An urgent plea to America's Smoker in Chief

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Brendan Smialowski/The New York TimesAs Vice President Joe Biden looks on, President Barack Obama joins in the applause from lawmakers and representatives of the Campaign for Tobacco Free Kids after signing the the Family Smoking Prevention and Tobacco Control Act at the White House on Monday, June 22. The legislation gives the Food and Drug Administration unprecedented authority to regulate tobacco.

President Barack Obama, who admits he struggles with his craving for cigarettes, should have been with us at the hospital the day surgeons removed part of my dad's tongue. It might have inspired the president to quit for good. Dad did. After battling his nicotine addiction unsuccessfully for three decades, he never smoked again after that surgery. By then, though, it was too late. His cancer finally took him a little more than a year later.
The president, like my late father, is a strong and intelligent man. That's the devilish thing about tobacco. You can be the strongest, smartest person in the room, someone like Obama or John Bates, who died last fall, and still not be able to figure out how to kick a powerful addiction to nicotine.
Some smokers manage to do it, of course. And more than a few of them are woefully self-righteous about it.
We saw that last week after Obama, pressed by reporters to talk about his smoking habit, admitted he battles with it "constantly," although he sidestepped the issue of whether he still lights up. That brought forth a barrage of blog posts from former smokers, several of whom slammed the president for being "weak" and lacking in will power.
What bunk. The truth is that precious few smokers can quit without help. And that's where our society continues to have a massive blind spot. Tobacco-caused disease has become the nation's leading preventable cause of death, killing more than 400,000 Americans every year, yet our health care system and federal government do next to nothing to help smokers who want to quit but can't conquer their cruel addiction.
Historically, nicotine addiction has been one of the most difficult of all drug addictions to break. A 1988 Surgeon General's report on it concluded that its pharmacological effects on the brain "are similar to those that determine addiction to drugs such as heroin and cocaine."
Ten years after that report, 46 states negotiated more than $246 billion in legal settlements against the tobacco industry for its crippling financial impact on the health care system. At the time, the states promised to spend a significant portion of the money on programs to protect kids from tobacco and help smokers like my dad quit. However, they've spent only 3.2 percent of their tobacco money -- just $6.5 billion -- on prevention and cessation programs.
Oregon ranks among the worst states at breaking this promise. In fiscal year 2009, a period when the state raked in $355 million in tobacco settlement revenue and cigarette taxes, Oregon allocated just 2.7 percent of it to protect kids and help smokers quit.
Dad tried so hard. So did my wife's father, Merle Burton. Both men got hooked on cigarettes while fighting overseas during World War II. By the time they came home they were heavy smokers and kept it up well into the 1970s before deciding to quit.
Neither could do so for long. Lung cancer killed Merle at age 58 in 1978. About that time my dad began trying nicotine patches, nicotine gum and hypnosis, over and over to no avail. The closest thing he ever got to actual help, if you could call it that, was an occasional lecture from his doctor.
Everyone marveled, though, that he never got lung disease. The official cause of death was pancreatic cancer, which doctors said was related to his smoking. He was 84 when we lost him last Oct. 9.
The president would certainly improve his own odds of living that long if he can kick what his aides describe as an "intermittent" smoking habit. In fact, he has a wonderful opportunity to provide some unprecedented leadership on the issue.
Obama has already done much. As a U.S. senator, he co-sponsored an unsuccessful bill to give the Food and Drug Administration broad authority to regulate tobacco products. Just last week, as president, he signed similar legislation recently passed by Congress.
That's huge, historic progress, but Obama could do more -- much, much more.
I'd like to see him enroll, very publicly, in a smoking cessation program. He could speak up about his struggle and demonstrate to the nation that even a strong, savvy person often needs help breaking the addiction.
Obama could also lead the way on ramping up spending on help for smokers who want to quit. States should be held to their early promises, and health insurers should be required to cover cessation programs.
Years ago, if my struggling father could have had a few hundred bucks worth of physician-supervised cessation treatment -- something he could not afford on his own -- it could have saved tens of thousands of dollars in surgeries and cancer treatment.
Even better, he'd still be here today.
-- Doug Bates, associate editor; dougbates@news.oregonian.com

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