Smoking: All Clear (<i> Cough, Cough</i> )

Starting today, it’s illegal to light up a cigarette on any domestic airline flight of six hours or less. Bad news for smokers, good news for airline crews and frequent flyers who, a recent Transportation Department study says, face an increased risk of premature death from exposure to other peoples’ smoke. The new law augments the ban on cigarette smoking aboard shorter domestic flights first enacted in 1987; pipe and cigar smoking was prohibited some time earlier. Little by little--but steadily--the idea that smoke-free zones are beneficial to public health is gaining acceptance.

Tobacco companies, to be sure, continue to fight most efforts to discourage smoking. They have a powerful incentive: Sales of cigarettes, cigars and pipe tobacco are a $40-billion a year business. That’s a lot of money, but it’s still much less than the $52 billion a year that the Department of Health and Human Services says smoking costs the nation in medical expenses and lost productivity. HHS Secretary Louis Sullivan puts the annual per capita cost of smoking-related diseases at $221, mostly for increased health care and higher insurance costs. The cost in California alone comes to $5.8 billion. That’s $1.2 billion more than the proposed 1991 budgets for the entire University of California and California State University systems.

The grimmer news is that 390,000 Americans can expect to die this year from smoking-related diseases, more deaths than will be caused by cocaine, heroin, alcohol, fire, auto accidents, homicides and suicides combined. One death out of six in the United States is now attributed to tobacco-related causes. That rate isn’t expected to drop soon. Even though the percentage of adults who smoke fell from 40% in 1965 to 29% in 1987, the HHS Office on Smoking and Health says that it takes 20 or 25 years after smoking rates go down before smoking-related deaths and the associated costs begin to decline.

So premature smoking-related deaths and associated costs promise to remain huge public health and economic problems for at least decades to come. Meanwhile, reports Dr. Sullivan, smoking is increasingly becoming a class-related problem, concentrated among lower-income, less-educated parts of the population. The tobacco companies fully understand that: Recent evidence suggests they are specifically aiming more of their marketing efforts at minorities and blue-collar workers. Sullivan sees a clear need to target these same groups for intense anti-smoking information campaigns. He’s right. Now let’s see what the Bush Administration plans to do about it.