COMMENTARY ON THE ANTI-SMOKING CAMPAIGN : South Coast Plaza Ban Is Commendable, Courageous Decision : It sends a powerful message that the rights of health-conscious individuals should be respected.

I have been engaged in the practice of medicine in Orange County since 1975, and nothing gives me greater pleasure than the progressive decline in tobacco-related illness that has occurred during this period. The recent closure of South Coast Plaza to smokers is another important step in the right direction.

Despite the overwhelming evidence linking tobacco addiction and human disease, the tobacco industry continues its calculated marketing programs targeting our youth, using programs like Joe Camel, the cartoon character of Camel cigarette ads that 5-year-old children identify more than they identify Mickey Mouse.

Fighting the awesome merchandising power of the tobacco industry is the responsibility of every American--for a variety of reasons. Parents must fight to protect children. Taxpayers must fight the enormous impact on the health care budget of this country.

There are various ways we can fight. As a physician, I worked to develop smoke-free hospitals, and I joined Tobacco Free California.

As a parent, I educated my children in the subtleties of advertising programs.

As a taxpayer, I petition the government to reject tobacco industry PAC contributions and protect us from secondhand smoke.

As a consumer, I avoid, when possible, establishments that allow smoking. South Coast Plaza’s decision to create a smoke-free environment must have been difficult given the possibility of losing the revenue of disgruntled shoppers who smoke.

The ban sends a powerful signal throughout Orange County, the state and the entire nation that the rights of health-conscious individuals should be respected given the evidence regarding the dangers of secondhand smoke.

The most recent evidence came on Jan. 6 when the U.S. Environmental Protection Agency reported that secondhand cigarette smoke is a carcinogen that kills nearly 3,000 nonsmokers a year from lung cancer and increases the risk of pneumonia and bronchitis in children.

According to Tobacco Free America, environmental tobacco smoke, or ETS, was responsible for 53,000 of the 434,000 tobacco-related deaths nationwide last year. In 1992, the price tag on tobacco-related illness totaled $120 billion. ETS is the third-leading preventable cause of death, after smoking and alcohol.

Other medical facts regarding ETS: Major studies have shown that the risk of lung cancer is approximately 30% higher for nonsmoking spouses of smokers than it is for nonsmoking spouses of nonsmokers. Children of parents who smoke have an increased frequency of asthma, bronchitis, pneumonia, ear infections and other respiratory illnesses and require more hospitalization than children of nonsmoking parents. This also applies to the workplace or other public places where smoking is permitted; and ETS often increases the symptoms associated with allergies, asthma, hay fever, emphysema and other respiratory diseases. Passive smokers often experience eye irritation, nasal congestion, headache, cough, sore throat, hoarseness, dizziness, nausea, loss of appetite, fatigue and irritability.

The bottom line: ETS has been found by the Environmental Protection Agency to be a Class A carcinogen.

In Orange County, grass-roots anti-smoking campaigns have been visible and successful. Laguna Beach passed a local ordinance that prohibits smoking in restaurants. Anaheim Stadium is considering going to a smoke-free environment. All local hospitals and most medical facilities have adopted such measures. And now South Coast Plaza. Hopefully, many entrepreneurs will follow.

Proposition 99 has resulted in a significant drop in cigarette consumption. Last year, the California Medical Assn. succeeded in getting SB 1100 passed to ban the distribution of cigarette samples in California. Many cities and counties have passed a variety of clean-indoor-air acts to protect people from the effects of secondhand smoke, and some areas ban cigarette vending machines. The CMA plans to seek to ban cigarette vending machines throughout the state and continues to offer assistance to any municipality wishing to take decisive action.

With the current dialogue regarding health care reform making headline news, we must take a serious look at reducing tobacco and cigarettes as a line item in such reform. This is a significant way to help control medical costs. A total of $120 billion is being spent annually on tobacco-related illness.

If the goal is long-term cost containment, then a stiff tax should be levied on each pack of cigarettes sold. In the United States, the medical consequences attributable to tobacco use cost $2.50 per pack consumed. And the United States is the only industrialized country without a $3-per-pack tax. In Canada, it costs $5.50 per pack. Californians know that taxing cigarettes works. After the CMA-supported Proposition 99 established a 25-cent-per-pack tax, $600 million per year in new revenue was raised to combat smoking and the illnesses it causes, and a 12% reduction in smoking followed.

Unfortunately, the tobacco industry remains one of the most powerful forces in state and national politics. In California, this support manifests itself by keeping tobacco taxes low and protecting the tobacco industry from lawsuits filed by terminally ill smokers.

According to California Common Cause, the contributions by tobacco interests to state legislators from 1989 to 1991 reached a total of $773,713. While California does not produce tobacco, the tobacco industry gave $6,179 per legislator, more than twice the $2,758 it gave per congressional representative. In addition to the direct contributions made to legislators, the tobacco industry spent another $4.1 million lobbying during the same three years.

Additional anti-tobacco educational efforts targeting minors and children in Orange County would not be in vain. Last year, the CMA actually captured on videotape minors who were given free samples of tobacco products. It was tragic to witness our youth being coerced first by special interests who have no regard for their health and well-being and ultimately by nicotine, a powerful and addictive drug as powerful as heroin or cocaine.

One final note on children: We focus so very much attention on educating our children, and this is rightly so. A colleague of mine, Dr. Steve Hansen, has had great success in capturing the attention of children on this issue. He sponsors poster contests in elementary schools. Children are encouraged to develop their own anti-smoking messages. I invite everyone to get involved in this anti-smoking campaign and urge the creation of anti-smoking poster contests in all the county’s elementary schools.

The children of Orange County deserve a smoke-free environment, one that will maximize their health. Supporting children by deterring tobacco use inside South Coast Plaza is a bold and admirable decision. Among locals, South Coast Plaza is already considered to be a crown jewel. Surely now it will shine more brightly, reflecting the beauty and innocence of happy, healthy children.