First We Take Manhattan

By Brownlee, Shannon | The Washington Monthly, November-December 2015 | Go to article overview

First We Take Manhattan


Brownlee, Shannon, The Washington Monthly


Saving Gotham: A Billionaire Mayor, Activist Doctors, and the Fight for Eight Million Lives

by Tom Farley, MD

W.W. Norton & Co., 320 pp.

[ILLUSTRATION OMITTED]

New York City Mayor Mike Bloomberg's public health G-men got smoking out of restaurants, trans fats out of foods, and calorie counts onto menus. The rest of the country soon followed.

Watch any movie made before 1990, and it's a little shocking to see how many people are smoking onscreen. Movie characters smoked at home, in restaurants, on airplanes, and at the office. They smoked while fighting wars, eating dinner, drinking in bars, having sex, and talking to the boss. Lighting up onscreen was acceptable practically everywhere, except maybe the hospital.

All that changed in the 1980s and '90s, during the "tobacco war," as that period is sometimes called. Those of us who reported on it vividly remember the heroes who launched the public relations and legislative battles that transformed the way we view smoking: Stanton Glantz, professor at the University of California, the Ralph Nader of anti-smoking; David Kessler, former commissioner of the U.S. Food and Drug Administration, who made it his mission to put cigarettes under the FDA's control; and all the state attorneys general who successfully sued the massively rich and powerful tobacco industry for the health costs of smoking.

The result has been a dramatic reduction in rates of smoking over the last twenty years. In 3.981, 33 percent of Americans were smokers. By 2011, it was down to 19 percent. Today, actors in movies are no longer wreathed in clouds of cigarette smoke, and smoking is far less acceptable as a habit. More importantly, deaths from lung cancer have been declining since the 1980s, a triumph of public health.

In Saving Gotham: A Billionaire Mayor, Activist Doctors, and the Fight for Eight Million Lives, author Tom Farley, MD, tells the story of a new cadre of public health heroes--Mayor Michael Bloomberg and his merry band in the New York City Department of Public Health. Farley, a former epidemic intelligence service officer with the Centers for Disease Control and Prevention (CDC) and the best doctor-writer you've never heard of, has turned the department's exploits into a compellingly readable tale. During Mayor Bloomberg's tenure, smoking was banned from New York City restaurants and bars; cigarette displays were banned from stores; trans fats were banned from foods; and calorie counts were mandated on the menus in all fast food restaurants. The only campaign the mayor and the department lost was a regulation that would have reduced soda consumption.

Many of these measures have come to be seen as nothing out of the ordinary, but at the time they were nothing short of revolutionary. Bloomberg appointed Tom Frieden, a physician from the CDC who had worked on tuberculosis in India, to serve as chief of the Public Health Department. Frieden, a fast-talking, fast-walking, even fast-eating New York native, brought brains, creativity, and a sometimes-abrasive sense of urgency to the job. When Frieden and his staff first announced their plan to ban smoking in restaurants and bars, the mayor's staff thought it was political suicide. Bloomberg, however, needed no convincing; he was already preparing to increase taxes on cigarettes from 8 cents a pack to $1.50. (Higher prices discourage smokers, especially the young, but the city also needed the tax revenue.) Restaurant and bar owners launched a furious campaign, lobbying the press, and the city council, maintaining that smokers would stay away from their establishments in droves and ruin their business.

In response, writes Farley, "Frieden and his allies approached the passing of the Smoke-Free Air Act as if it were an insurgent political campaign." They wrote to supporters and opponents on the city council and in the state legislature, and assigned department staff the job of calling them individually. …

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