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There ought to be a ban on No-Smoking Day to protect smokers from the unfair criticism of doctors. They think the Day gives them leave to speak unkindly about very nice people who smoke, like myself.
Also, it is pointless in a city in which five minutes of exposure to poisonous fumes from smoke-emitting vehicles is much, much more hazardous to health than five hours spent in a room filled with tobacco smoke.
However, the Day is sacred in the medical profession because doctors are fanatically anti-tobacco smoking. They are not that hot about transport-related smoke pollution.
Doctors love to pick on smokers even on ordinary days but they get hyper enthusiastic on No-Smoking Day. So they were enjoying themselves at a seminar organised by the Aga Khan University Hospital (AKUH) on May 31 which is international No-Tobacco Day. It is called No-Smoking Day in our country to target smokers. The argument is, that if people did not smoke the manufacture of cigarettes would automatically stop.
Even though the seminar concentrated on the effect of smoking on the health of the smoker and society subjected to secondary smoke, no smokers were invited to speak and so expose the oratory of the doctors for what it was: unoriginal, unconvincing bombast. They put the smoker, in absentia, in the dock and passed judgement without a qualm, as if to say the smoker had no right to a defence plea.
Newspapers covered the seminar in great detail and thus provided me an opportunity to comment on it. At the end of the seminar the doctors demanded, of God knows who, to strictly enforce the Prohibition of Smoking and Protection of the Non-Smoker Ordinance 2002. The Sindh chapter of WHO had sent a communication that WHO wished to "help colleagues around the world to take effective legislative and executive measures to safeguard health and happiness." In short, neither the doctors at the seminar nor in the World Health Organisation stressed the need to find medical solutions to end nicotine addiction.
There is no medical help for assuaging nicotine addiction, and who knows this better than chronic addicts. There comes a time in the life of every smoker when the flavour is gone and only the habit remains and they would like to kick the habit. Doctors have failed to solve the problem. No wonder they preferred to stress the need for enforcing an ordinance and finding legislative and executive measures to resolve it. Such measures are not in the province of the medical profession and amount to dabbling in a field of knowledge outside their competence.
I once asked a doctor if a nicotine patch would help me to stop smoking. He, being a family friend, said "No" Because he was a friend he gave me the low-down about the harm of nicotine patches. He said smoking is not only an addiction but a psychological dependence, a habit. Even if I used a patch I would still be reaching for a cigarette out of sheer habit and thus my blood system would get a double dose of nicotine.
Another popular suggestion, made by doctors and people who don't smoke is to "Just give it up." This requires strong will power. If smokers had it they wouldn't be smoking, would they? There are very few people who have been able to give up smoking through will power.
Some time in the 1970s the Adventist Hospital - situated on the smoke polluted M.A. Jinnah Road - launched a campaign. Its slogan was displayed in a large banner which said "stop smoking in 10 Days". An old colleague (after who in they have named a park in Nazimabad) gave it a shot. He reported they suggested a gradual increase in the time between smokes so as to increase his will power to stop smoking altogether. It didn't work and he continued to smoke till he died at a ripe old age.
The effect of smoking on health and life-expectancy are popular medical myths. The doctors at the seminar spent most of their time raising these bugbears. Details from the US surgeon general's report were read at the seminar. According to the report, environmental tobacco smoke had been found to cause premature death and disease in children and non-smoking adults. It may be true in the US. Over here most of us grew up in homes where all of the adult males and some of the females were heavy smokers. Here I am, a senior citizen.
Child mortality in Pakistan is largely due to malnutrition and, diarrhoea, the cause of which are poverty and instantiation. The AKUH must have the report of the wife of one of their foreign doctors who did a survey of the kachi abadis in the city. I acted as her interpreter on some of her visits and later saw a copy of her report. The doctors at the seminar didn't care to look at this report, they preferred what the US surgeon general has to say because what he says fits in nicely with their programme to condemn smokers.
In an attempt to show that even a puff of tobacco smoke is hazardous to health one doctor said, "There is no safe level of exposure to tobacco smoke. Active smokers as well as passive smokers are becoming victims of dangerous diseases of the lung, including cancer, tuberculosis, cardiac problems, obesity, diabetes and liver ailments." On a scale of 1-to-10 for the major cause of these ailments, tobacco smoke would figure at about eight or nine on the scale.
Carbon monoxide from exhaust fumes of vehicles, lead poisoning from water, substandard meat and vegetables, overeating, poverty which forces people to live in congested unhealthy surroundings, malnutrition, unplanned child bearing are the real killers in our society. To give out of proportion importance to tobacco smoke as the cause is unethical.
Doctors are so fanatically anti-smoking that if a patient happens to be a smoker they blame the habit as the chief, nay, only cause of whatever the smoker may be suffering from. My doctor friends are like that. If I sneeze it is because I smoke, if I cough its because of smoking, if I complain of a bad tummy it's because of smoking. Others may have a virus allergy that is why they sneeze, or their cough could be asthma or their tummy upset could be because of food poisoning. Not in the case of smokers.
I tell my friends, see, we have made diagnosis so easy and quick; everything that is wrong with us, you know it is because of smoking. They have the decency to look ashamed, and most have given up this glib, narrow-minded diagnosis that everything wrong with smokers is due to the weed.
Until the major culprits of bad health are tackled; until they clean the air of carbon monoxide and lead fumes, doctors should withhold criticism of nicotine air pollution from tobacco smoke. At the moment the health Johnnies have no moral right to pick on smokers. They should devote time to find viable medical means to end smoking.

Copyright Business Recorder, 2007

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