Cigarette packs will soon carry graphic horror stories but, asks CATHERINE MASTERS, will smokers take any notice?

Every smoker knows what to do when confronted with the hard evidence of why they should not. Justify - might get run over tomorrow, got to die one day. Defend - it's my choice. Turn the pack over. Put the lighter on top of the warning. They have all seen the warnings on the packs and managed to ignore them. But soon the warnings are going to get bigger and nastier. The Smoke-free Environments Amendment Bill, likely to be passed before Christmas, does not stop with banning smoking in bars and clubs. It includes other measures to get rid of the cigarette. No longer will you be able to light up while you watch your child play sport within the school grounds, for instance. Then there are the warnings, likely to take up half the pack and be much more graphic: images of rotting lungs and hearts, brains with blood clots, infected teeth - unavoidable, graphic and nasty. But will they make a blind bit of difference to smokers already immune to warnings of impending doom? Walk into any pub and ask. So, John May, a burly Scottish cop working in Auckland, drinking a beer and smoking Marlboro Lights in a pub in central Auckland, what do you think when you see the warning already on your pack? May, 41, from Torbay, glances at the pack, which says smoking is addictive. The warnings have no impact whatsoever, he says. But he concedes he does notice them. "It's a dreadful addiction. I keep trying to stop it but I've never really managed it." Shown the images of lungs, a heart and a blood clot on the brain - graphic warnings used in Canada, probably similar to those destined for New Zealand packets - he says: "That's not nice ... ugh ... ooh ... nah. "It's a good idea 'cause some people will stop. I might stop, I don't know. I would love to ... " He says he will probably stop when there is a little less stress in his life. He looks guilty. He knows that is just an excuse. He will probably go on until he gets "a little scare". Maybe breathlessness. "No, no, I don't want to get to that point. That would definitely make me stop." When asked if he knows he is inhaling poisons including arsenic, cyanide, carbon monoxide and the carcinogenic gas 1,3 butadienne, he recoils. Briefly. Almost everyone you talk to, including many smokers, agrees the bill to ban smoking from bars and clubs and increase the size of warnings is a great step forward that will save lives. But the bill does not deal with the cigarette itself, the bewildering array of additives put in by the tobacco companies, and the deadly gases ignited when the cigarette is lit. Tobacco companies disclose what the ingredients of a cigarette are - but this is only a range of what might be in any particular brand, although British American Tobacco New Zealand lists ingredients and quantities brand by brand on its website. The list is long, from cinnamon bark oil for binding to potassium sorbate as a preservative and ethyl acetate as flavouring. But nowhere in the world are companies forced to reveal exactly what is in there, in what quantities and what the ingredients do to the body. If cigarettes were a food they would not pass the cancer test and would not be put on the market. But they are still sold at every dairy. Cigarettes are estimated to contain around 4000 chemicals. There are some key nasties. The tobacco plant is rich in nicotine, probably as a defence against insects. Nicotine is used as an insecticide. It harms cardiovascular and endocrine systems. It also triggers addiction, although researchers now think something else in the cigarette or smoke may increase the addictiveness. Tar is the particulate matter in cigarette smoke, the black gooey stuff that is deposited and retained in the lungs. It contains chemicals that are considered carcinogenic. Carbon monoxide ties up haemoglobin in the blood and reduces the amount of oxygen blood can carry. It stays for several days until the red blood cell is renewed, but in the meantime smokers are continuing to smoke, so they always have a percentage of their blood cells and haemoglobin which are essentially useless. Hydrogen cyanide is a product of combustion and is a potent inhibitor of critical biochemical pathways in the body at very low concentrations. It is very toxic and long term can cause cardiovascular toxicity. Acetaldehyde is another product of combustion and a suspected carcinogen. One thing that forms it is burned sugars - and sugar and sweeteners are added to cigarettes. 1,3 butadienne is yet another product of combustion and yet another carcinogen. Its concentration in cigarette smoke is said to make it the leading carcinogen. There are a lot more - the likes of acrolein, acrylonitrile, ammonia, benzene, cadmium. ESR scientist Jeff Fowles has tested cigarettes and written reports. He describes how cigarette smoke irritates the mucous membranes of nasal and airway passages and the eyes, that this irritation is a natural warning sign by the body of ongoing harmful exposure. "A number of additives in cigarettes appear to serve the purpose of temporarily lessening this sensation of irritation, essentially removing a natural barrier for avoidance of cigarette smoke." In another report, he says little is known of the combustion chemistry of most compounds and substances added to tobacco. "If you look at the ingredients list the companies submit they have all sorts of harmless-sounding things like chocolate and fruit juices. It all sounds very wholesome and yummy. But of course no one ever inhales the fumes of a burning chocolate bar, so it's hard to know." When a smoker lights up, the impact on the body is instant - on them and non-smokers. The smoke reaches the eyes, irritating. It floats up into the nose, the sinuses. It is inhaled down the throat, deep into the lungs and the gooey tar deposited. Tom Marshall, of Doctors for a Smokefree New Zealand, says: "The moment you start puffing it's going in and doing damage. That's why these unusual or uncommon carcinomas, cancers of the mouth and the tongue and the nose, tend to occur predominantly in smokers." On entering a smoky room or lighting up, within minutes carbon monoxide in the smoke slightly decreases the oxygen supply to the heart. Over 20 minutes, the platelets in the blood become sticky, predisposing to clots and increasing the risk of a heart attack by a third. After 30 minutes the heart's arteries' capacity to open up under stress to supply oxygen to the heart is reduced by a fifth. Repeated exposure to smoke damages and ages the arteries, leading to thickening, stiffening and narrowing of the artery. Dr Murray Laugesen, of the anti-smoking lobby group Ash - in the gun from Rodney Hide for being paid by the Ministry of Health to lobby MPs - says tobacco companies should make cigarettes less dangerous, although there is no such thing as a safe cigarette. How can the tobacco executives sleep at night? "The real answer to that is they get well paid to forget about it," says Laugesen. "But it's the right question to ask." Tobacco companies contacted did not want to comment, although British American Tobacco directed the Weekend Herald to its website. This contains details about what is in cigarettes brand by brand and also health information. It lists lung cancer as one of the main health issues. "The statistical evidence indicates that the lung cancer risks associated with smoking are real and serious." But in Britain, Imperial Tobacco, which is being sued by a woman whose husband died of lung cancer, is refuting decades of scientific proof of a link between smoking and lung cancer, says the Observer newspaper. Trish Fraser, the New Zealand director of Ash, says the bill is a real coup - but once passed the lobbying begins for the next step. "The product needs to be phased out," she says. "It will happen ... How can they sell a product that kills every second person who uses it over a long period of time?" It all makes no difference to Kevin Hewson, a 44-year-old chef from Ponsonby, sitting at another bar in Auckland. He has some Brazilian cigarettes which already have big graphic warnings. "I must admit I was quite affected. It made me look at it and go, 'Ooh, that's a bit harsh'. I still lit up another cigarette." It is about choice. And the Government gets tax income of about $900 million a year from cigarettes. "As much as the Government says, 'Oh, but you cost us all this money for your health', well, so what if I do end up at 65 being in hospital having a lung removed or a leg amputated? I've paid for it in one way or another. I don't need Big Brother saying to me I'm not allowed to sit down and have a cigarette." But yes, he would like tobacco companies regulated and cigarettes made safer. That would definitely be the way to go.

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