May 31 is World No Tobacco Day, an appropriate day to announce my suggestion for the next Nobel Peace Prize: Jerry M. Reiss.
Jerry M. Reiss was the city councilman who first proposed the No Smoking Ban of 1990 in San Luis Obispo, California. The ban prohibited smoking in any indoor public area, including restaurants and bars, in the city.
San Luis Obispo was the first city in the world to have such a policy. We have watched the wave of similar bans spread across the United States from the West Coast, and across the Atlantic Ocean to Europe. Even the pubs in Ireland and tea houses of Istanbul adhere to smoking bans.
The consequences of the smoking ban include people quitting smoking and decreasing exposure to second-hand smoke for nonsmokers. Both tobacco smoke and second-hand smoke are classified as carcinogens by the International Agency for Research on Cancer. Tobacco smoking is not only a causative factor for lung cancer but also for other cancers such as oral cavity, nasal, pharynx, larynx, esophagus, and bladder cancer.
Smoke-free policies have had a tremendous impact. The data is clear: the lung cancer death rate has sharply decreased since 1990 [See Figure 4 from Siegel et al., 2013]. The reduction in lung cancer death rate contributes to the fact that over a million cancer deaths worldwide have been averted due to a reduction in cancer death rates since 1990.
If I may quote the title of a chapter in my book, Why Millions Survive Cancer, "All we had to do was quit." There is no doubt that recognition is due to the scientists who used epidemiology to prove beyond doubt that smoking causes cancer and to the scientists who elucidated the mechanisms of how smoking causes cancer at the cellular level. But special credit must be given to the creation of policies that provided the structure for change and to the one, far-sighted man who initiated the policy.
Mr Reiss commented to me:
The smoking ban seemed so simple and logical at the time -- I never imagined it would assume such prominence. Seldom does one have the opportunity to positively influence the health and well being of so many.
What's our current status?
Overall there is good news. The Cancer Trends Progress Report 2011/2012 states that the trend in adult smoking is falling and quitting smoking is rising. Although it is true that smoking is addictive due to its nicotine content, thousands have kicked the habit either on their own or with medical help. For the younger generations -- there is more work to be done. This report also flags up an issue for concern: although the percentage of people who initiated smoking has declined among the youngest cohort (age 12-17), it has risen among young adults (age 18-25). The message that 'smoking kills', must be repeated relentlessly for all future generations. Adults need to remind the young that smoking is not 'cool' anymore.
More to be done
San Luis Obispo continues to lead the cause against tobacco smoke. In 2010 it passed a new law prohibiting smoking in all public places, both indoors and outdoors. This includes sidewalks, parks, and stadiums. The adoption of broader current smoking bans is likely to spread and have further impact.
In my view, teaching the science and mechanism of how smoking causes lung cancer should be mandatory in schools. All Americans should know that there are 81 different chemicals in cigarette smoke that cause cancer. The chemicals act simply by masking the genetic code of our genes and lead to permanent changes called mutations. Mutations underlie cancer.
China, where smoking bans are not in place, is heading for a catastrophic epidemic of lung cancer. A recent study by Gu et al. (2009) published in the New England Journal of Medicine, concluded that smoking is a major risk factor for mortality in China. Smoking bans are needed.
A worthy candidate for the Nobel Prize
The banning of smoking in public places has been the single most influential act against cancer. No current diagnostic or treatment has saved so many lives. I cannot think of someone more deserving than Jerry M. Reiss as a candidate for the Nobel Peace Prize.