WEBVTT - Why Is Anyone Still Smoking? 0:00:02.400 --> 0:00:05.400 This is Alec Baldwin, and you were listening to Here's 0:00:05.400 --> 0:00:10.920 the Thing from iHeartRadio. These days, a pack of Marlboroughs 0:00:10.920 --> 0:00:14.840 could set you back thirteen dollars. If you actually want 0:00:14.880 --> 0:00:17.880 to smoke them, You've got to stand in a designated 0:00:17.960 --> 0:00:21.200 area twenty five feet from the building's entrance, and the 0:00:21.200 --> 0:00:25.360 package will contain the most dire warnings of illness and death. 0:00:26.320 --> 0:00:30.560 Overcoming these hurdles requires a true commitment to the habit. 0:00:31.160 --> 0:00:35.640 It's enough to ask who is still smoking? My guest today, 0:00:35.840 --> 0:00:39.159 Doctor Lin Koslowski is here to shed some light on 0:00:39.280 --> 0:00:43.280 this question. Doctor Kozlowski is an expert on tobacco use 0:00:43.720 --> 0:00:48.760 and nicotine policy and his professor Emeritus and Dean Emeritus 0:00:48.800 --> 0:00:53.800 of Community Health and Health Behavior at the University at Buffalo. 0:00:54.160 --> 0:00:57.400 He is also a founding member of the Society for 0:00:57.520 --> 0:01:01.560 Nicotine and Tobacco Research and has contributed to four US 0:01:01.640 --> 0:01:05.640 Surgeon General's Reports of smoking. I wanted to know if 0:01:05.680 --> 0:01:09.280 doctor Kozlowski was ever tempted to pick up a pack himself. 0:01:10.360 --> 0:01:13.600 I certainly tried to be a smoker, so in high 0:01:13.600 --> 0:01:17.360 school I experimented. In college, I had roommates who were 0:01:17.360 --> 0:01:21.080 devoted heavy smokers. I tried to smoke. There was no 0:01:21.959 --> 0:01:23.800 moral sense had got in the way. I just kept 0:01:23.800 --> 0:01:26.640 getting sick from smoking, so it wasn't worth it to me. 0:01:27.200 --> 0:01:30.520 But so it's fair to say I was tempted. I tried. 0:01:31.240 --> 0:01:34.720 I experimented with packs of cigarettes and pipes and cigars 0:01:34.760 --> 0:01:38.360 and so on. But I never became a regular smoker. 0:01:39.360 --> 0:01:43.600 I smoked, never heavily, never habitually. I'd smoke usually when 0:01:43.600 --> 0:01:45.800 I was shooting a film, because filmmaking is such a 0:01:45.840 --> 0:01:48.920 boring process. You work for ten or fifteen minutes, then 0:01:48.960 --> 0:01:50.720 you go away for an hour while they get ready 0:01:50.760 --> 0:01:52.640 for the next angle, and so forth. And I smoked 0:01:53.440 --> 0:01:55.960 out of boredom on the sets of films and so forth, 0:01:56.000 --> 0:01:58.280 And whenever the project was over and I went home, 0:01:58.400 --> 0:02:01.480 quote unquote, I stopped because the people in my life 0:02:01.640 --> 0:02:02.600 wouldn't tolerate that. 0:02:03.360 --> 0:02:06.120 So when you were smoking, how early in the morning 0:02:06.120 --> 0:02:07.400 did you have your first cigarette? 0:02:07.440 --> 0:02:09.960 Probably in the afternoon, Like when I was doing films 0:02:10.000 --> 0:02:12.480 and shooting, I didn't have the taste for it. And 0:02:12.560 --> 0:02:14.360 one thing I did for a period of time, I 0:02:14.400 --> 0:02:17.240 smoked cigars. To give up cigarette smoking. I would be 0:02:17.280 --> 0:02:20.280 on the road shooting films, traveling and I'd be making 0:02:20.320 --> 0:02:23.760 films and I could smoke cigars there unrepentantly because my 0:02:23.800 --> 0:02:26.960 wife was miles away, and I'd fire up and there 0:02:27.000 --> 0:02:29.200 was a period where I was smoking three of these 0:02:29.240 --> 0:02:32.079 big fat boomers every day. Well, I want to ask 0:02:32.120 --> 0:02:34.880 you in terms of I can probably guess what the 0:02:35.000 --> 0:02:37.560 order is in terms of the number of people who 0:02:37.600 --> 0:02:40.640 were consuming the following. But I was wondering, from your 0:02:40.880 --> 0:02:44.680 research and from your work, are they all equivalently bad 0:02:44.880 --> 0:02:49.160 in their own way? And I'm talking about cigarettes, pipes, cigars, 0:02:49.400 --> 0:02:50.239 chewing tobacco. 0:02:50.680 --> 0:02:54.120 It's very different in terms of harm, right, And cigarettes 0:02:54.120 --> 0:02:57.480 are at the pinnacle of risk, and cigars if you 0:02:57.560 --> 0:03:02.480 inhale them, or pipes you inhale them, are also pretty risky. 0:03:02.919 --> 0:03:06.640 So inhalation is a key issue with tobacco products. The 0:03:06.720 --> 0:03:09.399 key factors I think about and talking about different types 0:03:09.440 --> 0:03:12.960 of tobacco use. For it to be popular, it's got 0:03:13.040 --> 0:03:16.400 to get nicotine to the brain. Secondly, it's got to 0:03:16.480 --> 0:03:19.160 taste good. It's got to be pleasant for the user 0:03:19.200 --> 0:03:22.200 to be using. Often non users don't like it, but 0:03:22.280 --> 0:03:24.320 users like the taste of it and smell of it. 0:03:24.880 --> 0:03:28.040 And third's got to be a convenient product. So if 0:03:28.080 --> 0:03:30.560 you go back to the eighteen hundreds, when the US 0:03:30.720 --> 0:03:35.080 was a largely rural society, the most popular form of 0:03:35.080 --> 0:03:39.720 tobacco with smokeless tobacco, chewing tobacco, wet snuff, moist snuff. 0:03:40.360 --> 0:03:42.640 It got nicotine to the brain, it tasted good to 0:03:42.640 --> 0:03:45.240 the user, and it also didn't burn the barn down 0:03:45.400 --> 0:03:48.200 in an agrarian society, so that was a real advantage. 0:03:48.720 --> 0:03:52.520 But at the end of the eighteen hundreds, something called 0:03:52.560 --> 0:03:56.520 the germ theory of disease became common and public spitting 0:03:56.560 --> 0:04:00.360 got outlawed in major cities all over the country. So 0:04:00.960 --> 0:04:04.560 spitting became very inconvenient. And it's hard to use chewing 0:04:04.560 --> 0:04:08.000 tobacco if you don't have an opportunity to spit. And 0:04:08.040 --> 0:04:11.120 the late eighteen hundred cigars started to become popular. 0:04:11.200 --> 0:04:13.440 But also interjected that back in those days there were 0:04:13.480 --> 0:04:15.720 spittoons everywhere, replaces to spit. 0:04:16.160 --> 0:04:19.440 There's a wonderful account by Charles Dickens who visited the 0:04:19.520 --> 0:04:23.280 United States when chewing tobacco was king, and he was 0:04:23.360 --> 0:04:27.159 grossed out by all the spitting that he saw. But 0:04:27.839 --> 0:04:31.960 General Ulysses S. Grant, former President Ulysses S. Grant, died 0:04:32.000 --> 0:04:35.160 a very public death in eighteen eighty five of jaw cancer. 0:04:35.200 --> 0:04:38.000 It was the New York Times of supporting daily on 0:04:38.040 --> 0:04:40.919 the state of his health, and people got afraid of 0:04:40.960 --> 0:04:44.680 cigars because here you have this major figure dying of 0:04:44.720 --> 0:04:49.760 a very painful jaw cancer. That set the stage for cigarettes. 0:04:49.839 --> 0:04:54.080 Cigarettes started, if you will, as a safer kind of smoke. 0:04:54.640 --> 0:04:56.359 It was think of it. It was so safe you 0:04:56.360 --> 0:05:00.960 could inhale it easily. So in the early twentieth century 0:05:01.320 --> 0:05:03.320 that was the first time that there was a national 0:05:03.360 --> 0:05:07.360 marketing of cigarettes. Previously there had been local brands of cigarettes, 0:05:07.839 --> 0:05:11.039 but then they became national brands like Camel and Lucky 0:05:11.080 --> 0:05:16.840 Strike in Chesterfield, and Cigarette You started to take off dramatically. 0:05:17.279 --> 0:05:21.960 So physicians in the nineteen twenties almost never sought a 0:05:22.000 --> 0:05:24.839 case of lung cancer in their patients. In the nineteen 0:05:24.880 --> 0:05:27.840 thirties and forties, they started to see lung cancer, and 0:05:27.880 --> 0:05:31.960 this is coincident with the rise in cigarettes. Now marketing 0:05:32.520 --> 0:05:37.320 modern marketing, emotionally based marketing, imagery based marketing became important 0:05:37.839 --> 0:05:42.440 in the twentieth century and cigarettes was the biggest funder 0:05:42.480 --> 0:05:47.200 of advertising agencies, and there was no better marketer of 0:05:47.279 --> 0:05:50.880 cigarettes than movies. Companies were paying to get their products 0:05:50.880 --> 0:05:56.560 placed in movies. Now I know, Alec, you were interviewed 0:05:56.640 --> 0:06:00.320 in the twenty sixteen Toronto International Film festal Well, you 0:06:00.360 --> 0:06:04.000 talked about major actors who influenced you, and you spoke 0:06:04.000 --> 0:06:08.120 about their colorful, stylized performances. I'd like to mention four 0:06:08.160 --> 0:06:12.120 people that you mentioned in order. Jimmy Cagney. James Cagney, 0:06:12.880 --> 0:06:16.480 you mentioned his performance in White Heat. In that performance, 0:06:16.560 --> 0:06:20.120 Cody Jarrett doesn't touch a cigarette. Turns out that Cagney 0:06:20.480 --> 0:06:23.520 disliked cigarettes. He had been forced to market them in 0:06:23.560 --> 0:06:27.960 early films. Cagney was a pipe smoker. Cagney died at 0:06:28.040 --> 0:06:31.680 eighty six, eighty six years old. Keep that in mind. 0:06:31.760 --> 0:06:34.560 Let's go to the next actor you mentioned, Humphrey Bogart. 0:06:35.200 --> 0:06:38.920 I would say that for Humphrey Bogart, a cigarette was 0:06:38.960 --> 0:06:41.920 a kind of supporting actor in his performances. I mean, 0:06:43.080 --> 0:06:45.960 you can't imagine many of his performances without a cigarette 0:06:45.960 --> 0:06:50.080 being a player in it. Humphrey Bogart died of aesophageal 0:06:50.200 --> 0:06:54.599 cancer at age fifty seven fifty seven. Next, you mentioned 0:06:54.600 --> 0:06:59.279 Gary Cooper, who died at sixty. Gary Cooper advertised Lucky 0:06:59.320 --> 0:07:01.640 Strikes in the nightenineteen thirties, and one of his print 0:07:01.680 --> 0:07:06.240 ads he says, ever since switching to Lucky's, my throat 0:07:06.680 --> 0:07:09.400 has been in fine shape. Now, if you think of it, 0:07:09.440 --> 0:07:12.520 that's a bit of a health claim that an irritating 0:07:12.560 --> 0:07:16.600 product is a more dangerous product. Clark Gable use praised 0:07:16.680 --> 0:07:20.400 Clark Gable's performance in The Misfits. Two days after The 0:07:20.480 --> 0:07:23.520 Misfits wrapped, Gable had a heart attack and he was 0:07:23.560 --> 0:07:28.560 dead ten days later at age fifty nine. Now that 0:07:28.680 --> 0:07:32.160 comparison is just meant to get one's attention. That's not 0:07:32.200 --> 0:07:35.240 scientific data. But you've got Magna dyeing dying at a 0:07:35.280 --> 0:07:39.480 ripe old age of eighty six, and these major figures 0:07:39.560 --> 0:07:42.880 dying much too young. Let me talk a bit about 0:07:42.880 --> 0:07:45.160 the percentage of smokers in the United States and how 0:07:45.160 --> 0:07:50.239 that rose in nineteen forty young men at about twenty 0:07:50.320 --> 0:07:53.560 years old. Eighty percent of young men were smoking in 0:07:53.680 --> 0:07:57.520 nineteen forty eighty percent. If you jump to the most 0:07:57.520 --> 0:08:00.520 recent data provided by the CDC in twenty two twenty one, 0:08:01.000 --> 0:08:03.880 looking at a similar age group, people eighteen to twenty four, 0:08:04.440 --> 0:08:08.640 only five percent are smoking. So think of it when 0:08:08.680 --> 0:08:11.720 eighty percent of people are doing it. That's a very 0:08:11.760 --> 0:08:15.880 trendy activity. But the social pressures have changed. Smoking has 0:08:15.920 --> 0:08:20.040 become much more stigmatized and the bands that have become 0:08:20.080 --> 0:08:24.840 commonplace on indoor smoking and government buildings in many states. 0:08:25.520 --> 0:08:28.080 That adds to the inconvenience of smoking. 0:08:33.200 --> 0:08:37.920 Doctor Lynn Kaslowski. If you enjoy conversations with experts in 0:08:37.960 --> 0:08:41.760 public health, check out my episode with doctor Anthony Fauci, 0:08:42.360 --> 0:08:47.280 former director of the National Institute of Allergy and Infectious Diseases. 0:08:47.920 --> 0:08:51.600 Is know what a disease that can actually kill you 0:08:52.240 --> 0:08:55.960 by a rispiratory root? That is that people half of 0:08:56.000 --> 0:08:58.760 them don't have any symptoms. When we realize that, it 0:08:58.840 --> 0:09:01.800 became clear that we really needed to do mass But 0:09:01.880 --> 0:09:05.120 yet people who want to be ultraly critical will say, oh, 0:09:05.160 --> 0:09:09.880 he flip flops. If you don't change your mind with 0:09:10.000 --> 0:09:14.520 the evolution of the new information, then you are really 0:09:14.840 --> 0:09:16.800 guilty of something that's not good. 0:09:19.080 --> 0:09:22.319 To hear more of my conversation with doctor Fauci, go 0:09:22.400 --> 0:09:26.480 to Here's the Thing dot org. After the break, doctor 0:09:26.559 --> 0:09:31.160 Lynn Kozlowski gives a risk assessment for smoking traditional cigarettes 0:09:31.480 --> 0:09:44.960 versus vaping. I'm Alec Baldwin and you're listening to. Here's 0:09:44.960 --> 0:09:48.880 the thing. There are currently an estimated twenty eight point 0:09:48.920 --> 0:09:52.720 three million people in the United States who smoke, which 0:09:52.840 --> 0:09:57.360 incredibly is nearly twelve percent of adults. The figures can 0:09:57.400 --> 0:10:00.440 seem inexplicable when put up against the the fact that 0:10:00.480 --> 0:10:04.839 smoking manufactured cigarettes is the leading cause of premature death 0:10:05.160 --> 0:10:09.600 in much of Europe and North America, and smoking related 0:10:09.600 --> 0:10:13.760 diseases killed forty one million people in the US, UK, 0:10:13.920 --> 0:10:18.520 and Canada between nineteen sixty and twenty twenty. Doctor Lynn 0:10:18.600 --> 0:10:23.680 Keslowski has spent his career studying the deleterious effects of smoking. 0:10:24.240 --> 0:10:28.640 Working with these statistics must be no easy task, so 0:10:28.720 --> 0:10:31.120 I was curious to learn how he found his way 0:10:31.559 --> 0:10:32.920 to this line of study. 0:10:34.120 --> 0:10:38.200 My doctoral dissertation, which was conducted in nineteen seventy four, 0:10:38.880 --> 0:10:42.040 looked at the relationship between coffee drinking and nicotine use, 0:10:42.120 --> 0:10:46.000 coffee drinking and cigarette smoking. So I had an early 0:10:46.679 --> 0:10:51.319 contact with cigarette research and my mentor at Columbia University, 0:10:51.840 --> 0:10:55.400 Stanley Schachter, a very noted psychologist. He well, I would 0:10:55.440 --> 0:10:57.240 say he was my beloved mentor, and he was a 0:10:57.320 --> 0:11:02.000 very heavy smoker, and he got into smoking research initially 0:11:02.600 --> 0:11:05.719 because he was interested in the issue of why does 0:11:05.760 --> 0:11:10.400 smoking seem to calm people down when they're in stressful circumstances. 0:11:10.679 --> 0:11:12.600 What was his answer, Well, that's. 0:11:12.400 --> 0:11:14.800 Actually kind of interesting because what we looked at. I 0:11:14.840 --> 0:11:18.200 was involved with those studies that it turns out that 0:11:18.360 --> 0:11:23.240 under stress, your urine becomes more acidic and you excrete 0:11:23.360 --> 0:11:28.120 more nicotine from your blood, and so that under stressful circumstances, 0:11:28.920 --> 0:11:32.480 more nicotines leaving your bloodstream, and so you need to 0:11:32.480 --> 0:11:37.320 smoke more to maintain your doses of nicotine. And I 0:11:37.320 --> 0:11:41.800 would say the chacter, a very heavy smoker, smoked as 0:11:41.840 --> 0:11:44.720 soon as his eyes opened in the morning. He knew 0:11:44.760 --> 0:11:47.880 he was addicted to cigarettes, and so I learned a 0:11:47.880 --> 0:11:49.080 lot from him. 0:11:49.280 --> 0:11:52.240 So throughout your career, smoking has been the bulwark of 0:11:52.280 --> 0:11:53.000 what you've done. 0:11:52.840 --> 0:11:57.000 Correct, Yeah, largely. My first job was at Western University, 0:11:57.760 --> 0:12:01.120 and it was harder to do the kind of smoking 0:12:01.160 --> 0:12:03.160 research that I wanted to do there. And then I 0:12:03.160 --> 0:12:06.800 got a job in Toronto at the Addiction Research Foundation 0:12:07.000 --> 0:12:10.440 to become head of their behavioral research on tobacco use, 0:12:10.920 --> 0:12:14.800 and that was a perfect environment where I had physician colleagues, 0:12:14.800 --> 0:12:20.080 pharmacologist colleagues to collaborate with so in Toronto. That was 0:12:20.120 --> 0:12:21.400 the focus of my research. 0:12:22.520 --> 0:12:26.400 So when you start the Department of Health Behavior at 0:12:26.400 --> 0:12:29.080 the University of Buffalo, I mean one would assume even 0:12:29.120 --> 0:12:33.000 somebody that doesn't know much about the infrastructure of academia 0:12:33.000 --> 0:12:35.160 and the protocols of academia, you don't just walk up 0:12:35.160 --> 0:12:38.480 and go, hey, I got this idea. What were you 0:12:38.559 --> 0:12:40.280 working on that they thought was important? 0:12:41.120 --> 0:12:42.880 Well, I think the reason I got that job is 0:12:42.920 --> 0:12:48.080 that I had long experience as a department head at 0:12:48.120 --> 0:12:52.559 Penn State. I'd been department head for a department of 0:12:52.600 --> 0:12:55.800 buyby Here Full of Health at Penn State for over 0:12:55.840 --> 0:13:00.679 a decade, and so that experience as an academic and administrator, 0:13:01.200 --> 0:13:04.880 as well as having significant research credentials, was what wanted 0:13:04.880 --> 0:13:07.200 them to recruit me. They were trying to get the 0:13:07.280 --> 0:13:09.880 new School of Public Health and Health Professions accredit it 0:13:09.920 --> 0:13:12.240 as a school of public health, and they needed to 0:13:12.280 --> 0:13:15.480 create that new department. And in terms of public health, 0:13:16.160 --> 0:13:19.040 tobacco use has been one of the major public health 0:13:19.080 --> 0:13:21.840 issues of twentieth century. 0:13:22.480 --> 0:13:25.520 For me, the arc of smoking. I mean, I remember 0:13:25.559 --> 0:13:28.800 when I first came into this business, people lit cigarettes 0:13:28.840 --> 0:13:31.319 on the set of the TV show at thirty Rockefeller Plose. 0:13:31.440 --> 0:13:33.559 We'd be on the set of a soap opera that 0:13:33.600 --> 0:13:35.080 I was doing. The first job I had was one 0:13:35.080 --> 0:13:38.000 of the old school soap operas, and I could name 0:13:38.240 --> 0:13:41.640 a handful of people who were smokers, and those people 0:13:41.679 --> 0:13:44.600 who were non smokers didn't really say anything. They didn't 0:13:44.600 --> 0:13:47.559 really complain me. Now, you wouldn't hesitate to scold someone 0:13:48.000 --> 0:13:51.000 who's smoking publicly. I'll never forget. There was this line 0:13:51.000 --> 0:13:54.080 that someone said, they said, the moomme outlaws smoking. Only 0:13:54.160 --> 0:13:57.079 outlaws will smoke. You're really going to alienate them in 0:13:57.120 --> 0:13:58.480 a very strong and very kind. 0:13:58.320 --> 0:14:02.680 Of aggressive wayeen eighties, at the Addiction Research Foundation in Toronto, 0:14:03.400 --> 0:14:07.400 clinicians who were working with people with cocaine dependencies and 0:14:07.600 --> 0:14:13.000 opioid dependencies in their clinical sessions, they would often share cigarettes. 0:14:13.960 --> 0:14:17.200 The clinician and the patient would share a cigarette. Now, 0:14:17.800 --> 0:14:21.680 after a decade's work, that stopped that notion of it 0:14:21.720 --> 0:14:24.640 was appropriate for a clinician to be sharing a cigarette 0:14:24.640 --> 0:14:30.520 with somebody with alcohol or opioid problems. That was recognized 0:14:30.520 --> 0:14:34.080 as an ato, But in nineteen eighty it was commonplace. 0:14:34.400 --> 0:14:37.080 So for me, the next turn of the wheel, if 0:14:37.120 --> 0:14:40.720 you will, is these labels on cigarettes, which have become 0:14:40.840 --> 0:14:43.280 increasingly dire over the years have gone by. I mean 0:14:43.280 --> 0:14:45.960 they might as well say, you know, if you smoke, 0:14:46.120 --> 0:14:47.960 one of your eyeballs is going to fall out. I mean, 0:14:48.000 --> 0:14:50.280 they make it as stark and as dramatic as they can. 0:14:50.720 --> 0:14:53.560 When those first came on, I recall that the tobacco 0:14:53.640 --> 0:14:56.040 industry fought it tooth and nail. They didn't want those 0:14:56.040 --> 0:14:58.720 warnings on those cigarette pecks. Did that have a big 0:14:58.760 --> 0:15:01.640 effect on people warning labels in general? 0:15:01.760 --> 0:15:05.720 Yes, I would say the United States is behind many 0:15:05.720 --> 0:15:09.080 other places in the world in terms of warning labels. 0:15:09.280 --> 0:15:11.200 Where are the warning labels more effective as far as 0:15:11.240 --> 0:15:12.200 you're concerned. 0:15:12.160 --> 0:15:17.840 Canada, the United Kingdom, they have graphic images of diseases 0:15:17.960 --> 0:15:20.840 and set of loss to people and so on, and 0:15:21.120 --> 0:15:24.840 so much so that there was sure it still happens 0:15:24.880 --> 0:15:27.160 in Canada that when they first came on the pack, 0:15:27.280 --> 0:15:32.920 some smokers were buying little pouches or slipcases as they 0:15:32.920 --> 0:15:35.160 could put their packs in so they didn't have to 0:15:35.160 --> 0:15:37.280 look at the image of it. But no, there's no 0:15:37.360 --> 0:15:42.400 doubt that the strong warning labels do help remind smokers 0:15:42.840 --> 0:15:44.520 that it's a problem to be smoking. 0:15:44.640 --> 0:15:46.440 Yeah, I mean, I was always wondering because I thought, 0:15:46.520 --> 0:15:48.840 here's a set of words on the side of a box, 0:15:49.320 --> 0:15:50.920 and you got a cigarette in your hand, and you're 0:15:50.960 --> 0:15:54.080 just somebody who smoking is as natural as breathing or 0:15:54.200 --> 0:15:56.920 drinking water. If you're a real smoker, it just doesn't 0:15:56.960 --> 0:15:58.920 even occur to you. And here's a bunch of words 0:15:58.920 --> 0:16:00.520 on a box. How much of an efact is they're 0:16:00.520 --> 0:16:02.080 really going to have? But it had some effect? 0:16:02.560 --> 0:16:04.600 Yeah, Actually there have been in the US, there been 0:16:04.720 --> 0:16:07.400 some i would call negative effects to some of the warnings. 0:16:07.680 --> 0:16:10.600 You asked about the risks of different products. It turns 0:16:10.640 --> 0:16:14.200 out that smokeless tobacco products like moist snuff, the thing 0:16:14.280 --> 0:16:18.320 you put between your cheek and gums, that's much much 0:16:18.440 --> 0:16:21.880 less dangerous than cigarettes. Really, think about it, if you're 0:16:21.920 --> 0:16:25.400 not getting stuff in your lungs, that alone is going 0:16:25.440 --> 0:16:28.640 to knock off the majority of things that kill you 0:16:28.680 --> 0:16:32.840 from smoking. Lung cancer and respiratory diseases are the majority 0:16:32.880 --> 0:16:36.600 of things that kill you from smoking cigarettes. And with 0:16:36.680 --> 0:16:41.240 the first warning labels on smokeless tobacco products included a 0:16:41.280 --> 0:16:45.320 warning label that the industry supported, and it was this 0:16:45.480 --> 0:16:48.520 product is not a safe alternative to cigarettes. Now it 0:16:48.600 --> 0:16:52.640 turns out that the way consumers interpreted that warning this 0:16:52.800 --> 0:16:56.320 product is not a safe alternative cigarettes, they interpreted as 0:16:56.360 --> 0:16:59.160 saying they're just as dangerous as cigarettes, when in fact 0:16:59.440 --> 0:17:02.000 they're much dangerous and cigarettes. Let me give you a 0:17:02.000 --> 0:17:05.440 good example of that. I would bet you would think 0:17:05.840 --> 0:17:09.080 that oral tobacco like that is a major cause of 0:17:09.160 --> 0:17:09.760 oral cancer. 0:17:10.040 --> 0:17:10.920 I would assume. Yeah. 0:17:11.040 --> 0:17:13.600 It turns out cigarettes are a bigger cause of oral 0:17:13.640 --> 0:17:17.919 cancer than those products. Why, just because of the nature 0:17:17.920 --> 0:17:20.159 of the toxins exposed in the mouth and some of them, 0:17:20.920 --> 0:17:22.600 so the people don't know that. 0:17:22.720 --> 0:17:24.560 I would have assumed otherwise. Yeah. 0:17:24.640 --> 0:17:28.640 Yeah. And it turns out there are gross misunderstandings about 0:17:29.359 --> 0:17:33.320 the risks of different dement For example, if you talk 0:17:33.359 --> 0:17:38.080 about vaping products e cigarettes, that public understanding of the 0:17:38.160 --> 0:17:42.800 harms of vaping products has gotten more mistaken and more 0:17:42.880 --> 0:17:46.879 mistaken that a few years ago, about half of people 0:17:46.920 --> 0:17:50.880 were saying that vaping is equal in harm or more 0:17:50.920 --> 0:17:54.480 harmful in cigarettes. It turns out the eighty three percent 0:17:54.520 --> 0:17:58.280 of smokers think that vaping is as dangerous or more 0:17:58.359 --> 0:18:01.120 dangerous in cigarettes. And why did they think that, I'm 0:18:01.119 --> 0:18:03.919 not entirely clear why they do, But they're wrong. It 0:18:04.040 --> 0:18:07.080 turns out that again, when you get all of the 0:18:07.320 --> 0:18:11.800 carcinogens out of smoke, and that's what you're taking to 0:18:11.880 --> 0:18:14.880 your lungs, you do your lungs a big favor. Still 0:18:14.920 --> 0:18:18.880 an addictive product, but it's much less dangerous than cigarette. 0:18:18.920 --> 0:18:22.000 So there's a lot of studies now showing that it's 0:18:22.040 --> 0:18:26.120 a useful tool for adult smokers to give up smoking 0:18:26.160 --> 0:18:28.439 to switch to nicotine vape. 0:18:28.560 --> 0:18:30.879 Well, well, I want to get to vape right after 0:18:30.960 --> 0:18:34.200 this next point, which is that So in the next advancement, 0:18:34.200 --> 0:18:37.159 if you will we have the labels, then you have 0:18:37.520 --> 0:18:40.919 the outright banning of smoking. You start having smoking is 0:18:40.920 --> 0:18:44.520 not in places, an increasing number of places, and people 0:18:44.640 --> 0:18:47.000 have to go into a special room. Then they get 0:18:47.040 --> 0:18:48.919 rid of those rooms. They disappear. If they had them 0:18:48.920 --> 0:18:52.000 at airports for a while, here's the smoking room, and 0:18:52.240 --> 0:18:55.800 you saw everybody in a cloud of smoke inside some 0:18:55.840 --> 0:18:58.159 little chamber. I mean, I've lived in New York, you know, 0:18:58.400 --> 0:19:01.080 nearly all of my adult life, and you see people 0:19:01.200 --> 0:19:04.040 go from they go outside and they want to smoke 0:19:04.119 --> 0:19:07.520 so bad, and it's pouring rain, it's freezing cold. They're 0:19:07.600 --> 0:19:10.960 hunched over. Then they drive them away from the entrance 0:19:11.000 --> 0:19:14.600 of the building. The signs appear everywhere. You cannot smoke 0:19:14.640 --> 0:19:17.120 within one hundred feet of this entrance or fifty feet, 0:19:17.160 --> 0:19:19.200 so people have to go down, they have to walk 0:19:19.240 --> 0:19:21.199 down to the side of the building and blah blah blah. 0:19:21.320 --> 0:19:25.119 I mean, we've made it as difficult as possible in 0:19:25.160 --> 0:19:27.480 many parts of the country. Is it having an effect? 0:19:28.560 --> 0:19:32.000 Is smoking in a downward trend now in the twenty 0:19:32.080 --> 0:19:33.280 twenty three Oh definitely. 0:19:33.320 --> 0:19:35.720 I mean it's a whole bunch of things that have 0:19:35.960 --> 0:19:39.280 ganged up on smoking to diminish it. I mean, the 0:19:39.359 --> 0:19:43.080 indoor smoking rules have had a big effect. Remember when 0:19:43.119 --> 0:19:46.679 there were television ads for cigarettes. Of course, there was 0:19:46.720 --> 0:19:49.359 a period when there was an equal time law that 0:19:49.400 --> 0:19:54.480 you could get anti smoking ads on TV. It turned 0:19:54.520 --> 0:19:57.199 out those anti smoking ads had a big effect on 0:19:57.280 --> 0:20:01.399 discouraging smoking, so much so the companies were kind of 0:20:01.440 --> 0:20:05.600 happy to get off TV because that equal time anti 0:20:05.640 --> 0:20:06.879 smoking ad would go away. 0:20:07.000 --> 0:20:10.840 Then that battle was over. Yeah. Now, obviously in the 0:20:10.880 --> 0:20:13.119 business I've worked in for several years, there's been a 0:20:13.119 --> 0:20:17.320 lot of push to cut smoking. That it was a 0:20:17.440 --> 0:20:19.679 bad idea and a poor role model for a lot 0:20:19.720 --> 0:20:23.600 of kids. But that idea, the social stigma. You know, 0:20:23.680 --> 0:20:27.040 in Hollywood and TV, you know pretty much banning it. 0:20:27.080 --> 0:20:29.399 I mean, if you're going to smoke a cigarette, you 0:20:29.480 --> 0:20:31.600 better be playing Edward R. Murrow in order to be 0:20:31.600 --> 0:20:34.760 smoking a cigarette in the scene. But in my business 0:20:34.800 --> 0:20:36.960 that had a profound effect, I think, which they wanted 0:20:37.000 --> 0:20:38.360 us to be role models in. 0:20:38.320 --> 0:20:41.320 Some way, and you were role models. But let me 0:20:41.600 --> 0:20:45.600 say something about a watershed in the United States, and 0:20:45.640 --> 0:20:49.639 I was the nineteen sixty four Surgeon General's report which 0:20:50.160 --> 0:20:54.439 came out declaring smoking as a cause of cancer. Within 0:20:54.640 --> 0:20:59.479 days of the nineteen sixty four report being released, Carlton 0:20:59.520 --> 0:21:04.560 cigarette were advertised for the first time. Carlton were ultra 0:21:04.720 --> 0:21:09.080 ultra low tar cigarettes one milligram tar zero point one 0:21:09.160 --> 0:21:14.320 milligram nicotine. And if you will, that was the start 0:21:14.760 --> 0:21:19.560 of an ultra light light boondoggle that came about right 0:21:19.600 --> 0:21:22.119 after the nineteen sixty four report that people were thinking, 0:21:22.760 --> 0:21:25.600 I'm better off smoking a light cigarette than a full 0:21:25.640 --> 0:21:28.600 flavor cigarette, better off smoking an ultra light And it 0:21:28.640 --> 0:21:31.760 turned out it took years of research to show that 0:21:31.760 --> 0:21:34.600 that wasn't the case, and that one of the key 0:21:34.720 --> 0:21:38.320 features in creating a one milligram tar cigarette is to 0:21:38.359 --> 0:21:40.719 take the filter and punch a whole bunch of holes 0:21:40.720 --> 0:21:43.880 in it. They make it eighty percent diluted with air. 0:21:44.000 --> 0:21:47.359 So when the smoking machine takes a puff on the cigarette, 0:21:47.760 --> 0:21:50.679 it's trying in eighty percent air with each puff, and 0:21:50.720 --> 0:21:53.280 that's diluting it. Now, what does a human smoker do 0:21:54.000 --> 0:21:58.159 with a cigarette that's eighty percent ventilated. Some push it 0:21:58.200 --> 0:22:00.199 a little bit further in their mouth and their lips 0:22:00.240 --> 0:22:03.760 cover the vents, and that gets more smoke to their lungs, 0:22:03.960 --> 0:22:06.200 or they take bigger puffs, or they take more puffs. 0:22:06.400 --> 0:22:09.199 So in the early days of this tar derby, in 0:22:09.240 --> 0:22:13.720 the sixties, seventies and eighties, standard smoking machine tests were 0:22:13.720 --> 0:22:17.919 conducted by the government, and it turned out that people 0:22:17.960 --> 0:22:21.879 don't smoke like smoking machines. They take bigger puffs. If 0:22:21.880 --> 0:22:24.440 they want to, they take more puffs. And I had 0:22:24.640 --> 0:22:27.520 colleagues who did research on smoking machines that show you 0:22:27.520 --> 0:22:30.320 could have one cigarette that in a standard run and 0:22:30.359 --> 0:22:34.920 a smoking machine gave you seventeen milligrams of tar one 0:22:35.080 --> 0:22:38.480 seven seventeen milligrams of tar. But if you adjusted the 0:22:38.520 --> 0:22:42.480 machine to simulate a heavy smoke, big puffs, lots of puffs, 0:22:43.080 --> 0:22:46.320 you could get seventy milligrams of tar from the same cigarette, 0:22:47.000 --> 0:22:50.720 so that one of the key issues with cigarettes is 0:22:50.760 --> 0:22:53.399 that what you get from it depends how you puff 0:22:53.440 --> 0:22:55.840 on it. It's not like a pill. It's not like with 0:22:55.920 --> 0:22:58.320 a bottle of beer. If you don't miss your mouth, 0:22:58.359 --> 0:23:00.600 you know how much alcohol you get from a b beer. 0:23:01.200 --> 0:23:03.520 With a cigarette, it's a race between what's going in 0:23:03.520 --> 0:23:07.280 the air and what's going in your lungs. And people 0:23:07.320 --> 0:23:08.600 can compensate, and they did. 0:23:08.680 --> 0:23:10.720 There's games you can play with smoke. 0:23:10.560 --> 0:23:13.520 And so that people from with ultra light cigarettes could 0:23:13.520 --> 0:23:15.360 get as much as they were getting from bull Flavor. 0:23:15.800 --> 0:23:18.480 And that's actually one of the reasons why light and 0:23:18.560 --> 0:23:23.000