lNVEIGHING against the harmful effects of smoking, King James I, in 1604, noted that smoking is "a custome loathsome to the eye, hateful to the nose, harmful to the braine, and dangerous to the lungs . . ."
King James got it right, even if he did not yet know the specific names we would give these ailments, the enormous toll they would extract in human suffering and costs of medical care, or the way the nascent tobacco industry would cynically manipulate tobacco's addictive properties while denying (under oath) any harmful effects.
Four hundred years later, Maryland is poised to make a dramatic impact on this tenacious problem. Gov. Parris N. Glendening, with the support of state legislative leaders, has decided to employ an old judo trick: Use the strength of your opponents to defeat them.
In this case, the opponent is Big Tobacco, and the strength Maryland will employ is money from the tobacco settlement. The state plans to spend $1 billion over the next decade to expand the battle against tobacco, including preventing smoking and finding ways to better treat those suffering from smoking-related illness.
A major step
The boldness of the initiative deserves prominent recognition. Maryland is one of only a handful of states to deploy these funds in an effort to relieve human suffering, and even more importantly, prevent future costs and suffering.
Mr. Glendening wisely knows that funds are necessary, but not, by themselves, sufficient to fight tobacco. One needs institutions with the expertise and dedication to transform financial support into aggressive, effective programs. And that's an area in which Maryland already provides global leadership.
Local advocacy groups, including Smoke Free Maryland, have kept up a drumbeat of public education and concern, and will continue to inform and shape Maryland's strategic initiative.
Maryland is also blessed with an outstanding medical community that's capable of transforming an enlightened political initiative into a showcase of practical solutions and inspired medical discovery.
The Johns Hopkins School of Public Health's Institute for Global Tobacco Control already helps organize smoking cessation programs from Mexico to China. The institute will now be able to do more for Maryland residents.
With money from the tobacco settlement funds, the school's epidemiologists, toxicologists and environment health experts will have the resources to help them find out why Marylanders disproportionately suffer from smoking-related illnesses.
Maryland residents are not genetically dissimilar to those of other states.
The University of Maryland Medical Center has already announced its intent to expand treatment facilities, particularly to under-served rural communities that otherwise might not receive the latest medical care.
These institutions, along with community groups and individual concerned citizens, provide the infrastructure for transforming the governor's investment into effective programs for drastically reducing tobacco use across the state and treating those for whom it is too late to prevent disease.
With the battle finally joined, it should take less than a decade for Marylanders to boast a healthier populace, and for the rates of smoking-related disease and death to begin to decline.
Maryland medical research will inform and motivate the nation, and quite probably the rest of the world.
Dr. Alfred Sommer is dean of the Johns Hopkins School of Hygiene and Public Health and a professor of ophthalmology, epidemiology and international health.
Pub Date: 9/29/99