If smoking kills, then why not ban it?

The Abramson Cancer Center of the University of Pennsylvania
Last Modified: May 8, 2013

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Is there any real proof that smoking does kill? If it is so deadly, why isn't it banned?


Barbara Campling, MD, Medical Oncologist, responds:

The evidence that smoking can kill comes from many sources, and the evidence is very strong and very compelling. There are literally thousands of substances in cigarette smoke, many of which have been shown to be very potent cancer-causing chemicals. Smoking is the major cause of a variety of cancers, including lung, head and neck cancer, bladder, and a variety of other cancers. Lung cancer alone accounts for nearly 30% of cancer deaths in the Western world, and the vast majority of lung cancer cases are caused by smoking. In addition, smoking can cause premature vascular disease leading to heart attacks and strokes, and it is the major cause of chronic obstructive pulmonary disease. Smoking is by far the most significant cause of premature preventable death in our society. It is estimated that half of regular smokers will die as a result of their addiction.

Your next question is an excellent one. If smoking is so deadly, why is it not banned? Certainly if an addictive product like tobacco were being introduced into the market today, it would not stand a chance of being approved by the Food and Drug Administration. Tobacco use became widespread before safeguards were in place to protect people from such noxious products. When the "Pure Food and Drug Act" was passed in the early 1900's, tobacco was excluded from regulation because it was considered neither a food nor a drug. It has been said that "tobacco is the only legal substance, which when taken as directed leads to death."

It is amazing that the political clout of the major tobacco companies continues to prevent tobacco from being regulated like other addictive substances. The story of how "Big Tobacco" got into this position of power is an intriguing one. Here is a fascinating book that you might like to read on the history of the tobacco industry: "Ashes to Ashes" by Richard Kluger, Vintage Books, Random House Inc, New York, 1996. This book makes the point that "Governments...have themselves become addicted to the cigarette because of the taxes it harvests for them. Cigarettes are the most heavily taxed consumer product in the world." Yes, tobacco use should be banned, but how to achieve this is another matter. It may prove to be more difficult than moving a mountain.

Drop in preterm births appears to follow as a result

Nov 15, 2010 - The implementation of a smoking ban in a U.S. city appears to have reduced the prevalence of maternal smoking and improved fetal outcomes, according to a study presented at the annual meeting of the American Public Health Association, held from Nov. 6 to 10 in Denver.

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