Recently the US Surgeon General published a report on smoking called The Health Consequences of Smoking—50 Years of Progress. The 978-page report barely made the mainstream media.
It might have something to do with the Internet. Most online media don’t consider the progress news. But the Internet itself may have a lot to do with all that progress the report heralds.
The only mention of the Internet in the report celebrated how the 2009 Prevent All Cigarette Trafficking (PACT) closed a loophole letting individuals buy tobacco products on the Internet without paying the appropriate taxes, and restricted youth access to tobacco products on the Internet by requiring age verification prior to sale and upon delivery.
Fifty years ago, public reception to the Surgeon General’s Report was what the media like to call a ‘man-bites-dog’ story. It made (huge) news.
Then, US Surgeon General Luther L. Terry, in the report from his Advisory Committee on Smoking and health, advised that average smokers endured a nine-to ten-fold risk of developing lung cancer compared to non-smokers. Heavy smokers registered at least a 20-fold risk. Despite this, few of our peers heeded the warning. When we were university students 25 years ago, we still had to suffer classmates smoking in small common rooms designated for study. The second-hand billow of smoke made us so sick that we could not even think, never mind study.
Today, an increasing number of Universities across the world are smoke-free. Smoke-free campuses are especially popular now in California, whose alumnae will skip over to Silicon Valley to work at smoke-free start-ups or at smoke-free multinationals, like IBM.
Just as we never expected the Berlin wall to come down in our lifetime, we never expected the level of smoking in Western countries to drop so precipitously. One of us was on the board of a non-smokers rights association. It wasn’t a popular club. One of us ran for Mayor of Vancouver and was laughed at for suggesting in public forums that smoking be banned only in restaurants. Yet today, in almost all jurisdictions in North America, an effective ban on smoking exists inside all buildings. Some cities even ban smoking in public parks.
Tobacco is still the only legal product that we know of that increases morbidity and mortality when used precisely as directed. Changes in societal attitudes were slow to yield fruit. The 1964 US Surgeon General’s Advisory Committee Report on Smoking and Health did indeed change the world. On the basis of more than 7,000 articles on smoking and illness then available in the scientific literature, it concluded that tobacco was linked to cancer. Our parents, medical doctors and scientists, told us that the report had an important effect on the scientific community. Science thereafter moved the needle on public attitudes; legislation to limit the sale of cigarettes and their use in public places soon followed.
Today, people widely accept the connection between tobacco and cancer, as well as a wide range of other illnesses. New knowledge ensued: a non-smoker just being in the same room as a smoker on a regular basis can do irreparable carcinogenic harm to another. When insurance companies and their clients confronted the reality of the science – and the angry onslaught of workers’ rights lawyers – office rules changed rapidly. Greater awareness of the importance of fitness, good food and health generally has also played a large part in the change.
Official statistics in the United States show that smoking rates continue to fall. Particularly encouraging is that it is rare to see 20-somethings smoke in major Western cities or on campus, unlike even ten years ago. The US smoking rate, generally, has been falling for decades, but had seemed to stall at around 20 to 21 percent for about seven years. In 2011, the rate fell to 19 percent. In 2012, about 18 percent of US adults who participated in a national health survey described themselves as current smokers. But public health experts have been flummoxed by the cause of the recent, sequential downward blips.
Is it possible that the Internet encouraged young people to stop smoking? Joe Camel, the mascot for Camel cigarettes from late 1987 to 1997, disappeared around the same time social media emerged. Sixdegrees.com, the first social network, was launched in 1997.
Exposure to majority social norms ballooned with the social Web. Kids are persuaded by what their friends say, ‘like’ and ‘recommend’ on social media. Rigorous scientific evidence on the effects of social norms on obesity, for instance, has shown that those whose social media friends are slim, will, by dint of social pressure, be slim as well.
The Web contains all sorts of healthcare misinformation, including pernicious anti-vaccine sentiment and even appalling pro-anorexia sites aimed at young girls. But Google “smoking” and, among more than a million hits and images, you won’t find many sites promoting the social desirability of smoking.
Meanwhile, in China and Eastern Europe, people continue to smoke. Cigarette companies have targeted those regions since the early 90s – interestingly, those are also areas with low per capita Web usage.
A casual perusal of your Facebook ‘wall’ will tell somebody whether you think smoking is cool. Consider dating sites. Perhaps one of the many reasons why 20-somethings smoke less is the widespread use of online dating sites. Your dating profile can be easily filtered from view should you select the “I smoke” option. Filters on the tips of cigarettes were once marketed as a feature that could save lives. All of us parents should be pleased that dating site filters actually do save lives.
Originally, nerdy types on campuses made the Web cool – and some became billionaires. They’re suddenly very cool. And they don’t smoke.