In Cuba, to Smoke or Not to Smoke…

Irina Echarry

HAVANA TIMES — The Cuban government continues to support smoking in many ways; tobacco companies try to increase their sales and people keep choosing to smoke as a lifestyle choice, and they’re taking up the habit when they’re younger and younger.

An article published on the Infomed website lists the health risks associated with smoking:

  • Cancer, in its many forms such as lung, mouth, throat (pharynx and larynx), oesophageal, stomach, pancreas, cervical, kidney and bladder cancer.
  • Respiratory disease such as chronic bronchitis and emphysema.
  • Heart disease such as coronary heart disease and heart attacks.
  • Cerebrovascular disease, such as brain aneurysms, circulatory problems and high blood pressure.

According to the 2015 Annual Health Report, these are also the most frequent and deadliest diseases in Cuba: heart disease, respiratory disease, high blood pressure and cancer. You don’t have to be a genius to understand that smoking is slowly killing us.

However, nothing changes.

“How can you smoke when our own father died of lung cancer? Aren’t you scared?” I asked my brother.  To my surprise, he took his time to answer: “Yes, when I think about it I am scared, but I’m so irresponsible.”

My brother smokes nearly 30 cigarettes a day, in spite of his fear and his family being dead against it.

A lot of people consider smoking an act of freedom, a personal decision that other people have to respect. It’s interesting to see that this same argument can be used to both justify it and to combat it. However, bearing in mind I’m one of the ones who want to eradicate smoking off of the face of the earth, I’m going to focus on the argument against.

Of course, choosing what you do in life is freedom, choosing what you most like or what best suits you. However, every personal decision comes with great responsibility. That’s why, it pained me to say to my brother that he’s not only being irresponsible with himself but with the lives of all those who surround him. Smoking isn’t a private act that doesn’t have consequences on other people; on the contrary.

According to the WHO, “smoking kills approximately 6 million people a year: 5 million are smokers and over 600,000 people are passive smokers who’ve been exposed to secondhand smoke.”

Therefore, you’re free to smoke if you don’t care about filling your lungs with tar and that it causes you respiratory diseases, or that this evil habit gives you some kind of cancer. But, you could be more aware of the fact that smoke from your cigarette affects everyone around you too. The “innocent” act of lighting up has its consequences: smoke from a cigarette contains over 4000 different components, many of which are considered toxic, carcinogens or potential carcinogens.

The tobacco industry needs a lot of paper to roll up each and every cigarette found in their packets. The paper and cellulose acetate they use in filters aren’t biodegradable, and therefore, take years to disappear and add to the amount of solid waste we have on the planet. Furthermore, just one cigarette butt is enough to contaminate up to 50 liters of water; fish, birds and any other animals that come into contact with this water can die.

Smoking produces pollution, which in turn contributes to climate change, and can cause forest fires (out of negligence). No-smoking regulations put into effect in enclosed areas don’t always fix the problem, as gas emissions and toxic air pollutants escape into the atmosphere beyond where the cigarette was originally lit up.

That’s why I have no other option but to think: we’ve lost all respect for life. Even us non-smokers are accomplices in this disaster when, for example, we allow adults to sell cigarettes to minors – initiating them early on in the world of smoking – and we justify it by saying that “every one of us has to struggle to get by” or “it’s up to the parents to stop them.” When we accept that they sell cigarettes to pregnant women knowing that it can directly affect and harm the fetus that is developing. It’s not just about having our doctors hands’ smelling bad whilst they check us over, or that cigarette smoke bothers us when we’re at the bakery, the shop or on the bus, etc.; but about the fact that it’s slowly killing all of us, humans and the planet.

We are accomplices because we don’t band together to demand the Government to adopt a smoking ban in Cuba.

Sure, at this time, if we were to hold a referendum, I don’t know who would take the majority. To smoke or not to smoke. That is the question.


13 thoughts on “In Cuba, to Smoke or Not to Smoke…

  • It’s always surprised me just how widespread smoking is in Cuba. Even in places where “No Smoking” is clearly marked, that is still largely ignored. I stayed in a hotel recently that was supposedly completely smoke-free, yet the whole place was like an opium den. I had no choice but to spend most of my time in town, as I could barely breathe at the hotel.

  • Dann, Correlation does not equal causation. That is a core premise of statistics. Lung cancer occurs in both smokers and non-smokers. The incidence of lung cancer among non0-smokers is on the rise despite a decrease in smoking, enacting smoking bans, etc. The increase in lung cancer among smokers occurred at the same time mother vehicle use and atmospheric nuclear testing increased, in time period following exposure to mustard chemical agent among soldier in WW I. The actual deaths for lung cancer among smokers all required long term exposure (30-40 years, and the death largely occurred in old age (see Doll and Hill’s Hospital and Doctor’s studies). The increased incidence in among smokers still results in a situation where lung cancer among smokers (while occurring at a higher rate than non-smokers) is a rare.

    Interestingly location with high smoking rates such as Greece and Japan have lower rates of lung cancer than nation like the United State and the United Kingdom. In addition the lung cancer rates are consistently higher in urban as opposed to rural areas regardless of smoking status.

    The expected dose-response relationship is not as strong as suggested in tobacco control literature. On second hand smoking studies that accept disease causation from primary smoking largely discount that relationship with second hand smoke (as demonstrated in all the references I have already provided).

    Consider for example, recent (2013) large prospective study (76,000 women) showed that while there is a strong association between smoking and lung cancer no such link has been demonstrated with second hand smoke. The direct quote is “the fact that passive smoking may not be strongly associated with lung cancer points to a need to find other risk factors for the disease [in nonsmokers].” (Peres, J, “No Clear Link Between Passive Smoking and Lung Cancer,”J Natl Cancer Inst, 2013.)

    I wonder just whom is misdirecting?

  • I guess you are just good at blowing smoke.

  • In no way does lung cancer “appear to be independent of smoking tobacco.” Smoking IS the # 1 cause of lung cancer, it does not merely ‘appear’ to be so. And even though “the rate of lung cancer has increased among non-smokers,” it is still nowhere near the rate of lung cancer among smokers.
    However, in Cuba the danger of second-hand smoke, is probably negligible since most homes and offices are not as insulated as they tend to be in colder climates or in parts of the world, e.g. in the southern parts of the USA, where the prevalent use of air conditioning makes people insulate their living spaces.
    But don’t let yourselves be fooled by Vinny Gracchus’s attempt at misdirection: Smoking cigarettes kills, but it kills primarily the smokers themselves – in Cuba as well as in the rest of the world.

  • Cuban cigarette packages already have “frightening warnings about the consequences” of smoking from the Ministry of Health (MinSap). Here are some examples from packages of “Hollywood”:
    “¿Quieres una vida saludable?,
    ¡No fumes!”

    “Tu aire y el mio es el mismo,

    Tus hijos están fumando también.”

    All medical doctors in Cuba also warn against smoking.

  • Why do such a high percentage of smokers develop lung cancer in comparison with the non-smokers?
    Why do Cardiac specialists advise patients not to smoke?
    Are the researches into smoking undertaken across the western world during the last fifty years just a ‘smoke screen’ and do you believe that smoking ought to be encouraged for the younger generation?
    As a non-smoker – I was involved in a sport at top level for some 17 seasons and so had to be very fit – I am not directly affected but I do object to being subjected to the fumes of tobacco by others. To me it stinks and makes me cough.

  • On SHS and lung cancer consider: “The average intake of toxic and genotoxic compounds due to ETS exposure is that low that it is difficult, if not impossible, to explain the increased risk of lung cancer as found in epidemiological studies. The uncertainty is further increased because the validity of epidemiological studies on passive smoking is limited severely by numerous bias and confounding factors which cannot be controlled for reliability. The question of whether or not ETS exposure is high enough to induce and/or promote the carcinogenic effects observed in epidemiological studies thus remains open, and the assumption of an increased risk of lung cancer due to ETS exposure is, at present, more a matter of opinion than of firm scientific evidence.” (See Adlkofer F. Lung cancer due to passive smoking–a review.Int Arch Occup Environ Health. 2001 May;74(4):231-41.)

  • Lung cancer appears to be independent of smoking tobacco. Indeed while the rate of lung cancer appears to be greater among smokers, even Doll’s studies suggested a protective affect, The rate of lung cancer has increased among non-smokers. As for evidence to suggest second hand smoke has a deleterious effects, the studies I already provided suggest the answer is no. You might actually read them in their entirety rather than echo antismoking propaganda.

  • Has lung cancer increased or decreased as a consequence of smoking tobacco?
    Secondly is there any evidence to suggest that second hand tobacco smoke has any deleterious effect upon health?

  • None. Why do you rely on an ad hominem attack rather than address the actual data?

    Consider Boffetta, et al: Multicenter Case-Control Study of Exposure to Environmental Tobacco Smoke and Lung Cancer in Europe, Journal of the National Cancer Institute, Vol. 90, No. 19, October 7, 1998: “public indoor settings did not represent an important source of ETS exposure.”

    In addition, one large study looked at 38 years worth of data. Engstrom, JE and Kabat, GC. Environmental tobacco smoke and tobacco related mortality in a prospective study of Californians, 1960-98 BMJ 2003; 326:1057. This study found “No significant associations were found for current or former exposure to environmental tobacco smoke before or after adjusting for seven confounders and before or after excluding participants with pre-existing disease.”

    Another study (2010) found: “ETS exposure was not found to significantly increase risk among never smokers in this study” and “It is now clear that the molecular pathogenesis of lung cancer in smokers and non-smokers is different.” Darren R Brenner, Rayjean J Hung, Ming-Sound Tsao, Frances A Shepherd, Michael R Johnston, Steven Narod, Warren Rubenstein and John R McLaughlin. Lung cancer risk in never-smokers: a population-based case-control study of epidemiologic risk factors. BMC Cancer, 2010,10:285 DOI: 10.1186/1471-2407-10-285

  • I don’t think it’s realistic to demand the Cuban government ban smoking, for many reasons.
    But … it might be achievable to demand that they do what the Brazilian government does, or did while I as there, which is require that cigarette packages be printed with frightening warnings about the consequences, and shocking photos of the possible results of smoking. Also, it could promote ecigarettes among its own population, which would it allow to export more tobacco to kill off more Yankees.

  • Which tobacco company do you work for?

  • Reject smoking bans. See the latest study disputing the risks of second hand smoke: Peter N Lee, John S Fry, Barbara A Forey, Jan S Hamling, Alison J Thornton, Environmental tobacco smoke exposure and lung cancer: A systematic review. World J Meta-Anal. Apr 26, 2016; 4(2): 10-43, doi: 10.13105/wjma.v4.i2.10

    CONCLUSION: Most, if not all, of the ETS/lung cancer association can be explained by confounding adjustment and misclassification correction. Any causal relationship is not convincingly demonstrated.

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