While this may, at first, sound like a silly question, it’s actually surprisingly on point. We know all about what smoking cigarettes does to our health (as well as our wallets, for that matter) but not much about why we start using any particular form of tobacco over another, say cigarettes rather than a pipe, or chewing tobacco rather than cigars. Nor do we know much about why we switch from one form to another, stop using tobacco altogether, start up again and so on. We think we know, but very little authoritative research has been done in this area.
Tobacco use remains the leading cause of preventable, premature death in this country. About 4,000 children start smoking every day in the United States. For many, this is the beginning of a lifetime of corrosive, expensive addiction. So why do we do this? Why do we still smoke?
The Food and Drug Administration (FDA) and the National Institutes of Health (NIH) have decided to figure some of this out. They have introduced a major, nationwide study of more than 40,000 smokers and non-smokers, a project that includes some 7,000 very young smokers ages 12 to 18. The ambitious undertaking, in fact landmark legislation, is called the Population Assessment of Tobacco Health Study (PATH). With an initial budget of $118.3 million, PATH will enlist participants from all everywhere in the country who will be studied over the course of five years.
The FDA Commissioner, Margaret A. Hamburg, MD, believes that the launch of this study is a vital first step in addressing and solving one of this century’s most significant public health burdens. Further,
The results will strengthen FDA’s ability to fulfill our mission to make tobacco-related disease and death part of America’s past and will further guide us in targeting the most effective actions to decrease the huge toll of tobacco’s use on our nation’s health.
There are plans to include scientists from the National Institute on Drug Abuse and the FDA’s own Center for Tobacco Products (CTP) in the research. The CTP regulates the manufacture, marketing and distribution of tobacco products, generally with the aim of protecting the public health and limiting tobacco use by minors.
The study participants and researchers will examine such issues as:
- Susceptibility to tobacco use
- Frequency of use patterns
- the effects of regulatory changes on the perception of risk and other tobacco-related attitudes
- characteristics of smoking cessation and relapse
- differences in attitudes, behaviors and key health outcomes in racial-ethnic, gender and age groups and subgroups.
Researchers will make home visits nationwide, in all nine census districts. The impact, positive or negative, of the 2009 Family Smoking Prevention and Tobacco Control Act, will be measured – in theory, to help guide future regulatory actions.
No one is denying the value of the big agenda: to reduce initiation of tobacco use among young Americans. The CTP estimates that 20 percent of our high school kids smoke. The data shows that the use of other tobacco products among teenagers is on the rise, including hookahs (water pipes used to smoke tobacco), smokeless tobacco, small cigars and so on. While the manufacture and sale of fruit and candy flavored cigarettes has been banned, each day sees novel and creative ways to sell our children the tobacco products we all seem to crave. The smoking rates among adults may have been stalled since 2004, but we are still smoking. Even the threat of those terrifying and graphic warning labels hasn’t stopped us from lighting up.
There is always that line, that complex and fluid balance, between too much government and overbearing regulation and too much corporate power and runaway greed. And thoughtfully questioning authority is fine, indeed necessary. But in this instance, we should applaud sound efforts to understand everything about both the appeal and the dangers of smoking and tobacco use. That smoking is akin to playing Russian roulette with our long-term health is not up for debate. Why we do what we do, that’s less clear and so good, science-based research is worth supporting.
It’s what we do with that information that will be interesting.
FDA Consumer Updates