Smoking remains the leading preventable cause of death in Canada and worldwide, killing 1 in 2 smokers, and more than alcohol, drugs, car accidents, murder, suicide, and AIDS combined. The tobacco industry has repeatedly lied about what they knew and when, intentionally manufactured controversy, enhanced cigarette addictiveness, and targeted women, children and minorities.

The tobacco industry must continue to find ways to market to children if they hope to survive, as ~ 90% of smokers start by age 18. Movies are one of the main legal avenues remaining for such. A review  suggested that 37% of youth smoking initiation is due to smoking in movies.  The Surgeon General has concluded that ratings changes could reduce teen smokers by 18%, preventing 1 million deaths among US children.

Carrie Fisher was a lifelong smoker who died at 60 from a sudden heart attack. Tragic, but unfortunately common. She had also fought mental health and addiction battles. The prevalence of smoking is disproportionately elevated in both of these groups, and despite being traditionally viewed as their “lesser problem” during life, it most often ends up being the cause of their deaths.

 Carrie Fisher’s death, while very sad, can be turned into meaningful action. Restrict smoking in movies, set age limit for purchase at 21, increase cigarette taxes, institute plain packaging, divest governmental pension fund tobacco holdings, ban smoking in multi-unit dwellings and outdoor gathering areas, and dramatically increase anti-tobacco governmental expenditures. Most importantly take control of smoking’s image- not cool, but instead a never-ending beauty- and health-destroying, and poverty-inducing battle against nicotine withdrawal. Maybe Princess Leia can help us defeat true organized evil after all.

Stuart H. Kreisman, MD

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