Sir, - Your editorial "Smoking still kills" (August 13th) is timely and incisive. As someone who daily sees and tries to help those who have developed cancer as a consequence of their addiction, I feel just as guilty and angry as these patients. My guilt is as a member of our society which does so little to oppose the induction of addiction in our youth and my anger is towards those who continue to peddle their lethal compounds in the face of current knowledge. As you state, the effects of cigarette smoking go way beyond the cancer problem and an ever-increasing segment of our health-care budget is eaten up by attempts to remedy the effects of a lifetime of self-abuse resulting from this horrible addiction. The public seems incapable or unwilling to grasp the implications of this and it seems to me that less well-off members of our community as well as young people are particularly vulnerable to the advertising strategies of the tobacco industry.
You are correct in stating that only concerted social, educational and political action will have any meaningful impact on the problem and I assure you that, despite the faint hope outlined at the recent Eighth World Conference on Lung Cancer, treatment of this disease once established is not going to meet with significant success for the foreseeable future. What we must achieve, then, is a worldwide change in farming practice away from tobacco production, measures which eliminate advertising of tobacco products and their sale to young people and effective communication to the general public that the delivery of health-care will become impossible if resources are increasingly allocated to caring for those with smoking-induced diseases. The latter is an unpalatable fact which politicians will be reluctant to communicate. One mechanism of getting the message across would be to link health-care expenditure to smoking trends in society. A rise in smoking incidence should be accompanied by an appropriate reduction in health-care allocation from the public purse with the balance taken from the tobacco industry in the form of taxation.
We have recently witnessed the tragedy whereby innocent women in our society were infected with Hepatitis C. Controversy rages with regard to responsibility and accountability. We know much about the evils of tobacco and the cynicism of those who market it to successive generations. Ultimately society will have to bear the cost of the inevitable outcome in terms of disease and someone will have to accept responsibility and be held accountable. All among us who understand the issues need to speak out and to push our politicians in the right direction. We owe this to the present and coming generations. - Yours, etc.,
Prof. Peter A. Daly,
Consultant Physician (Medical Oncologist), Associate Professor of Medical Oncology, St. James's Hospital, Dublin 8.