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Jewish World Review /June 25, 1998 / 1 Tamuz, 5758

Larry Elder

And you thought "coke" was worse than smokes

IF YOU NEVER UNDERSTOOD JAMES JOYCE'S Ulysses, rest easy. Never quite got the hang of wind surfing, roller-skating or bridge? Relax. There's a reason -- and it ain't you. Your mother smoked cigarettes while pregnant with you. That's right.

Writing for the Journal of Pharmacology and Experimental Therapeutics, "Fetal Nicotine or Cocaine Exposure: Which One is Worse?" -- Duke University's Dr. Theodore Slotkin says that cigarette-smoking pregnant mothers propose a greater threat to their unborn fetuses than those who do crack cocaine.

Slotkin wrote,

Who knew!?

"Headlines concentrate on crack baby's syndrome, a condition for which there is no current medical consensus...whereas tobacco use during pregnancy received little or no attention...in actuality, cocaine is less likely to cause malformations than is cigarette smoking."

What? Dr. Slotkin argues that cigarette smoking poses a greater risk than cocaine for "perinatal morbidity, mortality and Sudden Infant Death Syndrome, and in persistent deficits in learning and in behavior." Worse, he says, the effects of a cigarette-smoking pregnant mom may not even show up until the baby gets older. Dr. Slotkin says that, while some doctors advise crack-smoking expectant mothers to abort, few dare suggest such a thing to a cigarette-smoking soon-to-be mother.

Now, he acknowledges some problems with his conclusion. After all, most crack smokers also smoke cigarettes. So, isolating effects of coke vs. smoke on an unborn fetus becomes difficult.

Still, he says, "Maternal smoking during pregnancy killed between tens of thousands and possibly over a hundred thousand babies each year in utero. That also results in tens of thousands of admissions to intensive care units after birth and kills or brain-damages more during the birth process. Smoking is also responsible for one-third to two-thirds of all cases of Sudden Infant Death Syndrome."

Studies show that nearly 11 percent of pregnant mothers do illicit drugs, whereas 25 percent of pregnant moms smoke cigarettes. Thus, according to Dr. Slotkin, the extent and degree of danger to the unborn fetus is far, far greater due to cigarettes than to cocaine.

A word for my reaction to Dr. Slotkin's conclusion -- counter-intuitive. You mean, local news' graphic images of crack babies on life support understate the problem? That there are many times more "cigarette babies"? Pretty strong stuff, doc.

Recently, several states proposed laws to prosecute expectant mother who consume illegal drugs. South Carolina just prosecuted and sentenced to eight years in prison a woman who smoked crack while pregnant. This year twelve states debated similar bills. Well, lawmakers, start your engines! Why should Connie Crackhead do time when Cindy Cigarettesmoker poses, according to Dr. Slotkin, a far more severe threat to her unborn child?

But hold the phone. Don't nearly 50 percent of men in Japan smoke? And, presumably, Japanese women smoke at a higher rate than do their American counterparts. But doesn't Japan have a lower rate of infant mortality than the U.S.? And don't IQ studies show that Asians, including the Japanese, score higher than other groups? Now we know how to reduce our trade deficit with the Japanese. Send them some more smokes!

Hey, maybe this coke's-worse-than-dope-theory explains America's crazy baby boom generation. The parents of the Love Generation smoked cigarettes! How else to explain bell-bottom jeans, tie-dyed shirts, Grand Funk Railroad, and "Louie Louie".

In California, the government runs television ads warning that cigarette smokers experience impotence more frequently than non-smokers. So, will the next media campaign suggest that cigarettes pose a greater risk to a fetus than crack? Slotkin acknowledges that many in his field fail to share his concerns. He found in pharmacology texts "80 percent of the pages devoted to substance abuse concerning illicit drugs, just over 10 percent concerned alcohol, and less than 5 percent concerned tobacco."

Maybe we should wait until some of Dr. Slotkin's colleagues come around -- if they ever do.

Meantime, imagine the lawsuits. Just recently, a Florida court awarded the family of a dead smoker a million dollars, despite 35 years of warning labels. The jury found for the plaintiffs, even though the deceased routinely referred to cigarettes as "coffin nails" or "cancer sticks."

Remember those Jonesboro, Arkansas, schoolboy shooters who massacred their classmates? Maybe their moms smoked. Move over, "Twinkie Defense." Make room for the "Butt Defense."

Counter-intuitive.

But the anti-smoking activists who emphatically tell us -- despite sketchy scientific evidence -- 50,000 people a year die from secondhand smoke, will require little confirmation. Slotkin for President!

Fair enough. Put up or shut up, you anti-smoking zealots. Demand that legislators pass bills allowing cops to bust those Marlboro Moms. I dare you. Go ahead. Make my day. Who knows, maybe my grandkid won't struggle with the Pythagorean theorem or the infield fly rule.