I have never smoked cigarettes. I do, on occassion, enjoy a good cigar. Thus, I have not paid much attention to the state of cigarettes in the United States. But, of late, I have taken notice. Several days ago I was filling my car at a convenience store and I noticed that Newport cigarettes were on sale for $45 a carton. I thought, "Forty-five dollars a carton is outrageous. How can people afford to smoke?" I know there was a recent tax increase on tobacco products. I never thought the tobacco-using public would find crack cocaine a cheaper alternative to cigarettes--but that appears to be the case now. But, after those thoughts I went on with my activities of daily living.
Last night the topic came up again. I was on a commuter jet in the mid-west. The fellow next to me was wearing a pressed, embroidered shirt with the name of his employer prominently displayed (a major US tobacco manufacturer). We conducted the standard idle airplane chatter. He asked me where I was going and what I did and I asked him the same. It turns out he was a tobacco purchaser and was going to visit local tobacco farmers where we were going. His job was to try and buy the best tobacco at the best rate before the farmers place the product in the local CO-OP. He told me about how tobacco was grown and selected. It was actually interesting. Then, I challenged him a little. I asked him, "Do you smoke?" He said, "Oh, gosh no." I responded, "Why not?" He said, "It's not good for you. You're a doctor--you know that." I asked, "Don't you feel guilty about selling a product that might harm people?" He took a deep breath--a little pissed--and said, "Don't you feel guilty about doing unnecessary surgery on people?" I told him that I was an emergency physician and the only unnecessary thing I do is see people who don't need to be in the emergency department. He cooled off and we took off.
When we landed he spoke up again. He said, "I don't like the effects of tobacco and I don't feel good about what I do. But, my dad was a tobacco farmer and that is all I know. I make a pretty good living and I have three kids to feed." I thought for a moment and apologized for criticizing him. We walked off the plane and I that was it.
But, I later thought more about the exchange. I know that I could never be in a profession (or occupation) that harmed people. I could not sleep well. Sure, I make my living off the misfortune of others. But, as a physician I strive to make people's lives and health better. The guy on the plane is doing the exact opposite. However, unlike him, I can sleep well.