Here’s a simple way to end cigarette smoking in a generation

Normally, when people have worked together to do something they know will inevitably result in many deaths, they are prosecuted for murder or conspiracy. When a product is found to be unsafe, such as tainted meat, it is immediately recalled and destroyed. When something is discovered to be carcinogenic, like asbestos, we stop producing it and remove it from the environment.

But we have known for 60 years now that smoking tobacco kills people, and yet Canada still has 4.6 million smokers, who purchased 29,478,234,315 cigarettes in 2014.

As a physician specializing in anesthesiology, I have a front-row seat to the damage caused by tobacco. It is my job to get smokers safely through their cancer surgery, their lung resections and their amputations with as little pain and suffering as possible. I wish I could eliminate the cause of their problems, so they could avoid surgery in the first place.

Most smokers start as teenagers – 19.8% of 18 to 19-year-olds smoke. The solution must lie in preventing people from getting addicted to cigarettes as teenagers because once people start smoking, it is very difficult for them to quit. I have seen a man who has had both legs and eight fingers amputated due to smoking, puffing on a cigarette held between his two remaining fingers!

The best way to compensate for our historical error is to ban people who are now too young to smoke from ever smoking in the future. This policy was proposed by Deborah Khoo and a group from Singapore in 2010. She suggested increasing the legal age for buying tobacco by one year, every year. Those born after a specific date (for example 2005, children who are now age ten or under) would never be old enough to smoke legally. By 2030, only people over 25 would be able to buy cigarettes. Few teens can pass for 25, and most of them would not have friends old enough to buy tobacco for them. By 2050, smoking would be restricted to those over 45, making it look uncool to teenagers, and eliminating the problem of mothers who smoke during pregnancy. At the end of the century, there would be no one legally smoking in Canada.

This simple law, phasing in a new generation of non-smokers, would cause minimal disruption. Current adult smokers could continue to smoke. Businesses that currently depend on selling tobacco would only experience a small decline in sales each year. Tobacco companies would have time to diversify. Governments would find ways to make up for the loss of tax revenue on tobacco products – which currently stands at $8.1 billion.

A survey by Khoo and colleagues showed that 73% of non-smokers and 60% of smokers supported the idea, which has not yet been taken up by Singapore’s government. Canada could lead the way by actually passing this law.

Smoking is the number one cause of preventable deaths, killing more Canadians than AIDS, traffic accidents, suicide, murder, fires, and accidents combined. If one hundred people died in a plane crash or a terrorist attack, it would make headlines. There would be investigations to find the cause and inquiries to try to prevent such a tragedy from happening again. Smoking kills over a hundred Canadians every single day (including two non-smokers due to secondhand smoke), but this is considered normal and acceptable.

In order to be financially sustainable, tobacco companies must constantly lure new, young customers as older customers die. It’s time to put a stop to this business model, to protect our children from death and disability due to smoking. Within a generation, the lethal business of growing tobacco and selling cigarettes could become history.