Dr. Michael Siegel
Siegel is a tobacco researcher and professor at Boston University's School of Public Health.
Q. Roughly 20 percent of Americans still smoke, down from about 40 percent when the Surgeon General’s report came out in 1964. Is that good enough?
A. There’s a perception out there that smoking has been taken care of, that we’ve largely controlled it. It’s a myth because we really haven’t made a heck of a lot of progress in 15 years. The smoking rate was 25 percent in 1995.
Q. Wasn’t the 2001 tobacco settlement supposed to provide millions of dollars a year in government funding to help reduce smoking?
A. A lot of the funding for tobacco programs has been diverted because of state budget shortfalls. It’s a particular shame in Massachusetts, because we had one of the best anti-smoking programs in the nation. It was showing tremendous promise.
Q. The settlement money was specifically designed to compensate states for medical costs from smokers, wasn’t it?
A. That’s been my biggest frustration. So many states, and particularly states like Massachusetts have taken money out of these campaigns. In the short-term maybe we’re saving money, but in the long-term, we’re squandering the opportunity to do something to control health care costs.
Q. You’ve spoken publicly in favor of electronic cigarettes, metal look-alikes that provide nicotine but are less harmful that tobacco-based products.
A. Here we have a product that is much safer than regular cigarettes and by anecdotal evidence at least is helping literally thousands of smokers to quit smoking. Another major benefit of e-cigarettes is there’s no secondhand smoke. In some ways, this is the product we’ve been looking for all these years, [though] certainly more research needs to be done on safety and effectiveness.
Q. But some anti-smoking advocates seem to hate these e-cigarettes.
A. Anti-smoking groups just have trouble saying something good about anything that looks like and acts like a cigarette. And every one of the groups that has come out against e-cigarettes has taken money from or partnered with pharmaceutical companies. If e-cigarettes are successful, they will take over the smoking cessation market from the pharmaceutical companies. It may be subconscious, but because a lot of [anti-smoking groups’] money and support comes from pharmaceutical companies, they are going to stand up and protect the interests of those companies.
Q. What about anti-smoking programs in schools? Do they help kids quit or stop them from starting the habit?
A. Most of those programs are based on telling kids what the health effects of smoking are. The fact that [smoking] is a risky behavior is one of the selling points for adolescents. What’s much more effective are approaches that show kids the [tobacco] industry is taking advantage of them and to get kids to rebel against the industry rather than against adult authority telling them not to smoke.
Q. Are the tobacco companies still worth rebelling against?
A. I have to give the tobacco companies a lot of credit. They knew that by signing onto this settlement you would create a public perception that the [smoking] problem was over. I think they also knew that the states were not going to allocate a lot of money to tobacco control. The deal was a disaster for the states because it gave the tobacco industry this victory of public perception, but it didn’t result in any actual allocation of funding to tobacco control programs which could have put a dent into tobacco sales. If every state had used this money to run anti-smoking campaigns, smoking rates could have gone down significantly.