April Gambado first noticed improvements in her general health about three months after she went back to work. The new job was as an operator associate at a technical-support call center, and when she was hired, the understanding that she would be trapped for eight hours a day, staring at a computer screen in a 48-square-foot cubicle, was daunting at best and depressing if she allowed herself to dwell on it.
But Gambado, recently divorced at 36, felt she had to take the job, if for no other reason than the health insurance that came with it. There was no possibility she could afford coverage on her own, and the thought of being uninsured terrified her. With her persistent weight problem and her family history, she knew she was at risk for diabetes.
"Maybe it was all in my imagination but I was getting this numb feeling in my feet and ankles. It only happened now and then but it had me scared," she said.
She had also begun to suspect she was developing asthma or something like it. On occasion she experienced a shortness of breath and refused to believe her pack-a-week cigarette habit would account for that.
The premium co-pay at the new job was steep, but it was a respectable policy and the human resources director assured her that she could not be denied coverage for any pre-existing conditions. The work was every bit as tedious as she had imagined it would be, but the shift supervisor was generous in allowing smokers the benefit of breaks.
"Just keep it away from the building," Gambado was warned.
After a week of using the elevator to get to the front entrance and the street, a co-worker who also smoked invited her along for a mid-morning trip outside. Instead of the elevator, they used the five flights of stairs at the back of the building. And instead of the front entrance, they went out over the loading dock into the alley. A half block away was a quiet nook, hidden away under an unruly hedge of syringa bushes. This served as the smoking area for employees from four separate businesses, including Gambado's employer.
The actual owner of the property--dubbed "Camel Pack Park" by its users--was a real estate manager who joined the smokers at every opportunity and welcomed their presence, as they provided him with the excuse to fire up another of his enormous Honduran cigars.
Three months, three trips every day--mid-morning, lunch hour, mid-afternoon--to the spot, and Gambado started seeing a spring in her step that she hadn't felt since her teens. The intermittent numbness in her ankles and toes had stopped, and she'd gone for weeks without any shortness of breath. Her skin tone was more robust than it had been in years, and by the time she hit the three-month mark, she had lost 5 pounds.
Her doctor asked what she had been doing differently.
"Going up and down a lot of stairs, that's all I can think of," she told him. "And maybe the time I spend outside."
He recommended that she keep it up, and also that she quit smoking.
Have your heart set on a cigarette?
Gambado's experience reflects a phenomenon seen increasingly in places that have taken strict measures against smoking in public. When the Republic of Ireland banned smoking from its iconic pubs in 2004, observers began noticing that the men and women who regularly slipped outside for a cigarette seemed to be noticeably more alert and energetic than those nonsmokers who were content to hunker over their pints of Guinness for hours on end without stirring.
"A lot of times, I'd pop down to the canal bank for a puff or two and when I come back, me little brother's nodded off in a corner. That's not right. He's only 67. So I got him going on Sweet Aftons [an Irish brand of cigarettes] just to brighten him up a bit," said Eddy Coyle, a patron of Limerick County's The Reeling Priest Public House.
The Cardial Health Union of Eire (CHUE), the Irish version of the American Heart Association, decided to put the anecdotal reports to the test. Using volunteers from dozens of pubs in three Irish cities (Dublin, Limerick and Killarney), they did exhaustive physical examinations and extensive follow-ups on just fewer than 1,500 subjects, each of whom frequented their favorite drinking establishment at least four evenings a week. Approximately half of the testees were smokers, or "duckers," as they had become known in the pub scene for their habit of ducking outside every few minutes for a nicotine fix.
Cardiovascular problems associated with smoking are numerous and not to be taken lightly. And as expected, the rates of atherosclerosis (a buildup of fatty substance in arteries), arrhythmia, congestive heart disease and coronary thrombosis were found to be above the norm among the smoking "duckers." However, elevated levels were also found in the non-smoking "nesters," who rarely move for anything other than a toilet call.
However, the statisticians were undeniably shocked when it was shown the duckers had a 32 percent better overall showing than the nesters. This rather impressive percentile differential was the result of the nesters control group including two more subjects found to have life-threatening blood clots in their lower extremities than the duckers group. (The statistical spread would have been 37.5 percent broader had the survey not ended less than a week before Anges O'Mickle, of the nesters group, was felled by a massive stroke as he sat on the very bar stool that had been named for him in recognition of the 30-plus years he had occupied it.)
Word of the results of the CHUE survey spread quickly throughout Europe, and a continental bevy of outraged medical researchers, convinced a mistake had been made, set about to refute those findings. However, after intensive testing in various public settings ranging from work environments to coffeehouses to Amsterdam's ubiquitous brothels, the CHUE results were duplicated in the Czech Republic, Estonia, Luxembourg, Denmark, the Netherlands and Turkey. Only in Turkey were the CHUE results not reinforced to within a 4 percent margin.
Gahlil Kibran, speaking for the Turkish Ministry of Health and Well-Being, offered a feasible explanation for what became known as the Istanbul Discrepancy.
"In our country, smoking is not so prohibited as elsewhere. And even if it were, probably half of our tobacco is imbibed by hookah. No self-respecting Turkish man would be seen carrying his hookah out to the alley for a smoke. You see what I mean, do you? It just would not happen," he said.
Yet in spite of the Istanbul Discrepancy (as well as a contrarian Italian survey that is widely believed to have been contaminated by false data supplied by Neapolitan gangsters aligned with a radical anti-tobacco faction) over the past four years, the original CHUE findings have been confirmed repeatedly.
It is now to the point at which the United Nations Health Implementation Panel--"Help On Our Longevity" (UNHIPHOOL) issued the following statement in November: "With corroboration coming in almost monthly from researchers as far afield as Argentina, Singapore and Canada, it has become increasingly hard to deny that a collateral effect of stricter smoking laws is an improved cardiovascular functioning in smokers over their more sedentary counterparts."
Repeated inquiries on this matter have been forwarded to the various American organizations that focus on the perils of tobacco, only to be met with a deafening refusal to comment.
Pure Air and Blue Smoke, Ummm
While the benefits of "kinetic smoking"--so called by a Swedish advertising firm that represents the R.J. Reynolds Tobacco Company in Scandinavia and Germany--on the cardiovascular system are borne out by European research, the effects of enforced open-air smoking on the body's pulmonary system have, to date, been less studied and are therefore less clear.
One thing is certain and was well expressed by writers Theodore Frech and Rev. Luther Higley many years ago (from The Evils of Tobacco, 1916): "The body needs food, clothing, sunshine, bathing and drink. But none of these wants are as pressing as pure air."
One of the few global organizations to tackle head on the question of fresh air smoking was the French association Ars Lunga, which concentrates its efforts on matters related to pulmonary health. For more than three decades, Ars Lunga has sponsored and conducted research into identifying environmental stimuli for the increase in incidents of such breath-inhibiting afflictions as asthma, emphysema, bronchitis and chronic obstructive pulmonary disease, and of course, lung cancer.
At the time they undertook their inside/outside smoking study in 2009, Mimyette Deludeaux, Ars Lunga's directeur de communications, expressed the dilemma they faced.
"What we must strive to know is whether God's pure air, even if it is diluted with a little tobacco smoke, is not preferable over the confined, inside air so polluted by radon gas, perfumes, colognes, cooking residues, cleaning chemicals, plastic emulsions, carpet dust, linen mites, atomized spider droppings, furniture varnishes, floor polishes, deodorants, hair sprays, elevator grease, bidet humidity, intestinal effluvium and etceteras. N'est-ce pas?"
The Ars Lunga researchers have primarily centered their attentions on the personnel of large business concerns, contrasting the pulmonary health of open-air smokers with that of nonsmoking employees who stay inside the closed buildings and sealed physical plants for up to 10 hours at a time.
"I have to say, I am happy for my friend Giselle. I am glad she goes out to smoke her Gaulboros [a French brand]. I never hardly see the out of doors. Without Giselle, we don't know if the sun shines or it rains. I am considering myself taking up the habit, only so I can see a blue sky now and then," said Magrit Phroggierre, a non-smoking clerical worker for McDonalds la France.
The Ars Lunga study has not been completed as of yet, so there are no firm results to be announced. Meanwhile, in South Korea, a similar study was undertaken--and completed--among 1,000 personnel of the giant Hyundai company. Secretarial and customer service employees volunteered to spend up to an hour a day smoking in the gardens and parking lots outside the enormous Accent Office Complex, located on the outskirts of Seoul.
At the end of a full year, the goal was to compare their lung capacity to that of a control population who stayed in their cubicles and office pools throughout every break and lunch period.
However, midway through the year, the research team recognized that their testing method was flawed. The pollution in Seoul's air space is so bad that even on the best of days, being outside meant the smokers were getting a double dose of toxic materials in their lungs and very little of that "pure air" whose benefits the test was intended to measure.
So as not to waste the expenditure and time already committed to the procedure, the researchers changed the description of what they were doing and redefined their work as an important survey of smoking as it relates to dermal health. When the year was up, they released their findings, which asserted that those subjects who spent an hour outside every day most definitely demonstrated a more "vigorous skin coloration" than the control group who stayed indoors.
"Furthermore," they concluded, "as smoking was the reason the subjects were outside, improving the tint-related factors of their skin in the process, then there was an obvious and undeniable health benefit to smoking.
"As long as it is done outside," clarified team leader Kim Ahn, and added, "Preferably on sunny days. And preferably if the 'vigorous skin coloration' does not turn to melanoma at some later date."
Wheeze to the Beat
Back on American soil, ironically the ancestral home of Nicotiana tabacum, there is virtually no research being done on the health benefits of smoking. To the contrary, the intransigent American medical establishment seems hell-bent on proving there is nothing but negative effects to any use of tobacco, and judging by their snubbery of the foreign research, they will not even consider an alternative scenario in which smoking plays a wellness-enhancing role.
Yet in spite of Mainstream Med's blind spot, word of that foreign research has reached the ears of an American sub-population starved for a hint of good news about smoking. Having endured at least three decades of being treated like infectious pariahs, sent outside to fume like flatulent dogs, denied the pleasantry of conversation and companionship in restaurants, theaters, bowling alleys and often their own homes, and treated like a bottomless tax well whenever state leaders thirst for some extra revenue, smokers at last had something to justify their inability to kick the habit.
As near as can be determined, aerobic smoking classes started in a women's fitness facility in West Palm Beach, Fla. The instructor, Victoria Zecreta, claims she got the idea from her grandfather, who told her of how he clambered up the beach at the Bay of Pigs with his companions, an invasion force of anti-Castroites, and every last one of los patriotas smoked like a chimney.
"I bet we each lost 10 pounds that night," she remembers Popo Zecreta telling her, and she never forgot his words.
"We go outside to do it. Around the block five times for every session. 'Salsa-smoke marching,' I call it," Zecreta said. "I lead and give them the moves. I have a boy who carries a boom box so we can march to music. Gloria Estefan is best, but J-Lo works OK, too. I carry a few Bic lighters in my fanny pack to make sure everyone is lit up, but they have to bring their own smokes."
Aerobic smoking has caught on in a big way. Those 45 million smoking Americans who have heretofore shunned gymnasiums and workout centers now feel they have a place to go where they will be accepted as they are, musty smoke smell and all.
Variations to the aerobic smoking craze have also arisen.
Back to Gambado: She and 15 to 18 other women meet three evenings a week in the back yard of a private home to do pilates while smoking--or as they like to call it in the class, "Virginia Slimming."
Just two months ago, there were fewer than 10 in the class. It is rapidly growing in popularity. The instructor, Helen Bach, is seriously considering leasing a commercial outdoor space and going about it full time.
"I have a dream of getting my hands on a used golf course," Bach said. "A whole, 18-hole golf course. We could meet on a different green every week. Wouldn't that be spectacular?"
"The trick for me was learning how to not burn a hole in my exercise ball with the cigarette. Once I got how to keep the hot end away from the rubber, it was easy," Gambado said. "The smoking makes the pilates go quicker, and the pilates makes up for what I'm doing to myself by smoking ... I hope. And best of all, I'm down 17 pounds since I started."
Next fall in what may well become the ultimate challenge in the smoking fitness craze, Winston-Salem, N.C., will sponsor the very first Smoke 'Em If You Got 'Em marathon, in which runners will be encouraged to keep a lit butt dangling from their lips throughout the entire 26-mile course. Nonsmokers are invited to enter the event, but they must agree to keep their snide comments and disdainful looks to themselves.
Dr. Roberta T. Axidea's professional credential is a Ph.D. in English literature earned online from Thomas A. Edison State College in New Jersey. To hide her smoking from her children, she locks herself in her home office and pretends she is writing a novel.
Dr. Sam E. Garcia is a Guatemalan-trained cardiologist. He neither confirms nor denies that he owns nearly 200,000 shares of stock in R.J. Reynolds.