Doc Ippel: Tobacco Revenue Trumps Health Concerns

August 29, 2014

By Bruce Ippel, M.D.

In the office, we have a handout for smokers that gives some potent hints and tools on how to quit. What it doesn’t cover, however, is the magnitude and scope of the economic interests trying to keep them addicted.

There’s a river of money flowing into a variety of pockets from tobacco — and money talks, not usually politely or with your health in mind. Here’s what it’s saying:

Virtually any product that you consume, whether food, booze, cosmetics, even rat poison, must have a legally mandated list of ingredients on every package. We know that most tobacco companies put lots of stuff in cigarettes besides tobacco. So much so that one company considers it worth advertising that its cigarette is purely “organic,” meaning it contains only tobacco. But try to find an ingredient list on your Marlboro pack or carton . . . ’taint there.

Why? In Indiana alone, nearly a half a billion dollars are paid in tobacco taxes every year. When the tax was proposed, our politicians bad-mouthed the big tobacco companies and the harm they do to all of us left paying for the health consequences of addiction. So it was decided we needed to tax those nasty smokers to help with the costs. As a doctor, though, I can tell you that I don’t see a single dollar of that coming to pay any bills for my patients with lung disease.

And there’s the National Master Tobacco Settlement, the biggest legal payout of all time, a $100 billion bonanza for the government and still counting. With that money, the tobacco industry in effect purchases immunization against additional government prosecution or lawsuits — ever. Do you think the Mafia could afford this kind of protection?

And there’s Chantix, the most potent medicine to free people of tobacco addiction. A daily dose costs about the same as a pack of Marlboro. The prescription is for two months. That is prohibitive for most smokers (who still smoke most of the first month). Medicaid covered that cost initially. Today, not so much.

And there’s electronic cigarettes, now taking on a life of their own as “vaping” (producing an apparently harmless vapor). Many if not most of the patients I can talk into using these e-cigs eventually become tobacco free. I saw a study from Britain in which more than 60 percent quit this way.

But here in the U.S., my medical publications bad-mouth vapor users, saying there’s no evidence it helps them quit and implying that vapor breathing may slide into opium or coke or who knows what. For only God knows what poisons the manufacturers are really putting in there. That is said even though electronic cigarettes, unlike tobacco cigarettes, are sold with a list of ingredients.

I’m waiting to hear that e-cigs are the major cause of global warming. Money talks.

Bruce Ippel, M.D., is a solo rural family physician in central Indiana. He and his wife of 42 years have 10 children. For the last 38 years, Dr. Ippel has run a private “hardscrabble” clinic that serves the under-served.



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