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Michael H. CrosbyMay 17, 2004

In August 2003, thousands of tobacco-control and health advocates converged upon Helsinki, Finland, for the 11th World Conference on Tobacco or Health. I was the only “official” Roman Catholic attending. Three months later, in mid-December 2003, I attended the National Conference on Tobacco or Health in Boston. Over 3,000 people participated. Again, I was the only person there from any Catholic Church body who was doing anything about tobacco.

At the Boston meeting, I attended a session entitled “Faith Perspectives on Building Partnership With Tobacco Control Coalitions.” The Rev. Cynthia Adams, the Native American director of the Alcohol and Other Addictions program of the United Methodist Church, discussed its national campaign to help people be free of addiction to tobacco. She was joined by the Rev. DeWitt Williams, the health coordinator for the Seventh-day Adventist Church. The Adventists have been one of the pioneering churches in creating religiously grounded, effective programs centered around addiction. A third presenter, the Rev. Douglas I. Miles of the Interdenominational Ministerial Alliance of Baltimore and pastor of the Koinonia Baptist Church there, described the efforts of the multi-faith community in Baltimore to ensure “the vision of a tobacco-free society of communities in which youth are not led to addiction and adults do not die prematurely from addiction.”

As I listened to the reports from these denominations, including accounts of their efforts to work together (e.g., collaborating on an increase in the tobacco tax in Maryland), I was struck by the total absence of any mention of the Catholic Church. The speakers mentioned the involvement of ministers, rabbis and imams, but not once was anything said about the efforts of priests (or women or men religious) to help people quit smoking or to challenge the tobacco companies’ efforts to get young people and less-educated people here and abroad to use tobacco. Simply stated: tobacco is not on the radar screen of the Catholic Church.

The Problem of Tobacco

A report from the federal Centers for Disease Control and Prevention says that in the United States 400,000 people die annually from smoking-related causes. The World Health Organization, moreover, says that world-wide every 6.5 seconds someone dies from tobacco-related causes. The tobacco companies make the only known product that will kill if used as intended. Nevertheless, the only official Catholic teaching I have come across that addresses tobacco in any way can be found in the Catechism of the Catholic Church. It makes no mention of nicotine’s addictiveness or the tobacco industry’s efforts to make people addicted; rather, tobacco is treated only once, under the virtue of temperance. It seems that for the official Catholic Church, a little tobacco is not a bad thing. Yet according to research reported in the British journalTobacco Control on Sept. 12, 2000, a “little” tobacco for some 12- and 13-year-olds is enough to produce signs of addiction within days of their first cigarette. “There’s been a suspicion that many people become addicted very quickly, but this is really the first hard evidence that we’ve had that this occurs,” said Dr. Richard Hurt, director of the Nicotine Dependency Unit at the Mayo Clinic.

Moving more specifically to the pro-life issue of abortion, J. R. DiFranza and R. A. Lew pointed out in an article in The Journal of Family Practice in April 1995 that both in the United States and abroad, even exposure to second-hand smoke among pregnant women can be a significant cause of spontaneous abortions and stillbirths, as well as sudden infant death syndrome after birth. Researchers have found that each year in this country, smoking during pregnancy causes 61,000 cases of low birth weight (20-30 percent of all low-birth weight babies), 4,800 perinatal deaths and up to 14 percent of preterm deliveries and 2,200 deaths from Sudden Infant Death Syndrome (SIDS). Babies of smoking mothers go through the symptoms of addiction withdrawal upon being born. A study at Emory University in 1996 showed that pregnant women smokers are 50 percent more likely to have mentally retarded children and that those smoking a pack a day were 85 percent more likely to give birth to a retarded child. A 1998 study from the Minnesota Cancer Center found that a cancer-causing substance from tobacco is transmitted to fetuses by pregnant smokers.

Why so few people involved in the pro-life movement have addressed the issue of tobacco baffles me. One would think that even apart from addressing the issue of the health hazards connected with tobacco use, at least concerns about the dangers of tobacco during pregnancy might be addressed. As early as 1996, the executive director of the pro-life Christian Defense Coalition tried to address the contradiction. But after lobbying six major pro-life groups to take on the tobacco issue, the Rev. Patrick Mahoney, a Protestant minister, said he got “nowhere.” Instead, he heard one excuse after another: “That’s not our issue.... We’re so involved right now with A, B, C and D.... We’ll take a look and see.” All effectively dismissed him.

Outside the Conversation

In 1997 I attended the 10th World Conference on Tobacco or Health in Beijing, where I gave a paper on the role of religion in tobacco control based on a questionnaire I had sent to major religious groups. Five areas were examined: 1) whether or not the group or its parent organization had issued any ethical statement regarding tobacco; 2) issues related to tobacco investments (screens, holding stocks, divestment and shareholder involvement on tobacco concerns); 3) smoke-free workplaces; 4) acceptance of ads or monies from tobacco interests as well as whether tobacco entities had ever been honored by the religious institution; and 5) personal impressions and rationales as to whether religious leaders had been silent or vocal on the issue of tobacco. The questionnaire was distributed using the official directories of the various groups.

Only 14 percent of the Catholic groups had any kind of statement. This included the one diocese that responded to the question: “Have you made a moral statement against tobacco usage?” with the answer, “Sort of.” Apart from this response, not a single Catholic diocese noted that it had taken a moral position related to tobacco. The stance of Catholic groups contrasts sharply with two-thirds of the Protestant groups, which indicated their denomination had a moral position regarding tobacco. A key rationale offered for their anti-tobacco position by such groups as the Presbyterian Church (U.S.A.), the Disciples of Christ and the Southern Baptists comes from St. Paul’s reminder to Christians that the body is the temple of God (1 Cor 6:19). For its statement, the American Baptist Church not only raised a moral concern about smoking for its members; it also noted the “Christian responsibility” of its members “to speak out against those who would seek profit and wealth by promoting the use of a substance shown to be destructive to health and life.”

In May 2000 I was questioned under oath by the defendants’ attorneys in the Engle anti-tobacco class action suit. This case addressed the issue of tobacco companies’ failure to warn adequately and/or admit health problems related to tobacco use. In the midst of the questioning, a Philip Morris attorney asked me “my church’s” position on tobacco. Referring to the study I had made a few years before, I noted that the only reference to tobacco in an official document can be found in No. 2290 of the Catechism of the Catholic Church: “The virtue of temperance disposes us to avoid every kind of excess: the abuse of food, alcohol, tobacco, or medicine.” When asked why I never tried to influence Catholic Church teaching on the matter, I told the lawyer that I had never thought of doing this because I did not think Iwould be heard. At the same time I told him that I thought it was a great idea to try.

Upon my return, I wrote a letter (May 11, 2000) to the then-president of the National Conference of Catholic Bishops, Bishop Joseph A. Fiorenza of Galveston-Houston. I asked him to “use your good offices to change the present tenor of Catholic teaching related to tobacco use in light of the fact that its practices undermine the seamless garment of life. I don’t know if this would mean developing something for the U.S. Catholic Church or advocating for such a step at the Vatican.” I also offered my services “to work with you on developing such teaching.”

Two months later Bishop Fiorenza replied. He noted that “before any project or statement can be placed before the membership of the Conference, it must move forward with the observations and recommendation of the appropriate committee of bishops.” He said he had forwarded my letter to the committees of the conference that work with health and life concerns.

Almost four years have now passed. No action has been taken at the national level or at the Vatican. The pandemic continues. Meanwhile more of us prematurely lose loved ones and bury them with the rites of the Catholic Church—having never heard a word from it aimed at halting such a preventable disease.

In November 2001 I participated in the efforts of nongovernmental organizations in Geneva to influence what became the Framework Convention on Tobacco Control of the World Health Organization. There I met the Holy See’s representative to the negotiations, to whom I indicated my concerns. His response left me with the distinct impression that the Vatican had other global issues more pressing than tobacco control.

It would be untrue to say that no steps at all have been taken by the Vatican. The most evident progress was a measure approved by Pope John Paul II in June 2002 that banned smoking in nearly all closed spaces within the 108-acre Vatican City state. The law makes the Vatican’s police force responsible for enforcement. All violators, even cardinals and archbishops, face a fine of 30 euros. But while going smoke-free is commendable, having the leaders of the institutional church in the United States and in the Vatican address the morality of tobacco use—as well as the unconscionable promotion and marketing of tobacco by the industry—would be more meaningful.

What will it take to elicit an official statement on the subject? In 1997, when I sent my tobacco survey to various religious entities, one bishop wrote: “The issue is complex and personal. The morality argument is not persuasive to everyone. Perhaps better and compelling research is needed demonstrating cause and effect relationships.” In a similar vein, another bishop explained that silence prevailed because people “were still sifting the evidence.”

When Philip Morris’s own Web site acknowledges that cigarette smoking causes ill health, continued calls for more “evidence” suggest an unwillingness to act. In the context of another statement about the moral issues connected with tobacco promotion, issues of marketing and use may simply fall on deaf ears. With the bishops’ moral credibility at an all-time low, a simple declaration of concern and some monies expended for literature on programs to help people quit smoking would be appropriate. It would also be helpful if the bishops would publicly ask for a serious study of the matter (addressing both consumers and producers) with a view to making appropriate changes in official church teaching on the use and abuse of tobacco.

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19 years 10 months ago
I was fascinated by the article "Against Tobacco, For LIfe," as I have brushed against this demon myself on a personal basis, and because one of my responsibilities as a medical professional is to address the problem wherever I find it in clinical practice. What would be unforgiveable to fail to address in a medical setting, seems to have no place in the sun as a concern of the Church.

Michael Crosby's efforts in this direction are both commendable and appropriate as a response to the call for social justice found within the documents of Vatican II. Do we ignore this demon because it is so very common, even among the clergy, or is it because we have no ready answers as to the source and effect of its evil?

As I have told countless patients, addressing my own addiction successfully was both the most difficult thing that I have ever accomplished, and one of the best things I have ever done (second only to marrying my beloved Nancy Ann).

What health care professionals have learned the hard way is that advising patients to live healthy and productive lives, when we ourselves fail in the effort, simply makes us the laughingstock of our communities. "Physician, heal yourself," was a quote given even by our Lord. Perhaps, we need to address the problem among ourselves before we begin to counsel others.

19 years 10 months ago
I was fascinated by the article "Against Tobacco, For LIfe," as I have brushed against this demon myself on a personal basis, and because one of my responsibilities as a medical professional is to address the problem wherever I find it in clinical practice. What would be unforgiveable to fail to address in a medical setting, seems to have no place in the sun as a concern of the Church.

Michael Crosby's efforts in this direction are both commendable and appropriate as a response to the call for social justice found within the documents of Vatican II. Do we ignore this demon because it is so very common, even among the clergy, or is it because we have no ready answers as to the source and effect of its evil?

As I have told countless patients, addressing my own addiction successfully was both the most difficult thing that I have ever accomplished, and one of the best things I have ever done (second only to marrying my beloved Nancy Ann).

What health care professionals have learned the hard way is that advising patients to live healthy and productive lives, when we ourselves fail in the effort, simply makes us the laughingstock of our communities. "Physician, heal yourself," was a quote given even by our Lord. Perhaps, we need to address the problem among ourselves before we begin to counsel others.

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