This commentary is by Rebecca Jones, a physician practicing in Brattleboro and a member of 350 Brattleboro, a local volunteer group dedicated to climate justice.
At midnight on Jan. 1, 1971, it became illegal under federal law for U.S. TV stations to air cigarette ads. At the time, roughly 38% of adults smoked, down from a high of 45% in 1954.
While it took until 2018 for most states to ban public smoking, there was a significant and steady decrease in smoking over those four decades. Along the way was the 1964 Surgeon General’s report on smoking and lung cancer, and in the 1990s came evidence linking secondhand smoke to chronic illness and death. Currently 11% of adults in the U.S. smoke, down from 20% in 2005.
Smoking behavior changed and public spaces became smoke-free when we agreed that smoking was harmful and that it was important to protect the public. The government stood up to the tobacco industry, publicizing the surgeon general’s warning and requiring the warning on cigarette packaging.
Reports, laws and public behavior each contributed in turn to a growing narrative, which in turn led more of us to decide that public smoking was unfair. A butterfly flapping its wings may or may not change history, but a report showing tobacco smoke can be deadly helped shift culture.
What is culture but an amalgam of laws, beliefs, desires, values, access, identity, alternatives, infrastructure and financial interests? We are only beginning to collectively understand its force, and our own control over it. We have the power to determine how culture impacts us, and we are each a part of culture’s force. Culture is more than us, and it is also us.
Smoking has been compared to other public health issues, including cars and climate change. Where exposure to public smoke threatens individual health, the impact of CO2 is global and all-encompassing. Where the tobacco industry spent billions on advertising and lobbying, withholding and denying information about the harms of smoking and opposing industry regulations, the fossil fuel industry engages in the same tactics of perception management.
Interestingly, the fossil fuel and tobacco industries share membership in ALEC (American Legislative Exchange Council), known for helping state and local lawmakers write bills with industry-favoring agendas. ALEC has been behind legislation that rolls back emissions standards, blocks the ability of the EPA to reduce carbon emissions, and blacklists companies that try to boycott the oil industry.
What smoking culture used to be, the car culture is now: a public health crisis. And yet it might seem impossible to imagine a world that is not car-dependent. Cars define our infrastructure; they dictate how we get around; it feels like we can’t live without them, and it feels like we don’t want to give them up — beliefs that industries (fossil fuel, tire and car) are all too eager to confirm.
Many of us love our cars, or at least appreciate what they do for us. We feel that they offer us protection, identity, mobility, freedom. We like the way they look and the way they feel, we like being able to go fast.
So it is hard to think about the harm cars can cause: Crashes cause 1.3 million deaths and 50 million injuries per year globally. Nearly half are pedestrians and cyclists, especially children. Car-filled roads mean there is less room for buses, trains, walking and biking. Urban air pollution, much of it from tailpipes, causes over a million deaths globally each year. Traffic noise leads to poor sleep and high blood pressure. Busy streets divide neighborhoods. And our cars’ contributions to climate change may be the biggest health impact of all.
The alternative to a car-centric system can be called “active transportation,” because walking, biking and rolling — even if it is to a bus or train — give us the opportunity to be physically active while we get where we want to go. People who use active transportation have decreased cardiovascular disease, diabetes, osteoporosis, some cancers, and depression compared to those who rely on cars. Our lack of good transportation in this country is a missed health opportunity.
What holds the car at the center of our lives is culture. Culture is so powerful, it makes it hard for us to see any alternative to the single-occupancy vehicle: We simply cannot imagine a different world.
Then again, smokers were once entitled to smoke anywhere, supported by the power of the industry and its influence on media through advertising, retail through sales, agriculture through federal subsidies of tobacco, even the government through tax income.
If you are old enough, you probably remember the ubiquity of cigarette smoke, and the way it lingered everywhere — airplanes, hospitals, restaurants. If you are too young to remember, it may be hard for you to imagine such a world. I believe that in the not too distant future we will look back with the same disbelief that we let cars limit us so much.
