Thursday, February 7, 2008

Passive even without smoking

The preceding year has been characterized by a series of events around the issues of health policies that will have great consequences in the future. Although, (or maybe just because) these events have gone almost unnoticed and enjoyed little publicity, one could say that we are entering a “new era”. The last example of this “New Era” is the smoking ban, which we would like to analyze here. Please have some patience, this is not just about smoking, it goes much further.

A smoking example

The smoking ban prohibits smoking in any enclosed public (even privately owned) place. There is a possibility for creating smoking rooms that is practically impossible to use in most places. The main reason for this policy is cited as the protection of workers. A more complete explanation of the policy can be found in the papers produced by the World Health Organization (WHO), who is the major global promoter of anti-smoking policies. According to the WHO, smoking (both active and passive) is a major health threat and “there is no safe level of exposure to tobacco smoke”. Smoking bans also “forcefully deliver the message that smoking is not socially acceptable”. Finally they are considered to be the most “cost-effective” strategy against smoking. With these arguments the WHO promotes smoking legislation that should “simply require all indoor workplaces, public places and public transportation to be 100% smoke-free, all of the time”. There is also an open possibility of banning smoking in various outdoor and quasi-outdoor environments (building entrances, stadiums and beaches are mentioned) since it is also considered to be dangerous. (1)

Passive or objective

The message that “only 100% smoke-free environments are safe” is constantly repeated as if repetition would make it truer. Many researches are cited to verify this claim. There are other researches that refute it but these are ignored since they are funded by the tobacco industry (with no mention of the WHO’s funding by pharmaceuticals).

Without entering the war of researches and trying to make sense of “risk factors”, “suggestive” or “sufficient” evidence, “inferences” and “casual relationships”, one can notice the way such investigations are promoted by the media. For example, according to an often-cited study of the Institute of Environmental Medicine and Hospital Epidemiology of the University Hospital of Freiburg, exactly 3301 people died in 2005 in Germany as a consequence of passive smoking. Not one more, not one less. In the presentation from the media of this result we were not told that over 65% of them died after reaching 85 years of age. We were also not told anything about any other major factors that may have contributed to their diseases.

Common sense dictates that every substance becomes a poison over some particular quantity. Cyanide, arsenic and strychnine are still being used in various applications. Carbon monoxide is produced in huge quantities although it is well known as poisonous and carcinogenic. Essential components of human nutrition such as iron may become deadly in large quantities. Even the deadly nicotine can be found in small quantities in tomatoes, potatoes, eggplants and green peppers but no one has thought of banning them; it is even known to be beneficial in various neurological diseases. However nicotine is considered dangerous enough so that a law that will affect the everyday life of 35% of Germans can be passed without second thoughts about ventilation or voluntary creation of non-smoking environments.

Image makers

Another effect (and aim, according to the WHO) of the ban is to stigmatize this 35% (almost 29 million people) as having a “not socially acceptable” behavior. Although elaborate arguments are used to prove that the smoking ban is not a violation of rights, it is an aim of the ban to force people to smoke cessation. The acceptance of this logic by the German state became clear in September 2007 with the prohibition of smoking in playgrounds; open places without smell nuisance or health considerations. The reason: the “bad example” that smoking adults give to children.

The use of media and advertisement strategies does not stop at the selective publication and misrepresentation of research findings. Until some time ago smoking was presented by advertisement as an adventurous stimulant (the infamous “Marlboro man”). In the last few years a media strategy organized by the WHO and pharmaceutical companies has managed to turn this picture upside down by using the same advertising strategies. “Smoking damages your skin” (that you try to keep young by using well-paid cosmetics); “smoking blackens the teeth” (that you try to keep white with so many invasive treatments); “smoking is the habit of the underclass” (an insult to our class-pride, if we still have any). In the majority of mainstream films, smokers appear as aggressive or desperate figures (who, naturally, quit smoking after their problems have been solved).

Long gone celebrities (like Albert Einstein) are shown only in photographs and films where they don’t smoke. Will we reach the Orwellian point were smoking will be erased from history as non-existent?

(Un)health insurance

A commonly asked question is: “Why should I (through my contribution to social security) pay the costs for the diseases of smokers?” The WHO is supporting this view by presenting increased health care costs as a serious problem of tobacco consumption and the smoking ban as the “cost-effective” solution. If we are to start thinking about human life in Euros we should note that smokers are supposed to die earlier and should logically cost less. Actually, a recent study found that smokers cost about 28% less to the social security than healthy-living people. (2)

Here it should be noted that taxes consttute more than 70% of the tobacco price. With 14 billion Euros every year in Germany, the tobacco tax is the second most productive indirect tax after the fuel tax. Smoking covers financial holes of the social security system, security (anti-terrorism) projects etc. All past prohibitions of smoking failed just because of this reason; at some point it was considered better to get money from smokers than to protect anybody’s health. Even today, although it is said that smoking is so dangerous no one has thought to ban it completely.

The real issue here is the finance of the health care system. This finance has been brought to a point of collapse not because of smoking but through excessive health insurance companies’ bureaucracy, mishandling, dealings with the pharmaceutical industry and chronic failure of policies. The solution now offered by politicians is to blame smoking, abolish the principle of solidarity on which the system was founded and turn to the free market.

Health as a duty

But as we said from the beginning this is not just about smoking. The German state has found many other enlightened ways of making people liable for their health and reducing health costs.

After some cases of health damages occuring during tattooing and plastic surgery operations the parliament in October 2007 decided in favor of the obligatory report of particular causes of disease: according to this, doctors and hospitals should convey to the state health insurance data when “There is available evidence that the insured person has contracted a disease through the commitment of a crime or through deliberate offence or through a not medically indicated measure”. The health insurance will be granted the right to oblige insured persons liable for their "self-caused" diseases to participate in the treatment costs. The obvious question here is: which diseases can be considered as "self-caused"? In a study made by the University of Freiburg we found a recommendation on the issue [selection]:

No personal responsibility: Illness from an unprovoked accident, HIV infection from rape.

Minor personal responsibility: Work-related illness with prior knowledge, illness as consequence of agreed medical intervention (long-term consequences from operations), cancer without clear genetic or behavioral background.

Personal responsibility: car and leisure-time accidents, diet-related illnesses, infections and their consequences when provoked by preventable illness.

Very high personal responsibility: lung cancer from smoking, liver damage through addiction, consequences of infections contracted in vacation trips, heart attack provoked from various behavior-based dangers.

Complete personal responsibility: illness provoked by leisure-time accidents, HIV infection or classic genital diseases from unprotected sexual intercourse. (3)

Unhealthy health worries
All this goes a bit too far to be justified only through the financial situation of social security. The pressure to become liable for our health goes much further. Although we live in the healthiest societies that ever existed with a life expectancy of at least 20 years more than our grandfathers’ we are constantly bombarded by research and news reports about dangers to our health. We are expected to take regular screenings and modify our behavior so as to avoid those (many times imaginary) dangers.

Normal human conditions such as pregnancy, menopause and old age have been classified as treatable illnesses. Sadness or everything else less than film-like happiness no longer exist, they have been renamed depression. More than 20% of Germans are classified as chronically ill. Pharmaceutical advertisement and health insurance programs turn everyone into a potential patient and consumer of health products.

The WHO has redefined health not as the absence of disease but “as a state of complete physical, mental and social well-being”. Of course the definition of “mental and social well-being” remains a privilege of the WHO and the state; we are not asked if the hysteria about health makes us feel any better. The WHO also recognizes that “the improvement of the health and well-being of people is the ultimate aim of social and economic development”; freedom, pleasure, solidarity, creativity and knowledge have been discarded as non-important or thought of being somehow untenable without regular medical check-ups. We seem to have forgotten that death, pain and old age are basic parameters of human existence (along with birth, pleasure and youth). A new utopia of continuous health and of continuous hysteria about the state of our health is proposed (and imposed). (4)

Health police

Unfortunately this is not constrained on the level of media articles and reports. The health hysteria is not only promoted by governments but has also started to become law. On the basis of the latest cases of parental neglect, preventive medical check-ups have become obligatory for children – the doctor’s obligation to report “suspicious parents” comes to effect in 2008. The youth welfare office should enforce “consultancies” on families with children who fail to attend. Parents who fail the duty-test for their children face legal sanctions. Millions of families are ordered to treat their children as potentially ill and submit them to medical examinations in order to hide the repeated failures of the youth welfare office and sweep under the carpet the real reasons of parental neglect.

Steps are taken to make certain screenings obligatory for anyone, not just children. The German federal committee has decided in favor of obligatory doctor consultancy about cancer screening from 2008: those who do not consult with their doctors should pay 2 instead of 1% of their income for a later cancer treatment. The new regulation includes cervical cancer screening, mammography, stool culture, colonoscopy and early diagnosis of skin cancer. Fortunately “insured German citizens shall not yet be actually forced to attend the cancer screenings”.

After the amendment of state regulations to telecommunications surveillance and other investigatory measures, communication between doctors and patients should: “be used for the investigation of criminal acts, after consideration of the states right to involve in civil freedom”. After that, medical confidentiality is practically abolished – and the scandal of the lost personal data of millions of elders, children and chronically ill in England leads us to imagine what more we are to expect. Telecommunications data retention was decided here last year too.

We are monitored; our data is stored, utilized and handed over to insurance companies and the police. We are forced to be examined. Do not think that any of this happens in order to improve your health.

Conclusion

No, this is not just about smoking. At that point the meaning of the “new era” should have become clear. This is a new era of health policies and how they affect our everyday lives. The welfare system is turned into a market economy business with the excuse that people are liable for their health. Preventive medicine is used as the cover for continuous surveillance. Alternative behaviors and life-styles are named pathological and are punished by policemen in white aprons.

The real danger of the “new era” is not smoking in the rain. The danger is the prohibition to handle our bodies freely, the way they are, the way we believe, at the point we are. The danger is the fear that we should hide from others because we are plump or short of breath, because we smell of alcohol or we have appetite for meat, because we are homosexuals or we are passing through a difficult moment that makes us “suspects for depression”. The danger is that our doctors will (have to) become informers; that all our words and actions are monitored, stored, evaluated and used against us. If all this happens we will long for a time when there was still a right to self-determination and delight, free of critiques.

Notes
1. Protection from exposure to second-hand tobacco smoke. Policy recommendations. World Health Organization 2007, available as pdf here.
2. Reported from AP. Read the article here.
3. Eigenverantwortung und gesunde Lebensweise: Thesen zu einer verantwortlichen Gesundheitspolitik für mündige Bürger - Harald Walach, Klaus-Michael Meyer-Abich (zusammen mit Wilfried Belschner). Available as pdf here.
4. From the WHO web site.

6 comments:

Anonymous said...

very interesting site! i never had thought about all this in such a way! is there anything to do against this all?

Miss Fallen said...

What ca be done? This is an important question that requires its own posts but here are a few simple ideas. For the details I assume you live in Berlin but the basics are the same everywhere:
1. Be informed. All these issues apear on the news but usualy we don't pay much attention.
2. Speak with people. Most people bypass these issues without understanding their importance. About the issues of health control it would be a very good idea to speak with doctors. If you check the Ärztekammer section of the links you will see that most doctors are against these measures.
3. Data retention is a very serious issue where resistance is already organized. Check this:
http://www.vorratsdatenspeicherung.de/
4. Effective resistance to the smoking ban is more localized. In Berlin one center is the Kasiske bar in Friedrichshein. They are organizing a petition for a referendum. They need 20.000 signatures from registered Berliners and they already got half of them.
5. In the next days you will find here some ideas for flyers and stickers for all these issues.

Susan Spies said...

wow! you have a real over-arching sense of all the consequences of this wierd trend. I don't smoke but it has felt like a violation of civil liberties and personal liberties all along, this witch hung againt the smokers. Here in Chicago we have no smoking since january 1 and the place has really become a little sadder. It's really not about cigarettes though but about big brother finding one more way to involve itself in our lives.

Oliver Kopp said...

Sehr geehrte Miss Fallen,

Chapeau für diesen hervorragenden Artikel. Seit langem das Beste was ich zu diesem Thema gelesen habe. Schön wie sie uns hier gleich das ganz große Bild liefern.

Leute wie Sie gelten inzwischen wahrscheinlich als Querdenker, weil Sie sehen, wovor die anderen die Augen verschliessen.

ich war so frei und habe Sie mal in unserem Forum beworben, denn dieser Artikel muß unter´s blinde Volk gebracht werden.

http://www.smokingrebels.com/forum/forum.php?fid=1&sec=showthread&id=179&show=last#lastreply

Weiter so,

ihr Herr o`Lee

Miss Fallen said...

It took us some time BUT: Miss Fallen finally has her own website and would love to invite you all! Keep reading, thinking and writing.

Our new adress:
http://www.missfallen.de/

Carolus Magnus said...

I cannot find your email address on your site. Would you please contact me at "contact [at] sackstark dot info"?

Thank you