HEALTH CARE/Joan Retsinas

A Pat on Back for Big Brother

“Big Brother.” The phrase conjures up an over-bearing omnipresence that watches, disparagingly, everybody. Totalitarian states are big brothers; so are the “nanny states” that preach, ad nauseam, the party line for all us little people to toe.

Not surprisingly, many Americans, schooled to admire the renegade Pilgrims, want to demarcate a “no pass zone” for private citizens, a terrain free from government intrusion. We Americans value privacy, and with privacy comes the right to make personal decisions outside the spotlight of a Big Brother, however well-intentioned he may be.

Sometimes, though, Big Brother is benevolent. Sometimes we should acknowledge — even thank — him.

Big Brother’s scourge of the past decade has been tobacco. Billboards, advertisements, the ever-rising taxes — all preach “no,” as do the “thank you for not smoking” signs that crop up everywhere, even in friends’ houses. Ashtrays are relegated to the back shelves of garage sales and second-hand stores.

The government’s insistence on smoking bans in public places ratcheted up Big Brother’s oversight: in certain spots, people who lit up would not be considered just boorish, or offensive. They’d be breaking the law.

Two impulses spurred this edict. First, it complemented the larger initiative to get smokers to stop smoking. The health data have been mounting for years. Even executives of tobacco companies acknowledge that the weed, whether filtered, mentholated, or flavored, wreaks havoc on the human body. For the sake of the nation’s smokers, Big Brother has pushed for bans, even though bans crossed many libertarians’ “no pass” zone for government intrusion. One inalienable right is to make unhealthy personal decisions.

More crucially, Big Brother wanted to protect the non-smokers among us. Data have linked “second-hand” smoke to a range of maladies, suggesting that not only is tobacco bad for smokers, but it’s noxious for everybody within breathing range. The Centers for Disease Control and Prevention estimate that each year second-hand smoke kills 46,000 Americans of heart disease. These people are not choosing to smoke, but suffering from the weed nonetheless. Libertarians faced a dilemma: a smoker’s freedom to warp his lungs was his license to warp other people’s lungs. A murky philosophical zone.

In this murky zone, Big Brother forged ahead. Today more than half the states prescribe no-smoking zones in public spots, including restaurants, airports, state parks, government buildings. Without government prodding, many workplaces have banned smoking.

Initially the evaluation data on these bans were too spotty, too inconsistent, to justify the edict. A ban on smoking is not like a guardrail on a mountain pass: you can’t easily measure the before and after results. The edict was more on the lines of an eat-your-vegetables harangue from your mother: you know she is probably right, but you can’t summon statistical support for her nagging. After all, vegetarians have heart attacks, and lusty carnivores live past 90.

So the news from two medical journals is refreshing (Circulation and the Journal of the American College of Cardiology). Scientists amassed data from a collection of studies to report: the bans do lower heart disease. One studied looked at 13 communities throughout the United States, Canada and Europe. One year after the ban, the number of heart attacks plummeted by 17%; three years post-ban, the number fell to 36%. The second study tracked bans in 10 communities: heart attacks dropped 26%.

Researchers estimate that a nationwide ban would lead to 145,000 fewer heart attacks.

The thousands of people whose lives were spared, thanks to smoking bans, should thank Big Brother.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email retsinas@verizon.net.

From The Progressive Populist, November 1, 2009