Mohammad R. Torabi is an Iranian scientist who works as the Chancellor's Professor in Applied Health Science Department of Indiana University, Bloomington.
Torabi and his colleagues have recently conducted a research about the effects of the smoking ban in preventing heart attacks in non-smokers. Their study showed that heart attacks among non-smokers dropped by 70 percent following the smoking ban. Dr. Torabi's research focuses on the evaluation of school and public health education programs. Q. What possible harms are caused by cigarette smoke to smokers and non-smokers? A. Tobacco is a number one public health enemy and is the main cause behind illnesses leading to premature death. I would term it as mother of all leading causes of death and health issues. Almost every organ in the body is affected by tobacco. Consequently, its impact on the body and mind is enormous. Tobacco also causes great human suffering, life loss, and poor productivity. Consequently, anyone who is exposed to it directly or indirectly is affected extensively. Q. Is there any global estimate of cigarette smoke related mortality? A. The estimate could be higher than 10 million deaths and the figure is rising. Q. Can you elaborate on how cigarette smoke is linked to heart disease? A. Well, I am not a cardiologist. But it has been clearly and repeatedly demonstrated that heart disease is the leading cause of death in the US and the number one risk factor behind it is smoking. While specific causes and effects in the connection between tobacco and heart disease are not fully understood, tobacco is extensively linked to cardiovascular diseases. Empirical data clearly substantiates the link, but clinical relationships can be better explained by cardiologists. Q. Some recent studies about traffic accidents indicate that public education is insufficient to change wrong habits, which necessitates law enforcement. In your field of study, what ideas do you suggest to reduce smoking? A. I agree that public health education alone is not enough when it comes to preventing or stopping smoking. Tobacco is a highly addictive drug, both physically and psychologically. Tobacco industries spend billions of dollars marketing this toxic product. It is glamorized by every advertisement marketing technique at their disposal. Adding to its cultural acceptability, it is very difficult to combat it with education alone. To work toward a smoke-free society, we should make investments in the following areas: (1) Comprehensive tobacco education which includes individuals, families, schools, and communities; (2) Developing and enforcing public health policies that restrict smoking in public places -transportation, and other open spaces; (3) Increasing tobacco tax to discourage non-smokers from starting to smoke. It would also make smokers think twice before purchasing the next packet of cigarettes; (4) Prohibit sale of cigarettes to minors under the age of 18; (5) Provide free or subsidized programs to encourage smokers to cease smoking Q. What issues should be considered along with smoking ban laws to guarantee and boost their effect? A. Some people argue that a smoking ban infringes a smoker's rights. In my opinion, there are no unlimited smoker's rights. With rights come responsibilities. When one smokes cigarettes, he/she not only harms himself/herself, but also harms others. It has been demonstrated that second-hand smoke not only kills but it has also been confirmed that for every packet of cigarettes smoked, the taxpayers pay over $12 for health care consequences. I believe that an individuals' right to be healthy clearly outweighs the individuals' rights to smoke and harm others. I want to clearly specify that we are not anti-smokers but anti-smoking. We need to be caring and compassionate to those who smoke and try to make them understand that tobacco is a very addictive habit which requires a great deal of will power, support, education, and possibly medical attention, if an individual is to stop smoking. It is important that we respect individual rights as long as it does not violate others -right to clean air and a cleaner environment. So the bottom line is that the individual and the community should be well educated about the importance of a smoking ban. Policies and regulations should be developed to such a level that can be enforced. It is sometimes best to impact the local community to develop enforceable policies that eventually will be further strengthened. Q. Regarding your study, second hand smokers may benefit more from the smoking ban. Why is it so? Some smokers may think that the law may not benefit them? A. I believe a smoking ban will benefit everybody. While discouraging smokers from smoking, it also creates a new cultural norm in which tobacco use is viewed as an unacceptable habit. It definitely protects non-smokers from the deadly consequences of smoking and it saves the taxpayers money and improves life quality of citizens which translate into economic prosperity from which everyone benefits. Q. Studies say that even an hour after smoking harmful toxics may be exhaled, passing it onto others through the smoker's clothes and breath. Can this cause harm to others, especially to children? A. While tens of thousands of studies across the world demonstrate that tobacco is a very harmful product, I believe that even less than an hour of exposure can harm non-smokers, but to what extent it affects them, remains to be seen. Q. As Iran is going to enforce some cigarette limitation laws as one of the countries committed to international treaties, what is your suggestion for success of the action? What is the importance of consistency of government's activities in law enforcement? A. The first step, I believe, is reducing and ultimately eliminating the demand for cigarettes through education and smoking cessation programs. The next steps should be to prevent and/or regulate tobacco advertisements, increase cigarette taxes, discourage farmers from growing tobacco and reward and subsidize those for growing food products, ban smoking in all public places, and offer free or affordable smoking cessation programs to all smokers. Any policies or legislation that are developed and established should be consistently enforced; otherwise, they will prove ineffective. It is crucial to start with enforceable smoking ban policies and gradually strengthening the rules so the public will be supportive of them. Q. Is it sometimes better to postpone a new regulation to a time that it may be employed completely or can this be a gradual process? A. The process is gradual and requires getting the community involved and to assume ownership of the process and policy. It is necessary to empower the community so they develop the policies and regulations that are enforceable. In addition, it will make the community realize that a prosperous family, community, and the country need to have healthy people. So tobacco should be eventually eliminated from their lives. Q. What is the aim of your research and are you and your colleagues going to run some complementary studies about smoking? A. We have been involved in this area for many years and our research on tobacco use and public policy is on-going. About a decade ago we demonstrated that tobacco serves as a gateway drug and clearly specified there was a close relationship between students' tobacco use and getting involved in other deadly and illegal drugs. Our latest study demonstrates that developing policies requiring smoke-free public places has reduced heart attacks in the community compared with a similar community that did not have such a policy.
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