Speaker 1: This is Alec Baldwin, and you were listening to Here's
Speaker 1: the Thing from iHeartRadio. These days, a pack of Marlboroughs
Speaker 1: could set you back thirteen dollars. If you actually want
Speaker 1: to smoke them, You've got to stand in a designated
Speaker 1: area twenty five feet from the building's entrance, and the
Speaker 1: package will contain the most dire warnings of illness and death.
Speaker 1: Overcoming these hurdles requires a true commitment to the habit.
Speaker 1: It's enough to ask who is still smoking? My guest today,
Speaker 1: Doctor Lin Koslowski is here to shed some light on
Speaker 1: this question. Doctor Kozlowski is an expert on tobacco use
Speaker 1: and nicotine policy and his professor Emeritus and Dean Emeritus
Speaker 1: of Community Health and Health Behavior at the University at Buffalo.
Speaker 1: He is also a founding member of the Society for
Speaker 1: Nicotine and Tobacco Research and has contributed to four US
Speaker 1: Surgeon General's Reports of smoking. I wanted to know if
Speaker 1: doctor Kozlowski was ever tempted to pick up a pack himself.
Speaker 2: I certainly tried to be a smoker, so in high
Speaker 2: school I experimented. In college, I had roommates who were
Speaker 2: devoted heavy smokers. I tried to smoke. There was no
Speaker 2: moral sense had got in the way. I just kept
Speaker 2: getting sick from smoking, so it wasn't worth it to me.
Speaker 2: But so it's fair to say I was tempted. I tried.
Speaker 2: I experimented with packs of cigarettes and pipes and cigars
Speaker 2: and so on. But I never became a regular smoker.
Speaker 1: I smoked, never heavily, never habitually. I'd smoke usually when
Speaker 1: I was shooting a film, because filmmaking is such a
Speaker 1: boring process. You work for ten or fifteen minutes, then
Speaker 1: you go away for an hour while they get ready
Speaker 1: for the next angle, and so forth. And I smoked
Speaker 1: out of boredom on the sets of films and so forth,
Speaker 1: And whenever the project was over and I went home,
Speaker 1: quote unquote, I stopped because the people in my life
Speaker 1: wouldn't tolerate that.
Speaker 2: So when you were smoking, how early in the morning
Speaker 2: did you have your first cigarette?
Speaker 1: Probably in the afternoon, Like when I was doing films
Speaker 1: and shooting, I didn't have the taste for it. And
Speaker 1: one thing I did for a period of time, I
Speaker 1: smoked cigars. To give up cigarette smoking. I would be
Speaker 1: on the road shooting films, traveling and I'd be making
Speaker 1: films and I could smoke cigars there unrepentantly because my
Speaker 1: wife was miles away, and I'd fire up and there
Speaker 1: was a period where I was smoking three of these
Speaker 1: big fat boomers every day. Well, I want to ask
Speaker 1: you in terms of I can probably guess what the
Speaker 1: order is in terms of the number of people who
Speaker 1: were consuming the following. But I was wondering, from your
Speaker 1: research and from your work, are they all equivalently bad
Speaker 1: in their own way? And I'm talking about cigarettes, pipes, cigars,
Speaker 1: chewing tobacco.
Speaker 2: It's very different in terms of harm, right, And cigarettes
Speaker 2: are at the pinnacle of risk, and cigars if you
Speaker 2: inhale them, or pipes you inhale them, are also pretty risky.
Speaker 2: So inhalation is a key issue with tobacco products. The
Speaker 2: key factors I think about and talking about different types
Speaker 2: of tobacco use. For it to be popular, it's got
Speaker 2: to get nicotine to the brain. Secondly, it's got to
Speaker 2: taste good. It's got to be pleasant for the user
Speaker 2: to be using. Often non users don't like it, but
Speaker 2: users like the taste of it and smell of it.
Speaker 2: And third's got to be a convenient product. So if
Speaker 2: you go back to the eighteen hundreds, when the US
Speaker 2: was a largely rural society, the most popular form of
Speaker 2: tobacco with smokeless tobacco, chewing tobacco, wet snuff, moist snuff.
Speaker 2: It got nicotine to the brain, it tasted good to
Speaker 2: the user, and it also didn't burn the barn down
Speaker 2: in an agrarian society, so that was a real advantage.
Speaker 2: But at the end of the eighteen hundreds, something called
Speaker 2: the germ theory of disease became common and public spitting
Speaker 2: got outlawed in major cities all over the country. So
Speaker 2: spitting became very inconvenient. And it's hard to use chewing
Speaker 2: tobacco if you don't have an opportunity to spit. And
Speaker 2: the late eighteen hundred cigars started to become popular.
Speaker 1: But also interjected that back in those days there were
Speaker 1: spittoons everywhere, replaces to spit.
Speaker 2: There's a wonderful account by Charles Dickens who visited the
Speaker 2: United States when chewing tobacco was king, and he was
Speaker 2: grossed out by all the spitting that he saw. But
Speaker 2: General Ulysses S. Grant, former President Ulysses S. Grant, died
Speaker 2: a very public death in eighteen eighty five of jaw cancer.
Speaker 2: It was the New York Times of supporting daily on
Speaker 2: the state of his health, and people got afraid of
Speaker 2: cigars because here you have this major figure dying of
Speaker 2: a very painful jaw cancer. That set the stage for cigarettes.
Speaker 2: Cigarettes started, if you will, as a safer kind of smoke.
Speaker 2: It was think of it. It was so safe you
Speaker 2: could inhale it easily. So in the early twentieth century
Speaker 2: that was the first time that there was a national
Speaker 2: marketing of cigarettes. Previously there had been local brands of cigarettes,
Speaker 2: but then they became national brands like Camel and Lucky
Speaker 2: Strike in Chesterfield, and Cigarette You started to take off dramatically.
Speaker 2: So physicians in the nineteen twenties almost never sought a
Speaker 2: case of lung cancer in their patients. In the nineteen
Speaker 2: thirties and forties, they started to see lung cancer, and
Speaker 2: this is coincident with the rise in cigarettes. Now marketing
Speaker 2: modern marketing, emotionally based marketing, imagery based marketing became important
Speaker 2: in the twentieth century and cigarettes was the biggest funder
Speaker 2: of advertising agencies, and there was no better marketer of
Speaker 2: cigarettes than movies. Companies were paying to get their products
Speaker 2: placed in movies. Now I know, Alec, you were interviewed
Speaker 2: in the twenty sixteen Toronto International Film festal Well, you
Speaker 2: talked about major actors who influenced you, and you spoke
Speaker 2: about their colorful, stylized performances. I'd like to mention four
Speaker 2: people that you mentioned in order. Jimmy Cagney. James Cagney,
Speaker 2: you mentioned his performance in White Heat. In that performance,
Speaker 2: Cody Jarrett doesn't touch a cigarette. Turns out that Cagney
Speaker 2: disliked cigarettes. He had been forced to market them in
Speaker 2: early films. Cagney was a pipe smoker. Cagney died at
Speaker 2: eighty six, eighty six years old. Keep that in mind.
Speaker 2: Let's go to the next actor you mentioned, Humphrey Bogart.
Speaker 2: I would say that for Humphrey Bogart, a cigarette was
Speaker 2: a kind of supporting actor in his performances. I mean,
Speaker 2: you can't imagine many of his performances without a cigarette
Speaker 2: being a player in it. Humphrey Bogart died of aesophageal
Speaker 2: cancer at age fifty seven fifty seven. Next, you mentioned
Speaker 2: Gary Cooper, who died at sixty. Gary Cooper advertised Lucky
Speaker 2: Strikes in the nightenineteen thirties, and one of his print
Speaker 2: ads he says, ever since switching to Lucky's, my throat
Speaker 2: has been in fine shape. Now, if you think of it,
Speaker 2: that's a bit of a health claim that an irritating
Speaker 2: product is a more dangerous product. Clark Gable use praised
Speaker 2: Clark Gable's performance in The Misfits. Two days after The
Speaker 2: Misfits wrapped, Gable had a heart attack and he was
Speaker 2: dead ten days later at age fifty nine. Now that
Speaker 2: comparison is just meant to get one's attention. That's not
Speaker 2: scientific data. But you've got Magna dyeing dying at a
Speaker 2: ripe old age of eighty six, and these major figures
Speaker 2: dying much too young. Let me talk a bit about
Speaker 2: the percentage of smokers in the United States and how
Speaker 2: that rose in nineteen forty young men at about twenty
Speaker 2: years old. Eighty percent of young men were smoking in
Speaker 2: nineteen forty eighty percent. If you jump to the most
Speaker 2: recent data provided by the CDC in twenty two twenty one,
Speaker 2: looking at a similar age group, people eighteen to twenty four,
Speaker 2: only five percent are smoking. So think of it when
Speaker 2: eighty percent of people are doing it. That's a very
Speaker 2: trendy activity. But the social pressures have changed. Smoking has
Speaker 2: become much more stigmatized and the bands that have become
Speaker 2: commonplace on indoor smoking and government buildings in many states.
Speaker 2: That adds to the inconvenience of smoking.
Speaker 1: Doctor Lynn Kaslowski. If you enjoy conversations with experts in
Speaker 1: public health, check out my episode with doctor Anthony Fauci,
Speaker 1: former director of the National Institute of Allergy and Infectious Diseases.
Speaker 3: Is know what a disease that can actually kill you
Speaker 3: by a rispiratory root? That is that people half of
Speaker 3: them don't have any symptoms. When we realize that, it
Speaker 3: became clear that we really needed to do mass But
Speaker 3: yet people who want to be ultraly critical will say, oh,
Speaker 3: he flip flops. If you don't change your mind with
Speaker 3: the evolution of the new information, then you are really
Speaker 3: guilty of something that's not good.
Speaker 1: To hear more of my conversation with doctor Fauci, go
Speaker 1: to Here's the Thing dot org. After the break, doctor
Speaker 1: Lynn Kozlowski gives a risk assessment for smoking traditional cigarettes
Speaker 1: versus vaping. I'm Alec Baldwin and you're listening to. Here's
Speaker 1: the thing. There are currently an estimated twenty eight point
Speaker 1: three million people in the United States who smoke, which
Speaker 1: incredibly is nearly twelve percent of adults. The figures can
Speaker 1: seem inexplicable when put up against the the fact that
Speaker 1: smoking manufactured cigarettes is the leading cause of premature death
Speaker 1: in much of Europe and North America, and smoking related
Speaker 1: diseases killed forty one million people in the US, UK,
Speaker 1: and Canada between nineteen sixty and twenty twenty. Doctor Lynn
Speaker 1: Keslowski has spent his career studying the deleterious effects of smoking.
Speaker 1: Working with these statistics must be no easy task, so
Speaker 1: I was curious to learn how he found his way
Speaker 1: to this line of study.
Speaker 2: My doctoral dissertation, which was conducted in nineteen seventy four,
Speaker 2: looked at the relationship between coffee drinking and nicotine use,
Speaker 2: coffee drinking and cigarette smoking. So I had an early
Speaker 2: contact with cigarette research and my mentor at Columbia University,
Speaker 2: Stanley Schachter, a very noted psychologist. He well, I would
Speaker 2: say he was my beloved mentor, and he was a
Speaker 2: very heavy smoker, and he got into smoking research initially
Speaker 2: because he was interested in the issue of why does
Speaker 2: smoking seem to calm people down when they're in stressful circumstances.
Speaker 1: What was his answer, Well, that's.
Speaker 2: Actually kind of interesting because what we looked at. I
Speaker 2: was involved with those studies that it turns out that
Speaker 2: under stress, your urine becomes more acidic and you excrete
Speaker 2: more nicotine from your blood, and so that under stressful circumstances,
Speaker 2: more nicotines leaving your bloodstream, and so you need to
Speaker 2: smoke more to maintain your doses of nicotine. And I
Speaker 2: would say the chacter, a very heavy smoker, smoked as
Speaker 2: soon as his eyes opened in the morning. He knew
Speaker 2: he was addicted to cigarettes, and so I learned a
Speaker 2: lot from him.
Speaker 1: So throughout your career, smoking has been the bulwark of
Speaker 1: what you've done.
Speaker 2: Correct, Yeah, largely. My first job was at Western University,
Speaker 2: and it was harder to do the kind of smoking
Speaker 2: research that I wanted to do there. And then I
Speaker 2: got a job in Toronto at the Addiction Research Foundation
Speaker 2: to become head of their behavioral research on tobacco use,
Speaker 2: and that was a perfect environment where I had physician colleagues,
Speaker 2: pharmacologist colleagues to collaborate with so in Toronto. That was
Speaker 2: the focus of my research.
Speaker 1: So when you start the Department of Health Behavior at
Speaker 1: the University of Buffalo, I mean one would assume even
Speaker 1: somebody that doesn't know much about the infrastructure of academia
Speaker 1: and the protocols of academia, you don't just walk up
Speaker 1: and go, hey, I got this idea. What were you
Speaker 1: working on that they thought was important?
Speaker 2: Well, I think the reason I got that job is
Speaker 2: that I had long experience as a department head at
Speaker 2: Penn State. I'd been department head for a department of
Speaker 2: buyby Here Full of Health at Penn State for over
Speaker 2: a decade, and so that experience as an academic and administrator,
Speaker 2: as well as having significant research credentials, was what wanted
Speaker 2: them to recruit me. They were trying to get the
Speaker 2: new School of Public Health and Health Professions accredit it
Speaker 2: as a school of public health, and they needed to
Speaker 2: create that new department. And in terms of public health,
Speaker 2: tobacco use has been one of the major public health
Speaker 2: issues of twentieth century.
Speaker 1: For me, the arc of smoking. I mean, I remember
Speaker 1: when I first came into this business, people lit cigarettes
Speaker 1: on the set of the TV show at thirty Rockefeller Plose.
Speaker 1: We'd be on the set of a soap opera that
Speaker 1: I was doing. The first job I had was one
Speaker 1: of the old school soap operas, and I could name
Speaker 1: a handful of people who were smokers, and those people
Speaker 1: who were non smokers didn't really say anything. They didn't
Speaker 1: really complain me. Now, you wouldn't hesitate to scold someone
Speaker 1: who's smoking publicly. I'll never forget. There was this line
Speaker 1: that someone said, they said, the moomme outlaws smoking. Only
Speaker 1: outlaws will smoke. You're really going to alienate them in
Speaker 1: a very strong and very kind.
Speaker 2: Of aggressive wayeen eighties, at the Addiction Research Foundation in Toronto,
Speaker 2: clinicians who were working with people with cocaine dependencies and
Speaker 2: opioid dependencies in their clinical sessions, they would often share cigarettes.
Speaker 2: The clinician and the patient would share a cigarette. Now,
Speaker 2: after a decade's work, that stopped that notion of it
Speaker 2: was appropriate for a clinician to be sharing a cigarette
Speaker 2: with somebody with alcohol or opioid problems. That was recognized
Speaker 2: as an ato, But in nineteen eighty it was commonplace.
Speaker 1: So for me, the next turn of the wheel, if
Speaker 1: you will, is these labels on cigarettes, which have become
Speaker 1: increasingly dire over the years have gone by. I mean
Speaker 1: they might as well say, you know, if you smoke,
Speaker 1: one of your eyeballs is going to fall out. I mean,
Speaker 1: they make it as stark and as dramatic as they can.
Speaker 1: When those first came on, I recall that the tobacco
Speaker 1: industry fought it tooth and nail. They didn't want those
Speaker 1: warnings on those cigarette pecks. Did that have a big
Speaker 1: effect on people warning labels in general?
Speaker 2: Yes, I would say the United States is behind many
Speaker 2: other places in the world in terms of warning labels.
Speaker 1: Where are the warning labels more effective as far as
Speaker 1: you're concerned.
Speaker 2: Canada, the United Kingdom, they have graphic images of diseases
Speaker 2: and set of loss to people and so on, and
Speaker 2: so much so that there was sure it still happens
Speaker 2: in Canada that when they first came on the pack,
Speaker 2: some smokers were buying little pouches or slipcases as they
Speaker 2: could put their packs in so they didn't have to
Speaker 2: look at the image of it. But no, there's no
Speaker 2: doubt that the strong warning labels do help remind smokers
Speaker 2: that it's a problem to be smoking.
Speaker 1: Yeah, I mean, I was always wondering because I thought,
Speaker 1: here's a set of words on the side of a box,
Speaker 1: and you got a cigarette in your hand, and you're
Speaker 1: just somebody who smoking is as natural as breathing or
Speaker 1: drinking water. If you're a real smoker, it just doesn't
Speaker 1: even occur to you. And here's a bunch of words
Speaker 1: on a box. How much of an efact is they're
Speaker 1: really going to have? But it had some effect?
Speaker 2: Yeah, Actually there have been in the US, there been
Speaker 2: some i would call negative effects to some of the warnings.
Speaker 2: You asked about the risks of different products. It turns
Speaker 2: out that smokeless tobacco products like moist snuff, the thing
Speaker 2: you put between your cheek and gums, that's much much
Speaker 2: less dangerous than cigarettes. Really, think about it, if you're
Speaker 2: not getting stuff in your lungs, that alone is going
Speaker 2: to knock off the majority of things that kill you
Speaker 2: from smoking. Lung cancer and respiratory diseases are the majority
Speaker 2: of things that kill you from smoking cigarettes. And with
Speaker 2: the first warning labels on smokeless tobacco products included a
Speaker 2: warning label that the industry supported, and it was this
Speaker 2: product is not a safe alternative to cigarettes. Now it
Speaker 2: turns out that the way consumers interpreted that warning this
Speaker 2: product is not a safe alternative cigarettes, they interpreted as
Speaker 2: saying they're just as dangerous as cigarettes, when in fact
Speaker 2: they're much dangerous and cigarettes. Let me give you a
Speaker 2: good example of that. I would bet you would think
Speaker 2: that oral tobacco like that is a major cause of
Speaker 2: oral cancer.
Speaker 1: I would assume. Yeah.
Speaker 2: It turns out cigarettes are a bigger cause of oral
Speaker 2: cancer than those products. Why, just because of the nature
Speaker 2: of the toxins exposed in the mouth and some of them,
Speaker 2: so the people don't know that.
Speaker 1: I would have assumed otherwise. Yeah.
Speaker 2: Yeah. And it turns out there are gross misunderstandings about
Speaker 2: the risks of different dement For example, if you talk
Speaker 2: about vaping products e cigarettes, that public understanding of the
Speaker 2: harms of vaping products has gotten more mistaken and more
Speaker 2: mistaken that a few years ago, about half of people
Speaker 2: were saying that vaping is equal in harm or more
Speaker 2: harmful in cigarettes. It turns out the eighty three percent
Speaker 2: of smokers think that vaping is as dangerous or more
Speaker 2: dangerous in cigarettes. And why did they think that, I'm
Speaker 2: not entirely clear why they do, But they're wrong. It
Speaker 2: turns out that again, when you get all of the
Speaker 2: carcinogens out of smoke, and that's what you're taking to
Speaker 2: your lungs, you do your lungs a big favor. Still
Speaker 2: an addictive product, but it's much less dangerous than cigarette.
Speaker 2: So there's a lot of studies now showing that it's
Speaker 2: a useful tool for adult smokers to give up smoking
Speaker 2: to switch to nicotine vape.
Speaker 1: Well, well, I want to get to vape right after
Speaker 1: this next point, which is that So in the next advancement,
Speaker 1: if you will we have the labels, then you have
Speaker 1: the outright banning of smoking. You start having smoking is
Speaker 1: not in places, an increasing number of places, and people
Speaker 1: have to go into a special room. Then they get
Speaker 1: rid of those rooms. They disappear. If they had them
Speaker 1: at airports for a while, here's the smoking room, and
Speaker 1: you saw everybody in a cloud of smoke inside some
Speaker 1: little chamber. I mean, I've lived in New York, you know,
Speaker 1: nearly all of my adult life, and you see people
Speaker 1: go from they go outside and they want to smoke
Speaker 1: so bad, and it's pouring rain, it's freezing cold. They're
Speaker 1: hunched over. Then they drive them away from the entrance
Speaker 1: of the building. The signs appear everywhere. You cannot smoke
Speaker 1: within one hundred feet of this entrance or fifty feet,
Speaker 1: so people have to go down, they have to walk
Speaker 1: down to the side of the building and blah blah blah.
Speaker 1: I mean, we've made it as difficult as possible in
Speaker 1: many parts of the country. Is it having an effect?
Speaker 1: Is smoking in a downward trend now in the twenty
Speaker 1: twenty three Oh definitely.
Speaker 2: I mean it's a whole bunch of things that have
Speaker 2: ganged up on smoking to diminish it. I mean, the
Speaker 2: indoor smoking rules have had a big effect. Remember when
Speaker 2: there were television ads for cigarettes. Of course, there was
Speaker 2: a period when there was an equal time law that
Speaker 2: you could get anti smoking ads on TV. It turned
Speaker 2: out those anti smoking ads had a big effect on
Speaker 2: discouraging smoking, so much so the companies were kind of
Speaker 2: happy to get off TV because that equal time anti
Speaker 2: smoking ad would go away.
Speaker 1: Then that battle was over. Yeah. Now, obviously in the
Speaker 1: business I've worked in for several years, there's been a
Speaker 1: lot of push to cut smoking. That it was a
Speaker 1: bad idea and a poor role model for a lot
Speaker 1: of kids. But that idea, the social stigma. You know,
Speaker 1: in Hollywood and TV, you know pretty much banning it.
Speaker 1: I mean, if you're going to smoke a cigarette, you
Speaker 1: better be playing Edward R. Murrow in order to be
Speaker 1: smoking a cigarette in the scene. But in my business
Speaker 1: that had a profound effect, I think, which they wanted
Speaker 1: us to be role models in.
Speaker 2: Some way, and you were role models. But let me
Speaker 2: say something about a watershed in the United States, and
Speaker 2: I was the nineteen sixty four Surgeon General's report which
Speaker 2: came out declaring smoking as a cause of cancer. Within
Speaker 2: days of the nineteen sixty four report being released, Carlton
Speaker 2: cigarette were advertised for the first time. Carlton were ultra
Speaker 2: ultra low tar cigarettes one milligram tar zero point one
Speaker 2: milligram nicotine. And if you will, that was the start
Speaker 2: of an ultra light light boondoggle that came about right
Speaker 2: after the nineteen sixty four report that people were thinking,
Speaker 2: I'm better off smoking a light cigarette than a full
Speaker 2: flavor cigarette, better off smoking an ultra light And it
Speaker 2: turned out it took years of research to show that
Speaker 2: that wasn't the case, and that one of the key
Speaker 2: features in creating a one milligram tar cigarette is to
Speaker 2: take the filter and punch a whole bunch of holes
Speaker 2: in it. They make it eighty percent diluted with air.
Speaker 2: So when the smoking machine takes a puff on the cigarette,
Speaker 2: it's trying in eighty percent air with each puff, and
Speaker 2: that's diluting it. Now, what does a human smoker do
Speaker 2: with a cigarette that's eighty percent ventilated. Some push it
Speaker 2: a little bit further in their mouth and their lips
Speaker 2: cover the vents, and that gets more smoke to their lungs,
Speaker 2: or they take bigger puffs, or they take more puffs.
Speaker 2: So in the early days of this tar derby, in
Speaker 2: the sixties, seventies and eighties, standard smoking machine tests were
Speaker 2: conducted by the government, and it turned out that people
Speaker 2: don't smoke like smoking machines. They take bigger puffs. If
Speaker 2: they want to, they take more puffs. And I had
Speaker 2: colleagues who did research on smoking machines that show you
Speaker 2: could have one cigarette that in a standard run and
Speaker 2: a smoking machine gave you seventeen milligrams of tar one
Speaker 2: seven seventeen milligrams of tar. But if you adjusted the
Speaker 2: machine to simulate a heavy smoke, big puffs, lots of puffs,
Speaker 2: you could get seventy milligrams of tar from the same cigarette,
Speaker 2: so that one of the key issues with cigarettes is
Speaker 2: that what you get from it depends how you puff
Speaker 2: on it. It's not like a pill. It's not like with
Speaker 2: a bottle of beer. If you don't miss your mouth,
Speaker 2: you know how much alcohol you get from a b beer.
Speaker 2: With a cigarette, it's a race between what's going in
Speaker 2: the air and what's going in your lungs. And people
Speaker 2: can compensate, and they did.
Speaker 1: There's games you can play with smoke.
Speaker 2: And so that people from with ultra light cigarettes could
Speaker 2: get as much as they were getting from bull Flavor.
Speaker 2: And that's actually one of the reasons why light and
Speaker 2: ultra light designations were removed. But people still know what
Speaker 2: a light and ultra light is because they can feel
Speaker 2: it from the taste of it. They taste different. I'm
Speaker 2: wondering if I could say a bit about cigars, please.
Speaker 2: The sixty four report came out and a few days later,
Speaker 2: the president of the American Medical Association was on the
Speaker 2: Today Show saying, if you can't give up cigarettes, you
Speaker 2: might switch to cigars or pipes. You'd be better off
Speaker 2: because in the sixty four report, cigars and pipes got
Speaker 2: a clean bill of health. It wasn't seen as a
Speaker 2: major cause of disease. And the reason for that was
Speaker 2: that the epidemiology at the time was based on people
Speaker 2: who were so called primary cigar smokers smoke cigarettes, they'd
Speaker 2: only smoke cigars, and those primary cigar smokers tended to
Speaker 2: not inhale cigars. So called secondary cigar smokers, people who
Speaker 2: were cigarette smokers switching to cigars, they tend to maintain
Speaker 2: the habit of inhalation, and that's a key issue in
Speaker 2: terms of the health risk. The other thing about cigars,
Speaker 2: as you know, smoking big cigars sometimes that sometimes it
Speaker 2: could take as much as an hour to smoke a
Speaker 2: big cigar. You could smoke sick cigarette does take an hour.
Speaker 2: You could smoke six cigarettes in the same interval. Yes,
Speaker 2: So when somebody says I just smoke two or three cigars,
Speaker 2: you got to consider how big are those cigars, how
Speaker 2: much puffing are they doing, are they inhaling and to
Speaker 2: the extent they're inhaling, to extent they're getting a lot
Speaker 2: of tobacco in their lungs. It's not a harm reducing
Speaker 2: product to be smoking cigars. The other thing about inhalation.
Speaker 2: I actually did research on this when I was in Canada.
Speaker 2: People can reliably tell you whether they inhale cigars or not.
Speaker 2: They know whether they.
Speaker 1: Inhale tobacco expert doctor Lynn Kozlowski. If you're enjoying this conversation,
Speaker 1: tell a friend and be sure to follow Here's the
Speaker 1: thing on the iHeartRadio apps, Spotify or wherever you get
Speaker 1: your podcasts. When we come back, doctor Lynn Kozlowski tells
Speaker 1: us what he believes is the best way to quit smoking.
Speaker 1: I'm Alec Baldwin and you're listening to Here's the thing.
Speaker 1: The data is sobering. Smokers who start early in life
Speaker 1: and keep smoking can lose up to a decade of
Speaker 1: life expectancy. I wanted to know for those who were interested,
Speaker 1: if doctor Lynn Koslowski thought there was the best time
Speaker 1: in their lives to quit smoking.
Speaker 2: As early as possible. Thirty is a benchmark if you
Speaker 2: can do it by thirty, and I think that needs
Speaker 2: to be promoted more widely. Probat Jaw, an epidemiologist at
Speaker 2: the University of Toronto, recently reviewed a lot of epidemiological
Speaker 2: studies and has come up with a very simple summary
Speaker 2: of the health risks of smoking, and the evidence shows
Speaker 2: that at least one in two smokers dies prematurely and
Speaker 2: they lose on an average ten years of life. And
Speaker 2: if a smoker can stop at age thirty, they go
Speaker 2: back to the longevity expectations of a never smoker. So
Speaker 2: if you can get people to stop at age thirty,
Speaker 2: that's great. At age forty it's ninety percent of a
Speaker 2: return to being a never smoker. At age fifty, you
Speaker 2: gain six years of life if you start smoking, and
Speaker 2: at age sixty's four years of life. I think there
Speaker 2: are a number of tools that people have to help
Speaker 2: them quit smoking, but I want to emphasize that those
Speaker 2: are tools, and I think of changing flo tire on
Speaker 2: a car. A lug wrench is a very useful tool
Speaker 2: for changing a flat tire, but it's a lot of
Speaker 2: work to change that tire. Any of these tools you
Speaker 2: might use for renclean is a prescription drug you might
Speaker 2: use to help quit smoking, nicotine replacement products, patch gum, lozenges,
Speaker 2: nicotine pouches, vaping. They're tools, and it's an important thing
Speaker 2: for the smoker. Not to be satisfied with just cutting
Speaker 2: down a bit on smoking. Your goal should be to
Speaker 2: try to get off smoking completely and switch to those
Speaker 2: other products, and then once you're securely off smoking, you
Speaker 2: can think about getting off those other products.
Speaker 1: So to the extent you can say, what do you
Speaker 1: think in the marketplace right now, would you say is
Speaker 1: among not the best, but among the best ways to
Speaker 1: quit smoking.
Speaker 2: I think for older adult smokers, vaping products are among
Speaker 2: the best ways to quit smoking, that they can provide
Speaker 2: the most satisfactory substitution for cigarettes. The other thing about
Speaker 2: quitting smoking is that repeated attempts you get smokers get
Speaker 2: better at it. For example, I've known people have given
Speaker 2: up smoking. They've been off for several months. They go
Speaker 2: to a gathering where others are smoking, and they think
Speaker 2: I could just have one cigarette. They do. They end
Speaker 2: up there wrong. So the next time they try to
Speaker 2: give up smoking, they know better. They know better than
Speaker 2: to be fooled by the illusion that I could just
Speaker 2: have one. And then I think there's also a kind
Speaker 2: of no more nice guy effect that people trying repeatedly
Speaker 2: give up they finally dig their heels in and have
Speaker 2: learned from what did and didn't work. I mean, I
Speaker 2: had one person tell me I tried this and I
Speaker 2: was off smoking for a year, and I said, that's
Speaker 2: a pretty good technique to try again. If you were
Speaker 2: off smoking for a year.
Speaker 1: I mean renew that subscription for another year.
Speaker 2: So I think it's important for smokers to keep at
Speaker 2: it now. The other thing about the health risks of smoking,
Speaker 2: the cardiovascular risks diminish very quickly within months once you
Speaker 2: stop smoking. The cancer risks are a bit of a
Speaker 2: different animal. The process of smoking is causing some cancer
Speaker 2: related issues to develop, and it takes longer for you
Speaker 2: to get the benefit of stopping smoking with respect to cancer.
Speaker 2: But the key message is stop as soon as you can.
Speaker 1: We'll get to vaping now, which is I mean to me?
Speaker 1: I find vaping just kind of just exploded. And I
Speaker 1: live in New York, and you know, street level in
Speaker 1: New York is nothing but food shops, coffee shops, and
Speaker 1: places to buy smoking paraphernalia and vaping. I was in
Speaker 1: a restaurant last night with my wife and a couple
Speaker 1: of friends, and it's a very nice restaurant, actually, one
Speaker 1: that we go to all the time in our neighborhood.
Speaker 1: And some young guy was there, probably twenty five in
Speaker 1: his late twenties, and his girlfriend and he whips out
Speaker 1: of machines, you know, whips out the device, starts vaping
Speaker 1: in the restaurant, which I don't think he was necessarily
Speaker 1: that wasn't permissible, But he goes ahead and vapes, And
Speaker 1: I thought, you know, what was the advent of vap
Speaker 1: meaning who developed this kind of stuff? And to explain
Speaker 1: to people who think they know what vaping is, vaping
Speaker 1: is a delivery system for like a liquid form or
Speaker 1: some other kind of form of nicotine, and they've extracted
Speaker 1: all the bad stuff for most of it.
Speaker 2: Yeah, the key thing is that the tobacco's gone in vaping,
Speaker 2: and you can vape all kinds of drugs like cannabis
Speaker 2: with a vaping product if you want to as well.
Speaker 2: But the key advantage is that there's no combustion, that
Speaker 2: you don't get the smoke and the tar and the glop,
Speaker 2: and you don't get the complex ingredients arising from burned tobacco.
Speaker 2: First products were developed in China, but there have been
Speaker 2: a lot of different generations of products. And it's interesting.
Speaker 2: I mentioned some of my college roommates smoked, and the
Speaker 2: heaviest smoker I ever knew was my college roommate who
Speaker 2: smoked unfiltered black tobacco goal walls. You could hear him
Speaker 2: when he walked into the room, just by the sound
Speaker 2: of his inhlation. You could hear him into a room.
Speaker 2: He took such a big drag. I learned years later
Speaker 2: that he had switched to East cigarettes. So I called
Speaker 2: him up and said, you know, how could this be?
Speaker 2: You were the heaviest smoker I ever knew, And he said,
Speaker 2: I love him. Actually, it was interesting he could indulge
Speaker 2: in his sense of connoisseurship by picking the right kind
Speaker 2: of vape product and the right kind.
Speaker 1: Of flavor he liked.
Speaker 2: But he was off cigarettes, and so that was very
Speaker 2: impressive to me to have that. One testimonial from an
Speaker 2: old friend who was able to switch to vape said
Speaker 2: he was the better for it.
Speaker 1: So is it safe to say that, in terms of
Speaker 1: all the components that you regard and the metrics that
Speaker 1: you regard, that vaping is much safer than cigarette smoking.
Speaker 2: I have no doubt about it. Right, Cigarettes inhale cigarette
Speaker 2: smokes are at the pinnacle of risk. Smokeless tobacco products
Speaker 2: are much less dangerous than cigarettes. Nicotine vaping is probably
Speaker 2: a little less dangerous than smokeless tobacco, nicotine pouches. You're
Speaker 2: really quite low levels of harm. I don't want to
Speaker 2: suggest that any of these products are health foods, but
Speaker 2: they reduce risk dramatically.
Speaker 1: But vaping has its hazards as well well.
Speaker 2: The anti tobacco forces were very quick to jump upon
Speaker 2: lung problems that were being caused by vaping. They even
Speaker 2: gave it a name, e Valley of Electronic Vaping Lung Disease.
Speaker 2: It turns out that that arose largely from people smoking
Speaker 2: black cannabis vapes that were polluted with toxins that did
Speaker 2: cause lung problems in other countries. Is of a non
Speaker 2: issue that once they got rid of that black market
Speaker 2: vaping product, it hasn't been an ongoing issue, but the
Speaker 2: field has continued to latch onto this, Oh, you can
Speaker 2: get lung problems from vaping based on this bout of
Speaker 2: lung disease a few years ago. But inhale cigarettes are
Speaker 2: at the pinnacle.
Speaker 1: Of ris They're the highest threat and they.
Speaker 2: Takes a big jump down, and things like a pouch
Speaker 2: that have no inhalation at all are much much less risky.
Speaker 1: I will say that in my lifetime borders a couple
Speaker 1: of different realities as far as smoking as concerned. My
Speaker 1: father was a cigarette smoker, he was a pipe smoker.
Speaker 1: He quit cigarettes the smoke pipes. He died at the
Speaker 1: age of fifty five of lung cancer. My smoking, and
Speaker 1: I will say that with unless I was completely inebriated,
Speaker 1: unless I was completely shit faced on some drugs and alcohol,
Speaker 1: which was certainly accompanied by a good amount of smoking
Speaker 1: and my drug use and drinking. But when I was
Speaker 1: in my right mind and I smoked, I knew it
Speaker 1: was wrong every time I did it. Every single time
Speaker 1: I put a cigarette in my mouth, I said this
Speaker 1: is wrong. I shouldn't do this. I remember saying to myself, Okay,
Speaker 1: this is a stupid idea. Click and I'd light up.
Speaker 2: Yeah, even a long time ago, people call cigarettes coffin mail.
Speaker 1: Right, right, But I was going to say, I'm many
Speaker 1: years in sobriety, I'm cleaning sober threaty seven years. And
Speaker 1: the only reason I mentioned is because this idea of addiction,
Speaker 1: of finding a way to cure the addictive mechanism, the
Speaker 1: addictive synaptic whatever it is that happens in human beings
Speaker 1: as it relates to smoking, as it relates to eating.
Speaker 1: Of course, smoking compounded with obesity. People who are not
Speaker 1: even morbidly obese, but who are significantly overweight and smoke,
Speaker 1: I mean that must be a double whammy for them, correct, Sure, I.
Speaker 2: Mean it turns out that heavy smokers have a worse
Speaker 2: diet than non smokers. Heavy smokers are more like to
Speaker 2: eat more fried foods, fewer fruits and vegetables. There are
Speaker 2: a whole bunch of things going on with heavy smokers
Speaker 2: that contribute to health ruts.
Speaker 1: You were mentioning before the name of a drug that
Speaker 1: I don't recall what you said. Now, what is that?
Speaker 2: It's a drug that FDA approved smoking cessation aid.
Speaker 1: That addresses addiction.
Speaker 2: It's a treating addiction. Yeah, it's a drug that's shown
Speaker 2: to help you stop smoking. That's a little bit, little
Speaker 2: bit too ambitious a claim. I mean that in terms
Speaker 2: of nicotine replacement products like nicotine vape, it's a harm
Speaker 2: reduction technique. You're replacing a very toxic form of nicotine
Speaker 2: use with a much less toxic form of nicotine use.
Speaker 2: But the addiction doesn't go away. It might be decreased.
Speaker 1: That's a dream, isn't it To address that addictive component
Speaker 1: in the human brain and human behavior.
Speaker 2: There are other factors too. It's not just the addiction,
Speaker 2: it's the environment you're in that For example, if you
Speaker 2: have a spouse who smokes and isn't giving up, good
Speaker 2: luck trying to give up smoking yourself. I mean, so
Speaker 2: these powerful social factors. If you have coworkers who are
Speaker 2: your best friends going outside in the winter time to smoke,
Speaker 2: you've got social pressures to continue to smoke. But go
Speaker 2: back to that figure of five percent of eighteen to
Speaker 2: twenty four year olds smoking in the United States, Now
Speaker 2: that's a nice low number compared to the eighty percent
Speaker 2: in nineteen. So there's been progress, has been a huge progress.
Speaker 1: My thanks to doctor Lynn Keaslowski. This episode was recorded
Speaker 1: at CDM Studios in New York City. Were produced by
Speaker 1: Kathleen Russo, Zach MacNeice, and Maureen Hobin. Our engineer is
Speaker 1: Frank Imperial. Our social media manager is Danielle Gingrich. I'm
Speaker 1: Alec Baldwin. Here's the thing is brought to you by
Speaker 1: iHeart Radio.