Friday, May 25, 2007

Rest of the Story Calls for Immediate Retraction of American Lung Association Ad and for a Public Apology to the Nation's Physical Abuse Victims

The Rest of the Story is today calling on the American Lung Association to immediately retract and remove from the airwaves its "Abuse" anti-smoking television advertisement and to issue a public apology to all victims of physical abuse for extreme insensitivity and offensiveness (ad also discussed here).

The television commercial begins by showing the exterior of a house with the door open. Through the door, you can hear a father yelling viciously at a child. The child is obviously in great peril and terribly fearful.

"No, daddy, no. Stop it!" the child screams. Clearly, the child is being physically beaten and abused.

The camera pans in on the living room, where to the viewer's surprise, there is no beating going on. Instead, a father is smoking while his children sit calmly watching television.

The narrator then states: "Exposing your children to the dangers of secondhand smoke is in fact abuse. A message from the American Lung Association."

The Rest of the Story

I find this to be an extremely disturbing spot. It is almost unbearable for me to watch, but terribly upsetting to find out at the end that the piece is actually making a mockery out of child abuse, rather than treating the issue with sensitivity and respect.

How dare the American Lung Association compare the horrors of child abuse and the severe, immediate, and irreversible physical and emotional damage that it does to the increased risk of ear and lower respiratory tract infections in children.

Does the American Lung Association not appreciate the difference between risk and harm. Physically beating a child is child abuse because it invariably causes harm. The harm is intentional, it is immediate, it is severe, and it is irreversible. You cannot physically abuse a child without causing harm.

In contrast, exposing a child to secondhand smoke does not necessarily cause harm. What it does is increase the risk of certain health problems. In all but very rare cases, the infliction of any harm is not intentional. In most cases, any harm done is reversible and not particularly severe (although it can be in some cases). But the most important point is that with smoking around a child we are talking about increasing that child's risk, by a relatively modest degree, of certain health conditions.

With physical child abuse, we are talking about inevitable, severe, irreversible harm.

To compare the two in this way is a profound disservice to physical abuse victims. It shows an overwhelming disrespect and insensitivity to these individuals. After all, if smoking around children is equivalent to child abuse, then the message being sent is that being physically abused is no more serious than merely being exposed to a little secondhand smoke.

The commercial does not present a very specific situation of a child with asthma, for example, whose asthma is severely exacerbated by secondhand smoke, and whose parents continually smoke around that child despite clearly being warned about the consequences. This is one situation where smoking around a child could be considered abuse because in this specific (and in my experience as a physician - extremely unusual) situation, the harm is definite and can be viewed as being intentional.

Instead, the commercial makes a very general statement about smoking around your children.

It is important to recognize that in the majority of cases, smoking around children does not have any severe health consequences. It is not an issue of harm, but of risk. And thus, the categorization of smoking around a child as child abuse fails definitively.

This advertisement is so offensive that I call for its immediate retraction and removal from the airwaves. I also call on the American Lung Association to publicly apologize to all victims of true child abuse for minimizing and trivializing the pain, suffering, and emotional havoc that their being physically abused has wrought in their lives.

There's no question that childhood exposure to secondhand smoke is a significant public health problem. But characterizing parents who smoke around their children as child abusers is not an appropriate way to address the problem. Perhaps we could start by providing adequate smoking cessation services and health insurance coverage of these programs for those smokers who want to quit. Then perhaps we could provide more education to parents so that they are aware of the health effects of smoking on young children.

But to address the problem by rubbing salt in the wounds of physical abuse victims is disgraceful.

These ads cannot be retracted soon enough.

(Thanks to JustTheFacts for the tip).

UPDATE: May 25, 2007; 3:45 p.m. -- The American Lung Association, upon being informed of the "Abuse" television advertisement that is circulating on YouTube, has immediately pulled the spot and ceased its circulation on YouTube and all other sources. Apparently, the spot was produced by an ALA-affiliate and the national office was not aware of, and did not approve, the ad. Immediately upon being informed about the ad, the American Lung Association's national office, under the direction of CEO and President John Kirkwood, pulled the ad and expressed its apologies. I applaud Mr. Kirkwood and the American Lung Association for responding immediately and definitively, and for expressing their thoughtful sentiments and apology. The statement from Mr. Kirkwood is posted here.

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