Oxygen ban has smokers fuming

by Mary Jane Boland - Health Reporter

Smokers with lung disease are being refused oxygen therapy at home, prompting an outcry from health watchdogs.

Most hospitals follow guidelines written by the Thoracic Society of Australia and New Zealand last year, which advise doctors to refuse oxygen to home patients with chronic lung disease who smoke.

The society says the fire risk is high if people smoke near oxygen and non-smokers have a higher recovery rate than smokers.

However, the policy has angered the ethics committees and smokers' rights groups, which have said everyone should have access to the same health care.

The issue was raised with the Wellington Ethics Committee last month. It decided that the fire risk was overstated and sick smokers at home should receive portable oxygen if needed.

The committee's chairwoman, Sharron Cole, said the policy seemed to punish honest people who admitted to still smoking. Smokers paid taxes and had a right to health care even if it was not as beneficial to them as to non-smokers.

Joy Faulkner, founder of Smokers Of The World Unite, said the policy "stinks".

Alcoholics would not be refused kidney dialysis if they needed it, she said.

The ethics committee was asked to consider the issue by Carolyn Rhodes, a Capital Coast Health (CCH) respiratory nurse doing a masters thesis on the ethics of withholding oxygen from smokers at home.

CCH respiratory physician Dr Peter Martin said he hoped the research would shed some light on the ethics of the guidelines.

Dr Martin said people were usually angry when told they would not get oxygen. He discussed the issue with a patient at least once every three weeks and was frustrated because smoking was extraordinarily addictive and there was no free nicotine replacement therapy.

Dr Martin said there had been cases of people being badly burnt from smoking near oxygen tanks.

He said the policy remained a vexed issue because there had been no research done on it.

But Auckland physician Dr Jeff Garrett said patients with lung diseases - like emphysema or chronic bronchitis - who smoked should not get oxygen at home because it was ineffective. Aucklanders who smoked had been denied such treatment for about 15 years, he said.

Dr Garrett, Greenlane Hospital's clinical leader of respiratory medicine, said he was more concerned about non-smokers who needed oxygen and had to wait because of funding issues.

Dr Garrett said the fire hazards of smoking near oxygen were not overstated. Three years ago an Auckland woman incinerated her nose while smoking near an oxygen tank.

The Evening Post - 1 July 1999

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The man, 56, is thought to be the first person to die since Australian doctors decided to take a stand on smokers and their treatment which, critics say, borders on �moral fascism�.

Some doctors have refused to perform transplants and other life-saving operations on smokers on �medical and moral� grounds.

But the doctors defended their position, saying that transplant organs are a very limited resource. �We have a very strict policy that we do not offer lung transplantations to people who smoke or have any other substance abuse in the last six months,� said Dr Greg Snell, a respiratory surgeon at Melbourne�s Alfred Hospital.

�Unconscionable�

The Australian Medical Association, which represents doctors, said treatment decisions should not be based on moral arguments. �It is unconscionable. We cannot judge our patients in that way,� said Dr Michael Sedgely of the AMA.

There have also been accusations that surgery bans have been imposed on fat people and drinkers and that sports injuries could be next, because of the person�s choice to take part in risky activities.

The man who died had been scehduled for a heart valve operation two days before Christmas. �He was shaved, he was ready, he was in his bed and the specialist came back and said �You haven�t given up smoking� ,� said his daughter.

Playing God

He finally went in for his operation last Friday but didn�t survive. �His lungs weren�t strong enough,� she said.

The AMA�s president Dr Kerryn Phelps defended the right to refuse non-emergency surgery to smokers, saying a cash-strapped health industry had no choice but to refuse treatment in such cases.

Smokers accuse the doctors of playing God and say they pay enough tax on cigarettes to warrant tax-funded surgery.

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Smokers nearly voiceless in tobacco tax debate

By Natalie Hopkinson
Palm Beach Post Washington Bureau

WASHINGTON - Last spring, a group of smokers offered to give their 2-cents' worth to a Senate hearing on the proposed tobacco settlement. But a Senate aide dismissed them, saying their testimony would be irrelevant.

"It's as if smokers themselves do not exist," said Wanda Hamilton of Miami, vice president of the Florida Smoker's Rights Association.

Smokers, already burdened by high taxes and restrictions on when and where they can puff, are about to be hit with the stiffest tax yet. The Senate is considering charging tobacco companies $516 billion over 25 years, paid directly by smokers through price hikes of at least $1.10 a pack.

"They are about to give us the biggest tax increase in history, and what we have to say is irrelevant?" Hamilton said incredulously.

Americans who smoke represent about one-fourth of the voting-age population, yet they've been largely silent on tobacco policy.

The National Smoker's Alliance, an Alexandria, Va.-based group that claims 3 million members, has sponsored radio and print advertisements across the country urging Congress and state legislatures to defeat anti-tobacco measures. It has a Web site (http://www.smokersalliance.org).

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But tobacco opponents say the industry - not individual smokers - drives the so-called smokers' rights movement. The alliance is widely considered a front group for Philip Morris, Brown & Williamson, and Lorillard, the three tobacco companies that sponsor it, and Burson-Marsteller, the public relations firm that masterminds its events.

There are a few non-industry-affiliated smoker's rights groups trying to stoke the movement, and there are dozens of pro-smoking Web sites emerging on the Internet.

The most prominent independent smoker's-rights group is FORCES (Fight Ordinances and Restrictions to Control and Eliminate Smoking). Founded in San Francisco in 1995, FORCES claims 5,000 members in 12 chapters across the United States, Canada, and New Zealand. The group, which says it gets no tobacco money, writes letters to Congress, operates a Web site (http://www.forces.org), and occasionally participates in pro-smoking demonstrations.

It's tough to get smokers fired up over their shrinking rights, said Raymond Sasso, the group's co-founder and president. After three years of agitation, even he's beginning to feel burned out.

"The fact is that people are very apathetic in this country," said Sasso, a 45-year-old hair cutter who has been smoking since he was 13. "I think it is an overall mentality that is alarming."

Across the country, there have been small uprisings by individual smokers, some of whom liken their struggle to that of other persecuted minorities. Smokers feel they are paying for their habit in more than just higher taxes.

"It seems as if they are blaming all the ills of society on us, and it is a bit extreme," said Steven Murphy, a 34-year-old auditor from New York City who smokes 1 1/2 packs a day and participates in smoker's rights Internet chat rooms.

The smoker's rights groups see the tobacco issue as a matter of civil liberties.

"Next it will be alcohol, then obesity," Sasso said.

For Suzy Thompson, the last straw came in January when California's ban on smoking in bars took effect.

"I've been quiet for a long time," said Thompson, a waitress who smokes one to three packs per day. Thompson organized a protest against the ban in Sacramento last week. "This time, we're not going to take it."

Andy Dilio became outraged when New Jersey doubled its cigarette tax from 40 cents to 80 cents in February. So the computer specialist and former Deptford town councilman created the New Jersey Smokers Online Web site. The site can be found at www.erols.com/potshot/index.htm

"If they can do this with tobacco and get away with it, that means they could target any business," Dilio said. But as a former '60s activist, Dilio is frustrated that he hasn't been able to rally more smokers.

"You can't get people out of their armchairs," he said.

Experts say it is more than just apathy that is preventing smokers from becoming active in the tobacco debate. They suggest smokers have been silent because many are trying to quit.

Smokers also may be hesitant to fight because they don't want to be associated with the industry's track record of targeting children and minorities, said Dee Burton, an associate professor at the University of Illinois at Chicago.

"Most smokers see the tobacco industry as a guilty party," said Burton, who has done studies on the topic for the past 25 years. "They feel the addiction doesn't come from themselves. They are more angry than guilty. And for the minority of smokers who want to keep on smoking, they still would not want to identify with a group that promotes smoking."

Those who do associate with such groups can expose themselves to hostility. The FORCES Web site and Dilio's New Jersey Smokers Online have received hate mail and nasty e-mail messages accusing them of contributing to the death of children. The smoker's advocates say they shouldn't be treated as pariahs for participating in a legal habit.

Sara Mahler-Vossler, a 59-year-old retired college professor from Andes, N.Y., says mistreatment by nonsmokers can be very hurtful.

"Suppose you had a friend of 15 or 20 years who decided your filthy dirty habit didn't belong in their house any more?" she said.

Mahler-Vossler said she wasn't surprised when her group, the Smoker's Information Network, was also shut out of a Senate tobacco hearing last October.

"Unfortunately, we are so used to getting rude comments from (Senate) aides, we don't even keep track.

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An anti-smoking lobby group will target people who illegally light up at Sydney's Central railway station by "fining" them and removing them from the platform.

Non Smokers of Australia president Brian McBride said the group would protest for the enforcement of non-smoking laws at Central from 1.15pm (AEST) to mark World No Smoking Day.

Members plan to hand smokers a mock $100 fine notification with a reprinted letter from NSW Transport Minister Carl Scully explaining that smoking under covered areas of the station is banned.

If the smoker continued, protesters were prepared to physically remove them from the station, Mr McBride said.

"If they decide to argue the toss we're prepared to try and physically remove them from the platform," Mr McBride said.

"We won't give up until we stop the smoking one way or the other."

He said protesters hoped to meet with the stationmaster at Central station later today.

Smoking is banned from all covered areas including platforms and walkways at City Rail stations, Mr McBride said.

However, City Rail revenue protection officers who were empowered to enforce the regulations turned a blind eye, often because they were smokers themselves, he said.

Any officer refusing to enforce smoking bans today would be identified and a formal demand for their sacking would be lodged, Mr McBride said.

Comment was being sought from City Rail and from Mr Scully's office.

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CTA a stickler for the rules-- just ask grandma

May 17, 2001

As desperate criminals go, I figured Jackie Quinn for a frightening specimen of urban lawlessness.

Just say the name to yourself:

Jackie Quinn. Jackie Quinn. Jackie Quinn.

It sounds tough, like some 19th Ward bully boy with puncher's knuckles.

So tough, that it took three beefy Chicago cops to pinch Jackie Quinn for a big crime against the Chicago Transit Authority on Wednesday.

One police officer started chasing Quinn on a crowded "L" platform during the morning rush. He called two other cops for backup.

They were giants, these two. They came charging forward, beefy, ready to grab the perpetrator.

But don't worry. They collared her.

"She's a feisty woman," said her friend, Caryn Gleixner, who tipped me to the crime of the century.

So I phoned the notorious Jackie Quinn.

How old are you?

"I'm almost 64," she said.

And how would you describe yourself physically?

"Let me put it this way," she said. "I weigh 84 pounds. And I'm 5 feet 3 inches tall.

"I'm probably the most unimposing physical specimen you'll run into anytime soon."

It turns out the notorious Quinn is a northwest suburban grandmother, the widow of a physician, a former nurse.

Currently, she works as a paralegal for a downtown law firm.

Just the facts, ma'am, I said.

"I come in from the suburbs on the `L', and I get off the Blue Line at Clark and Lake. I'm walking away from the train, and I light a cigarette. A heavyset police officer said, `No smoking' and I said, `Thank you and have a nice day' and I walked on."

Quinn is petite. But she's fearless, with a purposeful stride.

"I wasn't running away or anything. I was just walking, he doesn't want me to smoke there, I'm leaving anyway.

"But the next thing I know, he's yelling from behind me, `Grab her! Grab her!' He was yelling up ahead to two other policemen that were maybe 100 feet away. `Grab her!' he screams."

Picture the platform with commuters rushing to work.

"And he's screaming. The two other guys, the two other police officers, were huge. They were running toward us, it's crowded, and they were trying to grab people.

"They would go for somebody and the one behind me would say, `No! That one! That one!'

"It was a Keystone Kop type of situation. You know, they're running around, kind of confused, going up to people. And the one behind me keeps yelling, `Grab her! That one!'

"So I stop and put my hand up, the one with the cigarette in it. I said, `Officers, I think I'm the one he's looking for.'

"The two big guys were shocked. There was a sense of embarrassment. They kind of backed away a little bit."

Did they look you in the eye?

"Well, not really, though I kept looking at them and laughing. The heavyset officer runs up and writes a ticket."

What for?

"For smoking on a CTA platform. Have I committed a crime? I don't believe so."

It could cost her $500, city officials said. Police confirmed the essentials.

"But she told the officer, `What are you, the smoking police?'" said police spokesman Pat Camden, "And he said, `Yes, as a matter of fact, I am.'"

Obviously, no one should ever, ever, smoke on a train or a bus, in consideration of other passengers.

But pinching a sarcastic 84-pound grandmother for smoking as she's leaving an `L' platform is absolutely ridiculous.

Women are groped on the trains all the time. Panhandlers abound. Barbarians spit and morons spread disease by sneezing without tissue on the trains.

Have the CTA bosses begun ordering police to make arrests for tissueless sneezers?

The CTA bosses are sticklers for the rules. They are proud sticklers, actually.

Until it comes to spending your money. Then the CTA is flexible indeed.

Such as when a pal of the mayor's snaps up a prime chunk of CTA property in Lincoln Park, even though the mayoral pal bid $6 million less than anyone else.

Or, when favored City Hall political hacks retire on juicy public pensions, and then are put on the CTA payroll, for a double scoop.

Another fantastic CTA deal approaches, this one worth hundreds of millions of dollars for the construction of bus shelters.

The party favors are to be distributed by CTA boss Honest Frank Kruesi, CTA Board Chairman Valerie "East Bank" Jarrett; and a new CTA board member--City Hall patronage chief and airport contract tycoon, Whispering Victor Reyes.

The gravy will ooze like a river.

And Jackie Quinn?

Grandma broke the rules. She'll pay for it.

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FORCES INTERNATIONAL is gathering information on doctors who refuse to treat smokers, causing harm or death. Please let them know if you know of any such occurrences. Thank you.