on behalf of

American Lung Association

and

EFFORTS
(Emphysema Foundation For Our
Right To Survive )

before the

Committee on the Judiciary
U.S. Senate

September 5, 2001



Thank you, Mr. Chairman and members of the Committee. My name is Pam DeNardo, I live in St. Charles, Illinois, where I run my own small business, which markets small group health insurance. I am appearing today on behalf of the American Lung Association and EFFORTS, which stands for Emphysema Foundation For Our Right To Survive. I would like to tell you my story. It is not a new story. It is not an unusual story. There are literally hundreds of thousands just like me. I was a smoker. I started to smoke 40 years ago at the age of 17. I started smoking because I thought it was the cool thing to do. And for many, many years, I believed that I could quit at any time. That is until I really tried to quit. Then I truly understood the word "addiction." And now I am sick. I have been diagnosed with Chronic Obstructive Pulmonary Disease. Even after being diagnosed, quitting was extremely difficult. It was literally the hardest thing I have ever done. Even gasping for breath, I wanted a cigarette. I actually know people who will smoke a cigarette, suck on an inhaler and smoke another cigarette. That is addiction.

For those of you who are not familiar with Chronic Obstructive Pulmonary Disease, or COPD, I will attempt to explain. It is primarily a smokers' disease and consists of chronic bronchitis and/or emphysema. Each of these diseases shares a common characteristic, which is an obstruction of airflow out of the lungs, causing shortness of breath. COPD accounts for over 107,000 deaths per year in the United States alone. COPD is terminal and irreversible. There is no cure and not enough research is being conducted toward finding a cure. Once diagnosed, the patient is told to quit smoking, eat a sensible diet and exercise. COPD can be asymptomatic, especially in the early stages. The lung has a great deal of reserve. Many patients do not report any symptoms until they have lost over 50 percent of lung function.

COPD is the fourth largest killer in the United States behind heart disease, cancer and stroke (also smoking related illnesses). The World Health Organization estimates that in the year 2000, 2.74 million people died of COPD worldwide. What is COPD? In the simplest of terms, it robs you of the oxygen your body needs to survive and slowly progresses until you die. It is slow suffocation.

If the nonsmoking American public believes this is not their problem, they should think again. People who have severe difficulty breathing cannot work or pay taxes or survive without the help of our government. They have to go on disability, receive Medicare, Medicaid -- all paid for by taxes. Chronic bronchitis and emphysema take a heavy toll on the economy. According to estimates made by the National Heart Lung and Blood Institute, in 2000 the annual cost to the nation for COPD was an estimated $30.4 billion. This included $14.7 billion in direct health care expenditures, $6.5 billion in indirect morbidity costs and $9.2 billion in indirect mortality costs. Mortality from COPD has increased sharply for more than two decades. Data provided by the American Lung Association indicate that the number of deaths from COPD more than doubled between 1979 and 1998. This is not a disease or a problem that this country can afford to ignore.

In my case, I have emphysema. Believe it or not, I consider myself lucky. I am still able to function pretty well-I run my own small business, I have health insurance, and I am not yet on oxygen. Indeed, that is one of the reasons I was chosen to come here today. There are many people who could speak to you more eloquently and with a great deal more experience than I. However to book a flight on an airline if you are oxygen dependent is a nightmare. The rules and restrictions of the airline industry are such that a person on oxygen must start making arrangements months before departure. Some airlines will not take them at all. So, I am here to speak for people who are much braver and much sicker than I. People who suffer every day with this dreadful disease yet continue to help others learn how to cope. If you would like to experience first hand what it is like to breathe with this disease, there is a very simple exercise to provide you with this experience. Simply put a straw in your mouth at the beginning of your day. Do not breathe in or out except through this straw. Even with healthy lungs, you will soon tire as you go about your daily activities. COPD patients do not have the option of taking the straw out of our mouths. And our lungs are not healthy.

I am treated with asthma drugs because there are no drugs available for emphysema. When I was diagnosed I was shocked. Emphysema is an "old person's" disease. That is what I thought. I was diagnosed at age 55. I have since found out that today the average age of diagnosis is in the mid 40's and that average age is going down yearly. When I started smoking there were no warnings on the packages. Later the packages said "cigarettes may be hazardous to your health" and other than tar and nicotine, no other ingredients have ever been listed. Tobacco products are still on the shelves today. And there is still no list of ingredients. I have with me today a list of 599 ingredients added to tobacco in the manufacture of cigarettes by the five major American cigarette companies.

I am just your typical middle aged, tax-paying citizen. Perhaps I do not have the power and education that you have. But I know this, somewhere, sometime, someone is going to have to pay for all of this. Some people in this country think that it is all right to give carte blanche to an industry that is killing Americans. I disagree.

I believe that it is crucial that the Department of Justice aggressively continue its lawsuit against the tobacco industry. It is the Department of Justice's responsibility, on behalf taxpayers like me, to hold the tobacco industry accountable for their actions.

Americans are dying in great numbers from tobacco-related diseases. The tobacco industry needs to be held responsible for these deaths and the years of lies and deception to the American public about the dangers of their products. I am here to urge the continuation of the Department of Justice lawsuit. The American people deserve their day in court!

Believe it or not, I do take responsibility for smoking all of those years. That is why I am here today. I feel responsible to speak out against smoking. I belong to an Internet organization of people suffering from COPD. While my doctors take very good care of me, they could not tell me how to LIVE with COPD. How to cope and make the most of each and every day. Only people who live with this disease day in and day out can do that. EFFORTS encompasses over 1000 people in over six countries. They all have this disease and many are in their 30's and 40's.

EFFORTS' goals are to provide support to those suffering from COPD, to actively work towards medical research into the disease, to show responsibility in educating our youth about the dangers of smoking, to work diligently in making sure that insurance companies and Medicare do not withhold reimbursements for treatments of our disease and to become the most authoritative and effective source for information about emphysema and available treatments. I encourage you to visit our website at http//www.emphysema.net. Once there you will find endless testimonies regarding the effects of this disease, the difficulties of living with it and the personal stories of very real people, some still active and some who have passed away.

Please ensure that the Department of Justice aggressively pursues the case against the tobacco industry. It is critical to hold the tobacco industry accountable.

Thank you for allowing me to speak today, I have nothing but admiration for the greatest society on the face of the earth and am humbled by this opportunity to speak my mind. Only in this country is it possible for the average citizen to speak before its governing body. I am greatly appreciative of this opportunity.
Thank You.