Dr. Mielke is back.

If you’re not familiar with Dr. Mielke, let me bring you up to speed.

During a board of health meeting in March 2011, Commissioner Tom Mielke – a two-time former smoker – questioned whether nicotine was actually what made cigarettes addictive.

“I had a habit of reaching into my pocket, and I had a habit of putting something in my mouth,” he said at the time. “I always didn’t understand when people said they were addicted to the nicotine portion of it.”

“So I really wonder if it’s the nicotine that’s a habit or if it’s a nervous habit,” Mielke said. “I don’t know.”

Clark County Public Health staff did know.

They confirmed that – at least, according to the Surgeon General and countless research — nicotine is in fact the drug that causes addiction to cigarettes and other tobacco products.

Fast forward to last week and another board of health meeting.

Tobacco was once again a topic of discussion. This time, interim Public Health Director Marni Storey was discussing a new county report on tobacco use.

“As you know, tobacco use continues to be the No. 1 killer of Americans nationally and in Clark County,” Storey said.

Not so fast. Dr. Mielke had something to say about that.

“I always have to correct Marni on this because she always says the No. 1 killer of the general public, but that’s not taking into consideration the automobile, right?” Mielke asked.

Actually, Storey said, if you look at the impacts of tobacco use – it’s a leading cause of heart disease and numerous cancers – tobacco is the No. 1 killer of Americans. Higher than automobiles, she said.

“That might be a stretch,” Dr. Mielke responded. “I know people with cancer who never smoked or been around smoke.”

Real doctor Alan Melnick, the county’s health officer, couldn’t keep quiet any longer.

Researchers have analyzed years of death data, looking at the underlying causes of death, he said. Through that research, they determined tobacco use is responsible for about 400,000 deaths in the U.S. each year, Melnick said.

“Automobile accidents are significant, but they’re not anywhere close … to what tobacco does,” Melnick said.

Unconvinced, Mielke asked why he sees “people out there getting run over by cars on a daily basis” but doesn’t hear about people dying from tobacco.

“When someone dies of a car wreck people recognize that,” Melnick said. “People die silently in a hospital from cancer.”

Mielke wasn’t budging. He even said he would bring in automobile death statistics.

Allow me, Dr. Mielke.

According to the U.S. Centers for Disease Control and Prevention, about 33,700 people die annually from motor vehicle traffic crashes.

Tobacco, researchers concluded, causes 400,000 deaths annually.

Well, you were close.

Marissa Harshman

Marissa Harshman

I'm the health reporter for The Columbian newspaper in Vancouver, Wash. I started at The Columbian -- my hometown newspaper -- in September 2009. Reach me at marissa.harshman@columbian.com or 360-735-4546.

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