:22,280 --> 00:03:24,320 Speaker 2: users like the taste of it and smell of it. 61 00:03:24,880 --> 00:03:28,040 Speaker 2: And third's got to be a convenient product. So if 62 00:03:28,080 --> 00:03:30,560 Speaker 2: you go back to the eighteen hundreds, when the US 63 00:03:30,720 --> 00:03:35,080 Speaker 2: was a largely rural society, the most popular form of 64 00:03:35,080 --> 00:03:39,720 Speaker 2: tobacco with smokeless tobacco, chewing tobacco, wet snuff, moist snuff. 65 00:03:40,360 --> 00:03:42,640 Speaker 2: It got nicotine to the brain, it tasted good to 66 00:03:42,640 --> 00:03:45,240 Speaker 2: the user, and it also didn't burn the barn down 67 00:03:45,400 --> 00:03:48,200 Speaker 2: in an agrarian society, so that was a real advantage. 68 00:03:48,720 --> 00:03:52,520 Speaker 2: But at the end of the eighteen hundreds, something called 69 00:03:52,560 --> 00:03:56,520 Speaker 2: the germ theory of disease became common and public spitting 70 00:03:56,560 --> 00:04:00,360 Speaker 2: got outlawed in major cities all over the country. So 71 00:04:00,960 --> 00:04:04,560 Speaker 2: spitting became very inconvenient. And it's hard to use chewing 72 00:04:04,560 --> 00:04:08,000 Speaker 2: tobacco if you don't have an opportunity to spit. And 73 00:04:08,040 --> 00:04:11,120 Speaker 2: the late eighteen hundred cigars started to become popular. 74 00:04:11,200 --> 00:04:13,440 Speaker 1: But also interjected that back in those days there were 75 00:04:13,480 --> 00:04:15,720 Speaker 1: spittoons everywhere, replaces to spit. 76 00:04:16,160 --> 00:04:19,440 Speaker 2: There's a wonderful account by Charles Dickens who visited the 77 00:04:19,520 --> 00:04:23,280 Speaker 2: United States when chewing tobacco was king, and he was 78 00:04:23,360 --> 00:04:27,159 Speaker 2: grossed out by all the spitting that he saw. But 79 00:04:27,839 --> 00:04:31,960 Speaker 2: General Ulysses S. Grant, former President Ulysses S. Grant, died 80 00:04:32,000 --> 00:04:35,160 Speaker 2: a very public death in eighteen eighty five of jaw cancer. 81 00:04:35,200 --> 00:04:38,000 Speaker 2: It was the New York Times of supporting daily on 82 00:04:38,040 --> 00:04:40,919 Speaker 2: the state of his health, and people got afraid of 83 00:04:40,960 --> 00:04:44,680 Speaker 2: cigars because here you have this major figure dying of 84 00:04:44,720 --> 00:04:49,760 Speaker 2: a very painful jaw cancer. That set the stage for cigarettes. 85 00:04:49,839 --> 00:04:54,080 Speaker 2: Cigarettes started, if you will, as a safer kind of smoke. 86 00:04:54,640 --> 00:04:56,359 Speaker 2: It was think of it. It was so safe you 87 00:04:56,360 --> 00:05:00,960 Speaker 2: could inhale it easily. So in the early twentieth century 88 00:05:01,320 --> 00:05:03,320 Speaker 2: that was the first time that there was a national 89 00:05:03,360 --> 00:05:07,360 Speaker 2: marketing of cigarettes. Previously there had been local brands of cigarettes, 90 00:05:07,839 --> 00:05:11,039 Speaker 2: but then they became national brands like Camel and Lucky 91 00:05:11,080 --> 00:05:16,840 Speaker 2: Strike in Chesterfield, and Cigarette You started to take off dramatically. 92 00:05:17,279 --> 00:05:21,960 Speaker 2: So physicians in the nineteen twenties almost never sought a 93 00:05:22,000 --> 00:05:24,839 Speaker 2: case of lung cancer in their patients. In the nineteen 94 00:05:24,880 --> 00:05:27,840 Speaker 2: thirties and forties, they started to see lung cancer, and 95 00:05:27,880 --> 00:05:31,960 Speaker 2: this is coincident with the rise in cigarettes. Now marketing 96 00:05:32,520 --> 00:05:37,320 Speaker 2: modern marketing, emotionally based marketing, imagery based marketing became important 97 00:05:37,839 --> 00:05:42,440 Speaker 2: in the twentieth century and cigarettes was the biggest funder 98 00:05:42,480 --> 00:05:47,200 Speaker 2: of advertising agencies, and there was no better marketer of 99 00:05:47,279 --> 00:05:50,880 Speaker 2: cigarettes than movies. Companies were paying to get their products 100 00:05:50,880 --> 00:05:56,560 Speaker 2: placed in movies. Now I know, Alec, you were interviewed 101 00:05:56,640 --> 00:06:00,320 Speaker 2: in the twenty sixteen Toronto International Film festal Well, you 102 00:06:00,360 --> 00:06:04,000 Speaker 2: talked about major actors who influenced you, and you spoke 103 00:06:04,000 --> 00:06:08,120 Speaker 2: about their colorful, stylized performances. I'd like to mention four 104 00:06:08,160 --> 00:06:12,120 Speaker 2: people that you mentioned in order. Jimmy Cagney. James Cagney, 105 00:06:12,880 --> 00:06:16,480 Speaker 2: you mentioned his performance in White Heat. In that performance, 106 00:06:16,560 --> 00:06:20,120 Speaker 2: Cody Jarrett doesn't touch a cigarette. Turns out that Cagney 107 00:06:20,480 --> 00:06:23,520 Speaker 2: disliked cigarettes. He had been forced to market them in 108 00:06:23,560 --> 00:06:27,960 Speaker 2: early films. Cagney was a pipe smoker. Cagney died at 109 00:06:28,040 --> 00:06:31,680 Speaker 2: eighty six, eighty six years old. Keep that in mind. 110 00:06:31,760 --> 00:06:34,560 Speaker 2: Let's go to the next actor you mentioned, Humphrey Bogart. 111 00:06:35,200 --> 00:06:38,920 Speaker 2: I would say that for Humphrey Bogart, a cigarette was 112 00:06:38,960 --> 00:06:41,920 Speaker 2: a kind of supporting actor in his performances. I mean, 113 00:06:43,080 --> 00:06:45,960 Speaker 2: you can't imagine many of his performances without a cigarette 114 00:06:45,960 --> 00:06:50,080 Speaker 2: being a player in it. Humphrey Bogart died of aesophageal 115 00:06:50,200 --> 00:06:54,599 Speaker 2: cancer at age fifty seven fifty seven. Next, you mentioned 116 00:06:54,600 --> 00:06:59,279 Speaker 2: Gary Cooper, who died at sixty. Gary Cooper advertised Lucky 117 00:06:59,320 --> 00:07:01,640 Speaker 2: Strikes in the nightenineteen thirties, and one of his print 118 00:07:01,680 --> 00:07:06,240 Speaker 2: ads he says, ever since switching to Lucky's, my throat 119 00:07:06,680 --> 00:07:09,400 Speaker 2: has been in fine shape. Now, if you think of it, 120 00:07:09,440 --> 00:07:12,520 Speaker 2: that's a bit of a health claim that an irritating 121 00:07:12,560 --> 00:07:16,600 Speaker 2: product is a more dangerous product. Clark Gable use praised 122 00:07:16,680 --> 00:07:20,400 Speaker 2: Clark Gable's performance in The Misfits. Two days after The 123 00:07:20,480 --> 00:07:23,520 Speaker 2: Misfits wrapped, Gable had a heart attack and he was 124 00:07:23,560 --> 00:07:28,560 Speaker 2: dead ten days later at age fifty nine. Now that 125 00:07:28,680 --> 00:07:32,160 Speaker 2: comparison is just meant to get one's attention. That's not 126 00:07:32,200 --> 00:07:35,240 Speaker 2: scientific data. But you've got Magna dyeing dying at a 127 00:07:35,280 --> 00:07:39,480 Speaker 2: ripe old age of eighty six, and these major figures 128 00:07:39,560 --> 00:07:42,880 Speaker 2: dying much too young. Let me talk a bit about 129 00:07:42,880 --> 00:07:45,160 Speaker 2: the percentage of smokers in the United States and how 130 00:07:45,160 --> 00:07:50,239 Speaker 2: that rose in nineteen forty young men at about twenty 131 00:07:50,320 --> 00:07:53,560 Speaker 2: years old. Eighty percent of young men were smoking in 132 00:07:53,680 --> 00:07:57,520 Speaker 2: nineteen forty eighty percent. If you jump to the most 133 00:07:57,520 --> 00:08:00,520 Speaker 2: recent data provided by the CDC in twenty two twenty one, 134 00:08:01,000 --> 00:08:03,880 Speaker 2: looking at a similar age group, people eighteen to twenty four, 135 00:08:04,440 --> 00:08:08,640 Speaker 2: only five percent are smoking. So think of it when 136 00:08:08,680 --> 00:08:11,720 Speaker 2: eighty percent of people are doing it. That's a very 137 00:08:11,760 --> 00:08:15,880 Speaker 2: trendy activity. But the social pressures have changed. Smoking has 138 00:08:15,920 --> 00:08:20,040 Speaker 2: become much more stigmatized and the bands that have become 139 00:08:20,080 --> 00:08:24,840 Speaker 2: commonplace on indoor smoking and government buildings in many states. 140 00:08:25,520 --> 00:08:28,080 Speaker 2: That adds to the inconvenience of smoking. 141 00:08:33,200 --> 00:08:37,920 Speaker 1: Doctor Lynn Kaslowski. If you enjoy conversations with experts in 142 00:08:37,960 --> 00:08:41,760 Speaker 1: public health, check out my episode with doctor Anthony Fauci, 143 00:08:42,360 --> 00:08:47,280 Speaker 1: former director of the National Institute of Allergy and Infectious Diseases. 144 00:08:47,920 --> 00:08:51,600 Speaker 3: Is know what a disease that can actually kill you 145 00:08:52,240 --> 00:08:55,960 Speaker 3: by a rispiratory root? That is that people half of 146 00:08:56,000 --> 00:08:58,760 Speaker 3: them don't have any symptoms. When we realize that, it 147 00:08:58,840 --> 00:09:01,800 Speaker 3: became clear that we really needed to do mass But 148 00:09:01,880 --> 00:09:05,120 Speaker 3: yet people who want to be ultraly critical will say, oh, 149 00:09:05,160 --> 00:09:09,880 Speaker 3: he flip flops. If you don't change your mind with 150 00:09:10,000 --> 00:09:14,520 Speaker 3: the evolution of the new information, then you are really 151 00:09:14,840 --> 00:09:16,800 Speaker 3: guilty of something that's not good. 152 00:09:19,080 --> 00:09:22,319 Speaker 1: To hear more of my conversation with doctor Fauci, go 153 00:09:22,400 --> 00:09:26,480 Speaker 1: to Here's the Thing dot org. After the break, doctor 154 00:09:26,559 --> 00:09:31,160 Speaker 1: Lynn Kozlowski gives a risk assessment for smoking traditional cigarettes 155 00:09:31,480 --> 00:09:44,960 Speaker 1: versus vaping. I'm Alec Baldwin and you're listening to. Here's 156 00:09:44,960 --> 00:09:48,880 Speaker 1: the thing. There are currently an estimated twenty eight point 157 00:09:48,920 --> 00:09:52,720 Speaker 1: three million people in the United States who smoke, which 158 00:09:52,840 --> 00:09:57,360 Speaker 1: incredibly is nearly twelve percent of adults. The figures can 159 00:09:57,400 --> 00:10:00,440 Speaker 1: seem inexplicable when put up against the the fact that 160 00:10:00,480 --> 00:10:04,839 Speaker 1: smoking manufactured cigarettes is the leading cause of premature death 161 00:10:05,160 --> 00:10:09,600 Speaker 1: in much of Europe and North America, and smoking related 162 00:10:09,600 --> 00:10:13,760 Speaker 1: diseases killed forty one million people in the US, UK, 163 00:10:13,920 --> 00:10:18,520 Speaker 1: and Canada between nineteen sixty and twenty twenty. Doctor Lynn 164 00:10:18,600 --> 00:10:23,680 Speaker 1: Keslowski has spent his career studying the deleterious effects of smoking. 165 00:10:24,240 --> 00:10:28,640 Speaker 1: Working with these statistics must be no easy task, so 166 00:10:28,720 --> 00:10:31,120 Speaker 1: I was curious to learn how he found his way 167 00:10:31,559 --> 00:10:32,920 Speaker 1: to this line of study. 168 00:10:34,120 --> 00:10:38,200 Speaker 2: My doctoral dissertation, which was conducted in nineteen seventy four, 169 00:10:38,880 --> 00:10:42,040 Speaker 2: looked at the relationship between coffee drinking and nicotine use, 170 00:10:42,120 --> 00:10:46,000 Speaker 2: coffee drinking and cigarette smoking. So I had an early 171 00:10:46,679 --> 00:10:51,319 Speaker 2: contact with cigarette research and my mentor at Columbia University, 172 00:10:51,840 --> 00:10:55,400 Speaker 2: Stanley Schachter, a very noted psychologist. He well, I would 173 00:10:55,440 --> 00:10:57,240 Speaker 2: say he was my beloved mentor, and he was a 174 00:10:57,320 --> 00:11:02,000 Speaker 2: very heavy smoker, and he got into smoking research initially 175 00:11:02,600 --> 00:11:05,719 Speaker 2: because he was interested in the issue of why does 176 00:11:05,760 --> 00:11:10,400 Speaker 2: smoking seem to calm people down when they're in stressful circumstances. 177 00:11:10,679 --> 00:11:12,600 Speaker 1: What was his answer, Well, that's. 178 00:11:12,400 --> 00:11:14,800 Speaker 2: Actually kind of interesting because what we looked at. I 179 00:11:14,840 --> 00:11:18,200 Speaker 2: was involved with those studies that it turns out that 180 00:11:18,360 --> 00:11:23,240 Speaker 2: under stress, your urine becomes more acidic and you excrete 181 00:11:23,360 --> 00:11:28,120 Speaker 2: more nicotine from your blood, and so that under stressful circumstances, 182 00:11:28,920 --> 00:11:32,480 Speaker 2: more nicotines leaving your bloodstream, and so you need to 183 00:11:32,480 --> 00:11:37,320 Speaker 2: smoke more to maintain your doses of nicotine. And I 184 00:11:37,320 --> 00:11:41,800 Speaker 2: would say the chacter, a very heavy smoker, smoked as 185 00:11:41,840 --> 00:11:44,720 Speaker 2: soon as his eyes opened in the morning. He knew 186 00:11:44,760 --> 00:11:47,880 Speaker 2: he was addicted to cigarettes, and so I learned a 187 00:11:47,880 --> 00:11:49,080 Speaker 2: lot from him. 188 00:11:49,280 --> 00:11:52,240 Speaker 1: So throughout your career, smoking has been the bulwark of 189 00:11:52,280 --> 00:11:53,000 Speaker 1: what you've done. 190 00:11:52,840 --> 00:11:57,000 Speaker 2: Correct, Yeah, largely. My first job was at Western University, 191 00:11:57,760 --> 00:12:01,120 Speaker 2: and it was harder to do the kind of smoking 192 00:12:01,160 --> 00:12:03,160 Speaker 2: research that I wanted to do there. And then I 193 00:12:03,160 --> 00:12:06,800 Speaker 2: got a job in Toronto at the Addiction Research Foundation 194 00:12:07,000 --> 00:12:10,440 Speaker 2: to become head of their behavioral research on tobacco use, 195 00:12:10,920 --> 00:12:14,800 Speaker 2: and that was a perfect environment where I had physician colleagues, 196 00:12:14,800 --> 00:12:20,080 Speaker 2: pharmacologist colleagues to collaborate with so in Toronto. That was 197 00:12:20,120 --> 00:12:21,400 Speaker 2: the focus of my research. 198 00:12:22,520 --> 00:12:26,400 Speaker 1: So when you start the Department of Health Behavior at 199 00:12:26,400 --> 00:12:29,080 Speaker 1: the University of Buffalo, I mean one would assume even 200 00:12:29,120 --> 00:12:33,000 Speaker 1: somebody that doesn't know much about the infrastructure of academia 201 00:12:33,000 --> 00:12:35,160 Speaker 1: and the protocols of academia, you don't just walk up 202 00:12:35,160 --> 00:12:38,480 Speaker 1: and go, hey, I got this idea. What were you 203 00:12:38,559 --> 00:12:40,280 Speaker 1: working on that they thought was important? 204 00:12:41,120 --> 00:12:42,880 Speaker 2: Well, I think the reason I got that job is 205 00:12:42,920 --> 00:12:48,080 Speaker 2: that I had long experience as a department head at 206 00:12:48,120 --> 00:12:52,559 Speaker 2: Penn State. I'd been department head for a department of 207 00:12:52,600 --> 00:12:55,800 Speaker 2: buyby Here Full of Health at Penn State for over 208 00:12:55,840 --> 00:13:00,679 Speaker 2: a decade, and so that experience as an academic and administrator, 209 00:13:01,200 --> 00:13:04,880 Speaker 2: as well as having significant research credentials, was what wanted 210 00:13:04,880 --> 00:13:07,200 Speaker 2: them to recruit me. They were trying to get the 211 00:13:07,280 --> 00:13:09,880 Speaker 2: new School of Public Health and Health Professions accredit it 212 00:13:09,920 --> 00:13:12,240 Speaker 2: as a school of public health, and they needed to 213 00:13:12,280 --> 00:13:15,480 Speaker 2: create that new department. And in terms of public health, 214 00:13:16,160 --> 00:13:19,040 Speaker 2: tobacco use has been one of the major public health 215 00:13:19,080 --> 00:13:21,840 Speaker 2: issues of twentieth century. 216 00:13:22,480 --> 00:13:25,520 Speaker 1: For me, the arc of smoking. I mean, I remember 217 00:13:25,559 --> 00:13:28,800 Speaker 1: when I first came into this business, people lit cigarettes 218 00:13:28,840 --> 00:13:31,319 Speaker 1: on the set of the TV show at thirty Rockefeller Plose. 219 00:13:31,440 --> 00:13:33,559 Speaker 1: We'd be on the set of a soap opera that 220 00:13:33,600 --> 00:13:35,080 Speaker 1: I was doing. The first job I had was one 221 00:13:35,080 --> 00:13:38,000 Speaker 1: of the old school soap operas, and I could name 222 00:13:38,240 --> 00:13:41,640 Speaker 1: a handful of people who were smokers, and those people 223 00:13:41,679 --> 00:13:44,600 Speaker 1: who were non smokers didn't really say anything. They didn't 224 00:13:44,600 --> 00:13:47,559 Speaker 1: really complain me. Now, you wouldn't hesitate to scold someone 225 00:13:48,000 --> 00:13:51,000 Speaker 1: who's smoking publicly. I'll never forget. There was this line 226 00:13:51,000 --> 00:13:54,080 Speaker 1: that someone said, they said, the moomme outlaws smoking. Only 227 00:13:54,160 --> 00:13:57,079 Speaker 1: outlaws will smoke. You're really going to alienate them in 228 00:13:57,120 --> 00:13:58,480 Speaker 1: a very strong and very kind. 229 00:13:58,320 --> 00:14:02,680 Speaker 2: Of aggressive wayeen eighties, at the Addiction Research Foundation in Toronto, 230 00:14:03,400 --> 00:14:07,400 Speaker 2: clinicians who were working with people with cocaine dependencies and 231 00:14:07,600 --> 00:14:13,000 Speaker 2: opioid dependencies in their clinical sessions, they would often share cigarettes. 232 00:14:13,960 --> 00:14:17,200 Speaker 2: The clinician and the patient would share a cigarette. Now, 233 00:14:17,800 --> 00:14:21,680 Speaker 2: after a decade's work, that stopped that notion of it 234 00:14:21,720 --> 00:14:24,640 Speaker 2: was appropriate for a clinician to be sharing a cigarette 235 00:14:24,640 --> 00:14:30,520 Speaker 2: with somebody with alcohol or opioid problems. That was recognized 236 00:14:30,520 --> 00:14:34,080 Speaker 2: as an ato, But in nineteen eighty it was commonplace. 237 00:14:34,400 --> 00:14:37,080 Speaker 1: So for me, the next turn of the wheel, if 238 00:14:37,120 --> 00:14:40,720 Speaker 1: you will, is these labels on cigarettes, which have become 239 00:14:40,840 --> 00:14:43,280 Speaker 1: increasingly dire over the years have gone by. I mean 240 00:14:43,280 --> 00:14:45,960 Speaker 1: they might as well say, you know, if you smoke, 241 00:14:46,120 --> 00:14:47,960 Speaker 1: one of your eyeballs is going to fall out. I mean, 242 00:14:48,000 --> 00:14:50,280 Speaker 1: they make it as stark and as dramatic as they can. 243 00:14:50,720 --> 00:14:53,560 Speaker 1: When those first came on, I recall that the tobacco 244 00:14:53,640 --> 00:14:56,040 Speaker 1: industry fought it tooth and nail. They didn't want those 245 00:14:56,040 --> 00:14:58,720 Speaker 1: warnings on those cigarette pecks. Did that have a big 246 00:14:58,760 --> 00:15:01,640 Speaker 1: effect on people warning labels in general? 247 00:15:01,760 --> 00:15:05,720 Speaker 2: Yes, I would say the United States is behind many 248 00:15:05,720 --> 00:15:09,080 Speaker 2: other places in the world in terms of warning labels. 249 00:15:09,280 --> 00:15:11,200 Speaker 1: Where are the warning labels more effective as far as 250 00:15:11,240 --> 00:15:12,200 Speaker 1: you're concerned. 251 00:15:12,160 --> 00:15:17,840 Speaker 2: Canada, the United Kingdom, they have graphic images of diseases 252 00:15:17,960 --> 00:15:20,840 Speaker 2: and set of loss to people and so on, and 253 00:15:21,120 --> 00:15:24,840 Speaker 2: so much so that there was sure it still happens 254 00:15:24,880 --> 00:15:27,160 Speaker 2: in Canada that when they first came on the pack, 255 00:15:27,280 --> 00:15:32,920 Speaker 2: some smokers were buying little pouches or slipcases as they 256 00:15:32,920 --> 00:15:35,160 Speaker 2: could put their packs in so they didn't have to 257 00:15:35,160 --> 00:15:37,280 Speaker 2: look at the image of it. But no, there's no 258 00:15:37,360 --> 00:15:42,400 Speaker 2: doubt that the strong warning labels do help remind smokers 259 00:15:42,840 --> 00:15:44,520 Speaker 2: that it's a problem to be smoking. 260 00:15:44,640 --> 00:15:46,440 Speaker 1: Yeah, I mean, I was always wondering because I thought, 261 00:15:46,520 --> 00:15:48,840 Speaker 1: here's a set of words on the side of a box, 262 00:15:49,320 --> 00:15:50,920 Speaker 1: and you got a cigarette in your hand, and you're 263 00:15:50,960 --> 00:15:54,080 Speaker 1: just somebody who smoking is as natural as breathing or 264 00:15:54,200 --> 00:15:56,920 Speaker 1: drinking water. If you're a real smoker, it just doesn't 265 00:15:56,960 --> 00:15:58,920 Speaker 1: even occur to you. And here's a bunch of words 266 00:15:58,920 --> 00:16:00,520 Speaker 1: on a box. How much of an efact is they're 267 00:16:00,520 --> 00:16:02,080 Speaker 1: really going to have? But it had some effect? 268 00:16:02,560 --> 00:16:04,600 Speaker 2: Yeah, Actually there have been in the US, there been 269 00:16:04,720 --> 00:16:07,400 Speaker 2: some i would call negative effects to some of the warnings. 270 00:16:07,680 --> 00:16:10,600 Speaker 2: You asked about the risks of different products. It turns 271 00:16:10,640 --> 00:16:14,200 Speaker 2: out that smokeless tobacco products like moist snuff, the thing 272 00:16:14,280 --> 00:16:18,320 Speaker 2: you put between your cheek and gums, that's much much 273 00:16:18,440 --> 00:16:21,880 Speaker 2: less dangerous than cigarettes. Really, think about it, if you're 274 00:16:21,920 --> 00:16:25,400 Speaker 2: not getting stuff in your lungs, that alone is going 275 00:16:25,440 --> 00:16:28,640 Speaker 2: to knock off the majority of things that kill you 276 00:16:28,680 --> 00:16:32,840 Speaker 2: from smoking. Lung cancer and respiratory diseases are the majority 277 00:16:32,880 --> 00:16:36,600 Speaker 2: of things that kill you from smoking cigarettes. And with 278 00:16:36,680 --> 00:16:41,240 Speaker 2: the first warning labels on smokeless tobacco products included a 279 00:16:41,280 --> 00:16:45,320 Speaker 2: warning label that the industry supported, and it was this 280 00:16:45,480 --> 00:16:48,520 Speaker 2: product is not a safe alternative to cigarettes. Now it 281 00:16:48,600 --> 00:16:52,640 Speaker 2: turns out that the way consumers interpreted that warning this 282 00:16:52,800 --> 00:16:56,320 Speaker 2: product is not a safe alternative cigarettes, they interpreted as 283 00:16:56,360 --> 00:16:59,160 Speaker 2: saying they're just as dangerous as cigarettes, when in fact 284 00:16:59,440 --> 00:17:02,000 Speaker 2: they're much dangerous and cigarettes. Let me give you a 285 00:17:02,000 --> 00:17:05,440 Speaker 2: good example of that. I would bet you would think 286 00:17:05,840 --> 00:17:09,080 Speaker 2: that oral tobacco like that is a major cause of 287 00:17:09,160 --> 00:17:09,760 Speaker 2: oral cancer. 288 00:17:10,040 --> 00:17:10,920 Speaker 1: I would assume. Yeah. 289 00:17:11,040 --> 00:17:13,600 Speaker 2: It turns out cigarettes are a bigger cause of oral 290 00:17:13,640 --> 00:17:17,919 Speaker 2: cancer than those products. Why, just because of the nature 291 00:17:17,920 --> 00:17:20,159 Speaker 2: of the toxins exposed in the mouth and some of them, 292 00:17:20,920 --> 00:17:22,600 Speaker 2: so the people don't know that. 293 00:17:22,720 --> 00:17:24,560 Speaker 1: I would have assumed otherwise. Yeah. 294 00:17:24,640 --> 00:17:28,640 Speaker 2: Yeah. And it turns out there are gross misunderstandings about 295 00:17:29,359 --> 00:17:33,320 Speaker 2: the risks of different dement For example, if you talk 296 00:17:33,359 --> 00:17:38,080 Speaker 2: about vaping products e cigarettes, that public understanding of the 297 00:17:38,160 --> 00:17:42,800 Speaker 2: harms of vaping products has gotten more mistaken and more 298 00:17:42,880 --> 00:17:46,879 Speaker 2: mistaken that a few years ago, about half of people 299 00:17:46,920 --> 00:17:50,880 Speaker 2: were saying that vaping is equal in harm or more 300 00:17:50,920 --> 00:17:54,480 Speaker 2: harmful in cigarettes. It turns out the eighty three percent 301 00:17:54,520 --> 00:17:58,280 Speaker 2: of smokers think that vaping is as dangerous or more 302 00:17:58,359 --> 00:18:01,120 Speaker 2: dangerous in cigarettes. And why did they think that, I'm 303 00:18:01,119 --> 00:18:03,919 Speaker 2: not entirely clear why they do, But they're wrong. It 304 00:18:04,040 --> 00:18:07,080 Speaker 2: turns out that again, when you get all of the 305 00:18:07,320 --> 00:18:11,800 Speaker 2: carcinogens out of smoke, and that's what you're taking to 306 00:18:11,880 --> 00:18:14,880 Speaker 2: your lungs, you do your lungs a big favor. Still 307 00:18:14,920 --> 00:18:18,880 Speaker 2: an addictive product, but it's much less dangerous than cigarette. 308 00:18:18,920 --> 00:18:22,000 Speaker 2: So there's a lot of studies now showing that it's 309 00:18:22,040 --> 00:18:26,120 Speaker 2: a useful tool for adult smokers to give up smoking 310 00:18:26,160 --> 00:18:28,439 Speaker 2: to switch to nicotine vape. 311 00:18:28,560 --> 00:18:30,879 Speaker 1: Well, well, I want to get to vape right after 312 00:18:30,960 --> 00:18:34,200 Speaker 1: this next point, which is that So in the next advancement, 313 00:18:34,200 --> 00:18:37,159 Speaker 1: if you will we have the labels, then you have 314 00:18:37,520 --> 00:18:40,919 Speaker 1: the outright banning of smoking. You start having smoking is 315 00:18:40,920 --> 00:18:44,520 Speaker 1: not in places, an increasing number of places, and people 316 00:18:44,640 --> 00:18:47,000 Speaker 1: have to go into a special room. Then they get 317 00:18:47,040 --> 00:18:48,919 Speaker 1: rid of those rooms. They disappear. If they had them 318 00:18:48,920 --> 00:18:52,000 Speaker 1: at airports for a while, here's the smoking room, and 319 00:18:52,240 --> 00:18:55,800 Speaker 1: you saw everybody in a cloud of smoke inside some 320 00:18:55,840 --> 00:18:58,159 Speaker 1: little chamber. I mean, I've lived in New York, you know, 321 00:18:58,400 --> 00:19:01,080 Speaker 1: nearly all of my adult life, and you see people 322 00:19:01,200 --> 00:19:04,040 Speaker 1: go from they go outside and they want to smoke 323 00:19:04,119 --> 00:19:07,520 Speaker 1: so bad, and it's pouring rain, it's freezing cold. They're 324 00:19:07,600 --> 00:19:10,960 Speaker 1: hunched over. Then they drive them away from the entrance 325 00:19:11,000 --> 00:19:14,600 Speaker 1: of the building. The signs appear everywhere. You cannot smoke 326 00:19:14,640 --> 00:19:17,120 Speaker 1: within one hundred feet of this entrance or fifty feet, 327 00:19:17,160 --> 00:19:19,200 Speaker 1: so people have to go down, they have to walk 328 00:19:19,240 --> 00:19:21,199 Speaker 1: down to the side of the building and blah blah blah. 329 00:19:21,320 --> 00:19:25,119 Speaker 1: I mean, we've made it as difficult as possible in 330 00:19:25,160 --> 00:19:27,480 Speaker 1: many parts of the country. Is it having an effect? 331 00:19:28,560 --> 00:19:32,000 Speaker 1: Is smoking in a downward trend now in the twenty 332 00:19:32,080 --> 00:19:33,280 Speaker 1: twenty three Oh definitely. 333 00:19:33,320 --> 00:19:35,720 Speaker 2: I mean it's a whole bunch of things that have 334 00:19:35,960 --> 00:19:39,280 Speaker 2: ganged up on smoking to diminish it. I mean, the 335 00:19:39,359 --> 00:19:43,080 Speaker 2: indoor smoking rules have had a big effect. Remember when 336 00:19:43,119 --> 00:19:46,679 Speaker 2: there were television ads for cigarettes. Of course, there was 337 00:19:46,720 --> 00:19:49,359 Speaker 2: a period when there was an equal time law that 338 00:19:49,400 --> 00:19:54,480 Speaker 2: you could get anti smoking ads on TV. It turned 339 00:19:54,520 --> 00:19:57,199 Speaker 2: out those anti smoking ads had a big effect on 340 00:19:57,280 --> 00:20:01,399 Speaker 2: discouraging smoking, so much so the companies were kind of 341 00:20:01,440 --> 00:20:05,600 Speaker 2: happy to get off TV because that equal time anti 342 00:20:05,640 --> 00:20:06,879 Speaker 2: smoking ad would go away. 343 00:20:07,000 --> 00:20:10,840 Speaker 1: Then that battle was over. Yeah. Now, obviously in the 344 00:20:10,880 --> 00:20:13,119 Speaker 1: business I've worked in for several years, there's been a 345 00:20:13,119 --> 00:20:17,320 Speaker 1: lot of push to cut smoking. That it was a 346 00:20:17,440 --> 00:20:19,679 Speaker 1: bad idea and a poor role model for a lot 347 00:20:19,720 --> 00:20:23,600 Speaker 1: of kids. But that idea, the social stigma. You know, 348 00:20:23,680 --> 00:20:27,040 Speaker 1: in Hollywood and TV, you know pretty much banning it. 349 00:20:27,080 --> 00:20:29,399 Speaker 1: I mean, if you're going to smoke a cigarette, you 350 00:20:29,480 --> 00:20:31,600 Speaker 1: better be playing Edward R. Murrow in order to be 351 00:20:31,600 --> 00:20:34,760 Speaker 1: smoking a cigarette in the scene. But in my business 352 00:20:34,800 --> 00:20:36,960 Speaker 1: that had a profound effect, I think, which they wanted 353 00:20:37,000 --> 00:20:38,360 Speaker 1: us to be role models in. 354 00:20:38,320 --> 00:20:41,320 Speaker 2: Some way, and you were role models. But let me 355 00:20:41,600 --> 00:20:45,600 Speaker 2: say something about a watershed in the United States, and 356 00:20:45,640 --> 00:20:49,639 Speaker 2: I was the nineteen sixty four Surgeon General's report which 357 00:20:50,160 --> 00:20:54,439 Speaker 2: came out declaring smoking as a cause of cancer. Within 358 00:20:54,640 --> 00:20:59,479 Speaker 2: days of the nineteen sixty four report being released, Carlton 359 00:20:59,520 --> 00:21:04,560 Speaker 2: cigarette were advertised for the first time. Carlton were ultra 360 00:21:04,720 --> 00:21:09,080 Speaker 2: ultra low tar cigarettes one milligram tar zero point one 361 00:21:09,160 --> 00:21:14,320 Speaker 2: milligram nicotine. And if you will, that was the start 362 00:21:14,760 --> 00:21:19,560 Speaker 2: of an ultra light light boondoggle that came about right 363 00:21:19,600 --> 00:21:22,119 Speaker 2: after the nineteen sixty four report that people were thinking, 364 00:21:22,760 --> 00:21:25,600 Speaker 2: I'm better off smoking a light cigarette than a full 365 00:21:25,640 --> 00:21:28,600 Speaker 2: flavor cigarette, better off smoking an ultra light And it 366 00:21:28,640 --> 00:21:31,760 Speaker 2: turned out it took years of research to show that 367 00:21:31,760 --> 00:21:34,600 Speaker 2: that wasn't the case, and that one of the key 368 00:21:34,720 --> 00:21:38,320 Speaker 2: features in creating a one milligram tar cigarette is to 369 00:21:38,359 --> 00:21:40,719 Speaker 2: take the filter and punch a whole bunch of holes 370 00:21:40,720 --> 00:21:43,880 Speaker 2: in it. They make it eighty percent diluted with air. 371 00:21:44,000 --> 00:21:47,359 Speaker 2: So when the smoking machine takes a puff on the cigarette, 372 00:21:47,760 --> 00:21:50,679 Speaker 2: it's trying in eighty percent air with each puff, and 373 00:21:50,720 --> 00:21:53,280 Speaker 2: that's diluting it. Now, what does a human smoker do 374 00:21:54,000 --> 00:21:58,159 Speaker 2: with a cigarette that's eighty percent ventilated. Some push it 375 00:21:58,200 --> 00:22:00,199 Speaker 2: a little bit further in their mouth and their lips 376 00:22:00,240 --> 00:22:03,760 Speaker 2: cover the vents, and that gets more smoke to their lungs, 377 00:22:03,960 --> 00:22:06,200 Speaker 2: or they take bigger puffs, or they take more puffs. 378 00:22:06,400 --> 00:22:09,199 Speaker 2: So in the early days of this tar derby, in 379 00:22:09,240 --> 00:22:13,720 Speaker 2: the sixties, seventies and eighties, standard smoking machine tests were 380 00:22:13,720 --> 00:22:17,919 Speaker 2: conducted by the government, and it turned out that people 381 00:22:17,960 --> 00:22:21,879 Speaker 2: don't smoke like smoking machines. They take bigger puffs. If 382 00:22:21,880 --> 00:22:24,440 Speaker 2: they want to, they take more puffs. And I had 383 00:22:24,640 --> 00:22:27,520 Speaker 2: colleagues who did research on smoking machines that show you 384 00:22:27,520 --> 00:22:30,320 Speaker 2: could have one cigarette that in a standard run and 385 00:22:30,359 --> 00:22:34,920 Speaker 2: a smoking machine gave you seventeen milligrams of tar one 386 00:22:35,080 --> 00:22:38,480 Speaker 2: seven seventeen milligrams of tar. But if you adjusted the 387 00:22:38,520 --> 00:22:42,480 Speaker 2: machine to simulate a heavy smoke, big puffs, lots of puffs, 388 00:22:43,080 --> 00:22:46,320 Speaker 2: you could get seventy milligrams of tar from the same cigarette, 389 00:22:47,000 --> 00:22:50,720 Speaker 2: so that one of the key issues with cigarettes is 390 00:22:50,760 --> 00:22:53,399 Speaker 2: that what you get from it depends how you puff 391 00:22:53,440 --> 00:22:55,840 Speaker 2: on it. It's not like a pill. It's not like with 392 00:22:55,920 --> 00:22:58,320 Speaker 2: a bottle of beer. If you don't miss your mouth, 393 00:22:58,359 --> 00:23:00,600 Speaker 2: you know how much alcohol you get from a b beer. 394 00:23:01,200 --> 00:23:03,520 Speaker 2: With a cigarette, it's a race between what's going in 395 00:23:03,520 --> 00:23:07,280 Speaker 2: the air and what's going in your lungs. And people 396 00:23:07,320 --> 00:23:08,600 Speaker 2: can compensate, and they did. 397 00:23:08,680 --> 00:23:10,720 Speaker 1: There's games you can play with smoke. 398 00:23:10,560 --> 00:23:13,520 Speaker 2: And so that people from with ultra light cigarettes could 399 00:23:13,520 --> 00:23:15,360 Speaker 2: get as much as they were getting from bull Flavor. 400 00:23:15,800 --> 00:23:18,480 Speaker 2: And that's actually one of the reasons why light and 401 00:23:18,560 --> 00:23:23,000 Speaker 2: ultra light designations were removed. But people still know what 402 00:23:23,080 --> 00:23:25,240 Speaker 2: a light and ultra light is because they can feel 403 00:23:25,240 --> 00:23:27,640 Speaker 2: it from the taste of it. They taste different. I'm 404 00:23:27,680 --> 00:23:30,119 Speaker 2: wondering if I could say a bit about cigars, please. 405 00:23:30,760 --> 00:23:34,200 Speaker 2: The sixty four report came out and a few days later, 406 00:23:34,280 --> 00:23:36,919 Speaker 2: the president of the American Medical Association was on the 407 00:23:36,920 --> 00:23:40,520 Speaker 2: Today Show saying, if you can't give up cigarettes, you 408 00:23:40,600 --> 00:23:43,120 Speaker 2: might switch to cigars or pipes. You'd be better off 409 00:23:43,240 --> 00:23:47,120 Speaker 2: because in the sixty four report, cigars and pipes got 410 00:23:47,119 --> 00:23:49,760 Speaker 2: a clean bill of health. It wasn't seen as a 411 00:23:49,800 --> 00:23:53,399 Speaker 2: major cause of disease. And the reason for that was 412 00:23:53,480 --> 00:23:57,000 Speaker 2: that the epidemiology at the time was based on people 413 00:23:57,000 --> 00:24:01,400 Speaker 2: who were so called primary cigar smokers smoke cigarettes, they'd 414 00:24:01,440 --> 00:24:05,320 Speaker 2: only smoke cigars, and those primary cigar smokers tended to 415 00:24:05,359 --> 00:24:09,720 Speaker 2: not inhale cigars. So called secondary cigar smokers, people who 416 00:24:09,720 --> 00:24:14,080 Speaker 2: were cigarette smokers switching to cigars, they tend to maintain 417 00:24:14,119 --> 00:24:17,359 Speaker 2: the habit of inhalation, and that's a key issue in 418 00:24:17,440 --> 00:24:20,240 Speaker 2: terms of the health risk. The other thing about cigars, 419 00:24:20,600 --> 00:24:24,639 Speaker 2: as you know, smoking big cigars sometimes that sometimes it 420 00:24:24,680 --> 00:24:26,320 Speaker 2: could take as much as an hour to smoke a 421 00:24:26,320 --> 00:24:29,440 Speaker 2: big cigar. You could smoke sick cigarette does take an hour. 422 00:24:30,080 --> 00:24:32,800 Speaker 2: You could smoke six cigarettes in the same interval. Yes, 423 00:24:33,320 --> 00:24:36,639 Speaker 2: So when somebody says I just smoke two or three cigars, 424 00:24:37,560 --> 00:24:41,239 Speaker 2: you got to consider how big are those cigars, how 425 00:24:41,280 --> 00:24:45,199 Speaker 2: much puffing are they doing, are they inhaling and to 426 00:24:45,240 --> 00:24:47,920 Speaker 2: the extent they're inhaling, to extent they're getting a lot 427 00:24:47,920 --> 00:24:51,680 Speaker 2: of tobacco in their lungs. It's not a harm reducing 428 00:24:51,720 --> 00:24:55,000 Speaker 2: product to be smoking cigars. The other thing about inhalation. 429 00:24:55,680 --> 00:24:58,160 Speaker 2: I actually did research on this when I was in Canada. 430 00:24:58,400 --> 00:25:02,119 Speaker 2: People can reliably tell you whether they inhale cigars or not. 431 00:25:02,720 --> 00:25:03,919 Speaker 2: They know whether they. 432 00:25:03,760 --> 00:25:12,000 Speaker 1: Inhale tobacco expert doctor Lynn Kozlowski. If you're enjoying this conversation, 433 00:25:12,119 --> 00:25:14,679 Speaker 1: tell a friend and be sure to follow Here's the 434 00:25:14,760 --> 00:25:19,120 Speaker 1: thing on the iHeartRadio apps, Spotify or wherever you get 435 00:25:19,160 --> 00:25:23,280 Speaker 1: your podcasts. When we come back, doctor Lynn Kozlowski tells 436 00:25:23,359 --> 00:25:26,960 Speaker 1: us what he believes is the best way to quit smoking. 437 00:25:38,760 --> 00:25:41,880 Speaker 1: I'm Alec Baldwin and you're listening to Here's the thing. 438 00:25:42,720 --> 00:25:46,760 Speaker 1: The data is sobering. Smokers who start early in life 439 00:25:46,800 --> 00:25:49,919 Speaker 1: and keep smoking can lose up to a decade of 440 00:25:50,000 --> 00:25:53,680 Speaker 1: life expectancy. I wanted to know for those who were interested, 441 00:25:54,040 --> 00:25:56,800 Speaker 1: if doctor Lynn Koslowski thought there was the best time 442 00:25:57,200 --> 00:25:59,320 Speaker 1: in their lives to quit smoking. 443 00:26:00,000 --> 00:26:02,760 Speaker 2: As early as possible. Thirty is a benchmark if you 444 00:26:02,800 --> 00:26:05,240 Speaker 2: can do it by thirty, and I think that needs 445 00:26:05,280 --> 00:26:09,399 Speaker 2: to be promoted more widely. Probat Jaw, an epidemiologist at 446 00:26:09,359 --> 00:26:13,560 Speaker 2: the University of Toronto, recently reviewed a lot of epidemiological 447 00:26:13,600 --> 00:26:15,920 Speaker 2: studies and has come up with a very simple summary 448 00:26:15,960 --> 00:26:20,000 Speaker 2: of the health risks of smoking, and the evidence shows 449 00:26:20,000 --> 00:26:24,439 Speaker 2: that at least one in two smokers dies prematurely and 450 00:26:24,480 --> 00:26:27,600 Speaker 2: they lose on an average ten years of life. And 451 00:26:27,680 --> 00:26:30,879 Speaker 2: if a smoker can stop at age thirty, they go 452 00:26:31,040 --> 00:26:34,760 Speaker 2: back to the longevity expectations of a never smoker. So 453 00:26:34,800 --> 00:26:36,560 Speaker 2: if you can get people to stop at age thirty, 454 00:26:36,640 --> 00:26:41,240 Speaker 2: that's great. At age forty it's ninety percent of a 455 00:26:41,320 --> 00:26:45,000 Speaker 2: return to being a never smoker. At age fifty, you 456 00:26:45,119 --> 00:26:47,920 Speaker 2: gain six years of life if you start smoking, and 457 00:26:47,920 --> 00:26:50,439 Speaker 2: at age sixty's four years of life. I think there 458 00:26:50,480 --> 00:26:53,560 Speaker 2: are a number of tools that people have to help 459 00:26:53,640 --> 00:26:56,680 Speaker 2: them quit smoking, but I want to emphasize that those 460 00:26:56,680 --> 00:27:00,639 Speaker 2: are tools, and I think of changing flo tire on 461 00:27:00,720 --> 00:27:03,920 Speaker 2: a car. A lug wrench is a very useful tool 462 00:27:04,040 --> 00:27:06,520 Speaker 2: for changing a flat tire, but it's a lot of 463 00:27:06,520 --> 00:27:09,800 Speaker 2: work to change that tire. Any of these tools you 464 00:27:09,880 --> 00:27:14,000 Speaker 2: might use for renclean is a prescription drug you might 465 00:27:14,080 --> 00:27:18,680 Speaker 2: use to help quit smoking, nicotine replacement products, patch gum, lozenges, 466 00:27:19,160 --> 00:27:24,720 Speaker 2: nicotine pouches, vaping. They're tools, and it's an important thing 467 00:27:24,800 --> 00:27:28,520 Speaker 2: for the smoker. Not to be satisfied with just cutting 468 00:27:28,560 --> 00:27:31,320 Speaker 2: down a bit on smoking. Your goal should be to 469 00:27:31,359 --> 00:27:33,840 Speaker 2: try to get off smoking completely and switch to those 470 00:27:33,920 --> 00:27:37,919 Speaker 2: other products, and then once you're securely off smoking, you 471 00:27:37,960 --> 00:27:40,720 Speaker 2: can think about getting off those other products. 472 00:27:41,040 --> 00:27:43,800 Speaker 1: So to the extent you can say, what do you 473 00:27:43,840 --> 00:27:45,919 Speaker 1: think in the marketplace right now, would you say is 474 00:27:45,960 --> 00:27:48,720 Speaker 1: among not the best, but among the best ways to 475 00:27:48,800 --> 00:27:49,440 Speaker 1: quit smoking. 476 00:27:49,960 --> 00:27:54,240 Speaker 2: I think for older adult smokers, vaping products are among 477 00:27:54,280 --> 00:27:57,280 Speaker 2: the best ways to quit smoking, that they can provide 478 00:27:57,320 --> 00:28:01,840 Speaker 2: the most satisfactory substitution for cigarettes. The other thing about 479 00:28:01,880 --> 00:28:05,480 Speaker 2: quitting smoking is that repeated attempts you get smokers get 480 00:28:05,480 --> 00:28:08,359 Speaker 2: better at it. For example, I've known people have given 481 00:28:08,440 --> 00:28:10,760 Speaker 2: up smoking. They've been off for several months. They go 482 00:28:10,840 --> 00:28:13,560 Speaker 2: to a gathering where others are smoking, and they think 483 00:28:13,960 --> 00:28:17,280 Speaker 2: I could just have one cigarette. They do. They end 484 00:28:17,359 --> 00:28:19,520 Speaker 2: up there wrong. So the next time they try to 485 00:28:19,520 --> 00:28:22,000 Speaker 2: give up smoking, they know better. They know better than 486 00:28:22,040 --> 00:28:24,439 Speaker 2: to be fooled by the illusion that I could just 487 00:28:24,520 --> 00:28:26,880 Speaker 2: have one. And then I think there's also a kind 488 00:28:26,920 --> 00:28:30,360 Speaker 2: of no more nice guy effect that people trying repeatedly 489 00:28:30,440 --> 00:28:34,320 Speaker 2: give up they finally dig their heels in and have 490 00:28:34,480 --> 00:28:37,320 Speaker 2: learned from what did and didn't work. I mean, I 491 00:28:37,359 --> 00:28:39,800 Speaker 2: had one person tell me I tried this and I 492 00:28:39,840 --> 00:28:43,480 Speaker 2: was off smoking for a year, and I said, that's 493 00:28:43,520 --> 00:28:45,959 Speaker 2: a pretty good technique to try again. If you were 494 00:28:46,000 --> 00:28:47,160 Speaker 2: off smoking for a year. 495 00:28:47,080 --> 00:28:49,400 Speaker 1: I mean renew that subscription for another year. 496 00:28:50,320 --> 00:28:52,240 Speaker 2: So I think it's important for smokers to keep at 497 00:28:52,280 --> 00:28:55,040 Speaker 2: it now. The other thing about the health risks of smoking, 498 00:28:55,480 --> 00:28:59,920 Speaker 2: the cardiovascular risks diminish very quickly within months once you 499 00:29:00,040 --> 00:29:03,160 Speaker 2: stop smoking. The cancer risks are a bit of a 500 00:29:03,160 --> 00:29:09,720 Speaker 2: different animal. The process of smoking is causing some cancer 501 00:29:09,880 --> 00:29:13,719 Speaker 2: related issues to develop, and it takes longer for you 502 00:29:13,800 --> 00:29:17,120 Speaker 2: to get the benefit of stopping smoking with respect to cancer. 503 00:29:17,160 --> 00:29:20,160 Speaker 2: But the key message is stop as soon as you can. 504 00:29:20,800 --> 00:29:22,760 Speaker 1: We'll get to vaping now, which is I mean to me? 505 00:29:23,360 --> 00:29:27,280 Speaker 1: I find vaping just kind of just exploded. And I 506 00:29:27,320 --> 00:29:29,400 Speaker 1: live in New York, and you know, street level in 507 00:29:29,440 --> 00:29:32,560 Speaker 1: New York is nothing but food shops, coffee shops, and 508 00:29:32,680 --> 00:29:36,200 Speaker 1: places to buy smoking paraphernalia and vaping. I was in 509 00:29:36,240 --> 00:29:39,120 Speaker 1: a restaurant last night with my wife and a couple 510 00:29:39,120 --> 00:29:41,120 Speaker 1: of friends, and it's a very nice restaurant, actually, one 511 00:29:41,120 --> 00:29:43,280 Speaker 1: that we go to all the time in our neighborhood. 512 00:29:43,760 --> 00:29:46,520 Speaker 1: And some young guy was there, probably twenty five in 513 00:29:46,560 --> 00:29:49,040 Speaker 1: his late twenties, and his girlfriend and he whips out 514 00:29:49,040 --> 00:29:51,440 Speaker 1: of machines, you know, whips out the device, starts vaping 515 00:29:51,440 --> 00:29:54,320 Speaker 1: in the restaurant, which I don't think he was necessarily 516 00:29:54,320 --> 00:29:56,680 Speaker 1: that wasn't permissible, But he goes ahead and vapes, And 517 00:29:56,720 --> 00:30:00,120 Speaker 1: I thought, you know, what was the advent of vap 518 00:30:00,280 --> 00:30:02,800 Speaker 1: meaning who developed this kind of stuff? And to explain 519 00:30:02,840 --> 00:30:05,640 Speaker 1: to people who think they know what vaping is, vaping 520 00:30:05,760 --> 00:30:08,640 Speaker 1: is a delivery system for like a liquid form or 521 00:30:08,720 --> 00:30:11,440 Speaker 1: some other kind of form of nicotine, and they've extracted 522 00:30:11,440 --> 00:30:13,400 Speaker 1: all the bad stuff for most of it. 523 00:30:14,240 --> 00:30:17,720 Speaker 2: Yeah, the key thing is that the tobacco's gone in vaping, 524 00:30:17,760 --> 00:30:20,120 Speaker 2: and you can vape all kinds of drugs like cannabis 525 00:30:20,160 --> 00:30:22,560 Speaker 2: with a vaping product if you want to as well. 526 00:30:22,600 --> 00:30:26,920 Speaker 2: But the key advantage is that there's no combustion, that 527 00:30:27,000 --> 00:30:29,680 Speaker 2: you don't get the smoke and the tar and the glop, 528 00:30:29,760 --> 00:30:34,760 Speaker 2: and you don't get the complex ingredients arising from burned tobacco. 529 00:30:35,120 --> 00:30:38,200 Speaker 2: First products were developed in China, but there have been 530 00:30:38,280 --> 00:30:42,800 Speaker 2: a lot of different generations of products. And it's interesting. 531 00:30:43,720 --> 00:30:47,160 Speaker 2: I mentioned some of my college roommates smoked, and the 532 00:30:47,200 --> 00:30:50,000 Speaker 2: heaviest smoker I ever knew was my college roommate who 533 00:30:50,080 --> 00:30:54,800 Speaker 2: smoked unfiltered black tobacco goal walls. You could hear him 534 00:30:54,800 --> 00:30:57,160 Speaker 2: when he walked into the room, just by the sound 535 00:30:57,200 --> 00:31:00,760 Speaker 2: of his inhlation. You could hear him into a room. 536 00:31:00,760 --> 00:31:04,280 Speaker 2: He took such a big drag. I learned years later 537 00:31:05,040 --> 00:31:07,200 Speaker 2: that he had switched to East cigarettes. So I called 538 00:31:07,240 --> 00:31:09,880 Speaker 2: him up and said, you know, how could this be? 539 00:31:10,040 --> 00:31:13,680 Speaker 2: You were the heaviest smoker I ever knew, And he said, 540 00:31:13,920 --> 00:31:16,440 Speaker 2: I love him. Actually, it was interesting he could indulge 541 00:31:16,480 --> 00:31:20,480 Speaker 2: in his sense of connoisseurship by picking the right kind 542 00:31:20,520 --> 00:31:22,200 Speaker 2: of vape product and the right kind. 543 00:31:22,080 --> 00:31:23,120 Speaker 1: Of flavor he liked. 544 00:31:23,520 --> 00:31:26,000 Speaker 2: But he was off cigarettes, and so that was very 545 00:31:26,040 --> 00:31:30,040 Speaker 2: impressive to me to have that. One testimonial from an 546 00:31:30,040 --> 00:31:32,400 Speaker 2: old friend who was able to switch to vape said 547 00:31:32,560 --> 00:31:33,560 Speaker 2: he was the better for it. 548 00:31:34,000 --> 00:31:36,680 Speaker 1: So is it safe to say that, in terms of 549 00:31:36,720 --> 00:31:39,760 Speaker 1: all the components that you regard and the metrics that 550 00:31:39,800 --> 00:31:43,000 Speaker 1: you regard, that vaping is much safer than cigarette smoking. 551 00:31:43,400 --> 00:31:46,920 Speaker 2: I have no doubt about it. Right, Cigarettes inhale cigarette 552 00:31:46,960 --> 00:31:50,640 Speaker 2: smokes are at the pinnacle of risk. Smokeless tobacco products 553 00:31:50,680 --> 00:31:55,520 Speaker 2: are much less dangerous than cigarettes. Nicotine vaping is probably 554 00:31:55,520 --> 00:31:59,560 Speaker 2: a little less dangerous than smokeless tobacco, nicotine pouches. You're 555 00:31:59,600 --> 00:32:02,800 Speaker 2: really quite low levels of harm. I don't want to 556 00:32:02,800 --> 00:32:05,479 Speaker 2: suggest that any of these products are health foods, but 557 00:32:05,840 --> 00:32:07,840 Speaker 2: they reduce risk dramatically. 558 00:32:08,520 --> 00:32:10,800 Speaker 1: But vaping has its hazards as well well. 559 00:32:10,960 --> 00:32:15,640 Speaker 2: The anti tobacco forces were very quick to jump upon 560 00:32:16,440 --> 00:32:19,520 Speaker 2: lung problems that were being caused by vaping. They even 561 00:32:19,560 --> 00:32:24,560 Speaker 2: gave it a name, e Valley of Electronic Vaping Lung Disease. 562 00:32:24,960 --> 00:32:30,800 Speaker 2: It turns out that that arose largely from people smoking 563 00:32:30,960 --> 00:32:36,680 Speaker 2: black cannabis vapes that were polluted with toxins that did 564 00:32:36,720 --> 00:32:39,600 Speaker 2: cause lung problems in other countries. Is of a non 565 00:32:39,640 --> 00:32:42,200 Speaker 2: issue that once they got rid of that black market 566 00:32:42,280 --> 00:32:45,959 Speaker 2: vaping product, it hasn't been an ongoing issue, but the 567 00:32:46,000 --> 00:32:50,040 Speaker 2: field has continued to latch onto this, Oh, you can 568 00:32:50,080 --> 00:32:54,160 Speaker 2: get lung problems from vaping based on this bout of 569 00:32:54,280 --> 00:32:58,960 Speaker 2: lung disease a few years ago. But inhale cigarettes are 570 00:32:59,000 --> 00:33:00,120 Speaker 2: at the pinnacle. 571 00:32:59,680 --> 00:33:02,320 Speaker 1: Of ris They're the highest threat and they. 572 00:33:02,360 --> 00:33:05,800 Speaker 2: Takes a big jump down, and things like a pouch 573 00:33:06,080 --> 00:33:09,600 Speaker 2: that have no inhalation at all are much much less risky. 574 00:33:10,040 --> 00:33:13,200 Speaker 1: I will say that in my lifetime borders a couple 575 00:33:13,240 --> 00:33:15,560 Speaker 1: of different realities as far as smoking as concerned. My 576 00:33:15,600 --> 00:33:18,440 Speaker 1: father was a cigarette smoker, he was a pipe smoker. 577 00:33:19,080 --> 00:33:21,240 Speaker 1: He quit cigarettes the smoke pipes. He died at the 578 00:33:21,240 --> 00:33:25,280 Speaker 1: age of fifty five of lung cancer. My smoking, and 579 00:33:25,560 --> 00:33:28,880 Speaker 1: I will say that with unless I was completely inebriated, 580 00:33:28,920 --> 00:33:31,840 Speaker 1: unless I was completely shit faced on some drugs and alcohol, 581 00:33:32,640 --> 00:33:35,200 Speaker 1: which was certainly accompanied by a good amount of smoking 582 00:33:35,280 --> 00:33:38,680 Speaker 1: and my drug use and drinking. But when I was 583 00:33:39,000 --> 00:33:41,440 Speaker 1: in my right mind and I smoked, I knew it 584 00:33:41,560 --> 00:33:44,400 Speaker 1: was wrong every time I did it. Every single time 585 00:33:44,400 --> 00:33:45,959 Speaker 1: I put a cigarette in my mouth, I said this 586 00:33:46,000 --> 00:33:48,959 Speaker 1: is wrong. I shouldn't do this. I remember saying to myself, Okay, 587 00:33:49,280 --> 00:33:51,560 Speaker 1: this is a stupid idea. Click and I'd light up. 588 00:33:51,680 --> 00:33:54,840 Speaker 2: Yeah, even a long time ago, people call cigarettes coffin mail. 589 00:33:54,800 --> 00:33:57,200 Speaker 1: Right, right, But I was going to say, I'm many 590 00:33:57,280 --> 00:34:01,840 Speaker 1: years in sobriety, I'm cleaning sober threaty seven years. And 591 00:34:01,880 --> 00:34:04,480 Speaker 1: the only reason I mentioned is because this idea of addiction, 592 00:34:04,680 --> 00:34:08,239 Speaker 1: of finding a way to cure the addictive mechanism, the 593 00:34:08,280 --> 00:34:11,560 Speaker 1: addictive synaptic whatever it is that happens in human beings 594 00:34:12,800 --> 00:34:15,160 Speaker 1: as it relates to smoking, as it relates to eating. 595 00:34:15,960 --> 00:34:20,480 Speaker 1: Of course, smoking compounded with obesity. People who are not 596 00:34:20,560 --> 00:34:24,000 Speaker 1: even morbidly obese, but who are significantly overweight and smoke, 597 00:34:24,080 --> 00:34:27,359 Speaker 1: I mean that must be a double whammy for them, correct, Sure, I. 598 00:34:27,280 --> 00:34:30,520 Speaker 2: Mean it turns out that heavy smokers have a worse 599 00:34:30,600 --> 00:34:34,719 Speaker 2: diet than non smokers. Heavy smokers are more like to 600 00:34:34,840 --> 00:34:39,319 Speaker 2: eat more fried foods, fewer fruits and vegetables. There are 601 00:34:39,320 --> 00:34:41,560 Speaker 2: a whole bunch of things going on with heavy smokers 602 00:34:41,560 --> 00:34:43,080 Speaker 2: that contribute to health ruts. 603 00:34:43,560 --> 00:34:45,480 Speaker 1: You were mentioning before the name of a drug that 604 00:34:45,520 --> 00:34:47,960 Speaker 1: I don't recall what you said. Now, what is that? 605 00:34:48,480 --> 00:34:52,640 Speaker 2: It's a drug that FDA approved smoking cessation aid. 606 00:34:52,840 --> 00:34:54,000 Speaker 1: That addresses addiction. 607 00:34:54,200 --> 00:34:56,640 Speaker 2: It's a treating addiction. Yeah, it's a drug that's shown 608 00:34:56,680 --> 00:35:00,200 Speaker 2: to help you stop smoking. That's a little bit, little 609 00:35:00,200 --> 00:35:02,799 Speaker 2: bit too ambitious a claim. I mean that in terms 610 00:35:02,840 --> 00:35:07,080 Speaker 2: of nicotine replacement products like nicotine vape, it's a harm 611 00:35:07,160 --> 00:35:11,799 Speaker 2: reduction technique. You're replacing a very toxic form of nicotine 612 00:35:11,880 --> 00:35:14,960 Speaker 2: use with a much less toxic form of nicotine use. 613 00:35:15,160 --> 00:35:18,400 Speaker 2: But the addiction doesn't go away. It might be decreased. 614 00:35:18,760 --> 00:35:21,600 Speaker 1: That's a dream, isn't it To address that addictive component 615 00:35:21,840 --> 00:35:23,719 Speaker 1: in the human brain and human behavior. 616 00:35:24,160 --> 00:35:26,720 Speaker 2: There are other factors too. It's not just the addiction, 617 00:35:26,840 --> 00:35:30,520 Speaker 2: it's the environment you're in that For example, if you 618 00:35:31,440 --> 00:35:34,560 Speaker 2: have a spouse who smokes and isn't giving up, good 619 00:35:34,640 --> 00:35:37,440 Speaker 2: luck trying to give up smoking yourself. I mean, so 620 00:35:37,560 --> 00:35:42,120 Speaker 2: these powerful social factors. If you have coworkers who are 621 00:35:42,160 --> 00:35:44,840 Speaker 2: your best friends going outside in the winter time to smoke, 622 00:35:45,520 --> 00:35:49,640 Speaker 2: you've got social pressures to continue to smoke. But go 623 00:35:49,760 --> 00:35:53,359 Speaker 2: back to that figure of five percent of eighteen to 624 00:35:53,360 --> 00:35:56,120 Speaker 2: twenty four year olds smoking in the United States, Now 625 00:35:56,560 --> 00:35:59,480 Speaker 2: that's a nice low number compared to the eighty percent 626 00:35:59,480 --> 00:36:04,120 Speaker 2: in nineteen. So there's been progress, has been a huge progress. 627 00:36:07,280 --> 00:36:12,000 Speaker 1: My thanks to doctor Lynn Keaslowski. This episode was recorded 628 00:36:12,000 --> 00:36:15,200 Speaker 1: at CDM Studios in New York City. Were produced by 629 00:36:15,280 --> 00:36:19,480 Speaker 1: Kathleen Russo, Zach MacNeice, and Maureen Hobin. Our engineer is 630 00:36:19,560 --> 00:36:24,080 Speaker 1: Frank Imperial. Our social media manager is Danielle Gingrich. I'm 631 00:36:24,080 --> 00:36:26,400 Speaker 1: Alec Baldwin. Here's the thing is brought to you by 632 00:36:26,520 --> 00:36:27,760 Speaker 1: iHeart Radio.