ReconsiDer Tidbits

Author Hamilton uses quotes from Syracuse's Tom Szasz to look at the current attitudes about smoking cigarettes. Though tobacco is legal , attitudes toward it might need to be reconsidered.
Big Drug's Nicotine War
http://www.forces.org/evidence/pharma/conclusions.htm
XI - Saving lives or Pushing Drugs and Agendas?
By Wanda Hamilton - Publication date: August 31, 2001


"The pharmacrats' agenda, based on the new coercive-therapeutic concept of
disease, differs radically from the medical scientist's agenda, based on
the old noncoercive-pathological concept of disease. To advance their
agenda, the pharmacrats shift the focus - their own and the public's - from
phenomenon to tactic, from objectively demonstrable disease to dramatically
advertised prevention and treatment."

"The medical doctor treats cancer of the lung. The political doctor treats
smoking, preventable by legislation, litigation, and taxation, and curable
with nicotine administered by any route other than inhalation. Sanctimony
and hypocrisy replace honesty and self-discipline." Dr. Thomas Szasz, "The
Therapeutic State: The Tyranny of Pharmacracy," The Independent Review,
5(4), Spring 2001, p. 510.


Internationally renowned psychiatrist Dr. Thomas Szasz has written
extensively on the medicalization of America and the rise of the
therapeutic state. In the therapeutic state, individual choice and
responsibility are subverted in the name of health. What were once matters
of private health, important only to individuals, become matters of
collective health, important to the state. The public health focus is not
on treating physiological disease, but on preventing behaviors which could
lead to disease. Ultimately the state defines these behaviors themselves as
diseases to be treated. This is precisely what has happened in the global
war against smokers.

A quarter of a century ago, smoking was considered to be a habit hurting
only those who chose to indulge in it. As habits go, smoking was not viewed
particularly negatively. Everyone knew smoking was not good for those who
over-indulged in it, and about a tenth of those who did so eventually
contracted lung cancer. The public health establishment-rightly-warned
people repeatedly about the health risks of smoking. Those who took up the
habit did so knowing of the risks, but apparently feeling that the pleasure
and benefits of smoking outweighed its long-term risks. Or, if they
eventually concluded the pleasure and benefits were not worth the risks,
they stopped smoking. In fact, something like 50 million U.S. smokers have
quit, almost all of them on their own without "treatment" of any kind.

In the 1980s, after pharmacological smoking "treatments" began to emerge,
the health warnings about smoking changed focus. The public health
establishment began putting forth the notion that smokers were not just
hurting themselves but were hurting society at large. They claimed that
second-hand smoke was not only annoying to non-smokers, but could harm them
as well. Further, they said that society as a whole was harmed financially
because of excess health care costs of treating "smoking-related" diseases.

Then, with the publication of the 1988 Surgeon General's report, tobacco
use officially became a disease, an "addiction" needing "treatment." Of
course, by then the pharmaceutical industry was ready with drugs to treat
this new "disease," the physicians and addiction therapists were eager to
prescribe the drugs, and the public health establishment was delighted to
marshal its considerable influence and resources to attack the "epidemic"
of tobacco use and push drugs, litigation and legislation to "treat"
it.   "Today, when scientific medicine is a robust adult, physicians
routinely effect near-miraculous cures; politicians and their lackeys, led
by Surgeons General, define disease; the state shows intense interest in
the concept of disease; and the term treatment is often used in lieu of the
term coercion." Szasz, "The Therapeutic State," p. 487.


By the mid-1990s the nicotine war was fully engaged. Smoking--a legal,
voluntary adult behavior-- was declared to be a global "pandemic," the
"number one cause of premature death," and FDA head David Kessler even went
so far as to deem it "a pediatric disease," though no children die from
smoking. Ambient tobacco smoke became a deadly toxin, killing thousands of
innocent babies and adults, and smokers were ghettoized as social
undesirables who could be redeemed only with "treatment."

An April 1999 World Health Organization "Fact Sheet" illustrates perfectly
the pharmacrats' use of language to stigmatize and medicalize smoking.
Entitled "Tobacco Dependence," the three-page publication uses the word
"treatment" no fewer than thirty-six times. The WHO tract also refers to
smoking as "a paediatric epidemic" and implies that it kills millions of
children and adolescents: "This epidemic is predicted to kill 250 million
children and adolescents who are alive today, a third of whom live in
developing countries." And it reinforces the notion that smokers cannot
help themselves because they are in thrall to their addiction: "â?¦quitting
is not simply a matter of choice for the majority of tobacco users.
Instead, it involves a struggle to overcome an addiction."

This propaganda was, no doubt, funded by the pharmaceutical companies
marketing the "treatment," but in an effort to legitimize such outrageous
claims the WHO notes that the "fact" sheet was "based upon the best
available scientific information" and "was written by a group of experts
from developed and developing countries." The "experts'" names are not
given, but there is little doubt that at least some of them were paid
consultants to the drug companies in partnership with the WHO, possibly
even the same consultants who wrote the U.S. clinical guidelines on
treating tobacco "dependence."

The astonishing transformation of a relatively innocuous-albeit
individually risky-personal habit to a global disease pandemic in fewer
than twenty years could not have happened without the active complicity of
the governmental and private members of the public health establishment,
the American Medical Association, powerful "health" organizations such as
the American Cancer Society, the World Health Organization, and the
pharmaceutical industry. And each of these profited handsomely from their
partnership in the pharmacratic nicotine war.

Unfortunately, in this war, as in all wars, there have been casualties.
Among them are honest science, truth, individual freedom, and the millions
of real children and adults in developing countries who are suffering from
actual, not manufactured, diseases. While the WHO and wealthy countries
such as the U.S. devote billions of dollars to wipe out adults' choice to
use a legal product, in just one year at least 5 million babies born in
developing countries die in their first month of life, 17 million people
worldwide die from infectious or parasitic diseases, and millions of South
Africans contract HIV. Apparently the pharmacrats have been more interested
in lining their pockets, solidifying their political power and controlling
behavior of citizens in affluent countries than they have been in treating
actual preventable disease in developing countries.

Even more dangerous than the misplaced priorities of the WHO and their
American anti-tobacco partners are the political ramifications of their
focus on "health" as appropriate behavior. Not since Nazi Germany has the
world seen such emphasis on the medicalization of private behavior as a
means to achieve public health. "The truth is that the Nazi health ideology
closely resembles the American health ideology. Each rests on the same
premises - that the individual is incompetent to protect himself from
himself and needs the protection of the paternalistic state, thus turning
private health into public health." Szasz, p. 505.


In fact, the anti-tobacco movement could well have borrowed many of its
tactics directly from the Third Reich. Like the National Socialists, the
U.S. and the WHO have developed and funded agencies for the sole purpose of
eliminating tobacco use, agencies which have created vast propaganda
campaigns against smoking. Hitler's Germany severely restricted tobacco
advertising and enacted public smoking bans, two of the major goals of the
WHO and U.S. anti-tobacco movements. During the Third Reich, children were
subjected to anti-tobacco education in school, youth clubs were enlisted to
pass out anti-tobacco literature, and smoking was banned in public places
for anyone under 18. All these are key parts of the youth anti-tobacco
campaigns in the United States today.

It is understandable that the pharmaceutical corporations would fund
efforts to demonize tobacco use, prohibit tobacco advertising, enact
smoking bans, and push smoking "treatment." All these measures increase
sales of their smoking cessation products, especially when the public
health establishment, including government agencies, pushes these products
relentlessly, coercing even children to use them. The only agenda for any
corporation is to make money, and the means of making that money is of
little concern so long as they increase profits. The nicotine war benefits
the drug companies in many ways: increasing profits, opening new lines of
drugs to market, and promoting further development of the therapeutic
state, which will ensure increased future profits.

What is less obvious is why legislators, public health officials, doctors
and scientific researchers would allow themselves to become drug pushers
and facilitators for anti-tobacco programs like those developed by the
Nazis of the Third Reich. Many of the current anti-tobacco tactics go far
beyond those in the Third Reich. Even the Nazis did not prohibit smoking
outdoors or set up "snitch" lines for "good" citizens to report errant
smokers, as some locations in California and Canada have done. Even the
Nazis did not conduct studies to "prove" that smokers are ill educated,
poor, and mentally disturbed, though numerous "studies" like these are
publicly funded and conducted in the United States today. Even the Nazis
did not call smokers "child abusers," though this epithet is being used
more and more frequently by anti-tobacco workers in the United States.

It should not be forgotten that many doctors, scientists and public health
workers condoned genocide as "hygiene" and atrocities as scientific
experiments in the Third Reich, and they did so because at least some of
them believed they were improving the health of the society and saving
lives. Many of the modern anti-tobacco workers also believe they are
improving health and saving lives and that extreme measures are necessary
to prevent people from harming themselves by using tobacco. These are the
True Believers for whom safety and health are revered above all else. "It
was not fascism, which was not genocidal, but medical Puritanism that
motivated the Nazis to wage therapeutic wars against cancer and Jews. This
is a crucial point. Once we begin to worship health as an all-pervasive
good - a moral value that trumps all others, especially liberty - it
becomes sanctified as a kind of secular holiness," Szasz, p. 505.


However, the power wielders in the anti-tobacco movement are more cynical
and self-interested. They know that tobacco use isn't the greatest of
society's ills and that preventing people from smoking won't make any
appreciable difference in mortality rates. After all, if people don't die
from "smoking-related" diseases, they will die from something else, but the
anti-tobacco movement is a moneymaker and a career maker for them. The drug
companies pay well for anti-tobacco work and for anti-tobacco and nicotine
research, as does the federal government.

Only the most highly trained biomedical scientists can get grants for
trying to find a cure for cancer, but even mechanical engineers and
attorneys can easily get health-related, million-dollar government grants
for studies in tobacco prevention and control.

Non-governmental organizations such as the American Cancer Society and the
American Medical Association increase their income substantially with
grants and contracts from drug companies and from the Centers for Disease
Control and other agencies in the Public Health Service. They also increase
their influence on public policy by sitting on governmental tobacco control
committees and panels.

State and federal agencies also benefit financially from tobacco control.
Because these public agencies and their anti-tobacco "partners" have made
tobacco a hot-button political issue, legislators are persuaded to increase
funding for their anti-tobacco programs. Legislators who support
anti-tobacco are rewarded, while those who do not are said to have "sold
out" to Big Tobacco because of campaign donations and/or they are
excoriated in newspaper ads as being "for Big Tobacco and against children."

Everybody makes out well riding the anti-tobacco horse.

In the long-term view, organizations, government agencies and researchers
involved in the anti-tobacco movement are not at all averse to medicalizing
America because they will thrive financially and accrue enormous power in a
therapeutic state. Though such a state is undoubtedly tyrannical, they have
no reason to fear it, because they will be among its powerful elite.

It is the rest of us who have much to fear, because the Nicotine War is
about far more than mere nicotine, and it has nothing to do with saving
lives. "Formerly, people rushed to embrace totalitarian states. Now they
rush to embrace the therapeutic state. By the time they discover that the
therapeutic state is about tyranny, not therapy, it will be too late,"
Szasz, p. 516.
 
 

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