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To read the actual testimony read into the records, see and click on Pam DeNardo's name.

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As presented by Pam DeNardo, EFFORTS Member.

I have been requested by the American Lung Association to appear before you today 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 a 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. 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 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 obstruction of airflow out of the lungs, causing shortness of breath. Chronic Obstructive Pulmonary Disease or COPD accounts for over 170,000 deaths per year in the United States alone.

COPD is terminal and irreversible. There is no cure and very little research is being conducted toward finding a cure. 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. The World Health Organization estimates that in the year 2000, 2.74 million people died of COPD worldwide.

COPD is the fourth largest killer in the United States behind heart disease, cancer and stroke (also smoking related illnesses). According to the CDC, all tobacco related disease taken together makes COPD the third largest cause of death in the world.

What is it? In the simplest of terms, it robs you of the oxygen your body needs to survive and slowly progesses until you die. You could think of it as a slow suffocation.  Cigarettes are drugs and they are not just hazardous to your health. THEY WILL KILL YOU.

If the nonsmoking American public believes that this is not their problem, they should think again. People who cannot breathe 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 our economy. According to estimates made by the National Heart Lung and Blood Institute, in 2000 the annual cost to the nation for COPD was $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. COPD is the only major disease that continues to show increased mortality rates each year. In contrast, seven of the other ten leading causes of death actually showed decreases in mortality. Data provided by the American Lung Association indicate that death rates for COPD actually doubled between 1979 and

1998. By the year 2020, COPD is expected to be the third leading cause of death in the United States. This is not a disease nor a problem that this country can afford to ignore.

In my case I have emphysema. Believe it or not I consider myself lucky.

Diagnosed early, 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 a 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. It is then that you realize what it is like to continually have to breathe in that manner. We do not have the option of taking the straw out of our mouths.

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 persons” disease. That is what I thought. I have since found out that today the average diagnosis is in their 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” 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 here today a list of 599 ingredients added to tobacco in the manufacture of cigarettes by the five major American cigarette companies. Many of them also addictive.

As we all know, tobacco companies, under court order to reimburse states for the expense of treating smoking related illness, have paid out more than $21 billion so far. But less than half of it has gone to fund health care. And only 5% has been used to help Americans kick the cigarette habit. Instead lawmakers in each state are using the funds for anything but the purpose for which they were intended. College scholarships, flood control projects, upgrading public television, boot camps for juvenile delinquents, budget shortfalls, tax rebates and rainy day funds to name just a few. This money is being spent on the political whims of the states that receive it.

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. Only people who live with this disease day in and day out can do that. EFFORTS stands for Emphysema Foundation For Our Right To Survive and encompasses over 1000 people in over six countries. They all have this disease and, believe it or not, 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 in 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. EFFORTS is a non profit, politically impartial organization. We take money from no one. I encourage you to visit our website at .  Once there you will find endless testimonies regarding the effects of this disease, the difficulties living with this disease and the personal stories of very real people, some still active and some who have passed away.

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 alright to give carte blanche to an industry that is killing Americans. Some people in this government believe that the people of this country are ignorant and that we, the people, will continue to allow this to go on.

I don’t believe that and I am here today so that you can tell me that those people are wrong. Americans are dying in great numbers. The war on drugs does not include one of the most destructive and addictive drugs of all. Yes, I am responsible for smoking all those years. But who is responsible for allowing this deadly product to remain on the shelves.

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

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