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An accompanying editorial (appearing in CA:) by Otis W. Brawley,[link widoczny dla zalogowanych], M.D., chief medical officer of the American Cancer Society, says about 2.6 million of the 7.6 million cancer deaths that occurred in 2008, or about 7300 cancer deaths per day, were potentially avoidable through the prevention of known risk factors, including tobacco use, dietary factors, certain infections, and alcohol use.
“The worldwide application of existing cancer control knowledge according to the capacity and economic development of countries or regions could lead to the prevention of even more cancer deaths in the next 2 to 3 decades,” writes Dr. Brawley. “In order to achieve this, however,[link widoczny dla zalogowanych], national and international public health agencies, governments, donors, and the private sectors must play major roles in the development and implementation of national or regional cancer control programs worldwide.”
A comparison of cancer rates reveals differences in cancer causation between economically developed and economically developing countries. In economically developed countries, the three most commonly diagnosed cancers in 2008 were prostate, lung, and colorectal cancers in men and breast, colorectal, and lung cancers in women. In economically developing countries, cancers of the lung, stomach, and liver were most frequently diagnosed in men while breast, cervical, and lung cancers were the most commonly diagnosed in women.
Two of the three leading cancers in men (stomach and liver) and one of the three leading cancers in women (cervix) in developing countries are related to infection. Overall, about one in four cancers in developing countries are related to infection compared to fewer than one in ten in developed countries. Of course drinking and smoking aren’t direct parallels, and drinking is heavily regulated and kept out of public spaces (to an unnecessary extreme).
Yet,[link widoczny dla zalogowanych], it does seem that middle-ground steps — like separate smoking and non-smoking sections of the beach — could be a way of reducing smoking and its second-hand effects,[link widoczny dla zalogowanych], making the law more governable, and still allowing citizens to engage in their self-destructive actions without hurting everyone else. That said, I’ve been wrong before. Before the spring of 2002, though I wasn’t a smoker, I hung out in one of the smokiest nooks in Manhattan, the dive bar Rudy’s.
When the ban came, I remember feeling bad for the older regulars whose lifestyle was about to dramatically change, and for the owner who would no doubt lose money. However, the master settlement agreement with the tobacco companies doesn’t mandate how states must spend that money. In New Jersey’s case, then-Gov. Jim McGreevey, for his 2004 state budget,[link widoczny dla zalogowanych], borrowed against the cash New Jersey was to receive over 25 years to help plug a $5 billion deficit that year.
So those funds are gone, dedicated to paying off debt. “That tobacco settlement money was for tobacco treatment and prevention,” lamented Connie Greene, vice president of the Institute for Prevention with the Saint Barnabus Health System. “It was never written into the agreement that it had to be spent that way.” “They (the states) simply have not kept the promise of the tobacco settlement in how they’ve used the money,” said Danny McGoldrick,[link widoczny dla zalogowanych], vice president of research for the Washington,[link widoczny dla zalogowanych],[link widoczny dla zalogowanych], D.C.-based Campaign for Tobacco-Free Kids, which, among other things, keeps track of how much money states spend on anti-tobacco initiatives.