Dr Melissa Walton-Shirley

Disclosures

September 01, 2013

I awoke this morning with two goals: to attend a presentation called "The Smoking Room" on the adverse effects of cigarette smoke, including endothelial function, inflammatory pathways, and coagulation; but before I would rush to the Algiers room in Village 4 at the ESC Convention Center at 11 am, I was desperate to fulfill a high ranking personal desire: A tour of the Anne Frank house at Prinsengracht 267.

At 8.50 am

I walked in a light misting rain to find there were already 20 tourists ahead of me. As we moved behind the infamous bookshelf through the entrance to the Frank family hiding place, we began our long climb up the "leg-breaker" staircase, to the living room and kitchen. After an hour or so of emotion-stirring photographs and footage, I checked my watch and was forced to pick up the pace. We passed through a small stairwell where a large acrylic box mounted on the wall held a game board. Underneath it was the diary entry:

Yesterday was Peter's (sixteenth) birthday. I was upstairs by 8 and Peter and I looked at his presents. He received a game of monopoly, a razor and a cigarette lighter

November 9, 1942

The horrors of the Holocaust continue to shape our understanding of how hatred can scar a planet. How much the world has changed since a time when good and loving parents desperate to convey some sense of normalcy would give a cigarette lighter to a 16-year-old.

At 11 am 

I carried the image of this game board and a sad 16th birthday party into the Algiers room at the RAI Convention Center in Amsterdam.

The presentation began with Jay Emberson from Oxford on the Whitehall Resurvey. We learned that smokers who were lucky enough to survive to age 70 still lost four years of life compared with only two years in former smokers. Current smokers demonstrated a one-third higher vascular mortality and a two-thirds increase in pulmonary mortality, including COPD and lung cancer.

We next heard from Bijana Parapid of Belgrade, Serbia, who reported on the Seven Countries Study. Male cohorts from the US, Finland, the Netherlands, Italy, Croatia, Serbia, Greece, and Japan were studied from 1957 to 1964 and evaluated every five years thereafter. The active smokers' group lost 7.5 years in the Seven Countries report. What senseless loss.

As the morning progressed, we learned from T Sugiura of Nagoya, Japan, that smoking induces small- and large-vessel damage with persistent elevation in serotonin levels even after eight weeks of smoking cessation. R Mila Garcia from Montevideo, Uruguay, presented data on increased leukocyte activation and a decrease in regulatory T cells in smokers. AP Porretta discussed a marked 24% reduction in heart-attack incidence after a smoking ban in two cantons of Switzerland.  Finally, Konstantinos Farsalinos , a leading expert on the physiologic impact of the e-cigarettes, reported on the decrease in carboxyhemoglobin levels and improved coronary flow velocity reserve compared with active cigarette smoking.

Reflection

During the presentation, my mind drifted back to the Anne Frank house. Over 11 million people were killed between 1933 and 1945 as this most intelligent and precocious child chronicled her daily struggles. World leaders aware of the atrocities of the Holocaust that stood by idly or condoned such perversions of human interaction are damned by history for an eternity.

Are there world leaders today who are guilty in the court of indifference when it comes to another most efficient killing machine? Are world leaders without a vision for a smoke-free country and its impact on health and economics fit for leadership?

The definition of the word holocaust is "a great destruction resulting in extensive loss of life," and with that definition in mind, in the truest sense of the word, the tobacco industry is guilty of creating its own brand of holocaust. Big Burley, through greed and indifference, is responsible for five million deaths per year worldwide. Although many undertook the risk voluntarily, there is a large sector of the human population exposed to tobacco smoke that have no or little choice. In a WHO study previously published in the Lancet, "603 000 deaths were attributable to secondhand smoke in 2004, which was about 1.0% of worldwide mortality. 47% of deaths from secondhand smoke occurred in women, 28% in children, and 26% in men."

We must never underestimate the impact of the carnage imposed by the tobacco plague. It has permanently eroded our world and continues to etch a swathe of death, destruction, and poverty in its perpetual march across our planet.

Nothing will ever compare to the purposeful destruction of human life under Hitler's regime. Anne Frank's legacy is one of hope, joy, and love. It also remains among the greatest of tragedies, and our hearts will forever lament her suffering and death.

Perhaps with education, caring, and love, we can strive more diligently to bring an end to the ongoing holocaust at the hands of the tobacco industry. An end to preventable suffering and death is a legacy for any generation.

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