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Young and invincible



I am writing this letter for the young and invincible, and dedicating it to my dad, Paul Packham.

Like many men of his generation, Dad took his first puff of a cigarette in grade school, began smoking regularly as a teenager, and was completely hooked on tobacco by the time he returned from a tour of duty in Korea. Like the teenagers of today, my Dad was once young and invincible. Recently, Dad passed away at the age of 78 from respiratory failure associated with emphysema.

Dad's death certificate will list "chronic obstructive pulmonary disease" as the cause of death, but the real cause of his death, of course, was a lifelong addiction to tobacco and cigarette smoking.

It is an understatement to say that cigarette smoking was a ubiquitous feature of growing up in working-class Oklahoma City in the 1940s and 1950s. Cigarettes were cheap and easy, and the majority of men smoked.

Dad's generation preceded the Surgeon General's warnings and wasn't privy to the wealth of research on the consequences of smoking (or secondhand smoke or smokeless tobacco). Yet like the young and invincible of today, Dad's addiction was possible, in part, because he had no idea what a lifetime of cigarette smoking had in store for him, particularly in his final years.

Dad was a stubborn, but not ignorant, man. In his 50s, he grudgingly came to acknowledge the toll cigarette smoking was taking on his health just as he came to reckon with a health-damaging daily habit of four or five beers.

On New Year's Day 1990, he decided to give up alcohol and for the remaining 20 years of his life and never took another drink. Kicking cigarettes, however, was another matter. Dad was unable to stop smoking up to the day, literally, he was hospitalized with respiratory failure.

I chafe at the trite notion that, in the end, we "all die of something." Indeed, if I've learned anything in the final two weeks I spent with Dad, it's that you don't want to die of emphysema.

Some of my fondest memories of Dad were playing baseball and football with him well past his 50th birthday. In the past couple years, shortness of breath kept this once vital and energetic man from doing things as simple as tying his shoes or taking a shower.

Worse, Dad's final 16 days on earth were spent tied to a respirator gasping for breath, sedated and manacled to his hospital bed, unaware that death was near.

I am someone who has had the good fortune, if it can be called that, of thinking and dealing with the public health threat of tobacco in aggregate, if not abstract, terms. This has become personal.

Each day this year, 3,500 young and invincible kids under the age of 18 in the U.S. will try smoking for the first time. In Oklahoma, an estimated 4,700 kids will become new regular smokers this year, adding to the 46,000 high school students in Oklahoma who currently smoke.

Like Dad, these kids, too, will die of something, some day.

In Dad's memory, I call on those of my generation to redouble our efforts to make sure that it's not emphysema or any of the equally horrific ends that await these kids if today's taunts to invincibility become a lifetime addiction to cigarettes.
"John Packham
Reno, Nev.

Packham, who holds a doctorate, is director of Health Policy Research at the University of Nevada School of Medicine. He is a graduate of the University of Oklahoma.

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