Monday, March 9, 2015

New study shows cigarettes to be more dangerous than was previously realized

It’s not news to anybody that a great many homeless people smoke. Smoking is a pleasure for many who don’t have many other pleasurable things to do. Some smoke a pack a day or more, or the equivalent in especially dangerous filter-free rollies.

A friend gave me his best estimate of the percentage of Sacramento homeless adults who smoked tobacco. He said 85%, based on what he saw in Friendship Park. Well over 50% is my conservative, less-well-informed guess. John Lozier, the Executive Director for the National Healthcare for the Homeless Council, says, in an interview online, that “there are studies that say that 98 percent of the homeless [in the United States] smoke cigarettes.”

A Washington Post article, “The terrifying rate at which smokers die from smoking,” is about results from an extensive research project in Australia that showed that the danger from a habit of smoking is much more onerous than was realized. Smoking is highly lethal and has other invasive debilitating effects short of killing a person.

Here the alarming first sentence from the article:
Two-thirds of smokers will die early from cigarette-triggered illness -- unless they choose to kick the habit, according to new research from Australia.
Not only can a long-time smoker expect to forego having a normal lifespan, he can expect to be impoverished from the high cost of cigarettes and from the expense of staying alive while his health deteriorates. Smoking is bad news, all around. Likely, it is the worst of all drugs and well merits being made illegal.

When I was first homeless in 2008, a lot of ‘the guys’ were smoking rollies. That is, they bought cigarette papers and a can of tobacco such to roll their own cigarettes. Some bought a little devise to aid in the creation of a particularly well-formed small filterless cigarette.

If I remember correctly, a reason rollies were popular then was because tax on a can of mild pipe tobacco was low, compared to cigarette tobacco, such that roll-your-owns using pipe tobacco was an especially good way for a short-of-cash smoker to economize.

A few years later, the tax on pipe tobacco was hiked to better match that of cigarette tobacco and rollie cigarettes became less than the near-ubiquitous choice of the smoking crowd. I’m told that today rollies remain the most-commonly smoked cigarettes in the homeless community – which is worrisome since filter-free rollies are sure to be particularly unhealthy.

Nowadays, a small percentage of smoking homeless guys buy packs of cigarettes. Many struggle meeting the cost of their habit and buy bargain brands. Other fellows think of their smokes as their primary indulgence and don’t flinch at the price of a pack, even as the cost of cigarettes takes currency out of their wallet just as fast they can find ways to get money into it.


The dangers of smoking

The short 378-word Post article mentions some of the smoking risk factors:
  • Boosts the risks of 13 types of cancer
  • Smoking 10 cigarettes/day doubles the risk of death, while smoking a pack a day quadruples it
  • 67% of smokers perished from smoking-related illness.
  • Smoking causes 480,000 deaths/year in the U.S., or 1 in 5 deaths
  • Healthcare costs for smokers are 40% higher than for non-smokers
  • 30% of impoverished people smoke, whereas the rate is 16% for those above the poverty level.
Of states in the nation, California, to its credit, has the second-lowest rate of smoking – just 15% of its adult residents. Utah, the place where Mormonism is centered and thrives, has the lowest smoking rate, just 12.2% of adults.

I took a look at the research paper that prompted the Post article, seeking to better understand the alarming statistics. The research article is in the journal BioMed Central Medicine with the long-winded title “Tobacco smoking and all-cause mortality in a large Australian cohort study: findings from a mature epidemic with current low smoking prevalence.” It was published Feb. 26, 2015.

An immediate item of interest, that the Post piece doesn’t mention, is that the 204,953 people selected to participate in the study were at minimum 45 years old. Since the adult Sacramento homeless population skews toward older citizens, the study is in good synch with what health and mortality troubles homeless smokers here might, sadly, be met with.

People used in the Australia study were relatively healthy when they began as participants in the study. None had a history of cancer (other than melanoma), heart disease, stroke or thrombosis. Using data the participants provided, “hazard ratios” were computed for all the new participants to adjust for before-the-study lifestyle differences, thus to best understand how the singular element, cigarette smoking, impacted their health.

Those who have an unceasing smoking habit die, on average, ten years earlier than people who have never smoked.

People who stop smoking will be healthier and can hope to live a longer life. The advantage in stopping a cigarette habit accumulates such that, over decades, a former smoker can hope to have something that approximates the health and longevity of the average person who never smoked. In other words, the benefit of an absolute cessation of smoking tobacco is rather spectacular.

The study tells us that "In Australia, male and female smokers were estimated to have the [nearly] same risks of death -- 9.6 years and 10.1 years, respectively -- earlier than 75-year-old non-smokers. Starting from age 45, 44.6% of male smokers would be estimated to die by age 75, compared to 18.9% of male non-smokers. Corresponding figures for females were 33.0% for smokers; 12.2% for non-smokers." Smoking is horrible for everybody, but particularly so for men, in part, surely, because they tend to smoke deeper, faster, more-often than women.
What can be done in Homeless World, Sacramento,
to get people to give up their smoking habits?
Union Gospel Mission and all shelters in Sacramento that I am aware of disallow smoking in all of their buildings and, for most if not all, anywhere on their property, as well. Hooray, that.

Loaves & Fishes allows smoking in all but three areas in its Friendship Park. One of those areas where smoking is disallowed is near-to its Information Kiosk; another is at one of the six gazebos, where sheltered picnic-style tables are that people use to socialize, play cards and play chess.

Park Director Garren Bratcher should consider adding to the space that is off-limits for smoking. Adding a second gazebo area where smoking is disallowed sounds wise. The practice in cities to have less space in city parks where smoking is allowed has been a factor in cutting down on smoking in America. There is space in the cul-de-sac and elsewhere in open space at Loaves & Fishes, but outside Friendship Park, for guys who have a fierce need to smoke. A lot of secondhand smoke is getting into the lungs of non-smoking homeless people and volunteers and L&F staffers in the Park,

I am told, however, that the position of the Board of Directors of Loaves & Fishes emphasizes "freedom" -- with the implication being that homeless people should smoke pretty much when and where they want to outdoors at the property Loaves & Fishes controls. I am not sure if that sentiment wasn't in jest. Loaves & Fishes, after all, is Ground Zero in Northern California for politics connected to the League of Revolutionaries for a New America, which is identified as Stalinist Communist in outlook. There would be absolutely no freedom if the revolution L&F and associated charities seek were to occur.

Likely, it would also help if a Cigarette Smoking Cessation program were set up somewhere in Homeless World. Nothing is more addictive that cigarettes. It is true that guys who are accepted into the Rehab Program at Union Gospel Mission are disallowed to smoke -- one of many addictive habits that guys in the nine-month program are required to give up. I do know guys who have given up cigarettes after graduating from the program. Too, other guys I know have quit the program before graduating, but did get fully off their cigarettes habit. Another guy I know, took up smoking again after graduating from Rehab. Happily, his renewed habit was shallow/mild and within a couple months he was done with cigarettes forever. [Or, at least, he is done with ciggies up to NOW and plans to stay away from them.]

Another idea is to set up some sort of Kickstarter program to get homeless smokers to Vape. There is some research that shows that e-cigarettes reduce cravings to help people quit smoking. Possibly, a program like this would be of enormous benefit if the smoking guys and gals could take to vaping. A big problem with vaping, however, is that its unique risks are yet to be researched. There are gasses that get into people's lungs when they vape.

Another idea is to have a pile of copies of the Post article at the L&F Information Kiosk such that smoking guys pick up a copy and read about the great dangers that come from smoking. Fear can be a powerful incentive. But one smoking guy I talked to laughed and told me he needed to do everything he can to remain chipper NOW. Anything in the future couldn't be something he would obsess about. "Tomorrow comes, or it don't. Whatever."

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